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Cupozak-Pinheiro WJ, Araújo de Almeida-Apolonio A, Sasaki MH, Maran NH, Pires de Araújo R, Silva DBDS, Víctor de Andrade Dos Santos J, Barufatti A, Chang MR, Pires de Oliveira KM. Candida species contamination in drinking groundwater from residence wells in three municipalities of midwestern Brazil and the potential human health risks. Microb Pathog 2022; 169:105660. [PMID: 35764189 DOI: 10.1016/j.micpath.2022.105660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/03/2022] [Accepted: 06/25/2022] [Indexed: 10/17/2022]
Abstract
Groundwater represents one of the largest safe drinking water sources worldwide; however, it has been threatened by increased human activities in recent years. Candida species express virulence factors that contribute to the establishment and worsening of infections, although little is known about the virulence profiles of these species in potable groundwater. The aim of this study was to detect the presence of yeasts in groundwater from residential wells and to evaluate the antifungal susceptibility profile, hydrolytic enzyme production, adhesion capacity, and biofilm formation of Candida spp. Fifty yeasts representing nine genera were isolated: Candida (48%), Meyerozyma (20%), Pichia (8%), Exophiala (8%), Clavispora (4%), Kodamaea (4%), Rhodotorula (4%), Hanseniaspora (2%), and Kazachstania (2%). Candida parapsilosis was the most commonly isolated species, and approximately 29% of the Candida isolates were resistant to at least one azole. All Candida isolates were able to produce hydrolytic enzymes and adhere to polystyrene, and most were classified as hydrophobic. Candida spp. can establish and form biofilms when cultivated in different media such as Sabouraud broth, water, and calcium hypochlorite. The use of contaminated groundwater for human consumption represents a possible route for the transmission of clinically relevant yeasts that can cause fungal infections, especially in immunocompromised individuals. Therefore, it is important to evaluate and establish effective measures for groundwater treatment to ensure the quality and safety for consumption.
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Affiliation(s)
| | | | - Melina Hatsue Sasaki
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, 79804-970, Brazil
| | - Nayara Halimy Maran
- Faculty of Exact Sciences and Technology, Federal University of Grande Dourados, Dourados, MS, 79804-970, Brazil
| | - Renata Pires de Araújo
- Faculty of Exact Sciences and Technology, Federal University of Grande Dourados, Dourados, MS, 79804-970, Brazil
| | | | | | - Alexeia Barufatti
- Faculty of Biological and Environmental Science, Federal University of Grande Dourados, Dourados, MS, 79804-970, Brazil
| | - Marilene Rodrigues Chang
- Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, 79070-900, Brazil
| | - Kelly Mari Pires de Oliveira
- Faculty of Biological and Environmental Science, Federal University of Grande Dourados, Dourados, MS, 79804-970, Brazil.
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Marena GD, Carvalho GC, Monazzi LCS, Maschio-Lima T, De Almeida MTG, Da Silva JLM, Fortunato GC, Araújo VHS, Venancio DCV, Chang MR, Chorilli M. Infection caused by Candida auris: state of the art. MYCOSPHERE 2022. [DOI: 10.5943/mycosphere/13/1/10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Monteiro OMC, Higa Júnior MG, Palhares MA, Nunes MDO, Melhem MDSC, Chang MR. A Rare Case of Aspergillus Mediastinitis After Coronary Artery Bypass Surgery: A Case Report and Literature Review. Am J Case Rep 2021; 22:e933193. [PMID: 34907149 PMCID: PMC8689372 DOI: 10.12659/ajcr.933193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patient: Male, 74-year-old
Final Diagnosis: Aspergillus fumigatus infection
Symptoms: Anemia • elevated inflammatory marker • fever • mediastinal fluid collection • sternal disruptation
Medication: —
Clinical Procedure: —
Specialty: Cardiac Surgery • Infectious Diseases
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Affiliation(s)
| | - Minoru German Higa Júnior
- Hospital Infection Control Commission, Maria Aparecida Pedrossian University Hospital, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Murillo Augusto Palhares
- Postgraduate Program in Infectious and Parasitic Diseases, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Maína de Oliveira Nunes
- Mycology Laboratory, University Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Marcia de Souza Carvalho Melhem
- Postgraduate Program in Infectious and Parasitic Diseases, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.,Mycology Unit, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | - Marilene Rodrigues Chang
- Postgraduate Program in Infectious and Parasitic Diseases, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
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Rodrigues ACS, Chang MR, Santos ICDO, Carvalho-Assef APD. Molecular Epidemiology of blaKPC-Encoding Klebsiella pneumoniae Isolated from Public Hospitals in Midwest of Brazil. Microb Drug Resist 2021; 28:1-6. [PMID: 34264760 DOI: 10.1089/mdr.2020.0289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study was conducted to determine the molecular epidemiology of blaKPC-encoding Klebsiella pneumoniae recovered from three public hospitals in Brazil. Molecular investigation of blaOXA-48, blaKPC, blaNDM, blaCTX-M, blaSHV, blaTEM, blaIMP, and blaVIM resistance genes was performed in 99 K. pneumoniae isolates from inpatients of intensive care units. Antimicrobial susceptibility was determined with a Vitek-2 System, except for polymyxin B, which was evaluated by the microbroth dilution test. Clonal relatedness was established by pulsed-field gel electrophoresis and multilocus sequence typing. Screening resistance genes showed that K. pneumoniae isolates carried the blaKPC (88.9%), blaSHV (73.5%), blaTEM (72.2%), and blaCTX-M (43.9%) genes. The most frequent sequence types (STs) were ST273, ST11, ST 1298, ST13, ST2687, and ST37. We report new STs in K. pneumoniae that have not been detected previously in Brazil. K. pneumoniae belonging to the same clone is present in different hospitals in the same region, showing the spread of multidrug-resistant K. pneumoniae.
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Affiliation(s)
- Ana Claudia Souza Rodrigues
- Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro Oeste, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil.,Faculdade de Medicina, Universidade Anhanguera Uniderp, Campo Grande, Brazil
| | - Marilene Rodrigues Chang
- Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro Oeste, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil.,Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
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Teixeira MDM, Cattana ME, Matute DR, Muñoz JF, Arechavala A, Isbell K, Schipper R, Santiso G, Tracogna F, Sosa MDLÁ, Cech N, Alvarado P, Barreto L, Chacón Y, Ortellado J, Lima CMD, Chang MR, Niño-Vega G, Yasuda MAS, Felipe MSS, Negroni R, Cuomo CA, Barker B, Giusiano G. Genomic diversity of the human pathogen Paracoccidioides across the South American continent. Fungal Genet Biol 2020; 140:103395. [PMID: 32325168 PMCID: PMC7385733 DOI: 10.1016/j.fgb.2020.103395] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/27/2020] [Accepted: 04/16/2020] [Indexed: 12/30/2022]
Abstract
Paracoccidioidomycosis (PCM) is a life-threatening systemic mycosis widely reported in the Gran Chaco ecosystem. The disease is caused by different species from the genus Paracoccidioides, which are all endemic to South and Central America. Here, we sequenced and analyzed 31 isolates of Paracoccidioides across South America, with particular focus on isolates from Argentina and Paraguay. The de novo sequenced isolates were compared with publicly available genomes. Phylogenetics and population genomics revealed that PCM in Argentina and Paraguay is caused by three distinct Paracoccidioides genotypes, P. brasiliensis (S1a and S1b) and P. restrepiensis (PS3). P. brasiliensis S1a isolates from Argentina are frequently associated with chronic forms of the disease. Our results suggest the existence of extensive molecular polymorphism among Paracoccidioides species, and provide a framework to begin to dissect the connection between genotypic differences in the pathogen and the clinical outcomes of the disease.
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Affiliation(s)
- Marcus de Melo Teixeira
- Northern Arizona University, Flagstaff, AZ, USA; Universidade de Brasília, Brasilia, Brazil.
| | - Maria Emilia Cattana
- Northern Arizona University, Flagstaff, AZ, USA; Hospital Dr. Julio C. Perrando, Resistencia, Chaco, Argentina
| | - Daniel R Matute
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | - José F Muñoz
- Broad Institute of MIT and Harvard, Cambridge, USA
| | | | - Kristin Isbell
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | | | | | - Primavera Alvarado
- Servicio Autónomo Instituto de Biomedicina Dr. Jacinto Convit, Caracas, Venezuela
| | - Laura Barreto
- Instituto Superior de Formación Docente Salome Ureña, Santo Domingo, Dominican Republic
| | - Yone Chacón
- Hospital Señor del Milagro, Salta, Argentina
| | | | | | | | | | | | | | | | | | | | - Gustavo Giusiano
- Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina.
