ST88 ceftazidime-resistant Stenotrophomonas maltophilia is present in the saliva and gingival crevicular fluid of patients with periodontitis and AIDS from São Paulo State, Brazil.

Stenotrophomonas maltophilia (S. maltophilia) is an intrinsically drug-resistant and biofilm-forming bacteria causing infections in immunocompromised humans. This study reports the isolation of five S. maltophilia strains from saliva and gingival crevicular fluid (GCF) of AIDS patients with periodontitis in São Paulo, Brazil, showing resistance to ceftazidime, strong biofilm formation capacity and a close genetic relationship. The presence of S. maltophilia strains in saliva and CGF of patients with AIDS and periodontitis is a concern for the presence and persistence of intrinsically resistant bacteria in the oral environment, enhancing the risk for the development of severe infections in immunocompromised patients.

Insights on the genomic diversity, virulence and resistance profile of a Campylobacter jejuni strain isolated from a hospitalized patient in Brazil.

Campylobacteriosis is currently recognized as one of the major causes of foodborne bacterial diseases worldwide. In Brazil, there is insufficient data to estimate the impact of Campylobacter in public health. The aim of this present study was to characterize a C. jejuni CJ-HBSJRP strain isolated from a hospitalized patient in Brazil by its ability to invade human Caco-2 epithelial cells, to survive in U937 human macrophages, and to assess its phenotypic antimicrobial resistance profile. In addition, prophages, virulence and antimicrobial resistance genes were search using whole-genome sequencing data. The genetic relatedness was evaluated by MLST and cgMLST analysis by comparison with 29 other C. jejuni genomes isolated from several countries. The CJ-HBSJRP strain showed an invasion percentage of 50% in Caco-2 polarized cells, 37.5% of survivability in U937 cells and was phenotypically resistant to ampicillin, ciprofloxacin and nalidixic acid. A total of 94 virulence genes related to adherence, biofilm, chemotaxis, immune modulation, invasion process, metabolism, motility and toxin were detected. The resistance genes blaOXA-605 (blaOXA-61), cmeB and mutations in the QRDR region of gyrA were also found and none prophages were detected. The MLST analysis showed 23 different STs among the strains studied. Regarding cgMLST analysis, the CJ-HBSJRP strain was genetically distinct and did not group closely to any other isolate. The results obtained reinforce the pathogenic potential of the CJHBSJRP strain and highlighted the need for more careful attention to Campylobacter spp. infections in Brazil since this pathogen has been the most commonly reported zoonosis in several countries worldwide.

High levels of multidrug-resistant isolates of genetically similar Salmonella 1,4, [5],12:I:- from Brazil between 1983 and 2020.

Introduction. Salmonella 1,4, [5],12:i:- strains with different antimicrobial resistance profiles have been associated with foodborne disease outbreaks in several countries. In Brazil, S. 1,4, [5],12:i:- was identified as one of the most prevalent serovars in São Paulo State during 2004-2020.Gap Statement. However, few studies have characterized this serovar in Brazil.Aim. This study aimed to determine the antimicrobial resistance profiles of S. 1,4, [5],12:i:- strains isolated from different sources in Southeast Brazil and compare their genetic diversity.Methodology. We analysed 113 S. 1,4, [5],12:i:- strains isolated from humans (n=99), animals (n=7), food (n=5) and the environment (n=2) between 1983 and 2020. Susceptibility testing against 13 antimicrobials was performed using the disc diffusion method for all the strains. Plasmid resistance genes and mutations in the quinolone resistance-determining regions were identified in phenotypically fluoroquinolone-resistant strains. Molecular typing was performed using enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) for all strains and multilocus sequence typing (MLST) for 40 selected strains.Results. Of the 113 strains, 54.87 % were resistant to at least one antimicrobial. The highest resistance rates were observed against ampicillin (51.33 %), nalidixic acid (39.82 %) and tetracycline (38.05 %). Additionally, 39 (34.51 %) strains were classified as multidrug-resistant (MDR). Nine fluoroquinolone-resistant strains exhibited the gyrA mutation (Ser96→Tyr96) and contained the qnrB gene. The 113 strains were grouped into two clusters using ERIC-PCR, and most of strains were present in one cluster, with a genetic similarity of ≥80 %. Finally, 40 strains were typed as ST19 using MLST.Conclusion. The prevalence of MDR strains is alarming because antimicrobial treatment against these strains may lead to therapeutic failure. Furthermore, the ERIC-PCR and MLST results suggested that most strains belonged to one main cluster. Thus, a prevalent subtype of Salmonella 1,4, [5],12:i:- strains has probably been circulating among different sources in São Paulo, Brazil, over decades.

