Low performance of Policimbac® broth microdilution in determining polymyxin B MIC for Klebsiella pneumoniae

Klebsiella pneumoniae is a global threat to healthcare, and despite the availability of new drugs, polymyxins are still an important therapeutic option for this and other resistant gram-negative pathogens. Broth microdilution is the only method that is recommended for polymyxins. In this study, we evaluated the accuracy of a commercial Policimbac® plate in determining the polymyxin B MIC for K. pneumoniae clinical isolates. The results were compared with those of the broth microdilution method according to ISO 16782. The Policimbac® plate had an excellent 98.04% categorical agreement, but unacceptable 31.37% essential agreement rates. Almost 2% of major errors as observed. Additionally, 52.94% of the strains overestimated the MIC at 1 µg/mL. Three isolates were excluded from the analysis due to the drying of the Policimbac® plate. To avoid dryness, we included wet gauze for the test, obtaining a 100% of categorical agreement rate; however, a low essential agreement was maintained (25.49%). In conclusion, the Policimbac® plate was unable to correctly determine the polymyxin B MIC for K. pneumoniae isolates. This low performance may interfere with the clinical use of the drug and, thus, with the result of the patient’s treatment

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

In vitro selection of Neisseria gonorrhoeae unveils novel mutations associated with extended-spectrum cephalosporin resistance

The emergence of Neisseria gonorrhoeae strains resistant to extended-spectrum cephalosporins (ESCs) is a worldwide concern because this class of antibiotics represents the last empirical treatment option for gonorrhea. The abusive use of antimicrobials may be an essential factor for the emergence of ESC resistance in N. gonorrhoeae. Cephalosporin resistance mechanisms have not been fully clarified. In this study, we mapped mutations in the genome of N. gonorrhoeae isolates after resistance induction with cefixime and explored related metabolic pathways. Six clinical isolates with different antimicrobial susceptibility profiles and genotypes and two gonococcal reference strains (WHO F and WHO Y) were induced with increasing concentrations of cefixime. Antimicrobial susceptibility testing was performed against six antimicrobial agents before and after induction. Clinical isolates were whole-genome sequenced before and after induction, whereas reference strains were sequenced after induction only. Cefixime resistance induction was completed after 138 subcultures. Several metabolic pathways were affected by resistance induction. Five isolates showed SNPs in PBP2. The isolates M111 and M128 (ST1407 with mosaic penA-34.001) acquired one and four novel missense mutations in PBP2, respectively. These isolates exhibited the highest minimum inhibitory concentration (MIC) for cefixime among all clinical isolates. Mutations in genes contributing to ESC resistance and in other genes were also observed. Interestingly, M107 and M110 (ST338) showed no mutations in key determinants of ESC resistance despite having a 127-fold increase in the MIC of cefixime. These findings point to the existence of different mechanisms of acquisition of ESC resistance induced by cefixime exposure. Furthermore, the results reinforce the importance of the gonococcal antimicrobial resistance surveillance program in Brazil, given the changes in treatment protocols made in 2017 and the nationwide prevalence of sequence types that can develop resistance to ESC

Matrix-assisted laser desorption ionization-time of flight: a promising alternative method of identifying the major coagulase-negative Staphylococci species

Abstract INTRODUCTION. This study aimed to evaluate different methods for differentiation of species of coagulase-negative staphylococci (CoNS) that caused infections in hospitalized immunocompromised patients. METHODS. A total of 134 CoNS strains were characterized using four different methods. RESULTS. The results of matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) analysis were in complete agreement with those of tuf gene sequencing (kappa index = 1.00). The kappa index of Vitek 2® Compact analysis was 0.85 (very good) and that of the conventional method was 0.63 (moderate). CONCLUSIONS . MALDI-TOF MS provided rapid and accurate results for the identification of CoNS (134; 100%)

Cinética de liberação de chumbo de solos de área de mineração e metalurgia de metais pesados

O estudo de cinética de liberação de metais pesados é uma importante ferramenta de diagnóstico ambiental de áreas contaminadas, pois determina, além dos teores acumulados liberados após tempos crescentes de equilíbrio, a taxa (velocidade) de dessorção desses poluentes para a solução do solo. Com o objetivo de avaliar a cinética de liberação de Pb de solos da área de mineração e metalurgia de metais pesados, no município de Adrianópolis (PR), vale do rio Ribeira, selecionaram-se oito solos, submetidos a diferentes formas de contaminação (solos 2, 4 e 5 - incorporação de resíduos da metalurgia de metais pesados aos perfis; solos 3, 6 e 7 - adição de Pb particulado via chaminés da fábrica; solo 8 - contaminação por passagem da água pluvial pela fábrica desativada, que escorre em direção ao rio Ribeira). O solo 1, sob mata nativa, fora da direção de caminhamento das fumaças da metalurgia, localizado a 1.560 m de distância e a 380 m acima da cota da fábrica desativada, foi escolhido como referência dos teores naturais de Pb dos solos da região. As amostras de solo, coletadas em duas profundidades (0 a 10 e 20 a 40 cm), foram submetidas a extrações sequenciais com ácido cítrico 0,1 mol L-1 após diferentes períodos de contato (tempos acumulados: 2, 14, 38, 86, 182, 326, 518, 806 e 1.382 h). Os teores totais de Pb (extração com HF e HNO3 concentrados e H2O2 30 % v/v) foram altos (máximo de 24.755,6 mg kg-1) e indicaram intensa contaminação dos solos. Os dados da cinética de liberação foram ajustados às equações parabólicas de difusão, sendo a liberação do Pb gradual e bifásica, com velocidade de liberação maior na primeira fase. Os solos 3 e 5 foram considerados com elevado potencial de contaminação ambiental devido aos altos teores de Pb dessorvido acumulados nas extrações sequenciais com ácido cítrico (máximo de 18.577,4 mg kg-1). O solo 6, com baixos teores de argila, apresentou a maior velocidade (taxa) de dessorção de Pb

Matrix-assisted laser desorption ionization-time of flight: a promising alternative method of identifying the major coagulase-negative Staphylococci species

<div><p>Abstract INTRODUCTION. This study aimed to evaluate different methods for differentiation of species of coagulase-negative staphylococci (CoNS) that caused infections in hospitalized immunocompromised patients. METHODS. A total of 134 CoNS strains were characterized using four different methods. RESULTS. The results of matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) analysis were in complete agreement with those of tuf gene sequencing (kappa index = 1.00). The kappa index of Vitek 2® Compact analysis was 0.85 (very good) and that of the conventional method was 0.63 (moderate). CONCLUSIONS . MALDI-TOF MS provided rapid and accurate results for the identification of CoNS (134; 100%).</p></div

Group a streptococcus antibiotic resistance in southern Brazil: a 17-year surveillance study.

Scarce data are available about the antimicrobial resistance of Group A Streptococcus in South America.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe