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1.
Sci Rep ; 6: 28090, 2016 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-27312877

RESUMO

In oncologic patients fever is a non-specific clinical marker of different clinical settings. Procalcitonin (PCT) seems to be the most promising infection marker. We aimed to define the potential role of PCT as an earlier diagnostic marker in patients with fever and solid tumor. This retrospective study enrolled 431 patients. All of them performed hemoculture (HE) and basal PCT assessment (reference laboratory cut-off: ≤0.5 or >0.5 ng/dL) before starting antibiotic therapy. Gram positive (G+), negative (G-) or Fungi infection were detected. A statistically significant difference in PCT levels between patients with positive and negative HE was observed (P < 0.0001). Moreover comparing PCT values in patients with positive and negative HE, we obtain in the positive HE subpopulation an AUC of 0.7 and a cut-off of 1.52 ng/dL reached high sensitivity (61.6%) and specificity (70.1%). Using this last cut-off, instead of the normal reference value, we achieve a risk reduction to overestimate an infection status of 23.4%. We support the clinic usefulness of serum PCT dosage in febrile advanced solid tumor patients. A PCT cut-off of 1.52 ng/dL could be helpful in the management of the antibiotic therapy preventing delays of oncologic treatments.


Assuntos
Calcitonina/sangue , Febre/etiologia , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Positivas/diagnóstico , Micoses/diagnóstico , Neoplasias/complicações , Adolescente , Adulto , Idoso , Área Sob a Curva , Biomarcadores/sangue , Hemocultura , Feminino , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Positivas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/complicações , Neoplasias/patologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
2.
Clin Microbiol Infect ; 17(12): 1834-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21722258

RESUMO

During an area-based study, 75 group B streptococcus (GBS) strains isolated both from early-onset disease (EOD, 37 strains) and from late-onset disease (LOD, 38 strains) were analysed for serotype, pulsed field gel electrophoresis (PFGE) and multilocus sequence typing profiles, protein markers and antibiotic resistance. Serotype III, possessing the rib gene, was the most frequent (54 strains, 72%) and responsible for 89.5% and 54% of LOD and EOD, respectively. Forty-six serotype III strains belonged to the same PFGE type and clonal complex 17, already described as an over-represented clone in neonatal invasive GBS infections. Other serotypes were Ia (9.3%), II (6.7%), Ib (5.3%), V (5.3%) and IV (1.3%). Seventeen PFGE groups were identified comprising strains with related sequence types; conversely, strains displaying the same sequence type could belong to different PFGE groups. When both neonate and maternal strains from vaginorectal swabs and/or milk were available (eight cases), they were indistinguishable. Resistance to erythromycin (12%) was associated with a constitutive resistance to clindamycin in five cases (four carrying the erm(B) gene and one both the erm(B) and mef(E) genes) and with an inducible clindamycin resistance in two cases (one possessing the erm(A) gene, the other the erm(T) gene). Two isolates displayed the M phenotype (mef(E) gene). All strains but five were resistant to tetracycline, mostly mediated by the tet(M) gene (97.1%). The study underlined the importance of an active surveillance system for the elucidation of a GBS population structure causing neonatal infections and allowed the detection of rare antibiotic resistance determinants [erm(T)].


Assuntos
Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/patologia , Streptococcus agalactiae/isolamento & purificação , Antibacterianos/farmacologia , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Clindamicina/farmacologia , Análise por Conglomerados , Impressões Digitais de DNA , DNA Bacteriano/genética , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Eritromicina/farmacologia , Genótipo , Humanos , Lactente , Recém-Nascido , Itália/epidemiologia , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Fenótipo , Proteoma/análise , Sorotipagem , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/classificação , Streptococcus agalactiae/genética , Streptococcus agalactiae/imunologia , Tetraciclina/farmacologia
3.
Ann Oncol ; 22(5): 1141-1146, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21115601

