Pre-operative Colonization by Staphylococcus aureus and Cephalosporin Non-susceptible Bacteria in Patients with Proximal Femoral Fractures / Colonização pré-operatória por Staphylococcus aureus e as bactérias não suscetíveis à cefalosporina, em pacientes com fratura proximal do fêmur

Abstract Objective To estimate the frequency of Staphylococcus aureus and cephalosporin nonsusceptible bacteria colonization in patients with proximal femoral fracture during preoperative hospitalization. Methods Prevalence and incidence assessment in 63 hospitalized patients over 1 year. The median time of pretreatment hospitalization was 12 days. Samples were collected from the nostrils, groin skin and anal mucosa during the pretreatment hospitalization and were tested by the disc-diffusion technique. Results The hospital colonization incidence and the prevalence of positive results were 14.3 and 44.4% for S. aureus; 3.2 and 6.4% for meticillin-resistant S. aureus; 28.6 and 85.7% for meticillin-resistant coagulase-negative Staphylococcus; 28.6 and 61.9% for cefazolin nonsusceptible Enterobacteriaceae (KFNSE); and 20.6 and 28.6% for cefuroxime nonsusceptible Enterobacteriaceae (CXNSE). In addition, factors such as to the duration of the pretreatment hospitalization period, being non-walker before fracture, antimicrobial use, American Society of Anesthesiologists (ASA) 4 surgical risk, and previous hospitalization, were related to an increase in the incidence of hospital acquisition and prevalence of colonization by the evaluated strains. The prevalence of colonization by KFNSE was three times higher than by CXNSE on admission, and twice as high at the time of fracture treatment. Conclusion There was a high incidence of hospital colonization and prevalence of colonization by all strains studied, which may guide the indication of prophylactic measures for infection.

Resumo Objetivo Estimar a frequência da colonização por Staphylococcus aureus e as bactérias não suscetíveis à cefalosporina, em pacientes com fratura proximal do fêmur durante a internação pré-operatória. Métodos Avaliação da prevalência e incidência em 63 pacientes hospitalizados ao longo de um ano. O tempo médio de internação pré-tratamento foi de 12 dias. As amostras foram coletadas das narinas, pele da virilha e mucosa anal, durante a internação prévia ao tratamento e testadas pela técnica de disco-difusão. Resultados A incidência da colonização hospitalar e a prevalência de resultados positivos foram de 14,3% e 44,4% para Staphylococcus aureus; 3,2% e 6,4% para S. aureus resistente à meticilina; 28,6% e 85,7% para Staphylococcus coagulase-negativo resistente à meticilina; 28,6% e 61,9% para Enterobacteriaceae não suscetível à cefazolina (KFNSE); e 20,6% e 28,6% para Enterobacteriaceae não suscetível à cefuroxima (CXNSE). Além da duração do período de internação pré-tratamento, os pacientes não deambularam previamente à ocorrência da fratura e nem fizeram uso de antimicrobiano. Além disso, a duração do período de internação pré-tratamento cirúrgico, ser não-deambulador antes da fratura, uso de antimicrobianos, risco cirúrgico IV pela American Society of Anesthesiologists (ASA) e internação anterior, estiveram relacionados a um aumento na incidência de aquisição hospitalar e prevalência de colonização pelas cepas avaliadas. A prevalência de colonização pela KFNSE foi três vezes maior do que pela CXNSE na admissão e duas vezes maior no momento do tratamento da fratura. Conclusão Observou-se uma alta incidência da colonização hospitalar e prevalência da colonização por todas as cepas estudadas, o que pode orientar a indicação de medidas profiláticas contra a infecção.

High-resolution computed tomography findings in young infants with cystic fibrosis detected by newborn screening

