ABSTRACT
Sewage sludge (SS) presents a high agronomic potential due to high concentrations of organic matter and nutrients, encouraging its recycling as a soil conditioner. However, the presence of toxic substances can preclude this use. To enable the safe disposal of this waste in agriculture, SS requires additional detoxification to decrease the environmental risks of this practice. Although some alternatives have been proposed in this sense, little attention is provided to eliminating endocrine-disrupting chemicals (EDCs). To fill this gap, this study aimed to develop effective and low-cost technology to eliminate EDCs from SS. For this, a detoxification process combining microorganisms and biostimulating agents (soil, sugarcane bagasse, and coffee grounds) was performed for 2, 4, and 6 months with aerobic and anaerobic SSs. The (anti-)estrogenic, (anti-)androgenic, retinoic-like, and dioxin-like activities of SSs samples were verified using yeast-based reporter-gene assays to prove the effectiveness of the treatments. A fractionation procedure of samples, dividing the target sample extract into several fractions according to their polarity, was conducted to decrease the matrix complexity and facilitate the identification of EDCs. A decrease in the abundance and microbial diversity of the SS samples was noted along the biostimulation with the predominance of filamentous fungal species over yeasts and gram-positive bacteria and non-fermenting rods over enterobacteria. Among the 9 EDCs quantified by LC-ESI-MS/MS, triclosan and alkylphenols presented the highest concentrations in both SS. Before detoxification, the studied SSs induced significant agonistic activity, especially at the human estrogen receptor α (hERα) and the human aryl hydrocarbon receptor (AhR). The raw anaerobic sludge also activated the androgen (hAR), retinoic acid (RARα), and retinoid X (RXRα) receptors. However, no significant endocrine-disrupting activities were observed after the SS detoxification, showing that the technology applied here efficiently eliminates receptor-mediated toxicity.
Subject(s)
Endocrine Disruptors , Saccharum , Water Pollutants, Chemical , Humans , Sewage/chemistry , Cellulose , Tandem Mass Spectrometry , Cost-Benefit Analysis , Water Pollutants, Chemical/chemistry , Endocrine Disruptors/analysis , SoilABSTRACT
Among the treatment-related acute toxic effects, risks for bloodstream infections (BSIs) are associated with several variables. The authors carried out a retrospective cohort study with 259 children and adolescents with ALL, treated with the GBTLI-LLA 2009 protocol, in order to assess the incidence of BSIs in the induction phase; to determine the risk factors for these BSIs; and to identify the related microorganisms and sensitivity profile of the microorganisms related to these infections. BSIs were documented in 19.3% of patients. The isolated microorganisms were 39 Gram-negative bacteria, 21 Gram-positive bacteria, and four fungi. There was a statistically significant risk of BSI between the variables: protocol for T-line-derived leukemia (Derived T Protocol) (p = 0.020), oral manifestations (p = 0.015), central venous catheter (p = 0.008), and bladder catheter (p = 0.004). BSI is a frequent event in ALL patients during the induction phase. The identification of these factors can allow the elaboration and improvement of strategies for the intensification of supportive care, prevention, and rapid treatment of infections.
Subject(s)
Bacteremia , Catheter-Related Infections , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Sepsis , Adolescent , Bacteremia/epidemiology , Bacteremia/etiology , Catheter-Related Infections/epidemiology , Child , Humans , Incidence , Induction Chemotherapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Retrospective Studies , Risk FactorsABSTRACT
Wastewater reuse is an important strategy for water resource management. For this reason, the disinfection process must be appropriated, eliminating pathogenic microorganisms. Ozonation (O3) and UV/H2O2 treatments can be used for effluent disinfection, but few studies just address the Escherichia coli quantification. In this study, secondary effluents from two wastewater treatment plants with different characteristics were exposed to O3 (5 and 10 mg L-1) or UV/H2O2 (H2O2: 90 mg L-1) treatments and evaluated by BD Phoenix ™ 100 (Becton Dickinson, USA) and MALDI-TOF for the characterization of the indigenous microorganisms in the effluents, before and after treatments. Additionally, all the samples were tested for phytotoxicity by Lactuca sativa bioassay. The results showed that the highest ozone dose and the UV/H2O2 treatment were effective in removing E. coli. UV/H2O2 was more efficient as it eliminated most of the microorganisms. Acinetobacter sp., Aeromonas and Pseudomonas were still found after O3 treatment. Bacillus sp. was found after O3 and UV/H2O2 treatments. The results with L. sativa showed inhibition of root growth for all dry period (low rainfall) samples of one of the WWTP, due to the high concentration of the phytotoxicity compounds. For environmental and human health safety, treated effluents should be evaluated for their toxic and pathogenic potential before being released into the environment. Pathogens evaluation on treated effluents should cover a wider range of pathogenic microorganisms than those routinely required by legislation.
