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1.
Virulence ; 12(1): 260-269, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33356835

RESUMO

Atopic dermatitis (AD) is a chronic inflammatory skin disease and colonization by Staphylococcus aureus may affect up to 100% of these patients. Virulent and resistant isolates can worsen AD patient clinical condition and jeopardize the treatment. We aimed to detect virulence genes and to evaluate the biofilm production of S. aureus isolates from infected skin lesions of children with AD. Methicillin resistance was detected by phenotypic and molecular tests and the virulence genes were detected by PCR. Biofilm formation was assessed by bacterial growing on microtiter plates and later stained with safranin. Genotyping was performed by Pulsed-Field Gel Electrophoresis and Multilocus Sequence Typing. Among 106 AD patients, 55 (51.8%) had developed S. aureus cutaneous infections and 23 (41.6%) were methicillin-resistant (MRSA). All 55 isolates carried the fnbA, hla, icaA, sasG, and seu genes, and more than 70% presented cna, eap, ebpS, hlg, and pvl genes. Clonal complex (CC) 30 was the main lineage found (34.5%), especially among MRSA isolates (52.2%). The egc cluster and the bbp gene were significantly the most frequent in MRSA isolates and in USA1100/ST30/CC30 lineage. Most of the isolates (74.5%) were non-biofilm producers and many of them only started to produce it in the presence of fibrinogen. There was no significant association between S. aureus isolates features and the AD severity. This study demonstrated a high frequency of CC30 MRSA isolates presenting several virulence genes in infected skin lesions of AD children in Brazil, that may influence the severity of the disease and the treatments required.

2.
J Med Microbiol ; 69(6): 850-853, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32430095

RESUMO

Atopic dermatitis (AD) is a chronic skin disease that affects up to 20 % of the paediatric population worldwide. Staphylococcus aureus colonizes anterior nares and can be transmitted in the home environment, aggravating AD. This study aimed to detect S. aureus from nares of AD patients and their family contacts, as well as to evaluate the antimicrobial resistance, virulence and clonality of these isolates. Among the 48 family groups investigated, 30 groups were selected, as both the child and his/her respective contact had methicillin-sensitive S. aureus (MSSA) (24 cases; 54 MSSA isolates) or methicillin-resistant S. aureus (MRSA) isolates (6 cases; 13 MRSA isolates). All MRSA isolates carried SCCmec IV. S. aureus carrying PVL genes were detected in 60 % of patients. Pulsed-field gel electrophoresis (PFGE) analysis was performed for 31 isolates from 15 family groups: all 6 with MRSA and 9 with MSSA isolates. Similar genotypic profiles between isolates from patients and their family contacts were noted in 10 (66.6 %) family groups, 5 (83.3 %) of the MRSA family groups and 5 (55.5 %) of the MSSA family groups, indicating that the pathogen was transmitted through family contacts.


Assuntos
Dermatite Atópica/microbiologia , Mucosa Nasal/microbiologia , Staphylococcus aureus/genética , Adolescente , Criança , Pré-Escolar , Eletroforese em Gel de Campo Pulsado , Humanos , Lactente , Recém-Nascido , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus/efeitos dos fármacos
3.
J Glob Antimicrob Resist ; 19: 236-240, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31176072

RESUMO

OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) is an important causative agent of nosocomial infections. Mutations in the quinolone resistance-determining regions (QRDRs) of the gyr and par genes have been described. This study aimed to characterise phenotypic and genotypic fluoroquinolone resistance in 69 MRSA isolates of different clonal lineages from hospitals in Rio de Janeiro, Brazil. METHODS: QRDR mutations in the gyrA, gyrB, parC and parE genes were detected by DNA sequencing. Minimum inhibitory concentrations (MICs) for ciprofloxacin and moxifloxacin were determined by broth microdilution. The occurrence of associations between mutations and MICs among the different clonal lineages of MRSA isolates was then verified. RESULTS: Most isolates from the USA400/ST1/SCCmec IV lineage, but mainly USA100/ST5/SCCmec II isolates, which have been more recently found in Rio de Janeiro hospitals, showed different patterns of mutations, including double mutation in the QRDR of parC (Ser-80â¿¿â¿¿â¿¿Tyr and Glu-84â¿¿â¿¿â¿¿Lys/Gly) and/or gyrA (Ser-84â¿¿â¿¿â¿¿Leu and/or Glu-88â¿¿â¿¿â¿¿Lys) associated with higher moxifloxacin and ciprofloxacin MICs (MIC90, â¿¥8â¿¿mg/L and 256â¿¿mg/L, respectively). On the other hand, all USA800/ST5/SCCmec IV and the BEC/ST239/SCCmec III isolates, which have disappeared from hospitals, showed single mutations in parC (Ser-80â¿¿â¿¿â¿¿Phe) and gyrA (Ser-84â¿¿â¿¿â¿¿Leu or Glu-88â¿¿â¿¿â¿¿Gly) and lower fluoroquinolones MICs (MIC90, â¿¥2â¿¿mg/L and â¿¥16â¿¿mg/L). CONCLUSION: This study highlights an increase in the number and types of mutations in the QRDRs ofgyrA and parC associated with high fluoroquinolones MICs that may be related to changes in the epidemiological profile of MRSA isolates from hospitals in Rio de Janeiro.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , Mutação , Quinolonas/farmacologia , Brasil/epidemiologia , DNA Girase/genética , DNA Topoisomerase IV/genética , Genótipo , Hospitais/estatística & dados numéricos , Humanos , Testes de Sensibilidade Microbiana , Fenótipo , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia
4.
Braz J Infect Dis ; 23(2): 139-142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31028723

RESUMO

INTRODUCTION: This study aimed to characterize Staphylococcus aureus isolates from bloodstream infections in patients attending a teaching hospital, between 2011 and 2015. METHODS: The minimum inhibitory concentration for daptomycin, linezolid, oxacillin, teicoplanin, vancomycin, and trimethoprim/sulfamethoxazole was accessed by broth microdilution. SCCmec type and clonal profile were determined by molecular tests. Vancomycin heteroresistance was evaluated using screening tests and by population analysis profile/area under the curve. RESULTS: Among 200 S. aureus isolates, 55 (27.5%) were MRSA, carrying SCCmec II (45.5%) or IV (54.5%). The most frequent MRSA lineages were USA100 (ST5-II) (45.5%) and USA800 (ST5-IV) (30.9%). Six isolates were confirmed as vancomycin heteroresistant, showing area under the curve ratio 1.1, 1.2 or 1.3 (four USA100, one USA800 and one USA1100 isolates). CONCLUSIONS: Daptomycin and vancomycin non-susceptible MRSA clonal lineages were found in bloodstream infections over five years, highlighting the importance of continuous surveillance of multiresistant bacteria in hospitals.


Assuntos
Antibacterianos/farmacologia , Bacteriemia/microbiologia , Daptomicina/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Vancomicina/farmacologia , Brasil , Infecção Hospitalar/microbiologia , Hospitais de Ensino , Humanos , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/microbiologia
5.
Braz. j. infect. dis ; 23(2): 139-142, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039225

RESUMO

ABSTRACT Introduction: This study aimed to characterize Staphylococcus aureus isolates from bloodstream infections in patients attending a teaching hospital, between 2011 and 2015. Methods: The minimum inhibitory concentration for daptomycin, linezolid, oxacillin, teicoplanin, vancomycin, and trimethoprim/sulfamethoxazole was accessed by broth microdilution. SCCmec type and clonal profile were determined by molecular tests. Vancomycin heteroresistance was evaluated using screening tests and by population analysis profile/area under the curve. Results: Among 200 S. aureus isolates, 55 (27.5%) were MRSA, carrying SCCmec II (45.5%) or IV (54.5%). The most frequent MRSA lineages were USA100 (ST5-II) (45.5%) and USA800 (ST5-IV) (30.9%). Six isolates were confirmed as vancomycin heteroresistant, showing area under the curve ratio 1.1, 1.2 or 1.3 (four USA100, one USA800 and one USA1100 isolates). Conclusions: Daptomycin and vancomycin non-susceptible MRSA clonal lineages were found in bloodstream infections over five years, highlighting the importance of continuous surveillance of multiresistant bacteria in hospitals.


Assuntos
Humanos , Vancomicina/farmacologia , Bacteriemia/microbiologia , Daptomicina/farmacologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Antibacterianos/farmacologia , Infecções Estafilocócicas/microbiologia , Brasil , Testes de Sensibilidade Microbiana , Infecção Hospitalar/microbiologia , Hospitais de Ensino
6.
J Pept Sci ; 24(11): e3129, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30325566

RESUMO

Eight molecules, four peptides (SPs) and four lipopeptides (LPs) derived by rational design from surfactin, a well-known secreted biosurfactant from Bacillus subtilis, were produced employing Fmoc-based solid-phase synthesis. These new peptides were tested to evaluate their potential biosurfactant and biological activities, aiming at possible applications in industrial, biological, pharmaceutical, and medical use. Five molecules (SP1, SP2, SP4, LP5, and LP8) presented potential for medical uses, mainly due to their drug delivery properties as suggested by their synergistic activity with the antibiotic vancomycin against Staphylococcus aureus. All synthetic peptides showed low toxicity against Vero cell cultures, in assays of hemolysis, and in different cytotoxicity assays. In addition, we found that three peptides (SP1, LP6, and LP7) had potential technological and industrial use because of their emulsifying capacity, low toxicity, and ability to physically stabilize solutions. These novel molecules retained some properties of the parental molecule (surfactin, which was originally obtained through nonribosomal synthesis in Bacillus subtilis) but have the advantage of being linear peptides, which can be produced at large scales through the use of conventional heterologous protein expression protocols.


Assuntos
Bacillus subtilis/metabolismo , Lipopeptídeos/síntese química , Peptídeos Cíclicos/química , Peptídeos/síntese química , Técnicas de Síntese em Fase Sólida/métodos , Animais , Bacillus subtilis/química , Proteínas de Bactérias/química , Chlorocebus aethiops , Portadores de Fármacos/síntese química , Portadores de Fármacos/química , Portadores de Fármacos/farmacologia , Sinergismo Farmacológico , Emulsificantes/síntese química , Emulsificantes/química , Emulsificantes/farmacologia , Humanos , Lipopeptídeos/química , Lipopeptídeos/farmacologia , Peptídeos/química , Peptídeos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Vancomicina/farmacologia , Células Vero
7.
Open Dent J ; 12: 424-434, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29988222

RESUMO

Introduction: Atopic dermatitis is a chronic inflammatory skin condition that is more prevalent in children (10-20% of the world's population) than in adults. As its etiology is multifactorial, it is important to know the most frequent oral manifestations in atopic dermatitis patients. Methodology: In the last decades, the correlation between atopic dermatitis and conditions and/or changes in the oral cavity has been demonstrated by several studies. The objective of this paper was to describe, through a review of the literature, the oral health conditions and/or oral aspects identified in patients with atopic dermatitis. Search Strategy: A descriptive literature review was carried out through a bibliographical survey based on the last 10 years, in order to answer the study questions. Results: As a result, we found six studies with different sample sizes, ranging from 43 to 468 patients, and the majority of them were of cross-sectional study design. Discussion: Two studies performed their analysis through dental exams and reported that patients with atopic dermatitis tend to have a greater frequency of carious lesions, and two studies correlated Candida with atopic dermatitis through mycological analyzes. Conclusion: There are a few studies in the literature that identify the oral aspects of atopic dermatitis. More investigations are needed in order to contribute to the knowledge of such oral aspects and the approach to treat these patients regarding oral health.

8.
Am J Infect Control ; 45(11): 1190-1193, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28751036

RESUMO

BACKGROUND: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are associated with greater mortality and morbidity; however, risk factors for community-acquired infections caused by MRSA have not been established. Therefore, community patients who are admitted to hospitals without the necessary contact precautions and are infected with community-acquired lineages eventually cause these lineages to spread to these settings. The aim of this study was to detect community-acquired lineages of MRSA in patients on admission to a Brazilian teaching hospital. METHODS: The antimicrobial susceptibility of the MRSA isolates from nasal swabs was evaluated as was the molecular characteristics of the staphylococcal cassette chromosome mec (SCCmec). The clonality was determined using pulsed-field gel electrophoresis and multilocus sequence type analysis. RESULTS: A total of 702 patients were evaluated between March 2012 and March 2013; 180 (25%) of them were colonized by S aureus, and 21 (3%) were MRSA. The SCCmec IV/USA1100/sequence type (ST) 30 was the predominant MRSA lineage (42.8%), followed by SCCmec IV/USA800/ST5 (23.8%). CONCLUSIONS: The occurrence of MRSA colonization was very low, and only 1 patient from cardiac surgery developed an infection, which was caused by an SCCmec II/USA100/ST5 isolate. Screening for MRSA colonization on admission does not seem to be productive; however, for populations submitted to specific surgeries, active surveillance should be implemented.


Assuntos
Infecção Hospitalar/epidemiologia , Hospitais de Ensino/estatística & dados numéricos , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Adulto Jovem
9.
Acta Odontol Scand ; 75(6): 423-428, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28580816

RESUMO

OBJECTIVE: This study investigated the presence of Enterococcus faecalis in primary teeth with primary root canal infections and related to the possible failure of pulpectomy outcome after 36 months. MATERIAL AND METHODS: Root canal samples were obtained from 25 out of 244 patients using the sterile paper cone method. The identification of E. faecalis was done with culture and molecular tests using species-specific 16S rRNA gene-based polymerase chain reaction (PCR). After 36 months, the pulpectomy outcome was evaluated. RESULTS: Enterococcus faecalis was found in five (20%) samples, and dental caries were the cause of primary infection in all of them. Pulpectomy outcome was evaluated only in teeth that completed the entire clinical protocol and were followed up to 36 months (n = 8). From these, 75% (n = 6) were successful and 25% (n = 2) failed. E. faecalis was present in 50% of both successful and failed cases. CONCLUSIONS: Enterococcus faecalis was not related to the failure of endodontic treatment of primary teeth.


Assuntos
Cárie Dentária/microbiologia , Cavidade Pulpar/microbiologia , Enterococcus faecalis/isolamento & purificação , Tratamento do Canal Radicular , Dente Decíduo/microbiologia , Humanos , Masculino , Reação em Cadeia da Polimerase
10.
PLoS One ; 11(8): e0160506, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27575698

RESUMO

This study analyzed clinical and microbiological characteristics of heteroresistant (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA) from bloodstream infections (BSI) in a Brazilian teaching hospital, between 2011 and 2013. Minimum inhibitory concentrations (MIC) of antimicrobials were determined by broth microdilution method and SCCmec was detected by PCR. Isolates with a vancomycin MIC ≥ 2mg/L were cultured on BHI agar with 3, 4 or 6 mg/L (BHIa3, BHIa4 or BHIa6) of vancomycin and BHIa4 with casein (BHIa4ca). Macromethod Etest® and Etest® Glicopeptides Resistance Detection were also used. VISA and hVISA isolates were confirmed by the population analysis profile then typed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. Medical data from the patients were obtained from their medical records. Among 110 consecutive isolates, 31 (28%) were MRSA and carried the SCCmec type II (15 isolates) or IV (16 isolates). Vancomycin MIC50 and MIC90 were 1 and 2 mg/L, respectively. MRSA isolates had increased non-susceptibility to daptomycin (p = 0.0003). Six (5%) isolates were VISA, four of which were MRSA, three SCCmec type II/USA100/ST5 and one type IV/USA800/ST3192. One MRSA SCCmec II isolate grew on agar BHIa3, BHIa4 and BHIa4ca, and it was confirmed as hVISA. Among the six VISA isolates, five (83%) grew on BHIa3 and three (50%) on BHI4ca. Four of the six VISA isolates and the one hVISA isolate were from patients who had undergone dialysis. Thus, a possible dissemination of the SCCmec II/USA100/ST5 lineage may have occurred in the hospital comprising the VISA, hVISA and daptomycin non-susceptible S. aureus Brazilian isolates from health care associated bloodstream infections.


Assuntos
Antibacterianos/farmacologia , Bacteriemia/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Resistência a Vancomicina , Infecção Hospitalar/microbiologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Diálise Renal/efeitos adversos , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética
11.
Microb Drug Resist ; 22(8): 700-706, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27045297

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) carrying SCCmec type IV has emerged in hospitals worldwide. The aim of this study was to evaluate phenotypic and molecular characteristics of antimicrobial resistance in MRSA SCCmec IV isolates, presenting different genetic backgrounds, isolated from hospitals in Rio de Janeiro. The antimicrobial resistance of 128 S. aureus type IV isolates from 11 hospitals was characterized by the disk diffusion test and minimum inhibitory concentration (MIC) test. Mutations in parC gene, which encodes ciprofloxacin resistance, and genes associated with macrolide-lincosamide-streptogramin B (MLSb) resistance were also investigated. MRSA isolates belonging to USA400/ST1 (60 isolates), USA800/ST5 (40), USA1100/ST30 (13), and other 11 (15) lineages were mainly resistant to erythromycin (68%), ciprofloxacin (56%), and clindamycin (50%). The highest antimicrobial resistance rates were found among USA400 isolates (p < 0.05). The majority of them (90%) carried only the erm(C) gene and mainly presented two mutation types in the parC gene. The msr(A) gene was most frequently found among USA800 isolates (p < 0.05). Among MRSA type IV isolates from Rio de Janeiro hospitals, multiresistance, including mutations in parC gene, was associated to the USA400/ST1, while the msr(A) gene was associated with USA800/ST5 isolates, highlighting that these lineages could have more potential to persist in a hospital environment.


Assuntos
DNA Topoisomerase IV/genética , Farmacorresistência Bacteriana Múltipla/genética , Regulação Bacteriana da Expressão Gênica , Staphylococcus aureus Resistente à Meticilina/genética , Metionina Sulfóxido Redutases/genética , Metiltransferases/genética , Antibacterianos/farmacologia , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , DNA Topoisomerase IV/metabolismo , Hospitais , Humanos , Lincosamidas/farmacologia , Macrolídeos/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Metionina Sulfóxido Redutases/metabolismo , Metiltransferases/metabolismo , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Mutação , Quinolonas/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Estreptogramina B/farmacologia
13.
Diagn Microbiol Infect Dis ; 83(4): 331-4, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26431830

RESUMO

In a collection of 50 pvl-positive Staphylococcus aureus isolates from 10 Rio de Janeiro hospitals, 18 (36%) were from bloodstream infections, and 31 (62%) carried the SCCmec IV. Among 25 (50%) isolates of the USA1100/ST30/CC30 lineage present in 8 hospitals, 1 isolate was characterized as vancomycin-intermediate S. aureus.


Assuntos
Toxinas Bacterianas/genética , Exotoxinas/genética , Genótipo , Leucocidinas/genética , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Brasil , Hospitais , Humanos , Tipagem Molecular , Staphylococcus aureus/classificação
14.
Ann Agric Environ Med ; 22(3): 470-2, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26403117

RESUMO

Atopic dermatitis (AD) is a multifactorial and chronic disease, with genetic, environmental, immunological and nutritional origins. AD may be aggravated by allergies associated with infections. This study aims to describe a paediatric case of AD in which the peanut allergy was the triggering factor to aggravate the disease, and was also the concomitant precursor of staphylococcal (methicillin-sensitive Staphylococcus aureus, carrier of the Panton-Valentine leukocidine (PVL) genes) and herpetic (Herpes Simplex - HSV) infections. The clinical management approach and nursing strategies promoted a favourable evolution during the hospitalization period, besides the family approach, which was essential to control any flare-up of the disease. Adherence to a recommended diet and the use of strategies to prevent any recurrent infections were important to ensure the patient's quality of life.


Assuntos
Dermatite Atópica/complicações , Dermatite Atópica/imunologia , Herpes Simples/imunologia , Hipersensibilidade a Amendoim/complicações , Infecções Estafilocócicas/imunologia , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Antivirais/farmacologia , Antivirais/uso terapêutico , Brasil , Pré-Escolar , Dermatite Atópica/terapia , Dieta , Feminino , Herpes Simples/tratamento farmacológico , Herpes Simples/virologia , Humanos , Hipersensibilidade a Amendoim/imunologia , Hipersensibilidade a Amendoim/terapia , Qualidade de Vida , Simplexvirus/efeitos dos fármacos , Simplexvirus/fisiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/fisiologia , Resultado do Tratamento
15.
BMC Res Notes ; 7: 898, 2014 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-25494907

RESUMO

BACKGROUND: Voice dysfunction or dysphonia may be associated with several clinical conditions. Among these, laryngeal human papillomavirus (HPV)-induced lesions should be considered as a possible causative factor. We report a case of dysphonia in a patient presenting with an HPV laryngeal lesion. We also discuss the clinical features of the disease, its histopathological findings, and treatment and rigorous follow-up. CASE PRESENTATION: We report a case of laryngeal papilloma in a 29-year-old, Afro-descendant, male patient with dysphonia. He was a non-smoker and was not a drug user. Videolaryngostroboscopy revealed signs suggestive of pharyngolaryngeal reflux. The right vocal fold presented with a papillomatous aspect in the posterior third, which underwent excision. Histopathological examination showed a nodular lesion of the right vocal fold, conclusive of squamous papilloma with absence of malignancy. CONCLUSION: Patients presenting with persistent voice dysfunction or dysphonia should be investigated for possible laryngeal HPV infection. Diagnostic confirmation by HPV genotyping is important for follow-up of potential recurrence.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Disfonia/diagnóstico , Papiloma/diagnóstico , Infecções por Papillomavirus/diagnóstico , Adulto , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/cirurgia , Disfonia/etiologia , Interações Hospedeiro-Patógeno , Papillomavirus Humano 6/genética , Papillomavirus Humano 6/fisiologia , Humanos , Laringoscopia/métodos , Masculino , Papiloma/complicações , Papiloma/cirurgia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Reação em Cadeia da Polimerase , Gravação em Vídeo , Prega Vocal/patologia , Prega Vocal/cirurgia , Prega Vocal/virologia
16.
Clinics (Sao Paulo) ; 69(11): 770-6, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25518036

RESUMO

Staphylococcus aureus is an important cause of infections and HIV-infected individuals are frequently susceptible to this pathogen. The aim of this study was to perform a systematic review to identify both the risk factors associated with colonization/infection by methicillin-resistant S. aureus in HIV patients and the methods used for characterization of isolates. An electronic search of articles published between January 2001 and December 2013 was first conducted. Among 116 studies categorized as being at a quality level of A, B or C, only 9 studies were considered to have high methodological quality (level A). The majority of these studies were retrospective (4/9 studies). The risk factors associated with colonization/infection by S. aureus were use of antimicrobials (4/9 studies), previous hospitalization (4/9 studies) and low CD4+ T lymphocyte counts (<200 cells/µl) (3/9 studies). Culture in mannitol salt agar (3/9 studies) and the latex agglutination test (5/9 studies) were the main methods used for bacterial phenotypic identification. Genotypic profiles were accessed by pulsed-field gel electrophoresis (6/9 studies) and USA300 was the most prevalent lineage (5/9 studies). Most isolates were resistant to erythromycin (3/9 studies) and susceptible to vancomycin (4/9 studies). Ultimately, use of antimicrobials and previous hospitalization were the main risk factors for colonization/infection by methicillin-resistant S. aureus in HIV-infected individuals. However, the numbers of evaluated patients, the exclusion and inclusion criteria and the characterization of the S. aureus isolates were not uniform, which made it difficult to establish the characteristics associated with HIV patients who are colonized/infected by S. aureus.


