Evaluation of infliximab-induced genotoxicity and possible action on BCL-2 and P53 genes.

Although the last pandemic created an urgency for development of vaccines, there was a continuous and concerted effort to search for therapeutic medications among existing drugs with different indications. One of the medications of interest that underwent this change was infliximab (IFM). This drug is used as an anti-inflammatory, predominantly in patients with Crohn 's disease, colitis ulcerative, and rheumatoid arthritis. In addition to these patients, individuals infected with Coronavirus Disease (COVID-19) were administered this chimeric monoclonal antibody (IMF) to act as an immunomodulator for patients in the absence of comprehensive research. Consequently, the present study aimed to examine the genotoxic effects attributed to IFM treatment employing different assays in vivo using mouse Mus musculus. Therefore, IFM was found to induce genotoxic effects as evidenced by the comet assay but did not demonstrate genotoxic potential utilizing mouse bone marrow MN test. The results of evaluating the expression of the P53 and BCL-2 genes using RT-qPCR showed stimulation of expression of these genes at 24 hr followed by a decline at 48 hr. Although the comet assay provided positive results, it is noteworthy that based upon negative findings in the micronucleus test, the data did not demonstrate significant changes in the genetic material that might affect the therapeutic use of IFM. The stimulation of expression of P53 and BCL-2 genes at 24 hr followed by a decline at 48 hr suggest a transient, if any, effect on genetic material. However, there is still a need for more research to more comprehensively understand the genotoxic profile of this medication.

Profile analysis of emerging respiratory virus in children.

Acute respiratory infections (ARIs) are caused by a variety of microorganisms. Of all ARIs, 80% are caused by viruses such as human respiratory syncytial virus, metapneumovirus, influenza, parainfluenza, rhinovirus, and, more recently, Sars-CoV-2, which has been responsible for the COVID-19 pandemic. The objective of our study was to evaluate clinical data from a viral panel performed in children hospitalized with SARS or COVID-19 in the infirmary or ICU of 5 pediatric hospitals in the city of Goiânia, Goiás, Brazil. Demographic, clinical, and laboratory data were collected for analysis, and data on the outcomes underwent statistical treatment. A total of 128 patients were selected for the study, 54% of whom were male and 46% female. The viral panel included rhinovirus, COVID-19, metapneumovirus, adenovirus, and parainfluenza. Descriptive analyses of age profile showed differences in the involvement of particular viruses. The percentage of patients who required hospitalization in the ICU, infirmary, as well as individuals who were discharged after therapy or who died, were described. Our work shows that epidemiological surveillance measures are indispensable, especially if used in the continued analysis of viral panels in all pediatric patients with SARS.

Influenza and other respiratory viruses in children: prevalence and clinical features.

With the COVID-19 pandemic still ongoing, the annual season of influenza and other respiratory virus epidemics has arrived. Specimens from patients suspected of respiratory viruses infection were collected. Viral detection was performed following RNA extraction and real-time RT-PCR. During the study period, we received and tested a total of 606 specimens. Rhinovirus virus was the viral type most prevalent, detected in 186 (45.47%) specimens. The age range of patients positive for influenza A, influenza A (H1N1), and influenza B was 18 days to 13 years. With female prevalence for this viral type, cough and asthma were the main clinical manifestations presented by this viral type. Our results indicate that rhinoviruses, adenoviruses, metapneumoviruses, and influenza are among the most important agents of ARI in pediatrics. The epidemic period of respiratory infections observed in Goiânia can be useful for planning and implementing some prevention strategies.

Arboviruses (chikungunya, dengue, and Zika) associated with ophthalmic changes: a focus on aqueous fluid and vitreous humor.

The aim of this study was to conduct a bibliographic survey and correlates the presence of arboviroses in the eyeball with the main eye changes presented by the population under study. This study is a systematic review of journals and indexed articles, carried out between January 2019 and June 2019, in which there was a query in the Pubmed/Medline and Scielo databases without temporal restriction. In addition to the aforementioned databases, the Brazilian Association of Organ Transplantation Association database, which provides epidemiological data on organ and tissue transplants in Brazil, was used as a research source. The Midwest region contributed to the increase in the number of organ transplants in Brazil. The number of corneal transplants in Brazil surpassed the number of organ transplants by four times. Several ophthalmic changes associated with Chikungunya, Dengue, and Zika virus infections have been diagnosed; however, few studies have identified the presence of the virus in the eyeball. Arboviruses are of great relevance to public health due to a number of factors, ranging from the diversity of infectious agents involved and the plurality of clinical manifestations because the absence of efficient laboratory support, leading to delayed disease confirmation due to lack of differential diagnostics available. Added to these difficulties is the lack of specific therapy, leaving only the symptomatic control of clinical manifestations as the only treatment option. However, the manifestations are directly associated with the decreased quality of vision and consequently the quality of life of patients.

Evaluation of the raw water quality: physicochemical and toxicological approaches.

Environmental degradation has increased, mainly as a result of anthropogenic effects arising from population, industrial and agricultural growth. Water pollution is a problem that affects health, safety and welfare of the whole biota which shares the same environment. In Goiânia and metropolitan region, the main water body is the Meia Ponte River that is used for the abstraction of water, disposal of treated wastewater and effluents. In addition, this river receives wastewater from urban and rural areas. The aim in this present study was to evaluate the quality of raw water by some physical, chemical and toxicological tests. The physicochemical results found high levels of turbidity, conductivity, aluminum, phosphorus and metal iron, manganese, copper and lithium when compared to the standards of the Brazilian legislation. The values found of toxicity demonstrated a high degree of cytotoxicity and genotoxicity. Therefore, it was concluded that the Meia Ponte River has been undergoing constant environmental degradation, causing the poor quality of its waters. Thus, measures for the prevention and recovery should be adopted for the maintenance of the Meia Ponte River.

Cultivable microbiome and its resistance to antimicrobials isolated from Zaprionus indianus.

The objective of this study was to identify Z. indianus in PEJC and PESCAN. Listed are the following methods: to isolate bacteria from the integument of the Z. indianus species collected and to check the resistance of microorganisms to antibiotics. Collections of Z. indianus were performed in four seasons of the two parks. The results obtained suggest that the low amount of Z. indianus collected can be justified by environmental factors such as high average temperature and low average humidity. It is noted that there is a predominance of bacteria of the Enterobacteriaceae family found in both the PEJC and the PESCAN. The antibiogram performed for the isolated PEJC bacteria shows statistical significance when comparing the edge and inside values of the park. Studies with fungi were also carried out, and it was evidenced that Trichophyton spp. was the genus that most inhabited the two environments studied. The ability of fluconazole and ketoconazole to inhibit fungal growth was also investigated, and considering the concentration tested may suggest that they have good action spectra. Plasmid profile data show that 60% of antibiotic-resistant bacteria have plasmids. The values found show that Z. indianus can act as vectors of microorganisms that affect the healthy animals and humans and that these organisms may be influenced by seasons.

Bacteriological water quality in school's drinking fountains and detection antibiotic resistance genes.

The fecal coliform can contaminate water of human consumption causing problems to public health. Many of these microorganisms may contain plasmid and transfer them to other bacteria. This genetic material may confer selective advantages, among them resistance to antibiotics. The objectives of this study were to analyze the presence of fecal coliforms in water and at drinker surface, to identify the existence of plasmid, conducting studies of resistance to antibiotics, plasmid stability and capacity of bacterial conjugation. Were collected microorganisms in water of drinker surface and were used specific culture media and biochemical tests for identification of organisms, tests were performed by checking the resistance to antibiotics (ampicillin 10 µg, tetracycline 30 µg, and ciprofloxacin 5 µg), was performed extraction of plasmid DNA, plasmid stability and bacterial conjugation. Was obtained results of 31% of Salmonella spp. and 51% for other coliforms. Among the samples positive for coliforms, 27 had plasmid stable and with the ability to perform conjugation. The plasmids had similar forms, suggesting that the resistance in some bacteria may be linked to those genes extra chromosomal.

Occurrence of heavy metals and contaminants on the surface of adjacent rivers.