OBJECTIVE: High-resolution computed tomography (HRCT) allows the early detection of pathological changes in the lung structure, and reproducible scoring systems can be used to quantify chest computed tomography (CT) findings in patients with cystic fibrosis (CF). The aim of the study was to describe early HRCT findings according to a validated scoring system in infants with CF diagnosed by newborn screening (NBS). METHODS: This cross-sectional study included infants with CF diagnosed by NBS who were born between January 2013 and January 2017 and who underwent HRCT scanning within the first year after diagnosis when they were clinically stable. The CT scans were evaluated using the modified Bhalla score. RESULTS: Thirty-two subjects underwent HRCT scanning. The mean total-modified Bhalla score was 3.6±2.1, and 93.8% of the scans were abnormal. Pseudomonas aeruginosa airway colonization was associated with increased modified Bhalla score values. Bronchial wall thickening was the most common feature (90.6%), followed by bronchial collapse/consolidation (59.4%), mosaic attenuation/perfusion (50%), bronchiectasis (37.5%) and mucus plugging (15.6%). Bronchial wall thickening was diffuse in most of the patients. CONCLUSION: A substantial proportion of infants diagnosed with CF after detection by NBS already showed evidence of lung disease. P. aeruginosa colonization was associated with increased Bhalla scores, highlighting the importance of this CF pathogen in early structural lung disease. The presence of bronchial wall thickening at such a young age may reflect the presence of airway inflammatory processes. The detection and quantification of structural abnormalities with the modified Bhalla score may aid in the identification of lung disease before it is clinically apparent.

A practical molecular identification of nonfermenting Gram-negative bacteria from cystic fibrosis

Abstract Identification of nonfermenting Gram-negative bacteria (NFGNB) of cystic fibrosis patients is hard and misidentification could affect clinical outcome. This study aimed to propose a scheme using polymerase chain reaction to identify NFGNB. This scheme leads to reliable identification within 3 days in an economically viable manner when compared to other methods.

Methicillin-resistant Staphylococcus aureus in cystic fibrosis patients: do we need to care? A cohort study

ABSTRACT CONTEXT AND OBJECTIVE: The prevalence of a variety of potentially pathogenic microorganisms in cystic fibrosis patients, such as methicillin-resistant Staphylococcus aureus (MRSA), has increased over the past decade. Given the increasing prevalence of MRSA and the few data available in the literature, better understanding of the clinical repercussions of colonization by this bacterium in cystic fibrosis patients becomes essential. This study aimed to evaluate the repercussions of chronic colonization by MRSA in cystic fibrosis patients. DESIGN AND SETTING: Retrospective cohort study from January 2004 to December 2013 in a cystic fibrosis reference center. METHODS: Each patient with cystic fibrosis was evaluated for nutritional status (body mass index, BMI, and BMI percentile), pulmonary function and tomographic abnormalities (modified Bhalla scores) at the time of chronic colonization by MRSA or methicillin-susceptible Staphylococcus aureus (MSSA) and throughout the study period. RESULTS: Twenty pairs of patients were included. There were no significant differences between the groups regarding nutritional characteristics. Spirometric data showed a trend towards greater obstruction of the airways in patients with MRSA. Patients with MRSA presented greater structural damage to their lungs, demonstrated not only by the total Bhalla score but also by its parameters individually. CONCLUSIONS: Patients colonized by MRSA presented greater functional and structural respiratory impairment at the time of chronic colonization. Disease progression was also faster in patients chronically colonized by MRSA than in those with MSSA. This was shown through comparisons that avoided possible confounding variables.

Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from blood in Rio de Janeiro displaying susceptibility profiles to non-ß-lactam antibiotics

Abstract The distinction between healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections has become increasingly blurred. We assessed the molecular characterization and antimicrobial resistance profile for MRSA isolates from blood. Most of all (81.9%) isolates are related to known HA-MRSA and CA-MRSA epidemic lineages, such as, USA300, USA400, USA600, USA800 and USA1100. This is the first multicenter study in Rio de Janeiro.

Genomic information on multidrug-resistant livestock-associated methicillin-resistant Staphylococcus aureus ST398 isolated from a Brazilian patient with cystic fibrosis

Alarmingly, the isolation of methicillin-resistant Staphylococcus aureus (MRSA) has been increasing among patients with cystic fibrosis (CF). During a previous molecular characterisation of MRSA isolates obtained from patients with CF from Rio de Janeiro, Brazil, one isolate was identified as the ST398 clone, a livestock-associated (LA) MRSA. In this study, we report the draft genome sequence of an LA-MRSA ST398 clone isolated from a patient with CF.

Draft genome sequences of four Achromobacter ruhlandii strains isolated from cystic fibrosis patients

Achromobacter species are being increasingly isolated from the respiratory tract of cystic fibrosis patients. Recent reports indicate that Achromobacter ruhlandii is a potential human pathogen in cystic fibrosis-related infections. Here we report the draft genome of four A. ruhlandii strains isolated from cystic fibrosis patients in Brazil. This report describes A. ruhlandii as a potential opportunistic pathogen in cystic fibrosis and provides a framework to for additional enquires into potential virulence factors and resistance mechanisms within this species.

Draft genome sequence of Acinetobacter pittii ST643 shared by cystic fibrosis patients

Acinetobacter pittii has emerged as an important hospital pathogen that is associated with outbreaks and drug resistance. In cystic fibrosis (CF) patients, the detection of Acinetobacter spp. is rare; however, we isolated the A. pittii sequence type ST643 in several Brazilian CF patients treated in the same centre. The current study describes the draft genome of A. pittii ST643.

Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15

OBJECTIVE: The present studywas designed to evaluate the molecular epidemiology of CTX-M producing Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolated from bloodstream infections at tertiary care hospitals in the State of Rio de Janeiro, Brazil. MATERIAL AND METHODS: A total of 231 nonduplicate Enterobacteriaceae were isolated from five Brazilian hospitals between September 2007 and September 2008. The antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical Laboratory Standard Institute. Isolates showing resistance to third-generation cephalosporins were screened for ESBL activity by the double-disk synergy test. The presence of blaCTX-M , blaCTX-M-15 and blaKPC genes was determined by Polymerase Chain Reaction (PCR) amplification andDNA sequencing. The molecular typing of CTX-M producing isolateswas performed by pulsed-field gel electrophoresis (PFGE). RESULTS AND DISCUSSION: Ninety-three isolates were screened as ESBL positive and 85 (91%) were found to carry CTX-M-type, as follows: K. pneumoniae 59 (49%), E. cloacae 15 (42%), and E. coli 11 (15%). Ten isolates resistant for carbapenems in K. pneumoniae were blaKPC-2 gene positive. Among CTX-M type isolates, CTX-M-15 was predominant in more than 50% of isolates for K. pneumoniae, E. coli, and E. cloacae. PFGE analysis of CTX-M producing isolates showed the predominance of CTX-M-15 in 10 of 24 pulsotypes in K. pneumoniae, 6 of 13 in E. cloacae and 3 of 6 in E. coli. CTX-M-15 was also predominant among KPC producing isolates. In conclusion, this study showed that CTX-M-15 was circulating in Rio de Janeiro state in 2007-2008. This data reinforce the need for continuing surveillance because this scenario may have changed over the years.

Escore tomográfico em pacientes com fibrose cística colonizados por Pseudomonas aeruginosa ou Staphylococcus aureus / High-resolution computed tomography scores in cystic fibrosis patients colonized with Pseudomonas aeruginosa or Staphylococcus aureus

OBJETIVO: Comparar achados de TCAR em pacientes com fibrose cística (FC) colonizados cronicamente por Pseudomonas aeruginosa ou Staphylococcus aureus, empregando o escore de Bhalla modificado, e avaliar as confiabilidades intraobservador e interobservador do método. MÉTODOS: Estudo transversal retrospectivo incluindo 41 pacientes portadores de FC, 26 dos quais colonizados cronicamente por P. aeruginosa (grupo Pa) e 15 por S. aureus (grupo Sa). Dois radiologistas analisaram independentemente em duas ocasiões, as imagens de TCAR desses pacientes e aplicaram o escore de Bhalla modificado. As confiabilidades intra e interobservador foram avaliadas segundo o coeficiente de correlação intraclasse (CCI). RESULTADOS: Houve boa concordância intraobservador e interobservador (CCI > 0,8). Os resultados dos escores do grupo Pa foram mais elevados que os do grupo Sa para o observador 1 (média de 13,50 ± 3,90 e mediana de 13,5 vs. média de 5,0 ± 5,28 e mediana de 3,0) e para o observador 2 (média de 11,96 ± 5,07 e mediana de 12,0 vs. média de 5,07 ± 5,65 e mediana de 5,0). Alterações tomográficas, como bronquiectasias, espessamento das paredes brônquicas, formação de tampões mucosos, comprometimento de gerações de divisões brônquicas e padrão de atenuação em mosaico, foram mais prevalentes no grupo colonizado por P. aeruginosa. CONCLUSÕES: O escore de Bhalla modificado se mostrou reprodutível e confiável para a avaliação de TCAR e permitiu a diferenciação entre os pacientes incluídos nos dois grupos. Escores mais altos no grupo Pa evidenciaram maior comprometimento estrutural pulmonar nesse grupo.

OBJECTIVE: To compare HRCT findings in cystic fibrosis (CF) patients chronically colonized with Pseudomonas aeruginosa or Staphylococcus aureus using the modified Bhalla CT scoring system, as well as to evaluate intraobserver and interobserver reliability of the method. METHODS: This was a retrospective cross-sectional study involving 41 CF patients, 26 of whom were chronically colonized with P. aeruginosa (Pa group), and 15 of whom were colonized with S. aureus (Sa group).Two independent radiologists evaluated the HRCT scans of these patients using the modified Bhalla CT scoring system in two different moments. Intraobserver and interobserver reliability was calculated using the intraclass correlation coefficient (ICC). RESULTS: There was good intraobserver and interobserver agreement (ICC > 0.8). Scores were higher in the Pa group than in the Sa group for observer 1 (mean, 13.50 ± 3.90; median, 13.5 vs. mean, 5.00 ± 5.28; median, 3.0) and for observer 2 (mean, 11.96 ± 5.07; median, 12.0 vs. mean, 5.07 ± 5.65; median, 5.0). In addition, HRCT findings, such as bronchiectasis, bronchial wall thickening, mucus plugging, generation of bronchial divisions, and mosaic attenuation/perfusion pattern, were more prevalent in the Pa group. CONCLUSIONS: The modified Bhalla CT scoring system was reproducible and reliable for use in the evaluation of HRCT scans, allowing distinctions to be drawn between the two groups of patients under study. The higher scores in the Pa group provided evidence of greater pulmonary impairment in that group.

Bacteriologia da fibrose cística / Cystic fibrosis bacteriology

O exame bacteriológico é um dos principais parâmetros que auxiliam o diagnóstico e manuseio da infecção respiratória dos pacientes com Fibrose Cística (FC). Os microrganismos que colonizam e infectam o paciente fibrocístico determinam o tratamento, a qualidade de vida, as perspectivas para o transplante e a sua sobrevida global. A identificação precisa de patógenos respiratórios é essencial para o tratamento da infecção, seja como guia para o uso adequado de antibióticos por longos períodos para os pacientes com infecção bacteriana crônica ou para a aplicação adequada de medidas de controle de infecção. Embora exista um espectro limitado de patógenos respiratórios classicamente associados à doença respiratóriana FC, um número crescente de microrganismos vem sendo reconhecido como potenciais agentes patogênicos. O espectro de patógenos em FC varia com a idade do paciente, mas, de uma forma geral, é bem estabelecido na literatura que existem quatro bactérias “clássicas”: Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa e o complexo B. cepacia (CBC)...

The bacteriological culture is one of the main parameters that support the diagnosis and management of the respiratoryinfection in patients with cystic fibrosis (CF). The microorganisms that colonize and infect CF patients determine the treatment,quality of life, the lung transplant possibility and their overall survival. The accurate identification of respiratory pathogensis essential for the treatment of infection, either to guide the appropriate use of antibiotics for long periods to patientswith chronic bacterial infection or to the proper implementation of infection control measures. Although there is a limitedspectrum of respiratory pathogens classically associated with the respiratory disease in CF, an increasing number of microorganismshas been recognized as potential pathogens. The spectrum of pathogens in CF varies with the patients age but,in general, it is well established in the literature that there are four "classic" pathogens: Staphylococcus aureus, Haemophilusinfluenzae, Pseudomonas aeruginosa and the B. cepacia complex (Bcc)...

Comparison of the worldwide transmissible Pseudomonas aeruginosa with isolates from brazilian cystic fibrosis patients

Cross-infection with Pseudomonas aeruginosa among cystic fibrosis (CF) patients is a rare occurrence. However, the emergence of transmissible strains has been reported between unrelated individuals. We analyzed the genetic relationship among P. aeruginosa isolates from Brazilian CF patients and transmissible clones which are worldwide spread. The data does not indicate the presence of closely related variant clones.

