Analysis of Genetic Lineages and Their Correlation with Virulence Genes in Enterococcus faecalis Clinical Isolates from Root Canal and Systemic Infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Introduction: Entero coccus faecalis is a member of the mammalian gastrointestinal microbiota but has been considered a leading cause of hospital-acquired infections. In the oral cavity, it is commonly detected from root canals of teeth with failed endodontic treatment. However, little is known about the virulence and genetic relatedness among E. faecalis isolates from different clinical sources. This study compared the presence of enterococcal virulence factors among root canal strains and clinical isolates from hospitalized patients to identify virulent clusters of E. faecalis. Methods: Multilocus sequence typing analysis was used to determine genetic lineages of 40 E. faecalis clinical isolates from different sources. Virulence clusters were determined by evaluating capsule (cps) locus polymorphisms, pathogenicity island gene content, and antibiotic resistance genes by polymerase chain reaction. Results: The clinical isolates from hospitalized patients formed a phylogenetically separate group and were mostly grouped in the clonal complex 2, which is a known virulent cluster of E. faecalis that has caused infection outbreaks globally. The clonal complex 2 group comprised capsule-producing strains harboring multiple antibiotic resistance and pathogenicity island genes. On the other hand, the endodontic isolates were more diverse and harbored few virulence and antibiotic resistance genes. In particular, although more closely related to isolates from hospitalized patients, capsule-producing E. faecalis strains from root canals did not carry more virulence/antibiotic genes than other endodontic isolates. Conclusions: E. faecalis isolates from endodontic infections have a genetic and virulence profile different from pathogenic clusters of hospitalized patients' isolates, which is most likely due to niche specialization conferred mainly by variable regions in the genome.397858864Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [09/52661-5

Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998

From July 1995 to August 1998, mycobacterial blood Cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referncia e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referncia de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at LISP, and 18 (10.1%) at CRAS. the frequency of positive Cultures declined sharply from 22.6%, in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active anti retroviral therapy. in 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.Univ Fed Espirito Santo, Ctr Biomed, BR-29040091 Vitoria, ES, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilInst Adolfo Lutz Registro, São Paulo, BrazilCtr Referencia & Treinamento AIDS, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc