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  • 1
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    Online Resource
    Prevalence and Eradication of Colonizing Staphylococcus Aureus in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation
    American Society of Hematology ; 2016
    In:  Blood Vol. 128, No. 22 ( 2016-12-02), p. 3413-3413
    Details
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 3413-3413
    Abstract: Hematopoietic cell transplant (HCT) recipients are at increased risk for infections. Staphylococcus aureus (SA) colonizes 20-50% of healthy individuals and is a risk factor for subsequent invasive SA infections. Colonization rates in patients undergoing allogeneic HCT and clinical relevance for the time of aplasia and severely reduced immune function following HCT are not known. Only some retrospective data on methicillin-resistant SA infection rates are available. In this study, we prospectively assessed the prevalence of SA colonization in 110 consecutive patients before and during allo-HCT in a single-center observational study from June 2013 to January 2016. All patients undergoing allo-HCT were screened for nasal, pharyngeal and inguinal SA colonization weekly beginning at the time of admission to the transplant unit until neutrophil recovery. After swabs for the initial SA screening were taken all patients were put on oral gentamicin and vancomycin for gut decontamination until neutrophils had recovered. Quantitative stool analyses were performed weekly. In case of fever or increased of inflammatory laboratory parameters (C-reactive protein) blood cultures were drawn. In our cohort we found a SA prevalence of 14.5% (16/110 patients) at the time of admission to the transplant unit. All SA strains detected were sensitive to methicillin. Most patients colonized with SA in the nose (13/16), while pharyngeal and inguinal colonization was found less frequently (n=5 and n=6, respectively). Patients aged 60-67 years (n=14) showed the highest SA carrier rate (5/14, 36%, RR=1.36, p=0.02). There was no correlation between SA colonization and sex, underlying disease or chemotherapeutic pretreatment. Prior systemic antibiotic treatments using SA effective drugs within six months before admission to the transplant unit did not have relevant impact on SA prevalence at the time of screening. Within the group of the 16 SA-positive patients there were 2 patients (12.5%) who had received oral antibiotic gut decontamination (vancomycin and /or gentamicin) within twelve weeks prior to admission (during induction chemotherapy). In the SA negative group a similar proportion of patients had received oral gut decontamination (12/94; 12.8%). Despite the severe immunosuppression and skin and mucosal lesions incl. indwelling catheters no systemic SA infections (including bacteremia) were found during hospitalization in any of the HCT patients. All SA positive patients became SA negative within three weeks. These observations imply that decolonization is achieved by the consistent oral gut decontamination that all patients received in conjunction with the antibacterial soaps used. In conclusion, the SA colonization prevalence in our cohort of patients undergoing allogeneic HCT was 14.5% which is lower than described previously in the literature. Of note, our cohort did not comprise patients with MRSA. Here, we demonstrate in a prospective study that oral gut decontamination with vancomycin and gentamicin in addition to strict hygiene measures resulted in eradication of SA colonization in all 16 colonized patients within three weeks. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V128.22.3413.3413
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 2
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    CcpA Mediates the Catabolite Repression of tst in Staphylococcus aureus
    American Society for Microbiology ; 2008
    In:  Infection and Immunity Vol. 76, No. 11 ( 2008-11), p. 5093-5099
    Details
    In: Infection and Immunity, American Society for Microbiology, Vol. 76, No. 11 ( 2008-11), p. 5093-5099
    Abstract: Some clinical isolates of Staphylococcus aureus produce the superantigenic toxic shock syndrome toxin 1 (TSST-1), encoded by tst , located on pathogenicity islands. The expression of tst is complex and is influenced by environmental conditions such as pH, CO 2 , and glucose. We identified a putative catabolite-responsive element ( cre ) in the promoter regions of all known tst genes, indicating that tst transcription may be regulated by the catabolite control protein CcpA. By introducing tst genes under the control of their native promoters or tst promoter-reporter gene fusions in wild-type strain Newman, we showed that glucose was able to repress tst transcription and TSST-1 production, whereas glucose repression was abolished in the corresponding Δ ccpA mutant. Stabilizing the pH ruled out a pH effect due to acid production during glucose catabolism. CcpA thus directly regulates tst transcription, linking carbohydrate utilization to virulence gene expression in S. aureus .
    Type of Medium: Online Resource
    ISSN: 0019-9567 , 1098-5522
    URL: Article
    DOI: 10.1128/IAI.00724-08
    RVK:
    XA 10000
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2008
    detail.hit.zdb_id: 1483247-1
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  • 3
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    Combinatorial Phenotypic Signatures Distinguish Persistent from Resolving Methicillin-Resistant Staphylococcus aureus Bacteremia Isolates
    American Society for Microbiology ; 2011
    In:  Antimicrobial Agents and Chemotherapy Vol. 55, No. 2 ( 2011-02), p. 575-582
    Details
    In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 55, No. 2 ( 2011-02), p. 575-582
    Abstract: Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (PB) (positive blood cultures after ≥7 days of therapy) represents a clinically challenging subset of invasive MRSA infections. In this investigation, we examined the potential correlation of specific virulence signatures with PB versus resolving MRSA bacteremia (RB) (negative blood cultures within 2 to 4 days of therapy) strains. Thirty-six MRSA isolates from patients enrolled in a recent multinational clinical trial were studied for (i) susceptibility to host defense cationic peptides (HDPs) (i.e., thrombin-induced platelet microbicidal proteins [tPMPs] and human neutrophil peptide 1 [hNP-1] ); (ii) adherence to host endovascular ligands (fibronectin) and cells (endothelial cells); and (iii) biofilm formation. We found that PB isolates exhibited significantly reduced susceptibilities to tPMPs and hNP-1 ( P 〈 0.001 and P = 0.023, respectively). There was no significant association between the PB outcome and fibronectin binding, endothelial cell binding, or biofilm formation ( P = 0.25, 0.97, and 0.064 versus RB strains, respectively). However, multiple logistic regression analysis revealed that the PB outcome was significantly associated with the combination of reduced susceptibilities to HDPs and extent of biofilm formation ( P 〈 0.0001). Similar results were obtained in a second analysis using days of bacteremia as a continuous outcome, showing that reduced HDP susceptibilities and increased biofilm formation cocontributed to predict the duration of bacteremia. Our data indicate that PB isolates have specific pathogenic signatures independent of conventional antimicrobial susceptibility. These combinatorial mosaics can be defined and used to prospectively distinguish PB from RB strains in advance and potentially to predict ultimate clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 0066-4804 , 1098-6596
    URL: Article
    DOI: 10.1128/AAC.01028-10
    RVK:
    XA 24552
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2011
    detail.hit.zdb_id: 1496156-8
    SSG: 12
    SSG: 15,3
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  • 4
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    High level methicillin resistance correlates with reduced Staphylococcus aureus endothelial cell damage
    Elsevier BV ; 2017
    In:  International Journal of Medical Microbiology Vol. 307, No. 1 ( 2017-01), p. 11-20
    Details
    In: International Journal of Medical Microbiology, Elsevier BV, Vol. 307, No. 1 ( 2017-01), p. 11-20
    Type of Medium: Online Resource
    ISSN: 1438-4221
    URL: Article
    DOI: 10.1016/j.ijmm.2016.11.009
    RVK:
    XA 49980
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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    SSG: 12
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  • 5
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    Novel RGAG1-BCOR gene fusion revealed in a somatic soft tissue sarcoma with a long follow-up
    Springer Science and Business Media LLC ; 2022
    In:  Virchows Archiv Vol. 480, No. 5 ( 2022-05), p. 1107-1114
    Details
    In: Virchows Archiv, Springer Science and Business Media LLC, Vol. 480, No. 5 ( 2022-05), p. 1107-1114
    Abstract: BCOR -rearranged sarcomas are rare and belong to the Ewing-like sarcomas (ELS). Their morphology and histopathological features make the diagnosis challenging. We present a case, initially diagnosed as an unusual extraskeletal myxoid chondrosarcoma (EMC). A 54-year-old male patient developed an asymptomatic swelling of the lower leg. Imaging showed a 9.5-cm large intramuscular soft tissue mass. Due to its morphological and immunohistochemical profile on biopsy, it was initially diagnosed as an EMC. The patient was treated by complete resection and adjuvant radiotherapy and remained free of tumor at 7 years follow-up. Using next-generation sequencing (NGS), we retrospectively identified RGAG1-BCOR gene fusion (confirmed by RT-PCR), which has not been described in somatic soft tissue tumors so far. This finding broadens the spectrum of partner genes in the BCOR -rearranged sarcomas in a tumor with a well-documented, long clinical follow-up.
    Type of Medium: Online Resource
    ISSN: 0945-6317 , 1432-2307
    URL: Article
    DOI: 10.1007/s00428-021-03160-z
    RVK:
    XA 27000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463276-7
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  • 6
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    Compreensão do Termo de Consentimento Livre e Esclarecido em Cuidados de Reabilitação : Considerações para atingir os objetivos bioéticos.
    Fundacao de Ensino e Pesquisa em Ciencias da Saude ; 2019
    In:  Comunicação em Ciências da Saúde Vol. 29, No. 01 ( 2019-04-16), p. 52-60
    Details
    In: Comunicação em Ciências da Saúde, Fundacao de Ensino e Pesquisa em Ciencias da Saude, Vol. 29, No. 01 ( 2019-04-16), p. 52-60
    Abstract: Detalhe do Manuscrito // INTRODUÇÃO: O termo de consentimento informado(TCI) é obtido para realização de pesquisas e procedimentos em saúde, já bem estabelecido na prática e na literatura. O propósito do termo é proteger a autonomia do paciente. OBJETIVO: Analisar o TCI utilizado em Hospital publico de reabilitação em Brasília e as considerações para atingir os objetivos bioéticos. MÉTODO: Aplicação de questionários a pacientes durante o mês de outubro de 2016. Os dados foram analisados no Excell, análise de conteúdo e análise bioética. RESULTADOS: 87% dos pacientes declararam que não leram o (TCI) assinado. Foi solicitada a leitura e depois respondido os questionários, 65 aceitaram participar da pesquisa, média de idade 45 anos, sexo feminino (50,7%), 47,7% casado, 85% do Distrito Federal e Goiás, ensino médio completo (36,9%), católicos em 57%, 100,17 dias com a doença, 61% internados para procedimentos de ortopedia e Cirurgia Plástica (30%). Na análise do conteúdo surgiram classes como utilidade, compreensão, dúvidas e sugestões. A palavra "risco" foi a mais frequente. CONCLUSÃO: As considerações para melhorar o termo e atingir os objetivos bioéticos elencadas foram fornecer o termo com antecedência para que o paciente tenha tempo de ler e discutir com seus familiares; disponibilidade da equipe para responder as perguntas; promover o incentivo à leitura do TCI, diálogo e participação no processo decisório; apresentação na forma de áudio; aplicação de texto padrão com linguagem clara e a possibilidade de configurações específicas adequadas a necessidade do paciente e as especificidades do procedimento a ser realizado  
    Type of Medium: Online Resource
    ISSN: 1980-5101 , 1980-0584
    URL: Issue
    URL: Article
    DOI: 10.51723/ccs.v29i01
    DOI: 10.51723/ccs.v29i01.212
    Language: Unknown
    Publisher: Fundacao de Ensino e Pesquisa em Ciencias da Saude
    Publication Date: 2019
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  • 7
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    Relationship of agr Expression and Function with Virulence and Vancomycin Treatment Outcomes in Experimental Endocarditis Due to Methicillin-Resistant Staphylococcus aureus
    American Society for Microbiology ; 2011
    In:  Antimicrobial Agents and Chemotherapy Vol. 55, No. 12 ( 2011-12), p. 5631-5639
    Details
    In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 55, No. 12 ( 2011-12), p. 5631-5639
    Abstract: The accessory gene regulator ( agr ) locus has been shown to be important for virulence in several animal models of Staphylococcus aureus infection. However, the role of agr in human infections, and specifically in antibiotic treatment, is controversial. Interestingly, agr dysfunction has been associated with reduced vancomycin responses. To systematically investigate the role of agr in virulence and treatment outcome in the context of endovascular infection, 10 well-characterized vancomycin-susceptible methicillin-resistant S. aureus (MRSA) bloodstream isolates (5 agr-I [clonal complex 45, or CC45] and 5 agr-II [CC5]) were studied for (i) agr function, (ii) RNAIII transcriptional profiles, (iii) agr locus sequences, (iv) intrinsic virulence and responses to vancomycin therapy in an experimental infective endocarditis (IE) model, and (v) in vivo RNAIII expression. Significant differences in agr function (determined by delta-hemolysin activity) correlated with the time point of RNAIII transcription (earlier RNAIII onset equals increased agr function). Unexpectedly, four MRSA strains with strong delta-hemolysin activities exhibited significant resistance to vancomycin treatment in experimental IE. In contrast, five of six MRSA strains with weak or no delta-hemolysin activity were highly susceptible to vancomycin therapy in the IE model. agr sequence analyses showed no common single-nucleotide polymorphism predictive of agr functionality. In vivo RNAIII expression in cardiac vegetations did not correlate with virulence or vancomycin treatment outcomes in the IE model. Inactivation of agr in two strains with strong delta-hemolysin activity did not affect virulence or the in vivo efficacy of vancomycin. Our findings suggest that agr dysfunction does not correlate with vancomycin treatment failures in this experimental IE model in two distinct MRSA genetic backgrounds.
    Type of Medium: Online Resource
    ISSN: 0066-4804 , 1098-6596
    URL: Article
    DOI: 10.1128/AAC.05251-11
    RVK:
    XA 24552
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2011
    detail.hit.zdb_id: 1496156-8
    SSG: 12
    SSG: 15,3
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  • 8
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    Secretome Analysis Defines the Major Role of SecDF in Staphylococcus aureus Virulence
    Public Library of Science (PLoS) ; 2013
    In:  PLoS ONE Vol. 8, No. 5 ( 2013-5-3), p. e63513-
    Details
    In: PLoS ONE, Public Library of Science (PLoS), Vol. 8, No. 5 ( 2013-5-3), p. e63513-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
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    URL: Article
    DOI: 10.1371/journal.pone.0063513
    DOI: 10.1371/journal.pone.0063513.g001
    DOI: 10.1371/journal.pone.0063513.g002
    DOI: 10.1371/journal.pone.0063513.g003
    DOI: 10.1371/journal.pone.0063513.g004
    DOI: 10.1371/journal.pone.0063513.g005
    DOI: 10.1371/journal.pone.0063513.t001
    DOI: 10.1371/journal.pone.0063513.t002
    DOI: 10.1371/journal.pone.0063513.t003
    DOI: 10.1371/journal.pone.0063513.s001
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2013
    detail.hit.zdb_id: 2267670-3
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  • 9
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    Methicillin‐resistant Staphylococcus aureus eradication in young infants should include the diaper area and treat housing contacts
    Wiley ; 2015
    In:  Acta Paediatrica Vol. 104, No. 12 ( 2015-12)
    Details
    In: Acta Paediatrica, Wiley, Vol. 104, No. 12 ( 2015-12)
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    URL: Article
    DOI: 10.1111/apa.2015.104.issue-12
    DOI: 10.1111/apa.13179
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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  • 10
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    Epidemiology of Methicillin-Susceptible Staphylococcus aureus in a Neonatology Ward
    Cambridge University Press (CUP) ; 2015
    In:  Infection Control & Hospital Epidemiology Vol. 36, No. 11 ( 2015-11), p. 1305-1312
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 36, No. 11 ( 2015-11), p. 1305-1312
    Abstract: In-hospital transmission of methicillin-susceptible Staphylococcus aureus (MSSA) among neonates remains enigmatic. We describe the epidemiology of MSSA colonization and infection in a 30-bed neonatal ward. DESIGN Multimodal outbreak investigation SETTING A public 800-bed tertiary care university hospital in Switzerland METHODS Investigations in 2012–2013, triggered by a MSSA infection cluster, included prospective MSSA infection surveillance, microbiologic screening of neonates and environment, onsite observations, and a prospective cohort study. MSSA isolates were characterized by pulsed-field gel electrophoresis (PFGE) and selected isolates were examined for multilocus sequence type (MLST) and virulence factors. RESULTS Among 726 in 2012, 30 (4.1%) patients suffered from MSSA infections including 8 (1.1%) with bacteremia. Among 655 admissions in 2013, 13 (2.0%) suffered from MSSA infections including 2 (0.3%) with bacteremia. Among 177 neonates screened for S. aureus carriage, overall 77 (44%) tested positive. A predominant PFGE-1-ST30 strain was identified in 6 of 30 infected neonates (20%) and 30 of 77 colonized neonates (39%). This persistent clone was pvl -negative, tst -positive and belonged to agr group III. We found no environmental point source. MSSA carriage was associated with central vascular catheter use but not with a particular midwife, nurse, physician, or isolette. Observed healthcare worker behavior may have propagated transmission via hands and fomites. Despite multimodal interventions, clonal transmission and colonization continued and another clone, PFGE-6-ST5, became predominant. CONCLUSIONS Hospital-acquired MSSA clones represent a high proportion of MSSA colonization but not MSSA infections in neonate inpatients. In contrast to persisting MSSA, transmission infection rates decreased concurrently with interventions. It remains to be established whether eradication of hospital-acquired MSSA strains would reduce infection rates further. Infect. Control Hosp. Epidemiol. 2015;36(11):1305–1312
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2015.184
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2106319-9
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