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Many Omani patients with sickle cell disease (SCD) undergo red blood cell (RBC) transfusions that are only matched for ABO and D, making RBC alloimmunization a significant concern in this population. Currently, the integration of molecular assays and hemagglutination testing helps to determine RBC phenotypes and genotypes, facilitating the provision of compatible blood and minimizing additional alloimmunization risks in patients with SCD. Based on this finding, our objective was to use molecular methods to predict the extended antigen profile of Omani patients with SCD across various blood group systems including Rh, Kell, Duffy, Kidd, Colton, Lutheran, Dombrock, Diego, Cartwright, and Scianna. This approach aims to implement RBC matching strategies and enhance daily transfusion practices for these patients. Molecular methods encompassed multiplex polymerase chain reaction for RHD, BeadChip arrays for variants of RHD and RHCE, and ID CORE XT for the primary allelic variants of RBCs. This study enrolled 38 patients with SCD, comprising 34 patients with homozygous HbSS, 1 patient with HbSC, and 3 patients with HbS Oman. The predominant ABO blood group was group O, observed in 44.7 percent of patients, followed by group A in 21.1 percent and group B in 13.2 percent. The most prevalent Rh phenotype predicted from the genotype was D+C+E-c+e+, identified in 34.2 percent of patients. All patient samples were K-, exhibiting the k+ Kp(b+) Js(b+) phenotype, with 81.6 percent demonstrating Fy(a-b-) due to the homozygous FY*02N.01 genotype and 28.9 percent displaying Jk(a+b-). RH variant alleles were detected in five patients (13.2 %), with only one type of RHD variant (RHD*DIIIa) and one type of RHCE variant (RHCE*ceVS.02.01) identified. Alloantibodies were present in 26 patients (68.4%). This study presents the initial comprehensive report of extended RBC antigen profiling in Omani patients with SCD, revealing disparities in the prevalence of RBC phenotypes compared with SCD patients from other regions and countries. Furthermore, our findings underscore a high rate of alloimmunization in these patients, emphasizing the need to implement antigen-matching programs to improve daily transfusion practices.
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Anemia de Células Falciformes , Antígenos de Grupos Sanguíneos , Tipificación y Pruebas Cruzadas Sanguíneas , Humanos , Anemia de Células Falciformes/terapia , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/inmunología , Anemia de Células Falciformes/genética , Omán , Masculino , Femenino , Tipificación y Pruebas Cruzadas Sanguíneas/métodos , Adolescente , Adulto , Niño , Antígenos de Grupos Sanguíneos/genética , Antígenos de Grupos Sanguíneos/inmunología , Eritrocitos/inmunología , Preescolar , Transfusión de Eritrocitos , Adulto Joven , Sistema del Grupo Sanguíneo Rh-Hr/genética , Sistema del Grupo Sanguíneo Rh-Hr/inmunología , Genotipo , Persona de Mediana EdadRESUMEN
The Staphylococcus genus comprises multiple pathogenic and opportunistic species that represent a risk to public health. Epidemiological studies require accurate taxonomic classification of isolates with enough resolution to distinguish clonal complexes. Unfortunately, 16 S rRNA molecular analysis and phenotypic characterization cannot distinguish all species and do not offer enough resolution to assess intraspecific diversity. Other approaches, such as Multilocus Sequence Tagging, provide higher resolution; however, they have been developed for Staphylococcus aureus and a few other species. Here, we developed a set of genus-targeted primers using five orthologous genes (pta, tuf, tpi, groEs, and sarA) to identify all Staphylococcus species within the genus. The primers were initially evaluated using 20 strains from the Collection of Microorganisms of Interest in Animal Health from AGROSAVIA (CMISA), and their amplified sequences were compared to a set of 33 Staphylococcus species. This allowed the taxonomic identification of the strains even on close species and the establishment of intraspecies diversity. To enhance the scope and cost-effectiveness of the proposed strategy, we customized the primer sets for an Illumina paired-end amplicon protocol, enabling gene multiplexing. We assessed five genes across 177 strains, generating 880 paired-end libraries from the CMISA. This approach significantly reduced sequencing costs, as all libraries can be efficiently sequenced in a single MiSeq run at a fraction (one-fourth or less) of the cost associated with Sanger sequencing. In summary, this method can be used for precise identification and diversity analysis of Staphylococcus species, offering an advancement over traditional techniques in both resolution and cost-effectiveness.
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Coagulasa , ADN Bacteriano , ARN Ribosómico 16S , Staphylococcus , Staphylococcus/genética , Staphylococcus/clasificación , Staphylococcus/aislamiento & purificación , Staphylococcus/enzimología , Coagulasa/metabolismo , Coagulasa/genética , ARN Ribosómico 16S/genética , ADN Bacteriano/genética , Cartilla de ADN/genética , Filogenia , Infecciones Estafilocócicas/microbiología , Animales , Genes Bacterianos/genética , Proteínas Bacterianas/genética , Análisis de Secuencia de ADN , Tipificación de Secuencias Multilocus , Técnicas de Tipificación Bacteriana/métodos , Marcadores Genéticos , Secuenciación de Nucleótidos de Alto RendimientoRESUMEN
Introduction. Staphylococcus aureus is a leading agent in community-acquired bacteraemia (CAB) and has been linked to elevated mortality rates and methicillin resistance in Costa Rica.Gap statement and aim. To update and enhance previous data obtained in this country, we analysed the clinical manifestations of 54 S. aureus CAB cases in a tertiary hospital and delineated the sequence types (STs), virulome, and resistome of the implicated isolates.Methodology. Clinical information was retrieved from patient files. Antibiotic susceptibility profiles were obtained with disc diffusion and automated phenotypic tests. Genomic data were exploited to type the isolates and for detection of resistance and virulence genes.Results. Primary infections predominantly manifested as bone and joint infections, followed by skin and soft tissue infections. Alarmingly, 70% of patients continued to exhibit positive haemocultures beyond 48 h of treatment modification, with nearly a quarter requiring mechanical ventilation or developing septic shock. The 30-day mortality rate reached an alarming 40%. More than 60% of the patients were found to have received suboptimal or inappropriate antibiotic treatment, and there was an alarming tendency towards the overuse of third-generation cephalosporins as empirical treatment. Laboratory tests indicated elevated creatinine levels, leukocytosis, and bandaemia within the first 24 h of hospitalization. However, most showed improvement after 48 h. The isolates were categorized into 13 STs, with a predominance of representatives from the clonal complexes CC72 (ST72), CC8 (ST8), CC5 (ST5, ST6), and CC1 (ST188). Twenty-four isolates tested positive for mecA, with ST72 strains accounting for 20. In addition, we detected genes conferring acquired resistance to aminoglycosides, MLSB antibiotics, trimethoprim/sulfamethoxazole, and mutations for fluoroquinolone resistance in the isolate collection. Genes associated with biofilm formation, capsule synthesis, and exotoxin production were prevalent, in contrast to the infrequent detection of enterotoxins or exfoliative toxin genes.Conclusions. Our findings broaden our understanding of S. aureus infections in a largely understudied region and can enhance patient management and treatment strategies.
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Antibacterianos , Bacteriemia , Infecciones Comunitarias Adquiridas , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas , Staphylococcus aureus , Centros de Atención Terciaria , Humanos , Costa Rica/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/mortalidad , Bacteriemia/microbiología , Bacteriemia/epidemiología , Bacteriemia/mortalidad , Bacteriemia/tratamiento farmacológico , Masculino , Staphylococcus aureus/genética , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Persona de Mediana Edad , Femenino , Anciano , Adulto , Antibacterianos/uso terapéutico , Antibacterianos/farmacología , Anciano de 80 o más Años , Adulto Joven , Adolescente , Factores de Virulencia/genética , NiñoRESUMEN
1. Salmonella Gallinarum strains isolated from a southern Brazil fowl typhoid outbreak were subjected to phenotypic and genotypic analyses to identify genetic elements that could improve prevention and control strategies.2. Whole-genome sequencing revealed the presence of the aac(6')-Iaa gene, conferring aminoglycoside resistance, along with novel chromosomal point mutations, including the first detection of parE p.S451F in Salmonella Gallinarum.3. Additionally, IncFII(S) plasmid replicons, Salmonella pathogenicity islands and 105 virulence genes associated with cell adhesion, invasion and antimicrobial peptide resistance were identified.4. These findings shed light on the molecular mechanisms of fowl typhoid and provide crucial insights into emerging antimicrobial resistance and virulence factors.
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Objective To identify the predictive factors for the need for transfusion during and after surgery to treat hip fractures in the elderly and to evaluate a protocol to guide the request for blood reserves for surgery. Methods The medical records of 172 elderly patients undergoing surgical treatment for proximal femoral fractures were collected. Data on sex, age, preoperative hemoglobin level, diagnosis, and type of surgery were tested for correlation with blood transfusion. In our sample, we determined the number of units of packed red blood cells reserved, the transfusion rate, and the cross-test:transfusion ratio. We made the same calculations in a hypothetical situation in which the request for blood reserves for our sample followed the criteria of a defined protocol. Results We found a correlation between the American Society of Anesthesiologists (ASA) classification and the occurrence of transfusions, and an inverse correlation between the hemoglobin level on admission and the number of bags transfused. A reserve of 328 units of packed red blood cells was requested for 167 surgeries. Had the proposed protocol been applied, 72 units would have been requested for 61 surgeries. Conclusion We found a correlation regarding the variables ASA classification and preoperative hemoglobin level and the occurrence of transfusion. Applying a proposed protocol to decide between requesting a reserve and only typing for elderly individuals undergoing surgical treatment for hip fracture proved suitable to reduce the number of packed red blood cell reserves.
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Whole-genome sequencing identified three previously unidentified multilocus sequence types of Campylobacter jejuni (ST-12332) and Campylobacter coli (ST-12333 and ST-12663), harboring resistance genes for multiple antimicrobial classes. The sources of isolation highlight the circulation of resistance strains within animals and humans, emphasizing the need for preventive measures.
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Acute myeloid leukemia (AML) is the most frequent indication for allogeneic hematopoietic cell transplantation (alloHCT) worldwide; social and health system barriers limit its access. We performed an observational retrospective analysis in Mexico to analyze factors limiting alloHCT in fit patients with AML. With a median follow-up of 11.8 months, 301 patients were included, with a median age of 42; 33.5% were classified as adverse risk. Despite 215 patients (92.5%) achieving complete remission, only 103 (34%) had HLA-typing: 44.5% had a matched-sibling donor (MSD), 32% a haploidentical donor, and 23.5% had no donor. Only 23.5% of patients had an HCT consult; merely 36 underwent an HCT: 30 alloHCT, and six an autologous HCT. Age ≥ 60 years, HCT-CI score ≥ three, and the absence of a local transplant program negatively influenced HLA typing likelihood. Patients with an MSD had a higher alloHCT likelihood. The cumulative incidence of transplant (CIT) and relapse (CIR) at 6 and 12 months was 7.3% and 13.8%, 8.2% and 13%, respectively. A lack of HLA-typing was associated with a lower CIT (p < 0.001) and higher CIR (p = 0.033) (HR 11.72, CI 95% 4.39-31.27, p < 0.001), while the presence of an MSD was associated with a higher CIT (p = 0.002) (HR 4.22, CI 95% 1.89-9.44, p < 0.001). The main reasons hindering alloHCT are the lack of access to HLA-typing tests and the absence of an MSD. A national donor registry and improved HLA-typing accessibility are critical for increasing alloHCT access in Mexico.
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Trasplante de Células Madre Hematopoyéticas , Leucemia Mieloide Aguda , Humanos , México/epidemiología , Leucemia Mieloide Aguda/terapia , Persona de Mediana Edad , Masculino , Femenino , Adulto , Estudios Retrospectivos , Anciano , Adolescente , Adulto Joven , Prueba de Histocompatibilidad , Estudios de Seguimiento , AloinjertosRESUMEN
SUMMARY: This study aims to examine the hand morphometry of healthy young individuals from different countries and investigate the differences between countries in typing of hand based on the morphometric values obtained. In the study, 16 different parameters, including two surface areas and 14 lengths, were measured from the right hand of 579 volunteers (250 females, 329 males) from 7 different countries (Turkey, Chad, Morocco, Gabon, Kazakhstan, Senegal and Syria). Factor analysis was performed on the parameters, cluster analysis was performed according to the factor score obtained, and the hand types in the study were determined. As a result of the study, four different hand types were defined, and the distribution of these types according to countries was analyzed. All parameters showed significant differences between countries in both genders (p<0.05). According to the results of the study, there was a difference between male and female hand types between countries. In females, the type 1 hand type was found only in Gabon, the type 2 hand type was found only in Senegal, the type 3 hand type was found in Turkey, Morocco and Kazakhstan, while the type 4 hand type was significantly distributed in Senegal and Gabon (X2 =104.62; df=18, p<0.05). In males, type 1 hand type was found in Turkey, type 2 hand type in Senegal and Gabon, type 3 hand type in Turkey, while type 4 hand type was significantly distributed in Morocco and Kazakhstan (X2 =76.964; df=18, p<0.05).
Este estudio tuvo como objetivo examinar la morfometría de la mano de individuos jóvenes sanos de diferentes países e investigar las diferencias en la mecanografía de la mano entre países en función de los valores morfométricos obtenidos. En el estudio, se midieron 16 parámetros diferentes, incluidas dos superficies y 14 longitudes, de la mano derecha de 579 voluntarios (250 mujeres, 329 hombres) de 7 países diferentes (Turquía, Chad, Marruecos, Gabón, Kazajstán, Senegal y Siria). Se realizó un análisis factorial de los parámetros, un análisis de conglomerados según la puntuación factorial obtenida y se determinaron los tipos de manos en el estudio. Como resultado, se definieron cuatro tipos diferentes de manos y se analizó la distribución de estos tipos según países. Todos los parámetros mostraron diferencias significativas entre países en ambos sexos (p<0,05). Según los resultados del estudio, hubo una diferencia entre los tipos de manos de los hombres y de las mujeres entre países. En las mujeres, el tipo de mano tipo 1 se encontró solo en Gabón, el tipo de mano tipo 2 se encontró solo en Senegal, el tipo de mano tipo 3 se encontró en Turquía, Marruecos y Kazajstán, mientras que la mano tipo 4 se distribuyó significativamente en Senegal y Gabón (X2=104,62; gl=18, p<0,05). En los hombres, el tipo de mano tipo 1 se encontró en Turquía, el tipo de mano tipo 2 en Senegal y Gabón, el tipo de mano tipo 3 en Turquía, mientras que la mano tipo 4 se distribuyó significativamente en Marruecos y Kazajstán (X2=76,964; gl=18, p <0,05).
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Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Mano/anatomía & histología , Análisis por Conglomerados , Análisis de Varianza , Análisis Factorial , Caracteres Sexuales , AntropologíaRESUMEN
This study aimed to detect, isolate and to characterize by molecular methods a relapsing fever group (RFG) Borrelia in white-eared opossums (Didelphis albiventris) from Brazil. During 2015-2018, when opossums (Didelphis spp.) were captured in six municipalities of the state of São Paulo, Brazil, molecular analyses revealed the presence of a novel RFG Borrelia sp. in the blood of seven opossums (Didelphis albiventris), out of 142 sampled opossums (4.9% infection rate). All seven infected opossums were from a single location (Ribeirão Preto municipality). In a subsequent field study in Ribeirão Preto during 2021, two new opossums (D. albiventris) were captured, of which one contained borrelial DNA in its blood. Macerated tissues from this infected opossum were inoculated into laboratory animals (rodents and rabbits) and two big-eared opossums (Didelphis aurita), which had blood samples examined daily via dark-field microscopy. No spirochetes were visualized in the blood of the laboratory animals. Contrastingly, spirochetes were visualized in the blood of the two D. aurita opossums between 12 and 25 days after inoculation. Blood samples from these opossums were used for a multi-locus sequencing typing (MLST) based on six borrelial loci. Phylogenies inferred from MLST genes positioned the sequenced Borrelia genotype into the RFG borreliae clade basally to borreliae of the Asian-African group, forming a monophyletic group with another Brazilian isolate, "Candidatus B. caatinga". Based on this concatenated phylogenetic analysis, which supports that the new borrelial isolate corresponds to a putative new species, we propose the name "Candidatus Borrelia mimona".
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Methicillin-resistant Staphylococcus (MRS) has been associated with neonatal infections, with colonization of the anovaginal tract being the main source of vertical transmission. The COVID-19 pandemic has altered the frequency of antibiotic usage, potentially contributing to changes in the dynamics of bacterial agents colonizing humans. Here we determined MRS colonization rates among pregnant individuals attending a single maternity in Rio de Janeiro, Brazil before (January 2019-March 2020) and during (May 2020-March 2021) the COVID-19 pandemic. Anovaginal samples (n = 806 [521 samples before and 285 during the pandemic]) were streaked onto chromogenic media. Colonies were identified by MALDI-TOF MS. Detection of mecA gene and SCCmec typing were assessed by PCR and antimicrobial susceptibility testing was done according to CLSI guidelines. After the onset of the pandemic, MRS colonization rates increased significantly (p < 0.05) from 8.6% (45) to 54.7% (156). Overall, 215 (26.6%) MRS isolates were detected, of which S. haemolyticus was the most prevalent species (MRSH, 84.2%; 181 isolates). SCCmec type V was the most frequent among MRS (63.3%; 136), and 31.6% (68) of MRS strains had a non-typeable SCCmec, due to new combinations of ccr and mecA complexes. Among MRS strains, 41.9% (90) were resistant to at least 3 different classes of antimicrobial agents, and 60% (54) of them were S. haemolyticus harboring SCCmec V. MRS colonization rates and the emergence of multidrug-resistant variants detected in this study indicate the need for continuing surveillance of this important pathogen within maternal and child populations.
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COVID-19 , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Humanos , Femenino , Embarazo , COVID-19/epidemiología , COVID-19/virología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Adulto , Brasil/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/epidemiología , Antibacterianos/farmacología , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Pandemias , Vagina/microbiologíaRESUMEN
The high number of D variants can lead to the unnecessary use of Rh immune globulin, overuse of D- RBC units, and anti-D allommunization. D variant prevalence varies among ethnic groups, and knowledge of the main variants present in a specific population, their behavior in serologic tests, and their impact on clinical practice is crucial to define the best serologic tests for routine use. The present study aimed to explore the serologic profile of D variants and to determine which variants are most associated with false-negative D typing results and alloimmunization. Donor samples were selected in two study periods. During the first period, D typing was performed on a semi-automated instrument in microplates, and weak D tests were conducted in tube or gel tests. In the second period, D typing was carried out using an automated instrument with microplates, and weak D tests were performed in solid phase. Samples from patients typed as D+ with anti-D were also selected. All samples were characterized by molecular testing. A total of 37 RHD variants were identified. Discrepancies and atypical reactivity without anti-D formation were observed in 83.4 percent of the samples, discrepant D typing results between donations were seen in 12.3 percent, and D+ patients with anti-D comprised 4.3 percent. DAR1.2 was the most prevalent variant. Weak D type 38 was responsible for 75 percent of discrepant samples, followed by weak D type 11, predominantly detected by solid phase. Among the D variants related to alloimmunization, DIVa was the most prevalent, which was not recognized by serologic testing; the same was true for DIIIc. The results highlight the importance of selecting tests for donor screening capable of detecting weak D types 38 and 11, especially in populations where these variants are more prevalent. In pre-transfusion testing, it is crucial that D typing reagents demonstrate weak reactivity with DAR variants; having a serologic strategy to recognize DIVa and DIIIc is also valuable.
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Donantes de Sangre , Sistema del Grupo Sanguíneo Rh-Hr , Humanos , Sistema del Grupo Sanguíneo Rh-Hr/inmunología , Sistema del Grupo Sanguíneo Rh-Hr/genética , Donantes de Sangre/estadística & datos numéricos , Reacciones Falso Negativas , Tipificación y Pruebas Cruzadas Sanguíneas/métodos , Femenino , Isoanticuerpos/sangre , Isoanticuerpos/inmunología , Globulina Inmune rho(D)/inmunología , Globulina Inmune rho(D)/sangre , MasculinoRESUMEN
AIMS: To investigate the genetic profile and characterize antimicrobial resistance, including the main ß-lactam antibiotic resistance genes, in Acinetobacterbaumannii isolates from a tertiary hospital in Recife-PE, Brazil, in the post-COVID-19 pandemic period. METHODS AND RESULTS: Acinetobacter baumannii isolates were collected between 2023 and 2024 from diverse clinical samples. Antimicrobial resistance testing followed standardized protocols, with ß-lactamase-encoding genes detected via PCR and sequencing. Investigation into ISAba1 upstream of blaOXA-carbapenemase and blaADC genes was also conducted. Genetic diversity was assessed through ERIC-PCR. Among the 78 A. baumannii, widespread resistance to multiple antimicrobials was evident. Various acquired ß-lactamase-encoding genes (blaOXA-23,-24,-58,-143, blaVIM, and blaNDM) were detected. Furthermore, this is the first report of blaVIM-2 in A. baumannii isolates harboring either the blaOXA-23-like or the blaOXA-143 gene in Brazil. Molecular typing revealed a high genetic heterogeneity among the isolates, and multi-clonal dissemination. CONCLUSION: The accumulation of genetic resistance determinants underscores the necessity for stringent infection control measures and robust antimicrobial stewardship programs to curb multidrug-resistant strains.
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Infecciones por Acinetobacter , Acinetobacter baumannii , Antibacterianos , COVID-19 , Pruebas de Sensibilidad Microbiana , SARS-CoV-2 , Centros de Atención Terciaria , beta-Lactamasas , Acinetobacter baumannii/genética , Acinetobacter baumannii/efectos de los fármacos , Acinetobacter baumannii/aislamiento & purificación , Brasil , Humanos , Infecciones por Acinetobacter/microbiología , Infecciones por Acinetobacter/tratamiento farmacológico , Infecciones por Acinetobacter/epidemiología , beta-Lactamasas/genética , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , SARS-CoV-2/genética , Farmacorresistencia Bacteriana Múltiple/genética , Proteínas Bacterianas/genética , Masculino , Adulto , Femenino , Persona de Mediana Edad , Farmacorresistencia Bacteriana/genéticaRESUMEN
INTRODUCTION: Candidemia, a bloodstream infection predominantly affecting critically ill patients, poses a significant global health threat especially with the emergence of non-albicans Candida species, including drug-resistant strains. In Brazil, limited access to advanced diagnostic tools and trained microbiologists hampers accurate identification of Candida species and susceptibility to antifungals testing hindering surveillance efforts. METHODS: We conducted a systematic review spanning publications from 2017 to 2023 addressing Candida species distribution and antifungal susceptibility among Brazilian patients with candidemia. RESULTS: Despite initially identifying 7075 records, only 16 met inclusion criteria providing accurate information of 2305 episodes of candidemia. The predominant species were C. albicans, C. parapsilosis, and C. tropicalis, followed by notable proportions of Nakaseomyces glabratus. Limited access to diagnostic tests was evident as only 5 out of 16 studies on candidemia were able to report antifungal susceptibility testing results. In vitro resistance to echinocandins was rare (only 6/396 isolates, 1,5%). In counterpart, fluconazole exhibited resistance rates ranging from 0 to 43%, with great heterogeneity among different studies and species of Candida considered. CONCLUSION: Our review underscores the critical need for enhanced surveillance and research efforts to address the evolving landscape of candidemia and antifungal resistance in Brazil. Despite some limitations, available data suggest that while resistance to echinocandins and amphotericin B remains rare, there is a growing concern regarding resistance to fluconazole among Candida species.
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Antifúngicos , Candida , Candidemia , Farmacorresistencia Fúngica , Pruebas de Sensibilidad Microbiana , Candidemia/epidemiología , Candidemia/microbiología , Candidemia/diagnóstico , Candidemia/tratamiento farmacológico , Brasil/epidemiología , Humanos , Antifúngicos/farmacología , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Candida/clasificaciónRESUMEN
Stenotrophomonas maltophilia (S. maltophilia) is an intrinsically drug-resistant and biofilm-forming bacteria causing infections in immunocompromised humans. This study reports the isolation of five S. maltophilia strains from saliva and gingival crevicular fluid (GCF) of AIDS patients with periodontitis in São Paulo, Brazil, showing resistance to ceftazidime, strong biofilm formation capacity and a close genetic relationship. The presence of S. maltophilia strains in saliva and CGF of patients with AIDS and periodontitis is a concern for the presence and persistence of intrinsically resistant bacteria in the oral environment, enhancing the risk for the development of severe infections in immunocompromised patients.
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Síndrome de Inmunodeficiencia Adquirida , Antibacterianos , Biopelículas , Ceftazidima , Líquido del Surco Gingival , Infecciones por Bacterias Gramnegativas , Periodontitis , Saliva , Stenotrophomonas maltophilia , Humanos , Stenotrophomonas maltophilia/efectos de los fármacos , Stenotrophomonas maltophilia/genética , Stenotrophomonas maltophilia/aislamiento & purificación , Brasil , Saliva/microbiología , Periodontitis/microbiología , Líquido del Surco Gingival/microbiología , Líquido del Surco Gingival/química , Ceftazidima/farmacología , Antibacterianos/farmacología , Infecciones por Bacterias Gramnegativas/microbiología , Biopelículas/crecimiento & desarrollo , Biopelículas/efectos de los fármacos , Síndrome de Inmunodeficiencia Adquirida/microbiología , Masculino , Adulto , Femenino , Pruebas de Sensibilidad Microbiana , Farmacorresistencia Bacteriana , Persona de Mediana EdadRESUMEN
Syphilis remains a significant public health concern, with serological assays being the primary method for diagnosis. However, molecular techniques have proven to be reliable tools for the diagnosis and understanding of the transmission dynamics of Treponema pallidum infection. This study aimed to evaluate the efficacy of syphilis treatment using molecular assays, perform Enhanced Centers for Disease Control and Prevention (ECDC) typing, and analyze resistance (macrolide and doxycycline) in the T. pallidum isolate. PCR assay amplified treponemal DNA only from the lesion sample, whereas qPCR was able to amplify DNA in both lesion and blood samples before treatment. Throughout the treatment follow-up, qPCR effectively did not identify treponemal DNA in the blood for up to one to two weeks after treatment. ECDC typing revealed the genotype 14 e/g in the Brazilian T. pallidum isolate, and the presence of the A2058G mutation in 23 S rRNA gene, indicating macrolide resistance. Although, the G1058C mutation in 16 S rRNA gene was not detected. Notably, qPCR demonstrated its potential for diagnosing T. pallidum in blood samples, even when the treponemal DNA levels were low, enabling more accurate and sensitive diagnosis and guiding better syphilis therapy. In addition, to the best of our knowledge, this study represents the first identification of subtype 14 e/g and azithromycin resistance in a Brazilian T. pallidum isolate.
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Antibacterianos , Sífilis , Treponema pallidum , Treponema pallidum/genética , Treponema pallidum/aislamiento & purificación , Treponema pallidum/clasificación , Treponema pallidum/efectos de los fármacos , Sífilis/microbiología , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Humanos , Brasil , Antibacterianos/uso terapéutico , Antibacterianos/farmacología , Genotipo , Farmacorresistencia Bacteriana/genética , ADN Bacteriano/genética , Masculino , Macrólidos/farmacología , Tipificación Molecular/métodos , Doxiciclina/uso terapéutico , Adulto , ARN Ribosómico 23S/genética , Estudios de SeguimientoRESUMEN
This study aimed to identify and characterize isolates of Francisella salimarina associated with an outbreak on a marine fish farm in Brazil and to analyse their genetic variability and antimicrobial susceptibility. In 2021, diseased cobias (Rachycentron canadum, n = 10) and dusky groupers (Epinephelus marginatus, n = 10) were sampled and subjected to bacteriological and pathological examinations. The isolates obtained were morphologically and biochemically characterized and identified by matrix-assisted laser desorption/ionization-time of flight (MALDI-ToF) and 16S rRNA gene sequencing. The genetic diversity of these isolates was analysed using repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Antimicrobial susceptibility was assessed using the disk diffusion technique. Macroscopically, the fish presented skin ulcerations, ocular lesions, hepatomegaly and splenomegaly. A pleomorphic, gram-negative, catalase- and oxidase-positive bacterium was isolated from seven cobias and two groupers. The 16S rRNA gene sequences showed >99% coverage and identity with other deposited sequences of F. salimarina. The results of the biochemical analysis corresponded to these bacterial species. Histologically, granulomas were observed in the spleen, liver and heart of the cobias (n = 6), and necrotizing and fibrinous dermatitis and myositis were identified in some groupers (n = 2). The isolates exhibited the same banding pattern when REP-PCR was performed, indicating that they were clonally related. Finally, the antibiogram test, no inhibition halo was observed for amoxicillin and trimethoprim-sulfamethoxazole. To our knowledge, this is the first report of F. salimarina infection in cobias and dusky groupers.
RESUMEN
Chagas disease (CD), caused by the complex life cycle parasite Trypanosoma cruzi, is a global health concern and impacts millions globally. T. cruzi's genetic variability is categorized into discrete typing units (DTUs). Despite their widespread presence in the Americas, a comprehensive understanding of their impact on CD is lacking. This study aims to analyze life cycle traits across life cycle stages, unraveling DTU dynamics. Metacyclogenesis curves were generated, inducing nutritional stress in epimastigotes of five DTUs (TcI (MG), TcI (DA), TcII(Y), TcIII, TcIV, and TcVI), resulting in metacyclic trypomastigotes. Infection dynamics in Vero cells from various DTUs were evaluated, exploring factors like amastigotes per cell, cell-derived trypomastigotes, and infection percentage. Statistical analyses, including ANOVA tests, identified significant differences. Varying onset times for metacyclogenesis converged on the 7th day. TcI (MG) exhibited the highest metacyclogenesis potential. TcI (DA) stood out, infecting 80% of cells within 24 h. TcI demonstrated the highest potential in both metacyclogenesis and infection among the strains assessed. Intra-DTU diversity was evident among TcI strains, contributing to a comprehensive understanding of Trypanosoma cruzi dynamics and genetic diversity.
