YouTube® in Spanish as an information source for patients with autoimmune hepatitis.

INTRODUCTION AND AIM: A large number of patients with autoimmune hepatitis (AH) seek information about their disease on the Internet. The reliability, comprehensiveness, and quality of said information in Spanish has not been studied. Our aim was to describe the characteristics of the information about AH on YouTube®. METHODS: An analytic observational study evaluated videos in Spanish about AH available on YouTube®, describing their general characteristics, viewer engagement, and information sources. Standardized tools were utilized to analyze reliability (DISCERN), comprehensiveness, and overall quality (Global Quality Score [GQS]). RESULTS: One hundred videos were included, 93% of which provided information from healthcare professionals (group 1), and 7% of which reflected patient opinions (group 2). There were differences in the median reliability (DISCERN 4 vs 2, p ≤ 0.05) and comprehensiveness (4 vs 2, p ≤ 0.05) scores between groups, but equal overall quality (GQS 3 vs 2, p = 0.2). Reliability (DISCERN 4; RIC 3-4) and comprehensiveness (4.5; IQR 3-5) were higher in videos by professional organizations, compared with those by independent users, healthcare information websites, and for-profit organizations (DISCERN 3; IQR 2.5-3.5) (p < 0.001). Reliability (DISCERN 2; IQR 1.5-3), comprehensiveness (2; IQR 1.5-2.5), and quality (GQS 2.5; IQR 1.5-3.5) were lower for videos made by for-profit organizations. CONCLUSION: The majority of videos about AH in Spanish on YouTube® have good reliability, comprehensiveness, and quality. Videos created by academic organizations had higher scores, thus their collaboration, with respect to patient opinion videos, is suggested.

Antisepsys and profilatic antimicrobial therapy in prevention of surgical site infection of horses / [Antissepsia e terapia antimicrobiana profilática no controle infeccioso do foco cirúrgico em equinos

The efficacy of an antisepsis protocol comprising chlorhexidine gluconate and ethyl alcohol in combination with prophylactic antimicrobial therapy in controlling surgical site infection in horses was studied. To that purpose, seven mixed breed horses received potassium penicillin and gentamicin at least 30 minutes prior to surgery. The surgical site was scrubbed with chlorhexidine gluconate and rinsed with ethyl alcohol. Samples were collected at four time points: (A) - before and (B) - immediately following shaving of the hair coat, (C) - at the end of antisepsis procedures, and (D) - at the end of the surgical procedure. Duration of surgery was recorded. Samples were cultured in three different culture mediums: Mitis Salivarus (Streptococcus sp.), Staphylococcus 110 (Staphylococcus sp.), and Mac Conkey (Enterobacteria). A high level of bacterial growth was observed in all culture mediums at (A) and (B), with no bacterial growth in (C). Staphylococcus sp. growth was observed in (D) in a single patient whose surgical procedure lasted for 120 minutes. Shaving of the hair coat reduced microbial flora on the surface of the skin. Antisepsis in combination with prophylactic antimicrobial therapy was effective in controlling surgical site infection in elective procedures with an average duration of 90 minutes.(AU)

Objetivou-se averiguar a eficácia do protocolo de antissepsia com clorexidina degermante e álcool etílico hidratado 70%, em associação com terapia antimicrobiana profilática, no controle microbiano do foco cirúrgico de equinos submetidos a procedimentos cirúrgicos. Foram utilizados 07 cavalos adultos de raças variadas, onde ambos receberam o mesmo tratamento (terapia antimicrobiana profilática e antissepsia com clorexidina degermante 2% e álcool etílico hidratado 70%), coletando-se amostras em quatro tempos distintos [(A - antes da tricotomia), (B - imediatamente após tricotomia), (C - ao término da antissepsia), (D - ao término do procedimento cirúrgico)]. O tempo de cada procedimento cirúrgico foi contabilizado. Foram utilizados três meios de cultura diferentes, cada um com especificidade para um tipo de crescimento bacteriano. Constatou-se alta incidência de crescimento bacteriano nos três meios utilizados nos tempos de coleta A e B. Para o tempo C, não foi observado crescimento bacteriano. No tempo D averiguou-se crescimento bacteriano do tipo Staphylococcus sp. em um único paciente, cujo tempo cirúrgico foi de 120 minutos de duração. Desta forma, a tricotomia reduziu a carga microbiana na superfície da pele. A antissepsia associada à terapia antimicrobiana profilática mostrou-se eficaz no controle microbiano do foco cirúrgico em procedimentos eletivos, com duração média de 90 minutos.(AU)

Multidrug-resistant pathogenic Escherichia coli isolated from wild birds in a veterinary hospital.

Wild birds are carriers of Escherichia coli. However, little is known about their role as reservoirs for extra-intestinal pathogenic E. coli (ExPEC). In this work we investigated E. coli strains carrying virulence genes related to human and animal ExPEC isolated from free-living wild birds treated in a veterinary hospital. Multidrug resistance was found in 47.4% of the strains, but none of them were extended-spectrum beta-lactamase producers. Not only the virulence genes, but also the serogroups (e.g. O1 and O2) detected in the isolates of E. coli have already been implicated in human and bird diseases. The sequence types detected were also found in wild, companion and food animals, environmental and human clinical isolates in different countries. Furthermore, from the 19 isolates, 17 (89.5%) showed a degree of pathogenicity on an in vivo infection model. The isolates showed high heterogeneity by pulsed-field gel electrophoresis indicating that E. coli from these birds are clonally diverse. Overall, the results showed that wild birds can be reservoirs and/or vectors of highly pathogenic and multidrug-resistant E. coli that have the potential to cause disease in humans and poultry.

Use of probiotics to reduce faecal shedding of Shiga toxin-producing Escherichia coli in sheep.

Shiga toxin-producing Escherichia coli (STEC) are zoonotic, foodborne pathogens of humans. Ruminants, including sheep, are the primary reservoirs of STEC and there is a need to develop intervention strategies to reduce the entry of STEC into the food chain. The initiation of the majority of bacterial, enteric infections involves colonisation of the gut mucosal surface by the pathogen. However, probiotic bacteria can serve to decrease the severity of infection via a number of mechanisms including competition for receptors and nutrients, and/or the synthesis of organic acids and bacteriocins that create an environment unfavourable for pathogen development. The aim of the current study was to determine whether the administration of a probiotic mixture to sheep experimentally infected with a non-O157 STEC strain, carrying stx1, stx2 and eae genes, was able to decrease faecal shedding of the pathogen. The probiotic mixture contained Lactobacillus acidophilus, Lactobacillus helveticus, Lactobacillus bulgaricus, Lactobacillus lactis, Streptococcus thermophilus and Enterococcus faecium. The numbers of non-O157 STEC in faecal samples collected from sheep receiving daily doses of the probiotic mixture were significantly lower at the 3rd, 5th and 6th week post-inoculation when compared to the levels recorded in untreated animals. It was concluded that administration of the probiotic mixture reduced faecal shedding of non-O157 STEC in sheep, and holds potential as a pre-harvest intervention method to reduce transmission to humans.

Fate of non O157 Shigatoxigenic Escherichia coli in ovine manure composting / Eliminação de Escherichia coli Shigatoxigênica não O157 em compostagem de esterco ovino

Livestock manure may contain pathogenic microorganisms which pose a risk to the health of animal or humans if the manure is not adequately treated or disposed of. To determine the fate of Shiga toxigenic Escherichia coli (STEC) non O157 in composted manure from naturally colonized sheep, fresh manure was obtained from animals carrying bacterial cells with stx1/ stx2 genes. Two composting systems were used, aerated and non-aerated, and the experiments were done in Dracena city, São Paulo State. Every week, for seven weeks, one manure sample from six different points in both systems was collected and cultured to determine the presence of E. coli, the presence of the virulence genes in the cells, and also the susceptibility to 10 antimicrobial drugs. The temperature was verified at each sampling. STEC non-O157 survived for 49 days in both composting systems. E. coli non-STEC showing a high degree of antibiotic resistance was recovered all long the composting period. No relationship was established between the presence of virulence genes and antibiotic resistance. The presence of virulence genes and multiple antibiotic resistances in E. coli implicates a potential risk for these genes spread in the human food chain, which is a reason for concern...

