A ciclodextrina glucosiltransferase (CGTase) é uma enzima industrialmente muito importante, capaz de converter o amido em ciclodextrinas (CDs). As CDs são capazes de formar complexos de inclusão com uma grande gama de compostos orgânicos e inorgânicos, podendo mudar suas propriedades químicas e físicas, propriedades estas que lhes confere extensiva aplicabilidade na indústria de alimentos, farmacêutica, química, cosmética e agrícola. Atualmente, diversas CGTases já foram isoladas e caracterizadas a partir de vários microrganismos, principalmente Bacillus, Paenibacillus, Pseudomonas, Klebsiella, Xanthomonas, Thermococcus, Vibrio, Geobacillus e Thermoanaerobacterium. Neste trabalho, demonstramos o primeiro relato envolvendo a clonagem e expressão heteróloga da CGTase de Stenotrophomonas maltophilia, microrganismo isolado do solo brasileiro. O gene codificador da CGTase de S. maltophilia, foi amplificado com êxito através da técnica de PCR, clonado no vetor pET-23a(+) e expresso em Escherichia coli BL21(DE3). As células recombinantes necessitaram de aproximadamente 4 horas de cultivo em meio Luria Bertani (LB) após a adição de 0,1 mM de IPTG para a expressão elevada da proteína alvo. Porém, a CGTase recombinante foi expressa sob forma de corpos de inclusão permanecendo na fração insolúvel, sendo necessário utilizar protocolos para solubilização, incluindo diferentes concentrações de uréia, mas a precipitação não foi eficaz. Embora tenha sido observada uma expressão elevada da proteína com cerca de 60 kDa em SDS-PAGE 12%, que correspondeu ao tamanho esperado da proteína, a forma ativa da enzima não foi obtida. Uma análise bioinformática foi realizada, onde foi observou-se uma proteína conhecida como uma importante possível facilitadora transmembrana (PMFTP – putative Major Facilitator Transmembrane Protein) que ancora o gene cgt. Proteína esta que pode ser utilizada em novos estudos a fim de desenvolver um novo e mais eficaz sistema para expressão da CGTase, podendo facilitar a sua expressão extracelular. Assim, mais estudos são necessários para desenvolver um sistema de co-expressão de rCGTase::PMFTP em E. coli e obter mais informações desta proteína de Stenotrophomonas maltophilia. / Cyclodextrin glucosyltransferase (CGTase) is an industrially important enzyme, capable to convert starch into cyclodextrins (CDs). The CDs are able to form inclusion complexes with a wide range of organic and inorganic compounds, which can change their chemical and physical properties, that gives them extensive applicability in the food, pharmaceutical, chemical, cosmetics and agricultural. Currently, many CGTases have been isolated and characterized from various microorganisms, particularly Bacillus, Paenibacillus, Pseudomonas, Klebsiella, Xanthomonas, Thermococcus, Vibrio, Geobacillus and Thermoanaerobacterium. This work demonstrates the first report involving cloning and expression of heterologous CGTase from Stenotrophomonas maltophilia, microorganism isolated from Brazilian soil. The gene encoding the S. maltophilia CGTase, was successfully amplified by PCR, cloned into the vector pET-23a (+) and expressed in Escherichia coli BL21(DE3). Recombinant cells required about 4 h of cultivation in Luria Bertani (LB) after addition of 0.1 mM IPTG for high expression of the target protein. However, the CGTase was expressed recombinant form of inclusion bodies remaining in the insoluble fraction, being necessary use protocols for solubilization, including different concentrations of urea, but the precipitation was not effective. Although it was observed a high expression of the protein about 60 kDa on SDS-PAGE 12%, corresponding to the expected size of the protein, but the active form of the enzyme was not obtained. Bioinformatic analysis was performed and observed a Putative Major Facilitator Transmembrane Protein (PMFTP) harboring the cgt gene. This protein can be used in further studies to develop a new and more effective system for expression of the CGTase, which may facilitate its extracellular expression. Thus, more studies are needed to develop a system of co-expression of rCGTase::PMFTP in E. coli and acquire more information about this protein of Stenotrophomonas maltophilia.

