The chloroplast protein HCF164 is predicted to be associated with Coffea SH9 resistance factor against Hemileia vastatrix.

To explore the connection between chloroplast and coffee resistance factors, designated as SH1 to SH9, whole genomic DNA of 42 coffee genotypes was sequenced, and entire chloroplast genomes were de novo assembled. The chloroplast phylogenetic haplotype network clustered individuals per species instead of SH factors. However, for the first time, it allowed the molecular validation of Coffea arabica as the maternal parent of the spontaneous hybrid "Híbrido de Timor". Individual reads were also aligned on the C. arabica reference genome to relate SH factors with chloroplast metabolism, and an in-silico analysis of selected nuclear-encoded chloroplast proteins (132 proteins) was performed. The nuclear-encoded thioredoxin-like membrane protein HCF164 enabled the discrimination of individuals with and without the SH9 factor, due to specific DNA variants linked to chromosome 7c (from C. canephora-derived sub-genome). The absence of both the thioredoxin domain and redox-active disulphide center in the HCF164 protein, observed in SH9 individuals, raises the possibility of potential implications on redox regulation. For the first time, the identification of specific DNA variants of chloroplast proteins allows discriminating individuals according to the SH profile. This study introduces an unexplored strategy for identifying protein/genes associated with SH factors and candidate targets of H. vastatrix effectors, thereby creating new perspectives for coffee breeding programs.

Capsaicin and gingerol analogues inhibit the growth of efflux-multidrug resistant bacteria and R-plasmids conjugal transfer.

ETHNOPHARMACOLOGICAL IMPORTANCE: Capsicum and ginger are used widely in human diets and in folklore medicines. Chemically, gingerol is a relative of capsaicin and both classes of compounds are notable for their spiciness and characteristic pungent aroma. Previous studies have demonstrated that these compounds contain antimicrobial compounds with robust pharmacological importance. AIM: The present study evaluated the in vitro antibacterial activities of capsaicinoids and gingerols against a panel of clinical MRSA strains and their inhibitory effect on the conjugal transfer of R-plasmids harboured in E. coli. MATERIALS AND METHODS: Crude methanol extract of C. annum was fractionated using solid phase extraction (SPE) and screened for R-plasmid transfer inhibition: TP114, PUB 307, PKM 101, R6K and R7K. The bio-guided assay led to the isolation of bioactive compounds with strong R-plasmid transfer inhibition. The compounds were identified using Nuclear Magnetic resonance (NMR) and Mass spectroscopy (MS). Capsaicin analogues nonivamide, 6-gingerol, 6-shogaol, capsaicin and dihydrocapsaicin were screened for antimicrobial activity against a panel of methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria strains using microdilution method while the plasmid transfer inhibition assay of the compounds was determined by broth mating method. RESULTS: The bioactive fraction Ca-11 showed good inhibition rates (8.57-25.52%) against three R-plasmids PUB307, PKM 101, TP114 followed by the crude extract of C. annum (8.59%) respectively leading to the bioassay-guided isolation of capsaicin and dihydrocapsaicin as the bioactive principles. The antiplasmid effect of pure capsaicin and dihydrocapsaicin were broad and within active ranges (5.03-31.76%) against the various antibiotic resistance-conferring plasmids including R6K, R7K. Capsaicin, 6-gingerol and 6-shogaol had good broad antibacterial activity with MIC values ranging from 8 to 256 mg/L against effluxing MRSA strains SA1199B (NorA), XU212 (TetK) and RN4220 (MsrA). While they exhibited moderate antibacterial activity (128-512 mg/L) against the Gram-negative bacteria. The effect of 6-gingerol, 6-shogaol and nonivamide on the plasmids were very active on PKM 101 (6.24-22.16%), PUB 307 (1.22-45.63%) and TP114 (0.1-7.19%) comparative to the positive control plumbagin (5.70-31.76%). CONCLUSION: These results are suggestive that the R-plasmids could possess substrate for capsaicinoids-like compounds and for their ability to inhibit the plasmid conjugation processes. Plant natural products possess the potential value of antibacterial and mechanistic antiplasmid activity as demonstrated by the compounds and should be evaluated in developing antimicrobial leads to novel mechanism against multidrug-resistant bacteria.

Novel R-plasmid conjugal transfer inhibitory and antibacterial activities of phenolic compounds from Mallotus philippensis (Lam.) Mull. Arg.

Antimicrobial resistance severely limits the therapeutic options for many clinically important bacteria. In Gram-negative bacteria, multidrug resistance is commonly facilitated by plasmids that have the ability to accumulate and transfer refractory genes amongst bacterial populations. The aim of this study was to isolate and identify bioactive compounds from the medicinal plant Mallotus philippensis (Lam.) Mull. Arg. with both direct antibacterial properties and the capacity to inhibit plasmid conjugal transfer. A chloroform-soluble extract of M. philippensis was subjected to bioassay-guided fractionation using chromatographic and spectrometric techniques that led to the isolation of the known compounds rottlerin [5,7-dihydroxy-2,2-dimethyl-6-(2,4,6-trihydroxy-3-methyl-5-acetylbenzyl)-8-cinnamoyl-1,2-chromene] and the red compound (8-cinnamoyl-5,7-dihydroxy-2,2,6-trimethylchromene). Both compounds were characterised and elucidated using one-dimensional and two-dimensional nuclear magnetic resonance (NMR). Rottlerin and the red compound showed potent activities against a panel of clinically relevant Gram-positive bacteria, including meticillin-resistant Staphylococcus aureus (MRSA). No significant direct activities were observed against Gram-negative bacteria. However, both rottlerin and the red compound strongly inhibited conjugal transfer of the plasmids pKM101, TP114, pUB307 and R6K amongst Escherichia coli at a subinhibitory concentration of 100mg/L. Interestingly, despite the planar nature of the compounds, binding to plasmid DNA could not be demonstrated by a DNA electrophoretic mobility shift assay. These results show that rottlerin and the red compound are potential candidates for antibacterial drug lead development. Further studies are needed to elucidate the mode of inhibition of the conjugal transfer of plasmids.

Structures of two bacterial resistance factors mediating tRNA-dependent aminoacylation of phosphatidylglycerol with lysine or alanine.

The cytoplasmic membrane is probably the most important physical barrier between microbes and the surrounding habitat. Aminoacylation of the polar head group of the phospholipid phosphatidylglycerol (PG) catalyzed by Ala-tRNA(Ala)-dependent alanyl-phosphatidylglycerol synthase (A-PGS) or by Lys-tRNA(Lys)-dependent lysyl-phosphatidylglycerol synthase (L-PGS) enables bacteria to cope with cationic peptides that are harmful to the integrity of the cell membrane. Accordingly, these synthases also have been designated as multiple peptide resistance factors (MprF). They consist of a separable C-terminal catalytic domain and an N-terminal transmembrane flippase domain. Here we present the X-ray crystallographic structure of the catalytic domain of A-PGS from the opportunistic human pathogen Pseudomonas aeruginosa. In parallel, the structure of the related lysyl-phosphatidylglycerol-specific L-PGS domain from Bacillus licheniformis in complex with the substrate analog L-lysine amide is presented. Both proteins reveal a continuous tunnel that allows the hydrophobic lipid substrate PG and the polar aminoacyl-tRNA substrate to access the catalytic site from opposite directions. Substrate recognition of A-PGS versus L-PGS was investigated using misacylated tRNA variants. The structural work presented here in combination with biochemical experiments using artificial tRNA or artificial lipid substrates reveals the tRNA acceptor stem, the aminoacyl moiety, and the polar head group of PG as the main determinants for substrate recognition. A mutagenesis approach yielded the complementary amino acid determinants of tRNA interaction. These results have broad implications for the design of L-PGS and A-PGS inhibitors that could render microbial pathogens more susceptible to antimicrobial compounds.

Antibacterial & antiplasmid activities of Helicteres isora L.

