Efficacy of delafloxacin alone and incombination with cefotaxime againstcefotaxime non-susceptible invasive isolatesof Streptococcus pneumoniae / Eficacia de delafloxacino solo y en combinación con cefotaxima frente a aislados invasivos de Streptococcus pneumoniae no sensible acefotaxima

Objectives. We assessed the in vitro activity of delafloxacin and the synergy between cefotaxime and delafloxacin among cefotaxime non-susceptible invasive isolates of Streptococcus pneumoniae (CNSSP). Material and methods. A total of 30 CNSSP (cefotaxime MIC > 0.5 mg/L) were studied. Serotyping was performed by the Pneumotest-Latex and Quellung reaction. Minimum inhibitory concentrations (MICs) of delafloxacin, levofloxacin, penicillin, cefotaxime, erythromycin and vancomycin were determined by gradient diffusion strips (GDS). Synergistic activity of delafloxacin plus cefotaxime against clinical S. pneumoniae isolates was evaluated by the GDS cross method. Results. Delafloxacin showed a higher pneumococcal activity than its comparator levofloxacin (MIC50, 0.004 versus 0.75 mg/L and MIC90, 0.047 versus >32 mg/L). Resistance to delafloxacin was identified in 7/30 (23.3%) isolates, belonging to serotypes 14 and 9V. Synergy between delafloxacin and cefotaxime was detected in 2 strains (serotypes 19A and 9V). Antagonism was not observed. Addition of delafloxacin increased the activity of cefotaxime in all isolates. Delafloxacin susceptibility was restored in 5/7 (71.4%) strains. Conclusions. CNSSP showed a susceptibility to delafloxacin of 76.7%. Synergistic interactions between delafloxacin and cefotaxime were observed in vitro among CNSSP by GDS cross method. (AU)

Objetivos. Evaluamos la actividad in vitro de delafloxacino y la sinergia entre cefotaxima y delafloxacino entre aislados invasivos de Streptococcus pneumoniae no sensibles a cefotaxima (SPNSC). Material y métodos. Se estudiaron un total de 30 SPNSC (CIM de cefotaxima > 0,5 mg/L). El serotipado se realizó mediante la reacción Pneumotest-Latex y Quellung. Las concentraciones mínimas inhibitorias (CMI) de delafloxacino, levofloxacino, penicilina, cefotaxima, eritromicina y vancomicina se determinaron mediante tiras de difusión en gradiente (GDS). La actividad sinérgica de delafloxacino y cefotaxima frente aislados clínicos de S. pneumoniae se evaluó mediante el método cruzado GDS. Resultados. Delafloxacino mostró una mayor actividad neumocócica que su comparador levofloxacino (CIM50, 0,004 versus 0,75 mg/L y MIC90, 0,047 versus > 32 mg/L). Se identificó resistencia a delafloxacino en 7/30 (23,3%) aislados, pertenecientes a los serotipos 14 y 9V. Se detectó sinergia entre delafloxacino y cefotaxima en 2 cepas (serotipos 19A y 9V). No se observó antagonismo. La adición de delafloxacino aumentó la actividad de cefotaxima en todos los aislados. La sensibilidad a delafloxacino se restableció en 5/7 (71,4%) cepas. Conclusiones. SPNSC mostraron una susceptibilidad a delafloxacino del 76,7%. Se observaron interacciones sinérgicas in vitro entre delafloxacino y cefotaxima entre SPNSC mediante el método cruzado GDS. (AU)

Meningitis posquirúrgica por Acinetobacter baumannii multirresistente. Actividad sinérgica in vivo de la asociación sulbactam/avibactam / Post-surgical meningitis due to multiresistant Acinetobacter baumannii. In vivo synergistic activity of the sulbactam/avibactam association

Acinetobacter baumannii (AB) es un bacilo gram negativo, no fermentador,con frecuencia oportunista, ubicuo en el medio ambiente, con capacidad para sobrevivir en condiciones medioambientales adversas promoviendo su persistencia y diseminación en diferentes áreas de un hospital. Ha sido relacionado con múltiples brotes de infecciones asociadas al cuidado de la salud como neumonía, bacteriemias, contaminación de heridas quirúrgicas o infecciones del tracto urinario, especialmente entre pacientes con comorbilidades graves, como aquellos que motivan el ingreso a unidades de cuidados intensivos (UCI). Las cepas más problemáticas son aquellas resistentes a los carbapenémicos, resistencia causada por enzimas de la clase de las oxacilinasas (bla OXA) cromosómicas o plasmídicas y más recientemente bla NDM-1. La aparición de estas cepas deja escasos antimicrobianos activos (colistin, minociclina, tigeciclina; amikacina) que son limitados en su eficacia y su uso se asocia con toxicidad. A esto se agrega, como en la paciente que se describe, que desarrolló una meningitis posquirúrgica, la limitada capacidad de difusión en el sistema nervioso central (SNC) de estas últimas opciones. Una de las alternativas terapéuticas, es buscar asociaciones como sulbactam/avibactam que mostraron una adecuada actividad sinérgica y bactericida en asilamientos resistentes a ampicilina/sulbactam en base a una significativa reducción de la CIM que permite administrar dosis habituales, con mejor tolerancia y lograr concentraciones terapéuticas en SNC. Se presenta una paciente que desarrolló una meningitis posquirúrgica debida a una cepa de AB multirresistente.

