Navegando por Palavras-chave "Coagulase"
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- ItemSomente MetadadadosBacteremias hospitalares por estafilococos coagulase-negativos em hospital de ensino: aspectos clinicos, epidemiologicos e microbiologicos(Universidade Federal de São Paulo (UNIFESP), 1993) Rubio, Fernando Gongora [UNIFESP]
- ItemAcesso aberto (Open Access)Caracterização fenotípica e molecular de amostras de Staphylococcus coagulase negativo isoladas de infecções da corrente sanguínea de pacientes de dois hospitais gerais da cidade de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2009-04-29) Souza, Alinne Guimarães de [UNIFESP]; Pignatari, Antonio Carlos Campos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Coagulase negative staphylococci (CoNS) are important etiologic agents responsible for healthcare related infection (HCRI) in bloodstream infections. In a retrospective study we evaluate CoNS isolated from patients with HCRI in bloodstream infections admitted to two general hospitals at São Paulo city, from August 2005 to August 2007. The isolates were characterized at species level and antimicrobial susceptibility tested by the Vitek® system and ViteK® 2. Oxacillin resistance was evaluated by oxacillin and cefoxitin discs. The presence of mecA gene and the SCCmec type were determined by multiplex PCR. Staphylococcus epidermidis was the predominant specie followed by S. hominis, S. haemolyticus, S. simulans, S. warneri, S. capitis and S. auricularis. Oxacillin resistance was observed in 88.2% of the isolates with 100% concordance between oxacilin and cefoxitin discs confirmed by mecA gene. All isolates were susceptible to vancomycin and four isolates revealed intermediate resistance to teicoplanin by Etest®. One S. epidermidis showed resistance to linezolide. The predominant SCC type was the type III followed by the types IV, I, II and V. In 26.9% positive mecA isolates we did not characterize the SCCmec type by the molecular protocol utilized.
- ItemSomente MetadadadosCaracterização microbiológica de Staphylococcus coagulase negativa isolados em infecções oculares em São Paulo, no período de 2000 a 2006(Universidade Federal de São Paulo (UNIFESP), 2007) Oliveira, Adalia Dias Dourado [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]Objetivo: Esta tese teve como objetivo fazer uma caracterização microbiológica de Staphylococcus coagulase negativa, isolado de infecções oculares de uma mesma comunidade. Metodologia: Foram realizados quatro estudos com amostras de Staphylococcus coagulase negativa oculares: avaliou-se 0 padrão de suscetibilidade, in vitro, segundo 0 sítio da infecção (conjuntiva e córnea), em um período de quatro anos, em relação à meticilina, as fluorquinolonas (oftoxacina e ciprofloxacina) e aos aminoglicosídeos (tobramicina e gentamicina); avaliaram-se os diferentes métodos de detecção da suscetibilidade à oxacilina, comparando-se os Staphylococcus do grupo epidermidis com os do grupo não-epidermidis; estudou-se 0 perfil de suscetibilidade in vitro dessas amostras para outros antimicrobianos; comparou-se as suscetibilidades in vitro de cepas meticilina suscetíveis e resistentes, em relação a segunda e a quarta gerações das fluoroquinolonas e comparou-se as suscetibilidades in vitro, avaliando-se a concentração inibitória mínima (MICs) das fluoroquinolonas. Resultados e conclusões: Staphylococcus coagulase negativa foi responsável por vários casos de conjuntivites e ceratites nos pacientes que procuraram 0 serviço de Oftalmologia da UNIFESP-EPM durante 0 período de quatro anos. Documentou-se a existência e 0 aumento de cepas meticilina resistentes nesta comunidade estudada. Todos os testes de resistência à oxacilina avaliados foram estatisticamente concordantes com os resultados do PCR. 0 teste de triagem em ágar (OSAS), nas concentrações de 0,75 e 1 ,00μg oxacilina/ml, apresentou os melhores resultados nas provas de validação (sensibilidade de 100% e 98% e especificidade de 95% e 100%, respectivamente). 0 E-teste (oxacilina), 0 teste de disco difusão com a cefoxitina e 0 teste automatizado (Vitek) demonstraram sensibilidades acima dos 89%. Foram demonstrados, melhores resultados de validação dos testes de resistência à oxacilina, estudados para os Staphylococcus do grupo epidermidis, do que para os não-epidermidis, evidenciando a importância da adequada identificação das espécies dos Staphylococcus coagulase negativa, para sua melhor classificação e determinação do potencial patogênico. Houve uma maior proporção significativa de resistência para as amostras mecA-positivas para penicilina G, amoxicilina-ampicilina, cefazolina, ampicilina-sulbactam, eritromicina, clindamicina, gentamicina e tetraciclina (p≤0.05). Observou-se total suscetibilidade das amostras estudadas a vancomicina. Os padrões de suscetibilidade in vitro demonstraram que as fluoroquinolonas de quarta geração oferecem vantagens sobre as outras fluoroquinolonas de segunda geração, não só para os Staphylococcus coagulase negativa, como para todos os gram-positivos estudados. A ofloxacina apresentou os maiores valores de MIC, quando se compararam as quatro fluoroquinolonas estudadas. Comparando-se as fluoroquinolonas de quarta geração, a gatifloxacina demonstou ter uma potência in vitro semelhante a da moxifloxacina para os gram-positivos, e maior para os gram-negativos..
