Σκοπός της παρούσας ερευνητικής εργασίας ήταν η επιδημιολογική μελέτη των λοιμώξεων από πηκτάση-αρνητικούς σταφυλοκόκκους (CNS) σε ασθενείς με προσθετικά υλικά, όπως ενδαγγειακούς καθετήρες και η σύγκριση με στελέχη που προκαλούν βακτηριαιμία. Συνολικά μελετήθηκαν 168 Staphylococcus epidermidis και 58 S. haemolyticus από βακτηριαιμίες (BSIs, 100 στελέχη) και εντοπισμένες λοιμώξεις σχετιζόμενες με την εφαρμογή προσθετικών υλικών (PDAIs, 126 στελέχη) από ασθενείς του Πανεπιστημιακού Γενικού Νοσοκομείου Πατρών (ΠΓΝΠ) και του Νοσοκομείου Παίδων Πεντέλης (ΝΠΠ). Η πλειοψηφία των στελεχών (89.8%) ήταν ανθεκτικά στην methicillin (MR-CNS) και πολυανθεκτικά (90.7%). Βιομεμβράνη συνέθεταν τα 106/226 στελέχη, ενώ 208 παρήγαγαν β-λακταμάση. Τα γονίδια σύνθεσης προσκολλητινών aap, fnbA και bap βρέθηκαν σε συχνότητα 40.3%, 35.8% και 20.4% αντίστοιχα. Οι S. epidermidis έφεραν τα γονίδια atlE και fbe σε ποσοστά 88.1% και 81%, αντίστοιχα. Από τα γονίδια σύνθεσης τοξινών, συχνότερο ήταν το γονίδιο της τοξίνης τοξικής καταπληξίας tst (8.4%) ενώ τα γονίδια που κωδικοποιούν τις εντεροτοξίνες sea, sec βρέθηκαν μόνο σε μικρό ποσοστό στελεχών S. epidermidis και S. haemolyticus (5.3% και 3.1% του συνολικού πληθυσμού αντίστοιχα). Κανένα στέλεχος δεν έφερε τα γονίδια σύνθεσης των εντεροτοξινών seb και sed. Ο πληθυσμός των στελεχών S. epidermidis έδειξε μεγάλη γενετική ποικιλομορφία, με 67 PFGE τύπους, μεταξύ των οποίων δύο κύριοι τύποι (a, b) με 50 και 36 στελέχη αντίστοιχα. Έλεγχος με MLST ανέδειξε τρεις κύριους κλώνους (ST2, ST5 και ST16) που ανήκαν στο ίδιο κλωνικό σύμπλεγμα (Clonal Complex 2). Τα στελέχη του PFGE τύπου a παρουσίασαν υψηλότερα ποσοστά αντοχής στα αντιμικροβιακά clindamycin, ciprofloxacin, fusidic acid, SXT και στις αμινογλυκοσίδες, ενώ τα στελέχη του τύπου b έφεραν συχνότερα το γονίδιο aap (p=0.049). Τα στελέχη S. haemolyticus παρουσίασαν μικρότερη γενετική ποικιλομορφία, με έναν κύριο PFGE τύπο (h), που περιελάμβανε 44/58 στελέχη (75.9% του συνολικού πληθυσμού). Τα στελέχη CNS από BSIs ήταν συχνότερα ανθεκτικά στην methicillin (p<0.001) και στα υπόλοιπα αντιμικροβιακά (p<0.05), ενώ υπερείχαν και στην παραγωγή biofilm (p=0.003). Αντιθέτως, οι CNS από PDAIs έφεραν συχνότερα τα γονίδια των προσκολλητινών aap (p=0.006) και bap (p=0.045). Σε ένα δεύτερο σκέλος της παρούσας ερευνητικής εργασίας μελετήθηκε ένας πληθυσμός S. lugdunensis από το ΠΓΝΠ (37 στελέχη) και το ΝΠΠ (1 στέλεχος). Ο S. lugdunensis κατέχει ιδιαίτερη θέση μεταξύ των CNS, καθώς μπορεί να μιμηθεί την παθογόνο δράση του S. aureus και να προκαλέσει σοβαρές λοιμώξεις. Είκοσι δύο S. lugdunensis απομονώθηκαν από ασθενείς με λοιμώξεις δέρματος και μαλακών μορίων (Skin and Soft Tissue Infections: SSTIs), εννέα από εν τω βάθει λοιμώξεις (Deep Sited Infections: DSIs), συμπεριλαμβανομένων τριών στελεχών από ασθενείς με βακτηριαιμία, και επτά στελέχη από λοιμώξεις σχετιζόμενες με προσθετικά υλικά, κυρίως ενδαγγειακούς καθετήρες, (PDAIs). Όλα τα στελέχη ήταν ευαίσθητα στην methicillin (MS-CNS), στις αμινογλυκοσίδες (kanamycin, gentamicin), καθώς και στα: ciprofloxacin, rifampicin, teicoplanin, vancomycin, linezolid και daptomycin, ενώ μόνο τέσσερα στελέχη ήταν πολυανθεκτικά. Οι S. lugdunensis της συλλογής μας έδειξαν μικρή γενετική ποικιλομορφία. Τα 38 στελέχη ταξινομήθηκαν σε επτά κλώνους, με δύο κύριους PFGE τύπους (C και D), οι οποίοι περιελάμβαναν 22 και εννέα στελέχη αντίστοιχα. Τα 26 από τα 38 στελέχη έφεραν το οπερόνιο ica, ενώ συνολικά 14 ήταν biofilm-θετικά. Δεν παρατηρήθηκε συσχέτιση της παρουσίας του ica με κάποιο κλώνο, αλλά ούτε και με την παραγωγή βιομεμβράνης. Οι S. lugdunensis από PDAIs ήταν συχνότερα biofilm-θετικοί σε σχέση με τα στελέχη από SSTIs και DSIs, ενώ ο κύριος κλώνος C παρήγαγε biofilm σε μεγαλύτερο ποσοστό από τον D, δεύτερο σε συχνότητα κλώνο. Το γονίδιο fbl ανιχνεύθηκε σε όλα τα στελέχη S. lugdunensis που εξετάστηκαν, επιβεβαιώνοντας την φαινοτυπική ταυτοποίηση σε επίπεδο είδους. Ο επόμενος κατά σειρά συχνότητας παράγοντας παθογένειας που ανιχνεύθηκε ήταν το γονίδιο atlL, το οποίο βρέθηκε σε 36 από τα 38 στελέχη (94.7%). Ακολουθούν οι παράγοντες vwbl και slush, που βρέθηκαν σε 31 (81.6%) και 15 (39.5%) S. lugdunensis, αντίστοιχα. Τα στελέχη από εν τω βάθει λοιμώξεις (DSIs) έφεραν σε μεγαλύτερο