Subject(s)
Ozone , Water Pollutants, Chemical , Water Purification , Bacteria , Escherichia coli , Humans , Hydrogen Peroxide , Oxidation-Reduction , Ultraviolet Rays , Wastewater/analysis , Water Purification/methodsABSTRACT
PURPOSE: To propose a new coating to silicone implants using Manganese dioxide. We present bacterial adhesion and proliferation when implants are challenged with Escherichia coli. METHODS: Coated and control silicon implants were placed in two independent subcutaneous pouches in the dorsum of Wistar rats. After skin closure, 0.5 ml of E. coli solution was injected in each incision. The animals were euthanized at 7 and 28 days. Extracted material was cultured and analyzed by confocal microscopy. RESULTS: At 1 week, uncoated implants had a 17-fold higher infection rate (p < 0.001). Coated samples showed a mean bacterial count of 28,700 CFU/ml, while the control ones 503,000 CFU/ml, with a significant mean difference of 474,300 CFU/ml (95% CI 165,900-782,600). At 4 weeks, the mean bacterial growth in coated group was 7600; while in control one was 53,890. The mean difference between groups was 46,200 (95% CI 21,100-71,400). Confocal microscopy presented the percentage of implant's surface with attached bacteria: at 7 days, coated implants had 6.85% and controls 10.9% and the difference was not significant (p =0.32). At 4 weeks, the coated group showed 0.98% of the surface with attached bacteria, while control group showed 7.64%, which resulted in a significant 11-fold difference (p = 0.004). CONCLUSIONS: Manganese dioxide coating inhibits bacterial proliferation and adhesion in subcutaneous silicon implants in an animal model. These findings can be useful to improve development of biomaterials.
Subject(s)
Bacterial Adhesion/drug effects , Escherichia coli/drug effects , Manganese Compounds/pharmacology , Oxides/pharmacology , Prostheses and Implants/microbiology , Prosthesis-Related Infections/prevention & control , Silicones , Animals , Bacterial Load/drug effects , Coated Materials, Biocompatible , Escherichia coli Infections/prevention & control , Microscopy, Confocal , Rats , Rats, WistarABSTRACT
Our aim was to identify less common non-fermenting gram-negative rods during the bioremediation process. Five genera were found: Advenella, Castellaniella, Kaistia, Pusillimonas and Sphingobacterium, for a total of 15 isolates. Therefore, we evaluated the applicability of four methods currently available for bacteria identification: (1) conventional biochemical methods, (2) the VITEK®-2 system, (3) MALDI-TOF mass spectrometry and (4) 16S rRNA gene sequencing. The biochemical methods and the VITEK®-2 system were reliable only for the Sphingobacterium isolate and solely at the genus level. Both MALDI-TOF mass spectrometry platforms (Bruker and VITEK® MS) did not achieve reliable identification results for any of these genera. 16S rRNA gene sequencing identified eight isolates to the species level but not to the subspecies level, when applicable. The remaining seven isolates were reliably identified through 16S rRNA gene sequencing to the genus level only. Our findings suggest that the detection and identification of less common genera (and species) that appeared at certain moments during the bioremediation process can be a challenge to microbiologists considering the most used techniques. In addition, more studies are required to confirm our results.
Subject(s)
Alcaligenaceae/genetics , Rhizobiaceae/genetics , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Sphingobacterium/genetics , Alcaligenaceae/classification , Bacterial Typing Techniques , RNA, Ribosomal, 16S/genetics , Rhizobiaceae/classification , Sphingobacterium/classificationABSTRACT
Pseudomonas aeruginosa (Pa) detection in the paranasal sinuses may help to prevent or postpone bacterial aspiration to the lower airways (LAW) and chronic lung infection in cystic fibrosis (CF). We assessed the ability of an ELISA test for measurement of specific Pa secretory IgA (sIgA) in saliva (a potential marker of sinus colonization) to early detect changes in the Pa LAW status (indicated by microbiological sputum or cough swab culture and specific serum IgG levels) of 65 patients for three years, in different investigation scenarios. Increased sIgA levels were detected in saliva up to 22 months before changes in culture/serology. Patients who remained Pa-positive had significantly increased sIgA levels than patients who remained Pa-negative, both at the baseline (39.6 U/mL vs. 19.2 U/mL; p = 0.02) and at the end of the follow-up (119.4 U/mL vs. 25.2 U/mL; p < 0.001). No association was found between sIgA levels in saliva and emergence or recurrence of Pa in the LAW. A positive median sIgA result in the first year of follow-up implied up to 12.5-fold increased risk of subsequent Pa exposure in the LAW. Our test detected early changes in the P. aeruginosa LAW status and risk of exposure to P. aeruginosa in the LAW with two years in advance. Comparison with sinus culture is needed to assess the test's ability to identify CF patients in need of a sinus approach for Pa investigation, which could provide opportunities of Pa eradication before its aspiration to the lungs.
Subject(s)
Cystic Fibrosis/complications , Enzyme-Linked Immunosorbent Assay/methods , Immunoglobulin A, Secretory/immunology , Pseudomonas Infections/immunology , Pseudomonas aeruginosa/immunology , Respiratory Tract Infections/immunology , Saliva/immunology , Adolescent , Antibodies, Bacterial/immunology , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Time FactorsABSTRACT
A DNA microarray platform, based on the nucleotide sequences of the internal transcribed spacer regions (ITS1 and ITS2) of the rRNA gene, was developed to identify 32 fungal pathogens at the species level. The probe sequences were spotted onto polycarbonate slides with a mini-microarray printer, and after the hybridization, the results were visible with the naked eye. The performance of the microarray platform was evaluated against the commercial automated systems (Vitek 2 and BD Phoenix systems) and DNA sequencing (gold standard). A total of 461 blood culture bottles were tested: 127 positive for fungi, 302 positive for bacteria, and 32 that were negative. Once the microorganisms were identified by automated systems, fungal DNA was extracted directly from the blood culture bottles. The DNA products were tested using the microarray platform, and DNA sequencing was performed. The results of the microarray and DNA sequencing were concordant in 96.7% of cases, and the results from the automated systems and DNA sequencing were concordant in 98.4%. Of all the nucleotide sequences contained in the microarray platform, the microarray failed to identify four fungal isolates (one Candida parapsilosis, two Candida tropicalis, and one Cryptococcus neoformans). Of note, the microarray detected Candida krusei DNA in two blood cultures from the same patient, whereas the automated system was only positive for Enterococcus faecium Our microarray system provided reliable and fast fungal identification compared to that from DNA sequencing and the automated systems. The simplicity of reading the results by the naked eye made this DNA platform a suitable method for fungal molecular diagnosis.
Subject(s)
Fungi/classification , Fungi/genetics , Molecular Diagnostic Techniques/methods , Mycoses/diagnosis , Oligonucleotide Array Sequence Analysis , Blood Culture , DNA, Fungal/genetics , DNA, Ribosomal Spacer/genetics , Fungi/isolation & purification , Humans , Molecular Diagnostic Techniques/instrumentation , Molecular Diagnostic Techniques/standards , Mycoses/microbiology , Oligonucleotide Array Sequence Analysis/instrumentationABSTRACT
Sewage sludge (SS) obtained after sewage treatment process may contain several toxic substances. Bioremediation can decrease the toxicity of the sludge, mainly when it is associated with stimulant agents, such as sugarcane bagasse (B). Samples of pure SS (SSP); SS+B; SS+Soil; and SS+B+Soil were bioremediated for 1, 3, and 6 months (T1, T2, and T3, respectively). After each period, the cytotoxic, genotoxic, and mutagenic potentials of the solid samples and their respective aqueous extracts (aqueous eluate and percolate water) were evaluated by the Allium cepa test. A microbiological analysis of the samples was also performed after each period tested. All solid samples of SS+B (in T1, T2, and T3) and the solid sample of SSP (treatment T3) showed a significant decrease of cell division (cytotoxic effects). The aqueous eluate extracts of SS+B (T1 and T3) and SSP (T2 and T3) induced cytotoxic effect. The solid sample of SS+B (T2 and T3) and aqueous extracts of SSP (T1) were genotoxic, indicating a harmful effect of SS on A. cepa, even after 6 months of bioremediation. There was an alternation in the microbial community both in diversity and in abundance, with the predominance of nonfermenting gram-negative bacilli. The tested bioremediation periods were not sufficient for the complete detoxification of SS, and the use of B did not seem to contribute to the degradation of the pollutants to inert compounds. These data emphasize that a specific relationship should exist between the sludge characteristic and the biostimulating agent used to promote a more efficient bioremediation. These results suggest the necessity to study longer periods of biodegradation and the use of other decomposing agents for greater safety and sustainability for the agricultural use of this residue.
Subject(s)
Cellulose/chemistry , Saccharum/chemistry , Sewage/chemistry , Soil Microbiology , Soil Pollutants/toxicity , Biodegradation, Environmental , Cell Survival/drug effects , Ecotoxicology , Mutagenicity Tests , Onions/cytology , Onions/drug effects , Onions/genetics , Saccharum/enzymology , Sewage/microbiology , Soil/chemistry , Soil Pollutants/analysisABSTRACT
Parasitic agents have been associated with keratitis, but a diagnosis of parasitic keratitis has not been commonly made in domestic animals. The purpose of this study was to describe the clinical and histopathological findings in seven dogs with chronic keratitis caused by microfilariae diagnosed in Brazil. All dogs presented with superficial corneal opacities of varying degrees affecting the perilimbal and central regions of the cornea, with other opaque areas appearing as crystalline deposits and corneal vascularization. The lesions were bilateral and were associated with mild-to-moderate conjunctival hyperemia. There was no history of blepharospasm or pruritus, and no subjects presented with epithelial erosions. Corneal biopsy revealed free microfilariae in the corneal stroma, with varying degrees of inflammation and collagen fiber destruction. The microfilariae were also found in skin lesions by skin snip technique. No adult worms were found in these dogs, and no dogs were on heartworm preventative before diagnosis. Monthly doses of oral ivermectin improved ocular and dermal lesions. One dog showed complete remission with the treatment. The species of the microfilariae was not identified.
Subject(s)
Dog Diseases/parasitology , Eye Infections, Parasitic/veterinary , Keratitis/veterinary , Microfilariae , Nematode Infections/veterinary , Animals , Chronic Disease/veterinary , Dog Diseases/pathology , Dogs , Eye Infections, Parasitic/parasitology , Eye Infections, Parasitic/pathology , Keratitis/parasitology , Keratitis/pathology , Male , Nematode Infections/parasitology , Nematode Infections/pathologyABSTRACT
Surgical site infection (SSI) is a common complication that is associated with delayed recovery, prolonged length of hospital stay, exorbitant cost, and mortality. The present prospective longitudinal study aimed to evaluate the relationships between the microbial load of trocars used in laparoscopic gynecological surgery, microbiota in surgical sites, and SSI. The final sample consisted of 24 patients, including 68 swab samples and 48 trocars. Microorganisms were recovered in 100.0% of the swabs collected from the umbilicus and vaginal fornix and in 58.3% (14/24) of the swabs collected from skin at the left McBurney's point. Most of the samples collected from trocars (87.5%) did not exhibit bacterial growth, suggesting proper disinfection. In addition, antisepsis was effective for decolonization of the skin to create an aseptic surgical field.
