Companion psittacine birds as reservoir of gentamicin and vancomycin-resistant Enterococcus spp / Psitacídeos de companhia como reservatórios de Enterococcus spp. gentamicina e vancomicina-resistentes

Enterococcus are recognized worldwide as significant nosocomial agents that have been continuously envolving to adapt to different niches and acquire resistance to several antibiotic classes. Vancomycin and gentamicin-resistant strains of E. faecalis and E. faecium have been associated with nosocomial human infections. Some epidemiological studies suggest the participation of pets as reservoirs of vancomycin and gentamicin-resistant Enterococcus strains. However, the role of companion birds as reservoirs of these strains has been poorly studied. In this study, 126 psittacine birds were evaluated and 26.9% carried Enterococcus spp., including the species E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum and E. casseliflavus. The antibiotic resistance profile showed four high-level gentamicin-resistance (HLGR) strains. In addition, two strains presented intermediate levels of vancomycin resistance. Resistant strains were isolated from fecal and oropharynx samples of sick and clinically healthy birds, suggesting that psittacine birds may act as reservoirs of HLGR Enterococcus spp. However, sick birds appear to be more implicated in the enterococci transmission than healthy birds.(AU)

Enterococcus são reconhecidos mundialmente como significantes agentes nosocomiais, que têm continuamente se adaptado a diferentes nichos e adquirido resistência a várias classes de antibióticos. Cepas de E. faecalis e E. faecium vancomicina e gantamicina-resistentes têm sido associadas a infecções nosocomiais em humanos. Alguns estudos epidemiológicos sugerem a participação de aves como reservatórios de cepas de Enterococcus vancomicina e gentamicina-resistentes. Entretanto, a relação das aves de companhia como reservatórios destas cepas tem sido pouco estudada. Neste estudo, 126 psitacídeos foram avaliados, e 26,9% destes eram portadores de Enterococcus spp., incluindo as espécies E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum e E. casseliflavus. O perfil de resistência antibiótica mostrou quatro cepas com alto nível de resistência a gentamicina (ANRG). Além de duas cepas com nível intermediário de resistência a vancomicina. As cepas resistentes foram isoladas de amostras fecais e de orofaringe de aves doentes e clinicamente saudáveis, sugerindo que psitacídeos podem estar atuando como reservatórios para Enterococcus spp. com ANRG. Contudo, Aves doentes parecem estar mais relacionadas à transmissão de enterococcus, do que aves saudáveis.(AU)

Caracterização fenotípica e genotípica de Enterococcus spp. isolados de ambiente de processamento de queijo Minas Frescal / Phenotypic and genotypic characterization of Enterococcus spp. isolated from Minas Frescal cheese processing line

O objetivo deste trabalho foi identificar as fontes de contaminação de Enterococcus spp. em uma linha de processamento de queijo Minas Frescal e caracterizar estes micro-organismos quanto à capacidade proteolítica e lipolítica bem como quanto as características de patogenicidade. A partir dos resultados, pode-se verificar que os Enterococcus spp. estavam presentes em amostras de matéria-prima, ambiente e produto final, com destaque para o equipamento de ordenha que apresentou a maior contagem de Enterococcus spp. (5 log UFC/cm2) e a maçaneta que apresentou contaminação persistente ao longo das coletas. Aproximadamente 47% dos isolados apresentaram atividade proteolítica e lipolítica. Além disso, os isolados testados apresentaram resistência múltipla a antibióticos e possuíram múltiplos genes de virulência.

Determinação da sensibilidade microbiana in vitro em linhagens de Enterococcus spp. isolados em leite de tanques de refrigeração / Determination of in vitro microbial sensitivity in Enterococcus spp. isolated from bulk tanks milk

Enterococos resist entes à vancomicina são frequentemente multirresistentes e tornaram-se uma das principais causas de infecções nosocomiais. Estão presentes causando mastites em rebanhos leiteiros e contaminando o leite de tanques de refrigeração. Porém, os dados são escassos em relação à sensibilidade das linhagens isoladas na produção leiteira. O objetivo do presente estudo foi determinar o perfil de resistência “in vitro” de Enterococcus spp. isolados de leite de tanques de refrigeração. Foram analisadas 194 amostras de 10 fazendas de Minas Gerais e São Paulo. Foi analisado o perfil de sensibilidade microbiana dessas linhagens frente a 14 antimicrobianos. Mais de 70% das amostras apresentaram resistência à cefalexina, cefoxitina, oxacilina e neomicina, 21,19% foram resistentes intermediárias a vancomicina.

Isolamento de Enterococcus spp. de mortadela vendida fatiada em Niterói/RJ / Isolation of Enterococcus spp. of mortadela sold sliced in Niterói/RJ

Os derivados cárneos vêm, ao longo dos anos, se fazendo cada vez mais presentes no cardápio do brasileiro e, entre eles, a mortadela é de grande importância no setor de frios e embutidos e de maior aceite mundialmente. Foram adquiridos em estabelecimentos comerciais do bairro de Icaraí em Niterói/RJ 33 amostras de mortadela, sendo encaminhadas ao Laboratório de Controle Microbiológico de Produtos de Origem Animal da Faculdade de Veterinária da Universidade Federal Fluminense, onde foram submetidas a pesquisa de enterococos. Das 33 amostras de mortadelas analisadas no presente trabalho, 11 delas apresentaram resultados negativos para a presença de Enterococcus spp.. Entretanto, foram encontrados E. casseliflavus, E. faecium e E. faecalis. A presença do Enterococcus como microbiota contaminante pode tornar o seu consumo perigoso para a saúde humana.

Aqueous humor concentrations of topical fluoroquinolones alone or in combination with a steroid / Concentração de fluorquinolonas no humor aquoso após instilação tópica das associações com corticosteroides

ABSTRACT Purpose: To compare the aqueous humor (AH) concentrations of moxifloxacin 0.5% and gatifloxacin 0.3% solutions alone or when treatment was combined with steroids, and to correlate these concentrations with the minimum inhibitory concentrations (MIC) for the most common endophthalmitis-causing organisms. Methods: Patients undergoing phacoemulsification were enrolled to receive one drop of one of the following solutions: moxifloxacin (G1), moxifloxacin + dexamethasone (G2), gatifloxacin (G3), or gatifloxacin + c (G4), every 15 min, 1h before surgery. AH samples were collected before surgery and analyzed using HPLC-tandem mass spectrometry. Results: The mean antibiotic concentrations in the AH were: G1= 1280.8 ng/mL; G2= 1644.3 ng/mL; G3= 433.7 ng/mL; and G4= 308.1 ng/mL. The mean concentrations statistically differed between G1 and G2 (p=0.01), and G3 and G4 (p=0.008). All samples achieved the MIC for Staphylococcus epidermidis; 100% of the samples from G1 and G2, and 97% from G3 and G4 reached the MIC for fluoroquinolone-sensitive Staphylococcus aureus; 100% of the samples from G1 and G2, 88% from G3, and 72% from G4 reached the MIC for enterococci (p<0.001); and 100% of samples from G1 and G2, 59% from G3, and 36% from G4 reached the MIC for Streptococcus pneumoniae (p<0.001). For fluoroquinolone-resistant S. aureus, 23% from G1, 44% from G2, and no samples from G3 or G4 achieved the MIC (p<0.001). Conclusions: Moxifloxacin + dexamethasone demonstrated a higher concen­tration in the AH than the moxifloxacin alone. Gatifloxacin + steroids demonstrated less penetration into the anterior chamber than gatifloxacin alone. Moxifloxacin was superior to gatifloxacin considering the MIC for enterococci, S. pneumoniae, and fluoroquinolone-resistant S. aureus.

RESUMO Objetivos: Comparar a concentração no humor aquoso entre as soluções de moxifloxacina 0,5% e gatifloxacina 0,3% sozinhas ou combinadas com corticosteroides, e correlacionar a concentração com a concentração inibitória mínima (MIC) para os agentes microbianos mais comumente relacionados a endoftalmites. Métodos: Pacientes que seriam submetidos a cirurgia de catarata foram selecionados para receber 1 gota a cada 15 min, 1 hora antes do procedimento de uma das seguintes soluções: moxifloxacina (G1), moxifloxacina + dexametasona (G2), gatifloxacina (G3) ou gatifloxacina + prednisolona (G4). Amostras do humor aquoso foram coletadas antes do início da cirurgia. Espectrofotometria de massa por HPLC determinou a concentração do antibiótico nas amostras. Resultados: A concentração media de antibiótico nas amostras foram: G1= 1280,8 ng/mL; G2= 1644,3 ng/mL; G3= 433,7 ng/mL; G4= 308,1 ng/mL. Concentração média entre G1 e 2 (p=0,01), e G3 e 4 (p=0,008). Todas as amostras alcançaram MIC para S. epidermidis; 100% das amostras do G1 e 2, e 97% do G3 e 4 atingiram o MIC para S. aureus fluoroquinolona-sensível; 100% das amostras do G1 e 2, 88% do G3 e 72% do G4 atingiram o MIC para Enterococci (p<0,001); e 100% das amostras do G1 e 2, 59% do G3 e 36% do G4 atingiram o MIC para S. pneumoniae (p<0,001). Para o S. aureus resistente a fluoroquinolona, 23% do G1, 44% do G2, e nenhuma das amostras G3 e 4 atingiram o MIC (p<0,001). Conclusão: Moxifloxacina + dexamethasona demonstrou maior concentração no humor aquoso comparado com a moxifloxacina sozinha. Gatifloxacina + esteróide demonstrou menor penetração na câmara anterior comparado a solução de ga­ti­floxacin sem corticóide. A moxifloxacina foi superior a gatifloxacina considerando o MIC para Enterococci, S. pneumoniae e S. aureus fluorquinolona resistente.

Microorganismos aislados en pacientes ingresados. Hospital "Salvador Allende", La Habana. Febrero a junio de 2015 / Isolated microorganisms in admitted patients. "Salvador Allende" Hospital, Havana. February - June 2015

Introducción: Las infecciones constituyen un motivo de consulta frecuente en los servicios hospitalarios y en ocasiones por su gravedad, motivan el ingreso del paciente. En otros casos las infecciones se adquieren en el hospital, lo que incrementa notablemente la morbimortalidad nosocomial. De manera general, los microorganismos que con más frecuencia se aíslan en el medio hospitalario son: Staphylococcus aureus, Enterococcus spp, los bacilos no fermentadores y las enterobacterias. Objetivo: Determinar los microorganismos y sitios de aislamiento más frecuentes en muestras para estudio microbiológico de pacientes ingresados en el Hospital Salvador Allende de La Habana, durante el período de febrero a junio de 2015. Material y Métodos: Se realizó un estudio descriptivo de corte transversal para determinar los microorganismos y sitios de aislamiento más frecuentes en muestras para estudio microbiológico de pacientes ingresados durante el período mencionado. La información referente a la identificación de los microorganismos y al tipo de muestra se obtuvo de los registros del Laboratorio de Microbiología del hospital, se calcularon frecuencias absolutas y relativas y se tabularon los resultados. Resultados: Durante el período estudiado, los microorganismos que más se aislaron fueron:E. coli, bacilos no fermentadores, S. aureus y Enterobacter spp. En cuanto a los sitios de aislamiento, los más frecuentes fueron la piel, la orina, el aparato respiratorio y la sangre. Conclusiones: Fue evidente el predominio de los microorganismos gramnegativos, siendo E. coli el más frecuente de ellos(AU)

Introduction: Infections constitute a frequent chief complaint in hospital services and, because of their seriousness, they sometimes lead to patients´ admissions. In other cases, they are hospital-acquired infections which considerably increase nosocomial morbidity and mortality. Generally, the most frequently isolated microorganisms in hospitals are: Staphylococcus aureus, Enterococcus spp, the non-fermenting bacilli, and enterobacteria. Objective: To determine the most frequent microorganisms and isolation areas in samples used for a microbiological study, taken from patients admitted to Salvador Allende Hospital of Havana, during the February-June period 2015. Material and Methods: A descriptive cross- sectional study was conducted to determine the most frequent microorganisms and isolation areas in the in samples used for a microbiological study, taken from admitted patients during the period mentioned. The information about the identification of microorganisms and the type of sample were both obtained from the records of the Microbiology Laboratory of the hospital; the absolute and relative frequencies were calculated; and the results were tabulated. Results: During the period studied, the most isolated microorganisms were: E. coli, non- fermenting bacilli, S. aureus, and Enterobacter spp. Regarding the isolation areas, the most frequent ones were the skin, the urine, the respiratory system, and the blood. Conclusions: The predominance of gram-negative microorganisms was evident, being the E. coli, the most frequent of them(AU)

Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.

Sepsis neonatal temprana, incidencia y factores de riesgo asociados en un hospital público del occidente de México / Early neonatal sepsis, incidence and associated risk factors in a public hospital in western Mexico

Background: Early neonatal sepsis (EOS) is the second leading cause of death in the first week of life. Epidemiology differs in developed and developing countries. Aim: To describe the epidemiology of EOS among newborn patients in a public hospital in western Mexico. Methods: A prospective cohort study was performed in newborns of Nuevo Hospital Civil de Guadalajara "Dr. Juan I Menchaca". EOS was diagnosed with blood cultures or cultures of cerebrospinal fluid within the first 72 h of life. We analyzed risk factors (RF) by multivariate analysis with logistic regression. Results: We identified an EOS incidence of 4.7 events per 1,000 live births. Seventy two percent of the isolated bacteria were gram negative bacilli. Factors associated with EOS were maternal age ≤ 15 years (OR 3.50; 95% CI 1.56-7.85), rupture of membranes > 18 h (OR 2.65; 95% CI 1.18-5.92), maternal fever (OR 6.04; 95% CI 1.54-23.6), birth weight ≤ 2,500 g (OR 4.82; 95% CI 2.38-9.75) and gestational age < 37 weeks (OR 3.14; 95% CI 1.58-6.22). Conclusions: In addition to the RF known for EOS an independent association was observed with maternal age ≤ 15 years.

