Molecular epidemiology of a nosocomial outbreak due to Enterobacter cloacae and Enterobacter agglomerans in Campinas, São Paulo, Brazil

A total of 73 isolates (57 Enterobacter cloacae and 16 Enterobacter agglomerans), recovered during an outbreak of bacteremia in the Campinas area, São Paulo, Brazil, were studied. Of these isolates, 61 were from parenteral nutrition solutions, 9 from blood cultures, 2 from a sealed bottle of parenteral nutrition solution, and one was of unknown origin. Of the 57 E. cloacae isolates, 54 were biotype 26, two were biotype 66 and one was non-typable. Of 39 E. cloacae isolates submitted to ribotyping, 87.2% showed the same banding pattern after cleavage with EcoRI and BamHI. No important differences were observed in the antimicrobial susceptibility patterns among E. cloacae isolates exhibiting the same biotype, serotype and ribotype. All E. agglomerans isolates, irrespective of their origin, showed same patterns when cleaved with EcoRI and BamHI. The results of this investigation suggest an intrinsic contamination of parenteral nutrition solutions and incriminate these products as a vehicle of infection in this outbreak.

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Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.

10.21203/rs.2.10948/v1 ◽

2019 ◽

Author(s):

FRANK CHINOWAITA ◽

Wendy Chaka ◽

Tinashe K Nyazika ◽

Tendai C Maboreke ◽

Inam Chitsike ◽

...

Keyword(s):

Blood Culture ◽

Cancer Patients ◽

Antimicrobial Susceptibility ◽

Methicillin Resistance ◽

Antimicrobial Treatment ◽

Blood Cultures ◽

Gram Negative ◽

E Coli ◽

Patients With Cancer ◽

Susceptibility Patterns

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% gram positive, 42.0% gram negative bacteria and 2.0% yeast isolates. Most common isolates were Coagulase Negative Staphylococcus (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive and the same proportion was observed on methicillin resistance among Staphylococcus species. Conclusions: The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli, K. pneumoniae, E. faecalis and S. aureus. Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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High prevalence of clindamycin resistance in Staphylococcus aureus blood culture isolates in São Paulo, Brazil

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_161_16 ◽

2017 ◽

Vol 9 (04) ◽

pp. 314-316 ◽

Cited By ~ 1

Author(s):

Felipe S. Lupinacci ◽

Daniel Bussius ◽

Felipe Acquesta ◽

Gustavo Fam ◽

Raphael Rossi ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Blood Culture ◽

Susceptibility Testing ◽

Sao Paulo ◽

Resistance Rate ◽

Blood Cultures ◽

São Paulo ◽

Inducible Clindamycin Resistance ◽

Total Prevalence ◽

High Prevalence

Abstract BACKGROUND: Clindamycin has become an important antimicrobial option for the treatment of Staphylococcus aureus. However, little is known about the current patterns of clindamycin-susceptibility in S. aureus invasive isolates, both in our country and in other developing countries in the world. AIMS: The aim of this study was to determine the prevalence of constitutive and inducible clindamycin resistance in methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) blood culture isolates in São Paulo, Brazil. MATERIALS AND METHODS: From July 2011 to June 2012, all S. aureus isolates from blood cultures collected at our hospital were included in the study. Antimicrobial susceptibility testing was performed according to recommendations of the Clinical and Laboratory Standards Institute. RESULTS: Total prevalence of clindamycin resistance was 68%, including 7.2% with inducible resistance. In MRSA resistance rate was 90.8% whereas in MSSA the rate was 32.7%. CONCLUSIONS: Our high prevalence of clindamycin resistance highlights the importance of performing D-test in a routine base, as well of maintaining continued surveillance for the prevalence of clindamycin resistance.

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Fever of unknown origin and the role of Plasmodium vivax in Sao Paulo

BMJ Case Reports ◽

10.1136/bcr-2013-200189 ◽

2013 ◽

Vol 2013 (jul05 1) ◽

pp. bcr2013200189-bcr2013200189

Author(s):

M. R. Bacci ◽

J. A. B. Santos ◽

N. C. P. Zing ◽

F. B. Bragatto

Keyword(s):

Plasmodium Vivax ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Sao Paulo ◽

São Paulo

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Prevalence and antimicrobial susceptibility of Salmonella serotypes in patients from Ribeirão Preto, São Paulo, Brazil, between 1985 and 1999

The Brazilian Journal of Infectious Diseases ◽

10.1590/s1413-86702002000500005 ◽

2002 ◽

Vol 6 (5) ◽

Cited By ~ 10

Author(s):

Fabíola Attié de Castro ◽

Vanda Roseli dos Santos ◽

Carlos H. Gomes Martins ◽

Sueli A. Fernandes ◽

José Eduardo Zaia ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Sao Paulo ◽

São Paulo ◽

Salmonella Serotypes

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Antimicrobial susceptibility profile in vitro of milk samples from cows from a small property in Guatapará, São Paulo State

Revista Brasileira de Higiene e Sanidade Animal ◽

10.5935/1981-2965.20140080 ◽

2014 ◽

Vol 8 (5) ◽

Author(s):

Rafael Akira Sato ◽

Laryssa Freitas Ribeiro ◽

Breno Vinicius de Lima ◽

Rodrigo de Melo Magnabosco ◽

Maria Imaculda Fonseca ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

Milk Samples ◽

Antimicrobial Susceptibility Profile ◽

São Paulo State

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Antimicrobial susceptibility, phage types, and pulsetypes of Salmonella Typhimurium, in São Paulo, Brazil

Memórias do Instituto Oswaldo Cruz ◽

10.1590/s0074-02762006000300010 ◽

2006 ◽

Vol 101 (3) ◽

pp. 281-286 ◽

Cited By ~ 18

Author(s):

Ângela Cristina Rodrigues Ghilardi ◽

Ana Terezinha Tavechio ◽

Sueli Aparecida Fernandes

Keyword(s):

Salmonella Typhimurium ◽

Antimicrobial Susceptibility ◽

Sao Paulo ◽

São Paulo ◽

Phage Types

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Antimicrobial susceptibility of Streptococcus pneumoniae isolated from patients in the northeastern macroregion of São Paulo state, Brazil, 1998-2013

Jornal Brasileiro de Patologia e Medicina Laboratorial ◽

10.5935/1676-2444.20170029 ◽

2017 ◽

Vol 53 (3) ◽

Author(s):

Marta Inês C. Medeiros ◽

Samanta Cristine G. Almeida ◽

Sérgio Bokermann ◽

Evandro Watanabe ◽

Maria Luiza L. S. Guerra ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Antimicrobial Susceptibility ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

São Paulo State

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Antimicrobial susceptibility profile in vitro samples of milk from cows mastitis from a dairy farm located in Jaboticabal, Sao Paulo State

Revista Brasileira de Higiene e Sanidade Animal ◽

10.5935/1981-2965.20140058 ◽

2014 ◽

Vol 8 (5) ◽

Author(s):

Laryssa Freitas Ribeiro ◽

Rafael Akira Sato ◽

Isabela Cristina Canavari ◽

Carlos Eduardo Penner Belo ◽

Gabriel Augusto Marques Rossi ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Dairy Farm ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

Antimicrobial Susceptibility Profile ◽

São Paulo State

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Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.

10.21203/rs.2.10948/v2 ◽

2019 ◽

Author(s):

FRANK CHINOWAITA ◽

Wendy Chaka ◽

Tinashe K Nyazika ◽

Tendai C Maboreke ◽

Emmanuel Tizauone ◽

...

Keyword(s):

Blood Culture ◽

Cancer Patients ◽

Antimicrobial Susceptibility ◽

Antimicrobial Treatment ◽

Blood Cultures ◽

Gram Positive ◽

Gram Negative ◽

E Coli ◽

Patients With Cancer ◽

Susceptibility Patterns

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Clinical and laboratory standards institute (CLSI) standard breakpoints were used to interpret the antimicrobial susceptibility results. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% Gram positive, 42.0% Gram negative bacteria and 2.0% yeast isolates. Most common isolates were coagulase negative Staphylococcus spp. (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Gram negative isolates exhibited high resistance to gentamicin (61.9%) and ceftriaxone (71.4%) which are the empiric antimicrobial agents used in our setting. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all Gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all Gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive. Among Staphylococcus species it was also observed that 10/15 (66.7%) of the isolates were methicillin resistan t. Conclusions : The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli , K. pneumoniae , E. faecalis and S. aureus . Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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