BACKGROUND & OBJECTIVES: The multiple drug resistance (MDR) is a serious health problem and major challenge to the global drug discovery programmes. Most of the genetic determinants that confer resistance to antibiotics are located on R-plasmids in bacteria. The present investigation was undertaken to investigate the ability of organic extract of the fruits of Helicteres isora to cure R-plasmids from certain clinical isolates. METHODS: Active fractions demonstrating antibacterial and antiplasmid activities were isolated from the acetone extracts of shade dried fruits of H. isora by bioassay guided fractionation. Minimal inhibitory concentration (MIC) of antibiotics and organic extracts was determined by agar dilution method. Plasmid curing activity of organic fractions was determined by evaluating the ability of bacterial colonies (pre treated with organic fraction for 18 h) to grow in the presence of antibiotics. The physical loss of plasmid DNA in the cured derivatives was further confirmed by agarose gel electrophoresis. RESULTS: The active fraction did not inhibit the growth of either the clinical isolates or the strains harbouring reference plasmids even at a concentration of 400 microg/ml. However, the same fraction could cure plasmids from Enterococcus faecalis, Escherichia coli, Bacillus cereus and E. coli (RP4) at curing efficiencies of 14, 26, 22 and 2 per cent respectively. The active fraction mediated plasmid curing resulted in the subsequent loss of antibiotic resistance encoded in the plasmids as revealed by antibiotic resistance profile of cured strains. The physical loss of plasmid was also confirmed by agarose gel electrophoresis. INTERPRETATION & CONCLUSIONS: The active fraction of acetone extract of H. isora fruits cured R-plasmids from Gram-positive and Gram-negative clinical isolates as well as reference strains. Such plasmid loss reversed the multiple antibiotic resistance in cured derivatives making them sensitive to low concentrations of antibiotics. Acetone fractions of H. isora may be a source to develop antiplasmid agents of natural origin to contain the development and spread of plasmid borne multiple antibiotic resistance.

Piercing: una moda con riesgos para la salud / Piercing: a fashion putting health at risk

El uso de piercings se ha incrementado notablemente en el mundo Su práctica y creciente popularidad representa actualmente un auténtico fenómeno social(1). Los portadores corren series riesgos de salud, por la falta de medidas de higiene en los cuidados posteriores y la falta de capacitación de los colocadores. Esto favorece la aparición de algunas infecciones poco habituales y cuando se colocan en labios, lengua, frenillos, carrillos o úvula provocan frecuentemente lesiones en la cavidad bucal. El propósito de este trabajo fue evaluar las condiciones clínicas y radiográficas de piezas dentarias, mucosas y patologías óseas en 5 adolescentes que utilizan piercing bucal, atendidos en la Cátedra de Odontología Integral Niños de la FOUBA durante el año 2005. En el examen clínico y radiográfico de los pacientes se observó movilidad dentaria, pérdida ósea, fractura dentaria, infección con supuración ene l sitio del piercing, diastema y lesiones periodontales. Conclusiones: el personal de slaud debe orientar sobre el uso de piercing y ayudar a prevenir patologías asociadas, informando a los portadores sobre vacunación previa y cuidados posteriores a la instalación

Piercing: una moda con riesgos para la salud / Piercing: a fashion putting health at risk

El uso de piercings se ha incrementado notablemente en el mundo Su práctica y creciente popularidad representa actualmente un auténtico fenómeno social(1). Los portadores corren series riesgos de salud, por la falta de medidas de higiene en los cuidados posteriores y la falta de capacitación de los colocadores. Esto favorece la aparición de algunas infecciones poco habituales y cuando se colocan en labios, lengua, frenillos, carrillos o úvula provocan frecuentemente lesiones en la cavidad bucal. El propósito de este trabajo fue evaluar las condiciones clínicas y radiográficas de piezas dentarias, mucosas y patologías óseas en 5 adolescentes que utilizan piercing bucal, atendidos en la Cátedra de Odontología Integral Niños de la FOUBA durante el año 2005. En el examen clínico y radiográfico de los pacientes se observó movilidad dentaria, pérdida ósea, fractura dentaria, infección con supuración ene l sitio del piercing, diastema y lesiones periodontales. Conclusiones: el personal de slaud debe orientar sobre el uso de piercing y ayudar a prevenir patologías asociadas, informando a los portadores sobre vacunación previa y cuidados posteriores a la instalación (AU)