Esterco de animais de criação pode conter microrganismos patogênicos, o que representa um risco para a saúde animal e a humana se o esterco não for adequadamente tratado ou descartado. Determinou-se o tempo necessário para a eliminação de Escherichia coli Shiga toxigenica (STEC) não O157 em esterco ovino composto, obtido de fezes frescas de ovelhas naturalmente colonizadas com cepas STEC não O157 que apresentavam os genes stx1/ stx2. Foram utilizados dois sistemas de compostagem, aerado e não aerado, em experimentos realizados na cidade de Dracena, estado de São Paulo. Todas as semanas, durante sete semanas, uma amostra de compostagem proveniente de seis pontos diferentes na leira, nos dois sistemas, foi coletada e semeada para a determinação da presença de E. coli, da presença de genes de virulência nas células, bem como da sensibilidade dessas células a 10 drogas antimicrobianas. Em cada amostragem, a temperatura da leira foi analisada. Células de STEC não O157 sobreviveram por 49 dias nos dois sistemas de compostagem. E. coli não STEC com um alto grau de resistência a antibióticos foi recuperada ao longo de todo o período de compostagem. Não foi possível estabelecer relação entre a presença de genes de virulência e a resistência a antibióticos. A presença de genes de virulência e a resistência a múltiplos antibióticos em E. coli representam um risco potencial para o espalhamento desses genes na cadeia alimentar humana, o que é motivo de grande preocupação...

Virulence genes in isolates of Escherichia coli from samples of milk and feces from dairy cattle.

The aim of this work was to determine if Escherichia coli isolates carrying the virulence genes eae and eltB and exhibiting the Ehly phenotype are present in feces and milk samples from healthy dairy cattle on farms. Isolates from calves showed a statistically higher prevalence of eae and eltB compared with isolates from older animals. The other factors tested (stx(1), stx(2), and Ehly) were not statistically different between the two groups. Two isolates originating from calf feces were identified as serotype O157:H7; one of these isolates carried stx(1) and eae, the other stx(2) and eae. E. coli isolated from milk contained stx(1), stx(2), and eltB. The results show that feces or milk from healthy dairy cattle may contain E. coli pathotypes that express virulence genes, indicating that these materials have zoonotic potential. The results also reinforce the idea that host age can influence the dynamics of virulence genes in E. coli from cattle.

Prevalence of methicillin-resistant Staphylococci on a farm: staff can harbour MRS when animals do not.

The aim of this work was to establish the prevalence of methicillin-resistant Staphylococci (MRS) in the animals and staff of a teaching and research farm. Samples of dairy cattle (36), beef cattle (26), sheep (19), horses (21), pigs (23), goats (23) and humans (13) were collected and screened for the presence of MRS. The detection of mecA gene was performed by PCR to determine the resistance of the samples to methicillin. Antimicrobial-resistance testing to penicillin, meropenem, ceftriaxone, cephalothin, oxacillin, levofloxacin, enrofloxacin, chloramphenicol, ciprofloxacin, gentamicin, clindamycin, erytromycin, linezolid, sulfamethoxazole/trimethoprim, tetracycline, doxycycline and vancomycin was performed on the mecA+ isolates. From the 161 samples, four methicillin-resistant coagulase-negative Staphylococci (MRCoNS) were isolated from human beings (31%), whereas none was isolated from animals (0%). No methicillin-resistant Staphylococcus aureus (MRSA) were isolated. All of the MRCoNS isolates from this work presented different antimicrobial resistance patterns. MRCoNS may be present in humans associated with animals while not present in the animals. Selective pressure outside of the farm and a lack of MRCoNS transmission between humans and animals may be responsible for this lack of correlation.

Avaliação clínica da infecção experimental de bezerros com Salmonella Dublin / Clinical evaluation of experimental Salmonella Dublin infection in calves

The clinical conditions of healthy calves infected with experimental 10(8)CFU of Salmonella Dublin were evaluated and the viability of the experimental model in disease induction in calves was verified. Twelve 10 to 15-day-old male Holstein calves were examined. They were allocated into two groups, control and experimentally infected with 10(8)CFU of Salmonella Dublin. Animals were submitted to clinical examination after inoculation and at every 12 hours, during seven days after the experimental infection. Samples of rectal swabs were collected for Salmonella Dublin isolation. All animals had severe diarrhea, with mucus and bleeding, 12 to 84 hours after the experimental infection with Salmonella Dublin, accompanied by fever, dehydration and respiratory signs. The isolation of Salmonella Dublin from rectal swabs occurred 12 hours after the infection. Two out of the six animals inoculated with Salmonella Dublin died with symptoms of enteritis, fibrinous pneumonia, centrilobular hepatic steatosis, hepatocyte necrosis, spleen congestion, interstitial nephritis, and tubular degeneration. Thus, the oral administration of 10(8)CFU of Salmonella Dublin induced clinical signs of salmonellosis in 10 to 15-day-old calves.

Virulence factors of Escherichia coli isolated from diarrheic calves

One hundred seventy-three Escherichia coli strains isolated from calves from northwestern São Paulo State, having diarrhea were examined for the production of thermolabile (LT) and thermostable (ST) enterotoxins and for the presence of virulence factors associated with bovine colibacillosis. Eighty-five (49.1 percent) of the E.coli strains produced toxins; 53 isolates were detected as producing STa toxin, and 9 also produced LT toxin. By PCR, 23 isolates were shown to harbor only the LT-II gene. Nine (5.2 percent) isolates harbored Shiga toxin genes: four carried the stx2 gene, four the stx1 gene and one carried both. Three of the isolates showing stx1 also carried the eae gene. Among the E. coli isolates examined for susceptibility to 10 antimicrobial agents, resistance to cephalothin (46.1 percent), was most commonly observed, followed by resistances to tetracycline (45.7 percent), trimethoprim-sulfadiazine (43.3 percent) and ampicilin (41.0 percent). All isolates showed resistance to at least two antimicrobial agents; multidrug resistance was quite frequently encountered. Results showed that bovine E. coli produces some toxins and virulence factors, some of which may be involved in human disease. The isolates showed a high level of resistance to antimicrobial agents constituting a public health concern.

Cento e setenta e três cepas de Escherichia coli isoladas de bezerros com diarréia provenientes da região noroeste do estado de São Paulo foram examinadas para a produção de enterotoxinas termolábil (LT) e termoestável (ST), e examinadas quanto à presença de fatores de virulência associados a colibacilose bovina. Oitenta e cinco (49,1 por cento) das cepas de E. coli produziram toxinas, 53 cepas foram detectadas como produtoras de toxina STa, e nove dessas cepas também produziam toxina LT. Foram identificadas pela reação em cadeia de polimerase 23 cepas portadoras do gene LT-II. Nove (5,2 por cento) das cepas apresentavam os genes de toxina Shiga: quatro o gene stx 2, quatro o gene stx 1 e uma cepa apresentava os dois genes. Três das cepas que apresentavam o gene stx1 também possuiam o gene eae. Entre as cepas de E. coli examinadas quanto à susceptibilidade a 10 agentes antimicrobianos, a resistência à cefalotina (46,1 por cento) foi a mais comumente observada, seguida pelas resistências a tetraciclina (45,7 por cento), trimetropima-sulfadiazina (43,3 por cento) e ampicilina (41,0 por cento). Todas as cepas isoladas apresentaram resistência a pelo menos dois antimicrobianos, sendo a multirresistência detectada em elevada freqüência. Algumas toxinas e fatores de virulência, produzidos por essas cepas de E. coli podem estar envolvidos em doenças humanas. O alto nível de resistência a agentes antimicrobianos, apresentado pelas cepas isoladas, constitue motivo de preocupação em saúde pública.

Characterization of Escherichia coli isolated from carcasses of beef cattle during their processing at an abattoir in Brazil.

Beef carcass sponge samples collected between March 2003 and August 2005 at an abattoir in Brazil were surveyed for the presence of Shiga toxin-producing Escherichia coli (STEC). Only one carcass among the 80 tested showed a STEC, stx2-encoding gene by PCR amplification. The frequency of carcass contamination by E. coli during processing was tested at three situations, respectively: preevisceration, postevisceration and postprocessing, during the rain and dry seasons. The prevalence of E. coli at the three points was of 30.0%, 70.0%, 27.5% in the rain season and of 22.5%, 55.0%, 17.5% during the dry season, respectively. The E. coli isolates exhibited a high level (45.0%) of multidrug resistance to two or more antimicrobial agents.

Etiology of acute diarrhea among children in Ribeirão Preto-SP, Brazil.

To study the main enteropathogens causing diarrhea in the region of Ribeirão Preto regarding serogroups and serotypes, the feces of 1836 children under 10 years old, from both sexes, attack of acute gastroenteritis, were analysed during a period of 4 years in Adolfo Lutz Institute - Ribeirão Preto, SP. The pathogens identified by standard methods were the following: Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp., Yersinia spp., and Cryptosporidium spp. Positive samples were 22.8% (419) with 1.7% association of pathogens. Larger isolates were mainly from children 0 to 11 months old. Enteropathogenic E. coli (EPEC) was most frequent (8.7%) with predominance of serogroup O119 (40.2%), followed by Shigella (6.2%), 63.6% of which S. sonnei.

Avaliaçäo da eficiência de um probiótico no controle de diarréia e no ganho de peso de bezerros / Evaluation of the efficiency of a probiotic in the control of diarrhea and weight gain in calves

Foram utilizadas 99 vacas prenhes distribuídas em oito grupos que receberam os seguintes tratamentos: grupo I, com 29 vacas näo vacinadas e seus bezerros que näo receberam probiótico, ficando como controle; grupo II, com 10 vacas vacinadas e seus bezerros que näo receberam probiótico; grupos III,IV e V, com 10 animais cada, vacas vacinadas e seus bezerros que receberam probiótico durante 5, 15 e 30 dias, respectivamente; os grupos VI, VII e VIII, com 10 animais cada, vacas näo vacinadas e seus bezerros que receberam probiótico durante 5, 15 e 30 dias, respectivamente. Cada animal dos grupos vacinados recebeu duas doses vacinais contendo os pili K99 e A14 de Escherichia coli na dose de 5,0ml por via subcutânea. O probiótico contendo Ruminobacter amylophilum, Ruminobacter succinogenes, Succinovibrio dextrinosolvens, Bacillus cereus, Lactobacillus acidophilus e Streptococcus faecium, na dose de 3,0X10 elevado a oitava potência células vivas (UFC) de cada amostra em 250ml de leite, era administrado por via oral. Os animais foram observados diariamente e foram determinados os títulos de anticorpos anti-K99 e anti-A14 no soro e no colostro. Anotaram-se os pesos dos bezerros ao nascimento e aos 30 dias. Os resultados mostraram que a associaçäo de vacina com probiótico administrado por 15 e 30 dias foram os tratamentos mais eficientes no controle da diarréia e ganho de peso

Utilizaçäo de vacina e probiótico no controle de diarréia enterotoxigênica em suínos causada por Escherichia coli / Use of vaccine and probiotic in the control of swine diarrhea caused by enterotoxigenic Escherichia coli

Quarenta e duas porcas prenhes foram divididas em oito grupos e submetidas aos seguintes tratamentos: grupo I-com sete porcas näo vacinadas, cujos leitöes näo receberam probiótico, as quais permaneceram como controle, grupo II-com cinco porcas vacinadas e seus leitöes que näo receberam probiótico, grupos III, IV e V-com cinco porcas cada, vacinadas, e seus leitöes que receberam probiótico durante 5, 15 e 28 dias, respectivamente, e grupos VI, VII e VIII-com cinco porcas cada, näo vacinadas, e seus leitöes que receberam probiótico durante 5, 15 e 28 dias, respectivamente. Cada animal dos grupos vacinados recebeu duas doses de 5,0ml de vacina contendo os pili K88, K99, 987P e F42 de Escherichia coli por via subcutânea. O probiótico continha Lactobacillus acidophylus na dose de 2,0x10 elevado a oitava potência células vivas em 20ml de leite e administrado por via oral. Em todos os animais observados clinica e bacteriologicamente, foram determinados os títulos de anticorpos anti-K88, anti-K99, anti-987P e anti-F42 no soro e no colostro. Os resultados mostraram que a combinaçäo de vacina com o probiótico por 28 dias foi o mais eficiente tratamento para o controle de diarréia causada por Escherichia coli enterotoxigênica

Microbiota conjuntival normal de equinos / Normal conjunctival microflora in horses