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Patrial YC, Tortorelli LP, Rodrigues ACS, Santos ICDO, Volpe-Chaves CE, Capato GS, Barbosa GAR, Carvalho-Assef APD, Chang MR. Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases. Rev Inst Med Trop Sao Paulo 2019; 61:e69. [PMID: 31859846 PMCID: PMC6907419 DOI: 10.1590/s1678-9946201961069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/30/2019] [Indexed: 11/22/2022] Open
Abstract
Nosocomial bacterial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is associated with high mortality in neurosurgical patients. There are few reports in the literature on meningitis caused by CRKP. We report two cases of CRKP meningitis after neurosurgery. The K. pneumoniae identification and antimicrobial susceptibility testing were performed using the Vitek Compact System. Minimum inhibitory concentrations of polymyxin B were determined using the broth microdilution method. Molecular typing of K. pneumoniae isolates was investigated using multilocus sequence typing. Antimicrobial susceptibility testing showed that the K. pneumoniae isolates were multidrug resistant and co-produced extended-spectrum β-lactamases and KPC enzymes. The patients were treated with intrathecal polymyxin. Genetic polymorphism analyses revealed two different K. pneumoniae clones (ST1298 and ST2687), which were observed for the first time in CRKP infections. We recommend intravenous administration of intrathecal polymyxin for treating meningitis caused by multidrug-resistant K. pneumoniae .
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Affiliation(s)
| | | | - Ana Claudia Souza Rodrigues
- Universidade Anhanguera Uniderp, Campo Grande, Mato Grosso do Sul, Brazil.,Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro Oeste, Campo Grande, Mato Grosso do Sul, Brazil
| | - Ivson Cassiano de Oliveira Santos
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Laboratório de Pesquisa de Infecção Hospitalar, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Elizabeth Volpe-Chaves
- Hospital Regional de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.,Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Laboratório de Pesquisas Microbiológicas, Campo Grande, Mato Grosso do Sul, Brazil
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De Alencar GP, Sabino J, Gonçalves JL, Chang MR. Bacterial, Fungal and Viral Infections in Surgical Site: Clinical, Diagnostic and Epidemiological Aspects. J Health Scie 2019. [DOI: 10.17921/2447-8938.2019v21n3p219-224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractSurgical Site Infections (SSI) are infections related to surgical procedures in inpatients and outpatients, indicated with high prevalence in relation to infections linked to preventable health care. Thus, the objective of the study is to perform a review on bacterial, fungal and viral infections in surgical site in relation to clinical, diagnostic and epidemiological aspects. A bibliographic and exploratory research was carried out and the Virtual Health Library (VHL), Capes Periodicals and the Pubmed to search the articles were consulted. As for the clinical aspects, the phlogistic signs that allow to identify an inflammatory picture, being a response of the organism to some aggressive agent. Among the bacterial diagnostic methods, the most used ones are the color smear examination, cultural and biochemical characteristics, ELISA, PCR and SAR. As for the detection of fungi and yeasts are the production of the germ tube, micro-culture in agar-tween 80 agar, assimilation of carbohydrates or nitrogen and fermentation of carbohydrates. For viruses, virus isolation, cell culture, laboratory animals and embryonated eggs may be used. Although bacterial infections account for most surgical infections, fungal and viral infections can also be seen in hospital settings and their diagnosis needs to be performed as soon as possible for proper treatment, reducing costs for medical services and length of stay of the patient in the hospital environment, also reducing other risks of infection.Keywords: Surgical Wound Infection. Bacterial Infections. Mycoses. Virus Diseases.ResumoAs Infecções do Sítio Cirúrgico (ISC) são infecções relacionadas a procedimentos cirúrgicos em pacientes internados e ambulatoriais, indicadas com alta prevalência em relação às infecções ligadas aos cuidados em saúde evitáveis. Neste sentido, o objetivo do estudo é realizar uma revisão sobre as infecções bacterianas, fúngicas e virais em sítio cirúrgico em relação aos aspectos clínicos, diagnósticos e epidemiológicos. Foi realizada uma pesquisa bibliográfica e exploratória e consultada a Biblioteca Virtual em Saúde (BVS), os Periódicos Capes e o Pubmed para busca dos artigos. Quanto aos aspectos clínicos, os sinais flogísticos que permitem identificar um quadro inflamatório, sendo uma resposta do organismo frente a algum agente agressor. Dentre os métodos diagnósticos bacterianos, os mais utilizados são o Exame de esfregaços corados, Características culturais e bioquímicas, ELISA, PCR e o SAR. Quanto à detecção de fungos e leveduras estão a produção do tubo germinativo, micro cultivo em ágar fubá-tween 80, assimilação de carboidratos ou de nitrogênio e fermentação dos carboidratos. Em relação aos vírus, podem ser utilizadas o isolamento dos vírus, a cultura de células, os animais de laboratório e os ovos embrionados. Apesar das infecções bacterianas representarem a maior parte das infecções cirúrgicas, as infecções fúngicas e virais também podem ser vistas em ambientes hospitalares e seu diagnóstico precisa ser realizado o mais rápido possível para um tratamento adequado, reduzindo os custos com serviços médicos e o tempo de permanência do paciente no ambiente hospitalar, diminuindo também outros riscos de infecção.Palavras-chave: Infecção da Ferida Cirúrgica. Infecções Bacterianas. Micoses. Viroses.
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Rodrigues ACS, Santos ICDO, Campos CC, Rezende IN, Ferreira YM, Chaves CEV, Rocha-de-Souza CM, Carvalho-Assef APD, Chang MR. Non-clonal occurrence of pmrB mutations associated with polymyxin resistance in carbapenem-resistant Klebsiella pneumoniae in Brazil. Mem Inst Oswaldo Cruz 2019; 114:e180555. [PMID: 31116243 PMCID: PMC6528640 DOI: 10.1590/0074-02760180555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/29/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Polymyxins are currently used as a “last-line” treatment for multidrug-resistant Gram-negative infections. OBJECTIVES To identify the major mechanisms of resistance to polymyxin and compare the genetic similarity between multi-drug resistant Klebsiella pneumoniae strains recovered from inpatients of public hospitals in the Mid-West of Brazil. METHODS 97 carbapenems non-susceptible K. pneumoniae were studied. β-lactamases (blaOXA-48, blaKPC, blaNDM, blaCTX-M, blaSHV, blaTEM, blaIMP, blaVIM) and mcr-1 to mcr-5 genes were investigated by polymerase chain reaction (PCR). Mutations in chromosomal genes (pmrA, pmrB, phoP, phoQ, and mgrB) were screened by PCR and DNA sequencing. Clonal relatedness was established by using pulsed-field gel electrophoresis and multilocus sequence typing. FINDINGS K. pneumoniae isolates harbored blaKPC (93.3%), blaSHV (86.6%), blaTEM (80.0%), blaCTX-M (60%) genes. Of 15 K. pneumoniae resistant to polymyxin B the authors identified deleterious mutations in pmrB gene, mainly in T157P. None K. pneumoniae presented mcr gene variants. Genetic polymorphism analyses revealed 12 different pulsotypes. MAIN CONCLUSIONS Deleterious mutations in pmrB gene is the main chromosomal target for induction of polymyxin resistance in carbapenem-resistant K. pneumoniae in public hospitals in the Mid-West of Brazil.
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Affiliation(s)
- Ana Claudia Souza Rodrigues
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro-Oeste, Campo Grande, MS, Brasil.,Universidade Anhanguera Uniderp, Faculdade de Medicina, Campo Grande, MS, Brasil
| | | | - Caroline Conci Campos
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, MS, Brasil
| | - Isadora Nascimento Rezende
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, MS, Brasil
| | - Yanara Miranda Ferreira
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, MS, Brasil
| | | | - Cláudio Marcos Rocha-de-Souza
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Pesquisa em Infecção Hospitalar, Rio de Janeiro, RJ, Brasil
| | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro-Oeste, Campo Grande, MS, Brasil.,Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, MS, Brasil.,Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro-Oeste, Campo Grande, MS, Brasil
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Andrade UV, Oliveira SMDVLD, Chang MR, Pereira EF, Marques APDC, Carvalho LRD, Mendes RP, Paniago AMM. Treatment compliance of patients with paracoccidioidomycosis in Central-West Brazil. ACTA ACUST UNITED AC 2019; 45:e20180167. [PMID: 31017226 PMCID: PMC6733749 DOI: 10.1590/1806-3713/e20180167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 12/23/2018] [Indexed: 12/02/2022]
Abstract
Objective: To evaluate the treatment compliance of patients with paracoccidioidomycosis. Methods: We studied 188 patients with paracoccidioidomycosis admitted to a tertiary referral hospital in the Central-West Region of Brazil from 2000 to 2010, to assess their compliance to treatment. In order to be considered compliant, patients needed to present two established criteria: (1) receive medicines from the pharmacy, and (2) achieve a self-reported utilization of at least 80% of the dispensed antifungal compounds prescribed since their previous appointment. Results: Most patients were male (95.7%), had the chronic form of the disease (94.2%), and were treated with cotrimoxazole (86.2%). Only 44.6% of patients were treatment compliant. The highest loss to follow-up was observed in the first 4 months of treatment (p < 0.02). Treatment compliance was higher for patients with than for those without pulmonary involvement (OR: 2.986; 95%CI 1.351-6.599), and higher for patients with than without tuberculosis as co-morbidity (OR: 2.763; 95%CI 1.004-7.604). Conclusions: Compliance to paracoccidioidomycosis treatment was low, and the period with the highest loss to follow-up corresponds to the first four months. Pulmonary paracoccidioidal involvement or tuberculosis comorbidity predicts a higher compliance to paracoccidioidomycosis therapy.
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Dib HX, de Oliveira DGL, de Oliveira CFR, Taveira GB, de Oliveira Mello E, Verbisk NV, Chang MR, Corrêa Junior D, Gomes VM, Macedo MLR. Biochemical characterization of a Kunitz inhibitor from Inga edulis seeds with antifungal activity against Candida spp. Arch Microbiol 2018; 201:223-233. [DOI: 10.1007/s00203-018-1598-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/03/2018] [Accepted: 11/19/2018] [Indexed: 11/25/2022]
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Cury ESJ, Chang MR, Pontes ERJC. Non-viral microbial keratitis in adults: clinical and laboratory aspects. Braz J Microbiol 2018; 49 Suppl 1:205-212. [PMID: 30146181 PMCID: PMC6328808 DOI: 10.1016/j.bjm.2018.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/24/2018] [Accepted: 05/10/2018] [Indexed: 11/21/2022] Open
Abstract
This study compares patients with and without non-viral microbial keratitis in relation to sociodemographic variables, clinical aspects, and involved causative agent. Clinical aspects, etiology and therapeutic procedures were assessed in patients with and without keratitis that were diagnosed in an Eye Care Center in Campo Grande, MS, Brazil. Patients were divided into two groups: (a) cases: 64 patients with non-viral microbial keratitis diagnosed at biomicroscopy; and (b) controls: 47 patients with other eye disorders that were not keratitis. Labor activity related to agriculture, cattle raising, and contact lens use were all linked to keratitis occurrence (p < 0.005). In patients with keratitis, the most common symptoms were pain and photophobia, and the most frequently used medicines were fourth-generation fluoroquinolones (34.4%), amphotericin B (31.3%), and natamycin (28.1%). Microbial keratitis evolved to corneal perforation in 15.6% of cases; transplant was indicated in 10.9% of cases. Regarding the etiology of this condition, 23 (42.2%) keratitis cases were caused by bacteria (Pseudomonas aeruginosa, 12.5%), 17 (39.1%) by fungi (Fusarium spp., 14.1% and Aspergillus spp., 4.7%), and 4 (6.3%) by Acanthamoeba. Patients with keratitis present with a poorer prognosis. Rapid identification of the etiologic agent is indispensable and depends on appropriate ophthalmological collection and microbiological techniques.
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Nunes JDO, Tsujisaki RADS, Nunes MDO, Lima GME, Paniago AMM, Pontes ERJC, Chang MR. Cryptococcal meningitis epidemiology: 17 years of experience in a State of the Brazilian Pantanal. Rev Soc Bras Med Trop 2018; 51:485-492. [DOI: 10.1590/0037-8682-0050-2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal de Mato Grosso do Sul, Brazil
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Spalanzani RN, Mattos K, Marques LI, Barros PFD, Pereira PIP, Paniago AMM, Mendes RP, Chang MR. Clinical and laboratorial features of oral candidiasis in HIV-positive patients. Rev Soc Bras Med Trop 2018; 51:352-356. [PMID: 29972567 DOI: 10.1590/0037-8682-0241-2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We describe the clinical and laboratorial features of oral candidiasis in 66 HIV-positive patients. METHODS Polymerase chain reaction-based techniques were performed for differentiation of Candida spp. isolated from patients at a public teaching hospital in Midwest Brazil. RESULTS Oral lesions, mainly pseudomembranous, were significantly related to higher levels of immunosuppression. Of 45 Candida isolates, 66.7% were C. albicans. Most of the isolates were susceptible to the antifungal drugs tested. CONCLUSIONS Oral lesions were associated with higher immunosuppression levels. Lower susceptibility to antifungals by non-albicans isolates supports the importance of surveillance studies using susceptibility tests to aid in the treatment.
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Affiliation(s)
| | - Karine Mattos
- Programa de Pós-Graduação Stricto Sensu em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Luiza Inahe Marques
- Curso de Farmácia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Pedro Fernando Diniz Barros
- Programa de Pós-Graduação Stricto Sensu em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Pamela Iruama Peres Pereira
- Programa de Residência Multiprofissional em Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Anamaria Mello Miranda Paniago
- Programa de Pós-Graduação Stricto Sensu em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Rinaldo Poncio Mendes
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Marilene Rodrigues Chang
- Curso de Farmácia, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.,Programa de Pós-Graduação Stricto Sensu em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
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Lin H, Doebelin C, Patouret R, Garcia-Ordonez RD, Chang MR, Dharmarajan V, Bayona CR, Cameron MD, Griffin PR, Kamenecka TM. Design, synthesis, and evaluation of simple phenol amides as ERRγ agonists. Bioorg Med Chem Lett 2018; 28:1313-1319. [PMID: 29548571 PMCID: PMC5893368 DOI: 10.1016/j.bmcl.2018.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/01/2018] [Accepted: 03/06/2018] [Indexed: 10/17/2022]
Abstract
Herein we report the design and synthesis of a series of simple phenol amide ERRγ agonists based on a hydrazone lead molecule. Our structure activity relationship studies in this series revealed the phenol portion of the molecule to be required for activity. Attempts to replace the hydrazone with more suitable chemotypes led to a simple amide as a viable alternative. Differential hydrogen-deuterium exchange experiments were used to help understand the structural basis for binding to ERRγ and aid in the development of more potent ligands.
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Affiliation(s)
- Hua Lin
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Christelle Doebelin
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Rémi Patouret
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Ruben D Garcia-Ordonez
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - M R Chang
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Venkatasubramanian Dharmarajan
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Claudia Ruiz Bayona
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Michael D Cameron
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Patrick R Griffin
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA
| | - Theodore M Kamenecka
- The Scripps Research Institute, Scripps Florida, Department of Molecular Medicine, 130 Scripps Way #A2A, Jupiter, FL 33458, USA.
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Almeida-Apolonio AAD, Dantas FGDS, Rodrigues AB, Cardoso CAL, Negri M, Oliveira KMPD, Chang MR. Antifungal activity of Annona coriacea Mart. ethanol extracts against the aetiological agents of cryptococcosis. Nat Prod Res 2018; 33:2363-2367. [DOI: 10.1080/14786419.2018.1440221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Allan Belarmino Rodrigues
- Faculdade de Ciências Exatas e Tecnologia, Universidade Federal da Grande Dourados, Dourados, Brazil
| | | | - Melyssa Negri
- Departamento de Análise Clínicas, Universidade Estadual de Maringá, Maringá, Brazil
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Lima GME, Nunes MDO, Chang MR, Tsujisaki RADS, Nunes JDO, Taira CL, Thomaz DY, Negro GMBD, Mendes RP, Paniago AMM. Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e75. [PMID: 29267583 PMCID: PMC5738760 DOI: 10.1590/s1678-9946201759075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/22/2017] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to identify Candida spp. isolated from
candiduria episodes at a tertiary hospital in the Midwest region of Brazil, and to
determine their susceptibility profiles to antifungal compounds. From May 2011 to
April 2012, Candida spp. isolated from 106 adult patients with
candiduria admitted to the University Hospital of the Federal University of Mato
Grosso do Sul were evaluated. Both, species identification and susceptibility testing
with fluconazole-FLC, voriconazole-VRC, and amphotericin B-AmB were carried out using
the Vitek 2. To discriminate species of the C. parapsilosis complex,
a RAPD-PCR technique using the RPO2 primer was performed. From the total of 106
isolates, 42 (39.6%) C. albicans and 64 (60.4%)
Candida non-albicans (CNA) - 33 C.
tropicalis, 18 C. glabrata, 5 C.
krusei, 4 C. parapsilosis sensu stricto, 2 C.
kefyr, 1 C. lusitaniae, and 1 C.
guilliermondii were identified. All isolates were susceptible to AmB and
VRC, whereas all C. glabrata isolates presented either resistance
(5.6%) or dose-dependent susceptibility (94.4%) to FLC. The study of
Candida spp. and their resistance profiles may help in tailoring
more efficient therapeutic strategies for candiduria.
