SUMMARYWe describe an in vivo evolution of an antimicrobial profile from susceptibility to full-resistance to carbapenems, with heteroresistance as an intermediate stage, in an Acinetobacter baumannii strain. Heteroresistance was characterized by the growth of sub-populations within the susceptibility halo in both disk-diffusion and Etest. PCRs for the main A. baumannii carbapenemases were negative. The exact resistance mechanism, diagnostic methods and clinical relevance of heteroresistance in A. baumannii warrant further investigations. This is the first description of such phenomenon in vivo and the second report of heteroresistance to carbapenems in A. baumannii.
His study was performed to compare the methods of detection and to estimate the prevalence of extendedspectrum β-lactamases (ESBL) among Klebsiella spp and E. coli in a university hospital in southern Brazil. We also used a molecular typing method to evaluate the genetic correlation between isolates of ESBL K. pneumoniae. Production of ESBL was investigated in 95 clinical isolates of Klebsiella spp and Escherichia coli from Hospital de Clínicas de Porto Alegre, using Kirby-Bauer zone diameter (KB), double-disk diffusion (DD), breakpoint for ceftazidime (MIC CAZ), increased zone diameter with clavulanate (CAZ/CAC) and ratio of ceftazidime MIC/ceftazidime-clavulanate MIC (MIC CAZ/CAC). Molecular typing was performed by DNA macrorestriction analysis followed by pulsed-field gel electrophoresis. The KB method displayed the highest rates of ESBL (up to 70% of Klebsiella and 59% of E. coli), contrasting with all the other methods (p < 0.05). The confirmatory methods (DD, MIC CAZ, CAZ/CAC and MIC CAZ/CAC) showed a range of ESBL production from 8 to 13% for E. coli and from 33 to 40% for Klebsiella species. Therefore, the KB method was useful only as a screening method as it provided several false positive results. Molecular typing of 17 ESBL K. pneumoniae indicated that the isolates had no clonal relation. We found a good correlation among the confirmatory methods for ESBL detection although the methods which evaluate inhibition of the β-lactamase by clavulanate appeared to be more specific. The high prevalence of ESBL Klebsiella in our hospital is probably due to individual selection of resistant strains rather than the transmission of a common strain.
A compreensão das florestas em sucessão florestal é fundamental para revelar a contribuição dessas comunidades na conservação e para entender os filtros ecológicos que interferem em suas trajetórias sucessionais. O presente trabalho teve como objetivos descrever a composição florística e a estrutura fitossociológica da comunidade arbustivo-arbórea de um fragmento de Mata Atlântica em sucessão secundária, avaliar sua integridade biótica e estabelecer relações entre estes parâmetros registrados. Foram instaladas 14 parcelas com dimensões de 25 x 4 m, amostrados os indivíduos com DAP ≥ 5 cm e registrados indicadores para o cálculo do Índice de Integridade Biótica (IIB). Foram amostrados 222 indivíduos, pertencentes a 72 espécies, 48 gêneros e 24 famílias. O índice de diversidade foi de 3,62 nat/ind e a equabilidade 0,84. A densidade total foi de 1586 ind./ha e a área basal de 39 m². O IIB médio entre as parcelas foi de 32,35 que representa uma comunidade biótica regular. Os fatores que mais contribuíram para este índice foram o baixo número de palmeiras, epífitas vasculares e espécies tardias indicadoras e a grande quantidade de emaranhados de trepadeiras. Os resultados obtidos no levantamento fitossociológico foram largamente complementados pelos indicadores que compõe o IIB. A área de vegetação alvo deste estudo representa um fragmento florestal pequeno, degradado com, provavelmente, seu processo de sucessão florestal comprometido, sendo importante a implementação de ações de manejo.
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