Leifsonia xyli subsp. xyli (Davis et al.; 1984; Evtushenko et al.; 2000) é agente causal de uma das mais importantes doenças da cana-de-açúcar: o raquitismo-da-soqueira (Gillaspie Jr. & Davis, 1992; Davis et al.; 1994). O presente trabalho teve como objetivo principal usar métodos de análise cromossômica para corroborar o mapa genômico da estirpe CTC B07 de L. xyli subsp. xyli obtido através do seqüenciamento por "shotgun", realizado pelo grupo de seqüenciamento de Genomas Agronômicos e do Meio-ambiente (AEG) da rede ONSA-FAPESP. A identidade do isolado foi confirmada com a amplificação e seqüenciamento da região 23S do rRNA bem como por meio de testes sorológicos de microaglutinação com antissoro específico. Além destes, foram realizados testes de microscopia eletrônica de varredura da bactéria cultivada em meio líquido para confirmar a pureza do isolado. O tamanho do genoma de L. xyli subsp. xyli foi estimado com base na análise de fragmentos de restrição gerados por digestões com as enzimas de restrição XbaI e SpeI e eletroforese de campo pulsado (PFGE). As estimativas de 2.540 kb e 2.530 kb com XbaI e SpeI respectivamente ficaram próximas ao valor obtido pelo seqüenciamento genômico (2.596.959 pb). Em adição, o número de seqüências repetidas e de genes ribossomais identificados pelo projeto genoma foram confirmados por meio de hibridizações com sondas apropriadas. Comparações genômicas de L. xyli subsp. xyli, L. xyli subsp. cynodontis e duas espécies de Clavibacter também foram objetivos deste trabalho. As comparações foram baseadas em análise de RFLPs após a hibridização do DNA genômico utilizando como sondas elementos genéticos móveis presentes no genoma de L. xyli subsp. xyli. As estimativas dos números estimado de cópias destes elementos no genoma de L. xyli subsp. xyli obtidas por hibridizações concordam com aquelas obtidas pelo seqüenciamento, considerando fragmentos RFLPs menores que 9 kb. Informações referentes à fragmentos maiores não foram obtidas uma vez que estes não foram adequadamente resolvidos na corrida eletroforética. Finalmente, comparações através de análise de RFLP e rep-PCR mostraram diferenças entre L. xyli subsp. xyli e L. xyli subsp. cynodontis bem como entre estas e espécies de Clavibacter. Não foram verificadas diferenças entre a estirpe CTC B07 de L. xyli subsp. xyli e a estirpe australiana. / Leifsonia xyli subsp. xyli (Davis et al.; 1984; Evtushenko et al.; 2000) is the causal agent of one of the most economically important disease of sugarcane worldwide, i.e, ratoon stunting disease (Gillaspie Jr. & Davis, 1992; Davis et al.; 1994). The main objective of this study was to confirm the assembly of the genome of L. xyli subsp. xyli obtained after shotgun sequencing by the Agronomic and Enviromental Genomes group of the ONSA/FAPESP network. The identity of the strain was confirmed by amplification and sequencing of the 23S rRNA region as well as by microaglutination serological tests with specific antiserum. Besides this, scanning electron microscopic analysis was used to assess the purity of the strain culture. The size of the genome of L. xyli subsp. xyli was estimated based on restriction analysis after digestion of genomic DNA with SpeI and XbaI followed by pulsed-field gel electrophoresis. The estimates of 2,530 kb and 2,540 kb, respectively for SpeI and XbaI, are in agreement with the one obtained by whole genome sequencing (2,596 kb). In addition, the number of repeated sequences and ribossomal genes predicted by thesequencing project was confirmed by hybridization experiments with the appropriate probes. Genomic comparisons of L. xyli subsp. xyli, L. xyli subsp. cynodontis and two Clavibacter species comprised a second objective of this study. Comparisons were based on RFLP analysis after hybridization of digested genomic DNA using mobile genetic elements present in the genome of L. xyli subsp. xyli as probes. The estimates of number of copies of these elements in the genome of L. xyli subsp. xyli obtained by this approach agreed with the ones obtained by sequencing if RFLP fragments smaller than 9 kb are considered. Data from larger fragments were not obtained since they were not adequately resolved by electrophoresis. Finally, RFLP and rep-PCR comparisons unveiled differences between L. xyli subsp. xyli and L. xyli subsp. cynodontis as well as between these and Clavibacter. No differences were found between strain CTC B07 of L. xyli subsp. xyli and an Australian strain.

Sulfonated phthalocyanines were characterized using capillary electrophoresis and mass spectrometry. Derivatives investigated included the copper, cobalt, zinc and metal-free sulfonated phthalocyanines. The electropherograms of commercially available copper phthalocyanine-3,4',4'',4'''-tetrasulfonic acid and 4,4',4'',4'''-tetrasulfonic acid were very different, consistent with the latter compound having a structure that is not fully sulfonated. Matrix-assisted laser desorption/ionization (MALDI) and electrospray ionization (ESI) were used to characterize the sulfonated phthalocyanines. Mass spectral evidence was obtained for a pentasulfonated species of both the metal-free phthalocyanine and zinc phthalocyanine when these species were made by sulfonation of the metal-free phthalocyanine (followed by zinc insertion in the latter case). Many pathogenic bacteria require heme and obtain it from their environment. Heme transverses the cytoplasmic membrane via an ATP binding cassette (ABC) pathway. Although a number of heme ABC transport systems have been described in pathogenic bacteria, there is as yet little biophysical characterization of the proteins in these systems. The sia (hts) gene cluster encodes a heme ABC transporter in the Gram positive Streptococcus pyogenes. The heme binding protein (HBP) of this transporter is SiaA (HtsA). Several biophysical techniques were used to determine the coordination state, and spin state of both the ferric and ferrous forms of this protein. Identifiers from these techniques suggested that the heme is six-coordinate and low spin in both oxidation states of the protein, with methionine and histidine as axial ligands. The pKa of SiaA was determined, as were the reductive and oxidative midpoint potentials. Guanidinium titration studies of wild-type SiaA showed that the ferric state is less stable than the ferrous state. Free energy of unfolding values [ÄG(H2O)] for the oxidized and reduced proteins were 7.3 ± 0.8 and 16.0 ± 3.6 kcal mol−1, respectively. Denaturation of the histidine mutant H229A was not able to be followed via absorbance spectrometry, possibly due to the large amount of apoprotein present or to non-specific binding of the heme in the binding pocket. The biophysical characterization described herein will significantly advance our understanding of structure-function relationships in HBP.

Diss. Linköping : Linköpings universitet, 2007.

Thesis (MScFoodSc)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The regular consumption of probiotics is becoming a recognized trend in the food industry due to several reported health benefits. A probiotic is defined as a live microbial feed supplement that beneficially affects the host animal by improving its intestinal microbial balance. A wide variety of probiotic food products are available on the South African market and comprise an assortment of fermented milks, as well as lyophilized preparations in tablet or capsule form. Strains of Lactobacillus acidophilus and Bifidobacterium species are mostly used as probiotic microbes in the industry due to their health enhancing effect. The survival of sensitive probiotic microbial species in food matrices are influenced by various factors such as oxygen concentration, pH levels and manufacturing and storage conditions. These should be considered and monitored as the South African food and health regulations stipulate that probiotic microbes should be present at a concentration of 10⁶ cfu.ml ̄ ¹' in order to exert a beneficial effect. Some health benefits are also correlated to specific microbial species and strains and these factors have resulted in the need for the rapid and accurate identification of probiotic microbes present in food products. The probiotic microbes present in probiotic yoghurts and supplements have in the past been identified using traditional methods such as growth on selective media, morphological, physiological and biochemical characteristics. However, even some of the most sophisticated cultural-dependant techniques are not always sufficient for the identification and classification of especially Bifidobacterium, as well as closely related Lactobacillus species. Molecular techniques are more often employed for the rapid and accurate detection, identification and characterization of microbial species present in food products. The aim of this study was to detect and identify the probiotic species present in various commercial South African yoghurts and lyophilized preparations using peR-based DGGE analysis. A 200 bp fragment of the V2-V3 region of the 16S rRNA gene was amplified and the peR fragments were resolved by DGGE. The unique fingerprints obtained for each product were compared to two reference markers A and B in order to identify the bands present. The results obtained were verified by species-specific peR, as well as sequence analyses of bands that could not be identified when compared to the reference markers. Only 54.5% of the South African probiotic yoghurts that were tested did contain all the microbial species as were mentioned on the labels of these products, compared to merely one third (33.3%) of the