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1.
Arq. Inst. Biol ; 88: e00402020, 2021. mapas, tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1349004

RESUMO

The epidemiology of salmonellosis in poultry is complex, which makes it difficult to identify the origin and spread of this disease in poultry farms. The aims of this study were to characterize the spatial distribution of Salmonella enterica in epidemiological units in Paraná, Brazil; and to investigate correlations between this microorganism and associated factors. Among the epidemiological units, 78 of 243 (32.10%) were positive. Spatially, the northwestern and western regions had higher concentrations of positive cases than the other regions. In bivariate analyses, the presence of other animal species in the epidemiological unit (prevalence ratio, PR = 0.64; 95% confidence interval, CI = 0.43­0.95; p = 0.022) and proximity to establishments at risk (PR = 0.51; 95% CI = 0.32­0.81; p = 0.001) did not influence positivity, but the average population per poultry shed (between 30,501 and 32,500; PR = 2.57; 95% CI = 1.72­3.83; p = 0.001) was associated with Salmonella positivity. Multiple logistic regression demonstrated that the average population per poultry shed, presence of surrounding risk-posing establishments and presence of surrounding poultry sheds produced a significant multiple model for S. enterica. The results indicated that the presence of S. enterica may be related to higher density broiler in poultry sheds, presence of surrounding poultry sheds, proximity between positive and negative epidemiological units and altitude of the municipality. The information obtained showed that some factors were related to positivity for this microorganism and emphasizes the importance of serotyping to obtain other epidemiological data.


Assuntos
Aves Domésticas , Infecções por Salmonella/epidemiologia , Salmonella enterica , Aves , Sorotipagem , Estudos Retrospectivos , Razão de Prevalências , Fazendas
2.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(4): 365-372, Oct.-Dec. 2020. tab, graf, ilus
Artigo em Inglês | LILACS | ID: biblio-1142967

RESUMO

ABSTRACT Background: We evaluated different technological approaches and anti-D clones to propose the most appropriate serologic strategy in detecting the largest numbers of D variants in blood donors. Methods: We selected 101 samples from Brazilian blood donors with different expressions of D in our donor routine. The tests were performed in immediate spin (IS) with eleven commercially available anti-D reagents in a tube and microplate. The D confirmatory tests for the presence of weak D included the indirect antiglobulin test (IAT) in a tube, gel and solid-phase red blood cell adherence (SPRCA). All DNA samples were extracted from peripheral blood and the D variants were classified using different molecular assays. Results: The RHD variants identified by molecular analysis included weak D types (1, 2, 3, 11 and 38) and partial Ds (DAR1.2, DAR1, DAR3.1, DAU0, DAU2, DAU4, DAU5, DAU6, DMH and DVII). The monoclonal-monoclonal blend RUM-1/MS26 was the best anti-D reagent used in detecting the D antigen in the IS phase in a tube, reacting with 83.2% of the D variants, while the anti-D blend D175 + 415 was the best monoclonal antibody (MoAb) used in a microplate to minimize the need for an IAT, reacting with 83.2% of the D variants. The D confirmatory tests using SPRCA showed a reactivity (3 - 4+) with 100% of the D variant samples tested. Conclusion: Our results show that, even using sensitive methods and MoAbs to ensure the accurate assignment of the D antigen, at least 17% of our donor samples need a confirmatory D test in order to avoid alloimmunization in D-negative patients.


Assuntos
Humanos , Sistema do Grupo Sanguíneo Rh-Hr/análise , Doadores de Sangue , Sorotipagem , Alelos , Hemaglutinação
4.
Rev. chil. salud pública ; 24(1): 30-39, 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1121731

RESUMO

INTRODUCCIÓN: Las infecciones de transmisión sexual (ITS) se expresan con mayor frecuencia en poblaciones marginadas, como lo son los ciudadanos que se encuentran en situación de calle y con problemas de drogadicción. MATERIALES Y MÉTODOS: Mediante un estudio de campo descriptivo retrospectivo, se determinó la prevalencia de las ITS que se detallan en los ciudadanos residentes de un Centro de Inclusión Social en Venezuela durante los años 2013 a 2018. Para ello, suero de 280 individuos fue analizado mediante la prueba ELISA de diferentes compañías biotecnológicas. RESULTADOS: 50 casos (17,8%) fueron reactivos a cualquiera de las enfermedades investigadas. El biomarcador de mayor prevalencia durante el lapso estudiado fue el antiHBc con 13,9% y las menores fueron HBsAg con 0,75%, VHC con 0,71% y Treponema pallidum con 2,85%, así como 2,14% para VIH. No se detectó ningun caso de HTLV. Del mismo modo, se observó una tasa de co-infección entre hepatitis B y VIH de 2,32%, entre hepatitis C y VIH de 1,5% y en dos años se consiguió co-infeccion de hepatitis B y Sífilis con 1,5% y 5,8% en el 2014 y 2018 respectivamente. DISCUSIÓN: Se encontró que los sujetos acogidos en el Centro de Inclusión Social son un grupo vulnerable a las ITS y las coinfecciones, por lo que deben llevarse a cabo campañas de preven-ción y pruebas de detección de estas enfermedades en dicha población.


INTRODUCTION: Sexually Transmitted Infections (STIs) are most frequently expressed in marginalized populations, such as as homeless individuals or those with substance abuse issues. MATERIALS AND METHODS: Through a retrospective descriptive study, the prevalence of various STDs was determined among residents of a Social Inclusion Center in Venezuela from 2013 to 2018. For this purpose, serum from 280 individuals were analyzed with ELISA tests from different biotech companies. RESULTS: 50 cases (17.86%) were sero-reactive to any of the STIs investigated. The most preva-lent biomarker during the study period studied was antiHBc (13.9%) and the lowest prevalen-ces were HBsAg with 0.75%, HCV with 0.71%, and Treponema pallidum with 2.85%, as well as 2.14% for HIV. No cases of HTLV were detected. Similarly, there was coinfection between hepatitis B and HIV in 2.32% of cases, between hepatitis C and HIV in 1.5%, and between syphillis and hepatitis in 1,5% and 5,8% of cases (in 2014 and 2018 respectively). DISCUSSION: Individuals in Centers for Social Inclusion are at risk of presenting STIs and co-infections; therefore, STI prevention campaigns and screenings should be conducted in this vulnerable group.


