Submitted by Leticia Schettini (leticia@ufrrj.br) on 2017-03-16T14:03:46Z No. of bitstreams: 1 2008 - Telma de Figueiredo do Nascimento.pdf: 875301 bytes, checksum: 0d53eac4a000372a6c136ed189b7dd48 (MD5) / Made available in DSpace on 2017-03-16T14:03:46Z (GMT). No. of bitstreams: 1 2008 - Telma de Figueiredo do Nascimento.pdf: 875301 bytes, checksum: 0d53eac4a000372a6c136ed189b7dd48 (MD5) Previous issue date: 2008-11-19 / In Brazil it is believed that bovine tuberculosis is present in all states, as is in all continents. The official indices are 1.3% of the national herd infected, which represent a large number in the order of 2.5 million animals. Mycobacterium bovis stands out as zoonotic disease of major importance. Increasing are the economic losses, caused by tuberculosis in cattle, such as low productivity of the herd, condemnation of carcasses at slaughterhouses, reduction in the production of milk and meat, commitment marketing of animals and their products domestically and externally. It is estimated that about 5,0 % of human tuberculosis is caused by Mycobacterium bovis. The success of a program to control a disease is closely linked to various factors including the knowledge of the history of the causative agent and its spatial and temporal distribution. Molecular methods are used as auxiliary tools in combating the disease by providing information in order to achieve these goals. In the last decade, methods for molecular typing of M. tuberculosis were developed and implemented on a large scale. Although the genomes of the two parasites are very similar, the discriminatory power of the methods is smaller in Mycobacterium bovis. In this study were analyzed samples from cattle slaughtered in refrigerators under Federal Inspection in the state of Minas Gerais. A total of 215 cultures sent to the Laboratory of Applied Molecular biology to Micobacterioses, and only 159 confirmed a profile of Mycobacterium bovis through molecular techniques applied. The south and state has the highest prevalence of the disease in the samples studied. The method of Spoligotyping applied to the samples showed the presence of 32 different profiles, obtaining a HGDI of 0.86 and a departure from the MIRU-VNTR presented 40 different profiles with a HGDI of 0.87. In this study was to evaluate that when using these techniques together we get a greater discriminatory power between these strains. / No Brasil acredita-se que a tuberculose bovina est? presente em todos os Estados, assim como est? em todos os continentes. Os ?ndices oficiais est?o em 1,3% do rebanho nacional infectado, que representaria um n?mero elevado, na ordem de 2,5 milh?es de animais. Mycobacterium bovis destaca-se como zoonose de reconhecida import?ncia. Crescentes s?o as perdas econ?micas, causada pela tuberculose em bovinos, como a baixa na produtividade do rebanho, condena??o de carca?as em matadouros, redu??o na produ??o de leite e carne, comprometimento da comercializa??o de animais e seus produtos no mercado interno e externo. Estima-se que em torno de 5,0% da tuberculose humana ? causada por M. bovis. O sucesso de um programa de controle de uma doen?a est? estreitamente ligado a diferentes fatores entre os quais o conhecimento da hist?ria do agente etiol?gico e sua distribui??o espacial e temporal. Os m?todos moleculares s?o utilizados como ferramentas auxiliares no combate ? doen?a fornecendo informa??es com a finalidade de alcan?ar estes objetivos. Na ?ltima d?cada, m?todos para tipagem molecular de Mycobacterium tuberculosis foram desenvolvidos e aplicados em larga escala. Embora o genoma dos dois parasitos seja muito parecido, o poder discriminat?rio dos m?todos decresce para Mycobacterium bovis. Neste trabalho foram analisadas amostras de bovinos abatidos em Frigor?ficos sob Inspe??o Federal no estado de Minas Gerais. Um total de 215 culturas foram enviadas ao Laborat?rio de Biologia Molecular Aplicada ? Micobacterioses, e apenas 159 confirmaram um perfil de Mycobacterium bovis atrav?s das t?cnicas moleculares de Spoligotyping e 159 a t?cnica do MIRU-VNTR. A mesorregi?o Sul e Sudoeste mostraram a maior preval?ncia da doen?a nas amostras estudadas. O m?todo de Spoligotyping aplicados ?s amostras mostrou a presen?a de 32 perfis diferentes, obtendo um HGDI de 0,86 e em contra partida o MIRU-VNTR apresentou 40 perfis diferentes com um HGDI de 0,87. Neste estudo foi poss?vel avaliar que quando utilizamos estas t?cnicas em conjunto obtemos um maior poder discriminat?rio entre essas cepas.