- ItemAcesso aberto (Open Access)Fluoroquinolone susceptibilities to methicillin-resistant and susceptible coagulase-negative Staphylococcus isolated from eye infection(Conselho Brasileiro de Oftalmologia, 2007-03-01) Oliveira, Adália Dias Dourado [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Gayoso, Maria de Fátima; Francisco, Waldemar; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Misericórdia de São Paulo Faculdade de Ciências MédicasPURPOSE: To evaluate the fluoroquinolone susceptibilities of ocular isolate coagulase-negative staphylococci (CoNS), identified at the Microbiology Laboratory - UNIFESP. DESIGN: Experimental laboratory investigation. METHODS: The minimum inhibitory concentrations (MICs) of 21 strains of methicillin-resistant coagulase-negative staphylococci (MRCoNS) and 22 methicillin-sensitive coagulase-negative staphylococci (MSCoNS) to ciprofloxacin, ofloxacin, gatifloxacin and moxifloxacin were determined, using the E-test method standardized by the Clinical and Laboratory Standards Institute (CLSI/NCCLS). RESULTS: The MIC90s (µg/ml) for the second generation of tested fluoroquinolones were higher than the fourth generation, especially for the methicillin-resistant coagulase-negative staphylococci group. CONCLUSION: Our results indicate that methicillin-sensitive coagulase-negative staphylococci are more susceptible to quinolones than are methicillin-resistant coagulase-negative staphylococci and that fourth generation fluoroquinolones appear to be more potent, affecting even coagulase-negative staphylococcal strains resistant to second generation fluoroquinolones.
- ItemAcesso aberto (Open Access)Infeccoes oculares por Staphylococcus sp coagulase-nagativos portadores de sequencia genetica de virulencia em plasmidio R(Universidade Federal de São Paulo (UNIFESP), 1998) Kandelman, Sergio [UNIFESP]
- ItemAcesso aberto (Open Access)Laboratory detection methods for methicillin resistance in coagulase negative Staphylococcus isolated from ophthalmic infections(Conselho Brasileiro de Oftalmologia, 2007-08-01) Oliveira, Adália Dias Dourado [UNIFESP]; d'Azevedo, Pedro Alves [UNIFESP]; Sousa, Luciene Barbosa de [UNIFESP]; Viana-Niero, Cristina [UNIFESP]; Francisco, Waldemar; Lottenberg, Cláudio; Martino, Marines Dalla Valle; Hofling-Lima, Ana Luisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Departamento de Microbiologia e Parasitologia; Santa Casa de Misericórdia de São Paulo Faculdade de Ciências Médicas Departamento de Patologia; Hospital Israelita Albert EinsteinPURPOSE: To evaluate different methods of oxacillin susceptibility testing of ocular isolates, considering polymerase chain reaction (PCR) as the 'gold standard', and to compare the in vitro susceptibility to oxacillin with that of other antimicrobials used in ophthalmologic practice. METHODS: The Vitek gram-positive identification card was used to identify ocular coagulase negative Staphylococcus species. The presence of the mecA gene was determined by the polymerase chain reaction assay with a combination of two primer sets (mecA and 16S rRNA) in a single region. Results were analyzed and compared with other oxacillin susceptibility methods: PBP2a detection by rapid slide latex agglutination test (SLA); oxacillin E-test; the Vitek automated gram-positive susceptibility card (GPS-105); the oxacillin salt agar screening test (OSAS) at a concentration of 6.0, 1.0 and 0.75 µg oxacillin per ml and the cefoxitin disk diffusion test (CDD). Automated susceptibility was also determined to other antimicrobial agents (fluoroquinolones, penicillin G, amoxicillin-ampicillin, cefazolin, ampicillin-sulbactam, erythromycin, clindamycin, gentamicin, tetracycline, trimethoprim-sulfamethoxazole, vancomycin and rifampin. RESULTS: Of the 69 CoNS isolates tested, 71% were mecA-positive and 29% mecA-negative. All methods tested had a statistically significant agreement with polymerase chain reaction. There was a tendency of positive polymerase chain reaction predomination among the S. epidermidis isolates in comparison to non-epidermidis isolates, although this was not statistically significant (78.3% vs. 56.5%; chi2= 2.54; P= 0.11). The oxacillin salt agar screening test (0.75 µg oxacillin/ml) showed the best performance, with 100% sensitivity and negative predictive value; 95% specificity and 98% positive predictive value. Using the E-test, the mecA-positive isolates were statistically significantly more resistant to ciprofloxacin, ofloxacin, gatifloxacin and moxifloxacin (P= 0.002; P= 0.008; P= 0.002 and P= 0.003, respectively). There was a statistically significant higher proportion of resistance of the coagulase negative Staphylococcus mecA-positives for: penicillin G, amoxicillin-ampicillin, cefazolin, ampicillin-sulbactam, erythromycin, clindamycin, gentamicin and tetracycline (P<0.05). All coagulase negative Staphylococcus species were susceptible to vancomycin and there was no statistically significant correlation between the mecA-positive isolates and resistance to trimethoprim-sulfamethoxazole or to rifampin. CONCLUSIONS: In the present study, we found that the E-test and the oxacillin salt agar screening test S (0.75 µg oxacillin per ml), when compared with polymerase chain reaction, were the most accurate currently available methods to phenotypically detect oxacillin resistance of coagulase negative Staphylococcus species. This study demonstrated that a good option for screening of ocular isolates for oxacillin resistance in the microbiology laboratory is the cefoxitin disk diffusion test and the automated Vitek system. We believe it is important to have available methods that accurately detect methicillin resistance of the less commonly encountered species, chiefly because of their increasing importance as opportunistic pathogens.
- ItemAcesso aberto (Open Access)Suscetibilidade antimicrobiana in vitro dos Staphylococcus coagulase negativa oculares(Conselho Brasileiro de Oftalmologia, 2007-12-01) Gayoso, Maria de Fátima Azevedo [UNIFESP]; Oliveira, Adália Dias Dourado [UNIFESP]; d'Azevedo, Pedro Alves [UNIFESP]; Yu, Maria Cecília Zorat [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Francisco, Waldemar; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)PURPOSE: To assess the in vitro susceptibility of conjunctival and corneal coagulase negative Staphylococcus (CoNS) to methicillin, fluoroquinolones and aminoglycosides. METHODS: A total of 707 conjunctival and corneal CoNS disk diffusion test results were retrospectively analyzed, from January 2000 through December 2003. RESULTS: From 2000 to 2003, there was an increase in number of CoNS isolated from conjunctiva (n=57 to n=153) and cornea (n=28 to n=78). The frequency of conjunctival and corneal methicillin-resistant CoNS also increased (1.8 to 19.6% and 14.3 to 29.3%, respectively). There was no statistically significant difference between fluoroquinolones-resistant CoNS percentages in conjunctiva (ofloxacin: 1.8 to 7.8% and ciprofloxacin: 3.5 to 9.2%) and cornea (ofloxacin: 14.3 to 9.0% and ciprofloxacin: 14.3 to 10.3%). Evaluating the results of the conjunctival samples, there was increased resistance to tobramycin (15.8 to 34.0%) and to gentamycin (10.5 to 25.5%). There was no change in resistance of corneal isolates to tobramycin (28.6 to 26.9%) and to gentamycin (21.4 to 23.1%). CONCLUSIONS: there was a decrease in in vitro CoNS susceptibility to methicillin, tobramycin and gentamycin. Fuoroquinolones represented by ofloxacin and ciprofloxacin demonstrated stable in vitro susceptibility.