scholarly journals Emergence of vanA vancomycin-resistant Enterococcus faecium in a hospital in Porto Alegre, South Brazil

2014 ◽  
Vol 8 (02) ◽  
pp. 160-167 ◽  
Author(s):  
Mariah Resende ◽  
Juliana Caierão ◽  
Juliana Gil Prates ◽  
Gabriel Azambuja Narvaez ◽  
Cícero Armídio Gomes Dias ◽  
...  
Keyword(s):  
Clinical Information ◽  
Important Change ◽  
Porto Alegre ◽  
Vana Gene ◽  
Biofilm Production ◽  
Hemodialysis Unit ◽  
Vancomycin Resistant ◽  
Almost All ◽  
Epidemiological Characteristics ◽  
South Brazil

Introduction: In Porto Alegre (South Brazil), since the first VRE isolation in 2000 until the middle of the last decade, the epidemiology of enterococcal infections presented the peculiarity that, as opposed to other regions of the country, almost all VRE were E. faecalis. The aim of this study was to investigate the microbiological and epidemiological characteristics of a VRE outbreak that occurred between August 2010 and September 2011 in Porto Alegre, South Brazil. Methodology: Twenty-nine isolates from inpatients of Mãe de Deus Hospital that were identified and characterized for their susceptibility profile, vancomycin genotype, presence of esp gene, biofilm production, and clonal relationship were collected.  Patients’ records were reviewed for clinical information. Results: All isolates were identified as vancomycin/ampicillin resistant E. faecium carrying the vanA gene. Almost all were susceptible to gentamicin and streptomycin. Most patients died and were associated with a hemodialysis unit stay. All but the first isolate were clustered in a main clone. Conclusions: An important change in vancomycin-resistant enterococci was observed. Studies like this are necessary to monitor the dissemination of VRE, especially of some individual clones.

Differentiation between Schizoid and Avoidant Personalities: An Empirical Test*

1989 ◽  
Vol 34 (8) ◽  
pp. 785-790 ◽  
Author(s):  
James C. Overholser
Keyword(s):  
Personality Disorder ◽  
Empirical Test ◽  
Psychiatric Patients ◽  
Demographic Data ◽  
Clinical Information ◽  
Self Report ◽  
Almost All ◽  
Anxiety Depression ◽  
Univariate Analyses ◽  
Number Of Authors

A number of authors have questioned the rationale for subdividing the DSM-II schizoid diagnosis into three separate personality disorders in DSM-III, the schizoid, avoidant, and schizotypal. The present study was designed to explore differences between psychiatric patients with schizoid and avoidant personalities as compared to psychiatric controls with no personality disorder. Differences were examined on demographic data, self-report measures, and clinical information. A Multivariate Analysis of Variance (MANOVA) revealed a significant overall effect for groups across MMPI subscales. However, subsequent univariate Analyses of Variance (ANOVA's) revealed that almost all differences were between the two personality disorder groups as compared to the psychiatric controls. Contrary to expectations, schizoid and avoidant personalities were found to display equivalent levels of anxiety, depression, and psychotic tendencies as compared to psychiatric control patients. No meaningful distinctions were found between the avoidant and the schizoid personalities. Results are discussed in terms of problems with the assessment methods and the diagnostic criteria.

scholarly journals Antifungal Susceptibility and Biofilm Production of Candida spp. Isolated from Clinical Samples

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Munmun B. Marak ◽  
Biranthabail Dhanashree
Keyword(s):  
Antifungal Susceptibility ◽  
Clinical Information ◽  
Antibiotic Use ◽  
Microtiter Plate ◽  
Vaginal Swab ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Candida Spp ◽  
Disk Diffusion Method ◽  
Biofilm Production

Objective. The study aims to speciate clinical Candida isolates and detect their biofilm-forming ability and antifungal resistance. Methods. All the Candida spp. isolated from different clinical samples like pus, urine, blood, and body fluid were included in the study. Biofilm production was tested by the microtiter plate method. Antifungal susceptibility was studied by the disk diffusion method. Patient’s demographic details such as age, sex, and clinical information were collected. Presence of other risk factors such as diabetes mellitus, history of antibiotic use, and any urinary tract instrumentations was also recorded. Results. Among 90 Candida species isolated, most predominant species was found to be C. albicans (45.5%) followed by C. tropicalis (28.88%), C. krusei (20%), C. glabrata (3.33%), and C. parapsilosis (2.22%). Candida spp. were isolated from urine (43%), BAL/sputum (18.88%), high vaginal swab (8.88%), suction tips (7.77%), blood and wound swabs (6.66%), pus (3.33%), bile aspirate (2.22%), and deep tissue (1.11%). A larger number of females were affected than males, and the age group of 51 to 60 years was more susceptible to candidiasis. A higher number of C. albicans isolates produced biofilm followed by C. parapsilosis, C. tropicalis, and C. krusei. However, C. glabrata showed no biofilm production in our study. All Candida isolates were 100% sensitive to amphotericin B. Voriconazole was the next effective drug with 81.11% susceptibility. 24.44% of strains were resistant to fluconazole. Conclusion. Speciation of Candida isolates, detection of ability to form the biofilm, and monitoring of antifungal susceptibility testing are necessary for appropriate treatment.

scholarly journals IDENTIFICATION AND DETECTION OF BIOFILM PRODUCING STAPHYLOCOCCUS AUREUS AND ITS ANTIBIOGRAM ACTIVITIES

2021 ◽  
pp. 150-156
Author(s):  
SAPANA SHARMA ◽  
UPASHANA BHANDARI ◽  
YOGESH OLI ◽  
GANESH BHANDARI ◽  
SUNITA BISTA ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Disk Diffusion ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Methicillin Resistant ◽  
Clinical Specimens ◽  
Biofilm Production ◽  
Diffusion Technique ◽  
Almost All

Objectives: The main aim of this work is to determine the antibiogram profile of biofilm-producing Staphylococcus aureus from various clinical specimens of the patients. Methods: Various bacterial cultures of non-repeated clinical specimens from a total of 3388 patients were determined using standard microbiological and biochemical methods. Results: Out of 3388 only 604 (17.02%) displayed growth positive. A total of 65 (51.58%) S. aureus isolates were recovered, 25 (38.46%) were identified as methicillin-resistant S. aureus (MRSA) by Cefoxitin (30 μg) disk diffusion technique, of which majority were from pus/wound swab 22 (37.29%). The antibiogram of the isolates was analyzed by Kirby-Bauer disk diffusion technique analyzing Linezolid to be the most effective drug with susceptibility of 100% to both MRSA and methicillin-sensitive S. aureus, followed by vancomycin, tigecycline, and tetracycline. In vitro biofilm production by tissue culture plate (TCP) and Congo red agar method detected 52 (80%) and 25 (38.46%) as biofilm producers, respectively. TCP identified 2 (3.07%), 7 (10.76%), and 44 (67.69%) as strongly, moderately, and weakly adherent. About 30.7% of MRSA obtained were positive biofilm producers. The minimum inhibitory concentration value of Oxacillin for S. aureus by agar dilution method ranged from 0.025 μg/mL to 128 μg/mL. Conclusion: This study shows that biofilm production was more in methicillin-resistant strains and displayed a high degree of resistance to almost all groups of antibiotics.

scholarly journals A CRIANÇA QUE ESCUTA NA PROFESSORA QUE GINGA:

2021 ◽  
Vol 10 (20) ◽  
pp. 562-579
Author(s):  
Ronaldo Botelho
Keyword(s):  
Critical Consciousness ◽  
Capital City ◽  
Knowledge Mobilization ◽  
Porto Alegre ◽  
Knowledge Practices ◽  
Social Mediation ◽  
Black Teacher ◽  
Methodological Tool ◽  
Black Educator ◽  
South Brazil

O artigo analisa a trajetória de uma professora negra na periferia de uma capital do sul do Brasil e tem como objetivo explicitar como valores e memórias de uma certa formação étnico-racial podem influir no processo de “tornar-se professora”. O estudo se baseia em uma entrevista direta, realizada durante a atividade de uma disciplina de um curso de pós-graduação e tem como instrumental teórico-metodologico a autobiografia, concebida como uma ‘tipologia das mediações sociais” (NÓDOA e FINGER, 1988), construída a partir de “saberes distintos” (TARDIF, 2002). Recorremos, ainda, aos conceitos de Conscientização em FREIRE (1979) e outras referências em J. CANDAU e M.C. PASSEGI. PALAVRAS-CHAVE Autobiografia, Saberes, Práticas.   THE CHILD’S LISTENING TO THE TEACHER’S GINGA STYLE: the knowledge mobilization of a black educator from the outskirts of Porto Alegre on "becoming a teacher" ABSTRACT This article analyzes the pathway of a black teacher from a capital city in South Brazil and aims to explain how memories and values of a certain ethnic- racial education may influence the “becoming a teacher” process. The study, carried out during a postgraduate course activity, is based on a direct interview and its theoretical and methodological tool is autobiography, which was conceived as “typology of social mediation”(NÓDOA e FINGER,1988) and built from “distinct knowledge”(TARDIF, 2002). We have yet used the Critical Consciousness approach by Freire (1979) and other references in. Candau and M.C. PASSEGI. KEYWORDS Autobiography, Knowledge, Practices.

Benzodiazepine poisoning in Morocco: epidemiological study.

2021 ◽  
Vol 20 (2) ◽  
pp. 396-400
Author(s):  
Aicha Detsouli ◽  
Naïma Rhalem ◽  
Zakaria Abidli ◽  
Sara Jadda ◽  
Mohamed Fekhaoui ◽  
...  
Keyword(s):  
National Level ◽  
Medical Science ◽  
Poison Control ◽  
Cardiovascular Disorders ◽  
Psychomotor Agitation ◽  
Significant Percentage ◽  
Know How ◽  
Pharmacovigilance Center ◽  
Almost All ◽  
Epidemiological Characteristics

Objective: This study aims to describe the main epidemiological characteristics of benzodiazepine intoxication in Morocco. Methods: This is a retrospective study of cases of benzodiazepine poisoning reported at the Poison Control and Pharmacovigilance Center of Morocco between 2012 and 2016. Results: During the period 2012-2016, 1,544 cases of benzodiazepine poisoning were recorded in Morocco. The average age of the addicts is 21.68 ± 14.41 years. According to the data of the study, 70% are Female, with a sex ratio of 2.25.The suicidal act represents a significant percentage with 31.5% of cases. Almost all patients were orally intoxicated with 97.1%.The signs presented are various according to the quantity ingested and the time elapsed before the treatment in particular the psychiatric, neurological, digestive and cardiovascular disorders. Unfortunately, three cases died. The other cases survived with or without sequelae. Conclusion: benzodiazepines are drugs used in the treatment of several disorders such as anxiety, insomnia and psychomotor agitation. Unfortunately, many people do not know how to use this type of medicine.which exposes them to poisoning, for this reason it is necessary to carry out sensitization campaigns for the good use of benzodiazepines at the national level. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.396-400

Characterization of a vancomycin-resistant Enterococcus faecium isolate and a vancomycin-susceptible E. faecium isolate from the same blood culture

2020 ◽  
Author(s):  
Kyriaki Xanthopoulou ◽  
Julia Wille ◽  
Janine Zweigner ◽  
Kai Lucaßen ◽  
Thorsten Wille ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enterococcus Faecium ◽  
Core Genome ◽  
Blot Hybridization ◽  
Southern Blot Hybridization ◽  
Vana Gene ◽  
Plasmid Analysis ◽  
Vancomycin Resistant ◽  
Faecium Isolate

Abstract Objectives To characterize two Enterococcus faecium isolates with different resistance phenotypes obtained from the same blood culture. Methods The isolates were identified by MALDI-TOF MS and antimicrobial susceptibility testing (AST) was performed using a VITEK® 2 AST P592 card and Etest. WGS was performed on the MiSeq and MinION sequencer platforms. Core-genome MLST (cgMLST) and seven-loci MLST were performed. Plasmid analysis was performed using S1-PFGE followed by Southern-blot hybridization. Results Both E. faecium isolates were ST203. AST revealed that one was a vancomycin-resistant E. faecium (VREfm) isolate and the other was a vancomycin-susceptible E. faecium (VSEfm) isolate. The VREfm isolate harboured the vanA gene cluster as part of a Tn1546-type transposon encoded on a 49 kb multireplicon (rep1, rep2 and rep7a) plasmid (pAML0157.1). On the same plasmid, ant(6)-Ia, cat-like and erm(B) were encoded. The VSEfm isolate harboured a rep2 plasmid (pAML0158.1), 12 kb in size, which was present in full length as part of pAML0157.1 from the VREfm isolate. The vanA-encoding pAML0157.1 was a chimera of the rep2 pAML0158.1 and a second DNA segment harbouring vanA, ant(6)-Ia, erm(B) and cat-like, as well as the replicons rep1 and rep7a. By cgMLST analysis, the VREfm and VSEfm isolates were identical. Conclusions Our results demonstrate that the VREfm and VSEfm blood culture isolates represented ST203 and were identical. The investigated heterogeneous resistance phenotypes resulted from the acquisition or loss of plasmid segments in the enterococcal isolates. These data illustrate that mobile genetic elements may contribute to the spread of vancomycin resistance among enterococci and to the genotypic and phenotypic variation within clonal isolates.

