A systematic review of East African-Indian family of Mycobacterium tuberculosis in Brazil

ABSTRACT Introduction: The Mycobacterium tuberculosis East African-Indian (EAI) spoligotyping family (belonging to lineage 1, Indo-Oceanic, defined by the region of deletion RD239) is distributed worldwide, but is more prevalent in Southeast Asia, India, and East Africa. Studies in Latin America have rarely identified EAI. In this study, we describe the occurrence of the EAI family in Brazil. Methods: EAI was identified in a systematic literature review of genetic diversity studies pertaining to M. tuberculosis in Brazil, as well as in a survey conducted in Salvador, Bahia, located in the northeastern region of this country. Results: The EAI6-BGD1 spoligotyping family and the EAI5 Spoligotype International Type (SIT) 1983 clade were the most frequently reported, with wide distribution of this particular clade described in Brazil. The distribution of other EAI spoligotyping patterns with broader worldwide distribution was restricted to the southeastern region of the country. Conclusions: EAI may be endemic at a low frequency in Brazil, with some clades indicating increased fitness with respect to this population.

A systematic review of East African-Indian family of Mycobacterium tuberculosis in Brazil.

INTRODUCTION: The Mycobacterium tuberculosis East African-Indian (EAI) spoligotyping family (belonging to lineage 1, Indo-Oceanic, defined by the region of deletion RD239) is distributed worldwide, but is more prevalent in Southeast Asia, India, and East Africa. Studies in Latin America have rarely identified EAI. In this study, we describe the occurrence of the EAI family in Brazil. METHODS: EAI was identified in a systematic literature review of genetic diversity studies pertaining to M. tuberculosis in Brazil, as well as in a survey conducted in Salvador, Bahia, located in the northeastern region of this country. RESULTS: The EAI6-BGD1 spoligotyping family and the EAI5 Spoligotype International Type (SIT) 1983 clade were the most frequently reported, with wide distribution of this particular clade described in Brazil. The distribution of other EAI spoligotyping patterns with broader worldwide distribution was restricted to the southeastern region of the country. CONCLUSIONS: EAI may be endemic at a low frequency in Brazil, with some clades indicating increased fitness with respect to this population.

Uma abordagem sItuacional do gerenciamento de resíduos de serviços de saúde animal / Enfoque de la situación de la gestión de los residuos de servicios de salud animal / Findings about animal health waste management

O objetivo deste trabalho foi realizar uma análise situacional sobre o gerenciamento de resíduos de serviços de saúde em unidades veterinárias na cidade de Salvador, Bahia. O estudo foi realizado no período de abril de 2007 a setembro de 2008. Um questionário foi elaborado e aplicado em 38 unidades veterinárias distribuídas pelo município de Salvador, Bahia. Os dados foram avaliados e quantificados proporcionalmente. A maioria dos estabelecimentos entrevistados (79%) não possuía plano de gerenciamento de resíduos de serviços de saúde. Entre os poucos que o possuíam, apenas 25% cumpriam as regras plenamente. Quando questionados sobre a legislação, mais da metade dos entrevistados informava não conhecer nenhuma legislação referente ao assunto e afirmava que a falta de informação é o principal motivo para o não cumprimento do gerenciamento de resíduos de serviços de saúde. A maioria dos entrevistados informava ter interesse em cursos de capacitação para os funcionários. Adicionalmente, os dados obtidos mostraram que 63% dos estabelecimentos utilizavam empresa pública para a coleta externa dos resíduos. Acredita-se que a realização de mais estudos, aliada a um incremento nas atividades educativas e na fiscalização dos estabelecimentos são necessários para promover a resolução do problema.

The scope of this study was to realize a situational analysis about the health solid waste management in veterinary establishments in the city of Salvador, Bahia, Brazil. The study was realized in the period of April 2007 to September 2008. A questionnaire was elaborated and applied in 38 veterinary unities distributed in the municipal of Salvador, Bahia, Brazil. The data was evaluated and quantified proportionally. The majority of the interviewed establishments (79%) did not have a plan for the management of health solid waste. Among the few that had it, only 25% follow the rules. When questioned about the legislation, more than a half informed that they were not aware of any legislation regarding the issue and declared that the lack of information was the main reason for the non-compliance to the management of health solid waste. The majority of those interviewed had interest in training courses for their staff. Additionally, it was verified that 63% of the establishments used public institutions for the collection of waste. It is believed that the realization of more studies, together with an increment in the educative activities and inspection of the establishments are necessary to promote the resolution of the problem.

