Aspects related to biofilm production and antifungal susceptibility of clinically relevant yeasts of the genus Trichosporon.

Trichosporonosis corresponds to a systemic fungal disease that leads to high mortality rates and is frequently associated with medical devices. It affects immunosuppressed patients in particular and is strongly linked to acquired human immunodeficiency, organ and tissue transplants, and malignant hematologic diseases such as leukemia and lymphomas. Trichosporon infections have been increasingly reported worldwide; however, little information is available either about their characteristics or the causative microorganism. Thus, the aims of the present study were: to investigate 59 yeasts of the genus Trichosporon by verifying the biofilm formation capacity of isolates; to analyze the susceptibility patterns of planktonic cells against the antifungals fluconazole, itraconazole, amphotericin-B, voriconazole, and caspofungin by comparing European Committee for Antimicrobial Susceptibility Testing (EUCAST) broth microdilution technique with the commercial method Etest; and to assess the susceptibility patterns of biofilm cells (sessile) against the same antifungals through broth microdilution. The ability to form biofilm on the surface of polystyrene plates was noted for all isolates, and 54.3% of samples were considered strong producers. Comparison between the antifungal susceptibility techniques evidenced that Etest showed higher and discordant minimum inhibitory concentrations (MICs) from those obtained by the microdilution method, especially for fluconazole, itraconazole, and caspofungin. Considering the susceptibility of biofilms, most species had high MIC50 and MIC90 against the tested antifungals, showing 4-to-66-fold higher concentrations for amphotericin B and 2-to-33-fold greater concentrations for caspofungin. These results highlight the importance of further studies with Trichosporon spp. for comparison between laboratory findings and in vivo response, considering both the susceptibility tests and the behavior of biofilm cells against drugs.

This study investigated 59 isolates of the medically important yeast Trichosporon in relation to their ability to form biofilms and the susceptibility of biofilms to antifungal agents. All isolates were able to produce biofilms and biofilms showed lower antifungal susceptibility.

Effect of Biogenic Silver Nanoparticles on the Quorum-Sensing System of Pseudomonas aeruginosa PAO1 and PA14.

The increase in multidrug-resistant microorganisms represents a global threat requiring the development novel strategies to fight bacterial infection. This study aimed to assess the effect of silver nanoparticles (bio-AgNPs) on bacterial growth, biofilm formation, production of virulence factors, and expression of genes related to the quorum-sensing (QS) system of P. aeruginosa PAO1 and PA14. Biofilm formation and virulence assays were performed with bio-AgNPs. RT-qPCR was carried out to determine the effect of bio-AgNPs on the QS regulatory genes lasI, lasR, rhlI, rhlR, pqsA, and mvfR. Bio-AgNPs had an MIC value of 62.50 µM, for both strains. Phenotypic and genotypic assays were carried out using sub-MIC values. Experimental results showed that treatment with sub-MICs of bio-AgNPs reduced (p < 0.05) the motility and rhamnolipids and elastase production in P. aeruginosa PAO1. In PA14, bio-AgNPs stimulated swarming and twitching motilities as well as biofilm formation and elastase and pyocyanin production. Bio-AgNP treatment increased (p < 0.05) the expression of QS genes in PAO1 and PA14. Despite the different phenotypic behaviors in both strains, both showed an increase in the expression of QS genes. Demonstrating that the bio-AgNPs acted in the induction of regulation. The possible mechanism underlying the action of bio-AgNPs involves the induction of the rhl and/or pqs system of PAO1 and of the las and/or pqs system of PA14. These results suggest that exposure to low concentrations of bio-AgNPs may promote the expression of QS regulatory genes in P. aeruginosa, consequently inducing the production of virulence factors such as elastase, pyocyanin, and biofilms.

Quality of dialysis water and dialysate in haemodialysis centres: Highlight for occurrence of non-fermenting gram-negative bacilli.

AIMS: To evaluate the physicochemical and microbiological quality of dialysis water and dialysate samples from haemodialysis centres. METHODS AND RESULTS: Samples were fortnightly collected from three haemodialysis centres in Bauru City, Brazil, between July 2017 and June 2018, at the stages of post-reverse osmosis, reuse and dialysate. Analyses included determination of conductivity, fluoride, nitrate and sulphate; test for total coliform bacteria; count of heterotrophic bacteria; count and identification of non-fermenting gram-negative bacilli (NFGNB); drug susceptibility test; biofilm formation capacity; and genetic similarity among some isolated NFGNB. Of the analysed samples, only 4/72 (5.6%) had conductivity values ≥10 mS/cm, 4/216 (1.9%) presented total coliforms and 1/216 (0.5%) had heterotrophic bacteria count >100 CFU/ml. NFGNB were isolated from 99/216 (45.8%) samples, and the major identified micro-organisms included Herbaspirillum aquaticum/huttiense, Brevundimonas aurantiaca, Cupriavidus metallidurans, Pseudomonas aeruginosa and Ralstonia insidiosa. Isolates of P. aeruginosa and Burkholderia cepacia complex were sensitive to most antimicrobials and, together with isolates of Ralstonia insidiosa and Ralstonia pickettii, showed strong biofilm formation capacity. Some isolates expressed the same electrophoretic profile on pulsed-field gel electrophoresis, indicating the persistence of bacterial clones in the systems over time. CONCLUSIONS: NFGNB were observed in several dialysis water and dialysate samples from all investigated centres, which may represent a risk to the health of patients. SIGNIFICANCE AND IMPACT OF THE STUDY: Regular inclusion of actions for NFGNB control and monitoring in haemodialysis fluids are suggested for greater safety of the dialytic process.

Fungi in dialysis water and dialysate: occurrence, susceptibility to antifungal agents and biofilm production capacity.

The aim of this study was to investigate the occurrence of fungi in dialysis water and dialysate, in addition to evaluating the susceptibility to antifungals and the biofilm production capacity of isolated microorganisms. The samples were collected in three hemodialysis units in Bauru (Brazil), every 15 days (July 2017-June 2018) at post-reverse osmosis, reuse, and dialysate points. The fungi were isolated by spread plate on Sabouraud dextrose agar. Filamentous fungi were phenotypically identified and yeasts were subjected to molecular evaluation of the ITS region. Susceptibility test to antifungals was carried out by the broth microdilution method and biofilm production capacity was evaluated in microtiter plates using crystal violet staining. Fungi were isolated in 52/216 (24.1%) samples, with an average count of 16.3 (10-40) CFU/mL. Overall, 61 microorganisms were identified, with 54 (88.5%) filamentous fungi and 7 (11.5%) yeasts. The main genera included were Penicillium, Cladosporium, Scedosporium, Rhinocladiella, Fusarium, and Emmonsia. Most isolates showed high values of minimum inhibitory concentration for 5-flucytosine and fluconazole and 35/45 (77.8%) isolates were classified as strong producers of biofilm. In order to increase the safety of the dialysis process, the adoption of control measures and monitoring of fungi in hemodialysis fluids is suggested.

Comparing the phenotypic, genotypic, and proteomic identification of Trichosporon species: A globally emerging yeast of medical importance.

Trichosporon spp. are widely distributed in the nature, comprising species that inhabit different ecological niches and can be found in the water, soil, and body surface of animals and humans. Such microorganisms have been classically associated with superficial infections; however, in the last decades, they have also been related to disseminated infections in immunocompromised patients, behaving as opportunistic agents, which demands rapid and accurate species identification for efficient therapy. Concordance level between the traditional phenotypic method and the molecular technique (gold standard) in the identification of all 59 Trichosporon samples was 59.3%. Identification concordance between MALDI-TOF spectrometry and the molecular technique was 71.2%. No isolate of environmental origin was identifiable by MALDI-TOF mass spectrometry (MS), and 100% of such environmental isolates were discordant for IGS region sequencing and phenotypic characterization. Both comparisons evidenced greatest concordance in the identification of T. asahii. The species T. debeurmannianum, T. dermatis, T. venhuisii and T. insectorum were not properly identified by both MALDI-TOF MS and the phenotypic technique. MALDI-TOF MS, in particular, seems to be appropriate to investigate yeasts of the genus Trichosporon; however, database updates are still necessary, especially for species that are not common in the clinical routine. With the aim of helping understand the aspects involved in early and accurate diagnosis of infections caused by this opportunistic agent, the present study compared the phenotypic, molecular (IGS region) and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon which had clinical and environmental origin and were kept in a mycology collection.

