[Spasticity-correcting surgery can have long-lasting effects]. / Spasticitetskorrigerande kirurgi kan ge långvariga förbättringar.

Spasticity is a common secondary complication after injuries to the central nervous system (CNS). Spasticity may severely impair arm and hand function, and consequently, affect an individual's function, resulting in disabilities or limiting activities and participation. Today, there is conflicting evidence regarding the effectiveness of available spasticity treatments. The population of adults with spasticity problems due to a CNS injury is heterogenic. A multidisciplinary approach is essential in customizing treatment to individual needs. The planning of treatment should consider the remaining upper limb functions and the patient's potential to improveme. Spasticity-correcting surgery is an option that seems underutilized. This article describes a structured and standardized program for the preoperative assessment, the surgical technique and the postoperative rehabilitation of patients undergoing upper limb spasticity-correcting surgery.

Insights into the antimicrobial properties of a cationic steroid and antibiofilm performance in PDMS-based coatings to potentially treat urinary infections.

Currently, multidrug-resistant (MDR) infections are one of the most important threats, driving the search for new antimicrobial compounds. Cationic peptide antibiotics (CPAs) and ceragenins (CSAs) contain in their structures cationic groups and adopt a facially amphiphilic conformation, conferring the ability to permeate the membranes of bacteria and fungi. Keeping these features in mind, an amine steroid, DOCA-NH2, was found to be active against reference strains and MDR isolates of Gram-positive Enterococcus faecalis and Staphylococcus aureus and Gram-negative Escherichia coli and Pseudomonas aeruginosa. The compound was active against all the tested microorganisms, having bactericidal and fungicidal activity, displaying minimal inhibitory concentrations (MICs) between 16 and 128 µg mL-1. No synergy with clinically relevant antibacterial drugs was found. However, the compound was able to completely inhibit the biofilm formation of bacteria exposed to the MIC of the compound. For E. coli and E. faecalis, inhibition of biofilm formation occurred at half the MIC. Besides, DOCA-NH2 inhibited the dimorphic transition of Candida albicans at concentrations 4 times lower than the MIC, and can reduce the microorganism virulence and biofilm formation was significantly reduced at both MIC and half the MIC. Polydimethylsiloxane-based coatings containing DOCA-NH2 (0.5, 1.0, and 1.5 wt%) were prepared and tested against the E. coli biofilm formation under hydrodynamic conditions similar to those prevailing in ureteral stents. A biofilm reduction of approximately 80% was achieved when compared to the control.

Tibialis posterior muscle stiffness assessment in flat foot subjects by ultrasound based Shear-Wave Elastography.

BACKGROUND: Few methodologies are used to assess Tibialis Posterior muscle stiffness. Those present limitations leading to a lack of evidence. Muscle stiffness assessment can help in the injuries risk factors identification while coupling with Ultrasound based Shear-Wave Elastography for its management. However, a precise and reliable methodology needs to be utilized to increase stiffness accuracy among the entire Tibialis Posterior muscle. Therefore, this study aims to investigate the stiffness association between Tibialis posterior deep and superficial layer and between flat and neutral footed subjects. METHODS: The sample consisted of 18 participants, where 9 subjects represent the flatfoot group and 9 the neutral foot group. Only the subjects who presented a Navicular Drop Test value of > 9 mm were included in the flatfooted group. All participants were submitted to the Tibialis posterior stiffness assessment with the help of Ultrasound base Shear-Wave Elastography in a lying supine position. Association between Tibialis Posterior deep and superficial layers were determined by Pearson's correlation analysis and group differences were assessed using the U-Mann Whitney test in the comparison between flat foot and neutral foot group (p < 0.05). RESULTS: No significant correlations between Tibialis Posterior layers stiffness were found (p = 0.194), nor in the comparison between both neutral and flat foot groups (p = 0.424/p = 0.258). CONCLUSION: Among participants, no associations between tibialis posterior layers stiffness were found. Also, we did not find any differences in the stiffness between flat and neutral foot groups. In this study, the stiffness did not differentiate flat-footed subjects from neutral subjects.

Thoughts on Pain, Physical Activity, and Body in Patients With Recurrent Low Back Pain and Fear: An Interview Study.

OBJECTIVE: The purpose of this study was to explore thoughts and ideas about the body and pain in patients with nonspecific low back pain (LBP) who have a high degree of fear of movement. METHODS: Patients with nonspecific LBP and a high degree of fear of movement, as measured using the Tampa Scale of Kinesiophobia, were asked to participate in the study. Individual semistructured in-depth interviews were conducted with 11 participants. The material was analyzed using content analysis with an inductive approach. RESULTS: From these patients' stories, an overarching theme-decreased confidence in the body becomes a barrier to living life to the fullest-emerged. This theme was further divided into 4 subthemes: (1) "What is wrong with my body?"-the constant search for an explanation; (2) searching for the right way to move; (3) loss of mobility means a lack of meaning in life; and (4) the message from health care professionals guides feelings, thoughts, and movement behavior. CONCLUSION: This study indicates that the message of keeping physically active when experiencing LBP has succeeded, but patients with fear require support to feel secure and have enough confidence in their body to move and exercise. Clinicians need to better incorporate evidence-based practice for patients with fear and support them so that they can apply an understanding of pain to their bodies and their every day life. IMPACT: These results offer guidance for health care professionals to enhance their practice by providing more updated information to their patients who have recurrent LBP and fear. With better support, patients may be able to regain confidence in their bodies and live their lives to the fullest. LAY SUMMARY: If you have recurrent LBP and fear of moving your body, ask your health care professional to provide you with updated knowledge on pain and to help you regain confidence in your body so that you can live your life to the fullest.

Lyme aortitis.

A 72-year-old man was admitted with complaints of sudden-onset oppressive precordial pain radiating to the back for 1 hour. He had hypotension, peripheral cyanosis and cold extremities. An initial assessment was done and acute coronary syndrome was excluded. After the patient was admitted, he developed fever and increased levels of inflammatory markers. Data obtained from CT angiography and transoesophageal echocardiogram revealed diffuse parietal thickening of the arch and the descending thoracic aorta, as well as dilatation of the aortic root and the proximal ascending aorta. In addition, the test for Borrelia burgdorferi was positive, and the patient was diagnosed with Lyme vasculitis of the thoracic aorta. He was treated with doxycycline for 3 weeks. Two months later, the patient exhibited a Stanford type A aortic dissection (clinically stable), which was treated by prosthesis replacement. The patient has remained asymptomatic for 1 year after the episode, performing his routine daily activities.

Methicillin-resistant and vancomycin-intermediate Staphylococcus aureus colonizing patients and intensive care unit environment: virulence profile and genetic variability.

This study aims to determine the prevalence of Staphylococcus aureus colonizing patients and ICU environment of a teaching hospital, the virulence and antimicrobial susceptibility profile of the isolates, and to evaluate the genetic relationship among them. A total of 536 swabs (134 of patients and 402 of ICU environment) were collected and analyzed to detect S. aureus. The antimicrobial susceptibility of the isolates was determined by disk diffusion test, and the detection of the mecA and virulence factors genes was performed by PCR, in addition to SCCmec typing. The genetic similarity of the isolates was determined by PFGE. Staphylococcus aureus was isolated in 12.7% of the swabs. The prevalence of colonization was 13.4% in patients and 12.4% in the environmental samples. The multidrug resistance was determined in 82.4% of the isolates. The prevalence of methicillin-resistant S. aureus was 20.6%, with 50.0% classified as SCCmec IV. The intermediate resistance to vancomycin was detected in 5.9% and 4.4% of the isolates obtained from patients and environment, respectively. Identical isolates obtained from different patients and sources were grouped into several clusters. The results showed dissemination of multidrug-resistant strains between patients and fomites and the persistence of MRSA and VISA isolates in the ICU environment.

Staphylococcus aureus in tonsils of patients with recurrent tonsillitis: prevalence, susceptibility profile, and genotypic characterization.

INTRODUCTION: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. MATERIAL AND METHODS: In this study we evaluated 123 surgically removed tonsils from patients who had history of recurrent tonsillitis. The tonsils were submitted to microbiological analysis for detection of S. aureus. The isolates were identified by PCR for femA gene. Antimicrobial susceptibility of the isolates was determined by disk diffusion tests. All isolates were submitted to PCR to detect mecA and Panton-Valentine leucocidin (PVL) genes. The genetic similarity among all isolates was determined by pulsed field gel electrophoresis. RESULTS: Sixty-one S. aureus isolates were obtained from 50 patients (40.7%) with mean age of 11.7 years. The isolates showed high level resistance to penicillin (83.6%), 9.8% had inducible MLSb phenotype, and 18.0% were considered multidrug resistant (MDR). mecA gene was detected in two isolates and the gene coding for PVL was identified in one isolate. The genetic similarity analysis showed high diversity among the isolates. More than one genetically different isolate was identified from the same patient, and identical isolates were obtained from different patients. CONCLUSIONS: MDR isolates colonizing tonsils even without infection, demonstrate persistence of the bacterium and possibility of antimicrobial resistance dissemination and recurrence of infection. A specific clone in patients colonized by S. aureus was not demonstrated.

Staphylococcus aureus in tonsils of patients with recurrent tonsillitis: prevalence, susceptibility profile, and genotypic characterization

ABSTRACT Introduction: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. Material and methods: In this study we evaluated 123 surgically removed tonsils from patients who had history of recurrent tonsillitis. The tonsils were submitted to microbiological analysis for detection of S. aureus. The isolates were identified by PCR for femA gene. Antimicrobial susceptibility of the isolates was determined by disk diffusion tests. All isolates were submitted to PCR to detect mecA and Panton-Valentine leucocidin (PVL) genes. The genetic similarity among all isolates was determined by pulsed field gel electrophoresis. Results: Sixty-one S. aureus isolates were obtained from 50 patients (40.7%) with mean age of 11.7 years. The isolates showed high level resistance to penicillin (83.6%), 9.8% had inducible MLSb phenotype, and 18.0% were considered multidrug resistant (MDR). mecA gene was detected in two isolates and the gene coding for PVL was identified in one isolate. The genetic similarity analysis showed high diversity among the isolates. More than one genetically different isolate was identified from the same patient, and identical isolates were obtained from different patients. Conclusions: MDR isolates colonizing tonsils even without infection, demonstrate persistence of the bacterium and possibility of antimicrobial resistance dissemination and recurrence of infection. A specific clone in patients colonized by S. aureus was not demonstrated.

The Use of Feathers from Racing Pigeons for Doping Control Purposes.

The development of accurate and reliable analytical methodologies to detect the abuse of doping agents in sport animals is crucial to ensure their welfare, as well as to support continuing social acceptance of these sports. The detection of doping agents in racing pigeons is difficult, especially owing to the disadvantages and limitations of obtaining samples from conventional matrices. The present study aimed to develop and validate an analytical methodology combining a two-step extraction procedure (liquid-liquid extraction and solid-phase extraction) in feathers from racing pigeons with analysis by liquid chromatography tandem mass spectrometry (LC-MS-MS) that enabled the simultaneous detection of a beta-agonist drug (clenbuterol) and three corticosteroids (prednisolone, betamethasone and budesonide). The method was validated concerning linearity (with coefficients of determination always higher than 0.99), accuracy (87.3-112.4%), precision (repeatability and intermediate precision coefficient of variation (CV%) always below 15%), recovery (71.6-98.2%), limits of detection (0.24-0.52 ng/g) and quantification (0.79 and 0. 1.74 ng/g) and specificity. The applicability of the method was performed using feathers from pigeons administered orally with a daily dose of 0.075 mg of betamethasone. The drug was administered during 60 days and successive analyses of feathers were performed, at the end of the administration protocol and also after ceasing the oral administration of the drug, for a three weeks period.

Delineating species along shifting shorelines: Tropheus (Teleostei, Cichlidae) from the southern subbasin of Lake Tanganyika.

BACKGROUND: Species delineation is particularly challenging in taxa with substantial intra-specific variation. In systematic studies of fishes, meristics and linear measurements that describe shape are often used to delineate species. Yet, little is known about the taxonomic value of these two types of morphological characteristics. Here, we used Tropheus (Teleostei, Cichlidae) from the southern subbasin of Lake Tanganyika to test which of these types of characters best matched genetic lineages that could represent species in this group of stenotypic rock-dwelling cichlids. We further investigated intra-population variation in morphology. By linking this to a proxy of a population's age, we could assess the evolutionary stability of different kinds of morphological markers. RESULTS: Morphological data was collected from 570 specimens originating from 86 localities. An AFLP approach revealed the presence of five lineages in the southern subbasin: T. moorii, T. brichardi, T. sp. 'maculatus', T. sp. 'Mpimbwe' and T. sp. 'red', which we consider to represent distinct species. Although both types of morphological data supported this classification, a comparison of PST-values that describe inter-population morphological differentiation, revealed a better correspondence between the taxon delineation based on AFLP data and the patterns revealed by an analysis of meristics than between the AFLP-based taxon delineation and the patterns revealed by an analysis of shape. However, classifying southern populations of Tropheus was inherently difficult as they contained a large amount of clinal variation, both in genetic and in morphological data, and both within and among species. A scenario is put forward to explain the current-day distribution of the species and colour varieties and the observed clinal variation across the subbasin's shoreline. Additionally, we observed that variation in shape was larger in populations from shallow shores whereas populations from steep shores were more variable in meristics. This difference is explained in terms of the different timescales at which small and large scale lake level fluctuations affected populations of littoral cichlids at steep and shallow shores. CONCLUSIONS: Our results showed meristics to be more evolutionary stable, and of higher taxonomic value for species delimitation in Tropheus, than linear measurements that describe shape. These results should be taken into account when interpreting morphological differences between populations of highly stenotypic species, such as littoral cichlids from the Great East African Lakes.

Quantification of doping compounds in faecal samples from racing pigeons, by liquid chromatography-tandem mass spectrometry.

The use of performance enhancing drugs is not only common in humans, but also in animal sports, including racing of horses, greyhounds and pigeons. The development of accurate analytical procedures to detect doping agents in sports is crucial in order to protect the fair-play of the game, avoid financial fraud in the attribution of eventual awards and, even more important, to protect the animals from harmful drugs and/or dangerous dosage regimens. The present study aimed to develop and validate, a method that enabled the screening and confirmation of the presence of a beta-agonist (clenbuterol) and three corticosteroids (betamethasone, prednisolone and budesonide) in faeces from pigeons. The extraction procedure entailed the combination of liquid-liquid extraction with solid-phase extraction and the analysis was performed by liquid- chromatography coupled to tandem mass spectrometry, with a single 15 minute chromatographic run-time. The method was validated concerning selectivity, linearity (with coefficients of determination always >0.99), accuracy (87.5-114.9%), inter-day and intra-day precisions, limits of detection (0.14-1.81 ng/g) and limits of quantification (0.49-6.08 ng/g), stability and extraction recovery (71.0%-99.3%). The method was successfully applied for the analysis of samples from two pigeons that had been orally administered betamethasone, demonstrating its suitability for doping control purposes.

Acinetobacter baumannii strains isolated from patients in intensive care units in Goiânia, Brazil: Molecular and drug susceptibility profiles.

Resistance to antimicrobial agents is increasing worldwide and imposes significant life-threatening risks to several different populations, especially those in intensive care units (ICUs). Bacteria can quickly develop or acquire resistance to antimicrobial drugs, and combined with their intrinsic potential to cause disease in humans, these bacteria can become deadly. Among Gram-negative bacteria, Acinetobacter baumannii is notorious as a frequent opportunistic pathogen associated with critically ill patients, and understanding the genetic basis of A. baumannii resistance to beta-lactams among patients in ICUs will result in better protocols to prevent the development of resistance as well as improved treatment regimens. In this study, we assessed 1333 patients in five ICUs, 56 of whom developed A. baumannii infections. Most of the A. baumannii isolates were resistant to beta-lactam antimicrobial drugs, specifically, 3rd- and 4th-generation cephalosporins and carbapenems, and 91.1% of the isolates were multi-drug resistant (MDR). The most frequent OXA gene present was OXA-23 (55.1%), which is significantly associated with MDR strains. Most of the A. baumannii isolates (76.8%) were capable of forming a biofilm. The antimicrobial drug classes that were effective against most of these isolates were polymyxins and tigecycline. The molecular profile of the isolates allowed detection of 12 different clusters comprising 2 to 8 isolates each. In conclusion, our data indicate a high incidence of resistance to carbapenems as well as MDR strains among the observed A. baumannii isolates, most of which exhibited a high prevalence of OXA-23 gene expression. Only a few selective drugs were effective, reinforcing the notion that bacterial resistance is an emerging problem that should be prioritized in every healthcare facility.

Beneficios del masaje infantil. Percepción de las madres en un centro de Atención Primaria / Benefits of the infant massage noticed by mothers in a Primary Care

OBJETIVOS. El objetivo principal del estudio fue confirmar los beneficios del masaje infantil (MI) que perciben las madres. Como objetivos secundarios se planteó conocer datos sociodemográficos de las madres que realizan el MI en casa y el tipo de lactancia predominante. MATERIAL Y MÉTODOS. Estudio descriptivo longitudinal que incluyó a las madres que acudían al taller de masaje infantil de un centro de Atención Primaria de la provincia de León, con una muestra final de 49 madres. El periodo de recogida de datos fue de febrero de 2014 a febrero de 2015. Se entregó una encuesta diseñada para este estudio que recogía: tipo de lactancia, variables sociodemográficas (edad materna, estudios y etnia), los beneficios del masaje, si lo realizan en casa y si acuden acompañadas por su pareja. Para el análisis estadístico se utilizó el programa SPSS.13. RESULTADOS. Los beneficios más percibidos por las madres son el aumento del vínculo materno filial y la relajación, con un 95.9 % de respuesta positiva, seguido del aumento de la calidad del sueño en un 65.3 %. La disminución del llanto y la reducción de los cólicos tuvieron un 63.3 %. El 93.3 % de las madres realizan el masaje en casa. El tipo de lactancia predominante es la materna, con un 53.1 %. CONCLUSIONES. Las madres perciben los beneficios del masaje infantil en sus bebés y realizan la técnica en casa (AU)

OBJECTIVES. The main objective of the study was to confirm the infant massage benefits noticed by mothers. As for secondary objectives, the aim was to establish the sociodemographic characteristics of the mothers who practice the infant massage at home and the main type of feeding. MATERIAL AND METHODS. Longitudinal descriptive study which included the mothers who came to the infant massage workshop in a Primary Care Centre in León, with a sample composed of 49 mothers. Data were collected from February 2014 to February 2015. A questionnaire designed for this study was given, which contained: sociodemographic characteristics (mothers’ age, studies and ethnic group), benefits of the infant massage, if they did it at home and if the couple came to the workshop. For the statistical analysis, the software manager SPSS.13. was used. RESULTS. The main noticed benefits were increasing mother-child bond and relaxation, with a 95.9 % of positive answer, followed by the increasing of the sleep quality, in a 65.3 %. Less crying and decreasing of the colic had a 63.3 %. Most of the mothers, 93.3 %, did the massage at home. The main type of feeding was breast-feeding, 53.1 %. CONCLUSIONS. Mothers noticed the benefits of the infant massage and they do it at home (AU)

Effects of pretreatments and hydrothermal aging on biaxial flexural strength of lithium di-silicate and Mg-PSZ ceramics.

OBJECTIVES: To evaluate the effect of specimen thickness, pretreatment and hydrothermal aging on the biaxial flexural strength (BFS) of lithium di-silicate glass (e.max Cad) and magnesia-stabilized zirconia (ZirMagnum) ceramic discs. METHODS: The e.max Cad discs was studied: i) crystallized, ii) crystallized and glazed and iii) crystallized, glazed and unglazed side etched with hydrofluoric acid. The ZirMagnum discs were studied: i) as delivered, ii) after sandblasting and iii) after heat treatment similar to veneering. Hydrothermal aging was simulated by autoclave treatment. RESULTS: The BFS of all the ZirMagnum specimens was superior (p<0.001) to all the e.max Cad specimens. Glazing the 0.4mm e.max Cad discs reduced (p<0.05) their BFS compared with the unglazed 0.8mm specimens, whereas glazing of 0.8mm discs had no influence (p>0.05) on the strength. Etching and autoclaving of e.max Cad did not affect (p>0.05) the BFS. For ZirMagnum sandblasting with 0.2MPa or 0.6MPa did not influence the biaxial flexural strength (p>0.05), whereas heat treatment reduced (p<0.01) the BFS of 0.6MPa sandblasted ZirMagnum. Autoclaving reduced the strength (p<0.05) compared with ZirMagnum as delivered, whereas autoclaving of the 0.6MPa sandblasted and heat-treated specimens did not influence (p>0.05) the BFS. Glazing, etching and sandblasting increased (p<0.05) surface roughness. CONCLUSIONS: The effects of glazing, heat treatment, aging and mechanical treatment of the materials evaluated should be considered since their strength could be affected. CLINICAL SIGNIFICANCE: Mechanical properties of restorations made from prefabricated ceramic blocks could be affected of various treatments and could change over time.

Cancer Exosomes as Mediators of Drug Resistance.

In the last decades, several studies demonstrated that the tumor microenvironment is a critical determinant not only of tumor progression and metastasis, but also of resistance to therapy. Exosomes are small membrane vesicles of endocytic origin, which contain mRNAs, DNA fragments, and proteins, and are released by many different cell types, including cancer cells. Mounting evidence has shown that cancer-derived exosomes contribute to the recruitment and reprogramming of constituents associated with the tumor microenvironment. Understanding how exosomes and the tumor microenvironment impact drug resistance will allow novel and better strategies to overcome drug resistance and treat cancer. Here, we describe a technique for exosome purification from cell culture, and fresh and frozen plasma, and further analysis by electron microscopy, NanoSight microscope, and Western blot.

Id1 suppresses anti-tumour immune responses and promotes tumour progression by impairing myeloid cell maturation.

A central mechanism of tumour progression and metastasis involves the generation of an immunosuppressive 'macroenvironment' mediated in part through tumour-secreted factors. Here we demonstrate that upregulation of the Inhibitor of Differentiation 1 (Id1), in response to tumour-derived factors, such as TGFß, is responsible for the switch from dendritic cell (DC) differentiation to myeloid-derived suppressor cell expansion during tumour progression. Genetic inactivation of Id1 largely corrects the myeloid imbalance, whereas Id1 overexpression in the absence of tumour-derived factors re-creates it. Id1 overexpression leads to systemic immunosuppression by downregulation of key molecules involved in DC differentiation and suppression of CD8 T-cell proliferation, thus promoting primary tumour growth and metastatic progression. Furthermore, advanced melanoma patients have increased plasma TGFß levels and express higher levels of ID1 in myeloid peripheral blood cells. This study reveals a critical role for Id1 in suppressing the anti-tumour immune response during tumour progression and metastasis.

Pseudomonas spp. ISOLATED FROM THE ORAL CAVITY OF HEALTHCARE WORKERS FROM AN ONCOLOGY HOSPITAL IN MIDWESTERN BRAZIL.

This cross-sectional study, performed in an oncology hospital in Goiania, aimed to characterize the prevalence of oral colonization and antimicrobial susceptibility of Pseudomonas spp. isolated from the saliva of healthcare workers. Microorganisms were subjected to biochemical tests, susceptibility profile, and phenotypic detection. Of 76 participants colonized with Gram negative bacilli, 12 (15.8%) harbored Pseudomonas spp. Of all isolates, P. aeruginosa (75.0%), P. stutzeri (16.7%), and P. fluorescens (8.3%), were resistant to cefoxitin, and therefore likely to be AmpC producers. The results are clinically relevant and emphasize the importance of surveillance to minimize bacterial dissemination and multiresistance.

Streptococcus spp em faringotonsilite aguda recorrente: frequência e perfil mde susceptibilidade a antimicrobianos / Streptococcus spp in recurrent acute sore throat: frequency and susceptibility profile to antimicrobial

O objetivo deste trabalho foi determinar a frequência e o perfil de susceptibilidade a antimicrobianosde Streptococcus em faringotonsilite aguda recorrente. Para o estudo foram coletadas tonsilas de122 pacientes com idade entre 3 e 38 anos (66 pacientes do sexo masculino e 56 do sexo feminino)com histórico de faringotonsilite aguda recorrente, associada à hipertrofia tonsilar, e submetidosà tonsilectomia em um hospital escola. Após isolamento e identificação bacteriana, testes deantibiograma foram realizados para determinar o perfil de susceptibilidade a antimicrobianos. Foram isoladas e identificadas 151 amostras bacterianas pertencentes ao gênero Streptococcus.Destas, 41,1 por cento foram identificadas como Streptococcus grupo viridans não hemolítico; 39,1 por cento como Streptococcus grupo viridans a-hemolítico; 7,3 por cento como Streptococcus dos grupos C, F ou G;5,3 por cento como Streptococcus spp. Beta-hemolítico; 4,6 por cento como Streptococcus spp. não hemolítico; 1,3 por cento como Streptococcus spp. grupo a-hemolítico e 1,3 por cento como Streptococcus Beta-hemolíticos do grupo A. Observou-se nos testes de antibiograma resistência aos antibióticos Beta-lactâmicos. É importante omonitoramento da microbiota que coloniza a orofaringe, visto que alguns de seus componentes têmse tornado resistentes aos medicamentos mais utilizados no tratamento das faringotonsilites, o quepode contribuir para os processos de recidiva.

The aim of this study was to determine the frequency and the antimicrobial susceptibility profileof Streptococcus spp. obtained from recurrent acute pharyngo-tonsillitis. For this study, tonsilsfrom 122 patients ranging from 3 to 38 years old (66 males and 56 females) were collected. Allpatients had a history of recurrent acute pharyngo-tonsillitis associated with tonsillar hypertrophyand were submitted for tonsillectomy at a teaching hospital. After isolation and identification,antimicrobial susceptibility tests were performed. A hundred and fifty one isolates of Streptococcusspp. were obtained from tonsils, consisting of 41.06 percent non-hemolytic Streptococcus viridans group,39.07 percent a-hemolytic Streptococcus viridans group, 7.30 percent Streptococcus of C, F or G groups, 5.30 percent beta-hemolytic Streptococcus spp., 4.63 percent non-hemolytic Streptococcus spp., 1.32 percent a-hemolytic Streptococcus spp. and 1.32 percent group A beta hemolytic Streptococcus. Some of the isolates were resistantto beta-lactamic antibiotics. The study showed that components of the oropharynx microbiotapresented resistance to drugs commonly used to treat pharyngo-tonsillitis infections. Correctdiagnosis would improve treatment and could prevent recurrent infections.

Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital.

The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking.

Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital

The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking.