Modulation of Cancer Cell Autophagic Responses by Graphene-Based Nanomaterials: Molecular Mechanisms and Therapeutic Implications.

Graphene-based nanomaterials (GNM) are plausible candidates for cancer therapeutics and drug delivery systems. Pure graphene and graphene oxide nanoparticles, as well as graphene quantum dots and graphene nanofibers, were all able to trigger autophagy in cancer cells through both transcriptional and post-transcriptional mechanisms involving oxidative/endoplasmic reticulum stress, AMP-activated protein kinase, mechanistic target of rapamycin, mitogen-activated protein kinase, and Toll-like receptor signaling. This was often coupled with lysosomal dysfunction and subsequent blockade of autophagic flux, which additionally increased the accumulation of autophagy mediators that participated in apoptotic, necrotic, or necroptotic death of cancer cells and influenced the immune response against the tumor. In this review, we analyze molecular mechanisms and structure-activity relationships of GNM-mediated autophagy modulation, its consequences for cancer cell survival/death and anti-tumor immune response, and the possible implications for the use of GNM in cancer therapy.

Pulmonary isolation and clinical relevance of nontuberculous mycobacteria during nationwide survey in Serbia, 2010-2015.

The rates of pulmonary colonization and disease due to nontuberculous mycobacteria (NTM) appear to be increasing globally, but diversity of species recovered as well as clinical relevance of NTM isolates differ considerably by geographic region. The first nationwide study of isolation frequency and clinical significance of NTM in Serbia included all patients with respiratory specimens yielding a positive NTM culture over the six-year period, 2010-2015. We analyzed trends in annual NTM isolation and NTM pulmonary disease (PD) incidence rates, with NTM PD cases defined in accordance with microbiological criteria established by the American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA). 777 pulmonary NTM isolates were collected from 565 patients, of whom 126 (22.3%) met the ATS/IDSA criteria. The annual NTM isolation and NTM PD incidence rates per 100,000 changed over 2010-2015 from 0.9 to 1.6 (p = 0.1746) and from 0.18 to 0.48 (p = f0.0040), respectively. Both isolation and disease rates increased considerably with age, while higher NTM PD rates were also associated with residence in urbanized areas. Diversity of NTM species isolated was shown to be region-specific, with M. xenopi as the most prevalent species (17.3%), and increasing isolation rates of rapid growing mycobacteria (RGM) (p = 0.0072). M. xenopi was also the most common cause of NTM PD (28.6%), followed by RGM (27.8%). With 73% clinically relevant isolates, M. abscessus was identified as the most clinically relevant NTM species. While NTM PD obviously remains a rare disease in Serbia, the overall results justify recognition of NTM as pathogens of rising importance, and require further characterization of their epidemiology in the country.

Photodynamic antibacterial effect of graphene quantum dots.

Synthesis of new antibacterial agents is becoming increasingly important in light of the emerging antibiotic resistance. In the present study we report that electrochemically produced graphene quantum dots (GQD), a new class of carbon nanoparticles, generate reactive oxygen species when photoexcited (470 nm, 1 W), and kill two strains of pathogenic bacteria, methicillin-resistant Staphylococcus aureus and Escherichia coli. Bacterial killing was demonstrated by the reduction in number of bacterial colonies in a standard plate count method, the increase in propidium iodide uptake confirming the cell membrane damage, as well as by morphological defects visualized by atomic force microscopy. The induction of oxidative stress in bacteria exposed to photoexcited GQD was confirmed by staining with a redox-sensitive fluorochrome dihydrorhodamine 123. Neither GQD nor light exposure alone were able to cause oxidative stress and reduce the viability of bacteria. Importantly, mouse spleen cells were markedly less sensitive in the same experimental conditions, thus indicating a fairly selective antibacterial photodynamic action of GQD.

Aminoglycoside resistance in members of the Staphylococcus sciuri group.

This study investigated the prevalence of aminoglycoside resistance and genes encoding aminoglycoside-modifying enzymes in members of the Staphylococcus sciuri group. A total of 304 S. sciuri group member isolates (284 S. sciuri, 12 S. lentus, and 8 S. vitulinus) from humans (n = 34), animals (n = 133), and environmental sources (n = 137; out-hospital and hospital environment, food) were examined for their susceptibility to amikacin, gentamicin, isepamicin, kanamycin, neomycin, netilmicin, sisomicin, streptomycin, and tobramycin. The overall prevalence of resistance to aminoglycosides was low at 12.1%. Resistance to single aminoglycosides ranged from 0% to 7.2%. The aac(6')-Ie/aph(2"), ant(4')-Ia, and aph(3')-IIIa genes, either alone or in combination, were found in 16 out of 19 isolates showing resistance to nonstreptomycin aminoglycosides. Among the 22 isolates that showed resistance to streptomycin, the genes str and ant(6)-Ia were identified in 18 and 4 isolates, respectively.

