ESBL in positive hemoculture of a Southern-Brazil Teaching Hospital's Intensive Care Units / ESBL em hemoculturas positivas das Unidades de Terapia Intensiva de um Hospital Universitário do sul do Brasil

Bloodstream infections are among the most serious and frequent infections, and the people most exposed are patients in the Intensive Care Unit (ICU). ESBL (extended-spectrum beta-lactate) are resistant bacteria to penicillins, cephalosporins and monobactams. It´s necessary to know how often and which microorganisms are involved, checking their susceptibility. This study was carried out at the University Hospital. Data collection was performed in the Adult and Newborn ICUs, with assessment of microorganisms and their resistance profile. During six-month period, 156 samples were studied, and 42 were positive with microorganism isolation. Isolated species include Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella pneumoniae. Many resistant to carbapenem.

ESBL in Positive Hemoculture of a Southern-Brazil Teaching Hospital's Intensive Care Units As infecções da corrente sanguínea estão entre as infecções mais graves e frequentes, e os indivíduos mais expostos são os pacientes da Unidade de Terapia Intensiva (UTI). As ESBL (Beta-Lactamase de Espectro Estendido) são bactérias resistentes a penicilinas, cefalosporinas e monobactâmicos. Se faz necessário saber com que frequência e quais microrganismos estão envolvidos, verificando sua suscetibilidade. Este estudo foi realizado no Hospital Universitário. A coleta de dados foi realizada nas UTIs Adulto e Neonatal, com avaliação dos microrganismos e seu perfil de resistência. Durante o período de seis meses, foram estudadas 156 amostras, sendo 42 positivas com isolamento dos microrganismos. As espécies isoladas incluem Staphylococcus aureus, Staphylococcus epidermidis e Klebsiella pneumoniae. Muitos resistentes aos carbapenêmicos.

Resistance determinants of emerging pathogens isolated from an intensive care unit as a parameter of population health conditions of the Legal Amazon microregion / Determinantes de resistência a patógenos emergentes isolados de uma unidade de terapia intensiva como parâmetro das condições de saúde da população da microrregião da Amazônia Legal

Bacteria responsible for causing infections are common in hospital environments, water, soil, and food products. The infection risk is intensified by the absence of public sanitation, poor quality of life, and food scarcity. These external factors promote the dissemination of pathogens by direct contamination or biofilm formation. In this work, we identified bacterial isolates obtained from intensive care units in the southern region of Tocantins, Brazil. We compared matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) techniques and 16S ribosomal ribonucleic acid (rRNA) molecular analysis; we also performed phenotypic characterization. Fifty-six isolates characterized using morphotinctorial tests were classified as gram-positive (80.4%; n = 45) and gram-negative (19.6%; n = 11) and were resistant to several antibiotic classes; notably, we identified the blaOXA-23 resistance gene in the ILH10 isolate. Microbial identification using MALDI-TOF MS resulted in the identification of Sphingomonas paucimobilis and Bacillus circulans. 16S rRNA sequencing revealed four isolates belonging to the genera Bacillus and Acinetobacter. The similarity was superior to 99% for Acinetobacter schindleri in the Basic Local Alignment Search Tool (BLAST), grouped in the clade superior to 90%. Several strains isolated from intensive care units (ICU) were resistant to various antibiotic classes. These techniques allowed for the identification of several microorganisms of importance in public health, enabling improvements in human infection control and proving the quality of inputs, food, and water.

As bactérias responsáveis por causar infecções são comuns em ambientes hospitalares, água, solo e produtos alimentícios. O risco de infecção é intensificado pela ausência de saneamento público, má qualidade de vida e escassez de alimentos. Esses fatores externos promovem a disseminação de patógenos por contaminação direta ou formação de biofilme. Neste trabalho, identificamos isolados bacterianos obtidos de unidades de terapia intensiva na região sul do Tocantins, Brasil. Comparamos técnicas de espectrometria de massa de tempo de voo com ionização por dessorção a laser assistida por matriz (MALDI-TOF MS) e análise molecular de ácido ribonucleico ribossômico 16S (rRNA); também realizamos caracterização fenotípica. Cinquenta e seis isolados caracterizados por testes morfotintoriais foram classificados como gram-positivos (80,3%; n = 45) e gram-negativos (19,6%; n = 11) e foram resistentes a várias classes de antibióticos; notavelmente, identificamos o gene de resistência blaOXA-23 no isolado de ILH10. A identificação microbiana usando MALDI-TOF MS resultou na identificação de Sphingomonas paucimobilis e Bacillus circulans. O sequenciamento do 16S rRNA revelou quatro isolados pertencentes aos gêneros Bacillus e Acinetobacter. A similaridade foi superior a 99% para Acinetobacter schindleri no BLAST, agrupado no clado superior a 90%. Várias cepas isoladas de ICU foram resistentes a várias classes de antibióticos. Essas técnicas permitiram a identificação de diversos microrganismos de importância em saúde pública, possibilitando melhorias no controle de infecções humanas e comprovando a qualidade dos insumos, alimentos e água.

Non-invasive monitoring of intracranial pressure waveforms using Braincare® BCMM 2000 monitor in dogs with myelopathies undergoing myelography / Monitoramento não invasivo do formato das ondas de pressão intracraniana usando o monitor Braincare® BCMM 2000 em cães com mielopatias submetidos à mielografia

ABSTRACT: Intracranial pressure (ICP) monitoring is considered the gold standard for optimizing the treatment of humans in intensive care units. However, this procedure is not commonly performed in veterinary medicine because of the limitations and complications of the method. There are some new promising non-invasive techniques for monitoring ICP, but they have not been validated in veterinary medicine. This study aimed to correlate the non-invasive intracranial pressure (NI-ICP) waveforms obtained with the BCMM-2000 Brain4care monitor during myelography in dogs with myelopathies undergoing this exam for diagnostic purposes with the waveforms obtained through invasive monitoring of the subarachnoid pressure (SP). The NI-ICP waveform was monitored in six dogs with myelopathies before (M1), during (M2), and after (M3) contrast medium injection into the subarachnoid space. Cerebrospinal fluid (CSF) was collected before contrast injection. The SP waveform was simultaneously monitored in three of the six dogs. Correlations between the two methods were performed using Pearson's coefficient. The analysis of the morphology and amplitude of the waves at each moment was performed, and at M2, an increase in the P2:P1 ratio (p<0.05) was observed in both monitoring methods. In M3, the values were similar to those of M1, demonstrating the return of cerebral compliance. The comparison of the NI-ICP and SP had a positive correlation in those moments (Pearson's coefficient r=0.76; p=0.027). The speed of contrast administration, degree of spinal cord compression, and volume of CSF previously collected may affect P2:P1 and ICP dynamics. The BCMM-2000 Brain4care monitor was effective in detecting changes in ICP dynamics and abnormal pulse waveforms in dogs with meningoencephalitis of unknown origin, vertebral neoplasm and intervertebral disc disease with and without hemorrhagic myelomalacia, suggesting increased ICP induced by myelography.

RESUMO: A monitorização da pressão intracraniana (PIC) é considerada o padrão ouro para otimizar o tratamento de humanos em unidades de terapia intensiva, entretanto, esse procedimento não é comumente realizado na medicina veterinária devido às limitações e complicações do método. Existem algumas técnicas não invasivas promissoras de monitoramento da PIC, mas elas não foram validadas na medicina veterinária. Este estudo teve como objetivo correlacionar os formatos das ondas não invasivas da PIC (NI-PIC), obtidas com o monitor BCMM-2000 Brain4care, antes e após a injeção de meio de contraste no espaço subaracnóideo de cães com mielopatias submetidos à mielografia para fins diagnósticos, com as formas de onda obtidas por meio de monitoração invasiva da pressão subaracnóidea (PS). O formato das ondas NI-PIC foram monitoradas em seis cães com mielopatias antes (M1), durante (M2) e após (M3) injeção de meio de contraste no espaço subaracnóideo. O líquido cefalorraquidiano (LCR) foi coletado antes da injeção de contraste. A forma da onda da PS foi monitorada simultaneamente em três dos seis cães. As correlações entre os dois métodos foram feitas usando o coeficiente de Pearson. Foi realizada a análise da morfologia e amplitude das ondas em cada momento, e em M2 observou-se aumento da relação P2:P1 (p<0,05) em ambos os métodos de monitoramento. Em M3, os valores foram semelhantes aos de M1, demonstrando o retorno da complacência cerebral. A comparação do NI-PIC e PS apresentou correlação positiva nesses momentos (coeficiente de Pearson r=0,76; p=0,027). A velocidade de administração do contraste, o grau de compressão da medula espinhal e o volume de LCR coletado anteriormente podem afetar a dinâmica P2:P1 e PIC. O monitor BCMM-2000 Brain4care foi eficaz na detecção de alterações na dinâmica da PIC e dos formatos das ondas de pulso anormais em cães com meningoencefalite de origem desconhecida, neoplasia vertebral e doença do disco intervertebral com e sem mielomalácia hemorrágica, sugerindo aumento da PIC induzida pela mielografia.

Laboratory changes inherent to acute kidney injury induced by aminoglycosides in wistar rats / Alterações laboratoriais inerentes à lesão renal aguda induzida por aminoglicosídeos em ratos wistar

Acute kidney injury (AKI) is defined as an increase greater than 0.3 mg/L of serum creatinine within 48 hours and is a major cause of death in patients in intensive care units. Twenty-four Wistar rats were divided into three groups: Control (0.9% saline), Genta (gentamicin 50 mg.kg-¹ BID) and Deh+Genta (gentamicin 50 mg.kg-¹ BID + water restriction) and tested in an AKI model by aminoglycoside administration and dehydration implementation. The animals in the Deh+Genta group exhibited the lowest average weight and feed intake after the fifth day of the experiment. In this same period, water consumption by the Genta group was lower than the Control group, but in the following days of the experiment, polydipsia was noted for this group. The Deh+Genta group displayed the highest mean serum urea after the fifth day. The gentamicin-treated groups exhibited higher means than the Control group for serum creatinine, which proved to be a late renal marker for AKI. Serum GGT was higher in the Deh+Genta group, whereas urinary GGT was higher in the groups that received gentamicin, characterizing enzymuria, although severe dehydration can mask the results by indicating false negative values. The urinary GGT enzyme did not act as an early AKI biomarker. Decreased glomerular filtration rates enhanced the concentration of blood components and masked urinary and tissue components.

A lesão renal aguda (LRA) é definida como um aumento superior a 0,3 mg / L da creatinina sérica em 48 horas e é a principal causa de morte em pacientes em unidades de terapia intensiva. Vinte e quatro ratos Wistar foram divididos em três grupos: Controle (solução salina 0,9%), Genta (gentamicina 50 mg.kg-¹ BID) e Deh + Genta (gentamicina 50 mg.kg-¹ BID + restrição hídrica) e testados em um Modelo AKI por administração de aminoglicosídeos e sujeição à desidratação. Os animais do grupo Deh + Genta apresentaram o menor peso médio e o menor consumo de ração após o quinto dia de experimento. Nesse mesmo período, o consumo de água do grupo Genta foi inferior ao do grupo Controle, mas nos dias posteriores do experimento, o grupo Genta apresentou polidipsia. O grupo Deh + Genta apresentou média de uréia sérica mais elevada após o quinto dia. Os grupos tratados com gentamicina apresentaram médias superiores à do grupo Controle para a creatinina sérica, que se mostrou um marcador renal tardio de IRA. O valor de GGT sérico foi maior no grupo Deh + Genta, enquanto o valor de GGT urinário foi maior nos grupos que receberam gentamicina, caracterizando enzimúria, mas a desidratação severa pode mascarar os resultados por apresentar valores falsos negativos. A enzima GGT urinária não atuou como um biomarcador precoce de IRA. A diminuição da taxa de filtração glomerular aumentou a concentração de componentes do sangue e mascarou componentes urinários e teciduais.

Molecular epidemiology of Pseudomonas aeruginosa isolated from lower respiratory tract of ICU patients / Epidemiologia molecular de Pseudomonas aeruginosa isolada em pacientes com infecções do trato respiratório inferior admitidos em UTI

Lower respiratory tract infections (LRTIs) caused by Pseudomonas aeruginosa are the most common infection among hospitalized patients, associated with increased levels of morbidity, mortality and attributable health care costs. Increased resistant Pseudomonas worldwide has been quite meaningful to patients, especially in intensive care unit (ICUs). Different species of Pseudomonas exhibit different genetic profile and varied drug resistance. The present study determines the molecular epidemiology through DNA fingerprinting method and drug resistance of P. aeruginosa isolated from patients with LTRIs admitted in ICU. A total of 79 P. aeruginosa isolated from patients with LRTIs admitted in ICU were characterized by Restriction Fragment Length Polymorphism (RFLP), Random Amplified Polymorphic DNA (RAPD) and Repetitive Extrapalindromic PCR (REP-PCR). Antibiotic resistance was determined by minimum inhibitory concentration (MIC) assay while MDR genes, viz, blaTEM, blaOXA, blaVIM, blaCTX-M-15 were detected by polymerase chain reaction (PCR). Of the 137 Pseudomonas sp isolated from ICU patients, 57.7% of the isolates were reported to be P. aeruginosa. The overall prevalence of P. aeruginosa among the all included patients was 34.5%. The RAPD analysis yielded 45 different patterns with 72 clusters with 57% to 100% similarity level. The RFLP analysis yielded 8 different patterns with 14 clusters with 76% to 100% similarity level. The REP PCR analysis yielded 37 different patterns with 65 clusters with 56% to 100% similarity level. There was no correlation among the different DNA patterns observed between the three different methods. Predominant of the isolates (46.8%) were resistant to amikacin. Of the 79 isolates, 60.8% were positive for blaTEM gene and 39.2% were positive for blaOXA gene. P. aeruginosa was predominantly isolated from patients with LRTIs admitted in ICU. The difference in the similarity level observed between the three DNA fingerprinting methods indicates that there is high inter-strain variability. The high genetic variability and resistance patterns indicates that we should continuously monitor the trend in the prevalence and antibiotic resistance of P. aeruginosa especially in patients with LRTIs admitted in ICU.(AU)

