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1.
Medicine (Baltimore) ; 99(10): e18954, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150046

RESUMO

RATIONALE: In patients receiving biological therapies, serious infections are a major concern. Infections associated with anti-tumor necrosis factor antibody therapy include tuberculosis, viral, fungal, and bacterial infections. Likewise, severe infections of the upper and lower respiratory tract, lung, skin and soft tissue, urinary tract, gastrointestinal tract, joint, and bone have also been reported previously. However, infections involving the central nervous system are rare, especially an intracranial infection caused by odontogenic infection. To date, only few cases have been reported of this infection. This is the first case of a patient with psoriatic arthritis receiving adalimumab and developing brain abscess of odontogenic origin. PATIENT CONCERNS: A 39-year-old male with psoriatic arthritis receiving adalimumab treatment came to the emergency department with initial presentation of sudden onset convulsions. He had been receiving adalimumab treatment for 1 month. Two days after the third injection, the patient had an episode of sudden-onset general convulsion for nearly 5 min with the upgazing and general tonic presentation. Magnetic resonance imaging (MRI) showed left frontal lobe brain abscess. Pus culture from the brain abscess detected Streptococcus sanguinis (S. sanguinis), Fusobacterium nucleatum (F. nucleatum), and Parvimonas micra (P. micra). DIAGNOSIS: Brain abscess with odontogenic infection. INTERVENTIONS: The patient received left frontal craniotomy, abscess drainage and systemic empiric antibiotics treatment with vancomycin, cefepime, and metronidazole. Due to drug rash with eosinophilia and systemic symptoms during the treatment, vancomycin and metronidazole were discontinued, and systemic antibiotics were switched to teicoplanin and ceftriaxone. OUTCOMES: A brain MRI follow-up performed after 1 month of initial treatment revealed the reduced size of the abscess lesion and minimal oedema. The patient was discharged with stable condition. LESSONS: To the best of our knowledge, this is the first case of a patient with psoriatic arthritis receiving adalimumab and developing brain abscess of odontogenic origin. Such a rare diagnosis must be kept in mind when patients treated with adalimumab present with sudden-onset convulsions. Careful dental examination should be performed before administration of adalimumab.


Assuntos
Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Artrite Psoriásica/tratamento farmacológico , Abscesso Encefálico/diagnóstico , Cérebro , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/etiologia , Abscesso Encefálico/microbiologia , Ceftriaxona/administração & dosagem , Ceftriaxona/uso terapêutico , Terapia Combinada , Craniotomia , Diagnóstico Diferencial , Firmicutes/isolamento & purificação , Fusobacterium nucleatum/isolamento & purificação , Humanos , Imagem por Ressonância Magnética , Masculino , Periodontite/complicações , Streptococcus/isolamento & purificação , Teicoplanina/administração & dosagem , Teicoplanina/uso terapêutico
2.
PLoS One ; 15(1): e0219633, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990909

RESUMO

Increasing evidence supports the importance of the breast milk microbiome in seeding the infant gut. However, the origin of bacteria in milk and the process of milk microbe-mediated seeding of infant intestine need further elucidation. Presumed sources of bacteria in milk include locations of mother-infant and mother-environment interactions. We investigate the role of mother-infant interaction on breast milk microbes. Shotgun metagenomics and 16S rRNA gene sequencing identified milk microbes of mother-infant pairs in breastfed infants and in infants that have never latched. Although breast milk has low overall biomass, milk microbes play an important role in seeding the infant gut. Breast milk bacteria were largely comprised of Staphylococcus, Streptococcus, Acinetobacter, and Enterobacter primarily derived from maternal areolar skin and infant oral sites in breastfeeding pairs. This suggests that the process of breastfeeding is a potentially important mechanism for propagation of breast milk microbes through retrograde flux via infant oral and areolar skin contact. In one infant delivered via Caesarian section, a distinct strain of Bifidobacteria breve was identified in maternal rectum, breast milk and the infant's stool potentially suggesting direct transmission. This may support the existence of microbial translocation of this anaerobic bacteria via the enteromammary pathway in humans, where maternal bacteria translocate across the maternal gut and are transferred to the mammary glands. Modulating sources of human milk microbiome seeding potentially imply opportunities to ultimately influence the development of the infant microbiome and health.


Assuntos
Translocação Bacteriana , Bifidobacterium breve/isolamento & purificação , Intestinos/microbiologia , Glândulas Mamárias Humanas/microbiologia , Leite Humano/microbiologia , Acinetobacter/genética , Acinetobacter/isolamento & purificação , Adolescente , Adulto , Bifidobacterium breve/genética , Enterobacter/genética , Enterobacter/isolamento & purificação , Feminino , Microbioma Gastrointestinal/genética , Humanos , Lactente , Recém-Nascido , Metagenômica/métodos , Gravidez , RNA Ribossômico 16S/genética , Staphylococcus/genética , Staphylococcus/isolamento & purificação , Streptococcus/genética , Streptococcus/isolamento & purificação
3.
PLoS One ; 15(1): e0226817, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978082

