Camu-camu (Myrciaria dubia (Kunth) McVaugh) is a fruit economically relevant to the Amazon region, mostly consumed in the form of processed pulp. Our aim was to perform an unprecedented comparative study on the chemical composition and bioactivities of the camu-camu pulp and industrial bio-residues (peel and seed), and then the most promising fruit part was further explored as a functionalized ingredient in yogurt. A total of twenty-three phenolic compounds were identified, with myricetin-O-pentoside and cyanindin-3-O-glucoside being the main compounds in peels, followed by p-coumaroyl hexoside in the pulp, and ellagic acid in the seeds. The peel displayed the richest phenolic profile among samples, as well as the most significant antibacterial (MICs = 0.625–10 mg/mL) and anti-proliferative (GI50 = 180 µg/mL against HeLa cells) activities. For this reason, it was selected to be introduced in a food system (yogurt). Taken together, our results suggest the possibility of using the camu-camu peel as a source of food additives.

Vancomycin-resistant enterococci (VRE) are important hospital pathogens and have become increasingly common in patients admitted to the intensive care unit (ICU). To determine the incidence and the risk factors associated with VRE colonisation among ICU patients, active surveillance cultures for VRE faecal carriages were carried out in patients admitted to the ICU of the University Hospital of Uberlândia, Minas Gerais, Brazil. Risk factors were assessed using a case-control study. Seventy-seven patients (23.1%) were found to be colonised with vanC VRE and only one patient (0.3%) was colonised with vanA VRE. Independent risk factors for VRE colonisation included nephropathy [odds ratio (OR) = 13.6, p < 0.001], prior antibiotic use (OR = 5.5, p < 0.03) and carbapenem use (OR = 17.3, p < 0.001). Our results showed a higher frequency (23.1%) of Enterococcus gallinarum and Enterococcus casseliflavus, species that are intrinsically resistant to low levels of vancomycin (vanC), without an associated infection, associated with prior antibiotic use, carbapenem use and nephropathy as comorbidity. This study is the first to demonstrate the risk factors associated with vanC VRE colonisation in ICU hospitalised patients. Although vanA and vanB enterococci are of great importance, the epidemiology of vanC VRE needs to be better understood. Even though the clinical relevance of vanC VRE is uncertain, these species are opportunistic pathogens and vanC VRE-colonised patients are a potential epidemiologic reservoir of resistance genes.

Our findings demonstrated that the results obtained for ampicillin may accurately predict the in vitro susceptibility to amoxicillin but not to imipenem and piperacillin among isolates of Enterococcus faecalis resistant to penicillin but susceptible to ampicillin, which have emerged recently, in contrast to penicillin-and ampicillin-susceptible isolates. Enterococci are intrinsically resistant to several antimicrobial classes and show a great ability to acquire new mechanisms of resistance. Resistance to ␤-lactam antibiotics is a great concern because these drugs are commonly used for treatment of enterococcal infections, alone or associated with aminoglycosides, since such combination therapy results in the synergistic killing of the enterococci (5). ␤-Lactamase production, overproduction of lowaffinity penicillin-binding proteins (PBPs), and occurrence of point mutations in PBPs, especially PBP5, are the mechanisms of ␤-lactam resistance that have been reported in enterococci (5,12).Although all enterococci are intrinsically resistant to cephalosporins, Enterococcus faecalis remains usually susceptible to the other ␤-lactam antibiotics, including the carbapenems, in contrast to Enterococcus faecium. Furthermore, until recently, it was assumed that E. faecalis strains exhibiting susceptibility to ampicillin were also susceptible to penicillin; however, the emergence of isolates resistant to penicillin but susceptible to ampicillin showed that the resistance to both ␤-lactams may not be linked in enterococci (6,8). Currently, according to the Clinical and Laboratory Standards Institute (CLSI) (3), ampicillin results may be used to predict E. faecalis susceptibility to amoxicillin, imipenem, and piperacillin among non-␤-lactamase-producing E. faecalis strains, while isolates susceptible to ampicillin cannot be assumed to be susceptible to penicillin. Therefore, as there are few published studies about penicillin-resistant, ampicillin-susceptible E. faecalis strains, we propose here to evaluate whether the susceptibility to ampicillin can really predict the susceptibility to amoxicillin, imipenem, and piperacillin among E. faecalis isolates exhibiting this unusual penicillin resistance phenotype.(This study was presented in part at the 21st European Congress of Clinical Microbiology and Infectious Diseases [ESCMID], Milan, Italy, 7 to 10 May 2011.)A collection of 317 E. faecalis isolates, recovered during a study conducted at a Brazilian hospital in the period of February 2006 to June 2010 (4), was tested for ampicillin and penicillin susceptibility. Thirty-four (10.7%) isolates were penicillin resistant and ampicillin susceptible in the three susceptibility tests performed (Etest, broth dilution, and disk diffusion). The species identification of all selected isolates was performed based on phenotypic tests (9) and confirmed by PCR using specific primers described elsewhere (4). These isolates were recovered from wounds (35.3%), urine (32.4%), secretions (14.7%), blood (11.8%), and catheter tip (5.9%). They showe...