Epidemiology, molecular and phenotipic typing of Methicillin Resistant Staphylococcus aureus (MRSA) strains isolated from multi-drug resistant screening program and blood culture.

Epidemiologia e tipizzazione molecolare su 135 ceppi di Staphylococcus aureus meticillino resistenti isolati secondo il programma di screening del sistema di sorveglianza su ceppi multi resistenti e su emocoluture. 94 ceppi solati da tamponi faringei e rettali e 41 da emocolture del policlinico di Verona " G. Rossi.SLa ricerca in questo ambito si occupa dello studio di nuove strumenti diagnostici e terapia salvavita che permettano di individuare velocemente ceppi multi-resistenti, in campioni clinici riducendo i tempi di refertazione, per dare garanzia di una corretta e immediata terapia. STudio di una triplex real time home-made che indivia direttamente da campione la specie,la resistenza alla meticillina e la presenza della tossina PVL.Abbiamo inoltre caratterizzato la cassetta cromosomica mobile SCCmec e le rispettive correlazione con i diversi profili di antibiotico resistenza tra 6 spa-type pi\uf9 rappresentativi quali: t032 CC22, t1036 CC22, t1214 CC22 ,t022 CC22, t041 CC5 ,t121 CC8, ricercati su 135 ceppi di MRSA provenienti da tamponi faringei, rettali e emocolture di cui rispettivamente 94 da tamponi rettali e faringei e 41 da emocolture. 128 ceppi sono stati ritrovati appartenenti al tipo SCCmec IV e 7 appartenenti al tipo t041 appartenenti a SCCmec I, rispettivamente tutti tutti di classe B. Abbiamo notato inoltre che nei 41 ceppi isolati da emocolture mancano gli spa-type t1036 e t022 considerati tra i \u201c6 rappresentativi\u201d ritrovati in questo studio. Il nostro pensiero, per le ricerche future sar\ue0 quello di aumentare il numero di ceppi isolati da emocolture. Abbiamo individuato un nuovissimo spa-type t16026 CC22 sottomesso nell\u2019anno 2016.Possiamo quindi concludere che i ceppi di MRSA isolati presso i reparti di anestesia e rianimazione, terapia intensiva, medicina interna, oncologia, pediatria, centro ustioni del policlinico di Verona \u201cG. Rossi\u201d hanno un profilo molecolare attribuibile per definizione ai ceppi comunitari CA-MRSA ma un profilo di multi- resistenza tipico dei ceppi ospedalieri e solo 6 ceppi presentano il gene pvl.Quindi possiamo ipotizzare ad un cambiamento epidemiologico e microbiologico di ceppi di MRSA isolati in questa parte dell\u2019Italia e si potrebbe inoltre proporre un cambiamento di definizione dei CA-MRSA.Un altro obiettivo \ue8 stato quello di studiare una Real-time PCR che rilevasse rapidamente la resistenza alla meticillina , il fattore di virulenza PVL direttamente da un campione clinico e il gene nuc (specie -specifico) . Questa tecnica presentata in questo studio pu\uf2 identificare e differenziare MRSA, MSSA, resistente alla meticillina, Stafilococchi negativi alla coagulasi (MR-CNS) con un significato diagnostico e terapeutico di notevole importanza e una riduzione dei tempi di refertazione dalle 48h ad 1h 30 minuti. Questa tecnica automatizzata e standardizzata ha come risultato una concordanza del 100% con le tecniche molecolari standard , il 100% di specificit\ue0 e una sensibilit\ue0 di 514 UFC/ml.tudio del profilo antibiotico

Real-time PCR assay for detection of Staphylococcus aureus, Panton-Valentine Leucocidin and Methicillin Resistance directly from clinical samples

Rapid detection of Methicillin Resistant Staphylococcus aureus (MRSA) is an important concern for both treatment and implementation of infection control policies. The present study provides an \u2018in house\u2019 real-time PCR assay to detect directly nuc, pvl, and mecA genes. The assay is able to perform identification of MRSA, Methicillin-Sensitive S. aureus, Methicillin-Resistant Coagulase Negative Staphylococci and the Panton-Valentine leukocidin virulence gene from rectal and pharyngeal swab samples in a screening context. We found an analytical sensitivity of this current Triplex PCR assay of 514 CFU/mL. Analytical specificity was tested with different Gram-positive and Gram-negative species and yielded no false-positive PCR signal. The sensitivity and specificity of the Triplex Real Time PCR were both 100% for these targets when compared with the culture and conventional methods. This assay is readily adaptable for routine use in a microbiology laboratory, as it will enable the implementation of timely and properly guided therapy and infection control strategies

Intrinsic role of coagulase negative staphylococci norA-like efflux system in fluoroquinolones resistance

