Surveillance of Enteric Viruses and Thermotolerant Coliforms in Surface Water and Bivalves from a Mangrove Estuary in Southeastern Brazil.

This study was conducted to evaluate the microbiological quality of a mangrove estuary in the Vitória Bay region, Espírito Santo, Brazil. We analyzed the presence and concentration of enteric viruses and thermotolerant coliforms in water, mussels (Mytella charruana and Mytella guyanensis), and oysters (Crassostrea rhizophorae), collected over a 13-month period. Human adenovirus, rotavirus A (RVA), and norovirus genogroup II were analyzed by quantitative PCR. The highest viral load was found in RVA-positive samples with a concentration of 3.0 × 104 genome copies (GC) L-1 in water samples and 1.3 × 105 GC g-1 in bivalves. RVA was the most prevalent virus in all matrices. Thermotolerant coliforms were quantified as colony-forming units (CFU) by the membrane filtration method. The concentration of these bacteria in water was in accordance with the Brazilian standard for recreational waters (< 250 CFU 100 mL-1) during most of the monitoring period (12 out of 13 months). However, thermotolerant coliform concentrations of 3.0, 3.1, and 2.6 log CFU 100 g-1 were detected in M. charruana, M. guyanensis, and C. rhizophorae, respectively. The presence of human-specific viruses in water and bivalves reflects the strong anthropogenic impact on the mangrove and serves as an early warning of waterborne and foodborne disease outbreaks resulting from the consumption of shellfish and the practice of water recreational activities in the region.

High prevalence of enteric viruses associated with acute gastroenteritis in pediatric patients in a low-income area in Vitória, Southeastern Brazil.

Acute gastroenteritis (AGE) is a significant cause of child mortality worldwide. In Brazil, despite the reduction in infant mortality achieved in recent years, many children still die because of undiagnosed AGE. The prevalence, viral load, and circulating genotypes of rotavirus A (RVA), human adenovirus (HAdV), and norovirus GII (NoV GII) were investigated in children with AGE during 12 months in Vitoria, Espírito Santo, Southeastern Brazil. Enteric viruses were detected in stool samples, quantified by quantitative polymerase chain reaction, sequenced, and compared phylogenetically. The overall prevalence was 93.3% (125/134). Cases of single infection (41.8%) and mixed infection (51.5%) were observed; in 21.6% of cases, all the three viruses were detected. RVA had the highest number of copies in all infections. Phylogenetic analysis revealed predominantly the presence of RVA genotype G3, followed by G2 and G9. HAdV clustered within subgroup C, but some samples harbored subgroups A, D, or F. All sequenced NoV-positive samples clustered within the prevalent genotype GII.4. The high prevalence of RVA, HAdV, and NoV in diarrheal feces clarifies the etiology of AGE in this population, and the presence of RVA in vaccinated children reinforces the importance of monitoring programs to identify the causes of gastroenteritis and contribute to the reliability of diagnosis.

Prevalence of G6PD deficiency and molecular characterization of G202A, A376G and C563T polymorphisms in newborns in Southeastern Brazil.

OBJECTIVE: To evaluate the prevalence of G6PD deficiency and characterize G202A, A376G and C563T polymorphisms in neonates using molecular assays. METHODS: A total of one thousand samples were tested through quantitative analysis of enzyme activity, detecting 25 G6PD-deficient individuals. Patients identified as deficient were submitted to molecular analysis quantitative real-time polymerase chain reaction - (qPCR) to investigate the presence of variants associated with the deficiency. RESULTS: The total prevalence of G6PD deficient was 2.5%. Of the 25 samples identified as deficient, 21 were submitted to qPCR assay to analyze the presence of G202A, A376G and C563T variants. All samples showed the G202A/A376G genotype, characterizing G6PD A- phenotype. CONCLUSION: The prevalence of G6PD deficiency in the present study was similar to that observed in other study populations in Brazil. Molecular analysis identified in all patients the presence of the genetic polymorphism G202A/A376G, more common in the Brazilian population with G6PD deficiency, which is directly estimated by enzyme activity level.

Prevalence of G6PD deficiency and molecular characterization of G202A, A376G and C563T polymorphisms in newborns in Southeastern Brazil / Prevalência da deficiência de G6PD e caracterização molecular dos polimorfismos G202A, A376G e C563T em neonatos no Sudeste do Brasil

ABSTRACT Objective To evaluate the prevalence of G6PD deficiency and characterize G202A, A376G and C563T polymorphisms in neonates using molecular assays. Methods A total of one thousand samples were tested through quantitative analysis of enzyme activity, detecting 25 G6PD-deficient individuals. Patients identified as deficient were submitted to molecular analysis quantitative real-time polymerase chain reaction - (qPCR) to investigate the presence of variants associated with the deficiency. Results The total prevalence of G6PD deficient was 2.5%. Of the 25 samples identified as deficient, 21 were submitted to qPCR assay to analyze the presence of G202A, A376G and C563T variants. All samples showed the G202A/A376G genotype, characterizing G6PD A- phenotype. Conclusion The prevalence of G6PD deficiency in the present study was similar to that observed in other study populations in Brazil. Molecular analysis identified in all patients the presence of the genetic polymorphism G202A/A376G, more common in the Brazilian population with G6PD deficiency, which is directly estimated by enzyme activity level.

RESUMO Objetivo Avaliar a prevalência da deficiência de G6PD e caracterizar, por ensaios moleculares, os polimorfismos G202A, A376G e C563T em recém-nascidos. Métodos Foram testadas mil amostras por meio da análise quantitativa da atividade enzimática, detectando 25 portadores de deficiência de G6PD. Os pacientes identificados como deficientes foram submetidos à análise molecular reação em cadeia da polimerase em tempo real (qPCR) para pesquisa da presença das variantes associadas à deficiência. Resultados A prevalência total de deficientes de G6PD foi de 2,5%. Das 25 amostras identificadas como deficientes, 21 foram submetidas ao qPCR, para análise da presença das variantes G202A, A376G e C563T. Todas as amostras apresentaram o genótipo G202A/A376G, caracterizando fenótipo G6PD A-. Conclusão A prevalência da deficiência da G6PD no presente estudo foi semelhante à verificada em outras populações de estudo no Brasil. A análise molecular identificou em todos os pacientes a presença do polimorfismo genético G202A/A376G, mais comum na população brasileira portadora da deficiência de G6PD, que é diretamente estimada pelo nível de atividade enzimática.

Radiographic Evaluation of Root Canal Treatment Performed by Undergraduate Students, Part I; Iatrogenic Errors.

INTRODUCTION: The root canal preparation is an important stage in the undergraduate teaching and must be handled with care. Iatrogenic mishaps may occur during this procedure which might compromise the success of endodontic treatment. The aim of this study was to determine, the frequency of iatrogenic errors in endodontic treatments provided by undergraduate dental students at the School of Dentistry of Federal University of Espírito Santo (UFES), Brazil. METHODS AND MATERIALS: Radiographic records of 511 anterior teeth and pre-molars with endodontic treatment performed by undergraduate students, between 2012 and 2014 were randomly chosen. The final sample consisted of radiographic records of 397 teeth endodontically treated and were evaluated by using the projection of radiographic images. Iatrogenic errors that were detected in root filled teeth included: apical perforation, root perforation, furcation perforation, strip perforation, presence of fractured instruments, ledge and zip. Then they were classified, according to the absence or presence of iatrogenic errors, as adequate or inadequate. RESULTS: According to the results, 7.3% of the teeth were inadequate, and there was no statistically significant difference among the groups of anterior teeth, incisors, or canines (P>0.05). A ledge was present in 6.54% of root canals, a zip in 0.75% of root canals, and only one root canal presented a fractured instrument. In teeth with moderate curvature, the root curvature was a factor that possibly influenced the occurrence of the ledge (P<0.05). CONCLUSION: The majority of root canal preparations showed a low occurrence of iatrogenic errors.

Prevalence and antimicrobial susceptibility profile of microorganisms in a university hospital from Vitória (ES), Brazil / Prevalência de microrganismos e perfil de suscetibilidade antimicrobiana em um hospital universitário de Vitória (ES), Brasil

ABSTRACT INTRODUCTION: Healthcare associated infections (HAIs) occur during the hospital stay as a result of underlying morbidity, invasive procedures, acute pathology or medical treatment. They lead prolonged stay and, consequently, to an increase in financial charges. The main tool to control these infections is the use of antimicrobials. However, the increase in resistance and the low frequency of discovery of new drugs justify the research that evaluates the resistance profile of microorganisms to antimicrobials. OBJECTIVE: To evaluate the prevalence and antimicrobial susceptibility profile of HAIs at a philanthropic reference hospital in Espírito Santo, Brazil. METHODS: Observational, retrospective and cross-sectional study, between July 2014 and June 2016. Data on blood, urine and corporal secretions culture were collected from the data base of the Hospital Infection Control Commission. RESULTS: There was a high prevalence of HAIs in patients older than 60 years. Two hundred and forty three (47.55%) patients were female. The four most prevalent bacteria were: Acinetobacter spp., Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Polymyxin was the drug which presented the best antimicrobial effects. CONCLUSION: Polymyxin was active in vitro against all isolates of Acinetobacter spp. Regarding K. pneumoniae, both polymyxin and amikacin showed a significant effectiveness. Regarding Pseudomonas aeruginosa, polymyxin was effective in all samples. Regarding S. aureus, teicoplanin, daptomycin and vancomycin were effective in all samples. Polymyxin showed a good overall in vitro activity.

RESUMO INTRODUÇÃO: As infecções relacionadas com a assistência à saúde (IRAS) ocorrem durante a internação como resultado de morbidade subjacente, procedimentos invasivos, patologia aguda ou tratamento médico. Elas levam à prolongada permanência e, consequentemente, à carga econômica. A principal ferramenta para conter essas infecções são os antimicrobianos. No entanto, o aumento da resistência e a baixa taxa de descoberta de novos medicamentos justificam a pesquisa que avalia o perfil de resistência de microrganismos aos antimicrobianos. OBJETIVO: Avaliar a prevalência e o perfil de suscetibilidade antimicrobiana das IRAS ocorridas em um hospital filantrópico de referência do Espírito Santo, Brasil. MÉTODOS: Estudo observacional, retrospectivo e transversal, entre julho de 2014 e junho de 2016. Os dados sobre cultura de sangue, urina e secreções corporais foram coletados da base de dados do Centro de Controle de Infecção Hospitalar. RESULTADOS: Houve alta prevalência de IRAS em pacientes com mais de 60 anos. Duzentos e quarenta e três (47.55%) pacientes eram do sexo feminino. As quatro bactérias mais prevalentes foram: Acinetobacter spp., Klebsiella pneumoniae, Pseudomonas aeruginosa e Staphylococcus aureus. A polimixina foi a droga que apresentou os melhores efeitos antimicrobianos. CONCLUSÃO: A polimixina foi ativa in vitro contra todos os isolados de Acinetobacter spp. Quanto à K. pneumoniae, tanto a polimixina quanto a amicacina apresentaram eficácia significativa. Em relação à Pseudomonas aeruginosa, a polimixina foi efetiva em todas as amostras. Já em relação ao S. aureus, teicoplanina, daptomicina e vancomicina foram efetivas em todas as amostras. A polimixina demonstrou um bom desempenho geral in vitro.

Frequency of classes I and II HLA alleles in deceased donors of solid organs in Espírito Santo, Brazil / Frequência alélica HLA de classes I e II em doadores falecidos de órgãos sólidos no Espírito Santo, Brasil

ABSTRACT Introduction: The Brazilian population has a great racial mix, originating mainly from Europeans, Africans and Indians. Human leukocyte antigens (HLA) specificities vary among different population and ethnic groups, since they demonstrate greater similarity in populations of common origin. Objective: To determine the genetic structure of HLA classes I and II alleles in deceased donors of solid organs in the state of Espírito Santo, Brazil, from 2011 to 2015. Methods: The present study covered 208 brain-dead donors of solid organs, from 2011 to 2015, in the state of Espírito Santo, Brazil. HLA typing was performed by polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSP) using kits for generic classes I and II SSP DNA typing test, A, B and DR loci. Results: The profile of deceased donors found in Espírito Santo, Brazil, in the period from 2011 to 2015, was brown men, aged over 40 years. The most frequent HLA alleles were A2 (24.28%), B44 (10.34%) and DR15 (14.18%); and the least frequent, A43 (0.24%), B46, B47, B70, B75 and B78 (0.24%) and DR9 (1.68%), DR12 and DR18 (2.16%). Conclusion: The present study contributed with significant information about the frequency of HLA antigens in deceased donors of solid organs in the Brazilian population that will contribute to optimize the transplantation process in the country.

RESUMO Introdução: A população brasileira possui grande mistura racial, tendo sido originada, principalmente, de caucasoides de origem europeia, africanos e índios. As especificidades do sistema de antígenos leucocitários humanos (HLA) variam entre os diferentes grupos populacionais e étnicos, uma vez que demonstram maior similaridade entre populações com origem comum. Objetivo: Determinar a estrutura genética dos alelos HLA de classes I e II em doadores falecidos de órgãos sólidos no Estado do Espírito Santo, Brasil, no período de 2011 a 2015. Métodos: O presente estudo foi realizado em 208 indivíduos falecidos doadores de órgãos sólidos, diagnosticados com morte encefálica, no período de 2011 a 2015, no estado do Espírito Santo, Brasil. A tipificação HLA foi realizada pela técnica de reação em cadeia da polimerase-iniciador específico único (PCR-SSP) utilizando kits para teste de tipagem de ácido desoxirribonucleico (DNA) por SSP genérico de classes I e II, loci A, B e DR. Resultados: O perfil dos doadores falecidos encontrados no Espírito Santo, Brasil, no período de 2011 a 2015, foi de homens pardos, com faixa etária acima de 40 anos. Os alelos HLA mais frequentes foram A2 (24,28%), B44 (10,34%) e DR15 (14,18%); e os menos frequentes, A43 (0,24%), B46, B47, B70, B75 e B78 (0,24%) e DR9 (1,68%), DR12 e DR18 (2,16%). Conclusão: O presente estudo contribuiu com significativas informações acerca da frequência dos antígenos HLA em indivíduos falecidos doadores de órgãos que poderão otimizar o processo de transplantes no país.

Analysis of chromosomal abnormalities by CGH-array in patients with dysmorphic and intellectual disability with normal karyotype.

OBJECTIVE: To investigate chromosomal abnormalities by CGH-array in patients with dysmorphic features and intellectual disability with normal conventional karyotype. METHODS: Retrospective study, carried out from January 2012 to February 2014, analyzing the CGH-array results of 39 patients. RESULTS: Twenty-six (66.7%) patients had normal results and 13 (33.3%) showed abnormal results - in that, 6 (15.4%) had pathogenic variants, 6 (15.4%) variants designated as uncertain and 1 (2.5%) non-pathogenic variants. CONCLUSION: The characterization of the genetic profile by CGH-array in patients with intellectual disability and dysmorphic features enabled making etiologic diagnosis, followed by genetic counseling for families and specific treatment.

Analysis of chromosomal abnormalities by CGH-array in patients with dysmorphic and intellectual disability with normal karyotype / Análise de anomalias cromossômicas por CGH-array em pacientes com dismorfias e deficiência intelectual com cariótipo normal

ABSTRACT Objective To investigate chromosomal abnormalities by CGH-array in patients with dysmorphic features and intellectual disability with normal conventional karyotype. Methods Retrospective study, carried out from January 2012 to February 2014, analyzing the CGH-array results of 39 patients. Results Twenty-six (66.7%) patients had normal results and 13 (33.3%) showed abnormal results - in that, 6 (15.4%) had pathogenic variants, 6 (15.4%) variants designated as uncertain and 1 (2.5%) non-pathogenic variants. Conclusion The characterization of the genetic profile by CGH-array in patients with intellectual disability and dysmorphic features enabled making etiologic diagnosis, followed by genetic counseling for families and specific treatment.

RESUMO Objetivo Avaliar microalterações cromossômicas por CGH-array em portadores de dismorfias e deficiência intelectual com cariótipo normal. Métodos Estudo retrospectivo, realizado no período de janeiro de 2012 a fevereiro de 2014, analisando os resultados de CGH-array de 39 pacientes. Resultados Apresentaram resultados normais 26 (66,7%) pacientes; 13 (33,3%) tiveram resultados alterados, a saber: 6 (15,4%) com variantes patogênicas, 6 (15,4%) com variantes pertencentes à categoria designada como incerta, e 1 (2,5%) com variantes não patogênicas. Conclusão A caracterização do perfil genético por CGH-array nos pacientes com deficiência intelectual e dismorfias possibilitou complementar o diagnóstico etiológico, permitindo a realização do aconselhamento genético para as famílias e tratamento específico.