Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

In den vorliegenden Studien wurde die Eimeria zuernii – Kokzidiose im Hinblick auf den klinischen Verlauf, die Pathophysiologie, die Pathologie und einen metaphylaktischen Behandlungsansatz charakterisiert. Hierfür wurden experimentelle Infektionen an Kälbern durchgeführt, zusätzlich wurden natürlich infizierte Tiere in die Prüfung der Wirksamkeit der Behandlung einbezogen. Die parasitologischen und pathophysiologischen Untersuchungen wurden im Infektionsmodell an insgesamt 41 Kälbern durchgeführt, die in drei Gruppen eingeteilt wurden: eine uninfizierte Kontrollgruppe 1 (n=14), die moderat infizierte Gruppe 2 (150.000 sporulierte E. zuernii – Oozysten pro Kalb, n=11) und die hochdosiert infizierte Gruppe 3 (250.000 sporulierte E. zuernii – Oozysten pro Kalb, n=16). Die Tiere wurden regelmäßig klinisch und ihre Kotproben auf Konsistenz und Parasitenaussscheidung untersucht. Es wurden regelmäßig Blutproben zur Bestimmung hämatologischer und klinisch-chemischer Parameter sowie des Säure-Basen-Status entnommen, und die Tiere wurden wöchentlich gewogen. Die Infektion mit E. zuernii löste bei allen Tieren der Gruppen 2 und 3 nach einer variablen Präpatenzdauer eine Ausscheidung von E. zuernii-Oozysten aus. Im Gegensatz zur uninfizierten Kontrollgruppe entwickelten alle infizierten Tiere Durchfall mit teils hämorrhagischem Charakter, wobei eine deutliche Korrelation zwischen der Oozystenausscheidung und dem Auftreten von Diarrhoe nachgewiesen werden konnte. Klinische Erkrankungen traten häufiger in der hochdosiert infizierten als in der moderat infizierten Gruppe auf. Hierbei standen Exsikkosen und ein vermindertes Allgemeinbefinden im Vordergrund. Ein Tier der hochinfizierten Gruppe erkrankte aufgrund der Kokzidiose infaust. Die Gewichtszunahmen waren in beiden infizierten Gruppen, bezogen auf die Kontrollgruppe 1, signifikant erniedrigt, in der hochdosiert infizierten Gruppe 3 stärker als in der moderat infizierten Gruppe 2. Die Veränderungen bei den untersuchten Blutparametern traten im Allgemeinen dosisabhängig auf. In Gruppe 3 wurden stärkere Abweichungen von den Blutwerten der Kontrollkälber beobachtet als in Gruppe 2. Initial kam es während der Patenz zu einer Leukopenie, welche anschließend in eine Leukozytose überging. Im Zuge der enteralen Blut- und Wasserverluste bildeten sich eine Hämokonzentration sowie eine Retikulozytose heraus, was als Hinweis auf eine regenerative Anämie gewertet wird. Während der Patenz fand eine Umstellung des Organismus auf einen katabolen Stoffwechsel statt, was sich in einer Lipolyse und einem gesteigerten Proteinabbau niederschlug. Außerdem kam es zu einer Störung der Homoiostase. Es lagen Elektrolytverluste über den geschädigten Darm vor, und es entwickelte sich eine respiratorisch kompensierte metabolische Azidose. Die pathologischen Untersuchungen wurden an sechs weiteren moderat infizierten Kälbern (150.000 sporulierte E. zuernii – Oozysten pro Kalb) durchgeführt. In der späten Präpatenz (16 Tage p.i.) zeigten sich nur geringe Läsionen durch die Schizogoniestadien vom kaudalen Jejunum bis zum mittleren Kolon. Zum Höhepunkt der Patenz hin (21 Tage p.i.) wiesen die beiden untersuchten Tiere akute, teils nekrotisierende Enteritiden auf, vor allem im proximalen Kolon sowie im Zäkum. Offenbar verursacht die Gamogonie, welche zu diesem Zeitpunkt vorherrscht, die stärksten Schleimhautschäden und ist damit als Auslöser der Durchfallerscheinungen zu betrachten. Gegen Ende der Patenz, am 26. Tag p.i., lagen noch entzündliche Infiltrationen der Schleimhautabschnitte vom terminalen Ileum bis zum Kolon vor, parallel fanden regenerative und hyperplastische Prozesse statt. Im Infektionsmodell und anschließend unter Feldbedingungen wurde die Effektivität einer einmaligen oralen metaphylaktischen Toltrazurilbehandlung (15 mg pro kg Körpergewicht, Baycox® 5% Suspension) etwa 14 Tage nach der Infektion getestet. Für die Prüfung unter experimentellen Bedingungen wurden 23 Kälber mit einer Dosis von 150.000 sporulierten E. zuernii – Oozysten infiziert. Die Anwendung des Toltrazurils im Feld wurde im Rahmen einer multizentrischen Studie