NorA is a Staphylococcus aureus multidrug transporter that exports structurally distinct compounds including fluoroquinolones. In this study norA-like genes of Staphylococcus epidermidis (norASEP) and Staphylococcus haemolyticus (norASHAE) were identified and sequenced. The nucleotide identity of norASEP and norASHAE with norA was 75.3 and 74.1%, respectively, and the amino acid identity 87.7 and 86%, respectively. Inactivation of norASEP increased the ciprofloxacin susceptibility of E. coli DH5\u3b1 carrying the pB SK 198 norASEP EZ cat norASEP plasmid

Exploratory Survey on European Consumer and Stakeholder Attitudes towards Alternatives for Surgical Castration of Piglets

Simple SummaryIn many countries, surgical castration of piglets without pain relief or anaesthesia is still common practice. Castration is performed to minimise the incidence of boar taint, a bad taste (urine/fecal like), typically present in the meat of 5 to 10% of uncastrated male pigs. It also helps to avoid aggressive and sexual behaviour. For animal welfare reasons, alternatives are being considered, and in some countries, an alternative is already practiced. One option is to perform surgical castration with anaesthesia and relieve pain. A second option is to produce male pigs without castration, which requires detection of tainted carcasses in the slaughter house. A third option is to apply immunocastration: by a two-fold injection of a vaccine, the testes function is inhibited, which reduces boar-like behaviour and avoids boar taint. In this study, we evaluated the acceptability of each of these methods in 16 countries in Europe. Of the 4 presented options, the practice of surgical castration was least accepted (32%), whilst there was a high acceptance of castration with anaesthesia (85%), followed by immunocastration (71%) and production of boars (49%). The developed questionnaire and infographic can be used in future studies to further gain insights in consumer and stakeholder attitudes on this topic.Surgical castration of piglets without pain relief is still common practice in many countries. Possible alternatives for surgical castration are application of pain relief or anaesthesia or production of boars (entire males) and immunocastrates. Each of these alternatives faces advantages and disadvantages which may result in different citizen attitudes and consumers acceptability. Understanding which practice is acceptable to whom and why may further stimulate implementation. Consumer (n = 3251) and stakeholder (n = 1027) attitudes towards surgical castration without pain relief, surgical castration with anaesthesia, immunocastration, and production of boars were surveyed from April to June 2020 via an online questionnaire in 16 countries (>175 respondents per country). Surgical castration without pain relief was separated from each of the alternatives due to animal welfare and showed the lowest acceptability (32%). Within the alternatives, a further partitioning between the alternatives was based on perceived quality and food safety, with an acceptance of 85% for applying anaesthesia, 71% for immunocastration, and 49% for boar production. Differences depending on professional involvement and familiarity with agriculture could be observed, mainly for the acceptance of surgical castration without anaesthesia, immunocastration, and boars. Castration with anaesthesia was highly accepted by all types of respondents

LA CASA ESCRITA POR DENTRO DE SUS MORADORES MUESTRA DE POESÍA ESTUDIANTES DE MAESTRÍA DEL IDEAD

Gastón Bachelard en su ya icónico libro La poética del espacio, manifiesta que no es causal la relación entre la creación de una imagen poética nueva y un arquetipo dormido en el inconsciente. Nos describe la casa como lugar cósmico con sus dos puntos cardinales: el tejado “donde todos los pensamientos son claros” y el sótano como “locura enterrada, drama emparedado”. Reconoce en el “resplandor de la imagen”, la morada de un pasado lejano. A esa morada lejana, a ese cosmos de la infancia, a ese lugar que resplandece como un sol en los jardines claros u oscuros de nuestra memoria, habitada por hojas, pájaros, humo, voces, colores del amanecer, recuerdos amables y queridos de sus habitantes o espacio también de momentos aullantes, es al que retorna cada uno de estos ejercicios de poesía —cada cual a su manera—, a partir de la casa como primera morada. Fue esa la apuesta que hicimos en el curso Crítica del texto poético de la Maestría en Pedagogía de la Literatura del IDEAD, en los CAT de Cali y Chaparral. De ese tránsito por el taller como exploración de imágenes a cargo de los estudiantes, fue que surgieron estos ejercicios de la imaginación y de retorno al espacio íntimo de los afectos por parte de sus autores. Aquí una sencilla muestra de sensibilización poética

A systematic review on the excess health risk of antibiotic-resistant bloodstream infections for six key pathogens in Europe