lyophilized probiotic food supplements. Some Bifidobacterium species were incorrectly identified according to some product labels, while other products contained various microbes that were not mentioned on the label. Sequence analysis confirmed the presence of a potential pathogenic Streptococcus species in one of the yoghurt products and in some instances the probiotic species claimed on the labels were non-scientific and misleading. The data obtained in this study showed that the various South African probiotic products tested were of poor quality and did not conform to the South African regulations. peR-based DGGE analysis proofed to be a valuable approach for the rapid and accurate detection and identification of the microbial species present in South African probiotic products. This could help with future implementation of quality control procedures in order to ensure a reliable and safe probiotic product to the consumer. / AFRIKAANSE OPSOMMING: Die gereelde inname van probiotiese produkte is besig om In erkende tendens in die voedselindustrie te word, as gevolg van verskeie gesondheidsvoordele wat daaraan gekoppel word. In Probiotika word gedefinieer as In voedingsaanvulling wat uit lewendige mikrobes bestaan en wat In voordelige effek op mens of dier het deur In optimale mikrobiese balans in die ingewande te handhaaf. In Wye verskeidenheid probiotiese voedselprodukte is tans beskikbaar op die Suid- Afrikaanse mark. Hierdie bestaan hoofsaaklik uit verskeie gefermenteerde melkprodukte asook 'n reeks tablette en kapsules wat probiotiese mikrobes in gevriesdroogde vorm bevat. Lactobacillus acidophilus tipes en Bifidobacterium spesies word die algemeenste in die voedselindustrie gebruik aangesien hierdie spesifieke mikrobes bekend is om goeie gesondheid te bevorder. Die oorlewing van sensitiewe probiotiese mikrobiese spesies in voedsel matrikse word beïnvloed deur faktore soos suurstof konsentrasie, pH-vlakke en vervaardigings- en opbergings kondisies. Hierdie faktore moet in aanmerking geneem word en verkieslik gemonitor word aangesien die Suid-Afrikaanse voedsel en gesondheids regulasies stipuleer dat probiotiese mikrobes teen In konsentrasie van 10⁶ kolonie vormende eenhede per ml teenwoordig moet wees om In voordelige effek te toon. Sommige gesondheidsvoordele word direk gekoppel aan spesifieke mikrobiese spesies en spesie-tipes. Hierdie faktore het gelei tot In groot aanvraag na vinnige en akkurate metodes vir die identifikasie van probioties mikrobes in voedselprodukte. Die probiotiese mikrobes teenwoordig in probiotiese joghurts en ook die gevriesdroogde vorms in tablette en kapsules, was al geïdentifiseer deur gebruik te maak van tradisionele metodes soos groei op selektiewe media, morfologiese, fisiologiese en biochemiese eienskappe. Selfs van die mees gesofistikeerde kultuur-afhanklike tegnieke is egter nie altyd voldoende vir die identifikasie en klassifikasie van veral Bifidobacterium en na-verwante Lactobacillus spesies nie. Molekulêre metodes word dikwels aangewend vir die vinnige en akkurate deteksie, identifikasie en karakterisering van mikrobes teenwoordig in voedselprodukte. Die doel van hierdie studie was om die probiotiese mikrobes teenwoordig in verskeie Suid-Afrikaanse joghurts en gevriesdroogde aanvullings, te identifiseer deur gebruik te maak van polimerase kettingreaksie (PKR)-gebaseerde denaturerende gradiënt jelelektroforese (DGGE) analise. 'n PKR fragment van 200 bp van die V2-V3 gedeelte van die 16S ribosomale RNS (rRNS) geen is geamplifiseer, en die PKR fragmente is geskei met behulp van DGGE. Die unieke vingerafdrukke wat verkry is vir elke produk is teen twee verwysings merkers A en B vegelyk om die bande teenwoordig in die profiele te identifiseer. Die resultate is bevestig deur spesies-spesifieke PKR en ook deur die ketting volgordes van die DNS fragmente te bepaal wat nie geïdentifiseer kon word deur vergelyking met die verwysings merkers nie. Slegs 54.5% van die Suid-Afrikaanse probiotiese joghurts wat getoets is het al die mikrobiese spesies bevat soos aangedui was op die etikette van hierdie produkte, teenoor slegs 'n derde (33.3%) van die gevriesdroogde voedingsaanvullings. Sekere Bifidobacterium spesies is verkeerd geïdentifiseer op sommige van die produk etikette, terwyl ander produkte verskeie mikrobes bevat het wat nie op die etiket aangedui was nie. 'n Potensiële patogeniese Streptococcus spesie is in een van die joghurt produkte gevind soos bevestig deur DNS kettingvolgorde bepalings. In sommige gevalle was die probiotiese spesienaam wat aangedui is op die etiket onwetenskaplik en misleidend. Die resultate wat uit hierdie studie verkry is dui aan dat die Suid-Afrikaanse probiotiese produkte wat getoets is van 'n swak gehalte is en nie aan die Suid- Afrikaanse regulasies voldoen nie. Daar is getoon dat PKR-gebaseerde DGGE analise 'n waardevolle tegniek kan wees vir die akkurate deteksie en identifisering van die mikrobiese spesies teenwoordig in probiotiese produkte. Dit kan help met die toekomstige implementering van kwaliteitskontrolerings prosedures om 'n mikrobiologiese betroubare en veilige produk aan die verbruiker te verseker.

Actuellement, le traitement des pathologies infectieuses chez les bovins et les animaux de compagnie est menacé par l’accroissement de l’antibiorésistance et des bactéries multirésistantes. Il est donc primordial pour les entreprises pharmaceutiques vétérinaires de développer de nouvelles gammes d’agents antibactériens spécifiques au domaine animale. Dans ce contexte, il a été montré que certains polyaminostérols naturels tels que la squalamine possèdent un fort potentiel antimicrobien. Ainsi, l’objectif de ce travail de thèse est de répondre à la problématique présentée par la société Virbac dans le traitement des mammites (bovins) et des otites/pyodermites (chien) par le développement d’une nouvelle classe de dérivés polyaminostéroïdiens synthétiques à large spectre antimicrobien. Pour cela, nous avons constitué une chimiothèque de composés originaux préparés à partir de différents acides biliaires selon des voies de synthèse inédites. Ces composés ont été évalués in vitro pour leur cytotoxicité et leurs activités antibactériennes contre diverses bactéries à Gram positif et à Gram négatif et nous avons pu établir la preuve de concept in vitro de leur potentiel thérapeutique en tant qu’agents antibactériens ou adjuvants d’antibiotiques. De plus, nous avons montré que l’un de ces nouveaux dérivés, la claramine A1, agit sur l’intégrité physique des membranes bactériennes et sur les performances d'efflux des pompes AcrAB-TolC. Ainsi, il apparaît finalement que ces dérivés polyaminostéroïdiens au mode d’action non conventionnel pourraient constituer une nouvelle classe d’agents antibactériens pour un usage en tant que substituts d’antibiotiques en médecine vétérinaire. / Currently, the treatment of infectious pathologies in cattle and pets is threatened by the growing antimicrobial resistance and the development of multidrug-resistant bacteria. Thus it is necessary for the veterinary pharmaceutical firms to develop new lines of antibacterial agents. In this context, some natural polyaminosterols such as squalamine have gained interest due to their potent antimicrobial activities. Thus the aim of this PhD work is to provide an answer in the treatment of mastitis (cattle) and otitis/pyoderma (dog) by the development of a new class of synthetic polyaminosterols with a broad spectrum of antibacterial activity. In this purpose, a chemical library of original compounds has been prepared starting from various bile acids by using unprecedented synthesis procedures. These compounds were evaluated for their in vitro cytotoxicity on CHO cells as well as their antibacterial activities against Gram-positive and Gram-negative bacteria and we have establish the in vitro proof of concept of the therapeutic potential of this family of molecules as antibacterial agent or antibiotic adjuvant. Additional investigations were then conducted on one of these novel derivatives namely claramine A1 to deepen knowledge of its mechanism of action and showed that claramine A1 acts on the physical integrity of bacterial membranes and the efflux performance of AcrAB-TolC pumps. Based on the results of claramine A1, it finally appears that these new polyaminosterol derivatives possessing a non-classical mode of action pertain to a new class of antibacterial agents and could constitute a substitute for traditional antibiotics in veterinary medicine.

Leifsonia xyli subsp. xyli (Davis et al.; 1984; Evtushenko et al.; 2000) é agente causal de uma das mais importantes doenças da cana-de-açúcar: o raquitismo-da-soqueira (Gillaspie Jr. & Davis, 1992; Davis et al.; 1994). O presente trabalho teve como objetivo principal usar métodos de análise cromossômica para corroborar o mapa genômico da estirpe CTC B07 de L. xyli subsp. xyli obtido através do seqüenciamento por “shotgun”, realizado pelo grupo de seqüenciamento de Genomas Agronômicos e do Meio-ambiente (AEG) da rede ONSA-FAPESP. A identidade do isolado foi confirmada com a amplificação e seqüenciamento da região 23S do rRNA bem como por meio de testes sorológicos de microaglutinação com antissoro específico. Além destes, foram realizados testes de microscopia eletrônica de varredura da bactéria cultivada em meio líquido para confirmar a pureza do isolado. O tamanho do genoma de L. xyli subsp. xyli foi estimado com base na análise de fragmentos de restrição gerados por digestões com as enzimas de restrição XbaI e SpeI e eletroforese de campo pulsado (PFGE). As estimativas de 2.540 kb e 2.530 kb com XbaI e SpeI respectivamente ficaram próximas ao valor obtido pelo seqüenciamento genômico (2.596.959 pb). Em adição, o número de seqüências repetidas e de genes ribossomais identificados pelo projeto genoma foram confirmados por meio de hibridizações com sondas apropriadas. Comparações genômicas de L. xyli subsp. xyli, L. xyli subsp. cynodontis e duas espécies de Clavibacter também foram objetivos deste trabalho. As comparações foram baseadas em análise de RFLPs após a hibridização do DNA genômico utilizando como sondas elementos genéticos móveis presentes no genoma de L. xyli subsp. xyli. As estimativas dos números estimado de cópias destes elementos no genoma de L. xyli subsp. xyli obtidas por hibridizações concordam com aquelas obtidas pelo seqüenciamento, considerando fragmentos RFLPs menores que 9 kb. Informações referentes à fragmentos maiores não foram obtidas uma vez que estes não foram adequadamente resolvidos na corrida eletroforética. Finalmente, comparações através de análise de RFLP e rep-PCR mostraram diferenças entre L. xyli subsp. xyli e L. xyli subsp. cynodontis bem como entre estas e espécies de Clavibacter. Não foram verificadas diferenças entre a estirpe CTC B07 de L. xyli subsp. xyli e a estirpe australiana. / Leifsonia xyli subsp. xyli (Davis et al.; 1984; Evtushenko et al.; 2000) is the causal agent of one of the most economically important disease of sugarcane worldwide, i.e, ratoon stunting disease (Gillaspie Jr. & Davis, 1992; Davis et al.; 1994). The main objective of this study was to confirm the assembly of the genome of L. xyli subsp. xyli obtained after shotgun sequencing by the Agronomic and Enviromental Genomes group of the ONSA/FAPESP network. The identity of the strain was confirmed by amplification and sequencing of the 23S rRNA region as well as by microaglutination serological tests with specific antiserum. Besides this, scanning electron microscopic analysis was used to assess the purity of the strain culture. The size of the genome of L. xyli subsp. xyli was estimated based on restriction analysis after digestion of genomic DNA with SpeI and XbaI followed by pulsed-field gel electrophoresis. The estimates of 2,530 kb and 2,540 kb, respectively for SpeI and XbaI, are in agreement with the one obtained by whole genome sequencing (2,596 kb). In addition, the number of repeated sequences and ribossomal genes predicted by thesequencing project was confirmed by hybridization experiments with the appropriate probes. Genomic comparisons of L. xyli subsp. xyli, L. xyli subsp. cynodontis and two Clavibacter species comprised a second objective of this study. Comparisons were based on RFLP analysis after hybridization of digested genomic DNA using mobile genetic elements present in the genome of L. xyli subsp. xyli as probes. The estimates of number of copies of these elements in the genome of L. xyli subsp. xyli obtained by this approach agreed with the ones obtained by sequencing if RFLP fragments smaller than 9 kb are considered. Data from larger fragments were not obtained since they were not adequately resolved by electrophoresis. Finally, RFLP and rep-PCR comparisons unveiled differences between L. xyli subsp. xyli and L. xyli subsp. cynodontis as well as between these and Clavibacter. No differences were found between strain CTC B07 of L. xyli subsp. xyli and an Australian strain.

Indiana University-Purdue University Indianapolis (IUPUI) / Spore photoproduct lyase (SPL) is a radical SAM (S-adenosylmethionine) enzyme that is responsible for the repair of the DNA UV damage product 5-thyminyl-5,6-dihydrothymine (also called spore photoproduct, SP) in the early germination phase of bacterial endospores. SPL initiates the SP repair process using 5'-dA• (5'-deoxyadenosyl radical) generated by SAM cleavage to abstract the H6proR atom which results in a thymine allylic radical. These studies provide strong evidence that the TpT radical likely receives an H atom from an intrinsic H atom donor, C141 in B. subtilis SPL. I have shown that C141 can be alkylated in native SPL by iodoacetamide treatment indicating that it is accessible to the TpT radical. Activity studies demonstrate a 3-fold slower repair rate of SP by C141A which produces TpTSO2 - and TpT simultaneously with no lag phase observed for TpTSO2- formation. Additionally, formation of both products shows a Dvmax kinetic isotope effect (KIE) of 1.7 ± 0.2 which is smaller than the DVmax KIE of 2.8 ± 0.3 for the WT SPL reaction. Removal of the intrinsic H atom donor by this single mutation disrupts the rate-limiting process in the enzyme catalysis. Moreover, C141A exhibits ~0.4 turnover compared to the > 5 turnovers in the WT SPL reaction. In Y97 and Y99 studies, structural and biochemical data suggest that these two tyrosine residues are also crucial in enzyme catalysis. It is suggested that Y99 in B. subtilis SPL uses a novel hydrogen atom transfer pathway utilizing a pair of cysteinetyrosine residues to regenerate SAM. The second tyrosine, Y97, structurally assists in SAM binding and may also contribute to SAM regeneration by interacting with radical intermediates to lower the energy barrier for the second H-abstraction step.

No description available.

Introdução: O Clostridium difficile é um bacilo Gram-positivo, anaeróbio estrito, formador de esporos, que produz toxinas que podem causar diarreia, colite pseudomembranosa, dilatação do cólon, sepse e até morte. Nos últimos anos o quadro clínico e epidemiológico das infecções por Clostridium difficile tem se modificado e as limitações das opções terapêuticas tornaram-se mais evidentes. Objetivo Primário: Comparar as metodologias de disco-difusão e ágar-diluição na detecção de sensibilidade/resistência de isolados de Clostridium difficile. Objetivos Secundários: Avaliar prospectivamente o perfil de sensibilidade/resistência de isolados clínicos hospitalares de Clostridium difficile provenientes de seis hospitais terciários da cidade de São Paulo e fornecer evidências para fundamentar o diagnóstico e o tratamento empírico das diarreias causadas por Clostridium difficile. Métodos: utilizamos os métodos de disco-difusão e ágar-diluição, de acordo com os critérios estabelecidos pelo CLSI e EUCAST. Resultados: Os coeficientes de correlação observados entre os diâmetros dos halos de inibição e Concentração Inibitória Mínima foram abaixo do esperado tornando inviável o método de disco-difusão para determinação de sensibilidade aos antimicrobianos nitazoxanida, teicoplanina e tigeciclina. Todas as 50 cepas deste estudo foram sensíveis ao metronidazol (MIC50 foi de 1 ?g/mL a MIC90 foi de 2 ug/mL). Para o método de disco-difusão, sugerimos que halos de inibição >= 33mm possam ser interpretados como sensíveis. Devido à moderada correlação, significância estatística e distribuição de halos de inibição das amostras próximos aos valores encontrados utilizando a cepa ATTC, sugere-se a utilização do método de disco-difusão para vancomicina, onde halos com diâmetro >= 22mm possam ser considerados como sensíveis pelo método. Para o moxifloxacino houve uma boa correlação entre as duas metodologias: discodifusão e de ágar-diluição (O coeficiente de Pearson foi de -0,84, e o valor de p foi menor que 0,00001), sugerindo que halos de inibição >= 18mm possam ser interpretados como sensíveis pela metodologia de disco-difusão. A nitazoxanida foi à droga que mostrou melhor atividade in vitro (MIC50 foi 0,06 ?g/mL e a MIC90 de 0,12 ug/mL). Por se mostrar uma droga com potente atividade in vitro (MIC50 e a MIC90 foi de 0,12 ug/mL), a tigeciclina poderia ser mais uma opção terapêutica em infecções por Clostridium difficile, dependendo de mais estudos para avaliar sua real eficácia clínica e segurança. Conclusão: Os resultados verificados neste estudo indicam a necessidade de mais estudos in vitro e clínicos para definir os limites de sensibilidade/resistência para a teicoplanina e a nitazoxanida, pois faltam critérios de interpretação tanto para disco-difusão quanto para ágar-diluição. Os resultados deste trabalho in vitro confirmaram a utilidade do metronidazol como uma droga eficaz no tratamento de infecção por Clostridium difficile. A nitazoxanida foi à droga que mostrou melhor atividade in vitro por método dilucional. Sugerimos a utilização do método de disco-difusão para: metronidazol, vancomicina e moxifloxacino. Os resultados desse trabalho sugerem que halos de inibição para metronidazol ( >= 33mm), moxifloxacino ( >= 18mm) e vancomicina ( >= 22mm) poderiam ser considerados como sensíveis pelo método de disco-difusão. O método de ágardiluição é um método de boa acurácia, porém trabalhoso para ser executado na rotina laboratorial / Introduction: Clostridium difficile is a Gram-positive bacillus, strictly anaerobic, spore-forming, which produces toxins that can cause diarrhea, colitis pseudomembranous, colon expansion, sepsis and even death. In recent years the clinical and epidemiological picture of infection by Clostridium difficile has been modified and limitations of therapeutic options have become more evident. Primary Objective: Comparing the methods of disk diffusion and agar dilution in the detection sensitivity/resistance isolates of Clostridium difficile. Secondary Objectives: Prospectively evaluate the profile of sensitivity/resistance of hospital clinical isolates of Clostridium difficile from six tertiary hospitals in São Paulo city and provide evidence to support the diagnosis and empirical treatment of diarrhea caused by Clostridium difficile. Methods: We use the disk diffusion method and agar dilution method, according to the established criteria by CLSI and EUCAST. Results: The observed correlation coefficients