RESUMO

BACKGROUND: KRAS wild-type mutational status is necessary but not sufficient to get benefit from epidermal growth factor receptor inhibition. Predictive markers are currently being evaluated. In this study, we investigated early hypomagnesemia as a predictor of efficacy and outcome in terms of time to progression (TtP) and overall survival (OS) in a cohort of patients affected by advanced colorectal adenocarcinoma KRAS wild-type cetuximab-treated. PATIENTS AND METHODS: One hundred and forty-three patients affected by stage IV colorectal adenocarcinoma KRAS wild type receiving cetuximab + irinotecan (CTX+IRI) as third-line anticancer treatment and resistant to oxaliplatin- and irinotecan-based chemotherapy were retrospectively included. Magnesium plasma levels were measured before the first day and 7, 14, 21 and 28 days after CTX+IRI infusion. RESULTS: The median magnesium basal value showed a statistically significant decrease after the start of CTX+IRI treatment (at 28 days, P < 0.0001). Patients with an early decrease of magnesium levels >50% compared with the basal level had a higher tumor response rate (55.8% versus 16.7%, P < 0.0001), a longer TtP (6.3 versus 3.6, P < 0.0001) and a longer median OS (11.0 versus 8.1, P = 0.002). CONCLUSIONS: We have shown that early hypomagnesemia could be a predictor of efficacy and outcome in those patients. Magnesium circulating level is an easy and inexpensive biomarker to routinely be detected in patients treated with cetuximab.


Assuntos
Adenocarcinoma/sangue , Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/sangue , Neoplasias Colorretais/tratamento farmacológico , Magnésio/sangue , Proteínas Proto-Oncogênicas/genética , Proteínas ras/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Camptotecina/administração & dosagem , Camptotecina/análogos & derivados , Cetuximab , Neoplasias Colorretais/sangue , Intervalo Livre de Doença , Feminino , Genótipo , Humanos , Irinotecano , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Proteínas Proto-Oncogênicas p21(ras) , Estudos Retrospectivos
4.
Eur J Clin Microbiol Infect Dis ; 28(1): 99-103, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18663502

RESUMO

A total of 773 pneumococcal isolates were collected from a nationwide surveillance of invasive pneumococcal diseases during 1999-2003 prior to the implementation of the 7-valent conjugate vaccine (PCV7) in Italy. The isolates included vaccine serotypes (VS, 393 isolates), vaccine-related serotypes (VRS, 93), and nonvaccine serotypes (NVS, 279). The ten most prevalent serotypes were: 14 (16.4%), 3 (8.4%), 23F (8%), 19F (7.4%), 4 (5.9%), 7F (5.8%), 9V (5.3%), 6B (4.9%), 19A (4.7%), and 1 (3.7%). VRS or NVS isolates showed a lower rate of penicillin or drug resistance than VS. Representative isolates of the major VS, VRS, and NVS were genotyped by pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). The isolates examined were found to belong to 18 international clones and to eight newly described clones. VS isolates sharing clonal groups with VRS or NVS were also detected. Evidence of a past history of capsular switching events was observed in five clones.


Assuntos
Infecções Pneumocócicas/microbiologia , Vacinas Pneumocócicas/imunologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Técnicas de Tipagem Bacteriana , Pré-Escolar , Análise por Conglomerados , Impressões Digitais de DNA , DNA Bacteriano/genética , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Genótipo , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Lactente , Recém-Nascido , Itália , Epidemiologia Molecular , Análise de Sequência de DNA , Sorotipagem
5.
Clin Exp Immunol ; 154(3): 360-4, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18826495

RESUMO

In the present study we investigated the potential role of Toll-like receptor 4 (TLR-4) Asp299Gly and Thr399Ile polymorphisms as risk factors in the development of gastric cancer. TLR-4 Asp299Gly and Thr399Ile polymorphisms were investigated in 171 Italian patients with sporadic gastric cancer and in 151 controls. Unconditional regression (odds ratio and 95% confidence intervals) were used to investigate the association of the studied polymorphisms with gastric cancer. TLR-4 Thr399Ile polymorphism is linked with an increased susceptibility to gastric cancer (P = 0.023 and hazard ratio = 3.62). No significant association for TLR-4 Asp299Gly polymorphism was found. In the subgroup of patients with intestinal-type gastric cancer, a significant risk of gastric cancer was associated with TLR-4 Thr399Ile genotype (P = 0.006). Our results demonstrated that TLR-4 Thr399Ile polymorphism is linked with an increased susceptibility to gastric cancer. An increased risk for intestinal gastric cancer in carriers of the TLR4 Thr399Ile allele was observed. Future epidemiological studies should consider the possible interactions between proinflammatory genotypes (such as TLR and interleukin-1R polymorphisms) and other risk factors for cancer such as dietary habits and/or exposure to environmental carcinogens.


Assuntos
Adenocarcinoma/genética , Polimorfismo Genético , Neoplasias Gástricas/genética , Receptor 4 Toll-Like/genética , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Neoplasias Gástricas/patologia
6.
Br J Sports Med ; 42(9): 742-5, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18308870

RESUMO

OBJECTIVE: To determine the plasma levels of substance P (SP) in patients with postoperative stiffness after arthroscopic rotator cuff repair. DESIGN: Plasma samples were obtained at 15 months from surgery from two groups of patients who underwent arthroscopic repair of a rotator cuff tear. In group 1, 30 subjects (14 men, 16 women; mean age 64.6 years, range 47 to 78) with shoulder stiffness 15 months after arthroscopic rotator cuff repair were recruited. In group 2, 30 patients (11 men, 19 women; mean age 57.8 years, range 45 to 77) were evaluated 15 months after successful arthroscopic rotator cuff repair. Immunoassays were performed with commercially available assay kits to measure the plasma levels of SP. RESULTS: Plasma levels of SP in patients with postoperative stiffness were significantly greater than those in the control group (mean 81.06 (SD 27.76) versus 23.49 (5.64), p<0.05). CONCLUSIONS: The plasma concentrations of substance P in patients with shoulder stiffness after arthroscopic rotator cuff repair are higher compared with plasma levels of SP in patients with a good postoperative outcome. The neuronal upregulation of SP shown in the plasma of patients with postoperative shoulder stiffness may underlie not only the symptoms but also its development of adhesive capsulitis.


Assuntos
Artroscopia/efeitos adversos , Contratura/sangue , Complicações Pós-Operatórias/sangue , Manguito Rotador/cirurgia , Substância P/sangue , Idoso , Contratura/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Amplitude de Movimento Articular/fisiologia , Manguito Rotador/fisiopatologia , Lesões do Manguito Rotador , Regulação para Cima/fisiologia
7.
Clin Ter ; 158(2): 181-7, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-17566522

RESUMO

The systemic inflammation associated to the simultaneous activation of blood coagulation and the alterated blood fibrinolysis, leads to microvascular endothelial injury, acute organ dysfunction and possibly death. Activated Protein C, a natural, multifunctional protein, has demonstrated antithrombotic, anti-inflammatory, and profibrinolitic properties and may be an important modulator of the vicious cycle whereby inflammation initiates coagulation and coagulation amplifies inflammation. Protein C couples with its receptor, EPCR (endothelial-cell protein-C receptor), and the ligand-receptor complex then interact with thrombin-thrombomodulin on endothelial surface to produce activated protein C (APC). Once activated, protein C then interact with its cofactor, protein S, to catalyze the inactivation of factors Va and VIIILa, two important accelerators of the clotting cascade, reducing thrombin generation and microvascular thrombosis. In addiction to its anticoagulant activity APC promotes profibrinolytic activity through the inhibition of plasminogen activator inhibitor-1, which is upregulated during inflammation. Inhibition of thrombin generation by APC decreases inflammation by inhibiting platelet activation, neutrophil recruitment, and mast-cell degranulation. APC also shows direct antiinflammatory properties, including blocking of cytokines production by monocytes and blocking cell adhesion. Moreover, APC has antiapoptotic properties that may contribute to its efficacy. In conclusion, APC, besides its physiologic role in the coagulation cascade, plays a key role in the pathophysiology of systemic inflammation justifying its potential therapeutic role in sepsis and systemic inflammatory responses.


Assuntos
Proteína C/fisiologia , Coagulação Sanguínea/fisiologia , Humanos , Inflamação/imunologia , Proteína C/uso terapêutico , Deficiência de Proteína C/congênito , Deficiência de Proteína C/fisiopatologia
8.
Clin Microbiol Infect ; 12(2): 189-92, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16441461

RESUMO

Group A streptococci (n = 123), isolated consecutively from paediatric patients with pharyngitis from Palermo, Italy, were analysed. The emm and sof genes were sequenced, the presence of the speA and speC genes was investigated, and the macrolide resistance phenotypes and genotypes were determined. A limited number of emm/sof genotypes was found, and the most prevalent types were different from those found in a previous study from Rome. Macrolide resistance was found in the most prevalent clones, suggesting that the spread of mobile antibiotic resistance genes among the fittest clones in the community was the main mechanism influencing macrolide resistance rates in different emm types.


Assuntos
Faringite/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/classificação , Streptococcus pyogenes/genética , Adolescente , Antígenos de Bactérias/genética , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Bactérias/genética , Proteínas de Transporte/genética , Criança , Pré-Escolar , DNA Bacteriano/análise , DNA Bacteriano/química , DNA Bacteriano/genética , Farmacorresistência Bacteriana/genética , Exotoxinas/genética , Transferência Genética Horizontal , Genótipo , Humanos , Itália , Macrolídeos/farmacologia , Proteínas de Membrana/genética , Testes de Sensibilidade Microbiana , Peptídeo Hidrolases/genética , Fenótipo , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Streptococcus pyogenes/isolamento & purificação
10.
J Chemother ; 17(3): 264-9, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16038519

RESUMO

Staphylococcus haemolyticus strains (n=20), responsible of blood stream infections, were consecutively isolated from patients hospitalized in two different wards at high risk of infection. Strains displayed high rate of resistance to oxacillin (90%). All strains but two with decreased susceptibility (MIC = 4 microg/mL), were sensitive to vancomycin. Ten strains were resistant to teicoplanin. Among the strains susceptible to glycopeptides, three displayed heteroresistance to vancomycin and seven to teicoplanin, when tested by Etest technique with 2 x McFarland inoculum. Biochemical reactions allowed to assign strains to eight biotypes, with 11 strains clustering under two main biotype A and biotype B. Pulsed-field-gel-electrophoresis (PFGE) identified 11 different PFGE-types. Seven strains grouping under the major PFGE-type 1 and three strains clustering in PFGE-type 2, closely correlated to biotype A and biotype B respectively. Seven teicoplanin-resistant isolates clustered in the PFGE-type 1, two in the PFGE-type 2 and one in PFGE-type 5. Therefore, teicoplanin-resistant strains were biochemically and genetically related and clonally distributed, despite different clones of S. haemolyticus circulated in the units during the study period.


Assuntos
Bacteriemia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/fisiopatologia , Staphylococcus haemolyticus/genética , Staphylococcus haemolyticus/patogenicidade , Adulto , Idoso , Antibacterianos/farmacologia , Cuidados Críticos , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Feminino , Humanos , Pacientes Internados , Itália , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Staphylococcus haemolyticus/isolamento & purificação , Teicoplanina/farmacologia
11.
Microb Drug Resist ; 11(2): 141-5, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15910228

RESUMO

In the course of a survey to determine the epidemiology of enterococcal infections in Italy, a sudden increment, in a 1-year time, was noted in the number of glycopeptide resistant Enterococcus faecium isolated from different wards of the University Hospital in Rome, Italy. The isolates were characterized for clonal relatedness by comparing SmaI gel electropherotypes, presence of vancomycin-resistance genes, and expression of virulence factors. PFGE identified in a single pulsed type all the glycopeptide-resistant isolates but one. Resistance to high levels of aminoglycosides was expressed by these same isolates, which also included a majority of non biofilm-forming strains. Two esp gene-carrying strains were also identified in different PFGE types. Data indicates that a specific clone acquired, in the clinical setting, the genetic determinant for glycopeptide resistance, thus improving environmental adaptation and favoring its persistence and spread.


Assuntos
Enterococcus faecium/genética , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Enterococcus faecium/efeitos dos fármacos , Glicopeptídeos/farmacologia , Humanos
12.
J Biol Regul Homeost Agents ; 16(2): 105-9, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12144121

RESUMO

INTRODUCTION: Oxaliplatin, a third-generation platinum analogue, is a novel compound with proven anti-tumor activity in colorectal cancer. Moreover, oxaliplatin appears to be relatively well tolerated and easy to handle, even on an outpatient basis. PATIENTS AND METHODS: Five advanced colorectal cancer patients treated with oxaliplatin-based chemotherapy developed, after the end of oxaliplatin infusion, similar idiosyncratic reactions characterized by chills, high fever, hypotension, abdominal pain, nausea and often diarrhoea. Venous blood for IL-6 and TNF-alpha assessment was drawn just after the beginning of the reaction and 15 and 30 minutes later. After drawing the third venous sample, intravenous dexamethasone (8 mg) was administered and the drawing of other two venous samples was performed (180 and 360 minutes after the beginning of the reaction). RESULTS: TNF-alpha and IL-6 serum concentrations significantly decreased after steroid therapy administration. The decrease of TNF-alpha and IL-6 levels went along with the clinical complete regression of symptoms and signs in all the 5 patients. No statistically significant correlation was found between other laboratory parameters and basal cytokine levels or cytokine decrease after steroid therapy. DISCUSSION: Our results clearly show that that idiosyncratic reaction observed in colorectal cancer patients after oxaliplatin infusion may be due to a massive release of cytokines such as TNF-alpha and IL-6. Symptom regression following steroid therapy administration went along with significant decrease of cytokines levels, confirming that TNF-alpha and IL-6 play a role in the pathogenesis of this reaction.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Citocinas/sangue , Dexametasona/uso terapêutico , Compostos Organoplatínicos/efeitos adversos , Dor Abdominal/induzido quimicamente , Dor Abdominal/tratamento farmacológico , Idoso , Neoplasias Colorretais/patologia , Diarreia/induzido quimicamente , Diarreia/tratamento farmacológico , Feminino , Febre/induzido quimicamente , Febre/tratamento farmacológico , Humanos , Hipotensão/induzido quimicamente , Hipotensão/tratamento farmacológico , Interleucina-6/sangue , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/tratamento farmacológico , Oxaliplatina , Síndrome , Fator de Necrose Tumoral alfa/metabolismo
13.
Clin Cancer Res ; 7(12): 4049-53, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11751500

RESUMO

PURPOSE: PTEN/MMAC1/TEP1 is a tumor suppressor gene encoding a dual-specificity protein phosphatase with homology to the cytoskeleton proteins, chicken tensin and bovine auxilin. PTEN mutations have been described in several types of human cancer. Recently, mutations at an (A)(6) repeat of PTEN exons 7 and 8 in colorectal cancer (CRC) patients with microsatellite instability have been detected. Moreover, an involvement of the transforming growth factor (TGF)-beta pathway in hereditary colorectal syndromes has been proposed. EXPERIMENTAL DESIGN: In this study, we analyzed the frequency of PTEN gene mutations in 36 CRC patients and 5 colon cancer cell lines. Furthermore, in 16 of 36 patients, microsatellite instability and TGF-beta receptor II analysis was possible. The study was performed by PCR and automated sequencing of the entire coding region of the PTEN gene. RESULTS: About 17% of colon cancer patients and one of five (HSR 320) colon cancer cell lines had mutations. Mutations were detected only among patients with locally advanced or metastatic CRC. PTEN mutations were detected in three of five (60%) patients showing both microsatellite instability and TGF-beta receptor II mutations. These patients presented with advanced or metastatic CRC CONCLUSIONS: Overall, these results show that PTEN alteration together with TGF-beta pathway inactivation could contribute to tumorigenesis and metastatic spread of sporadic and microsatellite unstable CRC.


Assuntos
Mapeamento Cromossômico , Neoplasias do Colo/genética , Neoplasias Colorretais/genética , Genes Supressores de Tumor , Mutação , Monoéster Fosfórico Hidrolases/genética , Proteínas Supressoras de Tumor/genética , Animais , Sequência de Bases , Neoplasias do Colo/patologia , Neoplasias Colorretais/patologia , Primers do DNA , DNA de Neoplasias/genética , DNA de Neoplasias/isolamento & purificação , Éxons , Humanos , Repetições de Microssatélites , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , PTEN Fosfo-Hidrolase , Reação em Cadeia da Polimerase , Proteínas Serina-Treonina Quinases , Receptor do Fator de Crescimento Transformador beta Tipo II , Receptores de Fatores de Crescimento Transformadores beta/genética , Células Tumorais Cultivadas
14.
FEMS Microbiol Lett ; 201(2): 205-11, 2001 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-11470363

RESUMO

Fifty-four Enterococcus faecalis and 20 Enterococcus faecium isolates from clinical and non-human sources in Rome, Italy, were characterized by antibiotic resistance and pulsed field gel electrophoresis (PFGE). Resistance to vancomycin, teicoplanin, ampicillin, and ciprofloxacin was more frequent in E. faecium than in E. faecalis, whereas high-level resistance to aminoglycoside was found primarily in E. faecalis. Multi-resistance was found primarily among clinical isolates, but was also observed among environmental isolates. Common genotypes shared among clinical and environmental isolates were observed, however, the majority of isolates occurred as unique, source-specific clones. Several PFGE types were associated with shared features in their antibiotic resistance patterns; evidences of clonal spread between and within wards were also noted. This is the first report indicating clonal relatedness between human and environmental enterococci isolated in Italy.


Assuntos
Farmacorresistência Bacteriana/genética , Enterococcus/classificação , Enterococcus/genética , Microbiologia Ambiental , Hospitais , Antibacterianos/farmacologia , Análise por Conglomerados , Resistência a Múltiplos Medicamentos/genética , Eletroforese em Gel de Campo Pulsado , Enterococcus/efeitos dos fármacos , Enterococcus/metabolismo , Enterococcus faecalis/classificação , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/genética , Enterococcus faecalis/metabolismo , Genótipo , Glicopeptídeos , Humanos , Testes de Sensibilidade Microbiana , Filogenia , Cidade de Roma
15.
J Clin Microbiol ; 39(5): 1687-90, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11325974

RESUMO

In a study assessing genetic diversity, 114 group A streptococcus (GAS) isolates were recovered from pediatric pharyngitis patients in Rome, Italy. These isolates comprised 22 different M protein gene (emm) sequence types, 14 of which were associated with a distinct serum opacity factor/fibronectin binding protein gene (sof) sequence type. Isolates with the same emm gene sequence type generally shared a highly conserved chromosomal macrorestriction profile. In three instances, isolates with dissimilar macrorestriction profiles had identical emm types; in each of these cases multilocus sequence typing revealed that isolates with the same emm type were clones having the same allelic profiles. Ninety-eight percent of the pharyngeal isolates had emm types previously found to be highly associated with mga locus gene patterns commonly found in pharyngeal GAS isolates.


Assuntos
Antígenos de Bactérias , Faringite/microbiologia , Faringe/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/classificação , Streptococcus pyogenes/genética , Adolescente , Adulto , Proteínas da Membrana Bacteriana Externa/genética , Técnicas de Tipagem Bacteriana , Proteínas de Transporte/genética , Criança , Pré-Escolar , Eletroforese em Gel de Campo Pulsado , Feminino , Variação Genética , Genótipo , Humanos , Lactente , Recém-Nascido , Itália , Masculino , Peptídeo Hidrolases/genética , Polimorfismo de Fragmento de Restrição , Streptococcus pyogenes/isolamento & purificação
17.
J Clin Microbiol ; 39(2): 794-7, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11158155

RESUMO

For 279 clinically isolated specimens identified by commercial kits as enterococci, genotypic identification was performed by two multiplex PCRs, one with ddl(E. faecalis) and ddl(E. faecium) primers and another with vanC-1 and vanC-2/3 primers, and by 16S ribosomal DNA (rDNA) sequencing. For 253 strains, phenotypic and genotypic results were the same. Multiplex PCR allowed for the identification of 13 discordant results. Six strains were not enterococci and were identified by 16S rDNA sequencing. For 5 discordant and 10 concordant enterococcal strains, 16S rDNA sequencing was needed. Because many supplementary tests are frequently necessary for phenotypic identification, the molecular approach is a good alternative.


Assuntos
DNA Ribossômico/genética , Enterococcus/classificação , Enterococcus/genética , Reação em Cadeia da Polimerase/métodos , RNA Ribossômico 16S/genética , Primers do DNA , Enterococcus/isolamento & purificação , Enterococcus faecalis/classificação , Enterococcus faecalis/genética , Enterococcus faecium/classificação , Enterococcus faecium/genética , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Peptídeo Sintases/genética , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade
18.
Med Microbiol Immunol ; 190(3): 113-20, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11827199

RESUMO

Enterococcal clinical isolates were investigated for the ability to form biofilm on inert surfaces, as a measure of slime production, in an attempt to find new possible virulence factors for these microorganisms. This property was commonly found among Enterococcus faecalis. Also E. faecium isolates were able to form biofilm, although to a lesser extent; for this species, however, biofilm formation seemed more frequently associated with isolates from infection rather than with environmental strains or isolates from healthy individuals. Biofilm formation was strongly affected by the presence of an additional carbohydrate source in the medium, or by iron deprivation, indicating a role of slime for survival in stressful conditions. Slime-producing E. faecalis were able to survive inside peritoneal macrophages for extended periods compared to slime-negative strains or to slime-positive bacteria grown in conditions depressing slime production. In particular, slime-producing and slime-negative cells showed a decrease of 1 and 2 log units, respectively, at 1 h after infection; slime-negative cells were then rapidly killed, with clearance of bacterial cells at 24 h. Slime-producing bacteria persisted up to 48 h, which was the last time point examined, as after that time viability of both infected and non-infected macrophages started to decline. Scanning electron microscopy observations showed the presence of abundant amorphous extracellular material, of possible polysaccharide nature, embedding bacterial cells to form a multilayered biofilm. Even in conditions not supporting biofilm formation, bacterial cells appeared capsulated, suggesting that capsule and slime might represent different structures. Genes belonging to the epa locus or to a putative icaA homolog did not seem to be involved in synthesis and export of slime.


Assuntos
Biofilmes/crescimento & desenvolvimento , Enterococcus/fisiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Macrófagos Peritoneais/microbiologia , Animais , Meios de Cultura , Enterococcus/classificação , Enterococcus/genética , Humanos , Microscopia Eletrônica de Varredura , Reação em Cadeia da Polimerase , Ratos , Microbiologia da Água
20.
Eur J Clin Microbiol Infect Dis ; 19(5): 388-92, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10898144

RESUMO

Analysis of bacterial DNA using a polymerase chain reaction performed with broad-range eubacterial 16S rDNA primers may yield a diagnosis of bacterial meningitis in cases where Gram staining of cerebrospinal fluid (CFS), antigen detection techniques or culture fail. Since this PCR technique occasionally gives false-positive results due to contamination of samples or laboratory reagents, a study was performed to establish the diagnostic value of assaying concentrations of tumour necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) in 90 CSF samples. A high correlation was found between a positive PCR result and the concentrations of TNF-alpha and IL-10, indicating that cytokine assays may be used as a confirmatory test. The findings suggested that a combination of the PCR technique, amplicon sequencing and assay of TNF-alpha and IL-10 concentrations in CSF is a reliable and cost-effective procedure for diagnosis of culture-negative bacterial meningitis.


Assuntos
Bactérias/isolamento & purificação , Interleucina-10/líquido cefalorraquidiano , Meningites Bacterianas/diagnóstico , Reação em Cadeia da Polimerase/métodos , Fator de Necrose Tumoral alfa/líquido cefalorraquidiano , Bactérias/crescimento & desenvolvimento , Meios de Cultura , Humanos , Meningites Bacterianas/líquido cefalorraquidiano , Meningites Bacterianas/microbiologia
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