Methicillin-resistenta Staphylococcus aureus (MRSA) har blivit en allt vanligare patogen inom sjukvården och i samhället. MRSA orsakar infektioner som inte kan behandlas med β-laktamantibiotika. För att förhindra spridning genomgår patienter och sjukvårdspersonal screening-tester. I dessa screening-tester ingår PCR-analys av mecA, nuc och/eller Sa442. MecA är lokaliserad på Staphylococcal Cromosomal Cassette mec (SCCmec) och används som en markör för MRSA medan nuc och Sa442 anger S. aureus. PCR-positiva isolat odlas ut på agarplattor efter anrikning i en selektiv buljong. Kolonier av S. aureus resistensbestäms mot cefoxitin som MRSA är resistent mot. Idag används dock PCR-analys av mecA som en referensmetod för diagnostisering av MRSA. Under det senaste årtiondet har även rapporterats fynd av stammar som enligt resistensmönster är MRSA men som har utfallit negativt för mecA i PCR. Under 2011 rapporterades en ny variant av SCCmec och en ny variant av mecA, mecALGA251. I denna studie har en realtids-PCR tagits fram för att identifiera den nya varianten, mecALGA251. Denna PCR användes för att undersöka 43 kliniska isolat, fyra cefoxitin-känsliga S. aureus från rutinen och tre referensstammar. De kliniska isolaten hade samlats in under perioden 2004 – 2011 och hade uppvisat cefoxitin-resistens men gett negativt resultat i mecA-PCR. Totalt 40 av de 43 cefoxitin-resistenta kliniska isolaten visades bära mecALGA251. Resistensbestämningar med diskdiffusion och E-test mot cefoxitin, oxacillin, cefuroxim och cefotaxim visade att denna typ av MRSA inte kan skiljas från klassisk MRSA. Resultaten visar att cefoxitin-resistenta S. aureus isolat som bär mecALGA251 finns bland skånska patienter. De visar också att det finns cefoxitin-resistent S. aureus som saknar både klassiska mecA och mecALGA251. Dessa stammar har inte studerats vidare i denna studie. / Methicillin-resistant Staphylococcus aure s (MRSA) has become a more frequent pathogen within health care facilities and the community. MRSA causes infections that can’t be treated with β-lactamantibiotics. To prevent the spread of MRSA, patients and medical personnel undergo screening-tests. In the screening-tests PCR-analysis of mecA, nuc and/or Sa442 is included. MecA is located at Staphylococcal Chromosomal Cassette mec (SCCmec) and is a marker for MRSA, whereas nuc and Sa442 state regular S. Aureus infections. PCR-positive isolates are grown on agar plates after enrichment in selective broth. Colonies of S. aureus are tested for cefoxitin susceptibility to which MRSA is resistant. PCR-analysis of mecA is the reference method that is being used today when MRSA is being diagnosed. During the last decade cefoxitin-resistant strains that lack mecA in the PCR has been reported. In 2011 a new variant of SCCmec and a new variant of mecA, mecALGA251 was reported. In this study a new real-time-PCR has been developed in order to identify mecALGA251. The new PCR protocol was being used to examine 43 clinical isolates, four cefoxitin-susceptible S. aureus from the routine and three reference strains were examined. The clinical isolates had been collected during the period 2004-2011 and were cefoxitin-resistant but lacked mecA. In total of 40 of the 43 cefoxitin-resistant was PCR positive for mecALGA251. Susceptibility testing with disk diffusion and E-test for cefoxitin, oxacillin, cefuroxime and cefotaxime showed that this type of MRSA can’t be distinguished from regular MRSA. The results showed that cefoxitin-resistantS. aureus isolates carrying mecALGA251 exist among patients in Skåne County. One cefoxitin-resistant S. aureus isolate lacked both classic mecA and mecALGA251, which indicates that other mechanisms may exist, however these results has not been further analysed in this study.

Orientador: Maria de Lourdes Ribeiro de Souza da Cunha / Resumo: A alta frequência de Estafilococos Coagulase-Negativa (CoNS) na pele de indivíduos saudáveis e em doenças associadas ao sangue, associados à seleção de cepas resistentes devido a uso indiscriminado de antimicrobianos, tornou mais estreitos os limites entre o ambiente hospitalar e o comunitário quanto à distribuição de cepas. Objetivou-se, com este estudo, caracterizar isolados de CoNS de origem hospitalar e comunitária da cidade de Botucatu-SP quanto ao perfil clonal, analisar os aspectos de resistência à oxacilina pela aferição de metodologia de detecção, e investigar os determinantes de heterorresistência à vancomicina nessas cepas. As espécies estudadas incluíram S. epidermidis, S. haemolyticus, S. warneri, S. hominis, S. lugdunensis, S. capitis, S. saprophyticus, S. pasteuri, S. simulans e S. xylosus. O teste de disco-difusão (TDD) com discos de oxacilina e cefoxitina, fitas de Etest impregnadas com oxacilina e pesquisa do gene mecA por PCR em tempo real foram realizadas. A triagem em ágar com 6 e 8 µg/ml de vancomicina, microdiluição em caldo para aferição da Concentração Inibirtória Mínima (MIC), microscopia eletrônica de transmissão para verificar espessamento da parede celular e alterações fenotípicas por testes bioquímicos foram realizadas. O perfil clonal foi determinado por PFGE (Pulsed-Field Gel Eletrophoresis) e para clones de S. epidermidis, o MLST (Multilocus Sequence Typing). S. epidermidis apresentou alta diversidade clonal, mas presença de clusters no ambien... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The high frequency of Coagulase-Negative Staphylococci (CoNS) on the skin of healthy individuals and in bloodstream infections, together with the selection of resistant strains, has narrowed the boundaries between the hospital and the community environment for the distribution of strains. This study aimed to characterize CoNS isolated from clinical and colonization specimens of patients and individuals from Botucatu-SP, to compare their clonal profile, to analyze the determination of oxacillin resistance by the evaluation of the methodology of detection, and to investigate the determinants of reduced susceptibility to vancomycin in those strains. CoNS species included S. epidermidis, S. haemolyticus, S. warneri, S. hominis, S. lugdunensis, S. capitis, S. saprophyticus, S. pasteuri, S. simulans and S. xylosus. The disc diffusion test (DDT) using oxacillin and cefoxitin discs was employed, Etest strips impregnated with oxacillin and mecA gene detection by real-time PCR were used. An agar screening with 6 and 8 µg/ml of vancomycin, the broth microdiluition method for the Minimal Inhibitory Concentration (MIC), the transmission eletronic microscopy for evaluation of cellwall thickening and phenotypic modifications by biochemical tests were performed. Clonal profile was determined by PFGE (Pulsed-Field Gel Eletrophoresis) and, for S. epidermidis clones, MLST (Multilocus Sequence Typing). S. epidermidis presented high clonal diversity, despite some clusters circulating within hospi... (Complete abstract click electronic access below) / Doutor

Sporting nationality in the light of European Union law Jan Exner Abstract The aim of this master's thesis is to answer the question of how to grasp and categorize the concept of sporting nationality in the EU. Its goal is to consider compliance of the rules set up by international sporting governing bodies determining athletes' eligibility in national teams with the concrete provisions of EU law. The provisions under scrutiny are mostly those laying down the prohibition of discrimination on grounds of nationality in the fields of EU citizenship, internal market freedoms and competition. The master's thesis simultaneously aims at suggesting concrete recommendations to international sporting governing bodies in order to better adapt their rules to EU law requirements. The authors of this master's thesis first claims that rules governing athletes' eligibility in national teams fall within the scope of EU law since they have economic impact and effect. Secondly, it is submitted that these rules limit athletes' rights under EU law and constitute therefore a restriction to respective provisions of the EU legal order. That is why the question whether such a restriction to EU law may be justified is examined. In this respect, the Court of Justice provided sporting world with a useful manual on how to pass EU law...

