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1.
Braz J Microbiol ; 55(2): 1405-1414, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38598149

RESUMEN

BACKGROUND: Corynebacterium spp. are widely disseminated in the environment, and they are part of the skin and mucosal microbiota of animals and humans. Reports of human infections by Corynebacterium spp. have increased considerably in recent years and the appearance of multidrug resistant isolates around the world has drawn attention. OBJECTIVES: To describe a new species of Corynebacterium from human tissue bone is described after being misidentified using available methods. METHODS: For taxonomic analyses, phylogenetic analysis of 16S rRNA and rpoB genes, in silico DNA-DNA hybridization, average nucleotide and amino acid identity, multilocus sequence analysis, and phylogenetic analysis based on the complete genome were used. FINDINGS: Genomic taxonomic analyzes revealed values of in silico DNA-DNA hybridization, average nucleotide and amino acids identity below the values necessary for species characterization between the analyzed isolates and the closest phylogenetic relative Corynebacterium aurimucosum DSM 44532T. MAIN CONCLUSIONS: Genomic taxonomic analyzes indicate that the isolates analyzed comprise a new species of the Corynebacterium genus, which we propose to name Corynebacterium hiratae sp. nov. with isolate 332T (= CBAS 826T = CCBH 35,014T) as the type strain.


Asunto(s)
Infecciones por Corynebacterium , Corynebacterium , ADN Bacteriano , Filogenia , ARN Ribosómico 16S , Corynebacterium/genética , Corynebacterium/clasificación , Corynebacterium/aislamiento & purificación , Humanos , ARN Ribosómico 16S/genética , ADN Bacteriano/genética , Infecciones por Corynebacterium/microbiología , Huesos/microbiología , Tipificación de Secuencias Multilocus , Genoma Bacteriano , Técnicas de Tipificación Bacteriana , Hibridación de Ácido Nucleico
2.
BMC Genom Data ; 24(1): 65, 2023 11 08.
Artículo en Inglés | MEDLINE | ID: mdl-37940844

RESUMEN

BACKGROUND: Corynebacterium diphtheriae complex was formed by the species C. diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in the recent past. In addition to C. diphtheriae, C. ulcerans and C. pseudotuberculosis species can carry the tox gene, which encodes diphtheria toxin. Currently, three new species have been included in the complex: Corynebacterium rouxii, Corynebacterium silvaticum, and Corynebacterium belfantii. C. rouxii is derived from the ancient Belfanti biovar of C. diptheriae. We provide the complete genome sequences of two non-toxigenic strains C. rouxii isolated from a cat with a purulent infection in Brazil. The taxonomic status and sequence type, as well as the presence of resistance and virulence genes, and CRISPR-Cas system were additionally defined. RESULTS: The genomes showed an average size of 2.4 Mb and 53.2% GC content, similar to the type strain of the species deposited in Genbank/NCBI. Strains were identified as C. rouxii by the rMLST database, with 95% identity. ANI and DDH in silico were consistent with values above the proposed cut-off points for species limit, corroborating the identification of the strains as C. rouxii. MLST analyses revealed a new ST, which differs from ST-537 only by the fusA allele. No horizontal transfer resistance gene was predicted in both genomes and no mutation was detected in the constitutive genes gyrA and rpoB. Some mutations were found in the seven penicillin-binding proteins (PBPs) detected. The tox gene was not found, but its regulatory gene dtxR was present. Among the predicted virulence genes are those involved in iron uptake and adherence, in addition to the DIP0733 protein involved in epithelial cell adhesion and invasion. The CRISPR-Cas type I-E system was detected in both genomes, with 16 spacer sequences each. Of them, half are unknown according to the databases used, indicating that there is an unexplored reservoir of corynebacteriophages and plasmids. CONCLUSIONS: This is the first genomic study of C. rouxii reported in Brazil. Here we performed taxonomic analysis and the prediction of virulence factors. The genomic analyses performed in this study may help to understand the potential pathogenesis of non-toxigenic C. rouxii strains.


Asunto(s)
Corynebacterium diphtheriae , Corynebacterium diphtheriae/genética , Filogenia , Brasil , Tipificación de Secuencias Multilocus , Corynebacterium/genética
3.
Braz J Microbiol ; 54(2): 779-790, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36869213

RESUMEN

Non-diphtheria Corynebacterium species (NDC) belonging to the human skin and mucosa microbiota are frequently neglected as contaminants. However, reports of human infections by Corynebacterium spp. have increased considerably in recent years. In this study, a group of six NDC isolates of urine (n = 5) and sebaceous cyst (n = 1) from two South American countries were identified at genus level or misidentified based on API® Coryne and genetic/molecular analyses. The 16S rRNA (99.09-99.56%) and rpoB (96.18-97.14%) gene sequence similarities of the isolates were higher when compared with Corynebacterium aurimucosum DSM 44532 T. Multilocus sequence analysis (MLSA) indicated that these six NDC isolates compose a distinctive phylogenetic clade. Genome-based taxonomic analysis with the whole-genome sequences was able to separate these six isolates from other known Corynebacterium type strains. Average nucleotide identity (ANI), average amino acid identity (AAI), and digital DNA-DNA hybridization (dDDH) values between closely related type strains and the six isolates were considerably lower than the currently recommended threshold values for species circumscription. Phylogenetic and genomic taxonomy analyses indicated these microorganisms as a novel Corynebacterium species, for which we formally propose the name Corynebacterium guaraldiae sp. nov. with isolate 13T (= CBAS 827T = CCBH 35012T) as type strain.


Asunto(s)
Corynebacterium , ADN , Humanos , Análisis de Secuencia de ADN , Filogenia , ARN Ribosómico 16S/genética , Corynebacterium/genética , ADN Bacteriano/genética , Técnicas de Tipificación Bacteriana , Ácidos Grasos/química , Hibridación de Ácido Nucleico
4.
Braz J Microbiol ; 54(1): 69-80, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36477756

RESUMEN

Clustered regularly interspaced short palindromic repeats (CRISPR) are a prokaryotic adaptive immune system that, through Cas proteins, promote the degradation of foreign nucleic acids such as phages and plasmids. We analyzed 10 genomes of Corynebacterium striatum clinical isolates from a public hospital in Rio de Janeiro, Brazil, the most emergent multidrug-resistant Corynebacterium species. All isolates were submitted to antimicrobial susceptibility testing. The occurrence and diversity of the CRISPR system were investigated by bioinformatics tools. Our analysis revealed that the isolates exhibited type I-E gene arrangements, and 3 more multidrug-resistant isolates, alternative type I-E gene arrangements, showing a divergent gene arrangement within the cas operon. Phylogenetic analysis of the cas1 gene of this type I-E CRISPR-Cas system alternative arrangement, termed here type I-E', showed a cluster in a distinct clade of the type I-E CRISPR-Cas system. The systems' guanine-cytosine (GC) content is lower than the genomic DNA's GC content, and mobile genetic elements were found in some isolates near the CRISPR-Cas system. Most CRISPR spacers are unknown indicating that there is a reservoir of unexplored corynebacteriophages and plasmids. Some spacers showed perfect homologies with phage and plasmid sequences. Intact phage regions were found in 3 of our isolates, ranging from 9.1 to 43.8 kb, with regions showing similarity to Rhodococcus and Corynebacterium phages. Our results may contribute to research about the CRISPR-Cas system diversity in C. striatum, where there are no published data to date.


