Colonisation by multidrug-resistant organisms in health workers in primary care: narrow spectrum oral antimicrobials are a risk factor.

BACKGROUND: Limited information exists on carriage of multidrug-resistant organisms (MDRO) by health workers (HWs) in primary care settings. This study aims to determine the prevalence of MDRO carriage among HWs in primary care and to identify associated risk factors. METHODS: A cross-sectional study was conducted across all 12 primary care units in São Caetano do Sul-SP, Brazil, from October to December 2023. Self-collected samples (nasal, oropharyngeal, and inguinal) were obtained. Environment cultures (potable water, sewage and stream water) were evaluated. Stenotrophomonas maltophilia isolates (human and environmental) were typed. RESULTS: The study included 265/288 (92%) of HWs in primary care teams, mostly women with a median age of 47 years (IQR 38-57); 78% had no comorbidities. MDRO colonisation was found in 8.7% (23 HWs). The following bacteria were found: S. maltophilia (n = 9; 3.4%) in inguinal swabs; methicillin-resistant Staphylococcus aureus (n = 8; 3%) from all sites; extended-spectrum ß-lactamase-producing bacteria (n = 5; 2%) in inguinal swabs; and vancomycin-resistant enterococci in an inguinal swab (n = 1; 0.4%). Previous antibiotic use was significantly associated with MDRO colonisation (OR 2.91, 95% CI 1.19-7.09, p = 0.018), mainly narrow spectrum oral beta-lactams and macrolides. S. malthophilia was polyclonal and human and environmental isolates differed. CONCLUSION: Colonisation by MRSA, VRE, and ESBL-producing bacteria was low; however, 4% were surprisingly colonized by polyclonal S. maltophilia. This pathogen may also suggest using narrow-spectrum rather than the expected broad-spectrum antimicrobials. Antibiotic use was the only risk factor found, mainly with oral narrow-spectrum drugs.

Antimicrobial resistance characterization of Enterococcus faecium, Enterococcus faecalis and Enterococcus hirae isolated from marine coastal recreational waters in the State of São Paulo, Brazil.

Coastal water quality is facing increasing threats due to human activities. Their contamination by sewage discharges poses significant risks to the environment and public health. We aimed to investigate the presence of antibiotic-resistant Enterococcus in beach waters. Over a 10-month period, samples were collected from four beaches in the State of São Paulo (Brazil). Enterococcus isolates underwent matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) and molecular analysis for accurate genus and species identification. The antimicrobial susceptibility for 14 antibiotics was evaluated using the disc diffusion method followed by a multidrug-resistance (MDR) classification. PCR amplification method was used to detect antimicrobial resistance genes (ARGs). Our findings revealed the prevalence of Enterococcus faecalis, E. faecium and E. hirae. Out of 130 isolates, 118 were resistant to multiple antibiotics. The detection of resistance genes provided evidence of the potential transfer of antibiotic resistance within the environment. Our findings underscore the necessity for continuous research and surveillance to enhance understanding of the pathogenicity and antimicrobial resistance mechanisms of Enterococcus, which is crucial to implement effective measures to preserve the integrity of coastal ecosystems.

Human health risk assessment for (re)emerging protozoan parasites in surface water used for public supply and recreational activities.

Gastrointestinal diseases caused by protozoan parasites remain a major challenge in developing countries and ingestion of contaminated surface water represents one of the main sources by which these diseases are contracted. This study assessed the risk of infection and diseases caused by Cryptosporidium spp. and Giardia sp. due to ingestion of surface water used for public supply and recreational activities, focusing on the southeastern Brazilian Pardo River and applying the USEPA 1623 method to quantify (oo)cyst concentrations. Infection and disease probabilities due to ingestion of drinking water or during recreational activities were estimated using the Quantitative Microbial Risk Assessment (QMRA) approach. Mean concentrations of Cryptosporidium spp. and Giardia sp. in surface water ranged from 0.2 to 0.4 oocysts L-1 and 0.2 to 4.4 cysts L-1, respectively. Considering public water supply, annual infection probabilities were higher for adults than children and exceeded the USEPA limit; also, disease probabilities were higher for adults than children. For recreational activities, annual infection and disease probabilities were higher for children, followed by men and women. The occurrence of both parasites likely reflects raw sewage discharge, effluent from sewage treatment plants, and diffuse sources of pollution, such as runoff from pasture lands and deforested riparian forest corridors. Our results highlight substantial infection risks by both parasite types after conventional treatment of water used for public supply and also call for careful monitoring of water bodies used for recreational purposes.

Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) in drinking water fountains in urban parks.

The presence of Staphylococcus aureus in drinking water is a concern because of its potential to cause human infection and also because of its multiple antimicrobial resistance. This study evaluated the water quality of drinking water fountains and mist makers in four municipal parks of São Paulo for 13 months. Although all samples met bacteriological water quality criteria according to Brazilian regulations, the absence of residual chlorine (<0.1 mg/L) was observed. These data were significantly correlated with the frequency of S. aureus that was found in 25.2% of the samples. The mecA gene was detected in 36.7% of the isolates demonstrating its potential for resistance to several antimicrobials. Furthermore, 27.3% isolates carrying the mecA gene had methicillin-resistant Staphylococcus aureus (MRSA) phenotypic potential. The presence of S. aureus with characteristics of microbial resistance in water for human consumption is an unprecedented finding. Hence, conducting surveillance for opportunistic bacteria, such as staphylococci in drinking water, is reasonable to take control measures and to protect human health, especially in public places with high attendance.

Quantification and characterization of Salmonella spp. isolates in sewage sludge with potential usage in agriculture.

BACKGROUND: This study aims to scrutinize Salmonella spp. and its serotypes in sewage sludge samples from wastewater treatment plants, and assesses the presence of virulence genes and antibiotics resistant to the profile. Samples (n = 54) were collected and analyzed in accordance with the EPA Method 1682/2006. For positive serological reaction, 40 strains were selected for PCR analyses and detection of spvC, invA and sseL virulence genes, plasmid presence and resistance to antibiotics. RESULTS: Salmonella spp. was detected in 38.9% of the samples collected (<0.006473 to 12.19 MPN/gTS). The most prevalent serotype was Salmonella Infantis. All Salmonella spp. (n = 35) presented at least one of the three virulence genes mentioned above and 40% harboured plasmids. Salmonella Typhimurium strains were isolated harbouring at least one of the following virulence genes: spvC, invA or sseL. Four Salmonella spp. isolates were resistant to tetracycline; three were resistant to trimethoprim-sulfamethoxazole, and one isolate was resistant to ciprofloxacin. Two Salmonella spp. strains presented multi resistance to antimicrobial agents. CONCLUSIONS: The results obtained demonstrated that Salmonella spp. have been found in sewage sludge, thus it is essential to set measures to mitigate human health risks when it is intended to be applied on agricultural soils.

Antimicrobial profile of non-typhoidal Salmonella isolated from raw sewage in the Metropolitan Region of São Paulo, Brazil.

INTRODUCTION: Non-typhoidal Salmonella (NTS), are frequently found in sewage and are one of the main causes of diarrhea in developed and developing countries due to poor sanitation conditions. In addition, NTS can potentially act as reservoirs and vehicles for the transmission of antimicrobial resistance (AMR), which can be facilitated by the discharge of sewage effluents into environmental matrices. This study aimed to analyze a NTS Brazilian collection, focusing on their antimicrobial susceptibility profile and the presence of clinically relevant AMR-encoding genes. METHODOLOGY: Forty-five non-clonal NTS strains from serotypes Salmonella enteritidis (n = 6), Salmonella enterica serovar 1,4,[5],12:i:- (S. 1,4,[5],12:i:-) (n = 25), Salmonella cerro (n = 7), Salmonella typhimurium (n = 3) and Salmonella braenderup (n = 4) were studied. Antimicrobial susceptibility testing was done using the Clinical and Laboratory Standards Institute guidelines (2017) and genes encoding resistance to beta-lactams, fluoroquinolones and aminoglycosides were identified by polymerase chain reaction and sequencing. RESULTS: Resistance to ß-lactams, fluoroquinolones, tetracyclines and aminoglycosides was frequent. The highest rates were observed for nalidixic acid (89.0%), followed by tetracycline (67.0%), ampicillin (67.0%), amoxicillin + clavulanic acid (64.0%); ciprofloxacin (47.0%) and streptomycin (42.0%). The AMR-encoding genes detected were qnrB, oqxAB, blaCTX-M and rmtA. CONCLUSIONS: Raw sewage has been considered a valuable tool to evaluate epidemiological population patterns and this study supports the view that NTS with pathogenic potential and resistance to antimicrobials are circulating in the studied region. This is worrisome due to the dissemination of these microorganisms throughout the environment.

Quality of water sources used as drinking water in a Brazilian peri-urban area.

The objective of this paper was to assess bacteriological quality of drinking water in a peri-urban area located in the Metropolitan Region of São Paulo, Brazil. A total of 89 water samples were collected from community plastic tanks and 177 water samples from wells were collected bimonthly, from September 2007 to November 2008, for evaluating bacteriological parameters including: Escherichia coli, Enterococcus and heterotrophic plate count (HPC). Clostridium perfringens was investigated in a subsample (40 samples from community plastic tank and 40 from wells). E. coli was present in 5 (5.6%) samples from community plastic tanks (2.0 - 5.1x10(4) MPN/100mL) and in 70 (39.5%) well samples (2.0 - 8.6x10(4) MPN/100mL). Thus, these samples were not in accordance with the Brazilian Regulation. Enterococcus was detected in 20 (22.5%) samples of the community plastic tanks (1 to 79 NC/100mL) and in 142 (80.2%) well samples (1 to >200 NC/100mL). C. perfringens was detected in 5 (12.5%) community plastic tanks samples and in 35 (87.5%) wells samples (2.2 to >16 MPN/100mL). HPC were above 500 CFU/mL in 5 (5.6%) waters from community plastic tanks. In wells samples, the HPC ranged from <1 to 1.6x10(4) CFU/mL. The residual chlorine did not attend the standard established in the drinking water legislation (0.2 mg/L), except in 20 (22.5%) samples. These results confirm the vulnerability of the water supply systems in this peri-urban area what is clearly a public health concern.

Aeromonas presence in drinking water from collective reservoirs and wells in peri-urban area in Brazil.

Aeromonas genus is considered an emerging pathogen and its presence in drinking water supplies is a reason to public health concern. This study investigated the occurrence of Aeromonas in samples from collective reservoirs and wells used as drinking water sources in a peri-urban area. A total of 35 water samples were collected from collective reservoirs and 32 from wells bimonthly, from September 2007 to September 2008. Aeromonas spp determination was carried out using a Multiple-Tube Technique. Samples were inoculated into alkaline peptone water and the superficial film formed was transferred to blood agar plates amended with ampicillin. Typical Aeromonas colonies were submitted to a biochemical screening and then to biochemical tests for species differentiation. Aeromonas was detected in 13 (19%) of the 69 samples examined (6 from collective reservoirs and 7 from wells). Concentrations of Aeromonas in collective reservoirs ranged from <0.3 to 1.2 x10(2)MPN/100mL and, in wells, from <0.3 to 2.4 x10(2)MPN/100mL. The most frequent specie in the collective reservoir samples was Aeromonas spp (68%), followed by A. encheleia (14%) and A. allosaccharophila (8%) and A. hydrophila (8%). Aeromonas spp (87%) was the most frequent specie isolated from well samples, followed by A. allosacchariphila (8%), A. encheleia (2%) and A. jandaei (5%). These data show the presence and diversity of Aeromonas genus in the samples analyzed and highlight that its presence in drinking water poses a significant public health concern.

Effective characterization of Salmonella Enteritidis by most probable number (MPN) followed by multiplex polymerase chain reaction (PCR) methods.

