RESUMO
Introducción: El consumo de sustancias psicoactivas (SPA) en el entorno universitario ha sido una problemática de salud pública que es necesario abordar para fortalecer el desarrollo integral de los estudiantes. Objetivo: Indagar sobre elementos teóricos y metodológicos que permitan prevenir, controlar y mitigar la problemática al interior de la Universidad. Materiales y métodos: El proceso de investigación se desarrolló bajo la lógica del paradigma cualitativo, con un diseño de tipo etnográfico; para la construcción de la estrategia metodológica se utilizaron técnicas de investigación-acción. Resultados: La estrategia se fundamentó en factores relacionados con los determinantes estructurales e intermedios de la salud que guiaron la construcción de actividades asociadas con la psicología comunitaria, promoción, comunicación y educación para la salud, así como acciones propuestas por las autoridades de salud en Colombia. Conclusión: El estudio permitió evidenciar que existen puntos de confluencia entre las diferentes perspectivas en donde se reconoció que aspectos como las normas y leyes, el entorno familiar, el vínculo social, la raza, grupo étnico y costumbres de la sociedad, son factores de los determinantes sociales de la salud que pueden influir para que un joven consuma sustancias psicoactivas dentro de la Universidad.
Introduction: The use of psychoactive substances in the university environment has been a public health problem that must be addressed to strengthen the integral development of students. Objective: The purpose of the study carried out was to inquire about theoretical and methodological elements that allow to prevent, control and mitigate the problem within the University. Materials and methods: The research process was developed under the logic of the qualitative paradigm, with an ethnographic design, in the construction of the methodological strategy, Action research techniques were used. Results: The strategy was based on factors related to the structural and intermediate determinants of health that were the guides in the construction of activities related to community psychology, promotion, communication and health education, as well as actions proposed by the Health authorities in Colombia. Conclusions: The study made it possible to show that there are points of confluence between the different perspectives where it was recognized that aspects such as norms and laws, family environment, social bond, race, ethnic group and customs of society, are factors of social determinants that can influence a young person to consume psychoactive substances within the University.
Introdução: O consumo de substâncias psicoativas (SPA) no ambiente universitário tem sido um problema de saúde pública que deve ser enfrentado para fortalecer o desenvolvimento integral dos estudantes. Objetivo: Indagar sobre elementos teóricos e metodológicos que permitam prevenir, controlar e mitigar o problema dentro da Universidade. Materiais e métodos: O processo de investigação desenvolveu-se sob a lógica do paradigma qualitativo, com desígnio etnográfico e na construção da estratégia metodológica foram utilizadas técnicas de investigação-ação. Resultados: A estratégia foi baseada em fatores relacionados com os determinantes estruturais e intermediários da saúde que orientaram a construção de atividades associadas à psicologia comunitária, promoção, comunicação e educação para a saúde, bem como ações propostas pelas autoridades de saúde na Colômbia. Conclusão: O estudo permitiu mostrar que existem pontos de confluência entre as diferentes perspectivas onde se reconheceu que aspetos como as normas e leis, o ambiente familiar, o vínculo social, a raça, a etnia e os costumes da sociedade, são fatores dos determinantes sociais de saúde que podem influenciar um jovem a consumir substâncias psicoativas dentro da Universidade.
RESUMO
AIMS: Staphylococcus aureus is one of the most common pathogens associated with mastitis in dairy herds worldwide. This study evaluated the profile of virulence and antimicrobial resistance genes of spa type t605 methicillin-susceptible Staphylococcus aureus isolated from subclinical bovine mastitis in São Paulo, Brazil. METHODS AND RESULTS: A total of 57 S. aureus strains were screened by conventional PCR (Polymerase Chain Reaction) for 49 virulence genes. The most prevalent virulence genes detected were icaD (94.7%), fib (93%), fnbA (82.5%), clfA (80.7%), bap (78.9%), clfB (73.7%), icaA (66.7%), see (64.9%), and sed (61.4%). The blaZ (94.7%), aac6'aph2' (15.8%), and ant4 (12.3%) genes were the most common antimicrobial resistance genes; however, mecA and mecC genes were not found. All methicillin-susceptible S. aureus (MSSA) strains were characterized through spa and agr typing. The spa type t605 was found in all isolates. By agr typing, the most prevalent were type II (56.1%). Antimicrobial resistance was determined by the disk diffusion method, and 93% showed resistance to at least one antibiotic. Penicillin resistance was the most prevalent (87.7%), followed by tetracycline (12.3%), oxacillin (10.5%), and gentamicin (10.5%) resistance. CONCLUSION: Our study confirmed the spa type t605 as endemic, carrying a wide variety of virulence factors and high-level penicillin resistance. The profile seems to be associated with the colonization of MSSA and its persistence in subclinical mastitis.
Assuntos
Mastite Bovina , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Animais , Bovinos , Feminino , Staphylococcus aureus , Antibacterianos/farmacologia , Virulência/genética , Meticilina , Mastite Bovina/epidemiologia , Farmacorresistência Bacteriana/genética , Brasil , Infecções Estafilocócicas/veterinária , Infecções Estafilocócicas/epidemiologia , Fatores de Virulência/genética , Testes de Sensibilidade MicrobianaRESUMO
Genotyping of Staphylococcus aureus isolated from mastitis has become a fundamental tool to understand its complex epidemiology and to evaluate spillover events. The aim of this study was to describe the frequency of genotypes of the S. aureus strains isolated from intramammary infections by spa typing technique, and to evaluate the association between genotypes and the ability to form biofilm under in vitro conditions. Sixty-six strains of S. aureus recovered from bovines intramammary infections on 56 dairy herds located in 14 municipalities of the department of Antioquia were characterized. The majority of strains (65/66) were isolated from milk samples collected from dairy cows with subclinical intramammary infections. Nineteen different spa types were found in this study, t521 (19.70%), t267 (15.15%), and t605 (12.12%) being the most frequent. The strains from the t605 spa type showed the highest biofilm production. The high frequency of spa types with zoonotic potential found in this study, identified cattle as an important reservoir of theses clones for people in close proximity, such as milkers and consumers of unpasteurized dairy products.
Assuntos
Doenças dos Bovinos , Mastite Bovina , Infecções Estafilocócicas , Feminino , Bovinos , Animais , Staphylococcus aureus/genética , Leite , Mastite Bovina/epidemiologia , Variação Genética , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/veterináriaRESUMO
Abstract Background Secukinumab has shown high efficacy in randomized controlled trials in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Here, we investigated its real-life effectiveness and tolerability in a cohort of AS and PsA patients. Methods We retrospectively analyzed medical records of outpatients with AS or PsA treated with secukinumab between December 2017 and December 2019. ASDAS-CRP and DAS28-CRP scores were used to measure axial and peripheral disease activity in AS and PsA, respectively. Data were collected at baseline and after 8, 24, and 52 weeks of treatment. Results Eighty-five adult patients with active disease (29 with AS and 56 with PsA; 23 males and 62 females) were treated. Overall, mean disease duration was 6.7 years and biologic-naïve patients were 85%. Significant reductions in ASDAS-CRP and DAS28-CRP were observed at all time-points. Body weight (in AS) and disease activity status at baseline (particularly in PsA) significantly affected disease activity changes. ASDAS-defined inactive disease and DAS28-defined remission were achieved in comparable proportions between AS and PsA patients, at both 24 weeks (45% and 46%) and 52 weeks (65.5% and 68%, respectively); male sex was found an independent predictor of positive response (OR 5.16, P = 0.027). After 52 weeks, achievement of at least low disease activity and drug retention were observed in 75% of patients. Secukinumab was well-tolerated and only mild injection-site reactions were recorded in 4 patients. Conclusion In a real-world setting, secukinumab confirmed great effectiveness and safety in both AS and PsA patients. The influence of gender on treatment response deserves further attention.
RESUMO
Cryptographic algorithms (RSA, DSA, and ECC) use modular exponentiation as part of the principal operation. However, Non-profiled Side Channel Attacks such as Simple Power Analysis and Differential Power Analysis compromise cryptographic algorithms that use such operation. In this work, we present a modification of a modular exponentiation algorithm implemented in programmable devices, such as the Field Programmable Gate Array, for which we use Virtex-6 and Artix-7 evaluation boards. It is shown that this proposal is not vulnerable to the attacks mentioned previously. Further, a comparison was made with other related works, which use the same family of FPGAs. These comparisons show that this proposal not only defeats physical attack but also reduces the number of resources. For instance, the present work reduces the Look-Up Tables by 3550 and the number of Flip-Flops was decreased by 62,583 compared with other works. Besides, the number of memory blocks used is zero in the present work, in contrast with others that use a large number of blocks. Finally, the clock cycles (latency) are compared in different programmable devices to perform operations.
RESUMO
Preterm birth is the leading cause of infant mortality. The mechanisms that instigate preterm birth remain elusive and this makes it difficult to predict or prevent preterm birth. In this study, the authors found that SP-A induced pathological damage to the placenta and promoted preterm birth. Through mechanism, SP-A promoted the expression of STOX1 which further promoted the oxidative stress in the placenta by inhibiting the activities of a series of antioxidant enzymes including SOD, CAT and GSH-Px. SP-A also induced dysregulation of arginine metabolism by inhibiting NOS2 and ARG2. Overexpression of STOX1 aggravated SP-A induced oxidative stress, pathological damage, and preterm birth, whereas knockdown of STOX1 alleviated SP-A induced oxidative stress, pathological damage and preterm birth. The present study uncovers that SP-A induces preterm birth by promoting oxidative stress via upregulating STOX1, which provides new targets for the prediction and prevention of preterm birth.
Assuntos
Nascimento Prematuro , Antioxidantes/metabolismo , Proteínas de Transporte/metabolismo , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Estresse Oxidativo/fisiologia , Gravidez , TensoativosRESUMO
γ-Tubulin ring complexes (γ-TuRC) mediate nucleation and anchorage of microtubules (MTs) to microtubule organizing centers (MTOCs). In fungi, the spindle pole body (SPB) is the functional equivalent of the centrosome, which is the main MTOC. In addition, non-centrosomal MTOCs (ncMTOCs) contribute to MT formation in some fungi like Schizosaccharomyces pombe and Aspergillus nidulans. In A. nidulans, MTOCs are anchored at septa (sMTOC) and share components of the outer plaque of the SPB. Here we show that the Neurospora crassa SPB is embedded in the nuclear envelope, with the γ-TuRC targeting proteins PCP-1Pcp1/PcpA located at the inner plaque and APS-2Mto1/ApsB located at the outer plaque of the SPB. PCP-1 was a specific component of nuclear MTOCs, while APS-2 was also present at the septal pore. Although γ-tubulin was only detected at the nucleus, spontaneous MT nucleation occurred in the apical and subapical cytoplasm during recovery from benomyl-induced MT depolymerization experiments. There was no evidence for MT nucleation at septa. However, without benomyl treatment MT plus-ends were organized in the septal pore through MTB-3EB1. Those septal MT plus ends polymerized MTs from septa in interphase cells Thus we conclude that the SPB is the only MT nucleation site in N. crassa, but the septal pore aids the MT network arrangement through the anchorage of the MT plus-ends through a pseudo-MTOC.
Assuntos
Proteínas de Transporte , Proteínas Fúngicas , Proteínas Associadas aos Microtúbulos , Neurospora crassa , Benomilo/metabolismo , Proteínas de Transporte/metabolismo , Proteínas Fúngicas/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Centro Organizador dos Microtúbulos/metabolismo , Microtúbulos/metabolismo , Neurospora crassa/genética , Neurospora crassa/metabolismo , Corpos Polares do Fuso/metabolismo , Tubulina (Proteína)/genéticaRESUMO
OBJECTIVE: To assess the efficacy and safety of infliximab versus placebo in the treatment of patients with juvenile-onset spondyloarthritis (JoSpA). METHODS: Phase III, randomized, double-blind, placebo-controlled trial of 12 weeks that included patients ≤ 18 years old with JoSpA not responding to nonsteroidal anti-inflammatory drugs, sulfasalazine, or methotrexate. Patients were randomly assigned 1:1 to the infusion of infliximab 5mg/kg or placebo; completers entered then an open-label extension (OLE) period of 42 weeks. The primary endpoint was the number of active joints. Secondary outcomes included the assessment of disease activity, tender entheses, spinal mobility, serum C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity and Functional Index, and the Childhood Health Assessment Questionnaire (CHAQ). RESULTS: We randomized 12 patients to infliximab and 14 to placebo. No significant differences were found between groups at baseline. At week 12, the mean number of active joints was 1.4 (SD 2.4) in the infliximab group and 4.1 (SD 3.0) in the placebo group (p = 0.0002). A repeated-measures mixed model analysis that included all endpoints in the study demonstrated sustained favourable outcomes of infliximab for active joints, tender joints, swollen joints, and tender enthesis counts, as well as for CHAQ and CRP (p < 0.01). Adverse events were more frequent in the infliximab group, including infections and infusion reactions, but none of them was serious. CONCLUSION: Infliximab is efficacious for patients with JoSpA with an inadequate response to conventional treatment. No serious adverse events with the use of infliximab were observed.
Assuntos
Antirreumáticos , Artrite Juvenil , Espondilartrite , Espondilite Anquilosante , Adolescente , Artrite Juvenil/tratamento farmacológico , Proteína C-Reativa , Criança , Método Duplo-Cego , Humanos , Infliximab/uso terapêutico , Espondilartrite/tratamento farmacológico , Espondilite Anquilosante/tratamento farmacológico , Resultado do TratamentoRESUMO
Numerous host and environmental factors contribute to persistent and intermittent nasal Staphylococcus aureus carriage in humans. The effects of worsening glycemia on the odds of S. aureus intermittent and persistent nasal carriage was established in two cohorts from an adult Mexican American population living in Starr County, Texas. The anterior nares were sampled at two time points and the presence of S. aureus determined by laboratory culture and spa-typing. Persistent carriers were defined by the presence of S. aureus of the same spa-type at both time points, intermittent carriers were S. aureus-positive for 1 of 2 swabs, and noncarriers were negative for S. aureus at both time points. Diabetes status was obtained through personal interview and physical examination that included a blood draw for the determination of percent glycated hemoglobin A1c (%HbA1c), fasting plasma glucose, and other blood chemistry values. Using logistic regression and general estimating equations, the odds of persistent and intermittent nasal carriage compared to noncarriers across the glycemic spectrum was determined controlling for covariates. Increasing fasting plasma glucose and %HbA1c in the primary and replication cohort, respectively, were significantly associated with increasing odds of S. aureus intermittent, but not persistent nasal carriage. These data suggest that increasing dysglycemia is a risk factor for intermittent S. aureus nasal carriage potentially placing those with poorly controlled diabetes at an increased risk of acquiring an S. aureus infection. IMPORTANCE Factors affecting nasal S. aureus colonization have been studied primarily in the context of persistent carriage. In contrast, few studies have examined factors affecting intermittent nasal carriage with this pathogen. This study demonstrates that the odds of intermittent but not persistent nasal carriage of S. aureus significantly increases with worsening measures of dysglycemia. This is important in the context of poorly controlled diabetes since the risk of becoming colonized with one of the primary organisms associated with diabetic foot infections can lead to increased morbidity and mortality.
Assuntos
Infecções Estafilocócicas , Staphylococcus aureus , Adulto , Glicemia , Portador Sadio/epidemiologia , Hemoglobinas Glicadas , Humanos , Americanos Mexicanos , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/genéticaRESUMO
Staphylococcus aureus is a contagious pathogen frequently associated with bovine mastitis in Brazil. Molecular characterization of Staph. aureus isolated from affected mammary quarters of cows with clinical mastitis (CM) can provide data on epidemiological behavior of this pathogen and antimicrobial susceptibility (AMS) assessment at the genotypic level. This study genotypically characterized Staph. aureus isolates recovered from cows with CM and determined the association of genotypes and AMS. A total of 84 Staph. aureus strains identified from affected mammary quarters of cows with CM in 13 dairy herds from Southeastern Brazil were submitted for susceptibility testing to 10 antimicrobials using the technique of minimal inhibitory concentration. The same isolates were also genotyped using the spa-typing methodology. Results showed a high genotypic similarity between the Staph. aureus isolates within and between herds, which were categorized as resistant to most antimicrobials, especially to ß-lactam antibiotics. In addition, differences in AMS were observed among genotypic clusters, which may affect the efficacy of antimicrobials used to treat CM in different dairy herds.
RESUMO
Spa tourism has undergone important changes in recent decades, actively embracing wellness and wellbeing. However, this transition is taking place in different ways in Europe, and this has led to varying perceptions of thermalism that have little to do with its original conception. The main aim of this study was to analyse current perceptions of spa tourism amongst university students, so as to identify profiles and compare the differences between two study cases: Granada (Spain) and Aachen (Germany). For this purpose, we applied a methodology that combines artificial intelligence techniques with questionnaires containing both quantitative and qualitative variables. This enabled us to identify and characterize a series of profiles, so as to acquire detailed knowledge of the perceptions of these students regarding spa tourism in Granada and Aachen. On the basis of the results, the interviewees were grouped together into seven profiles from which we deduced that young Germans from Aachen visit spas more frequently and have a more realistic perception of the thermal sector than young Spanish people from Granada. This situation could limit present and future demand for spas in southern Spain. With this in mind, in this paper we present an updated assessment of the demand for spas amongst university students, in order to design effective geomarketing strategies in two cities with long spa traditions.
Assuntos
Inteligência Artificial , Turismo , Adolescente , Humanos , Espanha , Estudantes , UniversidadesRESUMO
Abstract Preterm birth is the leading cause of infant mortality. The mechanisms that instigate preterm birth remain elusive and this makes it difficult to predict or prevent preterm birth. In this study, the authors found that SP-A induced pathological damage to the placenta and promoted preterm birth. Through mechanism, SP-A promoted the expression of STOX1 which further promoted the oxidative stress in the placenta by inhibiting the activities of a series of antioxidant enzymes including SOD, CAT and GSH-Px. SP-A also induced dysregulation of arginine metabolism by inhibiting NOS2 and ARG2. Overexpression of STOX1 aggravated SP-A induced oxidative stress, pathological damage, and preterm birth, whereas knockdown of STOX1 alleviated SP-A induced oxidative stress, pathological damage and preterm birth. The present study uncovers that SP-A induces preterm birth by promoting oxidative stress via upregulating STOX1, which provides new targets for the prediction and prevention of preterm birth.
RESUMO
For non-destructive detection of water stress in lettuce, terahertz time-domain spectroscopy (THz-TDS) was used to quantitatively analyze water content in lettuce. Four gradient lettuce water contents were used . Spectral data of lettuce were collected by a THz-TDS system, and denoised using the S-G derivative, Savitzky-Golay (S-G) smoothing and normalization filtering. The fitting effect of the pretreatment method was better than that of regression fitting, and the S-G derivative fitting effect was obtained. Then a calibration set and a verification set were divided by the Kennan-Stone algorithm, sample set partitioning based on joint X-Y distance (SPXY) algorithm, and the random sampling (RS) algorithm, and the parameters of RS were optimized by regression fitting. The stability competitive adaptive reweighted sampling, iteratively retained information variables and interval combination optimization were used to select characteristic wavelengths, and then continuous projection was used on basis of the three algorithms above. After the successive projection algorithm was re-screened, partial least squares regression was used into modeling. The regression coefficients R²c and RMSEC reach 0.8962 and 412.5% respectively, and R²p and RMSEP of the verification set are 0.8757 and 528.9% respectively.
Para a detecção não destrutiva de estresse hídrico da alface, espectroscopia no domínio do tempo em terahertz (THz-TDS) foi usada para analisar quantitativamente o conteúdo de água na alface. Quatro gradientes de conteúdo de água de alface foram usados. Os dados espectrais da alface foram coletados por um sistema THz-TDS e denoised usando o derivado S-G, Savitzky-Golay (S-G) suavização e filtragem de normalização. O efeito de ajuste do método de pré-tratamento foi melhor do que o do ajuste de regressão, e o efeito de ajuste da derivada S-G foi obtido. Em seguida, um conjunto de calibração e um conjunto de verificação foram divididos pelo algoritmo Kennan-Stone, particionamento do conjunto de amostra com base no algoritmo de distância X-Y conjunta (SPXY) e o algoritmo de amostragem aleatória (RS), e os parâmetros de RS foram otimizados por ajuste de regressão. A amostragem adaptativa de estabilidade competitiva reponderada, variáveis de informação retidas iterativamente e otimização de combinação de intervalo foram usadas para selecionar comprimentos de onda característicos e, em seguida, a projeção contínua foi usada com base nos três algoritmos acima. Depois que o algoritmo de projeção sucessivo foi reprojetado, a regressão de mínimos quadrados parcial foi usada na modelagem. Os coeficientes de regressão R2 e erro quadrático médio (RMSEP) atingem 0,8962 e 412,50%, respectivamente, e R2 e RMSEP do conjunto de verificação são 0,8757 e 528,93%, respectivamente.
Assuntos
Lactuca , Desidratação , Espectroscopia Terahertz/métodos , UmidadeRESUMO
Resumen Introducción. El consumo de sustancias psicoactivas (SPA) se consideran como una enfermedad crónica debido a que el inicio, curso, dirección, y resultado es impredecible en algunos casos y adicionalmente son trastornos multicausales como es el caso de la depresión; según datos reportados por el Centro de Adicciones de Barcelona "la incidencia de depresión en pacientes con abuso de sustancias oscila entre el 6% y 70% en los consumidores de SPA". Con este panorama se debe comprender que la intervención debe desarrollar la promoción de la salud y la prevención de la enfermedad, con la aparición de la biotecnología con el uso y aplicación de las tecnologías de la información y las comunicaciones (TIC) en las ciencias de salud y la vida para el diagnóstico, prevención, supervisión, tratamiento. Objetivo. Desarrollar un software que permita generar una alerta para la identificación temprana de la depresión asociada al consumo de sustancias psicoactivas en adultos, mediante el uso de una TICs previamente validada, durante el año 2019. Metodología. Investigación Tecnológica, utilizando la metodología "UWE" con enfoque al desarrollo de software para el dominio web. Resultados. En esta propuesta de investigación se avanzará en el desarrollo del prototipo del producto para la identificación temprana de la depresión con el fin de mejorar el proceso de toma de decisiones clínicas, en el momento mismo de la atención, con base en la información registrada en el software llamado MEASDEP (Medición de la depresión en consumidores de SPA).
Abstract Introduction. The consumption of psychoactive substances (SPA) is considered a chronic disease because the onset, course, direction, and result is unpredictable in some cases and additionally they are multi-causal disorders such as depression; according to data reported by the Barcelona Addiction Center "the incidence of depression in patients with substance abuse ranges between 6% and 70% in SPA users". With this outlook, it should be understood that the intervention should develop the promotion of health and the prevention of disease, with the appearance of biotechnology with the use and application of information and communication technologies (ICT) in science, health and life for diagnosis, prevention, supervision, treatment. Objective. To develop a software that allows generating an alert for the early identification of depression associated with the use of psychoactive substances in adults, through the use of a previously validated ICT, during 2019. Methodology. Technological Research, using the "UWE "With a focus on software development for the web domain. Results. In this research proposal, progress will be made in the development of the product prototype for the early identification of depression in order to improve the clinical decision-making process, at the moment of care, based on the registered information in the software called MEASDEP (Measurement of depression in SPA consumers).
Assuntos
Transtornos Relacionados ao Uso de Substâncias , Biotecnologia , Software , DepressãoRESUMO
Histoplasmosis and pneumocystosis co-infections have been reported mainly in immunocompromised humans and in wild animals. The immunological response to each fungal infection has been described primarily using animal models; however, the host response to concomitant infection is unknown. The present work aimed to evaluate the pulmonary immunological response of patients with pneumonia caused either by Histoplasma capsulatum, Pneumocystis jirovecii, or their co-infection. We analyzed the pulmonary collectin and cytokine patterns of 131 bronchoalveolar lavage samples, which included HIV and non-HIV patients infected with H. capsulatum, P. jirovecii, or both fungi, as well as healthy volunteers and HIV patients without the studied fungal infections. Our results showed an increased production of the surfactant protein-A (SP-A) in non-HIV patients with H. capsulatum infection, contrasting with HIV patients (p < 0.05). Significant differences in median values of SP-A, IL-1ß, TNF-α, IFN-γ, IL-18, IL-17A, IL-33, IL-13, and CXCL8 were found among all the groups studied, suggesting that these cytokines play a role in the local inflammatory processes of histoplasmosis and pneumocystosis. Interestingly, non-HIV patients with co-infection and pneumocystosis alone showed lower levels of SP-A, IL-1ß, TNF-α, IFN-γ, IL-18, IL-17A, and IL-23 than histoplasmosis patients, suggesting an immunomodulatory ability of P. jirovecii over H. capsulatum response.