Water is fundamental to the survival of living beings. It registers every impact and can function as an indicator of environmental stressors. Our objective in the current study was to assess the sanitary conditions of the waters in the Açude, Maria Lucinda and Santa Rosa streams. This was done by checking pH, running quantitative analyses of heavy metals and testing for total coliforms. The effect of ultraviolet (UV) rays on samples positive for coliforms was evaluated. The average pH of the streams ranged between 4 and 7 and changed between drought and rainy season conditions. Chromium and nickel values were above those permitted by the Brazilian National Council on the Environment, CONAMA. In the dry season, zinc values were above those established by CONAMA for waterbodies of Classes 1 and 2. Thermotolerant coliforms were present in all samples collected and above permitted values. After exposing the bacteria to UV light, it was noted that UV irradiation was unable to decrease the bacteria count. Ninety residents who use stream water were interviewed: 24% of interviewees said they use the waters of the Açude and Mary Lucinda streams and along the Santa Rosa stream, 95% of inhabitants said they use the water.

PCR as a screening test for invasive aspergillosis in haematological patients: a pilot study.

Invasive aspergillosis is a leading cause of morbidity and mortality in immunocompromised patients, particularly in individuals with haematological malignancy and in haematopoietic stem cell transplant recipients. Nowadays, the galactomannan (GM) assay has been widely used as an indication of invasive aspergillosis, even though the test is known to generate false-positive results. The aim of this study was to compare the performance of GM and real-time PCR (qPCR) to detected Aspergillus in blood samples obtained from high-risk haematological patients. Haematological patients were screened twice weekly with GM testing, which was performed by the Platelia ELISA kit. An additional sample of whole blood (4 ml) was obtained for the purpose of qPCR testing. Sixty-four samples from 12 patients with haematopoietic stem cell transplant or haematological malignancy were studied. The overall accordance between GM and qPCR tests was 96.9 % (62 samples). Only two samples showed contradictory results, with positive GM test and negative real-time PCR results. Based on the high concordance between GM and qPCR in terms of negative results, the main utility of qPCR could be in the confirmation of positive results seen with GM testing.

Clinical and laboratory profile of patients with positive direct antiglobulin test attended at a university hospital in Goias, Brazil.

OBJECTIVE: To clinically and laboratory characterize patients with a positive direct antiglobulin test (DAT) treated at the Hospital das Clínicas of the Federal University of Goiás (HC-UFG). METHODS: A retrospective, descriptive, cross-sectional study was carried out collecting data from medical records of patients with a positive DAT who were treated at HC-UFG between August 2021 and August 2022. RESULTS: Eighty-four patients with positive polyspecific DAT results were screened in the clinical laboratory. Fifty-four patients had a laboratory profile compatible with autoimmune hemolytic anemia (AIHA), however, among these, 16 patients already had a diagnosis of AIHA in their medical records. The most common symptoms present among AIHA patients were pallor, asthenia, fatigue and dyspnea. For the remaining patients, the most common symptoms were severe thrombocytopenia, anemia, renal dysfunction, fever, myalgia, headache, thrombosis, asthenia, hematuria and joint pain. Only one patient had primary AIHA, that is, he had no evident underlying disease. The majority of AIHA patients (75 %) underwent corticosteroid therapy with 60 % having a positive response. For patients without AIHA, prednisone was the most frequently prescribed medication in 17 (25 %) patients, followed by hydroxychloroquine (14 patients - 20.1 %). CONCLUSION: It is essential to evaluate patients with positive DAT in detail in order to understand the real clinical case. The DAT serological result alone does not arrive at a conclusive diagnosis of AIHA, and so it must be evaluated in conjunction with both clinical data and other laboratory tests, such as hemoglobin concentration and hemolysis tests (reticulocytes, lactate dehydrogenase and/or haptoglobin).

Co-Infection of SARS-CoV-2 and Klebsiella pneumoniae: A Systematic Review and Meta-Analysis.

The study aimed to assess the prevalence of COVID-19 and Klebsiella spp. coinfection across continents. Conducted following PRISMA guidelines, a systematic review utilized PubMed, Embase, SCOPUS, ScienceDirect, and Web of Science databases, searching for literature in English published from December 2019 to December 2022, using specific Health Sciences descriptors. A total of 408 records were identified, but only 50 were eligible, and of these, only 33 were included. Thirty-three references were analyzed to evaluate the correlation between COVID-19 and Klebsiella spp. infections. The tabulated data represented a sample group of 8741 coinfected patients. The findings revealed notable disparities in co-infection rates across continents. In Asia, 23% of individuals were infected with Klebsiella pneumoniae, while in Europe, the proportion of co-infected patients stood at 15%. Strikingly, on the African continent, 43% were found to be infected with Klebsiella pneumoniae, highlighting significant regional variations. Overall, the proportion of Klebsiella pneumoniae co-infections among COVID-positive individuals were determined to be 19%. Particularly concerning was the observation that 1 in 6 ICU coinfections was attributed to Klebsiella pneumoniae, indicating its substantial impact on patient outcomes and healthcare burden. The study underscores the alarming prevalence of co-infection between COVID-19 and Klebsiella pneumoniae, potentially exacerbating the clinical severity of patients and posing challenges to treatment strategies. These findings emphasize the importance of vigilant surveillance and targeted interventions to mitigate the adverse effects of bacterial coinfections in the context of the COVID-19 pandemic.

Short Communication: Rotavirus Group A Occurrence in Rural Water Source Samples in a Midwest Region State of Brazil, Comparing Wet and Dry Seasons.

Identified as a potential reference pathogen by the WHO Guidelines for Drinking-Water Quality, Rotavirus (RV) is among the main enteric viruses that cause waterborne diseases. The aim of this study was to identify and correlate the presence of RV in collective and individual water sources of rural communities in the state of Goiás, within the seasons in which the collections were made (rainy and dry seasons). For this, 86 water samples in the dry period and 160 samples in the rainy period were collected. Concentration of water samples, extraction of viral genetic material and molecular tests were performed. When analyzing the presence of RV in the samples, taking into consideration the period studied, RV was found to be more prevalent in the dry season (54.7%) than in the rainy season (20%), showing a strong statistical association with the dry season (p-value < 0.001). The presence of pathogenic microorganisms in water is a public risk issue, enabling the emergence of outbreaks, endemics and epidemics. In the present research, there was an association between the presence of Rotavirus and the dry period of the year when compared to the rainy period.

Rhinovirus infection and co-infection in children with severe acute respiratory infection during the COVID-19 pandemic period.

Rhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.

Identification of 2,4-diacetylphloroglucinol production in the genus Chromobacterium.

The compound 2,4-diacetylphloroglucinol (DAPG) is a broad-spectrum antibiotic that is primarily produced by Pseudomonas spp. DAPG plays an important role in the biocontrol disease suppressing activity of Pseudomonas spp. In the current study, we report the discovery of the DAPG biosynthetic cluster in strains of Chromobacterium vaccinii isolated from Brazilian aquatic environments and the distribution of the biosynthetic cluster in the Chromobacterium genus. Phylogenetic analysis of the phlD protein suggests the biosynthetic cluster probably entered the genus of Chromobacterium after a horizontal gene transfer event with a member of the Pseudomonas fluorescens group. We were able to detect trace amounts of DAPG in wild type cultures and confirm the function of the cluster with heterologous expression in Escherichia coli. In addition, we identified and verified the presence of other secondary metabolites in these strains. We also confirmed the ability of C. vaccinii strains to produce bioactive pigment violacein and bioactive cyclic depsipeptide FR900359. Both compounds have been reported to have antimicrobial and insecticidal activities. These compounds suggest strains of C. vaccinii should be further explored for their potential as biocontrol agents.

Detection of Oxacillin/Cefoxitin Resistance in Staphylococcus aureus Present in Recurrent Tonsillitis.

BACKGROUND: Recurrent tonsillitis is one of the most common diseases in childhood, caused many times by ß-lactam-resistant S. aureus. The objective of this study was to investigate an alternative method to identify resistance to oxacillin/cefoxitin in S. aureus from hospitalized children with recurrent tonsillitis. METHODS: The samples of S. aureus came from patients with recurrent tonsillitis and were used in 16S rRNA sequencing and an antibiogram test for identification and verifying resistance, after which HSI methodology were applied for separation of S. aureus resistances. RESULTS: The S. aureus isolated showed sensitivity to oxacillin/cefoxitin and the diagnostic images show a visual description of the resistance different groups formed, that may be related to sensitivity and resistance to oxacillin/cefoxitin, characterizing the MRSA S. aureus. CONCLUSIONS: Samples that showed phenotypic resistance to oxacillin/cefoxitin were clearly separated from samples that did not show this resistance. A PLS-DA model predicted the presence of resistance to oxacillin/cefoxitin in S. aureus samples and it was possible to observe the pixels classified as MRSA. The HSI was able to successfully discriminate samples in replicas that were sensitive and resistant, based on the calibration model it received.