Supplementary biochemical tests useful for the differentiation of oxidase positive staphylococci.

Differentiation of the oxidase positive staphylococci, Staphylococcus sciuri, Staphylococcus lentus, Staphylococcus vitulinus and Staphylococcus fleurettii, based on tributyrin, urease, caseinase, gelatinase and DNase activity is described. These tests may be used for preliminary identification of oxidase positive isolates of staphylococci resulting in more accurate identification of these species.

Resistance to macrolides, lincosamides, streptogramins, and linezolid among members of the Staphylococcus sciuri group.

This study aimed to characterize the resistance profiles of the Staphylococcus sciuri group members to macrolides, lincosamides, streptogramins (MLS antibiotics), and linezolid upon analysis of large series of isolates that included 162 S. sciuri isolates, nine S. lentus, and one S. vitulinus. The evaluation of their susceptibility by disk diffusion and agar dilution methods, along with PCR detection of the resistance genes erm(A), erm(B), erm(C), mef(A), lnu(A), and lnu(B), were performed. Resistance to macrolides was detected in 10 (5.8%) tested strains, with three and six isolates exhibiting constitutive and inducible MLS(B) resistance phenotypes, respectively. Resistance mediated by active efflux was detected in one strain. The presence of genes conferring resistance, namely erm(B) or erm(C), was detected in two strains. All tested strains were susceptible to pristinamycin and linezolid. Of 172 tested strains, 70.9% were resistant and 26.2% had intermediary resistance to lincomycin, whereas 1.7% were resistant and 50% had intermediary resistance to clindamycin. The lnu(A) gene was detected in two strains only. The great majority of the tested S. sciuri strains (153 out of 162; 94.4%) presumably exhibited LS(A) phenotype because they did not carry lnu genes nor displayed constitutive MLSB resistance, but still showed intermediate resistance or resistance to lincomycin (MICs of 4, 8, 16, and 32 microg/ml). The results obtained indicate that S. sciuri may be naturally resistant to lincomycin. Expression of a novel type of inducible resistance to lincosamides, induced by erythromycin in erythromycinsusceptible strains, was observed in the S. sciuri group isolates.

Evaluation of phenotypic and molecular methods for detection of oxacillin resistance in members of the Staphylococcus sciuri group.

In this paper we report on an experimental evaluation of phenotypic and molecular methods as means for the detection of oxacillin resistance in members of the Staphylococcus sciuri group. A total of 109 S. sciuri group member isolates (92 S. sciuri isolates, 9 S. lentus isolates, and 8 S. vitulinus isolates) were tested by the disk diffusion method, the agar dilution method, the oxacillin salt-agar screening method, slide latex agglutination for PBP 2a, and PCR assay for mecA as the reference method. The mecA gene was detected in 29 S. sciuri isolates, and the true-positive and true-negative results of the other tests were defined on the basis of the presence or the absence of the mecA gene. For the different methods evaluated, the sensitivities and specificities were as follows: for the disk diffusion test with a 1-microg oxacillin disk, 100% and 55.9%, respectively; for the disk diffusion test with a 30-mug cefoxitin disk, 93.5% and 100%, respectively; for the agar dilution method, 100% and 50%, respectively; for the oxacillin salt-agar screen test (with 6 microg of oxacillin per ml and 4% NaCl) 100% and 100%, respectively; and for the slide latex agglutination test for PBP 2a, 100% and 100%, respectively. The disk diffusion test with various beta-lactam antibiotics was performed to evaluate their use for the prediction of oxacillin resistance. The results indicate that meropenem, cefazolin, cefamandole, cefuroxime, cefotetan, cefoperazone, cefotaxime, ceftriaxone, moxalactam, cefaclor, and cefprozil may be used as surrogate markers of oxacillin resistance, although further studies of their use for the detection of oxacillin resistance are required.

[Microbiological diagnosis of tuberculosis in Serbia in the period 2001-2003].

INTRODUCTION: The National tuberculosis Reference Laboratory (NTRL) and the National TB Laboratory Network in Serbia, provided data on drug susceptibility profiles of M. tuberculosis, incidence of TB among laboratory workers and on protective measures. MATERIAL AND METHODS: The TB laboratory network in Serbia comprises 46 laboratories. 11 laboratories perform acid fast microscopy only, 24 perform microscopic and culture examinations, and complete identification and drug susceptibility testing (DST) is performed in 11 laboratories. Protective measures for laboratory workers are mostly inadequate. Four cases of occupational TB were reported over the study period. RESULTS: DST was performed in 61.8% to 62.8% of bacteriologically proven TB cases. Isolates of M. tuberculosis strains showing drug-resistance ranged from 7.9% to 8.9%, while multidrug resistant (MDR) isolates varied from 2.2% to 2.5%. In order to determine the accuracy of DST in 6 local laboratories, NTRL carried out a quality assurance program for DST. Four laboratories reached 100% agreement with NTRL for rifampicin. At least 90% agreement with NTRL for isoniazid was achieved in three tested laboratories. CONCLUSION: A relatively low and stable rates of drug-resistant and MDR TB in our study indicate that the situation in Serbia is still satisfactory. However, a reliable surveillance of drug-resistant TB in the region requires routine DST of all patients with culture confirmed TB. This is one of the goals included in the new National TB Program. In summary, all laboratories in Serbia should be included in the quality assurance program and their number should be reduced in accordance with the annual number of analyses performed, geographical location and results of proficiency testing.

Survey of genes encoding staphylococcal enterotoxins, toxic shock syndrome toxin 1, and exfoliative toxins in members of the Staphylococcus sciuri group.

Genes encoding staphylococcal enterotoxins (sea to see, seg, and seh), toxic shock syndrome toxin 1 (tst), and exfoliative toxins (eta and etb) were not detected in a large panel of 48 Staphylococcus sciuri group isolates tested. This strongly suggests that production of the staphylococcal exotoxins by these bacteria is highly unlikely.

A comparative evaluation of phenotypic and molecular methods in the identification of members of the Staphylococcus sciuri group.

Members of the Staphylococcus sciuri group (S. sciuri, S. lentus, and S. vitulinus) are coagulase-negative, novobiocin-resistant staphylococci that could be distinguished from other staphylococci on the basis of positive oxidase activity. In the present study, a scheme based on conventional methods and utilization of various carbohydrates was evaluated for the identification of oxidase-positive staphylococci, and validated using two molecular techniques. Of the 173 oxidase-positive staphylococcal tested strains, 161 were identified as S. sciuri, 9 as S. lentus, 2 as S. vitulinus, and one as S. fleurettii by our scheme. The level of agreement with tRNA intergenic length polymorphism analysis (tDNA-PCR) was high (97.5-100% correlation). The accuracy and ease of use of this protocol suggest that it may be useful and valuable in microbiological laboratories for the identification of members of this group.

Isolation and molecular characterization of Staphylococcus sciuri in the hospital environment.

Staphylococcus sciuri is a principally animal-associated bacterial species, but its clinical relevance for humans is increasing. Our study aimed to provide the first insight into the prevalence of this bacterium in a hospital environment. A 3-month surveillance was conducted in a hospital located in Belgrade, Serbia, and 1,028 samples taken from hands of medical personnel, medical devices, and various hospital surfaces were screened for S. sciuri presence. In total, 108 isolates were obtained, which resulted in a relatively high rate of colonization (10.5%). These isolates, along with 7 S. sciuri strains previously isolated in the same hospital (n = 115), were phenotypically and genotypically characterized. Antimicrobial susceptibility testing revealed that 73% of the strains were resistant to one or more antibiotics, with 4.3% strains displaying multiresistance. Examination of 16S-23S ribosomal DNA intergenic spacer length polymorphism identified the strains at the subspecies level, and 74 (64.3%) strains of S. sciuri subsp. sciuri, 37 (32.2%) strains of S. sciuri subsp. rodentium, and 4 (3.5%) strains of S. sciuri subsp. carnaticus were established. Pulsed-field gel electrophoresis (PFGE) analysis showed 21 distinct pulsotypes, including 17 main types and 4 subtypes. One dominant cluster with 62 strains was found, while 19 (90.5%) of the PFGE types and subtypes identified had 5 or fewer strains. The predominance of small PFGE clusters suggests that the ubiquitous presence of S. sciuri in the outside environment presents the continuous source for colonization of the hospital environment. The presence of one dominant PFGE cluster of strains indicates that some S. sciuri strains may be capable for adaptation to hospital environment conditions and continuous existence in this environment.

Identification and characterization of clinical isolates of members of the Staphylococcus sciuri group.

A total of 28 staphylococcal isolates from human clinical specimens belonging to the Staphylococcus sciuri group were identified and characterized. The API Staph and ID32 STAPH correctly identified S. sciuri and S. lentus but not S. vitulinus strains. Identification to the subspecies level was possible only by a PCR-based method.

[Use of IS6110 polymorphism analysis in molecular epidemiological studies of tuberculosis (Belgrade study results)]. / Polimorfizam IS6110 u genomu Mycobacterium tuberculosis kao osnov molekularnih epidemioloskih studija tuberkuloze na primeru rezultata beogradske studije.

Tuberculosis (TB) remains a major health problem worldwide. One of the main approaches to tackling TB today is the control of transmission of the disease through monitoring the transmission of specific strains of Mycobacterium tuberculosis. In the past, efforts to type strains of M. tuberculosis were hampered by the lack of strain-specific phenotypic markers. In recent years, novel approaches to studying the epidemiology of TB have been provided by molecular biological techniques based on DNA fingerprinting. The most widely used polymorphic marker is the transposable element IS6110, which is an insertion sequence found throughout M. tuberculosis complex. It is a highly polymorphic marker which varies in both copy number and location in the M. tuberculosis genome. A standardized methodology for IS6110 DNA fingerpriniting of M. tuberculosis exploits restriction fragment length polymorphism analysis. To date, IS6110 fingerprinting has been successfully used to trace the TB transmission in different regions and populations, to quantify the relative contribution of recent infection to the TB population burden, to answer the question of endogenous reactivation versus exogenous reinfection, to trace small-scale outbreaks of TB, to analyze spread of drug-resistant and multidrug resistant strains, to confirm laboratory cross-contaminations, etc. The objective of this study was to illustrate the basic principles of molecular epidemilological studies of TB. Results of the study, which provided the first insight into the status of TB in Belgrade based on implementation of molecular methods, were used as an example.

Isolation of members of the Staphylococcus sciuri group from urine and their relationship to urinary tract infections.

During a 3-year study period, 32,741 urine samples were analyzed for the presence of members of the Staphylococcus sciuri group (S. sciuri, S. lentus, and S. vitulinus), and 13 isolates were identified. They presented 0.79% of the total number of coagulase-negative staphylococci isolated. One case of symptomatic urinary tract infection and five possible cases of asymptomatic bacteriuria caused by these bacteria were established. It is noteworthy, however, that over 50% of the isolates originated from hospitalized patients.

In vitro antimicrobial activity of propolis and synergism between propolis and antimicrobial drugs.

The aim of this study was to investigate antimicrobial properties of ethanolic extract of 13 propolis (EEP) samples from different regions of Serbia against 39 microorganisms (14 resistant or multiresistant to antibiotics), and to determine synergistic activity between antimicrobials and propolis. Antimicrobial activity of propolis samples was evaluated by agar diffusion and agar dilution method. The synergistic action of propolis with antimicrobial drugs was assayed by the disc diffusion method on agar containing subinhibitory concentrations of propolis. Obtained results indicate that EEP, irrespectively of microbial resistance to antibiotics, showed significant antimicrobial activities against Gram-positive bacteria (MIC 0.078%-1.25% of EEP) and yeasts (0.16%-1.25%), while Gram-negative bacteria were less susceptible (1.25%-->5%). Enterococcus faecalis was the most resistant Gram-positive bacterium, Salmonella spp. the most resistant Gram-negative bacteria, and Candida albicans the most resistant yeast. EEP showed synergism with selected antibiotics, and displayed ability to enhance the activities of antifungals. The shown antimicrobial potential of propolis alone or in combination with certain antibiotics and antifungals is of potential medical interest.

Surgical wound infection associated with Staphylococcus sciuri.

We describe a case of surgical wound infection due to Staphylococcus sciuri. The isolated strain was susceptible to trimethoprim-sulfamethoxazole, erythromycin, chloramphenicol, ciprofloxacin and vancomycin and resistant to gentamicin, clindamycin, rifampicin, methicillin, ampicillin and ceftriaxone. The multiresistance of the strain had a serious impact on the prolonged course of the infection. Although this bacterium is principally found in animals, our strain was probably of nosocomial origin.