Subject(s)
Surgical Instruments/microbiology , Surgical Wound Infection/epidemiology , Surgical Wound Infection/microbiology , Adolescent , Adult , Bacteria/isolation & purification , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Bacterial Load , Female , Gynecologic Surgical Procedures/statistics & numerical data , Humans , Laparoscopy/statistics & numerical data , Middle Aged , Prospective Studies , Young AdultABSTRACT
The Burkholderia cepacia complex (BCC) can cause a severe decline in lung function in cystic fibrosis (CF). Our objective was to determine the BCC prevalence and to evaluate its clinical impact on CF. Clinical and laboratory variables were determined for CF patients with BCC (Group-A = 50 patients) and without BCC (Group-B = 134 patients). The microorganisms were identified by biochemical tests, the Vitek2®Compact test, recA-PCR and recA-nested-PCR with species-specific primers and DNA sequencing. The patients were evaluated by the Shwachman-Kulczycki score (SKCS), Bhalla score (BS), spirometry and body mass index (BMI). The BCC prevalence was 22.5%. The most common species were Burkholderia multivorans (30%), Burkholderia cepacia (24%), Burkholderia cenocepacia IIIA (10%), B. cenocepacia IIIB (2%) and Burkholderia vietnamiensis (2%). There was difference between the groups in nutritional status (p = 0.02) and general activity (p = 0.026). There was difference in total BS points (p = 0.04) and the following parameters: bronchiectasis severity (p = 0.007), peribronchial thickening (p = 0.013), bronchiectasis extent (p = 0.01) and general aspects of the affected bronchial zone (p = 0.02). The respiratory disorder classifications were as follows: obstructive-4.8% (Group-A) and 23.8% (Group-B); restrictive-9.5% (Group-A and Group-B); obstructive + restrictive-19% (Group-A) and 1.6% (Group-B); and obstructive + restrictive with a decreased forced expiratory flow-47.6% (Group-A) and 30.2% (Group-B) (p = 0.02). Nutritional status was a minor contributing factor to weight, height and BMI in the Group-A (p = 0.02). The BCC prevalence, particularly the prevalence of B. multivorans, was higher in this study. The SKCS, BS, spirometry and nutritional status results showed that BCC has a negative impact on clinical status. Phenotypic methods are useful for the identification of presumptive BCC. The Vitek2®Compact test showed accuracy in BCC identification. PCR, nested-PCR, and recA sequencing showed specificity in BCC species identification.
Subject(s)
Burkholderia Infections/epidemiology , Burkholderia Infections/microbiology , Burkholderia/classification , Burkholderia/isolation & purification , Cystic Fibrosis/complications , Adolescent , Adult , Bacterial Typing Techniques , Brazil/epidemiology , Burkholderia/genetics , Burkholderia/physiology , Burkholderia Infections/pathology , Child , Child, Preschool , Cross-Sectional Studies , Cystic Fibrosis/pathology , Female , Humans , Infant , Infant, Newborn , Male , Molecular Diagnostic Techniques , Polymerase Chain Reaction , Prevalence , Sequence Analysis, DNA , Young AdultABSTRACT
PURPOSE: The aim of this study was to compare the qualitative and semi-quantitative detection of pathogens in the airway secretions of patients with cystic fibrosis (CF) and the sputum induction capacity before and after inhalation of 7% hypertonic saline solution (HSS). METHODS: The study enrolled 64 patients with CF. Airway secretions were collected from all enrolled patients with CF before and after inhalation of 7% HSS, and the samples were screened for pathogens. RESULTS: Inhalation of 7% HSS increased the probability of producing sputum from 36 to 52% (p = 0.002) in children with CF. The effect was most in children under 11 years. Inhalation of 7% HSS improved qualitative pathogen identification (p = 0.008). Inhalation of 7% HSS increased the mucoid Pseudomonas aeruginosa (p = 0.002) and non-mucoid P. aeruginosa in the semi-quantitative analysis (p = 0.035). Four new pathogens (Aspergillus fumigatus, Achromobacter xylosoxidans, Ochrobactrum anthropi, and Elizabethkingia meningoseptica) were identified in the sputum samples collected from the airways of patients with CF following 7% HSS. CONCLUSIONS: Inhalation of 7% HSS increased sputum production and pathogen identification in children with CF. The inhalation of 7% HSS was feasible and should be implemented for routine pathogen detection in the airways of patients with CF, particularly in those patients who do not produce sputum.