The present study compared the phenotypic, genotypic, and mass-spectrometry (MALDI-TOF) identification of 59 yeasts of the genus Trichosporon. MALDI-TOF MS, in particular, seems to be appropriate to investigate this yeasts when compared to a molecular technique (gold standard).

Subinhibitory Concentrations of Biogenic Silver Nanoparticles Affect Motility and Biofilm Formation in Pseudomonas aeruginosa.

Biogenic silver nanoparticles (bio-AgNPs) are increasingly recognized as an antibiofilm and antivirulence strategy against P. aeruginosa, a bacterium that causes chronic infections in immunocompromised and cystic fibrosis patients. This study aimed to investigate the effects of subinhibitory concentrations of bio-AgNPs on motility and biofilm formation in P. aeruginosa. Bio-AgNPs were synthesized via reduction of ionic silver catalyzed by cell-free culture filtrate from Fusarium oxysporum. A total of 17 P. aeruginosa isolates and strains were evaluated for swarming, swimming, and twitching motility in the presence and absence (control) of bio-AgNPs, including 10 clinical isolates from patients with and without cystic fibrosis, 5 environmental isolates obtained from the public water supply system, and 2 reference strains (PAO1 and PA14). Isolates were identified by biochemical and molecular methods. Minimum inhibitory concentrations (MICs) were determined by the broth microdilution method. Swarming, swimming, and twitching motility assays were performed in Petri dishes. Biofilm formation capacity was assessed quantitatively by the crystal violet method. MIC values ranged from 15.62 to 62.50 µM. The results showed that subinhibitory concentrations of bio-AgNPs (½ MIC, 7.81-31.25 µM) significantly increased (p < 0.05) swarming, swimming, and twitching motility in 40.0, 40.0, and 46.7% of isolates, respectively. Subinhibitory bio-AgNP treatment enhanced (p < 0.05) biofilm formation capacity in PA14 and a cystic fibrosis isolate (P11). It is concluded that subinhibitory concentrations of bio-AgNPs increased biofilm formation and swarming, swimming, and twitching motility in PA14 and some P. aeruginosa isolates. These virulence factors are directly involved with quorum-sensing systems. Further research should investigate the effects of AgNPs on P. aeruginosa quorum sensing to help elucidate their mechanism of action at subinhibitory concentrations.

Fungi in dialysis water and dialysate: occurrence, susceptibility to antifungal agents and biofilm production capacity

The aim of this study was to investigate the occurrence of fungi in dialysis water and dialysate, in addition to evaluating the susceptibility to antifungals and the biofilm production capacity of isolated microorganisms. The samples were collected in three hemodialysis units in Bauru (Brazil), every 15 days (July 2017­June 2018) at post-reverse osmosis, reuse, and dialysate points. The fungi were isolated by spread plate on Sabouraud dextrose agar. Filamentous fungi were phenotypically identified and yeasts were subjected to molecular evaluation of the ITS region. Susceptibility test to antifungals was carried out by the broth microdilution method and biofilm production capacity was evaluated in microtiter plates using crystal violet staining. Fungi were isolated in 52/216 (24.1%) samples, with an average count of 16.3 (10­40) CFU/ mL. Overall, 61 microorganisms were identified, with 54 (88.5%) filamentous fungi and 7 (11.5%) yeasts. The main genera included were Penicillium, Cladosporium, Scedosporium, Rhinocladiella, Fusarium, and Emmonsia. Most isolates showed high values of minimum inhibitory concentration for 5-flucytosine and fluconazole and 35/45 (77.8%) isolates were classified as strong producers of biofilm. In order to increase the safety of the dialysis process, the adoption of control measures and monitoring of fungi in hemodialysis fluids is suggested.

Apiotrichum veenhuisii isolated from a pediatric patient with acute myeloid leukemia: The first case in humans.

This is the first report of the yeast Apiotrichum veenhuisii (formerly Trichosporon veenhuisii) causing disease in humans; its virulence and in vitro behavior against antifungals were also studied. The sample was isolated from biopsy fragments of disseminated lesions on the skin of a pediatric patient with acute myeloid leukemia. The studied virulence factors evidenced that the strain tested negative for secretion of the enzymes proteinase, phospholipase, and hemolysin. The isolate was characterized as low biofilm producer. Except for amphotericin B and voriconazole, the sample presented high minimum inhibitory concentration values against azole and echinocandins.

Physicochemical and microbiological quality of the public water supply in 38 cities from the midwest region of the State of São Paulo, Brazil.

The public water supply is a constant subject of concern since its quality depends on many different factors. The intention of this paper was to evaluate the quality of the public water supply in 38 cities from the midwest region of the State of São Paulo, Brazil, during the year of 2016. The parameters investigated included free residual chlorine, pH, apparent color, turbidity, fluoride, nitrate, and the presence of total coliforms and Escherichia coli. In total, from the 2,897 samples of water under analysis, 545 (18.81%) samples conflicted with the country's current legislation. The highest rates of noncompliance were related to fluoride contents and the presence of total coliforms. In addition, high nitrate concentrations (>10 mg/L NO3 -N) were observed in one of the cities' water sample. Our data display the major critical points of the water offered to the population and expose the potential risks for human health, indicating the need of a regular surveillance of the water and the adoption of corrective and preventive measures, in order to avoid the waterborne diseases occurrence, thus contributing to the population's health improvement. PRACTITIONER POINTS: Approximately 20% of the unsatisfactory water samples. High nitrate concentrations in public supply water. Potential risks for human health.

Fluoretação das águas de abastecimento público: 10 anos de monitoramento em 38 municípios do Centro-Oeste Paulista, São Paulo, Brasil / Public water supply fluoridation: 10 years of monitoring in 38 municipalities of Centro-Oeste Paulista, São Paulo, Brazil

Introdução: No estado de São Paulo, a concentração de flúor na água de abastecimento público deve ser mantida na faixa de 0,6 a 0,8 mg/L, a fim de prevenir a cárie e evitar o risco de fluorose. Objetivo: Avaliar a concentração de fluoretos na água de abastecimento público dos municípios de abrangência do Grupo de Vigilância Sanitária de Bauru. Método: Os dados foram extraídos da rotina do Instituto Adolfo Lutz ­ Bauru e oriundos de 38 municípios monitorados pelo Programa de Vigilância da Qualidade da Água para Consumo Humano (Proágua), no período de 2007­2016. As análises laboratoriais foram realizadas utilizando-se o método potenciométrico com eletrodo íon-seletivo e a interpretação dos resultados baseou-se na Resolução SS nº 250/95 e na classificação proposta pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal (CECOL). Resultados: Das 8.887 amostras analisadas, 31,1% apresentaram teores inadequados de íons fluoretos, sendo que 22,7% estavam abaixo e 8,4% acima do limite estabelecido pela legislação. De acordo com a proposta do CECOL, 59,4% das amostras exibiram benefício máximo para prevenção de cárie e 0,6% revelaram risco muito alto para produção de fluorose dentária. Conclusões: Tais dados apontam a necessidade de aprimorar o controle operacional do processo de fluoretação e enfatiza a importância da vigilância da qualidade da água.