mit fünf Studienbetrieben und insgesamt 208 Kälbern getestet. Es lagen in allen Betrieben Mischinfektionen mit den Pathogenen E. zuernii und E. bovis vor. In jedem der beiden GCP-Versuche wurde etwa die Hälfte der Tiere behandelt, während die andere Hälfte als Negativkontrolle unbehandelt blieb. Durch den Einsatz des Antikokzidiums konnten im Experiment sowie unter Feldbedingungen die Durchfalldauer und –schwere ebenso wie die Dauer und Höhe der Oozystenausscheidung im Vergleich zur unbehandelten Kontrolle signifikant gesenkt werden. Die Gewichtszunahme war in der toltrazurilbehandelten Gruppe unter experimentellen Bedingungen signifikant höher als in der Kontrollgruppe, im Feld ließ sich dieser Effekt nicht zeigen. Damit konnte die E. zuernii – Infektion im zeitlichen Verlauf und im Einfluss auf das Zielorgan Darm und den Gesamtorganismus unter den standardisierten Bedingungen einer experimentellen Infektion dargestellt werden. Es konnte eine Behandlungsmöglichkeit als hochwirksam eingestuft werden, welche durch die frühe, metaphylaktische Anwendung eines Kokzidiostatikums die zu erwartenden Darmläsionen während der späten Schizogonie und der Gamogonie unterbindet.

Uropathogenic E. coli (UPEC) is the most frequent cause of urinary tract infection (UTI), being responsible for up to 85% of community acquired and 40% of nosocomial cases. UPEC strains harbour various virulence factors that contribute to their ability to cause disease. The high prevalence across the globe of multidrug resistant UPEC is a significant threat to therapy. Virulent and resistant UPEC strains have been recognised as belonging to major lineages and we have only recently begun to understand the factors contributing to their successful global dissemination. Work in this thesis was carried out to identify the population structure of E. coli isolates recovered from urosepsis and biliary sepsis, to reveal any differences in genetic background. A total of 100 isolates from the blood and urine of 50 patients presenting with urosepsis and 27 isolates from cases of biliary sepsis were subjected to genotypic and phenotypic analysis, including MLST, virulence gene detection and antibiogram and metabolic profiling. Urosepsis paired isolates showed identical genotypes and antimicrobial resistance profiles. However, several pairs of isolates showed discrepant metabolic activity profiles suggesting niche specific regulation of metabolism. Members of the ST131 clone were significantly associated with antibiotic resistance and ST38 isolates were associated with the highest level of metabolic activity. An in vivo infection model was used to investigate the virulence potential of isolates from the major UPEC lineages. Galleria mellonella larvae inoculated with ST69 and ST127 isolates showed significantly higher mortality rates than those infected with other strains. However, one isolate of ST127 (strain EC18) was avirulent and comparative genomic analyses with a single virulent ST127 strain revealed an IS1 mediated deletion in the O-antigen cluster in strain EC18, which is likely to explain the lack of virulence in the larvae and demonstrates the importance of this cell surface molecule in the model system. Finally, a total of 202 UPEC isolates were recovered from community and hospital urine samples from a tertiary care hospital in Riyadh, Saudi Arabia. Molecular epidemiological investigation of the strains was carried out to examine the overall UPEC population structure, for the first time in any part of Saudi Arabia. The most common lineages were ST131 (17.3%), ST73 (11.4%), ST38 (7.4%), ST69 (7.4%) and ST10 (6.4%). The findings highlight the successful spread of multidrug resistant, CTX-M positive ST38, ST131 and ST405 UPEC in Saudi Arabia. The high proportion (35%) of ESBL producing E. coli isolates is a particular concern and is driving frequent prescription of carbapenem antibiotics. A total of four isolates of ST38 were positive for aggR, which is a virulence marker of enteroaggregative E. coli (EAEC); ST38 strains that cause UTI but have an EAEC genetic background are becoming recognised as novel UPEC and this clonal group warrants further study.

Einleitung: Toxoplasma (T.) gondii zählt zu den häufigsten intrazellulären Parasiten weltweit. Alleinige Endwirte im fakultativ heteroxenen Lebenszyklus sind die Feliden. Als Zwischenwirte können jedoch zahlreiche Säugetier- und Vogelarten dienen, in denen sich parasitäre Gewebezysten entwickeln. Einer der Hauptübertragungswege auf den Menschen stellt der Verzehr von T. gondii-haltigem Fleisch infizierter Nutztiere dar. Inwieweit Putenfleisch ein potentielles Infektionsrisiko birgt und welche Bedeutung Puten in der Epidemiologie der humanen Toxoplasmose besitzen ist nicht ausreichend geklärt. Ziel der Untersuchungen: Ziel der vorliegenden Arbeit war es, ein reproduzierbares Infektionsmodell bei Puten für T. gondii zu entwickeln, um die Verteilung und Persistenz des Parasiten im Gewebe zu ermitteln. Es wurden verschiedene Parameter, wie Infektionsstadium, Infektionsdosis, Applikationsmodus und Untersuchungszeitpunkt hinsichtlich ihres Einflusses auf die Entwicklung parasitärer Gewebestadien verglichen. Material und Methoden: Insgesamt wurden 74 Puten nach einer Aufzuchtperiode von 4 bis 8 Wochen experimentell mit T. gondii-Tachyzoiten oder Oozysten infiziert. Je nach Versuchsgruppe wurden Tachyzoiten vom Stamm ME49 intravenös und/oder intramuskulär appliziert oder Oozysten vom Stamm ME49, DX oder Hannover 1 oral verabreicht. Die Verifikation der Infektion erfolgte über den Nachweis T. gondii-spezifischer Antikörper mit Hilfe eines kinetischen ELISA. Drei bis acht Puten jeder Versuchsgruppe wurden 6 bis 8 oder 10 bis 12 Wochen nach der Infektion getötet. Von jedem Tier wurden folgende Gewebeproben entnommen: Brust-, Oberschenkel- und Unterschenkelmuskulatur, Herz, Leber, Muskel- und Drüsenmagen, Gehirn, Lunge, Milz, Nieren, Darm, Pankreas und Hoden (sofern vorhanden). Die Organe wurden getrennt vollständig homogenisiert. Bei den Muskeln wurden Proben von verschiedenen Lokalisationen entnommen und ebenfalls einzeln homogenisiert. Der Nachweis von T. gondii-DNA in den Gewebeproben erfolgte mittels konventioneller PCR, basierend auf der Amplifizierung eines 469 bp Fragments des B1-Gens, und anschließender nested PCR (Länge Zielfragment: 375 bp). Zusätzlich wurden zu Beginn der Studie lichtmikroskopische Untersuchungen einzelner Organe in Form nativer Quetschpräparate (400fache Vergrößerung) auf T. gondii-Zysten durchgeführt. Ergebnisse: Ungeachtet der Infektionsdosis und des inokulierten Parasitenstadiums konnten bei keinem der Versuchstiere klinische Symptome einer Toxoplasmose beobachtet werden. Die unterschiedlich hohen Infektionsdosen hatten im Allgemeinen keinen signifikanten Einfluss auf die Anzahl positiv getesteter Puten oder Organproben. Lediglich die Anzahl positiver Gehirnproben nahm mit ansteigender Oozystendosis signifikant zu. Bei der Betrachtung aller Versuchsgruppen fiel auf, dass die Befallshäufigkeit der Organe sowohl zwischen den Tieren verschiedener Infektionsgruppen als auch innerhalb einer Infektionsgruppe stark schwankte. So variierte die Anzahl positiv getesteter Organe bei den Tachyzoiten-infizierten Puten zwischen 0 und 7, bei den Oozysten-infizierten Puten zwischen 0 und 9 Organen pro Tier. Die Untersuchungsergebnisse zeigen, dass sich T. gondii heterogen in der Pute verteilt und mindestens 12 Wochen persistieren kann. Bezogen auf alle Versuchstiere gab es kein Organ, dass durchgängig negativ blieb. Nach der Tachyzoiteninfektion waren am häufigsten Leber (43,3%), gefolgt von Brustmuskel (26,7%) und Herz (20,0%) infiziert, während bei den Oozysten-infizierten Tieren der Erreger am häufigsten im Gehirn (47,2%), gefolgt von Oberschenkelmuskulatur (25,0%) und Herz und Unterschenkelmuskulatur (je 22,2%) nachgewiesen werden konnte. Schlussfolgerungen: Tachyzoiten und Oozysten erwiesen sich als gleichermaßen geeignete Infektionsmedien und führten hinsichtlich der systemischen Verteilung des Parasiten in der Pute zu vergleichbaren Ergebnissen. Ein spezifischer Organtropismus des Erregers konnte nicht festgestellt werden. Aus Sicht der Lebensmittelhygiene und des Verbraucherschutzes bedeuten die Ergebnisse, dass im Fall einer T. gondii-Infektion ein potentielles Infektionsrisiko für den Menschen durch infiziertes Putenfleisch nicht ausgeschlossen werden kann.

Yes / Corneal ulcers, a leading cause of blindness in the developing world are treated inappropriately without prior microbiology assessment because of issues related to availability or cost of accessing these services. In this work we aimed to develop a device for identifying the presence of Gram-positive or Gram-negative bacteria or fungi that can be used by someone without the need for a microbiology laboratory. Working with branched poly (N-isopropyl acrylamide) (PNIPAM) tagged with Vancomycin, Polymyxin B, or Amphotericin B to bind Gram-positive bacteria, Gram-negative bacteria and fungi respectively, grafted onto a single hydrogel we demonstrated specific binding of the organisms. The limit of detection of the microbes by these polymers was between 10 and 4 organisms per high power field (100X) for bacteria and fungi binding polymers respectively. Using ex vivo and animal cornea infection models infected with bacteria, fungi or both we than demonstrated that the triple functionalised hydrogel could pick up all 3 organisms after being in place for 30 min. To confirm the presence of bacteria and fungi we used conventional microbiology techniques and fluorescently labelled ligands or dyes. While we need to develop an easy-to-use either a colorimetric or an imaging system to detect the fluorescent signals, this study presents for the first time a simple to use hydrogel system, which can be applied to infected eyes and specifically binds different classes of infecting agents within a short space of time. Ultimately this diagnostic system will not require trained microbiologists for its use and will be used at the point-of-care. / We gratefully acknowledge support for this research by the Well- come Trust which provided funding for Shivshetty, Swift and Pinnock (Grant 0998800/B/12/Z).

La détection de la protéine prion anormale dans les tissus lymphoïdes de patients britanniques suggère qu’après exposition à l’agent de la variante de la maladie de Creutzfeldt-Jakob (vMCJ) plus de 99% des contaminations pourraient demeurer cliniquement silencieuses. Ces données soulignent un risque de transmission secondaire par transfusion sanguine ce qui nous a conduit à une étude expérimentale. En parallèle des formes classiques de vMCJ, nos modèles murins et simiens de retransmission ont mis en evidence des phenotypes atypiques. Ces phénotypes échappent actuellement aux critères de diagnostic puisqu’aucune protéine prion anormale (PrPres) n’est détectée.Nos travaux ont eu pour but principal d’évaluer expérimentalement le risque sanguin au travers d’études de retransmission et de caractérisation de la replication des souches classiques et atypiques aux niveaux périphérique et central.Nous observons une très forte hétérogénéité dans la réplication de la PrP anormale dans les différents tissus lymphoïdes des macaques transfusés développant une vMCJ. Le niveau de contamination des tissus lymphoïdes apparait proportionnel à l’infectiosité sanguine de ces animaux et au risque de transmission de la maladie in vivo. Concernant les formes atypiques, la majorité des macaques transfusés n’ont pas de réplication dans les tissus lymphoïdes bien que ces phénotypes soient transmissibles expérimentalement à des modèles murins. Des transmissions à des souris immunodéficientes révèlent que les souches atypiques sont transmissibles par voie périphérique en l’absence d’un système immunitaire fonctionnel.Une alternative à l’expérimentation animale a été réalisée grâce aux « mini-brains » mimant la complexité du cerveau humain. Ces organoïdes cultivés en trois dimensions sont sensibles à au moins un isolat de prion associé aux formes sporadiques humaines. Les mini-brains pourraient ainsi constituer un nouvel outil d’étude des maladies à prions et permettre à termes la caractérisation des souches atypiques. / The detection of abnormal prion protein in the lymphoid tissues of UK patients suggests that after exposure to the agent of variant Creutzfeldt-Jakob disease (vCJD), more than 99% of contaminations may remain clinically silent. These data highlight a risk of secondary transmission through blood transfusion. In parallel to the classical vCJD forms, our experimental models in mice and macaques revealed another group which avoids the current diagnostic criteria, including the absence of abnormal prion protein (PrPres).The main goal of our work was to experimentally assess the risk of blood through retransmission studies and characterization of the abnormal replication of classical and atypical strains examined at peripheral and central levels.We observed a high heterogeneity of the distribution of the abnormal PrP in the lymphoid tissues of vCJD transfused macaques. The global level of contamination in lymphoid tissues seems proportional to the blood infectivity in these animals and to the risk of in vivo transmission of the disease. Regarding atypical forms, despite an absence of replication in lymphoid tissues, these phenotypes are experimentally transmissible. Transmissions to immunodeficient mice reveal that atypical strains are transmissible through peripheral routes in the absence of functional immune system.An alternative to animal testing has been achieved using to "mini-brains" mimicking the complexity of the human nervous system. These organoids cultured in three dimensions are sensitive to at least one prion isolate associated with human sporadic forms. Thus, mini-brains could constitute a new tool for studying prion diseases and improve the characterization of atypical strains.

The invasive pathways, InlA- and InB-mediated uptake and M cell transcytosis, that Listeria monocytogenes uses to invade the intestine have mainly been studied using infection models that do not truly replicate what occurs during a natural infection. Recently, our lab has developed an oral infection model that is more physiolocally relevant to what occurs during food borne listeriosis. We have sought to evaluate the relative roles of the previously defined invasive pathways, in our oral model of infection. We have done this by utilizing an InlAmCG Lm strain that is able to bind murine E-cadherin, knockout Lm strains, ΔinlA Lm, and ΔinlAΔinlB Lm. We also took advantage of a knockout mice strain CD137-/-that has M cells that are deficient in M cell transcytosis. We were able to show that these invasive pathways are relevant in our oral infection model, that M cell transcytosis is a compensatory pathway for InlA-mediated uptake, and that there might be another mechanism that L. monocytogenes uses to invade the intestines. To confirm this, it is necessary though that the M cell transcytosis deficiency be confirmed in the CD137-/- mice.

Chlamydial infections have been associated with several chronic human diseases, including trachoma, pelvic inflammatory disease, chronic obstructive pulmonary disease and atherosclerotic cardiovascular disease. In Chlamydia-associated disease, the organisms are believed to exist in an atypical, persistent phase that is not well understood at the genetic level. The research presented in this thesis investigated chlamydial gene expression in in vitro cell culture models of persistence. The first set of studies analysed a continuous-infection model of persistence that has been recently developed for two C. pneumoniae isolates (TW-183 and CM-1). The spontaneous establishment and unique cyclical nature of continuous infections could be particularly relevant to in vivo events. An initial analysis using a semi-quantitative reverse transcriptase PCR (sqRT-PCR) approach provided evidence of differential gene expression in C. pneumoniae TW-183 continuous infections relative to acute control infections. Using a subsequently established fully quantitative real-time reverse transcriptase PCR (rtRT-PCR) assay, up-regulated expression profiles were confirmed for five genes (CPn0483, nlpD, ompA, pmp1 and porB) in the continuous C. pneumoniae TW-183 infections. The omcB, pmp1 and porB genes, all of which encode membrane proteins, showed similar patterns of expression over both the acute and continuous time courses tested. Gene expression data for a second C. pneumoniae isolate, CM-1, revealed similar overall expression trends to those seen for C. pneumoniae TW-183 but also supported previous observations of different growth characteristics between the two isolates in the continuous-infection model. The rtRT-PCR assay was further optimised for use in gene expression studies of the gamma interferon (IFN-γ)-mediated model of C. pneumoniae A-03 persistence, in which altered growth and morphological traits typical of chlamydial persistence have been well characterised. Meanwhile, chlamydial genes such as euo, ftsK and hctB were emerging from the literature as reliable genetic markers of persistence. Therefore, a preliminary rtRT-PCR analysis of marker gene expression was used to assess the likely extent of persistence in individual IFN-γ-treated C. pneumoniae A-03 infections from a series of experiments that had been prepared for this persistence model. In this way, an appropriate pair of duplicate experiments was selected for further studies based on strong genetic evidence of persistence in IFN-γ-treated samples at 48 h post-infection (PI) in those experiments. Using rtRT-PCR, 14 genes of interest from the related peptidoglycan, aminosugars and lipopolysaccharide (LPS) biosynthetic pathways were analysed in the validated experiments of the IFN-γ-mediated C. pneumoniae A-03 persistence model. Selective up- and down-regulated expression trends were associated with IFN-γ-treatment at 48 h PI for genes encoding products that are located at specific enzymatic points in these pathways. Most strikingly, the expression of glmU, the product of which controls the amount of an essential precursor metabolite that enters both peptidoglycan and LPS biosynthesis, was strongly and reproducibly down-regulated in the 48-h PI IFN-γ-treated samples. This expression profile may contribute to a reduced rate of peptidoglycan biosynthesis in this persistence model and may therefore be related to the inhibited cell division and RB-to-EB differentiation that characterise chlamydial persistence. While most other genes in these pathways showed unchanged expression associated with IFN-γ treatment, murA and kdsB (from peptidoglycan and LPS biosynthesis, respectively) were selectively up-regulated in the 48-h PI IFN-γ-treated samples. Taken together, these data supported the concept of a persistence stimulon in C. pneumoniae that is regulated at key points in various metabolic pathways. In addition to the analysis of biosynthetic genes, the up-regulated gene set from continuous C. pneumoniae TW-183 infections was also analysed in the validated IFN-γ-mediated C. pneumoniae A-03 persistence experiments. The data revealed similarities and differences in gene expression patterns between these two in vitro persistence models. Furthermore, the profiles obtained for genes such as pmp1 and porB provided insights into the widely predicted phenomenon of late developmental gene shut-down during chlamydial persistence. A final investigation into an analogous IFN-γ-mediated persistence system for C. trachomatis serovar L2 focussed on one up-regulated (murA) and one down-regulated (glmU) gene from the validated IFN-γ-mediated persistent C. pneumoniae A-03 data set. Both genes were significantly down-regulated in persistent C. trachomatis, adding to a growing body of evidence for key differences among chlamydial species in their persistent gene expression patterns. This project has contributed significantly to our understanding of the molecular basis of the important persistent phase of chlamydial development.

Objetivo: O objetivo geral deste trabalho foi estabelecer modelo farmacocinéticofarmacodinâmico (modelo PK/PD) para descrever o perfil temporal do efeito bactericida do levofloxacino e do gatifloxacino contra Streptococcus pneumoniae. Método: Para alcançar este objetivo as seguintes etapas foram realizadas: i) foram validadas metodologias analíticas de SPE-HPLC para o gatifloxacino e HPLC para o levofloxacino e o gatifloxacino para quantificação destes em amostras de plasma, microdialisado tecidual e caldo de cultura; ii) foi avaliada a farmacocinética do gatifloxacino em roedores nas doses de 6 e 12 mg/kg via oral e 6 mg/kg via intravenosa (i.v.) e a biodisponibilidade oral foi determinada; iii) foram estabelecidas as condições ideais para microdiálise do gatifloxacino e as taxas de recuperação in vitro, por diálise (EE), retrodiálise (RD) e fluxo líquido zero (NNF) e in vivo, em tecido pulmonar e muscular, por retrodiálise e fluxo líquido zero. Essas recuperações foram utilizadas para determinar a penetração pulmonar do gatifloxacino após a administração i.v. bolus de 6 mg/kg a ratos Wistar sadios; iv) foram simuladas as concentrações livres pulmonares esperadas para humanos após tratamento com diferentes regimes de dosagem para o levofloxacino e o gatifloxacino em modelo de infecção in vitro frente a Streptococcus pneumoniae ATCC® 49619. Simulações de concentrações constantes múltiplas do MIC de cada fármaco também foram realizadas. As curvas de morte bacteriana por tempo obtidas foram modeladas com modelo PK/PD de Emax modificado, com auxílio do programa Scientist® v 2.01. Resultados e Conclusões: i) Os métodos analíticos por SPE-HPLC e HPLC para quantificação do gatifloxacino e do levofloxacino foram validados. As curvas foram lineares na faixa de 20 a 600 ng/mL para plasma e microdialisado tecidual de gatifloxacino e na faixa de 250 a 6000 ng/mL para caldo de cultura para ambos os fármacos, com r > 0,99, independente do método desenvolvido. Em plasma e microdialisado, a exatidão foi ≥ 94,3 %. A recuperação do gatifloxacino dos cartuchos de extração em fase sólida variou entre 95,6 e 99,7 %. A precisão não excedeu 5,8 % do CV. Em caldo de cultura, a exatidão foi ≥ 92,0 % e 93,4 % para o gatifloxacino e o levofloxacino, respectivamente. A precisão não excedeu 3,2 % e 4,2 % do CV para o levofloxacino e o gatifloxacino, respectivamente; ii) A avaliação farmacocinética demonstrou que os modelos abertos de dois compartimentos e de um compartimento com absorção de primeira ordem descreveram adequadamente os perfis plasmáticos após administração do gatifloxacino pelas vias i.v. e oral nas doses de 6 e 12 mg/kg, com CL de 0,9 ± 0,2 e 1,0 ± 0,3 L/h/kg, t½ de 3,3 ± 0,8 e 3,7 ± 0,3 h e Vd de 2,8 ± 0,4 e 3,1 ± 1,0 L/kg, respectivamente. Os parâmetros determinados por abordagem compartimental e não compartimental não diferiram significativamente para as duas vias investigadas (α = 0,05). A ASC0-∞ foi de 4,1 ± 1,6 e 6,6 ± 1,3 μg.h/mL após administração oral e i.v. das doses de 12 e 6 mg/kg, respectivamente, levando a uma biodisponibilidade de 31%. A constante de velocidade de absorção foi alta (5,0 ± 1,8 h-1) e a farmacocinética mostrou-se linear na faixa de doses investigada; iii) A recuperação das sondas de microdiálise in vitro por EE e RD para 80, 160 e 400 ng/mL de gatifloxacino foi de 33,5 ± 1,3%, 33,1 ± 1,2%, 31,8 ± 2,7% e 31,4 ± 2,6%, 33,1 ± 2,2%, 30,6 ± 3,3%, respectivamente. In vivo a recuperação por RD no músculo esquelético e pulmão de ratos Wistar foi de 29,1 ± 1,0% e 30,7 ± 1,4%, respectivamente. A recuperação por NNF in vitro e in vivo foi de 30,9 ± 2,9% e 29,0 ± 0,8%, respectivamente. Desse modo, concluiu-se que a recuperação foi constante e independente do método ou meio utilizado. Os perfis de concentração livre no músculo, pulmão e plasma de ratos Wistar foram virtualmente superpostos após dose de 6 mg/kg i.v., resultando em ASC similares de 3888 ± 734 ng.h/mL, 4138 ± 1071 ng.h/mL e 3805 ± 577 ng.h/mL, respectivamente (α = 0,05). O fator de distribuição tecidual foi de 1,02 e 1,08 para músculo e pulmão, respectivamente; iv) O modelo PK/PD empregado foi capaz de descrever o efeito do levofloxacino e do gatifloxacino contra o Streptococcus pneumoniae in vitro para todas as simulações investigadas. O EC50 médio para o levofloxacino (3,57 ± 2,16 mg/L) foi significativamente maior que o do gatifloxacino (0,95 ± 0,56 mg/L) quando regimes de doses múltiplas foram simulados. O mesmo foi observado para concentrações constantes, sendo o EC50,levofloxacino = 2,75 ± 0,45 mg/L e EC50,gatifloxacino = 1,03 ± 0,52 mg/L. O kmax foi estatisticamente semelhante para ambos os fármacos independente se foram simuladas concentrações flutuantes (kmax,levofloxacino = 0,40 ± 0,19 h-1; kmax,gatifloxacino = 0,48 ± 0,15 h-1) ou concentrações constantes (kmax,levofloxacino = 0,34 ± 0,06 h-1; kmax,gatifloxacino = 0,39 ± 0,23 h-1). Nenhum dos índices PK/PD foi capaz de prever o desfecho da infecção para todas as situações investigadas. O modelo PK/PD desenvolvido permitiu a comparação entre as duas fluorquinolonas e de diferentes posologias para cada fármaco, podendo ser utilizado para simular o efeito temporal de regimes de dosagem alternativos bem como para otimização da posologia desses fármacos para o tratamento da pneumonia adquirida na comunidade. / Objective: The aim of this work was to establish a pharmacokinetic-pharmacodynamic model (PK/PD model) to describe the profile of bactericidal effect over time of levofloxacin and gatifloxacin against Streptococcus pneumoniae. Method: To achieve this goal the following steps were carried out: i) an analytical method of SPE-HPLC to quantify gatifloxacin in plasma and tissue microdialysates, and an HPLC method for measuring levofloxacin and gatifloxacin in culture broth samples were developed and validated; ii) the pharmacokinetics of gatifloxacin in rodents after intravenous (6 mg/kg) and oral (6 and 12 mg/kg) administration was assessed as well as the oral bioavailability of the drug was determined; iii) microdialysis conditions for gatifloxacin were established and the recovery rates in vitro by dialysis (EE), retrodialysis (RD) and no-net-flux (NNF), and in vivo in lung and skeletal muscle tissue by RD and NNF were determined. Gatifloxacin tissue penetration in lung after intravenous administration (6 mg/kg) to healthy Wistar rats was determined; iv) levofloxacin and gatifloxacin free lung concentrations expected in humans following different dosing regimens of the drugs were simulated using Streptococcus pneumoniae ATCC® 49619 in vitro model of infection. The effect of constant concentrations multiples of MIC were also investigated. The time-kill curves obtained were modeled using an Emax modified model using Scientist® v. 2.01 software. Results and Conclusions: i) The analytical methods by SPE-HPLC and HPLC for quantifying gatifloxacin and levofloxacin were validated. Calibration curves were linear between 20-600 ng/mL for gatifloxacin in plasma and tissue microdialysate samples and between 250-6000 ng/mL for broth media for both drugs, with r > 0.99 independently of the method considered. The accuracy was ≥ 94.3 % for plasma and microdialysate. Gatifloxacin recovery from the solid phase extraction cartridges ranged from 95.6 to 99.7%. The precision did not exceed 5.8% of the CV. In broth media the accuracy was ≥ 92.0% and 94.3% for gatifloxacin and levofloxacin, respectively. The precision did not exceed 3.2% and 4.2% of the CV for levofloxacin and gatifloxacin, respectively; ii) Gatifloxacin experimental plasma profiles in rats were adequately fitted to a two-compartment model after intravenous and to a one compartment model with first order absorption after oral dosing. The total clearance (0.9 ± 0.2 and 1.0 ± 0.3 L/h/kg), the terminal half-life (3.3 ± 0.8 and 3.7 ± 0.3 h) and the apparent volume of distribution (2.8 ± 0.4 and 3.1 ± 1.0 L/kg) were statistically similar (α = 0.05) after i.v. and oral administration, by both model independent and compartmental approaches. The area under the curve was reduced after oral dosing (4.1 ± 1.6 μg.h/mL) in comparison to i.v. dosing (6.6 ± 1.3 μg.h/mL) leading to an oral bioavailability of 31%. The absorption was fast, with a constant rate of 5.0 ± 1.8 h-1. The results evidenced the linear pharmacokinetics of gatifloxacin in rodents in the dose range investigated; iii) Microdialysis recoveries determined in vitro by EE and RD at 80, 160 and 400 ng/mL resulted in 33.5 ± 1.3%, 33.1 ± 1.2%, 31.8 ± 2.7% and 31.4 ± 2.6%, 33.1 ± 2.2%, 30.6 ± 3.3%, respectively. In vivo recovery by RD in Wistar rat’s skeletal muscle and lung were 29.1 ± 1.0% and 30.7 ± 1.4%, respectively. Recoveries by no-net-flux in vitro and in vivo resulted in recoveries of 30.9 ± 2.9% and 29.0 ± 0.8%, respectively. In this way, it was shown that gatifloxacin recovery was constant and independent of the method or media used. Free skeletal muscle, lung and plasma profiles were virtually superimposed after i.v. administration of gatifloxacin 6 mg/kg dose resulting in similar area under the curve of 3888 ± 734 ng.h/mL, 4138 ± 1071 ng.h/mL and 3805 ± 577 ng.h/mL, respectively (α = 0.05). The tissue distribution factors were determined to be 1.02 and 1.08 for muscle and lung, respectively; iv) The PK/PD model used was able to describe the effect of levofloxacin and gatifloxacin against Streptococcus pneumoniae in vitro for all the regimens investigated. Levofloxacin EC50 (3.57 ± 2.16 mg/L) was higher than gatifloxacin (0.95 ± 0.56 mg/L) when multiple dosing regimens where simulated. Using constant concentrations, levofloxacin EC50 was also higher than gatifloxacin (EC50,levofloxacin = 2.75 ± 0.45 mg/L; EC50,gatifloxacin = 1.03 ± 0.52 mg/L). The kmax was statistically similar for both drugs independent of whether fluctuating (kmax,levofloxacin = 0.40 ± 0.19 h-1; kmax,gatifloxacin = 0.48 ± 0.15 h-1) or constant concentrations (kmax,levofloxacin = 0.34 ± 0.06 h-1; kmax,gatifloxacin = 0.39 ± 0.23 h-1) were simulated. None of the PK/PD indices was capable of predicting the infection outcome for all the situations investigated. The PK/PD model developed allowed not only the comparison between the fluoroquinolones effect but also the comparison of different dosing regimes for the same drug and can be used for simulating alternative regimens and optimizing therapy of these drugs to treat community-acquired pneumonia.