RESUMO
The objective was to evaluate Staphylococcus aureus and Pseudomonas aeruginosa colonisation of wounds treated with recombinant epidermal growth factor (EGF) and platelet-rich plasma (PRP); to analyse the susceptibility profiles of S. aureus and P. aeruginosa isolates from wounds treated with EGF and PRP; and to describe the presence of infection in EGF-treated and PRP-treated wounds. Experimental study was performed using clinical specimens collected with swabs. Patients were treated with PRP and EGF in the outpatient clinic of a university hospital. Forty-three isolates were obtained from 31 patients, 41.9% (13/31) of whom had been treated with EGF and 58.0% (18/31) with PRP. Ten of the 43 isolates were identified as S. aureus, 60.0% (6/10) of which were isolated from PRP-treated wounds. Among the 33 P. aeruginosa isolates, 66.6% (22/33) were isolated from PRP-treated wounds. Regarding antimicrobial susceptibility, only one strain isolated from an EGF-treated wound was identified as methicillin-resistant S. aureus (MRSA). Among the P. aeruginosa isolates, one obtained from a patient treated with EGF was multidrug-resistant. Patients treated with EGF had no infections during the follow-up period, and there was a significant difference between the 1st and 12th week in wound infection improvement in patients treated with PRP (P = .0078).
Assuntos
Fator de Crescimento Epidérmico/uso terapêutico , Plasma Rico em Plaquetas , Proteínas Recombinantes/uso terapêutico , Infecção dos Ferimentos/terapia , Farmacorresistência Bacteriana , Géis , Humanos , Infecções por Pseudomonas/terapia , Pseudomonas aeruginosa , Infecções Estafilocócicas/terapia , Infecção dos Ferimentos/microbiologiaRESUMO
The objective of this work was to assess the genetic characteristics of uropathogenic Escherichia coli, ciprofloxacin resistance or susceptibility, obtained from patients with gynecological cancer and urinary tract infection (UTI). Seventy-seven E. coli ciprofloxacin-resistant isolates and 38 ciprofloxacin-susceptible were analyzed by polymerase chain reaction (PCR) to determine the phylogenetic groups, virulence factors as iucC, fyuA, hlyC, cnf1 genes, and pks pathogenicity island. The presence of genes related to ciprofloxacin resistance such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA, and the sequencing of DNA gyrase genes and topoisomerase IV were determined. The genetic profile of the isolates was determined by pulsed-field gel electrophoresis (PFGE). Statistical analysis was performed using Fisher's exact test and Chi-square test. Phylogenetic group B2 was the most prevalent although a great genetic diversity was observed by PFGE. Only genes associated to siderophores were found in ciprofloxacin-resistant isolates; however, in ciprofloxacin-susceptible isolates, genes related to siderophores and toxin, were detected. Additionally qnrB was detected in both populations, ciprofloxacin resistant and susceptible. DNA mutations in gyrA were Ser-83-Leu and Asp-87-Asn and in parC were Ser-80-Ile and Glu-84-Val, Glu-84-Lys. In conclusion, it was observed a high prevalence of qnrB in the population studied; in addition, it was the first time the pks island was observed only in ciprofloxacin-susceptible isolates.
Assuntos
Antibacterianos/farmacologia , Ciprofloxacina/farmacologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/microbiologia , Neoplasias dos Genitais Femininos/complicações , Infecções Urinárias/microbiologia , Escherichia coli Uropatogênica/efeitos dos fármacos , Escherichia coli Uropatogênica/isolamento & purificação , Proteínas de Escherichia coli/genética , Feminino , Humanos , Testes de Sensibilidade Microbiana , Filogenia , Infecções Urinárias/etiologia , Escherichia coli Uropatogênica/classificação , Escherichia coli Uropatogênica/genéticaRESUMO
In this paper we carried out a study about prevalence of the clinically significant coagulase negative staphylococcal (CNS) isolates found in an university hospital. Two hundred four CNS isolates from 191 patients obtained between the period of 1998 to 2002, were studied. About 27% (52/191) of the infection cases studied were confirmed as CNS-associated diseases. Blood stream infection (BSI) was the most frequent CNS associated-disease (25%; 13/52). The great majority of the BSI was verified in the Neonatal Intensive Care Unit (NICU). The analysis of the 52 patients medical history showed that 85% of the BSI was acquired in hospital. Most of the CNS nosocomial infections were associated with the use of indwelling medical devices. The incidence of methicillin-resistance among significant CNS isolates was 38%. In this study, a high percentage of exogenous contaminant was verified (60%), indicating that contamination of clinical specimens during sample collection is critical.