Nontyphoidal Salmonella (NTS) is a relevant pathogen involved in gastroenteritis outbreaks worldwide. In this study, we determined the capacity to combine the most probable number (MPN) and multiplex polymerase chain reaction (PCR) methods to characterize the most important Salmonella serotypes in raw sewage. A total of 499 isolates were recovered from 27 raw sewage samples and screened using two previously described multiplex PCR methods. From those, 123 isolates were selected based on PCR banding pattern-identical or similar to Salmonella Enteritidis and Salmonella Typhimurium-and submitted to conventional serotyping. Results showed that both PCR assays correctly serotyped Salmonella Enteritidis, however, they presented ambiguous results for Salmonella Typhimurium identification. These data highlight that MPN and multiplex PCR can be useful methods to describe microbial quality in raw sewage and suggest two new PCR patterns for Salmonella Enteritidis identification.

Interface entre uso de drogas e lazer: percepção de usuários de um caps ad de Cuiabá­MT / Interface between drug use and leisure: perception of users of a caps ad de Cuiabá-MT

Esta pesquisa objetivou investigar a percepção de usuários de um CAPS ad de Cuiabá/MT, sobre a interface entre lazer e uso de drogas. Trata-se de uma pesquisa qualitativa, descritiva, com 10 participantes do sexo masculino, com idade média de 26 anos. Os dados foram coletados utilizando entrevistas semi estruturadas, e para análise a técnica de Análise de Conteúdo. Foram geradas quatro categorias: Interface entre lazer e uso de drogas; importância do lazer para a saúde; fatores que dificultam e que facilitam o lazer. Os participantes percebem prejuízos relacionados ao uso de drogas, atribuem dificuldade de acesso ao lazer decorrente da condição financeira, consideram que a mudança de comportamento pode facilitar a inserção do lazer na rotina. Compreendem que o lazer é importante para a saúde, e acreditam que o Estado deve contribuir com Políticas que promovam lazer acessível a todos.

This research aimed to investigate the perception of users of a CAPS ad from Cuiabá/MT related to the interface between leisure and drug use. This is a qualitative, descriptive study with 10 male participants, with a mean age of 26 years. The data were collected using semi-structured interviews, and for analysis the Content Analysis technique. Four categories were generated: Interface between leisure and drug use; importance of leisure for health; factors that hinder and facilitate leisure. The participants perceive damages related todrug use, consider difficulties of access to leisure due to the financial condition, consider that change of behavior can facilitate leisure routine. They understand that leisure is important for health and believe that the State should contribute with Polities that promote leisure accessible to all.

Instrumentos utilizados para avaliação do desenvolvimento de recém-nascidos pré-termo no Brasil: revisão da literatura / Assessment tools utilized for the evaluation of preterm neonates in Brazil: literature review

Os avanços tecnológicos na assistência ao neonato têm levado ao aumento da sobrevida dos recém-nascidos pré-termo. Esse aumento tem gerado preocupação quanto ao desenvolvimento desses bebês e provocado interesse dos pesquisadores em investigar o desenvolvimento neuropsicomotor de crianças que nasceram prematuramente. Revisar a literatura brasileira para identificar os principais instrumentos utilizados para avaliar o desenvolvimento de crianças nascidas pré-termo nos primeiro três anos de vida foi o objetivo deste trabalho. Foi realizado levantamento bibliográfico, nos anos de 1999 a 2011, nas bases de dados Lilacs e Scielo. Foram identificados 11 instrumentos de avaliação do desenvolvimento, sendo que, dos 24 artigos selecionados para a revisão, a maioria (11; 45,83%) utilizou as escalas Alberta Infant Motor Scale (AIMS) (6; 54,5%) e o teste de triagem do desenvolvimento Denver II (TDD-II) (5; 45,5%). Há predomínio do uso de instrumentos referenciados em normas, criados em outros países, sem validação para a criança brasileira. A revisão indica a necessidade de mais pesquisas voltadas para a tradução e validação tanto dos testes importados como dos instrumentos desenvolvidos no Brasil.

Introduction: Technological advances in neonatal care have led to increased survival of preterm newborns. This increase has raised concern about the development of these babies and generated interest among researchers to investigate the neuropsychomotor development of children born prematurely. Objective: To review the Brazilian literature to identify the main instruments used to evaluate the development of children born preterm in the first three years of life. Methodology: A literature search, from 1999 to 2011, was conducted in the Lilacs and Scielo databases. Results: Eleven developmental assessments were identified, and among the 24 articles selected for this review, most of them (11, 45.83%) used the Alberta Infant Motor Scale (AIMS) (6, 54.5%) and the Developmental Screening test Denver II (DDR II) (5, 45.5%). Conclusion: There is predominance of the use of norm-referenced instruments created in other countries, with no validation studies for the Brazilian children. This review indicates a need for more research focused on the translation and validation of international assessment tools as well as instruments developed in Brazil.

