Antagonistic activity expressed by Shigella sonnei: identification of a putative new bacteriocin.

Bacteriocins are antibacterial, proteinaceous substances that mediate microbial dynamics. Bacteriocin production is a highly disseminated property among all major lineages of bacteria, including Shigella. In this paper, we addressed the purification and characterisation of a bacteriocin produced by a Shigella sonnei strain (SS9) isolated from a child with acute diarrhoea. The substance was purified through ammonium-sulphate precipitation and sequential steps of chromatography. The intracellular fraction obtained at 75% ammonium sulphate maintained activity following exposure to pH values from 1-11 and storage at -80ºC for more than two years and was inactivated by high temperatures and proteases. The molecular mass of the purified bacteriocin was determined by mass spectrometry to be 18.56 kDa. The N-terminal sequence of the bacteriocin did not match any other antibacterial proteins described. A putative new bacteriocin produced by S. sonnei has been detected. This bacteriocin may represent a newly described protein or a previously described protein with a newly detected function. Considering that SS9 expresses antagonism against other diarrhoeagenic bacteria, the bacteriocin may contribute to S. sonnei virulence and is potentially applicable to either preventing or controlling diarrhoeal disease.

Antagonistic activity expressed by Shigella sonnei: identification of a putative new bacteriocin

Bacteriocins are antibacterial, proteinaceous substances that mediate microbial dynamics. Bacteriocin production is a highly disseminated property among all major lineages of bacteria, including Shigella. In this paper, we addressed the purification and characterisation of a bacteriocin produced by a Shigella sonnei strain (SS9) isolated from a child with acute diarrhoea. The substance was purified through ammonium-sulphate precipitation and sequential steps of chromatography. The intracellular fraction obtained at 75% ammonium sulphate maintained activity following exposure to pH values from 1-11 and storage at -80ºC for more than two years and was inactivated by high temperatures and proteases. The molecular mass of the purified bacteriocin was determined by mass spectrometry to be 18.56 kDa. The N-terminal sequence of the bacteriocin did not match any other antibacterial proteins described. A putative new bacteriocin produced by S. sonnei has been detected. This bacteriocin may represent a newly described protein or a previously described protein with a newly detected function. Considering that SS9 expresses antagonism against other diarrhoeagenic bacteria, the bacteriocin may contribute to S. sonnei virulence and is potentially applicable to either preventing or controlling diarrhoeal disease.

Shift in human rotavirus distribution in Belo Horizonte, Brazil detected by ribonucleic acid electrophoresis.

Rotavirus has been considered the main agent of infectious diarrhea especially among younger children. We addressed the prevalence of rotavirus-associated diarrhea and the diversity of circulating electropherotypes by immunochromatography and RNA electrophoresis. Stool samples were taken from 391 children (267 with diarrhea) from the lower socioeconomic stratum who sought treatment in the Hospital Infantil João Paulo II/Belo Horizonte, during 2005 and 2006. Rotavirus was detected in 79/20.2% of subjects, 64/24.0% with diarrhea and 15/12.1% with no diarrhea. The virus was strongly associated with diarrhea (p = 0.003). A total of 76/19.4% and 69/17.6% rotavirus-positive children were identified by immunochromatography and electrophoresis, respectively. Rotavirus-associated diarrhea was more frequently detected in dry months (p < 0.001) and almost exclusively in children aged up to three years. Long profile strains prevailed (54/78.3%) but a shift toward short electropherotype was identified. Despite the decrease seen in 2006, rotavirus infection is still very common in our area. Although viral RNA electrophoresis is useful as a typing method, it should not be used exclusively in the diagnosis of rotavirus infection. We confirmed a shift from long to short profile strains, as already described for other South American countries.

Shigella in Brazilian children with acute diarrhoea: prevalence, antimicrobial resistance and virulence genes.

Diarrhoeal disease is still considered a major cause of morbidity and mortality among children. Among diarrhoeagenic agents, Shigella should be highlighted due to its prevalence and the severity of the associated disease. Here, we assessed Shigella prevalence, drug susceptibility and virulence factors. Faeces from 157 children with diarrhoea who sought treatment at the Children's Hospital João Paulo II, a reference children´s hospital in Belo Horizonte, state of Minas Gerais, Brazil, were cultured and drug susceptibility of the Shigella isolates was determined by the disk diffusion technique. Shigella virulence markers were identified by polymerase chain reaction. The bacterium was recovered from 10.8% of the children (88.2% Shigella sonnei). The ipaH, iuc, sen and ial genes were detected in strains isolated from all shigellosis patients; set1A was only detected in Shigella flexneri. Additionally, patients were infected by Shigella strains of different ial, sat, sen and set1A genotypes. Compared to previous studies, we observed a marked shift in the distribution of species from S. flexneri to S. sonnei and high rates of trimethoprim/sulfamethoxazole resistance.