Acinetobacter baumannii (AB) is a non-fermenting gram-negative bacillus, largely opportunistic, ubiquitous in the environment, with the ability to survive in adverse environmental conditions, promoting its persistence and dissemination in different areas of the hospital. It has been implicated in many outbreaks of healthcare-associated infections such as pneumonia, bacteremia, surgical wounds contamination, or urinary tract infections, especially among patients with previous severe illnesses such as those requiring admission to intensive care units (ICU). The most problematic strains are those resistant to carbapenems, resistance caused by chromosomal or plasmid oxacillinase class (bla OXA), and more recently bla NDM-1. The appearance of these strains leaves few active antimicrobials (Colistin, Minocycline, Tigecycline; Amikacin) that are limited in their efficacy and toxic. To this we must add, as is the case of our patient who presented post-surgical meningitis, the limited diffusion capacity in the central nervous system (CNS) of these last options. One of the therapeutic alternatives is to search for synergistic associations such as sulbactam/avibactam that showed rapid synergistic and bactericidal activity in isolates resistant to ampicillin/sulbactam due to a significant reduction in its MIC, which allows us to administer usual, better tolerated doses that reach therapeutic concentrations in CNS. Here, we present a patient who developed a post-surgical meningitis due to multiresistant AB

In vitro activity of immunosuppressive agents against Cryptococcus neoformans.

INTRODUCTION: Infections caused by Cryptococcus neoformans are a major cause of fungal mortality in HIV-infected/AIDS patients and in those receiving organ transplants. We evaluated the in vitro activity of tacrolimus and cyclosporine in combination with amphotericin B and fluconazole against C. neoformans. METHODS: MICs were determined against a total of 30 clinical isolates of C. neoformans by the microdilution method following the CLSI M27-A3 guidelines and by the checkerboard method. RESULTS: Tacrolimus and cyclosporine A showed in vitro activity against cryptococcal isolates. The combination of amphotericin B with cyclosporine A or tacrolimus was synergistic against 90% and 30% of isolates, respectively. Synergism was also observed with the combination of fluconazole with cyclosporine A or tacrolimus, against 70% and 20% of isolates, respectively. CONCLUSIONS: The synergistic interactions between the calcineurin inhibitors and antifungal drugs against C. neoformans isolates, could potentially have a role in devising novel therapeutic strategies for this opportunistic mycosis.

In vitro activity of immunosuppressive agents against Cryptococcus neoformans / Actividad in vitro de agentes inmunosupresores frente a Cryptococcus neoformans

IntroductionInfections caused by Cryptococcus neoformans are a major cause of fungal mortality in HIV-infected/AIDS patients and in those receiving organ transplants. We evaluated the in vitro activity of tacrolimus and cyclosporine in combination with amphotericin B and fluconazole against C. neoformans.MethodsMICs were determined against a total of 30 clinical isolates of C. neoformans by the microdilution method following the CLSI M27-A3 guidelines and by the checkerboard method.ResultsIntroductionInfections caused by Cryptococcus neoformans are a major cause of fungal mortality in HIV-infected/AIDS patients and in those receiving organ transplants. We evaluated the in vitro activity of tacrolimus and cyclosporine in combination with amphotericin B and fluconazole against C. neoformans.MethodsMICs were determined against a total of 30 clinical isolates of C. neoformans by the microdilution method following the CLSI M27-A3 guidelines and by the checkerboard method.ResultsTacrolimus and cyclosporine A showed in vitro activity against cryptococcal isolates. The combination of amphotericin B with cyclosporine A or tacrolimus was synergistic against 90% and 30% of isolates, respectively. Synergism was also observed with the combination of fluconazole with cyclosporine A or tacrolimus, against 70% and 20% of isolates, respectively.ConclusionsThe synergistic interactions between the calcineurin inhibitors and antifungal drugs against C. neoformans isolates, could potentially have a role in devising novel therapeutic strategies for this opportunistic mycosis.

IntroducciónLas infecciones causadas por Cryptococcus neoformans son la principal causa de mortalidad por hongos en pacientes con infección por el VIH/SIDA o en pacientes trasplantados. Evaluamos la actividad in vitro de tacrolimus y ciclosporina A en combinación con anfotericina B y fluconazol frente a C. neoformans.MétodosSe determinaron las CMI de ciclosporina A y tacrolimus frente a 30 aislados clínicos de C. neoformans mediante microdilución, según el documento CLSI M27-A3 y por el método del tablero de ajedrez.ResultadosTacrolimus y ciclosporina A mostraron actividad in vitro frente a C. neoformans. La combinación de anfotericina B con ciclosporina A o tacrolimus fue sinérgica frente al 90 y 30% de aislados, respectivamente. Se observó sinergismo con fluconazol y ciclosporina A o tacrolimus, frente al 70 y 20% de aislados, respectivamente.ConclusionesLa actividad sinérgica entre inhibidores de la calcineurina y antimicóticos frente a C. neoformans podría ser una nueva estrategia terapéutica para esta micosis.

Óleo essencial de Pataqueira (Conobea scoparioides Cham. & Schltdl.) como conservante natural em Cosméticos / Pataqueira essential oil (Conobea scoparioides Cham. & Schltdl.) as a natural preservative in cosmetics