Assuntos
Humanos , Masculino , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Venezuela/epidemiologia , Ensaio de Imunoadsorção Enzimática , Biomarcadores/análise , Sorotipagem , Infecções por HIV/epidemiologia , Epidemiologia Descritiva , Prevalência , Estudos Retrospectivos , Hepatite C/epidemiologia , Populações Vulneráveis , Coinfecção , Hepatite B/epidemiologia
5.
Rev. Inst. Adolfo Lutz ; 78: e1770, dez. 2019. graf
Artigo em Português | LILACS, VETINDEX | ID: biblio-1489596

RESUMO

Oitenta porcento dos casos de paracoccidioidomicose (PMC) ocorrem no Brasil. As regiões brasileiras com maior número de casos são: sul, sudeste e centro-oeste, sendo emergente no norte e nordeste. A imunodifusão dupla em gel de agarose assume grande importância no diagnóstico, por permitir o monitoramento da doença e por oferecer subsídios para levantamentos soroepidemiológicos. O objetivo deste trabalho foi de avaliar e caracterizar os pacientes atendidos no Laboratório de Imunodiagnóstico das Micoses do Instituto Adolfo Lutz de São Paulo, em 2016. Trata-se de um estudo retrospectivo realizado utilizando-se dados secundários e avaliando-se as seguintes informações: idade, sexo, procedência do pedido médico, resultado e histórico sorológico dos pacientes. Dos 1.408 pacientes, 12,8% apresentaram reatividade sorológica para Paracoccidioides brasiliensis. Destes, 42,5% não possuiam histórico sorológico, sendo considerados como casos novos da doença. A classificação dos pacientes reagentes por gênero demonstrou que 83,4% eram do sexo masculino, com razão de masculinidade de 5:1. A faixa etária variou de um (1) a 92 anos, e aproximadamente 40% dos pacientes eram da faixa etária de 41 a 60 anos. Este estudo demonstra e reforça a importância da implementação dos estudos soroepidemiológicos como ferramenta auxiliar para nortear as ações de vigilância e políticas em saúde na PCM.


Eighty percent of paracoccidioidomycosis (PMC) cases occur in Brazil. The highest numbers occur in south, southeast and center-west region, being emergent in the north and northeast areas. The double immunodiffusion in agarose gel is valuable for its diagnosis, as it allows the monitoring of the disease and offers subsidies for the seroepidemiological surveys. This study evaluated and characterized the patients attended in 2016 at the Mycoses Immunodiagnosis Laboratory of Adolfo Lutz Institute of São Paulo. This retrospective study, based on the secondary data, evaluated the information: age, sex, medical request origin, result and serological history of the patients. Of 1,408 patients, 12.8% presented positive serological reactivity for Paracoccidioides brasiliensis. Of them, 42.5% had no serological history and they were considered as new cases. The classification of reactive patients by gender showed that 83.4% were males, being the masculinity ratio of 5:1. The age range was one (1) to 92 years old, and ±40% of the patients were of age ranging from 41-60 years old. This study reinforces the importance of the implementation of the seroepidemiological studies as to guide the surveillance actions and the public health politics in PCM.


Assuntos
Humanos , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/sangue , Sorotipagem , Brasil , Imunodifusão , Testes Imunológicos
6.
Bol. méd. Hosp. Infant. Méx ; 76(6): 281-286, nov.-dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1089145

RESUMO

Resumen Introducción: En México, cuando se inició la aplicación de la vacuna PCV13 (neumocócica conjugada), se cubría el 70.6% de los serotipos causantes de enfermedad invasiva por neumococo en menores de 5 años. Después de varios años, los casos de enfermedad causada por los serotipos incluidos en la vacuna han disminuido; sin embargo, se ha producido un reemplazo por los serotipos no incluidos en la vacuna. Caso clínico: Se presentan tres casos de pacientes pediátricos que desarrollaron enfermedad invasiva por serotipos no incluidos en la PCV13: uno con meningitis y bacteriemia (serotipo 15C) y dos con neumonía, uno de ellos complicado con derrame (serotipo 35B). Los pacientes fueron atendidos en un hospital pediátrico en Saltillo, Coahuila, durante el periodo de 2015 a 2018. Conclusiones: Resulta alarmante que se presenten tres casos graves por serotipos de Streptococcus pneumoniae no incluidos en la PCV13 en un solo hospital pediátrico en el norte del país. Este es un fenómeno que esta sucediendo a escala nacional e internacional: un incremento de casos de enfermedad invasiva por serotipos de neumococo no incluidos en la vacuna utilizada actualmente.


Abstract Background: In Mexico, 70.6% of serotypes causing invasive pneumococcal disease were covered since the application of the PCV13 vaccine in children under 5 years of age. After several years of immunization, cases of disease caused by the serotypes included in the vaccine have decreased. However, a replacement due to serotypes not included in the vaccine has been observed. Case report: Three cases of pediatric patients who developed invasive disease due to serotypes not included in PCV13 are described: one with meningitis and bacteremia (serotype 15C), and two with pneumonia, of which one complicated with effusion (serotype 35B). Patients were treated in a pediatric hospital in Saltillo, Coahuila, from 2015 to 2018. Conclusions: Three serious cases due to serotypes of Streptococcus pneumoniae not included in PCV13 were reported in a single pediatric hospital in a northern state of Mexico. This phenomenon is taking place nationwide and worldwide: an increase of cases of invasive disease due to pneumococcal serotypes not included in the vaccine currently used.


Assuntos
Pré-Escolar , Feminino , Humanos , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/classificação , Vacinas Pneumocócicas , Infecções Pneumocócicas/complicações , Infecções Pneumocócicas/tratamento farmacológico , Streptococcus pneumoniae/isolamento & purificação , Sorotipagem , Vacinas Conjugadas , México
7.
Rev. chil. infectol ; 36(5): 585-590, oct. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1058084

RESUMO

Resumen Introducción: Listeria monocytogenes es un patógeno transmitido por alimentos que causa listeriosis, una enfermedad que puede presentarse como gastroenteritis febril o en una forma invasora que tiene altas tasas de mortalidad. Hasta el momento, ha sido poco estudiada la diversidad genética de cepas de L. monocytogenes aisladas desde pacientes, alimentos y fuentes ambientales en Chile. Objetivo: Caracterizar genéticamente cepas de L. monocytogenes de estos tres orígenes recibidas por el Instituto de Salud Pública de Chile (ISP) entre los años 2007 y 2014. Material y Métodos: Se seleccionaron 94 cepas de L. monocytogenes correspondientes a 94 pulsotipos diferentes identificados por electroforesis en gel de campo pulsado (PFGE), se extrajo ADN y se realizó serotipificación mediante reacción de polimerasa en cadena (RPC) y tipificación de secuencias multilocus (MLST). Resultados: El serotipo más común fue 4b (55,3%), seguido de 1/2a (25,5%), 1/2b (17%) y 1/2c (2,2%). Se identificaron 32 secuencias tipo (ST), de las cuales cuatro fueron nuevas, y las predominantes fueron ST1 (28,7%) y ST2 (13,8%). La totalidad de las cepas se agrupó en los Linajes I y II. Conclusiones: Se observó una gran variabilidad genética en las cepas de L. monocytogenes analizadas, siendo predominantes las secuencias tipo ST1 y ST2, ambas pertenecientes al Linaje I. Nuestros resultados contribuyen a conocer la estructura poblacional de este patógeno en Chile y su presencia en muestras clínicas, alimentos y el medio ambiente.


Background: Listeria monocytogenes is a foodborne pathogen that causes listeriosis, a disease that can present as febrile gastroenteritis or as an invasive form that has high mortality rates. So far, the genetic diversity of strains of L. monocytogenes isolated from patients, foods and environmental sources in Chile has been poorly studied. Aim: To characterize genetically L. monocytogenes strains received by the Institute of Public Health of Chile (ISP) between 2007 and 2014. Methods: We selected 94 strains of L. monocytogenes corresponding to 94 different pulsotypes identified by pulsed field gel electrophoresis (PFGE), DNA was extracted and serotyping was performed by polymerase chain reaction (PCR) and multilocus sequence typing (MLST). Results: The most common serotype was 4b (55.3%), followed by serotypes 1/2a (25.5%), 1/2b (17%) and 1/2c (2.2%). 32 sequence-type (ST) were identified, of which 4 were new, and the predominant ones were ST1 (28.7%) and ST2 (13.8%). All the strains of L. monocytogenes were grouped in Lineages I and II. Conclusions: A great genetic variability was observed in the strains of L. monocytogenes analyzed, being predominant the ST1 and ST2, both belonging to Lineage I. Our results contribute to know the population structure of this pathogen in Chile and its presence in clinical samples, food and the environment.


Assuntos
Humanos , Listeria monocytogenes/isolamento & purificação , Listeria monocytogenes/genética , Fatores de Tempo , Variação Genética , Sorotipagem , Chile , Reação em Cadeia da Polimerase , Eletroforese em Gel de Campo Pulsado , Microbiologia Ambiental , Tipagem de Sequências Multilocus , Microbiologia de Alimentos , Listeriose/microbiologia
9.
Rev. argent. microbiol ; 51(3): 234-240, set. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1041830

RESUMO

The aim of this study was to assess the risk factors and clinical and microbiological characteristics of community-acquired pneumonia (CAP) in adult patients in Mexico. Streptococcus pneumoniae classified as the causative agent of CAP in adult patients and patients with invasive S. pneumoniae isolates presented to three tertiary teaching hospitals during the 15-year study period were selected. Serotyping and susceptibility testing were performed for all included isolates. Clinical and demographic data were recorded. A total of 96 patients infected with S. pneumoniae (71 with CAP, 25 with invasive disease) were included. The CAP group involved more males (74.6%) than the invasive disease group (p = 0.03). Head trauma was more common in the CAP group (21.1%) than in the invasive disease group (4.0%; p = 0.03). The most prevalent serotype was 19A, followed by serotypes 3 and 23F. After the introduction of the heptavalent conjugated pneumococcal vaccine (PCV7), the prevalence of included serotypes declined significantly; no such change was found after the introduction of the PCV13 vaccine, including in the prevalence of serotype 19A. Susceptibility to all antimicrobials tested except vancomycin declined over the study period. In conclusion, head trauma was the most common comorbidity in the CAP group. The most prevalent serotype was 19A. Decreased susceptibility to most antimicrobials tested was observed.


