Differences in Virulence Factors and Antimicrobial Susceptibility of Uropathogenic Enterococcus spp. Strains in a Rural Area of Uganda and a Spanish Secondary Hospital.

Enterococcus faecalis and Enterococcus faecium have become two of the most important agents of nosocomial diseases due to their constantly growing resistance. Enterococcal infections are associated with biofilms, which are intrinsically sensitive to antimicrobials. The main goal of this study was to compare and relate their capacity to form biofilm and their antimicrobial sensitivity, as well as their virulence factors and their implicated genes, of strains isolated from patients with urinary tract infection (UTI) in a rural hospital in Uganda and a secondary hospital in Spain. A prospective study was conducted with 104 strains of E. faecalis and E. faecium isolated from patients with suspected UTI and who presented leukocyturia at the Saint Joseph Kitgum hospital (Uganda) and at the Hospital Universitario Principe de Asturias (Spain). All microorganisms were identified in Spain by MALDI-TOF mass spectrometry. Antimicrobial susceptibility studies were carried out using the Vitek® 2 system (Biomériux, France). The biofilm formation capacity was studied by photospectrometry. Phenotypic and genotypic virulence factors were studied in all cases by PCR or expression techniques. In Uganda, we found a higher incidence of E. faecium (65.3%, n = 32), contrary to the situation found in Spain where most of the bacteria found belonged to E. faecalis (92.7%, n = 51). All E. faecalis strains were found to have very low levels of resistance to ampicillin, imipenem, and nitrofurantoin. However, E. faecium exhibited more than 25% resistance to these antibiotics. Although the esp gene has been shown in the results obtained to be an important initial agent in biofilm formation, we have also demonstrated in this study the intervention of other genes when esp is not present, such as the ace1 gene. No statistically significant relationships were found between the presence of agg and gelE genes and increased biofilm formation. The significant difference between the incidence of E. faecalis and E. faecium and biofilm formation, between samples from Spain and Uganda, shows us very different profiles between countries.

Development of Ti-C-N coatings with improved tribological behavior and antibacterial properties.

In artificial metallic joint implants, the failure is provoked by two effects in most of the cases: mass loss and wear debris removed due to tribological-corrosive effects on the implant alloy, and infections due to the presence of bacteria. In this work, several Ti-C-N corrosion and wear protective coatings were developed by Physical Vapour Deposition technology, and deposited on Ti6Al4V alloy. In order to provide the implant antibacterial properties, an additional silver top coating has been deposited. Tribological behavior was characterized through tribocorrosion and fretting tests. On the other hand, wettability tests were performed to study the grade of hydrophilicity/hydrophobia. Additionally, antibacterial properties were evaluated by means of bacterial adhesion tests. As a result of these characterization studies, the coating with the best performance was selected. The as-coated material includes excellent protection against tribocorrosion and fretting effects (in relation to the uncoated one) and the silver layer has been confirmed to exhibit antibacterial properties.