Caractérisation phénotypique des bétalactamases de souches d'enterobacteries multi résistantes isolées de divers produits pathologiques

Introduction: Les entérobactéries constituent les principales causes d'infections bactériennes.Ce sont des Bactéries Multi- résistantes (BMR)fréquentes par production de BLSE(Bêtalactamases à spectre élargi).Ceci constitue un problème de santé publique majeur car cette résistance est à l'origine d'une impasse thérapeutique et conduit à une prescriptiond'antibiotiques à large spectre (carbapénèmes). Notre étude prospective allant du 01 janvier au 31 décembre 2017 a porté sur 50 souches d'entérobactéries isolées au laboratoire et a pour but de caractériser les types de bêtalactamases.Méthodologie : Les souches ont été ré-isolées d'abord sur milieu Mueller Hinton, ensuite identifiées par la morphologie et les caractères biochimiques des entérobactéries. Les méthodes suivantes ont été réalisées pour la mise en évidence des classes de BLSE. - Méthode de rapprochement des disques (synergie entre un disque Amoxicilline + Acide clavulanique (AMC) et les disques de Céphalosporine de 3ieme (C3G) : BLSE de classe A. - Méthode de Dongeun Yong et al. utilisant l'EDTA (Ethylène Diamine Tétra-acétique) 0,5 M, PH 7 (Inhibition du zinc présent sur le site actif de l'enzyme par l'EDTA): BLSE de classe B. Résultat : Les souches d'entérobactéries étaient réparties ainsi : Enterobacter spp : 40%, Escherichia coli : 32%, Klebsiella pneumoniae : 24% et Klebsiella oxytoca : 4%. Cinquante-six pour cent 56% des souches produisaient une BLSE de classe A (image « bouchon de champagne ») et 14% une BLSE de classe B avec restauration de l'activité de l'imipenème après association de l'EDTA. Enterobacter spp était la souche la plus représentée avec 12 souches sécrétrices d'une BLSE de classe A et 5 souches de classe B, suivie d'E. coli avec 08 souches sécrétrices d'une BLSE de classe A et 01 souche de classe B. K. pneumoniae et K. oxytoca comptaient respectivement 06 et 02 souches sécrétrices de BLSE de classe A. Conclusion : L'acquisition par les entérobactéries et la transmission de résistance, par production de BLSE de classe A ou B est un problème majeur de santé publique causant une véritable impasse thérapeutique. Aujourd'hui, la prévalence de la résistance par production de Métallo-bêtalactamase (MBL) est faible comparée à celle de BLSE de classe A. Ainsi, des stratégies de diagnostic et de maîtrise de la diffusion doivent être appliquées rigoureusement

Detecção de bactérias enteropatogênicas e enteroparasitas em pacientes com diarreia aguda em Juruti, Pará, Brasil / Detection of enteropathogenic bacteria and enteroparasites in patients with acute diarrhea in Juruti, Pará, Brazil

Com o intuito de determinar a frequência de bactérias enteropatogênicas e enteroparasitas em pacientes com diarreia aguda no Município de Juruti, Pará, o qual passa por intenso processo imigratório face o grande projeto de exploração mineral, avaliaram-se 263 casos de diarreia aguda, dos quais 19 por cento foram atribuídos a bactérias enteropatogênicas, destacando-se a Shigella spp, que representou 13,7 por cento. Salmonella spp, Aeromonas spp e Plesiomonas shigelloides também foram detectados. Os sorotipos de Shigella mais frequentemente encontrados foram S. flexneri (61,1 por cento) e S. sonnei (38,9 por cento). Entre as Salmonella, identificaram-se os seguintes sorotipos: S. Panama (2), S. Newport (2), S. Bredeney, S. Saintpaul e S. Gaminara. A infecção pelos protozoários alcançou 85,3 por cento tendo como principais responsáveis, por ordem de frequência, Blastocystis hominis (37,3 por cento), Entamoeba histolytica/E. dispar (22,8 por cento), Endolimax nana (16,7 por cento), Entamoeba coli (9,5 por cento) e Giardia lamblia (8,4 por cento). Esses resultados fornecem valiosos subsídios à vigilância epidemiológica e ambiental, demonstrando as condições insatisfatórias de saneamento básico em que vive a população do Município.

With the aim of determining the frequency rate of enteropathogenic bacteria and enteroparasites in patients with acute diarrhea in the Municipality of Juruti, Pará State, which has been facing an intense migratory process due to a great mining project, we analyzed 263 cases of acute diarrhea. A total of 19 percent of those cases were related to enteropathogenic bacteria, particularly Shigella spp. that accounted for 13.7 percent of the cases. Salmonella spp, Aeromonas spp and Plesiomonas shigeloide were also detected. The most frequent Shigella serotypes found were S. flexneri (61.1 percent) and S. sonnei (38.9 percent). Among the Salmonella, we could observe the following serotypes: S. Panama (2), S. Newport (2), S. Bredeney, S. Saintpaul and S. Gaminara. The infection caused by protozoa reached 85.3 percent, mostly due to Blastocystis hominis (37.3 percent), Entamoeba histolytica/E. dispar (22.8 percent), Endolimax nana (16.7 percent), Entamoeba coli (9.5 percent) and Giardia lamblia (8.4 percent). These results provide valuable data to epidemiological and environmental surveillance because it presents the unsatisfactory basic sanitary conditions of the local population.

Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término / Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case

We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing disease mainly in patients with underlying illness or after surgery. It is a rare perinatal pathogen, causing severe disease in premature infants, in association with maternal chorioamnionitis and premature rupture of the membranes (RevMéd Chile 2009; 137: 1201-4).

Phenotyping and genotyping methods applied to investigate the relatedness of Brazilian isolates of Enterobacter cloacae

In order to evaluate the resolving power of several typing methods to identify relatedness among Brazilian strains of Enterobacter cloacae, we selected twenty isolates from different patients on three wards of a University Hospital (Orthopedics, Nephrology, and Hematology). Traditional phenotyping methods applied to isolates included biotyping, antibiotic sensitivity, phage-typing, and O-serotyping. Plasmid profile analysis, ribotyping, and macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) were used as genotyping methods. Sero- and phage-typing were not useful since the majority of isolates could not be subtyped by these methods. Biotyping, antibiogram and plasmid profile permitted us to classify the samples into different groups depending on the method used, and consequently were not reliable. Ribotyping and PFGE were significantly correlated with the clinical epidemiological analysis. PFGE did not type strains containing nonspecific DNase. Ribotyping was the most discriminative method for typing Brazilian isolates of E. cloacae

Circulation flow of enteropathogenia bacteria in institutionalized children. I. An epidemiologic study

Durante o período de um ano (maio de 1982 - abril de 1983) avaliou-se a circulaçäo e manutençäo de bactérias enteropatogênicas, em populaçäo de menor institucionalizada e funcionários adultos contactantes, na cidade do Rio de Janeiro, Brasil. Foram constituídos três grupos: A e B incluíram, respectivamente, 104 e 46 crianças, portadoras de quadro diarréico, diferenciando-se pelo período de ingresso na instituiçäo, anterior (B) e durante (A) o período do estudo; o grupo C era composto de 82 adultos contactantes. Fontes de infecçäo parcialmente expressas pela positividade de coproculturas: 35,2% no grupo A, 39,1% no B e 19,7% nos adultos sadios, sugerem a potencialidade de outras vias de transmissäo representadas pelo ambiente com 30% de contaminaçäo fecal. Maior taxa de isolamento combinada a elevados títulos de anticorpos indicaram Escherichia coli (EPEC) como o agente prevalente, enquanto que na hemaglutinacäo passiva, Shigella predominou. Admite-se que a instituiçäo deve desempenhar um papel importante na epidemiologia e transmissäo de infecçöes entéricas para a comunidade