El objetivo de este estudio fue evaluar los factores de riesgo y las características clínicas y microbiológicas de la neumonía adquirida en la comunidad (NAC) en pacientes adultos en México. Se seleccionaron pacientes adultos con NAC con Streptococcus pneumoniae como agente causal y pacientes con aislamientos invasivos de S. pneumoniae que concurrieron a tres hospitales de enseñanza de tercer nivel durante el período de estudio de 15 anos (2000-2015). Se realizaron pruebas de serotipificación y sensibilidad con todos los aislados incluidos. Se colectaron los datos clínicos y demográficos. Se incluyeron en total 96 pacientes infectados con S. pneumoniae (71 con NAC y 25 con enfermedad invasiva). El grupo con NAC incluía más varones (74,6%) que el grupo de enfermedad invasiva (p = 0,03). El traumatismo craneoencefálico fue más frecuente en el grupo NAC (21,1%) queen el grupo con enfermedad invasiva (4,0%; p = 0,03). El serotipo más frecuente fue 19A, seguido de los serotipos 3 y 23F. Después de la introducción de la vacuna antineumocócica conjugada heptavalente (PCV7), la prevalencia de los serotipos incluidos en aquella disminuyó significativamente; no sucedió lo mismo después de la introducción de la PCV13, incluso en relación con la prevalencia del serotipo 19A. La sensibilidad a todos los antimicrobianos evaluados, excepto la vancomicina, disminuyó durante el período de estudio. En conclusión, el traumatismo craneoencefálico fue la comorbilidad más frecuente en el grupo con NAC. El serotipo más frecuente fue el 19A, y se observó disminución de la sensibilidad a la mayoría de los antimicrobianos probados a lo largo del período considerado.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Infecções Comunitárias Adquiridas/microbiologia , Pneumonia Pneumocócica/epidemiologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/genética , Virulência , Resistência Microbiana a Medicamentos , Sorotipagem , Estudos Retrospectivos , Hospitais Privados/estatística & dados numéricos , Infecções Comunitárias Adquiridas/epidemiologia , Vacinas Pneumocócicas , Centros de Atenção Terciária/estatística & dados numéricos , Traumatismos Craniocerebrais/epidemiologia , Hospitais Públicos/estatística & dados numéricos , México/epidemiologia
10.
Braz. arch. biol. technol ; 62: e19180012, 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1011518

RESUMO

Abstract Ground bovine meat is commonly consumed by the population of Brazil. However, it constitutes an excellent medium for the multiplication of microorganisms due to available nutrients and handling practices prior to consumption. Here, we examined 100 samples of ground beef for the presence of diarrheagenic Escherichia coli (DEC) pathotypes by PCR, and characterized isolates by analyzing their adherence to HEp-2 cells, serotype, antimicrobial susceptibility, and phylogeny. Enteroaggregative E. coli was detected in five (5%) meat samples, Shiga toxin-producing E. coli in three (3%), and atypical enteropathogenic E. coli in two (2%). According to the phylogeny, six isolates (60%) were classified in group A, two (20%) in group B1, and two (20%) in group E. The detected serotypes were O3:H2, O93:H9, O93:H46, O105ab:H7, O152:H8, O156:H10, and O175:H7. The antimicrobial susceptibility testing showed that one sample (10%) was resistant to ampicillin, two (20%) to sulfamethoxazole-trimethoprim, and two (20%) to cephalothin. Based on these results, bovine ground meat for human consumption can serve as a reservoir of DEC, which emphasizes the importance of appropriate hygienic-sanitary conditions during handling at every stage from slaughter to table.


Assuntos
Escherichia coli/isolamento & purificação , Carne Vermelha/microbiologia , Sorotipagem/instrumentação , Gastroenterite/patologia
11.
Rev. Soc. Bras. Med. Trop ; 52: e20190060, 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1041555

RESUMO

Abstract INTRODUCTION: In this study, we aimed to identify DENV-2 subtypes in Aedes aegypti pools collected between 2011 and 2017 in a rural area of Northern Cordoba, Colombia ("La Balsa"). METHODS: RT-PCR was performed to analyze the capsid/pre-membrane region (C-PrM). Sequencing and phylogenetic bayesian inference using reference DENV-2 sequences were performed. RESULTS: Twelve pools that tested positive for DENV-2 were characterized based on the C-PrM region and grouped under the Asian/American clade. CONCLUSIONS: This study is the first to report the DENV-2 Asian-American subtype in a rural area of Cordoba region, which is associated with severe dengue and local epidemics.


Assuntos
Animais , Filogenia , Aedes/virologia , Dengue/virologia , Vírus da Dengue/classificação , Vírus da Dengue/genética , Mosquitos Vetores/virologia , Sorotipagem , Teorema de Bayes , Colômbia/epidemiologia , Dengue Grave , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Dengue/epidemiologia , Vírus da Dengue/isolamento & purificação , Sorogrupo
12.
Braz. j. infect. dis ; 22(5): 424-432, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-974235

RESUMO

ABSTRACT Introduction: Nontyphoidal Salmonella serotypes are the main cause of human food-borne infection, including several hospitalization cases in the developing countries. Aim: To detect the main serotypes and to characterize the antibiotic resistance of human non-enteric and enteric nontyphoidal Salmonella from clinical isolates in Brazil. Methods: Salmonella serotypes were identified by microbiological and molecular methods. Susceptibility testing to antibiotics was performed by agar disk diffusion. Real-time PCRs were carried out for the detection of the genus Salmonella as well as serotypes Typhimurium and Enteritidis. Results: A total of 307 nontyphoidal Salmonella were isolated from 289 different patients in a reference laboratory (LACEN-RS) from Southern Brazil in a six-year period (2010-2015). There were 45 isolates from emerging cases and 244 from sporadic cases in hospitalized patients. Non-enteric isolates were detected in 42.6% of the patients from sources such as urine, blood and other clinical fluids. Serological and PCR-specific tests demonstrated that Typhimurium (48.4%) and Enteritidis (18.3%) were the most frequent serotypes. Typhimurium isolates were generally resistant to three or more antibiotic classes, while Enteritidis isolates to one or two classes. Typhimurium was the most frequent serotype in all samples (48.4%), mainly among the hospitalized patients (55.6%), and presented the highest rates of multidrug resistance (59.3% of the isolates of this serotype). Further, the prevalence of this serotype increased along the years of the study in comparison to other nontyphoidal Salmonella serotypes. Conclusion: Greater public health attention should be given to prevent salmonellosis in the community and in hospital settings to reduce the rates of Typhimurium strains with multidrug resistance.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Infecções por Salmonella/microbiologia , Infecções por Salmonella/epidemiologia , Salmonella typhimurium/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Hospitalização/estatística & dados numéricos , Salmonella enteritidis/isolamento & purificação , Salmonella enteritidis/efeitos dos fármacos , Salmonella typhimurium/isolamento & purificação , Fatores de Tempo , Brasil/epidemiologia , Testes de Sensibilidade Microbiana , Sorotipagem , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Sorogrupo , Antibacterianos/farmacologia
14.
Rev. gastroenterol. Perú ; 38(3): 301-309, jul.-set. 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-1014100

RESUMO

Vibrio cholerae serogrupo NO-O1/NO-O139 (VCNO) es causa infrecuente de gastroenteritis. Sin embargo, se le asocia a infección extra-intestinal severa en huéspedes inmunocomprometidos, y entre ellas, la bacteremia en pacientes con cirrosis hepática es digna de mención. A continuación, presentamos el caso de una mujer de 58 años, con el diagnóstico de cirrosis hepática de fondo, que desarrolló progresivamente choque séptico, disfunción orgánica múltiple y desenlace fatal al cuarto día de su admisión. Los resultados obtenidos post mortem, de los hemocultivos previamente tomados, aislaron bacilos gram negativos compatibles con Vibrio cholerae. Posteriormente, se identificó el serogrupo NO-O1/NO-O139, a través de aglutinación en placa y PCR negativo para el gen ctxA. El antibiograma mostró susceptibilidad conservada a ampicilina, cloranfenicol, tetraciclina y ciprofloxacino, con resistencia al trimetoprim-sulfametoxazol. El presente caso, descrito en el Hospital Nacional Dos de Mayo, es hasta la fecha, el primer reporte de bacteremia VCNO en el Perú.


Non-O1, non-O139 Vibrio cholerae (NOVC) strains are an uncommon cause of gastroenteritis. However, they have been recently associated with severe extraintestinal infections in immunocompromised hosts. Among them, bacteremia in cirrhotic patients is noteworthy. We present the case of a 58-year-old woman with cirrhosis that developed septic shock, multiple organ failure and died four days after admission. Blood cultures yielded Gram-negative rods identified as Vibrio cholerae. Further serogrouping by slide agglutination and a negative PCR for ctxA gen confirmed the strain to be NOVC. Antimicrobial susceptibility testing showed sensitivity to ampicillin, chloramphenicol, tetracycline and ciprofloxacin; and resistance to trimethoprim-sulfamethoxazole. To the best of our knowledge, this is first report in Peru, described in the Hospital Nacional Dos de Mayo, of NOVC bacteremia.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Cólera/microbiologia , Bacteriemia/microbiologia , Vibrio cholerae O139/isolamento & purificação , Vibrio cholerae não O1/isolamento & purificação , Cirrose Hepática/complicações , Peru/epidemiologia , Choque Séptico/etiologia , Sorotipagem , Úlcera Péptica Hemorrágica/complicações , Cólera/complicações , Cólera/epidemiologia , Bacteriemia/epidemiologia , Evolução Fatal , Farmacorresistência Bacteriana Múltipla , Suscetibilidade a Doenças , Insuficiência de Múltiplos Órgãos/etiologia
15.
Rev. Soc. Bras. Med. Trop ; 51(2): 244-246, Mar.-Apr. 2018.
Artigo em Inglês | LILACS | ID: biblio-897060

RESUMO

Abstract Salmonella infections usually occur as gastroenteritis that is generally self-limited. However, some serotypes of Salmonella can cause severe extra-intestinal infections, such as bacteremia and meningitis. Here, we report the first Salmonella Panama case of meningitis in 4-month-old male newborn in Brazil. The invasive strain isolated was susceptible to all antimicrobial agents tested. The genes agfA, fimA, invA, sfbA, phoP, and slyA were detected using polymerase chain reactions. These findings are relevant and physicians should be alert to the possibility of meningitis in newborns due to S. Panama, which can present a high rate of mortality or recurrence of infection.


Assuntos
Humanos , Masculino , Meningites Bacterianas/microbiologia , Salmonella enterica/genética , Brasil/epidemiologia , Sorotipagem , Reação em Cadeia da Polimerase , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/epidemiologia , Salmonella enterica/isolamento & purificação
16.
São Paulo; s.n; 2018. 118 p. ilus, tab.
Tese em Português | LILACS, Sec. Est. Saúde SP, SESSP-CTDPROD, Sec. Est. Saúde SP, SESSP-ACVSES | ID: biblio-1005436

RESUMO

A doença pneumocócica invasiva (DPI) é uma das principais causas de morbidade e letalidade afetando especialmente crianças e idosos, resultando em um problema de saúde pública. O Brasil introduziu a vacina pneumocócica conjugada 10-valente (PCV10) no programa nacional de imunização infantil em 2010. Os estudos de efetividade e de impacto da PCV10 no Brasil foram realizados 3 a 5 anos após a introdução da vacina e mostraram redução nos casos de DPI causada pelos sorotipos vacinais e aumento de sorotipos não incluídos na vacina. Portanto, estudos realizados em um período de tempo mais longo após vacinação são fundamentais para se observar a sustentabilidade do aumento dos sorotipos não vacinais ao longo dos anos. O objetivo deste estudo foi investigar as características de S.pneumoniae (distribuição de sorotipos, perfil de suscetibilidade aos antimicrobianos e identificação das linhagens genéticas dos sorotipos prevalentes) nos períodos pré-PCV10 (2005-2009), pós-PCV10-imediato (2010-2013) e pós-PCV10-tardio (2014-2017), sendo o período pósPCV10 composto de 7 anos de avaliação. Isolados de DPI foram obtidos através da vigilância laboratorial nacional para S. pneumoniae. Os isolados foram encaminhados ao Instituto Adolfo Lutz pelos LACENs e por outras instituições públicas e privadas. Os isolados foram sorotipados por Quellung, o perfil de suscetibilidade antimicrobiana foi determinado pelos testes de disco-difusão e concentração inibitória mínima por microdiluição e a caracterização molecular foi realizada por MLST. A %change foi utilizada para calcular as diferenças na prevalência dos sorotipos e da resistência antimicrobiana por período de estudo. As sequências-tipo foram determinadas na página da web MLST e os complexos clonais pelo programa eBURST. Um total de 11.136 isolados invasivos foi estudado fenotipicamente. Uma amostragem de 688 isolados foi selecionada para a identificação das linhagens genéticas. No período pós-PCV10-tardio foi observada uma redução de 69,6% de DPI pelos sorotipos vacinais e, em paralelo, um aumento de 105,8% dos sorotipos não incluídos na PCV10. O aumento dos sorotipos não-PCV10 foi relacionado principalmente aos sorotipos 3, 6C, 8, 12F e 19A. Detectamos uma elevação de 304,6% na resistência à eritromicina no período pósPCV10-tardio. O estudo molecular identificou 33 CC e 182 STs. No período pós-PCV10, clones internacionalmente disseminados foram identificados ST180 (Clone Holanda3 -31), ST53-12574 (Clone Holanda8 - 33) e ST218 (Clone Dinamarca12F-34)], e duas principais STs foram relacionadas à resistência aos antimicrobianos, a citar a ST320/19A, presente desde o pré-PCV10 e a ST386/6C detectada no pós-PCV10. O monitoramento das características de S. pneumoniae em um período de tempo longo após a introdução da PCV10 confirmou a proteção da vacina contra a DPI pelos sorotipos vacinais e detectou a alta prevalência de sorotipos não incluídos na PCV10. O estudo molecular identificou uma disseminação de clones internacionais no Brasil


Invasive pneumococcal disease (IPD) is one of the leading causes of morbidity and lethality affecting especially children and the elderly, resulting in a public health problem. Brazil introduced the 10-valent pneumococcal conjugate vaccine (PCV10) in the national program of childhood immunization in 2010. The effectiveness and impact studies of PCV10 in Brazil were carried out 3 to 5 years after the introduction of the vaccine and showed a reduction in cases of IPD caused by vaccine serotypes and increase in non-vaccine serotypes. Therefore, studies conducted over a longer period of time after vaccination is essential to observe the sustainability of the increase in non-vaccine serotypes over the years. The aim of this study was to investigate the characteristics of S. pneumoniae (distribution of serotypes, antimicrobial susceptibility profile and genetic lineages identification of prevalent serotypes) in the pre-PCV10 (2005-2009), immediate-postPCV10 (2010-2013) and late-post-PCV10 (2014-2017) periods, the postPCV10 period being composed of 7 years of evaluation. Isolated of DPI were obtained through national laboratory surveillance for S. pneumoniae. The isolates were sent to the Institute Adolfo Lutz by LACENs and other public and private institutions. The isolates were serotype by Quellung, the antimicrobial susceptibility profile was determined by disc-diffusion and minimum inhibitory concentration microdilution assays and the molecular characterization were performed by MLST. %change was used to calculate differences in the prevalence of serotypes and antimicrobial resistance per study period. The sequences-type were determined at MLST website and clonal complexes were defined by the program eBURST. A total of 11,136 invasive isolates were phenotipically studied. A sample of 688 isolates was selected for the identification of the genetic lineages. In the latepost-PCV10 period, a 69.6% reduction in IPD was observed by vaccine serotypes and, in parallel, a 105.8% increase in non-PCV10 serotypes. The increase in non-PCV10 serotypes was mainly related to serotypes 3, 6C, 8, 12F and 19A. We detected a 304.6% increase in resistance to erythromycin in the late-post-PCV10 period. The molecular study identified 33 CC and 182 STs. In the post-PCV10 period, internationally disseminated clones were identified [ST180 (Clone Netherlands3-31), ST53-12574 (Clone Netherlands8-33) and ST218 (Clone Denmark12F34)], and two major STs were related to antimicrobial resistance, to be cited the ST320/19A, present since the pre-PCV10 and the ST386/6C detected post-PCV10. Monitoring the characteristics of S. pneumoniae a long-term period after the introduction of PCV10 confirmed the protection of the vaccine against IPD by the vaccine serotypes and detected the high prevalence of non-PCV10 serotypes. The molecular study identified the great spread of international clones in Brazil


Assuntos
Humanos , Masculino , Criança , Idoso , Streptococcus pneumoniae , Resistência Microbiana a Medicamentos , Sorotipagem
17.
Biomédica (Bogotá) ; 37(4): 466-472, oct.-dic. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-888491

RESUMO

Resumen Introducción. Clostridium difficile es el principal responsable de la diarrea asociada al uso de antibióticos. En Colombia y en Latinoamérica, el conocimiento sobre el comportamiento epidemiológico de la infección por C. difficile todavía es limitado. Objetivo. Describir las características de una serie de pacientes con infección por C.difficile . Materiales y métodos. Se hizo un estudio descriptivo de una serie de casos de pacientes con infección por C. difficile atendidos en la Fundación Clínica Shaio, entre enero de 2012 y noviembre de 2015. Resultados. Se estudiaron 36 pacientes con una edad promedio de 65 años. Se determinaron los siguientes factores relacionados con la infección por C. difficile: uso previo de antimicrobianos (94,4 %), hospitalización en los últimos tres meses (66,7 %) y uso de inhibidores de la bomba de protones (50 %). Las comorbilidades más comunes fueron la enfermedad renal crónica (41,7 %) y la diabetes mellitus (30,6 %). Los síntomas más frecuentes fueron más de tres deposiciones diarreicas (97,1 %) y dolor abdominal (42,9 %). En cuanto a la gravedad de los casos, 44,4 % se clasificó como leve a moderado, 38,9 % como grave, y 11,1 % como complicado o grave. El método de diagnóstico más utilizado (63,8% de los pacientes) fue la identificación de la toxina mediante reacción en cadena de la polimerasa (PCR). La mortalidad global durante la hospitalización fue de 8 %. Se identificaron cuatro cepas del serotipo NAP1/027 y nueve muestras fueron positivas para la toxina binaria. Conclusión. La infección por C. difficile debe sospecharse en pacientes con deposiciones diarreicas y factores asociados tradicionalmente a esta enfermedad. Se reportó la circulación de cepas hipervirulentas del serotipo NAP1/027 en Colombia, lo cual debe enfrentarse con la vigilancia epidemiológica y el diagnóstico temprano.


Abstract Introduction: Clostridium difficile is the main pathogen related to healthcare-associated diarrhea and it is the cause of 20 to 30% of diarrhea cases caused by antibiotics. In Colombia and Latin America, the knowledge about the epidemiological behavior of this infection is limited. Objective: To describe the characteristics of a series of patients with C. difficile infection. Materials and methods: We performed a descriptive case series study of patients with C. difficile infection hospitalized in the Fundación Clínica Shaio from January, 2012, to November, 2015. Results: We analyzed 36 patients. The average age was 65 years. The risk factors associated with the infection were: previous use of antibiotics (94.4%), prior hospitalization in the last three months (66.7%) and use of proton pump inhibitors (50%). The most common comorbidities were chronic kidney disease (41.7%) and diabetes mellitus (30.6%). The most frequent symptoms were more than three loose stools per day (97.1%) and abdominal pain (42.9%). According to the severity of the disease, 44.4% of cases were classified as mild to moderate, 38.9% as severe, and 11.1% as complicated or severe. The detection of the toxin by PCR (GeneXpert) was the most common diagnostic procedure (63.8%). Global mortality during hospitalization was 8%. We identified four strains with serotype NAP1/027 and nine samples positive for binary toxin. Conclusion: Clostridium difficile infection should be suspected in patients with diarrhea and traditional risk factors associated with this disease. We report the circulation of the hypervirulent strain serotype NAP1/027 in Colombia, which should be countered with epidemiological surveillance and a prompt diagnosis.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecção Hospitalar/microbiologia , Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/microbiologia , Proteínas de Bactérias/análise , Toxinas Bacterianas/análise , Virulência , Sorotipagem , Dor Abdominal/etiologia , Comorbidade , Infecção Hospitalar/epidemiologia , Fatores de Risco , Clostridioides difficile/classificação , Clostridioides difficile/patogenicidade , Infecções por Clostridium/epidemiologia , Colômbia/epidemiologia , Diabetes Mellitus/epidemiologia , Diarreia/microbiologia , Diarreia/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Hospitalização , Tempo de Internação/estatística & dados numéricos , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico
18.
Biomédica (Bogotá) ; 37(3): 425-430, jul.-set. 2017. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1038789

RESUMO

Resumen Introducción. La neurocriptococosis es una infección fúngica oportunista que representa un alto costo en vidas humanas y para la economía de los países. Sus agentes causales, las especies del complejo Cryptococcus neoformans/Cryptococcus gattii, tienen una fase sexuada y otra asexuada, cuatro serotipos principales y siete variedades moleculares con diferencias clínico-epidemiológicas, fenotípicas y de sensibilidad a los antifúngicos. Objetivo. Caracterizar molecularmente los aislamientos clínicos de C. neoformans de Guayaquil, Ecuador. Materiales y métodos. Se determinó el tipo de apareamiento, el serotipo y la variedad molecular mediante reacción en cadena de la polimerasa y análisis del polimorfismo de los fragmentos de restricción de 27 aislamientos levaduriformes previamente identificados como C. neoformans mediante métodos convencionales. Los aislamientos fueron recuperados del líquido cefalorraquídeo de pacientes con síndrome neurológico seropositivos para HIV, internados en el Hospital de Infectología "Dr. José Daniel Rodríguez Maridueña", entre diciembre de 2013 y enero de 2015. Resultados. Se demostró el amplio predominio de C. neoformans del serotipo A, MATα y el genotipo VNI entre los aislamientos estudiados. Conclusiones. Estos datos son similares a los obtenidos en otros países y son los primeros de su tipo en Guayaquil, Ecuador, por lo cual constituyen un aporte importante al conocimiento de la criptococosisen esta ciudad.


Abstract Introduction: Neurocryptococcosis is an opportunistic fungal infection that represents a high cost in human lives and for the economy of countries. Its causative agent, the Cryptococcus neoformans/Cryptococcus gattiispecies complex, has a sexual and an asexual phase, four major serotypes and seven molecular varieties with phenotypic, clinical-epidemiological and antifungal susceptibility differences. Objective: To characterize by molecular methods clinicalisolates of C. neoformans from Guayaquil, Ecuador. Materials and methods: We determined mating types, serotypes and molecular varieties by PCR and RFLP in 27 yeast isolates previously identified as C. neoformans by conventional methods. The isolates were recovered from cerebrospinal fluid of HIV seropositive patients with neurological syndrome admitted at "Dr. José Daniel Rodríguez Maridueña" Hospital from December, 2013, to January, 2015. Results: We established a wide prevalence of C. neoformans serotype A, MATαand genotype VNI among the studied isolates. Conclusions: These data are similar to those obtained in other countries and the first identified by molecular characterization in Guayaquil, Ecuador. Therefore, they constitute an important contribution to the knowledge on cryptococcosis in this country.


