Variantes de Smqnr de isolados clínicos de Stenotrophomonas maltophilia no Brasil

SUMMARY Stenotrophomonas maltophilia contains a novel chromosomally-encoded qnr gene named Smqnr that contributes to low intrinsic resistance to quinolone. We described Smqnr in 13 clinical isolates of S. maltophilia from two Brazilian hospitals, over a 2-year period. The strains were identified by API 20 NE (bioMérieux, France). Susceptibility by microdilution method to trimetroprim/sulfamethoxazole, ciprofloxacin, levofloxacin, minocycline, ceftazidime, chloramphenicol and ticarcillin/clavulanate was performed according to CLSI. PCR detection of Smqnr gene was carried out. The sequence of Smqnr was compared with those deposited in GenBank. Pulsed-field gel electrophoresis (PFGE) of all strains was performed. Thirteen Smqnr positives isolates were sequenced and three novel variants of Smqnr were identified. All 13 Smqnr isolates had distinguishable patterns by PFGE. This is the first report of Smqnr in S. maltophilia isolated in Brazil.RESUMO S. maltophilia contem um novo gene qnr cromossômico denominado Smqnr que contribui para baixa resistência intrínseca a quinolonas. Descrevemos Smqnr em 13 isolados clínicos de S. maltophilia de dois hospitais brasileiros, ao longo do período de dois anos. Os isolados foram identificados pela API 20 NE (bioMérieux, França). Susceptibilidade pelo método de microdiluição dos seguintes antibióticos trimetroprim/sulfametoxazol, ciprofloxacina, levofloxacina, minociclina, ceftazidima, cloranfenicol e ticarcilina/clavulanato foi realizada segundo o CLSI. Detecção do gene de Smqnr foi realizada por PCR. A sequência de Smqnr foi comparada com aquelas depositadas no GenBank. Foi realizada eletroforese em gel de campo pulsado (PFGE) de todos os isolados. Treze isolados contendo Smqnr foram sequenciados e identificados três variantes do gene Smqnr. Todos os 13 isolados de Smqnr apresentaram diferentes padrões por PFGE. Este é o primeiro relato de Smqnr em isolados de S. maltophilia no Brasil

Macroscopia do aparelho digestório do cágado sul-americano Mesoclemmys vanderhaegei (Bour, 1973)

Ainda há poucas descrições anatômicas a cerca do trato digestório de representantes da ordem Testudines, especialmente sobre o cágado-de-Vanderhaegei, Mesoclemmys vanderhaegei. A ocorrência desta espécie abrange as bacias dos rios Paraguai, Paraná e Amazônica. Estudos sobre a sua ecologia e morfologia ainda são pouco explorados, dessa forma, o aparelho digestório foi caracterizado macroscopicamente pela dissecção desse sistema em dez espécimes. A boca possui comprimento orocaudal ligeiramente maior que o laterolateral. Os lábios são formados por placas córneas. A língua é macia e está totalmente fixada ao assoalho da cavidade oral. O esôfago possui luz ampla e paredes delgadas na região cervical, tornando-se gradativamente mais estreito e de paredes espessas caudalmente. O estômago apresenta forma semelhante à letra "U" e podem ser distinguidas as regiões do cárdia, do corpo e do piloro, com mucosa totalmente pregueada. Na transição deste para o intestino delgado o esfíncter pilórico é conspícuo. O intestino apresenta-se disposto entre o delgado e grosso, sendo o primeiro constituído pelo duodeno e jejuno, não sendo possível identificar macroscopicamente o íleo. Da mesma forma, não se observa o ceco como primeiro segmento do intestino grosso, sendo este formado pelo cólon, que se abre em um pequeno compartimento pigmentado da cloaca. O fígado apresenta variação no padrão de lobação, no entanto, a presença dos lobos hepáticos direito e esquerdo é constante nos espécimes analisados. O pâncreas é facilmente observado em sintopia com o duodeno. Nesta análise, o trato digestório de Mesoclemmys vanderhaegei apresenta padrão semelhante ao de outras espécies de quelônios pesquisados da família Chelidae.There are few anatomical descriptions about the testudines's gastrointestinal tract, especially when concerned to the Vanderhaege's turtle, Mesoclemmys vanderhaegei. The geographical range of this species extends throughout the Paraguai, Paraná and Amazon river basins. Studies about its ecology and morphology are still little exploited, thus, the gastrointestinal apparatus was macroscopic characterized through the dissection of ten specimens. The mouth's oral-aboral length is wider than its oral-tail length. The lips are formed by keratinized structures. The tongue is soft and fixed to the floor of the oral cavity. The cervical esophagus is broad and has thin walls, becoming narrower and thicker in its caudal portion. The stomach's shape resembles the "U" letter. It has a creased mucosa and is divided in a cardiac, a main body, and a pyloric region. The gut is presented as the small and large intestine. The duodenum and jejunum are easily identified. The ileum, on the opposite, is unidentifiable macroscopically, as well as the caecum, the first segment of the large intestine. The colon, the posterior segment, opens itself into a cloaca. The liver presents individual variation regarding lobation pattern. However, the presence of both liver lobes, left and right, is a constant finding during the observation. The pancreas is easily seen running distally along the duodenum. In this analysis, it was verified that the digestive tract in Mesoclemmys vanderhaegei is similar to the tract of other chelids previously studied

Clonality, outer-membrane proteins profile and efflux pump in KPC- producing Enterobacter sp. in Brazil

Abstract\ud \ud Background\ud Carbapenems resistance in Enterobacter spp. has increased in the last decade, few studies, however, described the mechanisms of resistance in this bacterium. This study evaluated clonality and mechanisms of carbapenems resistance in clinical isolates of Enterobacter spp. identified in three hospitals in Brazil (Hospital A, B and C) over 7-year.\ud \ud \ud Methods\ud Antibiotics sensitivity, pulsed-field gel electrophoresis (PFGE), PCR for carbapenemase and efflux pump genes were performed for all carbapenems-resistant isolates. Outer-membrane protein (OMP) was evaluated based on PFGE profile.\ud \ud \ud Results\ud A total of 130 isolates of Enterobacter spp were analyzed, 44/105 (41, 9%) E. aerogenes and 8/25 (32,0%) E. cloacae were resistant to carbapenems. All isolates were susceptible to fosfomycin, polymyxin B and tigecycline. KPC was present in 88.6% of E. aerogenes and in all E. cloacae resistant to carbapenems. The carbapenems-resistant E. aerogenes identified in hospital A belonged to six clones, however, a predominant clone was identified in this hospital over the study period. There is a predominant clone in Hospital B and Hospital C as well. The mechanisms of resistance to carbapenems differ among subtypes. Most of the isolates co-harbored blaKPC, blaTEM and /or blaCTX associated with decreased or lost of 35–36KDa and or 39 KDa OMP. The efflux pump AcrAB-TolC gene was only identified in carbapenems-resistant E. cloacae.\ud \ud \ud Conclusions\ud There was a predominant clone in each hospital suggesting that cross-transmission of carbapenems-resistant Enterobacter spp. was frequent. The isolates presented multiple mechanisms of resistance to carbapenems including OMP alteration.The study was financial support by CNPQ (Conselho Nacional de\ud Desenvolvimento Científico e Tecnológico) and FAPESP (Fundação de\ud Amparo à pesquisa do Estado de São Paulo, Brazil

Clinical and microbiological characteristics of patients colonized or infected by Stenotrophomonas maltophilia: is resistance to sulfamethoxazole/trimethoprim a problem?

Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen in the last decade. Increased resistance to sulfamethoxazole/trimethoprim (SMX/TMP) has been reported in S. maltophilia strains in the past few years, leading to few therapeutic options. We conducted a prospective multicenter study at two Brazilian teaching hospitals that identified S. maltophilia isolates and evaluated their antimicrobial susceptibility profile, SMX/TMP resistance genes and their clonality profile. A total of 106 non-repeated clinical samples of S. maltophilia were evaluated. Resistance to SMX/TMP was identified in 21.6% of the samples, and previous use of SMX/TMP occurred in 19 (82.6%). PCR detected the sul1 gene in 14 of 106 strains (13.2%). Of these isolates, nine displayed resistance to SMX/TMP. The resistant strains presented a polyclonal profile. This opportunistic pathogen has emerged in immunocompromised hosts, with few therapeutic options, which is aggravated by the description of emerging resistance mechanisms, although with a polyclonal distribution profile

Evaluation of this temporomandibular joint space when using different occlusal splints by cone beam computerized tomography : a case report

Introduction: An occlusal splint is a removable, reversible, non-invasive device made of acrylic, used to promote a harmonious occlusal contact. It is part of an arsenal of therapeutic modalities used in the treatment of Temporomandibular Joint (TMJ) Disorders. However, its mechanisms of action remain controversial. Several hypotheses have been proposed to explain its efficiency, such as: repositioning of the condyle or disk; reduction of the masticatory electromyographic activity; change of harmful oral habits; increase of the intra-articular space reducing the overload on the TMJ. Case presentation: This case report aims to demonstrate the changes in TMJ spaces, assessed by Cone Beam Computed Tomography (CBTC) scans, in a patient with indication to use occlusal splints. She was submitted to occlusal splints of 1 and 3 mm which were used during CBTC acquisition. The measures of the joint spaces with and without splints were compared by image software that shows an alteration of the upper, anterior, posterior, medial and lateral joint spaces. The 3 mm plate promoted an initial translation of condyle. Conclusion: The thicknesses of 3 and 1 mm promoted different joint space variations. The use of different thicknesses enables the individualization of the treatment for different pathologies affecting the TMJ.info:eu-repo/semantics/publishedVersio

Bone tissue response to plasma-nitrided titanium implant surfaces

A current goal of dental implant research is the development of titanium (Ti) surfaces to improve osseointegration. Plasma nitriding treatments generate surfaces that favor osteoblast differentiation, a key event to the process of osteogenesis. Based on this, it is possible to hypothesize that plasma-nitrided Ti implants may positively impact osseointegration. Objective The aim of this study was to evaluate the in vivo bone response to Ti surfaces modified by plasma-nitriding treatments. Material and Methods Surface treatments consisted of 20% N2 and 80% H2, 450°C and 1.5 mbar during 1 h for planar and 3 h for hollow cathode. Untreated surface was used as control. Ten implants of each surface were placed into rabbit tibiae and 6 weeks post-implantation they were harvested for histological and histomorphometric analyses. Results Bone formation was observed in contact with all implants without statistically significant differences among the evaluated surfaces in terms of bone-to-implant contact, bone area between threads, and bone area within the mirror area. Conclusion Our results indicate that plasma nitriding treatments generate Ti implants that induce similar bone response to the untreated ones. Thus, as these treatments improve the physico-chemical properties of Ti without affecting its biocompatibility, they could be combined with modifications that favor bone formation in order to develop new implant surfaces

Genotoxicity of Nicotiana tabacum leaves on Helix aspersa

Tobacco farmers are routinely exposed to complex mixtures of inorganic and organic chemicals present in tobacco leaves. In this study, we examined the genotoxicity of tobacco leaves in the snail Helix aspersa as a measure of the risk to human health. DNA damage was evaluated using the micronucleus test and the Comet assay and the concentration of cytochrome P450 enzymes was estimated. Two groups of snails were studied: one fed on tobacco leaves and one fed on lettuce (Lactuca sativa L) leaves (control group). All of the snails received leaves (tobacco and lettuce leaves were the only food provided) and water ad libitum. Hemolymph cells were collected after 0, 24, 48 and 72 h. The Comet assay and micronucleus test showed that exposure to tobacco leaves for different periods of time caused significant DNA damage. Inhibition of cytochrome P450 enzymes occurred only in the tobacco group. Chemical analysis indicated the presence of the alkaloid nicotine, coumarins, saponins, flavonoids and various metals. These results show that tobacco leaves are genotoxic in H. aspersa and inhibit cytochrome P450 activity, probably through the action of the complex chemical mixture present in the plant

Telecondutas : coronavírus (COVID-19) : informações para profissionais da APS : versão 13

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