ποσοστό τα γονίδια vwbl και slush σε σχέση με αυτά από PDAIs και SSTIs . Ο κλώνος C υπερείχε στην παρουσία του ermC, ενώ τα στελέχη που ανήκαν στον κλώνο D έφεραν σε μεγαλύτερο ποσοστό τα γονίδια vwbl και slush. / Coagulase-negative staphylococci (CNS), especially Staphylococcus epidermidis and S. haemolyticus, have emerged as opportunistic pathogens in patients with low immune response or indwelling medical devices. In the present study, bloodstream (BSIs) and prosthetic-device associated infections (PDAIs) CNS isolates were compared in terms of biofilm formation, antimicrobial resistance, clonal distribution, adhesin and toxin genes carriage. A collection of 226 CNS (168 S. epidermidis and 58 S. haemolyticus) recovered from BSIs (100) and PDAIs (126) of different patients in the Patras tertiary-care University General Hospital (UGHP) and Pentelis Paediatric Hospital in Athens (PPHA), was tested for biofilm formation, antimicrobial susceptibility, mecA, ica operon, adhesin (aap, bap, fnbA, atlE, fbe) and toxin (tst, sea, seb, sec, sed) genes carriage. All CNS were classified into pulsotypes by PFGE, whereas S. epidermidis strains were assigned to sequence types by MLST. In total, 106 isolates (46.9%) produced biofilm, whereas 150 (66.4%) carried ica operon. Most isolates carried mecA and were multidrug resistant (90.7%). The adhesin encoding genes aap, fnbA and bap were identified in 40.3%, 35.8% and 20.4% of the total population, respectively. Genes encoding AtlE and Fbe were found in 88.1% and 81% of S. epidermidis isolates, respectively. CNS recovered from BSIs prevailed in biofilm formation (P=0.003), resistance to antimicrobials and mecA carriage (P<0.001) as compared to isolates derived from PDAIs. CNS from PDAIs carried more frequently aap and bap genes (P=0.006 and P=0.045, respectively). No statistically significant difference in toxin genes carriage was identified (P>0.05). Even though PFGE showed genetic diversity, especially among S. epidermidis, analysis of representative strains from the main PFGE types by MLST, revealed three major clones (ST2, ST5, ST16). A clonal relationship was found concerning antimicrobial susceptibility, ica and aap gene carriage, reinforcing the aspect of clonal expansion in hospital settings. Pathogenesis of BSIs is associated with biofilm formation and high-level antimicrobial resistance, whereas PDAIs are related to the adhesion capability of CNS. In the second part of this study we analyzed a collection of S. lugdunensis isolates recovered from different inpatients hospitalized in UGHP (37 isolates) and PPHA (one isolate) during a six-year period (2008-2013). S. lugdunensis has emerged as a significant human pathogen with distinct clinical and microbiological characteristics. A collection of 38 S. lugdunensis was tested for biofilm formation, antimicrobial susceptibility, clonal distribution, virulence factors (ica operon, fbl, atlL, vwbl, slush) and antibiotic resistance genes (mecA, ermC) carriage. The majority (22) was isolated from skin and soft tissue infections (SSTIs), nine from deep-sited infections (DSIs), including three bacteraemias and seven from PDAIs. All isolates were oxacillin-susceptible, mecA-negative and fbl-positive. The higher resistance rate was detected for ampicillin (50%), followed by erythromycin and clindamycin (18.4%). Fourteen isolates (36.8%) produced biofilm, 26 carried ica operon, but no relation between ica carriage and biofilm formation was identified. Biofilm formation was more frequent in isolates recovered from PDAIs. Thirty six strains (94.7%) carried atlL, 31 (81.6%) vwbl, whereas, slush was detected in fifteen (39.5%). PFGE revealed low level of genetic diversity: strains were classified into seven pulsotypes, with two major clones C and D including 22 and nine strains, respectively. Type C strains, recovered from all infection sites, prevailed in biofilm formation and ermC carriage, whereas, type D strains, associated with SSTIs and DSIs, carried more frequently vwbl, slush or both genes. Despite susceptibility to antimicrobials, clonal expansion and carriage of virulence factors combined with biofilm-producing ability render this species an important pathogen that should not be ignored.

Coagulase negative staphylococci (CoNS) are the most prevalent bacterial contaminants of platelet concentrates (PCs), and have been implicated in severe and fatal transfusion reactions. Of this group, Staphylococcus epidermidis is most frequently identified. The preliminary objective of this thesis was to confirm that S. epidermidis could form biofilms under platelet storage conditions. This was achieved using a modified crystal violet staining assay to detect plastic-adherent bacterial cells and examination of attachment processes by scanning electron microscopy. A collection of CoNS isolated from PCs obtained from reportedly healthy donors was then assessed for biofilm-forming potential at the genetic and phenotypic level. Despite the presumable commensal origin of these isolates, a high proportion of S. epidermidis strains displayed a biofilm positive phenotype. The threat of S. epidermidis biofilm formation during platelet storage identified herein signifies that any alterations made to platelet storage protocols should be evaluated with consideration of this risk. The advent of platelet additive solutions (PASs) as an alternative to plasma for PC storage provides a relevant example, since little is known about the effect of PAS on contaminant bacteria, and vice versa. Growth and biofilm formation by S. epidermidis and the Gram-negative bacterium Serratia liquefaciens were measured in PAS- or plasma-PCs over 5 days, simulating standard platelet storage conditions, after initial inoculation with low, clinically relevant bacterial concentrations. Assays for platelet quality were performed simultaneously. Only S. liquefaciens exhibited a slower doubling time in plasma-PCs than in PAS-PCs. Biofilm formation by both species was reduced during storage in PAS-PCs, increasing bacteria availability for detection. Although S. liquefaciens adversely affected platelet quality in both media, S. epidermidis contamination did not. Ultimately, culture-based detection remains the earliest indicator of bacterial presence in PAS-PCs. Lastly, since formation of platelet-bacteria aggregates is largely based on receptor-ligand interactions, it was postulated that biofilm formation by contaminant bacteria could be abrogated by receptor shielding. Methoxypoly(ethylene glycol) was applied to covalently modify the platelet surface using a process termed ‘PEGylation’. It is herein demonstrated that PEGylation of PCs inoculated with S. epidermidis results in significantly reduced bacterial binding and biofilm formation during platelet storage.

Made available in DSpace on 2014-12-17T14:10:22Z (GMT). No. of bitstreams: 1 EutaliaENFS_DISSERT.pdf: 2712662 bytes, checksum: 8c38ff6fb5ec0c379f1f2e3b3fe8a0c7 (MD5) Previous issue date: 2009-12-07 / In a hospital environment, these bacteria can be spread by insects such as ants, which are characterized by high adaptability to the urban environment. Staphylococcus is a leading cause of hospital infection. In Europe, Latin America, USA and Canada, the group of coagulase negative staphylococci (CoNS) is the second leading cause of these infections, according to SENTRY (antimicrobial surveillance program- EUA). In this study, we investigated the potential of ants (Hymenoptera: Formicidae) as vehicle mechanics of Staphylococcus bacteria in a public hospital, in Natal-RN. The ants were collected, day and night, from June 2007 to may 2008, in the following sectors: hospitals, laundry, kitchen, blood bank. The ants were identified according to the identification key of Bolton, 1997. For the analysis of staphylococci, the ants were incubated in broth Tryptic Soy Broth (TSB) for 24 hours at 35 ? C and then incubated on Mannitol Salt Agar. The typical colonies of staphylococci incubated for 24 hours at 35 ? C in Tryptic Soy Agar for the characterization tests (Gram stain, catalase, susceptibility to bacitracin and free coagulase). The identification of CoNS was performed through biochemical tests: susceptibility to novobiocin, growth under anaerobic conditions, presence of urease, the ornithine decarboxylation and acid production from the sugars mannose, maltose, trehalose, mannitol and xylose. The antimicrobial susceptibility examined by disk-diffusion technique. The technique of Polymerase Chain Reaction was used to confirm the presence of mecA gene and the ability to produce biofilm was verified by testing in vitro using polystyrene inert surface, in samples of resistant staphylococci. Among 440 ants, 85 (19.1%) were carrying coagulase-negative staphylococci (CoNS) of the species Staphylococcus saprophyticus (17), Staphylococcus epidermidis (15), Staphylococcus xylosus (13), Staphylococcus hominis hominis (10), Staphylococcus lugdunensis (10), Staphylococcus warneri (6), Staphylococcus cohnii urealyticum (5), Staphylococcus haemolyticus (3), Staphylococcus simulans (3), Staphylococcus cohnii cohnii (2), and Staphylococcus capitis (1). No Staphylococcus aureus was found. Among the isolates, 30.58% showed resistance to erythromycin. Two samples of CoNS (2.35%), obtained from the ant Tapinoma melanocephalum collected in the post-surgical female ward, S. Hominis hominis and S. lugdunensis harbored the mecA gene and were resistant to multiple antibiotics, and the specie S. hominis hominis even showed to be a biofilm producer. This study proves that ants act as carriers of multidrug-resistant coagulase-negative Staphylococci and biofilm producers and points to the risk of the spreading of pathogenic microorganisms by this insect in the hospital environment / No ambiente hospitalar, bact?rias podem ser disseminadas por insetos, tais como as formigas, que se destacam pela alta adaptabilidade ao ambiente urbano. As bact?rias do g?nero Staphylococcus s?o uma das principais causas de infec??o hospitalar. Em pa?ses da Europa, Am?rica Latina, Estados Unidos e Canad?, o grupo dos estafilococos coagulase-negativos (ECN) representa a segunda maior causa dessas infec??es, segundo o SENTRY (Programa de vigil?ncia antimicrobiana- EUA). No presente estudo foi analisado o potencial de formigas (Hymenoptera: Formicidae) como ve?culos mec?nicos de bact?rias do g?nero Staphylococcus em um hospital da rede p?blica de sa?de, no munic?pio de Natal-RN. As formigas capturadas em coletas diurnas e noturnas, entre junho de 2007 e maio de 2008, nos seguintes setores: enfermarias, lavanderia, cozinha, banco de sangue. Esses insetos foram identificados segundo a chave de identifica??o de Bolton, 1997. Para a an?lise da presen?a de estafilococos, as formigas foram incubadas em caldo de case?na de soja (TSB) por 24h, a 35?C para posterior semeadura em Agar Manitol Salgado. As col?nias caracter?sticas de estafilococos incubadas por 24h a 35?C, em Tryptic Soy Agar, para testes de caracteriza??o do g?nero (colora??o de Gram, catalase, susceptibilidade ? bacitracina e coagulase livre). A identifica??o dos ECN foi realizada atrav?s das provas bioqu?micas: susceptibilidade ? novobiocina, crescimento em anaerobiose, presen?a de urease, descarboxila??o da ornitina e produ??o de ?cidos a partir dos a??cares manose, maltose, trealose, manitol e xilose. A susceptibilidade aos antimicrobianos analisada atrav?s da t?cnica disco-difus?o. Para confirmar a presen?a do gene mecA foi utilizada a t?cnica da Rea??o em Cadeia da Polimerase e a capacidade de produ??o de biofilme foi verificada atrav?s de ensaio in vitro usando superf?cie inerte de poliestireno, em amostras de estafilococos resistentes. Entre 440 formigas, 85 (19,1%) estavam transportando os ECN das esp?cies Staphylococcus saprophyticus (17), Staphylococcus epidermidis (15), Staphylococcus xylosus (13), Staphylococcus hominis hominis (10), Staphylococcus lugdunensis (10), Staphylococcus warneri (6), Staphylococcus cohnii urealyticum (5), Staphylococcus haemolyticus (3), Staphylococcus simulans (3), Staphylococcus cohnii cohnii (2), e Staphylococcus capitis (1 ). Nenhum Staphylococcus aureus foi encontrado. Entre os isolados, 30,58% apresentaram resist?ncia ? eritromicina. Duas amostras de ECN (2,35%), obtidas a partir da formiga Tapinoma melanocephalum coletadas na enfermaria feminina p?s-cir?rgica, S. hominis hominis e S. lugdunensis albergavam o gene mecA e foram resistentes a m?ltiplos antibi?ticos. Al?m disso, a esp?cie S. hominis hominis ainda mostrou ser um produtor de biofilme. Este estudo demonstra que as formigas podem agir como veiculadoras de ECN multiresistentes aos antimicrobianos e produtores de biofilme, e, ainda, aponta para o risco da dissemina??o de microrganismos patog?nicos por esse inseto no ambiente hospitalar

Coagulase negative staphylococci (CoNS) are the most prevalent bacterial contaminants of platelet concentrates (PCs), and have been implicated in severe and fatal transfusion reactions. Of this group, Staphylococcus epidermidis is most frequently identified. The preliminary objective of this thesis was to confirm that S. epidermidis could form biofilms under platelet storage conditions. This was achieved using a modified crystal violet staining assay to detect plastic-adherent bacterial cells and examination of attachment processes by scanning electron microscopy. A collection of CoNS isolated from PCs obtained from reportedly healthy donors was then assessed for biofilm-forming potential at the genetic and phenotypic level. Despite the presumable commensal origin of these isolates, a high proportion of S. epidermidis strains displayed a biofilm positive phenotype. The threat of S. epidermidis biofilm formation during platelet storage identified herein signifies that any alterations made to platelet storage protocols should be evaluated with consideration of this risk. The advent of platelet additive solutions (PASs) as an alternative to plasma for PC storage provides a relevant example, since little is known about the effect of PAS on contaminant bacteria, and vice versa. Growth and biofilm formation by S. epidermidis and the Gram-negative bacterium Serratia liquefaciens were measured in PAS- or plasma-PCs over 5 days, simulating standard platelet storage conditions, after initial inoculation with low, clinically relevant bacterial concentrations. Assays for platelet quality were performed simultaneously. Only S. liquefaciens exhibited a slower doubling time in plasma-PCs than in PAS-PCs. Biofilm formation by both species was reduced during storage in PAS-PCs, increasing bacteria availability for detection. Although S. liquefaciens adversely affected platelet quality in both media, S. epidermidis contamination did not. Ultimately, culture-based detection remains the earliest indicator of bacterial presence in PAS-PCs. Lastly, since formation of platelet-bacteria aggregates is largely based on receptor-ligand interactions, it was postulated that biofilm formation by contaminant bacteria could be abrogated by receptor shielding. Methoxypoly(ethylene glycol) was applied to covalently modify the platelet surface using a process termed ‘PEGylation’. It is herein demonstrated that PEGylation of PCs inoculated with S. epidermidis results in significantly reduced bacterial binding and biofilm formation during platelet storage.

Orientador: Jose Luiz Pereira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-07T14:47:03Z (GMT). No. of bitstreams: 1 Pereira_KarenSignori_D.pdf: 795788 bytes, checksum: 3c56762962a9dfbb567a0cc78805f20c (MD5) Previous issue date: 2006 / Resumo: As bactérias pertencentes ao gênero Staphylococcus são bastante peculiares porque apesar de terem distribuição ubiqüitária e formarem a microbiota residente na pele e mucosa de humanos também podem ser causadoras de diversas enfermidades aos mesmos, tais como a intoxicação alimentar estafilocócica.Todavia, para a indústria de produtos cárneos a importância dos estafilococos está além do fato de serem microrganismos patogênicos. Algumas espécies do gênero são coadjuvantes de tecnologia para a fabricação de salames, estando presentes como componentes de culturas starter ou iniciadoras. Entre as características importantes das espécies utilizadas em culturas iniciadoras está a incapacidade enterotoxigênica, o que tem sido diretamente relacionado às espécies coagulase positiva. Diversos trabalhos, porém, têm demonstrado a capacidade de estafilococos coagulase negativa produzirem enterotoxina em meio de cultivo laboratorial e há, inclusive, registros de surtos de intoxicação estafilocócica associados a espécies não produtoras de coagulase. Assim, 90 amostras de salames industrializados, pertencentes a seis diferentes marcas, foram analisadas visando a enumeração, identificação e verificação do potencial enterotoxigênico das espécies de estafilococos coagulase negativa (ECN). Determinações de pH, Aw, análises de coliformes termotolerantes, Salmonella, Staphylococcus coagulase positiva e bactérias láticas também foram realizadas. Salmonella foi detectada em uma amostra. Entre os 266 isolados de ECN nenhum produziu enterotoxina, e dos 252 identificados cerca de 90% eram S. xylosus e S. carnosus / Abstract: Staphylococcus is ubiquitous distribution bacteria and present in skin of humans and other animals. However, staphylococci species can cause various diseases. Staphylococcal food poisoning is one of these diseases. But for meat industry staphylococci importance is not only because diseases. Some species are very important for the fermented sausage¿s manufacture like starter cultures. To be used, staphylococci have do not produce coagulase. However, many researches have demonstrated capacity of coagulase negative staphylococci (CNS) to produce enterotoxin and there are registers of staphylococcal food poisoning outbreaks linked to CNS. Ninety samples of industrialized salamis, for six different brands, had been studied. Enumeration, identification and potencial enterotoxigenic of CNS were analyzed. Additionally, termotolerants coliforms, staphylococci coagulase positive and lactic acid were counted; Salmonella isolated; pH and Aw measured. Salmonella was isolated of one sample. None of 266 CNS produced enterotoxins, 252 were identified and about 90% were S. xylosus and S. carnosus / Doutorado / Doutor em Ciência de Alimentos

Les staphylocoques à coagulase négative (SCN) sont généralement considérés comme des pathogènes opportunistes à faible virulence. Cependant, des études antérieures ont rapporté une pathogénicité de certaines souches similaire à celle observée chez S. aureus ce qui laisse supposer l’expression de facteurs de virulence. Cette thèse vise à contribuer à l’importance des SCN dans les infections primitives sévères. Nous avons évalué le potentiel pathogène de souches cliniques de SCN au Bénin. Pour atteindre cet objectif, des SCN associés à diverses infections cliniques sévères ont été collectés sur une période de 10 mois au Centre National Hospitalier et Universitaire Hubert Koutoukou Maga à Cotonou. Ces souches sont identifiées d’abord par la galerie API® Staph, puis par la spectrométrie de masse MALDI-TOF et analysées pour leur susceptibilité aux antibiotiques et leur capacité à produire des facteurs de virulence. Cette partie de l’étude a montré que les espèces les plus impliquées dans les infections à SCN au Bénin sont : S. haemolyticus et S. epidermidis suivi d’autres espèces comme S. cohnii, S. sciuri, S. arlettae, S. capitis. Nous avons aussi apporté la preuve de la multi-résistance des souches aux antibiotiques, ainsi que de la présence d’au moins un, voire plusieurs facteurs de virulence tels que la protéase, l’estérase, l’hémolysine, la leucotoxine et l’entérotoxine staphylococcique C chez 44% des souches testées particulièrement dans les souches hospitalières isolées d’hémocultures. Ensuite, nous avons caractérisé un nouveau facteur de virulence identifié chez deux souches de S. epidermidis : l’entérotoxine staphylococcique C nommée SECepi qui a été dosée à environ 100 µg/mL dans les surnageants de culture bactérienne. Le gène secepi est constitué de 801 pb correspondant à 266 acides aminés. Sur la base des résultats de la comparaison d'homologie entre la chaîne peptidique de SECepi et les séquences déjà connues, nous avons constaté que SECepi est proche de SEC3 de la souche de S. aureus Mu3, avec trois substitutions d'acides aminés dans le peptide signal et neuf substitutions d'acides aminés dans la protéine mature. Cependant, plusieurs résidus qui sont impliqués dans la formation du complexe trimoléculaire CMH-SEC-TCR sont conservés dans SECepi. L’analyse de la protéine recombinante (rSECepi) révèle une parenté antigénique et une forte homologie structurale prédite avec SECaureus. De plus, cette toxine présente les activités biologiques caractéristiques d'un superantigène (SAg) incluant la stimulation de la mitogénicité et de la production concomitante de fortes doses de cytokines pro-inflammatoires et suppressives chez des lymphocytes T humains activés. Par ailleurs, SECepi résiste assez bien au chauffage à 100°C et à la digestion par les enzymes gastro-intestinales telles que la pepsine et la trypsine. Ces résultats fournissent la preuve que SECepi peut agir comme un superantigène chez l'hôte humain bien que le type sauvage comporte plusieurs mutations chez S. epidermidis. L’étude du dossier médical de l’un des patients a montré que l’entérotoxine produite par la souche de S. epidermidis a bien pu être à l’origine d’éléments de gravité du tableau clinique présenté par ce dernier à son admission en hospitalisation. Enfin, l’analyse génomique des deux souches toxinogènes de S. epidermidis, ainsi que leur aptitude à former du biofilm, confirment les possibilités variées d’échanges génétiques entre cette espèce et S. aureus. Cette thèse souligne l'importance de la surveillance des infections à SCN chez l’homme parce que certaines souches, à l’instar de S. aureus, produisent des facteurs de virulence pouvant aggraver l’état générale l’hôte. / Coagulase-negative staphylococci (CNS) are generally considered as opportunistic pathogens with low virulence. However, previous studies have reported pathogenicity of some strains similar to that observed in S. aureus. This thesis aims to contribute to the importance of SCN in severe primitive infections. First, we evaluated the pathogenic potential of clinical CNS strains in Benin. To achieve this objective, CNS associated with various severe clinical infections were collected over at the Hubert Koutoukou Maga National Hospital and University Center in Cotonou. These strains are identified as well as their susceptibility to antibiotics and their ability to produce virulence factors. This part of the study showed that the most involved species in Benin are: S. haemolyticus and S. epidermidis followed by other species such as S. cohnii, S. sciuri, S. arlettae, S. capitis. We also demonstrated the multi-resistance of strains to antibiotics, as well as the presence of potential virulence factors such as protease, esterase, hemolysin, leukotoxin and, enterotoxin Staphylococcal C in 44% of strains tested particularly in hospital strains isolated from blood cultures. We, then, characterized a new virulence factor identified in two strains of S. epidermidis: staphylococcal enterotoxin C called SECepi, which was secreted at ~100 μg/mL in bacterial culture supernatants. The secepi gene consists of 801 bp corresponding to 266 amino acids. On the basis of the comparison between the peptide chain of SECepi and the already known peptide sequences of the SEC, we found that SECepi is close to SEC3 of S. aureus Mu3 strain with three amino acids substitutions in the signal peptide and nine amino acid substitutions in the mature protein. However, most residues involved in formation of the tri-molecular complex CMH-SEC-TCR are conserved in SECepi. Analysis of the recombinant protein (rSECepi) revealed antigenic relationships and a strong structural homology is predicted with SECaureus. Moreover, this toxin exhibits the biological activities characteristic of a SAg including the stimulation of the mitogenicity and the concomitant production of high doses of pro-inflammatory and suppressive cytokines in activated human T lymphocytes. Moreover, SECepi is resistant to heating at 100 °C and digestion by gastrointestinal enzymes such as pepsin and trypsin. These results provide evidence that SECepi can act as a superantigen in humans although the wild type has several mutations in S. epidermidis. The study of the medical record of one of the patients showed that the enterotoxin produced by the strain of S. epidermidis might be at the origin of severity of the clinics presented at hospital admission. Finally, genomic analysis of the two toxigenic S. epidermidis strains confirms the varied possibilities of genetic exchange between this species and S. aureus. This thesis underscores the importance of monitoring CNS infections in humans because some strains, like S. aureus, produce virulence factors that can aggravate the overall host condition.

Made available in DSpace on 2015-07-22T20:49:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-29. Added 1 bitstream(s) on 2015-08-11T03:26:19Z : No. of bitstreams: 1 Publico-154.pdf: 1362092 bytes, checksum: b56e51cd61b6e0026e1f047e7ce95328 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Staphylococcus coagulase negativo (SCoN) são importantes agentes etiológicos responsáveis por infecções relacionadas à assistência à saúde (IrAS) em infecções da corrente sanguínea. Em estudo retrospectivo foram avaliados SCoN isolados de pacientes com IrAS da corrente sanguínea em dois hospitais gerais da cidade de São Paulo no período de agosto de 2005 à agosto de 2007.Os isolados foram caracterizados a nível de espécies e testes de suscetibilidade aos antimicrobianos pelo Vitek® system e Vitek® 2. A presença do gene mecA e o tipo de SCCmec foram determinados por PCR multiplex. Staphylococcus epidermidis foi a espécie predominante seguido de S. hominis, S. haemolyticus, S. simulans, S. warneri, S. capitis e S. auricularis. Observou-se 88,2% de resistência à oxacilina nos isolados com 100% de concordância entre os discos de oxacilina e cefoxitina confirmados pelo gene mecA. Todos isolados foram suscetíveis à vancomicina e quatro isolados apresentaram resistência intermediária à teicoplanina pelo Etest®. Um S. epidermidis mostrou-se resistente à linezolida. O tipo de SCCmec predominante foi o tipo III seguido pelos tipos IV, I, II e V. Em 26,9% dos isolados mecA positivo não foram caracterizados nenhum tipo de SCCmec pelo protocolo utilizado. / Coagulase negative staphylococci (CoNS) are important etiologic agents responsible for healthcare related infection (HCRI) in bloodstream infections. In a retrospective study we evaluate CoNS isolated from patients with HCRI in bloodstream infections admitted to two general hospitals at São Paulo city, from August 2005 to August 2007. The isolates were characterized at species level and antimicrobial susceptibility tested by the Vitek® system and ViteK® 2. Oxacillin resistance was evaluated by oxacillin and cefoxitin discs. The presence of mecA gene and the SCCmec type were determined by multiplex PCR. Staphylococcus epidermidis was the predominant specie followed by S. hominis, S. haemolyticus, S. simulans, S. warneri, S. capitis and S. auricularis. Oxacillin resistance was observed in 88.2% of the isolates with 100% concordance between oxacilin and cefoxitin discs confirmed by mecA gene. All isolates were susceptible to vancomycin and four isolates revealed intermediate resistance to teicoplanin by Etest®. One S. epidermidis showed resistance to linezolide. The predominant SCC type was the type III followed by the types IV, I, II and V. In 26.9% positive mecA isolates we did not characterize the SCCmec type by the molecular protocol utilized. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-03-26T13:51:51Z (GMT). No. of bitstreams: 1 texto completo.pdf: 517056 bytes, checksum: 29070a0d8d4421b71f8bf632a8608739 (MD5) Previous issue date: 2010-09-20 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The use of micro-organisms as starter cultures may help in developing new products as well as improving quality and safety of food products. The aim of this study was to characterize isolates of coagulase negative staphylococci regarding their contribution the safety of a fermented meat product. Staphylocuccus spp. and Listeria spp. were grown in Nutritive Broth and BHI broth, respectively. Survival and inactivation of Staphylococcus spp. and Listeria spp. were evaluated in a laboratory model, Salami Broth. The inhibitory activity of cultures of Staphylococcus spp. on Listeria spp. was evaluated by agar diffusion assay and agar spot test. Acid production by Staphylococcus spp. was assessed by HPLC on culture supernatants. Italian salami was produced and inoculated with commercial starter culture and 106 CFU.g-1 S. pasteuri BIS 26 and, or 104 CFU.g-1 L. monocytogenes IP1-23 or L. innocua LMA 80. Staphylococcus spp. and Listeria spp. showed highest specific growth rates under aerobic conditions at 37 ° C. Staphylococcus spp. and Listeria spp. did not developed in salami broth under test conditions. No inhibitory activity was observed in culture supernatants of Staphylococcus spp. on Listeria spp., however, when cultivation was carried out on agar surface the diameter of inhibition zones ranged from 3 mm to 8 mm. HPLC analysis showed that lactic acid was in higher concentration as compared to other organic acids, with values between 0.2 and 0.4 % v/v. The final pH of the Italian type salami after 31 days of ripening ranged from 4.8 to 5.3. In the salami, the population of L. monocytogenes IP1-23 was reduced by about 5 log cycles when inoculated with the commercial starter culture and 2 log cycles when S. pasteuri BIS 26 was added. The difference between treatments indicates that L. monocytogenes IP1-23 was more sensitive than L. innocua LMA 80. However, results of in vitro assays showed that this is not always the case, recommending caution when using L. innocua as an indicator organism. / A utilização de micro-organismos como culturas starter pode contribuir para o desenvolvimento de novos produtos, para a melhoria da qualidade e da segurança dos produtos alimentícios. O objetivo deste estudo foi caracterizar isolados de Staphylococcus coagulase negativos quanto à sua possível contribuição para segurança de produto cárneo fermentado. O crescimento de Staphylocuccus spp. e Listeria spp. foi avaliado em caldo nutritivo e caldo BHI, respectivamente. A sobrevivência e inativação de Staphylococcus spp. e Listeria spp. foram avaliadas em um modelo laboratorial, caldo salame. A atividade de inibição de culturas de Staphylococcus spp. sobre Listeria spp. foi avaliada pelos métodos difusão em ágar e ágar &#8220;spot&#8221;. A análise da produção de ácidos em amostras de sobrenadantes de Staphylococcus spp. foi feita por HPLC. Salame tipo italiano foi produzido e inoculado com cultura starter comercial acrescida de 106 UFC.g-1 da cultura de Staphylococcus pasteuri BIS 26 e, ou 104 UFC.g-1 da cultura de Listeria monocytogenes IP1-23 ou Listeria innocua LMA 80. Staphylocuccus spp. e Listeria spp. apresentaram maiores velocidades específicas de crescimento em aerobiose na temperatura de 37 °C. Os isolados de Staphylococcus spp. e Listeria spp. não se desenvolveram no caldo salame, nas condições testadas. Não foi observada inibição do sobrenadante das culturas de Staphylococcus spp. sobre L. innocua e L. monocytogenes, entretanto, no cultivo em superfície, as médias dos diâmetro dos halos de inibição variaram de 3 mm a 8 mm. Na análise por HPLC, o ácido láctico foi o detectado em maior concentração, com valores entre 0,2 e 0,4 % v/v. O pH final dos salames tipo italiano após 31 dias de maturação variou entre 4,8 e 5,3. Nos salames, a população de L. monocytogenes IP1-23 foi reduzida em cerca de 5 ciclos logarítmicos quando inoculada juntamente com a cultura starter comercial enquanto no tratamento em que a cultura de S. pasteuri BIS 26 foi adicionada a redução foi de cerca de 2 ciclos log. A diferença observada entre os tratamentos indica que L. monocytogenes IP1-23 foi mais sensível que L. innocua LMA 80. No entanto, os resultados de ensaios in vitro mostraram que nem sempre isto ocorre, e deve-se ter cautela ao utilizar L. innocua como um organismo indicador.

Les staphylocoques à coagulase négative (SCN) sont des bactéries fréquemment isolées de viandes et de produits carnés. Parmi les SCN, seules les deux espèces S. xylosus et S. carnosus sont utilisées comme ferments dans les produits carnés. Dans ces produits, il est d’usage d’ajouter du nitrate/nitrite pour le développement de la couleur typique des salaisons. Les staphylocoques participent au développement et à la stabilité de la couleur en réduisant le nitrate en nitrite via leur activité nitrate réductase. Le nitrite est chimiquement réduit en monoxyde d’azote (NO), qui se lie au fer de l’hème de la myoglobine pour former la nitrosomyoglobine, un pigment rouge et stable. Le contexte actuel vise à réduire l’utilisation du nitrate/nitrite afin de limiter le risque de formation de composés N-nitrosés tels que les nitrosamines. Il a été montré que les bactéries pouvaient synthétiser du NO à partir d’une oxyde nitrique synthase (NOS). Le gène nos a été identifié dans une collection de souches de SCN isolées de viande. La séquence protéique de la NOS est fortement conservée entre les espèces. Pour mettre en évidence la production de NO, un test basé sur la conversion de metmyoglobine en pigments rouges, l’oxymyoglobine et la nitrosomyoglobine, a été utilisé. Le nitrosohème contenu dans la nitrosomyoglobine a été extrait. La formation du nitrosohème, chez un mutant de délétion du gène nos de la souche S. xylosus C2a, est fortement réduite en condition limitée en oxygène et abolie en condition aérobie. De plus, la NOS de S. xylosus C2a est impliquée dans la réponse à un stress oxydant. Afin de déterminer le potentiel de production de NO de souches de S. xylosus et d’autres espèces de SCN, leur capacité à former de la nitrosomyoglobine a été évaluée. Cette formation est espèce- et souche-dépendante. Les souches de S. xylosus ont un potentiel de production de NO plus élevé que les souches des autres espèces. Ce test a également révélé que certaines souches de SCN sont capables de former de l’oxymyoglobine à partir de la metmyoglobine.Cette étude a permis de mettre en évidence l’implication de la NOS dans la production de NO chez S. xylosus et la capacité de formation de nitrosomyoglobine chez d’autres souches de SCN isolées de viande. / Coagulase Negative Staphylococci (CNS) are usually isolated from meat and meat products. In meat products, S. xylosus and S. carnosus are the only CNS species used as meat starter cultures. In these products, nitrate and nitrite are used as additives where they contribute to the development of the typical red coloration. Staphylococci contribute to the development and stability of colour through their nitrate reductase activity that reduces nitrate to nitrite. Nitrite is chemically reduced to nitric oxide (NO) which is able to bind the ferrous-heme iron to form the stable bright red nitrosomyoglobin pigment. However, the safety regarding the use of these additives on meat products has been questioned as nitrite is able to form N-nitroso compounds such as nitrosamines. Some bacteria are able to synthesize NO by nitric oxide synthase (NOS). The nos gene was identified in a collection of CNS isolated from meat. The NOS sequence is well conserved between species. NO production has been investigated based on the formation of red myoglobin derivatives from metmyoglobin such as oxymyoglobin and nitrosomyoglobin. Subsequently, the nitrosoheme was extracted from nitrosomyoglobin. Nitrosoheme formation was reduced under limited oxygenated condition while it was abolished under aerobic condition in a S. xylosus C2a nos deleted mutant. Moreover, NOS is involved in oxidative stress resistance in S. xylosus C2a. In order to determine the potential of NO production among other strains of S. xylosus and other CNS species, their potential to form nitrosomyoglobin was evaluated. Nitrosomyoglobin formation is strain- and species-dependent. This assay has also revealed that several CNS strains are able to form oxymyoglobin from metmyoglobin.This study has demonstrated NOS-dependent NO production in S. xylosus and the ability of CNS isolated from meat to form nitrosomyoglobin.

Made available in DSpace on 2014-07-29T15:30:43Z (GMT). No. of bitstreams: 1 DISSERTACAO DE MESTRADO JULIANA ROSA.pdf: 303226 bytes, checksum: 9585889e11363ca2d5297656fdeae6e5 (MD5) Previous issue date: 2008-04-17 / Coagulase negative staphylococci (CNS) is in human and animal microbiota, but may cause with infections with significant morbidity and mortality rates. Healthy care workers may be carriers of many microorganisms and spread resistant ECN in the hospital. This study aimed to identify the CNS species isolated from healthy care workers saliva, establishe the oxacillin resistance pattern and detect the mecA gene in resistant isolates. We evaluated 100 ECN, isolated from the saliva of an institution of professional health of large Riberão Preto in Sao Paulo state. The ECN identification was based on biochemical tests, and 41 were identified as S. epidermidis, 25 S. saprophyticus, 18 S. haemolyticus, 8 S. cohnii, 4 S. lugdunenses, 3 S. capitis, and 1 S. simulans. Thirty-two percent were nonsusseptible to oxacillin, 84.4% to mupirocin, 43.7% to cefoxitin, but all were vancomycin susceptible. The oxacillin nonsusseptible ECN, detected by disk diffusion test were grown in agar screening oxacillin (6 &#956; g) supplemented with sodium chloride (4.0%) and submited to mecA detection by the PCR. Of the 32 nonsusseptible oxacillin CNS,, 93.7% developed in the oxacillin agar and the mecA gene was detected in 75.0%. This is the first report of mecA gene presence in CNS isolated from the saliva of healthy care workers. Attention must be given to CNS species identification, as well as the characterization of the nonsusceptible microorganisms, since healthy care workers may represent a reservoir of CNS / Estafilococos coagulase negativa (ECN) fazem parte da microbiota autóctone humana e animal, embora possam causar infecções. Profissionais da saúde podem ser portadores de inúmeros microrganismos virulentos entre eles os ECN resistentes a oxacilina que podem ser disseminados por esses profissionais. O estudo teve como objetivo identificar espécies de ECN isolados da saliva de profissionais da saúde, de uma instituição de saúde de grande porte em Riberão Preto no estado de São Paulo, determinar o perfil de resistência à oxacilina e detectar o gene mecA. Foram avaliados 100 ECN, e através de testes bioquímicos 41 estafilococos foram identificados como S. epidermidis, 25 S. saprophyticus, 18 S. haemolyticus, 8 S. cohnii, 4 S. lugdunenses, 3 S. capitis e um S. simulans. Trinta e dois por cento apresentaram resistência in vitro a oxacilina, 84,4% a mupirocina, 43,7% a cefoxitina, e todos suscetíveis a vancomicina. Os ECN resistentes a oxacilina, detectados pelo teste de disco difusão, foram cultivados no agar triagem oxacilina (6µg) suplementado com cloreto de sódio e a detecção do gene mecA foi realizada pela técnica de PCR. Dos 32 ECN resistentes a oxacilina, 93,7% desenvolveram no agar oxacilina e o gene mecA foi detectado em 75,0% das amostras analisadas. Vale ressaltar que este estudo é pioneiro em mostrar a presença do gene mecA em ECN isolados da saliva de profissionais da saúde saudáveis. Uma maior atenção deve ser dada na identificação das espécies de ECN, e na caracterização da resistência desse grupo de microrganismos, uma vez que os profissionais da saúde podem representar um reservatório de ECN resistentes