Virulence potential of Salmonella 1,4, [5],12:i:- strains isolated during decades from different sources in the Southeast region of Brazil.

Salmonella 1,4, [5],12:i:- is one of the most prevalent serovars associated with gastroenteritis in several countries, including Brazil. However, few studies have analyzed the virulence potential of this variant in this country. Therefore, this study aimed to characterize S. 1,4, [5],12:i:- strains isolated in Southeast Brazil. To this end, 113 S. 1,4, [5],12:i:- strains isolated from different sources between 1983 and 2020 were analyzed. For all strains, the frequencies of 11 virulence genes were investigated using PCR and the molecular typing was performed using pulsed-field gel electrophoresis (PFGE). Furthermore, 40 strains isolated from human and non-human sources were characterized by survival under acid and oxidative stress, and virulence analysis in Galleria mellonella was performed for 20 selected strains. All virulence genes were detected in more than 91% of the strains. The studied strains were grouped into four clusters using PFGE. Most strains were present in one cluster, named PFGE-A, with a genetic similarity of ≥ 79.5%. All 40 strains survived acid stress after 10 min and 1 h of exposure. Under oxidative stress, all 40 strains survived after 10 min, and 36 survived after 1 h of exposure. In the G. mellonella assay, nine isolates from non-human sources and six isolates from human showed high-to-intermediate virulence profiles. In conclusion, the pathogenic potential of the strains studied was corroborated by the high frequency of all the virulence genes identified. The PFGE results suggested that most strains belonged to one main cluster that has been prevailing in the São Paulo State, Brazil. The S. 1,4, [5],12:i:- strains isolated from human and non-human sources successfully survived the unfavorable conditions in the human gastrointestinal tract. Finally, strains isolated from non-human sources showed a higher proportion of isolates with high to intermediate virulence profiles in G. mellonella than in human isolates, suggesting a possible difference between isolates from different origins.

Draft Genome Sequences of 17 Campylobacter coli Strains Isolated from Animal and Food Sources in Brazil.

Campylobacter spp. have been reported as one of the most frequent causes of acute gastroenteritis in humans worldwide. Here, we report 17 draft genome sequences of C. coli strains isolated from animal and food sources in Brazil. These data will improve our understanding of this species in Brazil.

Antimicrobial resistance genotypes and phenotypes of Campylobacter coli isolated from different sources over a 16-year period in Brazil.

OBJECTIVES: This study aimed to identify antimicrobial resistance genotypes in 63 Campylobacter coli strains isolated from humans (12), animals (21), the environment (20), and food (10) in Brazil using whole genome sequencing (WGS) tools, comparing them with results obtained by antimicrobial susceptibility testing (AST) against some important antimicrobials in clinical use. METHODS: Phenotypic resistance profiles were determined by minimal inhibitory concentrations and the disk diffusion technique. The prediction of the resistance genes was performed using ABRicate v.0.8 and the Resistance Gene Identifier software of the CARD. RESULTS: The percentage of C. coli strains phenotypically resistant to antimicrobials were: ampicillin, 44.4%; doxycycline, 20.6%; tetracycline, 20.6%; ciprofloxacin, 12.7%; nalidixic acid, 12.7%; streptomycin, 6.3%; erythromycin, 4.8%; and gentamicin, 1.6%. The genes blaOXA-605 / blaOXA-61,tet(O), cmeB, aadE-Cc, aph (3 ') - IIIa, sat4 and aad9 were detected in 54%, 22.2%, 9.5%,6.3%, 1.6%, 1.6%, and 1.6% strains, respectively. Mutations T86I in the QRDR region of gyrA were detected in 8 (12.7%) strains. The agreement between AST and WGS was 100%, 92.9%, 82.4%, and 80% for quinolones, tetracycline, ß-lactam, and aminoglycoside classes, respectively. CONCLUSIONS: The rates of C. coli strains resistant to ß- lactams and quinolones may represent a public health concern. The partial agreement between AST and WGS shows that improvement in antibiotic resistance databases may be required to minimize this discrepancy observed in some antimicrobial classes and to become an acceptable tool to both clinical microbiologists and regulatory agencies.

Campylobacter coli isolated in Brazil typed by core genome Multilocus Sequence Typing shows high genomic diversity in a global context.

Campylobacter has been one of the most common causative agent of bacterial food-borne gastroenteritis in humans worldwide. However, in Brazil the campylobacteriosis has been a neglected disease and there is insufficient data to estimate the incidence of this pathogen in the country. AIMS: The current study aimed to determine the phylogenetic relationships among Campylobacter coli strains isolated in Brazil and to compare them with international Campylobacter isolates available in some public databases. METHODS AND RESULTS: A total of 63C. coli strains isolated in Brazil were studied. The MLST analysis showed 18 different STs including three STs not yet described in the PubMLST database. The cgMLST allocated the Brazilian strains studied into five main clusters and each cluster comprised groups of strains with nearly identical cgMLST profiles and with significant genetic distance observed among the distinct clusters. The comparison of the Brazilian strains with 3401 isolates from different countries showed a wide distribution of these strains isolated in this country. CONCLUSIONS: The results showed a high similarity among some strains studied and a wide distribution of the Brazilian strains when compared to isolates from different countries, which is an interesting data set since it showed a high genetic diversity of these strains from Brazil in a global context. This study contributed for a better genomic characterization of C. coli strains isolated in Brazil and provided important information about the diversity of this clinically-relevant pathogen.

Phenotypic analyses of Salmonella enterica serovar Enteritidis strains isolated in the pre- and post-epidemic period in Brazil.

Salmonella Enteritidis has caused, since the 1980s, a sustained epidemic of human infections in many countries. This study analyzed S. Enteritidis strains isolated before and after the epidemic period in Brazil regarding their capacities to survive to acid, oxidative, and high-temperature stresses, and capacity to grow in egg albumen. Moreover, the ability to invade human epithelial cells (Caco-2) and to survive inside human (U937) and chicken (HD11) macrophages was checked. Post-epidemic strains showed a better ability to survive after 10 min under acid stress at 37 °C (P ≤ 0.05). However, both groups of strains showed similar ability to survive after 1 h under acid stress at 37 °C and at 42 °C independently of the time of exposure. Similar ability was verified in both groups of strains regarding oxidative stress, growth in egg albumen, high-temperature stress, invasion to Caco-2 cells, and invasion and survival in macrophages. In conclusion, post-epidemic S. Enteritidis strains showed a better ability to survive under the acid stress found in the stomach, which might be an advantage to reach the intestine and colonize chickens and humans. However, both groups of strains did not differ significantly in the majority of the phenotypic tests analyzed in this study.

A high number of multidrug-resistant and predominant genetically related cluster of Shigella flexneri strains isolated over 34 years in Brazil.

