Cost-effectiveness of selective therapy for clinical mastitis based on on-farm pathogen identification / Custo-benefício da terapia seletiva para mastite clínica com base na identificação de patógenos na fazenda

This research aims to describe the cost-benefit analysis of selective therapy adoption for clinical mastitis based on the identification of pathogens using on-farm culture system. A survey of clinical mastitis cases was carried out in the database of a dairy herd with 500 lactating Holstein cows, during the period of September 2017 to October 2019. Variables such as frequency of cases, main pathogens identified, costs with antibiotic therapies and milk disposal were evaluated and compared between one year before (P1) and after (P2), the farm's selective therapy adoption. During the study period, 599 cases of clinical mastitis were identified, 361 in P1 and 238 in P2. The average cost of therapies was US74.33 and US91.82 for P1 and P2. Considering the two years of the study, the estimated cost of treating clinical mastitis was US45,444.31, of which US$27,559.97 were spent in P1 and US17,884.34 in P2. Based on the result of the identification of the pathogen types associated with clinical mastitis, selective therapy demonstrated cost reduction already in the first year of implementation.(AU)

Esta pesquisa objetivou descrever a análise custo-benefício da adoção de terapia seletiva para mastite clínica a partir da identificação de patógenos por meio da cultura em placas na fazenda. Foi realizado um levantamento de casos clínicos de mastite no banco de dados de uma fazenda com 500 vacas Holandesas em lactação, durante o período de setembro de 2017 à outubro de 2019. Foram avaliadas as variáveis frequência de casos, principais patógenos identificados, custos com antibioticoterapia e descarte de leite foram, as quais foram comparados entre um ano antes (P1) e após (P2), à adoção da terapia seletiva na fazenda. Durante o período do estudo, foram identificados 599 casos de mastite clínica, sendo 361 em P1 e 238 em P2. O custo médio das terapias foi de US74,33 e US91,82 para P1 e P2. Considerando os dois anos de estudo, o custo estimado do tratamento da mastite clínica foi de US45.444,31, dos quais US27.559,97 foram gastos em P1 e US17.884,34 em P2. Com base na identificação dos tipos de patógenos associados à mastite clínica, a terapia seletiva demonstrou redução de custos já no primeiro ano de implantação.(AU)

Profile of otitis externa isolates in dogs and cats diagnosed in laboratory of microbiology in 2020 / Perfil dos isolados de otites externas em cães e gatos diagnosticados em laboratório de microbiologia em 2020

Otitis externa is one of the most frequent diseases in the clinical routine of dogs and cats, and they can be caused by several associated factors. Due to incorrect use of antimicrobial products, the treatment and control of otitis have become challenging. This study aims to analyze the results of otological exams at the Laboratory of Microbiology HV-ULBRA in 2020 and demonstrate the profile of patients and isolated bacteria. Staphylococcus was the main genus isolated, and 71,11% of samples showed multi-drug resistance to antimicrobial testing. These results indicate the need to use complementary examinations to control otitis externa.(AU)

A otite externa é um das enfermidades mais frequentes na rotina clínica de cães e gatos e pode ser causada por diversos fatores associados. Devido ao uso incorreto de antimicrobianos, o tratamento e o controle das otites se tornaram desafiadores. O objetivo desse estudo é analisar os resultados dos exames otológicos encaminhados ao Laboratório de Microbiologia HV-ULBRA em 2020 e, além disso, delinear o perfil dos pacientes e das bactérias isoladas. Staphylococcus foi o principal gênero isolado e 71,11% das amostras apresentou multirresistência aos antimicrobianos testados. Esses resultados evidenciam a necessidade do uso de exames complementares para controle das otites externas.(AU)

Bacterias resistentes a antimicrobianos em hospitais veterinários: um desafio crescente / Antimicrobial resistant bacteria in veterinary hospitals: a growing challenge

Na medicina humana, o profundo impacto de infecções hospitalares sobre a morbidade e a mortalidade de pacientes hospitalizados destacou a necessidade de implementação de medidas de controle e prevenção cada vez melhores. Inicialmente, essas mudanças foram reativas, após a doença e a morte de grande número de indivíduos. Hoje, o controle 3. Bacterias resistentes a antimicrobianos em hospitais veterinários: um desafio crescente pixabay.com e a prevenção de infecções é um campo desenvolvido e reconhecido na medicina humana, com funcionários especificamente treinados e certificados e com grandes programas de vigilância fornecendo a avaliação aprofundada da epidemiologia de infecções hospitalares. Em contraste, o controle e a prevenção de infecções em medicina veterinária encontram-se ainda em um estágio inicial, com poucos funcionários dedicados, oportunidades de treinamento raros e sem sistemas de vigilância, sobretudo, por questões de financiamento limitado. Assim como aconteceu na medicina humana, os esforços para controle e prevenção de infecções em hospitais veterinários ainda são reativos, em resposta a situações desequilibradas, como surtos. Conforme a medicina veterinária avança, pacientes são submetidos a procedimentos cada vez mais invasivos e terapias imunossupressoras que aumentam sua susceptibilidade a infecções hospitalares. Diante dessa situação, o controle e a prevenção de infecções também precisam avançar.(AU)

Recent Advances in the Discovery and Function of Antimicrobial Molecules in Platelets.

The conventional function described for platelets is maintaining vascular integrity. Nevertheless, increasing evidence reveals that platelets can additionally play a crucial role in responding against microorganisms. Activated platelets release molecules with antimicrobial activity. This ability was first demonstrated in rabbit serum after coagulation and later in rabbit platelets stimulated with thrombin. Currently, multiple discoveries have allowed the identification and characterization of PMPs (platelet microbicidal proteins) and opened the way to identify kinocidins and CHDPs (cationic host defense peptides) in human platelets. These molecules are endowed with microbicidal activity through different mechanisms that broaden the platelet participation in normal and pathologic conditions. Therefore, this review aims to integrate the currently described platelet molecules with antimicrobial properties by summarizing the pathways towards their identification, characterization, and functional evaluation that have promoted new avenues for studying platelets based on kinocidins and CHDPs secretion.

PACAP modulates the transcription of TLR-1/TLR-5/MyD88 pathway genes and boosts antimicrobial defenses in Clarias gariepinus.

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a multifunctional neuropeptide that belongs to the secretin/glucagon/GHRH/VIP superfamily. Some of these molecules have antimicrobial activity and they are capable of stimulating the immune system. The present work studied the antibacterial and immunostimulatory activity of PACAP-38 from African catfish Clarias gariepinus against the Gram-negative bacterium Pseudomonas aeruginosa in an in vivo test. PACAP-38 improved antimicrobial activity of skin mucus molecules against P. aeruginosa. The peptide modulates the gene expression profile of TLR-1, TLR-5, MyD88, IL-1ß, TNF-ɑ, IL-8, pardaxin, hepcidin and G/C-type lysozymes in skin, spleen and head kidney. The influenced exerted depended on the time after infection and tissue analyzed. This study provides the first evidence of a link between PACAP and antimicrobial peptides hepcidin and pardaxin. Our results suggest further use of PACAP as antimicrobial agent that could potentially be used to control disease in aquaculture.

Eficácia de óleos vegetais no controle do biofilme dental: revisão integrativa / Efficacy of vegetable oils in control of dental biofilm: integrative review / Eficacia de los aceites vegetales en el control de biofilm dental: revision integrativa

Introdução:A terapia de bochecho com óleos vegetais é uma cultura tradicional na Índia com intuito de prevenir afecções bucais, como cárie e doença periodontal. Atualmente, com as mudanças nos padrões alimentares da sociedade, tem-se empregado com maior valor o uso de óleos naturais, já que estudos demonstram sua importância para saúde.Objetivo:Esta revisão integrativa teve como objetivo selecionar evidências que mostrassem a utilização de óleos vegetais, com ação antimicrobiana, no controle do biofilme dental. Metodologia:O levantamento bibliográfico foi realizado nos meses de julho e agosto de 2020, por meio de pesquisa por via eletrônica, consultando-se o banco de dados Pubmed e SciELO (Scientific Electronic Library Online). Foram utilizados os descritores: Óleos vegetais, agentes antimicrobianos, Placa dental, Odontologia preventiva e Odontologia, os descritores foram usados separadamente e em cruzamento com o operador boleano AND. Utilizou-se os seguintes critérios de inclusão: Estudos clínicos, artigos completos e disponíveis gratuitamente, publicados no período de 2010 a 2020 em português e/ou inglês, e indexados nas bases de dados já citadas. Foram excluídos os trabalhos de conclusão de curso, dissertações, teses, livros e capítulos de livros, além de artigos duplicados e que não abordaram o tema do estudo.Resultados:Atenderam os critérios da pesquisa 04 estudos do tipo clínico randomizado, os quais mostraram eficiência dos óleos vegetais utilizados no controle do biofilme dental. A realização de pesquisas envolvendo e motivando a industrialização de produtos naturaiscontribui para a Política Nacional de Práticas Integrativas e Complementares.Conclusões:Os artigos analisados mostraram eficácia na utilização de óleos vegetais no controle do biofilme dental, sendo esses aplicados clinicamente,não mostrando prejuízo aos participantes e indicados como coadjuvante na manutenção da saúde bucal (AU).

Introduction:Mouthwash therapy with vegetable oils is a traditional culture in India with the aim of preventing oral diseases, such as caries and periodontal disease. Currently, with the changes in the dietary patterns of society, the use of natural oils has been used with greater value, since studies demonstrate its importance for health.Objective:This integrative review aimed to select evidence that showed the use of vegetable oils, with antimicrobial action, in the control of dental biofilm. Methodology:Thebibliographic survey was carried out in July and August 2020, through electronic research, consulting the Pubmed and SciELO database (Scientific Electronic Library Online). The descriptors were used: Vegetable oils, antimicrobial agents, dental plaque, preventive dentistry and dentistry, the descriptors were used separately and in cross-section with the Boolean operator AND. The following inclusion criteria were used: Clinical studies, complete and freely available articles, published between 2010 and 2020in Portuguese and / or English, and indexed in the databases already cited. Course completion papers, dissertations, theses, books and book chapters were excluded, as well as duplicate articles that did not address the subject of the study. Results:Four studies of randomized clinical type met the research criteria, which showed efficiency of vegetable oils used in the control of dental biofilm. Conducting research involving and motivating the industrialization of natural products contributes to the National Policy on Integrative and Complementary Practices.Conclusions:The analyzed articles showed efficacy in the use of vegetable oils in the control of dental biofilm, which were applied clinically without showing any harm to the participants and indicatedas an adjunct in maintaining oral health (AU).

Introducción: La terapia de enjuague bucal con aceites vegetales es una cultura tradicional en India con el objetivo de prevenir enfermedades bucales, como caries y enfermedad periodontal. Actualmente, con los cambios en los patrones dietéticos de la sociedad, se ha utilizado con mayor valor el uso de aceites naturales, ya que los estudios demuestran su importancia para la salud. Objetivo: Esta revisión integradora tuvo como objetivo seleccionar evidencias que mostraran el uso de aceites vegetales, con acción antimicrobiana, en el control del biofilm dental.Metodología: El relevamiento bibliográfico se realizó en julio y agosto de 2020, mediante investigación electrónica, consultando la base de datos Pubmed y SciELO (Scientific Electronic Library Online). Se utilizaron los descriptores: Aceites vegetales, agentes antimicrobianos, placa dental, odontología preventiva y odontología, los descriptores se utilizaron por separado y en corte transversal con el operador booleano AND. Se utilizaron los siguientes criterios de inclusión: Estudios clínicos, artículos completos y de libre acceso, publicados entre 2010 y 2020 en portugués y / o inglés, e indexados en las bases de datos ya citadas. Se excluyeron trabajos de finalización de curso, disertaciones, tesis, libros y capítulosde libros, así como artículos duplicados que no abordaran el tema de estudio. Resultados: Cuatro estudios de tipo clínico aleatorizado cumplieron con los criterios de investigación, los cuales mostraron la eficiencia de los aceites vegetales utilizados enel control del biofilm dental. Realizar investigaciones que involucren y motiven la industrialización de productos naturales contribuye a la Política Nacional de Prácticas Integrativas y Complementarias.Conclusiones: Los artículos analizados mostraron eficacia en el uso de aceites vegetales en el control del biofilm dental, los cuales fueron aplicados clínicamente sin mostrar daño a los participantes e indicados como coadyuvante en el mantenimiento de la salud bucal (AU).