El objetivo de este estudio fue realizar un análisis de la situación en la Gestión de Residuos de Servicios de Salud en las unidades veterinarias de la ciudad de Salvador, Bahia. El estudio se realizó en el periodo comprendido entre abril de 2007 y septiembre de 2008. Fue elaborado y aplicado un cuestionario a 38 unidades veterinarias distribuidas por la ciudad de Salvador, Bahia. Los datos fueron evaluados y cuantificados proporcionalmente. La mayoría de los establecimientos encuestados (79%) no tenían Plan de Gestión de Residuos de Servicios de Salud, y entre los pocos que lo tenían sólo el 25% cumplen plenamente con las normas. En cuanto a la legislación, más de la mitad de los encuestados informaron no saber nada de la legislación con respecto al tema y que la falta de información es la principal razón para el incumplimiento de la Gestión de Residuos de Servicios de Salud. La mayoría de los encuestados reportaron un interés en cursos de capacitación para los empleados. Además, los datos obtenidos mostraron que el 63% de los establecimientos utilizaban empresa pública para recoger los residuos. Se cree que otros estudios, combinado con un aumento en las actividades educativas y la supervisión de las instituciones son necesarios para promover la resolución del problema.

Mycobacterium tuberculosis-induced neutrophil ectosomes decrease macrophage activation.

BACKGROUND: The existence of ectosome-like microvesicles released by neutrophils was proposed a few decades ago. Other studies revealed that the innate immune response during mycobacterial infection is accompanied by an intense migration of neutrophils to the site of infection, which may be important during the acute phase of tuberculosis. We found that the ectosomes derived from infected neutrophils are biologically active and can influence the survival of Mycobacterium tuberculosis within macrophages. METHODS: Mycobacteria were cultured on supplemented Middlebrook-7H9 broth. All strains were grown to the exponential phase and quantitated by serial dilution. Human neutrophils and macrophages were infected with mycobacteria. Ectosomes from neutrophils were isolated post-infection and characterized by transmission electron microscopy and flow cytometry. To determine whether these microvesicles influenced mycobactericidal activity, mycobacteria-infected macrophages were treated with isolated ectosomes. RESULTS: Ectosomes were released from neutrophils infected with mycobacteria. These ectosomes were derived from neutrophil plasma membrane and a small proportion stained with PKH26. These microvesicles, when incubated with infected macrophages, influenced antimycobacterial activity. CONCLUSIONS: This is the first study to demonstrate that ectosomes that are shed from infected neutrophils influence mycobactericidal activity in macrophages in vitro, suggesting that these microvesicles have biological significance. Nevertheless, major gaps in our knowledge of microvesicle biology remain.

Avaliação do papel do interferon-y na modulação da resposta tecidual durante a infecção pelo Mycobacterium bovis / Evaluation of the role of interferon-y in the modulation of tissue response during infection with Mycobacterium bovis

O IFN-y tem sido implicado na defesa do hospedeiro contra as micobactérias. Esta citocina, produzida e liberada por linfócitos T recrutados para o sítio da infecção, é considerada o agente chave da ativação endógena, promovendo efeitos antimicobacterianos de macrófagos. Diversos modelos experimentais têm sido desenvolvidos para delinear o papel de citocinas responsáveis pelo controle da tuberculose. O presente estudo visa delinear o papel do IFN-y na modulação da resposta inflamatória granulomatosa no tecido hepático e pulmonar em camundongos infectados experimentalmente com o M. bovis. Os experimentos foram realizados utilizando-se camundongos com deficiência do gene responsável pela produção do IFN-y (C57BL/6 IFN-y-l-) e camundongos que produzem IFN-y (C57BL/6 IFN-y+l+), ambos infectados por via intravenosa com M. bovis. Avaliou-se a capacidade de sobrevida e multiplicação do M. bovis no fígado e pulmões, assim como características histopatógicas nestes dois órgãos. No curso da infecção (15, 30, 50 e 100 dias pós-infecção) a CFU (unidade formadora de colônia) foi quantificada no tecido hepático e pulmonar dos dois grupos de camundongos. A carga bacilar dos animais IFN-y-l- foi significantemente maior que nos IFN-y+/+. A quantidade de CFU foi maior no fígado que nos pulmões dos animais IFN-y-l- durante todo o estudo, enquanto nos IFN-y+/+ apenas no primeiro ponto estudado (15 dias pós-infecção). Adicionalmente, nos camundongos IFN-y/- ocorreu um aumento contínuo da carga bacilar com o transcurso da infecção, enquanto os camundongos IFN-y+/+ foram capazes de reduzir a carga bacilar no tecido hepático nos períodos mais tardios da análise. As alteraíões histopatológicas começam mais tardiamente nos camundongos IFN-y-/- (30 dias de pós-infecção). Estes formam granulomas sempre em menor número e tamanho que os IFN-y+/+. As alterações granulomatosas no fígado persistem até os 100 dias no camundongo IFN-y-l- e diminuem nos IFN-y+/+. Portanto, a presença do...