RESUMO
Burkholderia cepacia complex (Bcc) is a bacterial group with 'natural' multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation. The species of Bcc exhibit both genetic and phenotypic hypervariability that complicate their accurate microbiological identification. Automated methods such as MALDI-TOF can err in the determination of species. Their slow growth even in selective agars and the absence of international consensuses on the optimal conditions for their isolation make early diagnosis a difficult challenge to overcome. The absence of correlations between antibiograms and clinical results has resulted in the absence of standardized cut-off values of antimicrobial susceptibility, a fact that brings a latent risk since incorrect antibiotic therapy can induce the selection of more aggressive variants that worsen the clinical picture of the host, added to the absence of a clear therapeutic guide for the eradication of pulmonary infections by Bcc in patients with CF, resulting in frequently ineffective treatments. There is an urgent need to standardize methods and diagnostic tools that would allow an early and accurate diagnosis, as well as to perform clinical studies of the effectiveness of available antibiotics to eradicate Bcc infections, which would allow us to establish standardized therapeutic schemes for Bcc-infected patients.
Assuntos
Bacteriemia , Complexo Burkholderia cepacia , Fibrose Cística , Transplante de Pulmão , Humanos , AntibacterianosRESUMO
Burkholderia cepacia complex (Bcc) species are opportunistic pathogens widely distributed in the environment and often infect people with cystic fibrosis (CF). This study aims to determine which genomovars of the Bcc can cause infections in non-CF patients from a tertiary care hospital in Mexico and if they carry virulence factors that could increase their pathogenicity. We identified 23 clinical isolates that carry the recA gene. Twenty-two of them belongs to the genomovar V (B. vietnamiensis) and one to the genomovar II (B. multivorans). Thirteen pulsotypes were identified among 22 B. vietnamiensis isolates. All clinical isolates produced biofilm were motile and cytotoxic on murine macrophage-like RAW264.7 and in A549 human lung epithelial cells. In conclusion, B. vietnamiensis causes infections in non-CF patients in a tertiary care hospital in Mexico, rapid identification of this pathogen can help physicians to establish a better antimicrobial treatment.
Assuntos
Infecções por Burkholderia , Complexo Burkholderia cepacia , Burkholderia cepacia , Fibrose Cística , Humanos , Animais , Camundongos , Burkholderia cepacia/genética , Infecções por Burkholderia/epidemiologia , México/epidemiologia , Centros de Atenção Terciária , Reação em Cadeia da Polimerase , Complexo Burkholderia cepacia/genética , Fibrose Cística/complicaçõesRESUMO
This review was conducted to assess the global incidence of transfusion-transmitted infections (TTIs) caused by contamination of blood components with the Burkholderia cepacia complex (Bcc). Our search encompassed various specialized databases such as Medline/PubMed, Web of Science, Scopus, Scielo, ScienceDirect, and ClinicalKey. An analysis of the literature revealed a total of eleven reported cases where blood components contaminated with Bcc had been transfused, resulting in sepsis among the affected patients. Of these cases, eight were documented in the literature, while the remaining three occurred within the institution involving the authors of this review. A comparative examination was conducted, considering factors such as primary diagnosis, transfused blood component, time elapsed between transfusion and manifestation of symptoms, administration of antibiotics, and final outcome. Interestingly, regardless of the storage temperature, all blood components were found to be susceptible to Bcc contamination. Furthermore, the cases investigated revealed diverse sources of contamination, and it was observed that all the affected patients had compromised immune systems due to underlying illnesses. Based on these findings, a series of preventive strategies were derived to mitigate and decrease the occurrence of similar cases.
RESUMO
INTRODUCCIÓN: En los niños, la bacteriemia debida a Burkholderia cepacia, es considerada una complicación grave y conducente a una elevada mortalidad. Con el objetivo de conocer la mortalidad asociada a esa condición, se realizó una revisión sistemática de la literatura médica. MATERIAL Y MÉTODOS: Se aplicó una estrategia de búsqueda bibliográfica con las palabras claves: "bacteriemia por B. cepacia", "humanos", "niños" y "adolescentes", como únicos filtros. Se informan la mediana y los valores intercuartílicos de la frecuencia de la mortalidad reportada por los estudios incluidos. RESULTADOS: Se identificaron 92 estudios potencialmente útiles. De ellos, se descartaron 81, incluyéndose finalmente, 11 estudios. Se trató de descripciones retrospectivas de casos, salvo uno de ellos, que respondió a un diseño analítico caso-control. La mediana de la mortalidad reportada por esta revisión, fue 0 (Q25 = 0 y Q75 = 28,57%). INTERPRETACIÓN: Si bien la evidencia disponible es escasa y de baja calidad, sugiere que el curso clínico de esta afección no siempre resulta en una elevada mortalidad.
