Relevancia clínica, diversidad y variabilidad genética de distintas especies del género Mycobacterium / Clinical Relevance, Diversity and Genetic Variability of Different Species within the Genus Mycobacterium

Introducción: El término micobacterias no tuberculosas (MNT) incluye distintas especies ambientales capaces de enfermar humanosy/o animales incluso mediante una probable transmisión zoonótica Objetivos. Determinar: la importancia clínica de varias especies del género Mycobacterium y la diversidad genética del Complejo M. avium (MAC), la sensibilidad bacteriana in vitro yel éxito del tratamiento especifico. Materiales y Métodos: Recolección de datos clínicos, epidemiológicos y aislamientos en el periodo 2009-2016; identificación molecular de los aislamientos; determinación de la sensibilidad bacteriana in vitro y de la diversidad genética del MAC; evaluación del tratamiento. Resultados: Fueron diagnosticados 225 casos de micobacteriosis, con prevalencia estable ≈ 6% por año, y 22 especies recuperadas: 4 de rápido desarrollo aisladas de 66 pacientes y 18 de lento desarrollo. MAC fue aislado en 95 casos, 40 M. avium hominissuis, 51 M. intracellulare, 3 M. chimaera, 1 M. colombiense. Se observó mayor probabilidad de enfermar por M. intracellulare en pacientes tratados previamente por tuberculosis (TB). Los pacientes HIV+ tuvieron riesgo incrementado de enfermedad causada por M. avium hominissuis. Los aminoglucósidos, fluoroquinolonas y macrólidos fueron las drogas más activas frente a la mayoría de las MNT. Aproximadamente la mitad de los casos curaron. Conclusiones: M. intracellulare, M. aviumhominissuis con una gran variabilidad genética, y M. abscessus fueron los patógenos más frecuentemente hallados. Un hallazgo importante fue el de casos de enfermedad mixta TB+MNT. Estos pacientes requirieron una terapia con agregado de drogas de segunda línea al esquema terapéutico para TB habiendo curado la mayoría de ellos.

Introduction: The term non-tuberculous mycobacteria (NTM) includes different ambient species capable of sickening humans and/or animals, even by means of a potential zoonotic transmission. Objectives: To determine: The clinical importance of several species within the genus Mycobacterium and the genetic diversity of the M. avium complex (MAC), the in vitro bacterial sensitivity and the success of the specific treatment. Materials and Methods: Collection of clinical and epidemiologic data and information about isolates of the 2009-2016 period; molecular identification of the isolates; determination of the in vitro bacterial sensitivity and genetic diversity of the MAC; treatment evaluation. Results: 225 mycobacteriosis cases were diagnosed, with a stable prevalence of ≈6% per year and 22 recovered species: 4 rapidly growing species isolated from 66 patients and 18 slowly growing species. The MAC was isolated in 95 cases, M. avium hominissuis - 40 cases, M. intracellulare - 51 cases, M. chimaera - 3 cases and M. colombiense - 1 case. We observed a greater probability of getting sick from M. intracellulare in patients previously treated for tuberculosis (TB). HIV-positive patients had a greater risk of falling ill from M. avium hominissuis. Aminoglycosides, fluoroquinolones and macrolides were the most active drugs against most NTM. Approximately half of the cases healed. Conclusions: M. intracellulare, M. aviumhominissuis with great genetic variability and M. abscessus were the most commonly found pathogens. The cases of TB+NTM mixed disease were an important finding. For treating these patients, it was necessary to add second line drugs to the therapeutic regimen for TB; and most of them healed.

Avaliação dos Efeitos Toxicológicos e Ambientais de Nanopartículas de Sais de Prata / Assessment of Toxic and Environmental Effects of Silver Salt Nanoparticles

As nanopartículas de sais de prata são compostos muito utilizados nas indústrias farmacêuticas e de cosméticos, além de seu uso hospitalar. Sua utilização, tanto em produtos comerciais como na medicina, e sua importante correlação com a saúde pública e meio ambiente despertaram grande interesse em ações diretas e indiretas sobre o ser humano. Particularmente as nanopartículas de sais de prata têm sido muito utilizadas como antimicrobianos na desinfecção de materiais hospitalares, desodorantes, materiais dentários, em próteses internas e cateteres intravenosos, e tem possibilitado a contaminação humana e ambiental. Seus efeitos, concentrações perigosas e valores aceitáveis como contaminante demandam estudos. Sua instabilidade frente a interações com outros produtos as torna de grande interesse em relação à contaminação e persistência no ambiente. Diversos trabalhos produzidos em nossos laboratórios demonstram a atividade desreguladora endócrina de vários produtos químicos contaminantes ambientais e prejudiciais à saúde humana. Deste modo buscou-se um levantamento das principais formas de uso, seus riscos e efeitos toxicológicos para a saúde pública e meio ambiente.

Nanoparticles of silver salts are compounds widely usedin the manufacture of pharmaceuticals and cosmetics, aswell as in hospitals. Their presence, both in commercialproducts and in medicine, and their strong correlationwith public health and environmental impact, havearoused great interest in direct and indirect actions onthe human being. Nanoparticles of silver salts have beenwidely used as antimicrobial agents, in the disinfectionof hospital supplies, deodorants, dental materials, ininternal prostheses and intravenous catheters and haveled to human and environmental contamination. Theireffects on the environment, dangerous concentrationsandacceptable levels of contamination demand study.Instability in their interactions with other productsmakes them of great interest in terms of contaminationand persistence in the environment. Several studiesperformed in our laboratories demonstrate theendocrine disrupting activity of various chemicalcontaminants, with environmental risk to humanhealth. Thus, our aim here was to survey the main usesof silver salt nanoparticles, their toxicological effectsand risks to public health and the environment.

Prenatal screening for congenital toxoplasmosis in Campania: preliminary report on activities and results

By 1997, an open cohort of 1,652 live newborn of 1,637 mothers with gestational toxoplasmosis had been recruited in the Campania region to monitor the burden of congenital toxoplasmosis (CT). Of the 1,556 mother-child pairs that completed the follow up, 92 definite cases were detected, yielding a 5.9 percent (4.8-7.1 95 percent CI) transmission rate. The onset was patent for 43 percent of patients and sensorineural complications were shown for a further 15 percent of subclinical onset patients later than two years of age. The overall prevalence of toxoplasmosis during gestation was 2.46 of 1,000 deliveries, while the prevalence of definite CT was 1.38 of 10,000 live newborns. However, there is still room for intervention, as only 23 percent of the maternal diagnoses were proven through seroconversion, 63 of the late-gestation seroconverters remained untreated, and six probable CT diagnoses were made following referrals due to patent sequelae and born during the study period. There was a positive secular trend on the rates of infant referral and definite CT diagnosis, according to the live birth rate (Ç2 for trend < 0.001). Extension of this surveillance system across the country could help to define a future strategy for prevention.