Molecular characterization, drug susceptibility profile, minimum inhibitory concentration, and drug interaction in the <i>M. tuberculosis</i> H₃₇Rv reference strain and multidrug-resistant clinical isolates.

<p>R, resistant; NP, not performed; INH, isoniazid; RIF, rifampicin; EMB, ethambutol; PZA, pirazinamid; FICI, fractional inhibitory concentration index; REDCA; Resazurin Drugs Combination Microtiter Assay. VP, verapamil; EtBr, ethidium bromide. Numbers in bold represent synergism.</p><p>Molecular characterization, drug susceptibility profile, minimum inhibitory concentration, and drug interaction in the <i>M. tuberculosis</i> H₃₇Rv reference strain and multidrug-resistant clinical isolates.</p

Time-kill curve of the <i>Mycobacterium tuberculosis</i> H₃₇Rv reference strain and multidrug-resistant clinical isolates 71A, 18, 19, 109, 3614, and 64A exposed to rifampicin (RIF), verapamil (VP), and RIF+VP combination for 7 days at 35–37°C.

<p>Time-kill curve of the <i>Mycobacterium tuberculosis</i> H₃₇Rv reference strain and multidrug-resistant clinical isolates 71A, 18, 19, 109, 3614, and 64A exposed to rifampicin (RIF), verapamil (VP), and RIF+VP combination for 7 days at 35–37°C.</p

First Baseline of Circulating Genotypic Lineages of <i>Mycobacterium tuberculosis</i> in Patients from the Brazilian Borders with Argentina and Paraguay

<div><p>Background</p><p>At the triple border Brazil/Paraguay/Argentina there is easy mobility from one city to another for economic and tourism activities. This constant and fast population mobility is mainly to visit Iguazu Falls, in the Iguazu River, on the border of the Brazilian state of Paraná and the Argentina. As the incidence of tuberculosis is high in this setting, our study aimed to establish a first baseline of circulating genotypic lineages of <i>Mycobacterium tuberculosis</i>.</p><p>Methodology/Principal Findings</p><p>This study included 120 patients from 10 cities in southwestern Paraná, Brazil with pulmonary symptoms, from July 2009 to July 2011. Information about sex, age, clinical features and address was collected by reviewing the national tuberculosis notification database. Of these, 96 (80%) isolates were identified as <i>M. tuberculosis</i> and 22 (22.9%) were drug resistant (20, 20.8% INH mono-resistant and 2, 2.1% multidrug-resistant). All isolates were subjected to genotyping by Spoligotyping and MIRU-VNTR typing. The distribution of the isolates analyzed by spoligotyping revealed 30 distinct patterns. The four mainly detected clades were Latin American and Mediterranean (LAM), ill-defined T, Haarlem (H) and S. The MIRU-VNTR showed 85 distinct patterns. Spoligotyping combined to MIRU-VNTR allowed 90 distinct patterns.</p><p>Conclusions/Significance</p><p>Our study demonstrated that there is significant molecular diversity in circulating <i>M. tuberculosis</i>, with predominance of the LAM and T clades in cities of southwestern Paraná, Brazil, bordering Argentina and Paraguay.</p></div

Allele polymorphism by 12 loci-MIRU-VNTR of 96 <i>Mycobacterium tuberculosis</i> from cities in southwestern Paraná, Brazil.

a<p>HGI: Hunter-Gaston index.</p><p>The allelic diversity of the loci was classified as highly discriminant (HGI >0.6), moderately discriminant (0.3≥ HGI ≤0.6) and poorly discriminant (HGI <0.3).</p><p>Allele polymorphism by 12 loci-MIRU-VNTR of 96 <i>Mycobacterium tuberculosis</i> from cities in southwestern Paraná, Brazil.</p

Spoligoforest tree of 96 <i>M. tuberculosis</i> clinical isolates from cities in the southwestern Paraná, Brazil, showing all spoligotyping clades represent changes (loss of spacers) by lane.

<p>Edges between nodes reflect evolutionary relationships between spoligotypes with arrowheads pointing to descendants. The area of each node is proportional to the number of isolates.</p

Sex and age of patients and drug susceptibility, Spoligotyping and MIRU patterns of 96 <i>Mycobacterium tuberculosis</i> isolates from cities in southwestern Paraná, Brazil.

<p>M: male; F: female; Drug susceptibility testing, DST; H, isoniazid resistant; MDR, isoniazid and rifampicin resistant; S, susceptible to isoniazid, rifampicin and pyrazinamide; SIT, Shared International Types; MIT, MIRU international types; -, no amplification; /, not described in SITVITWEB database; * family assignment by SPOTCLUST.</p><p>Sex and age of patients and drug susceptibility, Spoligotyping and MIRU patterns of 96 <i>Mycobacterium tuberculosis</i> isolates from cities in southwestern Paraná, Brazil.</p

Clusters by Spoligotyping/MIRU combination and epidemiological data of 12 <i>Mycobacterium tuberculosis</i> isolates from patients in cities in southwestern Paraná, Brazil.

<p>DST, Drug susceptibility testing; H, isoniazid resistant; MDR, isoniazid and rifampicin resistant; S, susceptible to isoniazid, rifampicin and pyrazinamide.</p><p>Clusters by Spoligotyping/MIRU combination and epidemiological data of 12 <i>Mycobacterium tuberculosis</i> isolates from patients in cities in southwestern Paraná, Brazil.</p

Comparison of <i>Streptococcus agalactiae</i> detection by Todd-Hewitt enrichment broth (TODD), sheep blood agar (SBA), and Hitchens-Pike-Todd-Hewitt (HPTH) culture media in pregnant women at 35–37 weeks of gestation.

<p>Comparison of <i>Streptococcus agalactiae</i> detection by Todd-Hewitt enrichment broth (TODD), sheep blood agar (SBA), and Hitchens-Pike-Todd-Hewitt (HPTH) culture media in pregnant women at 35–37 weeks of gestation.</p

Number of <i>Streptococcus agalactiae</i> positive pregnant women (35–37 weeks of gestation) detected by HPTH medium, Todd-Hewitt enrichment broth (TODD), and sheep blood agar (SBA) plating in anorectal samples.

<p>Number of <i>Streptococcus agalactiae</i> positive pregnant women (35–37 weeks of gestation) detected by HPTH medium, Todd-Hewitt enrichment broth (TODD), and sheep blood agar (SBA) plating in anorectal samples.</p

Prevalence of <i>Streptococcus agalactiae</i> in pregnant women at 35–37 weeks of gestation, based on clinical specimens tested with Todd-Hewitt enrichment broth (TODD), sheep blood agar (SBA), and Hitchens-Pike-Todd-Hewitt (HPTH) culture media.

<p>Prevalence of <i>Streptococcus agalactiae</i> in pregnant women at 35–37 weeks of gestation, based on clinical specimens tested with Todd-Hewitt enrichment broth (TODD), sheep blood agar (SBA), and Hitchens-Pike-Todd-Hewitt (HPTH) culture media.</p