BACKGROUND: Bacteremia due to Burkolderia cepacia in children is considered a severe complication and associated with high mortality incidence. In order to know the level of mortality associated with it, this systematic review of the literature was carried out. METHODS: A search strategy was carried out with the keywords: "bacteremia by B cepacia and human" and "children" and "adolescents" as filters. Global frequency of mortality reported by the included studies was calculated and informed as median (Q2) and its interquartile values (Q1 and Q3). RESULTS: The search identified 92 potentially useful studies. Of these, 81 were discarded, and then remained 11 studies to be included. One out of 11 studies is an analytic case-control design. Rest are retrospective case series. Related mortality median was 0 (Q25 = 0 and Q75 = 28,57%). CONCLUSION: Although the available evidence is scarce and of low quality, it suggests that clinical course of this condition does not always lead to high mortality rates.
Assuntos
Humanos , Criança , Bacteriemia/mortalidade , Infecções por Burkholderia/mortalidade , Burkholderia cepaciaRESUMO
Resumen Las heridas por quemadura representan un grave problema, sobre todo en la población pediátrica, dada la severidad de su presentación y la morbimortalidad asociada. La infección es la complicación más frecuente y grave en el paciente quemado. Las bacterias que conforman el complejo Burkholderia cepacia (CBc) son capaces de causar enfermedades en plantas, humanos y animales. En el hombre pueden establecer infecciones crónicas y frecuentemente graves, por lo general en pacientes con fibrosis quística y en inmunocomprometidos. El CBc está compuesto por al menos 22 especies filogenéticamente muy relacionadas. El objetivo de esta publicación fue describir el primer caso de una infección de piel y partes blandas por Burkholderia stabilis, una especie poco frecuente, en un niño con grandes quemaduras en la Argentina. Las especies del CBc son intrínsecamente resistentes a la mayoría de los antimicrobianos disponibles clínicamente, como aminoglucósidos, quinolonas, polimixinas y β-lactámicos. Esto representa un serio problema en el momento de tratar las infecciones por las escasas opciones terapéuticas.
Abstract Burn wounds represent a serious problem, especially in the pediatric population, given the severity of their presentation and the associated morbidity and mortality. Infection is the most frequent and serious complication in the burned patient. Burkholderia cepacia (CBc) complex bacteria are capable of causing disease in plants, humans, and animals. In human beings they can establish chronic and frequently serious infections, generally in patients with cystic fibrosis and in immunocompromised patients. The CBc is composed of 22 phylogenetically closely related species. The objective of this publication was to describe the first report of a skin and soft tissue infection by Burkholderia stabilis, a rare species, in a child with extensive burns in Argentina. CBc species are inherently resistant to most clinically available antimicrobials, such as aminoglycosides, quinolones, polymyxins, and β-lactams. This represents a serious problem when treating infections, due to the limited therapeutic options.
Resumo As feridas por queimadura representam um grave problema, principalmente na população pediátrica, devido à gravidade de sua apresentação e morbimortalidade associada. A infecção é a complicação mais frequente e grave do paciente queimado. As bactérias que compõem o complexo Burkholderia cepacia (CBc) são capazes de causar doenças em plantas, humanos e animais. No homem, podem estabelecer infecções crônicas e freqüentemente graves, geralmente em pacientes com fibrose cística e imunocomprometidos. O CBc é composto, no mínimo, por 22 espécies filogeneticamente muito relacionadas. O objetivo desta publicação é descrever o primeiro caso de uma infecção de pele e tecidos moles por Burkholderia stabilis, uma espécie rara, em uma criança com queimaduras extensas na Argentina. As espécies do CBc são inerentemente resistentes à maioria dos antimicrobianos disponíveis clinicamente, como aminoglicosídeos, quinolonas, polimixinas e β-lactâmicos. Isso representa um problema sério na hora de tratar as infecções devido às opções terapêuticas limitadas.
