Staphylococcus saprophyticus Recovered from Humans, Food, and Recreational Waters in Rio de Janeiro, Brazil.

Staphylococcus saprophyticus is an important agent of urinary tract infection (UTI) in young women, but information about this pathogen in human microbiota and in common environment is lacking. The aim of this study was to characterize S. saprophyticus isolates from genitoanal microbiota of 621 pregnant women, 10 minas cheese packs, and five beaches in Rio de Janeiro city and compare PFGE profiles of these isolates with five UTI PFGE clusters described in this city. We investigated 65 S. saprophyticus isolates from microbiota, 13 from minas cheese, and 30 from beaches and 32 UTI isolates. Antimicrobial resistance was determined by disk diffusion, MIC by agar dilution, and PCR. Erythromycin-resistance genes erm(C), msr(A), msr(B), mph(C), and lin(A) were found in 93% of isolates. Trimethoprim-sulfamethoxazole resistance correlated with dfrG or dfrA genes. Three cefoxitin-resistant isolates carried the mecA gene. All isolates obtained from cheese were susceptible to all antimicrobial agents. Six of 10 pregnant women with >1 isolate had monoclonal colonization. Isolates from pregnant women shared 100% similarity with UTI PFGE cluster types A and E obtained almost 10 years previously, suggesting temporal persistence of S. saprophyticus. Antimicrobial resistance of beach isolates reflected the profiles of human isolates. Taken together, results indicate a shared source for human and environmental isolates

Preventing diseases in round-the-world travelers: a contemporary challenge for travel medicine advice

Abstract Providing advice for travelers embarking on long-term trips poses a challenge in travel medicine. A long duration of risk exposure is associated with underuse of protective measures and poor adherence to chemoprophylaxis, increasing the chances of acquiring infections. Recently, in our clinic, we observed an increase in the number of travelers undertaking round-the-world trips. These individuals are typically aged around 32 years and quit their jobs to embark on one-to-two-year journeys. Their destinations include countries in two or more continents, invariably Southeast Asia and Indonesia, and mostly involve land travel and visiting rural areas. Such trips involve flexible plans, increasing the challenge, especially with regard to malaria prophylaxis. Advising round-the-world travelers is time-consuming because of the amount of information that must be provided to the traveler. Advisors must develop strategies to commit the traveler to his/her own health, and verify their learnings on disease-prevention measures. Contacting the advisor after the appointment or during the trip can be helpful to clarify unclear instructions or diagnosis made and prescriptions given abroad. Infectious diseases are among the most frequent problems affecting travelers, many of which are preventable by vaccines, medicines, and precautionary measures. The dissemination of counterfeit medicines, particularly antibiotics and antimalarial medicines, emphasizes the need for travelers to carry medicines that they may possibly need on their trip. Additional advice on altitude, scuba diving, and other possible risks may also be given. Considering the difficulties in advising this group, we present a review of the main recommendations on advising these travelers

IDENTIFICAÇÃO DE CLONES PANDÊMICOS E PRODUÇÃO DE BETALACTAMASE DE ESPECTRO ESTENDIDO (ESBL) EM AMOSTRAS DE ESCHERICHIA COLI ISOLADOS DA MICROBIOTA INTESTINAL DE VIAJANTES PARTINDO DO RIO DE JANEIRO

Viagens internacionais estão associadas a disseminação de microrganismos multirresistentes possivelmente adquiridos durante a ingestão de água, alimentos, ou mesmo contato com pessoas e ambientes. A aquisição de clones de Escherichia coli, considerados pandêmicos e de alto risco, como o ST131 tem sido relatada a partir da microbiota de viajantes. A aquisição de novos clones, mais adaptados ao hospedeiro humano e albergando maior número de genes de resistência e virulência pode ampliar a disseminação dessas linhagens, bem como a resistência aos antimicrobianos no país. Objetivos: Descrever a aquisição de E.coli produtora de ESBL e os principais clones pandêmicos obtidos a partir da microbiota intestinal de viajantes partindo do Rio de Janeiro. Métodos: Viajantes com mais de 18 anos atendidos em uma clínica de medicina de viagem do Rio de Janeiro de 2015 a 2020, após assinarem o TCLE, foram orientados a colher um swab anal antes e após a viagem. Esses espécimes foram armazenados em meio STGG de onde foram retiradas alíquotas para semeadura em agar MacConkey e agar MacConkey contendo ceftriaxone. Isolados de E. coli foram identificados por MALDI-TOF. Foi feito screening para os clones pandêmicos ST131, ST69, ST73 e ST95 através de PCR em pools de até 3 isolados de ida e volta de cada participante. Quando positivo para um ou mais clones, o PCR foi repetido isoladamente. Amostras com crescimento em meio com ceftriaxone foram submetidas a teste fenotípico para produção de ESBL. Resultados: De 243 viajantes incluídos, E.coli produtora de ESBL foi detectada em 17 (7%) viajantes antes da viagem e em 49 (22%) apenas após o retorno. Dos 1344 isolados de E. coli obtidos, 197 (15) pertenciam a algum dos clones pesquisados. Comparando isolados pré e pós viagem, em 6 viajantes o mesmo clone foi detectado antes e após a viagem, em 10 um diferente clone foi observado antes e após, em 37 um ST pandêmico foi observado apenas após a viagem e em 29 apenas antes da viagem. Conclusão: Apesar de antes da viagem clones pandêmicos já serem detectados na microbiota de viajantes, as viagens podem causar impacto na circulação de clones de alto risco ao redor do planeta. Para conhecer melhor a dinâmica de aquisição desses clones planejamos expandir a investigação do número de clones estudados e selecionar amostras para sequenciamento de genoma completo

Identification of Clinical Isolates of Indole-Positive and Indole-Negative Klebsiella spp.

Biochemical methods employed to classify bacterial species have limitations and may have contributed to the taxonomic complexity recently reported for the genus Klebsiella. The objective of the present study was to apply a simple biochemical test panel to classify a collection of human Klebsiella isolates. We found that with only three additional tests, it is possible to place most isolates in a defined species. Analysis of a 512-bp sequence of the rpoB gene was used as the reference. A total of 16 conventional and 4 supplementary tests were used to evaluate 122 recent isolates identified as Klebsiella from 120 patients, isolated at the clinical laboratory of a university hospital in Minas Gerais, Brazil. Of these, 102 (84%) isolates were identified as Klebsiella pneumoniae or Klebsiella variicola, 19 (15%) as Klebsiella oxytoca, and 1 (1%) as Raoultella planticola. Enterobacterial repetitive intergenic consensus-PCR typing revealed a diversity of genotypes. rpoB gene sequencing confirmed the phenotypic identification and detected five K. variicola isolates among the K. pneumoniae/K. variicola group. Three additional tests that include growth at 10°C and histamine and d-melezitose assimilation should be considered essential tests for the typing of Klebsiella isolates