Shigella flexneri has been a major public health problem in developing countries. This work analyzed the frequency of 16 virulence genes, the genotypic diversity, and the antimicrobial resistance profiles of 130 S. flexneri strains isolated in Brazil. The ipaH gene was found in all the 130 strains. The frequencies of the other genes were variable ial (88.5%), sigA (82.3%), iuc (74.6%), virA (73%), pic (72.3%), virF (57.7%), sat (48.5%), ipaBCD (37%), sen (36%), set1A (35.4%), sepA (30%), set1B (30%), virB (14%), icsA (10%), and ipgD (5.4%). A total of 57 (43.8%) strains were multidrug-resistant. ERIC-PCR grouped 96 of the strains into a single cluster with ≥ 70.4% of similarity, 75 of these strains presented a similarity ≥ 80.9%. PFGE grouped 120 of the strains into a single cluster with 57.4% of similarity and 82 of these strains presented a similarity ≥ 70.6%. In conclusion, the high frequency of some virulence genes reinforces the pathogenic potential of the strains studied. The high rates of MDR strains are alarming once it may lead to failure when antimicrobial treatment is necessary. Genotype techniques reveled a major cluster with high genetic similarity including S. flexneri strains from the different Brazilian states and distinct years of isolation, showing that they probably emerged from a common ancestor.

Virulence traits and expression of bstA, fliC and sopE2 in Salmonella Dublin strains isolated from humans and animals in Brazil.

Salmonella Dublin is a strongly cattle-adapted serovar that has also been responsible for severe invasive infections in humans. Although invasive infections by non-typhoid Salmonella have increased in developed and in developing countries, in sub-Saharan Africa these infections have been frequently related to Salmonella Typhimurium strains from Sequence Type (ST) 313 that harbor a possible virulence marker, the bstA gene, broadly detected in S. Dublin strains. The aims of this study were to verify the frequency of bstA by PCR in 113 Salmonella Dublin strains isolated from humans (83) and animals (30) in Brazil and the expression by RT-PCR of bstA, sopE2 and fliC in six strains isolated from humans (4) and animals (2). Moreover, the invasion capacity in Caco-2 human epithelial cells and U937 human macrophages, plus in vivo virulence analysis in Galleria mellonella and the motility were verified for 20 S. Dublin strains isolated from humans (15) and animals (5). All studied strains presented the bstA gene. The relative expression rates ranged from 0.1 to 2.3 fold change for bstA and from no expression to 16.6 fold change for sopE2, while no expression was detected for fliC. The invasion in Caco-2 cells ranged from 54.0 to 88.9% and in U937 cells from 72.9 to 98.1% in the 20 strains studied. In addition, 17 strains presented a highly virulent profile in the G. mellonella model and 15 strains presented a non-motile profile. In conclusion, the presence and expression of bstA in the S. Dublin strains studied suggested that this gene may influence in the invasive characteristic of this serovar. The low expression of sopE2 in strains from human invasive cases suggested that its expression may not be a limiting factor to the invasion of S. Dublin strains. The absence of fliC expression and the low motility rates observed suggest that the flagella absence may favor the host immune system evasion by S. Dublin and the establishment of infection. Moreover, the high mortality rates observed in vivo in Galleria mellonella reinforce the pathogenic potential of S. Dublin strains.

Molecular characterisation of multidrug-resistant Klebsiella pneumoniae belonging to CC258 isolated from outpatients with urinary tract infection in Brazil.

OBJECTIVES: This study characterised 48 Klebsiella pneumoniae isolates from outpatients with urinary tract infection in the micro-region of Ribeirão Preto, located in southeastern Brazil. METHODS: The isolates were identified by conventional biochemical and phenotypic tests and were confirmed as K. pneumoniae using a MALDI-TOF VITEK® MS system. Antimicrobial susceptibility testing was performed by the disk diffusion method as recommended by the Clinical and Laboratory Standards Institute (CLSI) using 38 different antibiotic discs. Fifteen ß-lactamase and ten virulence genes were investigated by PCR. Clonal relationships among the isolates were determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and multilocus sequence typing (MLST). RESULTS: Of the 48 isolates, 29 (60.4%) were classified as multidrug-resistant. A total of 46 ß-lactamase genes were found in 27 (56.3%) of the isolates, with blaKPC being the most prevalent distributed in 18 isolates (37.5%). Moreover, 73 virulence genes were found in 30 isolates (62.5%). ERIC-PCR results showed high genetic diversity among the isolates. Twelve different sequence types (STs) were found by MLST (ST14, ST17, ST101, ST200, ST334, ST433, ST437, ST442, ST449, ST502, ST1246 and ST2729), with ST2729 being described for the first time in this study. Seven STs were grouped in clonal complex 258 (CC258) frequently associated with various resistance and virulence genes. CONCLUSIONS: These results raise concern about epidemiological surveillance related to colonisation of patients discharged from hospitals in order to prevent both the occurrence and spread of resistant bacterial infections in the community.