Toposome: Source of antimicrobial molecules in the gonads of the sea urchin Lytechinus variegatus (Lamarck, 1816).

Sea urchins live in a challenging environment that requires rapid and efficient responses against pathogens and invaders. This response may be also important in reproductive processes once males and females release their gametes into water. In addition, the gonads are organs with dual function: reproductive organ and nutrient reserve, therefore it needs efficient protective mechanisms to preserve the nutrients as well as the reproductive cells. The aim of this study was to evaluate the presence and characterize antimicrobial molecules in the male and female gonads of the sea urchin Lytechinus variegatus. Through HPLC purification, antimicrobial activity test and mass spectrometry several antimicrobial molecules were found in the gonads of both gender. Computational in silico analyses showed that they are fragments of a glycoprotein called toposome, also known as major yolk protein (MYP) which is one of the major proteins found in the gonads. Although different functions have been reported for this protein, this is the first description of a direct antimicrobial activity in Lytechinus variegatus. The results indicate that when undergoing proteolysis the toposome generates different fragments with antimicrobial activity which may indicate the importance of a rapid defense response strategy against invading microorganisms in the gonads used by both males and females sea urchins.

Performance and biometry of the gastrointestinal tract in growing Japanese quails fed bee pollen / Desempenho e biometria do trato gastrointestinal de codornas japonesas em crescimento alimentadas com pólen apícola

The aim of this study was to evaluate the effects of different levels of bee pollen in the diet of growing Japanese quails on productive performance, relative weight of the gastrointestinal organs and length of small and large intestines. A total of 650 one-day-old female Japanese quails were distributed in a completely randomized design with five treatments according to the dietary levels of bee pollen (0.0, 0.4, 0.8, 1.2, and 1.6%), five replicates, and 26 birds per experimental unit. At the end of the experimental period (35 days of age), the performance and relative weight of the gastrointestinal organs and length of small and large intestines were evaluated. The dietary inclusion of bee pollen did not influence (P > 0.05) performance, relative weight of proventriculus, gizzard, pancreas, liver, and large intestine, as well as the length of small and large intestines. However, a linear reduction (P < 0.05) was observed in the relative weight of small intestine as dietary bee pollen levels increased. The inclusion of bee pollen from 0.4 to 1.6% in the diet of growing Japanese quails did neither improve productive performance nor alter the biometry of digestive organs.(AU)

O objetivo deste estudo foi avaliar os efeitos de diferentes níveis de pólen apícola nas dietas de codornas japonesas em crescimento sobre o desempenho produtivo, peso relativo dos órgãos do trato gastrointestinal e comprimento do intestino delgado e grosso. Um total de 650 codornas japonesas, fêmeas, de um dia de idade, foram distribuídas em um delineamento inteiramente casualizado com cinco tratamentos de acordo com os níveis dietéticos do pólen apícola (0,0; 0,4; 0,8; 1,2 e 1,6%), cinco repetições e 26 aves por unidade experimental. Ao final do período experimental (35 dias de idade), o desempenho e o peso relativo dos órgãos do trato gastrointestinal e o comprimento do intestino delgado e grosso foram avaliados. A inclusão dietética de pólen de abelha não influenciou (P > 0,05) o desempenho, peso relativo do proventrículo, moela, pâncreas, fígado e intestino grosso, bem como o comprimento do intestino delgado e intestino grosso. Entretanto, uma redução linear (P < 0,05) foi observada no peso relativo do intestino delgado de acordo com o aumento dos níveis de pólen apícola. A inclusão dietética de 0,4 a 1,6% de pólen apícola para codornas japonesas em crescimento não melhorou o desempenho produtivo e não alterou a biometria dos órgãos digestivos.(AU)

Antimicrobial Resistance in Salmonella Serovars Isolated From an Egg-Producing Region in Brazil

Fowl paratyphoid infections are caused by different Salmonella serovars that can affect a wide range of hosts. Due to its complex epidemiology, Salmonella serovar identification is crucial for the development and implementation of monitoring and control programs in poultry farms. Moreover, the characterization of the antimicrobial resistance profiles of Salmonella strains isolated from livestock is relevant to public health because they are a common causative agent of foodborne diseases. The objective of this study was to investigate the presence of Salmonella spp. and to identify the antimicrobial resistance profiles of strains isolated in the midwestern region of São Paulo state, which accounts for the highest production of table eggs in Brazil. For this purpose, 2008 fecal samples were collected on 151 commercial layer farms and submitted to microbiological analyses. Twenty-two serovars were isolated from 80 (52.9%) farms, among which S. Mbandaka and S. Braenderup were the most prevalent. All isolates expressed resistance to at least one of the 23 antimicrobials tested, and the highest resistance rates were determined against streptomycin (93.5%) and sulfonamide (84.6%). Moreover, multidrug resistance was observed in 41% of the isolates and the maximum drug resistance profile was against ten different antimicrobials. Therefore, the identification of Salmonella serovars in poultry production provides epidemiological knowledge to develop prevention and control measures in order to ensure poultry health and to prevent human infection by multiresistant strains.(AU)

Antimicrobial Resistance in Salmonella Serovars Isolated From an Egg-Producing Region in Brazil

Fowl paratyphoid infections are caused by different Salmonella serovars that can affect a wide range of hosts. Due to its complex epidemiology, Salmonella serovar identification is crucial for the development and implementation of monitoring and control programs in poultry farms. Moreover, the characterization of the antimicrobial resistance profiles of Salmonella strains isolated from livestock is relevant to public health because they are a common causative agent of foodborne diseases. The objective of this study was to investigate the presence of Salmonella spp. and to identify the antimicrobial resistance profiles of strains isolated in the midwestern region of São Paulo state, which accounts for the highest production of table eggs in Brazil. For this purpose, 2008 fecal samples were collected on 151 commercial layer farms and submitted to microbiological analyses. Twenty-two serovars were isolated from 80 (52.9%) farms, among which S. Mbandaka and S. Braenderup were the most prevalent. All isolates expressed resistance to at least one of the 23 antimicrobials tested, and the highest resistance rates were determined against streptomycin (93.5%) and sulfonamide (84.6%). Moreover, multidrug resistance was observed in 41% of the isolates and the maximum drug resistance profile was against ten different antimicrobials. Therefore, the identification of Salmonella serovars in poultry production provides epidemiological knowledge to develop prevention and control measures in order to ensure poultry health and to prevent human infection by multiresistant strains.

Resistência do Staphylococcus aureus à antimicrobianos: da suinocultura à saúde pública / Resistance of Staphylococcus aureus to antimicrobials: from swine to public health / Resistencia del Staphylococcus aureus a antimicrobianos: de la porcicultura a la salud pública

No cenário agroindustrial brasileiro a cadeia suinícola vem se destacando cada vez mais. A inserção no mercado internacional e as novas tecnologias aplicadas na prática de produção de suínos tem grande importância na economia do país. No entanto, algumas bactérias oportunistas estão presentes nas regiões nasais de suínos, sendo responsáveis por diversas alterações clínicas na suinocultura. Um dos principais patógenos que acomete esta espécie é o Staphylococcus aureus, responsável também por infeções nos seres humanos. O S. aureus possui características de virulência e resistência a diversos antibióticos, em especial à oxacilina, um antibiótico pertencente ao grupo ß-lactâmicos com ampla escala de utilização. A resistência do S. aureus à oxacilina está interligada a vários fatores, como a presença do gene mecA, que codifica a produção de uma proteína ligante e, assim, diminui a afinidade e a sensibilidade à ação de compostos antimicrobianos ß-lactâmicos. O uso errôneo de antibióticos é um dos fatores responsáveis por cepas resistentes e, a adição de melhoradores de desempenho nas rações de suínos, com a adição de antibióticos de forma preventiva pode favorecer e aumentar a existência de cepas multirresistentes, agravando ainda mais os dados já obtidos em pesquisas. A seleção destes genes resistentes causa preocupação à saúde coletiva, uma vez que indivíduos que tiveram contato com suínos e moradores residentes próximos as granjas apresentam cepas resistentes de S. aureus. Assim, a utilização de antibióticos de forma correta é fundamental para a redução dos índices de resistências à antibióticos..

Pig farming has been increasingly prominent in the Brazilian agroindustrial scenario. Its insertion in the international market and the use of new technologies applied to pig farming have been of great importance to the country's economy. Nevertheless, opportunistic bacteria present in the nasal regions of pigs are responsible for several clinical changes in the breeding of those animals. Staphylococcus aureus features among the main pathogens affecting that species, being also responsible for infections in humans. S. aureus is characterized by its virulence and resistance to several antibiotics, especially oxacillin, an antibiotic belonging to the ß-lactam group with a wide usage range. The resistance of S. aureus to oxacillin is linked to several factors, such as the presence of the mecA gene, which encodes the production of a binding protein and thus decreases the affinity and sensitivity to the action of ß-lactam antimicrobial compounds. Incorrect use of antibiotics is one of the factors responsible for generating resistant strains, and the addition of growth promoters in pig feeds with the addition of antibiotics as a form of prevention may favor and even increase the existence of multiresistant strains, further aggravating the current scenario, as expressed by data already obtained in research. The selection of these resistant genes is a matter of concern for collective health, since individuals that had contact with pigs and residents living near pig farms present S. aureus resistant strains. Thus, the correct use of antibiotics is pivotal for reducing the antibiotic resistance rates.

En el escenario agroindustrial brasileño la cadena porcina viene destacándose cada vez más. La inserción en el mercado internacional y las nuevas tecnologías aplicadas en la práctica de producción de cerdos, tiene gran importancia en la economía del país. Sin embargo, algunas bacterias oportunistas están presentes en las regiones nasales de cerdos, siendo responsables por diversas alteraciones clínicas en la porcicultura. Uno de los principales patógenos que acomete esta especie es el Staphylococcus aureus, responsable también por infecciones en los seres humanos. El S. aureus posee características de virulencia y resistencia a diversos antibióticos, en especial a la oxacilina, un antibiótico perteneciente al grupo ß-lactámicos con amplia escala de utilización. La resistencia del S. aureus a oxacilina está interconectada a varios factores, como la presencia del gen mecA, que codifica la producción de una proteína ligante y así disminuye la afinidad y la sensibilidad a la acción de compuestos antimicrobianos ß-lactámicos. El uso erróneo de antibióticos es uno de los factores responsables de cepas resistentes y, la adición de promotores de crecimiento en las raciones de cerdos, con la adición de antibióticos de forma preventiva, puede favorecer y aumentar la existencia de cepas multirresistentes, agravando aún más los datos ya obtenidos en investigaciones. La selección de estos genes resistentes causa preocupación a la salud colectiva, ya que individuos que tuvieron contacto con cerdos y residen cercano a las granjas presentan cepas resistentes de S. aureus. Así, la utilización de antibióticos de forma correcta es fundamental para la reducción de índices de resistencias a los antibióticos.

Resistência do Staphylococcus aureus à antimicrobianos: da suinocultura à saúde pública / Resistance of Staphylococcus aureus to antimicrobials: from swine to public health / Resistencia del Staphylococcus aureus a antimicrobianos: de la porcicultura a la salud pública

No cenário agroindustrial brasileiro a cadeia suinícola vem se destacando cada vez mais. A inserção no mercado internacional e as novas tecnologias aplicadas na prática de produção de suínos tem grande importância na economia do país. No entanto, algumas bactérias oportunistas estão presentes nas regiões nasais de suínos, sendo responsáveis por diversas alterações clínicas na suinocultura. Um dos principais patógenos que acomete esta espécie é o Staphylococcus aureus, responsável também por infeções nos seres humanos. O S. aureus possui características de virulência e resistência a diversos antibióticos, em especial à oxacilina, um antibiótico pertencente ao grupo ß-lactâmicos com ampla escala de utilização. A resistência do S. aureus à oxacilina está interligada a vários fatores, como a presença do gene mecA, que codifica a produção de uma proteína ligante e, assim, diminui a afinidade e a sensibilidade à ação de compostos antimicrobianos ß-lactâmicos. O uso errôneo de antibióticos é um dos fatores responsáveis por cepas resistentes e, a adição de melhoradores de desempenho nas rações de suínos, com a adição de antibióticos de forma preventiva pode favorecer e aumentar a existência de cepas multirresistentes, agravando ainda mais os dados já obtidos em pesquisas. (AU)

Pig farming has been increasingly prominent in the Brazilian agroindustrial scenario. Its insertion in the international market and the use of new technologies applied to pig farming have been of great importance to the country's economy. Nevertheless, opportunistic bacteria present in the nasal regions of pigs are responsible for several clinical changes in the breeding of those animals. Staphylococcus aureus features among the main pathogens affecting that species, being also responsible for infections in humans. S. aureus is characterized by its virulence and resistance to several antibiotics, especially oxacillin, an antibiotic belonging to the ß-lactam group with a wide usage range. The resistance of S. aureus to oxacillin is linked to several factors, such as the presence of the mecA gene, which encodes the production of a binding protein and thus decreases the affinity and sensitivity to the action of ß-lactam antimicrobial compounds. Incorrect use of antibiotics is one of the factors responsible for generating resistant strains, and the addition of growth promoters in pig feeds with the addition of antibiotics as a form of prevention may favor and even increase the existence of multiresistant strains, further aggravating the current scenario, as expressed by data already obtained in research. The selection of these resistant genes is a matter of concern for collective health, since individuals that had contact with pigs and residents living near pig farms present S. aureus resistant strains. Thus, the correct use of antibiotics is pivotal for reducing the antibiotic resistance rates.(AU)

En el escenario agroindustrial brasileño la cadena porcina viene destacándose cada vez más. La inserción en el mercado internacional y las nuevas tecnologías aplicadas en la práctica de producción de cerdos, tiene gran importancia en la economía del país. Sin embargo, algunas bacterias oportunistas están presentes en las regiones nasales de cerdos, siendo responsables por diversas alteraciones clínicas en la porcicultura. Uno de los principales patógenos que acomete esta especie es el Staphylococcus aureus, responsable también por infecciones en los seres humanos. El S. aureus posee características de virulencia y resistencia a diversos antibióticos, en especial a la oxacilina, un antibiótico perteneciente al grupo ß-lactámicos con amplia escala de utilización. La resistencia del S. aureus a oxacilina está interconectada a varios factores, como la presencia del gen mecA, que codifica la producción de una proteína ligante y así disminuye la afinidad y la sensibilidad a la acción de compuestos antimicrobianos ß-lactámicos. El uso erróneo de antibióticos es uno de los factores responsables de cepas resistentes y, la adición de promotores de crecimiento en las raciones de cerdos, con la adición de antibióticos de forma preventiva, puede favorecer y aumentar la existencia de cepas multirresistentes, agravando aún más los datos ya obtenidos en investigaciones. La selección de estos genes resistentes causa preocupación a la salud colectiva, ya que individuos que tuvieron contacto con cerdos y residen cercano a las granjas presentan cepas resistentes de S. aureus. Así, la utilización de antibióticos de forma correcta es fundamental para la reducción de índices de resistencias a los antibióticos.(AU)

Potencial antimicrobiano de extratos glicólicos vegetais sobre bactérias anaeróbias / Antimicrobial potential of plant glycolic extracts on anaerobic bacteria

A resistência microbiana aos antibióticos disponíveis é preocupação constante, devido à dificuldade no tratamento de infecções causadas por cepas resistentes, em decorrência do uso indiscriminado de antimicrobianos. Assim, a busca por terapias antimicrobianas alternativas tem sido crescente e necessária, sendo a fitoterapia umas das opções de escolha. O objetivo do presente estudo foi analisar a atividade antibacteriana de extratos glicólicos de Achyrocline satureioides (macela), Cynara scolymus (alcachofra), Hamamelis virginiana (hamamelis) e Persea americana (abacateiro), pelos períodos de 5 min e 24 h de exposição sobre bactérias anaeróbias Fusobacterium nucleatum subsp. nucleatum, Parvimonas micra, Porphyromonas endodontalis e Porphyromonas gingivalis, em culturas planctônica e biofilmes. As bactérias armazenadas a -80ºC foram ativadas em caldo Brucella enriquecido (hemina 1%, menadiona 1% e sangue de carneiro desfibrinado 5%) e incubadas em câmara de anaerobiose por 48 h a 37ºC por sete dias. A partir de culturas puras, o teste de microdiluição em caldo foi conduzido em microplacas por meio de suspensões bacterianas padronizadas em solução fisiológica estéril (NaCl 0,9%) e diluições dos extratos em caldo, sendo as placas incubadas por 48 h a 37ºC em anaerobiose. Alíquotas de cada poço foram semeadas em ágar Brucella enriquecido. Após incubação, a Concentração Inibitória Mínima (CIM) e Concentração Bactericida Mínima (CBM) foram determinadas. As concentrações efetivas de cada extrato foram aplicadas sobre os biofilmes de cada espécie, formados em microplacas a partir de suspensões bacterianas puras padronizadas na escala 0,5 de McFarland. As microplacas foram incubadas por sete dias a 37ºC para formação dos biofilmes, sendo o meio trocado a cada 48 h. Os biofilmes foram tratados por 5 min e 24 h. Em seguida, foram lavados e desprendidos por homogeneizador ultrassônico. As suspensões diluídas foram adicionadas em ágar Brucella enriquecido. Após 48 h, as Unidades Formadoras de Colônia por mililitro (UFC/mL) foram determinadas. Os resultados foram analisados por ANOVA e teste de Tukey ou por Kruskal-Wallis e teste Dunns, ambos com nível de significância de 5% (p≤0,05). Sobre as culturas planctônicas, a CIM e CBM dos extratos foi determinada apenas para F. nucleatum. A CBM dos extratos de A. satureioides, C. scolymus e P. americana foi obtida sobre P. micra. Não foi obtida atividade bactericida para P. endodontalis e P. gingivalis. Sobre biofilmes, todas as espécies apresentaram reduções significativas quando expostas aos extratos em ambos os tempos. Pode-se concluir que os extratos testados apresentaram efeito bacteriostático sobre F. nucleatum. Atividade bactericida dos extratos foi observada sobre F. nucleatum, bem como sobre P. micra, exceto para H. virginiana. Os extratos avaliados também apresentaram efeito antibiofilme sobre F. nucleatum, P. micra, P. endodontalis e P. gingivalis por 5 min e 24 h de exposição(AU)

Microbial resistance to antibiotics available is constant concern, due to the difficulty in treating infections caused by resistant strains as a result of the indiscriminate use of antimicrobials. Thus, the search for antimicrobial alternative therapies has been growing and necessary, being one option the herbal medicine. The objective of the present study was to analyze the antibacterial activity to Achyrocline satureioides glycolic extracts (macela), Cynara scolymus (artichoke), Hamamelis virginiana (Witch-Hazel) and Persea americana (avocado), for periods of 5 min and 24 h from exhibition on anaerobic bacteria Fusobacterium nucleatum subsp. nucleatum, Parvimonas micra, Porphyromonas gingivalis and Porphyromonas endodontalis in planktonic communities and biofilms. Bacteria stored at -80°C have been activated in Brucella broth enriched (hemin 1%, menadione 1% and defibrinated sheep blood 5%) and incubated in anaerobiose chamber for 48 h at 37° C for seven days. From pure cultures, the microdiluição test in broth was conducted in microplates through standardized bacterial suspensions in sterile saline solution (NaCl 0.9%) and dilution of the extracts in broth, being incubated plates for 48 h at 37° C in anaerobiosis. Aliquots of each well were sown in Brucella agar enriched. After incubation, the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were determined. Effective concentrations of each extract were applied on the biofilms of each species, formed in microplates from pure bacterial suspensions in 0.5 McFarland scale standard. The microplates were incubated for 7 days at 37°C for the formation of biofilms, being the culture medium replaced every 48 h. Biofilms were treated for 5 min and 24 h have been washed and given off by ultrasonic homogenizer. Dilute suspensions were added in Brucella agar enriched. After 48 h, the Colony Forming Units per milliliter (CFU/ml) were determined. The results were analyzed by ANOVA and Tukey test, or Kruskal-Wallis test and Dunns, both with a significance level of 5% (p ≤ 0.05). On the planktonic cultures, CIM and CBM of extracts was determined only to F. nucleatum. The CBM of the extracts of A. satureioides, C. scolymus and P. americana was obtained on P. micra. Bactericidal activity was not obtained for P. endodontalis and P. gingivalis. About biofilms, all species exhibited significant reductions when exposed to the extracts in both times. It can be concluded that the extracts tested showed bacteriostatic effect on F. nucleatum. Bactericidal activity of extracts was observed on F. nucleatum and P. micra, except for H. virginiana. The extracts evaluated also presented antibiofilme effect on F. nucleatum, P. micra, P. endodontalis and P. gingivalis for 5 min and 24 h(AU)

Susceptibilidad antimicrobiana en muestras clínicas de pacientes con infecciones asociadas a la atención de salud / Antimicrobial susceptibility in clinical samples of patients with health care associated infections

Introducción: Las infecciones asociadas a la atención de salud (IAAS) son uno de los principales problemas que afecta a los pacientes en las unidades hospitalarias, tanto en países desarrollados como carentes de recursos. Objetivo: Identificar los tipos de IAAS reportadas, microorganismo causal y susceptibilidad antimicrobiana en el Servicio de Medicina Interna del Hospital Clínico-Quirúrgico "Manuel Fajardo". Material y método: Estudio descriptivo, retrospectivo y transversal de 105 pacientes con IAAS, quienes ingresaron en el Servicio de Medicina Interna del Hospital Clínico-Quirúrgico Manuel Fajardo, desde enero 2013 hasta diciembre 2015. Se analizaron distintas variables. Se utilizó la estadística descriptiva y se relacionó la información nacional e internacional con los resultados obtenidos. Resultados: Predominaron los pacientes con edad superior a los 60 años. El diagnóstico más común fue la bronconeumonía en 58 pacientes (55.2 por ciento). El principal microorganismo causal para la bronconeumonía, la traqueobronquitis y las úlceras de presión fue Pseudomona spp.; mientras que para la infección del tracto urinario y flebitis-celulitis y absceso fueron E. coli y S. aureus respectivamente. Pseudomona spp. y E. coli mostraron alta resistencia a las cefalosporinas de primera, segunda y tercera generaciones testadas y a otros tipos de antibióticos; sin embargo, para los aminoglucósidos y Cefepime la sensibilidad fue favorable. La susceptibilidad de S. aureus mostró resultados muy adversos, pues solo para la Amikacina y Vancomicina tuvo aceptable sensibilidad. Conclusiones: Las IAAS predominaron en una población envejecida y fueron ocasionadas por una diversidad de microorganismos, principalmente Pseudomona spp., E. coli y S. aureus, los cuales mostraron elevada resistencia antimicrobiana(AU)

Introduction: The health care associated infections (HCAI) are one of the major problems which affect the patients in the hospital units, both in developed countries and in countries with low resources. Objective: To identify what kind of HCAI were reported, causal microorganism and antimicrobial susceptibility in the Internal Medicine Service at the "Manuel Fajardo" clinical-surgical hospital. Material and method: Descriptive, retrospective and transversal study of 105 patients with HCAI, who were admitted in the Internal Medicine Service at the Manuel Fajardo clinical-surgical hospital, from January 2013 to December 2015. It was analyzed different variables. It was used descriptive statistics and it was related the national and international information with the obtained results. Results: It were predominated the patients with age over 60 years. The more common diagnosis was broncho-pneumonia in 58 patients (55.2 percent). The principal causal microorganism for broncho-pneumonia, the tracheo-bronchitis and the pressure ulcers was Pseudomona spp.; while for urinary tract infection and flebitis-cellulitis and abscess were E. coli and S. aureus respectively. Pseudomona spp. and E. coli showed high resistance to cephalosporins of the first, second and third generation tested and other kinds of antibiotics; however, for the amynoglucosides and for Cefepime the sensibility was favourable. The susceptibility of S. aureus showed very adverse results, because only for Amikacin and Vancomicin had acceptable sensibility. Conclusions: The HCAI predominated in an aged population and were caused by a diversity of microorganisms, principally Pseudomona spp., E. coli and S. aureus, which showed high antimicrobial resistance(AU)

Antibacterial Activity of Melaleuca alternifolia (tea tree essential oil) on Bacteria of the Dental Biofilm