RESUMO
The extensive geographic spread of MRSA isolates belonging to the Brazilian epidemic clone (BEC) limited the value of pulsed-field gel electrophoresis (PFGE) in epidemiological studies of outbreaks caused by these strains. Thus, the discriminatory power of eight different molecular methods was evaluated in an attempt to establish a methodology for genotyping BEC isolates involved in intra-hospital outbreaks. BEC isolates from five hospitals in Teresina City, Piaui State were genotyped by conventional electrophoresis or PFGE of Cla I- or Sma I-digested genomic DNA hybridised with specific labelled mecA, Tn554, IS257 and IS256 probes. The combination of PFGE with Cla I/mecA, Cla I/Tn554, Cla I/IS257, Sma I/mecA and Sma I/IS257 probe-fingerprinting techniques provided a very poor discriminatory power for BEC strains. Although Cla I/IS256 fingerprinting discriminated 17 different polymorphisms among the isolates displaying PFGE A1 pattern, this strategy was not reproducible. In contrast, the combination of PFGE and Sma I/IS256 polymorphisms differentiated BEC isolates into nine stable polymorphisms. Thus combination of PFGE and hybridisation with IS256 probe may be recommended as a useful means of typing BEC strains involved in intra-hospital infections.
Assuntos
Técnicas de Tipagem Bacteriana/métodos , DNA Bacteriano/análise , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Brasil , Infecção Hospitalar , Impressões Digitais de DNA/métodos , Primers do DNA , Sondas de DNA , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado/métodos , Eletroforese em Gel de Poliacrilamida/métodos , Genótipo , Humanos , Immunoblotting/métodos , Resistência a Meticilina , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Análise de Sequência de DNA , Infecções Estafilocócicas/epidemiologiaRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) is recognised as an important cause of nosocomial infection. The spread of some MRSA epidemic clones is well documented. In Brazil, and more recently in Portugal, a considerable number of hospital infections has been caused by a unique multiresistant MRSA clone designated as the Brazilian epidemic clone. This paper describes the spread of this clone in hospitals in two cities in Argentina.
Assuntos
Proteínas de Transporte/genética , Infecção Hospitalar/epidemiologia , Hexosiltransferases , Resistência a Meticilina , Muramilpentapeptídeo Carboxipeptidase/genética , Peptidil Transferases , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/farmacologia , Argentina/epidemiologia , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Elementos de DNA Transponíveis , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Hospitais Urbanos , Humanos , Testes de Sensibilidade Microbiana , Proteínas de Ligação às Penicilinas , Polimorfismo Genético , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/transmissão , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificaçãoRESUMO
In this paper we carried out a study about prevalence of the clinically significant coagulase negative staphylococcal (CNS) isolates found in an university hospital. Two hundred four CNS isolates from 191 patients obtained between the period of 1998 to 2002, were studied. About 27 percent (52/191) of the infection cases studied were confirmed as CNS-associated diseases. Blood stream infection (BSI) was the most frequent CNS associated-disease (25 percent; 13/52). The great majority of the BSI was verified in the Neonatal Intensive Care Unit (NICU). The analysis of the 52 patients medical history showed that 85 percent of the BSI was acquired in hospital. Most of the CNS nosocomial infections were associated with the use of indwelling medical devices. The incidence of methicillin-resistance among significant CNS isolates was 38 percent. In this study, a high percentage of exogenous contaminant was verified (60 percent), indicating that contamination of clinical specimens during sample collection is critical.
Assuntos
Humanos , Animais , Bactérias Gram-Negativas/isolamento & purificação , Estudos Transversais , Coagulase/análise , Coagulase/isolamento & purificação , Infecções por Bactérias Gram-Negativas , Infecção Laboratorial , Infecções Estafilocócicas , Staphylococcus/isolamento & purificação , Staphylococcus/patogenicidade , Técnicas e Procedimentos Diagnósticos , Métodos , Métodos , VirulênciaRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a therapeutic problem. In the present study, the molecular characterization by pulsed-field gel electrophoresis of MRSA isolates collected from a university hospital revealed that the predominant variant of the Brazilian epidemic clonal complex (BECC) was responsible for the increase in the incidence of MRSA strains, which reached 28% in 1998. It was verified that this predominant variant of the BECC displayed an enhanced ability to produce biofilm on inert polystyrene surfaces and to adhere to and invade epithelial airway cells. These results indicate that MRSA strains belonging to the BECC have evolved advantageous properties that might play a role in their predominance as international nosocomial pathogens.
Assuntos
Biofilmes/crescimento & desenvolvimento , Infecção Hospitalar/microbiologia , Resistência a Meticilina , Doenças Respiratórias/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/fisiologia , Aderência Bacteriana , Brasil/epidemiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/patologia , DNA Bacteriano/química , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Células Epiteliais , Fibronectinas/fisiologia , Variação Genética , Humanos , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Transmissão , Oligopeptídeos/fisiologia , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/patologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/patologia , Staphylococcus aureus/genética , Staphylococcus aureus/crescimento & desenvolvimento , Staphylococcus aureus/ultraestruturaRESUMO
O meio LAL-1, descrito recentemente (14), foi modificado pela adiçäo de 15 ug/ml de ácido nalidíxico (meio LAL-2). OLAL-2 permitiu a detecçäo de todos os GBS isolados de mulheres altamente colonizadas pelo microrganismo. O meio modificado foi bastante eficiente para o enriquecimento de GBS visto que a detecçäo do microrganismo aumentou em aproximadamente 57