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- ItemAcesso aberto (Open Access)Emerging sporotrichosis is driven by clonal and recombinant Sporothrix species(Nature Publishing Group, 2014-05-07) Rodrigues, Anderson Messias [UNIFESP]; Sybren de Hoog, G.; Zhang, Yu; Camargo, Zoilo Pires de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); KNAW Fungal Biodivers CtrSporotrichosis, caused by agents of the fungal genus Sporothrix, occurs worldwide, but the infectious species are not evenly distributed. Sporothrix propagules usually gain entry into the warm-blooded host through minor trauma to the skin from contaminated plant debris or through scratches or bites from felines carrying the disease, generally in the form of outbreaks. Over the last decade, sporotrichosis has changed from a relatively obscure endemic infection to an epidemic zoonotic health problem. We evaluated the impact of the feline host on the epidemiology, spatial distribution, prevalence and genetic diversity of human sporotrichosis. Nuclear and mitochondrial markers revealed large structural genetic differences between S. brasiliensis and S. schenckii populations, suggesting that the interplay of host, pathogen and environment has a structuring effect on the diversity, frequency and distribution of Sporothrix species. Phylogenetic data support a recent habitat shift within S. brasiliensis from plant to cat that seems to have occurred in southeastern Brazil and is responsible for its emergence. A clonal structure was found in the early expansionary phase of the cathuman epidemic. However, the prevalent recombination structure in the plant-associated pathogen S. schenckii generates a diversity of genotypes that did not show any significant increase in frequency as etiological agents of human infection over time. These results suggest that closely related pathogens can follow different strategies in epidemics. Thus, species-specific types of transmission may require distinct public health strategies for disease control.
- ItemSomente MetadadadosEnviromnental contamination during a vancomycin-resistant Enterococci outbreak at a hospital in Argentina(Ediciones Doyma S/l, 2007-10-01) Zarate, Mariela Soledad; Gales, Ana [UNIFESP]; Jordd-Vargas, L'fiana; Yahni, Diego; RelloSo, Silvia; Bonvehi, Pablo; Monteiro, Jussimara [UNIFESP]; Campos-Pignatari, Antonio [UNIFESP]; Smayevsky, Jorgelina [UNIFESP]; Clin Norberto Quirno; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION. Vancomycin-resistant enterococci isolates (VRE) have caused numerous outbreaks in intensive care units (ICUs). A contaminated hospital environment, the hands of health care workers (HCW), and carrier patients may play important roles in perpetuating the chain of transmission in these outbreaks. the aims of this study were to report the first VRE outbreak in our center and assess the role of environmental contamination and HCW hands in the spread of new cases of enterococcal infection.MATERIAL and METHOD. Between August and December 2003, surveillance cultures were performed with samples from all patients (n = 113) admitted to the ICU, as well as cultures of samples from the environment (n = 69) and HCW hands (n = 23).RESULTS. Eighteen clinical samples from 8 patients and 7 environmental samples yielded Enterococcus faecium (24 strains) and E. avium (1 strain). VRE was not detected on HCW hands. All the VRE isolates belonged to a single clone and carried the vanA gene.CONCLUSION. Environmental contamination provides an important reservoir for future outbreaks of VRE, perpetuating transmission of the microorganism in the hospital setting.
- ItemSomente MetadadadosEpidemic of surgical-site infections by a single clone of rapidly growing mycobacteria in Brazil(Future Medicine Ltd, 2010-06-01) Leao, Sylvia Cardoso [UNIFESP]; Viana-Niero, Cristina; Matsumoto, Cristianne Kayoko; Batista Lima, Karla Valeria; Lopes, Maria Luiza; Palaci, Moises; Hadad, David Jamil; Vinhas, Solange; Duarte, Rafael Silva; Silva Lourenco, Maria Cristina; Kipnis, Andre; das Neves, Zilah Candida; Alcantara Gabardo, Betina Mendez; Ribeiro, Marta Osorio; Baethgen, Ludmila; Assis, Denise Brandao de; Madalosso, Geraldine; Chimara, Erica; Dalcolmo, Margareth Pretti; Universidade Federal de São Paulo (UNIFESP); Univ Fed Espirito Santo; Inst Evandro Chagas; Universidade Federal do Rio de Janeiro (UFRJ); Fundacao Oswaldo Cruz; Universidade Federal de Goiás (UFG); Secretaria Municipal Saude Goiania; Secretaria Estadual Saude Parana; Lab Cent Saude Publ; Ctr Vigilancia Epidemiol Prof Alexandre Vranjac; Inst Adolfo Lutz Registro; Ctr Referencia Prof Helio FragaAim: Our aim is to investigate if the clusters of postsurgical mycobacterial infections, reported between 2004 and 2008 in seven geographically distant states in Brazil, were caused by a single mycobacterial strain. Materials & methods: Available information from 929 surgical patients was obtained from local health authorities. A total of 152 isolates from surgical patients were identified by PCR restriction enzyme analysis of the hsp65 gene (PRA-hsp65) and sequencing of the rpoB gene. Isolates were typed by pulsed-field gel electrophoresis (PFGE) using two restriction enzymes. Dral and Asel. A total of 15 isolates not related to surgical cases were analyzed for comparison. Results: All isolates were identified as Mycobacterium abscessus ssp. massiliense. Isolates from surgical patients and one sputum isolate grouped in a single PFGE cluster, composed of two closely related patterns, with one band difference. A total of 14 other isolates unrelated to surgical cases showed distinctive PFGE patterns. Conclusion: A particular strain of M. abscessus ssp. massiliense was associated with a prolonged epidemic of postsurgical infections in seven Brazilian states, suggesting that this strain may be distributed in Brazilian territory and better adapted to cause surgical-site infections.