Background: Antimicrobial resistance is a global threat, which requires novel intervention strategies, for which priority pathogens and settings need to be determined. Objectives: We evaluated pathogen-specific excess health burden of drug-resistant bloodstream infections (BSIs) in Europe. Methods: A systematic review and meta-analysis. Data sources: MEDLINE, Embase, and grey literature for the period January 1990 to May 2022. Study eligibility criteria: Studies that reported burden data for six key drug-resistant pathogens: carbapenem-resistant (CR) Pseudomonas aeruginosa and Acinetobacter baumannii, third-generation cephalosporin or CR Escherichia coli and Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium. Excess health outcomes compared with drug-susceptible BSIs or uninfected patients. For MRSA and third-generation cephalosporin E. coli and K. pneumoniae BSIs, five or more European studies were identified. For all others, the search was extended to high-income countries. Participants: Paediatric and adult patients diagnosed with drug-resistant BSI. Interventions: Not applicable. Assessment of risk of bias: An adapted version of the Joanna-Briggs Institute assessment tool. Methods of data synthesis: Random-effect models were used to pool pathogen-specific burden estimates. Results: We screened 7154 titles, 1078 full-texts and found 56 studies on BSIs. Most studies compared outcomes of drug-resistant to drug-susceptible BSIs (46/56, 82.1%), and reported mortality (55/56 studies, 98.6%). The pooled crude estimate for excess all-cause mortality of drug-resistant versus drug-susceptible BSIs ranged from OR 1.31 (95% CI 1.03–1.68) for CR P. aeruginosa to OR 3.44 (95% CI 1.62–7.32) for CR K. pneumoniae. Pooled crude estimates comparing mortality to uninfected patients were available for vancomycin-resistant Enterococcus and MRSA BSIs (OR of 11.19 [95% CI 6.92–18.09] and OR 6.18 [95% CI 2.10–18.17], respectively). Conclusions: Drug-resistant BSIs are associated with increased mortality, with the magnitude of the effect influenced by pathogen type and comparator. Future research should address crucial knowledge gaps in pathogen- and infection-specific burdens to guide development of novel interventions

Prevalencia de genes qnr en bacterias gramnegativas provenientes de fuentes humana, animal y aguas residuales, en Cumaná, estado Sucre, Venezuela

La presencia de bacterias resistentes a las fluoroquinolonas en la comunidad, sugiere una fuerte presión selectiva de estos antibióticos fuera de los centros de salud. El objetivo de este trabajo fue detectar los marcadores moleculares qnr en cepas de diferentes ambientes para determinar el impacto del abuso de las fluoroquinolonas en Cumaná. En el año 2014, se aislaron bacterias de diferentes orígenes (aguas residuales, tracto intestinal de animales y humanos) siendo Escherichia coli la principal especie en todas las fuentes. Se determinó la CMI a ciprofloxacina y se buscaron los genes de resistencia qnr en las 42 cepas aisladas. Las cepas presentaron un amplio rango en las CMI a ciprofloxacina (0,25 – ≥128 mg/L). El principal determinante de resistencia a fluoroquinolonas fue qnrA (64%) en cepas de todas las fuentes. Este es el primer trabajo en Venezuela que detecta dos genes qnr diferentes en la misma cepa (nueve cepas en total), así como es el primer reporte mundial de cepas de Citrobacter farmeri que albergan el gen qnrA

Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries

Background: The increasing burden of candidemia and the emergence of resistance, especially among non-Candida albicans strains, represent a new threat for public health. We aimed to assess the status of surveillance and to identify publicly accessible resistance data in Candida spp. blood isolates from surveillance systems and epidemiological studies in 28 European and 4 European Free Trade Association member states. Methods: A systematic review of national and international surveillance networks, from 2015 to 2020, and peer-reviewed epidemiological surveillance studies, from 2005 to 2020, lasting for at least 12 consecutive months and with at least two centers involved, was completed to assess reporting of resistance to amphotericin B, azoles, and echinocandins in C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, and C. auris. Results: Only 5 (Austria, Italy, Norway, Spain, and United Kingdom) of 32 countries provided resistance data for Candida spp blood isolates. Among 322 surveillance studies identified, 19 were included from Belgium, Denmark, Iceland, Italy, Portugal, Spain, Sweden, Switzerland, and United Kingdom. C. albicans and C. glabrata were the most monitored species, followed by C. parapsilosis and C. tropicalis. C. krusei was not included in any national surveillance system; 13 studies assessed resistance. No surveillance system or study reported resistance for C. auris. Fluconazole, voriconazole, caspofungin, and amphotericin B resistance in C. albicans, C. glabrata, and C. parapsilosis were the most common drug-species combination monitored. Quality of surveillance data was poor, with only two surveillance systems reporting microbiological methods and clinical data. High heterogeneity was observed in modalities of reporting, data collection, and definitions. Conclusion: Surveillance of antifungal resistance in Candida spp blood-isolates is fragmented and heterogeneous, delaying the application of a translational approach to the threat of antifungal resistance and the identification of proper targets for antifungal stewardship activities. International efforts are needed to implement antifungal resistance surveillance programs in order to adequately monitor antifungal resistance