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.

Factores asociados a la colonización rectal por Enterobacteriaceae productoras de betalactamasas de espectro extendido en pacientes de consulta externa de un hospital al norte del Perú / Factors associated with rectal colonization by extended-spectrum beta-lactamase-producing Enterobacteriaceae in outpatients in a hospital in northern Peru

Introducción: Las Enterobacteriaceae productoras de betalactamasas de espectro extendido están presentes en las heces de los individuos de la comunidad. En Perú, la automedicación, el tipo de alimentación, condiciones sanitarias podrían asociarse a esta colonización. Objetivo: determinar la frecuencia de colonización rectal por EP-BLEE en pacientes de consulta externa del Hospital Regional Lambayeque, así como los factores asociados a la misma, durante los meses de julio 2018 a febrero 2019. Material y métodos: 331 pacientes participantes fueron entrevistados, de los cuales se obtuvieron tres muestras seriadas de heces recién emitidas. Las muestras fueron cultivadas en agar McConkey. Las EP-BLEE se confirmaron con la prueba de disco combinado (método americano). Resultados: el 85,8 % de los pacientes estuvieron colonizados por EP-BLEE, siendo Escherichia coli el aislamiento más frecuente (87,7 %). El análisis bivariado asoció el consumo de carne de cerdo (RP=1,15 IC 95%: 1,07 - 1,24), caprino (RP=1,18, IC 95%: 1,10 - 1,25) y el consumo de ensaladas frecuentemente (RP=1,15, IC 95 %: 1,05 - 1,28) con una mayor probabilidad de ser portador rectal de EP-BLEE. La automedicación presentó valores cercanos al límite de validez (p=0,051, RP 1,12, IC 95% 0,98 - 1,26). Conclusiones: Consumir carne de cerdo, caprino y ensaladas aumentan la probabilidad de ser portador de EP-BLEE, mientras que la automedicación podría estar asociada, por lo que es necesario seguir investigando, ya que se desconocen las razones de este hallazgo en pacientes de la comunidad.

Background:Extended-spectrumbeta-lactamase-producing Enterobacteriaceae(EP-BLEE) are present in the feces of individuals in the community. In Peru, self-medication, type of diet and sanitary conditions could be associated with this colonization. Objective:to determine the frequency of rectal colonization by EP-BLEE in outpatients of the "Hospital Regional Lambayeque", as well as the factors associated with it, during the months of July 2018 to February 2019. 331 participating patients Material and methods:were interviewed, and three serial samples of freshly emitted stool were obtained from them. The samples were cultured on McConkey agar. EP-BLEE were confirmed with the combined disc test (American method). 85.8% of patients were colonized by EP-BLEE, and Escherichia coliwas the most frequent isolate (87.7%). Bivariate Results:analysis associated the consumption of pork (RP=1.15, 95% CI: 1.07 - 1.24), goat (RP=1.18, 95% CI: 1.10 - 1.25) and frequent consumption of salads (RP=1.15, 95% CI: 1.05 - 1.28) with a higher probability of being a rectal carrier of EP-BLEE. Self-medication presented values close to the limit of validity (p=0.051, RP1.12, 95% CI 0.98 - 1.26). Consuming pork, goat meat and salads increase the probability Conclusions:of being a carrier of EP-BLEE, while self-medication could be associated, so further research is needed, since the reasons for this finding are unknown.

Resistencia a antibióticos del Staphylococcus aureus en estudiantes de una facultad de odontología / Antibiotic resistance of Staphylococcus aureus in students of a dental school

Introducción: el Staphylococcus aureus es un coco gram positivo que causa diferentes tipos de infecciones; circula no solo en la comunidad sino también en centros hospitalarios. El profesional de odontología está en contacto continuo y por largos periodos durante la atención clínica, lo que incrementa el riesgo de infección. Objetivo: evaluar la resistencia a algunos antibióticos del Staphylococcus aureus en estudiantes de una facultad de odontología. Material y métodos: estudio de corte transversal en estudiantes de 9° y 10° semestre de clínica odontológica de la ciudad de Medellín, Colombia (n=62) que cumplieran con los criterios de inclusión: estar realizando práctica clínica y no estar en tratamiento con antibiótico en los últimos tres meses, y como criterios de exclusión: no haber presentado fiebre, tos, dificultad para respirar, erupciones cutáneas, ni haber estado sometido a procedimientos quirúrgicos y hospitalizaciones en los últimos seis meses. Se recolectaron datos sociodemográficos y la presencia de S. aureus mediante la toma de muestras de fosas nasales. La identidad de la bacteria se verificó mediante la coloración de gram, pruebas de catalasa, coagulasa y crecimiento en manitol sal. A los aislamientos positivos se les realizó tamizaje con los siguientes antibióticos: cefoxitin, oxacilina, vancomicina, eritromicina y ciprofloxacina. Resultados: del total de muestras analizadas el 67,7 por ciento resultaron positivas para S. aureus y de estas el 28,5 por ciento resultaron resistentes a cefoxitina, 35,7 por ciento a oxacilina y el 7,14 por ciento a ciprofloxacina. Conclusiones: la presencia del S. aureus superó el 60 por ciento en la población de estudio y mostró mayor resistencia y su presencia estaba relacionada con haber tenido sintomatología respiratoria. En el presente estudio S. aureus resultó ser más resistente a la cefoxitina y a la oxacilina que a la ciprofloxacina(AU)