- ItemAcesso aberto (Open Access)Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil(Microbiology Soc, 2017) Everall, Izzy; Nogueira, Christiane Lourenco [UNIFESP]; Bryant, Josephine M.; Sanchez-Buso, Leonor; Chimara, Erica; Duarte, Rafael da Silva; Ramos, Jesus Pais; Batista Lima, Karla Valeria; Lopes, Maria Luiza; Palaci, Moises; Kipnis, Andre; Monego, Fernanda; Andres Floto, R.; Parkhill, Julian; Leao, Sylvia Cardoso [UNIFESP]; Harris, Simon R.An epidemic of post-surgical wound infections, caused by a non-tuberculous mycobacterium, has been on-going in Brazil. It has been unclear whether one or multiple lineages are responsible and whether their wide geographical distribution across Brazil is due to spread from a single point source or is the result of human-mediated transmission. 188 isolates, collected from nine Brazilian states, were whole genome sequenced and analysed using phylogenetic and comparative genomic approaches. The isolates from Brazil formed a single clade, which was estimated to have emerged in 2003. We observed temporal and geographic structure within the lineage that enabled us to infer the movement of sub-lineages across Brazil. The genome size of the Brazilian lineage was reduced relative to most strains in the three subspecies of Mycobacterium abscessus and contained a novel plasmid, pMAB02, in addition to the previously described pMAB01 plasmid. One lineage, which emerged just prior to the initial outbreak, is responsible for the epidemic of post-surgical wound infections in Brazil. Phylogenetic analysis indicates that multiple transmission events led to its spread. The presence of a novel plasmid and the reduced genome size suggest that the lineage has undergone adaptation to the surgical niche.
- ItemSomente MetadadadosOutbreak of surgical infection caused by non-tuberculous mycobacteria in breast implants in Brazil(W B Saunders Co Ltd, 2007-10-01) Padoveze, M. C.; Fortaleza, C. M. C. B.; Freire, M. P.; Assis, D. Brandao de; Madalosso, G.; Pellini, A. C. G.; Cesar, M. L. V.; Neto, V. Pisani; Beltramelli, M. M.; Chimara, E.; Ferrazoli, L.; Silva Telles, M. A. da; Sampaio, J. L. M.; Leao, S. C.; Ctr Vigilancia Epidemiol Prof Alexandre Vranjac; City Hlth Dept; Inst Adolfo Lutz Registro; Universidade Federal de São Paulo (UNIFESP)We investigated an outbreak caused by non-tuberculous mycobacteria (NTM) related to breast implant surgery in the city of Campinas, Brazil, by means of a retrospective cohort and molecular epidemiological study. A total of 492 records of individuals having breast surgery in 12 hospitals were evaluated. Twelve isolates were analysed using four different molecular typing methods. There were 14 confirmed cases, 14 possible cases and one probable case. One probable, nine possible and 12 confirmed cases were included in a cohort study; all occurred in eight of the hospitals and the confirmed cases in five. Univariate analysis showed that patients who had had breast reconstruction surgery in hospitals A and B were more likely to have NTM infections. No risk factor was independently associated with NTM infection in the multivariate model. the isolates obtained from patients at each hospital showed different molecular patterns, excluding isolates from hospital C that repeatedly showed the same genotype for approximately one year. in conclusion, this outbreak was caused by polyclonal strains at different institutions, and in one hospital a unique genotype caused most cases. No specific risk factors were found. (C) 2007 the Hospital Infection Society. Published by Elsevier B.V. All rights reserved.