Infecções do trato respiratório inferior (ITRIs) são as infecções mais comuns entre pacientes internados em unidade de terapia intensiva (UTI). Pseudomonas aeruginosa é a causa mais comum de ITRIs e está associada ao aumento da mortalidade. Diferentes espécies de Pseudomonas exibem diferentes perfis genéticos e resistência variada as drogas. O presente estudo determina a epidemiologia molecular através do método de fingerprinting de DNA e resistência as drogas de P. aeruginosa isoladas de pacientes com LTRIs internados em UTI. Um total de 79 P. aeruginosa isoladas de pacientes com ITRIs internados em UTI foram caracterizados por Polimorfismo de Comprimento de Fragmentos de Restrição (RFLP), DNA Polimórfico Amplificado ao Acaso (RAPD) e PCR Extrapalindrômico Repetitivo (REP-PCR). A resistência aos antibióticos foram determinadas pelos ensaios de concentrações inibitória mínima (MIC), enquanto os genes MDR, blaTEM, blaOXA, blaVIM, blaCTX-M-15 foram detectados pela reação em cadeia da polimerase (PCR). Das 137 Pseudomonas sp isoladas de pacientes de UTI, 57,7% dos isolados foram relatados como P. aeruginosa. A prevalência geral de P. aeruginosa entre os pacientes incluídos foram de 34,5%. A análise RAPD renderam 45 padrões diferentes com 72 clusters com nível de similaridade de 57% a 100%. A análise RFLP renderam 8 padrões diferentes com 14 clusters com 76% a 100% de similaridade. A análise de PCR do REP produziram 37 padrões diferentes com 65 clusters com nível de similaridade de 56% a 100%. Não houveram correlações entre os diferentes padrões de DNA observados entre os três diferentes métodos. Predominantes dos isolados (46,8%) eram resistentes à amicacina. Dos 79 isolados, 60,8% foram positivos para o gene blaTEM e 39,2% foram positivos para o gene blaOXA. P. aeruginosa foi predominantemente isolado de pacientes com ITRIs internados em UTI. A diferença no nível de similaridade observado entre os três métodos de fingerprinting do DNA indica que há alta variabilidade inter-strain. A alta variabilidade genética e os padrões de resistência indicam que devemos monitorar continuamente a tendência na prevalência e resistência a antibióticos de P. aeruginosa, especialmente em pacientes com ITRIs internados em UTI.(AU)

Molecular epidemiology of Pseudomonas aeruginosa isolated from lower respiratory tract of ICU patients / Epidemiologia molecular de Pseudomonas aeruginosa isolada em pacientes com infecções do trato respiratório inferior admitidos em UTI

Lower respiratory tract infections (LRTIs) caused by Pseudomonas aeruginosa are the most common infection among hospitalized patients, associated with increased levels of morbidity, mortality and attributable health care costs. Increased resistant Pseudomonas worldwide has been quite meaningful to patients, especially in intensive care unit (ICUs). Different species of Pseudomonas exhibit different genetic profile and varied drug resistance. The present study determines the molecular epidemiology through DNA fingerprinting method and drug resistance of P. aeruginosa isolated from patients with LTRIs admitted in ICU. A total of 79 P. aeruginosa isolated from patients with LRTIs admitted in ICU were characterized by Restriction Fragment Length Polymorphism (RFLP), Random Amplified Polymorphic DNA (RAPD) and Repetitive Extrapalindromic PCR (REP-PCR). Antibiotic resistance was determined by minimum inhibitory concentration (MIC) assay while MDR genes, viz, blaTEM, blaOXA, blaVIM, blaCTX-M-15 were detected by polymerase chain reaction (PCR). Of the 137 Pseudomonas sp isolated from ICU patients, 57.7% of the isolates were reported to be P. aeruginosa. The overall prevalence of P. aeruginosa among the all included patients was 34.5%. The RAPD analysis yielded 45 different patterns with 72 clusters with 57% to 100% similarity level. The RFLP analysis yielded 8 different patterns with 14 clusters with 76% to 100% similarity level. The REP PCR analysis yielded 37 different patterns with 65 clusters with 56% to 100% similarity level. There was no correlation among the different DNA patterns observed between the three different methods. Predominant of the isolates (46.8%) were resistant to amikacin. Of the 79 isolates, 60.8% were positive for blaTEM gene and 39.2% were positive for blaOXA gene. P. aeruginosa was predominantly isolated from patients with LRTIs admitted in ICU. The difference in the similarity level observed between the three DNA fingerprinting methods indicates that there is high inter-strain variability. The high genetic variability and resistance patterns indicates that we should continuously monitor the trend in the prevalence and antibiotic resistance of P. aeruginosa especially in patients with LRTIs admitted in ICU.

Infecções do trato respiratório inferior (ITRIs) são as infecções mais comuns entre pacientes internados em unidade de terapia intensiva (UTI). Pseudomonas aeruginosa é a causa mais comum de ITRIs e está associada ao aumento da mortalidade. Diferentes espécies de Pseudomonas exibem diferentes perfis genéticos e resistência variada as drogas. O presente estudo determina a epidemiologia molecular através do método de fingerprinting de DNA e resistência as drogas de P. aeruginosa isoladas de pacientes com LTRIs internados em UTI. Um total de 79 P. aeruginosa isoladas de pacientes com ITRIs internados em UTI foram caracterizados por Polimorfismo de Comprimento de Fragmentos de Restrição (RFLP), DNA Polimórfico Amplificado ao Acaso (RAPD) e PCR Extrapalindrômico Repetitivo (REP-PCR). A resistência aos antibióticos foram determinadas pelos ensaios de concentrações inibitória mínima (MIC), enquanto os genes MDR, blaTEM, blaOXA, blaVIM, blaCTX-M-15 foram detectados pela reação em cadeia da polimerase (PCR). Das 137 Pseudomonas sp isoladas de pacientes de UTI, 57,7% dos isolados foram relatados como P. aeruginosa. A prevalência geral de P. aeruginosa entre os pacientes incluídos foram de 34,5%. A análise RAPD renderam 45 padrões diferentes com 72 clusters com nível de similaridade de 57% a 100%. A análise RFLP renderam 8 padrões diferentes com 14 clusters com 76% a 100% de similaridade. A análise de PCR do REP produziram 37 padrões diferentes com 65 clusters com nível de similaridade de 56% a 100%. Não houveram correlações entre os diferentes padrões de DNA observados entre os três diferentes métodos. Predominantes dos isolados (46,8%) eram resistentes à amicacina. Dos 79 isolados, 60,8% foram positivos para o gene blaTEM e 39,2% foram positivos para o gene blaOXA. P. aeruginosa foi predominantemente isolado de pacientes com ITRIs internados em UTI. A diferença no nível de similaridade observado entre os três métodos de fingerprinting do DNA indica que há alta variabilidade inter-strain. A alta variabilidade genética e os padrões de resistência indicam que devemos monitorar continuamente a tendência na prevalência e resistência a antibióticos de P. aeruginosa, especialmente em pacientes com ITRIs internados em UTI.