Assuntos
Humanos , Masculino , Pré-Escolar , Tecidos , Bactérias , Queimaduras , Infecções dos Tecidos Moles , Burkholderia , Complexo Burkholderia cepacia , Pacientes , Pele , Terapêutica , Ferimentos e Lesões , Indicadores de Morbimortalidade , Doença , Morbidade , Mortalidade , Burkholderia cepacia , Hospedeiro Imunocomprometido , Polimixinas , Quinolonas , Fibrose Cística , Relatório de Pesquisa , Aminoglicosídeos , Infecções , Lactamas , Anti-InfecciososRESUMO
ABSTRACT Burkholderia cepacia complex (BCC) is group of widespread gram-negative bacillus organized in over 20 phylogenetically distinct bacterial species. According to previous studies, BCC species pathogens are widely reported in patients with cystic fibrosis (CF), but not in individuals with diabetes mellitus (DM). In this case report, a 42-year-old male patient with DM and a foot infection caused by BCC is presented. The patient was hospitalized after antibiotic treatment failure and improved after two surgical debridement procedures and a high-dose extended infusion (EI) of meropenem. The team of vascular surgeons and the infectious disease specialists worked fervently to solve the case. Finally, a scoping review was conducted to map BCC infections in patients with DM.
RESUMO
Burkholderia cenocepacia complex is associated with high transmissibility, virulence, and poor prognosis in cystic fibrosis (CF) patients. However, extrapulmonary infections are rare. We investigated the genome of a B. cenocepacia IIIA isolated from a liver abscess in a Brazilian CF patient and compared it to strain J2315. The whole genome was sequenced, and contigs were annotated by Rapid Annotation using Subsystem Technology. The Pathosystems Resource Integration Center was used to map antimicrobial and virulence genes. The genomic island (GIs) analysis was performed using two prediction methods, and the presence of putative plasmids and insertion sequences (ISs) was investigated. The isolate was confirmed as B. cenocepacia IIIA to ST-28 (ET12 lineage). A total of 64 genes for antimicrobial resistance and 47 genes related to virulence were identified. Among the virulence factors, there was a predominance of factors related to the invasion mechanism, to the flagellar biosynthesis protein, and to the RNA polymerase sigma factor for flagellar operon (cdpA). Two IS families (IS3 and IS5) and only one plasmid were found. On average 56 GIs were predicted by at least one of the methods applied. Comparative analysis showed resistance mechanisms and virulence factors revealing invasive determinants used by B. cenocepacia IIIA (ET12) in the process of disease spread to other infection sites (extrapulmonary) of highly virulent strains in CF patients.
Assuntos
Infecções por Burkholderia/microbiologia , Burkholderia cenocepacia/genética , Fibrose Cística/microbiologia , Genoma Bacteriano/genética , Abscesso Hepático/microbiologia , Adolescente , Brasil , Infecções por Burkholderia/complicações , Burkholderia cenocepacia/classificação , Burkholderia cenocepacia/isolamento & purificação , Fibrose Cística/complicações , Elementos de DNA Transponíveis/genética , DNA Bacteriano/genética , Farmacorresistência Bacteriana/genética , Feminino , Genes Bacterianos/genética , Ilhas Genômicas/genética , Humanos , Abscesso Hepático/complicações , Plasmídeos/genética , Fatores de Virulência/genéticaRESUMO
The Burkholderia genus has high ecological and nutritional versatility, having species capable of causing diseases in animals, humans, and plants. During chronic infections in humans, biofilm formation is a characteristic often associated with strains from different species of this genus. However, there is still no information on the formation of biofilms by plant pathogenic strains of B. cenocepacia (Bce) lineages IIIA and IIIB and B. gladioli pv. alliicola (Bga), which are associated with onion bacterial scale rot in the semi-arid region of northeast Brazil. In this study, we performed an in vitro characterization of biofilm formation ability in different culture media by the phytopathogenic strains of Bce and Bga and investigated its relationship with swarming motility. Our results indicated the existence of an intraspecific variation in biofilm formation capacity in vitro by these bacteria and the existence of a negative correlation between swarming motility and biofilm formation for strains of Bce lineage IIIB. In addition, histopathological analyses performed using optical microscopy and scanning electron microscopy revealed the formation of biofilm in vivo by Bce strains in onion tissues.
Assuntos
Biofilmes , Burkholderia cenocepacia , Doenças das Plantas , Brasil , Burkholderia cenocepacia/classificação , Burkholderia cenocepacia/fisiologia , Burkholderia cenocepacia/ultraestrutura , Microscopia Eletrônica de Varredura , Cebolas/microbiologia , Doenças das Plantas/microbiologiaRESUMO
A new design of cross-linked enzyme aggregates (CLEAs) of Burkholderia cepacia lipase (BCL) based mainly on the use of lignocellulosic residue of palm fiber as an additive was proposed. Different parameters for the preparation of active CLEAs in the hydrolysis of olive oil, such as precipitation agents, crosslinking agent concentration, additives, and coating agents were investigated. The highest activity yield (121.1 ± 0.1%) and volumetric activity (1578.1 ± 2.5 U/mL) were achieved for CLEAs prepared using the combination of a coating step with Triton® X-100 and polyethyleneimine plus the use of palm fiber as an additive. The variations of the secondary structures of BCL-CLEAs were analyzed by second-derivative infrared spectra, mainly indicating a reduction of the α-helix structure, which was responsible for the lipase activation in the supramolecular structure of the CLEAs. Thus, these results provided evidence of an innovative design of BCL-CLEAs as a sustainable and biocompatible opportunity for biotechnology applications.
Assuntos
Proteínas de Bactérias/química , Burkholderia cepacia/enzimologia , Enzimas Imobilizadas/química , Lipase/química , Estabilidade Enzimática , CinéticaRESUMO
The objective of the present work was to develop biodegradable polymeric films (starch-PBAT) as support for the immobilization of lipases using sodium montmorillonite (MMT) as a reinforcing agent (2% w/w) and itaconic acid (IA - 0.5-1.5% w/w) as a compatibilizing agent. The films were produced through a two steps blow-extrusion. The addition of MMT increased the tensile strength and Tg of the films, while the presence of IA made the films more flexible, reducing their Tg. Lipases from Burkholderia cepacia LTEB11 were immobilized in the films by the adsorption method. The ester yield (% of ethyl oleate synthesis) has shown best results (96%, 6 h) for immobilized enzyme in the MMT film and six cycles of reuse were carried out until a reduction of 50% in the catalytic activity of the enzyme.
Assuntos
Proteínas de Bactérias/química , Bentonita/química , Burkholderia cepacia/enzimologia , Enzimas Imobilizadas/química , Lipase/química , Poliésteres/química , Amido/química , Succinatos/químicaRESUMO
Burkholderia cepacia complex (Bcc) members have clinical relevance as opportunistic pathogens in patients with cystic fibrosis and are responsible of numerous nosocomial infections. These closely related bacteria are also reported as frequent contaminants of industrial products. In this retrospective study, we use PCR and recA gene sequence analysis to identify at species level Bcc isolates recovered from massive consumption products and industrial processes in Argentina during the last 25 years. The sequences obtained were also compared with recA sequences from clinical Bcc isolates deposited in GenBank database. We detected Bcc in purified water and preserved products from pharmaceutics, cosmetics, household cleaning articles, and beverages industries. B. contaminans (which is prevalent among people with cystic fibrosis in Argentina) was the most frequent Bcc species identified (42% of the Bcc isolates studied). B. cepacia (10%), B. cenocepacia (5%), B. vietnamiensis (16%), B. arboris (3%), and the recently defined B. aenigmatica (24%) were also detected. Rec A sequences from all B. cepacia and most B. contaminans industrial isolates obtained in this study displayed 100% identity with recA sequences from isolates infecting Argentinean patients. This information brings evidence for considering industrial massive consumption products as a potential source of Bcc infections. In addition, identification at species level in industrial microbiological laboratories is necessary for a better epidemiological surveillance. Particularly in Argentina, more studies are required in order to reveal the role of these products in the acquisition of B. contaminans infections.
Assuntos
Bebidas/microbiologia , Complexo Burkholderia cepacia/isolamento & purificação , Contaminação de Alimentos/análise , Alimentos em Conserva/microbiologia , Argentina , Proteínas de Bactérias/genética , Complexo Burkholderia cepacia/classificação , Complexo Burkholderia cepacia/genética , Cosméticos/análise , Detergentes/análise , Filogenia , Reação em Cadeia da Polimerase , Recombinases Rec A/genética , Estudos RetrospectivosRESUMO
Garlic (Allium sativum L.) is one of the crops whose economic importance has increased considerably in recent years in Brazil. The use of plant growth-promoting bacteria (PGPB) is a useful alternative for reducing the cost of agricultural inputs and, consequently, for increasing productivity. Therefore, the main objective of this work was to isolate and evaluate potential growth promoters in plants and plant pathogenic fungi growth inhibitors using endophytic bacteria from garlic roots and bacteria from the Agricultural Microbiology Culture Collection at the Federal University of Lavras. Besides verifying improvements in the growth and physiology of garlic meristems grown in vitro under the action of PGPB. Forty-eight endophytic bacteria were identified using matrix-assisted laser desorption/ionization-time of flight mass spectrometry based on the protein profile of each isolate. Four isolates were chosen according to their ability to fix nitrogen, to produce auxin and solubilize phosphate. The cultivation of garlic meristems in tissue culture with these bacteria was established at a population level of 106 CFU/mL. The evaluated criteria were: (1) the colonization capacity of the bacteria inside the garlic plants determined through scanning electron microscopy; (2) the chlorophyll content; and (3) the growth of garlic plants in vitro post-PGPB inoculation. Volatiles emitted by those isolates inhibited fungi growth. The inoculation of garlic meristems with Enterobacter cloacae and Burkholderia cepacia promoted an improvement in the growth and physiological attributes of garlic, indicating the feasibility of their application as plant growth promoters for commercial cultivation.
