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1.
Microbiol Spectr ; 10(5): e0056522, 2022 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-35993730

RESUMO

The epidemiology of antimicrobial resistance (AMR) is complex, with multiple interfaces (human-animal-environment). In this context, One Health surveillance is essential for understanding the distribution of microorganisms and antimicrobial resistance genes (ARGs). This report describes a multicentric study undertaken to evaluate the bacterial communities and resistomes of food-producing animals (cattle, poultry, and swine) and healthy humans sampled simultaneously from five Brazilian regions. Metagenomic analysis showed that a total of 21,029 unique species were identified in 107 rectal swabs collected from distinct hosts, the highest numbers of which belonged to the domain Bacteria, mainly Ruminiclostridium spp. and Bacteroides spp., and the order Enterobacterales. We detected 405 ARGs for 12 distinct antimicrobial classes. Genes encoding antibiotic-modifying enzymes were the most frequent, followed by genes related to target alteration and efflux systems. Interestingly, carbapenemase-encoding genes such as blaAIM-1, blaCAM-1, blaGIM-2, and blaHMB-1 were identified in distinct hosts. Our results revealed that, in general, the bacterial communities from humans were present in isolated clusters, except for the Northeastern region, where an overlap of the bacterial species from humans and food-producing animals was observed. Additionally, a large resistome was observed among all analyzed hosts, with emphasis on the presence of carbapenemase-encoding genes not previously reported in Latin America. IMPORTANCE Humans and food production animals have been reported to be important reservoirs of antimicrobial resistance (AMR) genes (ARGs). The frequency of these multidrug-resistant (MDR) bacteria tends to be higher in low- and middle-income countries (LMICs), due mainly to a lack of public health policies. Although studies on AMR in humans or animals have been carried out in Brazil, this is the first multicenter study that simultaneously collected rectal swabs from humans and food-producing animals for metagenomics. Our results indicate high microbial diversity among all analyzed hosts, and several ARGs for different antimicrobial classes were also found. As far as we know, we have detected for the first time ARGs encoding carbapenemases, such as blaAIM-1, blaCAM-1, blaGIM-2, and blaHMB-1, in Latin America. Thus, our results support the importance of metagenomics as a tool to track the colonization of food-producing animals and humans by antimicrobial-resistant bacteria. In addition, a network surveillance system called GUARANI, created for this study, is ready to be expanded and to collect additional data.


Assuntos
Anti-Infecciosos , Farmacorresistência Bacteriana , Humanos , Suínos , Bovinos , Animais , Farmacorresistência Bacteriana/genética , Brasil , Metagenômica/métodos , Bactérias , Antibacterianos/farmacologia , Aves Domésticas , Genes Bacterianos
2.
Am J Trop Med Hyg ; 105(5): 1218-1221, 2021 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-34544042

RESUMO

Sporotrichosis is usually a subcutaneous infection caused by thermodimorphic fungi of the genus Sporothrix. The disease occurs worldwide, but endemic areas are located in tropical and subtropical regions. The epidemiology of sporotrichosis in Brazil is peculiar because of the cat's entry in the chain of transmission of this mycosis, associated with Sporothrix brasiliensis, the most virulent species in the genus. Sinusitis caused by Sporothrix species is unusual and may be underdiagnosed or confused with other fungal etiologies, like mucormycosis. We report a case of sinusitis due to a Sporothrix species in a 6-year renal transplant recipient. Direct examination of smears of exudate of the sinus specimen (aspirate, biopsy) revealed budding yeasts and cigar-shaped cells. Sporothrix was subsequently recovered from the patient's exudate culture and identified as S. brasiliensis using species-specific polymerase chain reaction, and she was successfully treated with antifungal therapy. Her parents also developed the disease a week later, both only cutaneous involvement. Sporotrichosis sinusitis is a rare disease, even in immunocompromised patients. Diagnosis is crucial, and benefits from good epidemiological history.


Assuntos
Antifúngicos/uso terapêutico , Complicações Pós-Operatórias/microbiologia , Sinusite/tratamento farmacológico , Sinusite/microbiologia , Esporotricose/diagnóstico , Esporotricose/tratamento farmacológico , Triazóis/uso terapêutico , Adulto , Brasil/epidemiologia , Feminino , Humanos , Transplante de Rim/efeitos adversos , Complicações Pós-Operatórias/tratamento farmacológico , Sinusite/diagnóstico , Sporothrix/isolamento & purificação , Transplantados , Resultado do Tratamento
3.
PLoS One ; 16(8): e0255593, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411123

RESUMO

Recent studies report seasonality in healthcare-associated infections, especially those caused by Acinetobacter baumannii complex. We conducted an ecologic study aimed at analyzing the impact of seasons, weather parameters and climate control on the incidence and carbapenem-resistance in A. baumannii complex bloodstream infections (ABBSI) in hospitals from regions with different climates in Brazil. We studied monthly incidence rates (years 2006-2015) of ABBSI from hospitals in cities from different macro-regions in Brazil: Fortaleza (Ceará State, Northeast region), Goiânia (Goiás State, Middle-west) and Botucatu (São Paulo State, Southeast). Box-Jenkins models were fitted to assess seasonality, and the impact of weather parameters was analyzed in Poisson Regression models. Separate analyses were performed for carbapenem-resistant versus carbapenem-susceptible isolates, as well as for infections occurring in climate-controlled intensive care units (ICUs) versus non-climate-controlled wards. Seasonality was identified for ABSSI ICUs in the Hospitals from Botucatu and Goiânia. In the Botucatu hospital, where there was overall seasonality for both resistance groups, as well as for wards without climate control. In that hospital, the overall incidence was associated with higher temperature (incidence rate ratio for each Celsius degree, 1.05; 95% Confidence Interval, 1.01-1.09; P = 0.006). Weather parameters were not associated with ABBSI in the hospitals from Goiânia and Fortaleza. In conclusion, seasonality was found in the hospitals with higher ABBSI incidence and located in regions with greater thermal amplitude. Strict temperature control may be a tool for prevention of A. baumanii infections in healthcare settings.


Assuntos
Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/isolamento & purificação , Unidades de Terapia Intensiva/estatística & dados numéricos , Estações do Ano , Sepse/epidemiologia , Temperatura , Tempo (Meteorologia) , Infecções por Acinetobacter/microbiologia , Brasil/epidemiologia , Humanos , Incidência , Sepse/microbiologia
4.
Int J Pediatr Otorhinolaryngol ; 83: 94-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26968061

RESUMO

OBJECTIVE: To evaluate whether the quadrivalent human papillomavirus (HPV) (types 6, 11, 16, and 18) vaccine influences the clinical course of juvenile-onset recurrent respiratory papillomatosis (RRP) when administered to a group of patients with this condition. METHODS: Uncontrolled intervention study of patients with juvenile-onset RRP examined at the Pediatric Otorhinolaryngology Clinic, Federal University of São Paulo, where nine patients between the ages of nine and 17 received three doses of the prophylactic quadrivalent HPV vaccine (Gardasil(®)) and were followed for one year. Disease staging, intervals between relapses, intervals between surgeries, and the number of surgeries during the year prior to vaccination and during the first year after vaccination were compared. RESULTS: Eight patients were infected with HPV-6 and one with HPV-11. There were no statistically significant differences in the clinical scores (p=0.083), anatomical scores (p=0.257), intervals between relapses (p=0.062), intervals between surgeries (p=0.357), or the numbers of surgeries (p=0.180) when the years before and after vaccination were compared. All patients had relapses following vaccination. CONCLUSION: Patients with juvenile-onset RRP experienced a similar clinical course in the year after versus the year before vaccination with Gardasil(®).


Assuntos
Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/administração & dosagem , Papillomaviridae/imunologia , Infecções por Papillomavirus/tratamento farmacológico , Infecções Respiratórias/tratamento farmacológico , Adolescente , Brasil , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Resultado do Tratamento
5.
J Cataract Refract Surg ; 37(7): 1244-50, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21601416

RESUMO

PURPOSE: To determine the usefulness of real-time polymerase chain reaction (PCR) assays in the diagnosis of postoperative bacterial endophthalmitis in clinically diagnosed infectious cases and to test for bacterial DNA in control samples collected from noninfected eyes. SETTING: Federal University of São Paulo, Brazil. DESIGN: Evaluation of diagnostic test or technology. METHODS: This study comprised patients with clinically diagnosed infectious endophthalmitis after cataract surgery and vitreous samples (from noninflamed eyes obtained through vitrectomy) and aqueous samples (at end of phacoemulsification) from control patients at a single university setting. Universal and gram-specific real-time PCR, Gram staining, and culture were performed. Sensitivity and cycle thresholds were determined. Clinical and microbiologic data were also assessed. RESULTS: The study evaluated 11 patients with infectious endophthalmitis (9 vitreous and 7 aqueous samples), 12 control vitreous samples, and 50 control aqueous samples. Gram and culture identified 80% and 75%, respectively, of patients with infectious endophthalmitis. Real-time PCR assays were positive in 91% of patients with a clinical diagnosis of endophthalmitis using aqueous samples, vitreous samples, or both. None of the 12 vitreous controls were positive by PCR. Two aqueous control samples were positive by real-time PCR. The cycle threshold cutoff value was 36 for universal PCR (sensitivity 93.8%; specificity 100%) and 38 for gram-specific PCR (sensitivity 93.8%; specificity 100%). Gram-positive microorganisms prevailed, and visual acuity varied according to the causative bacteria. CONCLUSIONS: Real-time PCR provided fast and accurate diagnosis of bacterial endophthalmitis. As a quantitative technique, it may be useful in distinguishing between contamination and infection based on the cycle thresholds value.


Assuntos
DNA Bacteriano/análise , Endoftalmite/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Facoemulsificação , Complicações Pós-Operatórias , Idoso , Idoso de 80 Anos ou mais , Humor Aquoso/microbiologia , Bactérias/genética , Bactérias/isolamento & purificação , Técnicas Bacteriológicas , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/microbiologia , Feminino , Violeta Genciana , Humanos , Masculino , Pessoa de Meia-Idade , Fenazinas , Reação em Cadeia da Polimerase , Estudos Prospectivos , RNA Ribossômico 16S/genética , Curva ROC , Sensibilidade e Especificidade , Acuidade Visual/fisiologia , Corpo Vítreo/microbiologia
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