RESUMO
In the present study, we aimed to determine the antimicrobial resistance and molecular typing of Staphylococcus aureus recovered from transient and persistent intramammary infections and nares/muzzles in dairy cows. We investigated the antimicrobial resistance of 189 S. aureus strains using a broad antimicrobial susceptibility profile. Furthermore, 107 S. aureus isolates were strain-typed using staphylococcal protein-A (spa) typing. A large proportion of strains exhibited multidrug resistance to antimicrobials, including resistance to critically important antimicrobials, although no methicillin-resistant S. aureus strains were found. Our study did not strengthen the idea that extramammary niches (i.e., nares/muzzles) are an important source of S. aureus for bovine mastitis. A discrepancy in the antimicrobial resistance between S. aureus strains isolated from nares/muzzles and milk samples was observed. Furthermore, S. aureus isolates from transient and persistent intramammary infections (IMIs) did not differ by spa typing, suggesting that the persistence of bovine IMIs was determined by cow factors. Thus, the high level of multidrug-resistant S. aureus found in the two herds, considered together with the predominance of a well udder-adapted S. aureus strain, may contribute to our knowledge of the history of the high prevalence of mastitis caused by S. aureus, which is of great concern for animal and public health.
RESUMO
BACKGROUND: Staphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings. Methicillin-resistant Staphylococcus aureus (MRSA) has become a global public health issue. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones isolated in a tertiary-care hospital in Mexico. RESULTS: From April 2017 to April 2018, 191 Staphylococcus aureus isolates were collected. The frequency of MRSA was 26.7%; these strains exhibited resistance to clindamycin (84.3%), erythromycin (86.2%), levofloxacin (80.3%), and ciprofloxacin (86.3%). The majority of MRSA strains harbored the SCCmec type II (76.4%) and t895 (56.8%) and t9364 (11.7%) were the most common spa types in both hospital-associated MRSA and community-associated MRSA isolates. ST5-MRSA-II-t895 (New York /Japan clone) and ST1011-MRSA-II-t9364 (New York /Japan-Mexican Variant clone) were the most frequently identified clones. Furthermore, different lineages of Clonal Complexes 5 (85.4%) and 8 (8.3%) were predominantly identified in this study. CONCLUSION: Our study provides valuable information about the epidemiology of MRSA in a city of the central region of Mexico, and this is the first report on the association between t895 and t9364 spa types and ST5 and ST1011 lineages, respectively. These findings support the importance of permanent surveillance of MRSA aimed to detect the evolutionary changes of the endemic clones and the emergence of new strains.
Assuntos
Antibacterianos/farmacologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Staphylococcus aureus Resistente à Meticilina/classificação , Tipagem Molecular/métodos , Infecções Estafilocócicas/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , México/epidemiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Filogenia , Prevalência , Centros de Atenção Terciária , Adulto JovemRESUMO
Persistent methicillin-resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis (CF) patients has been associated with a more rapid decline in lung function, increased hospitalisation and mortality. The aim of this study was to evaluate the clonal relationships among 116 MRSA isolates from 12 chronically colonised CF pediatric patients over a 6-year period in a Rio de Janeiro CF specialist centre. Isolates were characterised by antimicrobial resistance, SCCmec type, presence of Panton-Valentine Leukocidin (PVL) genes and grouped according to DNA macrorestriction profile by pulsed-field gel electrophoresis (PFGE) and spa gene type. High resistance rates were detected for erythromycin (78%) and ciprofloxacin (50%) and SCCmec IV was the most common type (72.4%). Only 8.6% of isolates were PVL positive. High genetic diversity was evident by PFGE (39 pulsotypes) and of nine that were identified spa types, t002 (53.1%) and t539 (14.8%) were the most prevalent. We conclude that the observed homogeneity of spa types within patients over the study period demonstrates the persistence of such strain lineages throughout the course of chronic lung infection.
Assuntos
Fibrose Cística/microbiologia , Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Brasil/epidemiologia , Portador Sadio , Criança , Humanos , Resistência a MeticilinaRESUMO
BACKGROUND: Early initiation of breastfeeding (within an hour of birth) has benefits for newborn health and survival. Optimal breastfeeding supports growth, health, and development. Health facilities provide essential pregnancy, maternal, and newborn care and offer support for early breastfeeding. We examined the relationship between the breastfeeding-related health service environment during antenatal care (ANC) and early initiation of breastfeeding. METHODS: Using data from recent Service Provision Assessment (SPA) surveys in Haiti and Malawi, we defined three indicators of the health service environment: availability of facilities with ANC services reporting routine breastfeeding counseling; provider training on breastfeeding; and breastfeeding counseling during ANC. We linked SPA data geographically to Demographic and Health Surveys (DHS) data from Haiti and Malawi. Multilevel, multivariable logistic regressions examined associations between the health service environment and early initiation of breastfeeding, controlling for women's background characteristics, with separate analyses for urban and rural residence. RESULTS: Over 95% of facilities in Haiti and Malawi reported routinely providing breastfeeding counseling during ANC. Only 40% of both urban and rural providers in Malawi and 29 and 26% of providers at urban and rural facilities in Haiti (respectively) received recent training in counseling on breastfeeding. Further, only 4-10% of clients received counseling. Breastfeeding counseling was generally more common among clients who attended ANC with a provider who had received recent training. After linking SPA and DHS data, our analysis showed that having more providers recently trained on breastfeeding was significantly associated with increased odds of early breastfeeding among women in urban areas of Haiti and Malawi. Additionally, women in urban areas of Malawi lived near facilities with more counseling during ANC were more likely to begin breastfeeding within an hour of birth compared with women in areas with less counseling. CONCLUSIONS: Our study identified gaps in the health system's capacity to implement the recommended global guidelines in support of optimal breastfeeding practices. While breastfeeding counseling during ANC can promote early breastfeeding, counseling was not common. The study provides evidence that provider training could help improve counseling and support for early initiation of breastfeeding.
Assuntos
Aleitamento Materno , Aconselhamento/métodos , Instalações de Saúde , Saúde do Lactente , Cuidado Pré-Natal/métodos , Adolescente , Adulto , Análise por Conglomerados , Feminino , Haiti , Acessibilidade aos Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Recém-Nascido , Malaui , Pessoa de Meia-Idade , Gravidez , Adulto JovemRESUMO
Resumen Introducción: Staphylococcus aureus es uno de los patógenos con mayor prevalencia en el mundo, asociado a una alta tasa de mortalidad y un rápido desarrollo de resistencia a los antimicrobianos. A pesar de su patogenicidad, su seguimiento epidemiológico en México es escaso. Objetivo: Analizar la epidemiología molecular local y determinar el origen clonal de cepas resistentes a meticilina (RM) aisladas de pacientes internados en el Hospital Central "Dr. Ignacio Morones Prieto". Métodos: Se llevó a cabo un estudio prospectivo de corte transversal, de julio a diciembre de 2016. La caracterización de las cepas se realizó mediante genotipificación Spa, la determinación por RPC punto final de la frecuencia de genes de virulencia específicos y su antibiograma. Resultados: A partir de estos datos, se obtuvo que la prevalencia de S. aureus RM fue de 25,7%, destacando la presencia del tipo Spa t895 en 76% de las cepas resistentes y un patrón similar de susceptibilidad a antimicrobianos. Conclusión: Los resultados de este estudio indican que la prevalencia regional de SARM no se ha modificado en los últimos 10 años y proporcionan información valiosa del origen clonal y los factores de virulencia de las cepas de S. aureus aisladas en la región.
Abstract Background: Staphylococcus aureus is one of most prevalent pathogens in the world associated with a high mortality rate and a rapid development of resistance to antibiotics. Despite its pathogenicity, epidemiological monitoring in Mexico is scarce. Aim: To analyze the local molecular epidemiology and determine the clonal origin of methicillin-resistant (MR) strains isolated from patients admitted to Hospital "Dr. Ignacio Morones Prieto". Methods: A cross-sectional prospective study was carried out from July to December 2016. The characterization of the strains was carried out by Spa genotyping, frequency of specific virulence genes by PCR and antibiogram. Results: The prevalence of MRSA was 25.7%, highlighting the presence of the Spa type t895 in 76% of the resistant strains and a similar pattern of susceptibility to antibiotics. Conclusion: The results of this study indicate that the regional prevalence of MRSA has not changed in the last 10 years and provide valuable information on the clonal origin and the virulence factors of the strains of S. aureus isolated in the region.