Navegando por Palavras-chave "Enterobacteriaceae"
Agora exibindo 1 - 20 de 27
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Avaliação da prevalência de Carbapenemases em amostras de Enterobactérias isoladas no complexo Hospital São Paulo/UNIFESP(Universidade Federal de São Paulo (UNIFESP), 2010-04-28) Nicoletti, Adriana Giannini [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: The aim of this study was to evaluate the presence of carbapenemases in Enterobacteriaceae isolated in Hospital São Paulo Complex (UNIFESP) between June and July 2008. Methods: The presence of MBL- and KPC-encoding genes was investigated by PCR. A screening test was conducted to detect isolates non-susceptible to at least one carbapenem. The antimicrobial susceptibility profile was determined by the CLSI agar dilution method for all isolates non-susceptible to carbapenens. Modified Hodge test and the detection of β-lactam hydrolysis, carried out by spectrophotometer assays, were conducted for the isolates that confirmed to be non-susceptible to at least one carbapenem. The production of ESBL or plasmid-mediated AmpC β-lactamases was investigated by phenotypic tests and their respective encoding genes were investigated by PCR. Amplifications of ompK35 and ompK36 genes were performed to evaluate whether outer membrane proteins (OMPs)-encoding genes were disrupted or missing. Clonality among isolates non-susceptible to carbapenens was assessed by automated ribotyping. The incompatibility groups of plasmids were determined by PCR-based replicon typing as previously described by Carattoli et al., 2005 and Götz et al., 1996, for 10% of the isolates included in this study and of 7 MBL-producing control strains. Results: 450 Enterobacteriaceae clinical isolates were investigated. The MBL and KPC-encoding genes were not detected in any isolate. The susceptibility rate to meropenem, imipenem and ertapenem were 99.3%, 98.4% and 98%, respectively. Overall, 2.9% of the isolates were classified as nonsusceptible to carbapenens. Of those, only 45.5% (5 K. pneumoniae isolates) confirmed to be non-susceptible to at least one carbapenem by the agar dilution technique. The modified Hodge test and the β-lactam hydrolysis by spectrophotometer assays did not detect carbapenemase production in these isolates. The mechanisms conferring reduced susceptibility to carbapenems among these isolates are the production of ESBL (blaCTX-M, blaSHV and/or blaTEM) associated with altered OMPs (n=4), or only altered OMPs (n=1). Three K. pneumoniae isolates non-susceptible to carbapenens were clustered in one ribogroup. The determination of plasmids’ incompatibility group was carried out to verify if transmission of MBL-encoding genes was prevented due to incompatibility between plasmids occurring in the Enterobacteriaceae clinical isolates studied and those carrying MBL-encoding genes. The incompatibility group of 58.5% of isolates could not be determined due to lack of amplification. Among the remaining isolates the incompatibility groups I1, FIA, FIB, FIC, FrepB, FIIs, P, K/B, N, L/M, A/C and Q were found. Among the MBL producers, the incompatibility group could be determined only for two IMP-1 producers, S. marcescens (IncQ) and E. cloacae (IncQ and IncA/C). Conclusions: While MBL-production is highly prevalent among P. aeruginosa and Acinetobacter spp. clinical isolates from Hospital São Paulo, Enterobacteriaceae isolates nonsusceptible to carbapenens due to carbapenemase production were not detected. In contrast, reduced susceptibility to carbapenems occurred due to the association of β-lactamase production with altered OMPs. The hypothesis that incompatibility between plasmids could have prevented transmission of MBL-encoding genes from non-fermenter rods to Enterobacteriaceae could not be confirmed since most strains presented non-typable plasmid content.