Subject(s)
Bacteria/isolation & purification , Cystic Fibrosis/microbiology , Lung/microbiology , Respiratory Tract Infections/microbiology , Saline Solution, Hypertonic/administration & dosage , Sputum/microbiology , Administration, Inhalation , Adolescent , Adult , Bacteria/classification , Bacteriological Techniques , Brazil , Child , Child, Preschool , Cross-Sectional Studies , Cystic Fibrosis/diagnosis , Cystic Fibrosis/physiopathology , Feasibility Studies , Female , Humans , Lung/physiopathology , Male , Predictive Value of Tests , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/physiopathology , Young AdultABSTRACT
BACKGROUND: Enterocytozoon bieneusi are the most common microsporidia associated with different clinical manifestations such as diarrhoea, respiratory tract inflammation and acalculous cholecystitis, especially in immunocompromised patients. Infection usually occurs by ingestion of food and water contaminated with spores, but can also result from direct contact with spores through broken skin, eye lesions, and sexual transmission, depending on the microsporidian species. Although there are reports of E. bieneusi found in humans and animals in Brazil, there are no published studies of environmental samples examined by molecular methods. OBJECTIVES: The purpose of this study was to verify the presence of E. bieneusi in raw sewage and treated effluent from a combined system by molecular methods. METHODS: Raw sewage and treated effluent samples collected from a combined system were analysed for the presence of E. bieneusi using the internal transcriber spacer (ITS) region of E. bieneusi by nested polymerase chain reaction. FINDINGS: The analysis revealed E. bieneusi presence and a novel genotype (EbRB) in one raw sewage sample and one treated effluent. MAIN CONCLUSIONS: The presence of E. bieneusi in final effluent indicates that the combined system may not remove microsporidian spores. This study is the first report of E. bieneusi in environmental samples in Brazil.
Subject(s)
Enterocytozoon/genetics , Enterocytozoon/isolation & purification , Sewage/microbiology , Brazil , DNA, Fungal/genetics , Genotype , Phylogeny , Polymerase Chain Reaction , Sequence Analysis, DNAABSTRACT
BACKGROUND: Microbiological characteristics of sepsis and antimicrobial resistance are well studied, although in State University of Campinas, no data has been published yet. METHODS: The main agents related to sepsis and antimicrobial resistance were analyzed. The blood culture records requested from 4,793 hospitalized patients were analyzed. The samples were processed using the Bact/Alert system for agent identification and antimicrobial susceptibility. RESULTS: A total of 1,017 patients met the inclusion criteria for a sepsis diagnosis, with 2,309 samples tested (2.27 samples/patient). There were 489 positive samples (21% positive) isolated from 337 patients (33.13%), but more rigorous criteria excluding potential contaminants resulted in analysis being restricted to 266 patients (315 agents). The prevalent microorganisms were coagulase negative Staphylococcus (CNS) (15.87%), Escherichia coli (13.0%), Staphylococcus aureus (11.7%), Klebsiella pneumoniae (9.8%), Enterobacter sp (9.5%), Acinetobacter baumannii (9.2%), Pseudomonas aeruginosa (5.7%) and Candida sp (5.1%). Examining antimicrobial resistance in the agents revealed that 51% of the S. aureus isolates were methicillin-resistant S. aureus (MRSA) and 80% of the CNS isolates were oxacillin-resistant. For A. baumannii, the ideal profile drugs were ampicillin sulbactam and piperacillin/tazobactam, and for P. aeruginosa, they were piperacillin/tazobactam and ceftazidime. Enterobacteria showed on average 32.5% and 35.7% resistance to beta-lactams and ciprofloxacin, respectively. When all Gram-negative bacteria were considered, the resistance to beta-lactams rose to 40.5%, and the resistance to ciprofloxacin rose to 42.3%. CONCLUSIONS: Eighty percent of the agents identified in blood cultures from patients with sepsis belonged to a group of eight different agents. For empirical treatment, carbapenems and vancomycin unfortunately still remain the best therapeutic choice, except for A. baumannii and P. aeruginosa, for which piperacillin/tazobactan is the best option.
