Copaiba oil's bactericidal activity and its effects on health and zootechnical performance for Nile tilapia after oral supplementation.

Tilapia is one of the most important farmed fish in the world and the most cultivated in Brazil. The increase of this farming favors the appearance of diseases, including bacterial diseases. Therefore, the aim of this study was to evaluate the bactericidal activity of copaiba oil, Copaifera duckei, against Streptococcus agalactiae and Flavobacterium columnare and the dietary effect of copaiba oil on zootechnical performance, hematological, biochemical, immunological, and histological analysis before and after an intraperitoneal infection (body cavity) with S. agalactiae in Nile tilapia. For this, fish were randomly distributed into 15 fiber tanks in five treatments (0, 0.25, 0.50, 0.75, and 1.0%) and fed with a commercial diet supplemented with copaiba oil for 30 days. After this period, the fish were randomly redistributed for the experimental challenge with S. agalactiae into six treatments (T0, T1, T2, T3, T4, and T5), the fish were anesthetized, and blood samples were collected to assess hematological, biochemical, immunological, and histological parameters. Copaiba oil showed bactericidal activity against Streptococcus spp. and Flavobacterium spp. in vitro. In addition, concentrations of 0.75 and 1.0% of copaiba oil have an anti-inflammatory effect and improve hematological and immunological parameters, increasing leukocyte numbers, albumin, and serum lytic activity. Furthermore, there is an increase in the intestinal villus length and tissue damage in groups at concentrations of 0.75 and 1.0% of copaiba oil. In conclusion, copaiba oil presented bactericidal activity against Streptococcus spp. and Flavobacterium spp. in vitro, and oral supplementation at concentrations of 0.75 and 1.0% compared to the control group enhanced non-specific immune parameters and digestibility in Nile Tilapia.

[Streptococcus suis meningitis]. / Meningitis por Streptococcus suis.

Streptococcus suis (S. suis) is a globally prevalent swine pathogen, capable of generating infections in humans who were in contact with the animal or its raw meat. Clinical manifestations range from asymptomatic cases to systemic involvement, with low mortality, but with the possibility of leaving definitive sequelae such as ataxia and hearing loss. There are few case reports, due to lack of knowledge of the disease and its atypical presentation. The objective of this article is to report the case of a man with an occupational history of contact with pigs, who was admitted for meningitis and in whom the isolation of S. suis was obtained in cerebrospinal fluid and paired blood cultures; He completed antibiotic treatment adjusted to bacterial sensitivity, and was left with mild hearing loss as a consequence.

Streptococcus suis (S. suis) es un patógeno porcino prevalente a nivel mundial, capaz de generar infecciones en humanos que estuvieron en contacto con el animal o la carne cruda del mismo. Las manifestaciones clínicas comprenden desde casos asintomáticos hasta compromiso sistémico, con una baja mortalidad, pero con la posibilidad de dejar secuelas definitivas como la ataxia e hipoacusia. Son pocos los reportes de casos, debido al desconocimiento de la enfermedad y a su forma atípica de presentación. El objetivo de este artículo es relatar el caso de un varón con antecedentes ocupacionales de contacto con porcinos, que ingresó por meningitis y en el cual se obtuvo el aislamiento de S. suis en líquido cefalorraquídeo y hemocultivos pareados; completó tratamiento antibiótico ajustado a la sensibilidad bacteriana, quedó con hipoacusia leve como secuela.

High Incidence Rates of Early-onset Bacterial Sepsis in Infants Born in Two Brazilian Maternities: A 15-Year Retrospective Analysis.

BACKGROUND: Data on the burden and etiology of neonatal early-onset bacterial sepsis (EOBS) in low-to-middle-income countries are scarce. Surveillance is critical for optimizing prevention and treatment strategies. We aimed to estimate the incidence of EOBS in 2 large Brazilian cohorts of neonates. METHODS: Data were retrospectively obtained from 33,794 neonates born between 2009 and 2017 at low-risk (n = 17,981) and high-risk maternity centers (n = 15,813). Blood cultures were taken within 72 hours of life from neonates with perinatal risk factors for EOBS or suspected EOBS. A positive blood culture for a pathogenic microorganism and a compatible clinical evolution confirmed the diagnosis of EOBS. RESULTS: One-third of the infants born from high-risk and 18.5% from low-risk maternities were investigated for EOBS. Overall, EOBS was more incident in neonates born in the high-risk facilities [66 cases or 4.2/1000 (95% CI: 3.2-5.3)] than in the low-risk facilities [24 cases or 1.3/1000 (95% CI: 0.9-2.0)]. The incidence rate of EOBS increased with decreasing gestational age (<32 weeks: 20.5/1000; 32-36 weeks: 5.6/1000; ≥37 weeks: 1.5/1000). Group B Streptococcus (GBS) was the agent more frequently identified in high-risk and low-risk maternities: 1.8/1000 (95% CI: 1.1-2.4) and 0.4/1000 (95% CI: 0.2-0.9), respectively. EOBS's overall case fatality rate was 17.8% for all the agents and 22% for GBS. CONCLUSIONS: EOBS remains unacceptably high and is frequently fatal in preterm and term infants cared for in high- or low-risk maternities. Because GBS has emerged as the most frequent causative agent, preventive strategies are urgently needed.

Antimicrobial resistance of Streptococcus uberis isolated from bovine mastitis: Systematic review and meta-analysis.

Streptococcus uberis is one of the most common pathogens associated with bovine mastitis, commonly treated with antimicrobials (AM), favoring the appearance of antimicrobial resistance (AMR). The objective of this work was to determine the proportion of phenotypic AMR among S. uberis isolated worldwide from bovine intramammary infections between the years 1983-2022, and to assess the variables associated by means of a systematic review and metanalysis. Sixty articles were eligible for quantitative review. Ninety-four independent studies were obtained. The antimicrobials evaluated in more S. uberis strains were penicillin (21,987 strains), oxacillin (21,727 strains), erythromycin (20,013 strains), and ampicillin (19,354 strains). Most of the studies included in this meta-analysis were from Europe (44), followed by America (25), Africa (10), Asia (10), and Oceania (5). Among the included articles, 22 were published from 1983 to 2006, 23 from 2007 to 2012, 25 from 2013 to 2015, and the remaining 24 after 2016. Penicillin, erythromycin, and tetracycline were the antimicrobials with >25 studies. Therefore, the following analyses were performed only for these antimicrobials, presenting a high heterogeneity index (I2). The variability observed for penicillin and tetracycline was only explained, partially, by continent of origin. The variability observed for erythromycin was not explained by any of the potential explanatory variables included in this study. The S. uberis proportion of resistance to antimicrobials is highly variable and probably influenced by many factors other than those studied in this meta-analysis, where it was not possible to inform a unique average proportion of resistance.

Streptococcus agalactiae virulence factors isolated from bovine mastitis and antibiotic treatment response.

AIMS: This study aims to characterize the virulence factors of Streptococcus agalactiae strains isolated from bovine mastitis and their potential association with the antibiotic treatment response. METHODS AND RESULTS: Four different profiles were identified among the 181 S. agalactiae strains using polymerase chain reaction, of which hyl B and cylE were found in 100% of the isolated strains, followed by cfb (99.5%), scpB (40.3%), and lmb (15.5%). The cell invasion assay showed that lmb-positive strains exhibited higher invasion ability than lmb-negative. There was a significant association (P = 0.018) between lmb gene and cows that required more than one treatment cycle. CONCLUSIONS: These results showed that intramammary infections caused by lmb-carrier S. agalactiae strains did not adequately respond to the antibiotics administered, likely because of the presence of this virulence factor, which potentially favours the cell invasion capacity of these strains.

PANS-PANDAS, case report.

INTRODUCTION: Since 1980, there have been known cases of childhood neuropsychiatric syndromes in the world and its concept has evolved with changes in the definitions in 1995 (PITANDs - paediatric infection-triggered autoimmune neuropsychiatric disorders), 1998 (PANDAS - paediatric autoimmune neuropsychiatric syndrome associated with streptococci infection), 2010 (PANS - paediatric acute-onset neuropsychiatric syndrome) and 2012 (CANS - childhood acute neuropsychiatric syndrome). Despite being known for more than 20 years, it is still an illness that often goes unnoticed by many health professionals. OBJECTIVE: To sensitise the medical community about the identification of the disease and reduce the morbidity associated with a late diagnosis. CLINICAL CASE: A 6-year-old schoolgirl brought to the emergency department due to her refusal to eat. In the hospital treatment, a clinical history was identified with PANS-PANDAS diagnostic criteria. She exhibited a relapsing-remitting clinical course, as described in the literature, with poor response to first-line treatments. CONCLUSIONS: In all school-age child presenting with obsessive compulsive disorder or eating disorders, with other symptoms or not, a possible link to PANS-CANS should be evaluated and ruled out.

Beta-lactam antibiotics and viridans group streptococci.

The aim of this review is to present an update on the susceptibility of viridans group streptococci (VGS) to ß-lactam antimicrobials, with emphasis on the Argentinean scenario. VGS are a heterogeneous group including five groups of species, each one exhibiting peculiar susceptibility patterns to penicillin (PEN). Species of the Streptococcus mitis group are frequently nonsusceptible to PEN. PEN resistance is associated with changes in PEN-binding proteins. In Argentina, one to two thirds of VGS are nonsusceptible to PEN. Third generation cephalosporins and carbapenems are currently more effective in vitro than PEN against VGS. Mortality was associated to nonsusceptibility to PEN in at least two studies involving patients with bacteremia caused by VGS. Treatment of endocarditis due to VGS should be adjusted/to the PEN susceptibility of the isolates. Vancomycin may be an alternative choice for treating endocarditis caused by PEN-resistant isolates (MIC≥4µg/ml).

Enfermedades invasoras por Streptococcus pyogenes en población pediátrica. Caracterización clínico-molecular 2014-2020 / Invasive diseases due to Streptococcus pyogenes in the pediatric population. Clinical-molecular characterization 2014-2020

INTRODUCCIÓN: Streptococcuspyogenes (EGA) es agente de enfermedad invasora (EI); su alta morbimortalidad exige vigilancia epidemiológica. OBJETIVO: Describir características clínicas y epidemiológicas de niños hospitalizados con EI por EGA en un centro de referencia de Uruguay del 1/1/2014 al 31/12/2020 incluyendo el estudio de los factores de virulencia encontrados en las cepas aisladas. MATERIALES Y MÉTODOS: Descriptivo y retrospectivo. Definición de caso: aislamiento de EGA. en sitios estériles. Variables: epidemiológicas, clínicas, laboratorio, tratamiento y evolución. Se tipificó por secuenciación del gen emm. Se obtuvieron perfiles cromosómicos por digestión del ADN con la enzima SmaI. Presencia de los genes que codifican SpeB, SpeA, SpeC y Ssa, y susceptibilidad a antimicrobianos. RESULTADOS: Tasa de admisiones: 3,98/10.000. Se incluyeron 22 pacientes; infección osteoarticular (n = 11), infección pleuropulmonar (n = 6), absceso no cutáneo (n = 4) y aislamiento en sangre (n = 1). Media de edad: 44 meses; 8 fueron graves, siendo su media de edad menor (16 meses) Todas los casos con neumonías fueron graves y un paciente falleció. Se secuenciaron 12 cepas: 5 emm1 (4 emm 1.29 y 1 emm 1) y 1 de cada uno de los siguientes: emm 6.4, emm 81, emm12, emm28, emm 22, emm 87, emm 11. Todas eran SpeB+. Perfiles de toxinas: SpeA+SpeC-Ssa-(5), SpeA-SpeC+Ssa-(4) SpeA-SpeC-Ssa-(2) y SpeA-SpeC+Ssa+ (2). CONCLUSIONES: Este estudio permite dar continuidad a un estudio previo. Se logró mayor tipificación de EGA. que puede contribuir a su conocimiento clínico molecular. No hubo registro de pacientes con diagnóstico de SST ni de fascitis necrosante, a diferencia de la serie anterior.