Mycobacterium massiliense BRA100 strain recovered from postsurgical infections: resistance to high concentrations of glutaraldehyde and alternative solutions for high level disinfection / Mycobacterium massiliense clone BRA100 associado a infecções pós-cirúrgicas: resistência a altas concentrações de glutaraldeído e produtos alternativos para desinfecção de alto nível

PURPOSE: To evaluate the minimum inhibitory concentration (MIC) of GTA against these microorganisms and alternative disinfectants for high-level disinfection (HLD). METHODS: Reference mycobacteria and clinical M. massiliense strains were included in this study. Active cultures were submitted to susceptibility qualitative tests with GTA dilutions (ranging from 1.5 percent to 8 percent), and commercial orthophthaldehyde (OPA) and peracetic acid (PA) - based solutions, during the period of exposure as recommended by National Agency of Sanitary Surveillance for HLD. RESULTS: All reference and M. massiliense non-BRA100 strains, recovered from sputum, were susceptible to any GTA concentration, OPA and PA solutions. M. massiliense BRA100 strains presented MIC of 8 percent GTA and were susceptible to OPA and PA. CONCLUSION: M. massiliense BRA100 strain is resistant to high GTA concentrations (up to 7 percent), which proves that this product is non-effective against specific rapidly growing mycobacteria and should be substituted by OPA or PA - based solutions for HLD.

OBJETIVO: Avaliar a concentração mínima inibitória (CMI) de GTA frente a M. massiliense e a susceptibilidade a produtos alternativos para desinfecção de alto nível (DAN). MÉTODOS: Cepas de M. massiliense de origem clínica e de referência foram incluídas no estudo. As culturas ativadas foram submetidas a testes qualitativos com diluições de GTA (de 1,5 por cento a 8 por cento) e com soluções comerciais de ortoftaldeído (OPA) ou ácido peracético (PA), utilizando os tempos de exposição recomendados pela Agência Nacional de Vigilância Sanitária para DAN. RESULTADOS: Todas as cepas de referência e M. massiliense não-BRA100, obtida de escarro, foram susceptíveis às concentrações de GTA, e soluções de OPA e PA. As cepas de M. massiliense BRA100 apresentaram CMI de 8 por cento para GTA e foram susceptíveis a OPA e PA. CONCLUSÃO: M. massiliense BRA100 é resistente a altas concentrações de GTA (até 7 por cento), o que demonstra que esse composto não é eficaz, e deve ser substituído por OPA ou PA nos processos de DAN.

Eficácia do teste de acidez graxa na avaliação da qualidade do café Arábica (Coffea arabica L. ) submetido a diferente períodos e temperaturas de secagem / Efficiency of fatty acidity test on the evaluation of the quality of arabic coffee (C. A) submitted to different dry periods and temperatures

Conduziu-se este trabalho, com o objetivo de avaliar o efeito de diferentes temperaturas e períodos de pré-secagem em terreiro na composição química e qualidade da bebida do café ½cereja descascada½. Foram usadas temperaturas na massa de 40°C, 50°C e 60°C com fluxo de ar de 20m³ m-1 m2. Após a secagem, foram retirados os defeitos visíveis das amostras de café. Para avaliação da qualidade, foram realizadas as seguintes análises: análise sensorial, açúcares totais, açúcares redutores e não redutores, condutividade elétrica, lixiviação de potássio e acidez graxa. Verificou-se que menores temperaturas de secagem e um maior período de pré-secagem contribuíram para obtenção de uma bebida de melhor qualidade. Os açúcares não redutores diminuíram com o aumento da temperatura e com o aumento da pré-secagem, enquanto que elevaram-se os valores de açúcares redutores. A condutividade elétrica, lixiviação de potássio e acidez graxa aumentaram significativamente com a elevação da temperatura e a lixiviação de potássio reduziu com o aumento do período de pré-secagem. O teste de acidez graxa mostrou-se sensível a temperatura de secagem.

This work had the aim of evaluating the effect of different temperatures and pre-drying periods on yard on the chemical composition and quality of the beverage of peeled cherry coffee. Temperatures of 40°C, 50°C and 60°C were used in the mass with air flow of 20m³m-1m². After drying, the visible defects of the coffee samples were removed. For evaluation of quality, the following analyses were performed: sensorial analyses, total sugars, reducing sugars and non- reducing sugars, electrical conductivity, potassium leaching and fatty acidity. One verified that lower drying temperature and greater pre-drying period had contributed for the attainment of a better quality drink. The increase of temperature and pre-drying periods decreased the non-reducing sugars content while the values of reducing sugars increased. The electrical conductivity, potassium leaching and fatty acidity increased significantly with the rise of temperature and potassium leaching reduced with increasing of the pre-drying period. The fatty acidity test showed to be sensible to the drying temperature.

Infecção pulmonar por Pseudomonas aeruginosa na fibrose cística: diagnótico sorológico e conduta / Pseudomonas aeruginosa pulmonary infection in cystic fibrosis: serologic diagnosis and therapeutic / Infección pulmonar por Pseudomonas aeruginosa en la fibrosis cística: diagnóstico serológico y conducta

Objetivo: avaliar o diagnóstico da infecção e colonização pulmonar por Pseudomonas aeruginosa (Pa), através da detecção de anticorpos séricos específicos em pacientes fibrocísticos.Fontes pesquisadas: foi revisada a base de dados Medline, no período de 1986 a 2007, com os descritores fibrose cística e pseudomonas. Síntese dos dados: as alterações no transporte de íons nas células epiteliais levam à obstruçãocrônica das vias aéreas, com infecções secundárias. A Pa mucóide é o principal agente que aumenta a morbidade e a mortalidade nos pacientes fibrocísticos. A erradicação da bactéria é possível com antibioticoterapia precoce, queaumenta a sobrevida dos pacientes. A cultura de secreções respiratórias apresenta limitação como método diagnóstico, pela dificuldade decoleta da amostra. Parece promissora a detecção de anticorpos específicos no soro para Pa, que, em muitos casos, precede o isolamento bacterianoem cultura. O método mais utilizado é ode ELISA, com pesquisa de IgG ou IgG, IgM, e IgA. A positividade da sorologia não discrimina entre colonização e infecção pulmonar e, a condutaantibiótica não é uniforme nessa situação. Conclusões: a pesquisa sorológica de anticorpos para Pa pode ser útil no tratamento do pacientefibrocístico. Complementa a avaliação clínica, permite reavaliações não invasivas durante a evolução e possibilita a antibioticoterapia precoceem parte dos casos.

Objective: to evaluate the diagnosis of lung infection and colonization by Pseudomonas aeruginosa (Pa) through the detection of specific seric antibodies in fibrocystic patients. Data sources: the Medline database, was searched in the period 1986 to 2007, with the keywords cystic fibrosisand pseudomonas. Data synthesis: the epithelium cells disturb in ion transport cause a chronic airways obstruction, with secondary infections. Themucoid Pa is the main agent that increases morbidity and mortality in fibrocystic patients. The Objective: to evaluate the diagnosis of lung infectionand colonization by Pseudomonas aeruginosa (Pa) through the detection of specific seric antibodies in fibrocystic patients. Data sources: the Medline database, was searched in the period1986 to 2007, with the keywords cystic fibrosis and pseudomonas. Data synthesis: the epithelium cells disturb in ion transport cause a chronic airwaysobstruction, with secondary infections. The mucoid Pa is the main agent that increases morbidity and mortality in fibrocystic patients. The bacteria eradication is possible with early antibiotic therapy, which increases patients’ survival period. Respiratory secretions culture is limited as a diagnostic method, due to the difficulty incollecting samples. The detection of specific antibodies in serum for Pa, which in many cases precedesthe bacteria isolation in culture, seems to be promising. The most used method is the ELISA, with survey of IgG or IgG, IgM, and IgA. The serological positive result does not make a distinctionbetween lung colonization and infection, and the antibiotic procedure is not uniform in such situation. Conclusions: the serological antibodies survey for Pa can be useful in the treatment of fibrocystic patients. It completes the clinical evaluation, allowing non invasive reevaluations during the evolution as well as an early antibiotictherapy in some cases.

Objetivo: evaluar el diagnostico de la infección y colonización pulmonar por Pseudomonas aeruginosa (Pa) en pacientes con fibrosis cística, mediante la detección de anticuerpos sericosespecíficos. Fuente de los datos: fueron seleccionados los artículos en la base de datos Medline publicados entre 1986 y 2007, con las palabras clave fibrose cistica y pseudomonas. Síntesis delos datos: las alteraciones en el transporte de los iones de las células epiteliales llevan a la obstruccióncrónica de las vias aereas, con infecciones secundarias. La Pa mucoide es el principal agente que aumenta la morbidad y mortalidad de los pacientes fibrocisticos. La eliminación de labacteria es posible con antibióticoterapia precoz, qui determina mayor sobrevida de los pacientes.Lo cultivo de secreciones respiratorias presenta limitación como método diagnóstico, determinada por la dificultad de recolectar la muestra. Ladetección de anticuerpos específicos en el suero para Pa en muchos casos precede el islamiento bacteriano en cultura. Lo metodo más utilizadoes el de ELISA, con pesquisa de IgG, o IgG IgM y IgA. El resultado positivo non discrimina entre la ocurrencia de colonización o infección pulmonary, por lo tanto, a conducta non es uniforme en esta situación. Conclusiones: la pesquisa serologicade anticuerpos para Pa puede ser util en el tratamiento del paciente con fibrose cística. Complementa la evaluación clinica, permite reevaluaciones non invasivas, y posibilita la antibioticoterapia precoz en parte dos casos.

Do DNA extraction methods and Taq polimerase quality improve the double repetitive element (DRE) PCR typing method for Mycobacterium tuberculosis strains?

Double repetitive element (DRE) PCR amplification is a simple Mycobacterium tuberculosis typing method, however amplification failure or poor resolution of bands commit its efficacy. In order to verify if whether or not these features could be minimized by improving DNA extraction procedures or Taq polymerise quality, DRE-PCR was performed on 24 M. tuberculosis DNA samples extracted by heat-shock, mechanical and enzymatic methods applying conventional and hot start Taq pol. We demonstrated that when dealing with the Mycobacterium tuberculosis DRE-PCR typing method, Taq pol of better quality might be more important to improve amplification than the DNA extraction method.

Amplificação de duplo elemento repetido (DRE) por PCR é um método simples para tipagem de Mycobacterium tuberculosis, entretanto falha ou a baixa resolução das bandas na amplificação compromete a eficiência do método. Com o objetivo de verificar se estes problemas podem ou não ser minimizados pela utilização de diferentes procedimentos de extração de DNA ou de qualidades de Taq polimerase, DRE-PCR foi ensaiado em 24 amostras de DNA de M. tuberculosis extraídos pelos métodos de choque-térmico, - mecânico e enzimático utilizando Taq polimerase convencional e hot start Taq pol. Foi demonstrado que a qualidade da Taq pol utilizada talvez seja mais importante para uma melhor amplificação que o método de extração de DNA empregado.

Composição química de grãos crus de cultivares de Coffea arabica L. suscetíveis e resistentes à Hemileia vastatrix Berg et Br / Chemical composition of raw grains of cultivars the Coffea arabica L. susceptible and resistant to Hemileia vastatrix Berg et Br

Com este trabalho, buscou-se caracterizar a composição química e físico-química dos grãos crus de 16 cultivares de café Coffea arabica L., com o intuito de avaliar novos materiais desenvolvidos com resistência à ferrugem (Hemileia vastatrix Berg. et Br.) em comparação aos tradicionais. Desta forma, frutos provenientes do ensaio de melhoramento genético do MAPA/PROCAFÉ, localizado na Fazenda Experimental de Varginha em MG foram colhidos e transportados imediatamente para o Pólo de Tecnologia em Pós-Colheita do Café da UFLA, onde foram lavados, descascados e secados em terreiro de concreto. Após o beneficiamento, os grãos foram acondicionados em latas de alumínio e armazenados a 15°C. Os frutos avaliados correspondiam às cultivares 'Acaiá', 'Acauã', 'Bourbon Amarelo', 'Canário', 'Catuaí Amarelo', 'Catuaí Vermelho', 'Catucaí Amarelo', 'Catucaí Vermelho', 'Icatu Amarelo', 'Icatu Vermelho' 'Mundo Novo', 'Palma', 'Rubi', 'Sabiá 398', 'Siriema' e 'Topázio', do ano safra 2002. Os grãos crus foram moídos em moinho de bola com nitrogênio líquido. As análises realizadas foram: açúcares totais, redutores e não-redutores, extrato etéreo, polifenóis e cafeína. Diferenças foram consideradas significativas e as cultivares apresentaram variações para os teores de todos os compostos avaliados, indicando haver uma influência do genótipo sobre esses constituintes.

The aim of this article is characterizing the chemical and physical chemical composition of raw grains and analyzing new resistent material to rust (Hemilea vastatrix Berg. et Br.) compared to the traditional ones. The fruits were originated from breeding experiments from MAPA/PROCAFÉ, localized in the experimental farm of Varginha , Minas Gerais state. They were harvested and taken to the Postharvest Technology Center of Universidade Federal de Lavras, where they were washed, peeled and dried in a concrete ground. After cleaning, the grains were packed in aluminun box and stored at 15°C. The utilized fruits cultivars were: 'Acaiá', 'Acauã', 'Bourbon Amarelo', 'Canário', 'Catuaí Amarelo', 'Catuaí Vermelho', 'Catucaí Amarelo', 'Catucaí Vermelho', 'Icatu Amarelo', 'Icatu Vermelho', 'Mundo Novo', 'Palma', 'Rubi', 'Sabiá 398', 'Siriema' e 'Topázio', from 2002 harvest. The raw beans were tritured in a ball mills with liquid N2 . The accomplished analyses were: total sugars, reducers and non reducers, ethereal extract, polyphenols and caffeine. Differences were considered as significants and the cultivars showed variations related to tenors of all the evalued compositions, indicating to have influences of genotypo on these constituents.

Chronic infection of cystic fibrosis patient airways by a single clone of Burkholderia cepacia: replacement of non-mucoid to mucoid morphotype

O presente trabalho descreve a emergência de cepas mucoides do complexo B. cepacia em um paciente com Fibrose Cística dentro de um acompanhamento bacteriológico prospectivo de nove anos. Os dados clínicos sugerem a associação entre o isolamento do morfotipo mucoide e a deterioração clínica do paciente. Apesar da variação fenotípica, os testes moleculares mostraram que o paciente manteve-se cronicamente infectado por cepas de mesma origem clonal.

Nondiphtherial Corynebacterium species isolated from clinical specimens of patients in a university hospital, Rio de Janeiro, Brazil

Over a five-year period, 163 strains of Corynebacterium sp. were recovered from different clinical specimens of patients from a Brazilian University hospital. Genitourinary tract and intravenous sites specimens were the most frequent sources of corynebacteria (46.62 percent). Corynebacterium amycolatum (29.55 percent), Corynebacterium minutissimum (20.45 percent) and Corynebacterium pseudodiphtheriticum (13.63 percent) were the predominant species found in genitourinary tract. C. minutissimum (24.14 percent) and Corynebacterium propinquum (17.24 percent) in surgical and/or other skin wounds and abscesses; Corynebacterium xerosis (25 percent), C. amycolatum (21.87 percent) and C. pseudodiphtheriticum (18.75 percent) in intravenous sites; C. pseudodiphtheriticum (33.33 percent) and C. propinquum (33.33 percent) in lower respiratory tract. Microorganisms were all susceptible to vancomycin and most of the species was predominantly resistant to beta-lactams. Antimicrobial susceptibility patterns of corynebacteria were not predictable. Multiple antibiotic resistance observed in C. jeikeium was also found among C. xerosis, C. minutissimum, C. afermentans, C. propinquum, C. amycolatum and C. pseudodiphtheriticum strains. Data suggest awareness of clinicians and microbiologists to nosocomial infections especially due to antimicrobial multiresistant strains of Corynebacterium sp.

Chronic infection of cystic fibrosis patient airways by a single clone of Burkholderia cepacia: replacement of non-mucoid to mucoid morphotype

Mucoid Burkholderia cepacia morphotype emerged within a nine year follow-up of a cystic fibrosis patient. Clinical data suggested a linkage between the mucoid phenotype isolation and the deterioration of the patient's condition. Despite of the phenotypic variation, molecular typing showed that the patient was chronically infected with B. cepacia complex isolates belonging to a same genetic clone.

O presente trabalho descreve a emergência de cepas mucoides do complexo B. cepacia em um paciente com Fibrose Cística dentro de um acompanhamento bacteriológico prospectivo de nove anos. Os dados clínicos sugerem a associação entre o isolamento do morfotipo mucoide e a deterioração clínica do paciente. Apesar da variação fenotípica, os testes moleculares mostraram que o paciente manteve-se cronicamente infectado por cepas de mesma origem clonal.