RESUMEN
Nocardia is a ubiquitous microorganism related to pyogranulomatous infection, which is difficult to treat in humans and animals. The occurrence of the disease is on the rise in many countries due to an increase in immunosuppressive diseases and treatments. This report of cases from Brazil presents the genotypic characterization and the antimicrobial susceptibility pattern using the disk-diffusion method and inhibitory minimal concentration with E-test® strips. In summary, this report focuses on infections in young adult men, of which three cases were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary, neurological and systemic cases were attributed to immunosuppressive diseases or treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four isolates of Nocardia farcinica, two isolates of Nocardia nova and one isolate of Nocardia asiatica. N. farcinica was involved in two cutaneous, one systemic and other pulmonary cases; N. nova was involved in one neurological and one pulmonary case; and Nocardia asiatica in one cutaneous case. The disk-diffusion antimicrobial susceptibility test showed that the most effective antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin (100%) and ceftiofur (100%), while isolates had presented most resistance to gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However, on the inhibitory minimal concentration test (MIC test), only one of the four isolates of Nocardia farcinica was resistant to sulfamethoxazole/trimethoprim.
Asunto(s)
Antibacterianos/farmacología , Nocardiosis/microbiología , Nocardia/genética , Adulto , Animales , Técnicas de Tipificación Bacteriana , Brasil , ADN Bacteriano/genética , Pruebas Antimicrobianas de Difusión por Disco , Humanos , Masculino , Nocardia/clasificación , Nocardia/aislamiento & purificación , ARN Ribosómico 16S/genéticaRESUMEN
Nocardia is a ubiquitous microorganism related to pyogranulomatous infection, which is difficult to treat in humans and animals. The occurrence of the disease is on the rise in many countries due to an increase in immunosuppressive diseases and treatments. This report of cases from Brazil presents the genotypic characterization and the antimicrobial susceptibility pattern using the disk-diffusion method and inhibitory minimal concentration with E-test® strips. In summary, this report focuses on infections in young adult men, of which three cases were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary, neurological and systemic cases were attributed to immunosuppressive diseases or treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four isolates of Nocardia farcinica, two isolates of Nocardia nova and one isolate of Nocardia asiatica. N. farcinica was involved in two cutaneous, one systemic and other pulmonary cases; N. nova was involved in one neurological and one pulmonary case; and Nocardia asiatica in one cutaneous case. The disk-diffusion antimicrobial susceptibility test showed that the most effective antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin (100%) and ceftiofur (100%), while isolates had presented most resistance to gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However, on the inhibitory minimal concentration test (MIC test), only one of the four isolates of Nocardia farcinica was resistant to sulfamethoxazole/trimethoprim.
Nocardia é um microorganismo ubiquitário relacionado a infecções piogranulomatosas, com difícil resolução tecidual em humanos e animais. A doença é mundialmente emergente devido ao aumento de doenças e tratamentos imunossupressores. Este relato de casos ocorridos no Brasil visa apresentar a identificação molecular dos isolados e o padrão de sensibilidade a antimicrobianos por disco-difusão e concentração inibitória mínima (CIM) através de fitas E-test®. Os casos ocorreram em homens, em idade adulta. Três quadros foram cutâneos, dois pulmonares, um neurológico e um sistêmico. O quadro respiratório, o neurológico e um sistêmico estavam associados à doença ou terapia imunossupressoras. O sequenciamento do gene 16S rRNA (1491pb) possibilitou a identificação de quatro isolados de Nocardia farcinica, dois de Nocardia nova e um de Nocardia asiatica. N. farcinica foi observada em dois casos dermatológicos, um pulmonar e um quadro sistêmico, N. nova foi isolada de um caso neurológico e outro pulmonar; e N. asiatica em um caso dermatológico. O teste de disco-difusão mostrou que amicacina (100%), amoxicilina/clavulanato (100%), cefalexina (100%) e ceftiofur (100%) foram mais efetivos; enquanto gentamicina (43%), sulfametoxazol/trimetoprim (43%) e ampicilina (29%) foram menos efetivos. No entanto, no teste de concentração inibitória mínima (CIM), apenas um dos quatro isolados da espécie Nocardia farcinica mostrou-se resistente a sulfametoxazole-trimetropina.
Asunto(s)
Adulto , Animales , Humanos , Masculino , Antibacterianos/farmacología , Nocardiosis/microbiología , Nocardia/genética , Técnicas de Tipificación Bacteriana , Brasil , Pruebas Antimicrobianas de Difusión por Disco , ADN Bacteriano/genética , Nocardia/clasificación , Nocardia/aislamiento & purificación , /genéticaRESUMEN
Criptococose é uma doença causada pela levedura encapsulada Cryptococcus neoformans, está intimamente ligada a pessoas imunodeprimidas, quer seja por drogas imunossupressoras administradas pós-transplantes ou por doenças imunodepressorascomo a SIDA. A doença origina-se pela penetração do fungo através das vias aéreas superiores, seguindo para os pulmões, acometendo o paciente com uma pneumonia criptocócica, com posterior disseminação do microrganismo pela via hematogênica,chegando ao sistema nervoso central e até as meninges, originando uma meningite criptocócica. As amostras analisadas neste estudo são provenientes de restos vegetais, areia de galinheiros, fezes de morcegos, restos vegetais de eucaliptos como folhas e caules, e, principalmente, fezes de pombos. A análise de 88 amostras de diferentes materiais orgânicos resultou em 11 amostras positivas para o desenvolvimento da levedura. Os 11 isolados foram testados quanto à sensibilidade frente aos antifúngicos anfotericina B, fluconazol e itraconazol. C. neoformans não apresentou resistência às drogas testadas e as concentrações mínimas inibitóriasencontradas foram: CIM de 0,03 a 1 μg/mL para anfotericina B (média de 0,515 μg/mL), CIM de 0,125 μg/mL para fluconazol e CIM de 0,03 μg/mL para itraconazol.
Cryptococcosis is a fungal disease caused by Cryptococcus neoformans is closely with the imunodepressed people, as for imunodeletion drugs managed after-transplants as mmunosuppressives diseases, the illness where originates for the inoculation of fungus through the superior airways, in the lung causes the patient with a cryptococcal pneumonia, and follow dissemination of themicroorganism for the hematogênic way arriving at the central nervous system and until meninges, originating a cryptococcal meningitis. The samples analyzed in this study are proceeding from vegetal remaining portions, sand of poulterer, excrements of bats, vegetal remaining portions of eucalyptus as leaves and stem. The analysis of 88 samples of different organic materialsresulted in 11 positive samples for the development of the yeast. The 11 isolated ones had been tested to sensitivity antifungal for amphotericin B, fluconazole and itraconazole. C. neoformans did not present resistance to the tested drugs: the minimum inhibitory concentrations was founded: MIC of 0,03 to 1 μg/mL for amphotericin B (average of 0,515 μg/mL), CIM of 0,125 μg/mL for fluconazole and CIM of 0,03 μg/mL for itraconazole.