Clinical characteristics of 1,260 patients during an outbreak of carbapenem-resistant Acinetobacter spp in Porto Alegre, Brazil

Introdution: Over the last decade, Acinetobacter baumannii has been an important cause of nosocomial infections worldwide. The objective of this study was to assess clinical and epidemiological characteristics of patients during a large citywide- documented outbreak of carbapenem-resistant A. baumannii (CRAb). Methods: Retrospective cross-sectional study that evaluated the information obtained from the official notification system data of CRAb from the Health Department, Porto Alegre, Brazil, in the period of July 1st, 2007 to December 31st, 2008. The association among variables was analyzed with SPSS 13.0. Results: A total of 1,260 CRAb from infection (608 [48.3%]) or colonization (652 [51.7%]) were reported in 18 hospitals. Most patients (53.5%) were hospitalized at intensive care units and have been exposed to invasive procedures, but 757 (60.7%) patients had no underlying comorbidity reported. A total of 1,143 (90.7%) patients received some antimicrobial 90 days before CRAb detection and 36.4% received a carbapenem. The outcome was available for 618 (49.0%) patients and 54.3% of them died. The prevalence ratio (PR) of infection was statistically significant for variables admission to public hospitals; trauma and use of antibiotic in previous 90 days.Conclusion: This study suggests that in the context of an outbreak, baseline comorbidities and previous carbapenem exposure may be less important risk factors for CRAb infection/colonization

Características Clínicas e epidemiológicas de pacientes com tuberculose na cidade com a maior incidência da doença no Brasil [Clinical and epidemiological characteristics of patients with tuberculosis in the city with the highest incidence of the disease]

Introdução: O controle da tuberculose é um grave problema de saúde pública. É nos países de baixa e média renda, como no Brasil, que ocorre 95% das mortes causadas pela tuberculose. O nosso país está entre as 22 nações que são responsáveis por 80% da população infectada pelo Mycobacterium tuberculosis.Objetivo: Descrever o perfil dos casos de tuberculose no município de Alvorada, RS e os fatores associados com a recidiva da doença e o abandono do tratamento.Métodos: Estudo retrospectivo do período de 2008 a 2010 que avaliou o perfil dos novos casos de pacientes com tuberculose no município de Alvorada através da análise de prontuários. A associação entre as variáveis foi determinada pelo teste Qui-quadrado ou Teste Exato de Fisher com auxílio do SPSS 13.0.Resultados: A média de idade dos pacientes foi de 37,7 (DP ± 14,8) anos, sendo 73% do sexo masculino. Declararam-se tabagistas 50,6% dos pacientes, 41,6% faziam uso de bebida alcoólica e 20,6% uso de drogas. A forma clínica predominante foi a pulmonar e 41 pacientes apresentaram sorologia positiva para HIV. A cura ocorreu em 75,9% dos casos, 4,6% foram a óbito, 16,6% abandonaram o tratamento. A taxa de recidiva durante o período estudado foi de 6,6% em toda população.Conclusão: Os resultados ressaltam a importância do correto tratamento da tuberculose visto que a região estudada não atingiu as metas de cura preconizada pela OMS

Emergência de resistência antimicrobiana em Klebsiella spp. em município do interior do Estado do Rio Grande do Sul, Brasil

Background and Objectives: Several infections by multidrug-resistant Klebsiella spp. have been report worldwide, because of the capacity of these bacteria in acquire many resistance mechanisms and rapidly spread through clinical units. The aim of this study was evaluate the antimicrobial susceptibility profile of Klebsiella spp. in a hospital of a country town of Rio Grande do Sul, Brazil. Methods: This study investigated the resistance profile of Klebsiella spp. strains isolated between 2014 and 2015, in a regional hospital of a small town. The patient’s charts and microbiological assays were review, including age, sex, date, anatomical site of isolation, origin, and antimicrobial susceptibility test. Results: Forty-two strains were isolated during 2014 and 2015. The positive cultures were from urine (57%), secretions (38%), and blood (5%). Was observed antibiotic resistance in 81% of the strains, and 62% showed multidrugresistance. The resistance profile for β-lactams, mainly cefalosporin and carbapenem, and for aminoglycosides and tetracycline increased in the study period. Conclusion: In this study we showed an increase in antibiotic resistance in a hospital at a small town, highlighting the emergence of carbapenem resistant Klebsiella spp. during 2015. The spread of multidrug-resistant bacteria in this hospital enhance the importance of epidemiological surveillance and establishment of infection control procedures.Justificación y Objetivos: Las infecciones por Klebsiella spp. multirresistentes se han propagado a todas las regiones del mundo debido a su capacidad en adquirir mecanismos de resistencia y la rápida diseminación. El objetivo de essa investigación fue determinar el patrón de sensibilidad antimicrobiana de Klebsiella spp. en un hospital del estado de Rio Grande do Sul. Métodos: Se incluyeron todos los casos con cultivos positivos para Klebsiella spp. dentre los años 2014 y 2015. Los datos de los cultivos microbiológicos y registros médicos, edad, sexo, fecha, sitio anatómico del aislamiento, origen y los resultados de las pruebas de sensibilidad a los antimicrobianos fueron obtenidas del pacientes. Resultados: Durante el período se incluyeron 42 casos, 57% de las vías urinarias, 38% de las secreciones corporales, y 5% del torrente sanguíneo. Se observó resistencia en 81% de los casos y resistencia a múltiples fármacos en 62%. Durante el período se observó una reducción en la sensibilidad a los antibióticos β-lactámicos, en particular de cefalosporinas y carbapenémicos, aminoglicósidos y tetraciclinas. Conclusiones: Los resultados obtenidos muestran un aumento significativo de la resistencia a múltiples fármacos en la localidad, sobre todo la aparición de resistencia a los carbapenémicos ocurrido en 2015. La amenaza de establecimiento local de essas cepas alerta a la necesidad de medidas de control de las infecciones.Justificativa e Objetivos: Infecções por Klebsiella spp. multirresistentes têm sido relatadas globalmente em decorrência da capacidade de aquisição de diversos mecanismos de resistência e rápida propagação destes microrganismos. Assim, o objetivo deste estudo foi descrever a variação do perfil de suscetibilidade aos antimicrobianos de Klebsiella spp. em um hospital no interior do Estado do Rio Grande do Sul. Métodos: Foram incluídos todos os casos de pacientes com culturas de urina, hemoculturas ou culturas de secreções positiva para Klebsiella spp. entre os anos de 2014 e 2015. Os dados das culturas microbiológicas e dos prontuários médicos foram revisados sendo coletadas as seguintes variáveis, idade, sexo, data, sítio anatômico de isolamento, origem, e resultados do teste de suscetibilidade aos antimicrobianos. Resultados: Durante o período ocorreram 42 casos, sendo 57% de culturas do trato urinário, seguido de secreções 38% e infecções de corrente sanguínea 5%. Foram observadas resistências em 81% dos isolados, e multirresistência em 62%. No período houve significativa redução da suscetibilidade para a classe dos β-lactâmicos, principalmente cefalosporinas e carbapenêmicos, aminoglicosídeos e tetraciclinas. Conclusão: Os dados obtidos demonstram um significativo aumento da multirresistência aos antimicrobianos na localidade, com destaque para a emergência de resistência aos carbapenêmicos ocorrida no ano de 2015. A ameaça do estabelecimento local destes isolados alerta para a necessidade do contínuo monitoramento e implementação de medidas de controle de infecção

Whole-genome sequencing-based characterization of Streptomyces sp. 6(4) : focus on natural product

We have sequenced the whole genome of Streptomyces sp. 6(4) isolated from tomato roots that presents antifungal activity against phytopathogenic fungi, mainly Bipolaris sorokiniana. The genome has almost 7Mb and 3368 hypothetical proteins that were analysed and characterized in Uniprot with the emphasis on biological compounds. Multilocus sequence typing (MLST) analyses were performed in an effort to characterize and identify this isolate, resulting in a new sequence type (ST), classified as ST64. Phenetic and phylogenetic trees were constructed to investigate Streptomyces sp. 6(4) evolution and sequence similarity, and the isolate is a strain closer to Streptomyces prasinus and Streptomyces viridosporus. It is known that the genus Streptomyces possess huge metabolic capacity with the presence of cryptic genes. These genes are usually present in clusters, which are responsible for the production of diverse natural products, mainly antibiotics. In addition, 6(4) showed 11 biosynthetic gene clusters through antiSMASH, including 3 polyketide synthase (PKS) and non-ribosomal peptide synthase (NRPS) type clusters

Detection of SARS-CoV-2 lineage P.1 in patients from a region with exponentially increasing hospitalisation rate, February 2021, Rio Grande do Sul, Southern Brazil

The emergence of SARS-CoV-2 P.1 lineage coincided with a surge in hospitalisations in the North region of Brazil. In the South region’s Rio Grande do Sul state, severe COVID-19 case numbers rose 3.8 fold in February 2021. During that month, at a COVID-19 referral hospital in this state, whole-genome sequencing of a subset of cases’ specimens (n = 27) revealed P.1 lineage SARS-CoV-2 in most (n = 24). Findings raise concerns regarding a possible association between lineage P.1 and rapid case and hospitalisation increases

Genomic surveillance of SARS-CoV-2 lineages indicates early circulation of P.1 (gamma) variant of concern in Southern Brazil

The SARS-CoV-2 P.1 lineage emerged in Amazonas (AM), North Brazil and its evolution has been dynamically reported associated with increased transmissibility and/or immune evasion. Here, we evaluated the lineages circulating in 29 cities in Rio Grande do Sul (RS), Southern Brazil between March 2020 and May 2021 and investigated the genetic events associated with the emergence of the P.1. A total of 202 oro/nasopharyngeal SARS-CoV-2 specimens from patients during routine hospital care were submitted to whole-genome sequencing. Phylogenetic and Bayesian Evolutionary Analyses of the P.1 lineage were carried out to determine the relationship between sequences from RS and AM and dated their common ancestor and origin. One hundred six (53%) sequences were assigned as P.1 and most carried the 22 lineage-defining mutations. All the P.1 sequences included other important mutations, such as P314L and R203K/G204R, and revealed a high genetic diversity in the phylogenetic tree. The time-scaled inference suggests that the oldest P.1 sequences from different Brazilian states share a ancestor with those from AM, but the origin of some sequences from RS is unknown. Further, the common ancestor of sequences from RS is dated to mid-June/July 2020, earlier than those previously reported from AM. Our results demonstrate that there is a high degree of genetic diversity among P.1 sequences, which suggests a continuous evolution and community spread of the virus. Although the first P.1 outbreak was reported in AM, the lineage was associated with multiple introductory events and had already been circulating in Southern Brazil prior to November 2020