Calidad microbiológica: detección de Aeromonas sp y Pseudomonas sp en garrafones provenientes de pequeñas plantas purificadoras de agua / Microbiological quality: detection of Aeromonas sp and Pseudomonas sp in jugs from small water purification establishments

RESUMEN Las plantas purificadoras de agua que carecen de un adecuado sistema de control de calidad pueden generar problemas de salud pública. El objetivo de este estudio fue examinar la calidad microbiológica del agua proveniente de pequeñas plantas purificadoras de la ciudad de Puebla, así como, determinar la existencia de bacterias Aeromonas sp y Pseudomonas sp, y caracterizar si presentan un fenotipo patógeno oportunista. Se recolectaron 70 muestras de garrafones de agua de 25 establecimientos. La cuantificación bacteriana se realizó mediante el método de goteo en placa. Se comprobaron los géneros microbianos mediante análisis bioquímico. En las cepas que mostraron discrepancia se utilizó la identificación molecular con base a secuencias parciales del gen 16S rRNA para confirmar su especie y se les evaluaron sus características de patogenicidad: multirresistencia a antibióticos, producción de biopelícula y actividad hemolítica. El 40 % de las plantas purificadoras no cumplieron con la calidad microbiológica del agua para consumo humano. El 41.4 % de los garrafones de agua muestreados incumplió la normativa, presentando coliformes totales 35.7 %, Pseudomonas 30 %, Enterococcus faecalis 8.6 % y bacterias coliformes fecales el 5.7 %. Se obtuvieron 56 aislados, provenientes de los 29 garrafones contaminados; 10 de ellos se caracterizaron molecularmente, resultando 7 aislados relacionados con especies diferentes de P. aeruginosa y 3 con especies de Aeromonas. De los aislados de Pseudomonas, 5 presentaron resistencia a 2 familias de antibióticos y 2 mostraron multirresistencia. El 36 % de los 10 aislados produjeron hemólisis y biopelícula. Dos cepas de Aeromonas mostraron resistencia a Cefalosporina 3a generación pero no produjeron hemólisis. Los 10 aislados analizados fueron clasificados como no patógenos. Es necesario un seguimiento sanitario más estricto para lograr el cumplimiento de las normas nacionales e internacionales relacionadas con el consumo de agua purificada, para evitar dañar la salud de los consumidores.

ABSTRACT Water purification establishments that lack an adequate quality control system can cause public health problems. The objective of this study was to examine the microbiological quality of water from small purification establishments in the city of Puebla, as well as to determine the existence of Aeromonas sp and Pseudomonas sp bacteria, and to characterize whether they present an opportunistic pathogenic phenotype. 70 water jug samples were collected from 25 establishments. Bacterial quantification was performed using the drop plate method. Microbial genera were determined by biochemical analysis using the standard methodology. In the strains that showed discrepancy, molecular identification based on partial sequences of the 16S rRNA gene was used to confirm their species, and their pathogenic characteristics were evaluated: multiresistance to antibiotics, biofilm production, and hemolytic activity. The results showed that 40 % of the purification establishments did not comply with the microbiological quality of water for human consumption. Similarly, 41.4 % of the jugs of water sampled failed to comply with the regulations, presenting total coliforms 35.7 %, Pseudomonas 30 %, Enterococcus faecalis 8.6 % and fecal coliform bacteria 5.7 %. Likewise, 56 isolates were obtained from the 29 contaminated jugs, of which 10 were molecularly characterized, resulting in 4 different species for P. aeruginosa and 3 for Aeromonas. Of the 7 Pseudomonas isolates, 5 presented resistance to 2 families of antibiotics and 2 showed multiresistance. In total, 36 % of the 10 isolates produced hemolysis and biofilm. Two Aeromonas strains showed resistance to 3rd generation Cephalosporin but did not produce hemolysis. The 10 isolates analyzed were classified as non-pathogenic. A stricter sanitary monitoring is necessary to achieve compliance with national and international standards related to the consumption of purified water, to avoid harming the health of consumers.

Origanum vulgare essential oil and carvacrol: natural alternatives against resistant bacteria / Óleo essencial de origanum vulgare e carvacrol: alternativas naturais contra bactérias resistentes / El aceite esencial de origanum vulgare y el carvacrol: alternativos naturales contra las bacterias resistentes

Bacteria that are resistant to several antibiotics are a serious One Health problem, as new alternatives for treatment do not appear at the same speed. Thus, the aim of this work was to carry out a survey of studies involving the activity of the essential oil of O. vulgare and its isolated compound carvacrol on antibiotic-resistant bacteria. To this end, a qualitative review of the literature was carried out in the PubMed database from 2015 to 2020. Both for the essential oil and for the isolated compound, the inhibitory action extends to strains often associated with difficult-to-treat infections such as oxacillin and vancomycin-resistant Staphylococcus aureus, ß-lactamase-producing strains, carbapenemases, among others. The point that distinguishes the studies is the type of methodology used in the tests, with studies with carvacrol more directed towards mechanisms of molecular action and application in cells and animals, while those with oils are more preliminary. Although these substances have potential to control resistant bacteria, more research is needed to enable their use.

Bactérias resistentes a vários antibióticos são um grave problema para a Saúde Única, pois novas alternativas de tratamento não aparecem na mesma velocidade. Assim, o objetivo deste trabalho foi realizar um levantamento de estudos envolvendo a atividade do óleo essencial de O. vulgare e seu composto isolado, carvacrol, sobre bactérias resistentes a antibióticos. Para tanto, foi realizada uma revisão qualitativa da literatura na base de dados PubMed no período de 2015 a 2020. Tanto para o óleo essencial quanto para o composto isolado, a ação inibitória se estende a cepas frequentemente associadas a infecções de difícil tratamento como Staphylococcus aureus resistente à oxacilina e vancomicina, cepas produtoras de ß-lactamase, carbapenemases, entre outras. O ponto que diferencia os estudos é o tipo de metodologia utilizada nos testes, sendo os estudos com carvacrol mais direcionados para mecanismos de ação molecular e aplicação em células e animais, enquanto os com óleos são mais preliminares. Embora essas substâncias tenham potencial para controlar bactérias resistentes, mais pesquisas são necessárias para viabilizar seu uso.

Las bacterias resistentes a diversos antibióticos son un grave problema para la Sanidad Única, ya que las nuevas alternativas de tratamiento no aparecen a la misma velocidad. Así pues, el objetivo de este trabajo fue realizar una encuesta sobre los estudios relativos a la actividad del aceite esencial de O. vulgare y su compuesto aislado, el carvacrol, sobre las bacterias resistentes a los antibióticos. Para ello, se realizó una revisión bibliográfica cualitativa en la base de datos PubMed en el periodo comprendido entre 2015 y 2020. Tanto para el aceite esencial como para el compuesto aislado, la acción inhibidora se extiende a cepas frecuentemente asociadas a infecciones de difícil tratamiento como el Staphylococcus aureus resistente a la oxacilina y a la vancomicina, cepas productoras de ß-lactamasas, carbapenemasas, entre otras. El punto que diferencia los estudios es el tipo de metodología utilizada en las pruebas, siendo los estudios con carvacrol más dirigidos a mecanismos de acción molecular y aplicación en células y animales, mientras que los de aceites son más preliminares. Aunque estas sustancias tienen potencial para controlar las bacterias resistentes, es necesario seguir investigando para que su uso sea viable.

High antimicrobial resistance in Salmonella spp. and Escherichia coli isolates from swine fecal samples submitted to a veterinary diagnostic laboratory in Colombia

Background: Commensal microflora such as Escherichia coli and Enterococcus spp. are representative indicators of antimicrobial resistance (AMR) as they are part of the normal intestinal microflora and can acquire and disseminate AMR to pathogenic or zoonotic bacteria like Salmonella spp. Objective: To investigate the state of AMR among E. coli and Salmonella spp., potential pathogens in humans, isolated from cecal contents of pigs submitted to a veterinary diagnostic laboratory in Colombia from 2016 to 2019. Methods: Susceptibility testing was conducted using the Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines for antimicrobial zone diameter breakpoints. An E. coli strain (ATCC 25922) was used as the quality control organism. Isolates showing resistance to three or more antimicrobial classes were classified as multidrug-resistant (MDR) as defined by a joint group of the European Centre for Disease prevention and Control and the Center for Disease Control and Prevention of the USA. Results: A total of 112 E. coli and 192 Salmonella spp. colonies were isolated from 557 samples received between 2016 and 2019. In order of decreasing frequency, E. coli was resistant to tetracycline (100%), sulfamethoxazol-trimethoprim (97.5%), amoxicillin (86.4%), enrofloxacin (82.6%), tylosin (82.1%), doxycycline (59%), neomycin (50%), ciprofloxacin (45.5%), ceftiofur (35%), gentamicin (30%), tilmicosin (29%), and fosfomycin (12.5%). When compared with E. coli, Salmonella spp. was generally resistant to the same agents with slightly less resistance (between 10-30%) to eight of the antimicrobials tested. Salmonella spp. showed <20% resistance to three antimicrobials, as follows: neomycin (17%), gentamicin (16%), and fosfomycin (14%). Multi-resistance occurred in 68.7% (77/112) of E. coli and 70.3% (135/192) of Salmonella spp. isolates. Resistance of Salmonella spp. was alarming to all the critically important antimicrobials tested: fluoroquinolones (enrofloxacin, ciprofloxacin), ceftiofur (third- generation cephalosporin), and macrolides (tylosin). Conclusions: According to our results, there is a high level of multi- drug resistance (MDR) in E. coli and Salmonella spp. It is necessary to implement a nationwide antimicrobial resistance monitoring program in Colombia, together with proper antimicrobial prescribing guidelines for pigs. The indiscriminate use of antimicrobial growth promoters by the swine industry is generating widespread bacterial resistance and should be discontinued.

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Antecedentes: Flora comensal como espécies de Escherichia coli e Enterococcus são tipicamente escolhidas como indicadores representativos de la resistência antimicrobiana (AMR), pois fazem parte da flora intestinal normal e podem adquirir e disseminar AMR a bactérias patogênicas ou zoonóticas como Salmonella spp. Objetivo: Investigar o estado da AMR entre E. coli e Salmonella spp. isolados do conteúdo cecal de porcos colombianos submetidos ao Laboratório de Diagnóstico Veterinário de 2016 a 2019, ambos sendo patógenos potenciais em humanos. Métodos: O teste de suscetibilidade foi conduzido usando o método de difusão em disco Kirby-Bauer de acordo com as diretrizes do Instituto de Padrões Clínicos e Laboratoriais para pontos de quebra de diâmetro da zona antimicrobiana. A cepa de E. coli (ATCC 25922) foi usada como organismo de controle de qualidade. Os isolados que apresentam resistência a três ou mais classes de antimicrobianos foram classificados como multirresistentes (MDR), conforme definido por um grupo conjunto do Centro Europeu para Prevenção e Controle de Doenças e Centro para Controle e Prevenção de Doenças dos EUA. Resultados: Um total de 112 E. coli e 192 Salmonella spp. foram isolados de 557 amostras submetidas entre 2016 e 2019. Em ordem decrescente de frequência, a resistência a E. coli foi: tetraciclina (100%), sulfametoxazol-trimetoprim (97,5%), amoxicilina (86,4%), enrofloxacina (82,6%), tilosina (82,1%), doxiciclina (59%), neomicina (50%), ciprofloxacina (45,5%), ceftiofur (35%), gentamicina (30%), tilmicosina (29%) e fosfomicina (12,5%). Quando comparada com E. coli, Salmonella spp. foi geralmente resistente aos mesmos agentes com resistência ligeiramente menor (entre 10-30%) a oito dos antimicrobianos. Apenas três antimicrobianos apresentaram resistência a Salmonella spp. abaixo de 20% da seguinte forma: neomicina (17%), gentamicina (16%) e fosfomicina (14%). Multi-resistência ocorreu em 68,7% (77/112) de E. coli e 70,3% (135/192) de Salmonella spp. isolados. Resistência de Salmonella spp. foi alarmante para todos os antimicrobianos criticamente importantes testados: fluoroquinolonas (enrofloxacina, ciprofloxacina), ceftiofur (cefalosporina de terceira geração) e macrolídeos (tilosina). Conclusões: Esses resultados indicam um alto nível de resistência a múltiplos medicamentos (MDR) e que um Programa Nacional de Monitoramento da Resistência Antimicrobiana é necessário para a Colômbia, juntamente com a implementação de diretrizes de prescrição de antimicrobianos para suínos. O uso indiscriminado de antimicrobianos para promoção de crescimento na indústria suína está claramente promovendo resistência generalizada e deve ser interrompido.

Colonization of methicillin-resistant Staphylococcus aureus among healthcare students: an integrative review

ABSTRACT BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a worldwide concern given its presence even in non-hospitalized healthy individuals, such as university students. OBJECTIVE: To identify in the literature the prevalence of colonization by MRSA among healthcare students. DESIGN AND SETTING: Integrative review of the literature conducted in Universidade Federal do Piauí. METHOD: A search for primary studies was performed in the following databases: Medical Literature Analysis and Retrieval System on-line; Cumulative Index to Nursing and Allied Health Literature; Web of Science; Scopus; and LILACS. RESULTS: This review included 27 studies that demonstrated MRSA infection prevalence ranging from 0.0 to 15.3% among students. CONCLUSION: The prevalence of colonization of MRSA among healthcare students is high, and the nasal cavity was cited as an important reservoir location for these microorganisms.

Resistencia antimicrobiana y factores de virulencia en aislados de Vibrio cholerae O1. Cuba, 2012-2015 / Antimicrobial resistance and virulence factors in Vibrio cholerae O1 isolates. Cuba, 2012-2015

Introducción: El cólera es una infección intestinal aguda causada por cepas toxigénicas de Vibrio choleare. La rápida diseminación y emergencia de la multirresistencia que caracteriza a este patógeno, podría interferir en el éxito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la política de control de la resistencia antimicrobiana. Objetivo: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interés empleados en el tratamiento, la presencia de factores de virulencia enzimáticos y si existe relación entre ambos. Métodos: Se realizó un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, procedentes de brotes de enfermedades diarreicas agudas de la red nacional de laboratorios de Microbiología de Cuba. Se aplicaron métodos convencionales fenotípicos para determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimáticos y la relación de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente a azitromicina (98 por ciento), doxiciclina (96 por ciento) y ciprofloxacina (93 por ciento) y de resistencia frente a ampicilina (100 por ciento) y trimetoprim-sulfametoxazol (99,4 por ciento). Se encontraron 44 aislados (8,8 por ciento) multirresistente. Todos los aislamientos poseían al menos dos enzimas extracelulares como factores de virulencia, las más frecuentes: gelatinasa (96 por ciento) y lecitinasa (95 por ciento). Conclusiones: Se evidencia una relación directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidémicos(AU)

Introduction: Cholera is an acute intestinal infection caused by toxigenic strains of Vibrio choleare. The rapid dissemination and emergence of the multiresistance that characterizes this pathogen could interfere with the success of antimicrobial therapy, so it is a priority to monitor changes in susceptibility patterns, as a transcendental part of the resistance control policy antimicrobial. Objective: To determine the behavior of antimicrobial resistance against the antimicrobials of interest used in the treatment, the presence of enzymatic virulence factors and whether there is a relationship between them. Methods: A descriptive cross-sectional study was conducted during July 2012 to December 2015. Where 500 isolates belonging to the cepary of the National Reference Laboratory for Acute Diarrheal Diseases of the Institute of Tropical Medicine Pedro Kourí, from outbreaks of EDA of the national network of Microbiology laboratories in Cuba. Conventional phenotypic methods were applied to determine the behavior of antimicrobial resistance, the presence of enzymatic factors and their relationship with antimicrobial resistance. Results: The highest percentages of sensitivity were obtained against azithromycin (98 percent), doxycycline (96 percent) and ciprofloxacin (93 percent) and resistance to ampicillin (100 percent) and trimethoprim-sulfamethoxazole (99.4 percent). 44 isolated (8.8 percent) multi-resistant were found. All isolates had at least two extracellular enzymes as virulence factors, the most frequent: gelatinase (96 percent) and lecithinase (95 percent). Conclusions: There is a direct and proportional relationship between the presence of virulence factors and antimicrobial resistance, synergism that arises greater pathogenicity of the isolates studied from epidemic outbreaks(AU)

Resistance of bovine gastrointestinal nematodes to four classes of anthelmintics in the semiarid region of Paraíba state, Brazil / Resistência de nematódeos gastrintestinais de bovinos à quatro classes de anti-helmínticos no semiárido do Estado da Paraíba, Brasil

Abstract The effectiveness of four anthelmintic classes on cattle gastrointestinal nematodes in the semi-arid region of Paraiba State, Brazil, was evaluated. Twenty farms were used, testing 40 animals in each one, totaling 800 animals. Cattle were divided into four groups composed with ten animals: I, treated with albendazole sulfoxide 15%; II, treated with ivermectin 1%; III, treated with closantel 25%; IV, treated with levamisole hydrochloride 7.5%. All treatments were administered subcutaneously. For the Fecal Egg Count Reduction Test (FECRT), individual fecal samples were collected on days 0 and 14, and sent for analysis of egg count per gram of feces (EPG) and larval cultures. It was observed that multiresistance was present in 95% (19/20) of the farms. Resistance to ivermectin and albendazole was observed in 95% (19/20), to closantel in 75% (15/20) and to levamisole in 20% (4/20). The most used management system was semi-intensive (75%; 15/20) and the ivermectin was the most reported drug for controlling helminths (65%; 13/20). Haemonchus spp. was the most prevalent helminth genus. It was concluded that the anthelmintic resistance of bovine gastrointestinal nematodes is high in the semi-arid of Paraíba State, Brazil, with multiresistance observed mainly to ivermectin, albendazole and closantel.

Resumo Avaliou-se a eficácia de quatro classes de anti-helmínticos sobre nematódeos gastrintestinais de bovinos na região semiárida da Paraíba, Brasil. Foram utilizadas 20 fazendas, sendo testados 40 animais em cada uma, totalizando 800 animais. Os bovinos foram distribuídos em quatro grupos compostos por dez animais: I, tratado com sulfóxido de albendazol 15%; II, tratado com ivermectina 1%; III, tratado com closantel 25%; IV, tratado com cloridrato de levamisole 7,5%. Para o Teste de Redução da Contagem de Ovos Fecais (TRCOF), amostras fecais individuais foram coletadas nos dias 0 e 14 e enviadas para análises de contagem de ovos por grama de fezes (OPG) e coproculturas. Observou-se que a multirressistência estava presente em 95% (19/20) das fazendas. Foi observada resistência à ivermectina e ao albendazol, em 95% das fazendas (19/20); ao closantel, em 75% (15/20) e, ao levamisole, em 20% (4/20). O sistema de manejo mais utilizado foi o semi-intensivo (75%; 15/20) e a ivermectina foi o fármaco mais relatado para controle de verminose (65%; 13/20). O gênero de helminto mais prevalente foi Haemonchus spp. (76,7%). Conclui-se que é alta a resistência anti-helmíntica por nematódeos gastrintestinais de bovinos no Semiárido da Paraíba, Brasil, com multirressistência observada principalmente à ivermectina, ao albendazol e ao closantel.

Antimicrobial resistance evaluation of bacteria isolated from infections in small animals in the Umuarama region, Paraná / Avaliação da resistência antimicrobiana de bactérias isoladas de infecções em pequenos animais na região de Umuarama, Paraná

Bacterial resistance is shown to be an inevitable side effect due to the excessive use of antibiotics, becoming a significant concern worldwide. Knowledge of regional bacterial resistance profiles enables the development of site-specific infection control practices, making conscious and moderate use of commercially available antibiotics. The aim of this study was the retrospective evaluation of the antimicrobial resistance profile of bacteria isolated from companion animal infections in the region of Umuarama/PR, from 2013 to 2017. This research was performed by analyzing the database belonging to the "Laboratório de Microbiologia Animal" at the "Universidade Estadual de Maringá" (UEM). Staphylococcus spp. represented 45.53% of the bacteria isolated from clinical infections in small animals in the period and place evaluated, followed by enterobacteria (34.04%), non-fermenting Gram-negative bacilli (NFGNB, 11.06%) and Streptococcus/Enterococcus (9.36%). A high number of antimicrobial resistance to antibiotics used in veterinary medicine was found. The lowest resistances associated with the best impact factor values were found for aminoglycosides, especially amikacin, chloramphenicol, and fluoroquinolones (norfloxacin and ciprofloxacin). Intermediate results were found for sulbactam-associated ampicillin, ceftriaxone, amoxicillin-clavulanic acid, and enrofloxacin. According to the number of resistant antimicrobial drugs, 64.26% (151/235) of the isolates were classified as multidrug-resistant, being 15.32% extensively resistant. Considering the resistance to antimicrobial classes, 68.94% (162/235) of the isolates were classified as multiresistant, being 19.15% extensively resistant. No bacterial strains were characterized as pan-resistant, but ten bacteria were resistant to all classes tested, with isolated susceptibility to certain drugs. Through the evaluation of resistance profiles found in the period and place studied and relevant literature, it is clear that there is a growing increase in the number of multiresistant bacteria among domestic animals which characterizes a serious risk to public health. The therapeutic arsenal is becoming increasingly diminished, and there is more difficulty in empirical drug selection, making antimicrobial susceptibility testing essential for more specific selection in antimicrobial therapy. Educational measures on the conscious use of antibiotics, infection control, and prevention of local specific zoonoses need to be instituted for the knowledge of health professionals and general access of the population.(AU)

A resistência bacteriana, mostra-se como um efeito colateral inevitável pelo excessivo uso de antibióticos, tornando-se alvo de grande preocupação mundial. O conhecimento dos perfis de resistência bacteriana regionais possibilita o desenvolvimento de práticas de controle de infecções específicas para cada localidade, fazendo uso consciente e moderado dos antibióticos disponíveis no mercado. O objetivo deste estudo foi a avaliação retrospectiva do perfil de resistência antimicrobiana de bactérias isoladas de infecções de animais de companhia na região de Umuarama/PR, no período de 2013 a 2017. Esta pesquisa foi realizada por meio da análise do banco de dados pertencente ao Laboratório de Microbiologia Animal da Universidade Estadual de Maringá (UEM). Os Staphylococcus spp. representaram 45,53% das bactérias isoladas de infecções clínicas em pequenos animais no período e local avaliado, seguido por enterobactérias (34,04%), bacilos Gram-negativos não fermentados (BGNNF, 11,06%) e Streptococcus/Enterococcus (9,36%). Um número elevado de resistência antimicrobiana frente aos antibióticos utilizados na medicina veterinária foi encontrado. As menores resistências associadas aos melhores valores do fator de impacto foram encontrados para aminoglicosídeos, em especial amicacina, cloranfenicol, fluoroquinolonas (norfloxacina e ciprofloxacina). Já resultados intermediários foram encontrados para ampicilina associada a sulbactam, ceftriaxona, amoxacilina com ácido clavulônico e enrofloxacina. Conforme o número de drogas antimicrobianas resistentes, foram classificados como multirresistentes 64,26% (151/235) dos isolados, sendo 15.32% extensivamente resistentes. Já considerando a resistência a classes de antimicrobianos, 68,94% (162/235) dos isolados foram classificados como multirresistentes, sendo 19.15% extensivamente resistentes. Nenhum isolado bacteriano foi caracterizado como pan-resistente, porém 10 bactérias foram resistentes a todas as classes testadas, com susceptibilidade isolada a determinadas drogas. Por meio da avaliação dos perfis de resistência encontrados no período e local estudados e de literatura pertinente, percebe-se que há um aumento crescente no número de bactérias multirresistentes entre os animais domésticos o que caracteriza um grave risco à saúde pública. O arsenal terapêutico está se tornando cada vez mais diminuto e há mais dificuldade na seleção empírica de drogas, tornando essencial a realização de testes de susceptibilidade antimicrobiana para uma seleção mais específica na terapêutica antimicrobiana. Medidas educativas sobre o uso consciente dos antibióticos, controle de infecções e prevenção de zoonoses específicas para as localidades precisam ser instituídas para conhecimento dos profissionais do setor da saúde e acesso geral da população.(AU)

Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology

Urinary tract infections (UTIs) are one of the most common types of bacterial infections in humans, bothin the community and in health care settings. UTIs include a range of clinical entities ranging in severityfrom asymptomatic infection to acute cystitis, prostatitis, pyelonephritis, and urethritis. This is one of themost common diseases encountered in medical practice today, affecting people of all ages, from newborn togeriatric age group. The bacteria most commonly implicated as agents responsible for UTIs generally originatein the intestine and include Escherichia coli, Pseudomonas spp., Streptococcus spp., Proteus spp., Klebsiellaspp., Staphylococcus spp., Neisseria gonorrhoeae, Chlamydia trachomatis, and Candida spp. There arevirulence factors of urinary pathogens that promote adhesion to mucosal surfaces and subsequent infections.The multiresistant of these enterobacteria responsible for UTIs is a major public health problem. Antibioticresistance remains a major problem, especially in the developing countries where hygiene conditions are stillprecarious and antibiotic use is often abusive and poorly controlled. The multidrug-resistant Enterobacteriaceaemost implicated in UTIs by extended-spectrum beta-lactamases (ESBL) and carbapenemase production are:Klebsiella pneumoniae, E. coli, and Proteus spp., not to mention Acinetobacter baumanii and Pseudomonasaeruginosa, the most carbapenemase producing. The detection of ESBL and carbapenemase production isbased mainly on phenotypic and genotypic tests.

Occurrence and antimicrobial resistance of bacteria in retail market spices / Ocorrência e resistência antimicrobiana de bactérias em especiarias comercializadas no varejo

ABSTRACT: This study aimed to evaluate the microbiological quality and the transmission of multidrug-resistant bacteria in different spices sold in town fairs (local food markets) in the municipalities of Recôncavo Baiano. Samples of black pepper, oregano, and cinnamon were collected over a period of six months and investigated for coliforms at 45 °C, Staphylococcus spp., Staphylococcus aureus, Bacillus spp., Bacillus cereus, Escherichia coli and Salmonella spp. The contamination in the black pepper samples (log 4.66 CFU g-1) was higher (P>0.05), than those of cinnamon (log 2.55 CFU g-1) and oregano (log 2.49 CFU g-1), particularly for B. cereus. E. coli (89%) and Salmonella spp. (67%) were isolated only from black pepper. B. cereus and S. aureus showed greater resistance to β-lactams (penicillin, oxacillin, and cefepime), with approximately 40% of the strains with a multiple antimicrobial resistance (MAR) index of 0.33 (i.e., resistant to three antimicrobials). E. coli was more resistant to ampicillin and Salmonella spp. to nalidixic acid, ampicillin, and ceftriaxone. Salmonella spp. had a MAR index ranging from 0.16 to 0.91 (i.e, resistant to up to 11 antimicrobials), and E. coli to up to 0.58 (i.e., resistant to 7 antimicrobials). In conclusion, the spices sold in the town fairs of Recôncavo Baiano are of low microbiological quality, with the presence of pathogens, of which some display high resistance to antimicrobials that are commonly used for treating foodborne illnesses.

RESUMO: Este estudo teve como objetivo avaliar a qualidade microbiológica e a veiculação de bactérias multirresistentes em diferentes especiarias comercializadas em feiras livres nos municípios do Recôncavo Baiano. Foram analisadas amostras de pimenta-do-reino, orégano e canela durante seis meses e pesquisados coliformes a 45 °C, Staphylococcus spp., Staphylococcus aureus, Bacillus spp., Bacillus cereus, Escherichia coli e Salmonella spp. A contaminação nas amostras de pimenta-do-reino (log 4,66 UFC g-1) foi maior (P>0,05), quando comparado com as amostras de canela (log 2,55 UFC g-1) e orégano (log 2,49 UFC g-1), principalmente para B. cereus. E. coli (89%) e Salmonella spp. (67%) foram isoladas apenas na pimenta-do-reino. B. cereus e S. aureus apresentaram maior resistência aos β-lactâmicos (penicilina, oxacilina e cefepime), com cerca de 40% das cepas com índice MAR de 0,33 (resistência a 3 antimicrobianos). E. coli foi mais resistente a ampicilina e Salmonella spp. ao ácido nalidíxico, ampicilina e ceftriaxona. Salmonella spp. apresentou índice MAR variando de 0,16 a 0,91 (até 11 antimicrobianos), e E. coli até 0,58 (7 antimicrobianos). Com isso, as especiarias comercializadas nas feiras livres do Recôncavo Baiano apresentam baixa qualidade microbiológica, com presença de patógenos e elevada resistência a antimicrobianos comumente usados no tratamento de enfermidades transmitidas por alimentos.

Perfil de resistência antimicrobiana de Klebsiella pneumoniae isoladas de animais domésticos e silvestres / Antimicrobial resistance profile of Klebsiella pneumoniae isolated from domestic and wild animals

Klebsiella pneumoniae é um patógeno oportunista, responsável por diversos tipos de infecções nosocomiais, e é considerado um microrganismo multirresistente. Dados na literatura que forneçam informações a respeito da resistência desse microrganismo a antimicrobianos em amostras de animais são escassos. Dessa forma, o objetivo deste trabalho foi avaliar o perfil e o seu aumento das resistências a antimicrobianos dentro da medicina veterinária. Um total de 67 isolados de K. pneumoniae, provenientes de diferentes sítios de isolamento de animais domésticos (39/67) e silvestres (28/67), foi confirmado por sequenciamento do gene 16S rRNA. O maior percentual de isolamento de K. pneumoniae foi de amostras de urina, com 16% (11/67), fezes, com 15% (10/67), e pulmão, com 13,5% (09/67). No perfil de resistência, foram testadas 11 categorias de antibióticos, sendo a maior taxa de resistência ao metronidazol 97% (65/67), à ampicilina 94% (63/67), à amoxicilina 93% (62/67), às sulfonamidas 93% (62/67), à colistina 93% (62/67) e à nitrofurantoína 88% (59/67). Aqueles que apresentaram menor taxa de resistência foram: meropenem 3% (2/67), imipenem 6% (4/67) e amicacina 16% (11/67). Todos os isolados foram considerados bactérias multirresistentes (MRD), com o índice de resistência múltipla aos antibióticos (IRMA) variando de 0,15 a 0,85 e com 60 tipos de padrões de resistência. O resultado deste estudo reforça que os animais são reservatórios de K. pneumoniae multirresistentes.(AU)

Klebsiella pneumoniae is an opportunistic pathogen responsible for several types of nosocomial infections and is considered a multiresistant microorganism. Data in the literature that provide information regarding the resistance of this microorganism to antimicrobials in animal samples are scarce. Thus, the objective of this work was to evaluate the profile and its increase of antimicrobial resistance within Veterinary Medicine. A total of 67 K. pneumoniae isolates from different domestic (39/67) and wild (28/67) isolation sites were confirmed by sequencing the 16S rRNA gene. The highest percentage of K. pneumoniae isolation was from urine samples with 16% (11/67), faeces 15% (10/67) and lung 13.5% (09/67). In the resistance profile, 11 categories of antibiotics were tested, with the highest resistance to metronidazole being 97% (65/67), ampicillin 94% (63/67), amoxicillin 93% (62/67), sulfonamides 93% (62 / 67), 93% colistin (62/67), and 88% nitrofurantoin (59/67). The ones with the lowest resistance were: meropenem 3% (2/67), imipenem 6% (4/67) and amikacin 16% (11/67). All isolates were considered multiresistant bacteria (MDR), with the Multiple Resistance to Antibiotics Index (IRMA) ranging from 0.15 to 0.85 and with 60 types of resistance patterns. The result of this study reinforces that the animals are reservoirs of multiresistant K. pneumoniae.(AU)

Multirresistencia de Escherichia coli y Klebsiella pneumoniae provenientes de pacientes con infección del tracto urinario adquirida en la comunidad / Escherichia coli and Klebsiellap neumoniae multiresistance from patients with urinary tract infection acquired in the community