O conhecimento da microbiota conjuntival normal de equinos e a realizaçäo de testes de sensibilidade diante de antibióticos e quimioterápicos säo fundamentais para o diagnóstico e tratamento de afecçöes oculares. Colheram-se amostras do saco conjuntival de equinos isentos de afecçöes oculares e/ou sistêmicas que, eventualmente, pudessem levar à alteraçäo ocular. Essas coletas foram realizadas, durante o inverno e o veräo, com animais sob diferentes formas de manejo:; regime de hospitalizaçäo, de estabulaçäo e extensivo. O material coletado foi submetido a exames bacteriológicos e a testes de sensibilidade diante de antibióticos e quimioterápicos. A microbiota conjuntival normal de equinos foi composta por bactérias Gram-positivas, Gram-negativas e leveduras, tais como: Bacillus subtillis, Stafilococcus spp., Streptococcus spp., Enterobactérias, Candida spp.

A comparative study of the efficiency of a pro-biotic and the anti-K99 and anti-A14 vaccines in the control of diarrhea in calves in Brazil.

A total of 99 pregnant cows were divided into eight groups submitted to the following treatments: group I (n = 29) consisted of unvaccinated cows whose calves did not receive a probiotic and was used as control. Group II (n = 10) consisted of vaccinated cows whose calves did not receive a probiotic. Groups III, IV and V (n = 10 neach) consisted of vaccinated cows whose calves received a probiotic for 5, 15 and 30 days, respectively. Groups VI, VII and VIII (n = 10 each) consisted of unvaccinated cows whose calves received a probiotic for 5, 15 and 30 days, respectively. Each animal in the vaccinated groups received two 5.0 ml vaccine doses containing pili K99 and A14 of Escherichia coli by the subcutaneous route. The probiotic containing Lactobacillus acidophilus at the dose of 2.0 x 10(8) live cells in 250 ml milk, was administered orally. All animals were observed clinically and bacteriologically and anti-K99 and anti-A14 antibody titers were determined in serum and colostrum. Mean calf weight was measured at birth and at 30 days of age. The results showed that a combination of the vaccine with the probiotic administered for 15 and 30 days was the most efficient treatment for the control of diarrhea.

Virulence factors in Escherichia coli strains isolated from pigs in the Ribeirao Preto region, State of Sao Paulo, Brazil.

Three-hundred faecal swabs were obtained from pigs with diarrhoea in farms located in different areas of the Ribeirao Preto region in the State of Sao Paulo. One-hundred Escherichia coli strains were isolated and tested for production of thermolabile (TL) and thermostable (STRa and STb) enterotoxins, and for the presence of colonization factors F4, F5 and F6. The strains were also tested for sensitivity to 14 antibiotics and chemotherapeutic agents. Twenty-four Escherichia coli strains produced enterotoxin STb, 5 produced LT and 3 produced STa. In the mannose-resistant haemagglutination reaction, one strain reacted positively with sheep, chicken, horse and human red blood cells and another reacted positively with guinea pig, sheep, chicken, horse and human red cells. However, both strains were negative for colonization factors F4, F5 and F6 when submitted to the slide agglutination test. All Escherichia coli strains were resistant to at least one antibiotic, the highest percentages being obtained for resistance to penicillin, tetracycline and cephalotin. In addition to the importance of the virulence factors normally encountered in enterotoxigenic Escherichia coli strains from pigs, the present results show the possible existence of new colonization factors other than F4, F5 and F6 participating in E. coli-induced pigs colibacillosis in the Ribeirao Preto region.

[Anti-toxoplasma antibodies in bovine serums in Jaboticabal County; São Paulo, Brazil]. / Anticorpus anti-Toxoplasma em soros de bovinos do município de Jaboticabal; São Paulo, Brasil.

Sera of 204 cows in Jaboticabal, S.P., Brazil were examined by indirect immunofluorescent test for detecting anti-Toxoplasma antibody. Assuming titers from 1:64 as indicative of toxoplasmic infection it was observed 32.3% of positive reactions. The antibody titers even to 1:256 represented 7.8% of the reacting animals. The serological titers varied from 1:64 to 1:256. No clinical story could be correlated with the reacting animals and no isolation was performed.