Asunto(s)
Bacteriófagos , Sistemas CRISPR-Cas , Filogenia , Brasil , Corynebacterium , Bacteriófagos/genética
5.
Microbes Infect ; 24(8): 105001, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35569750

RESUMEN

For many years, the potential pathogenic of non-diphtheriae corynebacteria were underestimated. Nowadays, a growing number of Corynebacterium species are recognized as opportunistic agents of human infections, mainly in hospital settings. In addition, multidrug-resistant Corynebacterium isolates from clinical specimens, have been reported and the role of Corynebacterium spp. in urinary tract infections (UTIs) has been highlighted. Several studies have reported Corynebacterium species as the agent of UTIs especially in patients with risk factors. Thus, the present work aimed to report the first isolation of Corynebacterium mycetoides from human urine and an initial study on its virulence properties. The isolate, initially characterized by phenotypical tests as a multidrug-resistant Corynebacterium sp., was recovered from the urine of a female transplant patient. Mass spectrometry and 16S rRNA and rpoB genes sequencing identified the isolate as C. mycetoides. The isolate was found able to adhere to and survive into epithelial cells (Vero cells), and its pathogenic potential was confirmed when tested against Caenorhabditis elegans nematode. The results obtained suggest that C. mycetoides is a potential pathogen for the urinary tract in humans and for a better understanding of the multifactorial mechanisms of virulence, studies about this species should be continued.


Asunto(s)
Infecciones por Corynebacterium , Infecciones Urinarias , Animales , Chlorocebus aethiops , Humanos , Femenino , Infecciones por Corynebacterium/microbiología , Virulencia , ARN Ribosómico 16S/genética , Células Vero , Corynebacterium/genética
6.
Int J Mol Sci ; 22(14)2021 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-34299116

RESUMEN

Corynebacterium striatum, a bacterium that is part of the normal skin microbiota, is also an opportunistic pathogen. In recent years, reports of infections and in-hospital and nosocomial outbreaks caused by antimicrobial multidrug-resistant C. striatum strains have been increasing worldwide. However, there are no studies about the genomic determinants related to antimicrobial resistance in C. striatum. This review updates global information related to antimicrobial resistance found in C. striatum and highlights the essential genomic aspects in its persistence and dissemination. The resistome of C. striatum comprises chromosomal and acquired elements. Resistance to fluoroquinolones and daptomycin are due to mutations in chromosomal genes. Conversely, resistance to macrolides, tetracyclines, phenicols, beta-lactams, and aminoglycosides are associated with mobile genomic elements such as plasmids and transposons. The presence and diversity of insertion sequences suggest an essential role in the expression of antimicrobial resistance genes (ARGs) in genomic rearrangements and their potential to transfer these elements to other pathogens. The present study underlines that the resistome of C. striatum is dynamic; it is in evident expansion and could be acting as a reservoir for ARGs.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Corynebacterium/tratamiento farmacológico , Corynebacterium/efectos de los fármacos , Corynebacterium/genética , Farmacorresistencia Bacteriana Múltiple/genética , Secuencias Repetitivas Esparcidas , Infecciones por Corynebacterium/genética , Infecciones por Corynebacterium/microbiología , Humanos
7.
Antonie Van Leeuwenhoek ; 113(4): 589-592, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31736013

RESUMEN

The resistance to fluoroquinolones in corynebacteria is due to mutations occurring in the quinolone-resistance-determining region (QRDR) of the gyrA gene encoding the enzyme gyrase A subunit. In recent years we can observe an increasing number of infections caused by multidrug-resistant Corynebacterium striatum, Corynebacterium jeikeium and Corynebacterium urealyticum, including wide range of disorders, such as invasive infections. In this study 14 Corynebacterium spp. isolated from intravenous sites were sequenced and new combinations of mutations in the QRDR of the gyrA gene were found in C. jeikeium and C. urealyticum. Nowadays, no study comparing mutations in this region and the susceptibility to fluoroquinolones in C. jeikeium and C. urealyticum has been described. All the isolates that showed double mutation (position 87 and 91) in the QRDR gyrA gene had high MIC to the fluoroquinolones tested.


Asunto(s)
Antibacterianos/farmacología , Corynebacterium/efectos de los fármacos , Corynebacterium/genética , Girasa de ADN/genética , Farmacorresistencia Bacteriana Múltiple/genética , Bacteriemia/sangre , Bacteriemia/microbiología , Infecciones Relacionadas con Catéteres/microbiología , Infecciones por Corynebacterium/microbiología , Girasa de ADN/metabolismo , Humanos , Inyecciones Intravenosas , Mutación
8.
BMC Infect Dis ; 19(1): 672, 2019 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-31357945

RESUMEN

BACKGROUND: Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen associated with immunocompromised and chronically ill patients, as well as nosocomial outbreaks. In this study, we characterized 23 MDR C. striatum isolated of bloodstream and catheter-related infections from a hospital of Rio de Janeiro. METHODS: C. striatum isolates were identified by 16S rRNA and rpoB genes sequencing. The dissemination of these isolates was accomplished by pulsed-field gel electrophoresis (PFGE). All isolates were submitted to antimicrobial susceptibility testing by disk diffusion and by minimum inhibitory concentration using E-test strips methods. Antimicrobial resistance genes were detected by polymerase chain reaction. Quantitative tests were performed on four different abiotic surfaces and the ability to produce biofilm on the surface of polyurethane and silicone catheter was also demonstrated by scanning electron microscopy. RESULTS: Eleven PFGE profiles were found. The PFGE profile I was the most frequently observed among isolates. Five different MDR profiles were found and all PFGE profile I isolates presented susceptibility only to tetracycline, vancomycin, linezolid and daptomycin. Only the multidrug-susceptible isolate did not show mutations in the quinolone-resistance determinant region (QRDR) of the gyrA gene and was negative in the search of genes encoding antibiotic resistance. The other 22 isolates were positive to resistance genes to aminoglycoside, macrolides/lincosamides and chloramphenicol and showed mutations in the QRDR of the gyrA gene. Scanning electron microscopy illustrated the ability of MDR blood isolate partaker of the epidemic clone (PFGE profile I) to produce mature biofilm on the surface of polyurethane and silicone catheter. CONCLUSIONS: Genotyping analysis by PFGE revealed the permanence of the MDR PFGE profile I in the nosocomial environment. Other new PFGE profiles emerged as etiologic agents of invasive infections. However, the MDR PFGE profile I was also found predominant among patients with hematogenic infections. The high level of multidrug resistance associated with biofilm formation capacity observed in MDR C. striatum is a case of concern.


Asunto(s)
Bacteriemia/microbiología , Biopelículas/crecimiento & desarrollo , Infecciones Relacionadas con Catéteres/microbiología , Infecciones por Corynebacterium/microbiología , Corynebacterium/fisiología , Brotes de Enfermedades , Antibacterianos/farmacología , Bacteriemia/epidemiología , Proteínas Bacterianas/genética , Infecciones Relacionadas con Catéteres/epidemiología , Corynebacterium/efectos de los fármacos , Corynebacterium/genética , Infecciones por Corynebacterium/epidemiología , Infección Hospitalaria , Farmacorresistencia Bacteriana Múltiple , Electroforesis en Gel de Campo Pulsado , Femenino , Técnicas de Genotipaje , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , ARN Bacteriano/genética , ARN Ribosómico 16S/genética
9.
Mem Inst Oswaldo Cruz ; 113(9): e180051, 2018 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-29995109

RESUMEN

Multidrug-resistant (MDR) Corynebacterium striatum has been cited with increased frequency as pathogen of nosocomial infections. In this study, we report the draft genome of a C. striatum isolated from a patient with bloodstream infection in a hospital of Rio de Janeiro, Brazil. The isolate presented susceptibility only to tetracycline, vancomycin and linezolid. The detection of various antibiotic resistance genes is fully consistent with previously observed multidrug-resistant pattern in Corynebacterium spp. A large part of the pTP10 plasmid of MDR C. striatum M82B is present in the genome of our isolate. A SpaDEF cluster and seven arrays of CRISPR-Cas were found.