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Affiliation(s)
- Gláucia Moreira Espíndola Lima
- Universidade Federal de Mato Grosso do Sul, Hospital Universitário Maria Aparecida Pedrossian, Laboratório de Análises Clínicas, Campo Grande, Mato Grosso do Sul, Brazil
| | - Maína de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Hospital Universitário Maria Aparecida Pedrossian, Laboratório de Análises Clínicas, Campo Grande, Mato Grosso do Sul, Brazil
| | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Rosianne Assis de Sousa Tsujisaki
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Joslaine de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Cleison Ledesma Taira
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Danilo Yamamoto Thomaz
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Gilda Maria Bárbaro Del Negro
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Rinaldo Pôncio Mendes
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina, Botucatu, São Paulo, Brazil
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Mattos K, Rodrigues LC, Oliveira KMPD, Diniz PF, Marques LI, Araujo AA, Chang MR. Variability in the clinical distributions of Candida species and the emergence of azole-resistant non-Candida albicans species in public hospitals in the Midwest region of Brazil. Rev Soc Bras Med Trop 2017; 50:843-847. [DOI: 10.1590/0037-8682-0163-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal de Mato Grosso do Sul, Brazil; Universidade Federal de Mato Grosso do Sul, Brazil
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Conci Campos C, Franco Roriz N, Nogueira Espínola C, Aguilar Lopes F, Tieppo C, Freitas Tetila A, Volpe Chaves CE, Alexandrino de Oliveira P, Rodrigues Chang M. KPC: an important mechanism of resistance in K. pneumoniae isolates from intensive care units in the Midwest region of Brazil. J Infect Dev Ctries 2017; 11:646-651. [PMID: 31085826 DOI: 10.3855/jidc.8920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/01/2016] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Infections caused by multidrug-resistant Klebsiella pneumoniae are difficult to treat and pose a serious threat to public health worldwide. Here, we describe the presence of carbapenemase-producing K. pneumoniae in intensive care units (ICU) of three major Mato Grosso do Sul hospitals located in the Midwest region of Brazil. METHODOLOGY A total of 165 K. pneumoniae isolates with reduced susceptibility to carbapenems as identified by the VITEK-2 compact system were studied. Antimicrobial susceptibility testing was performed using the disk diffusion method, as recommended by the Clinical and Laboratory Standards Institute, and the E-test method. The detection of carbapenemase was performed using the modified Hodge test and polymerase chain reaction. RESULTS The blaKPC gene was identified in 88.1% (n=89) of the selected K. pneumoniae isolates from Beneficent Association of Campo Grande, 94.9% (n=34) of the isolates from the Regional Hospital of Mato Grosso do Sul and 95.2% (n=26) of the isolates from Maria Aparecida Pedrossian University Hospital. Resistance greater than 80% was observed against cephalosporins, aztreonam, ciprofloxacin and piperacillin/tazobactam. Carbapenemase-producing K. pneumoniae (Kp-KPC) isolates were considered important causative agents of urinary tract infections, pneumonia and bloodstream infections in ICU patients. While rarely reported in the literature, we documented three cases of meningoencephalitis caused by Kp-KPC. CONCLUSIONS Our study documents the presence of Kp-KPC in three major Mato Grosso do Sul state hospitals, providing key national epidemiology data. This is an important mechanism of resistance in K. pneumoniae isolates from ICU patients and is associated with resistance to multiple classes of antimicrobial drugs.
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Affiliation(s)
| | | | | | | | - Caroline Tieppo
- Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil.
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Ferreira KM, Rodrigues ACDS, Watanabe AC, Ferreira YM, Chang MR. First case of infection by metallo-β-lactamase-producing Pseudomonas aeruginosa in Mato Grosso do Sul, Brazil. Braz J Infect Dis 2017; 21:359-360. [PMID: 28212988 PMCID: PMC9427607 DOI: 10.1016/j.bjid.2016.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/05/2016] [Accepted: 12/10/2016] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso Sul, Laboratório de Pesquisas Microbiológicas, Campo Grande, MS, Brazil
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Alencar DDSOD, Tsujisaki RADS, Spositto FLE, Nunes MDO, Almeida AAD, Martins MDA, Melhem MDSC, Chang MR. Candidaemia due to Candida parapsilosis species complex at a hospital in Brazil: Clinical characteristics and antifungal susceptibility profile. Rev Iberoam Micol 2017; 34:106-108. [PMID: 28214273 DOI: 10.1016/j.riam.2016.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 06/20/2016] [Accepted: 06/24/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Recent decades have seen a global emergence of candidaemia caused by non-Candida albicans Candida species, particularly the Candida parapsilosis complex. AIMS To evaluate the clinical features and antifungal susceptibility profiles of isolates belonging to the C. parapsilosis species complex in patients with candidaemia in a midwestern Brazilian tertiary-care teaching hospital. METHODS Yeast identification was performed using an automated Vitek 2 Compact system. PCR-RFLP was employed for species differentiation. RESULTS Five cases of infection by C. parapsilosis sensu stricto and two by Candida orthopsilosis were found. Of the seven cases, five were adult patients undergoing haemodialysis. The only isolate of C. parapsilosis sensu stricto resistant to fluconazole (MIC=8μg/ml) was obtained from a patient on a long-term regimen with this drug. This was the only patient who evolved to death. CONCLUSIONS Resistance to antifungal agents poses a therapeutic challenge, especially for non-C. albicans Candida species, and requires continuous monitoring using susceptibility tests because resistance in vitro can be predictive of treatment failure. In the present study, in vitro antifungal susceptibility proved consistent with clinical outcome.
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Affiliation(s)
| | | | | | - Maína de Oliveira Nunes
- Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Adriana Araújo de Almeida
- Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | | | - Marilene Rodrigues Chang
- Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
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de Oliveira Nunes J, Pillon KRAP, Bizerra PL, Paniago AMM, Mendes RP, Chang MR. Erratum to: The Simultaneous Occurrence of Histoplasmosis and Cryptococcal Fungemia: A Case Report and Review of the Literature. Mycopathologia 2016; 181:899. [PMID: 27495123 DOI: 10.1007/s11046-016-0043-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joslaine de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil.
| | | | - Patrícia Lira Bizerra
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil
| | | | - Rinaldo Poncio Mendes
- Researcher of Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Marilene Rodrigues Chang
- Microbiological Research Laboratory, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Nunes JDO, Pillon KRAP, Bizerra PL, Paniago AMM, Mendes RP, Chang MR. The Simultaneous Occurrence of Histoplasmosis and Cryptococcal Fungemia: A Case Report and Review of the Literature. Mycopathologia 2016; 181:891-897. [PMID: 27423433 DOI: 10.1007/s11046-016-0036-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
Abstract
Simultaneous infections with Cryptococcus neoformans and Histoplasma capsulatum are rare and typically occur in immunocompromised individuals, particularly AIDS patients. Because both of those fungi can spur the development of latent infections, it is generally unknown which organism was first present. The diagnosis of one fungus can hide the diagnosis of the other, leading to underdiagnoses and poor prognosis. We report a case of C. neoformans and H. capsulatum co-infection. We also performed a systematic review of the literature. Our patient, a 69-year-old HIV-negative man, presented with a 9-month history of a productive cough, dyspnea and wheezing. His history showed chronic obstructive pulmonary disease and type II diabetes mellitus (DM). Pulmonary lesions of unidentified etiology were noted. Cryptococcal involvement of the central nervous system was confirmed, and C. neoformans and H. capsulatum were also isolated from blood cultures. In the literature, we found ten cases of simultaneous histoplasmosis and cryptococcosis. Including our patient, all of the cases were located in North America and Latin America, except for two, one Indian and one African diagnosed in France. AIDS was the main predisposing factor, followed by DM and age >60 years. Several diagnostic methods were employed. A blood culture and bronchoalveolar lavage (BAL) culture resulted in the growth of C. neoformans in most of the cases. H. capsulatum was more often detected in BAL and bone marrow cultures. Although co-infection by these pathogens is severe, it can be cured if it is diagnosed and treated early. We emphasized the importance of clinical suspicion and differential diagnosis of systemic mycoses.
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Affiliation(s)
- Joslaine de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil.
| | | | - Patrícia Lira Bizerra
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil
| | | | - Rinaldo Poncio Mendes
- Researcher of Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Marilene Rodrigues Chang
- Microbiological Research Laboratory, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Biberg CA, Rodrigues ACS, do Carmo SF, Chaves CEV, Gales AC, Chang MR. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil. Braz J Microbiol 2015; 46:501-4. [PMID: 26273265 PMCID: PMC4507542 DOI: 10.1590/s1517-838246246220140174] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 10/07/2014] [Indexed: 11/24/2022] Open
Abstract
The emergence of β-lactamase-producing Enterobacteriaceae in the
last few decades has become major challenge faced by hospitals. In this study,
isolates of Klebsiella pneumoniae carbapenemase-2
(KPC-2)-producing K. pneumoniae from a tertiary hospital in
Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was
performed by matrix-assisted laser desorption/ionization time-of-flight
(MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory
concentrations of carbapenems were determined using the agar dilution method as
recommended by the Clinical Laboratory Standards Institute guidelines.
Carbapenemase production was detected using the modified Hodge test (MHT) and
polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%)
K. pneumoniae isolates obtained between May 2009 and May
2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates,
thirty-six K. pneumoniae isolates that were positive by MHT and
PCR carried the blaKPC-2 gene.
Thus, KPC-2producing Klebsiella pneumoniae has been present in
a Brazilian hospital located in the Midwest region since at least 2009.
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Affiliation(s)
- Camila Arguelo Biberg
- Universidade Federal de Mato Grosso do Sul, Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Ana Claudia Souza Rodrigues
- Hospital Regional de Mato Grosso do Sul, Campo Grande, MS, Brasil, Laboratório de Microbiologia do Hospital Regional Rosa Pedrossian de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Sidiane Ferreira do Carmo
- Hospital Regional de Mato Grosso do Sul, Campo Grande, MS, Brasil, Laboratório de Microbiologia do Hospital Regional Rosa Pedrossian de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Claudia Elizabeth Volpe Chaves
- Hospital Regional de Mato Grosso do Sul, Campo Grande, MS, Brasil, Comissão de Controle de Infecção Hospitalar, Hospital Regional Rosa Pedrossian de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Ana Cristina Gales
- Universidade Federal de São Paulo, Laboratório Alerta, Divisão de Doenças Infecciosas, Universidade Federal de São Paulo, São Paulo, SP, Brasil, Laboratório Alerta, Divisão de Doenças Infecciosas, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Gauna TT, Oshiro E, Luzio YC, Paniago AMM, Pontes ERJC, Chang MR. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil. Rev Soc Bras Med Trop 2014; 46:426-32. [PMID: 23970309 DOI: 10.1590/0037-8682-0060-2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 07/10/2013] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI) and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. METHODS A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. RESULTS Fifty-nine patients were evaluated. Thirty-fi ve (59.3%) patients started dialysis due to urgency, 37 (62.7%) had BSI, and 12 (20%) died. Hyperemia at the catheter insertion site (64.9%) was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases), non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes), and Candida species (6). Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. CONCLUSIONS Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.
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Affiliation(s)
- Tamara Trelha Gauna
- Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Groso do Sul, Campo Grande, MS.
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Gouveia EMMF, Silva IS, Nakazato G, Onselem VJV, Corrêa RAC, Araujo FR, Chang MR. Action of phosphorylated mannanoligosaccharides on immune and hematological responses and fecal consistency of dogs experimentally infected with enteropathogenic Escherichia coli strains. Braz J Microbiol 2013; 44:499-504. [PMID: 24294246 PMCID: PMC3833152 DOI: 10.1590/s1517-83822013000200027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 09/10/2012] [Indexed: 11/21/2022] Open
Abstract
The therapeutic action of phosphorylated mannanoligosaccharides (MOS) was investigated regarding its prebiotic activity on enteropathogenic Escherichia coli (EPEC). Diarrhea was induced in dogs by experimental infection with EPEC strains. Then MOS was supplied once a day, in water for 20 days. Immunological (IgA and IgG), hematological (lymphocytes, neutrophils and monocytes) and bacteriological variables (PCR detection of the eae gene of EPEC recovered from stool culture), as well as occurrence of diarrhea were evaluated. All strains caused diarrhea at 24, 48 and 72 h after infection. PCR results indicated that E. coli isolated from stool culture of all infected animals had the eae gene. There was no significant difference among groups as to number of blood cells in the hemogram and IgA and IgG production. MOS was effective in recovering of EPEC-infected dogs since prebiotic-treated animals recovered more rapidly from infection than untreated ones (p < 0.05). This is an important finding since diarrhea causes intense dehydration and nutrient loss. The use of prebiotics for humans and other animals with diarrhea can be an alternative for the treatment and prophylaxis of EPEC infections.
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Affiliation(s)
- E M M F Gouveia
- Programa de Pós-Graduação em Saúde e Desenvolvimento para a Região Centro-Oeste, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Xavier PCN, Chang MR, Paula CR, Matsumoto FE, Asensi MD, Matos MDFC, Andreotti R. Molecular characterization of Candida spp. isolates from patients with bloodstream infections. Rev Soc Bras Med Trop 2013; 46:786-7. [PMID: 24142366 DOI: 10.1590/0037-8682-1718-2013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 07/25/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to conduct an epidemiological study comparing the genetic similarity of yeasts isolated from blood cultures. METHODS Random amplification of polymorphic DNA (RAPD) techniques were used for the Candida samples obtained from patients at the Hospital Universitário da Universidade Federal do Mato Grosso do Sul (HU/UFMS) in Campo Grande, State of Mato Grosso do Sul, Brazil, from 1998-2000. RESULTS The most frequently isolated species was Candida albicans (45.8%). DNA amplification from genomic yeast isolates indicated a genetic similarity of over 90%. CONCLUSIONS The RAPD profiles obtained were able to differentiate between the isolated Candida species, thereby suggesting that the method might be useful in epidemiological studies.
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Chang MR, Biberg CA, Lopes FA, Tetila AF, Pignatari ACC. The first report of infection with Klebsiella pneumoniae carrying the bla kpc gene in State of Mato Grosso do Sul, Brazil. Rev Soc Bras Med Trop 2013; 46:114-5. [DOI: 10.1590/0037-868215502013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 05/25/2012] [Indexed: 11/21/2022] Open
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Kim JY, Oh S, Chang MR, Cho YG, Park KH, Paek YJ, Yoo SH, Cho JJ, Caterson ID, Song HJ. Comparability and utility of body composition measurement vs. anthropometric measurement for assessing obesity related health risks in Korean men. Int J Clin Pract 2013; 67:73-80. [PMID: 23241051 DOI: 10.1111/ijcp.12038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Obesity is commonly assessed by body mass index (BMI) of which limitations come from an inability to distinguish body fat mass from lean mass. Several anthropometric measurements, including BMI, waist circumference, waist-to-height ratio and waist-to-hip ratio have been used to predict metabolic syndrome. The purpose of this study was to evaluate the utility of FMI or BF% combined with previous known anthropometric indices to assess the risk of metabolic syndrome in clinical practice. METHODS In 5534 men visiting a hospital for health check-ups, blood tests, anthropometric measurements and body composition analysis using BIA were performed. Logistic regression analysis was performed to compare the odds ratios for metabolic syndrome and each component of metabolic syndrome among BMI, waist-to-height ratio, waist-to-hip ratio, FMI and BF%. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) for metabolic syndrome was compared between several measurements. The net reclassification improvement with integrated discrimination improvement was used for assessing value of body composition measurement. RESULTS The adjusted odds ratios of metabolic syndrome was 1.80 (95% CI, 1.71-1.89) for FMI and 1.15 (95% CI, 1.13-1.17) for BF%. Odds ratio of each metabolic component was highest for FMI among several anthropometric and body composition measurements. AUCs using the ROC curve for metabolic syndrome was highest for waist-to-height ratio, 0.823 (95% CI, 0.808-0.837) by National Cholesterol Education Program criteria. FMI caused a mild increase in integrated discrimination improvement when combined with waist-to-height ratio. CONCLUSIONS Waist-to-height ratio seems to be the best screening tool for evaluating metabolic syndrome in Korean men, and adding FMI could result in a modest increase in integrated discrimination improvement.
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Affiliation(s)
- J Y Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seoul, Korea
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Violante IMP, Hamerski L, Garcez WS, Batista AL, Chang MR, Pott VJ, Garcez FR. Antimicrobial activity of some medicinal plants from the cerrado of the centralwestern region of Brazil. Braz J Microbiol 2012; 43:1302-8. [PMID: 24031956 PMCID: PMC3769025 DOI: 10.1590/s1517-83822012000400009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 01/17/2012] [Accepted: 06/07/2012] [Indexed: 11/21/2022] Open
Abstract
Ethanol extracts from six selected species from the Cerrado of the Central-Western region of Brazil, which are used in traditional medicine for the treatment of infectious diseases and other medical conditions, namely Erythroxylum suberosum St. Hil. (Erythroxylaceae), Hyptis crenata Pohl. ex Benth. (Lamiaceae), Roupala brasiliensis Klotz. (Proteaceae), Simarouba versicolor St. Hil. (Simaroubaceae), Guazuma ulmifolia Lam. (Sterculiaceae) and Protium heptaphyllum (Aubl.) March. (Burseraceae), as well as fractions resulting from partition of these crude extracts, were screened in vitro for their antifungal and antibacterial properties. The antimicrobial activities were assessed by the broth microdilution assay against six control fungal strains, Candida albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis and Cryptococcus neoformans, and five control Gram-positive and negative bacterial strains, Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Toxicity of the extracts and fractions against Artemia salina was also evaluated in this work. All plants investigated showed antimicrobial properties against at least one microorganism and two species were also significantly toxic to brine shrimp larvae. The results tend to support the traditional use of these plants for the treatment of respiratory and gastrointestinal disorders and/or skin diseases, opening the possibility of finding new antimicrobial agents from these natural sources. Among the species investigated, Hyptis crenata, Erythroxylum suberosum and Roupala brasiliensis were considered the most promising candidates for developing of future bioactivity-guided phytochemical investigations.
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Affiliation(s)
- Ivana Maria Póvoa Violante
- Departamento de Química, Universidade Federal de Mato Grosso do Sul , Campo Grande, MS , Brasil ; Departamento de Farmácia, Universidade de Cuiabá , Cuiabá, MT , Brasil
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Gouveia EMF, Silva IS, Nakazato G, Araujo FRD, Chang MR. Experimental infection with enteropathogenic Escherichia coli identified by PCR using enteric-coated capsules in boxer pups. Acta Cir Bras 2012; 26:144-8. [PMID: 21445479 DOI: 10.1590/s0102-86502011000200013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 12/21/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To verify the possibility of an experimental infection with enteropathogenic Escherichia coli and to confirm by PCR that the symptoms manifested after infection were due to the virulence factors of the studied bacteria. METHODS Experimental units were 14 healthy pups of Boxer breed, aged 60 days. The animals were divided into three groups. One animal from each litter was included in a control group and the remaining animals were divided into two groups: one inoculated with strain 4083, and another one inoculated with strain SPA14. Gelatinous capsules coated with enteric-coating solution were used for the inoculation of strains. E. coli isolation from feces was performed for all tested animals, and the extracted DNA was subjected to Polymerase Chain Reaction (PCR). RESULTS All infected animals presented diarrhea and had the gene eae amplified by PCR. CONCLUSION The efficiency of PCR for the studied strains indicates that this technique can be recommended for the diagnosis of enteropathogenic Escherichia coli as a differential from other pathogens causing diarrhea. It may also be used in the future to verify whether other virulence factors (bfpA gene and EAF plasmid) persist after infection and to assess the pathogenicity of these bacteria.
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Rodrigues ACS, Chang MR, Nóbrega GD, Rodrigues MS, Carvalho NCP, Gomes BG, Almeida DLD, Carvalho KR, Asensi MD. Metallo-β-lactamase and genetic diversity of Pseudomonas aeruginosa in intensive care units in Campo Grande, MS, Brazil. Braz J Infect Dis 2011; 15:195-9. [PMID: 21670916 DOI: 10.1016/s1413-8670(11)70174-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 12/21/2010] [Indexed: 10/27/2022] Open
Abstract
Infection by Pseudomonas aeruginosa has spread worldwide, with limited options for treatment. The purpose of this study was to investigate metallo-β-lactamase-producing P. aeruginosa strains and compare their genetic profile using samples collected from patients in intensive care units. Forty P. aeruginosa strains were isolated from two public hospitals in Campo Grande, Mato Grosso do Sul State, from January 1st, 2007 to June 31st, 2008. Profiles of antimicrobial susceptibility were determined using the agar diffusion method. Metallo-β-lactamase was investigated using the double-disk diffusion test and PCR. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Respiratory and urinary tracts were the most common isolation sites. Of the 40 samples tested, 72.5% (29/40) were resistant to ceftazidime and 92.5% (37/40) to imipenem, whereas 65% (26/40) were resistant to both antimicrobials. Fifteen pan-resistant samples were found. Five percent (2/40) of samples were positive for metallo-β-lactamase on the phenotype test. No metallo-β-lactamase subtype was detected by PCR. Macrorestriction analysis revealed 14 distinct genetic patterns. Based on the superior accuracy of PCR, it can be inferred that P. aeruginosa isolates from the investigated hospitals have alternative mechanisms of carbapenem resistance. The results also suggest clonal spread of P. aeruginosa between the studied hospitals.
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Affiliation(s)
- Ana Claudia Souza Rodrigues
- Health and Development Post-graduation Program, Central-West Region, Universidade Federal de Mato Grosso do Sul, MS, Brazil.
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Rodrigues ACS, Chang MR, Nóbrega GD, Rodrigues MS, Carvalho NCP, Gomes BG, Almeida DLD, Carvalho KR, Asensi MD. Metallo-β-lactamase and genetic diversity of Pseudomonas aeruginosa in intensive care units in Campo Grande, MS, Brazil. Braz J Infect Dis 2011. [DOI: 10.1590/s1413-86702011000300002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chang MR, Correia FP, Costa LC, Xavier PCN, Palhares DB, Taira DL, Paniago AMM, Pontes ERJC, Machado VE. Candida bloodstream infection: data from a teaching hospital in Mato Grosso do Sul, Brazil. Rev Inst Med Trop Sao Paulo 2009; 50:265-8. [PMID: 18949342 DOI: 10.1590/s0036-46652008000500003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 08/06/2008] [Indexed: 11/22/2022] Open
Abstract
The incidence of Candida bloodstream infection has increased over the past years. In the Center-West region of Brazil, data on candidemia are scarce. This paper reports a retrospective analysis of 96 cases of Candida bloodstream infection at a Brazilian tertiary-care teaching hospital in the state of Mato Grosso do Sul, from January 1998 to December 2006. Demographic, clinical and laboratory data were collected from medical records and from the hospital's laboratory database. Patients' ages ranged from three days to 92 years, with 53 (55.2%) adults and 43 (44.8%) children. Of the latter, 25 (58.1%) were newborns. The risk conditions most often found were: long period of hospitalization, utilization of venous central catheter, and previous use of antibiotics. Fifty-eight (60.4%) patients died during the hospitalization period and eight (13.7%) of them died 30 days after the diagnosis of candidemia. Candida albicans (45.8%) was the most prevalent species, followed by C. parapsilosis (34.4%), C. tropicalis (14.6%) and C. glabrata (5.2%). This is the first report of Candida bloodstream infection in the state of Mato Grosso do Sul and it highlights the importance of considering the possibility of invasive Candida infection in patients exposed to risk factors, particularly among neonates and the elderly.
