Colonization by Extended-Spectrum ß-Lactamase-Producing Enterobacterales and Bacteremia in Hematopoietic Stem Cell Transplant Recipients.

BACKGROUND: Assessing the risk of multidrug-resistant colonization and infections is pivotal for optimizing empirical therapy in hematopoietic stem cell transplants (HSCTs). Limited data exist on extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-E) colonization in this population. This study aimed to assess whether ESBL-E colonization constitutes a risk factor for ESBL-E bloodstream infection (BSI) and to evaluate ESBL-E colonization in HSCT recipients. METHODS: A retrospective analysis of ESBL-E colonization and BSI in HSCT patients was conducted from August 2019 to June 2022. Weekly swabs were collected and cultured on chromogenic selective media, with PCR identifying the ß-lactamase genes. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) assessed the colonizing strains' similarities. RESULTS: Of 222 evaluated HSCT patients, 59.45% were colonized by ESBL-E, with 48.4% at admission. The predominant ß-lactamase genes were blaTEM (52%) and blaSHV (20%). PFGE analysis did not reveal predominant clusters in 26 E. coli and 15 K. pneumoniae strains. WGS identified ST16 and ST11 as the predominant sequence types among K. pneumoniae. Thirty-three patients developed thirty-five Enterobacterales-BSIs, with nine being third-generation cephalosporin-resistant. No association was found between ESBL-E colonization and ESBL-BSI (p = 0.087). CONCLUSIONS: Although the patients presented a high colonization rate of ESBL-E upon admission, no association between colonization and infection were found. Thus, it seems that ESBL screening is not a useful strategy to assess risk factors and guide therapy for ESBL-BSI in HSCT-patients.

Biological effects of trans, trans-farnesol in Leishmania amazonensis.

Introduction: Farnesol, derived from farnesyl pyrophosphate in the sterols biosynthetic pathway, is a molecule with three unsaturations and four possible isomers. Candida albicans predominantly secretes the trans, trans-farnesol (t, t-FOH) isomer, known for its role in regulating the virulence of various fungi species and modulating morphological transition processes. Notably, the evolutionary divergence in sterol biosynthesis between fungi, including Candida albicans, and trypanosomatids resulted in the synthesis of sterols with the ergostane skeleton, distinct from cholesterol. This study aims to assess the impact of exogenously added trans, trans-farnesol on the proliferative ability of Leishmania amazonensis and to identify its presence in the lipid secretome of the parasite. Methods: The study involved the addition of exogenous trans, trans-farnesol to evaluate its interference with the proliferation of L. amazonensis promastigotes. Proliferation, cell cycle, DNA fragmentation, and mitochondrial functionality were assessed as indicators of the effects of trans, trans-farnesol. Additionally, lipid secretome analysis was conducted, focusing on the detection of trans, trans-farnesol and related products derived from the precursor, farnesyl pyrophosphate. In silico analysis was employed to identify the sequence for the farnesene synthase gene responsible for producing these isoprenoids in the Leishmania genome. Results: Exogenously added trans, trans-farnesol was found to interfere with the proliferation of L. amazonensis promastigotes, inhibiting the cell cycle without causing DNA fragmentation or loss of mitochondrial functionality. Despite the absence of trans, trans-farnesol in the culture supernatant, other products derived from farnesyl pyrophosphate, specifically α-farnesene and ß-farnesene, were detected starting on the fourth day of culture, continuing to increase until the tenth day. Furthermore, the identification of the farnesene synthase gene in the Leishmania genome through in silico analysis provided insights into the enzymatic basis of isoprenoid production. Discussion: The findings collectively offer the first insights into the mechanism of action of farnesol on L. amazonensis. While trans, trans-farnesol was not detected in the lipid secretome, the presence of α-farnesene and ß-farnesene suggests alternative pathways or modifications in the isoprenoid metabolism of the parasite. The inhibitory effects on proliferation and cell cycle without inducing DNA fragmentation or mitochondrial dysfunction raise questions about the specific targets and pathways affected by exogenous trans, trans-farnesol. The identification of the farnesene synthase gene provides a molecular basis for understanding the synthesis of related isoprenoids in Leishmania. Further exploration of these mechanisms may contribute to the development of novel therapeutic strategies against Leishmania infections.

Cancelamento cirúrgico ambulatorial: uma revisão integrativa / Cancellation of outpatient surgery: an integrative review / Cancelación quirúrgica ambulatoria: una revisión integradora

Objetivo: discutir as evidências científicas sobre as causas de cancelamento em cirurgia ambulatorial. Método: trata-se de uma revisão integrativa com busca nas bases de dados eletrônicas Medline, Embase, Lilacs, Cinahl, Web of Science e Scopus, a partir dos termos controlados Ambulatory Surgical Procedures, Ambulatory Surgery, Suspension e termos livres sinônimos. Resultados: selecionaram-se 13 estudos. O país com menor taxa de cancelamento cirúrgico ambulatorial foram os Estados Unidos com 0,5%, e o maior, a Nigéria com 25,40%. Foram encontradas 53 causas de cancelamento em cirurgia ambulatorial, das quais agrupou-se em três categorias: fatores do paciente, clínicos e institucionais. Conclusão: Evidencia-se que as causas de cancelamento cirúrgico ambulatorial foram diversas e comuns nas instituições, sendo o absenteísmo do paciente no dia do procedimento agendado a causa mais frequente, demonstrando que estratégias assistenciais e de gestão precisam ser realizadas.

Objective: to discuss the scientific evidence on the causes of cancellation in outpatient surgery. Method: this integrative review involved searching the Medline, Embase, Lilacs, Cinahl, Web of Science and Scopus electronic databases using the controlled terms Ambulatory Surgical Procedures, Ambulatory Surgery, Suspension and free synonyms. Results: 13 studies were selected. By country, the United States, with 0.5%, had the lowest outpatient surgery cancellation rate, and Nigeria, with 25.40%, the highest. The fifty-three causes of outpatient surgery cancellation found were grouped into three categories: patient, clinical, and institutional factors. Conclusion: the causes of outpatient surgical cancellation were found to be diverse and common in institutions, the most frequent cause being patient absence on the day of the scheduled procedure, demonstrating that care and management strategies need to be developed and applied.

Objetivo: discutir la evidencia científica sobre las causas de cancelación en cirugía ambulatoria. Método: se trata de una revisión integradora con búsqueda en las bases electrónicas de datos Medline, Embase, Lilacs, Cinahl, Web of Science y Scopus, utilizando los términos controlados Ambulatory Surgical Procedures, Ambulatory Surgery, Suspension y términos sinónimos libres. Resultados: se seleccionaron 13 estudios. El país con la tasa de cancelación quirúrgica ambulatoria más baja fue Estados Unidos con un 0,5% y el de más alta Nigeria, con un 25,40%. Se encontraron 53 causas de cancelación en cirugía ambulatoria, las cuales se agruparon en tres categorías: factores del paciente, clínicos e institucionales. Conclusión: Se pone en evidencia que las causas de cancelación de cirugía ambulatoria fueron diversas y comunes en las instituciones, siendo la causa más frecuente el absentismo del paciente el día del procedimiento programado, demostrando que es necesario realizar estrategias de atención y de gestión.

Insights from Leishmania (Viannia) guyanensis in vitro behavior and intercellular communication.

BACKGROUND: Pentavalent antimonial-based chemotherapy is the first-line approach for leishmaniasis treatment and disease control. Nevertheless antimony-resistant parasites have been reported in some endemic regions. Treatment refractoriness is complex and is associated with patient- and parasite-related variables. Although amastigotes are the parasite stage in the vertebrate host and, thus, exposed to the drug, the stress caused by trivalent antimony in promastigotes has been shown to promote significant modification in expression of several genes involved in various biological processes, which will ultimately affect parasite behavior. Leishmania (Viannia) guyanensis is one of the main etiological agents in the Amazon Basin region, with a high relapse rate (approximately 25%). METHODS: Herein, we conducted several in vitro analyses with L. (V.) guyanensis strains derived from cured and refractory patients after treatment with standardized antimonial therapeutic schemes, in addition to a drug-resistant in vitro-selected strain. Drug sensitivity assessed through Sb(III) half-maximal inhibitory concentration (IC50) assays, growth patterns (with and without drug pressure) and metacyclic-like percentages were determined for all strains and compared to treatment outcomes. Finally, co-cultivation without intercellular contact was followed by parasitic density and Sb(III) IC50 measurements. RESULTS: Poor treatment response was correlated with increased Sb(III) IC50 values. The decrease in drug sensitivity was associated with a reduced cell replication rate, increased in vitro growth ability, and higher metacyclic-like proportion. Additionally, in vitro co-cultivation assays demonstrated that intercellular communication enabled lower drug sensitivity and enhanced in vitro growth ability, regardless of direct cell contact. CONCLUSIONS: Data concerning drug sensitivity in the Viannia subgenus are emerging, and L. (V.) guyanensis plays a pivotal epidemiological role in Latin America. Therefore, investigating the parasitic features potentially related to relapses is urgent. Altogether, the data presented here indicate that all tested strains of L. (V.) guyanensis displayed an association between treatment outcome and in vitro parameters, especially the drug sensitivity. Remarkably, sharing enhanced growth ability and decreased drug sensitivity, without intercellular communication, were demonstrated.

Environmental disaster in the northeast coast of Brazil: Forensic geochemistry in the identification of the source of the oily material.

The characterization of petroleum or its products spilled in the environment in relation to its source rocks is an important tool to assist in the resolution of issues of environmental impact and legal responsibility since it clarifies the possible region or the producing country of that type of petroleum. This article analyzes the application of analytical techniques for petroleum geochemistry to identify the type and origin of oily material collected from beaches in Northeast Brazil in 2019. Samples of the oily material collected on the beaches in the states of Bahia and Sergipe were analyzed and for comparison purposes, samples of crude oils produced in Brazil, Middle East, Nigeria and Venezuela were also analyzed. The analytical results showed that the oily material that reached the beaches has geochemical characteristics compatible with those of the Venezuelan oil, indicating it was severely weathered or a product made with heavy oil produced.

The combination of compost or biochar with urea and NBPT can improve nitrogen-use efficiency in maize.

The addition of organic residues to agricultural soils has been used as a practical alternative to improve crop quality and health. The objective of this work was to evaluate maize physiological and nutritional responses to the application of compost and biochar combined with urea (N) and N-(n-butyl) thiophosphoric triamide (NBPT). The experiment was performed in plastic pots with 3 kg of soil under greenhouse conditions for 30 days. The compost and biochar were applied at the rate of 0.3 ton ha-1, using an amount of nutrient (nitrogen, phosphorus and potassium) demanded by crop growth. The physiological responses of maize were monitored by measuring the plant height, stalk diameter, leaf chlorophyll content, shoot dry weight and root dry weight. The nutritional responses of maize were assessed by using the nutrient concentration and the total nutrient assimilation by the plants. The results showed that the addition of compost or biochar did not alter the maize physiological response compared to the addition of mineral fertilizer used under the same conditions. However, a difference occurred in the maize nutritional responses to the compost and biochar amendments combined with urea and NBPT. The greatest N concentration in maize was observed in the treatment consisting of biochar combined with urea + NBPT. All the treatments in which compost or biochar was applied in combination with urea and NBPT presented greater total N assimilation compared to the treatment with conventional fertilization. The results of this survey showed that the combination of urea and NBPT improved the nitrogen-use efficiency of maize.

Parada cardiorrespiratória: vigilância, prevenção e cuidados após PCR / Paro cardíaco: vigilância, prevención y cuidados después de la PCR / Cardiorespiratory arrest: surveillance, prevention and care after PCR

Objective: to gather scientific productions about actions of surveillance, prevention and nursing care in cardiorespiratory arrest. Methods: Bibliographic search in the selected databases LILACS and MEDLINE. Results: The results of the bibliographic research according to research indicators were obtained 22 articles. Conclusions: Nursing is paramount in patient surveillance and prevention, recognizing predisposing factors that would lead to PCR. During PCR, in general, it is the first team to identify, trigger the rest of the professionals and initiate RCP. They assist the medical staff and make the nursing record in the patient’s chart. The nurse is a fundamental part in the distribution of the functions of the other members of the team and in the care after RCP.

Objetivo: reunir produções científicas acerca de ações de vigilância, prevenção e os cuidados de enfermagem na parada cardiorrespiratória. Métodos: Pesquisa bibliográfica nas bases de dados selecionadas LILACS e MEDLINE. Resultados: O resultado da pesquisa bibliográfica conforme indicadores de pesquisa obtiveram-se 22 artigos. Conclusões: A enfermagem é primordial na vigilância e prevenção do paciente, reconhecendo fatores predisponentes que levariam a uma PCR. Durante a PCR, em geral, é a primeira equipe a identificar, acionar o restante dos profissionais e iniciar a RCP. Auxiliam a equipe médica e fazem o registro de enfermagem no prontuário do paciente. O enfermeiro é peça fundamental na distribuição das funções dos demais membros da equipe e nos cuidados após RCP.

Objetivo: reunir producciones científicas sobre vigilancia, prevención y cuidados de enfermería en el paro cardíaco. Métodos: Una búsqueda bibliográfica en las bases de datos LILACS y MEDLINE seleccionados. Resultados: El resultado de la literatura de investigación como indicadores produjeron 22 artículos. Conclusiones: La enfermería es esencial para la vigilancia y la prevención de la paciente, reconociendo factores predisponentes que conducirían a una PCR. Durante la PCR, en general, es el primer equipo para identificar, involucrar al resto de los profesionales y comenzar la RCP. Ellos ayudan al personal médico y de enfermería hacen que el registro en el expediente del paciente. La enfermera es uma parte clave en la distribución de las funciones de los otros miembros Del equipo y el cuidado después de la RCP.

Isoflavones Reduce Copper with Minimal Impact on Iron In Vitro.

Isoflavones are commonly consumed in many Asian countries and have potentially positive effects on human being. Only a few and rather controversial data on their interactions with copper and iron are available to date. 13 structurally related isoflavones were tested in the competitive manner for their Cu/Fe-chelating/reducing properties. Notwithstanding the 5-hydroxy-4-keto chelation site was associated with ferric, ferrous, and cupric chelation, the chelation potential of isoflavones was low and no cuprous chelation was observed. None of isoflavones was able to substantially reduce ferric ions, but the vast majority reduced cupric ions. The most important feature for cupric reduction was the presence of an unsubstituted 4'-hydroxyl; contrarily the presence of a free 5-hydroxyl decreased or abolished the reduction due to chelation of cupric ions. The results from this study may enable additional experiments which might clarify the effects of isoflavones on human being and/or mechanisms of copper absorption.

Análise de evidências de comunicação quorum sensing mediada pelo isoprenóide farnesol em Leishmania amazonensis / Analysis of evidence of quorum sensing communication mediated by isoprenoid farnesol in Leishmania amazonensis

Quorum sensing (QS) é um tipo de comunicação intercelular descrito em microorganismos. Ela é intermediada por moléculas sinalizadoras (QSMs) liberadas constitutivamente pelos espécimes e por meio delas os microorganismos percebem a densidade populacional. [...] Em fungos, trans,trans-farnesol (t,t-FOH) atua como QSM. Esse isoprenóide regula a virulência de Candida albicans modulando os processos de transição morfológica. O t, t- FOH é produzido por uma rota alternativa a partir do farnesilpirofosfato (FPP), um intermediário da via biossíntética de esteróis. Em protozoários, QS já foi descrita no tripanossomatídeo Trypanossoma brucei. Adicionalmente, o processo de metaciclogênese que ocorre em Leishmania possui características de regulação QS, devido sua relação com a densidade populacional. Interessantemente, fungos e tripanossomatídeos possuem maquinaria própria de síntese de esteróis. Essa similaridade e a descrição do t,t-FOH como QSM em fungos sugere que ele pode desempenhar atividade similar em tripanossomatídeos. Em nossa hipótese, t,t-FOH é uma QSM que causa uma redução da capacidade proliferativa de Leishmania amazonensis quando a cultura atinge um quorum. Porém, o parasito mantem-se viável, de modo que a cultura fica estacionária. Inicialmente constatamos que L. amazonensis libera t,t-FOH ou seus derivados no sobrenadante. [...] Essas observações estão de acordo com o perfil de uma possível QSM. Em seguida determinamos as condições de cultivo em que o t,t-FOH possivelmente atua como QSM nas culturas...

Quorum sensing (QS) is a type of intercellular communication described in microorganisms.It is mediated by signaling molecules (QSMs) constitutively released by specimens andthrough them, the microorganisms sense the population density. [...] Infungi, trans,trans-farnesol (t,t-FOH) acts as QSM. This isoprenoid regulates virulence ofCandida albicans interfering the morphological transitions. t,t-FOH is produced by analternative route from farnesylpyrophosphate (FPP), an intermediate of the sterolbiosynthetic pathway. In protozoa, QS has been described in the trypanosomatidTrypanosoma brucei. Additionally, the metacyclogenesis of Leishmania has caracteristics ofQS regulation, due to its relationship with population density. Interestingly, fungi andtrypanosomatids have their own machinery sterol synthesis. This similarity and thedescription of the t, t-FOH as QSM in fungi suggests that it may play similar activity intrypanosomatids. In our hypothesis, t,t-FOH is a QSM which causes a reduction in theproliferative capacity of Leishmania amazonensis when the culture reaches a quorum.However, the parasite keeps viable, so the culture enters in the stationary phase. Initially, wefound that L. amazonensis releases t,t-FOH or its derivatives in the supernatant. Theconcentration of these metabolites enhances with the increase in population density. Theseobservations are consistent with the profile of a possible QSM. Then, we determined thegrowing conditions in which t,t-FOH possibly acts as QSM. [...] We observed that the concentrations that inhibited the proliferation were also apparently toxic. Consideringthat the t,t-FOH is lipophilic, we decided to remove the lipophilic compounds of thesupernatant...

Thiopurine derivatives containing triazole and steroid: synthesis, antimalarial and antileishmanial activities.

A series of novel 6-thiopurine derivates containing 1,2,3-triazole were synthesized and their in vivo antimalarial activity and in vitro antileishmanial activity were examined. The compounds 10, 11, 12 and 14 presented higher values of inhibition of parasite multiplication than chloroquine. For antileishmanial activity, the compound 14 showed activity against the three species of Leishmania tested. None of compounds showed cytotoxicity against mammalian cells.

Synthesis and antileishmanial activity of lipophilic aromatic aminoalcohols.

In this work, we report on the preparation and evaluation of the in vitro antileishmanial activity of a series of lipophilic aromatic aminoalcohols. All compounds were assessed for their in vitro antiproliferative activity against promastigotes of three Leishmania species. The most lipophilic aminoalcohols bearing an aliphatic moiety with eight to 12 carbon atoms displayed a good activity against L. amazonensis and L. major, and two of them also showed antiproliferative activity against L. chagasi. The best results were obtained for the N-dodecanoyl ethylenediamine derivative and for N-decyl aminoalcohol (IC50=5.2 and 0.7 microM, respectively).

Biomphalaria spp. (Preston, 1910) snails in the municipality of Juiz de Fora, Zona da Mata Mineira mesoregion, ate of Minas Gerais, Brazil

This study focuses on the geographic distribution of the snail of the genus Biomphalaria and evaluates its infectivity by Schistosoma mansoni in 5264 specimens collected in the municipality of Juiz de Fora, Minas Gerais, Brazil. Of the 31 locations studied, 6 were reservoirs, 11 rudimentary holding ponds, 7 irrigation ditches, 5 lakes, 1 ornamental pond, and 1 waterfall. Intermediate hosts were found only in the rudimentary ponds and ditches, which were 100 percent positive. Using morphological and molecular analysis techniques, B. tenagophila, B. peregrina, and B. straminea were identified. This is the first report of B. stramínea in the municipality, and evaluation of its infective potential revealed susceptibility of 25.4 percent. Although we did not find specimens of Biomphalaria infected by S. mansoni, the data obtained indicate the presence of intermediate hosts, especially in the irrigation ditches in Juiz de Fora, and their proximity to contaminated areas.

Biomphalaria spp. (Preston,1910) snails in the municipality of Juiz de Fora, Zona da Mata Mineira mesoregion, state of Minas Gerais, Brazil.

This study focuses on the geographic distribution of the snail of the genus Biomphalaria and evaluates its infectivity by Schistosoma mansoni in 5264 specimens collected in the municipality of Juiz de Fora, Minas Gerais, Brazil. Of the 31 locations studied, 6 were reservoirs, 11 rudimentary holding ponds, 7 irrigation ditches, 5 lakes, 1 ornamental pond, and 1 waterfall. Intermediate hosts were found only in the rudimentary ponds and ditches, which were 100% positive. Using morphological and molecular analysis techniques, B. tenagophila, B. peregrina, and B. straminea were identified. This is the first report of B. stramínea in the municipality, and evaluation of its infective potential revealed susceptibility of 25.4%. Although we did not find specimens of Biomphalaria infected by S. mansoni, the data obtained indicate the presence of intermediate hosts, especially in the irrigation ditches in Juiz de Fora, and their proximity to contaminated areas.