RESUMO

BACKGROUND: A large proportion of neonates are treated for presumed bacterial sepsis with broad spectrum antibiotics even though their blood cultures subsequently show no growth. This study aimed to investigate PCR-based methods to identify pathogens not detected by conventional culture. METHODS: Whole blood samples of 208 neonates with suspected early onset sepsis were tested using a panel of multiplexed bacterial PCRs targeting Streptococcus pneumoniae, Streptococcus agalactiae (GBS), Staphylococcus aureus, Streptococcus pyogenes (GAS), Enterobacteriaceae, Enterococcus faecalis, Enterococcus faecium, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium, a 16S rRNA gene broad-range PCR and a multiplexed PCR for Candida spp. RESULTS: Two-hundred and eight samples were processed. In five of those samples, organisms were detected by conventional culture; all of those were also identified by PCR. PCR detected bacteria in 91 (45%) of the 203 samples that did not show bacterial growth in culture. S. aureus, Enterobacteriaceae and S. pneumoniae were the most frequently detected pathogens. A higher bacterial load detected by PCR was correlated positively with the number of clinical signs at presentation. CONCLUSION: Real-time PCR has the potential to be a valuable additional tool for the diagnosis of neonatal sepsis.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/diagnóstico , Candida/isolamento & purificação , Candidíase/diagnóstico , Sepse Neonatal/microbiologia , RNA Ribossômico 16S/genética , Idade de Início , Bactérias/genética , Candida/genética , DNA Ribossômico/genética , Diagnóstico Precoce , Enterobacteriaceae/genética , Enterobacteriaceae/isolamento & purificação , Enterococcus/genética , Enterococcus/isolamento & purificação , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Reação em Cadeia da Polimerase Multiplex , Mycoplasma/genética , Mycoplasma/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Streptococcus/genética , Streptococcus/isolamento & purificação , Ureaplasma/genética , Ureaplasma/isolamento & purificação
4.
J Dairy Sci ; 103(1): 87-97, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677844

RESUMO

Previous research reported that fermented yak milk had a diverse microbial composition. For this study, raw yak milk, qula, and fermented yak milk samples were collected from the Aba Tibetan autonomous region of China. The genus and species microbial composition of these samples were analyzed by high-throughput sequencing of 16S rRNA and groEL gene amplicons, and the volatile profile of the samples was quantified by gas chromatography-mass spectrometry. The results indicated variation in abundance of microbiota at the genus level among the fermented yak milk samples, with Lactobacillus as the most abundant genus in the majority of samples, ranging from 41.6 to 98.3%. The volatile profile of the samples varied among those collected from different villages. Correlations between bacterial composition and volatile compounds of the samples were also observed. Lactobacillus displayed a significant correlation with volatile compounds such as benzaldehyde, 2,3-pentanedione, ethanol, and ethyl acetate, whereas the samples with relatively high abundance of Streptococcus and Lactococcus displayed relatively low contents of volatile compounds.


Assuntos
Bovinos , Produtos Fermentados do Leite/microbiologia , Lactobacillus/isolamento & purificação , Lactococcus/isolamento & purificação , Streptococcus/isolamento & purificação , Animais , Reatores Biológicos , China , Fermentação , Lactobacillus/genética , RNA Ribossômico 16S/genética
5.
J Dairy Sci ; 103(1): 915-921, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704014

RESUMO

Streptococcus uberis is an important causative agent for clinical and subclinical mastitis in dairy cattle. The aim of this study was to develop 2 multiplex PCR assays (mPCR) for the simultaneous detection of virulence factors and housekeeping genes for use when investigating the genetic variability and distribution of Strep. uberis virulence factors. The tuf, cpn60, pauA, sodA, sua, oppF, and gapC genes were grouped in assay 1 (mPCR1) and the hasA, hasB, and hasC genes were included in assay 2 (mPCR2). The detection limits were 11.8 pg and 5.9 pg of DNA for mPCR1 and mPCR2, respectively. The 2 mPCR assays were validated with 56 Strep. uberis strains isolated from mastitis milk samples collected from different bovine herds in northern Italy. Results revealed that gapC and oppF were detected in 98.2% of the strains, whereas sua and hasC genes were detected in 94.6 and 89.2% of the strains, respectively. The most common pattern was gapC+, oppF+, cpn60+, sua+, sodA+, pauA+, tuf+, hasA+, hasB+, and hasC+, which appeared in 59% of the strains analyzed. The molecular assays developed in the present study represent a powerful tool for the evaluation of virulence pattern distribution in Strep. uberis strains associated with intramammary infections.


Assuntos
Mastite Bovina/microbiologia , Infecções Estreptocócicas/veterinária , Streptococcus/isolamento & purificação , Animais , Proteínas de Bactérias/genética , Bovinos , Feminino , Itália/epidemiologia , Mastite Bovina/epidemiologia , Reação em Cadeia da Polimerase Multiplex , Reação em Cadeia da Polimerase/métodos , Infecções Estreptocócicas/microbiologia , Streptococcus/genética , Virulência , Fatores de Virulência/genética
6.
J Dairy Sci ; 103(2): 1785-1794, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31864733