Introduction: In the State of São Paulo, the concentration of fluoride in the public water supply should be maintained in the range of 0.6 to 0.8 mg/L, in order to prevent caries and avoid the risk of fluorosis. Objective: To evaluate the concentration of fluoride in public water supply in the municipalities covered by the Bauru Sanitary Surveillance Group. Method: Data were extracted from the routine of the Adolfo Lutz Institute ­ Bauru, from 38 municipalities monitored by the Proágua Program, in the period 2007­2016. Laboratory analyses were performed using the potentiometric method with ion-selective electrode and the interpretation of the results was based on Resolution SS-250/95 and the classification proposed by the Collaborating Center of the Ministry of Health in Oral Health Surveillance (CECOL) Results: Of the 8,887 samples analyzed, 31.1% had inadequate levels of fluoride ions, with 22.7% being below and 8.4% above the limit established by the legislation. According to the CECOL proposal, 59.4% of the samples showed maximum benefit for caries prevention and 0.6% revealed a very high risk for the production of dental fluorosis. Conclusions: These data point out the need to improve the operational control of the fluoridation process and emphasize the importance of water quality surveillance.

Human leishmaniasis in Brazil: A general review.

Leishmaniasis is a disease with ample clinical spectrum and epidemiological diversity and is considered a major public health problem. This article presents an overview of the transmission cycles, host-parasite interactions, clinical, histological and immunological aspects, diagnosis and treatment of various forms of the human disease.

Molecular detection of fungi of public health importance in wild animals from Southern Brazil.

Some animals have an important relationship with fungal infections, and searching for pathogens in animal samples may be an opportunity for eco-epidemiological research. Since studies involving wildlife are generally restricted, using samples from road kills is an alternative. The aim of this study was to verify whether pathogenic fungi of public health importance occur in wildlife road kills from Santa Catarina State, Brazil. Organ samples (n = 1063) from 297 animals were analysed according to Polymerase Chain Reaction (PCR) using universal primers to detect fungi in general and, subsequently, using primers specific to Paracoccidioides brasiliensis, Histoplasma capsulatum and Cryptococcus spp. There were 102 samples positive for fungal species. Eight samples were positive for P. brasiliensis, three samples were positive for Cryptococcus spp. and one sample had coinfection by these two fungi. No sample was positive for Histoplasma spp. according to the molecular detection. Genetic sequencing allowed the identification of Fungal sp. in 89 samples, Cryptococcus neoformans in two samples and Aspergillus penicillioides in three samples. This study shows the importance of wild animals in the epidemiology of fungal infections and assists in the mapping of pathogen occurrence in a region that was not previously evaluated.

Human leishmaniasis in Brazil: A general review / Leishmaniose humana no Brasil: uma revisão geral

Summary Leishmaniasis is a disease with ample clinical spectrum and epidemiological diversity and is considered a major public health problem. This article presents an overview of the transmission cycles, host-parasite interactions, clinical, histological and immunological aspects, diagnosis and treatment of various forms of the human disease.

Resumo A leishmaniose representa um complexo de doenças com amplo espectro clínico e diversidade epidemiológica, sendo considerada um grande problema de saúde pública. O presente artigo apresenta uma revisão geral sobre os ciclos de transmissão, as interações parasito-hospedeiro, os aspectos clínicos, histopatológicos e imunológicos, o diagnóstico e o tratamento das diversas formas da doença humana.

Identification of bat trypanosomes from Minas Gerais state, Brazil, based on 18S rDNA and Cathepsin-L-like targets.