Introducción: El incremento de la multirresistencia bacteriana constituye un problema de salud pública a nivel internacional. Objetivos: Determinar la susceptibilidad antimicrobiana y los patrones de multirresistencia en cepas de Escherichia coli y Klebsiella pneumoniae aisladas de urocultivos. Métodos: Se realizó un estudio descriptivo retrospectivo en el Centro Municipal de Higiene, Epidemiología y Microbiología, municipio Güines, provincia Mayabeque, Cuba, en el periodo comprendido de enero a diciembre de 2017. El estudio incluyó 250 cepas de Escherichia coli y 62 de Klebsiella pneumoniae aisladas e identificadas de muestras de orina de pacientes con infección del tracto urinario adquirida en la comunidad. La susceptibilidad antimicrobiana fue evaluada con el método de difusión en agar empleado la técnica de Kirby Bauer. Resultados: En Escherichia coli se observó niveles de resistencia superiores al 60 por ciento a los antimicrobianos ácido nalidíxico, cefotaxima, trimetoprim - sulfametoxazol y ceftazidima. La nitrofurantoína y la amikacina presentaron 88,8 por ciento y 83,8 por ciento de efectividad, respectivamente. Se apreció en Klebsiella pneumoniae altos valores de resistencia a ceftazidima, trimetoprim - sulfametoxazol y ácido nalidíxico. Amikacina, presentó niveles de sensibilidad de un 71 por ciento. La resistencia a las cefalosporinas de tercera generación se detectó en 78 (31,2 por ciento) de Escherichia coli y 26 (41,9 por ciento) de Klebsiella pneumoniae. De los aislados de Escherichia coli 143 (57,2 por ciento) y Klebsiella pneumoniae 35 (56,4 por ciento) presentaron multidrogoresistencia. Conclusiones: Existe la circulación de cepas resistentes a cefalosporinas de tercera generación y multidrogorresistentes causantes de infecciones de las vías urinarias adquiridas en la comunidad y se informa sobre los antibióticos (nitrofurantoína y amikacina) que podrían ser utilizados para combatirlas de forma empírica en esta área geográfica(AU)

Introduction: The increase of bacterial multiresistance constitutes a public health problem at the international level. Objectives: To determine antimicrobial sensitivity and multiresistance patterns in strains of Escherichia coli and Klebsiellapneumoniae isolated from urine cultures. Methods: A retrospective, descriptive study was conducted at the Municipal Center for Hygiene, Epidemiology and Microbiology, Güines municipality, Mayabeque Province, Cuba, in the period from January to December, 2017. The study included 250 Escherichia coli and 62 Klebsiellapneumoniae strains isolated and identified from urine samples from patients with urinary tract infection acquired in the community. Antimicrobial sensitivity was evaluated with the method of diffusion in agar using Kirby Bauer´s technique. Results: In Escherichia coli, resistance levels higher than the 60% were observed in antimicrobial nalidixic acid, cefotaxime, trimethoprim-sulfamethoxazole and ceftazidime. Nitrofurantoin and amikacin presented 88.8 percent and 83.8 percent of effectiveness, respectively. High values of resistance to ceftazidime, trimethoprim-sulfamethoxazole and nalidixic acid were present in Klebsiellapneumoniae. Amikacin presented sensitivity levels of 71 percent. Resistance to third-generation cephalosporins was detected in 78 (31.2 percent) of Escherichia coli and 26 (41.9 percent) Klebsiellapneumoniae. From the Escherichia coli and Klebsiellapneumoniae isolates, 143 (57.2 percent) and 35 (56.4 percent),respectively, presented multidrug resistance. Conclusions: There is circulation of strains which are resistant to third generation cephalosporins and multidrug resistants that cause urinary tract infections acquired in the community and there are reports on antibiotics (nitrofurantoin and amikacin) that might be used to combat them empirically in this geographical area(AU)

Occurrence of the vanA gene in Staphylococcus epidermidis from nasopharyngeal secretion of Health-Care Workers, Recife, Brazil

Abstract INTRODUCTION: The increasing reports of vancomycin-resistant Staphylococcus strains (VRS) haves caused concern worldwide, from the laboratory detection to patient management. This study aimed to identify the occurrence of VRS strains among healthcare professionals from a university hospital. METHODS: A total of 102 Staphylococcus sp. isolates from healthcare professionals, obtained in a previous study were evaluated according to standard techniques for VRS detection. RESULTS: After screening inoculation of plates containing 6µg/ml of vancomycin, 19 resistant isolates were identified. The susceptibility profile to other antimicrobials revealed 18 multidrug resistant isolates. The minimum inhibitory concentration (MIC) was determined by E-test and broth microdilution. According to E-tests, of 19 isolates grown in BHI-V6, four isolates presented MIC ≥ 128 µg/ml, seven with MIC ranging from 4 to 8 µg/ml, and eight with MIC ≤ 2µg/ml. By broth microdilution, 14 isolates presented MIC ≤ 2 µg/ml and five with MIC ≥ 16µg/ml. The presence of the gene vanA was determined by PCR in the five resistant isolates, and this gene was detected in one of the strains. Furthermore, among the 19 strains, the gene mecA was found in 13 (39,4%) isolates, including the strain carrying the gene vanA. CONCLUSIONS: Based on these results, we highlight the presence of one strain carrying both vanA and the mecA genes, as well as multidrug-resistant strains colonizing healthcare professionals, and their importance as potential vectors to spread strains carrying resistance genes in the hospital environment.

Biofilm production by clinical isolates of Pseudomonas aeruginosa and structural changes in LasR protein of isolates non biofilm-producing

ABSTRACT Introduction: Biofilm production is an important mechanism for the survival of Pseudomonas aeruginosa and its relationship with antimicrobial resistance represents a challenge for patient therapeutics. P. aeruginosa is an opportunistic pathogen frequently associated to nosocomial infections, especially in imunocompromised hosts. Objectives: Analyze the phenotypic biofilm production in P. aeruginosa isolates, describe clonal profiles, and analyze quorum sensing (QS) genes and the occurrence of mutations in the LasR protein of non-biofilm producing isolates. Methods: Isolates were tested for biofilm production by measuring cells adherence to the microtiter plates. Clonal profile analysis was carried out through ERIC-PCR, QS genes were by specific PCR. Results: The results showed that 77.5% of the isolates were considered biofilm producers. The results of genotyping showed 38 distinct genetic profiles. As for the occurrence of the genes, 100% of the isolates presented the lasR, rhlI and rhlR genes, and 97.5%, presented the lasI gene. In this study nine isolates were not biofilm producers. However, all presented the QS genes. Amplicons related to genes were sequenced in three of the nine non-biofilm-producing isolates (all presenting different genetic similarity profile) and aligned to the sequences of those genes in P. aeruginosa strain PAO1 (standard biofilm-producing strain). Alignment analysis showed an insertion of three nucleotides (T, C and G) causing the addition of an amino acid valine in the sequence of the LasR protein, in position 53. Conclusion: The modeling of the resulting LasR protein showed a conformational change in its structure, suggesting that this might be the reason why these isolates are unable to produce biofilm.

Phylogenetic analysis, biofilm production, and antimicrobial resistance profile of Escherichia coli isolated from slaughtered pigs / Análise filogenética, produção de biofilme e perfil de resistência antimicrobiana de Escherichia coli isoladas de suínos abatidos

Enteric diseases of bacterial origin are frequent in the pig industry, of particular notoriety are the colibacillosis that mainly affect piglets and cause great damage to the swine industry worldwide. The aim of the study was to analyze phylogenetics, to detect biofilm production, and to determine antimicrobial resistance profile in 126 strains of Escherichia coli isolated from swabs obtained from fragments of the small intestines of 235 healthy pigs killed in slaughterhouses in Pernambuco (Brazil) using polymerase chain reaction (PCR), adherence to microplates test and disc diffusion technique. Of the analyzed samples, 88.10% (111/126) were classified in phylogenetic group B1; 4.76% (6/126) in group D; 3.97% (5/126) in group B2 and, 3.17% (4/126) in group A. Antimicrobial resistance rates observed were: lincomycin 100% (126/126), erythromycin 100% (126/126), chlortetracycline 94.44% (119/126), cephalothin 51.59% (65/126), ampicillin 38.89% (49/126), sulfamethoxazole + trimethoprim 37.3% (47/126), ciprofloxacin 19.84% (25/126), norfloxacin 14.29% (18/126), gentamicin 8.73% (11/126) and, chloramphenicol 5.55% (7/126). Multiple antibiotic resistance (MAR) ranged from 0.2 to 0.9. Of the strains tested 46.03% (58/126) produced biofilm, and 99.21% (125/126) of the strains exhibited multi-resistance. Further studies are required to elucidate the importance of each phylogenetic group in pigs and to prevent the propagation of multi-resistant E. coli strains.(AU)

Doenças entéricas de origem bacteriana são frequentes na indústria de suínos, destacando-se a colibacilose, que afeta principalmente leitões e causa grandes danos à indústria suína em todo o mundo. Cento e vinte e seis cepas de Escherichia coli foram isoladas de swabs obtidos de fragmentos de intestino delgado de 235 suínos saudáveis abatidos em matadouros de Pernambuco (Brasil). O objetivo do presente estudo foi analisar filogeneticamente essas cepas, bem como detectar a produção de biofilme e determinar o perfil de resistência antimicrobiana delas, utilizando-se a reação em cadeia da polimerase (PCR), o teste de adesão em microplacas e a técnica de disco-difusão. 88,10% (111/126) das amostras foram classificadas no grupo filogenético B1; 4,76% (6/126) no grupo D; 3,97% (5/126) no grupo B2; e 3,17% (4/126) no grupo A. As taxas de resistência antimicrobiana observadas foram: lincomicina 100% (126/126), eritromicina 100% (126/126), clortetraciclina 94,44% (119/126), cefalotina 51,59% (65/126), ampicilina 38,89% (49/126), sulfametoxazol + trimetoprima 37,3% (47/126), ciprofloxacina 19,84% (25/126), norfloxacina 14,29% (18/126), gentamicina 8,73% (11/126) e cloranfenicol 5,55% (7/126). O índice de resistência múltipla (IRMA) variou de 0,2 a 0,9. Entre as amostras, 46,03% (58/126) produziram biofilme e 99,21% (125/126) foram multirresistentes. São necessários mais estudos para elucidar a importância de cada grupo filogenético em suínos e evitar a propagação de estirpes de E. coli multirresistentes.(AU)

The presence of plasmids in Aeromonas hydrophila and its relationship with antimicrobial and heavy metal-resistance profiles / Presença de plasmídeos em Aeromonas hydrophila e sua relação com perfis de resistência aos antimicrobianos e metais pesados

ABSTRACT: Aeromonas hydrophila is a common fish pathogen that causes extensive damage to aquaculture. To develop and implement a more adequate strategy to farm fish, it is crucial to understand the bacterial-resistance levels and their transference dynamics. The objective of this study was to analyze the resistance profile of isolated Aeromonas hydrophila to antimicrobial agents and heavy metals and draw a correlation of the observed profiles with the presence of plasmids. Resistance of the isolated bacteria to antimicrobial agents (oxacilin, gentamicin, tetracycline, and nalidixic acid) and heavy metals (cadmium, lead, copper, and manganese) was verified using the minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) standards. The Multiple Antibiotic Resistance Index (MAR Index) was calculated. Plasmids were extracted by using a common methodology described elsewhere. Mann-Whitney Test, implemented in the R environment, was used to determine the correlation between resistance and plasmids presence. A high resistance to almost all antimicrobial agents and heavy metals was observed, except to gentamicin and cadmium. The MAR index results showed resistance to all antimicrobial profiles. Of the isolated bacteria, 14 showed the presence of plasmids. However, no correlation was noted between the resistance profile and the plasmid presence for these isolates, indicating that the genes responsible for resistance to microbial agents and heavy metals are present in the cromossomic DNA, which in turn suggested the possibility of gene transfer between the isolated bacteria. The resistance to heavy metals can be linked to heavy utilization of fertilizers along the Sao Francisco River.

RESUMO: Bactérias da espécie Aeromonas hydrophila são patógenos que atacam peixes, causando grandes prejuízos à piscicultura. Entender os perfis de resistência dessa bactéria e a capacidade da mesma em transferir tal resistência é importante para implantação de um manejo adequado na produção de peixes. Os objetivos desse estudo foram analisar a resistência de isolados de Aeromonas hydrophila à antimicrobianos e metais pesados e, correlacionar os perfis encontrados com a presença de plasmídeos. A resistência dos isolados aos antimicrobianos (oxacilina, gentamicina, tetraciclina e ácido nalidíxico) e metais pesados (cádmio, chumbo, cobre e manganês) foi verificada pelas técnicas da Concentração Bactericida Mínima (CBM) e Concentração Inibitória Mínima (CIM). Foi calculado o Índice de Resistência Múltipla aos Antimicrobianos (IRMA). Os plasmídeos foram extraídos por metodologias descritas pela literatura. A relação entre a resistência aos antimicrobianos e metais pesados com a presença de plasmídeos foi determinada pelo teste de Mann-Whitney utilizando o ambiente R. Foi observada alta resistência aos antimicrobianos e metais pesados testados, com exceção à gentamicina e cádmio. No IRMA os isolados apresentaram resistência a todos os perfis de antimicrobianos possíveis. Quatorze isolados apresentaram plasmídeos, mas não foi encontrada relação dos perfis de resistência com a presença destes, o que indica que os genes de resistência a esses compostos estejam presentes no DNA cromossômico. Porém apontam a possibilidade de transferência dos genes de resistência entre os isolados. Estes resultados apontam alta resistência dos isolados e capacidade de transmissão dessa resistência a outras bactérias. A resistência aos metais pesados, pode estar ligada ao uso de fertilizantes nas plantações localizadas próximas as margens do Rio São Francisco.

Evaluation of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Rio Grande do Sul, Brazil

Abstract INTRODUCTION: The rapid global spread of carbapenem-resistant Enterobacteriaceae (CRE) is a threat to the health system. METHODS: We evaluated the antimicrobial susceptibility profiles of 70 CRE isolated in a tertiary hospital in Brazil between August and December 2015, and determined their resistance mechanisms. RESULTS: The most prevalent microorganism was Klebsiella pneumoniae (95.7%); it showed high-level resistance to carbapenems (>98%), with sensitivity to colistin (91.4%) and amikacin (98.6%). The bla KPC gene was detected in 80% of the CRE isolates. CONCLUSIONS: Evaluation of bacterial resistance contributes to an appropriate treatment, and the reduction of morbimortality and dissemination of resistance.

Intramammary treatment with gentamicin in lactating cows with clinical and subclinical mastitis / Tratamento intramamário com gentamicina em vacas com mastite clínica e subclínica durante a lactação

The study evaluated the microbiological profile of milk samples collected before and after mastitis treatment with gentamicin and investigated biofilms production and antimicrobial susceptibility of Staphylococcus spp. isolated. The presence of gentamicin residues in milk after the recommended withdrawal period was also evaluated. Antimicrobial residues were analyzed by Delvotest® SP NT over a period of 12 days beginning after 24 hours the last gentamicin application. Some of Staphylococcus spp. isolates were biofilm producers (19.05%). Staphylococcus spp. showed high levels of resistance to neomycin (16.95%), penicillin G (10.17%), and ampicillin (10.17%). Multidrug resistance to all antibiotics tested was observed in 1.69% of the Staphylococcus spp. isolates. Among 1440 mammary quarter milk samples 24.95% presented gentamicin residues after the withdrawal period. Gentamicin residues were also detected in 3.8% of samples from calibrated glass recorder jar (n=383) 4.1 days after treatment. The indiscriminate use of antibiotics may lead to the emergence of multidrug-resistant strains as well as increasing the risk of presence of residues of these drugs in milk. These problems affect the milk quality and may become a public health problem.

Este estudo avaliou o perfil microbiológico de amostras de leite colhidas antes e após o tratamento da mastite com gentamicina e investigou a produção de biofilmes e o perfil de susceptibilidade antimicrobiana de Staphylococcus spp. isolados. Avaliou-se também a presença de resíduos de gentamicina no leite após o período de carência recomendado. Resíduos de antimicrobianos foram analisados por Delvotest® SP NT ao longo de um período de 12 dias, iniciando 24 horas após a última aplicação de gentamicina. Alguns dos Staphylococcus spp. isolados apresentaram produção de biofilmes (19,05%). Staphylococcus spp. apresentaram elevados níveis de resistência à neomicina (16,95%), penicilina G (10,17%), e ampicilina (10.17%). Multirresistência a todos os antibióticos testados foi observada em 1,69% dos Staphylococcus spp. isolados. Do total de 1440 amostras de leite de quartos mamários, 24,95% apresentaram resíduos de gentamicina após o período de carência. Resíduos de gentamicina também foram detectados em 3,8% das amostras de balões volumétricos coletores de leite (n= 383), 4,1 dias após o tratamento. O uso indiscriminado de antibióticos pode levar ao aparecimento de estirpes multirresistentes bem como o aumento do risco da presença de resíduos destas drogas no leite. Esses problemas afetam a qualidade do leite e podem tornar-se um problema de saúde pública.

Nursing of a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria / 中国实用护理杂志

Objective To conclude the nursing experience in a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Methods Through the nursing process of patients, detailing the points of disinfection and isolation management, vacuum sealing drainage (VSD) care, drug therapy, hyperbaric oxygen therapy, strengthening primary care, psychological care of the patients with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Results Illness was cured after 24 days in the hospital. Conclusions Through the nursing of a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria, reinforces the basic knowledge of nurses, improve nursing skill, which increases the theoretical basis and practical experience in clinical work.

Antibiotic resistance and integrons in Shiga toxin-producing Escherichia coli (STEC)

Shiga toxin-producing Escherichia coli (STEC) cause hemorrhagic colitis (HC) and hemolytic-uremic syndrome in humans (HUS). Cattle are the main reservoir of STEC and transmission to humans occurs through contaminated food and water. Antibiotics are used in pig production systems to combat disease and improve productivity and play a key role in the dissemination of antibiotic resistance genes to the bacteria. Integrons have been identified in resistant bacteria allowing for the acquisition and dissemination of antibiotic resistance genes. STEC strains isolated from humans and animals have developed antibiotic resistance. In our laboratory, 21 non-157 STEC strains isolated from pigs were analyzed to detect class 1 and 2 integrons by PCR. Eight carried integrons, 7 of them harbored intl2. In another study 545 STEC strains were also analyzed for the presence of intl1 and intl2. Strains carrying intl1 belonged to isolates from environment (n = 1), chicken hamburger (n = 2), dairy calves (n = 4) and pigs (n = 8). Two strains isolated from pigs harbored intl2 and only one intl1/intl2, highlighting the presence of intl2 in pigs. The selection for multiresistant strains may contribute to the emergence of antibiotic resistant pathogens and facilitate the spreading of the mobile resistance elements to other bacteria.

Biofilm production by multiresistant Corynebacterium striatum associated with nosocomial outbreak

Corynebacterium striatum is a potentially pathogenic microorganism that causes nosocomial outbreaks. However, little is known about its virulence factors that may contribute to healthcare-associated infections (HAIs). We investigated the biofilm production on abiotic surfaces of multidrug-resistant (MDR) and multidrug-susceptible (MDS) strains of C. striatum of pulsed-field gel electrophoresis types I-MDR, II-MDR, III-MDS and IV-MDS isolated during a nosocomial outbreak in Rio de Janeiro, Brazil. The results showed that C. striatum was able to adhere to hydrophilic and hydrophobic abiotic surfaces. The C. striatum 1987/I-MDR strain, predominantly isolated from patients undergoing endotracheal intubation procedures, showed the greatest ability to adhere to all surfaces. C. striatum bound fibrinogen to its surface, which contributed to biofilm formation. Scanning electron microscopy showed the production of mature biofilms on polyurethane catheters by all pulsotypes. In conclusion, biofilm production may contribute to the establishment of HAIs caused by C. striatum.