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Waleria Hryniewicz

Publications and source records attributed to Waleria Hryniewicz.

At least 37 records · Page 2Linked to original sources

Susceptibility testing and resistance phenotypes detection in bacterial pathogens using the VITEK 2 System.

A set of well characterized strains, collected in Polish hospitals, including Gram-negative (n = 93) and Gram-positive (n = 90) isolates was used in the study. The VITEK 2 AST-cards were used in the analysis according to the manufacturer's recommendations. Comparison of the susceptibility data obtained by the standard method and by VITEK 2 cards proved concordant in 99% of cases. Clinically important mechanisms were revealed by the VITEK 2 AES with >95% agreement with reference data including methicillin resistance in staphylococci (98%), high-level aminoglycoside resistance in enterococci (100%), VanA and VanB phenotypes in enterococci (100%), and ESBLs in Enterobacteriaceae (93.8%). The VITEK 2 AES System appears a reliable tool for the detection and interpretive reading of clinically important mechanisms of resistance and can be recommended for routine work.

Drug Resistance, Bacterial↗

Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe.

OBJECTIVES: To forecast trends in resistance to penicillin and erythromycin among Streptococcus pneumoniae in Europe. METHODS: Since 1999, the European Antimicrobial Resistance Surveillance System (EARSS) has collected routine antimicrobial susceptibility test results of S. pneumoniae. To observe and predict changes of reduced susceptibility over time, we used a multinomial logistic regression model. RESULTS: Large variations in penicillin and erythromycin non-susceptibility were observed between countries, and reduced susceptibility to erythromycin (17%) has become more frequent than reduced susceptibility to penicillin (10%) in Europe overall. An overall decrease in single penicillin non-susceptibility, but an increase in dual non-susceptibility was observed, indicating a shift of single penicillin to combined non-susceptibility with erythromycin. By 2006, the proportion of single erythromycin and dual non-susceptibility could increase to as much as 20.4% and 8.9%, respectively. CONCLUSIONS: Our results indicate that appropriately dosed beta-lactams for empirical therapy are still the treatment of choice, and that macrolides should be used with prudence.

Adolescent↗

A rapid increase in macrolide resistance in Streptococcus pyogenes isolated in Poland during 1996-2002.

OBJECTIVES: The aim of this study was to investigate Polish clinical isolates of Streptococcus pyogenes collected during a 7 year period using phenotypic and genotypic techniques. METHODS: A total of 816 isolates of S. pyogenes recovered from 33 medical centres in Poland were tested for their susceptibility to various antimicrobial agents. Erythromycin-resistant isolates were analysed by PFGE, multilocus sequence typing and emm typing methods. RESULTS: The tetracycline resistance rate was high (43%) among all S. pyogenes strains. Ninety-eight (12%) isolates were resistant to erythromycin. A low prevalence of the M phenotype (5.1%) associated with the presence of the mef(A) gene was found. All the isolates of the iMLSB phenotype harboured the erm(TR) gene. Out of the cMLSB isolates, 71.4% and 28.6% carried erm(TR) and erm(B), respectively. All isolates with erm(B) were resistant to telithromycin. PFGE analysis discerned 13 different patterns, A-N, with two predominant PFGE profiles--A (41 isolates) and B (25 isolates)--that in multilocus sequence typing corresponded, respectively, to a novel sequence type (ST) 367 and ST63. Overall, the representatives of these clones accounted for >90% of isolates of the iMLSB phenotype. CONCLUSIONS: A significant increase in erythromycin resistance was observed among clinical S. pyogenes collected in Poland over a 7 year period driven by the spread of two epidemic clones.

Anti-Bacterial Agents↗

Four variants of the Citrobacter freundii AmpC-Type cephalosporinases, including novel enzymes CMY-14 and CMY-15, in a Proteus mirabilis clone widespread in Poland.

Twenty-nine Proteus mirabilis isolates from 17 Polish hospitals were analyzed. The isolates were resistant to a variety of antimicrobials, and their patterns of resistance to beta-lactams resembled those of the constitutive class C cephalosporinase (AmpC) producers. Indeed, beta-lactamases with a pI of approximately 9.0 were found in all of the isolates, and they were subsequently identified as four AmpC-type cephalosporinases, CMY-4, -12, -14, and -15, of which the two last ones were novel enzyme variants. The enzymes were of Citrobacter freundii origin and were closely related to each other, with CMY-4 likely being the evolutionary precursor of the remaining ones. The bla(CMY) genes were located exclusively in chromosomal DNA, within EcoRI restriction fragments of the same size of approximately 10 kb. In the CMY-12- and -15-producing isolates, an additional fragment of approximately 4.5 kb hybridized with the bla(CMY) probe as well, which could have arisen from a duplication event during the evolution of the genes. In all of the isolates, the ISEcp1 mobile element, which most probably is involved in mobilization of the C. freundii ampC gene, was placed at the same distance from the 5' ends of the bla(CMY) genes, and sequences located between them were identical in isolates carrying each of the four genes. These data suggested that a single chromosome-to-chromosome transfer of the ampC gene from C. freundii to P. mirabilis could have initiated the spread and evolution of the AmpC-producing P. mirabilis in Poland. The hypothesis seems to be confirmed by pulsed-field gel electrophoresis typing, which revealed several cases of close relatedness between the P. mirabilis isolates from distant centers and showed an overall similarity between the majority of the multiresistant isolates.

Amino Acid Sequence↗

Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis isolated from the nasopharynges of asymptomatic children and molecular analysis of S. pneumoniae and H. influenzae strain replacement in the nasopharynx.

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in 226 children in different settings (in a crèche [day care center], in an orphanage, and at home) during two seasons (winter and spring) was studied. The rates of carriage of S. pneumoniae and H. influenzae were markedly higher in the crèche and in the orphanage than in the home setting (e.g., 56.5, 63.3, and 25.9%, respectively, for S. pneumoniae in winter). Approximately 80% of the S. pneumoniae isolates identified in the crèche and in the orphanage belonged to the serotypes represented in the seven-valent pneumococcal vaccine, and 4.4% of the children were colonized by H. influenzae type b. Almost all H. influenzae isolates were fully susceptible to the antimicrobial agents tested, and only five (3.6%) produced beta-lactamase; in contrast, 100% of the M. catarrhalis isolates were beta-lactamase positive. Among S. pneumoniae isolates, 36.2% were nonsusceptible to penicillin (PNSP) and 11.8% were fully resistant to penicillin (PRP). All PNSP isolates were obtained from children at the crèche and at the orphanage but not among children brought up at home, and all PRP isolates showed a multiresistant phenotype. Colonization by PRP isolates correlated well with prior treatment with beta-lactams. For the majority of children colonized at both sampling times, strain replacement of S. pneumoniae and H. influenzae was observed; long-term colonization by a single strain was rare.

Anti-Bacterial Agents↗

[Anthrax as a bioweapon].

The risk of biological and chemical terrorism is growing according to availability of modern biotechnologies and financial resources. The most potent biological weapon mentioned in the last decade is anthrax. The number of naturally acquired infections in humans is constantly reduced, however endemic areas are located in South and Middle Americas, South Europe, Asia and Africa. In any case of infection laboratory confirmation is indicated. Primary basic testing is available in all microbiology laboratories. In the current situation the medical and epidemiological infrastructure and microbiology diagnostics must be prepared for early and rapid coordinated action in order to detect and respond to biological and chemical attacks.

Anthrax↗

[Chlamydia pneumoniae infection in patients with advanced carotid atherosclerosis].

Despite the growing number of scientific reports showing different markers of infection caused by Chlamydia pneumoniae in patients with advanced atherosclerosis, there is still no clear confirmation of a pathogenetic link between this infection and atherogenesis. The aim of the present study was to investigate the presence C. pneumoniae DNA in peripheral blood mononuclear cells and carotid endarterectomy samples obtained from patients with advanced atherosclerosis according to the presence specific antibodies against C. pneumoniae in serum. The levels of IgG, IgM and IgA antibodies to C. pneumoniae were determined by enzyme immunoassay (EIA) in sera of 36 patients with advanced atherosclerosis undergoing carotid endarterectomy. The presence of C. pneumoniae DNA in the carotid samples and in peripheral blood mononuclear cells was investigated by a nested polymerase chain reaction (PCR). We have not confirm the presence of C. pneumoniae DNA either in the carotid endarterectomy samples or in peripheral blood mononuclear cells, both in patients having the specific antibodies against C. pneumoniae and in seronegative patients. In the studied group of patients with advanced carotid atherosclerosis there was no correlation between the presence of specific antibodies against C. pneumoniae and the presence of C. pneumoniae DNA in endarterectomy samples and peripheral blood mononuclear cells.

Aged↗

Evolution of an integron carrying blaVIM-2 in Eastern Europe: report from the SENTRY Antimicrobial Surveillance Program.

As part of the SENTRY Antimicrobial Surveillance Program, an imipenem-resistant Pseudomonas aeruginosa strain (81-11963A) was isolated from the blood culture of a female neonate institutionalized at the local children's hospital in Warsaw, Poland. Cloning of an imipenem resistance determinant revealed it to be a VIM-2 metallo-beta-lactamase, but sequence analysis of DNA adjacent to blaVIM-2 revealed it to have a unique gene context. Downstream of the blaVIM-2 gene resides an aacA4 gene encoding the AAC(6')-Ib aminoglycoside acetyltransferase. The integron containing blaVIM-2 shows high similarity to that reported from In58 in France but was novel in that it possessed a gene cassette with a 59 truncated base element only 19 base pairs (bp) long, consisting of a conserved core site and an inverse core site separated by only 5 bp. This appears to be the first report of a metallo-beta-lactamase gene arising from a pathogenic strain in Eastern Europe.

Base Sequence↗

The new strategy for allele identification of the genes coding for pertussis toxin subunit S1 (ptx S1) and pertactin (prn) in Bordetella pertussis.

Bordetella pertussis strains demonstrate polymorphism in toxin subunit S1 (PT S1) and pertactin (Prn), which belong to major protective antigens of the pathogen. Changes in the distribution of particular alleles of ptxS1 and prn genes in local B. pertussis populations have been proposed as possible factors influencing the vaccination effectiveness. We have developed a new methodology for the identification of the alleles, which eliminates the necessity of DNA sequencing. The approach is based on the evaluation of the number of sequence repeats and detection of specific nucleotides at polymorphic sites of the genes, and utilizes products of their full or partial PCR amplification. The approach is available for a laboratory with standard equipment. The total conformity of the strategy with the DNA sequencing-based approach was proved on the full set of reference strains and a group of Polish clinical isolates. The new methodology was used to investigate a collection of 120 Polish B. pertussis strains isolated from the 1960s to 2001. Similarly to findings from other countries and to earlier Polish data, the tendency to change the vaccine types of PT S1 and Prn by the antigenically different ones was observed.

Alleles↗

Identification of multidrug-resistant Streptococcus pneumoniae strains isolated in Poland by multilocus sequence typing.

Multilocus sequence typing (MLST) of 35 isolates of multidrug-resistant Streptococcus pneumoniae recovered in Poland during 1995-1996 distinguished 10 different sequence types (ST). The majority of the isolates were assigned to two Polish clones of serotypes 6B and 23F, although the international clones, Spain23F-1 and Spain9V-3, were also identified. Similar results were obtained using pulsed-field gel electrophoresis (PFGE), providing a direct comparison of these two typing methods.

Bacterial Typing Techniques↗

Genetic relatedness, antibiotic susceptibility, and serotype distribution of Streptococcus pneumoniae responsible for meningitis in Poland, 1997-2001.

Streptococcus pneumoniae is the third most frequent etiologic agent of bacterial meningitis in Poland. Therefore, the objective of this study was to characterize S. pneumoniae isolates responsible for meningitis in Poland from 1997 to 2001 by determining their serotypes, antimicrobial susceptibility, and genetic relatedness. Among 36 serotypes and rough isolates, the most common were serotypes 3, 8, 19F, 6B, 4, and 23F, altogether accounting for 45.3% of cases. Penicillin-nonsusceptible pneumococci constituted 14.8% of all isolates. A high heterogeneity of pneumococcal isolates concerning serological features as well as genetic relatedness based on pulsed-field gel electrophoresis analysis was observed. With the exception of some serotypes (e.g., 3, 7F, 19F), isolates of the same serotype do not appear to be more closely related to each other than to isolates of different serotypes.

Adolescent↗

An Enterococcus faecium secreted antigen, SagA, exhibits broad-spectrum binding to extracellular matrix proteins and appears essential for E. faecium growth.

A gene encoding a major secreted antigen, SagA, was identified in Enterococcus faecium by screening an E. faecium genomic expression library with sera from patients with E. faecium-associated endocarditis. Recombinant SagA protein showed broad-spectrum binding to extracellular matrix (ECM) proteins, including fibrinogen, collagen type I, collagen type IV, fibronectin, and laminin. A fibrinogen-binding protein, purified from culture supernatants of an E. faecium clinical isolate, was found to match the N-terminal sequence of the predicted SagA protein and to react with the anti-SagA antibody, confirming that it was the SagA protein; this protein appeared as an 80- to 90-kDa smear on a Western blot that was sensitive to proteinase K and resistant to periodate treatment and glycoprotein staining. When overexpressed in E. faecium and Escherichia coli, the native and recombinant SagA proteins formed stable oligomers, apparently via their C-terminal domains. The SagA protein is composed of three domains: (i) a putative coiled-coil N-terminal domain that shows homology to the N-terminal domain of Streptococcus mutans SagA protein (42% similarity), previously shown to be involved in cell wall integrity and cell shape maintenance, and to the P45 protein of Listeria monocytogenes (41% similarity); (ii) a central domain containing direct repeats; and (iii) a C-terminal domain that is similar to that found in various proteins, including P45 (50% similarity) and P60 (52% similarity) of L. monocytogenes. The P45 and P60 proteins both have cell wall hydrolase activity, and the latter has also been shown to be involved in virulence, whereas cell wall hydrolase activity was not detected for SagA protein. The E. faecium sagA gene, like the S. mutans homologue, is located in a cluster of genes encoding proteins that appear to be involved in cell wall metabolism and could not be disrupted unless it was first transcomplemented, suggesting that the sagA gene is essential for E. faecium growth and may be involved in cell wall metabolism. In conclusion, the extracelluar E. faecium SagA protein is apparently essential for growth, shows broad-spectrum binding to ECM proteins, forms oligomers, and is antigenic during infection.

Amino Acid Sequence↗

New method for typing Staphylococcus aureus strains: multiple-locus variable-number tandem repeat analysis of polymorphism and genetic relationships of clinical isolates.

The PCR-based methodology applied to multiple-locus variable numbers of tandem repeat (VNTR) analysis was recently shown to be a useful technique for the molecular typing of clinical isolates of several bacterial species. We have adopted this method for the molecular typing of methicillin-resistant Staphylococcus aureus. Five staphylococcal VNTR loci (sdr, clfA, clfB, ssp, and spa) were subjected to analysis, and it was shown that the method allows typing of S. aureus strains with the discriminatory power and reproducibility of pulsed-field gel electrophoresis while at the same time being rapid and applicable to analysis of large numbers of isolates.

Bacterial Proteins↗

[Alexander Project--5 years in Poland].

The aim of the Alexander Project is to monitor resistance and its trends among the most common bacterial pathogens responsible for community-acquired lower respiratory tract infections and to compare the results obtained between different countries. In Poland, from 1996 to 2000 the percentage of Streptococcus pneumoniae isolates non-susceptible to penicillin was 14.1%. Most often decreased susceptibility to penicillin co-existed with resistance to other classes of antibiotics (multi-drug resistance). The biggest number of pneumococci were resistant to co-trimoxazole (35.2%) and doxycycline (33.6%). Of Haemophilus influenzae isolates, 5.3% produced beta-lactamases. All H. influenzae isolates were susceptible to amoxicillin/clavulanic acid and 3rd-generation cephalosporins. Many isolates of this species were resistant to co-trimoxazole (19.1%). The results of the Alexander Project provide crucial data for guiding national recommendations for empirical treatment of respiratory tract infections.

Anti-Bacterial Agents↗

[Modern possibilities of bioterrorism diagnosis].

One of the most important components of early detecting and response to biological attack are microbiological diagnostic methods. In order to provide the effectiveness of diagnosis continuous training in detection of potentially dangerous bioterrorist agents is needed. Basic information about selected microbiological agents most dangerous for public health, belonging to A and B CDC categories are presented in the article. The most potent biological weapon mentioned in the last decade is anthrax. Other potential bioterrorist agents discussed in this article are Francisella tularensis, Yersinia pestis, Brucella species and Coxiella burnetii.

Anthrax↗

[Epidemiology and therapy of infections caused by Neisseria meningitidis].

In spite of the progress in antibiotic therapy and immunoprophylaxis Neisseria meningitidis remains one of the major causes of meningitis and sepsis burdened by high mortality. In this paper characteristics of N. meningitidis and in particular its epidemiology, virulence factors, antibiotic therapy and resistance mechanisms, immuno- and chemoprophylaxis, are discussed. Data from the National Reference Centre for Bacterial Meningitis are also presented. These data indicate that this pathogen is the most common laboratory confirmed bacterial etiologic agent of community-acquired meningitis in Poland.

Anti-Bacterial Agents↗

Intercenter reproducibility of binary typing for Staphylococcus aureus.

The reproducibility of the binary typing (BT) protocol developed for epidemiological typing of Staphylococcus aureus was analyzed in a biphasic multicenter study. In a Dutch multicenter pilot study, 10 genetically unique isolates of methicillin-resistant S. aureus (MRSA) were characterized by the BT assay as presented by van Leeuwen et al. [J. Clin. Microbiol. 2001 39 (1) 328]. The BT assay, including a standardized DNA extraction protocol was performed in duplicate in eleven medical microbiology laboratories. Two different hybridization detection procedures were applied and a prelabeled DNA sample as process control was included. Only three laboratories accurately identified all strains. Divergence in technical procedures resulted in misinterpretation due to an increasing number of faint or absent hybridization signals in combination with high background staining. The binary type of the process control was determined correctly by all participating laboratories. The feasibility of the BT protocol was related directly to the skill of the laboratory personnel. On the basis of the national study, we concluded that the DNA extraction protocol needed modification to improve DNA yield and purity. Subsequently, seven European laboratories participated in an international study to determine the reproducibility of the modified BT protocol. Each center was asked to analyze 10 DNA samples previously extracted from 10 MRSA strains (phase 1) and, additionally, to analyze 10 MRSA strains, using the standardized or their in-house DNA isolation protocol (phase 2). A prelabeled DNA process control sample was included again. The binary types of all DNA samples were identified correctly by all but one laboratories. This latter laboratory diverged from the protocol by adding an excess of labeled DNA to the hybridization mixture, resulting in a high background and, therefore, noninterpretable BT results. All centers produced identical BT results for the process control. Five of the seven centers correctly identified the binary types of all 10 MRSA strains in phase 2 of the international study. Three of these centers used their in-house DNA extraction protocol. Divergence from the standard BT protocol in the remaining two centers resulted in no interpretable BT data for the 10 MRSA strains. The study demonstrated that each center that followed the BT protocol to the letter could generate reproducible results, irrespective whether or not an in-house DNA isolation protocol was used. The current BT protocol thus represents a simple method generating robust, reproducible genotype data for S. aureus strains.

Bacterial Typing Techniques↗