Genotypic Resistance to Quinolone and Tetracycline in Salmonella Dublin Strains Isolated from Humans and Animals in Brazil.

Resistance of Salmonella Dublin strains to quinolones and tetracycline has been increasing worldwide. Studies regarding the genotypic resistance traits of strains of this serovar isolated in Brazil are scarce. This study aims to examine the genetic characteristics of Salmonella Dublin strains isolated in Brazil, which are associated with resistance to quinolone and tetracycline. The minimum inhibitory concentrations (MICs) of nalidixic acid, ciprofloxacin, and tetracycline of the 10 strains sensitive and 21 strains resistant to quinolone and tetracycline were determined using Etest.® The mutation profiles of the gyrA, gyrB, parC, and parE genes were accessed by sequencing, while the presence of plasmid-mediated quinolone resistance and tet genes was analyzed by PCR. Quinolone-resistant strains presented the amino acid substitutions Ser96→Tyr, Ser96→Phe, Asp107→Asn, or Asp108→Gly on the gyrA gene, and the Ser224→Phe and Glu231→Asp mutations on the gyrB gene. The qnrA, tet(A), and tet(B) genes were detected in 5, 13, and 6 strains, respectively. Analysis of the MIC values revealed that 1 and 3 strains presented intermediate and resistant MIC profiles to nalidixic acid, respectively; 6 strains presented intermediate MIC profile to ciprofloxacin; and 13 strains presented resistant MIC profile to tetracycline. In the Salmonella Dublin strains studied, quinolone resistance was mainly related to mutation points that led to target alteration in the gyrA and gyrB genes, while tetracycline resistance was associated with the presence of tet(A) and/or tet(B) genes, with the highest resistance levels detected in strains bearing the tet(B) gene. The presence of the aforementioned genotypic resistance traits in Salmonella Dublin strains isolated over 33 years in Brazil indicates that ciprofloxacin or tetracycline therapy against such strains may fail.

Detection of virulence and ß-lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil.

Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several ß-lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.

Detection of virulence and beta-lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil

Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several β-lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.(AU)

Detection of virulence and -lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil

ABSTRACT Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several -lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.

Detection of virulence and ß-lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil

ABSTRACT Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several β-lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.

Avaliação da interação Imipenen e Fosfomicina frente à Klebsiella pneumoniae sensíveis e resistentes aos carbapenêmicos pelo método “checkerboard”

Nesse trabalho foram analisadas Klebsiella pneumoniae isoladas de pacientes hospitalizados, realizando identificação e antibiograma das espécies pelo sistema de automação Vitek2®, teste de Hodge Modificado para a avaliação da produção da enzima carbapenemase e teste de interação da atividade antimicrobiana do imipenem e fosfomicina pelo método ―checkerboard‖. As K.pneumoniae (n=50) foram isoladas entre fevereiro e agosto de 2011 de pacientes do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) de amostras clínicas de urina e sangue. As bactérias com perfil de resistência aos carbapenêmicos (n=36) foram fenotipicamente investigadas quanto à produção de carbapenemase através do teste de Hodge Modificado e 86,2% (n=31) foram positivas. Os isolados de K. pneumoniae foram analisados frente a interação das drogas imipenem e fosfomicina pelo método de ―checkerboard‖ e os resultados demonstraram potencial atividade sinérgica tanto nos isolados sensíveis quanto nos resistentes aos carbapenêmicos. Assim, este estudo envolvendo K.pneumoniae carbapenem-resistentes soma conhecimento aos já existentes, podendo orientar novas estratégias para o tratamento de infecções provocadas por estes microrganismos e dessa maneira, contribuir para reduzir o impacto da resistência a antimicrobianos, que é um dos maiores desafios dos microbiologistas e da comunidade científica mundial.