- ItemAcesso aberto (Open Access)Caracterização genética e bioquímica da BKC-1, uma nova carbapenemase da classe A de Ambler, isolada de amostras clínicas de Klebsiella pneumoniae(Universidade Federal de São Paulo (UNIFESP), 2014) Nicoletti, Adriana Giannini [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Em bacilos Gram negativos, a produção de β-lactamases é o fator contribuinte mais importante para a aquisição de resistência aos antimicrobianos β-lactâmicos. As carbapenemases, β-lactamases com eficiência catalítica contra os carbapenens, representam a família mais versátil destas enzimas, possuindo um amplo espectro de atividade, que compreende quase todos os antimicrobianos β-lactâmicos. O objetivo deste estudo foi caracterizar geneticamente e bioquimicamente uma nova carbapenemase da classe A de Ambler, identificada em amostras clínicas de Klebsiella pneumoniae resistentes aos carbapenens, isoladas de dois hospitais da cidade de São Paulo. Material e métodos: O teste de sensibilidade foi realizado pela técnica de microdiluição, de acordo com as recomendações do CLSI. O teste de hidrólise foi realizado para verificar se as amostras eram capazes de degradar o imipenem por meio da produção de enzimas. A reação da cadeia em polimerase foi utilizada para a detecção dos genes codificadores de β-lactamases, seguida pela reação de sequenciamento dos respectivos amplicons. A corrida eletroforética em géis de poliacrilamida com intervalos conhecidos de pH foi realizada para determinar o pI das β-lactamases presentes. A relação genética entre as amostras foi determinada pela técnica de PFGE, e o perfil plasmidial foi determinado por meio de eletroforese em gel de agarose 0,8% após a extração dos plasmídeos por duas metodologias diferentes. A transformação foi utilizada para determinar se o gene responsável pela resistência aos carbapenens estava localizado no plasmídeo, seguido pelo sequenciamento em larga escala do plasmídeo carreador do gene de resistência aos carbapenens. Após a identificação do gene, experimentos de cinética enzimática foram realizados para determinar os parâmetros bioquímicos da nova enzima. A determinação da frequência do gene blaBKC foi realizada por PCR para uma coleção de 472 amostras de Klebsiella spp. Resultados: O teste de sensibilidade confirmou a resistência a todos os antimicrobianos testados, incluindo os carbapenens, as quinolonas, e os aminoglicosídeos canamicina e amicacina. A hidrólise dos carbapenens foi detectada em todos os isolados, sendo inibida somente pelo ácido clavulânico. A PCR revelou a presença dos genes blaCTX-M-2 e blaSHV-like. Entretanto, nenhum gene codificador de carbapenemases foi detectado. As três amostras pertenciam ao mesmo clone e apresentaram o mesmo perfil plasmidial, com a presença de quatro plasmídeos (2, 8, 10 e 140 Kb). Somente o plasmídeo de 10 Kb foi recuperado da cepa transformante, sendo totalmente sequenciado. Além dos genes de mobilização e replicação, o plasmídeo também apresentou o gene aphA, responsável pela resistência aos aminoglicosídeos, e uma ORF que codificava uma proteína de 313 aminoácidos correspondente a uma β-lactamase, que foi nomeada de blaBKC. Esta enzima possui maior similaridade com uma β-lactamase presente no plasmídeo do Sinorhizobium meliloti AK83 (63%). O transformante mostrou um aumento de 10 vezes na CIM do ertapenem. Dentre as 472 amostras pesquisadas, somente uma carreava o gene blaBKC, correspondendo a uma frequência de 0,2%, Conclusões: Apesar da disseminação de K. pneumoniae produtora de KPC no Brasil, nós identificamos uma nova carbapenemase pertencente a classe A, demonstrando a diversidade e rápida evolução das β-lactamases em isolados clínicos de K. pneumoniae..