Introducción: La sepsis neonatal temprana (SNT) es la segunda causa de muerte en la primer semana de vida; la epidemiología difiere en países desarrollados y en vías de desarrollo. Objetivo: Describir la epidemiología de SNT en recién nacidos (RN) de un hospital público del occidente de México. Material y Métodos: Estudio de cohorte prospectivo en RN del Nuevo Hospital Civil de Guadalajara "Dr. Juan I Menchaca". Se diagnosticó SNT con cultivos de sangre o líquido cefalorraquídeo en las primeras 72 h de vida. Se indagaron factores de riesgo (FR) mediante análisis multivariado con regresión logística. Resultados: La incidencia de SNT fue de 4,7 eventos por 1.000 RN vivos. El 72% de las bacterias aisladas correspondió a bacilos gramnegativos. Los factores asociados a SNT fueron la edad materna ≤ 15 años (OR 3,50; IC 95% 1,56-7,85), ruptura de membranas > 18 h (OR 2,65; IC 95% 1,18-5,92), fiebre materna (OR 6,04; IC 95%1,54-23,6), peso al nacimiento ≤ 2.500 g (OR 4,82; IC 95% 2,38-9,75) y edad gestacional < 37 semanas (OR 3,14; IC 95% 1,58-6,22). Conclusiones: Además de los FR ya conocidos para SNT se observó asociación independiente con edad materna ≤ 15 años.

Evaluation of the chromogenic medium [CPS] in the isolation and identification of urinary tract pathogens

Urine cultures constitute the majority of the workload for a microbiology laboratory with only 20%-30% of urine sample resulting in significant growth. Chromogenic media [CM] are available for urine specimens to enable rapid identification of common pathogens and also has been reported to increase mixed culture detection, reducing unnecessary workup. Chromogenic media offers the potential to lower costs by providing decreased work time, storage space and identification costs. The present study focused on evaluation of the chromogenic medium [CPS] for the diagnosis of UTI in comparison with CLED as a conventional medium. Over the period of January to July 2014, fifty urine samples with >/=100 pus cells /HPF were examined. CPS and CLED media were used for direct inoculation in addition to conventional biochemical reactions and/or API as needed. In comparison with CLED, CPS showed a sensitivity of 93.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 57.1% and total agreement of 94%. The sensitivity of CPS for E. coli was 95%, for KESC was 75%, for Proteeae was 100% and for Enterococcus was 100%. The specificity of CPS for detection of E. coli was 100%, for KESC was 100%, for Proteeae was 97.9% and for Enterococcus was 100%. CPS proved to be a rapid, cost-effective diagnostic method for urinary tract infections. Therefore, CPS can replace the standard primary plating media used in routine diagnosis of urinary tract infection

Identification of anti-microbial producing enterococci isolated from Iranian raw milk cheeses using polyphasic approach

The search for new antimicrobial agents is a field of utmost importance since the prevalence of antimicrobial resistance among key microbial pathogens is increasing at an alarming rate worldwide. This study was performed in order to isolate and identify the potential Enterococci strains exhibiting anti-microbial activity with the help of two anti-microbial detection methods namely Agar-Spot and Well-Diffusion Assay. A collection of Enterococci spp. [about 96 isolates] were isolated from two Iranian raw milk cheeses, namely Lighvan and Koozeh, and subsequently, identified as Enterococcus faecium, Enterococcus faecalis, Enterococcus durans, Enterococcus casseliflavus and Enterococcus italicus by 16S rDNA sequencing. All of the 96 isolates were subjected to Agar-Spot and Well-Diffusion Assay in order to detect their ability to produce antimicrobial compounds. According to Agar-Spot method, 48 out of the 96 isolates produced clear zone on the plates against indicator organisms. With Well-Diffusion Assay, the positive isolates with clear zone decreased to 20 isolates. These 20 isolates [strains] were then subjected to rep-PCR for typing, and 15 distinct rep-PCR profiles [patterns] were identified, from these 15 positive strains, 11 strains were found to belong to Enterococcus faecium

Clinical significance of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization in liver transplant recipients

BACKGROUND/AIMS: Liver transplant patients are at high risk for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) colonization. We evaluated patients before and after liver transplant using active surveillance culture (ASC) to assess the prevalence of MRSA and VRE and to determine the effect of bacterial colonization on patient outcome. METHODS: We performed ASC on 162 liver transplant recipients at the time of transplantation and 7 days posttransplantation to monitor the prevalence of MRSA and VRE. RESULTS: A total of 142 patients had both nasal and rectal ASCs. Of these patients, MRSA was isolated from 12 (7.4%) at the time of transplantation (group 1a), 9 (6.9%) acquired MRSA posttransplantation (group 2a), and 121 did not test positive for MRSA at either time (group 3a). Among the three groups, group 1a patients had the highest frequency of developing a MRSA infection (p < 0.01); however, group 2a patients had the highest mortality rate associated with MRSA infection (p = 0.05). Of the 142 patients, VRE colonization was detected in 37 patients (22.8%) at the time of transplantation (group 1b), 21 patients (20%) acquired VRE posttransplantation (group 2b), and 84 patients did not test positive for VRE at either time (group 3b). Among these three groups, group 2b patients had the highest frequency of VRE infections (p < 0.01) and mortality (p = 0.04). CONCLUSIONS: Patients that acquired VRE or MRSA posttransplantation had higher mortality rates than did those who were colonized pre-transplantation or those who never acquired the pathogens. Our findings highlight the importance of preventing the acquisition of MRSA and VRE posttransplantation to reduce infections and mortality among liver transplant recipients.

Survey of canine tick-borne diseases in Lábrea, Brazilian Amazon: ‘accidental’ findings of Dirofilaria immitis infection / Pesquisa de agentes transmitidos por carrapatos em cães de Lábrea, Amazonas: achados “acidentais” de Dirofilaria immitis

Blood samples were collected from 99 domestic dogs from the urban and rural areas of the Lábrea municipality, state of Amazonas, Brazil. Canine serum samples were tested by immunofluorescence assay against Rickettsia spp., which revealed that only 3.0% (1/33) and 7.6% (5/66) of the dogs from urban and rural areas, respectively, reacted positively to at least one Rickettsia species. DNA was extracted from canine blood and tested by a battery of PCR assays targeting protozoa of the genera Babesia and Hepatozoon, and bacteria of the genera Rickettsia and Ehrlichia and family Anaplasmataceae. All samples were negative in the PCR assays targeting the genera Babesia, Hepatozoon, Ehrlichia and Rickettsia. For Anaplasmataceae, 3% (1/33) and 39.4% (26/66) of the urban and rural dogs, respectively, yielded amplicons that generated DNA sequences 100% identical to the corresponding sequence of Wolbachia endosymbiont of Dirofilaria immitis. Because of these results, all canine DNA samples were further tested in a PCR assay targeting filarial nematodes, which was positive for 18.2% (6/33) and 57.6% (38/66) urban and rural dogs, respectively. Filarial-PCR products generated DNA sequences 100% identical to D. immitis. While tick-borne infections were rare in Lábrea, D. immitis infection rates were among the highest reported in South America.

Amostras de sangue foram coletadas de 99 cães domésticos de áreas urbana e rural do município de Lábrea, estado do Amazonas. Soros caninos foram testados pela técnica de imunofluorescência indireta contra Rickettsia spp., resultando em apenas 3,0% (1/33) e 7,6% (5/66) de cães soropositivos nas áreas urbana e rural, respectivamente. DNA foi extraído do sangue canino e testado por diferentes protocolos da PCR para detecção de protozoários dos gêneros Babesia e Hepatozoon, e bactérias dos gêneros Rickettsia e Ehrlichia e da família Anaplasmataceae. Todas as amostras foram negativas nos protocolos de PCR para os gêneros Babesia, Hepatozoon, Ehrlichia e Rickettsia. Para Anaplasmataceae, 3% (1/33) e 39,4% (26/66) dos cães de áreas urbana e rural, respectivamente, geraram sequências de DNA 100% idênticas ao endosimbionte Wolbachia de Dirofilaria immitis. Posteriormente, as amostras foram testadas pela PCR para nematódeos filarídeos, resultando em 18,2% (6/33) e 57,6% (38/66) de amostras positivas nas áreas urbana e rural, respectivamente. Os produtos geraram sequências de DNA 100% idênticas a D. immitis. Em contraste com várias outras regiões do Brasil, infecções transmitidas por carrapatos foram raras em Lábrea. Por outro lado, as frequências de infecção por D. immitis estiveram entre as mais altas relatadas na América do Sul.

Bacterial microbiota present in the gallbladder of cattle and antimicrobial resistance of Staphylococcus isolates / Microbiota bacteriana presente na vesícula biliar de bovinos e resistência antimicrobiana de isolados de Staphyloccocus

Pathogenic microorganisms can reside transiently or permanently in the gallbladder of cattle. Thus, during slaughter, more attention should be given to the gastrointestinal tract, especially to the accessory organ, the gallbladder. The main aim of this study was to characterize the bacterial microbiota present in bile and gallbladder epithelium of cattle slaughtered in a slaughtering plant under sanitary conditions and to evaluate the antimicrobial resistance in strains of the genus Staphylococcus. Thirty intact gallbladders were collected and the in bile and epithelium were researched for the presence of Aerobic Mesophilic Heterotrophic Bacteria (AMHB), Staphylococcus spp., total Enterobacteriaceae, Enterococcus spp. and Salmonella spp.The frequency of isolation of the microorganism mentioned above were, respectively: 23.02 percent, 14.39 percent, 13.67 percent, 24.46 percent, 0 percent and 24.46 percent. Concerning both gallbladder environments, the frequency of isolation of the microorganisms in the epithelium was 64.03 percent, and in the bile 35.97 percent, with no statistical difference, but with significant difference between the population averages. In antimicrobial susceptibility testing, strains of Staphylococcus from both bile and gallbladder epithelium showed sensitivity to the antimicrobials: penicillin G, ceftriaxone, chloramphenicol and gentamicin. The observation that the gallbladder supports a high frequency of microorganisms brings us to the possible fact that cattle might be a persistent carrier of pathogens of great importance to public health...

Microrganismos patogênicos podem residir temporariamente ou permanentemente na vesícula biliar de bovinos. Assim, durante o abate, maior atenção deve ser dada ao trato gastrointestinal, especialmente para o órgão acessório, a vesícula biliar. O principal objetivo deste estudo foi caracterizar a microbiota bacteriana presente na bile e no epitélio de vesículas biliares de bovinos abatidos em matadouro frigorífico sob inspeção sanitária e avaliar a resistência antimicrobiana de estirpes do gênero Staphyloccocus. Foram coletadas 30 vesículas biliares íntegras e foi pesquisada na bile e no epitélio do órgão a presença de bactérias heterotróficas aeróbias mesófilas (BHAM), Staphylococcus spp. e Enterobacteriaceae totais, Escherichia coli, Enterococcus spp. e Salmonella spp. A frequência de isolamento dos microrganismos citados acima foi, respectivamente: 23,02 por cento, 14,39 por cento, 13,67 por cento, 24,46 por cento, 0por cento e 24,46 por cento. Em relação aos dois ambientes da vesícula, a frequência de isolamento dos microrganismos no epitélio foi de 64,03 por cento, e na bile 35,97 por cento, não sendo diferente estatisticamente, mas com diferença significativa entre as médias populacionais.No teste de susceptibilidade aos antimicrobianos, as estirpes de Staphylococcus isoladas a partir da bile e do epitélio da vesícula biliar apresentaram sensibilidade a: penicilina G, ceftriaxona, cloranfenicol e gentamicina. A observação de que a vesícula biliar comporta microrganismos em elevadas frequências atenta para o fato de que o bovino possa ser um portador persistente de patógenos de grande importância em saúde pública...

Isolation, enumeration, molecular identification and probiotic potential evaluation of lactic acid bacteria isolated from sheep milk

Lactic acid bacteria species were molecularly identified in milk from Lacaune, Santa Inês and crossbred sheep breeds and their in vitro probiotic potential was evaluated. The species identified were Enterococcus faecium (56.25%), E. durans (31.25%) and E. casseliflavus (12.5%). No other lactic acid bacteria species, such as lactobacilli, was identified. Most of the isolated enterococci were resistant to gastric pH (2.0) and to 0.3% oxgall. All tested enterococci were resistant to ceftazidime, oxacillin and streptomycin and sensible to clindamycin, erythromycin and penicillin. The resistance to ciprofloxacin, gentamicin, tetracycline and vancomycin varied among tested species. All tested enterococci strongly inhibited (P<0.05) Escherichia coli and Listeria monocytogenes, moderately inhibited E. faecalis and Staphylococcus aureus and did not inhibit Pseudomonas aeruginosa, Salmonella enterica var. Typhimurium and also one E. durans sample isolated from sheep milk. Four samples of E. faecium, one of E. durans and one of E. casseliflavus presented the best probiotic potential...

Espécies de bactérias ácido-lácticas foram identificadas em nível molecular em leite das raças ovinas Lacaune, Santa Inês e suas mestiças, e o seu potencial probiótico in vitro foi avaliado. As espécies identificadas foram Enterococcus faecium (56,25%), E. durans (31,25%) e E. casseliflavus (12,5%). Nenhuma outra espécie de bactéria ácido-láctica, como Lactobacillus sp., foi identificada. A maioria dos enterococos isolados foi resistente ao pH gástrico (2.0) e a 0,3% de oxgall. Todos os enterococos testados foram resistentes à ceftazidima, oxacilina e estreptomicina e sensíveis à clindamicina, eritromicina e penicilina. A resistência à ciprofloxacina, gentamicina, tetraciclina e vancomicina variou entre as amostras. Todos os enterococos testados inibiram fortemente (P<0,05) Escherichia coli e Listeria monocytogenes, inibiram moderadamente E. faecalis e Staphylococcus aureus e não inibiram Pseudomonas aeruginosa, Salmonella enterica var. Typhimurium e uma amostra de E. durans isolada de leite de ovelha. Quatro amostras de E. faecium, uma de E. durans e uma de E. casseliflavus apresentaram o melhor potencial probiótico...

Primary Aortoenteric Fistula to the Sigmoid Colon in Association with Intra-abdominal Abscess / 대한소화기학회지

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of massive gastrointestinal bleeding. Diagnosis of PAEF is difficult to make and is frequently delayed without strong clinical suspicion. Timely surgical intervention is essential for patient's survival. We report on a case of an 86-year-old woman with no history of abdominal surgery, who presented with abdominal pain. Initially, computed tomography scan showed an intra-abdominal abscess, located anterior to the aortic bifurcation. However, she was discharged without treatment because of spontaneous improvement on a follow-up computed tomography scan, which showed a newly developed right common iliac artery aneurysm. One week later, she was readmitted due to recurrent abdominal pain. On the second day of admission, sudden onset of gastrointestinal bleeding occurred for the first time. After several endoscopic examinations, an aortoenteric fistula bleeding site was found in the sigmoid colon, and aortography showed progression of a right common iliac artery aneurysm. We finally concluded that intra-abdominal abscess induced an infected aortic aneurysm and enteric fistula to the sigmoid colon. This case demonstrated an extremely rare type of PAEF to the sigmoid colon caused by an infected abdominal aortic aneurysm, which has rarely been reported.

Prevalence and phenotypic characterization of Enterococcus spp. isolated from food in Brazil

We evaluated the frequency of enterococci from food and found 95.2% of positivity, being E. faecium and E. faecalis the most frequent species. High-level streptomycin resistance was observed, as well as gelatinase and hemolysis activity, showing the potential role of environmental strains as reservoir of virulence and resistance traits.

Impacto de una técnica automatizada rápida en la identificación de SAMR/ERV en pacientes trasladados desde otros centros hospitalarios / Impact of an automated rapid MRSA/VRE identification technique in the surveillance of patients transferred from other medical centers

Introduction: Identification of patients with methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococci (VRE) is essential to limit the spread of these agents, through the use of isolation and contact precautions. Traditional microbiology has a long turn around time (3-5 days) extending the time of isolation, increasing complexity and cost of these patients. Objectives: To implement a new real time polymerase chain reaction (PCR) GeneXpert R for SAMR and VRE detection. To compare costs and turn around time of PCR versus traditional cultures. Methods: Two periods were compared, in the first, traditional microbiology (standard group) was used, and in the second, only PCR was used (PCR group). Results: MRSA or VRE were identified in 29.9% of patients in the PCR group and in 9.6% in the standard group. Turn around time was 15 ± 9 hours in PCR group and 53 ± 23 hours in standard group. PCR group had a net cost of USD 245 per patient and standard group USD 530 per patient. Discussion: PCR technique GeneXpert R for MRSA and VRE had a positive impact in the management of these patients and justifies its inclusion.

Introducción: La identificación de pacientes con Staphylococcus aureus resistente a meticilina (SARM) y Enterococcus resistente a vancomicina (ERV), permite limitar su diseminación usando aislamiento en cohorte y precauciones de contacto. Los resultados de los cultivos microbiológicos demoran 3 a 5 días, lo que retrasa el retiro de las precauciones y agrega costos económicos. Objetivos: Implementar técnica de reacción de polimerasa en cadena en tiempo real (RPC), GeneXpert R, para SARM y ERV y comparar tiempos de respuesta y costos en relación al uso de microbiología convencional. Material y Métodos: Se compararon dos períodos, uno en que se usó solo RPC (grupo RPC) y otro histórico, en el que se usó microbiología tradicional (grupo estándar) Resultados: Se confirmó SARM y/o ERV en 29,9% de los pacientes del grupo RPC, y en 9,6% del grupo estándar. Los tiempos de respuesta fueron 15 ± 9 h (grupo RCP) y 53 ± 23 h (grupo estándar). Los costos directos por paciente fueron de USD 245 en el grupo RPC y de USD 530 en el grupo estándar. Discusión: La RPC en tiempo real, GeneXpert, para SAMR y ERV tuvo un alto impacto alto clínico que justifica su incorporación.