Instrumentos utilizados para avaliação do desenvolvimento de recém-nascidos pré-termo no Brasil: revisão da literatura / Assessment tools utilized for the evaluation of preterm neonates in Brazil: literature review

Os avanços tecnológicos na assistência ao neonato têm levado ao aumento da sobrevida dos recém-nascidos pré-termo. Esse aumento tem gerado preocupação quanto ao desenvolvimento desses bebês e provocado interesse dos pesquisadores em investigar o desenvolvimento neuropsicomotor de crianças que nasceram prematuramente. Revisar a literatura brasileira para identificar os principais instrumentos utilizados para avaliar o desenvolvimento de crianças nascidas pré-termo nos primeiro três anos de vida foi o objetivo deste trabalho. Foi realizado levantamento bibliográfico, nos anos de 1999 a 2011, nas bases de dados Lilacs e Scielo. Foram identificados 11 instrumentos de avaliação do desenvolvimento, sendo que, dos 24 artigos selecionados para a revisão, a maioria (11; 45,83%) utilizou as escalas Alberta Infant Motor Scale (AIMS) (6; 54,5%) e o teste de triagem do desenvolvimento Denver II (TDD-II) (5; 45,5%). Há predomínio do uso de instrumentos referenciados em normas, criados em outros países, sem validação para a criança brasileira. A revisão indica a necessidade de mais pesquisas voltadas para a tradução e validação tanto dos testes importados como dos instrumentos desenvolvidos no Brasil.(AU)

Introduction: Technological advances in neonatal care have led to increased survival of preterm newborns. This increase has raised concern about the development of these babies and generated interest among researchers to investigate the neuropsychomotor development of children born prematurely. Objective: To review the Brazilian literature to identify the main instruments used to evaluate the development of children born preterm in the first three years of life. Methodology: A literature search, from 1999 to 2011, was conducted in the Lilacs and Scielo databases. Results: Eleven developmental assessments were identified, and among the 24 articles selected for this review, most of them (11, 45.83%) used the Alberta Infant Motor Scale (AIMS) (6, 54.5%) and the Developmental Screening test Denver II (DDR II) (5, 45.5%). Conclusion: There is predominance of the use of norm-referenced instruments created in other countries, with no validation studies for the Brazilian children. This review indicates a need for more research focused on the translation and validation of international assessment tools as well as instruments developed in Brazil.(AU)

Quality of water sources used as drinking water in a Brazilian peri-urban area

The objective of this paper was to assess bacteriological quality of drinking water in a peri-urban area located in the Metropolitan Region of São Paulo, Brazil. A total of 89 water samples were collected from community plastic tanks and 177 water samples from wells were collected bimonthly, from September 2007 to November 2008, for evaluating bacteriological parameters including: Escherichia coli, Enterococcus and heterotrophic plate count (HPC). Clostridium perfringens was investigated in a subsample (40 samples from community plastic tank and 40 from wells). E. coli was present in 5 (5.6 percent) samples from community plastic tanks (2.0 - 5.1x10(4) MPN/100mL) and in 70 (39.5 percent) well samples (2.0 - 8.6x10(4) MPN/100mL). Thus, these samples were not in accordance with the Brazilian Regulation. Enterococcus was detected in 20 (22.5 percent) samples of the community plastic tanks (1 to 79 NC/100mL) and in 142 (80.2 percent) well samples (1 to >200 NC/100mL). C. perfringens was detected in 5 (12.5 percent) community plastic tanks samples and in 35 (87.5 percent) wells samples (2.2 to >16 MPN/100mL). HPC were above 500 CFU/mL in 5 (5.6 percent) waters from community plastic tanks. In wells samples, the HPC ranged from <1 to 1.6x10(4) CFU/mL. The residual chlorine did not attend the standard established in the drinking water legislation (0.2 mg/L), except in 20 (22.5 percent) samples. These results confirm the vulnerability of the water supply systems in this peri-urban area what is clearly a public health concern.

Aeromonas presence in drinking water from collective reservoirs and wells in peri-urban area in Brazil

Aeromonas genus is considered an emerging pathogen and its presence in drinking water supplies is a reason to public health concern. This study investigated the occurrence of Aeromonas in samples from collective reservoirs and wells used as drinking water sources in a peri-urban area. A total of 35 water samples were collected from collective reservoirs and 32 from wells bimonthly, from September 2007 to September 2008. Aeromonas spp determination was carried out using a Multiple-Tube Technique. Samples were inoculated into alkaline peptone water and the superficial film formed was transferred to blood agar plates amended with ampicillin. Typical Aeromonas colonies were submitted to a biochemical screening and then to biochemical tests for species differentiation. Aeromonas was detected in 13 (19 percent) of the 69 samples examined (6 from collective reservoirs and 7 from wells). Concentrations of Aeromonas in collective reservoirs ranged from <0.3 to 1.2 x10²MPN/100mL and, in wells, from <0.3 to 2.4 x10²MPN/100mL. The most frequent specie in the collective reservoir samples was Aeromonas spp (68 percent), followed by A. encheleia (14 percent) and A. allosaccharophila (8 percent) and A. hydrophila (8 percent). Aeromonas spp (87 percent) was the most frequent specie isolated from well samples, followed by A. allosacchariphila (8 percent), A. encheleia (2 percent) and A. jandaei (5 percent). These data show the presence and diversity of Aeromonas genus in the samples analyzed and highlight that its presence in drinking water poses a significant public health concern.

Macroinvertebrados bentônicos como indicadores de poluiçäo na represa do Guarapiranga-SP / Benthic macroinvertebates as pollution indicators in Guarapiranga reservoir, Säo Paulo, Brazil

Desenvolvido na Represa do Guarapiranga, situada na Regiäo Metropolitana de Säo Paulo - RMSP; visa a utilizaçäo dos macroinvertebrados bentônicos como organismos indicadores de poluiçäo. No período de março de 1996 a fevereiro de 1997, realiza coletas mensais em dez estaçöes de amostragem. Obteve amostras de água para análise de parâmetros físicos e químicos (superfície, meia profundidade e fundo) e de macroinvertebrados bentônicos. No que se refere aos parâmetros colimétricos os resultados de Números Mais Prováveis de bactérias coliformes fecais e totais em algumas das coletas ultrapassam o padräo de resoluçäo CONAMA n. 20/1986 para águas de Classe 2 (1.000 coliformes fecais/100 mL e 5.000 coliformes totais/100 mL). Quanto à comunidade bentônica analisa: densidades numéricas, abundâncias relativas, índices de diversidade, eqüitatividade e riqueza. Elabora um dendograma de agrupamento para as estaçöes de coleta (espacial) com os valores das densidades numéricas dos organismos bentônicos. Para as estaçöes de coleta verifica as correlaçöes, por meio do teste näo paramétrico de correlaçäo por "rank" de Spearman entre os dados referentes `a comunidade bêntica e às variáveis abióticas e bióticas. A análise da fauna bentônica durante o período de estudo, permitiu evidenciar um gradiente trófico tanto em relaçäo aos parâmetros físicos e químicos quanto para os organismos bentônicos, sendo que as estaçöes mais afastadas da barragem mostraram-se menos eutróficas, enquanto que a poluiçäo orgânica acentuada caracterizou as estaçöes mais próximas à barragem, com predominância do grupo Tubificidae

Estudo da ocorrência do gênero Aeromonas em sistemas de tratamento de esgotos por lagoas de estabilização no Município de Lins - SP / The ocurrence of the genus Aeromonas in watewater treatment systems by stabilization ponds in the City of Lins, SP