Several bat species can be infected by trypanosomes, but there is not much information about which of these parasites infect bats from Triângulo Mineiro and Alto Paranaíba, Minas Gerais state, Brazil, a formerly endemic region for Trypanosoma cruzi, the causative agent of Chagas disease. The aim of this study was to describe, characterize, and identify the presence of trypanosomes in bats. The captured bats (448) belong to four families and to 19 different species. Of those, 37 bats were found to be positive for trypanosomes by microhematocrit, (infection rate 8.3%) and 27 were positive after hemoculture analysis. Initially, the isolates were identified by PCR (18S rDNA, 24Sα rDNA, spliced leader, COII RFLP-PCR) using primers originally designed for T. cruzi. PCRs (18S rDNA, 24Sα rDNA) showed compatible bands for TcI, whereas COII RFLP-PCR showed a similar pattern associated to TcII. However, there was no DNA amplification using spliced leader as a target, revealing a discrepancy between the results. Phylogenetic analysis of Cathepsin L-like and 18S rDNA sequences proved that 15 of the isolates corresponded to Trypanosoma cruzi marinkellei and one to Trypanosoma dionisii. These results revealed that the diversity of trypanosome species in a region considered endemic for Chagas disease is greater than previous descriptions. All this can confirm the necessity of using DNA sequencing approaches in order to determinate trypanosomes species isolated from bats.

Amiodarone and itraconazole improve the activity of pentavalent antimonial in the treatment of experimental cutaneous leishmaniasis.

Leishmaniasis affect millions of people, causing morbidity and mortality, especially in developing tropical and subtropical countries. Unfortunately, the possibilities of treatment for these infections are still quite limited and most of the available drugs present serious side effects. The objective of this paper was to evaluate the therapeutic role of amiodarone and itraconazole in the treatment of cutaneous leishmaniasis caused by Leishmania (Leishmania) amazonensis. In order to perform this evaluation, hamsters were infected with 1 × 106 metaciclic promastigotes of the parasite in the hind footpad and, after the onset of the lesions, were treated with glucantime, amiodarone, itraconazole, glucantime and amiodarone, glucantime and itraconazole or amiodarone and itraconazole. The treatments' efficacy was evaluated per analysis of the size of the cutaneous lesions and by parasitic investigation of the infected foot (by histopathological examination and PCR) and possible side effects were analyzed taking into account the weight of the animals and some biochemical and metabolic parameters (glucose, urea, creatinine, AST, ALT and ALP). The results have shown that, in hamsters, amiodarone and itraconazole, either used isolated or in combination, are unable to stop the development of cutaneous lesions caused by L. (L.) amazonensis, but improve the activity of glucantime in the treatment of these lesions and seem to present no evident side effects. More studies are necessary in order to investigate the clinical potential of these combinations, so there can be the possibility of broadening the therapeutic options available, especially in resistant cases.

Avaliação do conhecimento da população sobre leishmaniose visceral / Assessment of the population knowledge on the visceral leishmaniasis

A leishmaniose visceral encontra-se amplamente distribuída no mundo, e em virtude de sua elevadaocorrência e alto grau de letalidade, assume grande importância em saúde coletiva. Neste estudo foi avaliado o conhecimento sobre a leishmaniose visceral em um grupo da população no município de Bauru (SP), por meio de questionário aplicado em diferentes bairros da cidade. Do total de 280pessoas entrevistadas, 99,3 % afirmaram já terem ouvido falar da doença, 77,1 % conheciam o modode transmissão, 87,1 % reconheciam o papel do cão como reservatório doméstico, 59,6 % sabiam sobreos sinais clínicos nos humanos, 86,1 % conheciam os sinais clínicos em cães, 59,6 % reconheciam as medidas preventivas, 58,6 % compreendiam a necessidade da eutanásia canina, e 27,1 % tinham conhecimento sobre o principal período do dia em que o inseto vetor atua. Variações significativas no nível de instrução dos participantes foram evidenciadas em relação a alguns bairros e ao graude escolaridade, mas não quanto à renda familiar. No geral, o nível de conhecimento da população estudada revelou-se bom, porém, com carência de informações em alguns aspectos, principalmente quanto ao período de atuação dos flebotomíneos, ressaltando-se a necessidade de melhorias na divulgação de particularidades da parasitose.

