Phenotypic identification and antimicrobial susceptibility of black-pigmented bacteria

Univ São Paulo, Inst Ciencias Biomed, Dept Microbiol, BR-05508900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, São Paulo, BrazilWeb of Scienc

Caries prevalence, levels of mutans streptococci, and gingival and plaque indices in 3.0-to 5.0-year-old mouth breathing children

Universidade Federal de São Paulo, Disciplina Otorrinolaringol Pediat, BR-04025002 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Doencas Infecciosas, BR-04025002 São Paulo, BrazilUniv São Paulo, Inst Ciencias Biomed, Dept Microbiol, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Otorrinolaringol Pediat, BR-04025002 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Doencas Infecciosas, BR-04025002 São Paulo, BrazilWeb of Scienc

Comparative study of agar diffusion test and the NCCLS macrobroth method for in vitro susceptibility testing of Candida spp.

We performed a prospective double-blind study to evaluate the correlation between inhibition zones obtained by a disk-diffusion test, using Neo-sensitabs of fluconazole (Rosco Diagnostica), and the MICs generated by the NCCLS macrobroth dilution assay. Eighty clinical isolates, representing 5 of the clinically relevant species of Candida, were tested simultaneously by both methods. A clear inverse correlation was found between the results obtained by both tests (r = -0.69). in addition, there was high degree of agreement between methods in the identification of susceptible isolates. However, the resistance definition by disk-diffusion test had a positive predictive value of only 17%. Our data support the hypothesis that Rosco Fluconazole Neo-sensitabs have potential as a screening test for the identification of Candida isolates susceptible to fluconazole. Resistant isolates should be further investigated by standardized broth procedures.UNIFESP, Escola Paulista Med, Div Infect Dis, BR-04023062 São Paulo, BrazilUNIFESP, Escola Paulista Med, Div Cellular Biol, São Paulo, BrazilUNIFESP, Escola Paulista Med, Div Infect Dis, BR-04023062 São Paulo, BrazilUNIFESP, Escola Paulista Med, Div Cellular Biol, São Paulo, BrazilWeb of Scienc

Analysis of Genetic Lineages and Their Correlation with Virulence Genes in Enterococcus faecalis Clinical Isolates from Root Canal and Systemic Infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Introduction: Entero coccus faecalis is a member of the mammalian gastrointestinal microbiota but has been considered a leading cause of hospital-acquired infections. In the oral cavity, it is commonly detected from root canals of teeth with failed endodontic treatment. However, little is known about the virulence and genetic relatedness among E. faecalis isolates from different clinical sources. This study compared the presence of enterococcal virulence factors among root canal strains and clinical isolates from hospitalized patients to identify virulent clusters of E. faecalis. Methods: Multilocus sequence typing analysis was used to determine genetic lineages of 40 E. faecalis clinical isolates from different sources. Virulence clusters were determined by evaluating capsule (cps) locus polymorphisms, pathogenicity island gene content, and antibiotic resistance genes by polymerase chain reaction. Results: The clinical isolates from hospitalized patients formed a phylogenetically separate group and were mostly grouped in the clonal complex 2, which is a known virulent cluster of E. faecalis that has caused infection outbreaks globally. The clonal complex 2 group comprised capsule-producing strains harboring multiple antibiotic resistance and pathogenicity island genes. On the other hand, the endodontic isolates were more diverse and harbored few virulence and antibiotic resistance genes. In particular, although more closely related to isolates from hospitalized patients, capsule-producing E. faecalis strains from root canals did not carry more virulence/antibiotic genes than other endodontic isolates. Conclusions: E. faecalis isolates from endodontic infections have a genetic and virulence profile different from pathogenic clusters of hospitalized patients' isolates, which is most likely due to niche specialization conferred mainly by variable regions in the genome.397858864Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [09/52661-5

Detection and typing of human papillomavirus in cutaneous warts of patients infected with human immunodeficiency virus type 1

Background Cutaneous warts are caused by human papillomavirus (HPV). To date, more than 120 different types of HPV are known, of which 80 have been completely characterized. Prevalence studies on types of HPV present in cutaneous warts have been carried out in immunocompetent individuals and immunosuppressed organ allograft recipients, but not in human immunodeficiency virus (HIV)-positive patients.Objectives To determine the HPV types present in cutaneous warts of HIV-infected patients.Methods Twenty-five biopsies of cutaneous warts from HIV-infected patients and 14 samples from control non-HIV-infected patients were studied. HPV detection was performed by polymerase chain reaction using two sets of primers: MY09/MY11 and RK91. the type of HPV was determined by restriction fragment length polymorphism analysis and direct sequencing of the amplified products.Results HPV DNA was detected in 64% of cutaneous warts from HIV-infected patients and in 79% of samples from the control group. the HPV types identified in HIV-infected patients were: HPV 2 (38%), 57 (31%), 27 (12%), 6 (12%) and 7 (6%). HPV 2/27/57 predominated in both groups, being present in 81% of lesions from HIV-infected patients and 82% of samples from non-HIV-infected patients. HPV 6, a genital HPV type rarely found in cutaneous lesions, was detected in two warts from HIV-infected patients and in one lesion of the immunocompetent group. HPV 7, characteristically associated with butcher's warts, and recently detected in oral and perioral lesions of HIV-infected patients, was found for the first time in a non-facial lesion of an HIV-infected patient.Conclusions This is the first study evaluating the prevalence of HPV types in cutaneous warts of HIV-infected patients and immunocompetent individuals in Brazil.Universidade Federal de São Paulo, Sch Med, Infect Dis Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Dermatol, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Infect Dis Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Dermatol, São Paulo, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Pathol, São Paulo, BrazilWeb of Scienc

Occurrence of insertion sequences within the genomes and Tn1546-like elements of glycopeptide-resistant enterococci isolated in Brazil, and identification of a novel element, ISEfa5

Insertion sequences (IS) occur widely within the Tn1546-like elements responsible for VanA glycopeptide resistance in enterococci from several countries. As such insertions can be used as epidemiological markers and for studying horizontal transfer of gene clusters, we investigated the distribution of IS6770, IS1542, IS1216V, IS1476, and IS1251 elements in 26 VanA Enterococcus faecium and 21 VanA Enterococcus faecalis from Brazil. PCR, using genomic DNA as a template, indicated that most of the isolates contained IS6770 (97%), IS1216V (87%) and IS1476 (72%) elements. IS1251 was also detected, but at a higher frequency in E faecium (80%) than in E faecalis (14%). None of the isolates harboured IS1542. Only two of 47 isolates had IS elements within their Tn1546-like elements; one possessed IS1251 between vanS and vanH, as reported in the United States; another possessed a novel IS element, designated ISEfa5, located between vanX and van Y. This novel element was found in the genomic DNA of 25 (96%) E faecium and 11 (52%) E faecalis. in stability studies, no IS-mediated changes were detected in the Tn.1546-like elements of 25 vancomycin-resistant enterococci (VRE) monitored over 11 months. These results suggest that the occurrence of IS in Brazilian isolates is similar to that reported in American isolates, but that these elements occur rarely within the vanA gene clusters. As patterns of IS carriage did not correlate with the PFGE type of the VRE, the prevalence of IS elements in genomic DNA of VRE is not a useful epidemiological marker. However, the presence of IS-modified Tn1546-like elements, which appear to be rare in Brazil, could be a useful molecular marker in local epidemiological studies to monitor the evolution and horizontal transmission of VanA elements. (c) 2004 Published by Elsevier GmbH.Univ São Paulo, Fac Ciencias Farmaceut, BR-14040903 Ribeirao Preto, BrazilInst Adolfo Lutz Registro, São Paulo, BrazilUNIFESP, Dept Doencas Infecciosas & Parasitarias, São Paulo, BrazilHlth Protect Agcy, Specialist & Reference Microbiol Div, Antibiot Rsistance Monitoring & Reference Lab, London, EnglandUNIFESP, Dept Doencas Infecciosas & Parasitarias, São Paulo, BrazilWeb of Scienc

Phenotypic and genotypic characterization of VanA Enterococcus isolated during the first nosocomial outbreak in Brazil

We report the phenotypic and genotypic characterization of 50 VanA Enterococcus clinical isolates from infected patients and 97 isolates from colonized patients obtained during a nosocomial outbreak in a single hospital in São Paulo, Brazil during 1998. the identification of strains to the species level by conventional biochemical and phenotypic tests and by multiplex PCR assay had 100% agreement. Both E. faecalis and E. faecium were isolated from patients during this outbreak. the vanA genotype was confirmed by PCR. Antibiotic susceptibility testing showed that E. faecium isolates are generally less susceptible to antibiotics than E. faecalis. By PCR, 24 of 26 VRE strains tested carried the Tn1546 element. Pulsed-field gel electrophoresis identified five distinct patterns for E. faecalis (A, B, C, D, E) and three for E. faecium (M, N, and O). A single PFGE pattern was identified in the majority of strains of each species and does not discriminate between case and carrier isolates.Inst Adolfo Lutz Registro, Bacteriol Lab, BR-01246902 São Paulo, BrazilSt Marcelina Hosp, Hosp Lab, São Paulo, BrazilSt Marcelina Hosp, Hosp Infect Comiss, São Paulo, BrazilUNIFESP, São Paulo, BrazilUNIFESP, São Paulo, BrazilWeb of Scienc

Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998

From July 1995 to August 1998, mycobacterial blood Cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referncia e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referncia de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at LISP, and 18 (10.1%) at CRAS. the frequency of positive Cultures declined sharply from 22.6%, in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active anti retroviral therapy. in 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.Univ Fed Espirito Santo, Ctr Biomed, BR-29040091 Vitoria, ES, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilInst Adolfo Lutz Registro, São Paulo, BrazilCtr Referencia & Treinamento AIDS, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc