Relentless increase of resistance to fluoroquinolones and expanded-spectrum cephalosporins in Escherichia coli: 20 years of surveillance in resource-limited settings from Latin America.

Previous studies on commensal Escherichia coli from healthy children in the Bolivian Chaco have shown remarkable resistance rates to the old antibiotics since the early 1990s, and the emergence of resistance to newer drugs (fluoroquinolones and expanded-spectrum cephalosporins) in the 2000s. Here we report the results of a new survey conducted in 2011 in the same setting. Rectal swabs were obtained from 482 healthy children (aged 6-72 months) from three urban areas of the Bolivian Chaco. Screening for antibiotic-resistant E. coli was performed by a direct plating method, as in the previous studies. The blaCTX-M genes were investigated by PCR/sequencing, and CTX-M-producing isolates were subjected to genotyping and detection of several plasmid-mediated quinolone resistance mechanisms. Results showed high rates of resistance to nalidixic acid (76%), ciprofloxacin (44%) and expanded-spectrum cephalosporins (12.4%), demonstrating a relentless increase of resistance to those drugs over the past two decades. CTX-M-type extended-spectrum beta-lactamases were found to be widespread (12%, 97% of extended-spectrum beta-lactamase producers). Compared with the previous studies, CTX-M-producing E. coli underwent a dramatic dissemination (120-fold increase since early 2000s) and a radical change of dominant CTX-M groups (CTX-M-1 and CTX-M-9 groups versus CTX-M-2 group). Most CTX-M producers were not susceptible to quinolones (91%), and 55% carried plasmid-mediated quinolone resistance genes (different combinations of aac(6')-Ib-cr, qnrB and qepA). This study shows the rapid and remarkable increasing trend for resistance to fluoroquinolones and expanded-spectrum cephalosporins in one of the poorest regions of Latin America, and underscores the need for urgent control strategies aimed at preserving the efficacy of those drugs in similar settings.

A barium method for the cytochemical detection of sulfated glycosaminoglycans in mast cells and basophilic leukocytes.

Barium ions precipitate inorganic as well as organic sulfate compounds and they can be detected by a reaction with sodium rhodizonate. In this work, we describe the use of a barium method for the selective demonstration of sulfated glycosaminoglycans in cytoplasmic granules of mast cells and basophilic leukocytes. Methanol-fixed smears of mouse peritoneal mast cells and rat bone marrow basophils were treated with 5% BaCl2 for 10 min, followed by staining with either 0.2% sodium rhodizonate in 50% ethanol for 2 h at 60 degrees C, or 0.01% brilliant green in distilled water for 1 min. Light microscopic observation revealed a strong staining reaction of the cytoplasmic granules of these cell types, which was more selective when using sodium rhodizonate. Control smears treated with BaCl2 or sodium rhodizonate alone, and those subjected to methylation/extraction of sulfate groups before staining remained unstained. The selective binding of barium ions to mast cell granules was established with scanning electron microscopy using a backscattered electron detector, and confirmed by energy dispersive X-ray microanalysis as well as element mapping.

Fluorescence of chromatin DNA induced by antitumoral naphthalimides.

Treatment of chicken blood smears and semithin sections from Epon-embedded mouse tissues with aqueous solutions of the 3-aminonaphthalimides FA-142, FA-2043, and FA-2143 induced a strong green-yellow fluorescence of chromatin under violet or violet-blue excitation. Chromatin emission was abolished by previous DNase or hot TCA treatment. The use of 3-methoxy (FA-655) and 3-nitro derivatives (M-4212 and M-12210) resulted in very weak fluorescence of chromatin. Absorption maxima at 346 and 408 nm and an emission peak at 570 nm were observed for the free compound FA-142. Fluorescence properties open new and interesting applications for some of these antitumoral and DNA-intercalating naphthalimides.

A new fluorescence reaction in DNA cytochemistry: microscopic and spectroscopic studies on the aromatic diamidino compound M&B 938.

We describe the fluorescence properties and cytochemical applications of the aromatic diamidine M&B 938. Treatment of cell smears (chicken blood, Ehrlich ascites tumor, rat bone marrow, mouse mast cells, and Trypanosoma cruzi epimastigotes) with aqueous solutions of M&B 938 (0.5-1 microgram/ml at pH 6-7; UV excitation) induced bright bluish-white fluorescence in DNA-containing structures (interphase and mitotic chromatin, AT-rich kinetoplast DNA of T. cruzi), which was abolished by previous DNA extraction. DNA was the unique fluorescent polyanion after staining with M&B 938 at neutral or alkaline pH, other polyanions such as RNA and heparin showing no emission. M&B 938-stained mouse metaphase chromosomes revealed high fluorescence of the AT-rich centromeric heterochromatin, and strong emission of heterochromatin in human chromosomes 1, 9, 15, 16, and Y was found after distamycin A counterstaining. On agarose gel electrophoresis, M&B 938-stained DNA markers appeared as fluorescent bands. The 1.635-KBP fragment from DNA ladder revealed a higher emission value than that expected from linear regression analysis. Spectroscopic studies showed bathochromic and hyperchromic shifts in the absorption spectrum of M&B 938 complexed with DNA, as well as strong enhancement of fluorescence at 420 nm. In the presence of poly(dA)-poly(dT), the emission of M&B 938 was 4.25-fold higher than with DNA; no fluorescence was observed with poly(dG)-poly(dC). Experimental results and considerations of the chemical structure suggest that the minor groove of AT regions of DNA could be the specific binding site for M&B 938, which shows interesting properties and useful applications as a new DNA fluorochrome.

Differential reactivity of structural components of eosinophil leucocyte granules as revealed by ethanolic phosphotungstic acid.

After glutaraldehyde fixation and ethanolic phosphotungstic acid (E-PTA) treatment before embedding, thin sections of rat bone marrow and large intestine showed a characteristic pattern of electron opacity in eosinophil leucocyte granules. In both mature eosinophils and precursor cells, the matrix appeared highly contrasted while the crystalline core revealed no electron density. Additional treatment of sections with uranyl acetate did not modify the contrasting pattern of eosinophil granules. The absence of electron dense reaction in the crystalline core after E-PTA treatment seems to originate from removal of core components. The selective reactivity of the matrix toward E-PTA could be a valuable ultrastructural marker for studies on the differentiation of specific granules along the maturation of eosinophil leucocytes.

Fluorescence of the natural dye saffron: selective reaction with eosinophil leucocyte granules.

Treatment of methanol-fixed chicken, rat, horse and human blood smears with saturated solutions of saffron in borate buffer at pH 10 results in a bright yellow-green fluorescence reaction of the acidophilic cytoplasm granules in mammalian eosinophils and chicken heterophils under violet-blue exciting light. Spectral characteristics of saffron (emission peak at 543 nm under 436 nm excitation) and its selective fluorescence with acidophilic structures support the possibility of employing this old microscopic stain as a new fluorochrome.

Fluorescence of eosinophil leucocyte granules induced by 1-hydroxy-3,6,8-pyrenetrisulfonate. Visualization of differences in protein isoelectric points.

After treatment of horse, rat and human blood smears with alkaline solutions of 1-hydroxy-3,6,8-pyrenetrisulfonate (HPTS), eosinophil leucocyte granules were the unique cell components which showed a bright green fluorescence. When stained with HPTS at pH 10, the whole granule of horse eosinophils showed high emission which strongly diminished after washing or staining in salt solutions or by using blocking methods for amino groups. Using HPTS at pH 12, the fluorescence reaction of horse granules was specifically located in the peripheral region, appearing as fluorescent rings. These microscopic observations, which indicate differences in the isoelectric point of proteins within the eosinophil granule, were also confirmed by HPTS staining of protein blots as model substrates. Spectral analysis of HPTS at pH 10 and 12 showed practically identical absorption and emission spectra with peaks at 450 nm and 510 nm, respectively. Our results indicate that mainly ionic binding occurs between cationic proteins and HPTS in alkaline solution, and that the most cationic proteins (with isoelectric points at pH higher than 12) are located in the peripheral annular region of horse eosinophil granules.

Cytochemical application of tris (2,2'-bipyridine) ruthenium (II): fluorescence reaction with sulfated polyanions of mast cell granules.

We describe the use of tris (2,2'-bipyridine) ruthenium (II) (Rubipy) as a cationic fluorochrome for cytochemical and histochemical studies. After staining with Rubipy, mast cell granules (MCGs) and lymphocyte nuclei (LN) from mouse peritoneal cavity and human breast carcinoma showed intense orange fluorescence and no fading under blue or blue-violet exciting light. Staining at low pH (< 2) or pre-treatment with Al3+ ions strongly diminished the fluorescence of LN, whereas that of MCG was less affected. Ca2+ and Ba2+ ions only diminished MCG fluorescence. Blots of DNA, pectic acid, heparin, and other sulfated polysaccharides stained with Rubipy showed high emission, which was reduced in DNA and pectic acid staining at low pH. Studies with chemically modified heparins suggested that O-sulfates were more important than N-sulfates in Rubipy-heparin interactions. These results are in agreement with an ionic binding mode between Rubipy and heparin. A very suitable method for mast cell detection was found with Mayer's hematoxylin before Rubipy staining, which could be of great value for histopathological studies. This procedure allowed visualization of the mast cells by fluorescence microscopy, and nuclei and tissue morphology were easily visualized under brightfield illumination.

Fluorescence of mast cell granules in paraffin sections and cell smears induced by an N-quaternary oxazole scintillator.

The N-quaternized derivative of dimethyl-POPOP (termed Q4) induces a bluish-green fluorescent reaction in mast cell granules from paraffin sections and cell smears, in addition to a previously described bluish-white fluorescent reaction in chromatin DNA. The chromatin reaction was abolished by staining the samples either with Mayer's Haematoxylin before Q4 treatment or by Q4 treatment at pH 1.5. The reaction in mast cell granules was absent after substrate methylation. The staining sequence Haematoxylin-Eosin-Q4 also worked well in paraffin sections, allowing the observation of the current histological image under bright-field illumination as well as double-colour emission under fluorescence microscopy. The sequence is proposed as a new diagnostic procedure for demonstrating mast cell granules.

Selective fluorescence reaction of indigocarmine stained eosinophil leucocyte granules induced by alkaline reduction of the bound dye to its leuco derivative.

After staining of mammalian blood smears with indigocarmine, eosinophil granules were the unique cell components which stained deeply blue under bright field illumination. Treatment of stained smears with the reducing agent sodium borohydride completely abolished this colour reaction, while under violet-blue exciting light eosinophil granules appeared with bright green fluorescence. Other reducing agents proved less suitable. Spectral analysis of indigocarmine solutions reduced by sodium borohydride showed an emission peak at lambda = 528 nm and confirmed the microscopic observations. These results indicate that the treatment of indigocarmine stained structures with alkaline solutions of strong reducing agents converts the bound dye into its reduced and highly fluorescent leuco derivative.

A new fluorescence reaction in protein cytochemistry: formation of naphthalimide fluorophores from primary amino groups and 1,8-naphthalic anhydride derivatives.

In this work we describe the formation of fluorescent naphthalimide derivatives as a new cytochemical method for revealing protein amino groups. The reaction is based on the condensation of 1,8-naphthalic anhydrides in organic solvents with primary aliphatic amines. Under optimal violet-blue (436 nm) excitation, a strong yellow-green emission is observed in specific cell components from blood smears treated with 3-amino-1,8-naphthalic anhydride in N,N-dimethylformamide, which were the most suitable reagent and solvent for microscopic studies. Cytoplasmic granules of mammalian eosinophils and avian heterophils showed the highest fluorescence reaction, which was abolished by blocking procedures for amino groups. Spectrofluorometric analysis confirmed the emission characteristics of the naphthalimides produced from n-butylamine and gelatin. Taking into account the chemical reactivity of 1,8-naphthalic anhydrides and present results, the reaction can be considered selective for lysine and arginine residues of proteins.

A specific fluorogenic reaction for tryptophan residues using isatin in organic solvents.

The development of new fluorogenic reactions for specific chemical groups is of increasing interest in cytochemistry. We describe the application of the nonfluorescent compound isatin on methanol-fixed blood smears. When treated with 0.1% isatin in absolute ethanol or acetone for 30 min and observed under violet-blue exciting light, eosinophil leucocyte granules show a bright green fluorescence. This fluorogenic reaction is abolished after blocking of tryptophan residues by performic acid oxidation. Spectrofluorometric studies with amino acids in vitro reveal that isatin forms a unique and specific fluorescent product with tryptophan.

