RESUMO

Abstract Routine blood culture is used for the detection of bloodstream infections by aerobic and anaerobic bacteria and by common pathogenic yeasts. A retrospective study was conducted in a public hospital in Maceió-AL, by collecting data of all medical records with positive blood cultures. Out of the 2,107 blood cultures performed, 17% were positive with Staphylococcus coagulase negative (51.14%), followed by Staphylococcus aureus (11.21%) and Klebsiella pneumoniae (6.32%). Gram-positive bacteria predominated among positive blood cultures, highlighting the group of Staphylococcus coagulase-negative. While Gram-negative bacteria had a higher number of species among positive blood cultures.

Resumo A cultura sanguínea de rotina é usada para a detecção de infecções na corrente sanguínea por bactérias aeróbias e anaeróbias e por leveduras patogênicas comuns. Estudo retrospectivo realizado em hospital público de Maceió-AL, por meio da coleta de dados de todos os prontuários com culturas sanguíneas positivas. Das 2.107 culturas sanguíneas realizadas, 17% foram positivas com Staphylococcus coagulase negativo (51,14%), seguido por Staphylococcus aureus (11,21%) e Klebsiella pneumoniae (6,32%). As bactérias Gram-positiva predominaram entre as culturas de sangue positivas, destacando-se o grupo das Staphylococcus coagulase-negativo. Enquanto as bactérias Gram-negativas apresentaram um número maior de espécies entre as culturas de sangue positivas.

RESUMO

Abstract Routine blood culture is used for the detection of bloodstream infections by aerobic and anaerobic bacteria and by common pathogenic yeasts. A retrospective study was conducted in a public hospital in Maceió-AL, by collecting data of all medical records with positive blood cultures. Out of the 2,107 blood cultures performed, 17% were positive with Staphylococcus coagulase negative (51.14%), followed by Staphylococcus aureus (11.21%) and Klebsiella pneumoniae (6.32%). Gram-positive bacteria predominated among positive blood cultures, highlighting the group of Staphylococcus coagulase-negative. While Gram-negative bacteria had a higher number of species among positive blood cultures.

Resumo A cultura sanguínea de rotina é usada para a detecção de infecções na corrente sanguínea por bactérias aeróbias e anaeróbias e por leveduras patogênicas comuns. Estudo retrospectivo realizado em hospital público de Maceió-AL, por meio da coleta de dados de todos os prontuários com culturas sanguíneas positivas. Das 2.107 culturas sanguíneas realizadas, 17% foram positivas com Staphylococcus coagulase negativo (51,14%), seguido por Staphylococcus aureus (11,21%) e Klebsiella pneumoniae (6,32%). As bactérias Gram-positiva predominaram entre as culturas de sangue positivas, destacando-se o grupo das Staphylococcus coagulase-negativo. Enquanto as bactérias Gram-negativas apresentaram um número maior de espécies entre as culturas de sangue positivas.

Assuntos

RESUMO

Mixed infections by different Trypanosoma species or genotypes are a common and puzzling phenomenon. Therefore, it is critical to refine the diagnostic techniques and to understand to what extent these methods detect trypanosomes. We aimed to develop an accessible strategy to enhance the sensitivity of the hemoculture, as well as to understand the limitations of the hemoculture and the blood clot as a source of parasitic DNA. We investigated trypanosomatid infections in 472 bats by molecular characterization (18S rDNA gene) of the DNA obtained from the blood clot and, innovatively, from three hemoculture sample types: the amplified flagellates ("isolate"), the pellet of the culture harvested in its very initial growth stage ("first aliquot"), and the pellet of non-grown cultures with failure of amplification ("sediment"). We compared (a) the characterization of the flagellates obtained by first aliquots and isolates; and (b) the performance of the hemoculture and blood clot for trypanosomatid detection. We observed: (i) a putative new species of Bodo in Artibeus lituratus; (ii) the potential of Trypanosoma cruzi selection in the hemoculture; (iii) that the first aliquots and sediments overcome the selective pressure of the hemoculture; and (iv) that the blood clot technique performs better than the hemoculture. However, combining these methods enhances the detection of single and mixed infections.

RESUMO

Abstract Trypanosoma (Megatrypanum) theileri is a flagellated protozoan that infects ruminants and it displays high genetic diversity. In this study, we investigated the prevalence rates of this protozoan based on hemoculture and molecular diagnosis. The isolates of T. theileri thus obtained were characterized by molecular markers SSU rDNA and gGAPDH and molecular diagnosis based on Cathepsin L-like gene (PCR-TthCATL). The PCR-TthCATL and hemoculture indicated an overall prevalence rate of 8.13%, and the CATL derived sequence named IB was identified for the first time in cattle in the western Amazon region, as well as IF in Brazil. We also describe a possible new PCR-TthCATL derived sequence in cattle, designated IL.

Resumo Trypanosoma (Megatrypanum) theileri é um protozoário flagelado que infecta ruminantes e apresenta alta diversidade genética. Neste estudo, investigamos as taxas de prevalência deste protozoário com base na hemocultura e no diagnóstico molecular. Os isolados de T . theileri obtidos foram caracterizados pelos marcadores moleculares SSU rDNA e gGAPDH e o diagnóstico molecular foi baseado no gene do tipo Catepsina L (PCR-TthCATL). O PCR-TthCATL e a hemocultura indicaram uma taxa de prevalência total de 8,13% e a sequência derivada do gene Catepsina L denominada IB de T. theileri foi identificada pela primeira vez em bovinos da Amazônia Ocidental, bem como a IF no Brasil. Também descrevemos uma possível nova sequência derivada da PCR-TthCATL em bovinos, designada IL.

Assuntos

RESUMO

Trypanosoma (Megatrypanum) theileri is a flagellated protozoan that infects ruminants and it displays high genetic diversity. In this study, we investigated the prevalence rates of this protozoan based on hemoculture and molecular diagnosis. The isolates of T. theileri thus obtained were characterized by molecular markers SSU rDNA and gGAPDH and molecular diagnosis based on Cathepsin L-like gene (PCR-TthCATL). The PCR-TthCATL and hemoculture indicated an overall prevalence rate of 8.13%, and the CATL derived sequence named IB was identified for the first time in cattle in the western Amazon region, as well as IF in Brazil. We also describe a possible new PCR-TthCATL derived sequence in cattle, designated IL.(AU)

Trypanosoma (Megatrypanum) theileri é um protozoário flagelado que infecta ruminantes e apresenta alta diversidade genética. Neste estudo, investigamos as taxas de prevalência deste protozoário com base na hemocultura e no diagnóstico molecular. Os isolados de T. theileri obtidos foram caracterizados pelos marcadores moleculares SSU rDNA e gGAPDH e o diagnóstico molecular foi baseado no gene do tipo Catepsina L (PCR-TthCATL). O PCR-TthCATL e a hemocultura indicaram uma taxa de prevalência total de 8,13% e a sequência derivada do gene Catepsina L denominada IB de T. theileri foi identificada pela primeira vez em bovinos da Amazônia Ocidental, bem como a IF no Brasil. Também descrevemos uma possível nova sequência derivada da PCR-TthCATL em bovinos, designada IL.(AU)

Assuntos

RESUMO

Coagulase-negative staphylococci (CNS) are important pathogens causing nosocomial infections worldwide with increasing resistance to antimicrobials. The aim of this study was to characterize resistance aspects of CNS isolated from patients with bloodstream infections acquired in hospitals in Belo Horizonte, MG, Brazil. Staphylococcus strains were characterized using repetitive sequence-based polymerase chain reaction (rep-PCR) fingerprinting with (GTG)5 primer. Phenotypic resistance was analyzed using AST-P5085 card (bioMérieuxVitek®). PCR was used to detect mecA, vanA, blaZ, ermA/B/C, aac-aphD, and SCC-mec. For statistical analyses, we used hierarchical cluster, chi-square test (χ2), and correspondence. Several clusters were formed within the same species using (GTG)5 primer, and strains showed resistance to the following antimicrobials: benzylpenicillin (100%); oxacillin (93.1%); gentamicin (36.3%); ciprofloxacin (63.7%); moxifloxacin (32.7%); norfloxacin (81.0%); erythromycin (86.2%); clindamycin (75.8%); linezolid, teicoplanin and vancomycin (1.7%); tigecycline (0%); fusidic acid (10.35%); rifampicin (13.7%); and trimethoprim/sulfamethoxazole (46.5%). Regarding genotypic analyses, 40%, 0%, 78%, 42%, 100%, 24%, and 30% were positive for mecA, vanA, blaZ, ermA, ermB, ermC, and aac-aphD, respectively. Regarding staphylococcal cassette mec (SCCmec) type, 3.4% presented type I; 5.0% type II; 27.1% type III; 20.3% type IIIA; and 32.2% type IIIB. Six clusters were formed and frequency distributions of resistant strains to oxacillin, gentamicin, ciprofloxacin, moxifloxacin, norfloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, fusidic acid, rifampicin, and trimethoprim/sulfamethoxazole, and mecA, blaZ, ermC, aac-aphD, and SCCmec type differed (p < 0.001). In conclusion, the strains investigated in this study were multidrug resistant and carried multiple antibiotic resistance genes.

Assuntos

RESUMO

La bacteriemia es una complicación grave de las infecciones bacterianas. Un diagnóstico temprano del microorganismo responsable permite aplicar tratamientos efectivos en menor intervalo de tiempo. Los hemocultivos son diagnosticadores clínicos diseñado para este fin. Objetivo: Realizar un estudio de estabilidad acelerado de un lote del hemocultivo HemoCen Aerobio que permita planificar su diseño en estante en condiciones reales. Métodos: Se formuló un lote del hemocultivo HemoCen Aerobio en el Centro Nacional de Biopreparados, BioCen y se envasó asépticamente en los Laboratorios Biológicos Farmacéuticos, LABIOFAM. Se llevó a cabo un estudio de estabilidad acelerado por el Método de Arrenhius. Los frascos se conservaron durante 120 días a 15 °C, 30 °C y 50 °C. Se realizaron evaluaciones físico-químicas, organolépticas y capacidad de promoción de crecimiento de Staphylococcus aureus ATCC 25923 a los 7, 15, 30, 60 y 120 días. Resultados: El estudio de estabilidad demostró que el pH y el color del medio se deterioran progresivamente en el tiempo cuando las temperaturas aumentan entre 30 °C y 50 °C. La promoción de crecimiento de Staphylococcus aureus resultó favorable con índices de recuperación entre 20 y 40 UFC·frasco-1. Discusión: HemoCen Aerobio resulta funcional con un desempeño analítico satisfactorio, cuyos índices de recuperación microbiana se encuentran acorde a los valores reportados en bacteriemias de escasa magnitud. Estos resultados sientan las bases para planificar un estudio de estabilidad en estante en condiciones reales. Conclusión: Se estima un período de validez de 2 años(AU)

