RESUMO
OBJECTIVE: Detection of hyphomycetes of the Scedosporium apiospermum complex and Lomentospora prolificans (Sac-Lp) is not yet standardized. Prevalence rates in patients with cystic fibrosis (CF) and the resistance pattern of these pathogens in Germany are unknown. METHODS: In a one-year prospective study 11 laboratories used a selective medium for isolation of Sac-Lp, examining >11,600 respiratory samples from 2346 patients with CF. Isolates were identified by molecular methods and tested for susceptibility to antifungal drugs. RESULTS: The prevalence of Sac-Lp in patients with CF in Germany varied from 0.0 to 10.5% (mean: 3.1%) among the clinical centres. The benefit of the selective medium SceSel(+) compared to standard media for fungi was documented for >5000 samples. High antifungal resistance was detected in the S. apiospermum complex, and the multiresistance of L. prolificans was confirmed. CONCLUSION: Microbiology laboratories should be aware of these resistant species in patients with CF and consider using a selective medium.
Assuntos
Antifúngicos/farmacologia , Meios de Cultura/farmacologia , Fibrose Cística , Micoses , Scedosporium , Adulto , Fibrose Cística/complicações , Fibrose Cística/epidemiologia , Fibrose Cística/microbiologia , Farmacorresistência Fúngica , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Micoses/diagnóstico , Micoses/epidemiologia , Micoses/etiologia , Micoses/microbiologia , Prevalência , Estudos Prospectivos , Scedosporium/classificação , Scedosporium/efeitos dos fármacos , Scedosporium/isolamento & purificaçãoRESUMO
BACKGROUND: Scedosporium and Pseudallescheria species are the second most common lung-colonising fungi in cystic fibrosis (CF) patients. For epidemiological reasons it is important to trace sources of infection, routes of transmission and to determine whether these fungi are transient or permanent colonisers of the respiratory tract. Molecular typing methods like multilocus sequence typing (MLST) help provide this data. METHODS: Clinical isolates of the P. boydii complex (including S. apiospermum and P. boydii) from CF patients in different regions of Germany were studied using MLST. Five gene loci, ACT, CAL, RPB2, BT2 and SOD2, were analysed. RESULTS: The S. apiospermum isolates from 34 patients were assigned to 32 sequence types (STs), and the P. boydii isolates from 14 patients to 8 STs. The results revealed that patients can be colonised by individual strains for years. CONCLUSIONS: The MLST scheme developed for S. apiospermum and P. boydii is a highly effective tool for epidemiologic studies worldwide. The MLST data are accessible at http://mlst.mycologylab.org/.
Assuntos
Técnicas de Tipagem Bacteriana , Fibrose Cística/microbiologia , Tipagem de Sequências Multilocus , Técnicas de Tipagem Micológica , Pseudallescheria/classificação , Scedosporium/classificação , Adolescente , Adulto , Criança , Pré-Escolar , DNA Bacteriano/genética , DNA Fúngico/genética , Feminino , Frequência do Gene , Variação Genética , Técnicas de Genotipagem , Humanos , Masculino , Reação em Cadeia da Polimerase/métodos , Pseudallescheria/isolamento & purificação , Scedosporium/isolamento & purificação , Adulto JovemRESUMO
We report the emergence of carbapenem-resistant Enterobacteriaceae in Austria. Over a 10-year period, carbapenem-resistant Enterobacteriaceae isolates were obtained from 13 hospitalized patients, with the first isolation in the year 2005 and a remarkable increase in the number of involved patients in 2010. Carbapenem-resistant Enterobacteriaceae comprise eight Klebsiella pneumoniae isolates, four Klebsiella oxytoca isolates, and one Escherichia coli isolate. The detected carbapenemases were the metallo-ß-lactamases New Delhi ß-lactamase, VIM and IMP, and the serin-ß-lactamase Klebsiella pneumoniae carbapenemase.