Characterization of T Helper 1 and 2 Cytokine Profiles in Newborns of Mothers with COVID-19.

An infectious disease caused by SARS-CoV-2, COVID-19 greatly affects the pediatric population and is 3 times more prevalent in newborns than in the general population. In newborns, the overexpression of immunological molecules may also induce a so-called cytokine storm. In our study, we evaluated the expression of cytokines in newborns admitted to a neonatal ICU whose mothers had SARS-CoV-2 and symptoms of SARS. The blood of newborns of infected and healthy mothers was collected to identify their Th1 and Th2 cytokine profiles, and via flow cytometry, the cytokines TNF-α, IFN-γ, IL-2, IL-6, and IL-10 were identified. Overexpression was observed in the Th1 and Th2 cytokine profiles of newborns from infected mothers compared with the control group. Statistical analysis also revealed significant differences between the cellular and humoral responses of the infected group versus the control group. The cellular versus humoral responses of the newborns of infected mothers were also compared, which revealed the prevalence of the cellular immune response. These data demonstrate that some cytokines identified relate to more severe symptoms and even some comorbidities. IL-6, TNF-α, and IL-10 may especially be related to cytokine storms in neonates of mothers with COVID-19.

Viral Coinfection of Children Hospitalized with Severe Acute Respiratory Infections during COVID-19 Pandemic.

The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection. METHODS: This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study. RESULTS: The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of (p > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively. CONCLUSION: Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.

Elevated Mortality Risk from CRKp Associated with Comorbidities: Systematic Review and Meta-Analysis.

Carbapenem-resistant Klebsiella pneumoniae has become a public health problem with therapeutic limitations and high mortality associated with comorbidities. Methods: This is a systematic review and meta-analysis with a search in PubMed, SciELO, and Lilacs. Ten articles were selected, considering cohort, case-control, and cross-sectional studies. Tests for proportions and relative risk of mortality were performed, considering a 5% threshold for significance. Statistical analyses were performe dusing Rstudio® software, version 4.0.2 of Ross Ihaka and Robert Genleman in Auckland, New Zealand. Results: Klebsiella pneumoniae, associated with chronic kidney disease, was responsible for 26%/258 deaths, chronic lung disease 28%/169, diabetes 31%/185, liver disease 15%/262, and heart disease 51%/262 deaths. Carbapenem-resistant Klebsiella pneumoniae associated with chronic kidney disease was responsible for 49%/83 deaths, with diabetes 29%/73, and with liver disease 33%/73 deaths. The risk of death from carbapenem-resistant Klebsiella pneumoniae was twice as high as the number of deaths associated with carbapenem-sensitive Klebsiella pneumoniae, RR = 2.07 (p < 0.00001). Conclusions: The present study showed an increase in mortality from carbapenem-resistant Klebsiella pneumoniae when associated with comorbidities.

Draft Genome Sequences of Chromobacterium Strains Isolated from Water Systems in Central Western Brazil.

We report the draft genome sequences of four Chromobacterium strains. This report includes the draft genome sequences of four environmental strains, isolated from surface waters in Brazil.

Severe Neurological Manifestation in a Child with Multisystem Inflammatory Syndrome.

BACKGROUND AND OBJECTIVES: During the COVID-19 pandemic, we followed with concern the evolution of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is to describe the evolution of MIS-C in a previously healthy 3-year-old girl. METHODS: We tracked the daily medical report of all children admitted with suspected MIS-C to the five largest regional hospitals. RESULTS: Our screening identified a child who had several neurological complications associated with MIS-C. We report hematological alterations, transient cardiac dysfunction, and cerebral involvements such as laminar cortical necrosis caused by ischemic stroke. We present the course of treatment and clinical outcome, and other complications such as a severe subglottic stenosis occurring after extubation. CONCLUSION: Subglottic stenosis is an expected complication after prolonged intubation, and the presence of dysphonia and/or stridor is an important predictive factor. MIS-C with severe neurological alteration may occur in a healthy child, and early diagnosis and treatment with a pulse of corticoid with immunoglobulin are essential for a favorable outcome.