Abstract Ralstonia mannitolilytica, a Gram-negative bacterium, is rarely isolated in clinical laboratories. It has been associated with outbreaks due to its ability to survive in liquid media and hospital devices. We describe three cases of bacteremia caused by R. mannitolilytica in a neonatal intensive care unit in Curitiba, Southern Brazil. All isolates presented the same PFGE profile. The common source of infection was undetected in surveillance cultures for the outbreak survey. All patients received antimicrobial treatment and were discharged from the maternity. Due to the characteristics of the microorganism, clinicians and microbiologists should pay attention to the emergence of Ralstonia spp. infections.

Abstract INTRODUCTION. This study aimed to evaluate different methods for differentiation of species of coagulase-negative staphylococci (CoNS) that caused infections in hospitalized immunocompromised patients. METHODS. A total of 134 CoNS strains were characterized using four different methods. RESULTS. The results of matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) analysis were in complete agreement with those of tuf gene sequencing (kappa index = 1.00). The kappa index of Vitek 2® Compact analysis was 0.85 (very good) and that of the conventional method was 0.63 (moderate). CONCLUSIONS . MALDI-TOF MS provided rapid and accurate results for the identification of CoNS (134; 100%).

Abstract Background: Carbapenem-resistant Acinetobacter baumannii infection is a concern in developing countries due to high incidence, few therapeutic options, and increasing costs. Objective: Characterize and analyze the antibiotic susceptibility patterns of carbapenem-resistant A. baumannii isolates and evaluate clinical data of meningitis and bacteremia caused by this microorganism. Methods: Twenty-six A. baumannii isolates from 23 patients were identified by MALDI-TOF and automated methods and genotyped using pulsed field genotyping electrophoresis. Clinical data and outcomes were evaluated. Susceptibility of isolates to colistin, tigecycline, meropenem, imipenem, and doxycycline was determined. Results: Mortality due to A. baumannii infections was 73.91%; all patients with meningitis and 7/8 patients with ventilator-associated pneumonia died. All isolates were susceptibility to polymyxin (100%; MIC50, MIC90: 1 µg/mL, 1 µg/mL) and colistin (100%; MIC50, MIC90: 2 µg/mL, 2 µg/mL), and 92% were susceptible to tigecycline (MIC50, MIC90: 1 µg/mL, 1 µg/mL) and doxycycline (MIC50, MIC90: 2 µg/mL, 2 µg/mL). bla OXA-23 was identified in 24 isolates. Molecular typing showed 8 different patterns: 13 isolates belonged to pattern A (50%). Conclusion: Carbapenem-resistant A. baumannii infections mortality is high. Alternative antimicrobial therapy (doxycycline) for selected patients with carbapenem-resistant A. baumannii infection should be considered.

Cystic fibrosis (CF) patients with Burkholderia cepacia complex (Bcc) pulmonary infections have high morbidity and mortality. The aim of this study was to compare different methods for identification of Bcc species isolated from paediatric CF patients. Oropharyngeal swabs from children with CF were used to obtain isolates of Bcc samples to evaluate six different tests for strain identification. Conventional (CPT) and automatised (APT) phenotypic tests, polymerase chain reaction (PCR)-recA, restriction fragment length polymorphism-recA, recAsequencing, and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) were applied. Bacterial isolates were also tested for antimicrobial susceptibility. PCR-recA analysis showed that 36 out of the 54 isolates were Bcc. Kappa index data indicated almost perfect agreement between CPT and APT, CPT and PCR-recA, and APT and PCR-recA to identify Bcc, and MALDI-TOF and recAsequencing to identify Bcc species. The recAsequencing data and the MALDI-TOF data agreed in 97.2% of the isolates. Based on recA sequencing, the most common species identified were Burkholderia cenocepacia IIIA (33.4%),Burkholderia vietnamiensis (30.6%), B. cenocepaciaIIIB (27.8%), Burkholderia multivorans (5.5%), and B. cepacia (2.7%). MALDI-TOF proved to be a useful tool for identification of Bcc species obtained from CF patients, although it was not able to identify B. cenocepacia subtypes.

Prevalence of H. pylori infection was determined using cultures of gastric biopsy samples of patients attended at the academic hospital of the Federal University of Paraná, Curitiba, Paraná, Brazil. Molecular methods were used to characterize the cagA and vacA genes from bacterial isolates associated with different diseases presented by patients. Out of a total of 81, forty-two gastric biopsy samples tested were positive for H. pylori, with a prevalence of 51.9%. No significant difference was found with regard to the gender (p=0.793) and age (p=0.183) of the patients. Genotype s1m1 vacA gene was found in 67% of the cases of peptic ulcer investigated (p=1.0), despite the limited number of patients with this disease (n=3). A correlation between the presence of less virulent strains (s2m2) and reflux esophagitis was found in the majority of the cases (45%), but without statistical significance. An association between the prevalence of cagA gene, found in 92% of isolates, and peptic ulcer was not observed (p=1.0), suggesting that this gene cannot be considered a specific marker of severity in our environment. The results reinforce the importance of conducting regional studies and the need to characterize H. pylori virulence genes associated with different diseases.

O estudo de cinética de liberação de metais pesados é uma importante ferramenta de diagnóstico ambiental de áreas contaminadas, pois determina, além dos teores acumulados liberados após tempos crescentes de equilíbrio, a taxa (velocidade) de dessorção desses poluentes para a solução do solo. Com o objetivo de avaliar a cinética de liberação de Pb de solos da área de mineração e metalurgia de metais pesados, no município de Adrianópolis (PR), vale do rio Ribeira, selecionaram-se oito solos, submetidos a diferentes formas de contaminação (solos 2, 4 e 5 - incorporação de resíduos da metalurgia de metais pesados aos perfis; solos 3, 6 e 7 - adição de Pb particulado via chaminés da fábrica; solo 8 - contaminação por passagem da água pluvial pela fábrica desativada, que escorre em direção ao rio Ribeira). O solo 1, sob mata nativa, fora da direção de caminhamento das fumaças da metalurgia, localizado a 1.560 m de distância e a 380 m acima da cota da fábrica desativada, foi escolhido como referência dos teores naturais de Pb dos solos da região. As amostras de solo, coletadas em duas profundidades (0 a 10 e 20 a 40 cm), foram submetidas a extrações sequenciais com ácido cítrico 0,1 mol L-1 após diferentes períodos de contato (tempos acumulados: 2, 14, 38, 86, 182, 326, 518, 806 e 1.382 h). Os teores totais de Pb (extração com HF e HNO3 concentrados e H2O2 30 % v/v) foram altos (máximo de 24.755,6 mg kg-1) e indicaram intensa contaminação dos solos. Os dados da cinética de liberação foram ajustados às equações parabólicas de difusão, sendo a liberação do Pb gradual e bifásica, com velocidade de liberação maior na primeira fase. Os solos 3 e 5 foram considerados com elevado potencial de contaminação ambiental devido aos altos teores de Pb dessorvido acumulados nas extrações sequenciais com ácido cítrico (máximo de 18.577,4 mg kg-1). O solo 6, com baixos teores de argila, apresentou a maior velocidade (taxa) de dessorção de Pb.

Kinetics studies of heavy metal release are an important form of environmental diagnostics in contaminated areas, due to the possibility of determining, aside from the total release contents after increasing equilibrium times, the rate (velocity) of heavy metal to soil solution. The objective of this study was to determined Pb kinetics release from soils of the heavy metal mining and metallurgy area in Adrianópolis (PR), Brazil, in the Ribeira river valley. Eight soils were exposed to different contamination forms: (soils 2, 4 and 5 - residue incorporated in the soil profile; soils 3, 6 and 7 - sprinkled with particulate matter from the factory chimney; soil 8 - contamination by rain water flowing from the shut down factory towards the Ribeira river). Soil 1, under native forest, was chosen as reference of the natural soil Pb levels. The soil samples, collected from two layers (0-10 cm, 20-40 cm), were subjected to sequential extractions with 0.1 mol L-1 citric acid during different periods (2; 14; 38; 86; 182; 326; 518; 806; and 1,382 h). The high total Pb contents (extracted by concentrated HF and HNO3 and 30 % (v/v) H2O2) (maximum content of 24,755.6 mg kg-1) revealed intense soil contamination. The release kinetics data were fitted to parabolic equations of diffusion; lead release was gradual and biphasic (higher in the first phase). The environmental risks were considered high in the soils 3 and 5, where the evaluated levels of total Pb accumulated were high (reaching 18,577.4 mg kg-1). The Pb release rate was highest from soil 6, where clay content was low.