between the inhibitions diameter zone of the and Minimum Inhibitory Concentration were under expectations impeding the disk diffusion method for determining sensitivity to nitazoxanide antimicrobial, teicoplanin and tigecycline. All 50 strains of this study were sensitive to metronidazole (MIC50 was 1 Ug/ml to MIC90 was 2 ug/ml). For the method disk diffusion, we suggest that inhibition zones >= 33mm can be interpreted as sensitive. Due to the moderate correlation, statistical significance and distribution of zones of inhibition on samples of the next found values using the strain ATTC, we suggest using the disk diffusion method for vancomycin where halos diameter >= 22mm can be considered as sensitive by the method. There was a good correlation to moxifloxacin between the two methodologies: disk diffusion and agar dilution (Pearson\'s coefficient was -0.84 , and the \"p\" value was less than 0.00001), suggesting that inhibition zones >= 18mm can be interpreted as sensitive by disk diffusion method. Nitazoxanide was the drug that showed a better performance in vitro activity (MIC50 was 0.06 ?g/ml and MIC90 0.12 ug/ml). For a drug that shows potent activity in vitro (MIC50 and MIC90 was 0.12 ug/ml), the tigecycline could be a therapeutic option in infection by Clostridium difficile, depending on further studies to evaluate their real clinical efficacy and security. Conclusion: Obtained results in this study indicate the need for further studies in vitro and clinicians to define the limits of sensitivity/resistance to teicoplanin and nitazoxanide, so there is no interpretation criteria for both disk diffusion and for agar dilution. Results of this work in vitro study confirmed the utility of metronidazole as an effective drug in the treatment of infection by Clostridium difficile. Nitazoxanide was the drug that showed better performance in vitro by dilutional method. We suggest the use of disk diffusion method: metronidazole, vancomycin and moxifloxacin. This work suggest that inhibition zones for metronidazole ( >= 33mm), moxifloxacin ( >= 18mm) and vancomycin ( >= 22mm) could be considered as sensitive by disk diffusion method. The agar dilution method is a method to be accurate, but laborious to run in the laboratory routine

Introdução: O Clostridium difficile é um bacilo Gram-positivo, anaeróbio estrito, formador de esporos, que produz toxinas que podem causar diarreia, colite pseudomembranosa, dilatação do cólon, sepse e até morte. Nos últimos anos o quadro clínico e epidemiológico das infecções por Clostridium difficile tem se modificado e as limitações das opções terapêuticas tornaram-se mais evidentes. Objetivo Primário: Comparar as metodologias de disco-difusão e ágar-diluição na detecção de sensibilidade/resistência de isolados de Clostridium difficile. Objetivos Secundários: Avaliar prospectivamente o perfil de sensibilidade/resistência de isolados clínicos hospitalares de Clostridium difficile provenientes de seis hospitais terciários da cidade de São Paulo e fornecer evidências para fundamentar o diagnóstico e o tratamento empírico das diarreias causadas por Clostridium difficile. Métodos: utilizamos os métodos de disco-difusão e ágar-diluição, de acordo com os critérios estabelecidos pelo CLSI e EUCAST. Resultados: Os coeficientes de correlação observados entre os diâmetros dos halos de inibição e Concentração Inibitória Mínima foram abaixo do esperado tornando inviável o método de disco-difusão para determinação de sensibilidade aos antimicrobianos nitazoxanida, teicoplanina e tigeciclina. Todas as 50 cepas deste estudo foram sensíveis ao metronidazol (MIC50 foi de 1 ?g/mL a MIC90 foi de 2 ug/mL). Para o método de disco-difusão, sugerimos que halos de inibição >= 33mm possam ser interpretados como sensíveis. Devido à moderada correlação, significância estatística e distribuição de halos de inibição das amostras próximos aos valores encontrados utilizando a cepa ATTC, sugere-se a utilização do método de disco-difusão para vancomicina, onde halos com diâmetro >= 22mm possam ser considerados como sensíveis pelo método. Para o moxifloxacino houve uma boa correlação entre as duas metodologias: discodifusão e de ágar-diluição (O coeficiente de Pearson foi de -0,84, e o valor de p foi menor que 0,00001), sugerindo que halos de inibição >= 18mm possam ser interpretados como sensíveis pela metodologia de disco-difusão. A nitazoxanida foi à droga que mostrou melhor atividade in vitro (MIC50 foi 0,06 ?g/mL e a MIC90 de 