- ItemAcesso aberto (Open Access)Caracterização molecular de plasmídeos de amostras clínicas brasileiras carreadoras do gene QNR(Universidade Federal de São Paulo (UNIFESP), 2016-03-22) Segura, Wilson Dias [UNIFESP]; Minarini, Luciene Andrade da Rocha [UNIFESP]; http://lattes.cnpq.br/5226657617185982; http://lattes.cnpq.br/2418417219799837; Universidade Federal de São Paulo (UNIFESP)It is very important to know how microorganisms acquire and express resistance phenotype to promote the development of effective strategy for regulating the use of antimicrobial agents commonly used in Brazil. Therefore, the study was designed to investigate plasmideal mechanisms involved in the maintenance of resistant bacterial strains at the environment. Plasmids carrying qnr determinants previously reported in bacterial strains isolated in Brazil (n = 19) will be typed and sub-typed by Multiplex PCR and Sequencing by multilocus (pMLST), molecular methods that have not been explored in Brazil, which allow to compare data obtained from strains isolated in various parts of the world. It was possible to determine the incompatibility group from 21 plasmid, as belonging to 7 from 18 groups tested, the groups incN and incFIB present in Escherichia coli, and the incFIIk and incHI2 groups, more frequent in Klebsiella pneumoniae. It was also possible to identify the incompatibility groups in 4 of 8 Enterobacter cloacae tested. IncL/M, incA/C and incHI2 groups were found in these strains. Plasmids incN/STI, incN/ST5, incHI2/ST1, incI1/ST1, incFIIk/ST1 and incFIB/ST1 were identified by analysis of plasmid MLST. IcnN/ST1 plamids in E. coli UNIFAL 79 and E. coli UNIFAL 414 strains and incN/ST5 plasmids in E. coli JF 234 e K. pneumoniae JF 342 strains where associated to qnr genes. The results expand knowledge about types of plasmids involved in these resistance phenotypes, allowing the determination of the epidemiological profile of occurrence of plamideal group?s higher frequency.
- ItemAcesso aberto (Open Access)Comparative analysis of the complete genome of KPC-2-producing Klebsiella pneumoniae Kp13 reveals remarkable genome plasticity and a wide repertoire of virulence and resistance mechanisms(Biomed Central Ltd, 2014-01-22) Ramos, Pablo Ivan Pereira; Picao, Renata Christina; Almeida, Luiz Gonzaga Paula de; Lima, Nicholas Costa B.; Girardello, Raquel [UNIFESP]; Vivan, Ana Carolina P.; Xavier, Danilo Elias [UNIFESP]; Barcellos, Fernando G.; Pelisson, Marsileni; Vespero, Eliana Carolina; Medigue, Claudine; Vasconcelos, Ana Tereza Ribeiro de; Gales, Ana Cristina [UNIFESP]; Nicolas, Marisa Fabiana; Lab Nacl Computacao Cient; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Estadual de Londrina (UEL); Universidade Federal de São Paulo (UNIFESP); GenoscopeBackground: Klebsiella pneumoniae is an important opportunistic pathogen associated with nosocomial and community-acquired infections. A wide repertoire of virulence and antimicrobial resistance genes is present in K. pneumoniae genomes, which can constitute extra challenges in the treatment of infections caused by some strains. K. pneumoniae Kp13 is a multidrug-resistant strain responsible for causing a large nosocomial outbreak in a teaching hospital located in Southern Brazil. Kp13 produces K. pneumoniae carbapenemase (KPC-2) but is unrelated to isolates belonging to ST 258 and ST 11, the main clusters associated with the worldwide dissemination of KPC-producing K. pneumoniae. in this report, we perform a genomic comparison between Kp13 and each of the following three K. pneumoniae genomes: MGH 78578, NTUH-K2044 and 342.Results: We have completely determined the genome of K. pneumoniae Kp13, which comprises one chromosome (5.3 Mbp) and six plasmids (0.43 Mbp). Several virulence and resistance determinants were identified in strain Kp13. Specifically, we detected genes coding for six beta-lactamases (SHV-12, OXA-9, TEM-1, CTX-M-2, SHV-110 and KPC-2), eight adhesin-related gene clusters, including regions coding for types 1 (fim) and 3 (mrk) fimbrial adhesins. the rmtG plasmidial 16S rRNA methyltransferase gene was also detected, as well as efflux pumps belonging to five different families. Mutations upstream the OmpK35 porin-encoding gene were evidenced, possibly affecting its expression. SNPs analysis relative to the compared strains revealed 141 mutations falling within CDSs related to drug resistance which could also influence the Kp13 lifestyle. Finally, the genetic apparatus for synthesis of the yersiniabactin siderophore was identified within a plasticity region. Chromosomal architectural analysis allowed for the detection of 13 regions of difference in Kp13 relative to the compared strains.Conclusions: Our results indicate that the plasticity occurring at many hierarchical levels (from whole genomic segments to individual nucleotide bases) may play a role on the lifestyle of K. pneumoniae Kp13 and underlie the importance of whole-genome sequencing to study bacterial pathogens. the general chromosomal structure was somewhat conserved among the compared bacteria, and recombination events with consequent gain/ loss of genomic segments appears to be driving the evolution of these strains.