A doença decorrente da infecção por Salmonella é um dos maiores problemas de saúde no mundo em termos de morbidade e mortalidade. Entre as sorovariedades de Salmonella, a sorovariedade Enteritidis é a de maior ocorrência mundial e compreende linhagens que tem seu nicho biológico relacionado a frangos e ovos. Várias metodologias de tipagem fenotípicas e genotípicas foram desenvolvidas a fim de se delinear a epidemiologia das infecções por S. Enteritidis. Entretanto a tipagem fenotípica usualmente falha em discriminar linhagens relacionadas das nãorelacionadas epidemiologicamente e apresenta problemas de reprodutibilidade que foram minimizados com a utilização de métodos genotípicos. No Brasil, poucos estudos que utilizaram técnicas moleculares na tipagem de linhagens dessa sorovariedade foram realizados. Os objetivos desse estudo foram investigar o potencial patogênico, a resistência a antimicrobianos e realizar a tipagem molecular de linhagens de Salmonella Enteritidis isoladas de humanos, de alimentos e de frangos no Brasil. Para isso foram estudadas 188 linhagens de Salmonella Enteritidis isoladas de surtos e de casos esporádicos, de humanos (67) de alimentos (61) e de frangos (60), durante o período de 1986 a 2010, de vários locais do Brasil. A susceptibilidade frente a 14 antimicrobianos foi analisada através da técnica de disco difusão e a presença de 13 genes de virulência das ilhas de patogenicidade de Salmonella I e II e do plasmídio pSEV foram pesquisados por PCR. Os mecanismos de resistência a quinolonas foram verificados através da pesquisa de genes de resistência plasmidiais e cromossomais e também através da verificação de mutações no gene gyrA por High resolution melting analysis (HRMA) seguida de sequenciamento de algumas linhagens. As linhagens também foram tipadas molecularmente pelas metodologias Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR), Pulsed-field gel electrophoresis (PFGE) com a enzima XbaI, Multilocus variable-number tandem repeat analysis (MLVA) e por Multilocus sequence typing (MLST). Das 188 linhagens estudadas, 42,5% foi resistente ao ácido nalidíxico e somente 0,5% foi resistente a sulfametoxazol-trimetoprima e estreptomicina. A resistência a quinolonas foi relacionada principalmente a mutações no gene gyrA. A maioria das linhagens estudadas (98,4%) apresentou todos os genes de virulência pesquisados, sendo uma linhagem negativa para o gene sipA e duas linhagens negativas para o gene prot6E. ERIC-PCR dividiu as 128 linhagens isoladas de humanos e alimentos em 55 perfis diferentes com similaridade >79,7%. PFGE dividiu essas mesmas linhagens em 68 perfis diferentes com uma similaridade >73,1%. Para as linhagens isoladas de frango, o dendrograma concatenado de ERIC-PCR e PFGE dividiu as 60 linhagens em dois grandes grupos com 73,3% de similaridade. O grupo A consistiu de linhagens isoladas tanto de material clínico de frangos (23) quanto do ambiente da granja (5) com 81,2% de similaridade. O grupo B também consistiu de linhagens isoladas tanto de casos clínicos de frangos (21) quanto do ambiente da granja (11) com 81,1% de similaridade. MLVA dividiu as 188 linhagens isoladas no Brasil e outras 100 linhagens isoladas na América do Norte em dois grandes grupos. O grupo MLVA-A apresentou 71 linhagens isoladas na América do Norte e somente três linhagens isoladas no Brasil. Essas linhagens do ii Brasil incluíram as isoladas antes do início da pandemia de S. Enteritidis se iniciar no país. Em contraste, o grupo MLVA-B agrupou 185 linhagens isoladas no Brasil e 29 linhagens isoladas na América do Norte. As linhagens presentes no grupo A, foram divididas em 34 tipos genéticos diferentes com similaridade maior do que 46%, enquanto no grupo B as linhagens se diferenciaram em 15 tipos genéticos diferentes com mais de 66% de similaridade. MLST caracterizou 44 das 46 linhagens estudadas como pertencentes ao ST 11. As outras duas linhagens apresentaram alelos que não existiam no banco de dados e caracterizaram dois novos STs, o 1632 e o 1633. Os resultados de tipagem molecular obtidos por ERICPCR, PFGE e MLVA no presente estudo, demonstraram uma alta similaridade genotípica entre linhagens de S. Enteritidis isoladas no Brasil, o que sugere que as linhagens estudadas descendem de um precursor comum que pouco se diferenciou genotipicamente ao longo de 24 anos no país. Ademais, os resultados de MLVA sugerem que um novo e prevalente subtipo foi introduzido no Brasil após 1993 e tem contaminado alimentos e infectado humanos e animais. O grande número de genes de virulência encontrados reforça o potencial das mesmas causarem doenças em humanos e animais, bem como, os riscos de sua presença em alimentos. Ademais, a grande porcentagem de linhagens resistentes ao ácido nalidíxico observadas a partir de 1996 sugere o uso de quinolonas no tratamento de infecções em animais causadas por S. Enteritidis no Brasil. / The disease caused of the infection by Salmonella is one of the major health problem worldwide in terms of morbid and mortality. Among the Salmonella serovars, the Enteritidis is the most frequent isolated one and comprises strains that have their biological niche related to chickens and eggs. Several phenotypic and genotypic methodologies were developed to trace epidemiologically the infections by S. Enteritidis. However, the phenotypic typing usually fail to discriminate related from unrelated epidemiologicaly strains and presents problems of reproducibility that were minimized with the introduction of genotypic methods. In Brazil, few studies that used molecular typing techniques to type strains of this serovar were conducted. The aims of this study were to investigate the pathogenic potential, the antimicrobial resistance and to molecularly type of Salmonella Enteritidis strains isolated from humans, food and chickens in Brazil. For this, it was studied 188 strains of Salmonella Enteritidis isolated from outbreaks and sporadic cases, from humans (67), food (61) and chickens (60), during the period of 1986 to 2010, from various places of Brazil. The susceptibility to 14 antimicrobials were analyzed by the disc diffusion technique and the presence of 13 virulence genes of the Salmonella pathogenicity islands I and II and from the pSEV plasmid were searched by PCR. The mechanisms of resistance to quinolones were verified by the search of plasmidial and cromossomal resistance genes and also by the verification of mutations in the gyrA gene by High resolution melting analysis (HRMA) followed by sequencing of some strains. The strains were also molecularly typed by the methodologies Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR), Pulsed-field gel electrophoresis (PFGE) using the enzyme XbaI, Multilocus variable-number tandem repeat analysis (MLVA) and by Multilocus sequence typing (MLST). From the 188 strains studied, 42.5% were resistant to nalidixic acid and only 0.5% were resistant to sulfamethoxazoletrimethoprim and streptomycin. Resistance to quinolones was related mainly to mutations in the gyrA gene. The majority of the strains studied (98.4%) harbored all the virulence genes searched, being only one strain negative for the sipA gene and two strains negative for the prot6E gene. ERIC-PCR divided the 128 strains isolated from humans and food in 55 different profiles with >79.7% of similarity. PFGE divided the same strains in 68 different profiles with a similarity of >73.1%. Regarding the strains isolated from chickens, the concatenated dendrogram of ERIC-PCR and PFGE divided the 60 strains in two major groups with a similarity of 73.3%. Group A consisted of strains isolated either from chicken\'s clinical samples (23) or from the farm environment (5) with a similarity of 81.2%. Group B also consisted of strains isolated either from chicken\'s clinical samples (21) or from the environment (11) with a similarity of 81.1%. MLVA divided the 188 strains isolated in Brazil and other 100 strains isolated from North America in two major groups. MLVA-A group consisted of 71 strains isolated in North America and only three strains isolated in Brazil. These strains from Brazil included the ones isolated before the beginning of the pandemic of S. Enteritidis in this country. In contrast, MLVA-B group clustered 185 strains isolated in Brazil and 29 strains isolated in North America. The strains in the MLVA-A group were divided in 34 different genotypic types with a similarity of 46%, while strains in iv the group B were divided in 15 different genotypic types with a similarity of 66%. MLST characterized 44 of the 46 strains studied as belonging to ST 11. The other two strains presented new alleles that characterized two new STs, the 1632 and the 1633. The results of molecular typing obtained by ERIC-PCR, PFGE and MLVA in this study showed a high genotypic similarity among S. Enteritidis strains isolated in Brazil, which suggests that the strains studied descend from a common ancestor that differed little genotypically during 24 years in the country. Moreover, the results of MLVA suggest that a new and prevalent subtype was introduced in Brazil after 1993 and has been contaminating food and infecting humans and animals. The high prevalence of virulence genes found in the strains studied reinforce their potential to cause disease in humans and animals, as well as the risks of their presence in food. Moreover, the high percentage of strains resistant to nalidixic acid observed after 1996 suggests the use of quinolones in the treatment of animal infections by S. Enteritidis in Brazil.