Asunto(s)
Enfermedad de Chagas , Trypanosoma cruzi , Chlorocebus aethiops , Animales , Trypanosoma cruzi/genética , Células Vero , FenotipoRESUMEN
Cryptococcosis is one of the major life-threatening opportunistic/systemic fungal diseases of worldwide occurrence, which can be asymptomatic or establish pneumonia and meningoencephalitis mainly in immunosuppressed patients, caused by the Cryptococcus neoformans and C. gattii species complexes. Acquisition is by inhaling fungal propagules from avian droppings, tree hollows and decaying wood, and the association of the molecular types with geographic origin, virulence and antifungal resistance have epidemiological importance. Since data on cryptococcosis in Alagoas are limited, we sought to determine the molecular types of etiological agents collected from clinical and environmental sources. We evaluated 21 isolates previously collected from cerebrospinal fluid and from environment sources (pigeon droppings and tree hollows) in Maceió-Alagoas (Brazil). Restriction fragment length polymorphism of URA5 gene was performed to characterize among the eight standard molecular types (VNI-VNIV and VGI-VGIV). Among isolates, 66.67% (14) were assigned to C. neoformans VNI - 12 of them (12/14) recovered from liquor and 2 from a tree hollow (2/14). One isolate from pigeon droppings (4.76%) corresponded to C. neoformans VNIV, while five strains from tree hollows and one from pigeon droppings (6, 28.57%) to C. gattii VGII. VNI-type was present in clinical and environmental samples and most C. neoformans infections were observed in HIV-positive patients, while types VNIV and VGII were prevalent in environmental sources in Alagoas. This is the first molecular characterization of Cryptococcus spp. in Alagoas, our study provides additional information on the ecoepidemiology of Cryptococcus spp. in Brazil, contributing to a closer view of the endemic species.
Asunto(s)
Columbidae , Criptococosis , Cryptococcus gattii , Cryptococcus neoformans , Microbiología Ambiental , Cryptococcus neoformans/genética , Cryptococcus neoformans/aislamiento & purificación , Cryptococcus neoformans/clasificación , Brasil/epidemiología , Criptococosis/microbiología , Criptococosis/epidemiología , Cryptococcus gattii/genética , Cryptococcus gattii/aislamiento & purificación , Cryptococcus gattii/clasificación , Humanos , Animales , Columbidae/microbiología , Técnicas de Tipificación Micológica , Polimorfismo de Longitud del Fragmento de Restricción , Heces/microbiología , GenotipoRESUMEN
The study investigated the characteristics of Methicillin-resistant Staphylococcus aureus (MRSA) isolated in Santa Catarina. Findings revealed prevalent SCCmecII and IV, multiresistance, Leucocidin ED genes, and one ST105 isolate. The results indicated that the in-state MRSA isolates showed the same characteristics as the out-of-state isolates among the investigated features.
Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Antibacterianos/farmacología , Brasil/epidemiología , Infecciones Estafilocócicas/epidemiología , Pruebas de Sensibilidad MicrobianaRESUMEN
BACKGROUND: Understanding the epidemiology of Streptococcus pneumoniae (S. pneumoniae) isolates is important for pneumonia treatment and prevention. This research aimed to explore the epidemiological characteristics of S. pneumoniae isolated from pediatric inpatients and outpatients during the same period. METHODS: S. pneumoniae were isolated from unsterile samples of inpatients and outpatients younger than five years old between March 2013 and February 2014. The serotypes were determined using diagnostic pneumococcal antisera. The resistance of each strain to 13 antibiotics was tested using either the E-test or the disc diffusion method. The Sequence Types (STs) were analyzed via Multilocus Sequence Typing (MLST). RESULTS: The dominant serotypes obtained from inpatients were 19F (32.9 %), 19A (20.7 %), 23F (10.7 %), 6A (10.0 %), and 14 (8.6 %), while those from outpatients were 19F (13.6 %), 23F (12.9 %), 6A (10.0 %), 6B (10.0 %), and 19A (7.9 %). The coverage rates of 13-valent Pneumococcal Conjugate Vaccine (PCV) formulations were high in both groups. The nonsusceptibility to penicillin, cefuroxime, imipenem, erythromycin, and trimethoprim-sulfamethoxazole among the inpatient isolates was 7.1 %, 92.8 %, 65.7 %, 100 %, and 85.0 %, respectively, while that among the outpatient isolates was 0.7 %, 50.0 %, 38.6 %, 96.4 %, and 65.7 %, respectively. There were 45 and 81 STs detected from the pneumococci isolated from inpatients and outpatients, respectively. CC271 was common among both inpatients and outpatients (43.6 % and 14.3 %). CONCLUSIONS: Pneumococcal vaccine-related serotypes are prevalent among both inpatients and outpatients, especially among inpatients, who exhibit more severe antibiotic resistance. Therefore, universal immunization with PCV13 would decrease the hospitalization rate due to S. pneumoniae and the antibiotic resistance rate of S. pneumoniae.