- ItemSomente MetadadadosDetection of OXA-370 directly from rectal swabs and blood culture vials using an immunochromatographic assay(Elsevier Science Bv, 2017) Nodari, Carolina Silva [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Barth, Afonso Luis; Magagnin, Cibele Massotti; Zavascki, Alexandre Prehn; Carvalhaes, Cecilia Godoy [UNIFESP]We evaluated the performance of OXA-48 K-SeT assay for detecting OXA-370 directly from spiked rectal swabs and blood culture vials. The limit of detection of this test was 10(4) UFC/mL for rectal swabs. Detection of the OXA-370-producing isolates was successfully achieved directly from positive blood culture vials independent of growing conditions.
- ItemSomente MetadadadosDiarreia aguda em Brasília: estudo etiológico(Universidade Federal de São Paulo (UNIFESP), 1990) Gandolfi, Lenora [UNIFESP]; Fagundes Neto, Ulysses [UNIFESP]
- ItemSomente MetadadadosDistribuição e natureza genética da resistência ao mercúrio em enterobacterias(Universidade Federal de São Paulo (UNIFESP), 1974) Reis, Maria Henriqueta Lemos dos [UNIFESP]
- ItemSomente MetadadadosEdwardsiella tarda: Estudo da capacidade invasora e produção de toxinas(Universidade Federal de São Paulo (UNIFESP), 1983) Marques, Lilian Regina Macelloni [UNIFESP]; Trabulsi, Luiz Rachid [UNIFESP]
- ItemAcesso aberto (Open Access)Emergence of Klebsiella pneumoniae-producing KPC-2 carbapenemase in Paraíba, Northeastern Brazil(Brazilian Society of Infectious Diseases, 2012-12-01) Fehlberg, Lorena Cristina Corrêa [UNIFESP]; Carvalho, Albalucia M.c.; Campana, Eloiza Helena [UNIFESP]; Gontijo-Filho, Paulo P.; Gales, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba Hospital Universitário Lauro Wanderley; Universidade Federal de Uberlândia Biological Sciences InstituteThe emergence of KPC-2 producing K. pneumoniae in hospitalized patients at the intensive care unit (ICU) of a teaching hospital located in the city of João Pessoa, Paraíba, Brazil, is reported. Seven carbapenem-resistant K. pneumoniae recovered from different body sites of infection were analyzed. Most isolates showed a multidrug-resistance phenotype. Genotypic analysis demonstrated the presence of two genotypes, with the predominance of genotype A, which belongs to ST 437. These isolates also carry the encoding genes of five other betalactamases.
- ItemSomente MetadadadosEmergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: Report from the MYSTIC Program (1999-2005)(Elsevier B.V., 2006-12-01) Deshpande, Lalitagauri M.; Rhomberg, Paul R.; Sader, Helio S.; Jones, Ronald N.; JMI Labs; Universidade Federal de São Paulo (UNIFESP); Tufts UnivAmong 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (>= 2 mu g/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and I from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and I from Ohio, same ribotype), and I Serratia marcescens (New York), Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (I isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. the escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date. (c) 2006 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Frequência de enterobactérias produtoras de ß-Lactamases AmpC plasmidiais isoladas em infecção de corrente sangüínea(Universidade Federal de São Paulo (UNIFESP), 2009-04-29) Campana, Eloiza Helena [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The broad-spectrum cephalosporins are the main therapeutic options to Enterobacteriaceae infections and the resistance to these agents has been associated to ESβL production. However, plasmid-mediated AmpC β-lactamases (pAmpC) have been associated with this resistance phenotype. The aim of this study was to determine the occurrence of pAmpC among clinical isolates recovered from bloodstream from patients hospitalized at a Brazilian teaching hospital, collected between January and July 2006. A total of 133 non-repetitive Enterobacteriaceae per patients (65 K. pneumoniae, 41 E. coli, 18 P. mirabilis, 05 K. oxytoca and 04 Salmonella spp.) were studied. The antimicrobial susceptibility profile was determined by CLSI agar dilution method. ESβL phenotype was detected by doubledisk diffusion method while pAmpC production was evaluated by two phenotypic methods: modified three-dimensional and modified Hodge tests and the presence of pAmpC genes was confirmed by PCR and sequencing. Among tested antimicrobial, imipenem showed the highest susceptibility rate (99.2%), followed by cefoxitin (80.5%). K. pneumoniae presented high resistance to β-lactams. P. mirabilis isolates showed the lower susceptibility rate to ciprofloxacin (27.8%). Fifty-nine (44.4%) of studied isolates were phenotypically classified as ESβL producers. Modified threedimensional and Hodge methods classified 06 and 19 Enterobacteriaceae strains as pAmpC producers, respectively. Discordant results were observed between phenotypic pAmpC detection methods. Of those, a single K. pneumoniae isolate was confirmed as CMY-2 producer.
- ItemSomente MetadadadosHigh mortality rate associated with KPC-producing Enterobacter cloacae in a Brazilian hospital(Mosby-Elsevier, 2018) da Silva, Kesia Esther; Varella, Thaigor Rezek; dos Santos Bet, Graciela Mendonca; Carvalhaes, Cecilia Godoy [UNIFESP]; Correa, Maisa Estopa; Vasconcelos, Nathalie Gaebler; Croda, Julio; Gales, Ana Cristina [UNIFESP]; Simionatto, SimoneWe describe a clonal dissemination of KPC-producing Enterobacter cloacae in a Brazilian hospital. Patients diagnosed with theses isolates showed high mortality rate (41.8%) and were associated with previous use of antibiotics and urinary catheterization. Therefore, infection control measures and use of stricter antibiotic policies are required to control the spread of these organisms. (C) 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Impact of the introduction of an automated microbiologic system on the clinical outcomes of bloodstream infections caused by Enterobacteriaceae strains(Sociedade Brasileira de Medicina Tropical - SBMT, 2013-01-01) Callefi, Luciana Azevedo [UNIFESP]; Medeiros, Eduardo Alexandrino Servolo de [UNIFESP]; Furtado, Guilherme Henrique Campos; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Enterobacteriaceae strains are a leading cause of bloodstream infections (BSI). The aim of this study is to assess differences in clinical outcomes of patients with BSI caused by Enterobacteriaceae strains before and after introduction of an automated microbiologic system by the microbiology laboratory. METHODS: We conducted a retrospective cohort study aimed to evaluate the impact of the introduction of an automated microbiologic system (Phoenix(tm) automated microbiology system, Becton, Dickinson and Company (BD) - Diagnostic Systems, Sparks, MD, USA) on the outcomes of BSIs caused by Enterobacteriaceae strains. The study was undertaken at Hospital São Paulo, a 750-bed teaching hospital in São Paulo, Brazil. Patients with BSI caused by Enterobacteriaceae strains before the introduction of the automated system were compared with patients with BSI caused by the same pathogens after the introduction of the automated system with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. RESULTS: We evaluated 90 and 106 patients in the non-automated and automated testing periods, respectively. The most prevalent species in both periods were Klebsiella spp. and Proteus spp. Clinical cure/improvement occurred in 70% and 67.9% in non-automated and automated period, respectively (p=0.75). 14-day mortality rates were 22.2% and 30% (p=0.94) and 28-day mortality rates were 24.5% and 40.5% (p= 0.12). There were no significant differences between the two testing periods with regard to treatment adequacy, clinical cure/improvement and 14- and 28-day mortality rates. CONCLUSIONS: Introduction of the BD Phoenix(tm) automated microbiology system did not impact the clinical outcomes of BSIs caused by Enterobacteriaceae strains in our setting.
- ItemSomente MetadadadosIn vitro activity of garenoxacin tested against a worldwide collection of ciprofloxacin-susceptible and ciprofloxacin-resistant Enterobacteriaceae strains (1999-2004)(Elsevier B.V., 2007-05-01) Sader, Helio S.; Fritsche, Thomas R.; Jones, Ronald N.; JMI Labs Inc; Tufts Univ; Universidade Federal de São Paulo (UNIFESP)Garenoxacin is a novel des-F(6)-quinolone with a chemical Structure that lacks the C6 position fluorine and has a unique difluoromethoxy substitution at position C8. This Study evaluated the in vitro activity of garenoxacin tested against a large collection of Enterobacteriaceae collected worldwide. the bacterial isolates were consecutively collected from more than 70 medical centers from bloodstream, respiratory, urinary tract, and skin and soft tissue infections. the isolates were tested against garenoxacin, ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin, and many other oral and parenteral antimicrobial agents. All isolates were susceptibility tested by broth microdilution methods according to the Clinical and Laboratory Standards Institute (CLSI) guidelines and interpretative criteria. A garenoxacin-susceptible breakpoint of <= 2 mu g/mL was applied for comparison purposes only. the fluoroquinolones were the most active oral compounds with overall susceptibility rates of 87.5% to 90.0%. Garenoxacin showed in vitro activity comparable with that of ciprofloxacin and the other fluoroquinolones against Eycherichia coli (MIC50, <= 0.03 mu g/mL; 87.3% susceptible), Klebsiella SPP- (MIC50, 0.12 mu g/mL-1 90.4-94.5% susceptible), Enterobacter spp. (MIC50, 0.12 mu g/mL; 85.6-86.5% susceptible), Salmonella SPP. (MIC50, 0.06 mu g/mL; 99.7% susceptible), and Shigella spp. (MIC50, <= 0.03 mu g/mL; 99.9% susceptible), which accounted for 87.0% of the Enterobacteriaceae strains tested. Garenoxacin was highly active against ciprofloxacin-susceptible strains (98.1% susceptibility), whereas ciprofloxacin-resistant strains were generally resistant to all other fluoroquinolones and also showed high rates of resistance to other orally administered antimicrobials. in conclusion, garenoxacin in vitro activity was similar to that of currently marketed fluoroquinolones and superior to other orally administered antimicrobial agents (cephalosporins, amoxicillin/clavulanate, and trimethoprim/sulfamethoxazole) when tested against more than 45 000 globally collected Enterobacteriaceae. (c) 2007 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosInfecção peritoneal por conteúdo cólico: estudo experimental no rato(Universidade Federal de São Paulo (UNIFESP), 1983) Saad, Flávio [UNIFESP]; Haddad, Chibly Michel [UNIFESP]
- ItemAcesso aberto (Open Access)MUTATIONS IN THE QUINOLONE RESISTANCE-DETERMINING REGIONS OF GYRA AND PARC IN ENTEROBACTERIACEAE ISOLATES FROM BRAZIL(Soc Brasileira Microbiologia, 2012-10-01) Minarini, Luciene Andrade da Rocha [UNIFESP]; Darini, Ana Lucia C.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Mutations in the quinolone resistance-determining regions (QRDR) in chromosomal gyrA and parC genes and fluoroquinolone susceptibility profiles were investigated in quinolone-resistant Enterobacteriaceae isolated from community and hospitalized patients in the Brazilian Southeast region. A total of 112 nalidixic acid-resistant enterobacterial isolates collected from 2000 to 2005 were investigated for mutations in the topoisomerases genes gyrA and parC by amplifying and sequencing the QRDR regions. Susceptibility to fluoroquinolones was tested by the agar dilution method. Amongst the 112 enterobacterial isolates, 81 (72.3%) were resistant to ciprofloxacin and 5 (4.5%) showed reduced susceptibility. Twenty-six (23.2%) were susceptible to ciprofloxacin. Several alterations were detected in gyrA and parC genes. Escherichia coli isolates (47.7%) showed double mutations in the gyrA gene and a single one in the parC gene. Two unusual aminoacid substitutions are reported, an Asp87-Asn in a Citrobacter freundii isolate with reduced susceptibility to fluoroquinolones and a Glu84-Ala in one E. coli isolate. Only a parC gene mutation was found in fluoroquinolone-susceptible Enterobacter aerogenes. None of the isolates susceptible to ciprofloxacin presented mutations in topoisomerase genes. This comprehensive analysis of QRDRs in gyrA and parC genes, covering commonly isolated Enterobacteriaceae in Brazil is the largest reported up to now.