BACKGROUND: Streptococcus pyogenes (GAS) is an agent of invasive disease (ID); its high morbidity and mortality requires epidemiological surveillance. AIM: To describe the clinical and epidemiological characteristics of children hospitalized with ID due to GAS in a reference center in Uruguay from January 1-2014 to December 31-2020, including a study of virulence factors. METHODS: Descriptive and retrospective. Case definition: Isolation of GAS in sterile sites. Variables: epidemiological, clinical, laboratory, treatment and evolution. Strains were typified by sequencing of the emm gene. Chromosomal profiles were obtained by digestion of the DNA. with the Smal enzyme. Presence of SpeB, SpeA and SpeC genes and susceptibility to antibiotics were performed. RESULTS: Admissions rate: 3.98/10,000. 22 patients were included; osteoarticular infection (n = 11), pleuropulmonary infection (n = 6), non-cutaneous abscess (n = 4) and blood isolation (n = 1). Mean age: 44 months; 8 cases were severe, their mean age was lower (16 months). All pneumonia cases were severe and one patient died. Twelve strains were sequenced: 5 emm1 (4 emm1.29 and 1 emm1) and 1 of each: emm6.4, emm81, emm 12, emm28, emm 22, emm 87, emm 11. All were SpeB+. Toxin profiles: SpeA+SpeC-Ssa-(5), SpeA-SpeC+Ssa-(4) SpeA-SpeC-Ssa-(2) and SpeA-SpeC+Ssa+(2). CONCLUSIONS: This study allows to give continuity to a previous study. Greater typing of GAS was achieved, which may contribute to its molecular clinical knowledge. There was no record of patients diagnosed with TSS or necrotizing fascitis, unlike the previous series.

Household Transmission of Group A Streptococcus Necrotizing Fasciitis.

A healthy 40-year-old woman was diagnosed with necrotizing fasciitis 2 days after her husband's death from the same infectious process. Prompt identification and immediate surgical intervention prevented a similar result in this patient. Additional investigation into both patients' medical records found the inciting organism to be group A streptococcus. Although the exact mechanism of inoculation is unknown, the spread of this infection within a household prompts the question of whether antibiotic prophylaxis should be given among close contacts in future cases of necrotizing fasciitis.

Acute Post-Streptococcal Glomerulonephritis in Children: A Comprehensive Review.

BACKGROUND: Acute post-streptococcal glomerulonephritis (APSGN) is an immune- complex (ICs) mediated glomerular disease triggered by group A ß-hemolytic streptococcus (GAS) or Streptococcus pyogenes infections. APSGN represents a major cause of acquired kidney injury in children. METHODS: This non-systematic review summarizes recent evidence on APSGN. We discuss the epidemiology, pathogenesis, clinical and laboratory findings, histopathology, treatment and prognosis of the disease. RESULTS: The median APSGN incidence in children in developing countries is estimated at 24.3/100,000 per year, compared with 6.2/100,000 per year in developed countries. Nephritis-associated plasmin receptor, identified as glyceraldehyde-3-phosphate dehydrogenase, and the cationic cysteine proteinase streptococcal pyrogenic exotoxin B are thought to be two leading streptococcal antigens involved in the pathogenesis of APSGN, which activate the complement system, mainly via the alternative but also the lectin pathway. This process is critical for the generation of inflammation by the ICs deposited in the glomerulus. The classic phenotype is an acute diffuse proliferative glomerulonephritis leading to features of the nephritic syndrome, including hematuria, oliguria, hypertension and edema. The histopathology shows that the glomeruli are diffusely affected, mostly presenting enlarged glomerular tuffs due to hypercellularity. Proliferative endothelial and mesangial cells and inflammation have also been observed. APSGN frequently has spontaneous recovery. There is no specific therapy, but its morbidity and mortality are drastically reduced by the prevention and/or treatment of complications. CONCLUSION: Despite recent advances, the pathogenesis of APSGN is not fully understood. There is no specific treatment for APSGN. The prognosis is generally good. However, some cases may evolve into chronic kidney disease.

Sepsis precoz, osteoartritis y meningitis: a propósito de un caso clínico / Early sepsis, osteoarthritis and meningitis: a clinical case / Sepse precoce, osteoartrite e meningite: relato de caso

Se expone el caso de un recién nacido que desarrolló sepsis connatal precoz a Streptococcus agalactiae, con meningitis aguda supurada y osteoartritis de rodilla izquierda. Como factor de riesgo la madre no tenía realizado el exudado rectovaginal, pesquisa que detecta la colonización por estreptococo del grupo B (EGB). Se aisló el germen en hemocultivo y en líquido de punción articular. Recibió tratamiento antibiótico adecuado a la sensibilidad del microorganismo y según pauta de sepsis con meningitis, evolucionando favorablemente. En este trabajo se describe la epidemiología de la sepsis neonatal y los cambios ocurridos luego de la implementación de la profilaxis antibiótica en el preparto.

We hereby present the case of a newborn with early connatal sepsis due to Streptococcus agalactiae, with acute suppurative meningitis and left knee osteoarthritis. As a risk factor, the mother had not performed the rectus vaginal exudate screening that detects colonization by Group B Streptococcus (GBS). The germ was isolated in blood culture and in joint puncture fluid. The patient received germ-sensitive antibiotic treatment for meningitis sepsis and evolved favorably. This paper describes the epidemiology of neonatal sepsis and the changes that have occurred after the administration of the antibiotic prophylaxis during pregnancy.

Apresentamos o caso de um recém-nascido com sepse neonatal precoce por Streptococcus agalactiae, com meningite supurativa aguda e osteoartrite de joelho esquerdo. Como fator de risco, a mãe não realizou teste de exsudato vaginal do reto que detecta a colonização por estreptococos do grupo B (SGB). O germe foi isolado em hemocultura e líquido de punção articular. A paciente recebeu tratamento com antibióticos germinativos para padrão meningite sepse e evoluiu favoravelmente. Este artigo descreve a epidemiologia da sepse neonatal e as mudanças ocorridas após a administração da profilaxia antibiótica durante a gravidez.

Influence of Penicillin on Biofilm Formation by Streptococcus agalactiae Serotype Ia/CC23.

Streptococcus agalactiae (Group B Streptococcus , GBS) is a major agent of perinatal infections. Biofilms have been associated with GBS colonization and disease, as well as with infection persistence and recurrence. Although GBS remains susceptible to beta-lactams, it is still unknown how sessile cells respond to these antibiotics. Here, we evaluated the effect of different concentrations of penicillin (3-48 mg/L) on in vitro biofilm formation by four GBS strains belonging to serotype Ia/clonal complexes23 that were recovered from the oropharynx or urine of pregnant women and were previously characterized as strong biofilm producers. All four GBS strains were fully susceptible to penicillin (minimum inhibitory concentration = 0.023 mg/L), but penicillin was not able to fully prevent biofilm formation by these GBS strains. Biofilms formed in the presence of penicillin had reduced biomasses and thickness, but they were still classified as strong. Penicillin significantly reduced the density of live cells, but higher penicillin concentrations did not lead to improved prevention of biofilm formation. Biofilms formed in the presence of penicillin had no channels or long cocci chains observed in penicillin-free biofilms. Overall, results highlight the concerning possible impacts of biofilm formation in penicillin-based treatment and preventive strategies of GBS infections, even when the bacterial strain involved is fully antibiotic-susceptible.

Epidemiology of Invasive Infections Caused by Streptococcus agalactiae in Argentina.

In recent years, an increase in the number of cases of invasive infections due to Streptococcus agalactiae (group B Streptococcus [GBS]) in adults has been reported. During 2014 and 2015, a multicentric, observational, and prospective study, including 40 health centers, was developed to describe the phenotypic and genotypic characteristics of GBS isolates circulating in Argentina and to analyze the clinical and demographic characteristics of patients with invasive infections. We recovered 162 invasive (GBSi) isolates from adult patients (n = 130, 80.2%), neonates (n = 24, 15%), and children below 18 years of age (n = 8, 4.8%), and colonizing (GBSc) isolates were recovered in prenatal GBS screening. GBS infection in adults was associated with underlying diseases, mainly diabetes mellitus. All isolates were penicillin susceptible. Resistance rates to erythromycin (25%) and clindamycin (26%) among the GBSc isolates were significantly higher than those from GBSi strains (17.3% and 16.1%, respectively); by contrast, levofloxacin resistance was significantly higher in GBSi isolates (14.8% vs. 7%). Serotype Ia was the most frequent in neonates and Ib was most frequent in adults. Serotypes Ia and III were prevalent in GBSc isolates. The increase of levofloxacin resistance was associated with the presence of a serotype Ib clone. This work emphasizes the need for GBS infection surveillance studies to implement correct treatments and adequate prevention strategies.

Microbiology and Treatment Outcomes of Community-Acquired Hematogenous Osteoarticular Infections in Infants ≤12 Months of Age.

We investigated the microbiology, management, and orthopedic outcomes of osteoarticular infections in infants age ≤1 year at our institution. Among 87 patients, Staphylococcus aureus was the most common pathogen (44.8%), followed by group B Streptococcus. Twenty-nine patients (33%), with a median age of 9.2 months, were transitioned to oral antibiotic therapy after ≤14 days of parenteral therapy; orthopedic outcomes were similar to those with prolonged parenteral therapy.

Multiple Brain Abscesses by an Air Gun Shot: A Case Report

Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types ofmicroorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in nontraumatic patients. Multiple brain abscesses are not common. Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition. Conclusion Brain injurywith air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.

Adenitis cervical con anaerobios sin causa aparente en lactante / Cervical adenitis with anaerobes without apparent cause in infant

Las adenopatías cervicales benignas en lactantes son relativamente frecuentes, se definen como el aumento de volumen ganglionar de más de 1 cm, sin síntomas sistémicos y cuando están presentes, el término correcto es adenitis. Para su estudio, las adenitis se dividen en: locales, sistémicas, unilaterales, bilaterales, agudas, crónicas, y por edad, con diferentes etiologías. Se presenta el caso clínico de un lactante de 11 meses de edad con diagnóstico de adenitis cervical abscedada unilateral aguda, con cuadro de 72 h de evolución, con crecimiento constante a nivel cervical derecho, compromiso del estado general, fiebre y anorexia, por lo que se inician antibióticos de primera línea para los agentes bacterianos más frecuentes (Staphylococcus aureus y Streptococcus pyogenes), con evolución tórpida a las 48 h, por lo que se solicita ultrasonido cervical, ya que la familia no contaba con recursos para solicitar cultivo o tomografía, reportando el ultrasonido ganglio cervical de 3,5 cm de diámetro abscedado, por lo que se agrega cobertura para anaerobios, con respuesta muy favorable a las 24 h. Queda la duda del origen de los anaerobios en la paciente, sin antecedentes de importancia y en grupo etario diferente al afectado por esos gérmenes. Consideramos este caso interesante por su comportamiento atípico, para el enriquecimiento del ejercicio de la otorrinolaringología, recalcando el invaluable apoyo de la clínica y solo con un ultrasonido, ya que no siempre se tendrán todos los recursos disponibles, pero siguiendo las pautas de lo reportado en la literatura, se tuvo una resolución exitosa.

Benign cervical lymphadenopathies in infants are relatively frequent, they are defined as an increase in lymph node volume of more than 1 cm, without systemic symptoms, and when they are present, the correct term is adenitis. For its study, adenitis is divided into: local, systemic, unilateral, bilateral, acute, chronic, and by age, with different etiologies. An 11-month-old infant with a diagnosis of acute unilateral abscessed cervical adenitis, with a 72 h evolution, with constant growth at the right cervical level, fever and anorexia, for which first-line antibiotics were started to the most frequent bacterial agents (Staphylococcus aureus and Streptococcus pyogenes), with torpid evolution at 48 h, for which only cervical ultrasound is requested, since the family did not have the resources to request culture or tomography, reporting the cervical ganglion ultrasound of 3.5 cm of abscessed diameter, so coverage for anaerobes is added, with a very favorable response at 24 hrs. There remains the doubt of the origin of the anaerobes in the patient, without important antecedents and in an age group different from that affected by these germs. We consider this case interesting due to its atypical behavior, for the enrichment of the otolaryngology exercise, emphasizing the invaluable support of the clinic, and only with an ultrasound, since other clinical tools were not available, but following the guidelines of what is reported in literature, there was a successful resolution.

Garlic: An Alternative Treatment for Group B Streptococcus.

Prenatal screening in pregnant women between 35 and 37 weeks of gestation and intrapartum antibiotic prophylaxis has successfully reduced the incidence of neonatal morbidity and mortality related to Streptococcus agalactiae. However, the contamination rates of newborns are still considerable. In traditional and folk medicines, it has been observed that garlic has been effective in treating S. agalactiae infection. The aim of this study was to isolate and identify the active compounds from garlic that have antimicrobial activity against S. agalactiae. In order to do this, SP80 (Sep-Pak 80%) obtained from crude garlic extract (CGE) was fractionated by reverse-phase ultrafast liquid chromatography with UV (RP-UFLC-UV) using a Shim-pack PREP-ODS column. All fractions obtained were tested using a microbial growth inhibition test against the S. agalactiae strain (ATCC 12386). Five clinical isolates were used to confirm the action of the fractions with antimicrobial activity, and the bacterial growth curve was determined. Identification of the antimicrobial compounds was carried out through liquid chromatography coupled with mass spectrometry (LC/MS) and nuclear magnetic resonance (NMR). The active compounds found to exhibit antimicrobial activity were Ƴ-glutamyl-S-allyl-cysteine (fraction 18), Ƴ-glutamyl-phenylalanine (fraction 20), and the two stereoisomers (E and Z) of ajoene (fraction 42). The MICs of these fractions were 5.41 mg/ml, 4.60 mg/ml, and 0.16 mg/ml, respectively, and they inhibited the growth of the clinical isolates tested. Antimicrobial compounds from garlic may be a promising source in the search for new drugs against S. agalactiae. IMPORTANCE Invasive disease due to group B streptococcal (GBS) infection results in a wide spectrum of clinical disease in neonates. Maternal colonization by GBS is the primary risk factor for disease. The strategy recommended by the Centers for Disease Control to reduce neonatal GBS infection is the culture-based screening of all pregnant women at 35 to 37 weeks of gestation and intrapartum antibiotic prophylaxis (IAP). However, indiscriminate use of antibiotics favors the selection and spread of resistant bacteria. The global scenario of antibacterial resistance has been of great concern for public health, and natural products can be a source of new substances to help us grapple with this problem.

Bacteriemia por Streptococcus equi subespecie zooepidemicus en un binomio madre hijo / Streptococcus equi subspecies zooepidemicus bacteremia in a mother-child binomial

Resumen Streptococcus equi subespecie zooepidemicus es una cocácea grampositiva, p-hemolítica, considerada parte de la microbiota de los equinos y un patógeno oportunista en otros animales. La infección en humanos es poco frecuente, pero suele manifestarse como cuadros graves. Se ha asociado al contacto con animales, especialmente caballos, y al consumo de productos lácteos no pasteurizados. Presentamos el caso de una bacteriemia en un binomio madre-hijo por este agente, asociado al consumo de quesos artesanales. Pese a que la penicilina es el tratamiento de elección, la recién nacida fue tratada en forma exitosa con ampicilina y la madre con ceftriaxona. Ninguna de ellas presentó complicaciones asociadas a la bacteriemia. A nuestro conocimiento, este es el primer reporte de infección connatal por este agente.

Abstract Streptococcus equi subspecies zooepidemicus is a Gram-positive, P-hemolytic coccus considered part of the commensal flora in horses and an opportunistic pathogen in other animals. Infection in humans is rare, but it usually manifests as serious symptoms, it has been associated with contact with animals, especially horses, and the consumption of unpasteurized dairy products. In this report we describe a case of bacteremia of the mother-child binomial by this agent, associated with the consumption of artisan cheeses. Although penicillin is the treatment of choice, the newborn was successfully treated with ampicillin and the mother with ceftriaxone, none of them presented complications associated with bacteremia. To our knowledge, this is the first report of connatal infection by this agent.

[Streptococcus equi subspecies zooepidemicus bacteremia in a mother-child binomial]. / Bacteriemia por Streptococcus equi subespecie zooepidemicus en un binomio madre hijo.

Streptococcus equi subspecies zooepidemicus is a Gram-positive, P-hemolytic coccus considered part of the commensal flora in horses and an opportunistic pathogen in other animals. Infection in humans is rare, but it usually manifests as serious symptoms, it has been associated with contact with animals, especially horses, and the consumption of unpasteurized dairy products. In this report we describe a case of bacteremia of the mother-child binomial by this agent, associated with the consumption of artisan cheeses. Although penicillin is the treatment of choice, the newborn was successfully treated with ampicillin and the mother with ceftriaxone, none of them presented complications associated with bacteremia. To our knowledge, this is the first report of connatal infection by this agent.