Um dos principais grupos de conservantes utilizados na maioria dos cosméticos são os parabenos que em muitos estudos demonstraram que podem provocar reações alérgicas como dermatite de contato, entre outras sensibilizações cutâneas. A fim de minimizar esses problemas, a indústria está produzindo cosméticos livres de conservantes ou de origem natural e em associações aos sintéticos. Dentre os conservantes naturais utilizados, podemos citar os óleos essenciais como uma alternativa viável. Diante deste contexto o presente trabalho visa avaliar experimentalmente o potencial antimicrobiano do óleo essencial de Conobea scoparioides Cham. & Schltdl., conhecida popularmente como pataqueira, o efeito de sua associação com parabenos e de sua eficácia como conservante em bases cosméticas. A composição do óleo essencial foi avaliada, indicando que este é composto em sua maior parte por terpenos, tendo éter metílico do timol (39,2%), timol (33,8 %) e α-felandreno (15,9%) como compostos majoritários. A atividade antimicrobiana do óleo essencial e do timol foi acessada através da concentração inibitória mínima (CIM), cujos resultados em µg/mL para o óleo essencial e o timol foram respectivamente: Staphylococcus aureus 650,70 e 284,90, Escherichia coli 721,53 e 271,20, Pseudomonas aeruginosa 1748,00 e > 2.000, Burkholderia cepacia 833,03 e 1.077,70, Candida albicans 521,43 e 172,61 e Aspergillus brasiliensis 300 e 400. O efeito sinérgico da associação do óleo essencial com os parabenos foi realizado através de um delineamento experimental centroide simplex para uma mistura de metilparabeno, propilparabeno e óleo essencial frente aos mesmos micro-organismos utilizados na determinação da atividade antimicrobiana. As concentrações ideais obtidas pela análise estatística para cada componente em µg/mL foram: 1120 para o metilparabeno, 350 para o propilparabeno e 675 para o óleo essencial. O teste de eficácia do sistema conservante em formulação cosmética foi efetuado empregando as concentrações ideais e mais duas concentrações superiores e uma abaixo do ideal. Para todas as cepas microbianas desafiadas o resultado do teste foi de redução total da carga microbiana inoculada nos sete dias de ensaio e nenhum aumento até o vigésimo oitavo dia o que demonstra a eficácia da associação do óleo essencial com os conservantes sintéticos. O óleo essencial de C. scoparioides apresentou um potencial antimicrobiano importante tanto sozinho como em associação com conservantes sintéticos. Estes resultados sugerem que esse óleo pode ser usado para compor um sistema conservante para formulações cosméticas contendo uma menor quantidade de sintéticos

One of the main groups of preservatives used in most cosmetics are parabens, that many studies have shown that they can cause allergic reactions such as contact dermatitis, among other skin sensitizations. To minimize these problems, the industry is producing cosmetics preservative free or using natural products instead and their combination with the synthetics. Among the natural preservatives used, we can mention essential oils as a viable alternative. In this context, the present work aims to experimentally evaluate the antimicrobial potential of the Conobea scoparioides Cham. & Schltdl. essential oil, popularly known as pataqueira, the effect of its association with parabens and its effectiveness as a preservative in cosmetic bases. The essential oil composition was analyzed, indicating that it is composed mostly of terpenes, with thymol methyl ether (39.2%), thymol (33.8%) and -phelandrene (15.9%) as major compounds. The antimicrobial activity of essential oil and thymol was accessed through the minimum inhibitory concentration (MIC), whose results in µg/mL for essential oil and thymol were respectively: Staphylococcus aureus 650.70 and 284.90, Escherichia coli 721, 53 and 271.20, Pseudomonas aeruginosa 1748.00 and > 2,000, Burkholderia cepacia 833.03 and 1,077.70, Candida albicans 521.43 and 172.61 and Aspergillus brasiliensis 300 and 400. The synergistic effect of the association of essential oil with parabens was performed through a centroid simplex experimental design for a mixture of methylparaben, propylparaben and essential oil against the same microorganisms used in the antimicrobial activity evaluation The ideal concentrations obtained by statistical analysis for each component in µg/mL were: 1120 for methylparaben, 350 for propylparaben and 675 for essential oil. The effectiveness test of the preservative system in cosmetic formulation was carried out using the ideal concentrations plus two higher concentrations and one below the ideal. For all challenged microbial strains, the test result was a total reduction of the inoculated microbial load in the seven days of testing and no increase until the twenty-eighth day, which demonstrates the effectiveness of the association of essential oil with synthetic preservatives. C. scoparioides essential oil showed an important antimicrobial potential both alone and in association with parabens. These results demonstrated that it can be used to compose a preservative system for cosmetic formulations containing lower amounts of synthetics

In vitro interaction between glabridin and voriconazole against Aspergillus fumigatus isolates.

BACKGROUND: Voriconazole (VRC) is widely recommended as the first-line therapy for invasive aspergillosis. However, surveillance studies have demonstrated that there is an increase in the frequency of azole resistance among Aspergillus fumigates isolates. In recent years, more studies on effective synergisms between natural agents and antifungal drugs have been published. AIMS: To evaluate the synergistic antifungal effect of glabridin (Gla) and VRC against A. fumigatus isolates. METHODS: Potential interactions between Gla and VRC were studied by using a microdilution checkerboard method based on the CLSI reference technique. To assess the interaction of drugs the fractional inhibitory concentration index (FICI) was calculated based on the Loewe Additivity model. RESULTS: The minimum inhibitory concentrations (MIC) obtained with Gla alone were relatively high (MIC50 16µg/ml). However, our results showed synergistic interaction between Gla and VRC against A. fumigatus strains, with FICI range values between 0.15 and 0.5. CONCLUSIONS: Synergistic activity of Gla and VRC against both VRC-sensitive and -resistant A. fumigatus isolates may lead to design new antifungal agents, especially for inhibiting those azole-resistant strains.

Señuelo dirigido a HIF-1 potencializa efectos citotóxicos de dos agentes quimioterapéuticos en MDA-MB-231 / HIF decoy improve cytotoxic effects of two chemotherapeutic agents on MDA-MB-231

RESUMEN Procesos oncogénicos como proliferación incontrolable, resistencia apoptótica, aumento de mecanismos angiogénicos y evasión inmune son regulados generalmente por factores de transcripción, como HIF-1. Por tanto, se ha señalado a esta molécula como un blanco terapéutico prometedor. Para explorar esta posibilidad, un oligonucleótido tipo "señuelo" dirigido a HIF-1 a (ODN) fue diseñado para evaluar su eficiencia en esquema tanto monoterapéutico, como en combinación con dos agentes quimioterapéuticos en un modelo in vitro de cáncer de mama. Después de comprobar, mediante citometría de flujo e inmunofluorescencia, la localización del blanco, el señuelo fue transfectado en la línea celular MDA-MB-231. Se estableció la IC-50 de HIF-1 a ODN, Cisplatino y Taxol con el método de Resazurina. Mecanismos de muerte celular fueron evaluados con el método de TUNEL. Por último, se estableció el índice de combinación (IC) de cada uno de los quimio-agentes en combinación con el ODN. Se evidencio que HIF-1 a ODN causa un efecto citotóxico en MDA-MB-231 de hasta un 90% hacia las 72h pos-tratamiento. Este efecto no se observa tanto en los controles del ensayo, como en el cultivo primario de células no tumorales (FIBRO), siendo este agente altamente selectivo hacia células tumorales, al activar mecanismos pro-apoptóticos. A su vez, HIF-1 a ODN potencializa la actividad tumorogénica de Cisplatino y Taxol en la línea celular tumoral. Por tanto, HIF-1 a ODN demostró tener actividad selectiva potencialmente antitumoral, al disminuir la proliferación celular e inducir apoptosis; optimizando de forma sinérgica, la eficacia de fármacos quimioterapéuticos de alto espectro, en tratamientos combinados.

ABSTRACT Oncogenic processes like uncontrollable proliferation, resistance to apoptosis, increases in angiogenic mechanisms and immune evasion are regulated by transcription factors such HIF-1. Therefore, this molecule is regarded as a potential therapeutic target. To explore this possibility, a HIF-1 α oligonucleotide decoy (ODN) was designed to evaluate its efficiency on both a mono-therapeutic scheme and a mixed treatment with two chemotherapeutic agents within an in vitro model of breast cancer. After confirming the target location with flow cytometry and immunofluorescence assays, that decoy was transfected over the MDA-MB-231 cell line. We established the HIF-1 α ODN, Cisplatin and Taxol IC-50 using Resazurin tests. Cell death mechanisms was evaluated with TUNEL. Finally, we obtained the combination index (IC) of each chemical agents with the ODN. This study showed that HIF-1 α ODN caused a cytotoxic effect (up to 90%) in MDA-MB-231 during 72 hours post treatment. That effect did not appear in either the assay controls nor in non-tumor cell cultures (FIBRO). This agent is highly selective towards tumor cells, activating pro-apoptotic mechanisms. Additionally, HIF-1 α ODN increases the tumorigenic action of Cisplatin and Taxol on the cell line, due to an additive effect. For these reasons, HIF-1 α ODN has potential antitumor selective activity, decreasing cell proliferation, inducing apoptosis, and optimizing, in a synergistic manner, the efficacy of wide spectrum chemotherapeutic compounds when it used in a combined treatment.

In vitro activity of immunosuppressive agents against Cryptococcus neoformans.

INTRODUCTION: Infections caused by Cryptococcus neoformans are a major cause of fungal mortality in HIV-infected/AIDS patients and in those receiving organ transplants. We evaluated the in vitro activity of tacrolimus and cyclosporine in combination with amphotericin B and fluconazole against C. neoformans. METHODS: MICs were determined against a total of 30 clinical isolates of C. neoformans by the microdilution method following the CLSI M27-A3 guidelines and by the checkerboard method. RESULTS: Tacrolimus and cyclosporine A showed in vitro activity against cryptococcal isolates. The combination of amphotericin B with cyclosporine A or tacrolimus was synergistic against 90% and 30% of isolates, respectively. Synergism was also observed with the combination of fluconazole with cyclosporine A or tacrolimus, against 70% and 20% of isolates, respectively. CONCLUSIONS: The synergistic interactions between the calcineurin inhibitors and antifungal drugs against C. neoformans isolates, could potentially have a role in devising novel therapeutic strategies for this opportunistic mycosis.

In vitro inhibitory activity of sertraline against clinical isolates of Sporothrix schenckii.

BACKGROUND: Sertraline (SRT) is an antidepressant that has proven its activity in vitro against Cryptococcus, Coccidioides, Trichosporon and other fungi. Disseminated sporotrichosis, although rare, has a high mortality and its treatment is difficult and prolonged, often relying in combining two or more antifungals. AIMS: In our study we evaluate the antifungal activity of SRT, alone and in combination with itraconazole (ITC), voriconazole (VRC) and amphotericin B (AMB), against 15 clinical isolates of Sporothrix schenckii. METHODS: We used the broth microdilution method as described by the CLSI to test the susceptibility to antifungals, and the checkerboard microdilution method to evaluate drug interactions. RESULTS: The minimum inhibitory concentration (MIC) with SRT was in the range of 4-8µg/ml, while for AMB, VRC and ITC were 0.5-4µg/ml, 0.5-8µg/ml and 0.125-2µg/ml, respectively. In addition, SRT showed synergy with ITC in one strain, mainly additivity with VRC, and indifference with AMB in others. CONCLUSIONS: The MIC values with SRT for the isolates studied show the potential role of this drug as an adjuvant in the treatment of sporotrichosis, especially in disseminated or complicated cases.

Atividade antibacteriana de extratos aquosos de açafrão, cominho, estragão, endro e tomilho / Antibacterial activity of aqueous extracts of saffron, cumin and tarragon

Os registros das eficientes propriedades de conservação das especiarias constam desde a Antiguidade, porém acredita-se que o uso dessas ervas tenha ocorrido antes mesmo do domínio da cocção com fogo. No cenário atual, o crescente interesse do consumidor pela qualidade e composição dos produtos disponíveis no mercado junto com os questionamentos sobre a segurança do uso de aditivos químicos e a preocupação com suas implicações na saúde pública, motivam a busca e valorização de compostos antimicrobianos naturais. Diante disso, o presente trabalho objetivou verificar a ação antimicrobiana dos extratos aquosos de açafrão (Curcuma longa), cominho (Cuminum cyminum), estragão (Artemisia dracunculus), endro (Anethum graveolens) e tomilho (Thymus vulgaris) de forma individual e combinada sobre Samonella Tiphymurium, Samonella Enteritidis, Staphylococcus aureus, Bacillus cereus e Bacillus subtilis utilizando semeadura em superfície com Ágar Nutriente, após incubação a 35ºC de 24 e 48 horas. Por meio dos resultados obtidos, foi possível observar os fenômenos de sinergismo e antagonismo entre os extratos, destacando-se a combinação sinérgica entre cominho e tomilho, capaz de inibir três das cinco bactérias empregadas. Salmonella Enteritidis apresentou maior sensibilidade entre os micro-organismos testados e o maior halo de inibição registrado resultou da ação do extrato de endro adicionado ao extrato de tomilho sobre Salmonella Typhimurium.

Actividad in vitro de ampicilina-ceftriaxona frente a aislamientos de Enterococcus faecalis recuperados de infecciones invasivas / In vitro activity of ampicillin-ceftriaxone against Enterococcus faecalis isolates recovered from invasive infections

Se evaluó la actividad in vitro de la asociación entre ampicilina y ceftriaxona frente a 30 aislamientos de Enterococcus faecalis obtenidos de infecciones invasivas de pacientes atendidos en el Hospital de Clínicas José de San Martín, Ciudad Autónoma de Buenos Aires. Las sinergias entre ampicilina y ceftriaxona se determinaron mediante la técnica de dilución en caldo Müeller-Hinton con el agregado de diferentes concentraciones subinhibitorias de ceftriaxona o sin este. La asociación fue sinérgica en 22/30 aislamientos. En 14/30 aislamientos la asociación disminuyó los valores de concentración inhibitoria mínima (CIM) y de concentración bactericida mínima (CBM); en 6/30 se observó solamente una disminución de la CIM, mientras que en 2 solo se determinó una reducción de la CBM. La actividad bactericida de la asociación fue mayor a bajas concentraciones de ampicilina (menor de 1µg/ml). Se demostró la sinergia in vitro entre ampicilina-ceftriaxona; se confirmó así la utilidad de esta asociación en el tratamiento de infecciones severas causadas por E. faecalis

In vitro activity of the combination of ampicillin- ceftriaxone against 30 Enterococcus faecalis isolates recovered from invasive infections in patients admitted to Hospital de Clínicas José de San Martin in the city of Buenos Aires was assessed. Ampicillin- ceftriaxone synergies were determined by microdilution in Müeller-Hinton (MH) broth with and without subinhibitory concentrations of ceftriaxone. Synergy was detected in 22/30 isolates. A decrease in both minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was observed in 14/30 isolates, whereas in 6/30 isolates the decrease was observed in the MIC value and only in the MBC value in the 2 remaining isolates. The bactericidal activity of the combination showed to be higher at low concentrations of ampicillin (< 1µg/ml). We detected in vitro synergy using the ampicillin-ceftriaxone combination and thus, its efficacy was confirmed in the treatment of severe infections by E. faecalis

[In vitro activity of ampicillin-ceftriaxone against Enterococcus faecalis isolates recovered from invasive infections]. / Actividad in vitro de ampicilina-ceftriaxona frente a aislamientos de Enterococcus faecalis recuperados de infecciones invasivas.

In vitro activity of the combination of ampicillin- ceftriaxone against 30 Enterococcus faecalis isolates recovered from invasive infections in patients admitted to Hospital de Clínicas José de San Martin in the city of Buenos Aires was assessed. Ampicillin- ceftriaxone synergies were determined by microdilution in Müeller-Hinton (MH) broth with and without subinhibitory concentrations of ceftriaxone. Synergy was detected in 22/30 isolates. A decrease in both minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was observed in 14/30 isolates, whereas in 6/30 isolates the decrease was observed in the MIC value and only in the MBC value in the 2 remaining isolates. The bactericidal activity of the combination showed to be higher at low concentrations of ampicillin (< 1 µg/ml). We detected in vitro synergy using the ampicillin-ceftriaxone combination and thus, its efficacy was confirmed in the treatment of severe infections by E. faecalis.

Actividad antimicrobiana y sinérgica de metabolitos producidos por Streptomyces erythrogriseus M10-77 de origen marino / Antimicrobial and synergetic activity of metabolites produced by marine origin Streptomyces erythrogriseus M10-77

Los metabolitos de un actinomiceto de origen marino, identificado como Streptomyces erythrogriseus cepa M10-77, fueron evaluados por su capacidad antimicrobiana y sinérgica con antibióticos convencionales. Las pruebas de antagonismo se realizaron frente a patógenos multidrogorresistentes (MDR) de origen clínico, siendo muy efectivos principalmente frente a especies patógenas de Staphylococcus y Enterococcus. Se determinó la Concentración Mínima Inhibitoria (CMI) de extractos diclorometánicos frente a los patógenos S. aureus 1094, S. epidermidis 1093 y Staphylococcus coagulasa negativo 348, siendo estos valores de 3,9; 15,7 y 1,9 µg/mL respectivamente. Los componentes del extracto diclorometánico fueron fraccionados parcialmente, obteniéndose hasta 4 fracciones orgánicas (I, II, III, IV), las que mostraron actividades inhibitorias de la cepa referencial S. aureus ATCC 43300. Los bioensayos frente a S. aureus meticilino resistente (MRSA) mostraron actividad sinérgica de la fracción II del extracto con antibióticos betalactámicos y aminoglucósidos, resaltando la repotenciación de la actividad de la bencilpenicilina en 128 veces el valor basal; así como de la gentamicina en 8 veces sobre el valor basal. S. erythrogriseus cepa M10-77 resultó ser un productor de metabolitos antibacterianos de alta potencia y con actividad sinérgica con antibióticos de referencia médica.