Assuntos
Bactérias/metabolismo , Alho/microbiologia , Meristema/crescimento & desenvolvimento , Desenvolvimento Vegetal/fisiologia , Raízes de Plantas/crescimento & desenvolvimento , Antifúngicos/metabolismo , Bactérias/isolamento & purificação , Brasil , Burkholderia cepacia/metabolismo , Clorofila/análise , Endófitos/metabolismo , Enterobacter cloacae/metabolismo , Ácidos Indolacéticos/metabolismo , Microscopia Eletrônica de Varredura , Fixação de Nitrogênio/fisiologia , Raízes de Plantas/microbiologiaRESUMO
Abstract Cystic fibrosis patients with Burkholderia cepacia complex pulmonary infections have high morbidity and mortality. Worldwide, this disease is undergoing substantial epidemiological changes. Advances in the diagnosis and treatment have conditioned an increase in child sur-vival as well as in the proportion of affected adults. In order to know our reality, we refer to an epidemiological study in 64 CF patients during 11 years of surveillance, focusing on infections caused by Burkholderia species. Conventional and automated phenotypic tests, restriction fragment length polymorphism-recA, recA gene sequencing, and matrix-assisted laser desorp-tion ionization-time of flight (MALDI-TOF) mass spectrometry were applied. Bacterial isolates were also tested for antimicrobial susceptibility patterns. The prevalence of Burkholderia cepacia complex was 9.4%. Based on recA gene sequencing, the most common species identified were Burkholderia cenocepacia (67.3%) and Burkholderia vietnamiensis (20.3%). Ceftazidime and meropenem were the most active, inhibiting 53% and 46% of isolates, respectively. This report represents the first systematic study of Burkholderia infections in our CF population since beginning of monitoring and treatment and highlights the importance of continued longitudinal studies.
Resumen Los pacientes con fibrosis quística (FQ) con infecciones pulmonares causadas por especies del complejo Burkholderia cepacia tienen una alta morbimortalidad. En todo el mundo, esta enfermedad está experimentando cambios epidemiológicos sustanciales. Los avances en el diagnóstico y el tratamiento han condicionado un aumento en la supervivencia infantil, así como en la proporción de adultos afectados. Para conocer nuestra realidad, nos referimos a un estudio epidemiológico en 64 pacientes con FQ durante 11 años de vigilancia, focalizando las infecciones causadas por especies del género Burkholderia. Se aplicaron pruebas fenotípicas convencionales y automatizadas, polimorfismo de longitud de fragmentos de restricción-recA, secuenciación del gen recA y espectrometría de masa MALDI-TOF. Los aislados bacterianos también se analizaron para determinar los patrones de susceptibilidad antimicrobiana. La prevalencia de complejo B. cepacia fue del 9,4%. Con base en la secuenciación del gen recA, las especies más comunes identificadas fueron Burkholderia cenocepacia (67,3%) y Burkholderia vietnamiensis (20,3%). Ceftazidima y meropenem fueron los antibióticos más activos e inhibieron el 53 y el 46% de los aislamientos, respectivamente. Este informe representa el primer estudio sistemático de las infecciones por Burkholderia en nuestra población desde el comienzo de la monitorización y el tratamiento, y resalta la importancia de continuar los estudios de vigilancia longitudinales.
Assuntos
Adulto , Criança , Humanos , Fibrose Cística , Complexo Burkholderia cepacia , Argentina/epidemiologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Burkholderia , Fibrose Cística/complicações , Complexo Burkholderia cepacia/genéticaRESUMO
Cystic fibrosis patients with Burkholderia cepacia complex pulmonary infections have high morbidity and mortality. Worldwide, this disease is undergoing substantial epidemiological changes. Advances in the diagnosis and treatment have conditioned an increase in child survival as well as in the proportion of affected adults. In order to know our reality, we refer to an epidemiological study in 64 CF patients during 11 years of surveillance, focusing on infections caused by Burkholderia species. Conventional and automated phenotypic tests, restriction fragment length polymorphism-recA, recA gene sequencing, and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry were applied. Bacterial isolates were also tested for antimicrobial susceptibility patterns. The prevalence of Burkholderia cepacia complex was 9.4%. Based on recA gene sequencing, the most common species identified were Burkholderia cenocepacia (67.3%) and Burkholderia vietnamiensis (20.3%). Ceftazidime and meropenem were the most active, inhibiting 53% and 46% of isolates, respectively. This report represents the first systematic study of Burkholderia infections in our CF population since beginning of monitoring and treatment and highlights the importance of continued longitudinal studies.
Assuntos
Complexo Burkholderia cepacia , Fibrose Cística , Adulto , Argentina/epidemiologia , Burkholderia , Complexo Burkholderia cepacia/genética , Criança , Fibrose Cística/complicações , Humanos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizRESUMO
INTRODUCTION: cystic fibrosis (CF) is a chronic, progressive disease with multisystem involvement and high mortality. An early diagnosis and a multidisciplinary approach lead to longer survival and better quality of life. OBJECTIVE: to characterize the patients who died with CF diagnosis in the period between 2011 and 2017 in the Hospital Universitario San Vicente in Colombia. METHODOLOGY: descriptive study of case series, with retrospective data collection. Results: 168 patients with CF were found in follow-up at the institution during the study period, of which 17 died (10,1%). Eleven deaths corresponded to children under 15 years old (64.7%), with equal distribution of gender (women 52.9% and men 47.1%). The median age at diagnosis was 3 years and median death 12 years. The most frequent clinical compromise was sinopulmonary and gastrointestinal. Pulmonary hypertension occurred in 29.4%. All the patients had a severe functional and nutritional compromise and 82.4% were colonized by Pseudomona aeruginosa. None had multidisciplinary management and most had a low socioeconomic level. BiPAP was used as a palliative measure in 6 patients and all died from ventilatory failure. CONCLUSION: CF mortality in our population continues to present at an early age. The diagnosis of the disease is still made late, compared to developed countries. There was a high proportion of bacterial colonization of the airway and the patients presented a severe clinical and functional status before dying.
INTRODUCCIÓN: la fibrosis quística (FQ) es una enfermedad crónica, progresiva, con compromiso multisistémico y de alta mortalidad. Un diagnóstico temprano y un manejo multidisciplinario llevan a una mayor sobrevida y mejor calidad de vida. OBJETIVO: caracterizar los pacientes que fallecieron con diagnóstico de FQ en el periodo comprendido entre 2011 y 2017 en el Hospital Universitario San Vicente Fundación (HUSVF) de Colombia. METODOLOGÍA: estudio descriptivo de series de casos, con recolección de la información de forma retrospectiva. RESULTADOS: Se encontraron 168 pacientes con FQ en seguimiento en la institución durante el periodo del estudio, de los cuales 17 fallecieron (10.1%). Once muertes correspondieron a menores de 15 años (64.7%), hubo una distribución de género equitativa (mujeres 52.9% y hombres 47.1%). La mediana de edad al momento del diagnóstico fue de 3 años y la de muerte 12 años. El compromiso clínico más frecuente fue sinopulmonar y gastrointestinal. La hipertensión pulmonar se presentó en el 29.4%. Todos los pacientes tenían un grave compromiso funcional, nutricional y el 82,4% estaban colonizados por Pseudomonas aeruginosa. Ninguno tuvo manejo multidisciplinario y la mayoría presentaban un bajo nivel socieconómico. En 6 pacientes se utilizó BiPAP como medida paliativa y todos murieron por falla ventilatoria. CONCLUSIÓN: la mortalidad por FQ en nuestra población se sigue presentando a edades tempranas. El diagnóstico de la enfermedad aún se realiza de forma tardía, comparado con países desarrollados. Hubo alta proporción de colonización bacteriana de la vía aérea y los pacientes presentaron un estado clínico y funcional grave antes de morir.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Adulto Jovem , Fibrose Cística/mortalidade , Pobreza , Pseudomonas aeruginosa/isolamento & purificação , Fatores Socioeconômicos , Epidemiologia Descritiva , Estudos Retrospectivos , Burkholderia cepacia/isolamento & purificação , Colômbia , Fibrose Cística/microbiologia , Desnutrição , Hospitais Universitários/estatística & dados numéricosRESUMO
This study is focussed on a biocatalysing chemical synthesis in order to produce a green apple flavour (ethyl valerate) using an immobilised lipase from Burkholderia cepacia. A strategy to improve the lipase stability during the esterification is used. In order to increase the ethyl valerate efficiency, an alternative method using the buffer pH to dissolve the lipase into alginate is proposed. Parameters of the immobilised lipase such as pH, temperature, activation energy and stirring speed are evaluated. The optimal condition using the substrate concentration and the lipase loading is provided. After 5 recyclability cycles, the immobilised lipase reveals a decreasing â¼25% in the ethyl valerate yield. An economical ester synthetising associated with the esterification efficiency is evidenced. This induces that a potential industrial application can be considered. This due to the demand for ethyl valerate in the flavour industry is required.
