Melise Silveira Nunes

INVESTIGATION OF BIOFILM FORMATION IN COAGULASE-NEGATIVE STAPHYLOCOCCI ISOLATED FROM PLATELET CONCENTRATE BAGS

Platelet Concentrates (PCs) are the blood components with the highest rate of bacterial contamination, and coagulase-negative staphylococci (CoNS) are the most frequently isolated contaminants. This study investigated the biofilm formation of 16 contaminated units out of 691 PCs tested by phenotypic and genotypic methods. Adhesion in Borosilicate Tube (ABT) and Congo Red Agar (CRA) tests were used to assess the presence of biofilm. The presence of icaADC genes was assessed by means of the Polymerase Chain Reaction (PCR) technique. With Vitek(r)2, Staphylococcus haemolyticus was considered the most prevalent CoNS (31.25%). The CRA characterized 43.8% as probable biofilm producers, and for the ABT test, 37.5%. The icaADC genes were identified in seven samples by the PCR. The ABT technique showed 85.7% sensitivity and 100% specificity when compared to the reference method (PCR), and presented strong agreement (k = 0.8). This study shows that species identified as PCs contaminants are considered inhabitants of the normal skin flora and they might become important pathogens. The results also lead to the recommendation of ABT use in laboratory routine for detecting biofilm in CoNS contaminants of PCs.

Staphylococcal scalded skin syndrome in a premature newborn caused by methicillin-resistant Staphylococcus aureus: case report

CONTEXT Staphylococcal scalded skin syndrome is an exfoliative skin disease. Reports of this syndrome in newborns caused by methicillin-resistant Staphylococcus aureus are rare but, when present, rapid diagnosis and treatment is required in order to decrease morbidity and mortality. CASE REPORT A premature newly born girl weighing 1,520 g, born with a gestational age of 29 weeks and 4 days, developed staphylococcal scalded skin syndrome on the fifth day of life. Cultures on blood samples collected on the first and fourth days were negative, but Pseudomonas aeruginosa and Enterococcus sp. (vancomycin-sensitive) developed in blood cultures performed on the day of death (seventh day), and Pseudomonas aeruginosa and Serratia marcescens were identified in cultures on nasopharyngeal, buttock and abdominal secretions. In addition to these two Gram-negative bacilli, methicillin-resistant Staphylococcus aureus was isolated in a culture on the umbilical stump (seventh day). The diagnosis of staphylococcal scalded skin syndrome was based on clinical criteria.

Necrotizing fasciitis caused by Streptococcus agalactiae in a diabetic patient - case report

OBJETIVOS: Descrever um caso de fasciite necrosante e choque septico ocasionado por Streptococcus agalactiae, que acometeu uma paciente com diabetes mellitus. Esta analise foi realizada atraves dos dados do prontuario e resultados de exames laboratoriais da paciente, que estava internada no Hospital Universitario de Santa Maria, em Santa Maria, Rio Grande do Sul. DESCRICAO DO CASO: Paciente do genero feminino, 73 anos, diagnosticada com diabetes mellitus e cirrose micronodular, foi internada com suspeita de septicemia, simultânea a uma infeccao no membro inferior esquerdo, cuja hipotese diagnostica inicial foi de celulite. Pelas caracteristicas do quadro clinico, foi feito o diagnostico de fasciite necrosante. Hemoculturas de dois sitios diferentes positivaram para S. agalactiae. A paciente foi a obito por choque septico. CONCLUSOES: O relato deste caso enfatiza a gravidade da fasciite necrosante, que pode ocorrer principalmente em pacientes portadores de fatores predisponentes como diabetes mellitus e cirrose.Objetivos: Descrever um caso de fasciite necrosante e choque septico ocasionado por Streptococcus agalactiae, que acometeu uma paciente com diabetes mellitus. Esta analise foi realizada atraves dos dados do prontuario e resultados de exames laboratoriais da paciente, que estava internada no Hospital Universitario de Santa Maria, em Santa Maria, Rio Grande do Sul.Descricao do caso: Paciente do genero feminino, 73 anos, diagnosticada com diabetes mellitus e cirrose micronodular, foi internada com suspeita de septicemia, simultânea a uma infeccao no membro inferior esquerdo, cuja hipotese diagnostica inicial foi de celulite. Pelas caracteristicas do quadro clinico, foi feito o diagnostico de fasciite necrosante. Hemoculturas de dois sitios diferentes positivaram para S. agalactiae. A paciente foi a obito por choque septico.Conclusoes: O relato deste caso enfatiza a gravidade da fasciite necrosante, que pode ocorrer principalmente em pacientes portadores de fatores predisponentes como diabetes mellitus e cirrose. Aims: To report an unusual case of necrotizing fasciitis and septic shock caused by Streptococcus agalactiae, which affected a patient with diabetes mellitus. This analysis was performed using data from medical records and laboratory tests results, who was admitted to the University Hospital of Santa Maria, in Santa Maria, Rio Grande do Sul, Brazil.Case description: Female patient, 73 years old, diagnosed with diabetes mellitus and micronodular cirrhosis, was admitted with suspected septicemia simultaneous with an infection in the left lower limb, which initial diagnostic hypothesis was cellulitis. Based on characteristics of the clinical picture, the diagnosis of necrotizing fasciitis was done. Blood cultures from two different sites were positive for S. agalactiae. The patient died with septic shock.Conclusions: This case report emphasizes the severity of necrotizing fasciitis, which may occur especially in patients with predisposing factors such as diabetes mellitus and cirrhosis.