Visceral leishmaniasis is widely distributed in the world, and due to its high incidence and high degree of lethality, is of great importance in collective health. This study evaluated the knowledge about visceral leishmaniasis in a population group in the city of Bauru (SP), through a questionnaire applied in different neighborhoods of the city. Of the total of 280 people interviewed, 99.3% said they had heard of the disease, 77.1% knew the mode of transmission, 87.1% recognized the role of the dog as a domestic reservoir, 59.6% knew about the clinical signs in humans , 86.1% knew the clinical signs in dogs, 59.6% acknowledged the preventive measures, 58.6% understood the need for canine euthanasia, and 27.1% had knowledge about the main period of the day when the insect vector Act. Significant variations in the level of education of the participants were evidenced in relation to some neighborhoods and to schooling, but not to family income. In general, the level of knowledge of the studied population was good, however, with lack of information in some aspects, mainly regarding the period of action of sandflies, emphasizing the need for improvements in the divulgation of particularities of parasitosis.

Assessment of the population knowledge on the visceral leishmaniasis / Avaliação do conhecimento da população sobre leishmaniose visceral

Visceral leishmaniasis is a widespread disease in the world, and due to its high incidence and high mortality, it is of great importance in public health. This study aimed at evaluating the knowledge on visceral leishmaniasis in a group of population in the city of Bauru (SP), through a questionnaire applied in different districts of the city. Of 280 participant persons, 99.3 % stated they had heard about the disease, 77.1 % knew the mode of transmission, 87.1 % recognized the role of dogs as domestic reservoirs, 59.6 % knew on the clinical signs in human, 86.1 % knew the clinical signs in dogs, 59.6 % recognized the preventive measures, 58.6 % understood the need of canine euthanasia and 27.1 % had knowledge on the main day time in which the insect acts. Significant variance in the participants education degrees were shown in relation to some districts and to the educational level, but not regarding to the family income. Overall, the knowledge degree of the evaluated population proved to be good, however, lack of information in some aspects was observed, especially regarding to the period of sandflies activity, emphasizing the need for improving the disclosure of the parasite particulars.

A leishmaniose visceral encontra-se amplamente distribuída no mundo, e em virtude de sua elevada ocorrência e alto grau de letalidade, assume grande importância em saúde coletiva. Neste estudo foi avaliado o conhecimento sobre a leishmaniose visceral em um grupo da população no município de Bauru (SP), por meio de questionário aplicado em diferentes bairros da cidade. Do total de 280 pessoas entrevistadas, 99,3 % afirmaram já terem ouvido falar da doença, 77,1 % conheciam o modo de transmissão, 87,1 % reconheciam o papel do cão como reservatório doméstico, 59,6 % sabiam sobre os sinais clínicos nos humanos, 86,1 % conheciam os sinais clínicos em cães, 59,6 % reconheciam as medidas preventivas, 58,6 % compreendiam a necessidade da eutanásia canina, e 27,1 % tinham conhecimento sobre o principal período do dia em que o inseto vetor atua. Variações significativas no nível de instrução dos participantes foram evidenciadas em relação a alguns bairros e ao grau de escolaridade, mas não quanto à renda familiar. No geral, o nível de conhecimento da população estudada revelou-se bom, porém, com carência de informações em alguns aspectos, principalmente quanto ao período de atuação dos flebotomíneos, ressaltando-se a necessidade de melhorias na divulgação de particularidades da parasitose.

Epidemiologia da leishmaniose visceral em Bauru, São Paulo, no período de 2004 a 2012: um estudo descritivo* / Epidemiology of visceral leishmaniasis in Bauru, São Paulo, Brazil, 2004-2012: a descriptive study

Descrever as características epidemiológicas dos casos de leishmaniose visceral (LV) notificados no município de Bauru, estado de São Paulo, Brasil, no período de 2004 a 2012. Métodos: estudo descritivo, com dados obtidos do Sistema de Informação de Agravos de Notificação (Sinan), gerido pela Secretaria Municipal de Saúde. Resultados: no período estudado, foram notificados 381 casos de LV, distribuídos em 100 (28,6 por cento) bairros da cidade; 61,7 por cento dos casos pertenciam ao sexo masculino; 43,8 por cento eram crianças com idade ≤10 anos; 98,4 por cento eram moradores da zona urbana; a taxa de coinfecção LV/HIV encontrada foi de 9,2 por cento; e 8,1 por cento dos casos evoluíram para óbito. Conclusão: entre os casos, predominaram homens, residentes na área urbana, em bairros da periferia e com baixa escolaridade; a diversificação dessas características aponta para a necessidade de otimizar as ações de vigilância e controle da doença...

To describe the epidemiological aspects of visceral leishmaniasis (VL) cases reported in the municipality of Bauru, state of São Paulo, Brazil, 2004-2012. Methods: this was a descriptive study using data from the Notifiable Diseases Information System (SINAN) managed by the Municipal Health Department. Results: 381 cases of VL were reported in the period and were distributed over 100 of the city’s districts (28.6 per cent); 61.7 per cent of the studied cases were male; 43.8 per cent were children aged ≤10 years; 98.4 per cent lived in urban areas; VL/HIV co-infection rate was 9.2 per cent; 8.1 per cent of cases died. Conclusion: there were more cases among men and those living in the city’s urban area, in low-income neighborhoods and those with low education; the diversification of these characteristics point to the need to optimize disease surveillance and control...

Perfil epidemiológico dos casos de tuberculose notificados no município de Bauru, estado de São Paulo, Brasil / Epidemiological profile of cases of tuberculosis notified in Bauru, state of São Paulo, Brazil

A tuberculose (TB) é uma doença infectocontagiosa extremamente antiga e que, apesar dos avanços, ainda representa um importante problema para a saúde pública no mundo. O principal objetivo deste estudo foi analisar, por meio dos dados obtidos do programa TBWEB (Sistema de informação em tuberculose do Estado de São Paulo), o perfil clínico-epidemiológico dos casos de tuberculose notificados em Bauru (SP), no período de 2008 a 2012. Nesse período foram notificados 796 novos casos da doença, com média de 159,2 casos/ano. Dos acometidos, 80,7% eram homens, 54,8% tinham idade entre 21 e 40 anos e 16,5% eram pessoas privadas de liberdade. A taxa de coinfecção TB/HIV foi de 13,6% e, de forma geral, 69,7% dos casos evoluíram para a cura; 2,1% para o óbito decorrente da infecção e 18,0% abandonaram o tratamento. Contrariando as metas globais de redução e eliminação da TB implantadas pela OMS, em Bauru não se tem observado declínio no número de novos casos da doença e as taxas de cura, abandono e óbito TB ainda são insatisfatórias...

Anti-leishmania infantum IgG antibody avidity in visceral leishmaniasis.

IgG avidity tests are used to discriminate acute from chronic infections. There are few reports on the IgG avidity profile of patients with visceral leishmaniasis (VL). This study investigated the anti-Leishmania IgG avidity in patients with classic VL (n = 10), patients showing clinical cure after treatment (n = 18), and asymptomatic subjects with at least one positive Leishmania test (n = 20). All subjects were from areas in Brazil where VL is endemic. Serum samples were collected from each subject on two different occasions. IgG avidity was evaluated by Western blotting. The proportion of high-avidity antibodies was higher in all samples from patients with classic VL. In contrast, low-avidity antibodies predominated in subjects with a history of VL, including 13 cases (72.2%) in the first assessment and 14 (77.8%) in the second. Fifteen (75%) of the asymptomatic subjects presented a predominance of low-avidity antibodies in the first assessment, and the frequency of high-avidity antibodies increased over time in seven subjects (35%) of this group. Antibodies against the 14- and/or 16-kDa antigen fraction were detected in the first assessment in all patients with classic VL, in 10 (55.5%) treated patients, and in 10 (50%) asymptomatic subjects. These were high-avidity antibodies in most cases. In the asymptomatic group, an increase in IgG avidity against the 14- and/or 16-kDa antigen fraction was observed in three cases (15%). The results indicate distinct responses in infected and asymptomatic subjects, probably associated with the length of time after infection. In this respect, IgG avidity tests represent a new approach to better characterize asymptomatic VL.