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| Author(s): |
Andrei Nicoli Gebieluca Dabul
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Carlos. |
| Institution: | Universidade de São Paulo (USP). Instituto de Física de São Carlos (IFSC/BT) |
| Defense date: | 2014-02-17 |
| Examining board members: |
Ilana Lopes Baratella da Cunha Camargo;
Ana Lucia da Costa Darini;
Elsa Masae Mamizuka;
Luciene Andrade da Rocha Minarini;
Bento Vidal de Moura Negrini
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| Advisor: | Ilana Lopes Baratella da Cunha Camargo; Glaucius Oliva |
| Abstract | |
S. aureus is a pathogen that always surprises the medical staff regarding its capability to resist to the newest drugs marketed, in a short period of time. Some genetic changes which might cause the emergence of VISA were previously identified, among them a mutation on the twocomponent system GraRS. The proteins GraR and GraR*, the last one with the mutation that would lead to the VISA phenotype, were studied aiming to solve the tridimensional structure of both and determine their role on the process of vancomycin resistance. Cloning, expression, protein purification and circular dichroism experiments were performed, however, the crystallization was not successful. In the epidemiological study PFGE distributed the 36 isolates (25 from infection sites and 11 from colonization) from a hospital in Minas Gerais in 8 pulsotypes. Analysis of MLST and SCCmec of pulsotype A (58.3% of all samples) showed that the isolates belonged to CC5 (ST5 and ST105) and harbored SCCmecII. All three ST239 harbored SCCmecIII, being related to Brazilian Endemic Clone (BEC). Most ST5 isolates harbored SCCmecII as the NY/J clone. It was observed 24% of resistance to tigecycline on the infection sites isolates. On microdilution, 2 isolates were susceptible to daptomycin after 24 hours of incubation, but resistant after 48 hours. Tigecycline-resistants were all ST105-SCCmecII and were isolated from 5 different patients. Daptomycin-resistants were ST5-SCCmecII, from different patients, and they presented some mutations on the gene rpoB. A change in the prevalent lineage of the Brazilian hospitals has been reported and, in fact, the clone BEC was not prevalent in this hospital in 2009. ST5-SCCmecII and ST105-SCCmecII were prevalent, and also, the last one presents the aggravating factor of tigecycline resistance when this drug was not used in the hospital. However, there was no dissemination of only one pulsotype, suggesting these lineages to be endemic to the hospital. Knowledge of the profile of the local lineages helps on the adequation of empiric treatment given to the patients, besides demonstrating that care is needed on administering new drugs indiscriminately to avoid selection of the more resistant clones. (AU) | |
| FAPESP's process: | 10/11890-9 - Molecular epidemiologic study of Methicillin-Resistant Staphylococcus aureus (MRSA) isolated in Brazil and study of the response regulator protein GraR |
| Grantee: | Andrei Nicoli Gebieluca Dabul Dias de Sousa |
| Support Opportunities: | Scholarships in Brazil - Doctorate (Direct) |