Assuntos
Humanos , Meningite Criptocócica/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Cryptococcus neoformans/genética , Polimorfismo de Fragmento de Restrição , DNA Fúngico/genética , Sorotipagem , Líquido Cefalorraquidiano/microbiologia , Reação em Cadeia da Polimerase , Prevalência , Estudos Transversais , Estudos Prospectivos , Técnicas de Tipagem Micológica , Meningite Criptocócica/líquido cefalorraquidiano , Meningite Criptocócica/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/líquido cefalorraquidiano , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Cryptococcus neoformans/isolamento & purificação , Cryptococcus neoformans/classificação , Cryptococcus neoformans/efeitos dos fármacos , Farmacorresistência Fúngica , Equador/epidemiologia , Genótipo
19.
Biomédica (Bogotá) ; 37(supl.2): 193-200, jul.-set. 2017. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1038792

RESUMO

Resumen Introducción. La incidencia y la prevalencia del dengue en Cundinamarca son elevadas y, recientemente, se detectó Aedes aegypti en algunas áreas rurales del departamento. Objetivo. Evaluar la transmisión transovárica del virus del dengue en larvas y pupas recolectadas en áreas rurales del municipio de Anapoima. Materiales y métodos. Se recolectaron ejemplares vivos en 53 viviendas y se transportaron al laboratorio de Anapoima, donde se clasificaron, se agruparon y se congelaron. Llevadas a Bogotá, se las homogeneizó, se les extrajo el ARN con Trizol ® , se las sometió a una reacción en cadena de la polimerasa de transcripción inversa (Reverse Transcription Polymerase change reaction, RT-PCR) y a PCR convencional, y los productos amplificados se analizaron en geles de agarosa al 2 %. Resultados. En 54,7 % de las viviendas evaluadas se encontraron formas inmaduras del vector y el serotipo más frecuente fue el DENV-1. Sin embargo, en algunos pools se detectó la presencia simultánea de los serotipos DENV 1 y 2, DENV 1 y 3, y DENV 1 y 4, así como los serotipos DENV 1, 2 y 3. Conclusión. Los resultados confirmaron la transmisión vertical del virus de manera natural en el área rural del municipio, lo cual reafirma la capacidad vectorial de A. aegypti y explica, en parte, la persistencia del virus en la región y la posibilidad de que en la fase adulta el vector lo transmita sin haber consumido sangre infectada. Esta situación aumenta el riesgo de infección por el virus del dengue en Colombia y, por lo tanto, la necesidad de adelantar programas de prevención y control en todas las zonas con presencia del mosquito.


Abstract Introduction: There is a high incidence and prevalence of dengue in the department of Cundinamarca, and recently Aedes aegypti, the main vector of dengue virus (DENV), was detected in some of its rural areas. Objective: To evaluate viral transovarial transmission in larvae and pupae collected in rural areas of the municipality of Anapoima, Cundinamarca. Materials and methods: Live larvae and pupae were collected from 53 homes and later they were taken to the laboratory in Anapoima, where they were classified, pooled and frozen. In Bogotá, they were homogenized, RNA was extracted with Trizol™ , and RT-PCR and conventional PCR were performed. The amplified products were analyzed on 2% agarose gels. Results: In 54.7% of the houses we found A. aegypti in immature stages, and DENV-1 was the most frequent serotype. However, the simultaneous presence of DENV 1 and 2, DENV 1 and 3, DENV 1 and 4, and DENV 1, 2 and 3 serotypes was detected in some pools. Conclusion: The results confirmed the natural vertical transmission of the virus in the rural area under study. These findings confirmed the vector capacity of A. aegypti, and partly explains the persistence of the virus in the region and the possibility of transmission by the vector during adulthood without having ingested infected blood. This situation increases the risk of DENV infection in Colombia and the need for prevention and control programs in all areas where the mosquito is present.


Assuntos
Animais , Humanos , Aedes/virologia , Vírus da Dengue/isolamento & purificação , Mosquitos Vetores/virologia , Pupa/virologia , RNA Viral/análise , Sorotipagem , Saúde da População Rural , Colômbia/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Dengue/transmissão , Dengue/epidemiologia , Vírus da Dengue/classificação , Vírus da Dengue/genética , Geografia Médica , Habitação , Larva/virologia
20.
Bol. Hosp. Viña del Mar ; 73(3): 97-98, sept. 2017.
Artigo em Espanhol | LILACS | ID: biblio-948376

RESUMO

La enfermedad neumocócica invasiva (ENI) es causa de morbimortalidad prevenible en pediatría. Con la introducción de vacunas antineumocócicas conjugadas disminuyó la prevalencia de ENI en 61,9% en los menores de 2 años, y se produjo un cambio en la distribución de serotipos y un aumento de ENI por serotipos no vaccinales. En este contexto, es relevante la vigilancia epidemiológica de los serotipos emergentes causantes de ENI en la población. Se presentará el caso de una lactante de 11 meses con diagnóstico de meningitis causada por neumococo serotipo 38, su evolución y consecuencias clínicas, y se realiza un análisis de la situación epidemiológica actual.


In pediatrics,invasive pneumococcal disease is a preventable cause ofmorbidity andmortality.The introduction of conjugated pneumococcal vaccines has reduced the prevalence of invasive pneumococcal disease by 61.9% in the under two's and has brought about a change in the distribution of serotypes and a rise in invasive pneumococcal disease caused by non-vaccine serotypes.This being the case,itis very importanttomonitorthe epidemiology ofthe emerging serotypes causing the disease in the population.We presentthe case of an 11 month old infant diagnosed with meningitis caused by serotype 38, describing his clinical course andclinical consequences; andweperforman analysis ofthepresent epidemiologica lsituation


Assuntos
Humanos , Feminino , Lactente , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/terapia , Streptococcus pneumoniae/isolamento & purificação , Sorotipagem , Sorogrupo
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