Chlamydia trachomatis, the most common bacterial sexually transmitted disease agent worldwide, enters a viable, non-dividing and non-infectious state (historically termed persistence and more recently referred to as the chlamydial stress response) when exposed to penicillin G in culture. Notably, penicillin G-exposed chlamydiae can reenter the normal developmental cycle upon drug removal and are resistant to azithromycin-mediated killing. Because penicillin G is less frequently prescribed than other ß-lactams, the clinical relevance of penicillin G-induced chlamydial persistence/stress has been questioned. The goal of this study was to determine whether more commonly used penicillins also induce C. trachomatis serovar E persistence/stress. All penicillins tested, as well as clavulanic acid, induced formation of aberrant, enlarged reticulate bodies (RB) (called aberrant bodies or AB) characteristic of persistent/stressed chlamydiae. Exposure to the penicillins and clavulanic acid also reduced chlamydial infectivity by >95%. None of the drugs tested significantly reduced chlamydial unprocessed 16S rRNA or genomic DNA accumulation, indicating that the organisms were viable, though non-infectious. Finally, recovery assays demonstrated that chlamydiae rendered essentially non-infectious by exposure to ampicillin, amoxicillin, carbenicillin, piperacillin, penicillin V, and clavulanic acid recovered infectivity after antibiotic removal. These data definitively demonstrate that several commonly used penicillins induce C. trachomatis persistence/stress at clinically relevant concentrations.

Les taux de multi-résistance aux antibiotiques chez les entérobactéries sont croissants en milieu hospitalier en Tunisie. Cette évolution remet notamment en cause l'efficacité de certaines molécules d'importance clinique majeure telles que les ß-lactamines.Par ailleurs, la résistance aux ß-lactamines n'est pas restreinte aux bactéries responsables d'infections humaines, elleest également rencontrée chez les bactéries issues du milieu vétérinaire. C'est dans ce cadre que s'est inscrit ce travail de thèse, qui avait pour objectif d'identifier les mécanismes de résistance aux céphalosporines de dernière génération chez des souches bactériennes isolées des deux contextes (humain et animal), et de faire une caractérisation moléculaire des plasmides responsables dans le but de contribuer à une meilleure connaissance de l'épidémiologie comparée Homme/animal.La caractérisation génotypique a montré que, dans les deux contextes, l'enzyme CTX-M est largement dominante parmi les?-lactamases à spectre étendu (BLSE) identifiées. Plus spécifiquement, le plasmide CTX-M-1/IncI1/ST3, déjà bien implanté chez l'animal en Europe, est également très prévalent chez l'animal en Tunisie, qu'il s'agisse d'animaux de production ou de compagnie. Chez l'Homme, les souches hospitalières de K. pneumoniaeproduisent principalement l'enzyme CTX-M-15, dont le gène codant est porté par des plasmides de type IncFII.Egalement, une carbapénémase très récemment décrite (OXA-204) a été identifiée dans notre hôpital, associée à un plasmide du type IncA/C. Des gènes de résistance plasmidique aux fluoroquinolones ont également été décrits.Ces résultats d'épidémiologie moléculaire sont essentiels pour une meilleure compréhension des risques de transmission croisée entre l'Homme et l'animal, ainsi qu'entre différents contextes de soins (communauté et hôpital) en Tunisie / Multidrug resistance in Enterobacteriaceae is rising up dramatically at hospital in Tunisia. Such an evolution impairs the clinical efficacy of antibiotics for humans, in particular of the widely used ß-lactams.On the other hand, resistance to ß-lactamsis not restricted to bacteria affecting humans but has also been abundantly recognized in bacteria isolated in veterinary medicine. The aimof this thesis was to identify the resistance mechanisms to broad-spectrum cephalosporins in bacteria isolated from humans and animals and to fully characterize the plasmids carrying those genes in order to contribute to a better knowledge of the molecular epidemiology of resistance in both contexts.Genotypic characterization showed that the CTX-M was the Extended-Spectrum Beta-Lactamases (ESBL) dominant type in both cases. In particular, the CTX-M-1/IncI1/ST3 plasmid, which was already found to circulate in animals in Europe, was also found very prevalent both in food- and companion animals in Tunisia. On the other hand, in humans at hospital, we highlighted the dominance ofK. pneumoniaeisolates producing CTX-M-15 associated with the spread of IncFIIk-type plasmids. We also reported the recently described blaOXA-204carbapenemasegene located on an IncA/C-type plasmid. In addition, plasmid-mediated fluoroquinolone resistance genes were reported.Those data are essential for a better understanding of the comparative molecular epidemiology of resistance to ß-lactams (in particular to broad-spectrum cephalosporins) in Tunisia in order to accurately assess the risk of inter-transmission between humans and animals

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2017-01-27T09:34:21Z No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-30T10:01:07Z (GMT) No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-01-30T10:01:07Z (GMT). No. of bitstreams: 2 Dissertação - Lara Barroso Brito - 2016.pdf: 19284674 bytes, checksum: 73aa3e2fc34b886b960712220045839d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-03-23 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Pharmaceuticals can be introduced directly into the environmental by household disposal or pharmaceutical industry waste and indirectly through the excretion of humans and animals. Antibiotics are considered emerging contaminants because they are typically present at very low levels in the environmental and their human or ecological health effects are unclear. β-lactams represent more than 70% of antibiotics consumed in Brazil. Thus, in this context, this work evaluated the environmental impact of antibiotic amoxicillin (AMX) in different organisms, considering its presence in water. For that, we used the phytotoxicity test with seeds of tomato (Lycopersicon esculentum), cucumber (Cucumis sativus) and lettuce (Lactuca sativa), brine shrimp toxicity assay (Artemia salina), and embryo-larval toxicity test zebrafish (D. rerio), considering the lethal and sublethal effects and biomarkers determinations. AMX showed no toxicity to seeds of tomato, cucumber and lettuce in relation to seed germination and root elongation endpoints. For microcrustacean A. salina, AMX did not induce significant mortality after 24 h and 48 h exposure (LC50 > 100 mg/L) and it was classified as non-toxic (not categorized) according to the Globally Harmonized System (GHS). AMX also did not cause significant mortality in embryos and larvae zebrafish during 168 h of exposure. It had no significant effect on embryos hatching and larvae equilibrium. However, AMX significantly increased the larvae size at 6.25, 12.5 and 25 mg/L. Catalase (CAT), glutathione S-transferase (GST) and lactate dehydrogenase (LDH) activities in embryos and larvae of zebrafish were inhibited at 12.5 mg/L of AMX, 6.25, 12.5, 25, 50 and 100 mg/L of AMX and 1.5, 3.0, 6.25 and 12.5 mg/L of AMX, respectively. Therefore, AMX showed no significant acute toxicity to tested organisms, but it induced sublethal effects on larvae zebrafish in concentrations greater than those found in the aquatic environment, indicating that long-term chronic exposures must be investigated. / Os fármacos e insumos farmacêuticos podem ser introduzidos no ambiente de forma direta, ou seja, através do descarte doméstico ou por efluentes da indústria farmacêutica, e ainda indiretamente, por meio da excreção humana e animal. Os antibióticos são considerados contaminantes emergentes, uma vez que são detectados em concentrações muito baixas no ambiente e seus efeitos sobre o ambiente e saúde humana permanecem incertos. Os β- lactâmicos representam mais de 70% dos antibióticos consumidos no Brasil. Assim, dentro deste contexto, este trabalho propôs avaliar o impacto ambiental do antibiótico amoxicilina (AMX) em diferentes organismos, considerando a sua presença nos recursos hídricos. Para tanto foram utilizados os ensaios de fitotoxicidade com sementes de tomate (Lycopersicon esculentum), pepino (Cucumis sativus) e alface (Lactuca sativa) e de toxicidade aguda com Artemia salina, assim como o teste com o estágio embriolarval de zebrafish (Danio rerio), considerando os efeitos letais, subletais e atividade de biomarcadores enzimáticos. A AMX não foi tóxica para as sementes de tomate, pepino e alface, não apresentando diferenças estatísticas significativas para os parâmetros de germinação das sementes e do desenvolvimento das raízes. Para o microcrustáceo A. salina, a AMX não induziu mortalidade significativa com valores de CL50 maior que 100 mg/L para 24 h e 48 h de exposição, sendo classificada como não tóxica (não categorizada) de acordo com o Globally Harmonized System (GHS). A AMX não provocou mortalidade significante nos embriões e larvas de zebrafish durante as 168 h de exposição, assim como não alterou significativamente a eclosão dos embriões e o equilíbrio de larvas de zebrafish. Entretanto, o antibiótico aumentou significativamente o tamanho das larvas desse peixe nas concentrações de 6,25; 12,5 e 25 mg/L. As atividades da catalase (CAT), da glutationa Stransferase (GST) e da lactato desidrogenase (LDH) de embriões e larvas de peixezebra foram inibidas significativamente nas exposições à 12,5 mg/L de AMX, 6,25; 12,5; 25; 50 e 100 mg/L de AMX e 1,5; 3,0; 6,25 e 12,5 mg/L de AMX, respectivamente. Portanto, o antibiótico AMX não apresenta toxicidade aguda relevante para os organismos testados, mas causa alguns efeitos subletais em larvas de zebrafish em concentrações superiores às encontradas no ambiente aquático, o que indica a necessidade de se investigar exposições a esse composto a longo prazo.

The neurotoxic potential of intravenous administered benzylpenicillin (BPC) was studied in rabbits with intact blood-CNS barriers and rabbits with experimental E. coli meningitis. At onset of epileptogenic EEG activity or seizures, serum, CSF and brain tissue were collected for assay of BPC. Based on the fact that, in tissues, BPC seems to remain extracellularly, brain concentrations of BPC were expressed as brain tissue fluid (BTF) levels, calculated as lOx the concentration in whole brain tissue. Neurotoxicity could be precipitated in all rabbits. In normal rabbits BTF levels of BPC were considerably higher than those in CSF indicating a better penetration across the blood-brain barrier (BBB). BPC penetrated better to CSF and BTF in meningitic rabbits than in normal controls, suggesting some degree of damage of the BBB concomitant with meningeal inflammation. E. coli meningitis did not increase the neurotoxicity of BPC. In control rabbits the intracistemal injection of saline resulted in some degree of pleocytosis. Unmanipulated animals are therefore preferable as controls. Epileptogenic EEG-changes was the most precise of the two variables used for demonstration of neurotoxicity. EEG-changes were therefore used as neurotoxicity criterion in the following rabbit experiments. To evaluate the effect of uraemia alone and uraemia plus meningitis on the neurotoxity of BPC in rabbits, cephaloridine was used to induce uraemia. Meningitis was induced by intracistemal inoculation of a cephalosporinresistant strain of E. cloacae. Untreated  rabbits were used as controls. Uraemia resulted in increased BTF penetration of BPC, possibly explained by permeability changes in the BBB and/or decreased binding of BPC to albumin. Uraemia did not result in increased penetration of BPC into the CSF of non-meningitic rabbits. Uraemic non-meningitic rabbits had the highest BTF levels of BPC at the criterion, indicating that cephaloridine-induced renal failure increased the epileptogenic threshold in these rabbits. The combination of uraemia and meningitis increased the neurotoxicity of BPC since the criterion was reached at considerably lower BTF levels of BPC. Meningitis, either alone or together with uraemia, did not increase the neurotoxicity in comparison to control rabbits. Higher BTF levels of BPC were found in meningitic rabbits than in controls with intact blood-CNS barriers at onset of EEG-changes. In all groups of rabbits there was a pronounced variability of BPC levels in the CSF while the intra-group variations in BTF levels were much smaller. Thus, BTF and not CSF levels were decisive for the neurotoxicity of BPC. Using   the same EEG-model, the neurotoxic potential of imipenem/cilastatin (I) and a new penem derivative, FCE 22101 were compared in a cross-over study. Both I and FCE 22101 were significantly more neurotoxic than BPC. While BTF levels of the three antibiotics could be detected in all tested rabbits, detectable CSF levels were only found in one of twelve rabbits treated with I or FCE 22101, indicating that BTF concentrations rather than CSF ones are decisive for neurotoxicity of ß-lactam antibiotics. The EEG-model used was found to be a suitable model for cross-over studies of intravenously administered antibiotics. Using the "silent-second" as EEG-threshold, a CNS interaction between intraperitoneally administered BPC and intravenous thiopental was demonstrated in rats. The most probably site for this interaction is the organic acid transport system out of the CNS. Thiopental distribution in the rat brain seemed to depend not only on its lipid solubility. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1988, härtill 5 uppsatser.</p> / digitalisering@umu