- ItemSomente MetadadadosPesquisa de enterobactérias e estudo clínico-laboratorial em pacientes com pelve-espondilite anquilosante(Universidade Federal de São Paulo (UNIFESP), 1987) Ferraz, Marcos Bosi [UNIFESP]; Atra, Edgard [UNIFESP]
- ItemSomente MetadadadosPotency and spectrum trends for cefepime tested against 65,746 clinical bacterial isolates collected in North American medical centers: Results from the SENTRY Antimicrobial Surveillance Program (1998-2003)(Elsevier B.V., 2005-07-01) Sader, H. S.; Fritsche, T. R.; Jones, R. N.; JMI Labs Inc; Universidade Federal de São Paulo (UNIFESP); Tufts UnivWe evaluated the antimicrobial spectrum and potency of cefelpitne and selected comparators agents against clinical bacterial strains collected in North America over a 6-year period (1998-2003). Isolates were consecutively collected from bloodstream (44%), respiratory tract (41%), urinary tract (6%), and skin/soft tissue (5%) infections in 48 medical centers. Isolates were susceptibility tested by reference broth microdilution methods in a central laboratory. Oxacillin-resistant staphylococci and enterococci were excluded from the analysis. Imipenem (MIC90 = I mu g/mL, 99.9% susceptible) was the most active compound tested against Enterobacteriaceae (22 860 isolates tested) followed by cefepirne (MIC90 = 0.25 mu g/mL, 99.5% susceptible) > amikacin (99.4% susceptible) > ceftriaxone (95.6% susceptible) > aztreonant (95.1% susceptible). Among comparators, the lowest susceptibility rate for Enterobacteriaceac was observed with ciprofloxacin (92.8% susceptible). Imipenem was also the most active compound against ESBL-producing Klebsiella spp. and Escherichia coli (99.3% and 100% susceptible, respectively), followed by amikacin (81.4% and 97.2% susceptible, respectively) and cefepime (92.5% and 93.8% susceptible, respectively). Cefepime activity against Pseudonionas aeruginosa (85.2% susceptible) was similar to that of imipenem (86.9% susceptible). Against oxacillin-susceptible Staphylococcus aureus, cefepirne (MIC90 = 4 mu g/mL, 100.0% susceptible) was 4-fold more active than ceflazidime (MIC90 = 16 mu g/mL, 86.4% susceptible) and showed a higher susceptibility rate than ciprofloxacin (93.2% susceptible). Cefepime was the most active compound tested against Streptocoecus pneunioniae (MIC90 = 2 mu g/mL, 97.4% susceptible), ranked after gatifloxacin and levofloxacin (99.2% susceptible). the activity of cefepime remained stable during the study period evaluated with the susceptibility rates varying from 99.3% to 99.8% among the Enterobacteriaceae and 84.4% to 88.4% among P aeruginosa isolates. in summary, cefepime has retained broad activity and spectrum against Enterobacteriaceae, P aeruginosa, and Gram-positive cocci (except oxacillin-resistant staphylococci and enterococci) isolated from North American medical centers in the 1998-2003 period. Continued resistance Surveillance is critical to monitor the effectiveness of widely used parenteral antimicrobial agents such as cefepime. (c) 2005 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosProposicao de dois novos meios de cultura e de um sistema simplificado para identificacao de enterobacterias(Universidade Federal de São Paulo (UNIFESP), 1979) Fontes, Cleuber Franco [UNIFESP]
- ItemSomente MetadadadosRapid detection of bla(KPC) directly from surveillance rectal swabs by EasyQ KPC(Elsevier Science Inc, 2018) Ramos, Ana Carolina [UNIFESP]; Schandert, Lygia [UNIFESP]; Carvalhaes, Cecilia Godoy [UNIFESP]; Martins, Rafael Affini [UNIFESP]; Cappellano, Paola [UNIFESP]; Machado, Flavia Ribeiro [UNIFESP]; Gales, Ana Cristina [UNIFESP]The performance of EasyQ KPC assay was evaluated for the first time for bla(KPC) detection directly from surveillance rectal swabs without broth enrichment. Using conventional polymerase chain reaction as gold standard method, EasyQ KPC and culture-based molecular tests demonstrated a sensitivity/specificity of 100%/87.3% and 83.3%/98.2%, respectively. (C) 2017 Elsevier Inc. All rights reserved.