Introdução: Organismos pertencentes ao gênero Aeromonas estão amplamente distribuídos no ambiente aquático sendo atualmente considerados como patógenos emergentes. Estudos demonstraram que, estes podem produzir uma série de fatores de virulência, e ainda um maior número de casos clínicos vêm sendo confirmados e atribuídos às diferentes espécies de Aeromonas. Objetivo: Estudar a ocorrência do gênero Aeromonas em efluentes de um sistema de lagoas de estabilização e discutir o significado da presença destes para a saúde pública. Métodos: A determinação de Aeromonas spp foi realizada pela técnica de tubos múltiplos (NMP/100 mL). Para a verificação da presença e ausência (PA) as colônias foram isoladas em ágar sangue ampicilina, ágar amido ampicilina e ágar MacConkey. As colônias que apresentaram resultados presuntivos para o grupo Aeromonas foram submetidas ao reisolamento em Ágar Amido, e a provas bioquímicas para identificação das espécies. O perfil plasmidialfoi realizado de acordo com a metodologia escrita por BIRNBOIN & DOLLY 1979. Resultados: Aeromonas spp foram isoladas em 72,4 por cento e 55,1 por cento das amostras provenientes da entrada e saídsa da lagoa anaeróbia respectivamente , e em 48,3 por cento da saída facultativa variando as contagens entre <3 e 3,0 x 109 NMP/100 mL. Na unidade de desinfecção por cloro entre <3 e 9,0 x 105 NMP/mL Conclusões: Observou-se que embora haja uma tendência de dacaimento nas contagens de Aeromonas, não é possível eliminá-las do sistema estudado, mesmo após cloração. Esses organismos podem representar um risco à saúde devido à seleção de cepas resistentes que são lançadas no meio ambiente.

Sepse por Klebsiella pneumoniae: revisäo de 28 casos / Septicaemia caused by Klebsiella pneumoniae: a review of 28 cases

Foram estudadas 28 crianças de 1 mês a 12 anos de idade com quadro séptico e hemocultura positiva para Klebsiella pneumoniae e comparadas com um grupo de crianças com sepse para outros patógenos ou sem etiologia definida. Constatou-se qeu a sepse por Klebsiella pneumoniae ocorreu mais freqüentemente em crianças maiores de 2 anos, näo havendo diferença em relaçäo ao sexo acometido. A maioria das crianças estudadas havia sido internada em hospital nos últimos trinta dias, era portadora de cateter central, 64,3 por cento dos casos com patologia de base, salientando-se as hepatopatias e doenças oncológicas. O quadro clínico inicial caracterizou-se principalmente por acometimento do trato respiratório (35,7 por cento) e por doença diarréica aguda (28,6 por cento). A letalidade foi alta dos dois grupos e o agente infeccioso näo aumentou o risco relativo de óbito. Verificou-se que as cepas isoladas de Klebsiella pneumoniae apresentaram bons índices de sensibilidade à colistina (92,9 por cento) e à cefoxitina (82,1 por cento) e baixos índices às cefalosporinas de 3ª geraçäo e ao imipenen.

O INES e a educação de surdos no Brasil: aspectos da trajetória do Instituto Nacional de Educação de Surdos em seu percurso de 150 anos / INES and education of the deaf in Brazil: history aspects of the National Institute of Deaf Education in its journey 150 years

A pesquisa na área da educação de surdos vem aumentando e com ela a necessidade de conhecer aspectos de sua história. A rigor, temos em nosso país uma carência enorme de pesquisa histórica na área da surdez. O Instituto Nacional de Educação de Surdos (INES), no cenário da educação brasileira há 150 anos, possui uma riqueza extraordinária em fontes documentais prontas para serem pesquisadas, podendo assim contribuir para a construção de novos sentidos, novos olhares, novas narrativas para a história da educação de surdos, que irão enriquecer a pesquisa historiográfica no Brasil. No ano de 2007, o Instituto comemora os seus 150 anos e, com isso, um desafio se apresenta: o de produzir uma peça de memória com a finalidade de festejar seu longo percurso e, mais importante, festejar a sua capacidade de sobreviver a tantas mudanças políticas, educacionais e administrativas. O resultado desse trabalho foi fruto de nexos dialógicos entre narrativas orais, despachos administrativos, fotografias, filmes, cartas, livros, cadernos, enfim, toda sorte de documentação que nos habilita e desafia a olhar e compreender os possíveis sentidos emanados desses lugares de memória. (AU)