Asunto(s)
Bacteriemia/microbiología , Infecciones por Corynebacterium/microbiología , Corynebacterium/efectos de los fármacos , Corynebacterium/genética , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana Múltiple/genética , Genoma Bacteriano/genética , Antibacterianos/farmacología , Brasil , Corynebacterium/aislamiento & purificación , Brotes de Enfermedades , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Electroforesis en Gel de Campo Pulsado , Genotipo , Humanos , Pruebas de Sensibilidad Microbiana , Análisis de Secuencia de ADN
10.
Mem. Inst. Oswaldo Cruz ; 113(9): e180051, 2018. graf
Artículo en Inglés | LILACS | ID: biblio-955124

RESUMEN

Multidrug-resistant (MDR) Corynebacterium striatum has been cited with increased frequency as pathogen of nosocomial infections. In this study, we report the draft genome of a C. striatum isolated from a patient with bloodstream infection in a hospital of Rio de Janeiro, Brazil. The isolate presented susceptibility only to tetracycline, vancomycin and linezolid. The detection of various antibiotic resistance genes is fully consistent with previously observed multidrug-resistant pattern in Corynebacterium spp. A large part of the pTP10 plasmid of MDR C. striatum M82B is present in the genome of our isolate. A SpaDEF cluster and seven arrays of CRISPR-Cas were found.


Asunto(s)
Humanos , Infección Hospitalaria/transmisión , Genoma/genética , Infecciones por Corynebacterium/terapia , Brasil/epidemiología
11.
Vet Microbiol ; 178(1-2): 163-6, 2015 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-25937144

RESUMEN

Many new, emerging and re-emerging diseases of humans are caused by pathogens which originate from animals or products of animal origin. Corynebacterium lactis, a recently described species of the genus Corynebacterium, was first isolated from milk of asymptomatic cows. In the present study a cutaneous abscess caused by C. lactis in a dog was recognized by cytologic and histologic examination in addition to 16S rRNA gene analysis of the microorganism. Therefore, C. lactis should be included among other bacterial species recognized as emerging pathogens for companion animals.


Asunto(s)
Absceso/patología , Enfermedades Transmisibles Emergentes/veterinaria , Infecciones por Corynebacterium/veterinaria , Enfermedades de los Perros/microbiología , Enfermedades de los Perros/patología , Mascotas , Piel/patología , Animales , Enfermedades Transmisibles Emergentes/microbiología , Corynebacterium/genética , Infecciones por Corynebacterium/patología , Perros , ARN Ribosómico 16S/genética
12.
PLoS Negl Trop Dis ; 7(12): e2573, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24340116

RESUMEN

BACKGROUND: Nocardia sp. causes a variety of clinical presentations. The incidence of nocardiosis varies geographically according to several factors, such as the prevalence of HIV infections, transplants, neoplastic and rheumatic diseases, as well as climate, socio-economic conditions and laboratory procedures for Nocardia detection and identification. In Brazil the paucity of clinical reports of Nocardia infections suggests that this genus may be underestimated as a cause of human diseases and/or either neglected or misidentified in laboratory specimens. Accurate identification of Nocardia species has become increasingly important for clinical and epidemiological investigations. In this study, seven clinical Nocardia isolates were identified by multilocus sequence analysis (MLSA) and their antimicrobial susceptibility was also determined. Most Nocardia isolates were associated to pulmonary disease. METHODOLOGY/PRINCIPAL FINDINGS: The majority of Brazilian human isolates in cases reported in literature were identified as Nocardia sp. Molecular characterization was used for species identification of Nocardia nova, Nocardia cyriacigeorgica, Nocardia asiatica and Nocardia exalbida/gamkensis. Data indicated that molecular analysis provided a different Nocardia speciation than the initial biochemical identification for most Brazilian isolates. All Nocardia isolates showed susceptibility to trimethoprim-sulfamethoxazole, the antimicrobial of choice in the treatment nocardiosis. N. nova isolated from different clinical specimens from one patient showed identical antimicrobial susceptibility patterns and two distinct clones. CONCLUSIONS/SIGNIFICANCE: Although Brazil is the world's fifth-largest country in terms of land mass and population, pulmonary, extrapulmonary and systemic forms of nocardiosis were reported in only 6 of the 26 Brazilian states from 1970 to 2013. A least 33.8% of these 46 cases of nocardiosis proved fatal. Interestingly, coinfection by two clones may occur in patients presenting nocardiosis. Nocardia infection may be more common throughout the Brazilian territory and in other developing tropical countries than is currently recognized and MLSA should be used more extensively as an effective method for Nocardia identification.


Asunto(s)
Enfermedades Desatendidas/diagnóstico , Enfermedades Desatendidas/microbiología , Nocardiosis/diagnóstico , Nocardiosis/microbiología , Nocardia/aislamiento & purificación , Antibacterianos/farmacología , Técnicas de Tipificación Bacteriana , Brasil , ADN Bacteriano/química , ADN Bacteriano/genética , Humanos , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Nocardia/clasificación , Nocardia/efectos de los fármacos , Nocardia/genética , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/microbiología , Análisis de Secuencia de ADN
13.
Mem Inst Oswaldo Cruz ; 108(1): 23-9, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23440110

RESUMEN

Corynebacterium striatum is a potentially pathogenic microorganism with the ability to produce outbreaks of nosocomial infections. Here, we document a nosocomial outbreak caused by multidrug-resistant (MDR) C. striatum in Rio de Janeiro, Brazil. C. striatum identification was confirmed by 16S rRNA and rpoB gene sequencing. Fifteen C. striatum strains were isolated from adults (half of whom were 50 years of age and older). C. striatum was mostly isolated in pure culture from tracheal aspirates of patients undergoing endotracheal intubation procedures. The analysis by pulsed-field gel electrophoresis (PFGE) indicated the presence of four PFGE profiles, including two related clones of MDR strains (PFGE I and II). The data demonstrated the predominance of PFGE type I, comprising 11 MDR isolates that were mostly isolated from intensive care units and surgical wards. A potential causal link between death and MDR C. striatum (PFGE types I and II) infection was observed in five cases.


Asunto(s)
Infecciones por Corynebacterium/microbiología , Corynebacterium/efectos de los fármacos , Infección Hospitalaria/microbiología , Brotes de Enfermedades , Farmacorresistencia Bacteriana Múltiple/genética , Adulto , Anciano de 80 o más Años , Antibacterianos/farmacología , Técnicas de Tipificación Bacteriana , Brasil , Clonación Molecular , Corynebacterium/genética , Infecciones por Corynebacterium/epidemiología , Infección Hospitalaria/epidemiología , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado , Femenino , Genotipo , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Fenotipo , Adulto Joven
14.
Mem. Inst. Oswaldo Cruz ; 108(1): 23-29, Feb. 2013. ilus, graf, tab
Artículo en Inglés | LILACS | ID: lil-666039

RESUMEN

Corynebacterium striatum is a potentially pathogenic microorganism with the ability to produce outbreaks of nosocomial infections. Here, we document a nosocomial outbreak caused by multidrug-resistant (MDR) C. striatum in Rio de Janeiro, Brazil. C. striatum identification was confirmed by 16S rRNA and rpoB gene sequencing. Fifteen C. striatum strains were isolated from adults (half of whom were 50 years of age and older). C. striatum was mostly isolated in pure culture from tracheal aspirates of patients undergoing endotracheal intubation procedures. The analysis by pulsed-field gel electrophoresis (PFGE) indicated the presence of four PFGE profiles, including two related clones of MDR strains (PFGE I and II). The data demonstrated the predominance of PFGE type I, comprising 11 MDR isolates that were mostly isolated from intensive care units and surgical wards. A potential causal link between death and MDR C. striatum (PFGE types I and II) infection was observed in five cases.


Asunto(s)
Adulto , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Infecciones por Corynebacterium/microbiología , Corynebacterium/efectos de los fármacos , Infección Hospitalaria/microbiología , Brotes de Enfermedades , Farmacorresistencia Bacteriana Múltiple/genética , Antibacterianos/farmacología , Técnicas de Tipificación Bacteriana , Brasil , Clonación Molecular , Infecciones por Corynebacterium/epidemiología , Corynebacterium/genética , Infección Hospitalaria/epidemiología , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado , Genotipo , Pruebas de Sensibilidad Microbiana , Fenotipo
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