A ciclodextrina glucosiltransferase (CGTase) é uma enzima industrialmente muito importante, capaz de converter o amido em ciclodextrinas (CDs). As CDs são capazes de formar complexos de inclusão com uma grande gama de compostos orgânicos e inorgânicos, podendo mudar suas propriedades químicas e físicas, propriedades estas que lhes confere extensiva aplicabilidade na indústria de alimentos, farmacêutica, química, cosmética e agrícola. Atualmente, diversas CGTases já foram isoladas e caracterizadas a partir de vários microrganismos, principalmente Bacillus, Paenibacillus, Pseudomonas, Klebsiella, Xanthomonas, Thermococcus, Vibrio, Geobacillus e Thermoanaerobacterium. Neste trabalho, demonstramos o primeiro relato envolvendo a clonagem e expressão heteróloga da CGTase de Stenotrophomonas maltophilia, microrganismo isolado do solo brasileiro. O gene codificador da CGTase de S. maltophilia, foi amplificado com êxito através da técnica de PCR, clonado no vetor pET-23a(+) e expresso em Escherichia coli BL21(DE3). As células recombinantes necessitaram de aproximadamente 4 horas de cultivo em meio Luria Bertani (LB) após a adição de 0,1 mM de IPTG para a expressão elevada da proteína alvo. Porém, a CGTase recombinante foi expressa sob forma de corpos de inclusão permanecendo na fração insolúvel, sendo necessário utilizar protocolos para solubilização, incluindo diferentes concentrações de uréia, mas a precipitação não foi eficaz. Embora tenha sido observada uma expressão elevada da proteína com cerca de 60 kDa em SDS-PAGE 12%, que correspondeu ao tamanho esperado da proteína, a forma ativa da enzima não foi obtida. Uma análise bioinformática foi realizada, onde foi observou-se uma proteína conhecida como uma importante possível facilitadora transmembrana (PMFTP – putative Major Facilitator Transmembrane Protein) que ancora o gene cgt. Proteína esta que pode ser utilizada em novos estudos a fim de desenvolver um novo e mais eficaz sistema para expressão da CGTase, podendo facilitar a sua expressão extracelular. Assim, mais estudos são necessários para desenvolver um sistema de co-expressão de rCGTase::PMFTP em E. coli e obter mais informações desta proteína de Stenotrophomonas maltophilia. / Cyclodextrin glucosyltransferase (CGTase) is an industrially important enzyme, capable to convert starch into cyclodextrins (CDs). The CDs are able to form inclusion complexes with a wide range of organic and inorganic compounds, which can change their chemical and physical properties, that gives them extensive applicability in the food, pharmaceutical, chemical, cosmetics and agricultural. Currently, many CGTases have been isolated and characterized from various microorganisms, particularly Bacillus, Paenibacillus, Pseudomonas, Klebsiella, Xanthomonas, Thermococcus, Vibrio, Geobacillus and Thermoanaerobacterium. This work demonstrates the first report involving cloning and expression of heterologous CGTase from Stenotrophomonas maltophilia, microorganism isolated from Brazilian soil. The gene encoding the S. maltophilia CGTase, was successfully amplified by PCR, cloned into the vector pET-23a (+) and expressed in Escherichia coli BL21(DE3). Recombinant cells required about 4 h of cultivation in Luria Bertani (LB) after addition of 0.1 mM IPTG for high expression of the target protein. However, the CGTase was expressed recombinant form of inclusion bodies remaining in the insoluble fraction, being necessary use protocols for solubilization, including different concentrations of urea, but the precipitation was not effective. Although it was observed a high expression of the protein about 60 kDa on SDS-PAGE 12%, corresponding to the expected size of the protein, but the active form of the enzyme was not obtained. Bioinformatic analysis was performed and observed a Putative Major Facilitator Transmembrane Protein (PMFTP) harboring the cgt gene. This protein can be used in further studies to develop a new and more effective system for expression of the CGTase, which may facilitate its extracellular expression. Thus, more studies are needed to develop a system of co-expression of rCGTase::PMFTP in E. coli and acquire more information about this protein of Stenotrophomonas maltophilia.

Paez JIG. Fatores associados à mortalidade em infecções nosocomiais por Stenotrophomonas maltophilia [dissertação]. São Paulo: Faculdade de Medicina, Universidade de São Paulo; 2007. 154p. Infecção de corrente sanguínea (ICS) e pneumonia por S. maltophilia são associadas á alta mortalidade. A identificação de fatores relacionados à mortalidade em pacientes com infecções por esse agente pode permitir intervenções no sentido de diminuir a sua mortalidade. Realizamos um estudo retrospectivo com 60 pacientes com ICS ou pneumonia de origem hospitalar no Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICHC-FMUSP) durante o período de 30 de julho de 1999 a 30 de julho de 2005. Analisamos os fatores de risco relacionados à mortalidade global e a mortalidade nos primeiros 14 dias da infecção por meio de um estudo de coorte retrospectivo comparando os pacientes que apresentaram óbito com os que não apresentaram óbito.As seguintes características foram encontradas na população estudada no momento da infecção, 57 (85%) dos pacientes receberam antibióticos prévios, 88% tinham cateter venoso central, 57% estavam em uso de ventilação mecânica, 35% em uso de quimioterapia e 75% estavam internados em unidade de cuidado intensivo. Neoplasia foi a principal doença de base presente em 45%. Choque séptico foi descrito em 30% dos casos, a média de pontuação na escala de APACHE II foi de 17 pontos e a média de pontuação da escala SOFA foi de 7 pontos. Foram diagnosticadas 8 pneumonias e 52 ICS, 47% foram ICS primárias, entre estas 13% foram ICS relacionadas ao cateter. Foram diagnosticadas também 40% ICS secundárias, sendo o principal foco pulmonar (18%). 27% das infecções foram polimicrobianas. Os fatores de risco independentes associados à mortalidade nos primeiros 14 dias identificados na análise multivariada foram, pontuação maior que 6 no índice SOFA (RR=18,9. IC95%=2,4-146,2) e presença de choque séptico (RR=11,6. IC95%=1,3-105,9). O fator de risco associado à mortalidade global na análise multivariada foi, pontuação maior que 6 no índice SOFA (RR=37,1. IC95%=2,8-494,3). A instituição de terapia antimicrobiana inadequada para o tratamento das infecções por S. maltophilia foi freqüente, sendo observada em 40 (85%) pacientes, principalmente por atraso no inicio e por tempo curto de tratamento. Não houve diferença estatística quando comparado o tratamento adequado do tratamento inadequado. A curva de sobrevida de Kaplan-Meier mostrou que pacientes com APACHE II >20 e SOFA > 10 tinham respectivamente uma chance de sobrevida menor que 8% e menor que 10% (P=<0.001) até 21 dias após a primeira cultura positiva. A mortalidade global foi de 75% e a mortalidade nos primeiros 14 dias de infecção foi de 38%. Estes resultados mostram que infecções por S. maltophilia acontecem em pacientes gravemente doentes com múltiplos fatores de risco e que os fatores associados à mortalidade são principalmente relacionados ao estado da condição clínica de base e gravidade do paciente. / Paez JIG. Factors associated with mortality in Nosocomial infections with Stenotrophomonas maltophilia [dissertation]. São Paulo: ?Faculdade de Medicina, Universidade de São Paulo?; 2007. 154p. Bloodstream infections (BSI) and pneumonia caused by Stenotrophomonas maltophilia are associated with high mortality. A retrospective study with 60 patients with nosocomial BSI and pneumonia was done at the Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICHC-FMUSP). Cases were selected from July 30, 1999 through July 30, 2005. Risk factors associated with overall mortality and 14-day mortality after the onset of infection were accessed. 57 (85%) patients had received previous antimicrobial therapy, 88% had CVC, 57% mechanical ventilation and 75% stay in intensive care unit in the onset of infection. Malignancy (45%) was the most frequent underlying diseases. From 60 patients, 30% had septic shock, the mean of APACHE II score was 17 points and the mean of SOFA index was 7 points. A total of 60 infections were identified. Among these, 8 were pneumonias and 52 BSI, that for this turn, 33% were primary BSI, 13% were CVC-related and 40% secondary. 35% of the infections were polymicrobial. Risk factors associated with 14-day mortality after the onset of infections in the multivariate analysis were, SOFA index > 6 points (RR=18.9. 95%CI=2.4-146.2) and septic shock (RR=11.6. 95%IC=1.3-105.9). Risk factor associated with overall mortality was SOFA index > 6 points, (RR=37.1. 95%IC=2.8-494.3). Used of inappropriate antimicrobial therapy was observed in 40 (85%) patients, of whom received therapy with more 72 hours and received therapy for an insufficient length of time and there was no difference when compared appropriated and non-appropriated therapy. Kaplan-Meier estimations curves showed that patients with APACHE II >20 and SOFA > 10 had respectively a survival chance less than 8% and less than 10% (P=<0.001) at 21 days after the first positive S. maltophilia culture. The overall mortality and 14-day mortality after the onset of infections rates were 75% and 38% respectively. Our results showed that infections caused by S. maltophilia occur in critically ill patients with multiple risk factors and that the most important risk factors associated with mortality are the initial clinical condition and severity of diseases.

Thesis (Ph. D.)--Miami University, Dept. of Chemistry and Biochemistry, 2004. / Title from second page of PDF document. Includes bibliographical references.

Thesis (Ph. D.)--Miami University, Dept. of Chemistry and Biochemistry, 2004. / Title from second page of PDF document. Includes bibliographical references.

Master of Science / Division of Biology / Michael A. Herman / Stenotrophomonas maltophilia is an opportunistic bacterial pathogen found ubiquitously in the environment. Although S. maltophilia is an emerging pathogen associated with hospital-acquired infections in patients with respiratory diseases, particularly cystic fibrosis, very little is known about its mechanism of pathogenesis in any system. In addition, S. maltophilia isolates vary in pathogenicity to several hosts and are genetically diverse, including variation in virulence factors. In this thesis, I address the genetic basis of S. maltophilia pathogenesis from both host and bacterial perspectives. Our lab has previously developed Caenorhabditis elegans as a model for S. maltophilia infection. Stenotrophomonas is found in relatively high abundance in the microbiome of C. elegans, making it a suitable platform for studying S. maltophilia-host interactions. I performed a transcriptomic analysis to determine C. elegans responses to several S. maltophilia strains of varying pathogenicity. Treatments included K279a, an avirulent clinical isolate, JCMS, a virulent environmental strain isolated in association with nematodes near Manhattan, KS, and JV3, an even more virulent environmental isolate. Overall, I found that most genes (89%) that are differentially expressed in response to pathogenic S. maltophilia strains are upregulated, with many even further upregulated in response to the more virulent strain, JV3. Using information from a variety of transcriptomic datasets, I found that most of these genes are also commonly differentially expressed in C. elegans in response to other pathogens. Many more genes were differentially expressed specifically in response to JV3 when compared to all other strains (221 genes) than JCMS as compared to all other strains (14 genes), suggesting JV3 has unique virulence mechanisms that could explain its observed increased virulence. Candidate genes were chosen from the above differentially expressed gene sets (differentially expressed in response to both pathogenic S. maltophilia strains or in a strain-specific manner) for functional analysis. Mutational analysis of these candidate genes revealed that several mutants caused increased susceptibility of C. elegans to pathogenic S. maltophilia, regardless of the strain(s) that caused differential expression of that gene. Furthermore, many of these mutants also caused increased susceptibility to K279a, suggesting that K279a may also employ virulence mechanisms that wild-type C. elegans are able to defend against. To address the pathogen side of the interaction, we analyzed draft assemblies of the S. maltophilia strains, with the addition of another slightly pathogenic environmental strain, R551-3. We hypothesized that differences in observed pathogenicity and host responses to strains of S. maltophilia could be explained by differences in their genomes. When comparing draft assemblies to their respective reference genomes, few differences were observed. However, several genomic features were present in some strains and absent in others, including components of the CmeABC efflux pump and the Type IV secretion system, that might play a role in different virulence mechanisms. Genome-wide comparison of shared and unique genetic features across many S. maltophilia strains revealed that most S. maltophilia genes are strain-specific, suggesting that many potential virulence factors are unique and have yet to be functionally analyzed. Overall, variation in observed pathogenicity, differences in host transcriptional responses, and comparative genomics of S. maltophilia strains reveal that strain-specific mechanisms play important roles in S. maltophilia pathogenesis.

No description available.

Stenotrophomonas maltophilia é um bacilo Gram-negativo, não fermentador, considerado um microorganismo pouco virulento, relacionado principalmente a infecções associadas à assistência a saúde. A S. maltophilia apresenta um padrão de resistência intrínseca à maioria das classes de antibióticos. A droga de escolha para o tratamento das infecções por S. maltophilia é a sulfametoxazol/ trimetoprima (SMX/TMP). Entretanto, estudos atuais relatam o aumento da resistência a esse antibiótico, o que limita assim as opções para terapia efetiva. Outras opções de tratamento são o levofloxacino e a tigeciclina, porém, faltam estudos clínicos e in vitro dessas drogas. A proposta deste estudo foi avaliar os possíveis mecanismos de resistência a SMX/TMP e as quinolonas em isolados clínicos de pacientes internados no Instituto Central do Hospital das Clínicas e do Hospital A.C. Camargo. Foram avaliadas 106 amostras de S. maltophilia isoladas de pacientes adultos com infecção relacionada à assistência a saúde, internados no Instituto Central do Hospital das Clínicas da FMUSP e no Hospital de Câncer A.C Camargo durante o período de dezembro de 2008 a dezembro de 2010. A sensibilidade à SMX/TMP foi de 78,3%, para levofloxacino de 82% e 14,2% para cirpofloxacino, para minociclina de 100% e tigeciclina 91,6%. Foi realizado PCR para detecção dos genes sul1, sul2 e dfrA1 para avaliar a resistência à SMX/TMP, os genes int1 e iscr2 para avaliação da presença de elementos genéticos móveis e os genes gyrA, qnr, smeD, smeT e aac(6)-Ib-cr para avaliação da resistência as quinolonas. Quatorze amostras (13,2%) foram positivas para o gene sul1. Desses isolados, nove amostras apresentavam resistência ao SMX/TMP com CIM50 de 8 g/mL e CIM90 de 128 g/mL. Cinco amostras positivas para o gene sul1 foram sensíveis a SMX/TMP com CIM50 de 1 g/mL e CIM90 de 1 g/mL. A sequencia do integron1 da amostra com CIM >125 g/mL mostrou um tamanho aproximado de 4000 pb contendo os genes cassetes aac4 e aadA1 e a região qac/sul1. Uma amostra resistente a SMX/TMP foi positiva para o gene sul2 localizado na transposase-like ISCR 2. Observamos a presença de quatro novos qnr em cepas de S. maltophilia e a presença da enzima aac(6)-ib-cr em 4 amostras. 100% das cepas foram positivas para o gene do sistema de efluxo smeDEF e 12/38 amostras tiveram o gene smeT do sistema de efluxo smeDEF, ,porém não foi observada mutação nesse gene. Na sequencia de aminoácidos da girase A de 15 amostras resistentes a levofloxacino não observamos mutações relacionadas à resistência a quinolonas. As cepas resistentes a SMX/TMP apresentaram um padrão policlonal. Dezoito amostras resistentes ao levofloxacino apresentaram 14 perfis clonais, distribuídos em 10 clusters. S. maltophilia exibe múltiplos mecanismos de resistência, nesse estudo observamos um grande número de cepas com elementos genéticos móveis carregando o gene sul1 e outros genes de resistência. A S. maltophilia pode ser um importante reservatório de transmissão de genes de resistência / Stenotrophomonas maltophilia is a gram-negative, non-fermenter, considered a low virulent organism, mainly related to healthcare associated infections. S. maltophilia shows a pattern of intrinsic resistance to many classes of antibiotics. The drug of choice for the treatment of infections caused by S. maltophilia is SMX/TMP, however, current studies have reported increased resistance to this antibiotic, thus limiting the options for effective therapy. Among the treatment options appear tigecycline and levofloxacin, but clinical trials and studies in vitro to such drugs are lacking. The purpose of this study was to evaluate the possible mechanisms of resistance to SMX/TMP and quinolones in clinical isolates from patients admitted to the Institute\'s Central Clinical Hospital and the Hospital A.C Camargo. We evaluated 106 strains of S. maltophilia isolated from adult patients with healthcare associated infections, at the Instituto Central do Hospital das Clínicas and the Cancer Hospital AC Camargo in the period of December 2008 to December 2010. The sensitivity to SMX/TMP was 78.3%, 82% for levofloxacin, 14,2% for ciprofloxacin, minocycline 100% and for tigecycline 91.6%. PCR was performed for detection of gene sul1, sul2 and dfrA1 to evaluate the resistance to SMX/TMP, genes iscr2 int1 was performed to evaluate the presence of mobile genetic elements and genes gyrA, qnr, smeD , smeT and aac (6 \')-Ib-cr for evaluation of resistance to quinolones. Fourteen samples (13.2%) were positive for the gene sul1. In these isolates, nine samples showed resistance to SMX/TMP with MIC50 of 8 g/ml and MIC90 of 128 g/mL. Five strains were positive for sul1 gene and were susceptible to SMX/TMP with MIC50 of 1 g/ml and MIC90 of 1 g/mL. The sequence of the integron class 1 strain with an MIC> 125 g/mL showed an approximate size of 4000 bp containing the gene cassettes aadA1, aac4 and qac/sul1. A strain resistant to SMX/TMP was positive for the gene sul2 located on ISCR2 a transposase-like. We observed the presence of four new qnr in strains of S. maltophilia and the presence of the enzyme aac (6 \')-ib-cr in 4 samples. 100% of the strains were positive for the gene of the efflux system smeDEF and 12/38 samples had the gene smeT repressor of smeDEF efflux system, however there was no mutation in this gene. In the amino acid sequence of gyrase A of 15 strains resistant to levofloxacin did not observe mutations related to resistance to quinolones. Strains resistant to SMX/TMP had a polyclonal PFGE pattern. Eighteen strains resistant to levofloxacin showed 14 clonal profiles 14 divided into 10 clusters S. maltophilia displays multiple mechanisms of resistance. In this study, we observed a large number of strains with mobile genetic elements carrying the sul1 gene and other resistance genes. S. maltophilia is may be an important source for transmission of genes of resistance

Stenotrophomonas maltophilia é um bacilo Gram-negativo, não fermentador, considerado um microorganismo pouco virulento, relacionado principalmente a infecções associadas à assistência a saúde. A S. maltophilia apresenta um padrão de resistência intrínseca à maioria das classes de antibióticos. A droga de escolha para o tratamento das infecções por S. maltophilia é a sulfametoxazol/ trimetoprima (SMX/TMP). Entretanto, estudos atuais relatam o aumento da resistência a esse antibiótico, o que limita assim as opções para terapia efetiva. Outras opções de tratamento são o levofloxacino e a tigeciclina, porém, faltam estudos clínicos e in vitro dessas drogas. A proposta deste estudo foi avaliar os possíveis mecanismos de resistência a SMX/TMP e as quinolonas em isolados clínicos de pacientes internados no Instituto Central do Hospital das Clínicas e do Hospital A.C. Camargo. Foram avaliadas 106 amostras de S. maltophilia isoladas de pacientes adultos com infecção relacionada à assistência a saúde, internados no Instituto Central do Hospital das Clínicas da FMUSP e no Hospital de Câncer A.C Camargo durante o período de dezembro de 2008 a dezembro de 2010. A sensibilidade à SMX/TMP foi de 78,3%, para levofloxacino de 82% e 14,2% para cirpofloxacino, para minociclina de 100% e tigeciclina 91,6%. Foi realizado PCR para detecção dos genes sul1, sul2 e dfrA1 para avaliar a resistência à SMX/TMP, os genes int1 e iscr2 para avaliação da presença de elementos genéticos móveis e os genes gyrA, qnr, smeD, smeT e aac(6)-Ib-cr para avaliação da resistência as quinolonas. Quatorze amostras (13,2%) foram positivas para o gene sul1. Desses isolados, nove amostras apresentavam resistência ao SMX/TMP com CIM50 de 8 g/mL e CIM90 de 128 g/mL. Cinco amostras positivas para o gene sul1 foram sensíveis a SMX/TMP com CIM50 de 1 g/mL e CIM90 de 1 g/mL. A sequencia do integron1 da amostra com CIM >125 g/mL mostrou um tamanho aproximado de 4000 pb contendo os genes cassetes aac4 e aadA1 e a região qac/sul1. Uma amostra resistente a SMX/TMP foi positiva para o gene sul2 localizado na transposase-like ISCR 2. Observamos a presença de quatro novos qnr em cepas de S. maltophilia e a presença da enzima aac(6)-ib-cr em 4 amostras. 100% das cepas foram positivas para o gene do sistema de efluxo smeDEF e 12/38 amostras tiveram o gene smeT do sistema de efluxo smeDEF, ,porém não foi observada mutação nesse gene. Na sequencia de aminoácidos da girase A de 15 amostras resistentes a levofloxacino não observamos mutações relacionadas à resistência a quinolonas. As cepas resistentes a SMX/TMP apresentaram um padrão policlonal. Dezoito amostras resistentes ao levofloxacino apresentaram 14 perfis clonais, distribuídos em 10 clusters. S. maltophilia exibe múltiplos mecanismos de resistência, nesse estudo observamos um grande número de cepas com elementos genéticos móveis carregando o gene sul1 e outros genes de resistência. A S. maltophilia pode ser um importante reservatório de transmissão de genes de resistência / Stenotrophomonas maltophilia is a gram-negative, non-fermenter, considered a low virulent organism, mainly related to healthcare associated infections. S. maltophilia shows a pattern of intrinsic resistance to many classes of antibiotics. The drug of choice for the treatment of infections caused by S. maltophilia is SMX/TMP, however, current studies have reported increased resistance to this antibiotic, thus limiting the options for effective therapy. Among the treatment options appear tigecycline and levofloxacin, but clinical trials and studies in vitro to such drugs are lacking. The purpose of this study was to evaluate the possible mechanisms of resistance to SMX/TMP and quinolones in clinical isolates from patients admitted to the Institute\'s Central Clinical Hospital and the Hospital A.C Camargo. We evaluated 106 strains of S. maltophilia isolated from adult patients with healthcare associated infections, at the Instituto Central do Hospital das Clínicas and the Cancer Hospital AC Camargo in the period of December 2008 to December 2010. The sensitivity to SMX/TMP was 78.3%, 82% for levofloxacin, 14,2% for ciprofloxacin, minocycline 100% and for tigecycline 91.6%. PCR was performed for detection of gene sul1, sul2 and dfrA1 to evaluate the resistance to SMX/TMP, genes iscr2 int1 was performed to evaluate the presence of mobile genetic elements and genes gyrA, qnr, smeD , smeT and aac (6 \')-Ib-cr for evaluation of resistance to quinolones. Fourteen samples (13.2%) were positive for the gene sul1. In these isolates, nine samples showed resistance to SMX/TMP with MIC50 of 8 g/ml and MIC90 of 128 g/mL. Five strains were positive for sul1 gene and were susceptible to SMX/TMP with MIC50 of 1 g/ml and MIC90 of 1 g/mL. The sequence of the integron class 1 strain with an MIC> 125 g/mL showed an approximate size of 4000 bp containing the gene cassettes aadA1, aac4 and qac/sul1. A strain resistant to SMX/TMP was positive for the gene sul2 located on ISCR2 a transposase-like. We observed the presence of four new qnr in strains of S. maltophilia and the presence of the enzyme aac (6 \')-ib-cr in 4 samples. 100% of the strains were positive for the gene of the efflux system smeDEF and 12/38 samples had the gene smeT repressor of smeDEF efflux system, however there was no mutation in this gene. In the amino acid sequence of gyrase A of 15 strains resistant to levofloxacin did not observe mutations related to resistance to quinolones. Strains resistant to SMX/TMP had a polyclonal PFGE pattern. Eighteen strains resistant to levofloxacin showed 14 clonal profiles 14 divided into 10 clusters S. maltophilia displays multiple mechanisms of resistance. In this study, we observed a large number of strains with mobile genetic elements carrying the sul1 gene and other resistance genes. S. maltophilia is may be an important source for transmission of genes of resistance

Pseudomonas aeruginosa et Stenotrophomonas maltophilia, pathogènes opportunistes majeurs, pourraient acquérir leur résistance aux antibiotiques dans l’environnement, sous la pression exercée par les métaux lourds par co-sélection de résistance. Nous avons tout d’abord évalué la distribution et l’abondance de ces espèces dans un large panel de sols d’origine géographique différente (France et Afrique) et évalué l’influence d’activités anthropiques susceptibles d’exposer les sols en éléments métalliques sur cette distribution. Alors que la présence de P. aeruginosa est sporadique et plutôt liée à un apport exogène, S. maltophilia est présente dans tous les sols étudiés, suggérant son endémicité. L’évaluation des résistances des souches isolées de ces sols a également montré des différences entre les deux espèces. Les souches environnementales de P. aeruginosa sont pour la plupart caractérisées par un phénotype sauvage alors que celles de S. maltophilia présentent une grande diversité de phénotypes en fonction des sites, parfois similaires à ceux de souches cliniques. Cette diversité peut être attribuée à l’adaptation aux conditions environnementales très différentes rencontrées mais il est difficile d‘attribuer précisément aux métaux un rôle dans la co-sélection de ces résistances. L’étude menée sur la communauté bactérienne d’un sol contaminé a également permis de mettre en évidence une forte proportion de bactéries résistantes à différents antibiotiques représentée par des espèces qualifiées de pathogènes opportunistes ainsi que la présence du gène blaIMP, permettant la résistance à l’imipénème, utilisé en milieu clinique pour le traitement de clones multi-résistants. / Pseudomonas aeruginosa and Stenotrophomonas maltophilia, two major opportunistic pathogens, could acquire antibiotic resistance in the environment under heavy metal pressure that co-selects both resistances. We first investigated the distribution and abundance of these species in a wide range of soils of different geographical origin (France and Africa) and evaluated the influence of human activities that may expose soils to metallic elements on this distribution. While the presence of P. aeruginosa is rather sporadic and could be linked to exogenous intake, S. maltophilia is present in all studied soils, that suggests its endemicity. Evaluating resistance capacities of strains isolated from these soils also showed differences between the two species. Environmental strains of P. aeruginosa are mostly characterized by a wild type phenotype, whereas those of S. maltophilia present a wide diversity of phenotypes depending on the site, sometimes similar to those of clinical strains. This diversity could be attributed to a deep adaptation to the very different environmental conditions encountered in the original niche but it is difficult to attribute specifically to metals a role in coselection of resistance. The study conducted on the bacterial community present in a contaminated soil has also highlighted a high proportion of bacteria resistant to different antibiotics represented by species qualified as opportunistic pathogens and the presence of the gene blaIMP, enabling resistance to imipenem, used in the hospital to treat infections due to multidrug-resistant clones.