Presented diploma thesis was created in cooperation with Siemens s.r.o., and deals with the analysis of the bending of aluminium sheets which are later used as a conductors of high voltage electrical energy. These parts are completed into assemblies which serves as connectors of particular segments of an electrical network. The problem occurs as a result of incorrect bend, because it is impossible to join these sections properly. The customer would like to verify if the defined tolerances of semi-finished products are sufficient for proper bend and in case they are not, the tolerances should be modified. Due to the requirement for running numerical simulation in one of the open source software, the Salome-Meca program environment was used.

La tesis doctoral tiene como objetivo la edición, traducción y estudio de la obra de viajes autobiográfica Nişāb al-ajbār wa-taḏkirat al-ajyār del converso al islam Abd Allāh Ibn al-Şabbāḥ, peregrino asceta que recorrió el mundo árabe musulmán en el s.XV, en base al manuscrito unicum en árabe depositado en la Bibliotèque Nationale de Túnez. En primer lugar se hace una edición diplomática del unicum, con abundantes apreciaciones y correcciones en notas a pie de página de la riḥla (relato de viajes). En segundo lugar, se aporta una traducción al español y, por último, se incluye un estudio en el que se pone de manifiesto el origen setabense del autor, se fija una cronología para el autor y obra, se estudian las peculiaridades lingüísticas del unicum así como las fases en la composición de la obra y se estudian las ilustraciones de la Meca, Medina, Hebrón y Jerusalén que están reflejadas en el manuscrito

Staphylococcus pseudintermedius affecting dogs is analogous to S. aureus on humans, acting as both normal flora and opportunistic pathogen. Methicillin resistance in S. pseudintermedius is recent, with the first documented occurrence of an isolate bearing the methicillin resistance gene, mecA, in 1999. This gene encodes penicillin binding protein 2a, which renders all beta-lactam drugs ineffective and functions as a “gateway” antibiotic resistance determinant. In the presence of ineffective antibiotics, opportunities for mutational events and acquisition of mobile genetic elements increase as microbial densities increase, often leading to multi-drug resistance. Methicillin-resistant S. pseudintermedius (MRSP) infections have become increasingly common. For example, approximately 30% of the S. pseudintermedius isolates tested by the University of Tennessee College of Veterinary Medicine Clinical Bacteriology Laboratory are resistant to methicillin. An increasing number of MRSP isolates are also resistant to most clinically useful antibiotics available to veterinarians except for chloramphenicol, and resistance to this antibiotic is common among European MRSP isolates. Chloramphenicol resistance has begun to appear in the US and if this trend continues there may soon be few viable antibiotic treatment options. Compared with the arrival of methicillin-resistant S. aureus in the 1960s, the opportunity currently exists to apply advanced molecular methods early in this recognized emergence of MRSP. To that end I have pursued projects utilizing multilocus sequence typing, pulsed-field electrophoresis, and SCCmec characterization of both susceptible and resistant S. pseudintermedius. The initial result was the detection of a clonal population of MRSP in the southeastern United States. Further characterization of this and other clonal lineages using genomic sequencing and real-time RT-PCR expression analysis of antibiotic resistance and quorum sensing genes revealed a marked difference in the regulation of antibiotic resistance between regional clones. These discoveries have interesting epidemiological implications and provide a foundation for the development of novel therapeutics to circumvent the expanding antibiotic resistance repertoire of MRSP. Potential targets identified by this work include membrane-bound beta-lactamase receptors responsible for the regulation of mecA, non-cognate auto-inducing peptides, and synthetic antisense oligonucleotides.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-05-07T13:39:49Z No. of bitstreams: 2 Dissertação - Thiago Damasceno Pinto Milhomem - 2018.pdf: 14290151 bytes, checksum: 86ef286d465a454e620f90c2592bfcb4 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-05-07T14:00:10Z (GMT) No. of bitstreams: 2 Dissertação - Thiago Damasceno Pinto Milhomem - 2018.pdf: 14290151 bytes, checksum: 86ef286d465a454e620f90c2592bfcb4 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-05-07T14:00:10Z (GMT). No. of bitstreams: 2 Dissertação - Thiago Damasceno Pinto Milhomem - 2018.pdf: 14290151 bytes, checksum: 86ef286d465a454e620f90c2592bfcb4 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-02-27 / Pilgrimage to the holy city of Mecca (ḥajj) has been one of the pillars of Islam since the seventh century, the time of the advent of the religion in the Arabian Peninsula, as an ordering in the Holy Qur'an and in the sayings and deeds of Prophet Muḥammad. Being this pilgrimage mandatory for all faithful adults in good enough physical and material conditions, different personalities of the Islamic world have realized the sacred journey in different times. Many have left their written testimonies, as a legacy of their observations and impressions on societies and historical events of Islamic and non-Islamic domains, thus influencing the emergence of a specific literary genre of Arab-Islamic culture, the travel journal (rihla). One of the pioneers of this genre was Ibn Jubayr (1145-1217), a Muslim from the city of Valencia, writer of a journal of his travels to the region that today corresponds to the Middle East, between 1183 and 1185, a period between the Second and the Third Crusade. We use Ibn Jubayr's travel journal edited as “Through the East (Rihla)”, a version published by Alianza Literaria in 2007, and which consists of a translation from Arabic into Spanish by Felipe Maíllo Salgado. From this testimony, centered on the religious journey of the writer-traveler to Mecca, we analyze the possibilities and social conditions of ḥajj at the end of the twelfth century, in the context of the Crusades, a long-lasting historical phenomenon permeated by important religious, political, economic, military and cultural aspects / A peregrinação à cidade santa de Meca (ḥajj) é um dos pilares do Islã desde o século VII, época do advento da religião na Península Arábica, configurando como uma ordenação no Alcorão Sagrado e nos ditos e feitos do Profeta Muḥammad. Sendo essa peregrinação obrigatória para todo fiel adulto e são e em condições físicas e materiais para tal, diferentes personalidades do mundo islâmico realizaram a jornada sagrada em diversas épocas. Muitos deixaram seus testemunhos por escrito, legando à posteridade suas observações e impressões sobre sociedades e eventos históricos de domínios islâmicos e não islâmicos, influenciando assim no surgimento de um gênero literário específico da cultura árabe-islâmica, o relato de viagem (rihla). Um dos pioneiros do gênero foi Ibn Jubayr (1145-1217), muçulmano natural da cidade de Valência, escritor de um relato referente às suas viagens à região que hoje corresponde ao Oriente Médio, entre 1183 e 1185, período situado entre a Segunda e a Terceira Cruzada. Utilizamos o relato de viagens de Ibn Jubayr editado como A través del Oriente (Rihla), versão publicada pela editora Alianza Literaria em 2007 e que consiste em uma tradução do árabe para o espanhol feita por Felipe Maíllo Salgado. A partir desse testemunho, centrado no périplo religioso do viajante-escritor a Meca, analisaremos as possibilidades e condições sociais de realização do ḥajj em fins do século XII, contexto de Cruzadas, fenômeno histórico de longa duração permeado por importantes aspectos religiosos, políticos, econômicos, militares e culturais.

Staphylococcus aureus est une bactérie commensale et pathogène qui s’est rapidement adaptée à la pression sélective des antibiotiques entraînant la diffusion de souches résistantes à la méticilline (MRSA). En Belgique, des souches appelées Healthcareassociated (HA)-MRSA sont devenues endémiques dans les hôpitaux, causant de nombreuses épidémies durant les années 90.<p>Parallèlement, des cas d’infections communautaires par des souches appelées Community-associated (CA)-MRSA produisant la leucocidine de Panton-Valentine (PVL) ont été rapportées en Europe, en Australie et aux USA, chez des patients jeunes sans contact avec les institutions de soins. Depuis 2005, une prévalence élevée de portage de MRSA a été observée chez les porcs, les éleveurs et les vétérinaires aux Pays-Bas et dans les pays voisins. Ces souches dites Livestock-associated (LA)-MRSA montrent une origine génétique distincte des souches humaines précédemment décrites.<p>Nos travaux de recherche ont porté sur l’épidémiologie et la caractérisation moléculaire de la colonisation et l’infection par S. aureus dans diverses populations humaines en Belgique afin d’élucider :1) l’évolution de la distribution spatio-temporelle des clones épidémiques de MRSA parmi les patients hospitalisés au cours de la période de 1995 à 2003 ;2) les mécanismes moléculaires de résistance aux antibiotiques associés à ces clones ;3) les relations phylogénétiques entre souches de S. aureus sensibles et résistantes à la méticilline parmi les patients hospitalisés afin d’identifier l’origine probable des clones épidémiques ;4) la prévalence et les facteurs de risque de portage de MRSA parmi les résidents des maisons de repos et l’origine de ces souches ;5) l’origine des souches de CA-MRSA et les profils cliniques des infections associées ;6) la prévalence et les facteurs de risque associés au portage de MRSA et la diffusion des souches de MRSA dans les fermes d’élevage porcin.<p>Des enquêtes multicentriques nous ont permis de caractériser les souches de S. aureus résistantes et sensibles à la méticilline affectant les patients hospitalisés (4 enquêtes, 1995 -2003), les patients ambulants (1 enquête, 2002-2004), les résidents dans des maisons de repos et de soins (1 enquête en 2005) et les habitants des fermes d’élevage porcin (1 enquête en 2007). Ces souches ont été caractérisées par détermination du type de cassette mec (SCCmec typing), séquençage d’un gène hypervariable (spa typing) et de 7 gènes de ménage (multi-locus sequence typing, MLST), combinées à l’analyse par électrophorèse en champs pulsé (PFGE) du profil de acrorestriction génomique. Les gènes codant pour trois classes d’antibiotiques et les toxines, PVL, TSST-1 et exfoliatines, ont été recherchés par PCR.<p>L’étude des souches de MRSA a montré une diversification importante des clones dans les hôpitaux, avec le remplacement d’un clone multi-résistant par des clones plus sensibles aux antibiotiques. La distribution des gènes de résistance ainsi que du gène TSST-1 était fortement liée au génotype. Les S. aureus sensibles à la méticilline (MSSA) montraient une plus grande diversité génotypique que les MRSA. La majorité des MRSA épidémiques appartient à des génotypes endémiques de MSSA, suggérant la possibilité d’émergence locale de MRSA par acquisition récente de l’élément mobile SCCmec.<p>D’autres souches de génotypes pandémiques pourraient avoir été importées en Belgique. L’enquête dans les maisons de repos et de soins a montré une prévalence élevée de résidents porteurs de MRSA. L’exposition aux antibiotiques, les lésions cutanées, la perte de mobilité, l’absence de formulaire thérapeutique et de procédures d’hygiène pour le contrôle du MRSA, associée à un nombre élevé de médecins, augmentaient significativement le risque de portage. La présence des mêmes génotypes dans les hôpitaux et les maisons de repos d’une même province suggère des transferts locaux de MRSA entre patients résidant dans et circulant entre ces secteurs de soins.<p>Les souches de CA-MRSA productrices de toxine PVL importées ou acquises en Belgique appartiennent à divers génotypes. La présence de MRSA de même lignée clonale mais présentant des profils de virulence différents clonale dans les institutions de soins et dans la population générale suggère que ces souches ont évolué de manière divergente dans des environnements différents.<p>Nous avons documenté une prévalence très élevée de porteurs de MRSA de génotype ST398 chez les éleveurs de porcs. Le réservoir de ce clone est très probablement d’origine animale, la transmission à l’homme ayant lieu par contact avec des animaux d’élevage ou de compagnie et potentiellement, par voie alimentaire.<p>En conclusion, S. aureus est un pathogène capable de s’adapter dans des environnements très différents. Les souches épidémiques résistantes aux antibiotiques, qu’elles soient d’origine hospitalière, communautaire ou animale, appartiennent à un nombre limité de génotypes bien établis dans chaque écosystème au niveau local ou régional. L’étude approfondie de la dynamique de transmission des MRSA, et de leur profil de résistance dans la communauté, les secteurs des soins aigus et chroniques et l’élevage, est indispensable pour définir les stratégies cliniques et de santé publique pour adapter les schémas thérapeutiques et endiguer l’endémie d’infections à MRSA.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished