Search

Ty~lebsiella pneumoniae is an opportunistic bacteria that is a normal part of the nasopharyngeal and gastrointestinal tract microbiome of humans and animals (1). The hypermucoviscous variant of K. pneumoniae (hvKp), [...]

Public health faces daily challenges due to increasing reports of pathogenic microorganisms with new antimicrobial resistance. Klebsiella michiganensis, an emerging pathogen, poses difficulty in its identification using conventional techniques. This study presents the first documented case of NDM-1-producing K. michiganensis in Brazil, identified as the new ST418. Initially, the isolate from a tracheal secretion was misidentified as K. oxytoca. However, accurate identification was achieved through ANI analyses. Whole-genome sequencing was conducted to characterize the genetic context of the resistance genes, to identify virulence factors, and to construct a phylogenetic tree. The blaNDM-1 gene was found to be harbored on an IncFIB plasmid approximately 112 kb in length, which was transferable in conjugation assays. The detection of carbapenem resistance genes in this species highlights the importance of public health vigilance, as it may serve as a reservoir and disseminator of significant resistance genes. [ABSTRACT FROM AUTHOR]

Over the last decade, New Delhi metallo‐beta‐lactamase (NDM) carbapenemase has silently spread in Brazil. In this study, we analyzed a large collection of Enterobacterales other than Klebsiella spp. received in our reference laboratory between 2013 and 2022. A total of 32 clinical isolates displaying different pulsed‐field gel electrophoresis profiles, and represented by 11 species in the families Enterobacteriaceae (Citrobacter freundii, Citrobacter portucalensis, Enterobacter hormaechei, and Escherichia coli), Morganellaceae (Morganella morganii, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, and Raoultella ornithinolytica), and Yersiniaceae (Serratia marcescens) had their whole genomes sequenced and further analyzed. Antimicrobial susceptibility was determined by disk diffusion, except for polymyxin B, assessed by broth microdilution. The blaNDM‐1 allele was predominant (n = 29), but blaNDM‐5 was identified in an E. coli specimen with a novel ST, and the blaNDM‐7 allele was found in E. hormaechei ST45 and E. coli ST1049. Polymyxin was active against all but one Enterobacteriaceae isolate: an mcr‐1–producing E. coli presenting minimal inhibitory concentration (4 mg/L). Isolates producing extended‐spectrum β‐lactamases were common: cefotaximase from Munich (CTX‐M)‐15 (n = 10), CTX‐M‐2 (n = 4), and CTX‐M‐8 (n = 3) were detected, and the mcr‐1–producing E. coli was found to co‐produce both CTX‐M‐8 and CTX‐M‐55 β‐lactamases. The mcr‐9 gene was found in 5/8 E. hormaechei isolates, distributed in four different sequence types, all of them presenting susceptibility to polymyxin. This study showed that NDM‐producing Enterobacterales other than Klebsiella are already spread in Brazil, in diversified species, and cocarrying important resistance genes. Prompt detection and effective implementation of measures to prevent further spread are mandatory for mitigating the dissemination of NDM carbapenemase in hospital settings and preserving the already limited antimicrobial therapy options. [ABSTRACT FROM AUTHOR]

In Brazil, meningococcal disease is endemic; 1.5-2.0 cases per 100,000 inhabitants were reported during 2000-2009. Since 2002, a substantial increase has been observed in the proportion of cases attributed to [...]

In the present study we examine the potential use of oligonucleotide probes to characterize Neisseria meningitidis serotypes without the use of monoclonal antibodies (MAbs). Antigenic diversity on PorB protein forms the bases of serotyping method. However, the current panel of MAbs underestimated, by at least 50% the PorB variability, presumably because reagents for several PorB variable regions (VRs) are lacking, or because a number of VR variants are not recognized by serotype-defining MAbs12. We analyzed the use of oligonucleotide probes to characterize serotype 10 and serotype 19 of N. meningitidis. The porB gene sequence for the prototype strain of serotype 10 was determined, aligned with 7 other porB sequences from different serotypes, and analysis of individual VRs were performed. The results of DNA probes 21U (VR1-A) and 615U (VR3-B) used against 72 N. meningitidis strains confirm that VR1 type A and VR3 type B encode epitopes for serotype-defined MAbs 19 and 10, respectively. The use of probes for characterizing serotypes possible can type 100% of the PorB VR diversity. It is a simple and rapid method specially useful for analysis of large number of samples.