Assuntos
Infecções por HIV/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Antibacterianos/uso terapêutico , Humanos , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Fatores de Risco
17.
Clinics ; 69(11): 770-776, 11/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-731101

RESUMO

Staphylococcus aureus is an important cause of infections and HIV-infected individuals are frequently susceptible to this pathogen. The aim of this study was to perform a systematic review to identify both the risk factors associated with colonization/infection by methicillin-resistant S. aureus in HIV patients and the methods used for characterization of isolates. An electronic search of articles published between January 2001 and December 2013 was first conducted. Among 116 studies categorized as being at a quality level of A, B or C, only 9 studies were considered to have high methodological quality (level A). The majority of these studies were retrospective (4/9 studies). The risk factors associated with colonization/infection by S. aureus were use of antimicrobials (4/9 studies), previous hospitalization (4/9 studies) and low CD4+ T lymphocyte counts (<200 cells/μl) (3/9 studies). Culture in mannitol salt agar (3/9 studies) and the latex agglutination test (5/9 studies) were the main methods used for bacterial phenotypic identification. Genotypic profiles were accessed by pulsed-field gel electrophoresis (6/9 studies) and USA300 was the most prevalent lineage (5/9 studies). Most isolates were resistant to erythromycin (3/9 studies) and susceptible to vancomycin (4/9 studies). Ultimately, use of antimicrobials and previous hospitalization were the main risk factors for colonization/infection by methicillin-resistant S. aureus in HIV-infected individuals. However, the numbers of evaluated patients, the exclusion and inclusion criteria and the characterization of the S. aureus isolates were not uniform, which made it difficult to establish the characteristics associated with HIV patients who are colonized/infected by S. aureus.


Assuntos
Humanos , Infecções por HIV/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Antibacterianos/uso terapêutico , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Fatores de Risco
18.
Diagn Microbiol Infect Dis ; 80(4): 307-10, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25294302

RESUMO

In this work, the molecular and phenotypic antimicrobial resistance and clonal diversity of 10 linezolid-resistant Staphylococcus spp. isolates were investigated. The 7 Staphylococcus haemolyticus isolates presented Staphylococcal cassete chromosome mec (SCCmec) V and belonged to the same pulsed-field gel electrophoresis pulsotype. Their MICs for oxacillin, vancomycin, and linezolid were ≥ 256 µg/mL, 1-4 µg/mL, and 8-16 µg/mL, respectively. The 3 S. hominis presented MIC values 32 to >256 µg/mL, 2-4 µg/mL, and 12-24 µg/mL, and all carried the nontypeable SCCmec (ccr1 + mecA class) and belonged to 2 different genotypes. The cfr gene was not found, but the mutation G2603T was detected in S. haemolyticus and C2190T and G2603T in Staphylococcus hominis in 23S rRNA. This study demonstrates the spread of a linezolid-resistant S. haemolyticus genotype and, for the first time, describes the mutation C2190T among S. hominis isolates with a double mutation in Brazil.


Assuntos
Acetamidas/farmacologia , Farmacorresistência Bacteriana/genética , Mutação , Oxazolidinonas/farmacologia , RNA Ribossômico 23S/genética , Staphylococcus haemolyticus/genética , Staphylococcus hominis/genética , Antibacterianos/farmacologia , Brasil , Farmacorresistência Bacteriana/efeitos dos fármacos , Eletroforese em Gel de Campo Pulsado , Hospitais , Humanos , Linezolida , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/microbiologia , Staphylococcus haemolyticus/efeitos dos fármacos , Staphylococcus haemolyticus/isolamento & purificação , Staphylococcus hominis/efeitos dos fármacos , Staphylococcus hominis/isolamento & purificação
19.
Braz. j. infect. dis ; 18(4): 387-393, Jul-Aug/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-719296

RESUMO

OBJECTIVE: To investigate the pathogenesis of bloodstream infection by Staphylococcus epidermidis, using the molecular epidemiology, in high-risk neonates. METHODS: We conducted a prospective study of a cohort of neonates with bloodstream infection using central venous catheters for more than 24 h. "National Healthcare Safety Network" surveillance was conducted. Genotyping was performed by DNA fingerprinting and mecA genes and icaAD were detected by multiplex-PCR. RESULTS: From April 2006 to April 2008, the incidence of bloodstream infection and central venous catheter-associated bloodstream infection was 15.1 and 13.0/1000 catheter days, respectively, with S. epidermidis accounting for 42.9% of episodes. Molecular analysis was used to document the similarity among six isolates of bloodstream infection by S. epidermidis from cases with positive blood and central venous catheter tip cultures. Fifty percent of neonates had bloodstream infection not identified as definite or probable central venous catheter-related bloodstream infection. Only one case was considered as definite central venous catheter-related bloodstream infection and was extraluminally acquired; the remaining were considered probable central venous catheter-related bloodstream infections, with one probable extraluminally and another probable intraluminally acquired bloodstream infection. Additionally, among mecA+ and icaAD+ samples, one clone (A) was predominant (80%). A polyclonal profile was found among sensitive samples that were not carriers of the icaAD gene. CONCLUSIONS: The majority of infections caused by S. epidermidis in neonates had an unknown origin, although 33.3% appeared to have been acquired intraluminally and extraluminally. We observed a polyclonal profile between sensitive samples and a prevalent clone (A) between resistant samples. .


Assuntos
Humanos , Recém-Nascido , Bacteriemia/microbiologia , Infecções Relacionadas a Cateter/microbiologia , Cateterismo Venoso Central/efeitos adversos , Infecção Hospitalar/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus epidermidis/genética , Estudos de Coortes , Impressões Digitais de DNA , DNA Bacteriano/análise , Eletroforese em Gel de Campo Pulsado , Genótipo , Reação em Cadeia da Polimerase , Estudos Prospectivos , Staphylococcus epidermidis/isolamento & purificação
20.
Arch Oral Biol ; 59(8): 848-54, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24880500

RESUMO

OBJECTIVE: This study sought to investigate the possible association between clinical and radiographic data of the patients with the bacterial community profiles involved in cases of necrosis in primary root canals. METHODS: Microbial community profiles for 25 samples from necrotic deciduous root canals were analyzed using the polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) fingerprinting approach. These results were related to the clinical and radiographic data of these patients. RESULTS: The analysis showed a large diversity of microbial communities in necrotic deciduous root canals. The statistical results pointed out that posterior and anterior teeth were associated with <20 bands and >20 bands in PCR-DGGE method, respectively. A relationship was verified between ages >4 years old and posterior teeth and, ages ≤4 years old and anterior teeth. CONCLUSIONS: The data showed a polymicrobial community and pointed out the association of age with necrosis in anterior and posterior teeth.


Assuntos
Cavidade Pulpar/microbiologia , Doenças Periapicais/microbiologia , Tratamento do Canal Radicular , Dente Decíduo/microbiologia , Técnicas de Tipagem Bacteriana , Criança , Pré-Escolar , Eletroforese em Gel de Gradiente Desnaturante , Feminino , Humanos , Lactente , Masculino , Necrose/microbiologia , Reação em Cadeia da Polimerase
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