Acute diarrhea associated with Salmonella enterica in Belo Horizonte-MG: prevalence and characterization of isolates / Diarreia aguda associada a Salmonella enterica em Belo Horizonte-MG: prevalência e caracterização das amostras isoladas

Introduction: Acute infectious diarrhea is still regarded as a public health problem associated with a wide range of etiologic agents, from which Salmonella enterica is particularly worth mentioning inasmuch as it is a major cause of inflammatory diarrhea in both developed and developing countries. Objective: To assess the distribution of S. enterica among children with acute diarrhea in Belo Horizonte and to characterize bacterium isolates. Material and methods: The study group comprised a total of 157 children from low socioeconomic background. Stool samples were collected for leukocyte analysis and Salmonella bacterial culture. The isolates were serotyped and evaluated as to antimicrobial susceptibility profile, extended-spectrum â-lactamases (ESBL) production, and presence of virulence markers (invA, iroB, and spvC). RESULTS: A total of 5/3.2% children were infected by S. enterica, 3/60% by S. enterica Typhimurium, 1/20% by S. enterica Enteritidis and 1/20% S. enterica subsp. enterica serotype 8.20:z4,z23:-. Fecal leucocytes were detected in two out of five fecal specimens positive for S. enterica. Isolates from three children were resistant to nalidixic acid, nalidixic acid + chloramphenicol, and nalidixic acid + chloramphenicol + ampicillin. ESBL production was not detected. All samples presented invA and iroB genes. spvC marker was observed in isolates from two children infected by S. Typhimurium and S. Enteritidis. Conclusion: The results demonstrate that S. enterica infection is uncommon among children from our region. Furthermore, they indicate the need for periodic monitoring of bacterial antimicrobial susceptibility profile in order to establish suitable antimicrobial therapy when required.

INTRODUÇÃO: A diarreia infecciosa aguda é considerada um problema de saúde pública associado a uma ampla gama de agentes etiológicos, entre os quais destaca-se Salmonella enterica, causa importante de diarreia inflamatória em países desenvolvidos e em desenvolvimento. OBJETIVOS: Avaliar a distribuição de S. enterica em crianças com diarreia aguda em Belo Horizonte e caracterizar as amostras isoladas. MATERIAL E MÉTODO: O grupo de estudo consistiu de 157 crianças de nível socioeconômico baixo. Espécimes fecais foram empregados para pesquisa de leucóc itos e cultivo de Salmonella. As amostras isoladas foram sorotipadas e submetidas à avaliação do perfil de suscetibilidade a antimicrobianos, da produção de betalactamases de amplo espectro (ESBL) e da presença de marcadores de virulência (invA, iroB e spvC). RESULTADOS: Cinco/3,2% crianças apresentaram-se infectadas por S. enterica; três/60%, por S. enterica Typhimurium; uma/20%, por S. enterica Enteritidis; e uma/20%, por S. enterica subsp. enterica sorotipo 8,20:z4,z23:-. Leucócitos fecais foram detectados em dois dos cinco espécimes positivos para S. enterica. As amostras isoladas de três crianças apresentaram resistência a ácido nalidíxico, ácido nalidíxico + cloranfenicol e ácido nalidíxico + cloranfenicol + ampicilina. Nenhuma amostra produziu ESBL. Todas as amostras albergavam os genes invA e iroB. O marcador spvC foi observado em amostras isoladas de duas crianças infectadas por S. Typhimurium e S. Enteritidis. CONCLUSÃO: Os resultados demonstram que diarreia associada a S. enterica é raramente observada entre crianças da nossa região e indicam a necessidade de avaliação periódica do perfil de suscetibilidade a antimicrobianos da bactéria para orientar o estabelecimento de antibioticoterapia, quando indicada.

