Antimicrobial susceptibility profile and research of mec A and erm genes in coagulase-negative staphylococci isolated from platelet concentrates bags

In recent years, several studies have described the clinical impact of bacterial infection associated with transfusion of platelet concentrates (PCs). Among the blood components, PCs are responsible for the highest rates of bacterial contamination as well as septic transfusion reactions. We assessed antimicrobial susceptibility profile, resistance to methicillin (MRCoNS), and resistance to macrolides, lincosamides and streptogramins of group B (MLSB) of 16 coagulase-negative staphylococci (CoNS) isolates from an investigation in 691 PCs bags. We then compared conventional and automated phenotypic methods, disc diffusion test (DD) and VITEK(r) 2, respectively as well as phenotypic and genotypic methods (Polymerase Chain Reaction - PCR). All CoNS were susceptible to vancomycin. The disc diffusion test characterized 18.75% as MRCoNS and 37.5% with inducible resistance to MLSB (iMLSB), and with VITEK(r) 2, 6.3% and 31.25%, respectively. The mecA gene was detected in 18.75% and the erm gene in 31.25% of the isolates. In this study, we found equal percentage values between presence of the mecA gene by PCR and resistance to methicillin using cefoxitin by DD test, evidence of the erm gene by PCR, and iMLSB resistance by automation (VITEK(r) 2). Moreover, we identified three strains with beta-lactamase overproduction, and the occurrence of a bigger mistake was verified when automation was compared with DD test. And we observed that D-test was the most reliable for the detection of iMLSB resistance in Staphylococcus sp

Práticas educativas na área da saúde: realização de exames Bacterioscópicos para o controle das doenças sexualmente Transmissíveis (DST)

Trabalho apresentado no 31º SEURS - Seminário de Extensão Universitária da Região Sul, realizado em Florianópolis, SC, no período de 04 a 07 de agosto de 2013 - Universidade Federal de Santa Catarina.Reportamos os resultados do nosso projeto de extensão intitulado “Práticas educativas na área da saúde: realização de exames bacterioscópicos para o controle das Doenças Sexualmente Transmissíveis (DST) na Universidade Federal de Santa Maria, Santa Maria - RS. O objetivo geral desse trabalho foi o de proporcionar aos acadêmicos do curso de Farmácia da UFSM a oportunidade de aprender a coletar secreções vaginais, cervicais e/ou uretrais solicitadas pelos médicos que fazem parte da equipe da Estratégia de Saúde da Família (ESF) nas Unidades Básica de Saúde da Vila Maringá e Vila Schirmer em Santa Maria, RS. Estas comunidades carentes são composta por aproximadamente 5 mil habitantes, os quais têm dificuldade de se locomover até o laboratório municipal do Centro de Diagnóstico e Atenção Secundária (CEDAS) para a realização de exames laboratoriais, aliado ao fato de que esse tipo de exame (bacterioscópico de secreções) não é efetuado nesse local. Portanto, esse projeto, além de realizar esse tipo de análise não disponibilizada ainda à população, auxilia na formação de recursos humanos qualificados, capacitando a equipe multidisciplinar dessas unidades, e despertando nos discentes o comprometimento com o social, uma vez que representam os futuros profissionais da saúde. Finalmente contribuem para a melhoria na qualidade de vida das pessoas que lá residem, atuando na prevenção da transmissão das Doenças Sexualmente Transmissíveis (DSTs), o que constitui uma das estratégias básicas na sua prevenção. Até o presente momento, foram coletadas 17 secreções vaginais das quais 70,58% (12/17) foram visualizados microrganismos envolvidos em vaginites. Os microrganismos encontrados foram: Gardnerella vaginalis 58,33% (7/12), Leptothrix vaginalis 8,33% (1/12), Lactobacillus acidophilus (Doederlein) exacerbado 8,33% (1/12), floras anaeróbias 16,66% (2/12) e Neisseria gonorrhoeae 8,33% (1/12)

Perfil epidemiológico de pacientes com leucemia mieloide aguda: Uma revisão integrativa

As leucemias são um grupo de neoplasias malignas caracterizadas pela expansão clonal de células progenitoras hematopoiéticas imaturas presentes no sangue e na medula óssea. São divididas em agudas e crônicas e mieloide e linfoide. Assim, o presente estudo teve como objetivo, no manuscrito enviado ao editor, apresentar o perfil epidemiológico de pacientes com leucemia mieloide aguda. Trata-se de uma revisão integrativa da literatura, utilizando trabalhos científicos disponibilizados nas bases de dados SciELO, LILACS e PubMed entre os anos 2015 a 2020, em português, inglês e espanhol. Para a busca dos artigos, foram utilizados os descritores: “Leucemia mielóide aguda” e “Perfil epidemiológico”. Foram adotados os seguintes critérios de inclusão para a seleção dos trabalhos: textos publicados em português, inglês e espanhol. Dos 26 textos encontrados, 21 foram excluídos da pesquisa por não se enquadrarem nos critérios de inclusão. Dos 5 trabalhos incluídos, a maioria foi publicada em 2016 e 2017, seguidos pelo ano de 2018. Todos os estudos que pesquisaram o sexo apresentaram mais incidência da LMA em indivíduos do sexo masculino, o subtipo de LMA mais frequente foi a LMA M3 e a causa de morte mais frequente foi a sepse. Em estudos com crianças a idade com mais casos foi de 4 a 10 anos. Sobre a etnia, 66,67%, dos artigos que abordaram essa característica, apresentaram indivíduos da etnia branca como maioria nos casos de LMA. Constatou-se uma crescente, mas ainda existem poucos estudos que abordam o perfil epidemiológico de pacientes com LMA. A síntese de dados epidemiológicos apresentados nesse estudo pode ser utilizada como alicerce na construção e o desenvolvimento de políticas públicas para melhoria do diagnóstico e tratamento da LMA. A atualização constante dos dados epidemiológicos reverterá em avanço na qualidade da assistência prestada a esses pacientes, contribuindo, para o aumento da taxa de cura dessa doença

Coagulase-negative staphylococci isolates from blood cultures of newborns in a tertiary hospital in southern Brazil

Neonatal sepsis continues to be a major cause of morbidity and mortality worldwide. Coagulase-negative staphylococci (CoNS), commonly found on the skin, being the main agents isolated. The aim of this study was to evaluate CoNS isolated from blood cultures of newborn (NB) infants. The study took place between 2014 and 2016/2017 in a tertiary hospital in southern Brazil. Using the VITEK 2 system (bioMérieux, Marcy l'Etoile, France), the microorganisms were identified and had their sensitivity profiles determined. The minimum inhibitory concentrations of linezolid, tigecycline, and vancomycin were also determined. The clinical parameters and mortality rates of NBs were evaluated. From January to December 2014, 176 CoNS isolates were obtained from 131 patients and from June 2016 to July 2017, 120 CoNS isolates were obtained from 79 patients. Staphylococcus epidermidis was most prevalent in both periods. Resistance rates increased between 2014 and 2016/2017, especially against ciprofloxacin (52.27% and 73.11%, p = 0.0004), erythromycin (51.40% and 68.07%, p = 0.0054), gentamicin (50.59% and 67.23%, p = 0.0052), and penicillin (71.3% and 99.17%, p = 0.0001), respectively. With 100% susceptibility to linezolid, tigecycline, and vancomycin in both periods and methodologies tested. In 2014, 53.44% of the NBs received antibiotic therapy, and of these, 77.14% used a catheter; in 2016/2017, these were 78.48% and 95.16%, respectively. Regarding laboratory tests, a hemogram was ineffective, since patients with sepsis presented normal reference values. In 2014 and 2016/17, 15.71% and 17.74% of the NBs died, respectively. S. epidermidis was the predominant microorganism, related to catheter use in most cases. The resistance rates have increased over time, demonstrating the importance of adopting control and prevention measures in this hospital. CoNS are responsible for a significant neonatal sepsis mortality rate in infants

Synergistic antibacterial effect of statins with the complex {[1-(4-bromophenyl)-3-phenyltriazene N3-oxide-κ2 N1 ,O4] (dimethylbenzylamine-κ2 C1 ,N4)palladium(II)}

The treatment of infections caused by resistant microorganisms represents a big challenge in healthcare due to limited treatment options. For this reason, the discovery of new active substances which are able to perform innovative and selective actions is of great impact nowadays. Statins and triazenes (TZC) have consolidated as a promising class of compounds, characterized by the expressive biological activity, especially antimicrobial activities. The aim of this study was to assess the in vitro synergistic antibacterial effect of the association of statins and a new TZC complex {[1-(4-bromophenyl)-3-phenyltriazene N3- oxide-κ2 N1 ,O4 ](dimethylbenzylamine-κ2 C1 ,N4 )palladium(II)} (Pd(DMBA)LBr) against American Type Culture Collection (ATCC) strains and clinical isolates. The complex and the statins showed bacterial activity of all tested strains and clinical isolates, evidencing that TZC complexion with metals can be promising. Simvastatin showed synergy when associated to the complex (FICI≤0.5), being the minimum inhibitory concentration (MIC) of 16 µg mL-1 found in 6 samples. Thus, it is possible to infer that the association between Pd(DMBA)LBr and simvastatin consists of an alternative to increase the pontential of these compounds, since statins have low toxicity

Synergistic effect of sertraline and disulfiram against multidrug resistant bacteria as a new alternative to drug repositioning

The repositioning of approved drugs is atopic of interest for the academy and the pharmaceutical industry. The synergistic combination of these drugs can be successful in the treatment of infections caused by resistant bacteria. This study aimed to assess the in vitro synergistic antibacterial activity of sertraline and disulfiram and their interaction with ciprofloxacin and sulfamethoxazole/trimethoprim. We determined the minimum inhibitory concentration, the minimum bactericidal concentration and the fractional inhibitory concentration index. Eighteen bacterial strains were used, being nine American Type Culture Collection reference strains and nine multidrug resistant clinical isolates. Synergy was detected between sertraline and disulfiram against a strain of Staphylococcus aureusATCC 25923 and a clinical isolate of S. aureus. When associated to sulfamethoxazole/trimethoprim and ciprofloxacin, sertraline and disulfiram showed eight synergistic events, which occurred against three different standard strains and two multidrug resistant clinical isolates. When the minimum bactericidal concentration was determined, the bactericidal activity of sertraline was enhanced with disulfiram. Our results suggest that these drugs, widely used to treat depression and chronic alcoholism, have antibacterial potential individually, in association, and combined with antimicrobials, what makes their repositioning a promising therapeutic alternative for the effective treatment of infections caused by multidrug resistant bacteria

Prevalence of methicillin-resistant Staphylococcus aureus in a University Hospital in the South of Brazil

Methicillin-resistant Staphylococcus aureus (MRSA) stand out as one of the main agents causing nosocomial and community infections. This retrospective study aimed to analyze the MRSA predominance in a university hospital in the south of Brazil and it was carried out for five years (from 2007 to 2011). 616 MRSA (33,3% of the total) were isolated and an important reduction in the MRSA predominance was observed along the study. Although it was registered a reduction in the MRSA predominance, male adult patients (41-70 years old), who were in the Medical Clinic and Adult ICU, had the highest infection rates and concerning MRSA isolates rates, these were higher in blood and tracheal aspirates. In conclusion, studies of this type are becoming relevant to recognize pathogens like MRSA and to determine its predominance.Staphylococcus aureus resistentes à meticilina (MRSA) destacam-se mundialmente como um dos mais frequentes patógenos nosocomiais e comunitários. Este estudo retrospectivo teve por objetivo analisar a prevalência de MRSA em um hospital universitário no sul do Brasil. Durante cinco anos (2007 a 2011), 616 MRSA (33,3% do total de S. aureus) foram isolados, sendo que sua frequência de isolamento apresentou considerável redução no decorrer do estudo. Nossos resultados demonstraram que as maiores taxas de isolamento dos MRSA ocorreram em amostras de sangue e secreção traqueal. As infecções prevaleceram em pacientes adultos (41 a 70 anos), do sexo masculino, internados na Clínica Médica e UTI adulto. Estudos como este se tornam importantes para o reconhecimento de patógenos resistentes, como o MRSA, e para a determinação da sua prevalência

ESTUDO DA EFICÁCIA DE UM NOVO PRODUTO À BASE DE ÁLCOOL GEL UTILIZADO NA ANTI-SEPSIA EM UM SERVIÇO DE NEFROLOGIA

The healthcare is always challenged by medical assistance related infections, which generate higher rates of morbidity and mortality as well as unnecessary costs. The ethyl alcohol has been recognized for its antimicrobial activity against most microorganisms that cause infections in the healthcare setting. The major disadvantage of alcohol for skin antisepsis is its drying effect. This study was performed at the Clínica Renal in Santa Maria, RS, with the objective of testing a new biogel product, alcohol gel, to evaluate its efficacy as a hospital antiseptic, eliminating the necessity of washing the arm of the arterial-venous fistula (AVF) of the patient submitted to hemodialysis. The methodology used was the “Randomized Clinical Trial” and was carried out in eleven patients submitted to hemodialysis in January and February 2005. The study included the culture of skin before and after the antiseptic proceedings, using alcohol 70% and the Biogel® product, and the evaluation of the bacteriostatic and bactericide of the Biogel against gram-negative and gram-positive bacteria. The results showed that the performance of both antiseptics methods was the same, presenting an antiseptic activity of 72.7% and giving the Biogel® bactericide activity against the tested microorganisms.A atenção à saúde é permanentemente desafiada pelas infecções relacionadas aos procedimentos assistenciais, que resultam no aumento da morbidade, mortalidade e custos operacionais. O álcool etílico possui propriedades antimicrobianas reconhecidas, capazes de eliminar os microrganismos mais freqüentemente envolvidos nas infecções em serviços de saúde. A maior desvantagem do álcool para a anti-sepsia da pele é seu efeito ressecante. Este estudo foi realizado na Clínica Renal de Santa Maria, RS, com o objetivo de avaliar a eficácia antiséptica de um novo produto à base de álcool gel (Biogel®), na tentativa de eliminar a necessidade da lavagem com água e sabão do braço com a Fístula Artério Venosa (FAV), dos pacientes submetidos à hemodiálise. A metodologia utilizada foi um estudo experimental do tipo “Ensaio Clínico Randomizado” realizado com onze pacientes ambulatoriais submetidos à hemodiálise nos meses de janeiro a fevereiro de 2005. Foi efetuada cultura da pele anterior e posterior ao procedimento da anti-sepsia, utilizando o álcool 70 % e o produto Biogel®, e avaliação da atividade antibacteriana do Biogel®, frente à bactérias gram-positivas e gram-negativas correspondentes à cepas nosocomiais isoladas de pacientes atendidos no Hospital Universitário de Santa Maria (HUSM). Os resultados mostraram igual desempenho dos dois métodos de anti-sepsia, apresentando uma atividade anti-séptica de 72,7%, e conferindo também atividade bactericida ao Biogel®, frente às cepas testadas

INVESTIGATION OF BIOFILM FORMATION IN COAGULASE-NEGATIVE STAPHYLOCOCCI ISOLATED FROM PLATELET CONCENTRATE BAGS

Platelet Concentrates (PCs) are the blood components with the highest rate of bacterial contamination, and coagulase-negative staphylococci (CoNS) are the most frequently isolated contaminants. This study investigated the biofilm formation of 16 contaminated units out of 691 PCs tested by phenotypic and genotypic methods. Adhesion in Borosilicate Tube (ABT) and Congo Red Agar (CRA) tests were used to assess the presence of biofilm. The presence of icaADC genes was assessed by means of the Polymerase Chain Reaction (PCR) technique. With Vitek(r)2, Staphylococcus haemolyticus was considered the most prevalent CoNS (31.25%). The CRA characterized 43.8% as probable biofilm producers, and for the ABT test, 37.5%. The icaADC genes were identified in seven samples by the PCR. The ABT technique showed 85.7% sensitivity and 100% specificity when compared to the reference method (PCR), and presented strong agreement (k = 0.8). This study shows that species identified as PCs contaminants are considered inhabitants of the normal skin flora and they might become important pathogens. The results also lead to the recommendation of ABT use in laboratory routine for detecting biofilm in CoNS contaminants of PCs