Metabolites of a marine actinomycete, identified as Streptomyces erythrogriseus M10-77 strain were evaluated for antimicrobial and synergistic activity with conventional antibiotics. Antagonism tests were conducted against multidrug resistant (MDR) pathogens of clinical origin, being very effective mainly against pathogenic Staphylococcus and Enterococcus. Minimum Inhibitory Concentrations (MIC) of dichloromethane extracts were determined against pathogenic S. aureus 1094, S. epidermidis and coagulase-negative Staphylococcus 1093 348, these values being 3.9; 15.7 and 1.9 μg/mL respectively. The components of dichloromethane extracts were fractionated partially yielding four organic fractions (I, II, III, IV), which showed inhibitory activity against the reference strain S. aureus ATCC 43300. The bioassays against S.aureus methicillin-resistant (MRSA ) produced synergistic activity of the extract fraction II with beta-lactams and aminoglycoside antibiotics, highlighting the upgrading of the activity of penicillin at 128 times above the baseline and gentamicin 8-fold above baseline. S. erythrogriseus M10-77 strain proved to be a producer of antibacterial metabolites with high power and synergistic activity with antibiotics of medical use.

Linking ecosystem services and human-values theory.

Understanding why people make the decisions they do remains a fundamental challenge facing conservation science. Ecosystem service (ES) (a benefit people derive from an ecosystem) approaches to conservation reflect efforts to anticipate people's preferences and influence their environmental behavior. Yet, the design of ES approaches seldom includes psychological theories of human behavior. We sought to alleviate this omission by applying a psychological theory of human values to a cross-cultural ES assessment. We used interviews and focus groups with fish workers from 28 coral reef fishing communities in 4 countries to qualitatively identify the motivations (i.e., human values) underlying preferences for ES; quantitatively evaluate resource user ES priorities; and identify common patterns among ES motivations and ES priorities (i.e., trade-offs and synergies). Three key findings are evident that align with human values theory. First, motivations underlying preferences for individual ESs reflected multiple human values within the same value domain (e.g., self-enhancement). Second, when averaged at community or country scales, the order of ES priorities was consistent. However, the order belied significant variation that existed among individuals. Third, in line with human values theory, ESs related to one another in a consistent pattern; certain service pairs reflected trade-off relationships (e.g., supporting and provisioning), whereas other service pairs reflected synergistic relationships (e.g., supporting and regulating). Together, these findings help improve understanding of when and why convergence and trade-offs in people's preferences for ESs occur, and this knowledge can inform the development of suitable conservation actions.

Modulation of the erythromycin resistance in Staphylococcus aureus by ethanolic extracts of Ximenia americana L and Schinopsis brasiliensis Engl / Modulación de la resistencia a la eritromicina en Staphylococcus aureus por extractos etanólicos de Ximeniaamericana L y Schinopsis brasiliensis Engl

It was evaluated the in vitro efficacy of ethanolic extract of leaves and bark of Ximenia americana L and Schinopsis brasiliensis Engl. alone and in association with erythromycin as modulators of microbial resistance against six clinical isolates of Staphylococcus aureus resistant to erythromycin (SA1-SA6) and S. aureus ATCC 25923 by the microdilution method. The extracts were also subjected to bioassay with Artemia salina. The ethanolic extract of barks of X. americana showed a synergistic effect with erythromycin against SA01, SA03 and SA04. The leaf extract of S. brasiliensis exerted synergistic effect against SA03 and the bark extract showed against SA01 and S03. The results suggest that extracts from S.brasiliensis and X. americana have potential as modulator agents of bacterial resistance, which could be used as adjuvants in the treatment of infections by S. aureus resistant to erythromycin, with previous studies of toxicity.

Se evaluó la eficacia in vitro de los extractos etanólicos de hojas y corteza de Ximenia americana L y Schinopsis brasiliensis Engl solos y en asociación con eritromicina como moduladores de la resistencia microbiana frente a seis aislados clínicos de Staphylococcus aureus resistentes a Eritromicina (SA1-SA6) y S. aureus ATCC 25923, por el método de microdilución. Además se determinó la actividad tóxica de los extractos contra Artemia salina. Solo el extracto etanólico de la corteza de X. americana mostró un efecto sinérgico con la eritromicina frente a SA01, SA03 y SA04. El extracto de las hojas de S. brasiliensis ejerció efecto sinérgico contra SA03 y el extracto de corteza, contra SA01 y S03. Los resultados sugieren que S. brasiliensis y X. americana tienen potencial como agentes moduladores de la resistencia bacteriana, que podrían ser utilizados como adyuvantes en el tratamiento de infecciones por S. aureus resistentes a eritromicina, con estudios previos de toxicidad.

Efecto combinado del aceite esencial de Cinnamomum zeylanicum blume y nistatina sobre cepas de Candida no-albicans / Combined effect of Cinnamomum zeylanicum blume essential oil and nystatin on strains of non-albicans Candida

Introduction: considering the emergence of resistant species of albicans and non-albicans Candida to agents therapeutically available as a result of the increased number of immunocompromised population and of the increasingly frequent use of prophylaxis and empirical treatment with antifungals, it's verified that there is a clear and emerging need to introduce new antimicrobials agents in the therapeutic arsenal. The purpose of this study was to evaluate the antifungal activity of essential oil of Cinnamomum zeylanicum Blume alone and combined with Nystatin on strains of C. tropicalis and C. krusei. Methods: this was an experimental research in laboratory. It was determined the Minimum Inhibitory Concentration, using the microdilution method, as well as the Fractional Inhibitory Concentration to determine the possible synergistic effects of the association. Strains of C. tropicalis ATCC 40147 and C. krusei ATCC 40042 were used in the tests. When assessed separately, C. zeylanicum essential oil and Nystatin presented Minimum Inhibitory Concentration of 312,5 µg/mL and 64 µg/mL, respectively, on both tested strains. Results: When combined, were found Minimum Inhibitory Concentration of 39 µg/mL and 32 µg/mL for the essential oil and for Nystatin, respectively. The Fractional Inhibitory Concentration value was 0,6024 for both tested strains, indicating additivity of the inhibitory effect on fungal growth. Conclusions: the results indicate that C. zeylanicum essential oil has antifungal activity against the strains of non-albicans Candida evaluated and that its association with Nystatin potentiates this effect(AU)

Introducción: es necesaria la introducción de nuevos agentes antimicrobianos por el surgimiento de especies de Candida albicans y no albicans resistentes a los agentes terapéuticos disponibles .El objetivo del estudio fue evaluar la actividad antifúngica del aceite esencial de Cinnamomum zeylanicum Blume aislado y asociado con nistatina sobre cepas Candida tropicalis y Candida krusei. Métodos: se realizó una investigación experimental de laboratorio. La concentración mínima inhibitoria fue determinada utilizando el método de microdilución, y la concentración inhibitoria fraccionada se usó para determinar los posibles efectos sinérgicos de la asociación. Para las pruebas fueron utilizadas las cepas de C. tropicalis ATCC 40147 y C. krusei ATCC 40042. Se usaron el aceite esencial de C. zeylanicum y nistatina. Cuando fueron evaluados por separado presentaron la concentración mínima inhibitoria de 312,5 µg/mL y de 64 µg/mL, respectivamente, sobre ambas cepas ensayadas. Resultados: una vez asociados, la concentración mínima inhibitoria fue de 39 µg/mL para el aceite esencial y de 32 µg/mL para la nistatina. El valor de la concentración inhibitoria fraccionada para ambas cepas probadas fue de 0,6024, lo que indica adicción del efecto inhibidor sobre el crecimiento de hongos. Conclusiones: los resultados indican que el aceite esencial de C. zeylanicum tiene actividad antifúngica frente a las cepas de Candida no albicans y que la asociación del mismo con la nistatina promueve la potenciación de este efecto(AU)

Synergysm of voriconazole or itraconazole with other antifungal agents against species of Fusarium.

BACKGROUND: Infections caused by Fusarium are difficult to treat because these fungi show in vitro and in vivo resistance to practically all the antifungal agents available, which explains the high mortality rates. An attempt to overcome fungal resistance is the combination of antifungal agents, especially those with different mechanisms of action. AIMS: Evaluate the in vitro interactions of combinations of voriconazole or itraconazole with other antifungal agents against 32 isolates of Fusarium spp.: Fusarium chlamydosporum, Fusarium oxysporum, Fusarium proliferatum and Fusarium solani. METHODS: Drug interactions were assessed by a checkerboard microdilution method that also included the determination of the MIC of each drug alone according to CLSI (Clinical and Laboratory Standards Institute) document M38-A2, 2008. RESULTS: The best combinations were voriconazole+terbinafine which showed synergism against 84% of Fusarium strains. Other synergistic combinations were voriconazole+itraconazole (50%), voriconazole+fluconazole (50%), voriconazole+miconazole (38%), voriconazole+flucytosine (22%) and voriconazole+ketoconazole (25%). The synergisms observed with itraconazole combinations were itraconazole+terbinafine (25%) and itraconazole+flucytosine (9.37%). The antagonisms observed were: voriconazole+fluconazole (3%) and itraconazole+flucytosine (12.5%). CONCLUSIONS: The synergism showed by voriconazole+terbinafine was remarkable. To better elucidate the potential usefulness of our findings, new in vivo and in vitro studies deserve be performed.

Actividad in vitro de piperacilina-tazobactam en combinación con aminoglucósidos y fluoroquinolonas en Pseudomonas aeruginosa productoras de metalo-β-lactamasas / In vitro piperacillin-tazobactam activity in combination with aminoglycosides and fluoroquinolones in Pseudomonas aeruginosa metallo-β-lactamases producers

Pseudomonas aeruginosa es un bacilo gramnegativo, capaz de adquirir genes que codifican la producción de metalo-β-lactamasas (MBL) haciéndose multirresistente, lo cual dificulta el tratamiento de las infecciones causadas por este microorganismo. Se evaluó la actividad in vitro de piperacilina-tazobactam, en combinación con aminoglucósidos y fluoroquinolonas, en 8 aislamientos de P. aeruginosa productoras de MBL, provenientes de cuatro hospitales del oriente y sur de Venezuela mediante el método epsilométrico. Las combinaciones de antimicrobianos que presentaron mayor efecto sinérgico fueron piperacilina-tazobactam/gentamicina y piperacilina-tazobactam/ciprofloxacina en 5/8 aislamientos. La combinación de piperacilina-tazobactam/amikacina presentó sinergia en 4 de los casos y adición en los otros 4, manifestando el menor índice de concentración inhibitoria fraccionada promedio. No hubo antagonismo en ninguna combinación de antimicrobianos. Los resultados de este estudio sugieren que piperacilina-tazobactam en combinación con gentamicina, amikacina o ciprofloxacina podrían ser utilizadas como alternativas terapéuticas en las infecciones por P. aeruginosa multirresistentes productoras de MBL en los hospitales del estado Bolívar, mientras que en los hospitales del oriente de Venezuela se sugiere la combinación piperacilina-tazobactam/amikacina.

Pseudomonas aeruginosa is a gram negative bacillus able to acquire genes which codify for production of metallo-β-lactamases (MBL) becoming multiresistant, which difficults the treatment of infections produced by this microorganism. The in vitro activity of piperacilline-tazobactam, in combination with aminoglycosides and fluoroquinonolones was evaluated in 8 P. aeruginosa MBL producers obtained at four hospitals of the west and south areas of Venezuela through an epsilometric method. The antimicrobial combinations which showed the greatest synergic effect were piperacillin-tazobactam/gentamicin and piperacillin-tazobactam/amikacin in 5/8 isolates. The piperacilline-tazobactam/amikacin combination showed synergy in 4 cases and addition in the other 4, with the lowest index of mean fractionated inhibitory concentration. There was no antagonism in any of the antimicrobial combinations. The results of this study suggest that piperacilline-tazobactam in combination with gentamicin, amikacin or ciprofloxacin, could be used as therapeutic alternatives in multiresistant P. aeruginosa MBL producers at all the hospitals of Bolivar State, while in hospitals located in the west of Venezuela, the piperacilline-tazobactan/amikacin combination is suggested.

Synergy: an old wisdom, a new paradigm for pharmacotherapy / Sinergia: uma sabedoria antiga, um novo paradigma para a farmacoterapia

Synergy is one of the governing principles of the natural world, and is one of the reasons for the increasing complexity of the evolutionary process. Broadly speaking, it relates to the cooperative effects produced by the interaction between various forces, elements, parts or individuals in a given context. Since the last century, some clinical studies have described the increased efficiency of a combination of drugs. To study the effects of the drug interactions, the most commonly cited model is that of Loewe, and the classical graphical representation is the iso-effect curve (isobologram). Plants contain an enormous diversity of specialized micromolecules, therefore there is a high likelihood of interactions between them. Through recent synergy studies, various synergistic interactions have been demonstrated among extracts of different plants, and between components of the same extract.

Sinergia é um dos princípios que rege o mundo natural, apontado como uma das razões para a crescente complexidade do processo evolutivo. De uma forma ampla, ela se refere aos efeitos cooperativos produzidos pela interação entre diversas forças, elementos, partes ou indivíduos em um dado contexto. Desde o ultimo século, alguns estudos clínicos tem descrito a eficiência ampliada da combinação de fármacos. Para estudar os efeitos da interação de fármacos, o modelo mais citado é o da aditividade de Loewe, e também a representação clássica é o isobolograma, ou curva iso-efeito. As plantas contem uma diversidade enorme de micromoléculas especializadas, e consequentemente, alta probabilidade de interações entre elas. Através de estudos recentes dos efeitos sinérgicos, varias interações sinérgicas estão sendo demonstradas entre extratos de diferentes plantas e também entre componentes de um mesmo extrato.

ESTUDIO DRX EN MATERIALES CATALIZADORES Cu-Ni-SiO2 PARA HIDROGENACIÓN DE ACEITE DE SOYA. DESARROLLO DE ESTRUCTURA CRISTALINA Y ACTIVIDAD CATALÍTICA / DRX STUDY IN CATALYSTS MATERIAL Cu-Ni-SiO2 FOR HYDROGENATION OF SOY OIL. DEVELOPMENT OF CRYSTALLINE STRUCTURE AND CATALYTIC ACTIVITY / ESTUDO DRX EM MATERIAIS CATALISADORES Cu-Ni-SiO2 PARA HIDROGENACIÓN DE AZEITE DE SOYA. DESENVOLVIMENTO DE ESTRUTURA CRISTALINA E ATIVIDADE CATALÍTICA

Para buscar elementos experimentales que soporten la hipótesis según la cual se forman estructuras cristalinas Cu-Ni o, eventualmente, Cu-Ni-SiO2 en la síntesis de catalizadores para la hidrogenación de aceite de soya, se prepararon mezclas de estos tres materiales a partir de sales de los metales con sílice (aerosil). Se calcinaron a 270 °C y se redujeron a 330 °C en atmósfera de hidrógeno. En los materiales reducidos se estudió el difractógrama de RX en el rango 37 a 53°, y se comparó con el difractograma de aleaciones Cu-Ni -en las cuales se conoce la formación de cristales mixtos-, y con los difractogramas de los elementos puros Cu y Ni. Los resultados muestran señales de difracción diferentes a las señales de los componentes puros. La actividad catalítica se muestra diferente en los materiales que presentan distorsión en su estructura cristalina.

Looking for experimental facts that support the hypothesis of formation of Cu-Ni or Cu-Ni-SiO2 crystals formation hypo- thesis in the syntesis of catalytic materials for soja oil hydrogenation, different mixtures of the metals nitrates with SiO2 (aerosil), were prepared and calcined at 270 oC, then reduced in hydrogen atmosphere at 330 oC. RX Diffraction registers of the prepared materials, Ni-Cu alloys, Ni and Cu pure metals, show that differences in diffraction signal in prepared materials exist with respect to pure metals. The catalytic activity show differences too.

Para procurar elementos experimentais que suportem a hipótese segundo a qual se formam estruturas cristalinas Cu-Ni ou eventualmente Cu-Ni-SiO2 na síntese de catalisadores para a hidrogenación de azeite de soya, prepararam-se misturas destes três materiais a partir de sais dos metais com sílice (aerosil). Se calcinaron a 270 °C e se reduziram a 330 °C em atmosfera de hidrogênio. Nos materiais reduzidos se estudou o difractógrama de RX na casta 36 a 53 graus, e se comparou com o difractógrama de ligas de metais Cu-Nem, nas quais se conhece a formação de cristais mistos, e com os difractógramas dos elementos puros Cu e Nem. Os resultados mostram que se apresentam sinais de difracção diferentes aos sinais dos componentes puros. A atividade catalítica se mostra diferente nos materiais que apresentam distorção em sua estrutura cristalina.