Microbiological analysis of oral biofilms in patients admitted to intensive care unit: Pilot study.

AIM: To identify Pseudomonas aeruginosa and Staphylococcus aureus in oral biofilms of intubated and non-intubated patients admitted to an Intensive Care Unit (ICU). METHODS: This was a cross-sectional study, with 30 biofilm sites sampled. S. aureus and P. aeruginosa were identified by conventional biochemical assays. Antimicrobial susceptibility was tested by disk-diffusion. RESULTS: Of 30 sites, 50% contained P. aeruginosa and 3.33% S. aureus. P. aeruginosa was detected in similar amounts in all 3 sample sites, with 5 colonized sites (50%). S. aureus colonized a single supragingival site (3.33%). There was resistance to multiple antimicrobial agents of P. aeruginosa in 7 sites (100%) and S. aureus in 1 (100%). CONCLUSIONS: This study revealed an important relationship between P. aeruginosa and S. aureus colonization at supragingival, subgingival and lingual sites and intubation, thus revealing antimicrobial resistant bacteria colonization of medical interest, which may contribute to the therapy choice directed to these microorganisms.

Decreased susceptibility to chlorhexidine and distribution of qacA/B genes among coagulase-negative Staphylococcus clinical samples.

BACKGROUND: Healthcare-associated infection (HAI) is a major public health problem. As a form of prevention and control, preparations of chlorhexidine are used extensively; however, the reduction of susceptibility to chlorhexidine has been reported. The aim of this study was to investigate the susceptibility to chlorhexidine and the distribution of the qacA/B genes in 211 clinical isolates of coagulase-negative Staphylococci (CoNS). METHODS: CoNS were identified by conventional biochemical tests. Antimicrobial susceptibility was tested by disk-diffusion. Minimum inhibitory concentration (MIC) of chlorhexidine was determined by agar dilution test; detection of the qacA/B and mecA genes were evaluated by PCR. RESULTS: The most frequently isolated species were S. epidermidis, S. hominis hominis, S. auricularis, and S. haemolyticus, respectively. The strains presented a multidrug resistance profile of 87%, including methicillin resistance. Reduced susceptibility to chlorhexidine was observed in 31%. The qacA/B genes were detected in samples resistant (32/32) and susceptible (17/32) to chlorhexidine. The vast majority (94%) of the samples with reduced susceptibility to chlorhexidine were multidrug resistant. CONCLUSIONS: Our results show that qacA/B genes are not restricted to strains expressing chlorhexidine resistance. Further studies are needed to understand how the expression of these genes occurs.

Evaluation of microbiological, cellular and risk factors associated with subclinical mastitis in female buffaloes.

OBJECTIVE: This study aimed to evaluate the microbiological and cellular milk profile for the diagnosis of subclinical mastitis in female buffaloes and to assess risk factors for predisposition of the disease. METHODS: Analyses were carried out by standard plate count (SPC), identification of species and antibiotic resistance, somatic cell count (SCC), electrical electrical conductivity of milk (ECM), and lactoferrin content in milk. Teat cups were swabbed to evaluate risk factors, observing hyperkeratosis, milking vacuum pressure and cleanliness of the site. Hence, 30 female buffaloes were randomly selected (15 from a group in early lactation and 15 in late lactation). RESULTS: The most common bacteria in the microbiological examination were Staphylococcus spp., Streptococcus spp. and Corynebacterium sp. In the antibiotic sensitivity test, 10 (58.82%) of the 17 antibiotics tested were sensitive to all isolates, and resistant bacteria were Streptococcus uberis, Streptococcus dysgalactiae, Streptococcus haemolyticus, and Escherichia coli. It was observed that positive samples in the microbiological examination showed total bacterial count between 9.10×103 to 6.94×106 colony forming units/mL, SCC between 42,000 to 4,320,000 cells/mL and ECM ranging from 1.85 to 7.40 mS/cm. It was also found that the teat cups had high microbial counts indicating poor hygiene, and even faults in the cleanliness of the animals' waiting room were observed. It is concluded that values of SCC above 537,000 cells/mL and ECM above 3.0 mS/mL are indications of mammary gland infection for this herd; however, the association of these values with a microbiological analysis is necessary to more accurately evaluate the health status of mammary glands with subclinical mastitis. CONCLUSION: Through phenotypic characterization of bacteria involved in the samples, the genera Staphylococcus spp., Streptococcus spp., and Corynebacterimum bovis were the most prevalent in this study. Faults in environment and equipment hygienization are factors that are directly associated with mastitis.

Enterotoxin-Encoding Genes in Staphylococcus spp. from Food Handlers in a University Restaurant.

Food handlers carrying enterotoxin-producing Staphylococcus are a potential source of food poisoning. The aim of this study was to analyze genes encoding enterotoxins in coagulase-positive Staphylococcus (CoPS) and coagulase-negative Staphylococcus (CoNS) isolated from the anterior nostrils and hands of food handlers at a university restaurant in the city of Natal, Northeast Brazil. Thirty food handlers were screened for the study. The isolates were subjected to Gram staining, a bacitracin sensitivity test, mannitol fermentation, and catalase and coagulase tests. CoNS and CoPS strains were subsequently identified by a Vitek 2 System (BioMerieux, France) and various biochemical tests. Polymerase chain reaction was used to detect genes for enterotoxins A, B, C, D, E, G, H, and I (sea, seb, sec, sed, see, seg, seh, and sei) and a disc-diffusion method was used to determine susceptibility to several classes of antimicrobials. All food handlers presented staphylococci on their hands and/or noses. The study found 58 Staphylococcus spp., of which 20.7% were CoPS and 79.3% were CoNS. S. epidermidis was the most prevalent species. Twenty-nine staphylococci (50%) were positive for one or more enterotoxin genes, and the most prevalent genes were seg and sei, each with a frequency of 29.3%. Indeed, CoNS encoded a high percentage of enterotoxin genes (43.5%). However, S. aureus encoded even more enterotoxin genes (75%). Most isolates showed sensitivity to the antibiotics used for testing, except for penicillin (only 35% sensitive). The results from this study reinforce that coagulase-negative as well as coagulase-positive staphylococci isolated from food handlers are capable of genotypic enterotoxigenicity.

Emergence of methicillin-resistant coagulase-negative staphylococci resistant to linezolid with rRNA gene C2190T and G2603T mutations.

The aim of this article were to determinate the mechanism of linezolid resistance in coagulase-negative methicillin-resistant staphylococci from hospitals in the northeast of Brazil. We identified the isolates using VITEK(®) 2 and MALDI-TOF. Susceptibility to antibiotics was measured by the disk-diffusion method and by Etest(®) . Extraction of the whole genome DNA was performed, followed by screening of all the strains for the presence of mecA and cfr genes. The domain V region of 23S rRNA gene was sequenced and then aligned with a linezolid-susceptible reference strain. Pulsed-field gel electrophoresis (PFGE) macro-restriction analysis was performed. Three linezolid-resistant Staphylococcus hominis and two linezolid-resistant Staphylococcus epidermidis strains were analyzed. The isolates showed two point mutations in the V region of the 23S rRNA gene (C2190T and G2603T). We did not detect the cfr gene in any isolate by PCR. The S. hominis showed the same pulsotype, while the S. epidermidis did not present any genetic relation to each other. In conclusion, this study revealed three S. hominis and two S. epidermidis strains with resistance to linezolid due to a double mutation (C2190T and G2603T) in the domain V of the 23S rRNA gene. For the first time, the mutation of C2190T in S. epidermidis is described. This study also revealed the clonal spread of a S. hominis pulsotype between three public hospitals in the city of Natal, Brazil. These findings highlight the importance of continued vigilance of linezolid resistance in staphylococci.

Prevalence of subgingival Staphylococcus at periodontally healthy and diseased sites.

Staphylococci are considered members of the transient oral microbiota and are seldom isolated from the oral cavity. The aim of this study was to establish the prevalence of subgingival staphylococci in healthy and periodontal disease sites. Sterile endodontic paper points were used to isolate subgingival staphylococci in periodontally healthy and periodontally diseased sites in 30 adult subjects (n=540 sites). Staphylococcus spp were identified by an automated method and confirmed by conventional biochemical tests. All the samples were identified as coagulase-negative staphylococci. The results were analyzed using Mann-Whitney U, chi-square and Fisher's exact test at 5% significance level. A total of 86.7% of the subjects harbored these microorganisms in 11.7% of their periodontal sites. The most frequently isolated species was S. auricularis, which was isolated from 31.4% of the periodontal sites, followed by S. epidermidis, isolated from 21.4% of them. There was no statistically significant difference between the frequencies of these species isolated either from the healthy and the diseased sites (p>0.153). Although staphylococci are present in the subgingival environment and contribute to the pathogenic synergism involved in periodontal diseases, the results suggest that they do not participate directly in the pathogenesis of these diseases.

Quantification of polyphenols and evaluation of antimicrobial, analgesic and anti-inflammatory activities of aqueous and acetone-water extracts of Libidibia ferrea, Parapiptadenia rigida and Psidium guajava.

ETHNOPHARMACOLOGICAL RELEVANCE: Vast numbers of plant species from northeastern Brazil have not yet been phytochemically or biologically evaluated. AIM OF THE STUDY: The goal of this work was to obtain, characterize and show the antimicrobial, analgesic and anti-inflammatory activities of aqueous and acetone-water extracts of Libidibia ferrea, Parapiptadenia rigida and Psidium guajava. MATERIALS AND METHODS: The plant material (100g) was dried, and the crude extracts were obtained by using turbo-extraction (10%; w/v) with water or acetone:water (7:3, v/v) as the extraction solvent. High-performance liquid chromatography (HPLC) methods were used to screen the crude extracts for hydrolysable tannins (gallic acid) and condensed tannins (catechins). The antibacterial activity was evaluated by agar-diffusion and microdilution methods against Gram-positive strains (Staphylococcus aureus ATCC 25923, Staphylococcus epidermidis INCQS 00016, Enterococcus faecalis ATCC 29212 and a clinical isolate of methicillin-resistant Staphylococcus aureus) as well as Gram-negative strains (Escherichia coli ATCC 25922, Salmonella enteritidis INCQS 00258, Shigella flexneri and Klebsiella pneumoniae). To evaluate the anti-inflammatory activity, a leukocyte migration model was used. Analgesic activity was determined by the hot plate test and the acetic acid-induced abdominal writhing test. Data were analyzed by analysis of variance (ANOVA) at a significance level of 5%. RESULTS: Parapiptadenia rigida presented the highest amount of total polyphenols (35.82 ± 0.20%), while the greatest catechin content was found in the acetone-water extract of Psidium guajava (EAWPg; 1.04 µg/g). The largest amounts of catechins were found in the aqueous extract of Libidibia ferrea (EALf; 1.07 µg/g) and the acetone-water extract of Parapiptadenia rigida (EAWPr; 1.0 µg/g). All extracts showed activity against Gram-positive bacteria. The aqueous and acetone-water extracts of Psidium guajava showed the greatest inhibition zones in the agar diffusion tests. In the evaluation of the minimum inhibitory concentration (MIC), the most susceptible Gram-positive bacterium was Staphylococcus epidermidis and the most susceptible Gram-negative bacterium was Shigella flexneri. EAPg and EAWPg showed the greatest MIC values. All extracts were significant inhibitors of leukocyte migration (p<0.05). Using the writhing test, significant analgesic activity was found for EAPr (50 mg/kg), EAWPr (100 mg/kg and 200 mg/kg) and EAWPg (50 mg/kg) (p<0.05). CONCLUSIONS: Thus, the appropriate extraction procedure preserves the chemical components such as gallic acid and catechin, and showed antimicrobial, anti-inflammatory and analgesic properties.

Feature selection strategies for identification of Staphylococcus aureus recovered in blood cultures using FT-IR spectroscopy successive projections algorithm for variable selection: a case study.

Staphylococcus aureus is one of the leading causes of bacteremia, with high levels of accompanying morbidity and mortality. Current gold standard for the detection of S. aureus is very time-consuming, typically taking 24h or longer. We set out to determine whether Fourier-transform infrared spectroscopy (FT-IR) combined with variable selection techniques, such as, genetic algorithm-linear discriminant analysis (GA-LDA) and successive projection algorithm-linear discriminant analysis (SPA-LDA) could be applied to detect this pathogen of bloodstream infection in samples based on the unique spectral "fingerprints" of their biochemical composition. Thirty real blood samples from healthy volunteers were contaminated with five different concentrations (10(7) until 10(3) CFU/mL) of microorganism and it analyzed by IR spectroscopy. The resulting GA-LDA model successfully classified all test samples with respect to their concentration in contaminated blood using only 18 wavenumbers. Discriminant functions revealed that GA-LDA clearly segregated different microorganism concentrations and the variable selected confirmed the chemical entities associated with the microorganism. The current study indicates that IR spectroscopy with feature selection techniques have the potential to provide one rapid approach for whole-organism fingerprint diagnostic microbial directly in blood culture.

The use of near infrared spectroscopy and multivariate techniques to differentiate Escherichia coli and Salmonella Enteritidis inoculated into pulp juice.

This study shows the application and usefulness of near infrared (NIR) transflectance spectra measurements in the identification and classification of Escherichia coli and Salmonella Enteritidis from commercial fruit pulp (pineapple). Principal component analysis (PCA), soft independent modeling of class analogy (SIMCA) analysis and partial least-squares discriminant analysis (PLS-DA) were used in the analysis. It was not possible to obtain total separation between the samples using PCA and SIMCA. PLS-DA presented good performance achieving prediction ability of 87.5% for E. coli and 88.3% for S. Enteritidis, respectively. For the best models, the sensitivity and specificity was 0.87 and 0.83 for PLS-DA with second derivative spectra. These results suggest that NIR spectroscopy and PLS-DA can be used to discriminate and detect bacteria in fruit pulp for modeling linear class boundaries.

Evaluation of different methods for detecting methicillin resistance in Staphylococcus aureus isolates in a university hospital located in the Northeast of Brazil.

Many methods have been described for the detection of methicillin-resistant Staphylococcus aureus (MRSA), but the heterogeneous expression of methicillin resistance affects the reliability of these methods. The aim of the present study was to evaluate some methods for detecting methicillin resistance in Staphylococcus aureus isolates in a university hospital located in the Northeast of Brazil. Among the isolates, 15 were methicillin-susceptible and 45 were methicillin-resistant, including low-level heterogeneous resistance strains. Both the 30 ηg-cefoxitin disk and PBP2a test had 100% sensibility/specificity and appear to be good options for the detection of MRSA in the clinical laboratory.