Homeless Outreach Psychiatric Engagement for Lisboa (HOPE 4 Lisboa): One year of marontology, and one John Doe living with Diogenes syndrome.

BACKGROUND: In Europe, psychiatric disorders seem to affect up to 50% of the homeless. In Portugal there were, at a certain time, circa 3,396 homeless people, half living in the capital city, Lisboa. AIMS: The Homeless Outreach Psychiatric Engagement for Lisboa (HOPE 4 Lisboa) was created, in January 1st 2022, as a collaboration including staff from the local state asylum, medical school and town hall in Lisboa, Portugal, in order to provide better treatment for the super difficult cases of psychiatric patients living homeless in Lisboa. METHOD: During 2022, the HOPE 4 team made night rounds, every 15 days on Tuesday's night (20:30 to 23:30) trying to reach, at least, one dozen of homeless psychiatric patients, previously identified. RESULTS: The HOPE 4 Lisboa interviewed 101 patients (53.4%) out of the 189 programed visits. From this group, 72 (72%) had already a previous psychiatric diagnosis. From those 101 patients, reports for 47 (47%) were sent for an eventual compulsory psychiatric assessment. From those 47 only 21 patients (21%) were admitted in the psychiatry ward. Finally we discuss the most super difficult patient we found, as a small case report: a John Doe living in complete Diogenes syndrome. CONCLUSIONS: there are still a few psychiatrists interested in treating homeless people completely or partially out of the classic mental health care systems. Some claim to be doing interstitial psychiatry, others street psychiatry, but we could also call it marontology.

Municipal solid waste management with recyclable potential in developing countries: Current scenario and future perspectives.

Municipal solid waste (MSW) is a complex challenge to be solved worldwide, intensified in developing countries since in addition to economic and environmental aspects there is also the social aspect represented by the collector individual. From an integrative bibliographic review this study longitudinally analyses the socio-productive inclusion of collectors in the municipal solid waste management (MSWM) at an international level. Aiming: (a) to identify relevant articles describing/studies on MSWM with social inclusion of scavengers around the world; (b) to analyse these articles in order to present its main characteristics; (c) to describe municipal solid waste management with recyclable potential (MSWRP) with socio-productive inclusion of collectors; (d) the study provides a more detailed summary of MSWRP management in some developing countries: Brazil, China, India, Indonesia, Mexico, Nigeria and Pakistan; and (e) to provide a framework indicating the future practices and perspectives of MSWRP. As result, this study presents the paradigms and future questions for an effective improvement of WSWM, such as: Professional Training of Scavengers, Cultural Issues, Empowerment of Scavenger, Recycling Cooperatives and Cooperativism, Policy Issues and Recycling Chain, Management Systems and Process Improvement, Quality of Services Provided, Circular Economy and Informal Sector, Health Quality and Safety at Work, Barriers and Solutions for the Inclusion of the Informal Sector, Environmental, Economic and Social Benefits.

Potential for Ammonia Generation and Emission in Broiler Production Facilities in Brazil.

Air quality is one of the main factors that must be guaranteed in animal production. However, the measurement of pollutants is still a problem in several countries because the available methods are costly and do not always apply to the reality of the constructive typology adopted, as in countries with a hot climate, which adopt predominantly open facilities. Thus, the objective of the present study was to develop predictive models for the potential generation and emission of ammonia in the production of broiler chickens with different types of litter, different reuse cycles and under different climatic conditions. Samples of poultry litter from thirty commercial aviaries submitted to different air temperatures were analyzed. The experiment was conducted and analyzed in a completely randomized design, following a factorial scheme. Models were developed to predict the potential for generation and emission of ammonia, which can be applied in facilities with ambient conditions of air temperature between 25 and 40 °C and with wood shaving bed with up to four reuse cycles and coffee husks bed with up to six reuse cycles. The developed and validated models showed high accuracy indicating that they can be used to estimate the potential for ammonia generation and emission.

In vitro activity of imipenem/relebactam against Pseudomonas aeruginosa isolates recovered from ICU patients in Spain and Portugal (SUPERIOR and STEP studies).