Objective: To evaluate the antibacterial activity of tea tree EO on Streptococcus mutans (ATCC 25175), S. salivarius (ATCC 7073) and Lactobacillus rhaminosus (ATCC 9595). Material and Methods: The antibacterial activity of M. alternifolia EO was evaluated by the broth dilution method, by which minimum inhibitory and bactericidal concentrations (MIC and MBC) were determined. Serial dilutions range from 70243.90 µg/mL to 26.14 µg/mL. The MIC evaluation was performed in 96-well microplates, in which 100 µL of Brain Heart Infusion (BHI), 100 µL of the EO dilution and 5 µL of the inoculum (final concentration = 5x105 CFU/mL) were inserted. After 24 h of incubation, MIC was determined as the lowest concentration capable of inhibiting microbial growth, identified by the resazurin reaction (100 µg/mL). CBM was identified by the absence of subculture growths (50 µL) of dilutions equal to or greater than MIC. Tests were performed in triplicate and at three different times (n = 9). Pharmacological controls (0.05% and 0.12% Chlorhexidine), growth and sterility were used to validate the results. Results: The MIC of M. alternifolia compared to S. mutans, S. salivarius and L. rhaminosus was 1940.16 µg/mL, 3977.34 µg/mL and 3977.34 µg/mL, respectively. The MBC values were 70243.90 µg/mL, 3977.34 µg/mL and 34265.31 µg/mL, respectively. Conclusion: The essential oil of M. alternifolia presented antibacterial activity against the microorganisms evaluated when in high concentration.

Perfil de prescrição de antimicrobianos nas unidades básicas de saúde conveniadas com a universidade de Itaúna/MG / Antimicrobial prescription profile in the basic health units agreed with the university of Itaúna/MG

INTRODUÇÃO: O uso abusivo de antibacterianos está intimamente relacionado ao desenvolvimento de resistência bacteriana, considerada, atualmente, um problema de saúde pública mundial. Segundo a Organização Mundial de Saúde, em 2001, mais da metade das prescrições de antimicrobianos foram inapropriadas e dois terços de sua utilização foram feitas sem prescrição médica. Assim, o uso racional desse medicamento requer uma seleção criteriosa e bom senso clínico do prescritor. OBJETIVOS: Analisar o perfil de prescrição de antimicrobianos nas Unidades Básicas de Saúde da Família (UBSF) do município de Itaúna-MG, conveniados com a Universidade de Itaúna (UIT) e contribuir para que futuras intervenções possam ser conduzidas promovendo do uso racional dos antimicrobianos na atenção primária. MÉTODOS: Estudo transversal de prontuários médicos de pacientes atendidos nas UBSF de Itaúna/MG conveniadas com a UIT, realizado entre março de 2013 e março de 2014, para os quais foram prescritos antibióticos. RESULTADOS: A classe de antimicrobianos mais prescrita foi a das penicilinas seguido pelas quinolonas e macrolídeos. Quanto à duração do tratamento, o período de cinco a dez dias foi observado na maioria das prescrições. As principais indicações clínicas foram infecção das vias aéreas superiores não especificadas, amigdalite, otite, sinusite, infecção do trato urinário entre outros. A solicitação de culturas foi realizada em apenas 5,5% dos casos. CONCLUSÃO: A análise do perfil das prescrições revelou a necessidade de reciclagem da equipe e adoção de protocolos clínicos. Tais medidas permitirão a uniformização das condutas, otimizando as prescrições e reduzindo o risco do uso inapropriado de antimicrobianos. (AU)

Introduction: The overuse of antibacterials is closely related to the development of bacterial resistance, currently considered a problem of public health worldwide. According to the World Health Organization, in 2001 over half of the antimicrobial prescriptions were inappropriate and two thirds of its use were made without prescription. Thus, the rational use of this drug requires careful selection and clinical judgment of the prescriber. Objectives: To analyze the antimicrobial prescription profile in the Basic Health Units of family of Itaúna-MG, that have agreements with the University of Itaúna (UIT) and contribute to future interventions that can be conducted to promote the rational use of antimicrobials in primary care. Methods: Cross-sectional study of medical records of patients treated in Basic Health Units of family Itaúna / MG with agreement with the UIT, held between March 2013 and March 2014, for which antibiotics were prescribed. Results: The most prescribed class of antimicrobials was the penicillins followed by quinolones and macrolides. About the duration of treatment, five to ten days was observed in the majority of prescriptions. The main clinical indications were infection of the upper airways unspecified, tonsillitis, otitis, sinusitis, urinary tract infection, among others. The request of cultures was performed in only 5.5% of cases. Conclusion: The analysis of the profile of prescriptions revealed the need for retraining of staff and adoption of clinical protocols. These measures will enable to uniform the procedures, optimizing the regulations and reducing the risk of inappropriate use of antimicrobials. (AU)

Phenotypic and Genotypic Antibiotic Resistance of Salmonella from Chicken Carcasses Marketed at Ibague, Colombia

Salmonella enterica is responsible for alimentary toxic infections associated with the consumption of contaminated poultry products and the antimicrobial resistant patterns of Salmonella circulating in the Tolima region are currently unknown. To address this issue, both the phenotype and genotype antibiotic resistance patterns of 47 Salmonella isolated from raw chicken carcasses sold at the Ibague city were analyzed by the disc diffusion, microdilution and PCR assays. All 47 Salmonella isolates showed resistance to five or more antimicrobial agents. Resistance to Ampicillin (AMP), Amikacin (AMK), Gentamicin (GEN), Tobramycin (TOB), Cefazoline (CFZ), Cefoxitin (FOX), Nitrofurantoin (NIT), Trimethoprim-Sulfamethoxazole (SXT), Tetracycline (TET), Ciprofloxacin (CIP) and Enrofloxacin (ENR) was observed in 42.35% of Salmonella isolates. All tested S. Paratyphi B var Java isolates showed resistance to at least 12 antibiotics. S. Hvittingfoss showed resistance to 5 antibiotics, whereas S. Muenster showed resistance to seven antibiotics. Amplification of a number of antibiotic resistance genes showed that blaTEM (100%) correlated well with resistance to Ampicilin and Cephalosporin, whereas aadB (87%) correlated well with resistance to Aminoglycosides. It is concluded that Salmonella isolated from raw chicken meat marketed at Ibague showed MDR by both phenotypic and genotypic methods and they may represent an important threat to human health. Additional studies are needed to establish the relationship between antibiotic resistance in Salmonella from poultry products and clinical isolates.

Phenotypic and Genotypic Antibiotic Resistance of Salmonella from Chicken Carcasses Marketed at Ibague, Colombia

Salmonella enterica is responsible for alimentary toxic infections associated with the consumption of contaminated poultry products and the antimicrobial resistant patterns of Salmonella circulating in the Tolima region are currently unknown. To address this issue, both the phenotype and genotype antibiotic resistance patterns of 47 Salmonella isolated from raw chicken carcasses sold at the Ibague city were analyzed by the disc diffusion, microdilution and PCR assays. All 47 Salmonella isolates showed resistance to five or more antimicrobial agents. Resistance to Ampicillin (AMP), Amikacin (AMK), Gentamicin (GEN), Tobramycin (TOB), Cefazoline (CFZ), Cefoxitin (FOX), Nitrofurantoin (NIT), Trimethoprim-Sulfamethoxazole (SXT), Tetracycline (TET), Ciprofloxacin (CIP) and Enrofloxacin (ENR) was observed in 42.35% of Salmonella isolates. All tested S. Paratyphi B var Java isolates showed resistance to at least 12 antibiotics. S. Hvittingfoss showed resistance to 5 antibiotics, whereas S. Muenster showed resistance to seven antibiotics. Amplification of a number of antibiotic resistance genes showed that blaTEM (100%) correlated well with resistance to Ampicilin and Cephalosporin, whereas aadB (87%) correlated well with resistance to Aminoglycosides. It is concluded that Salmonella isolated from raw chicken meat marketed at Ibague showed MDR by both phenotypic and genotypic methods and they may represent an important threat to human health. Additional studies are needed to establish the relationship between antibiotic resistance in Salmonella from poultry products and clinical isolates.(AU)

Síntese, caracterização e efeito microbiológico de nanopartículas de sílica revestidas por prata quando associadas a resina acrílica quimicamente ativada, reembasador macio e ao glaze / Synthesis, characterization and microbiological effect of silver-coated silica nanoparticles when associated with chemically activated acrylic resin, soft reliner and glaze

O objetivo deste trabalho foi sintetizar e caracterizar nanopartículas de sílica recobertas por prata, e avaliar a influência quando incorporadas à resina acrílica quimicamente ativada, ao reembasador macio, e a um glaze, em suas características microbiológicas, microestruturais e mecânicas. Foi confeccionada, pelo método de hidrólise e condensação controlada (método de Stober), uma solução contendo nanopartículas de sílica revestidas por nanopartículas de prata em duas proporções, 10 milimols e 30 milimols, onde as mesmas foram caracterizadas. As nanopartículas de sílica incorporadas com a prata foram analisadas por energia dispersiva de raios-X integrado (EDS), microscopia eletrônica de varredura (MEV), e espalhamento de luz dinâmico (DLS). Para análise microbiológica foram confeccionadas 10 amostras cilíndricas (2mmx10mm), em resina acrílica quimicamente ativada onde as partículas foram incorporadas em duas concentrações: 2.5% e 5% com as duas molaridades diferentes 10 mM e 30 mM. Em outra situação foram confeccionadas 10 amostras cilíndricas (2mmx10mm) de reembasador macio, com concentrações de 2,5% e 5% com as duas molaridades diferentes 10 mM e 30 mM, no terceiro caso as partículas foram acrescentadas a um glaze nas duas concentrações e molaridades e aplicada sob uma amostra de reembasador macio SoftConfort (Dencril) a base de resina acrílica. Uma suspensão de Candida albicans e Estreptococos mutans foi utilizada para análise de concentração inibitória mínima. Amostras retangulares em resina acrílica (n=6) de 30x10x3mm, foram confeccionadas para realização do teste de resistência a flexão de três pontos de ensaios mecânicos EMIC (Modelo DL-1000, EMIC Equipamentos e Sistemas LTDA., São José dos Pinhais - PR ­ Brasil), com velocidade de 1mm/min. Amostras sem a presença de nanopartículas foram confeccionadas como grupo controle. A sílica inicialmente apresentava-se como um pó de coloração branca e fina, após a sua caracterização com as partículas de Nitrato de Prata, houve alteração da coloração para um tom amarelado, aumento da sua densidade e do tamanho de suas nanopartículas. Os resultados de ação antimicrobiana foram positivos para as amostras de reembasador macio e glaze com 5% e 30 mMol de nanopartículas, já no ensaio mecânico não houve diferença significante estatisticamente entre os grupos(AU)

The aim of this work was to synthesize and characterize silver - coated silica nanoparticles, and to evaluate the influence when incorporated into chemically activated acrylic resin, soft reliner, and glaze, in their microbiological, microstructural and mechanical characteristics. A solution containing silica nanoparticles coated by silver nanoparticles in two proportions, 10 millimols and 30 millimols, where they were characterized, was prepared by the hydrolysis and controlled condensation method (Stober method). Silica nanoparticles incorporated with silver were analyzed by integrated X-ray dispersive energy (EDS), scanning electron microscopy (SEM), and dynamic light scattering (DLS).For the microbiological analysis, 10 cylindrical samples (2mmx10mm) were made in chemically activated acrylic resin where the particles were incorporated in two concentrations: 2.5% and 5% with two different molarities of 10 mM and 30 mM. In another situation, 10 cylindrical samples (2mmx10mm) of soft reliner were made, with concentrations of 2.5% and 5% with the two different molarities 10 mM and 30 mM, in the third case the particles were added to a glaze in the two concentrations and molarities and applied under a sample of soft reliner Soft Confort (Dencril). A suspension of Candida albicans and Streptococcus mutans was used for analysis of minimal inhibitory concentration. The samples were made in acrylic resin (n = 6) of 30x10x3mm and were made to perform the three-point flexural strength test of EMIC (Model DL-1000, EMIC Equipamentos e Sistemas Ltda., São José dos Pinhais - PR - Brazil), with a speed of 1mm / min. Samples without the presence of nanoparticles were made as a control group. The silica initially presented as a fine white powder after its characterization with the Silver Nitrate particles, there was a change of coloration to a yellowish tone, increase of its density and the size of its nanoparticles. The results of antimicrobial action were positive for the soft reliner and glaze samples with 5% and 30 mMol of nanoparticles, whereas in the mechanical assay there was no statistically significant difference between the groups (AU)

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on -lactams and polymyxins

During the last 30 years there has been a dissemination of plasmid-mediated -lactamases in Enterobacteriaceae in Brazil. Extended spectrum -lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo--lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.(AU)