Post-surgical wound infections involving Enterobacteriaceae with reduced susceptibility to ß-lactams in two Portuguese hospitals

The post-surgical period is often critical for infection acquisition. The combination of patient injury and environmental exposure through breached skin add risk to pre-existing conditions such as drug or depressed immunity. Several factors such as the period of hospital staying after surgery, base disease, age, immune system condition, hygiene policies, careless prophylactic drug administration and physical conditions of the healthcare centre may contribute to the acquisition of a nosocomial infection. A purulent wound can become complicated whenever antimicrobial therapy becomes compromised. In this pilot study, we analysed Enterobacteriaceae strains, the most significant gram-negative rods that may occur in post-surgical skin and soft tissue infections (SSTI) presenting reduced β-lactam susceptibility and those presenting extended-spectrum β-lactamases (ESBL). There is little information in our country regarding the relationship between β-lactam susceptibility, ESBL and development of resistant strains of microorganisms in SSTI. Our main results indicate Escherichia coli and Klebsiella spp. are among the most frequent enterobacteria (46% and 30% respectively) with ESBL production in 72% of Enterobacteriaceae isolates from SSTI. Moreover, coinfection occurred extensively, mainly with Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (18% and 13%, respectively). These results suggest future research to explore if and how these associations are involved in the development of antibiotic resistance

From antimicrobial agents to health promotion

A emergência de multiresistência apresentada por microrganismos é um dos grandes desafios que enfrentam actualmente os profissionais de Saúde e a população em geral. Os factores que contribuem para o desenvolvimento de resistência a antibióticos na comunidade podem ser categorizados como comportamentais ou ambientais/políticas. O objectivo deste trabalho foi caracterizar a situação actual na visão dos Pais de alunos do pré-escolar e 1º ciclo. De modo a avaliar as necessidades de intervenção e as actividades a serem desenvolvidas, um instrumento para estudar os hábitos e comportamentos adoptados na utilização de antibióticos, foi adaptado, validado e aplicado numa amostra piloto.The emergence of multi-resistance presented by microorganisms is one of the greatest challenges that health professionals and the general populations faces nowadays. The factors that contribute for the development of resistance to antimicrobial agents may be categorized as behavioral or environmental/ political. The aim of this work was to characterize the present situation in the parents of 1º cycle students’ point of view. Thus, to assess the need of intervention and the activities to be developed, an instrument to study the habits and behavior adopted in the use of antibiotics was adapted and validate being further applied to a pilot sample

Antibiotic resistance in enterobacteriaceae isolated from Portuguese deli meats

This study aimed to identify the presence of β-lactam-resistant bacteria in different types of Portuguese deli meats. The numbers of ampicillin resistant bacteria varied from negative in 25 g to 1.0 × 108colony-forming units/g. Within 78 randomly selected β-lactam-resistant bacteria, 24 different resistant phenotypes were found and 35.9% were multidrug resistant (MDR). The majority (87.2%) of the isolates identified belonged to the Enterobacteriaceae family. The presence of the blaTEM gene was detected in 23 out of 67 isolates (34.3%) and 16 of them presented MDR phenotypes. Four Klebsiella oxytoca isolates (6%) harbored a gene for the CTX-M/OXY-type enzyme. The direct sequencing of their purified amplicons confirmed the presence of three types of blaOXYgenes (blaOXY-1, blaOXY-2 and blaOXY-5). These results suggest that without good hygienic practices, deli meats may act as a vehicle of transfer of β-lactam-resistant bacteria to the gastrointestinal tract of consumers

Molecular Characterization of ESBL-Producing Enterobacteriaceae in Northern Portugal

Extended-spectrum β-lactamases (ESBLs) prevalence was studied in the north of Portugal, among 193 clinical isolates belonging to citizens in a district in the boundaries between this country and Spain from a total of 7529 clinical strains. In the present study we recovered some members of Enterobacteriaceae family, producing ESBL enzymes, including Escherichia coli (67.9%), Klebsiella pneumoniae (30.6%), Klebsiella oxytoca (0.5%), Enterobacter aerogenes (0.5%), and Citrobacter freundii (0.5%). β -lactamases genes blaTEM, blaSHV, and blaCTX-M were screened by polymerase chain reaction (PCR) and sequencing approaches. TEM enzymes were among the most prevalent types (40.9%) followed by CTX-M (37.3%) and SHV (23.3%). Among our sample of 193 ESBL-producing strains 99.0% were resistant to the fourth-generation cephalosporin cefepime. Of the 193 isolates 81.3% presented transferable plasmids harboring bla ESBL genes. Clonal studies were performed by PCR for the enterobacterial repetitive intragenic consensus (ERIC) sequences. This study reports a high diversity of genetic patterns. Ten clusters were found for E. coli isolates and five clusters for K. pneumoniae strains by means of ERIC analysis. In conclusion, in this country, the most prevalent type is still the TEM-type, but CTX-M is growing rapidly.info:eu-repo/semantics/publishedVersio

A new strategy against malaria – antimalarial ionic liquids derived from aminoquinolines and fatty acids

Based on the recent promising results obtained by us, where ionic liquids (ILs) derived from primaquine were found as triple-stage antimalarial hits, we have now produced, by simple, quantitative, and low-cost methods, new ILs via simple acid-base titration of antimalarial aminoquinolines (primaquine and chloroquine) with natural fatty acids (Figure 1). We have also synthesized, in good to high yields, the covalent amide analogues of these ILs (Figure 1), in order to establish how the nature of the chemical bond (ionic ammonium carboxylate versus covalent amide) between both building blocks influences the physico-chemical and biological properties of the final compounds. Results obtained thus far allow us to conclude that both ionic and covalent compounds (i) have higher thermostability than the parent drugs, and (ii) display remarkable in vitro activity against liver-stage malaria parasites.info:eu-repo/semantics/publishedVersio

Yeast resistance and its reversion

Actualmente, a resistência a drogas é um dos grandes problemas na terapia de diferentes patologias e também na biotecnologia e agricultura. O objectivo do presente estudo foi elucidar a resistência a drogas em leveduras patogénicas ou alimentares, que mais frequentemente são encontradas. Assim, diferentes antifungicos clínicos e novos compostos recentemente sintetizados foram testados por um método para avaliar a resistência e sua reversão que foi previamente desenvolvido. Foi testado um painel de diferentes drogas para reverter a resistência. Mostramos que alguns destes moduladores foram capazes de reverter eficazmente a resistência.Nowadays, drug resistance is one of the major problems in the therapy of different pathologies and also in agriculture and biotechnology. The aim of the present study is to elucidate drug resistance and its reversion in some of the more common pathogenic and foodborn yeasts. Thus, different clinical antifungal agents of more common use as well as new synthesized compounds were tested by a previously developed method to detect resistance and its reversion. A panel of different drugs was tested to lower the resistance to the antifungal agents. We have shown that some of these were able to lower resistance

Resistance to β-lactams in Bacteria Isolated from Different Types of Portuguese Cheese

The purpose of this study was to investigate the presence of β-lactam-resistant bacteria in six different types of Portuguese cheese. The numbers of ampicillin resistant (AMPr) bacteria varied from 4.7 × 102 to 1.5 × 107 CFU/g. Within 172 randomly selected β-lactam-resistant bacteria, 44 resistant phenotypes were found and 31.4% were multidrug resistant. The majority (85%) of the isolates identified belonged to the Enterobacteriaceae family. The presence of the blaTEM gene was detected in 80.9% of the tested isolates. The results suggest that without thermal processing of the milk and good hygienic practices, cheese may act as a vehicle of transfer of β-lactam-resistant bacteria to the gastrointestinal tract of consumers

New Quinoxalines with Biological Applications

In search of alternatives to antimicrobial agents currently in use, and in order to respond to the landscape of loss of efficacy due to the emergence of resistance, several research groups are evaluating several familiesof compounds, among them the quinoxaline derivatives family, which presented several other potential biological applications.info:eu-repo/semantics/publishedVersio

Performance of a new HPLC-based method for 3-NT quantification in different biological matrices

3-nitrotyrosine (3-NT) levels in biological samples have been associated with numerous physiological and pathological conditions. For this reason, throughout the last years, several attempts have been made in order to develop methods that accurately detect and quantify 3-NT in biological samples. In fact, a variety of works have been published on methods that allow the detection of 3-NT in several biological fluids and tissues. However, the accurate quantification of this molecule, which is present at very low concentrations both at physiological and pathological conditions, is always a complex task and a matter of concern.info:eu-repo/semantics/publishedVersio

Bacterial Resistance

Nowadays, bacterial resistance to the different antibiotics is a major public health problem [1-4]. Recent outbreaks, like the one found in Germany for E. coli O104 [5,6] as well as the emergence of multidrug resistant organisms, such as gram-negative Enterobacteriaceae associated to the New Delhi metallo β-lactamase [7-9] evidence this problem [4,10-12], that not only has public health implications, but also at an economic and social level, threatening global safety [13,14]. The latest studies reported also the significant financial burden on health care-associated infections (HAIs) in the USA[15,16]. In the UK, approximately 9% of hospitalized patients acquire an infection after post-admission to hospital which increases the budget in the health care system [15,17].info:eu-repo/semantics/publishedVersio