[Necrotizing pneumonia due to methicillin-resistant Staphylococcus aureus]. / Pneumonia necrotizante por Staphylococcus aureus resistente à meticilina.

The aim of this study was to describe a case of necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus. The sample was isolated from a blood culture collected less than 48 hours after hospital admission. The patient had been healthy until the infectious process started. The isolate had the mecA gene with "staphylococcal cassette chromosome mec" (SCCmec) type IVa. The possibility that Staphylococcus aureus harboring this genetic determinant might be present in our setting should be considered in situations of severe pneumonia within the community.

Pneumonia necrotizante por Staphylococcus aureus resistente à meticilina / Necrotizing pneumonia due to methicillin-resistant Staphylococcus aureus

O objetivo desse estudo foi descrever um caso de pneumonia necrotizante por Staphylococcus aureus resistente a meticilina. A amostra foi isolada em hemocultura coletada menos de 48 horas da admissão hospitalar. A paciente era previamente hígida quando do início do processo infeccioso. O isolado possuía o gene mecA, com "staphylococcal cassette chromosome mec" tipo IVa". A presença de Staphylococcus aureus carreando esse determinante genético em nosso meio deve ser considerada em pneumonias comunitárias graves.

The aim of this study was to describe a case of necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus. The sample was isolated from a blood culture collected less than 48 hours after hospital admission. The patient had been healthy until the infectious process started. The isolate had the mecA gene with "staphylococcal cassette chromosome mec" (SCCmec) type IVa. The possibility that Staphylococcus aureus harboring this genetic determinant might be present in our setting should be considered in situations of severe pneumonia within the community.

Molecular assessment of invasive Streptococcus pneumoniae serotype 1 in Brazil: evidence of clonal replacement.

In Brazil, serotype 1 Streptococcus pneumoniae is one of the most prevalent causes of severe infection. This study investigated the genetic relatedness of 134 serotype 1 isolates obtained from invasive diseases during the period 1977-2005. Molecular typing by PFGE revealed two major lineages using visual inspection and computer analysis. Type A comprised 94 isolates (70.2 %) with four subtypes, whereas type B comprised 40 isolates (29.8 %) with eight subtypes. Subtype A3, the most frequent genotype, accounting for 65 % of the total isolates, was identified as a representative of clone Sweden(1)-40 (ST304). Type B was predominant in the period 1977-1988. In contrast, an increase in the type A lineage was detected from 1990 in Brazil, significantly associated with isolates recovered from pneumonia cases and from young patients. This study clearly established a temporal switch between two lineages of S. pneumoniae serotype 1 in Brazil, with a wide dispersion of clone Sweden(1)-40 in recent years.

Mites in clinical stool specimens: potential misidentification as helminth eggs.

We report the finding of unexpected microscopic oval structures in clinical stool samples processed by AFIP/Medicina Laboratorial, a laboratory performing routine clinical analysis in São Paulo, Brazil. Surprisingly, these objects were identified as mite eggs, sometimes accompanied by adult mites. Because misidentification of mite eggs as helminth ova may lead to erroneous treatment with far-reaching consequences, we sought to verify the frequency of adult mites and mite eggs among a number of processed stool specimens. Given their similarity to some helminth eggs, it is important that clinical laboratories recognize these structures, especially in geographic regions where intestinal parasitosis is prevalent.

Resistance trends of Acinetobacter spp. in Latin America and characterization of international dissemination of multi-drug resistant strains: five-year report of the SENTRY Antimicrobial Surveillance Program.

OBJECTIVES: To analyze the antimicrobial susceptibility of Acinetobacter spp. isolates collected from Latin American medical centers as part of the SENTRY Antimicrobial Surveillance Program and also to evaluate the dissemination of multi-drug resistant Acinetobacter spp. strains in the region. METHODS: A total of 826 isolates of Acinetobacter spp. from multiple infection sites were collected from January 1997 to December 2001 in ten medical centers and susceptibility tested to >25 selected agents by broth microdilution. Multi-drug resistant Acinetobacter spp. isolates were molecular typed. RESULTS: Resistance rates to carbapenems varied significantly among countries. A continued annual increase occurred in the Argentinean medical centers. In contrast, carbapenem resistance was rare in Chilean centers, and decreased significantly in the Brazilian institutions. Acinetobacter spp. isolates recovered from lower respiratory tract and bloodstream infections were associated with lower antimicrobial susceptibility rates. Resistance rates to imipenem were higher among isolates collected from intensive care units (13.5%) than among isolates from other units. A major ribogroup pattern (521-1) was detected among eight Acinetobacter spp. strains isolated from three distinct Latin American countries. CONCLUSIONS: This study found that antimicrobial resistance is still a major issue among Acinetobacter spp. isolates collected from some Latin American countries. The dissemination of a major bacterial cluster in different regions reinforces the importance of longitudinal surveillance programs, such as SENTRY, as valuable tools for monitoring antimicrobial susceptibility rates and guiding local interventions.