Assuntos
Burkholderia cepacia/enzimologia , Enzimas Imobilizadas/metabolismo , Aromatizantes/metabolismo , Lipase/metabolismo , Valeratos/metabolismo , Alginatos/química , Biotecnologia , Enzimas Imobilizadas/química , Esterificação , Lipase/químicaRESUMO
In order to recover biomolecules, a single downstream processing step is carried out. In this sense, an aqueous two-phase system (ATPS) containing polyethylene glycol (PEG) and potassium phosphate salts is used. Intending the purification of Burkholderia cepacia (Bc) lipase, the effects of the molecular masses of 1500 (PEG 1500), 4000 (PEG 4000), and 6000 (PEG 6000), pH (6, 7, and 8) and distinct tie line lengths are perfomed. Although this is reasonable reported in literature, a study covering an economical production aspect considering the Bc is scarce. This characterizes a novelty proposed in this investigation. Lipase is recovered in a polymer phase at lower pH value. PEG 1500/phosphate salt ATPS at pH 6 is considered a good method with ~ 98% of the extraction efficiency. Another contribution of this proposed investigation concerns to a biotechnological material synthesis, which is applied in several advanced and revolutionize engineering practices. Additionally, an economic analysis of the proposed method indicates a minimal sale price (~ US$410/L) inducing to a future and potential commercial application.
Assuntos
Proteínas de Bactérias/química , Proteínas de Bactérias/isolamento & purificação , Burkholderia cepacia/enzimologia , Lipase/química , Lipase/isolamento & purificação , Proteínas de Bactérias/economia , Concentração de Íons de Hidrogênio , Lipase/economia , Polietilenoglicóis/químicaRESUMO
Introducción: Burkholderia cepacia es causante de brotes cuyo origen frecuentemente son fuentes ambientales. Materiales y métodos: Ante la sospecha de brote por B. cepacia en hemocultivos. Se realizó toma de cultivos ambientales y de insumos. Los aislamientos microbiológicos fueron sometidos a análisis molecular. Resultados: Se identificaron 8 pacientes con hemocultivos para B. cepacia en la UCI Adultos y UCI Pediátrica, edades entre 3 meses y 88 años, Los hemocultivos fueron tomados a través de catéter venoso central. Ningún paciente presentó infección por este microorganismo. Se documentó crecimiento de B. cepacia en lote de bolsitas ("sachet") jabón de clorhexidina al 4% y en lavamanos que se correlacionaron con el clon identificado en los pacientes. Con el retiro del lote de jabón de clorhexidina, optimización de los procesos de limpieza y desinfección, lavado de manos y medidas de aislamiento se controló el pseudobrote. Conclusiones: Se presenta un pseudobrote por B. cepacia causado por la contaminación de un lote de clorhexidina jabón y de los lavamanos, llamando la atención acerca de la posibilidad de contaminación de antisépticos con este microorganismo.
Introduction: The Burkholderia cepacia has been described as an outbreaks-causing agent, in which case frequently corresponds to environmental sources. Materials and Methods: Having the clinical suspicion of an outbreak or a pseudo-outbreak of B. cepacia in an Intensive Care Unit (ICU), samples in sterile solutions were sent to the laboratory for microbiologic study and molecular analysis. Results: Eigth patients with positive blood cultures for B. cepacia were identifed in the adults and pediatric ICU, ages between 3 months to 88 years. Blood cultures were taken through a central venous catheter. None of the patients presented clinical manifestations of infection. There was a positive culture of B. cepacia in a chlorhexidine sachet soap batch and in samples from the washbasin that was correlated with molecular analysis with patient samples. The withdrawal of the chlorhexidine sachet soap batch plus the optimization of cleaning and disinfection processes and patient isolation, were effective to control the pseudo-outbreak, without presenting infection. Conclusions: One pseudo-outbreak was documented by B. cepacia, affecting the adult and pediatric ICU caused by the contamination of a chlorhexidine sachet soap batch and the washbasins.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Burkholderia cepacia , Poluição Ambiental , Unidades de Terapia Intensiva , Isolamento de Pacientes , Sabões , Desinfecção das Mãos , Surtos de Doenças , Otimização de Processos , Hemocultura , Anti-Infecciosos LocaisRESUMO
In this work, the effect of several phosphonium-based ionic liquids (ILs) on the activity of lipase from Burkholderia cepacia (BCL) was evaluated by experimental assays and molecular docking. ILs comprising different cations ([P4444 ]+ , [P444(14) ]+ , [P666(14) ]+ ) and anions (Cl- , Br- , [Deca]- , [Phosp]- , [NTf2 ]- ) were investigated to appraise the individual roles of IL ions on the BCL activity. From the activity assays, it was found that an increase in the cation alkyl chain length leads to a decrease on the BCL enzymatic activity. ILs with the anions [Phosp]- and [NTf2 ]- increase the BCL activity, while the remaining [P666(14) ]-based ILs with the Cl- , Br- , and [Deca]- anions display a negative effect on the BCL activity. The highest activity of BCL was identified with the IL [P666(14) ][NTf2 ] (increase in the enzymatic activity of BCL by 61% at 0.055 mol·L-1 ). According to the interactions determined by molecular docking, IL cations preferentially interact with the Leu17 residue (amino acid present in the BCL oxyanion hole). The anion [Deca]- has a higher binding affinity compared to Cl- and Br- , and mainly interacts by hydrogen-bonding with Ser87, an amino acid residue which constitutes the catalytic triad of BCL. The anions [Phosp]- and [NTf2 ]- have high binding energies (-6.2 and -5.6 kcal·mol-1 , respectively) with BCL, and preferentially interact with the side chain amino acids of the enzyme and not with residues of the active site. Furthermore, FTIR analysis of the protein secondary structure show that ILs that lead to a decrease on the α-helix content result in a higher BCL activity, which may be derived from an easier access of the substrate to the BCL active site.
Assuntos
Líquidos Iônicos/química , Lipase/química , Lipase/metabolismo , Ânions/química , Cátions/química , Ativação Enzimática , Estabilidade Enzimática , Hidrólise , Simulação de Acoplamento Molecular , Azeite de Oliva/química , Conformação Proteica , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
El complejo Burkholderia cepacia está formado por 22 especies conocidas como patógenos oportunistas en personas inmunocomprometidas, especialmente en aquellas con fibrosis quística. También se aíslan de infecciones nosocomiales y son difíciles de erradicar debido a su capacidad intrínseca para resistir una gran variedad de antibióticos. En general, estas especies presentan genomas de gran tamaño (hasta 9 Mpb) divididos en 2-5 replicones. Esta característica aporta una gran versatilidad metabólica, que se considera importante para habitar el suelo, el agua, las plantas, incluso los nódulos en leguminosas. Algunas especies del complejo B. cepacia exhiben actividades benéficas, como biorremediación, biocontrol y promoción del crecimiento vegetal. No obstante, debido a su papel en infecciones de humanos, su uso en la agricultura está restringido. El complejo B. cepacia es un tema constante de estudio debido a su impacto en el sector salud y su potencial en la agricultura. En este trabajo se examina la historia del complejo B. cepacia y se revisa la información reciente relacionada con este grupo de bacterias.
The Burkholderia cepacia complex is a group of 22 species, which are known as opportunistic pathogens in immunocompromised people, especially those suffering from cystic fibrosis. It is also found in nosocomial infections and is difficult to eradicate due to intrinsic resistance to several antibiotics. The species have large genomes (up to 9 Mbp), distributed into 2-5 replicons. These features significantly contribute to genome plasticity, which makes them thrive in different environments like soil, water, plants or even producing nodules in legume plants. Some B. cepacia complex species are beneficial in bioremediation, biocontrol and plant-growth promotion. However, because the B. cepacia complex is involved in human infection, its use in agriculture is restricted. B. cepacia complex is being constantly studied due to the health problems that it causes and because of its agricultural potential. In this review, the history of B. cepacia complex and the most recently published information related to this complex are revised.