RESUMO

We investigated the distribution of pathogenic non-agalactiae gram-positive, catalase-negative cocci (GPCN) in a convenience sample of New York State dairy farms. Our primary objective with the clinical mastitis (CM) GPCN samples was to evaluate somatic cell count (SCC) resolution and bacteriological cure of Streptococcus dysgalactiae or Streptococcus uberis versus Lactococcus lactis or Lactococcus garvieae in cows that received an approved intramammary treatment. In phase I, we assessed the distribution of the GPCN and SCC resolution. In phase II, we evaluated the SCC resolution and bacteriological cure in CM samples from the 4 farms with the highest prevalence of L. lactis or L. garvieae in phase I. In phase I, 8,868 CM and subclinical mastitis (SCM) milk samples were received from 143 farms. The GPCN samples identified by culture were confirmed with MALDI-TOF. From the 473 MALDI-TOF-confirmed GPCN samples, 155 were S. dysgalactiae (33%); 150, S. uberis (32%); 112, L. lactis (24%); 16, L. garvieae (3%); and 40, other GPCN (8%). From these, 277 were CM samples and 127 were eligible for the evaluation of SCC resolution, which was defined as SCC ≤200,000 cells/mL in a composite sample 15 to 60 d post-diagnosis. The odds of SCC resolution in CM samples was evaluated with multivariable logistic regression, and the odds were 6.1 [95% confidence interval (CI):2.7-13.9] times higher for S. dysgalactiae or S. uberis compared with L. lactis or L. garvieae. In phase II, a total of 1,662 CM and SCM samples were evaluated with microbiological methods as in phase I, of which 211 samples were confirmed by MALDI-TOF: 39% were S. dysgalactiae (n = 61) and S. uberis (n = 21); 55%, L. lactis (n = 114) and L. garvieae (n = 2); and 6%, other GPCN (n = 13). In total, 168 CM samples were eligible for analysis and 118 were included in the final SCC resolution model. Similar statistical methods as in phase I were performed, and the odds of SCC resolution were 2.4 (95% CI: 1.1-5.5) times higher for S. dysgalactiae or S. uberis compared with L. lactis or L. garvieae. Bacteriological cure was defined as having a different or negative culture on a quarter sample taken 14 to 28 d after initial diagnosis. The odds of bacteriological cure (n = 121) were 8.0 (95% CI: 2.5-25.6) times higher for S. dysgalactiae or S. uberis compared with L. lactis or L. garvieae. Differences in SCC resolution and bacteriological cure between these groups may dictate a different management approach.


Assuntos
Fazendas , Lactococcus/isolamento & purificação , Mastite Bovina/microbiologia , Animais , Antibacterianos/uso terapêutico , Bovinos , Contagem de Células/veterinária , Indústria de Laticínios , Feminino , Humanos , Lactococcus lactis/isolamento & purificação , Mastite Bovina/epidemiologia , Mastite Bovina/patologia , Mastite Bovina/prevenção & controle , Leite/citologia , Leite/microbiologia , New York , Prevalência , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação
7.
J Dairy Sci ; 103(2): 1776-1784, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31864745

RESUMO

The aim of this study was to demonstrate the noninferiority of a novel teat disinfectant based on copper and zinc (ZkinCu; Copper Andino, Santiago de Chile, Chile) compared with a previously proven glycolic acid active disinfectant (OceanBlu; DeLaval, Kansas City, MO) as a positive control, with respect to the incidence of new intramammary infections under natural challenge conditions on a commercial robotic dairy farm. This study was conducted in 6 robotic pens of approximately 60 milking cows each. The pens were randomly assigned to 1 of the 2 studied disinfectants. Throughout the 8 wk study, the same pre- and post-milking teat disinfectant was used in each pen. The same milking procedures were used in each robot throughout the study. Pre-milking hygiene consisted of applying the disinfectant (OceanBlu or ZkinCu) with the robotic arm. The same product was applied on the teats after milking. At the beginning of the study, all quarters of all study cows were sampled. In successive samplings (wk 2, 4, 6, and 8), composite milk samples were collected on farm to determine SCC. Once composite SCC results were available (2 d) and based on an SCC of ≥100,000 cells/mL, quarter milk samples underwent bacteriological culture. Clinical mastitis was identified by study personnel. Intramammary infection in biweekly quarter milk samples was determined based on composite SCC levels (≥100,000 cells/mL) and the presence of bacteria. A new IMI was defined as a quarter in which the organism isolated was not present in the previous bacteriological sample, or the previous composite SCC sample was <100,000 cells/mL. Clinical mastitis samples were also considered to be new IMI. The trial was designed as a positive control field trial, in which the objective was to show noninferiority of ZkinCu versus the control (OceanBlu). The overall crude incidences of new IMI for 2 wk at risk were 4.9 and 7.3% for the ZkinCu and OceanBlu groups, respectively. The predominant organisms recovered from quarters with new IMI were Streptococcus uberis, Corynebacterium spp., and coagulase-negative staphylococci in both the ZkinCu and OceanBlu groups. The risk of infection in the OceanBlu group was higher (ß = 0.644; 95% confidence interval = 0.05-1.22). The interaction of treatment by week was not significant. The new IMI rate estimates (95% confidence interval) for ZkinCu and OceanBlu were 1.7% (0.8-2.5) and 3.2% (1.7-4.7), respectively. One novel aspect of this study is that it was one of the first commercial noninferiority trials to evaluate a new pre- and post-milking teat disinfectant in a dairy herd with an automatic milking system. The experimental teat disinfectant ZkinCu, evaluated in this field trial with naturally occurring IMI, showed noninferiority relative to the positive control for the prevention of new IMI. This study was conducted in a herd with an automatic milking system, and the results are applicable to herds with similar characteristics. Additional studies are needed to ensure reproducibility under different management conditions.


Assuntos
Cobre/farmacologia , Desinfetantes/farmacologia , Mastite Bovina/prevenção & controle , Zinco/farmacologia , Animais , Bovinos , Chile , Feminino , Glândulas Mamárias Animais/microbiologia , Mastite Bovina/microbiologia , Leite/microbiologia , Mamilos/microbiologia , Reprodutibilidade dos Testes , Staphylococcus/isolamento & purificação , Streptococcus/isolamento & purificação
8.
J Dairy Sci ; 103(1): 128-140, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677843

RESUMO

The dairy farm environment influences the raw milk microbiota and consequently affects milk processing. Therefore, it is crucial to investigate farm management practices such as the bedding materials. The aim of this study was to evaluate the effect of recycled manure solids (RMS) as bedding material on bulk tank milk and microbiological implications for cheese quality. Bulk tank samples were collected from 84 dairy farms using RMS or straw bedding. The use of RMS did not influence thermophilic and mesophilic aerobic viable counts from spores. However, straw-milk samples gave higher values for mesophilic anaerobic spore-forming bacteria (0.44 log cfu/mL) than RMS-milk samples (0.17 log cfu/mL). The presence of thermoresistant lactic acid bacteria was not increased in milk from farms using RMS. Nevertheless, taxonomic profiles of thermoresistant bacteria isolated were different between the 2 types of milk. More Enterococcus faecalis and Streptococcus spp. were identified in RMS-milk samples. Thermoresistant enterococci and streptococci could easily end up in cheese. Therefore, milk proteolytic activities of these isolates were tested. Neither Streptococcus spp. nor Enterococcus faecium isolates exhibited proteolytic activities, whereas 53% of E. faecalis showed some. Also, only 1 vancomycin-resistant enterococcus was detected. Survival of selected RMS-milk samples isolates (3 E. faecalis and 1 Streptococcus thermophilus) was evaluated during a model Cheddar cheese manufacture. Although those strains survived well, they did not modify the acidification curve of milk. However, they might cause organoleptic defects during cheese maturing.


Assuntos
Bactérias/classificação , Roupas de Cama, Mesa e Banho/veterinária , Queijo/normas , Leite/microbiologia , Animais , Bactérias/isolamento & purificação , Roupas de Cama, Mesa e Banho/microbiologia , Queijo/microbiologia , Enterococcus/classificação , Enterococcus/isolamento & purificação , Fazendas , Microbiologia de Alimentos , Esterco/microbiologia , Reciclagem , Streptococcus/classificação , Streptococcus/isolamento & purificação , Termotolerância
9.
J Dairy Sci ; 103(2): 1238-1249, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31864732

RESUMO

Cheese is a fermented dairy product that is popular for its unique flavor and nutritional value. Recent studies have shown that microorganisms in cheese play an important role in the fermentation process and determine the quality of the cheese. We collected 12 cheese samples from different regions and studied the composition of their bacterial communities using PacBio small-molecule real-time sequencing (Pacific Biosciences, Menlo Park, CA). Our data revealed 144 bacterial genera (including Lactobacillus, Streptococcus, Lactococcus, and Staphylococcus) and 217 bacterial species (including Lactococcus lactis, Streptococcus thermophilus, Staphylococcus equorum, and Streptococcus uberis). We investigated the flavor quality of the cheese samples using an electronic nose system and we found differences in flavor-quality indices among samples from different regions. We found a clustering tendency based on flavor quality using principal component analysis. We found correlations between lactic acid bacteria and the flavor quality of the cheese samples. Biodegradation and metabolism of xenobiotics, and lipid-metabolism-related pathways, were predicted to contribute to differences in cheese flavor using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt). This preliminary study explored the bacterial communities in cheeses collected from different regions and their potential genome functions from the perspective of flavor quality.


Assuntos
Bactérias/isolamento & purificação , Queijo/microbiologia , Variação Genética , Bactérias/classificação , Bactérias/genética , Queijo/análise , DNA Bacteriano/análise , Microbiologia de Alimentos , Lactobacillales/genética , Lactobacillales/isolamento & purificação , Lactobacillus/genética , Lactobacillus/isolamento & purificação , Lactococcus lactis/genética , Lactococcus lactis/isolamento & purificação , Filogenia , Análise de Sequência de DNA , Streptococcus/genética , Streptococcus/isolamento & purificação , Streptococcus thermophilus/genética , Streptococcus thermophilus/isolamento & purificação
10.
Am J Case Rep ; 20: 1930-1935, 2019 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-31871313

RESUMO

BACKGROUND Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). CASE REPORT A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. An electrocardiogram (ECG) showed ST elevation in leads II, III, aVF, and V3-V5, consistent with an anterior-inferior STEMI. He underwent percutaneous intervention (PCI) with two drug-eluting stents to the mid-distal LAD coronary artery. The patient also had fever, chills, a history of weight loss, and signs of peripheral emboli. Blood cultures identified Gram-positive Streptococcus parasanguinis, a member of the Streptococcus viridans group. Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone CONCLUSIONS A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement.


Assuntos
Neoplasias Cardíacas/microbiologia , Neoplasias Cardíacas/cirurgia , Mixoma/microbiologia , Mixoma/cirurgia , Infarto do Miocárdio com Supradesnível do Segmento ST/microbiologia , Adulto , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Angiografia Coronária , Trombose Coronária/cirurgia , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Eletrocardiografia , Gentamicinas/uso terapêutico , Humanos , Masculino , Intervenção Coronária Percutânea , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus/efeitos dos fármacos , Streptococcus/isolamento & purificação
11.
Ann Clin Microbiol Antimicrob ; 18(1): 43, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847847

RESUMO

BACKGROUND: Staphylococcus has replaced streptococcus as the most common cause of infective endocarditis (IE) in developed health care systems. The trend in developing countries is less clear. AIM: To examine the epidemiological trends of infective endocarditis in a developing nation. METHODS: Single-centre, retrospective study of patients admitted with IE to a tertiary hospital in Malaysia over a 12-year period. RESULTS: The analysis included 182 patients (n = 153 Duke's definite IE, n = 29 possible IE). The mean age was 51 years. Rheumatic heart disease was present in 42%, while 7.6% were immunocompromised. IE affected native valves in 171 (94%) cases. Health-care associated IE (HCAIE) was recorded in 68 (37.4%). IE admission rates increased from 25/100,000 admissions (2012) to 59/100,000 admissions (2017). At least one major complication on admission was detected in 59 (32.4%) patients. Left-sided IE was more common than right-sided IE [n = 159 (87.4%) vs. n = 18 (9.9%)]. Pathogens identified by blood culture were staphylococcus group [n = 58 (40.8%)], streptococcus group [n = 51 (35.9%)] and Enterococcus species [n = 13 (9.2%)]. staphylococcus infection was highest in the HCAIE group. In-hospital death occurred in 65 (35.7%) patients. In-hospital surgery was performed for 36 (19.8%) patients. At least one complication was documented in 163 (85.7%). CONCLUSION: Staphylococcus is the new etiologic champion, reflecting the transition of the healthcare system. Streptococcus is still an important culprit organism. The incidence rate of IE appears to be increasing. The rate of patients with underlying rheumatic heart disease is still high.


Assuntos
Endocardite Bacteriana , Staphylococcus aureus/isolamento & purificação , Adulto , Idoso , Antibacterianos/uso terapêutico , Infecção Hospitalar , Países em Desenvolvimento , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/mortalidade , Feminino , Humanos , Malásia/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Streptococcus/isolamento & purificação , Adulto Jovem
12.
BMC Infect Dis ; 19(1): 1062, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852453

RESUMO

BACKGROUND: To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand's largest national tertiary referral center. METHODS: Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. RESULTS: Of 380 patients, 66.3% had definite IE, and 81.3% had native valve IE (NVE). Cumulative IE incidence was 5.67/1000 admissions. The most common pathogens were viridans group streptococci (VGS) (39.7%), methicillin-sensitive Staphylococcus aureus (MSSA) (13.1%), and beta-hemolytic streptococci (11.5%) in NVE; and, MSSA (20.3%), VGS (20.3%), and Enterococcus spp. (16.9%) in prosthetic valve (PVE) or device-related IE (DRIE). Overall in-hospital mortality was 18.4%. Mortality was significantly higher in PVE/DRIE than in NVE (26.8% vs. 16.5%, p = 0.047). End-stage renal disease (ESRD) (aOR: 9.43, 95% CI: 2.36-37.70), diabetes mellitus (DM) (aOR: 2.81, 95% CI: 1.06-7.49), neurological complication (aOR: 14.16, 95% CI: 5.11-39.22), congestive heart failure (aOR: 4.32, 95% CI: 1.91-9.75), hospital-acquired infection (aOR: 3.78, 95% CI: 1.66-8.57), renal complication (aOR: 3.12, 95%CI: 1.32-7.37), and other complication during admission (aOR: 3.28, 95% CI: 1.41-7.61) were independently associated with mortality. CONCLUSIONS: The incidence of IE, and the mortality rate among those diagnosed with IE are both increasing in Thailand - particularly among those with PVE or DRIE. End-stage renal disease, diabetes mellitus, and development of IE-related complications during admission were found to be independent predictors of mortality.


Assuntos
Endocardite Bacteriana/epidemiologia , Enterococcus/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Streptococcus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/mortalidade , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Tailândia/epidemiologia , Estreptococos Viridans/isolamento & purificação , Adulto Jovem
13.
Nat Commun ; 10(1): 5714, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31844063

RESUMO

The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and severe exacerbations. Here we report that the microbiota's dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium + Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium + Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium's relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002).


Assuntos
Asma/diagnóstico , Fluticasona/uso terapêutico , Interações entre Hospedeiro e Microrganismos/imunologia , Microbiota/imunologia , Simbiose/imunologia , Administração por Inalação , Asma/tratamento farmacológico , Asma/imunologia , Asma/microbiologia , Carnobacteriaceae/imunologia , Carnobacteriaceae/isolamento & purificação , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Moraxella/imunologia , Moraxella/isolamento & purificação , Mucosa Nasal/imunologia , Mucosa Nasal/microbiologia , Estudos Prospectivos , Índice de Gravidade de Doença , Staphylococcus/imunologia , Staphylococcus/isolamento & purificação , Streptococcus/imunologia , Streptococcus/isolamento & purificação , Exacerbação dos Sintomas , Resultado do Tratamento
14.
BMC Infect Dis ; 19(1): 937, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694555

RESUMO

BACKGROUND: Infective endocarditis (IE) especially in the elderly is a serious disease, with a worse prognosis. METHODS: A retrospective cohort study was conducted. A total of 405 patients with definite IE were divided into three groups: 205 patients under 50 years old, 141 patients between 50 and 64 years old and 59 patients over 65 years old. RESULTS: For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as the younger patients. IE in old patients had more frequent nosocomial origin (P = 0.007) and tended to be more frequent with bad oral hygiene (p = 0.008). The most frequent isolated pathogens in the old groups was streptococci and coagulase-negative staphylococci. The old patients had a lower operation rate (40.7% vs 58.9% vs 62.4%, P = 0.012) and higher in-hospital mortality (20.3% vs 10.6% vs 8.8%, P = 0.044) compared with the younger patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR = 2.45, 95% CI 1.027-10.598, P = 0.009). The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P = 0.007). CONCLUSIONS: Older patients with IE presented with more comorbidities, bad oral hygiene, more nosocomial origin and a more severe prognosis than younger patients. Streptococci was the most frequent micro-organisms in this group. Surgery were underused in old patients and those with surgical treatment had better prognosis.


Assuntos
Endocardite Bacteriana/diagnóstico , Hospitais Universitários , Infecções Estafilocócicas/diagnóstico , Staphylococcus/isolamento & purificação , Infecções Estreptocócicas/diagnóstico , Streptococcus/isolamento & purificação , Centros de Atenção Terciária , Adulto , Idoso , China , Comorbidade , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/mortalidade , Endocardite Bacteriana/cirurgia , Feminino , Febre , Seguimentos , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Prognóstico , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estreptocócicas/microbiologia , Taxa de Sobrevida
15.
BMC Infect Dis ; 19(1): 887, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651256

RESUMO

BACKGROUND: Arthroscopic partial meniscectomy is a common procedure in orthopedic practice. Infections are uncommon complications of this procedure with an incidence rate of 0,01% - 3,4%. Staphylococcus spp are the predominant causative agents in such cases. We present a case of knee septic arthritis caused by α-hemolytic Streptococcus. CASE PRESENTATION: A 22-year-old woman diagnosed with obesity (body mass index [BMI] 35 kg/m2) but with no other major comorbidities underwent an arthroscopic selective meniscectomy with administration of intravenous cefazolin for antibiotic prophylaxis. After an uneventful period of 2 months, the patient returned with pain, fever and a discharging sinus at the site of anterolateral arthroscopic portal. Blood tests and magnetic resonance imaging revealed osteomyelitis involving the tibial plate. Cultures of synovial fluid obtained from the knee and a pharyngeal swab yielded α-hemolytic Streptococcus. Five days later, the patient underwent arthroscopic debridement with partial synovectomy. Intraoperative specimens yielded α-hemolytic Streptococcus. The patient received intravenous piperacillin/tazobactam, followed by an associative regimen of amoxicillin and clindamycin with clinical, laboratory and instrumental evidence of symptom resolution. CONCLUSION: The incidence of knee septic arthritis after arthroscopic partial meniscectomy is 0.01-3.4%. This infection is usually caused by Staphylococcus spp. and in rare cases by commensal bacteria, such as α-hemolytic streptococci, secondary to transient bacteremia. Screening of the colonized area is important to prevent possible transient bacteremia. Diagnosis is based on isolation of the causative organisms from synovial fluid cultures, and treatment comprises arthroscopic debridement with individualized systemic antibiotic therapy based on the results of an antibiogram.


Assuntos
Artrite Infecciosa/microbiologia , Artroscopia/efeitos adversos , Bacteriemia/tratamento farmacológico , Meniscectomia/efeitos adversos , Osteoartrite do Joelho/microbiologia , Infecções Estreptocócicas/tratamento farmacológico , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/etiologia , Bacteriemia/etiologia , Desbridamento/métodos , Feminino , Humanos , Osteoartrite do Joelho/tratamento farmacológico , Infecções Estreptocócicas/etiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Streptococcus/patogenicidade , Líquido Sinovial/microbiologia , Adulto Jovem
16.
BMC Vet Res ; 15(1): 364, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651316

RESUMO

BACKGROUND: Ovariectomy is a common procedure in laboratory rodents used to create a post-menopausal state. Complications including post-surgical abscess are rarely reported, but merit consideration for the health and safety of experimental animals. CASE PRESENTATION: A female C57/black6 mouse was ovariectomized as part of a cohort study. At Day 14 post-surgery, she developed a visible swelling on the right side, which 7 days later increased in size over 24 h, leading to euthanasia of the animal. Gross pathology was consistent with abscess. A core of necrotic tissue was present in the uterine horn. Abscess fluid and affected tissue were collected for Gram stain and bacteriological culture. The abscess core and fluid yielded three distinct types of bacterial colonies identified by 16S ribosomal RNA sequencing as Streptococcus acidominimus, Pasteurella caecimuris, and a novel species in the genus Gemella. CONCLUSIONS: This is the first report of polymicrobial abscess in a rodent as a complication of ovariectomy, and the first description of a novel Gemella species for which we have proposed the epithet Gemella muriseptica. This presentation represents a potential complication of ovariectomy in laboratory animals.


