The mutant prevention concentration (MPC) is defined as the lowest antimicrobial concentration required to inhibit the growth of the least susceptible bacterial cell based on an inoculum of ≥109 colony forming units (CFUs). The current protocol for MPC testing is technically demanding and time-consuming which limits its implementation into clinical microbiology laboratories. In an attempt to simplify the current MPC protocol we developed a modified MPC method, the microbroth dilution method, which requires two fewer days to complete than the current or traditional method. MPC values were consistent for all organisms and strains tested using both the traditional MPC method and the modified microbroth dilution MPC method.<p> Tigecycline is the first of a new class of compound glycylcyclines- with potent in vitro activity against Gram-positive organisms including penicillin-resistant and multi-drug resistant <i>Streptococcus pneumoniae</i> (SP) and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA). We measured minimum inhibitory concentration (MIC) and MPC values for tigecycline against 47 clinical isolates of SP and found that the MPC90 values were >500 fold higher than the MIC90 values. To determine if MPC testing of tigecycline against SP is impacted by blood in the medium, we developed a new medium able to sustain the growth of SP without the need for blood; solidified Todd-Hewitt broth (sTHB). The MPC90 values of tigecycline against SP on sTHB were only 2 fold higher than the MIC90 values. When blood was added to the sTHB, the MPC90 values again became much greater than the MIC90 values (> 256 fold higher). MPC results for <i>Staphylococcus spp.</i> against tigecycline were not impacted by blood in the medium.<p> Benzalkonium chloride (BAK) is a cationic surface-acting agent that acts on bacterial cells by disrupting the intermolecular interaction of the lipid bilayer. To determine if the <i>fluoroquinolones gatifloxacin</i> (Gfx) and moxifloxacin (Mfx) are more active (lower MIC values) in the presence of BAK, we conducted MIC, MPC, and time-kill assays. MIC testing showed that in the presence of 3.125 to 50 µg/ml of BAK, the MIC of Gfx and Mfx decreased by 8- to 5000-fold against clinical isolates of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA), MRSA, Coagulase-negative <i>Staphylococci</i>(CNS), SP, <i>Escherichia coli</i> (EC), and <i>Pseudomonas aeruginosa</i> (PA). MPC testing showed that the presence of 7 to 10 µg/ml of BAK, the MPC of Gfx and Mfx decreased by 32- to 1000-fold against clinical isolates of MRSA. Conventional time-kill studies (using a bacterial load of 105 CFUs) showed that the killing activity of Gfx against clinical MRSA isolates was enhanced in the presence of BAK with a log10-reduction (percent kill) of 1.6 (76.08%) for Gfx alone at 180 minutes compared to a log10-redecution (percent kill) of 5.4 (100%) for Gfx plus BAK at 180 minutes.<p> Alexidine (Alx) is a bisbiguanide that has been used as an effective disinfectant in the dental industry and is potentially being developed for use as an antimicrobial agent for ocular infections. We conducted susceptibility testing of Alx using MIC testing, MPC testing, and time-kill assays against Gram-positive and Gram-negative pathogens. MIC testing showed that Alx is more active against Gram-positive pathogens than Gram-negative pathogens and showed better activity than the fluoroquinolones Gfx, Mfx, and levofloxacin (Lfx) against MRSA. The MPC values measured for MRSA and MSSA against Alx were non-reproducible using the traditional MPC method. Using the microbroth dilution MPC method, MPC90 values were found to be 32 fold higher than the MIC90 values. If the experimentally determined MPC values are true MPC values, initial MPC testing indicates that Alx may have a high likelihood for selecting for resistance, however, if the MPC values are not accurate it may be necessary to modify the MPC protocol in order to complete MPC testing of Alx against MRSA and MSSA. Conventional time-kill studies (using a bacterial load of 105 CFUs) measured bactericidal activity (> 3 log10-reduction) against MRSA, MSSA, SP, and PA.

The mutant prevention concentration (MPC) is defined as the lowest antimicrobial concentration required to inhibit the growth of the least susceptible bacterial cell based on an inoculum of ≥109 colony forming units (CFUs). The current protocol for MPC testing is technically demanding and time-consuming which limits its implementation into clinical microbiology laboratories. In an attempt to simplify the current MPC protocol we developed a modified MPC method, the microbroth dilution method, which requires two fewer days to complete than the current or traditional method. MPC values were consistent for all organisms and strains tested using both the traditional MPC method and the modified microbroth dilution MPC method.<p> Tigecycline is the first of a new class of compound glycylcyclines- with potent in vitro activity against Gram-positive organisms including penicillin-resistant and multi-drug resistant <i>Streptococcus pneumoniae</i> (SP) and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA). We measured minimum inhibitory concentration (MIC) and MPC values for tigecycline against 47 clinical isolates of SP and found that the MPC90 values were >500 fold higher than the MIC90 values. To determine if MPC testing of tigecycline against SP is impacted by blood in the medium, we developed a new medium able to sustain the growth of SP without the need for blood; solidified Todd-Hewitt broth (sTHB). The MPC90 values of tigecycline against SP on sTHB were only 2 fold higher than the MIC90 values. When blood was added to the sTHB, the MPC90 values again became much greater than the MIC90 values (> 256 fold higher). MPC results for <i>Staphylococcus spp.</i> against tigecycline were not impacted by blood in the medium.<p> Benzalkonium chloride (BAK) is a cationic surface-acting agent that acts on bacterial cells by disrupting the intermolecular interaction of the lipid bilayer. To determine if the <i>fluoroquinolones gatifloxacin</i> (Gfx) and moxifloxacin (Mfx) are more active (lower MIC values) in the presence of BAK, we conducted MIC, MPC, and time-kill assays. MIC testing showed that in the presence of 3.125 to 50 µg/ml of BAK, the MIC of Gfx and Mfx decreased by 8- to 5000-fold against clinical isolates of methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA), MRSA, Coagulase-negative <i>Staphylococci</i>(CNS), SP, <i>Escherichia coli</i> (EC), and <i>Pseudomonas aeruginosa</i> (PA). MPC testing showed that the presence of 7 to 10 µg/ml of BAK, the MPC of Gfx and Mfx decreased by 32- to 1000-fold against clinical isolates of MRSA. Conventional time-kill studies (using a bacterial load of 105 CFUs) showed that the killing activity of Gfx against clinical MRSA isolates was enhanced in the presence of BAK with a log10-reduction (percent kill) of 1.6 (76.08%) for Gfx alone at 180 minutes compared to a log10-redecution (percent kill) of 5.4 (100%) for Gfx plus BAK at 180 minutes.<p> Alexidine (Alx) is a bisbiguanide that has been used as an effective disinfectant in the dental industry and is potentially being developed for use as an antimicrobial agent for ocular infections. We conducted susceptibility testing of Alx using MIC testing, MPC testing, and time-kill assays against Gram-positive and Gram-negative pathogens. MIC testing showed that Alx is more active against Gram-positive pathogens than Gram-negative pathogens and showed better activity than the fluoroquinolones Gfx, Mfx, and levofloxacin (Lfx) against MRSA. The MPC values measured for MRSA and MSSA against Alx were non-reproducible using the traditional MPC method. Using the microbroth dilution MPC method, MPC90 values were found to be 32 fold higher than the MIC90 values. If the experimentally determined MPC values are true MPC values, initial MPC testing indicates that Alx may have a high likelihood for selecting for resistance, however, if the MPC values are not accurate it may be necessary to modify the MPC protocol in order to complete MPC testing of Alx against MRSA and MSSA. Conventional time-kill studies (using a bacterial load of 105 CFUs) measured bactericidal activity (> 3 log10-reduction) against MRSA, MSSA, SP, and PA.

Made available in DSpace on 2014-07-29T15:16:38Z (GMT). No. of bitstreams: 1 Dissertacao Deyze Alencar Soares.pdf: 632456 bytes, checksum: 33012995df8eabb3f4b7509fe372764d (MD5) Previous issue date: 2010-03-26 / Paracoccidioides brasiliensis, a thermodimorphic fungus, is the causative agent of the most prevalent systemic mycosis in Latin America, paracoccidioidomycosis. The phospholipase B (PLB) enzyme is considered an important virulence factor in this dimorphic fungus, involved in the immune response of the host-pathogen interaction. Our objective was to determine whether a P. brasiliensis (Pb18) PLB is involved in adhesion / internalization of yeast and evasion of host immune responses. The effect of PLB was analysed using specific inhibition of PLB (alexidine dihydrochloride) and pulmonary surfactant in an ex vivo model (Pb18) of alveolar macrophage (MHS cells) infection. PLB enzyme assays and real time RT-PCR (qRTPCR) analysis of genes differentially expressed in the process of evasion: plb1 (phospholipase B1), icl1 (isocitrate lyase) and sod3 (Cu, Zn dismutase) and immune responses: clec2 (C-type lectin domain 2), cd14 (cluster of differentiation 14), tlr2 (toll-like receptor 2), nfkb (nuclear factor kappa B), nkrf (NF-kappaB repressing factor), il1&#946; (inteleukin-1&#946;) and tnf&#945; (tumor necrosis factor alpha) were carried out using selective inhibition of PLB activity and pulmonary surfactant. The levels of cytokines inteleukin 10 (IL-10), IL-12 and TNF-&#945;) were also determined by ELISA. PLB activity under adhesion conditions of P. brasiliensis (Pb18) to alveolar macrophage cells was found at high levels up to 6 hours post-infection. In the conditions of exposure to pulmonary surfactant and alexidine dihydrochloride, PLB activity and the level of transcripts of genes related to phagocytosis and inflammatory response were measured. We found that PLB activity had an influence on the phagocytic activity of alveolar macrophages. Alexidine dihydrochloride (0,25 &#956;M) selectively inhibited PLB activity by 66% and decreased significantly the adhesion and internalization of yeast on MHS cells. Genes involved in phagocytosis (trl2 and cd14) and inflammatory response (nrkf, tnf&#945; and il1&#946;) were down-regulated in the presence of the PLB inhibitor. In contrast, the PLB activity and internalization of fungal yeast cells increased significantly in the presence of pulmonary surfactant (100 &#956;g/mL) and genes such as clec2, important for effective phagocytosis by MHS cells, and the pro-inflammatory inhibitor (nkrf) were up-regulated. Also, the pulmonary surfactant did not alter cytokine production, while alexidine dihydrochloride decreased the levels of IL-10 and increased the levels of IL-12 and TNF-&#945;. In addition, through simultaneous analyses of gene expression for the pathogen, P. brasiliensis, we found upregulation of the genes sod3, icl1 and plb1, required for the evasion of alveolar macrophages. P. brasiliensis PLB is important for the binding and internalization of yeast at macrophage surfaces. The specific effect of inhibiting PLB enzyme activity indicates that adhesion may be facilitated indirectly via fatty acid release from phospholipids of the membrane of host cells. This is the first study to show that PLB activity may modulate immune responses to P. brasiliensis infection. / Paracoccidioides brasiliensis, fungo dimórfico, é o agente etiológico principal micose sistêmica da América Latina, paracoccidioidomicose. A enzima fosfolipase B (PLB) é considerada um importante fator de virulência nesse fungo dimórfico e está envolvida na resposta imune da interação patógeno-hospedeiro. Nosso objetivo foi determinar se a PLB de P. brasiliensis (Pb18) está envolvida na adesão e internalização de leveduras e na evasão da resposta imune hospedeira. O efeito da PLB foi analisado usando o inibidor seletivo de PLB (alexidine dihydrochloride) e o surfactante pulmonar (Survanta) em um modelo ex vivo de infecção de macrófagos alveolares (MHS) com Pb18. Ensaio enzimático de PLB e análise de genes diferencialmente expressos por RT-PCR em tempo real (qRT-PCR) no processo de evasão: plb1 (fosfolipase B1), icl1 (isocitrato liase) e sod3 (Cu, Zn dismutase); e na resposta imune: clec2 (lecitina tipo-C 2), cd14 (cluster de diferenciação 14), tlr2 (receptor toll-like 2), nfkb (fator nuclear kappaB), nkrf (repressor fator nuclear kappaB), il1&#946; (interleucina- 1 beta) e tnf&#945; (fator de necrose tumoral alfa) foram realizados usando o inibidor seletivo da atividade de PLB e surfactante pulmonar. Os níveis de citocinas interleucina 10 (IL-10), IL-12 e TNF- &#945;) foram determinados por ELISA. A atividade de PLB usadas em baixas condições para a adesão de P. brasiliensis (Pb18) obteve altos níveis em 6 horas pós-infecção. Na presença do surfactante pulmonar e alexidine dihydrochloride, a atividade da PLB e os níveis de transcritos dos genes relacionados à fagocitose e à resposta inflamatória foram quantificados. A PLB teve influência na atividade fagocítica dos macrófagos. Alexidine dihydrochloride (0,25 &#956;M) inibiu seletivamente a atividade PLB em 66% e diminuiu significativamente a adesão e internalização de leveduras por macrófagos alveolares (MHS). Genes envolvidos na fagocitose (trl2 e cd14) e resposta inflamatória (nrkf, tnf&#945; e il1&#946;) foram reprimidos na presença do inibidor de PLB. Em contraste, a atividade PLB e internalização de leveduras aumentou significativamente na presença do surfactante pulmonar (100 &#956;g/mL) e genes assim como clec2, importante para uma fagocitose efetiva pelos macrófagos alveolares (MHS), e o inibidor pró-inflamatório (nkrf) foram induzidos. Entretanto, o surfactante pulmonar não alterou a produção de citocinas, enquanto que alexidine dihydrochloride diminuiu os níveis de IL-10 e aumentou os níveis de IL-12 e TNF-&#945;. Em adição, nas análises simultâneas de expressão de genes, P. brasiliensis, houve indução dos genes sod3, icl1 e plb1, requeridos para a evasão dos macrófagos alveolares. A PLB de P. brasiliensis é importante na adesão e internalização de leveduras pelos macrófagos alveolares. O efeito específico da inibição da atividade da PLB indica que a adesão pode ser facilitada indiretamente via liberação de ácidos graxos dos fosfolipídeos de membrana das células hospedeiras. Esse é o primeiro estudo mostrando que a atividade da PLB pode modular a resposta imune à infecção pelo P. brasiliensis.