Background: The lack of information regarding the burden of acute bacterial meningitis in Latin America leads to a reduction in the estimated incidence rates of the disease, and impairs public health decisions on the use and follow-up of preventive interventions, particularly, the evaluation of existing vaccination policies. The use of the real-time PCR in diagnostic routine procedures has resulted in a substantial increase in confirmed bacterial meningitis cases. However, in resource-poor countries, these assays are only available in reference laboratories. Sample transportation to these laboratories is a critical constraint, as it requires specialized, high cost courier services. To overcome this barrier we evaluated the use of FTATM Elute filter paper cards for the conservation and processing of samples under normal environmental conditions, as they would be when transported from remote and under-equipped healthcare facilities to the reference centers. A total of 401 samples received in 2015 as part of Sao Paulo’s national surveillance for routine diagnosis were selected for this study. Methods: The sensitivity and specificity of real-time PCR were evaluated using fresh serum and cerebrospinal fluid (CSF) samples processed using our laboratory’s standard DNA extraction, and processing the same samples after being dried and stored on FTATM card, and DNA extracted following the manufacturer’s instructions. Results: The sensitivities for detection of Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae from CSF dried and stored on FTATM cards were 98%, 92%, and 100%, respectively, and with serum samples were 73%, 88%, and 100%, respectively. When compared to our laboratory’s standard methodology, results showed high concordance, with Kappa index ranges of 0.9877–1.00 for CSF, and 0.8004–1.00 for serum samples. Conclusion: The use of FTATM cards for CSF and serum conservation and transport represents a rapid, reliable, and cost-effective alternative that will allow obtaining valuable epidemiological information that would otherwise be lost. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Results Conclusion Infections by carbapenem‐resistant Pseudomonas aeruginosa (CRPA) have been associated with high morbidity and mortality among solid organ recipients.To delineate the epidemiological and molecular characteristics of a recurrent outbreak of imipenem (IMP)‐producing P. aeruginosa (CRPA) among kidney transplant (KT) recipientWe described a recurring CRPA outbreak in a KT ward, divided into two periods: before unit closure (Feb 2019–2020) and after reopening (Aug 2020–Dec 2023). Routine surveillance cultures (SCs) were performed using axillary‐perineum‐rectal swabs with immunochromatographic tests. A case‐control study identified risk factors for CRPA acquisition. Pulsed‐field gel electrophoresis and whole genome sequencing characterized the strains.After reopening, new cases arose from patients previously colonized, peaking 18 months later. A total of 67 KT recipients with CRPA‐IMP‐producing strains were identified. All except one sequenced strain belonged to the ST446 clone, differing by a maximum of 110 single nucleotide polymorphisms. Forty‐five (67.2%) cases were identified through SC, with 45.7% showing intermittent SC positivity. Patients remained colonized for up to 623 days. Twenty‐four (35.8%) patients had infections, with the most common site being the urinary tract. Identified risk factors included older age, deceased donor, re‐transplantation, reoperation, carbapenem or quinolone use, lymphopenia, hospital stay >10 days, and the first 60 days post‐KT.KT recipients can harbor CRPA for extended periods, and detecting CRPA‐colonized patients is challenging. These characteristics highlight the patient as the major source and a critical point in outbreak control. [ABSTRACT FROM AUTHOR]

Focuses on a study of a Cuban-produced outer-membrane-protein-based serogroup B meningococcal vaccine, in an attempt to control serogroup B meningococcal disease in greater Sao Paulo, Brazil, during 1989 and 1990. Case control study to evaluate the efficacy of the vaccine; Results that suggest that this vaccine may be effective for prevention of serogroup B meningococcal disease in older children and adults; Details.