Introduction:The aim of this study was to identify a rapid and simple phenotypic method for extended-spectrum β-lactamase (ESBL) detection in Enterobacter cloacae. Methods: A total of 79 consecutive, non-repeated samples of E. cloacae were evaluated. Four phenotypic methods were applied for ESBL detection, results were compared to multiplex polymerase chain reaction (PCR) as the gold standard reference method: 1) ceftazidime and cefotaxime disks with and without clavulanate, both with boronic acid added; 2) disk approximation using cefepime and amoxicillin/clavulanate; 3) ESBL screening by minimum inhibitory concentration (MIC) ≥ 16µg/mL and 4) by MIC ≥ 2µg/mL for cefepime. Results: Method 4 showed the best combination of sensitivity (100%) and specifi city (94%). Conclusions: MIC ≥ 2µg/mL for cefepime would be very useful for the phenotypic detection of ESBL in samples of E. cloacae.

Molecular heterogeneity of Acinetobacter baumannii isolates during seasonal increase in prevalence.

In this study, we investigated the frequency of isolates included in the susceptible-dose dependent (SDD) category, according to the Clinical and Laboratory Standards Institute guidelines, carrying bla, bla and bla genes among 92 Klebsiella pneumoniae and 80 Enterobacter cloacae clinical isolates. The presence of one or more extended-spectrum β-lactamases (ESBLs) genes was observed in 64% K. pneumoniae and 69% E. cloacae isolates. Nineteen isolates were included in SDD interpretive category criteria, of which 15 carried ESBL genes (seven K. pneumoniae and eight E. cloacae). Considering the high proportion of ESBL gene-containing isolates included in the SDD category (79%), we recommend that physicians exercise caution in the use of cefepime for treatment of infections caused by these isolates, reducing possible therapeutic failure, particularly in cases of ESBL-producing bacterial strains.

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O objetivo deste artigo é compreender como os recursos e capacidades, influenciam na estratégia de diferenciação de nutricionistas que atuam na cidade de Maringá. Para tanto, identificou-se as principais bases de diferenciação presentes no trabalho das nutricionistas investigadas, bem como os principais recursos das firmas selecionadas, a fim de analisar o seu potencial competitivo, com base em seu valor, raridade e imitabilidade. Metodologicamente, optou-se por uma pesquisa qualitativa e descritiva, envolvendo a realização de entrevistas semiestruturadas com sete nutricionistas mais seguidas no Instagram da cidade de Maringá. Os resultados evidenciaram que a principal base de diferenciação explorada é o marketing de conteúdo, bem como a customização dos serviços fornecidos. Quanto aos recursos, observou-se que os mais importantes são os recursos humanos e físicos, notadamente os tecnológicos. Em tempo, verificou-se que o pioneirismo pode contribuir para a vantagem competitiva das empresas investigadas, tanto em termos de liderança tecnológica, como pela abordagem profissional inédita. Conclui-se que as mídias sociais auxiliam na captação do cliente e na criação de públicos-alvo, além de auxiliarem na comunicação quanto a personalização dos atendimento das nutricionistas, apesar do número de seguidores não estar diretamente relacionado à posse de recursos estratégicos e ao potencial competitivo das empresas.     ABSTRACT   The purpose of this article is to understand how resources, bases of differentiation (BD), and social media can build a strategic approach based on the differentiation of nutritionists. In order to do so, the main differentiation bases present in the work of the investigated nutritionists were identified, as well as the main resources of the selected firms, in order to analyze their competitive potential, based on their value, rarity, and imitability. Methodologically, qualitative and descriptive research was chosen, involving semi-structured interviews with the seven most followed nutritionists on Instagram in the city of Maringá. The results showed that the main differentiation base explored is content marketing, as well as the customization of the services provided. As for resources, it was observed that the most important are human and physical resources, especially technological ones. In time, it was found that pioneering can contribute to the competitive advantage of the investigated companies, both in terms of technological leadership and the unprecedented professional approach. It is concluded that social media help in attracting customers and creating target audiences, in addition to assisting in communication regarding the personalization of nutritionists' care, despite the number of followers not being directly related to the possession of strategic resources and the potential competitive of companies.