Pesquisa de Campylobacter spp. em frangos caipiras no município de Valença/RJ / Search of Campylobacter spp. in caipiras chickens in the city of Valença/RJ

As aves domésticas criadas em sistema extensivo no Brasil são denominadas popularmente de frangos caipiras pois apresentam importância relevante nos âmbitos econômico, social e cultural para as populações rurais em vários países da África, da Ásia e da América do Sul e difere amplamente das criações industriais. O Campylobacter spp. pode ser isolado de suínos, bovinos e ovinos, porém as aves são consideradas como o meio mais importante de transmissão da doença para as pessoas, principalmente por meio da ingestão da carne mal cozida e há pouco tempo a campilobacteriose foi reconhecida como zoonose. Existe uma preocupação com a mudança de perfil do consumidor, pela procura de um produto mais saudável, menos industrializado, mas também existe uma falta de conhecimento da sanidade e das condições higiênico-sanitárias da cadeia produtiva desta ave, desde sua criação, obtenção do produto final e comercialização, o que pode resultar em agravos à saúde coletiva. Este trabalho teve por objetivo pesquisar em 20 amostras de pequenos criadores de frango caipira que comercializam este tipo de ave oriundas de 4 propriedades no Município de Valença/ RJ, onde observou-se a presença do Campylobacter spp. em 25% das amostras analisadas.

Spread of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa clones in patients with ventilator-associated pneumonia in an adult intensive care unit at a university hospital

Background:In Brazil, ventilator-associated pneumonia (VAP) caused by carbapenem resis- tant Acinetobacter baumanniiand Pseudomonas aeruginosaisolates are associated with significant mortality, morbidity and costs. Studies on the clonal relatedness of these isolates could lay the foundation for effective infection prevention and control programs.Objectives: We sought to study the epidemiological and molecular characteristics of A. baumannii vs. P. aeruginosaVAP in an adult intensive care unit (ICU).Methods: It was conducted a cohort study of patients with VAP caused by carbapenem resistant A. baumanniiand P'. aeruginosaduring 14 months in an adult ICU. Genomic studies were used to investigate the clonal relatedness of carbapenem resistant OXA-23-producing A. baumanniiand P. aeruginosaclinical isolates. The risk factors for acquisition of VAP were also evaluated. Clinical isolates were collected for analysis as were samples from the environment and were typed using pulsed field gel electrophoresis.Results: Multivariate logistic regression analysis identified trauma diagnosed at admission and inappropriate antimicrobial therapy as independent variables associated with the development of A. baumanniiVAP and hemodialysis as independent variable associated with P. aeruginosaVAP. All carbapenem resistant clinical and environmental isolates of A. baumanniiwere OXA-23 producers. No MBL-producer P. aeruginosawas detected. Molecular typing revealed a polyclonal pattern; however, clone A (clinical) and H (surface) were the most frequent among isolates of A. baumanniitested, with a greater pattern of resistance than other isolates. In P. aeruginosathe most frequent clone I was multi-sensitive.Conclusion: These findings suggest the requirement of constant monitoring of these microor- ganisms in order to control the spread of these clones in the hospital environment.

Spread of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa clones in patients with ventilator-associated pneumonia in an adult intensive care unit at a university hospital.