Assuntos
Abscesso/veterinária , Gemella/classificação , Ovariectomia/veterinária , Complicações Pós-Operatórias/veterinária , Abscesso/microbiologia , Animais , Feminino , Gemella/isolamento & purificação , Infecções por Bactérias Gram-Positivas/veterinária , Camundongos Endogâmicos C57BL , Pasteurella/isolamento & purificação , Infecções por Pasteurella , Complicações Pós-Operatórias/microbiologia , RNA Ribossômico 16S/genética , Streptococcus/isolamento & purificação
17.
J Dairy Sci ; 102(12): 11384-11400, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31606215

RESUMO

Objectives of this study were to (1) describe the intramammary infection (IMI) prevalence and pathogen profiles in quarters of cows approaching dry-off in US dairy herds, (2) compare IMI prevalence in quarters of cows exposed to different bedding material types, and (3) identify associations between bedding bacteria count and IMI in cows approaching dry-off. Eighty herds using 1 of 4 common bedding materials (manure solids, organic non-manure, new sand, and recycled sand) were recruited in a multi-site cross-sectional study. Each herd was visited twice for sampling. At each visit, aseptic quarter-milk samples were collected from 20 cows approaching dry-off (>180 d pregnant). Samples of unused and used bedding were also collected. Aerobic culture was used to determine the IMI status of 10,448 quarters and to enumerate counts (log10 cfu/mL) of all bacteria, Staphylococcus spp., Streptococcus spp. and Streptococcus-like organisms (SSLO), coliforms, Klebsiella spp., noncoliform gram-negatives, Bacillus spp., and Prototheca spp. in unused (n = 148) and used (n = 150) bedding. The association between bedding bacteria count and IMI was determined using multivariable logistic regression with mixed effects. Quarter-level prevalence of IMI was 21.1%, which was primarily caused by non-aureus Staphylococcus spp. (11.4%) and SSLO (5.6%). Only modest differences in IMI prevalence were observed between the 4 common bedding material types. Counts of all bacteria in unused bedding was positively associated with odds of IMI caused by any pathogen [ALL-IMI; odds ratio (OR) = 1.08]. A positive association was also observed for counts of SSLO in unused bedding and SSLO-IMI (OR = 1.09). These patterns of association were generally consistent across the 4 common bedding materials. In contrast, the association between counts of all bacteria in used bedding and ALL-IMI varied by bedding type, with positive associations observed in quarters exposed to manure solids (OR = 2.29) and organic non-manure (OR = 1.51) and a negative association in quarters exposed to new sand (OR = 0.47). Findings from this study suggest that quarter-level IMI prevalence in late-lactation cows is low in US dairy herds. Furthermore, bedding material type may not be an important risk factor for IMI in late lactation. Higher levels of bacteria in bedding may increase IMI prevalence at dry-off in general, but this relationship is likely to vary according to bedding material type.


Assuntos
Infecções por Klebsiella/veterinária , Mastite Bovina/microbiologia , Leite/microbiologia , Infecções Estafilocócicas/veterinária , Infecções Estreptocócicas/veterinária , Animais , Carga Bacteriana/veterinária , Roupas de Cama, Mesa e Banho/microbiologia , Roupas de Cama, Mesa e Banho/veterinária , Bovinos , Estudos Transversais , Feminino , Klebsiella/isolamento & purificação , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Lactação , Modelos Logísticos , Glândulas Mamárias Animais/microbiologia , Esterco/microbiologia , Mastite Bovina/epidemiologia , Prevalência , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação
18.
J Dairy Sci ; 102(12): 11401-11413, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31606221

RESUMO

Because cloth udder towels (CUT) may function as a fomite for mastitis-causing pathogens, most udder health laboratories offer towel culture services as a tool to monitor towel hygiene. However, no studies have investigated if an association exists between bacteria levels in CUT and udder health outcomes. The objectives of this cross-sectional study were to (1) describe associations between herd-level measures of towel bacteria count (ToBC) and quarter-level intramammary infection (IMI) status in late-lactation cows, (2) establish pathogen-specific target levels of bacteria in CUT to aid the interpretation of towel culture reports, and (3) identify laundering-related risk factors for high ToBC. The study was conducted in 67 herds from 10 dairy states in the United States that used CUT. These 67 herds were originally recruited as part of a larger (80 herd) cross-sectional study of bedding management. Each herd was visited once during December 2017 to April 2018 and quarter-milk samples (n = 4,656) were collected from late-gestation (>180 d pregnant) cows (n = 1,313). Two recently laundered CUT were collected and a questionnaire was used to collect information about pre-milking teat preparation and CUT management practices. Quarter-level IMI status was determined using standard bacteriologic methods. In addition, colony-forming units of all bacteria (total bacteria), Staphylococcus spp., Streptococcus spp. or Streptococcus-like organisms (SSLO), coliforms, noncoliform gram-negatives, and Bacillus spp. were determined for each pair of CUT (log10 cfu/cm2). The association between ToBC and IMI was determined using multivariable logistic regression with mixed effects. After dichotomizing ToBC into high and low categories, associations between towel management practices and ToBC category were determined using unconditional logistic regression. The quarter-level prevalence of IMI was 19.6%, which was predominantly caused by non-aureus Staphylococcus spp. (NAS; 10.2%) and SSLO (5.1%). The predominant bacteria in CUT were Bacillus spp. (median = 3.13 log10 cfu/cm2). Total bacteria count was not associated with odds of IMI (odds ratio = 1.06), likely due to the predominance of Bacillus spp. in CUT and low number of IMI caused by Bacillus spp. In contrast, counts of Staphylococcus spp. and SSLO were positively associated with odds of IMI caused by NAS (odds ratio = 1.33) and SSLO (odds ratio = 1.45), respectively. Of 12 CUT management practices evaluated, only the failure to use a dryer was identified as a clear predictor of risk for a high ToBC (risk ratio of high coliform count = 8.17). Our study findings suggest that CUT may act as a fomite for NAS and SSLO. We recommend that herds aim to keep counts of Staphylococcus spp. and SSLO in CUT below 32 cfu/cm2 (or 5 cfu/in2), and that laundered towels be completely dried in a hot air dryer.


Assuntos
Infecções por Klebsiella/veterinária , Mastite Bovina/microbiologia , Leite/microbiologia , Infecções Estafilocócicas/veterinária , Infecções Estreptocócicas/veterinária , Animais , Carga Bacteriana/veterinária , Bovinos , Estudos Transversais , Feminino , Klebsiella/isolamento & purificação , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Lactação , Modelos Logísticos , Glândulas Mamárias Animais/microbiologia , Esterco/microbiologia , Mastite Bovina/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação
19.
Eur J Clin Microbiol Infect Dis ; 38(12): 2253-2258, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31392445

RESUMO

The clinical characteristics and outcomes of Streptococcus dysgalactiae subspecies equisimilis (SDSE) bacteremia cases have not been adequately evaluated. We retrospectively enrolled consecutive adult patients with SDSE or S. agalactiae (group B streptococci, GBS) bacteremia at a tertiary care hospital (Republic of Korea) from August 2012 to December 2016. We compared the incidence, seasonality, clinical characteristics, and outcomes of 52 SDSE bacteremia cases with 151 GBS bacteremia cases. The incidence of SDSE and GBS bacteremia in these patients was 1.28/100,000 and 4.22/100,000 person-days, respectively. Most SDSE bacteremia cases were of community-onset infection (SDSE 94.2% vs GBS 83.4%; p = 0.052). Lancefield group G was the most common bacteria type among SDSE isolates (43/47; 91.5%). Patients with SDSE bacteremia were older (median, 68.0 years vs 61.0 years; p = 0.03). In both groups, solid tumor was the most common underlying disease, and more than half of the patients were immunocompromised (51.9% vs 54.3%; p = 0.77). Chronic kidney disease was more common in the SDSE group (19.2% vs 5.3%; p < 0.01). Cellulitis was the most common clinical syndrome of SDSE bacteremia and was more common in the SDSE group (59.6% vs 29.1%; p < 0.01). SDSE bacteremia cases occurred more frequently in the warm season compared with GBS bacteremia cases (65.4% vs 37.1%; p < 0.01); in-hospital mortalities were not significantly different between the groups (3.8% vs 10.6%; p = 0.17). In conclusion, SDSE bacteremia is commonly associated with cellulitis, especially in older and immunocompromised patients during the warm season.


Assuntos
Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Streptococcus/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Bacteriemia/patologia , Feminino , Humanos , Incidência , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/patologia , Streptococcus/classificação , Streptococcus/efeitos dos fármacos , Streptococcus agalactiae/classificação , Streptococcus agalactiae/efeitos dos fármacos , Centros de Atenção Terciária
20.
J Med Microbiol ; 68(10): 1526-1533, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418669

RESUMO

Introduction. Among beta-haemolytic streptococci, Streptococcus pyogenes (GAS) is the prototype agent of bacterial pharyngitis and causes other human infections. Streptococcus dysgalactiae subsp. equisimilis (SDSE) causes GAS-like infections, while Streptococcus agalactiae (GBS) is a common neonate pathogen that is rarely associated with pharyngitis.Aim. To determine the prevalence and persistence of beta-haemolytic streptococci throat carriage and type the bacterial population.Methods. Throat swabs were collected from 121 children and 127 young adult volunteers and cultured. Colonized volunteers were screened quarterly, for up to 1 year, while beta-haemolytic streptococci could be detected. Isolates were identified and submitted to antimicrobial susceptibility testing and epidemiological typing.Results. Carriage was detected in 34 (13.7 %) volunteers. Seventeen children carried GAS (14 %), while 17 young adults carried SDSE (8, 6.3 %), GBS (4, 3.1 %), GAS (3, 2.4 %) and the Streptococcus anginosus group (2, 1.6 %). Persistent carriage was detected for up to 6 months in two children and for up to 1 year in three young adults. Three new emm subtypes were found, emm87.16 and emm90.9 (GAS) and stC36.11 (SDSE). While the GAS population among children was unexpectedly clonal, substantial genetic diversity was found among the isolates recovered from young adults. Resistance to erythromycin, clindamycin and tetracycline was detected in GAS, GBS and SDSE recovered from young adults.Conclusions. Prevalence was slightly greater among children, but persistent carriage was greater among young adults, with SDSE being the species most associated with persistence. Few sources seemed to disseminate GAS among children, since only two clonal types were found. The volunteers hosted pathogenic streptococci persistently, including macrolide-resistant strains.


Assuntos
Portador Sadio/microbiologia , Faringe/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Adolescente , Adulto , Antibacterianos/farmacologia , Brasil/epidemiologia , Portador Sadio/epidemiologia , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Humanos , Macrolídeos/farmacologia , Masculino , Faringite/epidemiologia , Faringite/microbiologia , Estudos Prospectivos , Infecções Estreptocócicas/epidemiologia , Streptococcus/classificação , Streptococcus/efeitos dos fármacos , Streptococcus/genética , Tetraciclina/farmacologia , Adulto Jovem
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