Piercing: una moda con riesgos para la salud / Piercing: a fashion putting health at risk

El uso de piercings se ha incrementado notablemente en el mundo Su práctica y creciente popularidad representa actualmente un auténtico fenómeno social(1). Los portadores corren series riesgos de salud, por la falta de medidas de higiene en los cuidados posteriores y la falta de capacitación de los colocadores. Esto favorece la aparición de algunas infecciones poco habituales y cuando se colocan en labios, lengua, frenillos, carrillos o úvula provocan frecuentemente lesiones en la cavidad bucal. El propósito de este trabajo fue evaluar las condiciones clínicas y radiográficas de piezas dentarias, mucosas y patologías óseas en 5 adolescentes que utilizan piercing bucal, atendidos en la Cátedra de Odontología Integral Niños de la FOUBA durante el año 2005. En el examen clínico y radiográfico de los pacientes se observó movilidad dentaria, pérdida ósea, fractura dentaria, infección con supuración ene l sitio del piercing, diastema y lesiones periodontales. Conclusiones: el personal de slaud debe orientar sobre el uso de piercing y ayudar a prevenir patologías asociadas, informando a los portadores sobre vacunación previa y cuidados posteriores a la instalación (AU)

Carica papaya seed macerate as inhibitor of conjugative R plasmid transfer from Salmonella typhimurium to Escherichia coli in vitro and in the digestive tract of gnotobiotic mice.

In this study, the effect of Carica papaya seed macerate on conjugal R plasmid transfer from Salmonella typhimurium to Escherichia coli was investigated in vitro and in the digestive tract of gnotobiotic mice. Twenty-five micrograms per milliliter and 430 mg (administered intragastrically twice a day) of papaya seed macerate concentrations were used during conjugation for in vitro and in vivo assays, respectively. High frequency of conjugation inhibition by macerate was observed for both in vitro and in vivo experiments, independently of bacterial growth and mating conditions. Papaya seed macerate caused a reduction of the transconjugant population ranging from 71% to about 100%. There was no lethal effect of the seed macerate on donor or recipient cells in the concentrations used. Once the mechanisms and magnitude of resistance gene transfer are clearly understood, strategies to reduce or minimize the dissemination of these genes could be relevant. The data here obtained show a clinical potential use of papaya seed macerate on this transfer.

Resistência aos medicamentos anti-tuberculose de cepas de Mycobacterium tuberculosis isoladas de pacientes atendidos em hospital geral de referência para tratamento de AIDS no Rio de Janeiro / Drug-resistant Mycobacterium tuberculosis strains isolated at an AIDS reference center general hospital in Rio de Janeiro

INTRODUÇAO: A tuberculose tem trazido importantes desafios ao setor de saúde. O Brasil tem alta prevalência da doença e o Estado do Rio de Janeiro possui as maiores taxas de incidência do país. O município do Rio de Janeiro é responsável pela maior notificação do estado e cerca de 30 por cento dos casos diagnosticados têm origem em hospitais. OBJETIVO: Estimar a prevalência de resistência inicial e adquirida e identificar fatores associados à ocorrência de resistência em hospital geral referência para tratamento de AIDS no Rio de Janeiro. MÉTODO: Foram analisadas cepas de Mycobacterium tuberculosis de 165 pacientes, entre agosto de 1.996 e fevereiro de 1.998. RESULTADOS: Vinte por cento (33/165) apresentaram resistência a pelo menos um medicamento: 13 por cento (22/165) à isoniazida, 1,8 por cento (3/165) à rifampicina e 3,6 por cento (6/165) a ambas. Entre pacientes infectados pelo HIV (52/165), 28,85 por cento (15/52) apresentaram resistência a pelo menos um fármaco. Resistência adquirida ocorreu em 12,5 por cento dos pacientes que referiram tratamento anterior (3/24), com associação significativa com imagem radiológica não cavitária (p = 0,05). Resistência inicial ocorreu em 18,4 por cento dos pacientes virgens de tratamento (26/141), com associação significativa com ser profissional de saúde (p = 0,004), desemprego (p = 0,03) e diarréia (p = 0,01) na análise bivariada. Na análise multivariada, ser profissional de saúde manteve-se fortemente associado com a ocorrência de resistência inicial (p = 0,002). CONCLUSAO: Taxas de resistência elevadas foram encontradas nesta série. Estes achados corroboram a necessidade de que atenção maior seja dada à tuberculose em ambiente hospitalar, em especial no que diz respeito à preocupante associação entre resistência nas cepas isoladas e profissionais de saúde.

Estados hipertensivos del embarazo / Hypertensive disorders of pregnancy

Los estados hipertensivos del embarazo son situaciones que complican seriamente su evolución. La preeclampsia es una enfermedad patognomónica del embarazo y que causa muchas complicaciones maternas y perinatales. Una atención adecuada en la gestación, el parto y el puerperio puede contribuir a una disminución de las complicaciones y unos mejores resultados obstétricos. (AU)

Actinobacillus pleuropneumoniae serotype 7 siderophore receptor FhuA is not required for virulence.

A ferrichrome receptor, FhuA, was identified in Actinobacillus pleuropneumoniae serotype 7. An isogenic mutant with a deletion in the ferrichrome uptake receptor gene (fhuA) was constructed and examined in an aerosol infection model. The disease caused by the mutant was indistinguishable from disease induced by A. pleuropneumoniae serotype 7 wild-type; an isogenic mutant lacking expression of the exbB gene that is required for the uptake of transferrin-bound iron retained the ability to utilize ferrichrome, thereby indicating that an energy-coupling mechanism involved in ferrichrome transport remains to be identified.

Kinetic characterization of the pH-dependent oligomerization of R67 dihydrofolate reductase.

Protein-protein recognition results from the assembly of complementary surfaces on two molecules that form a stable, noncovalent, specific complex. Our interest was to describe kinetic aspects of the recognition in order to understand the subtle molecular mechanism of association. R67 dihydrofolate reductase (DHFR) provides an ideal model to investigate kinetic parameters of protein-protein association since it is a homotetramer resulting from the pH-dependent dimerization of homodimers. We took advantage of the presence of a tryptophan residue at the dimer-dimer interface to monitor pH-dependent oligomerization of R67 DHFR using stopped-flow fluorescence techniques. Except for pH near neutrality where dissociation exhibited biphasic kinetics, association and dissociation followed monophasic kinetics fitted on a two-state model. Apparent rate constants of association k(on) and dissociation k(off) were determined at various pHs and pointed to the key role of a histidine located at the dimer-dimer interface in the pH control of tetramerization. The values of the tetramer-dimer equilibrium dissociation constant were calculated from the ratio k(off) /k(on) and correlated well with those previously measured at equilibrium. The thermodynamic parameters and the activation energies of both the association and dissociation were determined and indicated that the association is enthalpy driven and suggested that the formation of four hydrogen bonds (one per monomer) is responsible for the thermodynamic stability of the tetramer. Detailed analysis of the biphasic kinetics led to an original model, in which protonation of the tetramer is the triggering event for the dissociation process while the association involves primarily the unprotonated dimers.

Tasas de letalidad por GRD en un hospital general básico / The mortality rate by GRD in a community hospital

Introducción: La mortalidad hospitalaria es un indicador clásico de calidad asistencial, influenciada de forma importante por la patología y estructura de edad de la población asistida. Los Grupos Relacionados con el Diagnóstico (GRD) se han convertido en el sistema de clasificación de pacientes más utilizado en nuestro país. Objetivos: Conocer y analizar la letalidad hospitalaria por GRD en los pacientes menores de 80 años del Hospital del SAS de Algeciras durante el período 1995 - 1998 .Metodología: Estudio del conjunto mínimo básico de datos al alta hospitalaria (CMBDH). Se usaron los programas CLINOS v 3.31, SPSS v7.5 y C.I.A. v1.0.Resultados: La tasa de mortalidad fue de 2.95 por ciento para los enfermos menores de 80 años (IC 95 por ciento 2.79 - 3.11).Los GRD con mayor número de defunciones fueron: 082 neoplasias respiratorias (éxitus 86, letalidad IC 95 por ciento 16,9 24,7 ), 014 Trastornos cerebro-vasculares (84, letalidad 15,0 - 22,2), 123 Trastornos circulatorios con infarto agudo de miocardio y con defunción (83, letalidad 100 por ciento), 470 No agrupables (81, letalidad3,9 - 6,1) y 127 Insuficiencia cardíaca/shock (55, letalidad 5,8 - 9,9).Los éxitus están agrupados en un número reducido de GRD. El 52.4 por ciento de los fallecimientos se concentran en 15 GRD y el 63.1 por ciento se reúnen en 25 GRD. Conclusiones: la tasa de letalidad por GDR en pacientes menores de 80 años es un indicador de fácil obtención que permite monitorizar resultados adversos de la asistencia hospitalaria (AU)

[Experimental evaluation of prospects for the use of beta-lactams in plague infection caused by pathogens with plasmid resistance to penicillins]. / Eksperimental'naia otsenka perspektiv ispol'zovaniia betalaktamov pri chumnoi infektsii, vyzvannoi vozbuditelem s plazmidnoi ustoichivost'iu k penitsillinam.

High therapeutic efficacies of ceftriaxone, ceftazidime, cefotaxime and azthreonam in the treatment of experimental plague induced by beta-lactamase-producing strains of the plague microbe containing R plasmids RP-1, R57b and R40a were shown to correlate with their in vitro antibacterial activities. The therapeutic efficacy of sulbactam/ampicillin was recorded in the treatment of plague induced by the strain containing R plasmids R57b and R40a (the treatment course of 7 days). However, it was lower when the infection was due to the strain containing plasmid RP-1 (beta-lactamase TEM-2). Cefoperazone was not active in the treatment of experimental plague induced by the strains containing plasmids RP-1 and R57b (beta-lactamases TEM-2 and OXA-3). Ceftriaxone versus the antibiotics tested was considered to be the drug of choice for the etiotropic therapy of plague induced not only by the type strains of the plague microbe but also by its variants with the plasmid pattern resistance to penicillins.

Increasing resistance of Neisseria gonorrhoeae in west and central Africa. Consequence on therapy of gonococcal infection.