BACKGROUND: In Brazil, ventilator-associated pneumonia (VAP) caused by carbapenem resistant Acinetobacter baumannii and Pseudomonas aeruginosa isolates are associated with significant mortality, morbidity and costs. Studies on the clonal relatedness of these isolates could lay the foundation for effective infection prevention and control programs. OBJECTIVES: We sought to study the epidemiological and molecular characteristics of A. baumannii vs. P. aeruginosa VAP in an adult intensive care unit (ICU). METHODS: It was conducted a cohort study of patients with VAP caused by carbapenem resistant A. baumannii and P. aeruginosa during 14 months in an adult ICU. Genomic studies were used to investigate the clonal relatedness of carbapenem resistant OXA-23-producing A. baumannii and P. aeruginosa clinical isolates. The risk factors for acquisition of VAP were also evaluated. Clinical isolates were collected for analysis as were samples from the environment and were typed using pulsed field gel electrophoresis. RESULTS: Multivariate logistic regression analysis identified trauma diagnosed at admission and inappropriate antimicrobial therapy as independent variables associated with the development of A. baumannii VAP and hemodialysis as independent variable associated with P. aeruginosa VAP. All carbapenem resistant clinical and environmental isolates of A. baumannii were OXA-23 producers. No MBL-producer P. aeruginosa was detected. Molecular typing revealed a polyclonal pattern; however, clone A (clinical) and H (surface) were the most frequent among isolates of A. baumannii tested, with a greater pattern of resistance than other isolates. In P. aeruginosa the most frequent clone I was multi-sensitive. CONCLUSION: These findings suggest the requirement of constant monitoring of these microorganisms in order to control the spread of these clones in the hospital environment.

Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15

OBJECTIVE: The present studywas designed to evaluate the molecular epidemiology of CTX-M producing Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolated from bloodstream infections at tertiary care hospitals in the State of Rio de Janeiro, Brazil. MATERIAL AND METHODS: A total of 231 nonduplicate Enterobacteriaceae were isolated from five Brazilian hospitals between September 2007 and September 2008. The antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical Laboratory Standard Institute. Isolates showing resistance to third-generation cephalosporins were screened for ESBL activity by the double-disk synergy test. The presence of blaCTX-M , blaCTX-M-15 and blaKPC genes was determined by Polymerase Chain Reaction (PCR) amplification andDNA sequencing. The molecular typing of CTX-M producing isolateswas performed by pulsed-field gel electrophoresis (PFGE). RESULTS AND DISCUSSION: Ninety-three isolates were screened as ESBL positive and 85 (91%) were found to carry CTX-M-type, as follows: K. pneumoniae 59 (49%), E. cloacae 15 (42%), and E. coli 11 (15%). Ten isolates resistant for carbapenems in K. pneumoniae were blaKPC-2 gene positive. Among CTX-M type isolates, CTX-M-15 was predominant in more than 50% of isolates for K. pneumoniae, E. coli, and E. cloacae. PFGE analysis of CTX-M producing isolates showed the predominance of CTX-M-15 in 10 of 24 pulsotypes in K. pneumoniae, 6 of 13 in E. cloacae and 3 of 6 in E. coli. CTX-M-15 was also predominant among KPC producing isolates. In conclusion, this study showed that CTX-M-15 was circulating in Rio de Janeiro state in 2007-2008. This data reinforce the need for continuing surveillance because this scenario may have changed over the years.

Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15.

OBJECTIVE: The present study was designed to evaluate the molecular epidemiology of CTX-M producing Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolated from bloodstream infections at tertiary care hospitals in the State of Rio de Janeiro, Brazil. MATERIAL AND METHODS: A total of 231 nonduplicate Enterobacteriaceae were isolated from five Brazilian hospitals between September 2007 and September 2008. The antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical Laboratory Standard Institute. Isolates showing resistance to third-generation cephalosporins were screened for ESBL activity by the double-disk synergy test. The presence of blaCTX-M, blaCTX-M-15 and blaKPC genes was determined by Polymerase Chain Reaction (PCR) amplification and DNA sequencing. The molecular typing of CTX-M producing isolates was performed by pulsed-field gel electrophoresis (PFGE). RESULTS AND DISCUSSION: Ninety-three isolates were screened as ESBL positive and 85 (91%) were found to carry CTX-M-type, as follows: K. pneumoniae 59 (49%), E. cloacae 15 (42%), and E. coli 11 (15%). Ten isolates resistant for carbapenems in K. pneumoniae were blaKPC-2 gene positive. Among CTX-M type isolates, CTX-M-15 was predominant in more than 50% of isolates for K. pneumoniae, E. coli, and E. cloacae. PFGE analysis of CTX-M producing isolates showed the predominance of CTX-M-15 in 10 of 24 pulsotypes in K. pneumoniae, 6 of 13 in E. cloacae and 3 of 6 in E. coli. CTX-M-15 was also predominant among KPC producing isolates. In conclusion, this study showed that CTX-M-15 was circulating in Rio de Janeiro state in 2007-2008. This data reinforce the need for continuing surveillance because this scenario may have changed over the years.

Update of the molecular epidemiology of KPC-2-producing Klebsiella pneumoniae in Brazil: spread of clonal complex 11 (ST11, ST437 and ST340).

OBJECTIVES: To perform molecular epidemiology for 113 KPC-producing Klebsiella pneumoniae isolated in 2010 from 12 Brazilian states. METHODS: The resistance profile was determined by disc diffusion and Etest. Genetic polymorphism was analysed by PFGE and multilocus sequence typing. The genetic environment of the bla(KPC) gene was determined by PCR and identification of the carrier plasmid was determined by hybridization. RESULTS: Most of the isolates were multidrug resistant, with 15% and 49% being resistant to polymyxin and tigecycline, respectively. Twenty-two sequence types (STs) were observed, with ST11, ST437 and ST340 [clonal complex 11 (CC11)] being the most prevalent (75% of isolates) observed in 10 states. bla(KPC-2) was associated with transposon Tn4401 'b' and in 36% this gene was found in IncN plasmids of 40 kb. CONCLUSIONS: In Brazil, the spread of bla(KPC-2) is occurring due to dispersion of Tn4401 'b', carried by IncN plasmids of 40 kb, and mainly the dissemination of CC11, with ST437 and ST11 playing an important role.

Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

OBJECTIVE: The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. MATERIAL AND METHODS: Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC50 and MIC90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for blaTEM, blaSHV, blaCTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. RESULTS AND DISCUSSION: Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil.

OBJECTIVE: The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. MATERIAL AND METHODS: Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC50 and MIC90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for blaTEM, blaSHV, blaCTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. RESULTS AND DISCUSSION: Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

Phage typing and Multidrug resistance profile in S. Typhimurium isolated from different sources in Brazil from 1999 to 2004

Salmonella Typhimurium has become a widespread cause of salmonellosis among humans and animals worldwide. In Brazil, Salmonella Typhimurium (STM) is one of the most prevalent serovars isolated from food for human consumption. The uncontrolled sale and use of antimicrobials in agriculture and for treating human patients contributes to increase multidrug resistance of this serovar. In the present study, a total of 278 STM isolates from different sources and regions of Brazil over the period 1999 to 2004 were phage typed and analyzed for their antimicrobial resistance profile at Laboratory of Enterobacteria, Oswaldo Cruz Institute, FIOCRUZ. The main STM phage types isolated were DT 193 (64.3 percent), DT 19 (17.4 percent) and DT 18 (4 percent). Others phage types as DT 10 (2 percent), DT 27 (3.24 percent), DT 13 (0.36 percent), DT 22 (0.36 percent), DT 28 (0.36 percent), DT 29 (0.36 percent) and DT 149 (0.36 percent) were obtained in low percentages. A total of 54 percent STM strains were resistant to three or more antimicrobial classes, while no resistance to third generation cephalosporin or ciprofloxacin was identified in these strains. Those results show the STM phage types circulating among animals, food for human consumption and humans in Brazil as well as the increasing of multidrug resistance. The surveillance of STM strains based on phage typing and antimicrobial resistance profile are useful for detecting outbreaks, identifying sources of infection and implementing prevention and control measures.

