Physiological and vegetative changes in grapevines (cv. Alvarinho) promoted by biological control agents (BCAs) : preliminary results

The induction of a natural disease resistance in grape using several biological and/or chemical elicitors, known as Biological Control Agents (BCAs), has received increasing attention over the last years, and is now considered the elected strategy for disease management. Vegetative and physiological changes (number of leaves; roots and stem length; total photosynthetic pigments; leaf gas exchanges) promoted by four BCAs (Best Cure; Mycotric; FitoAlgas; BioClean) and four conventional chemical products (Maestro M; Flint; Aliette; Horizon) were evaluated in potted grapevines (cv. Alvarinho) comparatively to a control group (Ctl). Each compound was applied, independently, to a minimum of 12 plants (to Ctl plants just distillated water was added), every fifteen days, during July and August of 2007. The results, in the first year, do not reveal significant physiological differences between the treatments and the Ctl. In vegetative terms, some differences were observed in the roots and leaves. However, the results were erratic, eventually due to the short time of the experience. The trial will proceed for a 2nd and a 3rd year.Fundação para a Ciência e a Tecnologia (FCT

Effects of Esca disease on leaf gas exchange of cv. Alvarinho in a vineyard of the Portuguese Vinho Verde region

Esca is a very complex disease that is usually noticed when the grapevine show external symptoms. However, the grapevines can be infected for a long period of time and rarely manifest the typical leaf symptoms. Moreover, little is know about the consequences of Esca on vineyard productivity. In Portugal, in Vinho Verde region, Alvarinho sub-region, most vineyards are infected with Esca. In this work we evaluate the impact of Esca on some physiological parameters of grapevines cv. Alvarinho.This preliminary work reveal the importance that these kind of physiological measurements can have in the valuation of the infected Esca grapevine physiological conditions. These results may be used as a pattern to predict the damage magnitude of Esca disease in grapevines.Fundação para a Ciência e a Tecnologia (FCT)Fundação Luso-American

Molecular characterization of carbapenem-resistant and metallo-β-lactamase-producing Pseudomonas aeruginosa isolated from blood cultures from children and teenagers with cancer

INTRODUCTION: The objective of this study was to evaluate the prevalence and dissemination of carbapenem-resistant and metallo-β-lactamase-producing Pseudomonas aeruginosa isolated from blood-stream samples (2000-2005) that were collected from patients admitted to the Institute of Pediatric Oncology, UNIFESP (IOP-GRAACC). METHODS AND RESULTS: Fifty-six P. aeruginosa samples were isolated from 49 patients. Thirty-two of these samples were classified as carbapenem-resistant using the disc diffusion method and were subjected to the PCR reaction in order to detect MBL genes. Eighteen of these 32 isolates showed the blaSPM-1 gene. Eight samples selected in different years over the study period presented the same genetic profile according to pulsed-field gel electrophoresis. The antimicrobial therapy was considered adequate for only 23.5% of the patients with bacteremia due to P. aeruginosa carrying the blaSPM-1 gene, and a high lethality rate of 70.6% was observed during the 30-day period after bacteremia and an inadequate initial antibiotic regimen. CONCLUSIONS: We detected the presence of a clone of carbapenem-resistant P. aeruginosa carrying blaSPM-1 that persisted in blood culture samples over a six-year period at the institution, with high lethality, thus justifying rigorous epidemiological surveillance and a rearrangement of the antimicrobial therapy regimens at the institution.INTRODUCÃO: O objetivo do estudo foi avaliar a prevalência e a disseminação de amostras de Pseudomonas aeruginosa resistente aos carbapenêmicos e produtoras de metalo-β-lactamases isoladas de hemoculturas (2000-2005) de pacientes do Instituto de Oncologia Pediátrica da UNIFESP (IOP-GRAACC). MÉTODOS E RESULTADOS: Cinquenta e seis amostras de Pseudomonas aeruginosa foram isoladas de 49 pacientes. Trinta e duas dessas amostras foram classificadas como resistentes aos carbapenêmicos pela técnica de disco difusão e submetidas a reação de PCR para detecção de genes de MBL. Dezoitos dessas 32 amostras evidenciaram o gene blaSPM-1. Oito amostras selecionadas em diferentes anos no período de estudo apresentaram o mesmo perfil genético por pulsed-field gel electrophoresis. A terapêutica antimicrobiana foi considerada adequada em apenas 23,5% dos pacientes com bacteremia por P. aeruginosa carreando blaSPM-1 e letalidade de 70,6% no período de até 30 dias após a bacteremia e uma inadequação inicial dos esquemas antibióticos utilizados CONCLUSÕES: Evidenciamos a presença de um clone de P. aeruginosa resistente aos carbapenêmicos carreando blaSPM-1 que persistiu em amostras de hemocultura pelo período de 6 anos na instituição, com alta letalidade, justificando uma vigilância epidemiológica rigorosa e uma readequação dos esquemas de terapia antimicrobianos na instituição.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório Especial em Microbiologia ClínicaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Instituto de Oncologia Pediátrica-Grupo de Apoio ao Adolescente e à Criança com CâncerUNIFESP, EPM, Laboratório Especial em Microbiologia ClínicaUNIFESP, EPM, Instituto de Oncologia Pediátrica-Grupo de Apoio ao Adolescente e à Criança com CâncerSciEL

Brain abscess by Nocardia sp in immunocompromised patient

Pacient with autoimmune haemolytic anaemia and thrombocytopenic purpura (Evans Syndrome), treated with immunosuppressive therapy (prednisone and azathioprine) developed brain abscess unresponsive to antimicrobial therapy, in spite of its 23 days duration. Diagnosis could be possible after recover secretion of peribulbar abscess and maintenance of this material over seven days in incubation.Paciente portadora de anemia hemolítica autoimune e púrpura trombocitopênica idiopática (Síndrome de Evans) em uso de terapia imunossupressora (predinisona e azatioprina), desenvolveu quadro de abscesso cerebral não responsivo a 23 dias de terapia antimicrobiana. O diagnóstico de nocardiose foi possível após coleta de material de abscesso peribulbar e observação deste material por período superior há uma semana.Faculdade de Medicina do Triângulo Mineiro Disciplina de Doenças Infecciosas e ParasitáriasFaculdade de Medicina do Triângulo Mineiro Disciplina de HematologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Doenças Infecciosas e ParasitáriasUNIFESP, EPM, Disciplina de Doenças Infecciosas e ParasitáriasSciEL

Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection

Background: Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in fungal bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Candida albicans BSIs and to assess its impact on clinical outcome.Methods: A historical cohort study with 89 adults patients with C. albicans BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded.Results: Patients with BSIs and TTPs of culture of 36 h (n = 50) were compared. Septic shock occurred in 46.2% of patients with TTPs of 36 h (p = 0.56). A central venous catheter source was more common with a BSI TTP of = 20 at BSI onset, the development of at least one organ system failure (respiratory, cardiovascular, renal, hematologic, or hepatic), SOFA at BSI onset, SAPS II at BSI onset, and time to positivity were associated with death. By using logistic regression analysis, the only independent predictor of death was time to positivity (1.04; 95% CI, 1.0-1.1, p = 0.035), with the chance of the patient with C. albicans BSI dying increasing 4.0% every hour prior to culture positivity.Conclusion: A longer time to positivity was associated with a higher mortality for Candida albicans BSIs; therefore, initiating empiric treatment with antifungals may improve outcomes.Universidade Federal de São Paulo UNIFESP, Div Infect Dis, São Paulo, BrazilHosp Israelita Albert Einstein, Div Med Practice, São Paulo, BrazilVirginia Commonwealth, Univ Sch Med, Dept Internal Med, Richmond, VA USAUniversidade Federal de São Paulo UNIFESP, Div Infect Dis, São Paulo, BrazilWeb of Scienc

Oral moxifloxacin in the outpatient treatment of low-risk children with fever and neutropenia

Universidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilWeb of Scienc

Epidemiology and mortality of the multidrug resistant gram-negative bloodstream infection in acute myeloid leukemia

Universidade Federal de São Paulo, Escola Paulista Med, Infectol Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Hematol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Infectol Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Hematol, São Paulo, BrazilWeb of Scienc

Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

BACKGROUND: The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative. METHODS: We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T) or ceftriaxone plus amikacin (C+A). RESULTS: Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm³ (T) and 201cells/mm³ (C+A). The mean duration of neutropenia was 8.7 days (T) and 7.6 days (C+A). Treatment was successful without the need for modifications in 71% of the episodes in the T group and 81% in the C+A group (p=0.23). Treatment was considered to have failed because of death in two episodes (3%) in the T group and three episodes (4%) in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96% (T) and 93% (C+A). Adverse events that occurred in group T were not related to the drugs used in this study. CONCLUSION: In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections.Federal University of São Paulo Division of Infectious Disease Pediatric Oncology InstituteUNIFESP, Division of Infectious Disease Pediatric Oncology InstituteSciEL

Bloodstream infections in febrile neutropenic children with cancer

Universidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Oncol Inst, Dept Infect Dis, São Paulo, BrazilWeb of Scienc