Evaluación de la peptona papaínica de corazón de res para el enriquecimiento selectivo de Enterococcus / Evaluation of beef heart papainic peptone for selective enrichment of Enterococcus

Introducción: el control microbiológico de aguas y alimentos ha motivado el desarrollo de medios de cultivo selectivos capaces de detectar Enterococcus, los cuales necesitan de una fuente de energía apropiada para garantizar la recuperación de estos. Objetivos: comparar diferentes bases nutritivas elaboradas a partir de productos y subproductos alimenticios según su capacidad de promoción de crecimiento del género Enterococcus y evaluar la exactitud del medio de cultivo caldo azida dextrosa. Métodos: para el ensayo se seleccionaron 80 cepas de diferentes géneros. Se prepararon dos variantes experimentales del caldo azida dextrosa (una tamponada) y se inocularon los microorganismos seleccionados a una concentración estandarizada. El incremento de la biomasa se determinó midiendo la densidad óptica en un espectrofotómetro a 640 nm cada una hora. La evaluación microbiológica del medio de cultivo se realizó utilizando diferentes géneros microbianos a distintas concentraciones. Se determinó la sensibilidad, especificidad, exactitud diagnóstica y relativa y el índice Kappa del diagnosticador. Como medio de referencia se utilizó el caldo azida glucosa proveniente de la firma comercial Merck (Alemania). ..

Introduction: microbiological control of water and food has motivated the development of selective culture media capable of detecting Enterococcus, which need an appropriate source of energy to ensure the recovery of microorganisms. Objectives: compare different nutrient bases produced from food products and by-products according to their growth promotion capacity for the genus Enterococcus, and evaluate the accuracy of dextrose azide broth culture medium. Methods: eighty strains of different genera were selected for the test. Two experimental variants of dextrose azide broth were prepared (one buffered) and the microorganisms selected were inoculated at a standardized concentration. Biomass increase was determined by measuring optical density in a spectrophotometer at 640 nm every 1 h. Microbiological evaluation of the culture medium was carried out using different microbial genera at different concentrations. Diagnostic and relative sensitivity, specificity and accuracy, and the Kappa index were determined for the culture medium. Glucose azide broth (Merck, Germany)ss production than the other genera...

Evaluación del medio cromogénico CromoCen® ENT para el diagnóstico clínico de Enterococcus / Assessment of the CromoCen ENT® chromogenic medium for clinical diagnosis of Enterococcus species

Introducción: la frecuente incidencia de Enterococcus en los hospitales y su creciente resistencia antimicrobiana a nivel mundial, ha incrementado la necesidad de su vigilancia y control intrahospitalario, por lo que resulta imprescindible contar con medios diagnósticos más sensibles y exactos. Objetivo: ampliar la evaluación de la funcionalidad del medio cromogénico CromoCen® ENT para el aislamiento e identificación de Enterococcus spp. procedentes de muestras clínicas. Métodos: se analizaron 150 muestras clínicas (orina, sangre, fecales, exudados vaginales, exudados de lesiones de piel y de catéteres) desde enero hasta abril de 2010, empleando el medio cromogénico y los medios convencionales correspondientes como controles, se evaluó la incidencia de Enterococcus spp. Se identificaron los aislamientos con un conjunto de 12 pruebas bioquímicas. A partir de los datos de la identificación bioquímica se determinaron los indicadores de calidad tanto para el medio CromoCen® ENT como para los medios de referencia. Resultados: el medio cromogénico promovió el crecimiento de Enterococcus spp. en solo 24 h, lo cual permitió su fácil reconocimiento por la coloración rosada de las colonias. Los indicadores de calidad diagnóstico mostraron valores superiores a 95 %. El mayor porcentaje de aislamientos se obtuvo en las muestras de orina. Enterococcus faecalis resultó la especie mayormente encontrada en el total de las muestras. Conclusiones: CromoCen® ENT permitió la correcta y rápida identificación de Enterococcus spp. procedentes de diversas muestras clínicas.

Introduction: the frequent incidence of Enterococci at hospitals and their growing antimicrobial resistance worldwide make the in-hospital surveillance and control a pressing need; consequently, it is indispensable to avail of more sensitive and accurate diagnostic means. Objective: to broaden the evaluation of functionality of CromoCen® ENT chromogenic medium for the isolation and identification of Enterococcus spp. from clinical samples. Methods: one hundred and fifty clinical samples were analyzed (urine, blood, feces, vaginal smears, skin lesion exudates and exudates from catheters) in the January-April period, 2010 by using the chromogenic medium and the corresponding conventional culture media as controls; the incidence of Enterococcus spp was evaluated. The isolations were identified with 12 biochemical tests. From the biochemical identification data, it was possible to determine the quality indicators for both CromoCen® ENT and the reference media. Results: the chromogenic medium encouraged the growth of Enterococcus species in 24 hours, allowing their easy recognition due to the pink coloration of the colonies. The diagnostic quality indicator values were over 95 %. The highest percentage of isolates was observed in the urine samples. Enterococcus faecalis was the mostly found species. Conclusions: CromoCen® ENT allowed quick and accurate identification of Enterococcus spp. from various clinical samples.