OBJECTIVES: To study the in vitro activity of imipenem/relebactam and comparators and the imipenem/relebactam resistance mechanisms in a Pseudomonas aeruginosa collection from Portugal (STEP, 2017-18) and Spain (SUPERIOR, 2016-17) surveillance studies. METHODS: P. aeruginosa isolates (n = 474) were prospectively recovered from complicated urinary tract (cUTI), complicated intra-abdominal (cIAI) and lower respiratory tract (LRTI) infections in 11 Portuguese and 8 Spanish ICUs. MICs were determined (ISO broth microdilution). All imipenem/relebactam-resistant P. aeruginosa isolates (n = 30) and a subset of imipenem/relebactam-susceptible strains (n = 32) were characterized by WGS. RESULTS: Imipenem/relebactam (93.7% susceptible), ceftazidime/avibactam (93.5% susceptible) and ceftolozane/tazobactam (93.2% susceptible) displayed comparable activity. The imipenem/relebactam resistance rate was 6.3% (Portugal 5.8%; Spain 8.9%). Relebactam restored imipenem susceptibility to 76.9% (103/134) of imipenem-resistant isolates, including MDR (82.1%; 32/39), XDR (68.8%; 53/77) and difficult-to-treat (DTR) isolates (67.2%; 45/67). Among sequenced strains, differences in population structure were detected depending on the country: clonal complex (CC)175 and CC309 in Spain and CC235, CC244, CC348 and CC253 in Portugal. Different carbapenemase gene distributions were also found: VIM-20 (n = 3), VIM-1 (n = 2), VIM-2 (n = 1) and VIM-36 (n = 1) in Spain and GES-13 (n = 13), VIM-2 (n = 3) and KPC-3 (n = 2) in Portugal. GES-13-CC235 (n = 13) and VIM type-CC175 (n = 5) associations were predominant in Portugal and Spain, respectively. Imipenem/relebactam showed activity against KPC-3 strains (2/2), but was inactive against all GES-13 producers and most of the VIM producers (8/10). Mutations in genes affecting porin inactivation, efflux pump overexpression and LPS modification might also be involved in imipenem/relebactam resistance. CONCLUSIONS: Microbiological results reinforce imipenem/relebactam as a potential option to treat cUTI, cIAI and LRTI caused by MDR/XDR P. aeruginosa isolates, except for GES-13 and VIM producers.

Imipenem-Relebactam Susceptibility in Enterobacterales Isolates Recovered from ICU Patients from Spain and Portugal (SUPERIOR and STEP Studies).

Imipenem-relebactam is a novel ß-lactam-ß-lactamase inhibitor combination. We evaluated the in vitro activity of imipenem-relebactam and comparators against Enterobacterales clinical isolates recovered in 8 Spanish and 11 Portuguese intensive care units (ICUs) (SUPERIOR, 2016-2017; STEP, 2017-2018). Overall, 747 Enterobacterales isolates (378 Escherichia coli, 252 Klebsiella spp., 64 Enterobacter spp., and 53 other species) were prospectively collected from ICU patients with complicated intraabdominal (cIAI), complicated urinary tract (cUTI), and lower respiratory tract (LRTI) infections. MICs were determined (ISO-broth microdilution), and whole-genome sequencing (WGS) was performed in a subset of isolates displaying susceptible and resistant imipenem-relebactam MICs. Imipenem-relebactam (98.7% susceptible) showed similar activity to ceftazidime-avibactam (99.5% susceptible) and higher than ceftolozane-tazobactam (86.9% susceptible). Imipenem-relebactam was inactive against 1.3% (10/747) isolates, all of them due to carbapenemase production (9 K. pneumoniae and 1 E. cloacae). Imipenem-relebactam was active against 100% of extended-spectrum ß-lactamase (ESBL)-E. coli and ESBL-Klebsiella spp. isolates and 80.4% of carbapenemase-Klebsiella spp. producers. Carbapenemase genes were confirmed by WGS in 41 Klebsiella spp.: OXA-48 (20/41), KPC-3 (14/41), OXA-181 (4/41), NDM-1 (1/41), OXA-48 + VIM-2 (1/41), and KPC-3 + VIM-2 (1/41). In Klebsiella spp. isolates, relebactam restored imipenem susceptibility in all KPC-3 producers, and resistant isolates (7/41) were mostly OXA-48 + CTX-M-15-K. pneumoniae high-risk clones (7/9). Intercountry differences were detected as follows: OXA-48 (17/21) was dominant in Spain, unlike KPC-3 (14/15) in Portugal. Imipenem-relebactam was 100% active against CTX-M-15-ST131-H30Rx-E. coli high-risk clone, predominant in both countries. Our results depict the potential role of imipenem-relebactam in ICU patients with cIAIs, cUTIs, and LRTIs due to wild-type ESBL- and carbapenemase-producing Enterobacterales, particularly KPC producers. IMPORTANCE We comparatively evaluate the in vitro activity of a drug combination consisting of a carbapenem (imipenem) and a novel inhibitor of beta-lactamases (relebactam), a mechanism that destroys beta-lactam antibiotics. We assess the activity against a collection of Enterobacterales clinical isolates recovered from difficult-to-treat infections in patients admitted to different intensive care units in Portugal and Spain. Imipenem-relebactam shows excellent activity in avoiding common resistance mechanisms in this setting, such as extended-spectrum beta-lactamases and carbapenemases widely distributed, including KPCs. We show few resistant isolates (<2%). Molecular characterization by whole-genome sequencing shows that most of the resistant isolates produced specific carbapenemase, such as OXA-48 or metalo-betalactamases. Our study updates the activity of imipenem-relebactam in light of current epidemiology in a hospital setting in which the use of this combination is needed due to the presence of infections due to multidrug-resistant isolates.

Invasive and Subcutaneous Infections Caused by Filamentous Fungi: Report from a Portuguese Multicentric Surveillance Program.

Invasive fungal infections (IFI) have significantly increased over the past years due to advances in medical care for the at-risk immunocompromised population. IFI are often difficult to diagnose and manage, and can be associated with substantial morbidity and mortality. This study aims to contribute to understanding the etiology of invasive and subcutaneous fungal infections, their associated risk factors, and to perceive the outcome of patients who developed invasive disease, raising awareness of these infections at a local level but also in a global context. A laboratory surveillance approach was conducted over a seven-year period and included: (i) cases of invasive and subcutaneous fungal infections caused by filamentous/dimorphic fungi, confirmed by either microscopy or positive culture from sterile samples, (ii) cases diagnosed as probable IFI according to the criteria established by EORTC/MSG when duly substantiated. Fourteen Portuguese laboratories were enrolled. Cases included in this study were classified according to the new consensus definitions of invasive fungal diseases (IFD) published in 2020 as follows: proven IFI (N = 31), subcutaneous fungal infection (N = 23). Those proven deep fungal infections (N = 54) totalized 71.1% of the total cases, whereas 28.9% were classified as probable IFI (N = 22). It was possible to identify the etiological fungal agent in 73 cases (96%). Aspergillus was the most frequent genera detected, but endemic dimorphic fungi represented 14.47% (N = 11) of the total cases. Despite the small number of cases, a high diversity of species were involved in deep fungal infections. This fact has implications for clinical and laboratory diagnosis, and on the therapeutic management of these infections, since different species, even within the same genus, can present diverse patterns of susceptibility to antifungals.

Spatial distribution of bed variables, animal welfare indicators, and milk production in a closed compost-bedded pack barn with a negative tunnel ventilation system.

This research aimed to characterize, evaluate and compare the spatial distribution of the leading bed variables, animal welfare indicators, and milk production in a closed compost-bedded pack barn (CBP) with a negative tunnel ventilation system, for summer and winter periods. The study was carried out in a CBP located in the Zona da Mata region, Minas Gerais, Brazil. The geostatistical modeling technique evaluated the variables of temperature, moisture content, and pH (on the surface and depth of 0.20m) across the length of the bed. Bed samples were characterized for carbon (C), nitrogen (N), and C:N ratio. Cows housed in the CBP were assessed for locomotion and hygiene scores and average milk production. To evaluate the thermoregulation of the cows, the respiratory rate (RR) and surface temperature (ST) were measured. Geostatistical analysis showed spatial dependence and the non-uniformity of the spatial distribution of bed variables. The worst levels of bed temperature and moisture were found in the regions close to the evaporative cooling plate, surrounding the feeding alley, and in the region with the highest cow stocking. The C:N ratio, obtained in both climatic seasons of the year, remained outside the recommended range for ideal composting. During the summer and winter, the bed variables' values suggest that the material was below levels for optimal composting; however, the aerated inner layer was biologically active. The high animal density significantly impacted the worsening of the bed moisture content and internal temperature. In general, dairy cows showed adequate hygiene (score of 1 and 2) and locomotion (score of 0 and 1) scores for the two climatic seasons evaluated, indicating good welfare conditions. In relation to RR and ST, the summer period presented less favorable environmental conditions. During winter, the average milk production was 28.1 ± 7.2 kg day-1, and during summer, it was 26.9 ± 6.7 kg day-1.

Unicentric Castleman Disease and Pheochromocytoma.

Castleman disease is an uncommon and heterogenous lymphoproliferative disorder which is classified as unicentric or multicentric depending on the number of lymph nodes involved. Each type has a different clinical presentation, aetiology, treatment and prognosis. We report the case of a young woman who presented with cervical lymphadenopathy and a retroperitoneal mass, and was diagnosed with unicentric Castleman disease and pheochromocytoma. We describe the diagnostic steps, the complications that developed, and the importance of the differential diagnosis in the evaluation of these patients. LEARNING POINTS: Castleman disease in an uncommon disease and should be considered in all patients with adenomegalies and systemic symptoms.Pheochromocytoma should not be overlooked in the differential diagnosis of a retroperitoneal mass.It is important that doctors consider these two diagnoses in patients with adenomegalies and a retroperitoneal mass due to the potential harmful impact of a missed diagnosis.

Xyloglucan processing machinery in Xanthomonas pathogens and its role in the transcriptional activation of virulence factors.

Xyloglucans are highly substituted and recalcitrant polysaccharides found in the primary cell walls of vascular plants, acting as a barrier against pathogens. Here, we reveal that the diverse and economically relevant Xanthomonas bacteria are endowed with a xyloglucan depolymerization machinery that is linked to pathogenesis. Using the citrus canker pathogen as a model organism, we show that this system encompasses distinctive glycoside hydrolases, a modular xyloglucan acetylesterase and specific membrane transporters, demonstrating that plant-associated bacteria employ distinct molecular strategies from commensal gut bacteria to cope with xyloglucans. Notably, the sugars released by this system elicit the expression of several key virulence factors, including the type III secretion system, a membrane-embedded apparatus to deliver effector proteins into the host cells. Together, these findings shed light on the molecular mechanisms underpinning the intricate enzymatic machinery of Xanthomonas to depolymerize xyloglucans and uncover a role for this system in signaling pathways driving pathogenesis.

Distinct epidemiology and resistance mechanisms affecting ceftolozane/tazobactam in Pseudomonas aeruginosa isolates recovered from ICU patients in Spain and Portugal depicted by WGS.

OBJECTIVES: To analyse the epidemiology, the resistome and the virulome of ceftolozane/tazobactam-susceptible or -resistant Pseudomonas aeruginosa clinical isolates recovered from surveillance studies in Portugal (STEP, 2017-18) and Spain (SUPERIOR, 2016-17). METHODS: P. aeruginosa isolates were recovered from intra-abdominal, urinary tract and lower respiratory tract infections in ICU patients admitted to 11 Portuguese and 8 Spanish hospitals. MICs were determined (ISO-standard broth microdilution, EUCAST 2020 breakpoints). A subset of 28 ceftolozane/tazobactam-resistant P. aeruginosa isolates were analysed and compared with 28 ceftolozane/tazobactam-susceptible P. aeruginosa strains by WGS. RESULTS: Clonal complex (CC) 235 (27%) and CC175 (18%) were the most frequent, followed by CC244 (13%), CC348 (9%), CC253 (5%) and CC309 (5%). Inter-hospital clonal dissemination was observed, limited to a geographical region (CC235, CC244, CC348 and CC253 in Portugal and CC175 and CC309 in Spain). Carbapenemases were detected in 25 isolates (45%): GES-13 (13/25); VIM type (10/25) [VIM-2 (4/10), VIM-20 (3/10), VIM-1 (2/10) and VIM-36 (1/10)]; and KPC-3 (2/25). GES-13-CC235 (13/15) and VIM type-CC175 (5/10) associations were observed. Interestingly, KPC-3 and VIM-36 producers showed ceftolozane/tazobactam-susceptible phenotypes. However, ceftolozane/tazobactam resistance was significantly associated with GES-13 and VIM-type carbapenemase production. Six non-carbapenemase producers also displayed ceftolozane/tazobactam resistance, three of them showing known ceftolozane/tazobactam resistance-associated mutations in the PBP3 gene, ftsI (R504C and F533L). Overall, an extensive virulome was identified in all P. aeruginosa isolates, particularly in carbapenemase-producing strains. CONCLUSIONS: GES-13-CC235 and VIM type-CC175 were the most frequent MDR/XDR P. aeruginosa clones causing infections in Portuguese and Spanish ICU patients, respectively. Ceftolozane/tazobactam resistance was mainly due to carbapenemase production, although mutations in PBP-encoding genes may additionally be involved.

Confronting Ceftolozane-Tazobactam Susceptibility in Multidrug-Resistant Enterobacterales Isolates and Whole-Genome Sequencing Results (STEP Study).

Ceftolozane-tazobactam (C/T) is frequently used for infections caused by multidrug-resistant (MDR)-Enterobacterales isolates. Whole-genome sequencing (WGS, Illumina-Hiseq 4000/NovaSeq 6000, OGC, UK) was used to study the population structure, the resistome and the virulome of C/T-susceptible and -resistant MDR Escherichia spp. (n=30) and Klebsiella spp. (n=78) isolates, recovered from lower respiratory, intra-abdominal and urinary tract infections of ICU patients from 11 Portuguese Hospitals (STEP study, 2017-2018). Minimum inhibitory concentrations (MICs) were determined (ISO-broth microdilution, breakpoints EUCAST-2020). In Escherichia spp., a weak concordance between the phenotypic and the WGS method (P=0.051) was observed in the carbapenemase detection (3/30) [blaVIM-2 (2/3), blaKPC-3 (1/3)]; VIM-2-Escherichia coli isolates were C/T-susceptible and only the KPC-3-Escherichia marmotae producer showed C/T-resistance. Overall, CTX-M-15-E. coli-ST131-O25:H4-H30-Rx (11/30) was the most frequent subclone, followed by CTX-M-27-E. coli-ST131-O25:H4-H30 (4/4). Moreover, a wide resistome and virulome were detected in all E. coli isolates. Among Klebsiella spp. isolates [K. pneumoniae (67/78), K. aerogenes (7/78), K. oxytoca (2/78), K. variicola (2/78)], concordance (P<0.001) was observed between the phenotypic and the genomic carbapenemase detection (21/78) [blaKPC-3 (14/21), blaOXA-48 (3/21), blaOXA-181 (3/21)]. A high correlation between C/T-resistance and carbapenemase detection was established (P<0.05). Overall, a high clonal diversity was observed, mainly in KPC-3-producing K. pneumoniae isolates. An extensive resistome was detected in Klebsiella spp. isolates, whereas virulence determinants were mostly identified in carbapenemase producers (P<0.001). WGS is a powerful tool for typing characterization and microbiological study of MDR-Enterobacterales pathogens. Furthermore, carbapenemase genes are associated with C/T-resistance in Klebsiella spp., but other mechanisms might also be involved.

Xyloglucan processing machinery in Xanthomonas pathogens and its role in the transcriptional activation of virulence factors

Xyloglucans are highly substituted and recalcitrant polysaccharides found in the primary cell walls of vascular plants, acting as a barrier against pathogens. Here, we reveal that the diverse and economically relevant Xanthomonas bacteria are endowed with a xyloglucan depolymerization machinery that is linked to pathogenesis. Using the citrus canker pathogen as a model organism, we show that this system encompasses distinctive glycoside hydrolases, a modular xyloglucan acetylesterase and specific membrane transporters, demonstrating that plant-associated bacteria employ distinct molecular strategies from commensal gut bacteria to cope with xyloglucans. Notably, the sugars released by this system elicit the expression of several key virulence factors, including the type III secretion system, a membrane-embedded apparatus to deliver effector proteins into the host cells. Together, these findings shed light on the molecular mechanisms underpinning the intricate enzymatic machinery of Xanthomonas to depolymerize xyloglucans and uncover a role for this system in signaling pathways driving pathogenesis.

Withdrawal Notice: Inflammatory Bowel Disease in migrant populations - a narrative review

The article has been withdrawn from the journal "Current Drug Targets" on behalf of the author's request. Bentham Science apologizes to its readers for any inconvenience this may have caused. The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/journals/current-drug-targets/editorial-policies/ Bentham Science Disclaimer: It is a condition of publishers that manuscripts submitted to this journal should not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure, or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and while submitting- ting the article for publication, the authors agree that the publishers have the legal right to take appropriate action against the authors if plagiarism or fabricated information is discovered. By submitting a manuscript the authors agree that the copyright of their article is transferred to the publishers, if and when the article is accepted for publication.

[The Age of Multidrug Resistance: Ten Year Incidence in a Neonatal Intensive Care Unit]. / A Era da Multirresistência: Incidência em Dez Anos Numa Unidade de Cuidados Intensivos Neonatais.

INTRODUCTION: The emergence of multidrug-resistant bacteria is a medical challenge nowadays. The objective of the present study was to determine the incidence of multidrug-resistant bacteria infections in a neonatal Intensive Care unit. MATERIAL AND METHODS: Retrospective, descriptive, incidence study of infectious episodes by multidrug-resistant bacteria from 2008 to 2017 in a differentiated perinatal support unit. RESULTS: Sixty-four infectious episodes included (median gestational age of 28 weeks and birth weight of 885 g). The isolated bacteria were: Enterobacteriaceae (n = 46); Methicillin-resistant Staphylococcus aureus (n = 12); Acinetobacter baumannii (n = 4); Pseudomonas aeruginosa (n = 2). A risk factor was identified in 90.6% of the episodes, with emphasis on central catheter (89%) and previous antibiotic therapy (78%). The lethality rate of these infections was 10.9% (Unit mortality rate: 4.4%). The overall incidence rate was 3.2 infectious episodes/100 hospitalizations, corresponding to 1.7 episodes/1000 days of hospitalization. There were three infectious outbreaks, with an increasing impact of Enterobacteriaceae. DISCUSSION: The reported incidence rate reflects a risk population, hospitalized in an Intensive Care unit, over a long period of time. The distribution of isolated bacteria, with Enterobacteriaceae predominance, is in accordance with the shift in multidrug resistance reported worldwide. The outbreaks point to the need of understanding risk factors and means of local dissemination. The relevance of these infections is evident in their lethality rate, which is higher compared to that of general hospital infections. CONCLUSION: The incidence rate reflects the local dimension of the problem, representing a quality indicator which is relevant for controlling these infections.