Subject(s)
Hospitals, University , Sepsis/microbiology , Acinetobacter baumannii/isolation & purification , Adult , Aged , Child , Drug Resistance, Microbial , Enterobacteriaceae/isolation & purification , Female , Gram-Negative Bacteria/isolation & purification , Hospitals, University/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests/methods , Retrospective Studies , Sepsis/blood , Sepsis/epidemiology , Staphylococcus/isolation & purification , Staphylococcus aureus/isolation & purificationABSTRACT
OBJECTIVE: to investigate the associations of oral microbiota, leucocytes count, neutrophil count, platelet counts and hemoglobin level, and the severity of oral mucositis in pediatric patients with acute lymphoblastic leukemia (ALL) receiving chemotherapy. MATERIALS AND METHODS: 71 prospective patients were included. Analyses of oral microbiota and blood sample were conducted on days 14 (D14) and 56 (D56) of the Brazilian GBTLI-99 treatment protocol. Herpes simplex virus (HSV) identification was performed by PCR followed by DNA sequencing analysis. Bacteria and fungi identification was obtained by standard microbiological culture tests. RESULTS: 103 episodes of mucositis occurred, being 65 at D14 and 38 at D56. Most cases positive for herpes viral DNA sequences were identified as HSV-1. At D14, we found a significant association between the severity of mucositis and presence of HSV-1 (p = 0.0347), Candida spp. (p = 0.0078), and low platelet count (p = 0.0064). At D56, we found a significant association between the severity of mucositis and the presence of HSV-1 (p = 0.0317), previous HSV-1 presence on D14 (p < 0.0001) and neutrophil count (p = 0.0211). CLINICAL RELEVANCE: the identification of risk factors for mucositis in children and adolescents may contribute to the development of new strategies for prevention and/or treatment, reducing the complications associated with this condition. CONCLUSIONS: the presence of HSV, platelet count, and Candida spp. presence at D14 of ALL induction treatment is associated with increased severity of mucositis in children and adolescents. At D56 of ALL treatment, mucositis severity was associated with neutrophil count, HSV presence, and previous presence of HSV (at D14).
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Candida , Candidiasis/epidemiology , Herpes Simplex/epidemiology , Herpesvirus 1, Human , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Stomatitis/epidemiology , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Brazil/epidemiology , Candidiasis/chemically induced , Child , Child, Preschool , Female , Herpes Simplex/chemically induced , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Prospective Studies , Stomatitis/chemically inducedABSTRACT
We sequenced the oldest blaKPC-2-bearing plasmid isolated in Brazil and another plasmid also carried by a Klebsiella pneumoniae strain of sequence type 442 (ST442), isolated 52 months later. Both plasmids present an IncN backbone and few acquired regions. Because the 2005 plasmid presented deletions and a truncated gene within Tn4401b compared to the 2009 plasmid, we can thus infer that IncN blaKPC-2-bearing plasmids pFCF1305 and pFCF3SP had a common ancestor circulating in Brazil prior to May 2005.
Subject(s)
Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/genetics , Plasmids/genetics , Brazil , Drug Resistance, Multiple, Bacterial/genetics , beta-Lactamases/geneticsABSTRACT
Bartonella spp. are bacteria responsible for neglected diseases worldwide. Bartonella henselae is the species most associated with human infections. It is associated with a large spectrum of clinical manifestations and is potentially fatal. The identification of Bartonella spp. is considered a challenge in clinical routine. These bacteria are fastidious, and the time required to isolate them varies from one to six weeks. MALDI-TOF mass spectrometry has emerged as an application for research on Bartonella spp. , and has still been little explored. We investigated whether three different B. henselae strains with different growth times-14 and 28 days-could be correctly identified by MALDI-TOF mass spectra fingerprint comparison and matching. We found that the spectra from strains with different growth times do not match each other, leading to misidentification. We suggest creating database entries with multiple spectra from strains with different growth times to increase the chances of accurate identification of Bartonella spp. by MALD-TOF MS.
Subject(s)
Bartonella henselae , Bartonella , Humans , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methodsABSTRACT
BACKGROUND: Oral mucositis is a common collateral effect among the secondary complications resulting from chemotherapy. The objective of this study was to prospectively evaluate the association of HSV-1, Candida spp., and oral bacteria on the severity of oral mucositis in pediatric acute lymphoblastic leukemia (ALL). PROCEDURE: Seventy-one prospective patients were included. Analyses of oral microbiota were conducted on days 14 (D14) and 56 (D56) of the Brazilian GBTLI-99 treatment protocol. Herpes simplex virus (HSV) identification was performed by PCR followed by DNA sequencing analysis. Bacteria and fungi identification was obtained by standard microbiological culture tests. RESULTS: HSV-1 was found in 10.37% of individual patient samples. One sample was positive for HSV-4. On D14, we found an association between the severity of mucositis and the presence of HSV (p = 0.0347) and Candida spp. (p = 0.0078). At D56, we found an association between the severity of mucositis and the presence of HSV on D14 (p < 0.0001) and HSV presence (p = 0.0317). CONCLUSION: The presence of HSV, mainly HSV-1, and Candida spp. was associated with mucositis severity in pediatric ALL. No association could be found between bacterial CFU and severity of mucositis.
Subject(s)
Bacteria/isolation & purification , Candida/isolation & purification , Herpesvirus 1, Human/isolation & purification , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Stomatitis/chemically induced , Adolescent , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Child , Child, Preschool , Colony Count, Microbial , Female , Humans , Infant , Male , Polymerase Chain Reaction , Prospective Studies , Sequence Analysis, DNA , Severity of Illness Index , Stomatitis/microbiology , Stomatitis/pathology , Young AdultABSTRACT
Aeromonas spp. are opportunistic and ubiquitous bacteria considered emerging pathogens that can cause infections in animals, especially fish, as well as humans. In humans, these bacteria are associated with gastroenteritis but can also be related to extraintestinal diseases. Its main infection route is through water, but it has been increasingly associated with foods. Their association with ready-to-eat foods may be a concern, especially because these products are for immediate consumption. This study aimed to investigate the prevalence of Aeromonas spp. in ready-to-eat foods (temakis, cheeses and minimally processed fruits) and to characterize the virulence profile and antimicrobial resistance of the isolates. The species A. hydrophila, A. caviae and A. veronii were identified using polymerase chain reaction (PCR), which was later compared with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS). The performance of two isolation selective agars (starch-ampicillin agar-SAA and Aeromonas agar-AA) was also evaluated. Aeromonas spp. was isolated in 66.67 % (20/30) of temaki, 3.23 % (1/31) of fruits and none (0/30) of cheeses, observing high microorganism counts from <102 to 2.6 × 105 CFU/g. A. caviae (26.39 %) was the most prevalent species, followed by A. hydrophila (20.83 %) and A. veronii (8.34 %), and 44.44 % were classified as Aeromonas sp. The performance analysis between PCR and MALDI-TOF/MS for Aeromonas identification was not statistically significant, and the Kappa index showed moderate agreement (p < 0.01 and Kappa = 0.718). The SAA selective medium performed better than AA. We identified seventeen virulence profiles, and 59.72 % of the isolates had some of the genes studied. The aerA gene (47.2 %) was the most abundant, followed by act (41.7 %), hlyA and alt (38.9 %), and ast (18.1 %). A. hydrophila was the species most associated with these genes. The antimicrobial susceptibility test showed that 90 % of the isolates were resistant to amoxicillin-clavulanic acid, 17 % to tetracycline, 10 % to imipenem and 3 % to aztreonam. The results showed that temakis are carriers of potentially pathogenic Aeromonas spp. and therefore should be avoided by children, elderly individuals, pregnant women, and immunocompromised people. We also found strains resistant to antimicrobials, meaning that these microorganisms need constant monitoring.
Subject(s)
Aeromonas , Agar , Aged , Animals , Anti-Bacterial Agents/pharmacology , Child , Drug Resistance, Bacterial/genetics , Female , Humans , Incidence , PregnancyABSTRACT
Visceral leishmaniasis remains a serious public health issue, and Brazil was among the seven countries with the highest prevalence of this disease worldwide. The measures to control this disease are not easily developed, and the improvement of its diagnosis, surveillance, and control is still needed. This study aimed to carry out the polymerase chain reaction (PCR) diagnosis of Leishmania infantum in vector samples in some municipalities of the State of São Paulo, which included two municipalities with human disease transmission and two with dog transmission only. Vectors were collected in traps with luminous bait. Next, they were killed at -4 °C and kept in 70% alcohol. Groups of ten female insects (pools) were mashed on cation exchange paper (fine cellulose phosphate with 18 µEq/cm² ionic exchange capacity) for DNA extraction. The PCR was carried out to identify the natural infection of the Leishmania genus in female Lutzomyia longipalpis (Lu. Longipalpis). Out of the 3,880 Lu. longipalpis phlebotomines, 1060 were female and 2820 were male (3:1). The method used to extract the DNA in pools of ten phlebotomines and the PCR resulted in sensitivity, specificity, practicality, and faster analyses when compared to the individual analysis method. The procedure described can be used on a large scale in the leishmaniasis epidemiological surveillance, enabling a higher number of analyses and the optimization of human resources because the traditional diagnostic method is carried out via desiccation of the insect digestive system and microscopic examination, which is time-demanding and there is the need of manual skills.