Pediatric scorpionism in northern Amazonia: a 16-year study on epidemiological, environmental and clinical aspects

The Amazon basin is one of the seven major geographical areas where scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants are registered per year. As the severity of cases is higher in children, descriptive studies are needed to have a better understanding of this pathology. The aim of the present study is to describe pediatric scorpionism in French Guiana. Methods: We conducted a monocentric descriptive retrospective study on scorpion stings in all pediatric patients admitted to Cayenne General Hospital from January 1, 2002 to December 31, 2018. Results: In this survey, 132 patients were included. Of them, 63% were male. Patients with general signs of envenomation were younger and lighter (p = 0.04). The picture was "one sting" (95.3%) by a "big" (47.6%), "black" (60%) and "small pincer" (58%) scorpion on the extremity of the body (84%). Stings occurred mainly during the day, while patients changed clothes. There was no envenomation during night. The monthly evaluation highlights that the number of stings and percentage of general signs of envenomation were closely connected to a composite variable including the variation of the level of rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with general signs of envenomation. The presence of pulmonary; ear, nose, and throat (ENT); or gastrointestinal symptoms are related to major envenomation (p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia increased according to the envenomation grade whereas serum potassium and alkaline reserve decreased. Forty-six patients needed hospitalization and seven of them required intensive care. No patient died nor presented sequelae at discharge from the hospital. Conclusion: Pediatric scorpionism in French Guiana is closely associated with child activities and climatic conditions. Severe envenomation presented most of the time with cardiac, pulmonary, and gastrointestinal symptoms.(AU)

Pediatric scorpionism in northern Amazonia: a 16-year study on epidemiological, environmental and clinical aspects

The Amazon basin is one of the seven major geographical areas where scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants are registered per year. As the severity of cases is higher in children, descriptive studies are needed to have a better understanding of this pathology. The aim of the present study is to describe pediatric scorpionism in French Guiana. Methods: We conducted a monocentric descriptive retrospective study on scorpion stings in all pediatric patients admitted to Cayenne General Hospital from January 1, 2002 to December 31, 2018. Results: In this survey, 132 patients were included. Of them, 63% were male. Patients with general signs of envenomation were younger and lighter (p = 0.04). The picture was "one sting" (95.3%) by a "big" (47.6%), "black" (60%) and "small pincer" (58%) scorpion on the extremity of the body (84%). Stings occurred mainly during the day, while patients changed clothes. There was no envenomation during night. The monthly evaluation highlights that the number of stings and percentage of general signs of envenomation were closely connected to a composite variable including the variation of the level of rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with general signs of envenomation. The presence of pulmonary; ear, nose, and throat (ENT); or gastrointestinal symptoms are related to major envenomation (p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia increased according to the envenomation grade whereas serum potassium and alkaline reserve decreased. Forty-six patients needed hospitalization and seven of them required intensive care. No patient died nor presented sequelae at discharge from the hospital. Conclusion: Pediatric scorpionism in French Guiana is closely associated with child activities and climatic conditions. Severe envenomation presented most of the time with cardiac, pulmonary, and gastrointestinal symptoms.(AU)

Airborne fungi in an intensive care unit / Fungos anemófilos em uma unidade de terapia intensiva

The presence of airborne fungi in Intensive Care Unit (ICUs) is associated with increased nosocomial infections. The aim of this study was the isolation and identification of airborne fungi presented in an ICU from the University Hospital of Pelotas RS, with the attempt to know the places environmental microbiota. 40 Petri plates with Sabouraud Dextrose Agar were exposed to an environment of an ICU, where samples were collected in strategic places during morning and afternoon periods for ten days. Seven fungi genera were identified: Penicillium spp. (15.18%), genus with the higher frequency, followed by Aspergillus spp., Cladosporium spp., Fusarium spp., Paecelomyces spp., Curvularia spp., Alternaria spp., Zygomycetes and sterile mycelium. The most predominant fungi genus were Aspergillus spp. (13.92%) in the morning and Cladosporium spp. (13.92%) in the afternoon. Due to their involvement in different diseases, the identified fungi genera can be classified as potential pathogens of inpatients. These results reinforce the need of monitoring the environmental microorganisms with high frequency and efficiently in health institutions.(AU)

A presença de fungos anemófilos nas UTIs estão associada com o aumento de infecções nosocomiais. O objetivo deste estudo foi isolar e identificar quais os principais fungos anemófilos presentes em uma Unidade de Terapia Intensiva (UTI) de um Hospital Universitário de Pelotas RS, na tentativa de conhecer a microbiota ambiental do local. Através de 40 placas de Petri com Agar Sabouraud dextrose expostas no ambiente de UTI foram coletadas amostras por exposição em locais estratégicos durante períodos da manhã e tarde por dez dias. Sete gêneros fúngicos foram identificados: Penicillium spp. (15,18%), o gênero de maior frequência, seguido de Aspergillus spp., Cladosporium spp., Fusarium spp., Paecelomyces spp., Curvularia spp., Alternaria spp., além de Zigomicetos e micélios estéreis. Houve predomínio de Aspergillus spp. (13,92%) pela manhã e Cladosporium spp. (13,92%) a tarde. Por estarem envolvidos em diferentes enfermidades, os gêneros identificados podem ser classificados como patógenos em potencial aos pacientes internados. Estes resultados reforçam a necessidade de um monitoramento dos micro-organismos ambientais com maior freqüência e eficiência nas instituições de saúde.(AU)

Atividade in vitro do extrato etanólico de própolis e do digluconato de clorexidina sobre as espécies de Candida isoladas da mucosa bucal de pacientes internados em Unidade de Terapia Intensiva (UTI) / In vitro activity of ethanolic extract of propolis and chlorhexidine digluconate on Candida species isolated from the oral mucosa of patients hospitalized in the Intensive Care Unit (ICU)

Avaliou-se a atividade dos extratos de própolis e digluconato de clorexidina em Candida sp isoladas da mucosa bucal de pacientes em UTI. Foram determinadas as concentrações fungicidas mínimas (CFM) e comparadas, nas doses sub-inibitórias, à produção de exoenzimas proteinase e fosfolipase e formação de franjas. Em 72 isolados foram avaliadas a atividade antifúngica pela técnica de microdiluição em série, na “base 2”, a produção das exoenzimas proteinase e fosfolipase, e a formação de franjas, antes e após a exposição às própolis e clorexidina. Dos 72 isolados, 53 eram C. albicans, 11 C. tropicalis, quatro C. guilhermondii e quatro sugestivas de C. dubliniensis. CFM 90% do extrato de própolis foi de 5% para C. albicans, 20% C. tropicalis, 0,625% C. guilhermondii e 0,312% sugestivas de C. dubliniensis. CFM 90% da clorexidina foi de 0,0018% para C. albicans, 0,012% C. tropicalis, de 0,0018% C. guilhermondii e de 0,00375% sugestivas de C. dubliniensis. Ocorreu inibição das exoenzimas e franjas, em ambos os produtos. Apesar da inibição da clorexidina ser menor que a da própolis, seu uso diário não causa efeitos colaterais indesejáveis como manchas nos dentes e na língua, perda do paladar e sensação de queimação na mucosa bucal.

