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au:Reis, Adriana O.
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1.
BIOMARCADORES MOLECULARES DE DOENÇAS HUMANAS: CONCEITOS FUNDAMENTAIS, MODELOS DE ESTUDO E APLICAÇÕES CLÍNICAS
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Zamora-Obando, Hans R.
; Godoy, Adriana T.
; Amaral, Alan G.
; Mesquita, Alessandra de S.
; Simões, Bruna Eduarda S.
; Reis, Heloise O.
; Rocha, Isabela
; Dallaqua, Matheus
; Baptistão, Mariana
; Fernandes, Milena Cristina V.
; Lima, Monica F.
; Simionato, Ana Valéria C.
.
Molecular biomarkers correspond to all endogenous or exogenous biomolecules, whose presence or alteration in metabolic pathways indicate the response of a biological system to a disturbance caused by internal or external factors. The search for biomarkers has allowed deepening the knowledge of complex pathophysiological mechanisms of diseases, interactions with potential drugs, and the improvement of diagnostic and therapeutic tests, establishing itself as a central point in personalized medicine. In addition, the development of the omics sciences has fostered an increasing exploration in this field of research. This review presents essential and relevant concepts in biomarker research, explores the various definitions and classifications of biomarkers according to their purpose, the critical aspects to be considered in experimental design, the primary employed study models (in vivo, in vitro, and in silico) and the factors that have hindered their ultimate implementation. Finally, important, and current clinical and pharmacological research areas in which biomarker research play a central role are presented.
2.
Growing knowledge: an overview of Seed Plant diversity in Brazil
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Zappi, Daniela C.
; Filardi, Fabiana L. Ranzato
; Leitman, Paula
; Souza, Vinícius C.
; Walter, Bruno M.T.
; Pirani, José R.
; Morim, Marli P.
; Queiroz, Luciano P.
; Cavalcanti, Taciana B.
; Mansano, Vidal F.
; Forzza, Rafaela C.
; Abreu, Maria C.
; Acevedo-Rodríguez, Pedro
; Agra, Maria F.
; Almeida Jr., Eduardo B.
; Almeida, Gracineide S.S.
; Almeida, Rafael F.
; Alves, Flávio M.
; Alves, Marccus
; Alves-Araujo, Anderson
; Amaral, Maria C.E.
; Amorim, André M.
; Amorim, Bruno
; Andrade, Ivanilza M.
; Andreata, Regina H.P.
; Andrino, Caroline O.
; Anunciação, Elisete A.
; Aona, Lidyanne Y.S.
; Aranguren, Yani
; Aranha Filho, João L.M.
; Araújo, Andrea O.
; Araújo, Ariclenes A.M.
; Araújo, Diogo
; Arbo, María M.
; Assis, Leandro
; Assis, Marta C.
; Assunção, Vivian A.
; Athiê-Souza, Sarah M.
; Azevedo, Cecilia O.
; Baitello, João B.
; Barberena, Felipe F.V.A.
; Barbosa, Maria R.V.
; Barros, Fábio
; Barros, Lucas A.V.
; Barros, Michel J.F.
; Baumgratz, José F.A.
; Bernacci, Luis C.
; Berry, Paul E.
; Bigio, Narcísio C.
; Biral, Leonardo
; Bittrich, Volker
; Borges, Rafael A.X.
; Bortoluzzi, Roseli L.C.
; Bove, Cláudia P.
; Bovini, Massimo G.
; Braga, João M.A.
; Braz, Denise M.
; Bringel Jr., João B.A.
; Bruniera, Carla P.
; Buturi, Camila V.
; Cabral, Elza
; Cabral, Fernanda N.
; Caddah, Mayara K.
; Caires, Claudenir S.
; Calazans, Luana S.B.
; Calió, Maria F.
; Camargo, Rodrigo A.
; Campbell, Lisa
; Canto-Dorow, Thais S.
; Carauta, Jorge P.P.
; Cardiel, José M.
; Cardoso, Domingos B.O.S.
; Cardoso, Leandro J.T.
; Carneiro, Camila R.
; Carneiro, Cláudia E.
; Carneiro-Torres, Daniela S.
; Carrijo, Tatiana T.
; Caruzo, Maria B.R.
; Carvalho, Maria L.S.
; Carvalho-Silva, Micheline
; Castello, Ana C.D.
; Cavalheiro, Larissa
; Cervi, Armando C.
; Chacon, Roberta G.
; Chautems, Alain
; Chiavegatto, Berenice
; Chukr, Nádia S.
; Coelho, Alexa A.O.P.
; Coelho, Marcus A.N.
; Coelho, Rubens L.G.
; Cordeiro, Inês
; Cordula, Elizabeth
; Cornejo, Xavier
; Côrtes, Ana L.A.
; Costa, Andrea F.
; Costa, Fabiane N.
; Costa, Jorge A.S.
; Costa, Leila C.
; Costa-e-Silva, Maria B.
; Costa-Lima, James L.
; Cota, Maria R.C.
; Couto, Ricardo S.
; Daly, Douglas C.
; De Stefano, Rodrigo D.
; De Toni, Karen
; Dematteis, Massimiliano
; Dettke, Greta A.
; Di Maio, Fernando R.
; Dórea, Marcos C.
; Duarte, Marília C.
; Dutilh, Julie H.A.
; Dutra, Valquíria F.
; Echternacht, Lívia
; Eggers, Lilian
; Esteves, Gerleni
; Ezcurra, Cecilia
; Falcão Junior, Marcus J.A.
; Feres, Fabíola
; Fernandes, José M.
; Ferreira, D.M.C.
; Ferreira, Fabrício M.
; Ferreira, Gabriel E.
; Ferreira, Priscila P.A.
; Ferreira, Silvana C.
; Ferrucci, Maria S.
; Fiaschi, Pedro
; Filgueiras, Tarciso S.
; Firens, Marcela
; Flores, Andreia S.
; Forero, Enrique
; Forster, Wellington
; Fortuna-Perez, Ana P.
; Fortunato, Reneé H.
; Fraga, Cléudio N.
; França, Flávio
; Francener, Augusto
; Freitas, Joelcio
; Freitas, Maria F.
; Fritsch, Peter W.
; Furtado, Samyra G.
; Gaglioti, André L.
; Garcia, Flávia C.P.
; Germano Filho, Pedro
; Giacomin, Leandro
; Gil, André S.B.
; Giulietti, Ana M.
; A.P.Godoy, Silvana
; Goldenberg, Renato
; Gomes da Costa, Géssica A.
; Gomes, Mário
; Gomes-Klein, Vera L.
; Gonçalves, Eduardo Gomes
; Graham, Shirley
; Groppo, Milton
; Guedes, Juliana S.
; Guimarães, Leonardo R.S.
; Guimarães, Paulo J.F.
; Guimarães, Elsie F.
; Gutierrez, Raul
; Harley, Raymond
; Hassemer, Gustavo
; Hattori, Eric K.O.
; Hefler, Sonia M.
; Heiden, Gustavo
; Henderson, Andrew
; Hensold, Nancy
; Hiepko, Paul
; Holanda, Ana S.S.
; Iganci, João R.V.
; Imig, Daniela C.
; Indriunas, Alexandre
; Jacques, Eliane L.
; Jardim, Jomar G.
; Kamer, Hiltje M.
; Kameyama, Cíntia
; Kinoshita, Luiza S.
; Kirizawa, Mizué
; Klitgaard, Bente B.
; Koch, Ingrid
; Koschnitzke, Cristiana
; Krauss, Nathália P.
; Kriebel, Ricardo
; Kuntz, Juliana
; Larocca, João
; Leal, Eduardo S.
; Lewis, Gwilym P.
; Lima, Carla T.
; Lima, Haroldo C.
; Lima, Itamar B.
; Lima, Laíce F.G.
; Lima, Laura C.P.
; Lima, Leticia R.
; Lima, Luís F.P.
; Lima, Rita B.
; Lírio, Elton J.
; Liro, Renata M.
; Lleras, Eduardo
; Lobão, Adriana
; Loeuille, Benoit
; Lohmann, Lúcia G.
; Loiola, Maria I.B.
; Lombardi, Julio A.
; Longhi-Wagner, Hilda M.
; Lopes, Rosana C.
; Lorencini, Tiago S.
; Louzada, Rafael B.
; Lovo, Juliana
; Lozano, Eduardo D.
; Lucas, Eve
; Ludtke, Raquel
; Luz, Christian L.
; Maas, Paul
; Machado, Anderson F.P.
; Macias, Leila
; Maciel, Jefferson R.
; Magenta, Mara A.G.
; Mamede, Maria C.H.
; Manoel, Evelin A.
; Marchioretto, Maria S.
; Marques, Juliana S.
; Marquete, Nilda
; Marquete, Ronaldo
; Martinelli, Gustavo
; Martins da Silva, Regina C.V.
; Martins, Ângela B.
; Martins, Erika R.
; Martins, Márcio L.L.
; Martins, Milena V.
; Martins, Renata C.
; Matias, Ligia Q.
; Maya-L., Carlos A.
; Mayo, Simon
; Mazine, Fiorella
; Medeiros, Debora
; Medeiros, Erika S.
; Medeiros, Herison
; Medeiros, João D.
; Meireles, José E.
; Mello-Silva, Renato
; Melo, Aline
; Melo, André L.
; Melo, Efigênia
; Melo, José I.M.
; Menezes, Cristine G.
; Menini Neto, Luiz
; Mentz, Lilian A.
; Mezzonato, A.C.
; Michelangeli, Fabián A.
; Milward-de-Azevedo, Michaele A.
; Miotto, Silvia T.S.
; Miranda, Vitor F.O.
; Mondin, Cláudio A.
; Monge, Marcelo
; Monteiro, Daniele
; Monteiro, Raquel F.
; Moraes, Marta D.
; Moraes, Pedro L.R.
; Mori, Scott A.
; Mota, Aline C.
; Mota, Nara F.O.
; Moura, Tania M.
; Mulgura, Maria
; Nakajima, Jimi N.
; Nardy, Camila
; Nascimento Júnior, José E.
; Noblick, Larry
; Nunes, Teonildes S.
; O'Leary, Nataly
; Oliveira, Arline S.
; Oliveira, Caetano T.
; Oliveira, Juliana A.
; Oliveira, Luciana S.D.
; Oliveira, Maria L.A.A.
; Oliveira, Regina C.
; Oliveira, Renata S.
; Oliveira, Reyjane P.
; Paixão-Souza, Bruno
; Parra, Lara R.
; Pasini, Eduardo
; Pastore, José F.B.
; Pastore, Mayara
; Paula-Souza, Juliana
; Pederneiras, Leandro C.
; Peixoto, Ariane L.
; Pelissari, Gisela
; Pellegrini, Marco O.O.
; Pennington, Toby
; Perdiz, Ricardo O.
; Pereira, Anna C.M.
; Pereira, Maria S.
; Pereira, Rodrigo A.S.
; Pessoa, Clenia
; Pessoa, Edlley M.
; Pessoa, Maria C.R.
; Pinto, Luiz J.S.
; Pinto, Rafael B.
; Pontes, Tiago A.
; Prance, Ghillean T.
; Proença, Carolyn
; Profice, Sheila R.
; Pscheidt, Allan C.
; Queiroz, George A.
; Queiroz, Rubens T.
; Quinet, Alexandre
; Rainer, Heimo
; Ramos, Eliana
; Rando, Juliana G.
; Rapini, Alessandro
; Reginato, Marcelo
; Reis, Ilka P.
; Reis, Priscila A.
; Ribeiro, André R.O.
; Ribeiro, José E.L.S.
; Riina, Ricarda
; Ritter, Mara R.
; Rivadavia, Fernando
; Rocha, Antônio E.S.
; Rocha, Maria J.R.
; Rodrigues, Izabella M.C.
; Rodrigues, Karina F.
; Rodrigues, Rodrigo S.
; Rodrigues, Rodrigo S.
; Rodrigues, Vinícius T.
; Rodrigues, William
; Romaniuc Neto, Sérgio
; Romão, Gerson O.
; Romero, Rosana
; Roque, Nádia
; Rosa, Patrícia
; Rossi, Lúcia
; Sá, Cyl F.C.
; Saavedra, Mariana M.
; Saka, Mariana
; Sakuragui, Cássia M.
; Salas, Roberto M.
; Sales, Margareth F.
; Salimena, Fatima R.G.
; Sampaio, Daniela
; Sancho, Gisela
; Sano, Paulo T.
; Santos, Alessandra
; Santos, Élide P.
; Santos, Juliana S.
; Santos, Marianna R.
; Santos-Gonçalves, Ana P.
; Santos-Silva, Fernanda
; São-Mateus, Wallace
; Saraiva, Deisy P.
; Saridakis, Dennis P.
; Sartori, Ângela L.B.
; Scalon, Viviane R.
; Schneider, Ângelo
; Sebastiani, Renata
; Secco, Ricardo S.
; Senna, Luisa
; Senna-Valle, Luci
; Shirasuna, Regina T.
; Silva Filho, Pedro J.S.
; Silva, Anádria S.
; Silva, Christian
; Silva, Genilson A.R.
; Silva, Gisele O.
; Silva, Márcia C.R.
; Silva, Marcos J.
; Silva, Marcos J.
; Silva, Otávio L.M.
; Silva, Rafaela A.P.
; Silva, Saura R.
; Silva, Tania R.S.
; Silva-Gonçalves, Kelly C.
; Silva-Luz, Cíntia L.
; Simão-Bianchini, Rosângela
; Simões, André O.
; Simpson, Beryl
; Siniscalchi, Carolina M.
; Siqueira Filho, José A.
; Siqueira, Carlos E.
; Siqueira, Josafá C.
; Smith, Nathan P.
; Snak, Cristiane
; Soares Neto, Raimundo L.
; Soares, Kelen P.
; Soares, Marcos V.B.
; Soares, Maria L.
; Soares, Polyana N.
; Sobral, Marcos
; Sodré, Rodolfo C.
; Somner, Genise V.
; Sothers, Cynthia A.
; Sousa, Danilo J.L.
; Souza, Elnatan B.
; Souza, Élvia R.
; Souza, Marcelo
; Souza, Maria L.D.R.
; Souza-Buturi, Fátima O.
; Spina, Andréa P.
; Stapf, María N.S.
; Stefano, Marina V.
; Stehmann, João R.
; Steinmann, Victor
; Takeuchi, Cátia
; Taylor, Charlotte M.
; Taylor, Nigel P.
; Teles, Aristônio M.
; Temponi, Lívia G.
; Terra-Araujo, Mário H.
; Thode, Veronica
; Thomas, W.Wayt
; Tissot-Squalli, Mara L.
; Torke, Benjamin M.
; Torres, Roseli B.
; Tozzi, Ana M.G.A.
; Trad, Rafaela J.
; Trevisan, Rafael
; Trovó, Marcelo
; Valls, José F.M.
; Vaz, Angela M.S.F.
; Versieux, Leonardo
; Viana, Pedro L.
; Vianna Filho, Marcelo D.M.
; Vieira, Ana O.S.
; Vieira, Diego D.
; Vignoli-Silva, Márcia
; Vilar, Thaisa
; Vinhos, Franklin
; Wallnöfer, Bruno
; Wanderley, Maria G.L.
; Wasshausen, Dieter
; Watanabe, Maurício T.C.
; Weigend, Maximilian
; Welker, Cassiano A.D.
; Woodgyer, Elizabeth
; Xifreda, Cecilia C.
; Yamamoto, Kikyo
; Zanin, Ana
; Zenni, Rafael D.
; Zickel, Carmem S
.
Resumo Um levantamento atualizado das plantas com sementes e análises relevantes acerca desta biodiversidade são apresentados. Este trabalho se iniciou em 2010 com a publicação do Catálogo de Plantas e Fungos e, desde então vem sendo atualizado por mais de 430 especialistas trabalhando online. O Brasil abriga atualmente 32.086 espécies nativas de Angiospermas e 23 espécies nativas de Gimnospermas e estes novos dados mostram um aumento de 3% da riqueza em relação a 2010. A Amazônia é o Domínio Fitogeográfico com o maior número de espécies de Gimnospermas, enquanto que a Floresta Atlântica possui a maior riqueza de Angiospermas. Houve um crescimento considerável no número de espécies e nas taxas de endemismo para a maioria dos Domínios (Caatinga, Cerrado, Floresta Atlântica, Pampa e Pantanal), com exceção da Amazônia que apresentou uma diminuição de 2,5% de endemicidade. Entretanto, a maior parte das plantas com sementes que ocorrem no Brasil (57,4%) é endêmica deste território. A proporção de formas de vida varia de acordo com os diferentes Domínios: árvores são mais expressivas na Amazônia e Floresta Atlântica do que nos outros biomas, ervas são dominantes no Pampa e as lianas apresentam riqueza expressiva na Amazônia, Floresta Atlântica e Pantanal. Este trabalho não só quantifica a biodiversidade brasileira, mas também indica as lacunas de conhecimento e o desafio a ser enfrentado para a conservação desta flora.
Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora.
https://doi.org/10.1590/2175-7860201566411
33340 downloads
3.
Virulence factors and biofilm production by isolates of Bacteroides fragilis recovered from dog intestinal tracts
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Reis, Ana Catarina M.
; Silva, Janice O.
; Laranjeira, Bruno J.
; Pinheiro, Adriana Q.
; Carvalho, Cibele B.M.
.
Bacteroides fragilis colonizes dog guts both as a commensal and as an opportunistic pathogen. This study aims to evaluate virulence factors of 13 B. fragilis strains isolated from dog intestinal tracts and their ability for biofilm formation. Capsules were detected in all the evaluated strains. A total of 61.5% of all strains were biofilm producers. These attributes most likely play an important role in B. fragilis persistent colonization in the gut.
4603 downloads
4.
Ability of Latin America laboratories to detect antimicrobial resistance patterns: experience of the SENTRY antimicrobial surveillance program (1997-2000)
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The accuracy of antimicrobial susceptibility tests is a crucial step for the clinical management of patients with serious infections. They must be reliable and precise because they will guide antimicrobial therapy. Our main objective was to compare the results of susceptibility testing performed by the SENTRY coordinator laboratory with those reported by the participating Latin American medical centers. A total of 10,277 bacterial isolates were tested by the reference broth microdilution method at the coordinator laboratory in the United States. The tests were performed and interpreted following the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. Ten antimicrobial agent-organism combinations were analyzed. The susceptibility methods utilized in each of the medical centers were also evaluated. Total agreement of the results was obtained in nearly 88% of the antimicrobial agent-organism combinations. "Very major" (false-susceptible results) and "major errors" (false-resistant results) were observed in 12% and 6% of the cases, respectively. The highest disagreements were observed for coagulase-negative Staphylococcus - oxacillin (20% - very major error) and Burkholderia cepacia - imipenem (21% - very major error). The susceptibility method with the highest agreement rate was Etest® (92%) > PASCO® (91%) > agar dilution (91%) > MicroScan® (90%) > Vitek® (87%). External quality assurance data obtained by surveillance programs such as the SENTRY Antimicrobial Surveillance Program are not only helpful for detecting the emergence of patterns of antimicrobial resistance, but also to monitor the performance of the participating microbiology laboratories.
2126 downloads
5.
Avaliação da qualidade dos discos com antimicrobianos para testes de disco-difusão disponíveis comercialmente no Brasil
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Jornal Brasileiro de Patologia e Medicina Laboratorial
- Journal Metrics
Introdução: O teste de suscetibilidade a antimicrobianos representa um dos testes de maior importância clínica realizados pelo laboratório de microbiologia. Devido ao grande número de antimicrobianos e à complexidade dos mecanismos de resistência desenvolvidos pelas bactérias, fica muito difícil hoje a detecção de problemas nos testes de suscetibilidade pela simples avaliação dos resultados obtidos. Sendo assim, é extremamente importante que haja uma avaliação constante da qualidade destes testes. Objetivo: O objetivo do presente estudo foi avaliar a qualidade dos discos de antimicrobianos comercializados no Brasil. Material e métodos: Foram avaliados discos de 18 antimicrobianos obtidos de cinco diferentes fontes comerciais, os quais foram testados frente a quatro cepas bacterianas oriundas da ATCC, pelo método de difusão em ágar, seguindo as recomendações do National Committee for Clinical Laboratory Standards (NCCLS). Cada teste foi repetido 20 vezes. Resultados: Nenhuma das marcas apresentou desempenho satisfatório para o uso na rotina de um laboratório de microbiologia. O melhor desempenho foi apresentado pela marca Cecon®, com 89,6% de concordância. A marca Sensifar® apresentou taxa de concordância geral semelhante (90,8%). A marca com o pior desempenho foi a Pimenta Abreu®, com apenas 58,6% de concordância. Conclusão: Os resultados do presente estudo indicam que os discos de antimicrobianos comercializados no Brasil são de baixa qualidade, possivelmente refletindo a falta de controle de qualidade na produção e/ou estocagem dos produtos antes da sua distribuição. Esses dados chamam a atenção para a necessidade de implantação de sistemas efetivos de fiscalização da comercialização desses produtos e de programas criteriosos de controle de qualidade por parte dos laboratórios que os utilizam.
Background: The antimicrobial susceptibility test is one of the most important clinical test carried out in the microbiology laboratory. Due to the great number of antimicrobial agents and the complexity of resistance mechanisms evolved, it has become very difficult to detect problems in these tests by simply evaluating the results obtained. Consequently, a quality control program must be performed continuously. Objective: The objective of the present study was to evaluate the quality of the antimicrobial susceptibility disks used in Brazil. Methods: Eighteen antimicrobial susceptibility disks manufactured from five commercial trade marks were evaluated. These antimicrobial disks were tested against four ATCCs and following the National Committee for Clinical Laboratory Standards (NCCLS) procedures for disk-diffusion. Each test was repeated 20 times. Results: None of the trade marks presented a satisfactory performance for routine use in a microbiology laboratory. The best performance was presented by Cecon®, with 89,6% of overall agreement. Sensifar® disks showed a similar overall concordance of 90,8%. The trade mark with the least adequate performance was Pimenta Abreu®, with only 58,6% overall agreement. Conclusion: The results from this study indicate that the disks commercialized in Brazil are inappropriate to be used in clinical microbiology laboratories showing lack of quality control during the process of production and/or storage. They also show the importance of the implementation of both external and internal quality control programs.
29645 downloads
6.
In vitro antimicrobial activity of linezolid tested against vancomycin-resistant enterococci isolated in Brazilian hospitals
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The emergence of vancomycin-resistant enterococci (VRE) has been described recently in Brazil. This is in contrast to the USA and Europe, where the VRE appeared in the late 1980s. The progressive increase in VRE isolation poses important problems in the antimicrobial therapy of nosocomial infections. Treatment options and effective antimicrobial agents for VRE are often limited and the possibility of transfer of vancomycin genes to other Gram-positive microorganisms continues. In the search for antimicrobial agents for multiresistant Gram-positive cocci, compounds such as linezolid and quinupristin/dalfopristin have been evaluated. The present study was conducted to evaluate the in vitro activity of the oxazolidinone linezolid and 10 other antimicrobial agents, including quinupristin-dalfopristin, against multiresistant enterococci isolated in Brazilian hospitals. Thirty-three vancomycin resistant isolates (17 Enterococcus faecium and 16 E. faecalis), were analyzed. Strains were isolated from patients at São Paulo Hospital, Oswaldo Cruz Hospital, Hospital do Servidor Público Estadual, Santa Marcelina Hospital, Santa Casa de Misericórdia de São Paulo, and Hospital de Clínicas do Paraná. The samples were tested by a broth microdilution method following the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. All isolates were molecular typed using pulsed-field gel electrophoresis (PFGE). Linezolid was the most active compound against these multiresistant enterococci, showing 100% inhibition at the susceptible breakpoints. Quinupristin/dalfopristin and teicoplanin showed poor activity against both species. The molecular typing results suggest that there has been interhospital spread of vancomycin resistant E. faecium and E. faecalis among Brazilian hospitals. The results of this study indicate that linezolid is an appropriate therapeutic option for the treatment of vancomycin-resistant enterococci infections in Brazil.
2367 downloads
7.
In vitro antimicrobial activity of the aminoglycoside arbekacin tested against oxacillin-resistant Staphylococcus aureus isolated in Brazilian hospitals
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Arbekacin is an aminoglycoside used in Japan for treating infections caused by gentamicin and oxacillin-resistant S. aureus (ORSA). The objective of this study was to determine the in vitro antimicrobial activity of arbekacin against 454 clinical isolates of ORSA. The isolates were consecutively collected between January and July, 2000, from patients hospitalized in 8 Brazilian medical centers. The antimicrobial susceptibility testing was performed by disk diffusion method according to NCCLS recommendations. The vast majority of the isolates, 453 strains (99.8%), were considered susceptible to arbekacin based on the criteria proposed by the Requirements for Antibiotic Products of Japan. Only 1 isolate (0.2%) was classified as resistant. On the other hand, high rates of resistance were demonstrated for other aminoglycosides, such as gentamicin (97.6% resistance) and amikacin (97.0% resistance). Resistance rate was also high for ciprofloxacin (98.0%). All isolates were considered susceptible to vancomycin. The excellent in vitro antimicrobial activity of arbekacin demonstrated in this study indicates that this antimicrobial agent may play an important role in the treatment of severe ORSA infections, especially those that show poor clinical response with vancomycin monotherapy. Since the aminoglycosides should not be used as monotherapy to treat Gram positive infections, further studies evaluating in vitro and in vivo synergistic activity of arbekacin combinations are necessary to clarify the clinical role of this aminoglycoside.
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Sensibilidade a antimicrobianos de bactérias isoladas do trato respiratório de pacientes com infecções respiratórias adquiridas na comunidade: resultados brasileiros do Programa SENTRY de Vigilância de Resistência a Antimicrobianos dos anos de 1997 e 1998
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SADER, HÉLIO S.
; GALES, ANA C.
; REIS, ADRIANA O.
; ZOCCOLI, CASSIA
; SAMPAIO, JORGE
; JONES, RONALD N.
.
O tratamento da pneumonia adquirida na comunidade (PAC) é habitualmente empírico e o uso de antimicrobianos é baseado em estudos de vigilância. O programa SENTRY foi desenhado para monitorar a resistência a antimicrobianos através de uma rede internacional de laboratórios. Três centros no Brasil participaram do Programa SENTRY em 1997 e em 1998. Métodos: Um total de 344 isolados bacterianos coletados de pacientes com PAC em 1997 e 1998 foram testados contra mais de 20 agentes antimicrobianos pelo método de microdiluição em caldo. Resultados: Entre os S. pneumoniae (176 isolados), 71,6% foram sensíveis à penicilina. Alto nível de resistência à penicilina e resistência à cefotaxima foram encontrados em 2,3 e 4,0%, respectivamente. As novas quinolonas levofloxacina (MIC90, 2mig/mL) e gatifloxacina (MIC90, 0,5mig/mL) foram ativas contra 100% dos isolados testados. Entre os outros antimicrobianos não beta-lactâmicos testados, os mais ativos foram (% de sensibilidade): cloranfenicol (97,5%) > clindamicina (94%) > azitromicina (90,3%) > claritromicina (89,4%) > tetraciclina (76,4%) > sulfametoxazol/trimetoprim (60,2%). A percentagem de Haemophilus influenzae (101 isolados) resistentes à amoxicilina foi de 90,1%, enquanto entre Moraxella catarrhalis (67 isolados) somente 9,0% foram sensíveis. O ácido clavulânico restaurou a atividade de amoxicilina contra H. influenzae e M. catarrhalis. Porém, H. influenzae demonstrou níveis aumentados de resistência para sulfametoxazol/trimetoprim (55,1% de sensibilidade), claritromicina (80,4% de sensibilidade) e cefaclor (88,2% de sensibilidade). Todos os isolados de H. influenzae e M. catarrhalis foram sensíveis à levofloxacina (MIC90, <= 0,5mig/mL para ambos) e gatifloxacina (MIC90, <= 0,06mig/mL para ambos) apresentando MICs muito baixos. Conclusões: Os resultados indicam que a prevalência de S. pneumoniae com alto grau de resistência à penicilina é ainda baixa no Brasil; porém, a prevalência de S. pneumoniae com resistência intermediária à penicilina e resistência cruzada a outras classes de antimicrobianos é relativamente alta em nosso meio. Por outro lado, as novas quinolonas são altamente ativas contra S. pneumoniae e outros patógenos responsáveis por infecções respiratórias adquiridas na comunidade.
Background: Antimicrobial treatment of community-acquired respiratory tract infections (CARTI) is usually empiric and antibiotics are chosen on the basis of surveillance studies. The SENTRY Program was designed to monitor antimicrobial resistance via a worldwide surveillance network of sentinel laboratories. Three sites in Brazil participated in the 1997 and 1998 SENTRY Program. Methods: A total of 344 bacterial isolates, collected from patients with CARTI in 1997 and 1998, were tested against more than 20 antimicrobial agents by the broth microdilution method. Results: Among S. pneumoniae (176 isolates), 71.6% were susceptible to penicillin. High level resistance to penicillin and resistance to cefotaxime was found in 2.3 and 4.0%, respectively. The newer quinolones, levofloxacin, (MIC90 of 2 mug/mL) and gatifloxacin (MIC90 of 0.5 mug/mL) were active against 100% of the isolates tested. Among the other non-beta-lactam drugs tested, the rank order of pneumococci activity was (% susceptible): chloramphenicol (97.5%) > clindamycin (94.0%) > azithromycin (90.3%) > clarithromycin (89.4%) > tetracycline (76.4%) > trimethoprim/sulfamethoxazole (60.2%). The percentage of Haemophilus influenzae (101 isolates) susceptible to amoxicillin was 90.1%, whereas among Moraxella catarrhalis (67 isolates) only 9.0% were susceptible. Clavulanic acid restored the activity of amoxicillin against both H. influenzae and M. catarrhalis. However, H. influenzae showed increased levels of resistance to trimethoprim/sulfametoxazole (55.1% susceptibility), clarithromycin (80.4% susceptibility), and cefaclor (88.2%) susceptibility). All H. influenzae and M. catarrhalis isolates were susceptible to levofloxacin (MIC90, < 0.5 mug/mL for both) and gatifloxacin (MIC90, < 0.06 mug/mL for both) with very low MICs. Conclusion: Results indicate that the rate of S. pneumoniae showing high-level penicillin resistance is still low in Brazil. However, intermediate resistance to penicillin associated with resistance to other classes of antimicrobial agents was relatively high. On the other hand, the new quinolones were highly active against 100% of the respiratory pathogens tested.
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