scholarly journals 573. Enterococcal Bacteremia in a Tertiary Care Center in Mexico: A Retrospective Analysis Focus on Vancomycin-Resistant E. faecium and Ampicillin-Resistant E. faecalis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S270-S271
Author(s):  
Bruno A Lopez Luis ◽  
Darwin Lambraño-Castillo ◽  
Edgar Ortiz-Brizuela ◽  
Andrea Ramirez-Fontes ◽  
Yanet Estrella Tovar-Calderon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Care Center ◽  
Strong Association ◽  
Tertiary Care ◽  
Acquired Resistance ◽  
Venous Catheter ◽  
Vana Gene ◽  
Vancomycin Resistant ◽  
History Of Use

Abstract Background The primary pathogens in genera enterococcus are E. faecalis and E. faecium, increasing acquired resistance to glycopeptides and β lactamic has done the management more challenging. We aimed to describe the risk factors for acquisition of bacteremia for vancomycin-resistant E. faecium (VRE) and ampicillin-resistant E. faecalis (ARE) and the 30-day mortality in comparison to susceptible enterococcal bloodstream infection (BSI) Methods From 2007- 2017 medical records of all BSI for E. faecalis and E. faecium were evaluated. Risk factor for acquisition of VRE and ARE as well as the significant variables associated with 30-day mortality for enterococcal BSI were determined by univariate and multivariate analysis. The molecular mechanism of VRE was performed by PCR Results There were 192 patients with E. faecium BSI of which 107(56%) patients had VRE BSI with 94% VRE strains expressing vanA gene. The index bacteremic episodes were classified as nosocomial o healthcare associated in 99%, 102(95%) had hospitalization 1 year before and 101(94%) history of use of antibiotics 3 months earlier, the multivariate analysis showed duration of the previous hospitalization >10 days (OR, 80.18; 95% CI, 1.81–634), use of central venous catheter [OR, 11.15; 95% CI, 2.48–50.2), and endotracheal cannula [OR, 17.91; 95% CI, 1.22–262) as significant associated variables. The mortality for VRE was greater than susceptible E. faecium (60% vs. 24%, P < 0.001). The only factors for 30-day mortality for E. faecium BSI in the multivariate analysis was APACHE ll score [OR,1.45; 95% CI, 1.26–1.66) and patients with chemotherapy of cancer. (OR, 3.52; 95% CI, 1.09–11.39). 147 patients had E. faecalis BSI of which 18 (11%) patients had ARE, we did not find relevant clinical differences of ARE in comparison with ampicillin-susceptible E. faecalis, neither in risk factors for acquisition of ARE nor 30-day mortality [7(39%) vs. 38(29%), P = 0.58] in uni and multivariate analysis Conclusion Our evaluation showed in a period of 10 years that VRE expressing vanA gene had a strong association with patients with previous nosocomial exposure. Severely ill patients and cancer patients on chemotherapy during the bacteremic episode were the variables more associated with 30-day mortality. ARE is yet of low prevalence and less known, constant surveillance about it is warranted Disclosures All authors: No reported disclosures.

scholarly journals Molecular Analysis of VanA Outbreak ofEnterococcus faeciumin Two Warsaw Hospitals: The Importance of Mobile Genetic Elements

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Ewa Wardal ◽  
Katarzyna Markowska ◽  
Dorota Żabicka ◽  
Marta Wróblewska ◽  
Małgorzata Giemza ◽  
...  
Keyword(s):  
Insertion Sequence ◽  
Molecular Data ◽  
Multidrug Resistant ◽  
Common Source ◽  
Hospital Acquired Infections ◽  
Vancomycin Resistant ◽  
Clonal Variability ◽  
Almost All ◽  
Hospital Acquired ◽  
Vntr Analysis

Vancomycin-resistantEnterococcus faeciumrepresents a growing threat in hospital-acquired infections. Two outbreaks of this pathogen from neighboring Warsaw hospitals have been analyzed in this study. Pulsed-field gel electrophoresis (PFGE) ofSmaI-digested DNA, multilocus VNTR analysis (MLVA), and multilocus sequence typing (MLST) revealed a clonal variability of isolates which belonged to three main lineages (17, 18, and 78) of nosocomialE. faecium. All isolates were multidrug resistant and carried several resistance, virulence, and plasmid-specific genes. Almost all isolates shared the same variant of Tn1546transposon, characterized by the presence of insertion sequence ISEf1and a point mutation in thevanAgene. In the majority of cases, this transposon was located on 50 kb or 100 kb pRUM-related plasmids, which lacked, however, theaxe-txetoxin-antitoxin genes. 100 kb plasmid was easily transferred by conjugation and was found in various clonal backgrounds in both institutions, while 50 kb plasmid was not transferable and occurred solely in MT159/ST78 strains that disseminated clonally in one institution. Although molecular data indicated the spread of VRE between two institutions or a potential common source of this alert pathogen, epidemiological investigations did not reveal the possible route by which outbreak strains disseminated.

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