Shigella in Brazilian children with acute diarrhoea: prevalence, antimicrobial resistance and virulence genes

Diarrhoeal disease is still considered a major cause of morbidity and mortality among children. Among diarrhoeagenic agents, Shigella should be highlighted due to its prevalence and the severity of the associated disease. Here, we assessed Shigella prevalence, drug susceptibility and virulence factors. Faeces from 157 children with diarrhoea who sought treatment at the Children's Hospital João Paulo II, a reference children´s hospital in Belo Horizonte, state of Minas Gerais, Brazil, were cultured and drug susceptibility of the Shigella isolates was determined by the disk diffusion technique. Shigella virulence markers were identified by polymerase chain reaction. The bacterium was recovered from 10.8% of the children (88.2% Shigella sonnei). The ipaH, iuc, sen and ial genes were detected in strains isolated from all shigellosis patients; set1A was only detected in Shigella flexneri. Additionally, patients were infected by Shigella strains of different ial, sat, sen and set1A genotypes. Compared to previous studies, we observed a marked shift in the distribution of species from S. flexneri to S. sonnei and high rates of trimethoprim/sulfamethoxazole resistance.

Prevalência baixa de adenovírus em crianças com diarreia em Belo Horizonte-MG / Low prevalence of adenoviruses in children with acute diarrhea in Belo Horizonte-MG

INTRODUÇÃO: Diversos microrganismos são reconhecidos como agentes de diarreia aguda, entre eles, os adenovírus, cuja associação com a doença apresenta variações geográficas e é pouco conhecida no Brasil. OBJETIVOS: Investigar a presença de adenovírus em fezes de crianças com diarreia aguda e sem diarreia, em Belo Horizonte-MG, e estudar os fatores epidemiológicos associados à adenovirose intestinal. MATERIAL E MÉTODOS: O teste imunocromatográfico qualitativo (kit VIKIA® Rota-Adeno, bioMérieux) foi utilizado para pesquisa de antígenos de adenovírus em amostras fecais obtidas de 268 crianças com diarreia aguda e 124 sem diarreia, em 2005 e 2006, no Hospital Infantil João Paulo II, Belo Horizonte-MG. Dados laboratoriais, clínicos e epidemiológicos foram registrados em banco de dados (SPSS Statistical package, IBM). RESULTADOS: Adenovírus foi detectado nas fezes de 16 crianças (4,1%): 12 (4,5%) com diarreia e quatro (3,2%) sem diarreia. A virose foi mais comum em meninas e a distribuição etária da infecção foi homogênea. Entre as 16 crianças com infecção pelo vírus, 11 (68,8%) tinham até 12 meses de idade. Entretanto, diferença significativa não foi observada para os parâmetros analisados. Distribuição sazonal da infecção por adenovírus não foi detectada. CONCLUSÃO: Nossos dados demonstram que a prevalência da adenovirose é baixa na população pediátrica no nosso meio.

INTRODUCTION: Several microorganisms, among them enteric adenovirus, are widely recognized as etiological agents of acute diarrhea. The association between adenovirus and the disease varies among geographical regions and is poorly known in Brazil. OBJECTIVES: To investigate the presence of adenovirus in stool samples from children with and without diarrhea in Belo Horizonte-MG. To study factors associated with enteric adenovirus infection. MATERIAL AND METHOD: A qualitative immunochromatographic assay (kit VIKIA® Rota-Adeno, bioMérieux) was performed to detect adenovirus antigens in stool samples from 268 children with acute diarrhea and 124 without diarrhea at Hospital Infantil João Paulo II from January/2005 to December/2006. Clinical, laboratory, and epidemiologic data were recorded in SPSS database (SPSS Statistical package, IBM). RESULTS: Adenovirus was detected in 16 samples (4.1%): 12 of them (4.5%) were from children with acute diarrhea and 4 of them (3.2%) from children without diarrhea. The viral infection was more prevalent among girls and the age distribution was homogenous. Among the 16 children infected by adenovirus,11 (68.8%) were younger than 12 months old. However, no significant statistical difference was observed within the analyzed parameters. There was no seasonal distribution of adenovirus infection. CONCLUSION: Our data demonstrate that the prevalence of enteric adenovirus infection is low among children with diarrhea in Belo Horizonte-MG.

Prevalência de Salmonella enterica em crianças com idade inferior a 5 anos com diarreia aguda e controles em Teresina-PI / Prevalence of Salmonella enterica in children aged less than 5 years with acute diarrhea and controls in Teresina-PI

We investigated the prevalence of Salmonella enterica (SE) among children (n = 400/250 with diarrhea) in Teresina-PI from 2004 to 2007. SE Newport was isolated from two samples and O-C2-C3-ND, Enteritidis, and Muenchen serological variants were isolated from one sample each. SE infection was more prevalent among children aged less than six months. Increased fecal volume, 3-10 evacuations/day, vomit and fever were reported for all cases. Resistance to nalidixic acid (NAL) and sulphamethoxazole-trimethoprim (SXT) was ubiquitous. Our data substantiate the need for monitoring SE infections worldwide and the emergence of antimicrobial resistance.

Foi estudada a prevalência de Salmonella enterica (SE) em crianças (n = 400; 250 com diarreia) em Teresina-PI, entre 2004 e 2007. SE Newport foi isolada de duas crianças e os sorotipos O-C2-C3-ND, Enteritidis e Muenchen foram encontrados em uma criança cada. A infecção foi mais comum em crianças com até 6 meses de idade. Volume fecal aumentado, três a 10 evacuações/dia, vômitos e febre foram relatados para todas as crianças. Foi comum resistência a ácido nalidíxico (NAL) e sulfametoxazol-trimetoprima (SXT). Nossos dados demonstram a necessidade de monitoramento da magnitude das salmoneloses em diferentes regiões do mundo e da emergência de padrões de resistência.

Attaching and effacing Escherichia coli and Shiga toxin-producing E. coli in children with acute diarrhoea and controls in Teresina/PI, Brazil.

This 3.5-year prospective study was conducted to ascertain the level of attaching and effacing Escherichia coli (AEEC) associated diarrhoea in children from Teresina, a northeastern state of Brazil. Passed faecal specimens from 400 patients (250 with and 150 without diarrhoea) up to 60 months of age attending from 2004 to 2007 at two public hospitals were investigated. Conventional microbiology methods and PCR were employed. Escherichia coli was isolated from 390 children, 240 of them with diarrhoea. A total of 117 AEEC strains were cultivated from specimens from 63 children, 37 with and 26 without diarrhoea. No association between AEEC and diarrhoea was observed. Atypical enteropathogenic E. coli (a-EPEC) (79.4%) was more commonly found than typical EPEC (t-EPEC). Association between EPEC and EPEC subtypes and diarrhoea was not detected. Mixed infection by t-EPEC and a-EPEC and infection by Shiga toxin-producing E. coli (STEC) were rare. Enteropathogenic E. coli was more common in males and in children aged less than 12 months. Correlation between serotyping and PCR results was 0.19. High resistance rates of AEEC to ampicillin, cephalotin, and trimethoprim-sulfamethoxazole were found. In conclusion, EPEC is very common in children with diarrhoea and controls in the population we studied, with a-EPEC predominating. This diarrhoeagenic E. coli (DEC) pathotype is more common in infant males and is resistant to drugs frequently used in clinical practice.

Bacteriocin production by Shigella sonnei isolated from faeces of children with acute diarrhoea.

Shigella is a common agent of diarrhoea, a worldwide major health problem. The bacterium produces bacteriocins; however, the role of these substances as a virulence factor is completely unknown. With the aim to search for colicin production by Shigella sonnei, to evaluate the influence of culture conditions on bacteriocin expression, and to characterize the substance partially, 16 S. sonnei strains isolated from children with diarrhoea were tested for antagonism against members of the intestinal microbiota or agents of diarrhoea. Nine strains exhibited isoantagonism and heteroantagonism against S. flexneri and diarrhoeagenic Escherichia coli. Autoantagonism and antagonism against the intestinal microbiota were not detected. Culture medium and incubation conditions influenced antagonism expression. Antagonism resulting from bacteriophages, low pH, fatty acids, hydrogen peroxide, and chloroform was excluded. The activity of the intracellular fraction obtained with 75% ammonium sulphate was preserved at pH 1.0-11.0, and was found to be reduced by organic solvents and affected by high temperatures and proteases. The antagonistic spectrum and the in vitro conditions for better antagonism expression suggest that the role of colicin in S. sonnei virulence, if any, would be expressed prior to infection, and may regulate population density of enteropathogens by helping in organism transmission.

Actinobacillus actinomycetemcomitans serotype-specific genotypes and periodontal status in Brazilian subjects.

Periodontitis is associated with members of the oral microbiota, such as Actinobacillus actinomycetemcomitans. To our knowledge, this is the first study to evaluate, by PCR, the occurrence of the six known bacterium serotypes that included subjects with and without periodontitis. Our group comprised 49 Brazilian subjects. We studied 146 bacterial isolates from 23 patients with aggressive or chronic periodontitis and 26 subgingival specimens from subjects with or without periodontitis, all originating in our collection. Serotypes b and c were observed in similar frequencies, and no subject harboured d, e, or f serotype strains. Around 78% subjects had single-serotype infection. Mixed infection was seen only in aggressive periodontitis patients. An association between serotype b and healthy periodontium and between serotype c and chronic periodontitis was observed. Our results diverge from those previously reported, which may be explained by specific distribution patterns in distinct populations. The association of different serotypes with the same periodontal status or conversely of a serotype with different periodontal conditions indicates that organism serotyping should not be used as a sole reliable marker for predicting the outcome of the infection. Evaluation of factors involved in human oral cavity colonization by subsets of A. actinomycetemcomitans is essential for elucidating organism-host-environment relationships.

Microbiota indígena de seres humanos / Indigenous microbiota of human beings

As superfícies do corpo humano são colonizadas por uma comunidade de organismos, principalmente bactérias, que constitui a microbiota indígena. A composição desta microbiota se altera ao longo da vida e é influenciada por diversos fatores, tais como dieta e status imunológico do hospedeiro. A microbiota pode agir de maneira benéfica ou, em algumas situações, pode ser prejudicial para o indivíduo. Podem ser distinguidas a microbiota residente, constituída por organismos específicos, encontrados, freqüentemente, em determinadas áreas e a microbiota transitória, que consiste de microrganismos provenientes do ambiente, que habitam a pele e as superfícies mucosas por horas ou poucas semanas. Trato gastrointestinal, vagina, cavidade oral e pele possuem a microbiota mais rica e diversificada do corpo humano. O conhecimento da constituição da microbiota indígena é extremamente relevante para os médicos, principalmente para orientar a interpretação de resultados de exames microbiológicos e a escolha da terapia antimicrobiana empírica mais adequada. Deve-se salientar que a microbiota geralmente é benéfica. Por esse motivo, é fundamental que se tenha consciência dos riscos do rompimento da homeostasia entre microbiota e hospedeiro.

Body surfaces are colonized by a community of organisms that are recognized as indigenous microbiota, that is mainly constituted by bacteria. Its constitution changes with time and is influenced by several conditions such as diet and the immune status of the individual, among others. There are now evidences that the microbiota could be beneficial or, in some instances, dangerous to human health. It could be classified as resident, composed by fixed organisms, frequently found in certain areas, or as transitory, consisting of organisms from the environment that inhabits skin and mucosa for hours to few weeks. The gastrointestinal tract, vagina, oral cavity and skin show the richest and most diverse microbiota of the human body. The knowledge of the constitution of the indigenous microbiota is extremely important for clinicians, mainly because it can help them to interpret results of microbiological tests and to choose appropriate empirical therapy. It should be pointed out that microbiota is, in general, harmless and beneficial; for these reason, physicians must keep in mind that the disruption of the homeostasis between microbiota and host should be avoided.

Leucocitúria / Urine leukocytes

A leixocitúria pode ser detectada, no exame de urina rotina, pela pesquisa de esterase leucocitária e pelo exame do sedimento urinário. Admitem-se 5 leucócitos/campo como ponto de corte do valor de referência. O jato médio urinário constitui a amostra mais utilizada para a avaliação de leucocitúria. A causa mais comum de leucocitúria é a infecção bacteriana do trato urinário. Outras causas incluem doenças inflamatórias renais ou do trato urinário, calculose, exercício físico extenuante e febre. O uso de nitrofurantoina e o emprego de formalina como conservante são causas de falso positivo no teste da esterase leucocitária e proteinúria (> 500 mg/dl), glicosúria (> 3g/dl), densidade elevada e a eliminação de alguns antimicrobianos e de ácido ascórbico são causas de falso negativo. A densidade baixa é a principal causa de falso negativo observada na sedimentoscopia.

Leukocyturia is usually detected by a positive leukocyte esterase test and/or by the microscopic examination of urine sediment. Although there is not an agreement on the number of urine leukocytes that means leukocyturia, the cut off used by most authors is 5 leukocytes/high power field. First-morning clean-catch midstream specimens are preferred but other samples such as timed, catheterized, or suprapubic ones may occasionally be colected. Any blood leukocyte may be found in the urine but the most common are polymorphonuclear neutrophils, that are frequently associated with bacterial urinary rract infections. Other causes of leukocyturia are renal diseases (tumors, glomerulonephritis, interstitial nephritis), nephrolithiasis, fever, and strenuous exercise. Cellular lysis, common in low specific graviry urine, is the most common cause of false negative results in the microscopic analysis. False positive results are commonly due to specimen contamination. Leukocyte esterase false results are due to pigmented foodstuffs or drugs (positive) or increased proteinuria, glucosuria, and specific graviry or the presence of gentamycin or cephalosporin (negative).

Associaçäo entre cagA e alelos do vacA de Helicobacter pylori e úlcera duodenal em crianças no Brasil / VacA alleles, cagA, and duodenal ulcer in children in Brazil

Helicobacter pylory é o principal agente de gastrite em seres humanos e fator de risco para úlcera péptica e câncer gástrico. A evoluçäo da infecçäo está relacionada a diversos fatores, inclusive bacterianos, como presença de cagA e genótipo s1ðm1 do vacA, associados com o desenvolvimento de úlcera e adenocarcinoma gástrico. O objetivo deste estudo foi investigar a associaçäo entre cagA e alelos do vacA em H. pylori isolado de crianças e relacionar os achados com a doença apresentada pelo paciente. Foram estudadas 65 crianças (24 com úlcera duodenal e 41 sem úlcera gástrica ou duodenal). A pesquisa de cagA e de alelos do vacA foi feita por PCR em amostras da bactéria isoladas do estômago dos pacientes. Infecçäo mista foi identificada em dez (15,4 por cento) crianças. Entre os pacientes com monoinfecçäo, o alelo s1 foi detectado em amostras isoladas de 40 (72,7 por cento), e o m1 em 34 (61,8 por cento). CagA foi identificado em H. pylori isolado de 38 (69,1 por cento) pacientes. Foi observada associaçäo entre presença de cagA de genótipo s1ðm1 (p = 10ð7) e entre cagA e padräo s1ðm1 com úlcera duodenal (p = 0,073 e p = 0,037, respectivamente). Em conclusäo, infecçäo mista por H. pylori é comum em crianças brasileiras, e amostras da bactéria apresentando o alelo s1 e cagA säo as mais prevalentes no nosso meio. A concomitância do alelo s1 do vacA e de cagA foi freqüentemente observada, e a associaçäo de amostras positivas de s1 e de cagA com úlcera duodenal foi confirmada neste trabalho

Prevalence of Helicobacter pylori infection in a rural area of the State of Mato Grosso, Brazil

The prevalence of Helicobacter pylori infection was evaluated by ELISA in 40 children and teenagers and in 164 adults from a rural area of the State of Mato Grosso, Brazil. Antibodies to H. pylori were detected in the serum of 31 (77.5 per cent) children and teenagers and in 139 (84.7 per cent) adults. The prevalence of infection increased with age (x² for trend, p<0.01) even though no variation occurred in the region in the present century in terms of living conditions or sanitation, economical development and migratory influx supporting the hypothesis that the infection is also acquired during later life in developing countries. An inverse correlation was observed between the prevalence of infection and annual family income (x² for trend, p<0.013). There was no correlation between type of system for sewage disposal and prevalence of infection (p=0.08). In conclusion, the prevalence of H. pylori infection in Nossa Senhora do Livramento, a rural area from Brazil, is very high and similar to that observed in other developing countries. Furthermore, the increase in the prevalence of infection with age observed in this population seems to be due to both, cohort effect and acquisition of the infection during later life.

Furazolidona x cimetidine em pacientes portadores de úlcera duodenal ativa e Helicobacter pylori no antro gástrico / Furazolidone and cimetidine in patients with active duodenal ulcer and Helicobacter pylori in the gastric antrum

Para se avaliar o efeito da furazolidona na doença ulcerosa e na erradicaçäo do Helicobacter pylori (Hp) foi realizado um ensaio terapêutico comparando-a com a cimetidina. O delinemento do estudo foi prospectivo, duplo-cego, duplo-placebo e randomizado, envolvendo 31 pacientes com úlcera duodenal ativa de Hp no antro gástrico. Avaliaçöes clínica, endoscópica, bacteriológica e histológica foram feitas antes e após 4 semanas de tratamento. Naqueles pacientes que näo cicatrizaram suas úlceras nas primeiras 4 semanas, o tratamento foi continuado por mais 4 semanas, quando novo exame endoscópico com biopsia era realizado. Foi observado que a furazolidona, quando comparada à cimetidina, mostrou-se mais eficaz na erradicaçäo do Hp, tnato logo após o tratamento (27% x 0%), quanto após 6 meses (18% x 0%), cicatriza a úlcera péptica duodenal (91% x 87%), e reduz significativamente (p < 0,025) a recidiva da úlcera (30% x 92%), 6 meses após tratamento

Estudo bacteriológico semi-quantitativo de pontas e catéteres endovenosos

Setenta e seis catéteres endovenosos retirados de setenta e seis pacientes internados no Hospital das Clínicas/UFMG foram cultivados, empregando-se técnicas semi-quantitativas. Vinte e seis deles exibiram um crescimento igual ou superior a 15 colônias por placa (34,21%). Neste grupo, Klebsiella pneumoniae foi o microrganismo mais freqüentemente isolado (23,33%). No grupo de catéteres com crescimento entre 1 e 14 colônias por placa predominou o Staphylococcus epidermidis (50,00%). Seis pacientes com cultura de catéter positiva apresentaram também hemoculturas positivas, tendo sido isolados nestes casos, os mesmos microrganismos do sangue e do catéter. Nenhum catéter com crescimento de 1 a 14 colônias por placa associou-se à bacteremia (P < 0,001). Foram ainda executados testes de suscetibilidade a antimicrobianos das amostras isoladas

Participaçäo de rotavírus e adenovírus na diarréia aguda da infância, em Belo Horizonte / Participation of rotavirus and adenovirus in acute diarrhoea of childhood, in Belo Horizonte

Rotavírus e adenovírus foram pesquisados nas fezes de 152 crianças com diarréia aguda, de até 5 anos de idade, em Belo Horizonte, no período de 1981 a 1985. Os espécimes foram diluídos em soluçäo tamponada e centrifugados. Os sobrenadantes foram usados para a detecçäo do vírus, empregando-se o método imunoenzimático (EIARA). A pesquisa do Rotavírus foi positiva em 32 crianças (21,05%) e de Adenovírus em 7 (4,60%) tendo sido identificados 2 vírus, simultaneamente, em 3 pacientes. Através de eletroforese em gel de poliacrilamida identifiocou-se, nas fezes de um paciente com 3 meses de idade, uma amostra de Rotavírus com perfil do grupo C

Valor do exame de esfregaço de fezes corado pelo método de Gram modificado no diagnóstico da enterite causada pelo Campylobacter jejuni / The value of a modified Gram staining of feces smears for diagnosis of Campylobacter jejuni enteritis

Foram estudadas 128 crianças (98 com diarréia aguda e 30 sem diarréia), de até dois anos de idade, que näo se encontravam em uso de drogas antimicrobianas, no período de agosto/82 a janeiro/84, em Belo Horizonte, MG, com o objetivo de se pesquisar o valor do exame do esfregaço de fezes, corado pelo método de Gram Modificado como proposto por Sazie & Titus, no diagnóstico da enterite causada pelo Campylobacter jejuni. Foram pesquisados microrganismos corados em vermelho pela carbolfucsina, curvos, em forma de "S" ou espiralados e os resultados obtidos foram comparados com os da cultura das fezes em meio de Butzler modificado. Foram visualizados microorganismos com morfologia sugestiva de Campylobacter jejuni em 14 pacientes com diarréia aguda (14,3%). Neste grupo, esta bactéria foi isolada em 10 pacientes. Apenas um paciente apresentou cultura negativa e exame direto positivo. Näo foram visualizados microrganismoss com morfologia sugestiva de Campylobacter jejuni nas amostras de fezes de crianças sem diarréia. A especificidade, sensibilidade e valor preditivo do Gram modificado foi de 95,4%, 90,9% e 71,4% respectivamente. Portanto, este método parece ser de grande valor no diagnóstico da diarréia aguda causada pelo Campylobacter jejuni, especialmente no nosso meio onde grande parte dos laboratórios de bacteriologia säo dotados de poucos recursos, pois trata-se de um método diagnóstico rápido, de fácil execuçäo e de baixo custo, devendo ser particularmente recomendado em pacientes com doença severa, nos quais o tratamento específico com antibacterianos pode ser necessário