Infections due to Vagococcus spp. Microbiological and clinical aspects and literature review.

INTRODUCTION: An increase in recent years in the isolation of Vagococcus spp. is suggestive of emerging infection by this pathogen in our hospital. METHODS: Prospective, descriptive study. PERIOD: July 2014-January 2019. Phenotypic identification of 15 isolates of Vagococcus spp. was performed by conventional biochemical tests, automated methodology and mass spectrometry (MALDI-TOF MS). Molecular identification was achieved by sequencing the 16S rRNA gene. The Vitek™ 2C automated system was used to test antibiotic susceptibility. RESULTS: The molecular method identified 11 Vagococcus fluvialis, one Vagococcus lutrae and three Vagococcus spp. MALDI-TOF MS facilitated the rapid recognition of the genus. The most active antibiotics were ampicillin, trimethoprim/sulfamethoxazole, vancomycin, teicoplanin and linezolid. Most of the cases of isolation were associated with skin and soft tissue or osteoarticular infections in patients with diabetes. CONCLUSION: This article is the most extensive review of cases of Vagococcus spp. infection reported in the literature and highlights the microbiological and clinical aspects of this pathogen.

Infecciones por Vagococcus spp. Aspectos microbiológicos y clínicos y revisión de la literatura / Infections due to Vagococcus spp. Microbiological and clinical aspects and literature review

Introducción: En los últimos años un aumento en la frecuencia de aislamiento de Vagococcus spp. estaría indicando la urgencia de la infección por este patógeno en nuestra institución. Métodos: Estudio prospectivo y descriptivo que abarca el periodo de julio de 2014 a enero de 2019. La identificación fenotípica de 15 aislados de Vagococcus spp. se realizó por pruebas bioquímicas convencionales, por metodología automatizada y por espectrometría de masas (MALDI-TOF MS). La identificación molecular por secuenciación del gen ARNr 16S. La sensibilidad antibiótica fue realizada utilizando el sistema automatizado Vitek® 2C. Resultados: Se identificaron 11 Vagococcus fluvialis, un Vagococcus lutrae y tres Vagococcus spp. por metodología molecular. MALDI-TOF MS permitió el rápido reconocimiento de este género. Los antibióticos más activos fueron ampicilina, trimetoprima/sulfametoxazol, vancomicina, teicoplanina y linezolid. La mayoría de los aislamientos se asociaron con infecciones en la piel y partes blandas u osteoarticulares en pacientes diabéticos. Conclusión: Esta comunicación representa la mayor revisión de casos de infecciones por Vagococcus spp. reportados en la literatura, en la que se destacan los aspectos microbiológicos y clínicos de este patógeno.(AU)

Introduction: An increase in recent years in the isolation of Vagococcus spp. is suggestive of emerging infection by this pathogen in our hospital. Methods: Prospective, descriptive study. Period: July 2014-January 2019. Phenotypic identification of 15 isolates of Vagococcus spp. was performed by conventional biochemical tests, automated methodology and mass spectrometry (MALDI-TOF MS). Molecular identification was achieved by sequencing the 16S rRNA gene. The Vitek™ 2C automated system was used to test antibiotic susceptibility. Results: The molecular method identified 11 Vagococcus fluvialis, one Vagococcus lutrae and three Vagococcus spp. MALDI-TOF MS facilitated the rapid recognition of the genus. The most active antibiotics were ampicillin, trimethoprim/sulfamethoxazole, vancomycin, teicoplanin and linezolid. Most of the cases of isolation were associated with skin and soft tissue or osteoarticular infections in patients with diabetes. Conclusion: This article is the most extensive review of cases of Vagococcus spp. infection reported in the literature and highlights the microbiological and clinical aspects of this pathogen.(AU)

Legionella pneumophila: un patógeno emergente en Argentina / Legionella pneumophila: an emerging pathogen in Argentina

La enfermedad del Legionario es causada por bacterias pertenecientes al género Legionella, siendo la especie pneumophila el principal agente etiológico de esta patología. Esta bacteria se describió por primera vez en 1977 como causa de un brote de neumonía grave registrado en 1976 en un centro de convenciones en los Estados Unidos de América. La enfermedad se presenta como una neumonía atípica, responsable del 1 al 15 % de los casos de neumonías adquiridas en la comunidad (NAC), del 5 al 10% de neumonías del adulto y del 1% en menores de 15 años. Los miembros de la familia Legionellaceae son bacilos aeróbicos gramnegativos que crecen lentamente y se encuentran ampliamente distribuidos en cuerpos de agua. La forma más común de transmisión de Legionella spp es la inhalación de aerosoles contaminados generados a partir de fuentes de agua artificiales. Se asocian con la aparición de brotes esporádicos y epidémicos en la comunidad y en infecciones nosocomiales. Las especies pertenecientes al género Legionella se consideran patógenos emergentes transmitidos por el agua. El objetivo de este trabajo es realizar una revisión sobre las manifestaciones y presentaciones clínicas de la infección causada por L. pneumophila, en virtud de que es considerado mundialmente un patógeno emergente y por existir evidencias de su presencia en sistemas de almacenamiento de agua tratada en la región nordeste de la República Argentina, razón primordial para alertar y actualizar conocimientos al respecto

Legionnaires' disease is caused by bacteria belonging to the genus Legionella, being the pneumophila specie the main etiological agent of this pathology. This bacterium was first described in 1977 as the cause of a severe pneumonia outbreak in 1976 at a convention center in the United States of America. The disease presents as an atypical pneumonia, responsible for 1% to 15% of cases of community-acquired pneumonia (CAP), 5% to 10% of pneumonia in adults and 1% in children under 15 years of age. Members of the Legionellaceae family are aerobic, gram-negative rods that grow slowly and are widely distributed in water bodies. The most common way of transmission of Legionella spp is the inhalation of contaminated aerosols generated from artificial water sources. They are associated with the appearance of sporadic and epidemic outbreaks in the community and in nosocomial infections. Species belonging to the genus Legionella are considered emerging waterborne pathogens.The aim of this work is to carry out a review on the manifestations and clinical presentations of the infection caused by L. pneumophila, due to that it is considered an emerging pathogen worldwide and because there is evidence of its presence in storage systems of treated water in the Northeast region of the Argentine Republic, primary reason to alert and update knowledge in this regard.

Hafnia alvei: uma revisão sistemática de literatura / Hafnia alvei: a review systems of literature

A presença de Enterobacteriaceae indica a qualidade higiênica dos produtos alimentícios. Dentro do grupo das bactérias que fazem parte dessa família está Hafnia alvei. Estudo bibliométrico é uma importante ferramenta metodológica de revisão sistemática para reunir e sintetizar as diversas informações que surgem sobre um tema, inclusive sobre os estudos relativos a micro- -organismos. O objetivo deste trabalho foi realizar um estudo bibliométrico sobre este agente. Para tal foi utilizada a base de dados Web of Science usando o nome do agente e o termo food para a busca e limitando a pesquisa entre 2007 e 2017. As informações principais dos documentos foram registradas, bem como a característica principal das publicações sobre o tema. Foram encontrados 42 artigos científicos que contemplaram os termos de busca. A maioria das publicações ocorreu em países e períodos onde ocorreram surtos alimentares e há uma grande pesquisa relacionada à genoma e resistência a antimicrobianos. Avalia-se que ainda existem várias oportunidades de pesquisa sobre os micro-organismos, visto que eles são pouco estudados, principalmente em nosso país.

The presence of Enterobacteriaceae indicates the hygienic quality of food products. As a part of this family, there is an emergent pathogen: Hafnia alvei. Bibliometrics appears as an important tool to gather and synthesize all the information that appears about the new microorganisms. The objective of this paper is to perform a systematic review of literature with bibliometric analysis in order to know the evolution of these bacteria and seek opportunities for new research. To do this, the Web of Science database was searched, individually searching for Hafnia alvei refining for "food". The articles found were analyzed from the annual production, countries, institutions, areas of knowledge, authors who produced the most and periodicals most used. A total of 42 articles were selected for Hafnia alvei. Most publications have occurred in countries and periods where there have been food outbreaks and there is great genomerelated research and antimicrobial resistance. It is evaluated that there are still several research opportunities on microorganisms, since they are little studied, mainly in our country.

[Nosocomial infection due to Trichosporon asahii in a critical burned patient]. / Infección nosocomial por Trichosporon asahii en un paciente quemado crítico.

BACKGROUND: Invasive fungal infection is an important cause of morbimortality in patients with severe burns. The advances in burn care therapy have considerably extended the survival of seriously burned patients, exposing them to infectious complications, notably fungal infections, with increased recognition of invasive infections caused by Candida species. However, some opportunistic fungi, like Trichosporon asahii, have emerged as important causes of nosocomial infection. CASE REPORT: A case of nosocomial infection due to T. asahii in a severely ill burned patient successfully treated with voriconazole is presented. The management of invasive fungal infections in burned patients, from diagnosis to selection of the therapeutic protocol, is often a challenge. Early diagnosis and treatment are associated with a better prognosis. In this case report, current treatment options are discussed, and a review of previously published cases is presented. CONCLUSIONS: Due to the difficulty in the diagnosis of invasive mycoses and their high associated mortality rates, it is advisable to keep a high degree of clinical suspicion of trichosporonosis in susceptible patients, including burned patients. The isolation of T. asahii in clinical specimens of this type of host must raise clinical alert, since it may precede an invasive infection.

[Saccharomyces cerevisiae infections]. / Infección por Saccharomyces cerevisiae.

BACKGROUND: Saccharomyces cerevisiae is an ubiquitous yeast widely used in industry and it is also a common colonizer of the human mucosae. However, the incidence of invasive infection by these fungi has significantly increased in the last decades. AIMS: To evaluate the infection by S. cerevisiae in a hospital in southern Brazil during a period of 10 years (2000-2010). METHODS: Review of medical records of patients infected by this fungus. RESULTS: In this period, 6 patients were found to be infected by S. cerevisiae. The age range of the patients was from 10 years to 84. Urine, blood, ascitic fluid, peritoneal dialysis fluid, and esophageal biopsy samples were analyzed. The predisposing factors were cancer, transplant, surgical procedures, renal failure, use of venous catheters, mechanical ventilation, hospitalization in Intensive Care Unit, diabetes mellitus, chemotherapy, corticosteroid use, and parenteral nutrition. Amphotericin B and fluconazole were the treatments of choice. Three of the patients died and the other 3 were discharged from hospital. CONCLUSIONS: We must take special precautions in emerging infections, especially when there are predisposing conditions such as immunosuppression or patients with serious illnesses. The rapid and specific diagnosis of S. cerevisiae infections is important for therapeutic decision. Furthermore, epidemiological and efficacy studies of antifungal agents are necessary for a better therapeutic approach.