Electron microscopical morphology of cytoplasmic granules from horse eosinophil leucocytes.

The structure of specific granules from horse eosinophil leukocytes is still largely unknown. In this work, electron microscopical studies of horse eosinophils reveal that the large cytoplasmic granules contain an external membrane, a matrix of less density, and a dense (non crystalline) core. Round vacuolar inclusions of matrix materials were often observed within the cores. Horse eosinophil granules showed a considerable heterogeneity, and three morphological types could be identified according to structural features of the core and matrix.

Fluorescence of eosinophil leukocyte granules induced by the fluorogenic reagent 2-methoxy-2,4-diphenyl-3 (2H)-furanone.

The fluorogenic reagent MDPF forms highly fluorescent products specifically with primary amino groups (e.g., from lysine). Although widely used in analytical biochemistry, MDPF has infrequently been employed in cytochemical techniques for proteins. In this work, we describe the application of MDPF in fluorescence microscopy studies of horse, rat, and human blood cells. Under ultraviolet excitation, MDPF selectively induces an intense white-blue fluorescence reaction in the granules of eosinophil leukocytes, which contain strongly basic proteins. The advantages of MDPF for identification to reveal protein components in hematological cytochemistry are briefly discussed.

Influence of inorganic salts on the staining reaction of eosinophil leukocyte granules by anionic dyes.

The use of salts as competing agents in staining solutions allows to evaluate to what extent ionic interactions take place between microscopical substrates and cationic or anionic dyes. We have employed this method to study the staining reaction of horse eosinophil leucocyte granules by the anionic dyes nuclear fast red, naphthol yellow S, eosin Y, indigocarmin, acid fuchsin, alizarin red S, orange G, and Evans blue in the presence of NaCl (from 0.015 to 2 mol/l). Different values of "minimal electrolyte concentration" (the least amount of salt which reduces the staining intensity) were found for these dyes. Comparative observations using ammonium sulphate as competing salt showed that it is less effective than NaCl. Staining of eosinophil granules by anionic dyes could be not suppressed at 2 mol/l NaCl, which indicates that in addition to electrostatic forces, other non-ionic interactions are also responsible for some staining reaction of these acidophilic structures.

DNA fluorescence induced by polymethine cation pyrvinium binding.

Pyrvinium is a polymethine cation which shows interesting fluorescence emission and DNA binding properties. In diluted aqueous solution, pyrvinium pamoate induced a bright yellow fluorescence in kinetoplast DNA from Trypanosoma cruzi epimastigotes as well as in chicken erythrocyte nuclei under a wide range of excitations. No fading was observed after mounting in suitable media. Spectroscopic studies on pyrvinium solutions revealed bathochromic and hypochromic shifts in the absorption spectrum of its complex with DNA. A striking enhancement of pyrvinium fluorescence was found in solvents of high viscosity or after binding to DNA. Experimental results and the chemical structure of pyrvinium allow us to suggest that the minor groove of adenine-thymine DNA regions could be the specific binding site for this new DNA fluorochrome.

Tungsten and molybdenum heteropolyacids as staining and contrasting agents: reactivity with epoxyresin-embedded cell and tissue structures.

In this work, we carry out a further approach to the knowledge of the reaction mechanism of phosphotungstic and phosphomolybdic acids (PTA and PMA), as well as some derivatives, with cell structures from epoxyresin-embedded materials. Applied on thin sections from glutaraldehyde-fixed tissues, PTA and PMA induced a strong electron contrasting reaction in spermatid acrosomes, goblet cell mucin, callose and plant cell walls, endexine, intine and starch granules. In light microscopy, the localization of heteropolyacids on these structures was achieved by treatments of semithin sections with suitable reducing agents (titanous sulfate, stannous chloride, sodium borohydride, or p-phenylenediamine) to form the mixed-valence heteropolyblues, or with Schiffs's reagent. The use of PTA-dye complexes (pyronin-PTA and Mallory's PTA-hematoxylin) also showed the same staining pattern. Taking into account the chemical characteristics of the PTA- and PMA-reactive tissue elements, the present results indicate that heteropolyacids selectively enter into the highest hydrophilic structures from non-polar epoxy-embedded sections; after brief washing, they appear predominantly retained in tissue structures containing a great amount of carbohydrate components.