Salmonella Typhimurium é considerada uma das principais bactérias causadoras de salmonelose nos animais e no homem em todo o mundo. No Brasil, Salmonella Typhimurium é um dos mais prevalentes sorovares isolados de alimentos para consumo humano. O uso indiscriminado de antibióticos em produtos agrícolas e no tratamento de pacientes humanos tem contribuído para aumentar a multirresistência desse sorovar a diversos antimicrobianos. No presente estudo, 278 cepas de STM foram selecionadas de diferentes fontes e regiões do Brasil, no período de 1999 a 2004 e realizadas a fagotipagem e análise do perfil de resistência antimicrobiana no Laboratório de Enterobactérias, Instituto Oswaldo Cruz, FIOCRUZ. Os principais fagotipos isolados foram DT 193 (64,3 por cento), DT 19 (17,4 por cento) e DT 18 (4 por cento). Os fagotipos DT 10 (2 por cento), DT 27 (3,24 por cento), DT 13 (0,36 por cento), DT 22 (0,36 por cento), DT 28 (0,36 por cento), DT 29 (0,36 por cento) e DT 149 (0,36 por cento) foram isolados em menores percentuais. Um total de 54 por cento das cepas de STM foi resistente a três ou mais classes de antimicrobianos e não foi observada resistência a cefalosporinas de terceira geração ou ciprofloxacina. Esses resultados indicam os principais lisotipos de Salmonella Typhimurium circulantes entre os animais, alimentos de consumo humano e seres humanos no Brasil, bem como o aumento da multirresistência antimicrobiana. O monitoramento de cepas de Salmonella Typhimurium baseado na fagotipagem e no padrão de resistência antimicrobiana são ferramentas úteis para detectar surtos, identificar a fonte de infecção e implementar programas de prevenção e controle de salmonelose.

Phage types of Salmonella enteritidis isolated from clinical and food samples, and from broiler carcasses in southern Brazil.

272 isolates of Salmonella Enteritidis (111 isolated from frozen broiler chicken carcasses, 126 from human food and other biological materials involved in food poisoning outbreaks and 35 from different poultry materials) were selected for phage typing. From these, 111 were phage typed, 57.65% being classified as phage type 4, 32.43% as phage type 4a, 3.60% as phage type 6a and 0.90% as phage type 7, whereas 5.40% samples were not phage typeable. The predominance of phage type 4 is in agreement with the results published worldwide, and reinforces the need for studies related to the epidemiological meaning of these findings.

Phage types of Salmonella enteritidis isolated from clinical and food samples, and from broiler carcasses in Southern Brazil

272 isolates of Salmonella Enteritidis (111 isolated from frozen broiler chicken carcasses, 126 from human food and other biological materials involved in food poisoning outbreaks and 35 from different poultry materials) were selected for phage typing. From these, 111 were phage typed, 57.65 percent being classified as phage type 4, 32.43 percent as phage type 4a, 3.60 percent as phage type 6a and 0.90 percent as phage type 7, whereas 5.40 percent samples were not phage typeable. The predominance of phage type 4 is in agreement with the results published worldwide, and reinforces the need for studies related to the epidemiological meaning of these findings

Emergência da múltipla resistência a antimicrobianos em Vibrio cholerae isolados de pacientes com gastroenterite no Ceará, Brasil / Emergence of multiple drug resistence in Vibrio cholerae isolated from patients with gastroenteritis in Ceará, Brasil

Das 7058 amostras de Vibrio cholerae isoladas de pacientes com suspeita de síndrome coleriforme, no período de 1991 a 1993, no Estado do Ceará, foram detectadas duas com as características de múltipla resistência aos antimicrobianos (tetraciclina, ampicilina, sulfametoxazol-trimetoprima) e ao composto vibriostático O/129 (2,4-diamino-6, 7-diisopropilpteridina). Do ponto de vista bacteriológico uma amostra foi identificada como V.cholerae sorogrupo O:1, biotipo El Tor e sorovar Inaba e a outra, caracterizada como V. cholerae sorogrupo O:22, classificada bioquimicamente no tipo II de Heiberg. Foi demonstrado que apenas na amostra do sorogrupo O:1, a multirresistência era codificada por um plasmídio, transferível por conjugaçäo para Escherichia coli K12 e amostras sensíveis de V. cholerae O1 e näo O1, numa frequência entre 8x10-² a 5x10-(6). O plasmídio responsável pela multirresistência apresentou um peso molecular de 147 Kb, compatível com as descriçöes em outras partes do mundo