Bacteremia is a serious complication of bacterial infections. Early diagnosis of the causative organism allows applying appropriate treatments in a shorter time interval. Hemocultures are clinical diagnosticians designed for this purpose. Objective: Perform an accelerated stability study of a batch of HemoCen Aerobic hemoculture that allows planning its shelf designed in true conditions. Methods: A batch of HemoCen Aerobic hemoculture was formulated at the National Bioproducts Center, BioCen, and aseptically packaged at the Biological Pharmaceutical Laboratories, LABIOFAM. An accelerated stability study was carried out by the Arrenhius Method. The bottles were stored for 120 days at 15 °C, 30 °C and 50 °C. Physicochemical, organoleptic and growth promotion capacity evaluations of Staphylococcus aureus ATCC 25923 were realized at 7, 15, 30, 60 and 120 days. Results: The stability study demonstrated that the pH and the color of the medium progressively deteriorate over time as temperatures increase between 30 °C and 50 °C. Growth promotion of Staphylococcus aureus was favorable with recovery rates between 20 and 40 CFU bottle-1. Discussion: HemoCen Aerobic is functional with a satisfactory analytical performance, which recovery rates are consistent with the values reported in bacteremia of low magnitude. These results provide the basis for planning a shelf stability study under real conditions. Conclusion: A durability period of 2 years was estimated(AU)

Assuntos

RESUMO

Abstract Trypanosoma (Megatrypanum) theileri is a flagellated protozoan that infects ruminants and it displays high genetic diversity. In this study, we investigated the prevalence rates of this protozoan based on hemoculture and molecular diagnosis. The isolates of T. theileri thus obtained were characterized by molecular markers SSU rDNA and gGAPDH and molecular diagnosis based on Cathepsin L-like gene (PCR-TthCATL). The PCR-TthCATL and hemoculture indicated an overall prevalence rate of 8.13%, and the CATL derived sequence named IB was identified for the first time in cattle in the western Amazon region, as well as IF in Brazil. We also describe a possible new PCR-TthCATL derived sequence in cattle, designated IL.

Resumo Trypanosoma (Megatrypanum) theileri é um protozoário flagelado que infecta ruminantes e apresenta alta diversidade genética. Neste estudo, investigamos as taxas de prevalência deste protozoário com base na hemocultura e no diagnóstico molecular. Os isolados de T . theileri obtidos foram caracterizados pelos marcadores moleculares SSU rDNA e gGAPDH e o diagnóstico molecular foi baseado no gene do tipo Catepsina L (PCR-TthCATL). O PCR-TthCATL e a hemocultura indicaram uma taxa de prevalência total de 8,13% e a sequência derivada do gene Catepsina L denominada IB de T. theileri foi identificada pela primeira vez em bovinos da Amazônia Ocidental, bem como a IF no Brasil. Também descrevemos uma possível nova sequência derivada da PCR-TthCATL em bovinos, designada IL.

RESUMO

Contaminated and infected wounds occur very frequently in veterinary medicine and can cause systemic inflammatory response syndrome, sepsis, and death. This study aimed to test the feasibility of collecting wound material by deep-tissue or punch biopsy for microbial culture, determine the frequency of bacteria in the wound(s) and blood cultures and the susceptibility of these microbes to antimicrobials, and evaluate clinical parameters that could be related to prognosis. Thirty dogs with wounds and signs of SIRS/sepsis were included in this study. Bacteria were isolated from all wounds and 41 bacterial isolates could be identified based on culture of the materials collected by punch biopsy; 53.66% of the isolates were gram-negative, mainly involving Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp., and 46.34% were gram-positive bacteria such as Streptococcus spp., Enterococcus spp., and Staphylococcus spp. The survival rate was 66.67%. Based on blood culture analysis, we identified bacteremia in seven patients, predominantly of gram-negative bacteria, which negatively affected patient survival, as six dogs died. Hypoglycemia (≤60mg/dL) and severe hyperglycemia (≥180mg/dL) also negatively affected survival as 23.33% of the hypo/hyperglycemic dogs died. Factors such as blood lactate level at admission and hematocrit levels, and mean arterial pressure were not significantly correlated with death or survival of the dogs.(AU)

As feridas contaminadas e infectadas em cães ocorrem com grande frequência na medicina veterinária e podem causar síndrome da resposta inflamatória sistêmica, sepse e morte. Os objetivos do presente trabalho foram verificar a viabilidade da técnica de coleta de material da ferida por biópsia para realização de cultura microbiana, determinar a frequência das bactérias nas culturas das feridas e hemoculturas e a susceptibilidade destes agentes aos antimicrobianos, bem como avaliar parâmetros clínicos que pudessem ser relacionados ao prognóstico em 30 cães com feridas e sinais de SIRS/sepse. Foram isoladas bactérias de todas as feridas e a técnica de coleta de material para cultura por biópsia permitiu a obtenção de 41 agentes microbianos, sendo isoladas 53,66% bactérias Gram negativas e 46,34% Gram positivas, principalmente Pseudomonas aeruginosa, Klebsiella pneumoniae e Enterococcus spp. As bactérias gram positivas isoladas foram Streptococcus spp., Enterococcus spp. e Staphylococcus spp. A taxa de sobrevivência foi 66,67%. Na hemocultura constatou-se bacteremia em sete pacientes, com predominância de bactérias Gram negativas, o que influenciou negativamente na sobrevivência dos pacientes, pois seis cães vieram a óbito. A hipoglicemia (≤60mg/dL) ou hiperglicemia severa (≥180mg/dL), também influenciaram negativamente a sobrevivência, pois 23,33% dos pacientes hipo/hiperglicêmicos vieram a óbito. Já fatores como nível sérico de lactato na admissão do paciente, pressão arterial média (PAM) e hematócrito não apresentaram correlação estatística com o óbito ou sobrevivência destes pacientes.(AU)

Assuntos

RESUMO

Contaminated and infected wounds occur very frequently in veterinary medicine and can cause systemic inflammatory response syndrome, sepsis, and death. This study aimed to test the feasibility of collecting wound material by deep-tissue or punch biopsy for microbial culture, determine the frequency of bacteria in the wound(s) and blood cultures and the susceptibility of these microbes to antimicrobials, and evaluate clinical parameters that could be related to prognosis. Thirty dogs with wounds and signs of SIRS/sepsis were included in this study. Bacteria were isolated from all wounds and 41 bacterial isolates could be identified based on culture of the materials collected by punch biopsy; 53.66% of the isolates were gram-negative, mainly involving Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp., and 46.34% were gram-positive bacteria such as Streptococcus spp., Enterococcus spp., and Staphylococcus spp. The survival rate was 66.67%. Based on blood culture analysis, we identified bacteremia in seven patients, predominantly of gram-negative bacteria, which negatively affected patient survival, as six dogs died. Hypoglycemia (≤60mg/dL) and severe hyperglycemia (≥180mg/dL) also negatively affected survival as 23.33% of the hypo/hyperglycemic dogs died. Factors such as blood lactate level at admission and hematocrit levels, and mean arterial pressure were not significantly correlated with death or survival of the dogs.(AU)

As feridas contaminadas e infectadas em cães ocorrem com grande frequência na medicina veterinária e podem causar síndrome da resposta inflamatória sistêmica, sepse e morte. Os objetivos do presente trabalho foram verificar a viabilidade da técnica de coleta de material da ferida por biópsia para realização de cultura microbiana, determinar a frequência das bactérias nas culturas das feridas e hemoculturas e a susceptibilidade destes agentes aos antimicrobianos, bem como avaliar parâmetros clínicos que pudessem ser relacionados ao prognóstico em 30 cães com feridas e sinais de SIRS/sepse. Foram isoladas bactérias de todas as feridas e a técnica de coleta de material para cultura por biópsia permitiu a obtenção de 41 agentes microbianos, sendo isoladas 53,66% bactérias Gram negativas e 46,34% Gram positivas, principalmente Pseudomonas aeruginosa, Klebsiella pneumoniae e Enterococcus spp. As bactérias gram positivas isoladas foram Streptococcus spp., Enterococcus spp. e Staphylococcus spp. A taxa de sobrevivência foi 66,67%. Na hemocultura constatou-se bacteremia em sete pacientes, com predominância de bactérias Gram negativas, o que influenciou negativamente na sobrevivência dos pacientes, pois seis cães vieram a óbito. A hipoglicemia (≤60mg/dL) ou hiperglicemia severa (≥180mg/dL), também influenciaram negativamente a sobrevivência, pois 23,33% dos pacientes hipo/hiperglicêmicos vieram a óbito. Já fatores como nível sérico de lactato na admissão do paciente, pressão arterial média (PAM) e hematócrito não apresentaram correlação estatística com o óbito ou sobrevivência destes pacientes.(AU)

Assuntos

RESUMO

La leishmaniasis visceral (LV) es una zoonosis importante causada por Leishmania infantum (syn. chagasi) en las Américas, y transmitida por flebótomos del género Lutzomyia. El diagnóstico de la infección por Leishmania en los gatos es importante para una mejor comprensión del papel de los gatos em la cadena epidemiológica de LV . Este estudio tuvo como objetivo determinar la presencia de L. infantum (syn. chagasi) en 109 gatos de Birigui - SP, Brasil, una zona endémica de leishmaniasis canina y humana, mediante la prueba de inmunofluorescencia indirecta (IFI), hemocultivo y la Reacción en Cadena de la Polimerasa (PCR). Cincuenta y dos (47,7% ; IC95 % 38,6-57,0 % ) muestras fueron positivas por el hemocultivo, tres (2,8 % ; IC 95 % 1,0-7,8 %) por el IFI y 17 (15,6 % ; IC95 % 10,0-23,6 %) por PCR. De acuerdo con los resultados presentados, puede concluir que los gatos de zonas endémicas para la infección pueden ser expuestos com frecuencia al agente y sugieren la importância de estos animales em el ciclo epidemiológico, lo que demuestra la necesidad de investigación y alternativas diagnósticas para ayudar en el establecimiento de medidas preventivas para controlar esta enfermidad.

Visceral leishmaniasis (VL) is an important zoonosis caused by Leishmania infantum (syn. chagasi) in Americas and transmitted by Lutzomyia longipalpis, genus phlebotomines. The diagnosis of Leishmania infection in cats is very important to better comprehend the role of felines on LVs epidemiological chain. This study aimed to determine the occurrence of L. infantum (syn. chagasi) in 109 cats from Birigui, SP, Brazil, an endemic area for canine and human leishmaniasis, by using Indirect Fluorescent Antibody Test (IFAT), hemoculture and Polymerase Chain Reaction (PCR). Fifty two (47.7%; CI95% 38.6-57.0%) samples were positive by the hemoculture, three (2.8%; CI95% 1.0-7.8%) by IFAT and 17 (15.6%; CI95% 10.0-23.6%) by PCR. According to the results, we can conclude that cats from endemic areas for the infection can be frequently exposed to the agent and suggest the importance of these animals in the epidemiological cycle, demonstrating the need for further research and diagnostic alternatives to aid in the establishment of preventive steps to control this disease.

Leishmaniose visceral (LV) é uma importante zoonose causada por Leishmania infantum (syn. chagasi) nas Américas e transmitida por flebotomíneos do gênero Lytzomyia. O diagnóstico da infecção por Leishmania em gatos é muito importante para a melhor compreensão do papel dos felinos na cadeia epidemiológica da LV. Este estudo objetivou determinar a ocorrência de L. infantum (syn. chagasi) em 109 gatos domésticos de Birigui-SP, Brasil, uma área endêmica para leishmaniose canina e humana, utilizando o Teste de Imunofluorescência Indireta (IFI), hemocultura e Reação em Cadeia pela Polimerase (PCR). Cinqüenta e dois (47,7%; CI95% 38.6-57.0%) amostras foram positivas pela hemocultura; três (2.8%; CI95% 1.0-7.8%) pela IFI e 17 (15.6%; CI95% 10.0-23.6%) pela PCR. De acordo com os resultados apresentados, pode-se concluir que gatos provenientes de áreas endêmicas para leishmaniose podem estar frequentemente expostos ao agente e sugerem a importância desses animais no ciclo epidemiológico, demonstrando a necessidade de pesquisas e alternativas de diagnóstico para auxiliar no estabelecimento de medidas preventivas de controle da doença.

Assuntos

RESUMO

La leishmaniasis visceral (LV) es una zoonosis importante causada por Leishmania infantum (syn. chagasi) en las Américas, y transmitida por flebótomos del género Lutzomyia. El diagnóstico de la infección por Leishmania en los gatos es importante para una mejor comprensión del papel de los gatos em la cadena epidemiológica de LV . Este estudio tuvo como objetivo determinar la presencia de L. infantum (syn. chagasi) en 109 gatos de Birigui - SP, Brasil, una zona endémica de leishmaniasis canina y humana, mediante la prueba de inmunofluorescencia indirecta (IFI), hemocultivo y la Reacción en Cadena de la Polimerasa (PCR). Cincuenta y dos (47,7% ; IC95 % 38,6-57,0 % ) muestras fueron positivas por el hemocultivo, tres (2,8 % ; IC 95 % 1,0-7,8 %) por el IFI y 17 (15,6 % ; IC95 % 10,0-23,6 %) por PCR. De acuerdo con los resultados presentados, puede concluir que los gatos de zonas endémicas para la infección pueden ser expuestos com frecuencia al agente y sugieren la importância de estos animales em el ciclo epidemiológico, lo que demuestra la necesidad de investigación y alternativas diagnósticas para ayudar en el establecimiento de medidas preventivas para controlar esta enfermidad.(AU)

Visceral leishmaniasis (VL) is an important zoonosis caused by Leishmania infantum (syn. chagasi) in Americas and transmitted by Lutzomyia longipalpis, genus phlebotomines. The diagnosis of Leishmania infection in cats is very important to better comprehend the role of felines on LVs epidemiological chain. This study aimed to determine the occurrence of L. infantum (syn. chagasi) in 109 cats from Birigui, SP, Brazil, an endemic area for canine and human leishmaniasis, by using Indirect Fluorescent Antibody Test (IFAT), hemoculture and Polymerase Chain Reaction (PCR). Fifty two (47.7%; CI95% 38.6-57.0%) samples were positive by the hemoculture, three (2.8%; CI95% 1.0-7.8%) by IFAT and 17 (15.6%; CI95% 10.0-23.6%) by PCR. According to the results, we can conclude that cats from endemic areas for the infection can be frequently exposed to the agent and suggest the importance of these animals in the epidemiological cycle, demonstrating the need for further research and diagnostic alternatives to aid in the establishment of preventive steps to control this disease.(AU)

Leishmaniose visceral (LV) é uma importante zoonose causada por Leishmania infantum (syn. chagasi) nas Américas e transmitida por flebotomíneos do gênero Lytzomyia. O diagnóstico da infecção por Leishmania em gatos é muito importante para a melhor compreensão do papel dos felinos na cadeia epidemiológica da LV. Este estudo objetivou determinar a ocorrência de L. infantum (syn. chagasi) em 109 gatos domésticos de Birigui-SP, Brasil, uma área endêmica para leishmaniose canina e humana, utilizando o Teste de Imunofluorescência Indireta (IFI), hemocultura e Reação em Cadeia pela Polimerase (PCR). Cinqüenta e dois (47,7%; CI95% 38.6-57.0%) amostras foram positivas pela hemocultura; três (2.8%; CI95% 1.0-7.8%) pela IFI e 17 (15.6%; CI95% 10.0-23.6%) pela PCR. De acordo com os resultados apresentados, pode-se concluir que gatos provenientes de áreas endêmicas para leishmaniose podem estar frequentemente expostos ao agente e sugerem a importância desses animais no ciclo epidemiológico, demonstrando a necessidade de pesquisas e alternativas de diagnóstico para auxiliar no estabelecimento de medidas preventivas de controle da doença.(AU)

Assuntos

RESUMO

BACKGROUND: False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required. METHODS: Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals. Patients aged 16 years or older with suspected bloodstream infection who were allocated in the emergency room, internal medicine ward, or intensive care unit were included. RESULTS: Five of 563 (0.9%) blood cultures from the isopropyl arm and 10 of 539 (1.9%) from the chlorhexidine arm were contaminated. No significant differences were observed among the rate of contamination (χ2=1.27; P = .3) or the relative risk of contamination (relative risk = 2.09; 95% confidence interval, 0.72-6.07; P = .2). CONCLUSIONS: The rates of blood contamination were not different when isopropyl alcohol and chlorhexidine were compared. Isopropyl alcohol could be used for skin antisepsis before blood collection.

Assuntos

RESUMO

Abstract Trypanosoma (Megatrypanum) theileri is a flagellated protozoan that infects ruminants and it displays high genetic diversity. In this study, we investigated the prevalence rates of this protozoan based on hemoculture and molecular diagnosis. The isolates of T. theileri thus obtained were characterized by molecular markers SSU rDNA and gGAPDH and molecular diagnosis based on Cathepsin L-like gene (PCR-TthCATL). The PCR-TthCATL and hemoculture indicated an overall prevalence rate of 8.13%, and the CATL derived sequence named IB was identified for the first time in cattle in the western Amazon region, as well as IF in Brazil. We also describe a possible new PCR-TthCATL derived sequence in cattle, designated IL.

Resumo Trypanosoma (Megatrypanum) theileri é um protozoário flagelado que infecta ruminantes e apresenta alta diversidade genética. Neste estudo, investigamos as taxas de prevalência deste protozoário com base na hemocultura e no diagnóstico molecular. Os isolados de T . theileri obtidos foram caracterizados pelos marcadores moleculares SSU rDNA e gGAPDH e o diagnóstico molecular foi baseado no gene do tipo Catepsina L (PCR-TthCATL). O PCR-TthCATL e a hemocultura indicaram uma taxa de prevalência total de 8,13% e a sequência derivada do gene Catepsina L denominada IB de T. theileri foi identificada pela primeira vez em bovinos da Amazônia Ocidental, bem como a IF no Brasil. Também descrevemos uma possível nova sequência derivada da PCR-TthCATL em bovinos, designada IL.

RESUMO

Coagulase-negative staphylococci (CNS) represent one of the most prevalent microorganisms in nosocomial infections worldwide, nevertheless little is known about their pathogenicity features. Thus, our aim was to characterize virulence aspects of CNS isolated from patients with bloodstream infections assisted in hospitals of Belo Horizonte, MG, Brazil. Strains were identified using bioMérieuxVitek® and for biofilm production evaluation, Congo Red Agar (CRA) and polystyrene plates were used. PCR was applied to detect icaA, icaB, icaC, atlE, sea, sec, sed, tsst-1 and agr. For statistical analyses were used hierarchical cluster, chi-square test and correspondence. 59 strains were analyzed, being S. haemolyticus the most prevalent. On CRA, 96.5% were biofilm producer, whereas on polystyrene plate, 100% showed adhesion at different times evaluated. Regarding genotypic analyses, 15.2%, 38.9%, 8.4%, 49.1%, 76.2%, 23.7%, 1.6%, 30.5% and 38.9% were positive for icaA, icaB, icaC, atlE, sea, sec, sed, tsst-1 and agr, respectively. Six clusters were formed and frequency distributions of agr, atlE, icaA, icaB, sea, sec, tsst-1 differed (P < 0.001). In conclusion, all strains were biofilm producer, with high prevalence of atlE, and had potential of toxin production, with high prevalence of sea. According to the group-analyses, icaB showed relationship with the strong adherence in samples.

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Trypanosoma cruzi is the etiological agent of American trypanosomiasis (Chagas' disease), which affects 6-7 million people worldwide, mainly in Latin America. It presents great genetic and biological variability that plays an important role in the clinical and epidemiological features of the disease. Our working hypothesis is that the genetic diversity of T. cruzi has an important impact on detection of the parasite using diagnostic techniques. The present study evaluated the diagnostic performance of parasitological, molecular, and serological techniques for detecting 27 strains of T. cruzi that belonged to discrete typing units (DTUs) TcI (11 strains), TcII (four strains), and TcIV (12 strains) that were obtained from different hosts in the states of Amazonas and Paraná, Brazil. Blood samples were taken from experimentally infected mice and analyzed by fresh blood examination, hemoculture in Liver Infusion Tryptose (LIT) medium, polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA). Polymerase chain reaction presented the best detection of TcI, with 80.4% positivity. For all of the detection methods, the animals that were inoculated with TcII presented the highest positivity rates (94.1-100%). ELISA that was performed 7 months after inoculation presented a higher detection ability (95.4%) for TcIV. Intra-DTU comparisons showed that the reproducibility of the majority of the results that were obtained with the different methods was weak for TcI and good for TcII and TcIV. Our data indicate that the detection capability of different techniques varies with the DTUs of the parasites in mammalian blood. The implications of these findings with regard to the diagnosis of human T. cruzi infection are discussed.

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A doença de Chagas (ou Tripanossomíase Americana) é uma zoonose de caráter crônico, causada pelo protozoário Trypanosoma cruzi (T.cruzi). No ciclo silvestre, insetos triatomíneos são importantes vetores, podendo infectar roedores, marsupiais e outros animais silvestres, que constituem os reservatórios do parasito. Devido à intensa destruição do ambiente natural onde vivem os animais, estes estão sendo forçados a mudar de habitat. Os insetos vetores têm se adaptado a fontes alternativas de alimento, tanto no peridomicílio, como no intradomicílio, condições que podem determinar o aumento da incidência da doença em humanos. Considerando a importância dos animais silvestres como reservatórios de T. cruzi, o objetivo do presente estudo foi avaliar, por hemocultura e Reação em Cadeia pela Polimerase (PCR), a infecção natural em alguns animais silvestres de três zoológicos do Estado de São Paulo. Foram colhidas amostras de sangue de três cachorros-do-mato (Cerdocyon thous), de três quatis (Nasua nasua), de um gambá (Didelphis marsupialis), de uma jaguatirica (Felis pardalis), de um veado-catingueiro (Mazama gouazoubira), de cinco tatus-galinha (Dasypus novemcinctus), e de um tamanduá-bandeira (Myrmecophaga tridactyla). Somente duas das três amostras de sangue dos cachorros-do-mato foram positivas pela hemocultura e pela PCR, entretanto uma das amostras que foi negativa na hemocultura foi positiva pela PCR. Estes resultados demonstram a importância do cachorro-do-mato como reservatório de T.cruzi, no ciclo epidemiológico da doença de Chagas.

Chagas disease (or American Trypanosomiasis) is an essentially chronic zoonosis caused by Trypanosoma cruzi (T. cruzi) protozoa. In the wild cycle, wild Triatominea insects are important vectors. They can transmit the protozoa to rodents, marsupials and to other wild animals, which are important reservoirs. Due the increasing destruction of the wild animals' natural environment, they are being forced to change its habitat. Moreover, the disease-vector insects can become adapted to different food alternatives in next-domiciliary and/or intra-domiciliary areas. All these conditions can determine the increase of human disease's incidence. Considering the importance of wild animals as T.cruzi reservoirs, the objective of this study was to evaluate by hemoculture and PCR, the Trypanosoma natural infection in some wild animals collected from three zoos in Sao Paulo state. It was collected blood samples from three Crab-eating Fox (Cerdocyon thous), three Coati (Nasua nasua), one Opossum (Didelphis marsupialis), one Ocelot (Felis pardalis), one Grey-Brocket Deer (Mazama gouazoubira), five Nine-Banded Armadillo (Dasypus novemcinctus), and one wild-life Giant Anteater (Myrmecophaga tridactyla). Two of three blood samples of Crab-eating fox were both positive by hemoculture and PCR. However, one negative sample by hemoculture was positive by PCR. Results show the importance of the Crab-eating fox as T.cruzi reservoir and its epidemiological importance in the Chagas' disease cycle.

La enfermedad de Chagas (o Tripanossomiasis Americana) es una zoonosis de carácter crónico, causada por el protozoário Trypanosoma cruzi (T.cruzi). En el ciclo silvestre, los insectos triatomíneos son importantes vectores, y pueden infectar roedores, marsupiales y otros animales silvestres, que constituyen los reservórios del parásito. Debido a la intensa destrucción del ambiente natural donde viven los animales, estos están siendo forzados a cambiar de hábitat. Los insectos vectores han se adaptado a fuentes alternativas de alimento, tanto en el peridomicílio, como en el intradomicílio, condiciones que pueden determinar el aumento de la incidencia de la enfermedad en humanos. Considerando la importancia de los animales silvestres como reservórios de T.cruzi, el objetivo del presente estudio fue evaluar, por hemocultura y Reación en Cadena por la Polimerase (PCR), la infección natural en algunos animales silvestres de tres zoológicos del Estado de Sao Paulo. Fueron colectadas muestras de sangre de tres grisons (Cerdocyon thous), tres coatis (Nasua nasua), un gamba (Didelphis marsupialis), una jaguatirica (Felis pardalis), un ciervo (Mazama gouazoubira), cinco tatús (Dasypus novemcinctus), y un oso hormiguero (Myrmecophaga tridactyla). Solamente dos de las tres muestras de sangre de los grisons fueron positivas por la hemocultura y por la PCR, entretanto una de las muestras que fue negativa en la hemocultura fue positiva por la PCR. Estos resultados muestran la importancia del grison como reservorio de T.cruzi, en el ciclo epidemiológico de la enfermedad de Chagas.

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The aim of the present study was to investigate the presence of Trypanosoma cruzi in the heart, liver, lung, and kidneys, using hemoculture and PCR analysis, of mice infected with different parasite strains during the acute and chronic phases of infection. Parasitemia curves revealed strain-specific biological behaviors. For the Y and JLP strains, the acute phase of infection started at days six and ten post-infection, parasitemia peaked at days seven and 15 post-infection, the chronic phase started at days nine and 28 post-infection, and animals started dying at days 19 and 120 post-infection, respectively. When the two strains were compared, the JLP strain exhibited reduced and slower replication rates associated with a delayed peak of parasitism and reduced parasite burdens. However, parasites were detected in all studied organs using PCR analysis. The capacity of both strains to infect different organs likely influences disease pathogenesis.

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The aim of the present study was to investigate the presence of Trypanosoma cruzi in the heart, liver, lung, and kidneys, using hemoculture and PCR analysis, of mice infected with different parasite strains during the acute and chronic phases of infection. Parasitemia curves revealed strain-specific biological behaviors. For the Y and JLP strains, the acute phase of infection started at days six and ten post-infection, parasitemia peaked at days seven and 15 post-infection, the chronic phase started at days nine and 28 post-infection, and animals started dying at days 19 and 120 post-infection, respectively. When the two strains were compared, the JLP strain exhibited reduced and slower replication rates associated with a delayed peak of parasitism and reduced parasite burdens. However, parasites were detected in all studied organs using PCR analysis. The capacity of both strains to infect different organs likely influences disease pathogenesis.(AU)

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Optimizar el manejo terapéutico de los pacientes adultos con cuadro clínico de bacteriemia posquirúrgica, ingresados es el objetivo de este trabajo. Es una investigación, descriptiva, retrospectiva en un universo de casos con edad igual o mayor a 15 años, ingresados y operados en el período comprendido desde el 1ro de enero de 1999 hasta 31 de diciembre de 2006. Los que tuvieron bacteriemia posquirúrgica constituyen la muestra. El 49 por ciento de los pacientes tenía 60 años o más y de estos el 27,5 por ciento eran del sexo femenino. Los diagnósticos de fractura o coxartrosis de cadera con sustitución endoprotésica parcial o total predominaron con el 27,5 y el 21,6 por ciento respectivamente. La tasa de incidencia de bacteriemia clínica con hemocultivo positivo, fue de 12 por cada 10 000. Los estafilococos coagulasa positivos y estafilococos coagulasa negativos causaron más del 70 por ciento de las bacteriemias, con un 39,2 y un 37,2 por ciento respectivamente. Veinticinco o más de las 39 cepas de gérmenes grampositivos estudiadas hicieron resistencia a la cefazolina, la penicilina, la ceftriaxona, la ampicilina, la kanamicina y el sulfametoxazol + trimetoprim. De las 12 cepas de gérmenes gramnegativos estudiados seis o más se mostraron resistentes a la cefazolina, la ampicilina, la cefotaxima, la vancomicina, la gentamicina, la eritromicina y la estreptomicina. La mayoría eran mujeres que tenían 60 años o más, operadas de cadera ya sea por fractura o por coxartrosis, con implantación de prótesis parciales o totales, le siguieron los operados con diagnóstico de fractura abierta de tibia. Doce pacientes por cada 10 000 tenían riesgo de padecer bacteriemia primaria posquirúrgica confirmada microbiológicamente.

The aim of present paper is to optimize the surgical management of admitted adult patients with a clinical picture of postsurgery bacteremia. It is a retrospective and descriptive research in a case cohort aged 15 or more, admitted and operated on from January 1, 1999 to December 31, 2006. Sample is composed by those with postsurgical bacteremia. The 49 percent of patients aged 60 or more, and from these, the 27.5 percent were female patients. There was a predominance of fracture or hip coxarthrosis diagnoses with partial or total endoprosthetic replacement for 27.5 and 21.5 percent, respectively. Clinical bacteremia incidence rate with positive hemoculture was of 12 of 10 000. Positive-and negative coagulase staphylococci accounted for more of 70 percent of bacteremias, for a 39.2 and a 37.2 percent, respectively . Twenty five or more from the 39 study gram-positive germs strains were resistant to Cefazolin sodium, Penicillin, Ceftriaxone sodium, Ampicillin, Kanamycin, and the Sulfamethoxazole +Trimethoprim. From the 12 study gram-negative germ strains, six or more were resistant to Cefazolin, Ampicillin, Sefotaxime sodium, Vancomycin, Gentamicin sulfate, Erythromycin, and Streptomycin sulfate. Most of patients were women aged 60 or more, operated on from a hip fracture or by coxarthrosis with partial or total prostheses placement, followed by operated on diagnoses with tibial open fracture. Twelve patients of 10 000 had a risk of postsurgical primary bacteremia confirmed by microbiology.

Ce travail est visé à analyser l'optimisation de la prise en charge thérapeutique des patients adultes hospitalisés dû à une bactériémie post-chirurgicale. C'est une étude descriptive et rétrospective de nombreux patients ayant un âge = 15 ans, hospitalisés et opérés entre le 1er janvier 1999 et le 31 décembre 2006. L'échantillon comprend des patients atteints de bactériémie postopératoire. Une partie de ces patients avaient 60 ans (49 percent), dont 27,5 percent étaient du sexe féminin. La fracture ou coxarthrose de hanche avec prothèse partielle ou totale ont prédominé (respectivement, 27,5 percent et 21,6 percent). Le taux d'incidence de la bactériémie clinique avec des hémocultures positives a été de 12 p. 10,000. Les Staphylococcus-coagulase positifs et les Staphylococcus-coagulase négatifs ont causé plus de 70 percent des bactériémies (respectivement, 39,2 et 37,2 percent). Vingt-cinq souches de germes gram-positifs étudiées sur 39 ont fait résistance à la céphazoline, à la pénicilline, à la ceftriaxone, à l'ampicilline, à la kanamicine et à la sulfaméthoxazole + trimétroprime. Six ou plus souches de germes gram-négatifs étudiées sur 12 ont fait résistance à la céphazoline, à l'ampicilline, à la céfotaxime, à la vancomycine, à la gentamicine, à l'érythromycine et à la streptomycine. Parmi les patients les plus touchés, on a trouvé des femmes ayant 60 ans ou plus, opérées de hanche soit pour fracture soit pour coxarthrose, avec implant de prothèses partielles ou totales, suivies des patients diagnostiqués et opérés de fractures ouvertes de tibia. Douze patients p. 10,000 sont au risque de souffrir une bactériémie primaire post-chirurgicale qui est microbiologiquement confirmée.