BACKGROUND AND OBJECTIVES: Antimicrobial resistant strains of Neisseria gonorrhoeae have spread with remarkable rapidity in many African countries. Chromosomal resistance to penicillin, tetracycline, and thiamphenicol is frequent now, and reported prevalences of penicillinase-producing N. gonorrhoeae isolates vary between 15% and 80%. Plasmid-mediated tetracycline-resistant N. gonorrhoeae isolates have been observed in several African countries. GOALS: To characterize gonococcal isolates from three sites in West and Central Africa, to determine antimicrobial susceptibility patterns, to document the spread of plasmid-mediated resistance to penicillin and tetracycline in these three sites, and to discuss the consequences of rising antimicrobial resistance on the management of gonococcal infection in Africa. STUDY DESIGN: Over time, a total of 2,288 gonococcal isolates were obtained from Abidjan, Ivory Coast (1992-1993, n = 251), from Kigali, Rwanda (1988-1993, n = 952), and from Kinshasa, Zaire (1988-1990, n = 1,085). The isolates were characterized by auxotyping and serotyping. Plasmid-mediated resistance to penicillin and to tetracycline was determined. Antimicrobial susceptibility testing to ceftriaxone, ciprofloxacin, penicillin, spectinomycin, tetracycline, and thiamphenicol was performed with an agar dilution method. RESULTS: The prevalence of penicillinase-producing N. gonorrhoeae increased significantly over time from 44% to 57% in Kigali and remained stable at a high level in Abidjan (73%) and in Kinshasa (67%). The frequency of tetracycline-resistant N. gonorrhoeae increased significantly during the observation periods in all three sites: from 20% to 65% in Abidjan, from 0% to 64% in Kigali, and from 14% to 41% in Kinshasa. Chromosomal resistance to penicillin was common in Kigali and Kinshasa, and chromosomal resistance to tetracycline and thiamphenicol was frequent in all three sites. All gonococcal isolates were susceptible to ceftriaxone, ciprofloxacin, and spectinomycin. Prototrophic and proline requiring strains were predominant, and IA-6 was the most common serovar in the three sites. IB-specific serovars were more common among penicillinase-producing N. gonorrhoeae and IA-specific serovars were more frequent among tetracycline-resistant N. gonorrhoeae, but there was no evidence for a clonal spread of resistant strains. CONCLUSIONS: This study illustrates the high frequency of resistant gonococci in Africa and shows that tetracycline-resistant N. gonorrhoeae have become highly endemic in different geographic areas of the continent. The use of effective drugs is essential to reduce gonorrhea transmission. Surveillance of temporal changes in antimicrobial resistance in gonococcal strain populations should be part of sexually transmitted diseases control programs.

[Experimental study of R plasmid eliminating action of Coptis chinensis on E. coli].

The R plasmid curing experiment was performed in vitro with E. coli strain E. 102 bearing R plasmid as target bacteria and Coptis chinensis as elimination agent. The influence of different time on R plasmid elimination was also observed. Results showed that when the acting time was 24 hours, the cure rate of R plasmid was 2.42% and when the acting time increased to 48 hours, the cure rate elevated to 22.57%. The Missing patterns of R plasmid might be occurred in disappearence of either multiple or single resistance.

[Mitral endocarditis caused by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin: description of 2 cases with fatal course]. / Endocarditis mitral por Staphylococcus aureus resistente a meticilina, aminoglucósidos y rifampicina: descripción de 2 casos de evolución fatal.

Two patients with infectious endocarditis (IE) by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin (SARMAR) acquired in hospital during the course of an epidemic outbreak of this microorganism in the Hospital Clínic i Provincial of Barcelona. Both patients had undergone surgery of the lower limbs. The entrance of the microorganism was the infection of the surgical wound, with bacteriemia, followed by mitral IE after a short time interval (20 days). Despite adequate treatment with vancomycin both patients died. The culture of mitral vegetation was positive for SARMAR in one. Analysis of the chromosomic DNA of all the isolations from the patients was identical and coincided with that of the SARMAR strains isolated in the epidemic outbreak of the hospital. The current situation of IE by SARMAR is reviewed and the therapeutic implications commented upon suggesting that treatment of this entity should simultaneously include the administration of vancomycin and phosphomycin or cotrimoxazole, with surgery being considered if infection persists.

[Amikacin resistance of clinical strains of Enterobacteriaceae and Pseudomonas]. / Ustoichivost' k amikatsinu klinicheskikh shtammov bakterii semeistva Enterobacteriaceae i roda Pseudomonas]

Amikacin resistance was studied in 380 bacterial strains of Enterobacter, Klebsiella, Serratia, Pseudomonas and E. coli isolated in clinics of the Moscow Region. It was shown that 69 isolates were resistant to amikacin. Plasmid DNA was detected in 10 amikacin resistant isolates. Three of them belonging to Klebsiella and 3 belonging to E. coli contained plasmids controlling resistance to amikacin. The plasmids isolated from the strains of Klebsiella determined as well resistance to kanamycin and streptomycin but did not control resistance to sisomicin, tobramycin and gentamicin while the plasmids isolated from the strains of E. coli determined resistance to amikacin, kanamycin, gentamicin, tobramycin and sisomicin.