The activity of propolis extract and chlorhexidine digluconate on Candida sp isolated from oral mucosa of patients in ICU was evaluated. The minimum fungicidal concentrations (MFC) were determined, and also the production of proteinase and phospholipase exoenzymes and the fringe formation. Seventy-two isolates were used and identified by the API 20C AUX® System. The antifungal activity was evaluated by “at base 2” serial microdilution technique. Also the exoenzymes production (proteinase and phospholipase), the fringes formation, before and after being exposed to propolis and chlorhexidine, were analysed. Of 72 isolates, 53 were C. albicans, 11 C. tropicalis, four C. guilhermondii and four suggestive C. dubliniensis. The MFC 90% of propolis extract was 5% C. albicans, 20% C. tropicalis, 0.625% C. guilhermondii; and 0.312% suggestive of C. dubliniensis. MFC 90% of chlorhexidine was 0.0018% C. albicans, 0.012% C. tropicalis, 0.0018% C. guilhermondii and 0.00375% suggestive of C. dubliniensis. The inhibition of exoenzymes and fringes occurred in the both products. Although the inhibition of chlorhexidine is lower than that showed by propolis, its daily use neither cause undesirable side effects as blemishes on the teeth and tongue, nor the loss of the taste and the burning sensation in the oral mucosa.

Atividade in vitro do extrato etanólico de própolis e do digluconato de clorexidina sobre as espécies de Candida isoladas da mucosa bucal de pacientes internados em Unidade de Terapia Intensiva (UTI) / In vitro activity of ethanolic extract of propolis and chlorhexidine digluconate on Candida species isolated from the oral mucosa of patients hospitalized in the Intensive Care Unit (ICU)

Avaliou-se a atividade dos extratos de própolis e digluconato de clorexidina em Candida sp isoladas da mucosa bucal de pacientes em UTI. Foram determinadas as concentrações fungicidas mínimas (CFM) e comparadas, nas doses sub-inibitórias, à produção de exoenzimas proteinase e fosfolipase e formação de franjas. Em 72 isolados foram avaliadas a atividade antifúngica pela técnica de microdiluição em série, na “base 2”, a produção das exoenzimas proteinase e fosfolipase, e a formação de franjas, antes e após a exposição às própolis e clorexidina. Dos 72 isolados, 53 eram C. albicans, 11 C. tropicalis, quatro C. guilhermondii e quatro sugestivas de C. dubliniensis. CFM 90% do extrato de própolis foi de 5% para C. albicans, 20% C. tropicalis, 0,625% C. guilhermondii e 0,312% sugestivas de C. dubliniensis. CFM 90% da clorexidina foi de 0,0018% para C. albicans, 0,012% C. tropicalis, de 0,0018% C. guilhermondii e de 0,00375% sugestivas de C. dubliniensis. Ocorreu inibição das exoenzimas e franjas, em ambos os produtos. Apesar da inibição da clorexidina ser menor que a da própolis, seu uso diário não causa efeitos colaterais indesejáveis como manchas nos dentes e na língua, perda do paladar e sensação de queimação na mucosa bucal.(AU)

The activity of propolis extract and chlorhexidine digluconate on Candida sp isolated from oral mucosa of patients in ICU was evaluated. The minimum fungicidal concentrations (MFC) were determined, and also the production of proteinase and phospholipase exoenzymes and the fringe formation. Seventy-two isolates were used and identified by the API 20C AUX® System. The antifungal activity was evaluated by “at base 2” serial microdilution technique. Also the exoenzymes production (proteinase and phospholipase), the fringes formation, before and after being exposed to propolis and chlorhexidine, were analysed. Of 72 isolates, 53 were C. albicans, 11 C. tropicalis, four C. guilhermondii and four suggestive C. dubliniensis. The MFC 90% of propolis extract was 5% C. albicans, 20% C. tropicalis, 0.625% C. guilhermondii; and 0.312% suggestive of C. dubliniensis. MFC 90% of chlorhexidine was 0.0018% C. albicans, 0.012% C. tropicalis, 0.0018% C. guilhermondii and 0.00375% suggestive of C. dubliniensis. The inhibition of exoenzymes and fringes occurred in the both products. Although the inhibition of chlorhexidine is lower than that showed by propolis, its daily use neither cause undesirable side effects as blemishes on the teeth and tongue, nor the loss of the taste and the burning sensation in the oral mucosa.(AU)

DIVERSIDADE E ANÁLISE DE RISCO DA PRESENÇA DE FUNGOS FILAMENTOSOS ISOLADOS EM OBJETOS DE UM HOSPITAL LOCALIZADO NO NORTE DO ESTADO DO TOCANTINS

Um dos grandes problemas da saúde pública são as Infecções Relacionadas à Assistência à Saúde (IRAS). A entrada e permanência de indivíduos em instituições de saúde o expõe à uma multiplicidade de microrganismos patogênicos, especialmente em hospitais, o que pode agravar o estado do paciente possibilitando uma infecção cruzada por esses microrganismos. A frequência de infecções causadas por fungos, aumentou consideravelmente e vários fatores contribuíram para este aumento como a invasão e a proliferação de fungos a sistemas biológicos em ambientes hospitalares, se tornando um assunto de grande importância em saúde pública. Uma das formas para manter o ambiente hospitalar seguro e ter controle da contaminação ambiental, é por meio da limpeza das unidades hospitalares, seguindo protocolos e padronizações de produtos higiênicos sanitários. Assim sendo, o objetivo deste trabalho foi verificar a diversidade e análise de risco por meio da identificação de fungos isolados de objetos antes a após o procedimento operacional padrão (POP) de higienização e desinfecção de uma unidade hospitalar pública localizada no Norte do Tocantins. Foram coletadas, no total, 48 amostras oriundas de oito objetos de cada ambiente pesquisado: pronto atendimento (PA), enfermaria e unidade semi-intensiva. A coleta foi realizada em dois momentos, antes e após os procedimentos de higienização e limpeza do local, no período de fevereiro a maio de 2021. As identificações microbiológicas foram realizadas pela associação das características macroscópicas dos fungos cultivados em placa de Petri e microscópicas, por meio da técnica de microcultivo em lâmina. Houve crescimento de fungos filamentosos em todas as amostras analisadas tanto antes quanto após a higienização do ambiente, totalizando 191 Unidades Formadoras de Colônias (UFC) sendo identificado o gênero de 179 UFC. Os objetos pertencentes ao pronto atendimento foram os mais contaminados, seguidos pelos da unidade semi-intensiva e os menos contaminados foram os da enfermaria com porcentagens de 40%, 34,% e 26% do total de fungos respectivamente, porém não houve diferença estatística significativa. Foram isolados vários fungos pertencentes a 13 gêneros que possuem representantes patogênicos, tanto antes quanto após a limpeza, sendo: Acremonium, Alternaria, Aspergillus, Cladosporium, Curvularia, Fusarium, Geotrichum, Microsporum, Paecilomyces, Penicillum, Rhizopus, Sporothrix e Trichophyton. Não houve diferença estatística significativa entre os tratamentos pressupostos antes e após limpeza segundo o teste Student t (p=0.3435). Conforme os cálculos de diversidade alfa, a diversidade e uniformidade foi maior no pronto atendimento (1-D = 0,8370 e H = 2,0090) e a riqueza das espécies fúngicas foi maior na enfermaria (DMg = 2,8120). Os gêneros de maior frequência foram Aspergillus (32,0%), Penicillium (22,0%) e Cladosporium (17,0%). O objeto telefone da unidade semi-intensiva, foi o mais contaminado dentre todos os amostrados antes e após a limpeza com 10 UFC cada amostra. Conclui-se que, o ambiente hospitalar pesquisado apresenta grande quantidade de fungos ambientais e sugere-se que medidas de controle e monitoramento devem ser reforçadas pelas equipes de controle de infecção hospitalar para evitar que os microrganismos permaneçam no ambiente hospitalar e causem infecções cruzadas acometendo principalmente pacientes imunossuprimidos nos pacientes do referido hospital.

One of the major public health problems is Health Care Related Infections (HAI). The entry and permanence of applicants in health institutions exposes them to a multiplicity of pathogenic microorganisms, especially in hospitals, which can aggravate the patient's condition, enabling cross-infection by these microorganisms. The frequency of infections caused by fungi has increased considerably and several factors have contributed to this increase, such as the invasion and proliferation of fungi into biological systems in hospital environments, making it a matter of great importance in public health. One of the ways to keep the hospital environment safe and control environmental contamination is by cleaning the hospital units, following protocols and standards for hygienic sanitary products. Therefore, the objective of this work was to verify the diversity and risk analysis through the identification of public fungi obtaining objects before and after the standard operating procedure (SOP) of cleaning and disinfection of a hospital located in the North of Tocantins. A total of 48 were collected from eight objects from each researched environment: emergency care (ER), infirmary and semi-intensive unit. The collection was carried out in two moments, before and after the sanitation and cleaning procedures of the place, in the period from February to May 2021. The microbiological identifications were carried out by the association of the macroscopic characteristics of the fungi cultivated in Petri dishes and microscopic, by using the slide microculture technique. Fungi were preserved using the Castellani technique. There was growth of filamentous fungi in all analyzed both before and after cleaning the environment, totaling 191 Colony Forming Units (CFU) and the genus of 179 CFU was identified. The objects belonging to the emergency room were the most contaminated, followed by those from the semi-intensive unit and the least contaminated were those from the ward with percentages of 40%, 34.% and 26% of the total of fungi, respectively, but there was no statistical difference significant. Several fungi belonging to genera that have pathogenic representatives were isolated, both before and after cleaning, totaling 13 being: Acremonium, Alternaria, Aspergillus, Cladosporium, Curvularia, Fusarium, Geotrichum, Microsporum, Paecilomyces, Penicillum, Rhizopus, Sporothryx and Trichophyton. There was no statistically significant difference between the treatments assumed before and after cleaning according to the student t test (p=0.3435). According to alpha diversity calculations, diversity and uniformity were higher in the emergency room (1-D = 0.8370 and H = 2.0090) and fungal species richness was higher in the ward (DMg = 2.8120). The most frequent genera were Aspergillus (32.0%), Penicillium (22.0%) and Cladosporium (17.0%). The object telephone in the semi-intensive unit was the most contaminated among all those sampled before and after cleaning with 10 CFU each sample. It is concluded that the hospital environment surveyed has a large amount of environmental fungi and it is suggested that control and monitoring measures should be reinforced by the hospital infection control teams to prevent microorganisms from remaining in the hospital environment and causing cross infections to affect mainly immunosuppressed patients in the patients of that hospital.

Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates

Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR) K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs) at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL) producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38) and class II integrons (10/38). All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX and aadA1 genes. β-lactam resistance was conferred through bla_SHV (22/38), bla_TEM (10/38), and bla_CTX-M (7/38). The highly conserved bla_KPC-2 (37/38) and bla_OXA-23(1/38) alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38) and the plasmid-mediated qnrB gene (13/38) were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR) fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. ...(AU)

Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates

Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR) K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs) at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL) producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38) and class II integrons (10/38). All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX’ and aadA1 genes. β-lactam resistance was conferred through blaSHV (22/38), blaTEM (10/38), and blaCTX-M (7/38). The highly conserved blaKPC-2 (37/38) and blaOXA-23(1/38) alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38) and the plasmid-mediated qnrB gene (13/38) were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR) fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. ...

Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt

Vancomycin resistant Enterococcus faecium (VREF) ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs) of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs), and fulfilled the healthcare-associated infection (HAI) criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE). Out of 52 E. faecium isolates, 12 (23.1%) were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs); however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients..(AU)

ESTUDO DA ATIVIDADE ANTI-ESTAFILOCÓCICA E ANÁLISE DE TOXICIDADE DE EXTRATOS VEGETAIS BIOATIVOS.

O patógeno Staphyloccocus aureus dispõem da capacidade de disseminar infecções tanto na medicina humana e veterinária, particularmente as nosocomiais, cujas estirpes virulentas e resistentes a antimicrobianos são responsáveis por índices elevados de mortalidade em unidades de terapia intensivas. Extratos de espécies vegetais são uma abundante fonte de novos medicamentos a serem introduzidos na terapêutica antimicrobiana. Os extratos aquosos e orgânico oriundos de plantas da flora Amazônica e Mata Atlântica foram submetidos a testes de suscetibilidade antimicrobiana pelo método de disco difusão em ágar. Os extratos vegetais que apresentaram halo de inibição, foram selecionados como ativos frente ao Staphylococcus aureus, sujeitados posteriormente á análise de concentração bactericida mínima, seguido de análise em bioautografia e ensaios de toxicidade em Artemia salina. Os resultados obtidos na triagem através da suscetibilidade antimicrobiana pelo disco difusão em ágar dos 2236 extratos vegetais, foram de 73 extratos devidamente confirmados em triplicata, sequentemente concentração bactericida mínima e bioautografia unidimensional e bidimensional. A partir da análise em bioautografia, somente 51 extratos mantiveram a atividade, e destes, 26 apresentaram toxicidade contra artêmia acima de 1 mg/mL e foram considerados de baixa toxicidade. Estes extratos mostraram-se fontes potenciais de identificação de moléculas antibacterianas. Por meio dos resultados é possível visualizar o quanto os extratos vegetais estudados podem ser fonte para o desenvolvimento de novos fármacos no tratamento contra o Staphylococcus aureus e estires resistentes.

Introduction The pathogen Staphyloccocus aureus has the ability to spread infections in both human and veterinary medicine, particularly nosocomial ones, whose virulent and antimicrobial resistant strains are responsible for high mortality rates in intensive care units. Plant species extracts are an abundant source of new drugs to be introduced in antimicrobial therapy. The aqueous and organic extracts from plants of the Amazon and Atlantic Forest were subjected to antimicrobial susceptibility tests by the agar diffusion disc method. The plant extracts that presented a halo of inhibition were selected as active against Staphylococcus aureus, which were subsequently subjected to the analysis of minimum bactericidal concentration, followed by analysis in bioautography and toxicity tests on Artemia salina. The results obtained in the screening through antimicrobial susceptibility by the agar diffusion disc of the 2236 plant extracts, were 73 extracts duly confirmed in triplicate, sequentially minimum bactericidal concentration and one-dimensional and two-dimensional bioautography. From the bioautography analysis, only 51 extracts maintained their activity, and of these, 26 presented toxicity against artemia above 1 mg / mL and were considered to be of low toxicity. These extracts proved to be potential sources of identification of antibacterial molecules. Through the results it is possible to visualize how much the plant extracts studied can be a source for the development of new drugs in the treatment against Staphylococcus aureus and resistant strains.

Synergistic effects of sulbactam in multi-drug-resistant Acinetobacter baumannii

Abstract Acinetobacter baumannii is a frequently isolated etiologic agent of nosocomial infections, especially in intensive care units. With the increase in multi-drug resistance of A. baumannii isolates, finding appropriate treatment alternatives for infections caused by these bacteria has become more difficult, and available alternate treatments include the use of older antibiotics such as colistin or a combination of antibiotics. The current study aimed to evaluate the in vitro efficacy of various antibiotic combinations against multi-drug resistant A. baumannii strains. Thirty multi-drug and carbapenem resistant A. baumannii strains isolated at the Ankara Training and Research Hospital between June 2011 and June 2012 were used in the study. Antibiotic susceptibility tests and species-level identification were performed using conventional methods and the VITEK 2 system. The effects of meropenem, ciprofloxacin, amikacin, tigecycline, and colistin alone and in combination with sulbactam against the isolates were studied using Etest (bioMérieux) in Mueller-Hinton agar medium. Fractional inhibitory concentration index (FIC) was used to determine the efficacy of the various combinations. While all combinations showed a predominant indifferent effect, a synergistic effect was also observed in 4 of the 5 combinations. Synergy was demonstrated in 43% of the isolates with the meropenem-sulbactam combination, in 27% of the isolates with tigecycline-sulbactam, and in 17% of the isolates with colistin-sulbactam and amikacin-sulbactam. No synergy was detected with the sulbactam-ciprofloxacin combination and antagonism was detected only in the sulbactam-colistin combination (6.66% of the isolates). Antibiotic combinations can be used as an alternative treatment approach in multi-drug resistant A. baumannii infections.(AU)

OCORRÊNCIA DE MALASSEZIA PACHYDERMATIS NO MICROBIOMA CUTÂNEO DE TUTORES DE CÃES COM MALASSEZIOSE E PESSOAS QUE NÃO CONVIVEM COM ANIMAIS

Malassezia spp. são leveduras que compõem o microbioma cutâneo de animais e do homem, podendo eventualmente causar infecções. Em cães, as infecções são particularmente associadas a M. pachydermatis, que é zoofílica e não lipodependente. Embora a malasseziose não seja considerada zoonose, se aventou a possibilidade da transmissão da doença a neonatos por profissionais de Unidades de Terapia Intensiva (UTIs) que possuíam cães. Há poucos estudos sobre a ocorrência de intercâmbio de espécies de Malassezia entre animais e homens que mantenham contato estreito. O objetivo deste trabalho foi isolar espécies de Malassezia em cães com otite e/ou dermatite, verificando-se a relação com as espécies encontradas no tutor. Foram estudados 18 cães com sinais condizentes com a infecção, dos quais foram colhidas amostras de conduto auditivo e pelame. De seu tutor, foram colhidas três amostras clínicas, da região superior do tronco, retroauricular e couro cabeludo. Em paralelo, foram colhidas amostras clínicas das mesmas regiões de 24 pessoas que não mantinham contato com animais (não-tutores). As amostras foram isoladas em meio de Dixon modificado e a identificação fenotípica realizada por macro e micromorfologia e provas bioquímicas. Após extração do DNA, o gene 26S rDNA foi amplificado através de PCR. Isolou-se Malassezia spp. em 77,8% (14/18) dos cães com sinais clínicos condizentes com malasseziose. Não se verificou predileção por sexo ou faixa etária. Malassezia spp. foram verificadas em porcentagens similares em pessoas que conviviam e que não conviviam com cães, respectivamente, 78,6% (11/14) e 83,3% (20/24). Malassezia pachydermatis foi a espécie mais prevalente em cães, sendo verificada em 95,7% (22/23) dos isolados. Em relação às pessoas, M. pachydermatis foi a espécie mais frequente no microbioma cutâneo dos tutores e representou 66,7%% (10/15) das cepas isoladas nas amostras clínicas, e Malassezia lipodependente 33,3% (5/15). Malassezia pachydermatis foi isolada dos três sítios amostrados, couro cabeludo, tronco superior e região retroauricular. Quanto aos indivíduos que não conviviam com cães, M. pachydermatis não foi isolada, verificando-se apenas Malassezia lipodependentes. Estatisticamente o fator convivência com cães influenciou na presença de M. pachydermatis, espécie considerada zoofílica, no microbioma cutâneo dos tutores (p<0.05). Os resultados obtidos nesta pesquisa comprovam que há alteração no microbioma cutâneo das espécies de Malassezia em pessoas que convivem com cães com malasseziose.

Malassezia spp. represent a type of yeasts occurring in the cutaneous microbiome of animals and humans, and may eventually cause infections. In dogs, infections are particularly associated with M. pachydermatis, which is zoophilic and not lipodependent. Although malasseziosis is not considered a zoonosis, the possibility of transmission of the disease to neonates by professionals from Intensive Care Units (ICUs) who had dogs was suggested. There are a few studies on the occurrence of exchange of Malassezia species between animals and men those are in close contact. The aim of this study was to isolate Malassezia spp. in dogs with otitis and/or dermatitis and to establish the relationship between the species found and their owners. Eighteen dogs with the signs suggestive of infection were studied. Of them, samples from the ear canal and haircoat were collected. From their owners, three clinical samples were collected from the upper trunk, retroauricular area, and scalp. Clinical samples were collected from the same areas from 24 people who did not have contact with animals (not-tutor). The samples were seeded on modified Dixons medium and phenotypic identification was performed by analysis of macro- and micromorphology and biochemical tests. After DNA extraction, the 26S rDNA gene was amplified by PCR. Malassezia spp. were isolated in 77.8% (14/18) of dogs with clinical signs consistent with malasseziosis. There was no predilection for gender or age. Malassezia spp. were verified in similar percentages, as 78.6% (11/14) and 83.3% (20/24), in people who lived and those who did not live with dogs, respectively. Malassezia pachydermatis was the most prevalent species in dogs and was verified in 95.7% (22/23) of the isolates. It was also the most frequent species in the cutaneous microbiome of the dog owners and represented 66.7% (10/15) of the isolates, while lipodependent Malassezia spp. represented 33.3% (5/15). M. pachydermatis was isolated from the three sampled sites: scalp, upper trunk and retroauricular region. As for individuals who did not live with dogs, M. pachydermatis was not isolated, and they showed only lipodependent Malassezia. Statistically, living with dogs influenced the presence of M. pachydermatis, a species considered zoophilic, in the cutaneous microbiome of the owners (p<0.05). The results obtained in this research reinforce an alteration in Malassezia species in the cutaneous microbiome of people living with dogs showing malasseziosis.