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Affiliation(s)
- Marilene Rodrigues Chang
- Department of Pharmacy-Biochemistry, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
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Brustoloni YM, Chang MR, Lyrio de Oliveira AL, Silva de Alexandre A. Trichuris trichiura eggs found in oral mucosal lesions in a child in Brazil. Parasitol Int 2009; 58:98-100. [PMID: 18848902 DOI: 10.1016/j.parint.2008.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 08/24/2008] [Accepted: 09/05/2008] [Indexed: 10/21/2022]
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Xavier PCN, Chang MR, Nunes MO, Palhares DB, Silva RAE, Bonfim GF, Almeida Júnior NF. Candidemia neonatal, em hospital público do Mato Grosso do Sul. Rev Soc Bras Med Trop 2008; 41:459-63. [DOI: 10.1590/s0037-86822008000500005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 08/27/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo de nosso estudo foi realizar tipagem molecular de 25 amostras clínicas de Candida spp, isoladas de crianças com candidemia, internadas na unidade de terapia intensiva neonatal de um Hospital Universitário entre 1998 a 2006. Dados demográficos e clínicos foram obtidos de prontuários para conhecimento dos aspectos clínicos e epidemiológicos. Identificação das leveduras foi feita por método convencional e a susceptibilidade antifúngica por método de microdiluição. O perfil genético foi determinado pela técnica de RAPD-PCR. Candida albicans (11; 44%) e Candida parapsilosis (10; 40%) foram as mais isoladas. Dezessete (68%) dos recém-nascidos tinham peso inferior a 1.500g. Prematuridade (92%), uso de cateter venoso central (100%), foram as condições de risco mais associados. Dezenove (76%) pacientes foram a óbito. Apenas uma cepa de Candida parapsilosis, mostrou ser sensível dose dependente ao fluconazol. Na análise molecular, foram observados 11 padrões genéticos distintos. Somente em dois casos foi observada relação epidemiológica, sugerindo mesma fonte de infecção.
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Lindenberg ADSC, Chang MR, Paniago AMM, Lazéra MDS, Moncada PMF, Bonfim GF, Nogueira SA, Wanke B. Clinical and epidemiological features of 123 cases of cryptococcosis in Mato Grosso do Sul, Brazil. Rev Inst Med Trop Sao Paulo 2008; 50:75-8. [DOI: 10.1590/s0036-46652008000200002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 02/01/2008] [Indexed: 11/22/2022] Open
Abstract
To identify the clinical and epidemiological profile of cryptococcosis diagnosed at the University Hospital of the Federal University of Mato Grosso do Sul, Brazil, medical records of 123 patients admitted from January 1995 to December 2005 were analyzed. One hundred and four cases (84.5%) had HIV infection, six (4.9%) had other predisposing conditions and 13 (10.6%) were immunocompetent. Male patients predominated (68.3%) and their age ranged from 19 to 69 years (mean: 35.9). Most patients (73.2%) were born and lived lifelong in the state of Mato Grosso do Sul. Involvement of the central nervous system occurred in 103 patients (83.7%) and headache and vomiting were the most frequent symptoms. In 77 cases it was possible to identify the Cryptococcus species: 69 (89.6%) C. neoformans and eight (10.4%) C. gattii. Amphotericin B was the drug of choice for treatment (106/123), followed by fluconazole in 60% of cases. The overall lethality rate was 49.6%, being 51% among the HIV infected patients and 41.2% among the non-HIV infected (p > 0.05). Although cryptococcosis exhibited in our region a similar behavior to that described in the literature, the detection of an important rate of immunocompetent individuals and five C. gattii cryptococcosis in HIV-infected patients is noteworthy.
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Chang MR, Lee DJ, Lai JY. Nanoparticles in wastewater from a science-based industrial park - coagulation using polyaluminum chloride. J Environ Manage 2007; 85:1009-14. [PMID: 17202026 DOI: 10.1016/j.jenvman.2006.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Revised: 10/28/2006] [Accepted: 11/06/2006] [Indexed: 05/13/2023]
Abstract
The Hsinchu Science-based Industrial Park (HSIP) is the hi-tech manufacturing hub of Taiwan. Wastewater from the HSIP contains numerous nano-sized silicate particles whose size distributions peak at 2 and 90 nm. A 3-5 mg l(-1) as Al dose of polyaluminum chloride (PACl) was used in the field to coagulate these particles, but the removal efficiency was low. Laboratory scale tests indicated that although PACl coagulation removed 52% of the turbidity and 48% of the chemical oxygen demand (COD) from water, its effect on nano-particle removal was minimal. About 58% of the soluble COD was associated with colloidal Si particles. A light scattering test and transmission electron microscopy (TEM) demonstrated that the nano-particles agglomerated in approximately linear aggregates of sizes 100-300 nm. Prolonged contact between residual PACl and the nano-particles generated large aggregates with sizes of up to 10 microm and a fractal dimension of 2.24-2.63. The results presented herein should be of interest in the processing of "high-tech" wastewater that contains nanosized silica particles.
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Affiliation(s)
- M R Chang
- Department of Chemical Engineering, National Taiwan University, Taipei 10617, Taiwan
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Chang MR, Taira CL, Paniago AMM, Taira DL, Cunha RV, Wanke B. Study of 30 cases of histoplasmosis observed in the Mato Grosso do Sul State, Brazil. Rev Inst Med Trop Sao Paulo 2007; 49:37-9. [PMID: 17384818 DOI: 10.1590/s0036-46652007000100007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Accepted: 08/14/2006] [Indexed: 11/22/2022] Open
Abstract
Thirty cases of histoplasmosis observed at the University Hospital of the Federal University of Mato Grosso do Sul (HU-UFMS) from January 1998 to December 2005 are reported. Most (83.3%) of the patients were men, average 33.4 years old, 63.3% of them were born and living in Mato Grosso do Sul and 83.3% presented AIDS as an underlying disease. In almost all cases (96.7%) the disease occurred in its disseminated form and the most frequent clinical manifestations were: fever (83.3%), weight loss (70.0%), cough (63.3%), hepatomegaly and splenomegaly (40.0%), and lymph node enlargement (36.7%). The laboratory diagnosis was obtained in 29 patients by isolation of Histoplasma capsulatum from various clinical specimens cultivated in Sabouraud dextrose and brain heart infusion agar and in 16 patients the fungus was observed by direct microscopy of Giemsa-stained smears. The observed mortality was 40%. This is the first report in the literature of the occurrence of histoplasmosis in Mato Grosso do Sul State.
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Paniago AMM, de Oliveira PA, Aguiar ESA, Aguiar JIA, da Cunha RV, Leme LM, Salgado PR, Domingos JA, Ferraz RL, Chang MR, Bóia MN, Wanke B. Neuroparacoccidioidomycosis: analysis of 13 cases observed in an endemic area in Brazil. Trans R Soc Trop Med Hyg 2007; 101:414-20. [PMID: 17011605 DOI: 10.1016/j.trstmh.2006.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2006] [Revised: 07/29/2006] [Accepted: 07/31/2006] [Indexed: 10/24/2022] Open
Abstract
The epidemiological, clinical and laboratory features of 13 cases of neuroparacoccidioidomycosis (NPCM) were analysed. All patients were men, with a mean age of 41.6 years. The lungs were involved in 11 cases (84.6%) and only two cases had mycosis limited to the central nervous system. Co-morbidity was observed in four patients (malignant neoplasm in three and diabetes mellitus in one). The most frequent neurological manifestations were paresis (eight cases), headache (five cases) and gait disturbance (four cases). Neuroimaging diagnosis showed a predominance of multiple round lesions with ring enhancement following contrast medium injection. Lesions were seen in the brain hemispheres (nine cases), thalamus (nine cases), cerebellum (four cases), brainstem (four cases) and spinal cord (four cases). Most cases responded well to therapy. Lesions with enhancement following contrast medium injection persisted in four patients for a period of 6 months to 8 years. These findings emphasize the importance of considering NPCM in the differential diagnosis of brain and spinal cord lesions in endemic areas of paracoccidioidomycosis.
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Chang MR, Carvalho NCP, Oliveira ALL, Moncada PMF, Moraes BA, Asensi MD. Surveillance of pediatric infections in a teaching hospital in Mato Grosso do Sul, Brazil. Braz J Infect Dis 2003; 7:149-60. [PMID: 12959687 DOI: 10.1590/s1413-86702003000200009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nosocomial infections (NI) result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE). Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38), Pseudomonas aeruginosa (19), S. aureus (26), K. pneumoniae (18), and Candida spp. (13). The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4%), prematurity (60.9%) and exposure to high-risk device procedures (95.4%). Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23% of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains.
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Affiliation(s)
- M R Chang
- Federal University of Mato Grosso do Sul, Campo Grande/MS, Brazil.
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Abstract
The involvement of the central nervous system in paracoccidioidomycosis and its meningeal form of clinical presentation have rarely been described. This is a case report of a 23 years old man who developed paracoccidioidomycosis meningitis achieved by fungus' presence in direct research and culture of cerebrospinal fluid. The meningeal form of paracoccidioidomycosis, its laboratorial and imaging diagnostic are discussed, and the importance of the routine investigation of the fungus is emphasized.
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Affiliation(s)
- Paulo Jos Lorenzoni
- Hospital Univesitário, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.
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Le HH, Chang MR, Cheng Q, Lee DA, Hartenbaum D. The effectiveness and safety of dorzolamide 2% in addition to multiple topical antiglaucoma medications. J Ocul Pharmacol Ther 1999; 15:305-12. [PMID: 10463869 DOI: 10.1089/jop.1999.15.305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dorzolamide is the first commercial topical carbonic anhydrase inhibitor approved by the Food and Drug Administration (FDA) for the treatment of glaucoma. In a prospective, open label, uncontrolled study on 245 glaucoma patients, dorzolamide significantly lowered the intraocular pressure at least 14% when used alone or in combination with one, two, or three other antiglaucoma medications over ten weeks. There were very few adverse reactions to dorzolamide. Dorzolamide is effective and safe when used alone or in combination with other topical antiglaucoma medications for the treatment of glaucoma.
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Affiliation(s)
- H H Le
- Jules Stein Eye Institute, University of California at Los Angeles, 90095-7004, USA
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Chang MR, Cury AE. Amphotericin B-metronidazole combination against Candida spp. Rev Iberoam Micol 1998; 15:78-80. [PMID: 17655414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Interaction between amphotericin B and metronidazole was studied against Candida albicans, Candida tropicalis, Candida parapsilosis, Candida krusei, and Candida lusitaniae strains. Minimum inhibitory concentrations (MICs) of the drugs alone and in combination were determined by means of the checkerboard method on YNB supplemented agar. Minimum fungicidal concentrations (MFCs) were determined on Sabouraud dextrose agar. Based on the MIC and MFC values, fractionary indices were determined respectively for inhibitory and lethal activities of the amphotericin B-metronidazole combination. These indices showed occurrence of additive and synergistic interactions between the drugs, but the synergysm was predominant against the studied strains.
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Affiliation(s)
- M R Chang
- Faculdade de Ciências Farmacêuticas da Universidade de São Paulo, Brasil
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Abstract
Success of glaucoma filtration surgery is influenced by the wound healing response. Attention has been focused on pharmacological agents to control a process that leads to excessive scarring and eventual failure of glaucoma filtration surgery. Several agents, including 5-fluorouracil and mitomycin C, as well as other antiproliferative drugs will be discussed. Newer antifibrotic agents and novel drug delivery systems are under development in tissue culture and animal models in an effort to improve efficacy and safety. This article summarizes current treatment modalities and future prospects to prevent excessive wound healing and improve the success of glaucoma filtration surgery.
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Affiliation(s)
- M R Chang
- Jules Stein Eye Institute, Department of Opthalmology, UCLA School of Medicine, Los Angeles, California 90095-7004, USA
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Takeuchi Y, Kitaomo M, Chang MR, Shirasaka S, Shimamura C, Okuno Y, Yamato M, Harayama T. Synthesis and antitumor activity of fused quinoline derivatives. V. Methylindolo[3,2-b]quinolines. Chem Pharm Bull (Tokyo) 1997; 45:2096-9. [PMID: 9433781 DOI: 10.1248/cpb.45.2096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Indolo[3,2-b]quinoline derivatives (1b-i) with a methyl group at each possible position have been synthesized. The 1-methyl (1b) and 9-methyl (1i) derivatives were inactive, but the 3-methyl (1d), 4-methyl (1e), and 6-methyl (1f) derivatives exhibited high treatment/control (T/C) value and cure rates against leukemia P388 in mice. These results indicated that modification of indolo[3,2-b]quinoline derivatives at 3, 4, and 6 positions may be useful approach for lead optimization.
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Affiliation(s)
- Y Takeuchi
- Faculty of Pharmaceutical Sciences, Okayama University, Japan
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Galati EA, Nunes VL, Rego Júnior FDA, Oshiro ET, Chang MR. [Phlebotomines (Diptera: Psychodidae) focusing visceral leishmaniasis in the State of Mato Grosso do Sul, Brazil]. Rev Saude Publica 1997; 31:378-90. [PMID: 9595767 DOI: 10.1590/s0034-89101997000400007] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION In the Americas, Lutzomyia longipalpis has been incriminated as the vector of visceral leishmaniasis in almost all the areas in which this disease has been reported. The notification of human cases of visceral leishmaniasis and the presence of dogs with an appearance suggestive of the disease in the country of Corumbá, Mato Grosso do Sul State, Brazil, led us to undertake an entomological investigation in this area, for the purpose of identifying the phlebotomine vector. MATERIAL AND METHOD The county of Corumbá is located in the Pantanal region and its urban area is situated at 18 degrees 59' 44" South and 57 degrees 39' 16" West. The research project was carried out in peri and intradomiciliary environments, in three urban districts, one of which was central and the other two on the outskirts, and in a cave situated outside the urban perimeter. Most of the captures were made weekly with light automatic traps, in the period from February 1984 to December 1986. Meteorological data for this period were obtained from the city's meteorological station and those for the period from 1925 to 1982 from the literature. RESULTS The urban phlebotomine fauna consisted of eight species and was similar to that of the cave, except that in the latter the species were more abundant. Lutzomyia cruzi was predominant in the peri and intradomiciliary environments. Its prevalence in the central district was of 90.3% and lower in the outskirts. Lu. forattinii presented considerable prevalence (39.0%) in one of the outlying districts too. In the cave, Lu. corumbaensis was the predominant species, followed by Lu. sordellii, Lu. forattinii, Lu. peresi and Lu. cruzi. The impact of the climatic condition and the action of insecticides in the urban area on the frequency of the species, as well as the use of the cave as a breeding ground by the phlebotomines, in view of the changes in the sex rate, are commented. Data on anthropophily and captures of Lu. forattinii using dog bait have been added. CONCLUSION The predominance of Lu. cruzi in the urban area; the great prevalence of Lu. forattinii in most of the outlying areas studied and the anthropophily of this latter species, as well as the strong affinity of these species with Lu. longipalpis, the main vector of visceral leishmaniais in other areas of the Americas, suggest the participation of both in the transmission of the disease in Corumbá.
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Affiliation(s)
- E A Galati
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Brasil.
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Takeuchi Y, Oda T, Chang MR, Okamoto Y, Ono J, Oda Y, Harada K, Hashigaki K, Yamato M. Synthesis and antitumor activity of fused quinoline derivatives. IV. Novel 11-aminoindolo[3,2-b]quinolines. Chem Pharm Bull (Tokyo) 1997; 45:406-11. [PMID: 9118455 DOI: 10.1248/cpb.45.406] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Indolo[3,2-b]quinoline derivatives (1) having various amine moieties were prepared and their antitumor activities against P388 leukemia in mice were evaluated, for the purpose of gaining an insight into the role of the amine moiety in the antitumor activity and searching for an effective amine moiety. Introduction of a methylene group between the phenyl group and amino or methanesulfonamido group resulted in decrease or loss of activity.
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Affiliation(s)
- Y Takeuchi
- Faculty of Pharmaceutical Sciences, Okayama University, Japan
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Danciger M, Kozak CA, Suzuki S, Chang MR, Shinohara T, Farber DB. Transcription factor IID probes localize a single gene to the proximal region of mouse chromosome 17. Gene X 1993; 130:283-6. [PMID: 8359696 DOI: 10.1016/0378-1119(93)90432-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
We have used a 5' fragment of the gene GTF2D, which encodes human transcription factor IID, and Chinese hamster-mouse somatic cell hybrids to map the murine homologue, Gtf2d, to a single locus on mouse chromosome 17 (Chr 17). Linkage analysis of progeny from an interspecific backcross localized the gene near the marker D17Leh66 in the proximal region of Chr 17.
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Affiliation(s)
- M Danciger
- Jules Stein Eye Institute, UCLA School of Medicine 90024
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Takeuchi Y, Chang MR, Hashigaki K, Tashiro T, Tsuruo T, Tsukagoshi S, Yamato M. Synthesis and antitumor activity of fused quinoline derivatives. III. Novel N-glycosylamino-indolo[3,2-b]quinolines. Chem Pharm Bull (Tokyo) 1992; 40:1481-5. [PMID: 1394666 DOI: 10.1248/cpb.40.1481] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Novel indolo[3,2-b]quinolines (1b-k), having a nitro, amino, acetamido, methanesulfonamido, or glycosylamino group at the 2, 7, or 8-position, were prepared and their antitumor activities against P388 leukemia in mice were examined. The 7-galactopyranosylamino derivative (1g) showed the most potent activity (optimal dose = 25 mg/kg, T/C greater than 333%, cure rate 5/6).
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Affiliation(s)
- Y Takeuchi
- Faculty of Pharmaceutical Sciences, Okayama University, Japan
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