Introdução: A emergência de bactérias multirresistentes constitui um desafio médico na atualidade. O objetivo do presente estudo foi determinar a incidência das infeções por bactérias multirresistentes numa unidade de Cuidados Intensivos Neonatais. Material e Métodos: Estudo de incidência, retrospetivo, descritivo dos episódios infeciosos por bactérias multirresistentes, de 2008 a 2017, numa unidade de apoio perinatal diferenciado. Resultados: Incluíram-se 64 episódios infeciosos (medianas - idade gestacional: 28 semanas; peso ao nascimento: 885 g). As bactérias isoladas foram: Enterobacteriaceae (n = 46); Staphylococcus aureus meticilino-resistente (n = 12); Acinetobacter baumannii (n = 4); Pseudomonas aeruginosa (n = 2). Identificou-se um fator de risco em 90,6% dos episódios, destacando-se cateter central (89%) e antibioticoterapia prévia (78%). A taxa de letalidade associada foi 10,9% (taxa de mortalidade unidade: 4,4%). A incidência global foi 3,2 episódios infeciosos/100 internamentos, correspondentes a 1,7 episódios/1000 dias de internamento. Verificaram-se três surtos infeciosos com impacto crescente de Enterobacteriaceae.Discussão: A taxa de incidência descrita reflete uma população de risco, internada numa unidade de Cuidados Intensivos e num período longo de tempo. A distribuição das bactérias isoladas evidencia a evolução da multirresistência relatada internacionalmente, com predomínio crescente de Enterobacteriaceae. A ocorrência de surtos aponta para a necessidade de perceber fatores de risco e meios de disseminação local. A relevância destas infeções está patente na taxa letalidade, superior às infeções hospitalares em geral. Conclusão: A taxa de incidência reflete a dimensão local do problema, constituindo um indicador de qualidade, relevante para o controlo destas infeções.

In vitro activity of ceftolozane-tazobactam against Enterobacterales and Pseudomonas aeruginosa causing urinary, intra-abdominal and lower respiratory tract infections in intensive care units in Portugal: The STEP multicenter study.

The STEP surveillance study was designed to increase knowledge about distribution of multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa in Portugal, focusing on the intensive care unit (ICU). Antimicrobial susceptibility of common agents was also evaluated and compared with that of one of the latest therapeutic introductions, ceftolozane-tazobactam (C/T). Clinical isolates of Enterobacterales (n=426) and P. aeruginosa (n=396) from patients admitted in Portuguese ICUs were included. Activity of C/T and comparators was investigated using standard broth microdilution. Isolates were recovered from urinary tract (UTI, 36.9%), intra-abdominal (IAI, 24.2%) and lower respiratory tract (LRTI, 38.9%) infections. In P. aeruginosa, overall distribution of MDR/extremely-drug resistant (XDR)/pan-drug resistant (PDR) isolates accounted for 21.2%, 23.2% and 0.8%, respectively. C/T was the most potent agent tested against P. aeruginosa and MDR/XDR/PDR phenotypes. In Escherichia coli, extended-spectrum beta-lactamases (ESBL) and carbapenemase (CP) phenotypes accounted for 16.6% and 1.7%, respectively, whereas in Klebsiella spp., ESBL and CP-phenotypes represented 28.5% and 17.9%, respectively. Overall, susceptibility of C/T against Enterobacterales was 86.9%. C/T was the least affected agent in E. coli (99.4% susceptibility), whereas its activity was moderate in Klebsiella spp. (71.5%) and Enterobacter spp. (70.4%), due in part to a high rate of ESBL and CP-phenotypes. In Enterobacterales, blaKPC was the most prevalent CP gene (63.0%), followed by blaOXA-48 (33.3%) and blaVIM (3.7%). These microbiological results reinforce C/T as a therapeutic option in ICU patients with UTI, IAI or LRTI due to P. aeruginosa or Enterobacterales isolates, but not for CP producers.

Structure-guided design combined with evolutionary diversity led to the discovery of the xylose-releasing exo-xylanase activity in the glycoside hydrolase family 43.

Rational design is an important tool for sculpting functional and stability properties of proteins and its potential can be much magnified when combined with in vitro and natural evolutionary diversity. Herein, we report the structure-guided design of a xylose-releasing exo-ß-1,4-xylanase from an inactive member of glycoside hydrolase family 43 (GH43). Structural analysis revealed a nonconserved substitution (Lys247 ) that results in the disruption of the hydrogen bond network that supports catalysis. The mutation of this residue to a conserved serine restored the catalytic activity and crystal structure elucidation of the mutant confirmed the recovery of the proper orientation of the catalytically relevant histidine. Interestingly, the tailored enzyme can cleave both xylooligosaccharides and xylan, releasing xylose as the main product, being the first xylose-releasing exo-ß-1,4-xylanase reported in the GH43 family. This enzyme presents a unique active-site topology when compared with closely related ß-xylosidases, which is the absence of a hydrophobic barrier at the positive-subsite region, allowing the accommodation of long substrates. Therefore, the combination of rational design for catalytic activation along with naturally occurring differences in the substrate binding interface led to the discovery of a novel activity within the GH43 family. In addition, these results demonstrate the importance of solvation of the ß-propeller hollow for GH43 catalytic function and expand our mechanistic understanding about the diverse modes of action of GH43 members, a key and polyspecific carbohydrate-active enzyme family abundant in most plant cell-wall-degrading microorganisms.

Essential oils of Tahiti lemon and cinnamon bark in control of storage fungi and the physiological and sanitary quality of beans / Óleos essenciais de limão Taiti e canela em casca no controle de fungos de armazenamento e na qualidade fisiológica e sanitária de feijão

With the objective to evaluate the efficiency of essential oils of Citrus latifolia (Tahiti lemon) and Cinnamomum zeylanicum (cinnamon bark) in the control of plant pathogens Penicillium sp. and Aspergillus sp. and the quality of the bean seeds, two experiments were conducted. In the first one, the effect of essential oils of C. latifolia and C. zeylanicum was evaluated in vitro development of the fungi Penicillium sp. and Aspergillus sp. and, in the second one, the influence of essential oils on the physiological and sanitary quality of bean seeds. The variables mycelial growth, conidial germination and sporulation of Penicillium sp. and Aspergillus sp. were measured in the first experiment, while the seed germination test, first count of germination, germination speed index (GSI) and sanity test of bean seeds were measured in the second. The essential oil (EO) of C. zeylanicum was more efficient than C. latifolia in the control of Aspergillus sp. and Penicillium sp., but decreased the physiological quality of the beans seeds. The fungal diversity identified in the seed health test was composed by fungi of the genera Aspergillus, Penicillium, Cladosporium, Fusarium, Chaetomium and Rhizopus. The results indicate the potential of the use of these EOs in the seeds treatment.(AU)

Com o objetivo de avaliar a eficiência dos óleos essenciais de Citrus latifolia (limão taiti) e Cinnamomum zeylanicum (canela em casca) no controle dos fitopatógenos Penicillium sp. e Aspergillus sp. e na qualidade das sementes de feijão, foram conduzidos dois experimentos. No primeiro, avaliou-se o efeito dos óleos essenciais de C. latifolia e C. zeylanicum no desenvolvimento in vitro dos fungos Penicillium sp. e Aspergillus sp. e, no segundo, a influência dos óleos essenciais sobre a qualidade fisiológica e sanitária das sementes de feijão. As variáveis crescimento micelial, germinação de conídios e esporulação de Penicillium sp. e Aspergillus sp. foram aferidas no primeiro experimento, enquanto o teste de germinação de sementes, primeira contagem de germinação, índice de velocidade de germinação (IVG) e teste de sanidade de sementes de feijão foram aferidas no segundo. O óleo essencial (OE) de C. zeylanicum foi mais eficiente que C. latifolia no controle dos fungos Aspergillus sp. e Penicillium sp., mas diminuiu a qualidade fisiológica das sementes de feijão. A diversidade fúngica identificada no teste de sanidade de sementes foi composta por fungos dos gêneros Aspergillus, Penicillium, Cladosporium, Fusarium, Chaetomium e Rhizopus. Os resultados indicam o potencial do uso desses óleos essenciais no tratamento de sementes.(AU)

Brazilian ground beef authentication by multiplex polymerase chain reaction / Autenticação de carne moída brasileira através de uma reação em cadeia da polimerase multiplex

ABSTRACT: The aim of the present study was to assess the efficacy ofmultiplex PCR in detecting the adulterationof commercially available ground beefvia addition and/orsubstitution ofground buffalo meat. Experimentally adulterated ground beefsamples were prepared in triplicate, and dilutions of DNA from Bos taurus and Bubalusbubalis were prepared to determine the detection limit of the method. Concurrently, 91 ground meatsamples sold as "ground beef" were collected from differentstores in northern Brazil andanalyzed bymultiplex PCR. Buffalo DNA was detected in 17.5% of the collected ground meat samples.Our results showed that multiplex PCR is an efficient method for detectingthe incorporation of groundbuffalo meatatpercentages ranging from 10 to 100% and the incorporation of beef at percentages ranging from0.1 to 100% intoground meat samples.

RESUMO: O objetivo do presente estudo foi avaliar a eficácia da PCR multiplex na detecção da adulteração por adição e/ou substituição de carne bubalina em carne moída bovina, comercialmente disponível. A fim de determinar o limite de detecção da técnica, carnes moídas bovinas fraudadas intencionalmente foram fabricadas em triplicata e, adicionalmente, concentrações conhecidas de DNA das espécies Bostaurus e Bubalusbubalis foram diluídos. Ao mesmo tempo, 91 amostras de carne moída comercializadas como sendo de origem bovina foram coletadas em diferentes comércios na região Norte do Brasil e a PCR multiplex proposta foi realizada. Os resultados demonstraram que o DNA bubalino foi detectado em 17,5% das amostras de carne moída coletadas. Concluiu-se que a PCR multiplex é uma técnica eficaz, capaz de detectar a incorporação de carne moída bubalina em percentagens que variaram de 10 a 100%, e a incorporação de carne bovina em percentagens que variaram de 0,1 a 100% em amostras de carne moída.

Bioactive Potential of 3D-Printed Oleo-Gum-Resin Disks: B. papyrifera, C. myrrha, and S. benzoin Loading Nanooxides-TiO2, P25, Cu2O, and MoO3.

This experimental study investigates the bioactive potential of filaments produced via hot melt extrusion (HME) and intended for fused deposition modeling (FDM) 3D printing purposes. The oleo-gum-resins from benzoin, myrrha, and olibanum in pure state and also charged with 10% of metal oxide nanoparticles, TiO2, P25, Cu2O, and MoO3, were characterized by ultraviolet-visible (UV-Vis) and Fourier transform infrared (FTIR) spectroscopy, energy-dispersive X-ray microanalysis (EDXMA), scanning electron microscopy (SEM), and differential scanning calorimetry (DSC). Disks were 3D-printed into model geometries (10 × 5 mm) and the disk-diffusion methodology was used for the evaluation of antimicrobial and antifungal activity of materials in study against the clinical isolates: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans. Due to their intrinsic properties, disks containing resins in pure state mostly prevent surface-associated growth; meanwhile, disks loaded with 10% oxides prevent planktonic growth of microorganisms in the susceptibility assay. The microscopy analysis showed that part of nanoparticles was encapsulated by the biopolymeric matrix of resins, in most cases remaining disorderly dispersed over the surface of resins. Thermal analysis shows that plant resins have peculiar characteristics, with a thermal behavior similar to commercial available semicrystalline polymers, although their structure consists of a mix of organic compounds.

Aggregatibacter aphrophilus aortic valve infective endocarditis / Endocarditis infecciosa en válvula aórtica por Aggregatibacter aphrophilus

Nowadays, infective endocarditis remains a major cause of morbidity and mortality worldwide and there are concerns related to the increased number of infections associated with virulent agents and medical procedures. We present a case of a homeless man with unknown medical history, admitted for lumbar pain who became confused, hypotensive and tachy cardic, evolving to severe sepsis. His initial investigation was also suggestive of acute myocardial infarction but the transthoracic echocardiogram revealed massive aortic valve vegetation with perivalvular abscess leading to severe aortic regurgitation. The patient died with the final diagnosis of infective endocarditis. Later on the blood cultures was identified Aggregatibacter aphrophilus, an HACEK group agent. This case confirms that, albeit the general favorable outcomes, there are cases of serious infections, especially if the diagnosis and treatment were late.

Hoy día, la endocarditis infecciosa continúa siendo una causa importante de mor-bimortalidad en todo el mundo y es preocupante el aumento del número de infecciones asociadas con agentes virulentos y procedimientos médicos. Presentamos el caso de un indigente con antecedentes médicos desconocidos, ingresado por dolor lumbar, que comenzó a sentirse confuso, hipotenso y taquicárdico. Poco después de su ingreso su estado evolucionó a septicemia grave. Los resultados de las pruebas iniciales también eran indicativos de infarto agudo de miocardio, pero el ecocardiograma transtorácico reveló una vegetación masiva en la válvula aórtica con absceso perivalvular condicionando regurgitación aórtica grave. El paciente murió, con el diagnóstico definitivo de endocarditis infecciosa. Más tarde, en los hemocultivos se identificó Aggregatibacter aphrophilus, un microorganismo del grupo HACEK. Este caso confirma que, a pesar de los resultados favorables en general, hay casos de infecciones graves, sobre todo si el diagnóstico y el tratamiento fueron tardíos.