El cobre como superficie de contacto antimicrobiana y su potencial aplicación en la Medicina Veterinária / The copper as an antimicrobial touch surface and its potential application in Veterinary Medicine / O cobre como superfície de contato antimicrobiana e sua potencial aplicação na medicina veterinária

El cobre metálico ha atraído atención desde 2008, cuando casi 300 aleaciones fueron registradas por la agencia estadounidense Environmental Protection Agency (EPA) como superficies de contacto antimicrobianas. Escherichia coli O157: H7; Staphylococcus aureus meticilina resistente (MRSA); Clostridium difficile; Salmonella enterica; Campylobacter jejuni; Listeria monocytogenes; Candida albicans e Influenza A (H1N1) están entre los microorganismos comprobadamente inactivados por el cobre. Ensayos hospitalarios demostraron una reducción de 58% de las infecciones nosocomiales en pacientes de Unidades de Cuidados Intensivos (UCI) en habitaciones equipadas con superficies de cobre. El presente trabajo tuvo por objetivo evaluar la posibilidad de introducir esas superficies en diversas áreas de la veterinaria a través de una revisión bibliográfica de los principales estudios realizados a respecto del cobre y de sus aleaciones. Con base en las propiedades bactericidas, fungicidas y virucidas encontradas, se puede inferir la cantidad de beneficios que el cobre puede traer a la medicina veterinaria tanto en la producción animal como en seguridad de los alimentos y la salud pública. La aplicación de las superficies antimicrobianas podrá resultar en menores tasas de infecciones y menor uso de antibióticos, reducción de costos con tratamiento, mejor desempeño zootécnico y reducción de la transmisión de zoonosis.(AU)

The metallic copper has attracted attention since 2008, when nearly 300 alloys were registered by the Environmental Protection Agency (EPA) as antimicrobial touch surfaces. Escherichia coli O157:H7; Staphylococcus aureus methicillin-resistant (MRSA); Clostridium difficile; Salmonella enterica; Campylobacter jejuni; Listeria monocytogenes; Candida albicans and Influenza A (H1N1) have proven to be inactivated by copper. Hospital assays showed a 58% reduction of nosocomial infections in intensive care units (ICU) in rooms with copper surfaces. This study aimed to assess the possibility of introducing these surfaces in various areas of veterinary medicine through a review of major studies with regard to copper and its alloys. Based on the bactericidal, fungicide and virucide properties found, it can be inferred that the amount of benefits that copper may bring to veterinary medicine, regarding livestock as well as for food safety and public health. The application of antimicrobial surfaces could result in lower rates of infections and less antibiotic use, reduce treatment costs, better production performance and reducing transmission of zoonosis.(AU)

O cobre metálico tem atraído atenção desde 2008, quando quase 300 ligas foram registrada pela agência norte-americana Environmental Protection Agency (EPA) como superfícies de contato antimicrobianas. Escherichia coli O157:H7; Staphylococcus aureus meticilina-resistente (MRSA); Clostridium difficile; Salmonella enterica; Campylobacter jejuni; Listeria monocytogenes; Candida albicans e Influenza A (H1N1) estão entre os microrganismos comprovadamente inativados pelo cobre. Ensaios hospitalares demonstraram uma redução de 58% das infecções nosocomiais em pacientes de Unidades de Terapia Intensiva (UTI) em quartos equipados com superfícies de cobre. O objetivo do trabalho foi avaliar a possibilidade da introdução dessas superfícies nas diversas áreas da veterinária através de uma revisão bibliográfica dos principais estudos realizados a respeito do cobre e de suas ligas. Com base nas propriedades bactericidas, fungicidas e virucidas encontradas, pode-se inferir a quantidade de benefícios que o cobre pode trazer à medicina veterinária, tanto na produção animal, quanto em segurança dos alimentos e saúde pública. A aplicação das superfícies antimicrobianas poderá resultar em menores taxas de infecções e menor uso de antibióticos, redução de custos com tratamento, melhor desempenho zootécnico e redução da transmissão de zoonoses.(AU)

Estudo da incidência de SIRS, sepse, sepse grave e choque séptico, diagnosticados no atendimento de emergência em cães hospitalizados com gastroenterite / Study of the incidence of SIRS, sepsis, severe sepsis and septic shock diagnosed in the emergency room care of hospitalized dogs with gastroenteritis

A sepse é hoje, reconhecidamente, uma das principais causasde mortalidade e de elevados custos nas unidades de terapiaintensiva de todo o mundo. Diversas são as alterações que agastroenterite, em especial a causada pela parvovirose, podemcausar nos parâmetros fisiológicos do paciente acometido, taisquais nos perfis hematológico e bioquímico, como também nahemodinâmica, verificada na maioria das vezes em casos desepse grave e choque séptico. Este estudo teve por objetivoavaliar a frequência de SIRS, sepse, sepse grave e choque sépticoem 50 cães com gastroenterite, atendidos na sala de urgência, eposterior necessidade de hospitalização para cuidados intensivos.Dos pacientes, apenas 10% não se enquadraram em algumadas classificações, e dos demais, a maior frequência observadafoi de sepse grave, uma vez que 66% dos pacientes foramclassificados nesta categoria. Com os resultados obtidos, concluiseque diversas são as alterações fisiológicas e metabólicas quecães com gastroenterite podem apresentar, levando-os a quadrosinflamatórios sistêmicos, infecciosos ou não, e agravados pordisfunções orgânicas.

Sepsis is recognized as a major cause of mortality and highcosts in intensive care units around the world. There are severalchanges that gastroenteritis, especially that caused by parvovirus,can cause in the physiological parameters of patients affected,such that the hematological and biochemical profiles, as well asin hemodynamics, observed most often in cases of severe sepsisand septic shock. This study aimed to evaluate the frequencyof SIRS, sepsis, severe sepsis and septic shock in 50 dogs withgastroenteritis treated in the emergency room, and later requiredhospitalization for intensive care. Only 10% of patients didnot fit into any of the classifications, and about the rest, thegreater frequency was of severe sepsis, since 66% of patientswere classified in this category. With the obtained results, it isconcluded that there are several physiological and metabolicchanges that occur in dogs with gastroenteritis, leading themto systemic inflammatory conditions, infectious or not, andaggravated by organ dysfunction.