Clonal Spread And Accumulation Of β-lactam Resistance Determinants In Enterobacter Aerogenes And Enterobacter Cloacae Complex Isolates From Infection And Colonization In Patients At A Public Hospital In Recife, Pernambuco, Brazil

Enterobacter aerogenes and Enterobacter cloacae complex are the two species of this genus most involved in healthcareassociated infections that are ESBL and carbapenemase producers. This study characterized, phenotypically and genotypically, 51 isolates of E. aerogenes and E. cloacae complex originating from infection or colonization in patients admitted to a public hospital in Recife, Pernambuco, Brazil, by antimicrobial susceptibility profile, analysis of β-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaKPC, blaVIM, blaIMP and blaSPM), PCR and DNA sequencing, plasmid profile and ERIC-PCR. In both species, the genes blaTEM, blaCTX-M and blaKPC were detected. The DNA sequencing confirmed the variants blaTEM-1, blaCTX-M-15 and blaKPC-2 in isolates. More than one gene conferring resistance in the isolates, including the detection of the three previously cited genes in strains isolated from infection sites, was observed. The detection of blaCTX-M was more frequent in isolates from infection sites than from colonization. The gene blaKPC predominated in E. cloacae complex isolates obtained from infections; however, in E. aerogenes isolates, it predominated in samples obtained from colonization. A clonal relationship among all of E. aerogenes isolates was detected by ERIC-PCR. The majority of E. cloacae complex isolates presented the same ERIC-PCR pattern. Despite the clonal relation presented by the isolates using ERIC-PCR, different plasmid and resistance profiles and several resistance genes were observed. The clonal dissemination and the accumulation of β-lactam resistance determinants presented by the isolates demonstrated the ability of E. aerogenes and E. cloacae complex, obtained from colonization and infection, to acquire and maintain different resistance genes. © 2017 The Authors.661707

Filariose bancroftiana no Brasil Bancroftian filariasis in Brazil

Foi feita revisão dos estudos sobre a distribuição geográfica e prevalências da filariose linfática bancroftiana no Brasil. Entre 1951 a 1958 foram realizados inquéritos hemoscópicos e entomológicos no País, sendo a transmissão autóctone comprovada em apenas 11 Municípios: Ponta Grossa (SC), 14,5%; Belém (PA), 9,8%; Barra de Laguna (SC), 9,4%; Recife (PE), 6,9%; Castro Alves (BA), 5,9%; Florianópolis (SC), 1,4%; São Luís (MA), 0,6%; Salvador (BA), 0,4%; Maceió (AL), 0,3%; Manaus (AM), 0,2% e Porto Alegre (RS), 0,1%. A distribuição da parasitose era urbana e focal, principalmente em cidades litorâneas. As ações de controle implementadas levaram a uma apreciável queda nas taxas de microfilarêmicos sendo consideradas, a partir de então, áreas endêmicas para filariose linfática no Brasil somente as cidades de Belém e Recife. Estudos recentes mostram transmissão ativa da parasitose, com prevalências superiores às detectadas no passado, em Maceió, cujo foco era considerado extinto, e em Recife. O conhecimento da situação atual da bancroftose no Brasil é de fundamental importância para a implementação de ações de controle da endemia envolvendo o Ministério da Saúde e órgãos de saúde pública.<br>The past and present distribution of Bancroftian filariasis in Brazil is reviewed. Parasitological and entomological surveys were conducted between 1951 and 1958, the autochthonous transmission of Wuchereria bancrofti having been found only in 11 places in the country as follows, with the corresponding prevalences: Ponta Grossa (SC), 14.5%; Belém (PA), 9.8%; Barra de Laguna (SC), 9.4%; Recife (PE), 6.9%; Castro Alves (BA), 5.9%; Florianópolis (SC), 1.4%; São Luis (MA), 0.6%; Salvador (BA), 0.4%; Maceió (AL), 0.3%; Manaus (AM), 0.2% and Porto Alegre (RS), 0.1%. The distribution of infection was urban and focal, occurring mainly along the coast. Control measures carried out against filariasis achieved considerable success, reducing infection and transmission, only Belém and Recife being considered endemic areas. Recent studies show the active transmission of filariasis with higher prevalences than those observed in the past,in Maceió, considered to be free from infection, and in Recife. The knowledge of the present status of Bancroftian filariasis in Brazil is important as baseline information, because it will allow for the establishment of control measures by Public Health organizations