Listeria monocytogenes é um importante patógeno de origem alimentar que causa listeriose, infecção severa que acomete, principalmente, gestantes, idosos, crianças e imunocomprometidos, e que apresenta elevada taxa de mortalidade. A bactéria está amplamente distribuída no ambiente e é comumente encontrada em produtos cárneos. O presente estudo teve como objetivos caracterizar 439 isolados de L. monocytogenes obtidos de salsicha bovina e produtos cárneos crus (carne moída, linguiça suína e coxa de frango) refrigerados, adquiridos no comércio do município de São Paulo, e previamente submetidos à sorotipagem molecular. Os isolados foram caracterizados quanto ao perfil de susceptibilidade antimicrobiana; presença dos genes de virulência actA, inlA, inlC, inlJ, prfA, iap, hly, plcA, plcB e mpl; perfil genético por eletroforese em campo pulsado (PFGE) e sequenciamento parcial dos genes actA e lmo0737. Baixa frequência de resistência antimicrobiana (0,5%) foi observada entre os 416 isolados avaliados. Um isolado pertencente ao sorogrupo 1 apresentou resistência à penicilina e à clindamicina e outro identificado como 4a ou 4c apresentou resistência à tetraciclina. Todos os isolados foram positivos para os genes de virulência testados. O sequenciamento parcial do gene actA mostrou a ocorrência de 14 sequências de nucleotídeos distintas nos 97 isolados avaliados. Além disso, verificou-se a ocorrência de uma deleção de 35 aminoácidos no gene actA em 36 isolados, além de substituições de nucleotídeos que resultaram em mutações nas sequências de aminoácidos da grande maioria dos isolados. A análise filogenética do gene actA possibilitou o agrupamento dos isolados em duas linhagens distintas (I e II). Os resultados do PFGE indicaram grande variabilidade nos perfis genéticos dos isolados analisados, principalmente naqueles pertencentes aos grupos 2 (1/2c e 3c), 3 (1/2b e 3b) e 4 (4b, 4d e 4e). Os resultados deste estudo mostram que os isolados de L. monocytogenes provenientes de salsicha bovina e produtos cárneos crus comercializados no município de São Paulo, apresentam grande diversidade genética, importante potencial de virulência e baixa frequência de resistência antimicrobiana. A diversidade observada deve-se, provavelmente, à característica ubíqua deste micro-organismo, tornando-o mais susceptível a grande pressão seletiva do ambiente. / Listeria monocytogenes is an important foodborne pathogen that causes listeriosis, a severe infection that affects primarily pregnant women, elderly, children and imunocompromised individuals, and has a high mortality rate. The bacteria is widely distributed in the environment and commonly found in meat products. The present study aimed to characterize 439 isolates of L. monocytogenes obtained from pork sausage and raw chilled meat products (ground beef, beef sausage, and chicken thigh) purchased in supermarkets in the city of São Paulo, and previously submitted to molecular serotyping. The isolates were characterized for antimicrobial susceptibility profile; presence of virulence genes actA, inlA, inlC, inlJ, prfA, iap, hly, plcA, plcB and mpl; genetic profile by pulsed field gel electrophoresis (PFGE) and partial sequencing of genes actA and lmo0737. A low frequency of antimicrobial resistance (0.5%) was observed among the 416 evaluated isolates. One isolate belonging to serogroup 1 presented resistance to clindamycin and penicillin and another one identified as 4a or 4c was resistant to tetracycline. All isolates were positive for the tested virulence genes. The partial sequencing of the gene actA indicated the occurrence of 14 distinct nucleotide sequences in the 97 isolates tested. Furthermore, a deletion of 35 amino acids in the actA gene was detected in 36 isolates, and nucleotide substitutions that resulted in amino acid changes in the sequences of most isolates. Phylogenetic analysis of the actA gene clustered the isolates in two distinct lineages (I and II). Results of PFGE indicated a great genetic variability among isolates, especially among those belonging to groups 2 (1/2c and 3c), 3 (1/2b and 3b) and 4 (4b, 4d and 4e). The results of this study show that isolates of L. monocytogenes from pork sausage and raw meat products marketed in the city of São Paulo present a great genetic diversity, significant virulence potential and low frequency of antimicrobial resistance. The detected diversity is probably due the ubiquitous nature of these microorganisms, making them more susceptible to selective pressure of the environment.

Les Acinetobacter sont des bactéries opportunistes impliquées dans les infections nosocomiales.Le but de ce travail était d’étudier leur épidémiologie et écologie au Liban.Tout d’abord, nous avons analysé 119 souches d’A.baumannii isolées de plusieurs hôpitaux. 76.5 % étaient résistantes aux carbapénèmes et le gène OXA-23 était le plus fréquemment trouvé. Le typage par Multilocus sequence typing a montré que le clone international II était majoritairement détecté. L’électrophorèse en champ pulsé a révélé que 72.6% des souches appartenant au ST2 ont été classées dans un même cluster qui semble être prédominant à Beirut et Tripoli. Ensuite, les réservoirs extrahospitaliers ont été investigués sur 2361 prélèvements collectés au Liban. Au total, 171 souches ont été isolées dans l’environnement, les produits alimentaires ainsi que chez l’homme et les animaux. La majorité de ces souches, globalement sensibles aux antibiotiques, était des Acinetobacter non baumannii, Seuls 15 A.baumannii, de 14 STs différents dont 10 nouveaux ont été isolés. Enfin, nous avons conduit une étude taxonomique approfondie sur plusieurs souches d’Acinetobacter non identifiées au rang d’espèce et retrouvées dans notre étude. Nous avons ainsi caractérisé une nouvelle espèce, nommée « Acinetobacter lebanonensis ».Ce travail a montré que le Liban était un pays à forte endémie d’A.baumannii résistants aux carbapénèmes. Nous n’avons toutefois pas mis en évidence de lien entre les souches cliniques et extrahospitalières, les clones correspondants étant globalement différents. D’autres études sont nécessaires pour élucider l’origine des souches multi-résistantes émergeant dans les hôpitaux. / Acinetobacter spp are opportunistic bacteria widely involved in nosocomial infections. The aim of this work was to study the epidemiology and the ecology of these bacteria in Lebanon. First, we have analyzed 119 clinical strains of A.baumannii. 76.5% of them were resistant to carbapenems and the production of OXA-23 was the main mechanism. Multi-locus sequence typing revealed the predominance of international clone II. Pulsed field gel electrophoresis showed that 72.6% of strains belonging to ST2 were classified in the same cluster which appeared to be predominant in Beirut and Tripoli. On the other hands, Acinetobacter reservoirs were investigated on 2361 samples collected in Lebanon. A total number of 171 strains have been isolated in the environment, food, humans and animals. The majority of these strains was identified as non baumannii Acinetobacter and was susceptible to antibiotics. Besides, typing of A.baumannii revealed the presence of 14 STs including 10 new ones. Finally, we have described a novel species called “Acinetobacter lebanonensis” by conducting a taxonomic study on several strains isolated in Lebanon and other countries. Although the data may be limited, this work has shown the endemic situation of carbapenem resistant A.baumannii circulating in the Lebanese hospitals while the extra hospital ones were different. However, further studies are needed to elucidate the origin of these emerging multidrug resistant strains.

Gonorrhea, caused by the human pathogen Neisseria gonorrhoeae, is a severe public health problem worldwide with more than 82 million new infections each year. N. gonorrhoeae is transmitted by sexual contact and primarily causes urogenital mucosal infections in men and women. Left untreated, this infection may cause severe complications, especially in females. Eye infections of the newborn can occur. Gonorrhea infections enhance HIV transmission. The highly prevalent antibiotic resistance and the emergence of new drug resistances render treatment of the infections increasingly difficult. Close monitoring of antimicrobial susceptibility of this pathogen is crucial, and enhanced knowledge of molecular mechanisms of gonococcal antimicrobial resistance is urgently needed. There are no vaccines available against N. gonorrhoeae. Control of gonorrhea relies on comprehensive strategies which can be better formulated by understanding, at molecular levels, how N. gonorrhoeae is transmitted in communities. My research aimed to illustrate the severe burden of antimicrobial resistance in N. gonorrhoeae temporally and geographically in China and to reveal the molecular mechanisms of antibiotic resistance particularly the development of reduced susceptibility to ceftriaxone in N. gonorrhoeae isolates. To determine specific strain distributions, N. gonorrhoeae isolates were characterized using molecular typing methods such as a modified porB-based typing scheme and the N. gonorrhoeae Multi-Antigen Typing (NG-MAST) method, compared to traditional epidemiological approaches. The ultimate goal was to provide information for better formulating disease control strategies for gonorrhea. In this research, male patients with gonorrhea and their sex partners were recruited in Shanghai (2005 and 2008) and in Urumchi (2007-2008), China. Epidemiological information pertaining to sexual contacts was collected. N. gonorrhoeae isolates were investigated for their antimicrobial susceptibility. Molecular mechanisms of antimicrobial resistance were explored by analysis of potential resistant determinants (gyrA, parC, porB, mtrR, ponA and penA). The molecular data were combined with bioinformatic analysis and traditional epidemiological data. High percentages of N. gonorrhoeae isolates (11% - 19% in Shanghai, 4.5% in Urumchi) exhibited reduced susceptibility to ceftriaxone (MICs = 0.125-0.25 mg/L), the first line drug recommended for the treatment of gonorrhea in China. The majority of isolates (>98%) were susceptible to spectinomycin, an alternative regimen for gonorrhea treatment; however, the proportion of isolates having intermediate levels of susceptibility increased from 1.9% in 2005 to 9.9% in 2008. The majority of isolates tested were resistant to penicillin (80% - 93%), tetracycline (56% - 65%) and ciprofloxacin (98% - 100%). Plasmid-mediated resistance in N. gonorrhoeae isolates were highly prevalent (51% - 79%) in Shanghai and Urumchi. Analysis of 60 clinical isolates revealed that reduced susceptibility to ceftriaxone is mediated by porB1b allele and is associated with specific mutations in penicillin binding protein 2 and in the DNA binding and dimerization domains of MtrR. Penicillin binding protein 1 is not involved in reduced susceptibility to ceftriaxone. Although mutation patterns in quinolone resistant determinant regions (QRDRs) varied, the majority of ciprofloxacin resistant isolates had double mutations in GyrA (S91F and D95G/A/N) and most isolates also carried a S87R/N mutation in ParC. The presence of mutations in the QRDR of ParC is correlated with elevated ciprofloxacin MICs. A modified porB-based molecular typing scheme was developed and involved ~82% of the DNA sequence of gonococcal porB. This typing method proved to have high discriminatory ability (index of discrimination = 0.93 0.96), and was cost effective and easy to perform as compared to the NG-MAST analysis. Using the modified porB-based typing method, N. gonorrhoeae isolates were reliably differentiated, and transmission clusters were identified. Molecular epidemiology using the porB-based method confirmed direct sexual connections and identified sexual networks otherwise unrevealed by the patient self-reporting or traditional case-tracing methods.

Gonorrhea, caused by the human pathogen Neisseria gonorrhoeae, is a severe public health problem worldwide with more than 82 million new infections each year. N. gonorrhoeae is transmitted by sexual contact and primarily causes urogenital mucosal infections in men and women. Left untreated, this infection may cause severe complications, especially in females. Eye infections of the newborn can occur. Gonorrhea infections enhance HIV transmission. The highly prevalent antibiotic resistance and the emergence of new drug resistances render treatment of the infections increasingly difficult. Close monitoring of antimicrobial susceptibility of this pathogen is crucial, and enhanced knowledge of molecular mechanisms of gonococcal antimicrobial resistance is urgently needed. There are no vaccines available against N. gonorrhoeae. Control of gonorrhea relies on comprehensive strategies which can be better formulated by understanding, at molecular levels, how N. gonorrhoeae is transmitted in communities. My research aimed to illustrate the severe burden of antimicrobial resistance in N. gonorrhoeae temporally and geographically in China and to reveal the molecular mechanisms of antibiotic resistance particularly the development of reduced susceptibility to ceftriaxone in N. gonorrhoeae isolates. To determine specific strain distributions, N. gonorrhoeae isolates were characterized using molecular typing methods such as a modified porB-based typing scheme and the N. gonorrhoeae Multi-Antigen Typing (NG-MAST) method, compared to traditional epidemiological approaches. The ultimate goal was to provide information for better formulating disease control strategies for gonorrhea. In this research, male patients with gonorrhea and their sex partners were recruited in Shanghai (2005 and 2008) and in Urumchi (2007-2008), China. Epidemiological information pertaining to sexual contacts was collected. N. gonorrhoeae isolates were investigated for their antimicrobial susceptibility. Molecular mechanisms of antimicrobial resistance were explored by analysis of potential resistant determinants (gyrA, parC, porB, mtrR, ponA and penA). The molecular data were combined with bioinformatic analysis and traditional epidemiological data. High percentages of N. gonorrhoeae isolates (11% - 19% in Shanghai, 4.5% in Urumchi) exhibited reduced susceptibility to ceftriaxone (MICs = 0.125-0.25 mg/L), the first line drug recommended for the treatment of gonorrhea in China. The majority of isolates (>98%) were susceptible to spectinomycin, an alternative regimen for gonorrhea treatment; however, the proportion of isolates having intermediate levels of susceptibility increased from 1.9% in 2005 to 9.9% in 2008. The majority of isolates tested were resistant to penicillin (80% - 93%), tetracycline (56% - 65%) and ciprofloxacin (98% - 100%). Plasmid-mediated resistance in N. gonorrhoeae isolates were highly prevalent (51% - 79%) in Shanghai and Urumchi. Analysis of 60 clinical isolates revealed that reduced susceptibility to ceftriaxone is mediated by porB1b allele and is associated with specific mutations in penicillin binding protein 2 and in the DNA binding and dimerization domains of MtrR. Penicillin binding protein 1 is not involved in reduced susceptibility to ceftriaxone. Although mutation patterns in quinolone resistant determinant regions (QRDRs) varied, the majority of ciprofloxacin resistant isolates had double mutations in GyrA (S91F and D95G/A/N) and most isolates also carried a S87R/N mutation in ParC. The presence of mutations in the QRDR of ParC is correlated with elevated ciprofloxacin MICs. A modified porB-based molecular typing scheme was developed and involved ~82% of the DNA sequence of gonococcal porB. This typing method proved to have high discriminatory ability (index of discrimination = 0.93 0.96), and was cost effective and easy to perform as compared to the NG-MAST analysis. Using the modified porB-based typing method, N. gonorrhoeae isolates were reliably differentiated, and transmission clusters were identified. Molecular epidemiology using the porB-based method confirmed direct sexual connections and identified sexual networks otherwise unrevealed by the patient self-reporting or traditional case-tracing methods.

Les entérovirus (EV) humains, membres de la famille des Picornaviridae, comprennent plus de 100 génotypes appartenant à 4 espèces : Enterovirus A, B, C et D. Ces virus sont à l’origine de pathologies très variées et occupent une place importante en santé publique. La méthode conventionnelle de typage des EV consiste en une réaction de séroneutralisation avec des antisérums spécifiques à partir de souches isolées en culture cellulaire ; cette technique est longue, coûteuse et limitée par sa capacité à identifier correctement les variants antigéniques et les nouveaux génotypes. De plus, elle est limitée aux génotypes cultivables. De nouvelles méthodologies de typage moléculaire par séquençage partiel du génome ont été récemment développées ; elles consistent à analyser une partie variable de la région codant une des protéines de capside (VP1 ou alternativement VP2 ou VP4). Cependant ces techniques sont le plus souvent réalisées à partir de souches isolées en culture cellulaire. Le but de ce travail a été de développer une technique de typage des EV directement sur des prélèvements cliniques en se basant sur le séquençage partiel de la région VP2 dont le laboratoire avait montré précédemment l’intérêt (Nasri et al., 2007). Pour le dessin des amorces, nous avons utilisé la stratégie CODEHOP (COnsensus DEgenerate Hybrid Oligonucleotide Primer) de manière à améliorer à la fois la spécificité et la sensibilité de la méthode d’amplification. Nous présentons ici un premier article décrivant la nouvelle technique de typage VP2 et rapportons son application au typage d’échantillons cliniques trouvés positifs par une PCR ciblant la région 5’ non codante du génome des EV sur une période de trois ans. Le deuxième article présente pour la première fois l’application d’une technique de typage direct à des échantillons environnementaux d’eaux usées. Le troisième article montre l’intérêt de coupler deux techniques de typage ciblant des régions différentes (VP1 et VP2) pour l’identification de souches d’EV isolées par culture cellulaire en Centre-Afrique. Malgré des problèmes de sensibilité, cette nouvelle technique de typage directement à partir d’échantillons peut rendre de grands services tant en clinique humaine que pour la surveillance environnementale / Human enteroviruses (EV), members of the Picornaviridae family, comprise more than 100 genotypes belonging to four species: Enterovirus A, B, C and D. These viruses are responsible for a wide range of pathologies and play an important role in Public Health. The classic method for typing EVs consists in a seroneutralisation assay with specific antisera using strains isolated by cell culture; this technique is cumbersome, expensive and unable to type currently antigenic variants and new serotypes. In addition, it is limitated to culturable serotypes. New methods of molecular typing by partial sequencing of the genome have been recently developed; they consist in analysing a variable part of the region coding for capsid protein (VP1 or alternatively VP2 or VP4). However, these techniques are usually performed on strains isolated by cell culture. The aim of this work was to develop a typing method able to work from clinical specimens by partial sequencing of the VP2 region, which had been shown to exhibit a good typing performance (Nasri et al., 2007). For the design of primers, we used the CODEHOP (COnsensus DEgenerate Hybrid Oligonucleotide Primer) strategy on order to improve the sensitivity and the specificity of the amplification assay. We present herein a first article that describes in details the new VP2 typing method and requests its use for typing clinical specimens found positive by a PCR assay targeting the 5’ non coding region of EVs over a period of three years. The second paper describes for the first time the direct use of a typing method on environtmental wastewater samples. The third article shows the interest of coupling 2 typing techniques targeting different regions (VP1 and VP2) of the EV genome for the identification of strains isolated by cell culture in Republic of Central Africa. Despite a loss of sensitivity, the new VP2 typing method used directly on specimens was found to be of great help both for human diagnosis and environmental surveillance

La sécurité alimentaire est basée sur des systèmes de cultures durables. Les agents phytopathogènes présentent un risque sérieux pour la stabilité de l'agriculture mondiale. Dans ce contexte, la biosurveillance des agents phytopathogènes s'avère indispensable afin de connaitre et de comprendre la répartition, les routes et les facteurs de dispersion des populations phytopathogènes, et de prendre les mesures adaptées pour limiter leur propagation. Le genre bactérien Xanthomonas comprend un ensemble d'espèces phytopathogènes-spécifiques s'attaquant a une large gamme d'espèces végétales dont certaines sont importantes pour la production agricole. Les deux espèces d'étude, i.e les pathovars de Xanthomonas oryzae (Xo) et Xanthomonas axonopodis pathovar manihotis (Xam), pathogènes respectivement du riz et du manioc, font partie du « top 10 » des bactéries phytopathogènes d'importance majeure dans le monde. Des travaux portant sur l''épidémiosurveillance de ces bactéries phytopathogenes doivent pouvoir être mis en place en routine. L'objectif est de typer et de relier ces souches bactériennes à différentes échelles géographiques, ainsi que de détecter et caractériser les épidémies de manière précoce. Pour ce faire, plusieurs approches de typage moléculaire à haut niveau de résolution ont été explorées. Des marqueurs moléculaires basés sur les loci VNTR (Variable Number of Tandem repeats) ont été étudiés. Chez X. oryzae, un outil MLVA-25 (Multilocus VNTR Analysis) pour le pathovar Xanthomonas oryzae pv. oryzicola (Xoc) et un outil MLVA-16 pour les trois lignées génétiques de X. oryzae ont été développés. L'étude par le MLVA-16 de populations de X. oryzae a permis de caractériser des complexes clonaux généralement associés à de nouvelles épidémies. La description de nouvelles souches de Xoc en Afrique Centrale et Afrique de l'Est indique une provenance vraisemblablement d'origine asiatique. Chez Xam, la recherche de loci VNTR polymorphiques sur 65 génomes de Xam complets a abouti à la description de seize loci VNTR robustes donc cinq ont été ensuite utilisés pour l'étude de populations de Xam dans les plaines de l'est Colombien. Cette dernière étude met en avant une structuration des populations de Xam selon les régions. Enfin, une méthode de spoligotypage associée aux locus CRISPR-Cas (Clustered Regularly Interspaced Short Palindromic Repeats) et des marqueurs minisatellites ont été développés chez les souches du pathovar Xanthomonas oryzae pv. oryzae (Xoo). Les analyses préliminaires ont permis de définir la composition de la cassette CRISPR et de proposer des outils de spoligotypage utiles pour les souches asiatiques de Xoo. D'autre part, 18 marqueurs minisatellites ont indiqué une corrélation significative avec les races des souches et peuvent servir à l'étude plus large de populations Xoo philippines ou asiatiques. En conclusion, des nouvelles approches de typage moléculaire ont été évaluées, mises au point et employées avec succès pour étudier les bactéries pathogènes du riz et du manioc appartenant au genre Xanthomonas. / Food and agriculture safety rely on durable cropping systems. Consequently, phytopathogens pose a serious risk for durable agriculture in the world. In this context, surveillance of phytopathogens is a mandatory prerequisite in order to understand and to predict pathogen repartition, dispersion routes and factors, and to trigger appropriate measures to reduce the pathogen's propagation. The genus Xanthomonas displays a large diversity of host-specific plant-pathogenic species that infect a wide range of plant species, including commercially grown crops. The two studied species, i.e. the rice-pathogenic Xanthomonas oryzae and the cassava-pathogenic Xanthomonas axonopodis pathovar manihotis (Xam), belong to the top-10 of phytopathogenic bacteria and are thus of major interest. Routine epidemiological surveillance of these bacteria has to be achieved in order to type and link strains at different geographic scales as well as to characterize outbreaks and epidemics. For this purpose, several high-resolution molecular typing approaches were explored. Firstly, VNTR (Variable Number of Tandem repeats)-based molecular markers were studied. For X. oryzae, multilocus VNTR analyses (MLVA) were developed: MLVA-25 for the pathovar oryzicola (Xoc) and MLVA- 16 for the three known lineages of X. oryzae. A large population study of X. oryzae by MLVA-16 allowed us to characterize genetic clonal complexes, which were likely associated with new epidemics. Also, the novel description of Xoc strains from central and east Africa indicated their probable Asian provenance. For Xam, the exploration of polymorphic VNTR loci in 65 available genome sequences allowed the description of sixteen robust VNTR loci. Among them, five highly polymorphic loci were further used in a population study of Xam in the eastern plain of Colombia. The results provided evidence of a geographical Xam population structuration. Secondly, CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-associated spoligotyping and minisatellites markers were explored for a largely divergent set of Philippine strains of Xanthomonas oryzae pv. oryzae (Xoo). Both approaches were compared to genome-wide SNPs and races. Preliminary studies identified the composition of CRISPR arrays, which could be useful for a spoligotyping approach. On the other hand, 18 minisatellites markers revealed a significant correlation with races and could be used for a larger study of Philippine or Asian Xoo populations. In conclusion, novel molecular typing approaches were successfully evaluated, implemented and used to study rice- and cassava-pathogenic bacteria of the genus Xanthomonas.

La bactériose vasculaire du riz (BLB) et bactériose non-vasculaire du riz (BLS), causées respectivement par Xanthomonas oryzae pv. oryzae (Xoo) et X. oryzae pv. oryzicola (Xoc), sont les deux plus importantes maladies bactériennes du riz. Ces maladies limitent le rendement de la production de riz dans les zones rizicoles en Asie et dans certaines régions d'Afrique. L'infection et la multiplication bactérienne dans les tissus de l'hôte dépendent souvent des facteurs de virulence de ces bactéries dont le type le système de sécrétion de type III (T3SS) et ses substrats. Dans cette thèse, nous avons identifié neuf effecteurs non-TAL (transcription Transcription activator-like) sécrétés par des effecteurs de type III de la souche chinoise 13751 de Xoo en utilisant le domaine d'induction HR de la protéine avirulente AvrBs1 comme gène reporter. Parmi eux, XopAE13751 a été expérimentalement confirmé pour la première fois comme étant un effecteur non-TAL. Ensuite, par l'analyse mutationnelle de ces gènes effecteurs identifiés dans Xoo, nous avons constaté que l'effecteur non-TAL XopR13751 était nécessaire pour la virulence de la souche chinoise de Xoo sur le riz hybride Teyou63. En parallèle, nous avons démontré que le gène rsmA (repressor of secondary metabolism) - comme le gène rsmAXoo de l'espèce chinoise Xoo 13751- régule positivement l'expression des gènes associés aux facteurs de virulence, tels que le système de sécrétion de type III, les enzymes extracellulaires et le DSF (diffusible signal factor). De plus, le gène effecteur non-TAL xopO s'est avéré être peu répandu chez les Xanthomonas puisqu'il est présent uniquement chez X. euvesicatoria (Xe) et Xoc mais est absent chez Xoo. En considérant les deux pathovars de X. oryzae, avec deux modes d'infection différents, xopO a été examiné comme un facteur de la spécificité du tissu par l'inactivation mutationnelle du gène dans Xoc et par l'expression du gène dans Xoo. Les résultats ont montré que xopO n'est pas la cause déterminante de la spécificité de tissu chez Xoc. Enfin, nous avons étudié les VNTRs (Variable Number of Tandem Repeats) comme outil de typage moléculaire rapide, fiable et rentable, pour améliorer le contrôle des épidémies et pour évaluer la structure de population des souches de Xoc. 28 loci candidats VNTR ont été prédits par le criblage de trois génomes de Xoc (souche philippine BLS256, souche chinoise GX01 et souche malienne MAI10). Des paires d'amorces pour l'amplification de PCR de chacun des 28 loci ont été conçues et testées à un pannel de 20 souches de Xoc provenant de l'Asie et de l'Afrique. Le séquençage des amplicons de PCR a confirmé 25 loci VNTR robustes et polymorphes communs entre les souches Xoc asiatiques et africaines. Un dendrogramme, construit à partir de la combinaison des 25 loci de VNTR (MLVA-25), a montré que la plupart des souches asiatiques sont clairement distinguables des souches africaines. Cependant, en accord avec de précédents rapports, une souche Malienne se distingue et semble être liée aux souches asiatiques, suggérant une introduction possible de souches sur le continent africain. Ce nouvel outil de typage basé sur les VNTR sera utile pour l'étude de structures de populations et pour la surveillance épidémiologique de Xoc. / Bacterial leaf blight (BLB) and Bacterial leaf streak (BLS), caused respectively by Xanthomonas oryzae pv. oryzae (Xoo) and X. oryzae pv. oryzicola (Xoc), are two most important bacterial diseases on rice, constraining severely the rice yield in the rice-growing areas in Asia and in parts of Africa. Successful infection and bacterial multiplication in host tissue often depend on virulence factors from these bacteria including type Ⅲ secretion system (T3SS) and its substrates. In this thesis, we identified nine type Ⅲ secreted non-TAL (Transcription activator-like) effectors of Xoo Chinese strain 13751 using HR-inducing domain of avirulence protein AvrBs1 as the reporter, among them, XopAE13751 was first found experimentally to be non-TAL effector. Subsequently, through mutational analysis of these identified effector genes in Xoo, we showed non-TAL effector XopR13751 was found to be required for full virulence of Xoo Chinese strain in hybrid rice Teyou63. In parallel, we demonstrated that rsmA (repressor of secondary metabolism)-like gene rsmAXoo of Xoo Chinese strain 13751 positively regulated the expression of genes associated with virulence factors such as type Ⅲ secretion system, extracellular enzymes and diffusible signal factor (DSF). Furthermore, non-TAL effector gene xopO was found to be narrowly distributed in Xanthomonas, which was only present in X. euvesicatoria (Xe) and Xoc, but not in Xoo. Based on the consideration of two X. oryzae pathovars carrying two different infection ways, xopO was tested in host and tissue specificity by analysis of mutational analysis of the gene in Xoc and expression of the gene in Xoo. The results showed that xopO of Xoc did not function as a determinant in host and tissue specificity. Finally, we explored Variable Number of Tandem Repeats (VNTRs) as a fast, reliable and cost-effective molecular typing tool, to better monitoring epidemics and assess the population structure of Xoc strains. 28 candidate VNTR loci were predicted by screening of three Xoc genome sequences (Philippine strain BLS256, Chinese strain GX01 and Malian strain MAI10). Primer pairs for PCR amplification of all 28 loci were designed and applied to a panel of 20 Xoc strains originating from Asia and Africa. Sequencing of PCR amplicons revealed 25 robust and polymorphic VNTR loci which are shared among Asian and African strains of Xoc. A dendrogram was constructed from 25 VNTR loci-combinating data (MLVA-25), indicating that most Asian strains were clearly discriminated from African strains. However, in agreement with previous reports, one strain from Mali appeared to be related to Asian strains, pointing to a possible introduction of strains to the African continent. A detailed analysis of the evolutionary relationships among a larger set of Xoc strains from China will be presented, considering different spatial scales. In conclusion, a new VNTR-based tool useful for studies of population structures and epidemiological monitoring of Xoc was successfully established.

A doença de Chagas é caracterizada por um amplo espectro de manifestações clínicas, que vão desde a ausência de sintomas à doença grave com comprometimento cardíaco e/ou digestivo. A influência do parasito, Trypanosoma cruzi (T. cruzi), agente etiológico da doença, nessas apresentações clínicas têm sido largamente estudada, não se tendo demonstrado o papel da diversidade genética de populações de T. cruzi na determinação das diferentes formas clínicas em humanos. Este trabalho teve como objetivos: a) geral: analisar as características moleculares de T. cruzi em pacientes com doença de Chagas com e sem imunodepressão (infecção por HIV e transplante de órgãos com e sem reativação); b) específicos: 1. Analisar comparativamente isolados do parasito quanto à distribuição em DTU; 2. Relacionar os resultados obtidos pela análise molecular do gene ND7 com a forma clínica e origem; 3. Avaliar por LSSP-PCR a variabilidade da sequência do kDNA de T. cruzi diretamente de amostras biológicas assim como em isolados de T. cruzi obtidos pelos exames de hemocultura/xenodiagnóstico; 4. Comparar os padrões polimórficos obtidos por LSSP-PCR em amostras repetidas de um mesmo paciente no mesmo sítio ou distintos sítios biológicos. Foram incluídos, após aprovação do protocolo na CAPPesq e mediante assinatura de TCLE, 106 pacientes com doença de Chagas crônica ou com imunossupressão, provenientes dos ambulatórios e enfermarias do HCFMUSP, além de 75 indivíduos controle, com provas sorológicas e moleculares negativas. Foram analisadas 187 amostras isoladas de hemocultura/xenodiagnóstico e 236 diretamente de amostras sanguíneas de pacientes. Os seguintes grupos foram constituídos: Agudo-AG, Crônico-CR, Crônico Imunodeprimido-CRI (doenças autoimunes/neoplasias), Coinfecção-CO (infecção por HIV/T.cruzi), Coinfecção-CO/RE (infecção por HIV/T.cruzi e reativação da doença de Chagas), Transplantado-TX, Transplantado-TX/RE (Transplantado com reativação da doença de Chagas). Foram identificados DTU TcI, TcV, TcVI e em maior número TcII, por ensaios de tipagem molecular do parasito, com distribuição estatisticamente significantemente de acordo com a naturalidade dos pacientes (P=0,013). Quanto ao gene ND7, observou-se que a banda de ~900 bp ocorreu em 83,0% das amostras das regiões norte, nordeste, centro-oeste e Bolívia e a de ~400pb em 54% das amostras nas regiões sul e sudeste brasileiras sendo esta diferença estatisticamente significante (P < 0,001). A comparação dos perfis observados por LSSP-PCR a partir de amostras extraídas diretamente do sangue e de isolados obtidos de hemocultura/xenodiagnóstico mostrou maior variabilidade em amostras sanguíneas, confirmada pelo dendrograma. Adicionalmente, o estudo de amostras repetidas do mesmo paciente permitiu confirmar a maior variabilidade nas amostras diretamente extraídas do sangue, com mudança dos padrões durante e após o tratamento com reaparecimento de perfis antigos não presentes no período prétratamento imediato, além de presença de perfis diferentes em distintos sítios biológicos do mesmo paciente. O encontro de DTU diferentes de TcII nos grupos CR/CRI e AG enfatiza a necessidade de atentar para a diferença em limiares de reatividade segundo DTU na análise da parasitemia por PCRq (quantitativa), conforme registrado na literatura. Os dados observados por LSSP-PCR acrescentam informações adicionais não revelados por tipagem molecular, representando novos desafios para o entendimento da relação hospedeiro-parasito em pacientes com doença de Chagas sem e com imunossupressão, ao lado de fatores como nível de parasitemia e pressão seletiva de medicamentos antiparasitários e imunossupressores / Chagas\' disease is characterized by a broad spectrum of clinical manifestations, ranging from asymptomatic cases to severe cardiovascular and/or gastrointestinal involvement. The clinical presentations are thought to be determined primarily by genetic diversity of populations of Trypanosoma cruzi (T. cruzi), but no correlation was clearly demonstrated yet. This study aimed to: a) general: to analyze the molecular characteristics of T. cruzi in patients with Chagas\' disease with and without immunosuppression (HIV infection and organ transplantation with or without reactivation); b) specifics: 1.To analyze comparatively isolates from the parasite as for the distribution in DTU; 2. To describe the results obtained by molecular analysis of gene ND7 in relationship with the clinical form and origin; 3. To assess by LSSP-PCR the variability of the sequence of the T. cruzi kDNA directly from biological samples, as well as in T. cruzi isolates obtained by examination of blood culture/xenodiagnosis; 4. To compare the polymorphic patterns obtained by LSSP-PCR in repeated samples of the same patient on the same site or different biological sites. After approval of the protocol in CAPPesq and by signing an informed consent, 106 patients with chronic Chagas disease or immunosuppression, from the HCFMUSP\'s clinics and wards, and 75 control subjects with negative serological and molecular tests were included. They were analyzed 187 isolated samples from blood culture/xenodiagnosis and 236 directly from blood samples of patients. The following groups were formed: Acute-AC, Chronic-CR, Chronic immunocompromised-CRI (autoimmune diseases/ neoplasms), Coinfection-CO (HIV/T. cruzi infection), Coinfection-CO/RE (HIV/T. cruzi and reactivation of Chagas disease), Transplantation-TX, Transplantation-TX/RE (Transplantation/ with reactivation of Chagas\' disease). DTU TcI, TcV, TcVI and higher TcII number were identified for molecular typing assays of the parasite and the distribution of DTU was statistically significant according to patient´s naturality (P=0.013). As for ND7 gene, was observed that the band of ~ 900 bp was prevalent in 83% of the samples in the North, Northeast, Midwest regions and Bolivia and the band of ~400bp occurred in 54% of the samples of Brazilian\' South and Southeast regions, this distribution was statistically significant (P < 0.001). The comparison between the profiles observed by LSSP-PCR from samples taken directly from blood and isolates obtained from blood culture/xenodiagnosis showed greater variability in blood samples, confirmed by dendrogram. Additionally, the study of repeated samples from the same patient allowed to confirm the greater variability in blood samples taken directly, with changing patterns during and after the treatment with reappearance of old profiles not present in the immediate pre-treatment period, and the presence of different profiles at different biological sites in the same patient. The presence of other DTUs than TcII in chronic and chronic immunosuppressed patients and AC groups emphasizes the need to pay attention to the different reactivity thresholds for the various DTU in the analysis of parasitaemia by PCRq (quantitative), according to the data registered in the literature. The results observed by LSSP-PCR add further information not revealed by molecular typing, representing new challenges for the understanding of the host-parasite relationship in patients with Chagas\' disease with and without immunosuppression, alongside factors such as level of parasitaemia and selective pressure of antiparasitic drugs and immunosuppressive