Antimicrobial activity of ceftobiprole against Gram-negative and Gram-positive pathogens: results from INVITA-A-CEFTO Brazilian study

Ceftobiprole is a broad-spectrum cephalosporin with potent activity against staphylococci, including those resistant to oxacillin, as well as against most Gram-negative bacilli including Pseudomonas aeruginosa. In this study, the in vitro activity of ceftobiprole and comparator agents was tested against bacterial isolates recently collected from Brazilian private hospitals. A total of 336 unique bacterial isolates were collected from hospitalized patients between February 2008 and August 2009. Each hospital was asked to submit 100 single bacterial isolates responsible for causing blood, lower respiratory tract or skin and soft tissue infections. Bacterial identification was confirmed and antimicrobial susceptibility testing was performed using CLSI microdilution method at a central laboratory. The CLSI M100-S21 (2011) was used for interpretation of the antimicrobial susceptibility results. Among the 336 pathogens collected, 255 (75.9%) were Gram-negative bacilli and 81 (24.1%) were Gram-positive cocci. Although ceftobiprole MIC50 values for oxacillin resistant strains were two-fold higher than for methicillin susceptible S. aureus, ceftobiprole inhibited 100% of tested S. aureus at MICs 6 µg/mL for both species. Our results showed that ceftobiprole has potent activity against staphylococci and E. faecalis, which was superior to that of vancomycin. Our data also indicates that ceftobiprole demonstrated potency comparable to that of cefepime and ceftazidime against key Gram-negative species.Janssen-CilagUniversidade Federal de São Paulo (UNIFESP) Post-graduation Course in SciencesUNIFESPUNIFESP, Post-graduation Course in SciencesSciEL

Detection of PER-2-Producing Enterobacter cloacae in a Brazilian Liver Transplantation Unit

Universidade Federal de São Paulo, Dept Med, Lab Alerta, São Paulo, BrazilUniv Fed Parana, Hosp Clin, BR-80060000 Curitiba, Parana, BrazilFac & Inst Pesquisa Pele Pequeno Principe, Curitiba, Parana, BrazilUniversidade Federal de São Paulo, Dept Med, Lab Alerta, São Paulo, BrazilWeb of Scienc

Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: Geographic patterns, epidemiological features, and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999)

As part of the SENTRY Antimicrobial Surveillance Program, a total of 1078 Acinetobacter species and 842 Stenotrophomonas maltophilia isolates were collected between January 1997 and December 1999 from 5 geographic regions (Canada, the United States, Latin America, Europe, and the Asia-Pacific). the frequency of infections (by geographic region and body site), including those due to imipenem-resistant Acinetobacter species and trimethoprim-sulfamethoxazole (TMP-SMZ)-resistant S. maltophilia, was evaluated. the possibility of seasonal variations in bloodstream infections caused by Acinetobacter species was studied, as was the activity of several therapeutic antimicrobials against all strains. Acinetobacter species and S. maltophilia were most frequently associated with pulmonary infections, independent of the region evaluated. in contrast, patterns of antimicrobial resistance markedly varied among distinct geographic regions, especially for nosocomial isolates. Although the carbapenems were the most active antimicrobials against Acinetobacter species, nearly 11.0% of the nosocomial isolates were resistant to this drug group in both regions. TMP-SMZ, ticarcillin-clavulanic acid, gatifloxacin, and trovafloxacin were the only agents with consistent therapeutic activity against S. maltophilia isolates. Rates of resistance to TMP-SMZ ranged from 2% in Canada and Latin America to 10% in Europe. the geographic differences in resistance patterns among Acinetobacter species and S. maltophilia isolates observed in this study emphasize the importance of local surveillance in determining the most adequate therapy for acinetobacter and S. maltophilia infections and the possible clonal, epidemic nature of occurrence.Universidade Federal de São Paulo, Div Infect Dis, BR-04025010 São Paulo, BrazilUniv Iowa, Coll Med, Iowa City, IA USAQueen Elizabeth II Hlth Sci Ctr, Halifax, NS, CanadaBellvitge Hosp, Barcelona, SpainUniv Utrecht, Utrecht, NetherlandsUniversidade Federal de São Paulo, Div Infect Dis, BR-04025010 São Paulo, BrazilWeb of Scienc

A perspetiva dos professores de educação especial sobre a importância da expressão dramática como técnica psicopedagógica no desenvolvimento da comunicação da criança com perturbação de Asperger

Os princípios pelos quais a escola inclusiva se rege defendem que os alunos não devem apenas estar juntos, mas acima de tudo, devem aprender juntos, de forma a perceberem que a escola é de todos e para todos, ainda que dentro das suas diferenças. Terá o professor capacidades, conhecimentos e estratégias suficientes para abraçar este desafio? Numa tentativa de aprofundarmos o nosso conhecimento acerca da Perturbação de Asperger propomo-nos a desenvolver um trabalho que defina a doença, dentro do já então conhecido, e evidencie tanto as “fragilidades” como as “capacidades” dos portadores, carinhosamente apelidados de “Aspies”. Trata-se de uma tentativa de reunir os conhecimentos necessários para começar a entender a essência dos Asperger. Porque é que na opinião do psicólogo clínico Tony Attwood, especialista mundial nesta Perturbação, precisamos de pessoas com Asperger, sugerindo que estes indivíduos possam ser, de alguma forma, especiais e capazes de grandes feitos. Neste sentido, surge este estudo para tentar perceber a perspetiva dos professores de Educação Especial sobre a importância da Expressão Dramática como técnica psicopedagógica no desenvolvimento da comunicação da criança com Perturbação de Asperger. Pretendemos perceber a influência que a utilização desta técnica pode ter no desenvolvimento comunicacional da criança com Perturbação de Asperger, pois talvez seja relevante sugerir a elaboração de um programa de treino de competências comunicacionais que utilize a Expressão Dramática. A Expressão Dramática vai além do seu papel de ferramenta lúdica e de distração, daí a importância de se conhecer as vantagens da sua utilização nesta área e tentar perceber se pode contribuir ou não para o sucesso de uma criança com esta problemática

Novel beta-Lactams

The beta-lactam class constitutes the largest group of antimicrobial agents, which includes penicillins, cephalosporins, monobactams, and carbapenems. These compounds, which have in common the beta-lactam ring in their structure, are the most prescribed antibiotic class due to their clinical efficacy and safety. This article reviews the beta-lactam compounds which have been recently approved by the United States Food and Drug Administration (US-FDA) or have reached at least phase III of development. We also discuss ME1036, a carbapenem with anti-methicillin-resistant Staphylococcus aureus (MRSA) activity, which is in phase 11 of development. An important advance in the beta-lactam field was the development of cephalosporins and carbapenems with potent anti-MRSA activity such as ceftobiprole, ceflaroline and ME1036. This manuscript also reviews data on doripenem, a new 1-beta-methyl carbapenem that shows potent in vitro activity against Gram-positive and -negative pathogens, and a low propensity to select for in vitro resistance in Pseudomonas aeruginosa and, Enterobacteriaceae. In addition, doripenem showed to be a safe and effective drug in phase III clinical trials that resulted in its recent US-FDA approval. Although ME1036 is still in phase II of development its data was included in this revision since it is one of the first carbapenems to demonstrate anti-MRSA in vitro activity and efficacy in animal models of MRSA infection.Univ Fed Sao Paulo, Div Infect Dis, Dept Med, UNIFESP EPM, Sao Paulo, BrazilJMI Labs, N Liberty, IA USAUniv Fed Sao Paulo, Div Infect Dis, Dept Med, UNIFESP EPM, Sao Paulo, BrazilWeb of Scienc

Metallo-β-lactamase-production in meropenem-susceptible Pseudomonas aeruginosa isolates: risk for silent spread

The aim of this study was to characterize two metallo-β-lactamases (MBLs)-producing Pseudomonas aeruginosa clinical isolates showing meropenem susceptibility. Antimicrobial susceptibility was assessed by automated testing and Clinical and Laboratory Standards Institute agar dilution method. MBL production was investigated by phenotypic tests. Molecular typing was determined by pulsed field gel electrophoresis (PFGE). MBL-encoding genes, as well as their genetic context, were identified by polymerase chain reaction (PCR) and sequencing. The location of blaIMP-16 was determined by plasmid electrophoresis, Southern blot and hybridization. Transcriptional levels of blaIMP-16, mexB, mexD, mexF, mexY, ampC and oprD were determined by semi-quantitative real time PCR. The P. aeruginosa isolates studied, Pa30 and Pa43, showed imipenem and meropenem susceptibility by automated testing. Agar dilution assays confirmed meropenem susceptibility whereas both isolates showed low level of imipenem resistance. Pa30 and Pa43 were phenotypically detected as MBL producers. PFGE revealed their clonal relatedness. blaIMP-16 was identified in both isolates, carried as a single cassette in a class 1 integron that was embedded in a plasmid of about 60-Kb. Pa30 and Pa43 overexpressed MexAB-OprM, MexCD-OprJ and MexXY-OprM efflux systems and showed basal transcriptional levels of ampC and oprD. MBL-producing P. aeruginosa that are not resistant to meropenem may represent a risk for therapeutic failure and act as silent reservoirs of MBL-encoding genes

The Enid Echo

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