0,12 ug/mL). Por se mostrar uma droga com potente atividade in vitro (MIC50 e a MIC90 foi de 0,12 ug/mL), a tigeciclina poderia ser mais uma opção terapêutica em infecções por Clostridium difficile, dependendo de mais estudos para avaliar sua real eficácia clínica e segurança. Conclusão: Os resultados verificados neste estudo indicam a necessidade de mais estudos in vitro e clínicos para definir os limites de sensibilidade/resistência para a teicoplanina e a nitazoxanida, pois faltam critérios de interpretação tanto para disco-difusão quanto para ágar-diluição. Os resultados deste trabalho in vitro confirmaram a utilidade do metronidazol como uma droga eficaz no tratamento de infecção por Clostridium difficile. A nitazoxanida foi à droga que mostrou melhor atividade in vitro por método dilucional. Sugerimos a utilização do método de disco-difusão para: metronidazol, vancomicina e moxifloxacino. Os resultados desse trabalho sugerem que halos de inibição para metronidazol ( >= 33mm), moxifloxacino ( >= 18mm) e vancomicina ( >= 22mm) poderiam ser considerados como sensíveis pelo método de disco-difusão. O método de ágardiluição é um método de boa acurácia, porém trabalhoso para ser executado na rotina laboratorial / Introduction: Clostridium difficile is a Gram-positive bacillus, strictly anaerobic, spore-forming, which produces toxins that can cause diarrhea, colitis pseudomembranous, colon expansion, sepsis and even death. In recent years the clinical and epidemiological picture of infection by Clostridium difficile has been modified and limitations of therapeutic options have become more evident. Primary Objective: Comparing the methods of disk diffusion and agar dilution in the detection sensitivity/resistance isolates of Clostridium difficile. Secondary Objectives: Prospectively evaluate the profile of sensitivity/resistance of hospital clinical isolates of Clostridium difficile from six tertiary hospitals in São Paulo city and provide evidence to support the diagnosis and empirical treatment of diarrhea caused by Clostridium difficile. Methods: We use the disk diffusion method and agar dilution method, according to the established criteria by CLSI and EUCAST. Results: The observed correlation coefficients between the inhibitions diameter zone of the and Minimum Inhibitory Concentration were under expectations impeding the disk diffusion method for determining sensitivity to nitazoxanide antimicrobial, teicoplanin and tigecycline. All 50 strains of this study were sensitive to metronidazole (MIC50 was 1 Ug/ml to MIC90 was 2 ug/ml). For the method disk diffusion, we suggest that inhibition zones >= 33mm can be interpreted as sensitive. Due to the moderate correlation, statistical significance and distribution of zones of inhibition on samples of the next found values using the strain ATTC, we suggest using the disk diffusion method for vancomycin where halos diameter >= 22mm can be considered as sensitive by the method. There was a good correlation to moxifloxacin between the two methodologies: disk diffusion and agar dilution (Pearson\'s coefficient was -0.84 , and the \"p\" value was less than 0.00001), suggesting that inhibition zones >= 18mm can be interpreted as sensitive by disk diffusion method. Nitazoxanide was the drug that showed a better performance in vitro activity (MIC50 was 0.06 ?g/ml and MIC90 0.12 ug/ml). For a drug that shows potent activity in vitro (MIC50 and MIC90 was 0.12 ug/ml), the tigecycline could be a therapeutic option in infection by Clostridium difficile, depending on further studies to evaluate their real clinical efficacy and security. Conclusion: Obtained results in this study indicate the need for further studies in vitro and clinicians to define the limits of sensitivity/resistance to teicoplanin and nitazoxanide, so there is no interpretation criteria for both disk diffusion and for agar dilution. Results of this work in vitro study confirmed the utility of metronidazole as an effective drug in the treatment of infection by Clostridium difficile. Nitazoxanide was the drug that showed better performance in vitro by dilutional method. We suggest the use of disk diffusion method: metronidazole, vancomycin and moxifloxacin. This work suggest that inhibition zones for metronidazole ( >= 33mm), moxifloxacin ( >= 18mm) and vancomycin ( >= 22mm) could be considered as sensitive by disk diffusion method. The agar dilution method is a method to be accurate, but laborious to run in the laboratory routine