Introduction: Staphylococcus aureus is a gram-positive coccus that causes different types of infections. It spreads not only in the community but also in hospital centers. Dental professionals are in continuous contact with this bacterium for long periods of time during clinical care, which increases the risk of infection. Objective: To evaluate antibiotic resistance of Staphylococcus aureus in students of a dental school. Materials and methods: A cross-sectional study was conducted in ninth and tenth semester students of a dental clinic in Medellin, Colombia (n = 62) that met the inclusion criteria: carrying out clinical practice and not receiving antibiotic treatment during the last three months; they also met the following exclusion criteria: not having fever, cough, shortness of breath or skin rashes as well as not having undergone surgical procedures or been hospitalized during the last six months. Sociodemographic data were collected. The presence of S. aureus was detected by taking samples from the nostrils. The identity of bacteria was verified by gram staining, catalase and coagulase tests and growth on mannitol salt. Positive samples were screened using the following antibiotics: cefoxitin, oxacillin, vancomycin, erythromycin, and ciprofloxacin. Results: Of the total of samples analyzed, 67.7 percent were positive for S. aureus and of these, 28.5 percent were resistant to cefoxitin, 35.7 percent to oxacillin and 7.14 percent to ciprofloxacin. Conclusions: Staphylococcus aureus was present in 60 percent of the study population, showing great resistance and being associated with respiratory symptoms. In this study, S. aureus was found to be more resistant to cefoxitin and oxacillin than to ciprofloxacin(AU)

O viajante como agente ativo na transmissibilidade do SARS-CoV-2: uma revisão sistemática / The traveler as an active agent of SARS-CoV-2 transmission: a systematic review

O objetivo deste trabalho foi evidenciar o papel dos viajantes na transmissão e na disseminação do novo coronavírus. A busca pelos artigos foi realizada nas bases de dados PubMed®, SciELO, MEDLINE®, Cochrane, Center for Disease Control and Prevention e UpToDate. Foram incluídos artigos relacionados à transmissibilidade, principalmente aqueles associados à disseminação realizada por viajantes, do novo coronavírus. Excluíram-se artigos relacionados a outros surtos de coronavírus. Todos os estudos foram lidos e analisados integralmente. Onze artigos foram selecionados e tabulados, dos quais se pôde desenvolver uma fundamentação teórica, que expõe o grande impacto dos viajantes perante o crescimento da pandemia relacionada ao SARS-CoV-2, levando em consideração as diversas formas com que esse vírus pode se propagar, sendo elas por contato com superfícies contaminadas ou pessoa a pessoa, visto que a infecção pode ser decorrente de gotículas, aerossóis, fômites e, possivelmente, contato sexual, estando os indivíduos sintomáticos ou não.

The objective of this study was to highlight the travelers role in the transmission and dissemination of new coronavirus. The search for the articles was carried out in PubMed®, SciELO, MEDLINE®, Cochrane, Centers for Disease Control and Prevention, and UpToDate databases. Articles related with transmissibility of the new coronavirus were included, mainly those linked with the dissemination from travelers. Articles related with other coronavirus outbreaks were excluded. All of the studies were read and analyzed in their entirety. Eleven articles were selected and tabulated, from which a theoretical framework was developed, which exposes the great impact of travelers in the face of the growth of the pandemic related to the SARS-CoV-2, considering the several ways in which this virus can spread, either through contact with contaminated surfaces or person-to-person, since the infection may occur through droplets, aerosols, fomites, and possibly sexual contact, whether individuals are symptomatic or not.

Genetic counseling to a DMD asymptomatic carrier: First case report in the Peruvian public healthcare system / Asesoramiento genético a una portadora asintomática de DMD: Primer caso reportado en el Sistema de Salud Pública del Perú

SUMMARY Duchenne muscular dystrophy (DMD) is a rapidly progressive dystrophinopathy with X-linked inheritance. This report describes a woman with a family history of male relatives affected by DMD, as she sought out genetic counseling about her concerns related to family planning and risks of eventually having children with the disease. We proposed her to get involved in a pilot program for carrier-status diagnosis and genetic counseling. This case illustrates the importance of a genetic counseling program for diagnosis of asymptomatic carriers in neurogenetic diseases, particularly in regions with low-resource settings. We discussed successes and misunderstandings faced throughout the process, supporting policies for present and future challenges from this and similar kinds of diagnoses.

RESUMEN La distrofia muscular de Duchenne (DMD) es una distrofinopatía rápidamente progresiva con herencia ligada al cromosoma X. Este reporte describe el caso de una mujer con historia familiar de hermano y sobrinos con DMD, que acudió a consulta para orientación e información sobre riesgos inherentes a una eventual planificación familiar. Le propusimos participar en un programa piloto de asesoramiento genético para determinar su estado de portador o no de la variante causal de DMD en la familia. Esta primera experiencia ilustra la importancia de tener un programa de asesoramiento genético para el diagnóstico de portadores asintomáticos de enfermedades neurogenéticas en regiones con bajos recursos. Se incluyen reflexiones y comentarios sobre aspectos positivos y retos presentados durante el proceso, las políticas de apoyo presente y futuro para el afronte de los complejos problemas planteados por éste y similares diagnósticos.

Colonización nasal por Staphylococcus aureus resistente a la meticilina en pacientes sometidos a cirugía cardiovascular en un hospital universitario de Bogotá, Colombia / Methicillin-resistant Staphylococcus aureus nasal colonization in cardiovascular surgery patients at a university hospital in Bogotá, Colombia

Introducción. Staphylococcus aureus resistente a la meticilina (SARM) es un microorganismo que coloniza las fosas nasales y diferentes partes del cuerpo, lo cual se considera un factor de riesgo para adquirir infecciones invasivas, especialmente en pacientes sometidos a cirugía cardiovascular. Objetivo. Determinar la colonización nasal por SARM y establecer las características clínicas en pacientes programados para cirugía cardiovascular. Materiales y métodos. Se hizo un estudio descriptivo entre febrero y diciembre de 2015. Se incluyeron pacientes adultos programados para cirugía cardiovascular en el Hospital Universitario San Ignacio de Bogotá. La colonización se identificó mediante reacción en cadena de la polimerasa (Polymerase Chain Reaction, PCR) en tiempo real en muestras obtenidas mediante hisopados nasales. Los pacientes fueron descolonizados con mupirocina al 2,0 % intranasal dos veces al día y baños con gluconato de clorhexidina al 4 % del cuello hacía abajo durante cinco días, al cabo de lo cual se hizo una PCR de control. Resultados.Se incluyeron 141 pacientes, 52 hospitalizados y 89 ambulatorios. Del total, 19 (13,4 %) tenían colonización nasal por SARM, correspondientes a 9 (17,3 %) de los 52 hospitalizados y 10 (11,2 %) de los 89 ambulatorios. Todos los pacientes sometidos a descolonización tuvieron resultado negativo en la PCR al final del proceso y ninguno presentó infección del sitio operatorio por S. aureus. Conclusiones.Se demostró colonización nasal por SARM tanto en los pacientes hospitalizados como en los ambulatorios. La descolonización con mupirocina fue efectiva para erradicar el estado de portador a corto plazo, lo que podría tener efecto en las tasas de infección del sitio operatorio en las cirugías cardiovasculares.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a microorganism that colonizes nostrils and different parts of the body, which is considered a risk factor to acquire invasive infections, especially in cardiovascular surgery patients. Objective: To determine the frequency of nasal colonization by MRSA and to establish the clinical characteristics in patients scheduled for cardiovascular surgery. Materials and methods: This was a descriptive study conducted between February and December, 2015. We included adult patients scheduled for cardiovascular surgery at the Hospital Universitario San Ignacio in Bogotá, Colombia. Colonization was identified by real-time PCR from nasal swabs. Colonized patients were treated with mupirocin 2.0% intranasally twice a day and bathed with chlorhexidine 4% from the neck downwards for five days. At the end of this treatment, PCR control was carried out. Results: We included 141 patients with a percentage of nasal colonization of 13.4% (19/141). There were 52 hospitalized patients and 89 outpatients with a percentage of nasal colonization of 17.3% (9/52), and 11.2% (10/89), respectively. All colonized patients who received treatment had a negative PCR at the end of the regime and none of the participating patients had a surgical site infection by S. aureus at the end of the study. Conclusions: Nasal colonization was observed both in hospitalized patients and outpatients. Decolonization treatment with mupirocin was effective to eradicate the carrier state in the short term, which could impact the rates of surgical wound infection associated with cardiovascular surgery.

The direct and indirect effects of the pneumococcal conjugated vaccine on carriage rates in children aged younger than 5 years in Latin America and the Caribbean: a systematic review / Efeitos diretos e indiretos da vacina pneumocócica conjugada no estado de portador em crianças menores de 5 anos, na América Latina e no Caribe: uma revisão sistemática

ABSTRACT Objective To demonstrate the impact of pneumococcal conjugate vaccine in Streptococcus pneumoniae carriage status in children younger than 5 years in Latin America and the Caribbean. Methods A systematic literature review was carried out on the direct and indirect effects of pneumococcal vaccine in the carriage status, after implementation in childhood immunization programs. Studies carried out in children younger than 5 years were selected from the PubMed® and Virtual Health Library databases, and data collected after implementation of pneumococcal vaccine in Latin America and the Caribbean, between 2008 and 2018. Results From 1,396 articles identified, 738 were selected based on titles and abstracts. After duplicate removal, 31 studies were eligible for full-text reading, resulting in 6 publications for analysis. All selected publications were observational studies and indicated a decrease in the carriage and vaccine types, and an increase in the circulation of non-vaccine serotypes, such as 6A, 19A, 35B, 21 and 38. We did not identify changes in the antimicrobial resistance after vaccine implementation. Conclusion A decrease in the carriage status of vaccine types and non-vaccine types was detected. The continuous monitoring of pneumococcal vaccine effect is fundamental to demonstrate the impact of the carriage status and, consequently, of invasive pneumococcal disease, allowing better targeting approaches in countries that included pneumococcal vaccine in their immunization programs. Our study protocol was registered in PROSPERO (www.crd.york.ac.uk/prospero) under number CRD42018096719.

RESUMO Objetivo Demonstrar o impacto das vacinas pneumocócicas conjugadas no estado de portador de Streptococcus pneumoniae em crianças menores de 5 anos na América Latina e no Caribe. Métodos Foi realizada revisão sistemática da literatura sobre os efeitos diretos e indiretos da vacina pneumocócica no estado de portador em crianças menores de 5 anos, após a implantação da vacina nos calendários de imunização infantil. A partir de dados da PubMed®e da Biblioteca Virtual da Saúde, foram selecionados estudos de portador em crianças menores de 5 anos, com dados coletados após implementação da vacina de 2008 a 2018, na América Latina e no Caribe. Resultados Dos 1.396 artigos identificados, 738 foram selecionados mediante leitura de títulos e resumos. Após a extração dos duplicados, 31 foram elegíveis para leitura do texto completo, restando 6 artigos para análise. Todos os estudos selecionados eram observacionais e indicavam diminuição do portador e tipos vacinais, e aumento da circulação de sorotipos não vacinais, como 6A, 19A, 35B, 21 e 38. Não foi observada alteração na resistência antimicrobiana após a introdução da vacina. Conclusão Detectou-se redução no estado de portador, dos tipos vacinais e não vacinais. O monitoramento contínuo do efeito das vacinas pneumocócicas é fundamental, para demonstrar o impacto do estado de portador e, consequentemente, da doença pneumocócica invasiva, permitindo o melhor direcionamento nas ações em saúde para os países que incluíram a vacina no calendário de imunização. Nosso protocolo de estudo foi registrado no PROSPERO (www.crd.york.ac.uk/prospero) sob o número CRD42018096719.

Staphylococcus aureus resistentes a meticilina (SARM) y productores de enterotoxina A aislados de portadores nasales asintomáticos entre estudiantes universitarios de México / Methicillin resistant Staphylococcus aureus (MRSA) and enterotoxin A producer isolated from asymptomatic nasal carriage among undergraduate students of Mexico

El objetivo de este estudio fue determinar la frecuencia de S. aureus, incluyendo resistentes a meticilina y la producción de enterotoxina A en fosas nasales de estudiantes universitarios en México. Este fue un estudio transversal realizado en 471 estudiantes universitarios de una ciudad del suroeste de México. Las muestras nasales y los datos sociodemográficos fueron obtenidos de los pacientes. Las cepas fueron identificadas como S. aureus basándose en la morfología, tinción de Gram, prueba de catalasa, prueba de coagulasa y fermentación en agar manitol salado. Las cepas se biotipificaron, se determinó la resistencia a meticilina por difusión en agar y la producción de enterotoxina A por Dot- Blot. La frecuencia de portadores nasales de S. aureus fue 10,40 %; 73,46 % resistentes a meticilina; 36,73 % producen enterotoxina A. En un análisis bivariado, se encontraron diferencias estadísticamente significativas en pacientes que viven cerca de aguas residuales y granjas con el estado de portador de S. aureus, (p=0,01, OR 2,59 [1,06-5,81]; p=0,01, OR 3,18, [1,07- 8,33]). Los portadores nasales muestran una diversidad de cepas de S. aureus, mayormente resistentes a meticilina, pero no todas producen enterotoxina A.

The aim at this study was determine the frequency of S. aureus, including methicillin-resistant and enterotoxin A production in nostrils of university students in Mexico. This was a cross-sectional study conducted in 471 university students from a city in southwestern Mexico. Nasal samples and sociodemographic data were obtained from the patients. Strains were identified as S. aureus based on morphology, Gram stain, catalase test, coagulase test and fermentation on salted mannitol agar. Isolated strains were subjected to biotyping, their methicillin resistance was analyzed using the agar diffusion method and examined their enterotoxin A (SEA) production by a Dot-blot analysis. The nasal carriage rate of S. aureus was 10.40%; 73.46% of the isolates were resistant to methicillin; 36.73% of the strains produced enterotoxin A. In the bivariate analysis, a statistically significant difference was found in patients who lived near sewage and farms with S. aureus carriage (p=0.012, odds ratio 2.59, [ 1.06-5.81]; p=0.009, odds ratio 3.18, [1.07- 8.33]) and the first group also associated with methicillin resistant S. aureus carriage (p=0.020, odds ratio 3.38, [1.30-8.06]). Nasal carriers show a wide variety of strains of S. aureus, mostly MRSA strains, but not all produce enterotoxin A.

Cobertura de inmunización contra el virus de la hepatitis B en hijos nacidos de madres portadoras de la infección: Huanta, Ayacucho, 2014-2018 / Immunization coverage against the hepatitis B virus in children from chronic carrier mothers: Huanta, Ayacucho, 2014-2018

Introducción. En el marco del plan de eliminación de la infección por virus de la hepatitis B (HBV) es necesario conocer la cobertura de inmunización en los hijos de madres portadoras. Objetivo. Determinar el nivel de cobertura de inmunización en los hijos nacidos de madres portadoras de la infección por HBV en el Hospital de Huanta, Ayacucho, entre los años 2014 a 2018. Métodos. Se realizó un estudio observacional descriptivo. La población incluyó a los hijos nacidos de madres portadoras de la infección por HBV. Se utilizaron fuentes de información secundaria de registro de inmunización contra HBV. Resultados. Se registraron 90 madres portadoras de la infección por HBV cuyos hijos nacieron en el lugar de estudio. La cobertura total de inmunización contra HBV fue 64,47%, la cobertura de la dosis de nacimiento de la vacuna fue 100% y la cobertura de aplicación de la inmunoglobulina antihepaitis B de 77,78%. Conclusiones. La cobertura total de inmunización contra HBV se encuentra por debajo de lo esperado según las recomendaciones de la OMS.

Introduction. In the framework of the plan for the elimination of infection with hepatitis B virus (HBV), it`s necessary to know the immunization coverage in the children of carrier mothers. Objective. To determine the level of immunization coverage in children born to mothers with HBV infection at the Hospital de Huanta, Ayacucho, between 2014 and 2018. Methods. A descriptive observational study was carried out. The population included children born to mothers with HBV infection. Secondary information sources of immunization record against HBV were used. Results There were 90 mothers carrying the HBV infection whose children were born at the study site. The total immunization coverage against HBV was 64,47%, the coverage of the birth dose of the vaccine was 100% and the coverage of application of immunoglobulin antihepaitis B of 77,78%. Conclusions. The total immunization coverage against HBV is below what was expected according to WHO recommendations.

"Cell ELISA" como ferramenta auxiliar no controle da adenite equina / "Cell ELISA" as an auxiliary tool for the control of equine adenitis

Este trabalho relata o desenvolvimento e a avaliação de um ensaio imunoenzimático (ELISA) como ferramenta auxiliar no controle da adenite equina. Foi avaliada a presença de anticorpos anti-Streptococcus equi subsp. equi em equinos com doença clínica de garrotilho, portadores assintomáticos e potros vacinados. Equinos doentes demonstraram absorbâncias médias superiores (P<0,05) às médias observadas nas demais categorias examinadas. Equinos portadores assintomáticos apresentaram valores médios de absorbância superiores (P<0,05) aos animais com cultura negativa. Logo após a vacinação, potros apresentaram elevação nos níveis de anticorpos, seguida de um decréscimo nos níveis 90 dias após a segunda vacinação. O "Cell ELISA" foi eficiente para a detecção de anticorpos em equinos expostos a antígenos de S. equi, diferenciando-se de infecções por S. zooepidemicus. O "Cell ELISA" mostrou-se uma alternativa clínica para o diagnóstico indireto da adenite equina, diferenciando-se, entre equinos assintomáticos, os potenciais portadores da infecção. Os resultados observados em potros vacinados confirmam o potencial de utilização desse teste como ferramenta em programas de vacinação contra garrotilho pelo monitoramento de rebanhos pós-vacinação. Esses resultados sugerem que o "Cell ELISA" é uma promissora ferramenta auxiliar no controle da adenite equina.(AU)

This study reports the development and evaluation of the use of "Cell ELISA" as a tool for clinical interpretation for the control of strangles. The presence of anti-S. equi antibodies was evaluated in horses with strangles, in asymptomatic carriers and in vaccinated foals. Equine positive for strangle showed higher average of absorbance (P<0.05) when compared with the average for the other categories of horses studied. Asymptomatic S. equi equine carriers had higher average of absorbance (P<0.05) than equines with negative culture. After vaccination, foals presented an increase in antibody levels, followed by a decrease in antibody levels 90 days post the second vaccination. The "Cell ELISA" was efficient for the detection of antibodies in horses exposed to S. equi antigens, differentiating infections with S. zooepidemicus. Thus, the test might be a clinical tool for indirect diagnosis of the strangles, differentiating, between the asymptomatic horses, the potential carriers of infection. The results observed in vaccinated foals confirm the potential use of this test as an auxiliary instrument for strangles vaccination programs based in the serological monitoring of the herd after immunization. These results suggest that the "Cell ELISA" is a promising auxiliary tool in the control of equine adenitis.(AU)

Tipificación SARM en trabajadores asistenciales de las unidades de cuidados intensivos en una institución hospitalari / MRSA Typing in health care workers from intensive care units of a Hospital Institution

Objetivo. Caracterizar microbiológicamente SARM en trabajadores asistenciales de las Unidades de Cuidados Intensivos en una institución hospitalaria de la ciudad de Montería. Materiales y métodos. Se realizó un estudio descriptivo longitudinal, en 52 trabajadores de dos unidades de cuidado intensivo; se tomaron hisopados nasales y faríngeos a cada individuo, con una periodicidad de 15 días/cinco meses. Mediante pruebas convencionales como fermentación de manitol, catalasa y coagulasa se realizó la identificación de S. aureus, con el disco de cefoxitín por Kirby- Bauer se evaluó la resistencia a Meticilina mediada por el gen mecA; antibióticos como Vancomicina, Eritromicina y Clindamicina fueron evaluados por esta prueba y confirmados por MicroScan ®. Resultados. se obtuvieron 88 aislamientos de S. aureus y 21 aislamientos SARM, una prevalencia de portación de SARM del 25%. El 90,5 % de las cepas de SARM fueron recuperadas de la faringe, en mayor proporción (50%) en el personal de enfermería. Conclusiones. La evidencia de su circulación de SARM en el personal asistencial dentro de una institución hospital, genera una alerta que le permite a la misma establecer políticas de contención para evitar la diseminación de estas cepas y evitar la aparición de brotes o infecciones hospitalarias asociadas a este patógeno.

Objective. To characterize microbiologically MRSA in health care workers of the Intensive Care Units at a hospital institution in the city of Montería. Materials and methods. A longitudinal descriptive study was carried out in 52 workers from two intensive care units; nasal and pharyngeal swabs were taken from each individual, with a periodicity of 15 days / five months. Examined through microbiological methods such as fermentation of mannitol, catalase and coagulase the identification of S. aureus was performed, with the cefoxitin disc by Kirby-Bauer disc-diffusion method the methicillin resistance mediated by the mecA gene was evaluated; antibiotics such as Vancomycin, Erythromycin and Clindamycin were evaluated by this test and confirmed by MicroScan ®. Results. we obtained 88 isolates of Staphylococcus aureus and 21 MRSA, a prevalence of MRSA of 25%. 90.5% of strains Of SARM were recovered from the pharynx, in a greater proportion (50%) in nursing staff. Conclusions. Evidence of MRSA circulation in care staff within a hospital institution generates an alert that allows it to establish containment policies to avoid the dissemination of these strains and to avoid the appearance of outbreaks or hospital infections associated with this pathogen.

Selected lactobacilli and bifidobacteria development in solid state fermentation using soybean paste / Desarrollo de lactobacilos y bifidobacterias seleccionadas en fermentación en estado sólido utilizando pasta de soja

At present, consumers are looking for more natural foods so as to improve health through their active compounds. Within this context, soybean is an excellent substrate due to its beneficial effects on consumers' health. Moreover, lactic cultures are widely used in the food industry to improve the technological, nutritional and functional characteristics of fermented foods. It is interesting to find new matrices in which to transport these starter cultures (potentially probiotic microorganisms). The aim of this research was to obtain a solid state fermentation system from soybean to analyze the behavior of selected lactobacilli and bifidobacteria, with the potential to develop a functional vegetarian food to serve as carrier for the microorganisms. A soybean solid substrate system was optimized by selecting the relationship of the main processing parameters. Homogeneous soybean pastes with different moisture content (60-80%) were obtained and used as substrate and support for solid substrate fermentation. Moisture, inoculum size and temperature were optimized: 80%, 4%, 37 °C, respectively. L. rhamnosus CRL 981 was chosen as the best starter to use in this kind of fermentation, showing high acidification and cell counts at 24 h of fermentation and increased specific growth rate in tested soybean pastes. It was demonstrated that the selected soybean paste could be used as a carrier of these microorganisms having probiotic potential for the production of vegetarian foods. Moreover, these microorganisms are able to modify the substrate to enhance their nutritional and functional characteristics, which would change the soybean into a more attractive product for consumers.

Actualmente los consumidores están en la búsqueda de alimentos naturales, a fin de mejorar la salud a través de sus compuestos activos. En este contexto, la soja es un excelente sustrato debido a sus efectos beneficiosos sobre la salud del consumidor. En la industria alimentaria se emplean cultivos lácticos para mejorar las características tecnológicas, nutricionales y funcionales de los alimentos fermentados. Es interesante encontrar nuevas matrices para transportar estos cultivos iniciadores, que potencialmente son microorganismos probióticos. El objetivo de este estudio fue obtener un sistema de fermentación en estado sólido a partir de soja para analizar el comportamiento de lactobacilos y bifidobacterias seleccionadas, con potencial para desarrollar un alimento vegetariano funcional que sirva de portador de los microorganismos. El sistema de sustrato sólido de soja se optimizó mediante la selección de la relación de parámetros principales de procesamiento. Se obtuvieron pastas de soja homogéneas con diferente contenido humedad (60-80%) y se utilizaron como sustrato y soporte para la fermentación en sustrato sólido. Las variables humedad, tamaño del inóculo y temperatura fueron optimizadas en 80%, 4% y 37°C, respectivamente. Lactobacillus rhamnosus CRL 981 fue elegido como el mejor cultivo iniciador para utilizar en este tipo de fermentación; este mostró acidificación y recuentos celulares altos en 24 horas de fermentación, y mayor velocidad específica de crecimiento en las condiciones evaluadas. Se demostró que la pasta de soja seleccionada podría ser utilizada como portadora de estos microorganismos con potencial probiótico para la elaboración de alimentos vegetarianos. Además, estos microorganismos son capaces de modificar el sustrato y mejorar sus características nutritivas y funcionales, lo que convertiría a la soja en un producto más atractivo para los consumidores.

Portadores de bacterias multirresistentes de importancia clínica en áreas críticas (UCI-UCIN) de un hospital al norte del Perú

Objetivo: Determinar la frecuencia de portadores de bacterias multirresistentes (BMR) y su perfil de resistencia en áreas críticas (UCI-UCIN) de un hospital público al norte del Perú (HRL). Material y métodos: Se realizó un estudio observacional de corte transversal durante febrero - mayo 2015 en 48 pacientes y 32 personales de salud. Se consideraron 4 regiones anatómicas para el muestreo y emplearon medios suplementados con antibióticos para el aislamiento primario de BMR. El fenotipo de resistencia fue confirmado por los test de Jarlier, Hodge modificado y susceptibilidad a cefoxitin. Resultados: La frecuencia de portadores de BMR en pacientes y personal asistencial fue del 79,1% y 3,1% respectivamente, además el 89,5% de pacientes ya eran portadores al momento de la admisión procedentes principalmente del servicio de emergencia, siendo la región ano-rectal la principal fuente de aislamientos con 75,0%. Así mismo se determinó que la producción de betalactamasas de espectro extendido (BLEE) fue el principal fenotipo de resistencia con 77,65%, seguido de la producción de carbapenemasas y meticilino resistencia con 14.2% y 8.24% respectivamente. Conclusiones: Este estudio revela la alta frecuencia de portadores de bacterias multirresistentes en pacientes de áreas críticas del HRL y que la mayoría de estos ingresan ya colonizados principalmente en la región ano-rectal

Objective: To determine the frequency of multiresistant bacteria Carriers (BM) and its profile of resistance in critical areas (ICU-INCU) in a public hospital in northern Peru (HRL). Material and methods: A cross-sectional observational study was conducted during February to May 2015, in 48 patients and 32 healthcare staff. 4 anatomical regions for sampling were considered and supplemented instruments with antibiotics were used for primary isolation of BM. The resistance phenotype was confirmed by Jailer's test, Modified Hodge and susceptibility to cefoxitin. Results: The frequencies of BM in patients and healthcare staff were 79.1% and 3.1% respectively; also 89.5% of patients were already carriers at the time of admission mainly from Emergency Service, being anorectal region the principal source of isolates with 75.0%. It also was determined that production of extended spectrum beta-lactamase (ESBL) was the principal resistance phenotype with 77.65%, followed by the production of carbapenemases and methicillin resistance with 14.2% and 8.24% respectively. Conclusions: This study reveals the high frequency of multiresistant bacteria carriers in patients in critical areas of HRL and that most of these already were colonized in the anorectal region

Resistência antimicrobiana, genotipagem capsular e detecção de genes de resistência destreptococcus pneumoniae isolados de crianças não vacinadas usuárias de creches em Fortaleza

O Streptococcus (S.) pneumoniae é considerado como o principal agente causador de morbidade e mortalidade em crianças menores de cinco anos de idade. As doenças pneumocócicas começam com o estabelecimento da colonização do S. pneumoniae na nasofaringe. O principal fator de risco para colonização é o confinamento, como em crianças que frequentam creches. Nas últimas décadas, o aumento do número de cepas de S. pneumoniae resistentes à antibióticos β-lactâmicos e a outras classes de antimicrobianos tem dificultado o tratamento da infecção pneumocócica. Atualmente cerca de 13 sorotipos de S. pneumoniae respondem por mais de 85% dos isolados invasivos. A vacina pneumocócica polissacarídica conjugada 10-valente (VPC-10) foi recentemente incluída no calendário de vacinação nacional. Os objetivos desse estudo foram determinar a prevalência, a resistência antimicrobiana, os genótipos de S. pneumoniae que colonizam a nasofaringe de crianças usuárias de creches em Fortaleza, Brasil, bem como para avaliar a cobertura potencial da VPC-10. Entre janeiro e dezembro de 2011, os isolados de crianças portadores foram recuperados a partir de swabs de nasofaringe. Foram determinadas as sensibilidades para penicilina, ceftriaxona, sulfametoxazol/trimetoprim, amoxilina, clindamicina e eritromicina, das cepas isoladas utilizando-se o método de e-test...

Streptococcus (S.) pneumoniae is considered the principal causative agent of morbidity and mortality in children younger than five years of age. All pneumococcal diseases are initiated by establishing a S. pneumoniae colonization in nasopharynx. The main risk factor for colonization is crowding, as in children attending day care. During the last decades, the increasing amount of resistant S. pneumoniae strains to β-lactams and other classes of antimicrobials has modified the treatment of pneumococcal infection. At present, nearly 13 serotypes respond for more than 85% of invasive isolates. The 10-valent pneumococcal polysaccharide-conjugated vaccine (PCV-10) has recently been included in the national vaccination schedule. The aims of this study were to determine the prevalence, antimicrobial resistance and genotypes of S. pneumoniae isolated of carriage children attending day care centers in Fortaleza, Brazil, as well as to assess the potential coverage of the PCV-10. Between January and December of 2011, isolates from carrier children were recovered by nasopharyngeal swabs. Susceptibility to penicillin,amoxicillin, erythromycin, sulfamethoxazole-trimethoprim, clindamycin, were determined by e-test method...

¿Es realmente asintomático el portador de la hemoglobina S? / Is hemoglobin s carrier really asymptomatic?

La controversia sobre si el estado de portador de la hemoglobina S debe ser visto como una enfermedad benigna o como un fenotipo intermedio de la anemia de células falciformes se mantiene hasta nuestros días. Los reportes de complicaciones renales, tromboembólicas y de muerte súbita relacionadas con el ejercicio en estos individuos, demandan la necesidad de un consenso en relación con este concepto. Nuestro objetivo es dirigir la atención hacia este grupo de personas que presentan una afectación genética de la síntesis de hemoglobina, identificar y detectar tempranamente complicaciones derivadas de esta condición genética, con el fin de proporcionarles una mejor atención médica y contribuir a definir si realmente el portador de la hemoglobina S es asintomático(AU)

Controversy over whether sickle cell trait should be considered as a benign disease or as an intermediate phenotype of sickle cell anemia has remained to this day. Reports of renal complications and sudden death associated to exercise in these individuals as well as thromboembolic complications demand the need for consensus regarding this concept. It is our goal with this paper to draw attention to this group of individuals, identifying and detecting early complications of their genetic condition in order to provide better health care and actually help to define whether or not sickle cell trait is asymptomatic in carriers(AU)

Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient / Zoster optic neuritis in immunocompentent

A 58-year-old woman presented with rash over the left side of the face and intense acute uveitis. Following careful review of the symptoms and dilated fundus examination unilateral optic neuritis was discovered. The rash was typical of varicella zoster dermatitis. Patients presenting with herpes zoster ophthalmicus should always undergo dilated fundus examination, as there is a potential risk of unexpected posterior segment inflammation. Early diagnosis and prompt treatment can avoid visual sequelae.

Paciente de 58 anos de idade apresentando erupção cutânea no lado esquerdo da face e intensa uveíte unilateral. Após cuidadosa revisão dos sintomas e exame de fundo do olho foi detectada neurite óptica. O rash era típico de dermatite por varicella zoster. Pacientes apresentando quadro de herpes zoster oftálmico devem ser submetidos ao exame de fundo do olho devido ao risco de inesperada inflamação do segmento posterior. Diagnóstico precoce e tratamento imediato podem evitar danos visuais.

Intervenção psicossocial por meio de oficina de dinâmica de grupo em uma instituição: relato de experiência / Psychosocial intervention with workshops for groupdynamics analysis in an institution: reporting a case study

Este relato de experiência é produto de uma atividade prática, realizada por duas estudantes do curso de Psicologia e um psicólogo, e visou a promover uma oficina de dinâmica de grupo com pais, amigos e colaboradores de uma Instituição que atende pessoas portadoras de necessidades especiais (PNEs) de Mato Grosso. O objetivo da oficina foi sensibilizar refletir e discutir o processo de exclusão social vivenciada por muitos PNEs. Para isso, adotou-se como ferramenta a proposta das oficinas de dinâmicas de grupo em uma perspectiva psicossocial de Afonso, levando em consideração as contribuições de Lewin sobre pesquisa-ação. Busca-se apresentar e discutir as oficinas de dinâmica de grupo como recurso metodológico para o desenvolvimento de atividades que visem a trabalhar temas relacionados à educação especial. O primeiro momento, que antecede as atividades, Afonso denomina de demanda, pré-análise, foco e enquadre, e planejamento flexível. Já o segundo momento, a atividade em si, é caracterizado pelo aquecimento, a reflexão e a elaboração do tema, a sistematização e avaliação do trabalho. Essa forma de estruturar as oficinas de dinâmica de grupos permitiu ampliar os elementos de análise, incluindo a pré-análise do trabalho realizado.

This report is the result of activities carried out by two Psychology students and a psychologist. We held a workshop for group dynamics analysis with parents, friends and employees of an institution that serves people with special needs (PSNs) in Mato Grosso. The purpose of the workshop was to reflect, discuss and raise awareness about the process of social exclusion experienced by many PSNs. To achieve our goal, we centered on Afonso’s group dynamics proposal from a psychosocial perspective, taking also into account the contributions of Lewin on action research. We seek to present and discuss workshops for group dynamics analysis as a methodological resource for the development of activities to work with topics related to special education. The first points of analysis actually come before the activities and are namely: demand, pre-analysis, focus and frame, and flexible planning. The second stage, the activityit self, is characterized by: warm-up, reflection and development of the theme, systematization and evaluation of work production. This way of structuring the workshops for group dynamics analysis made it possible to extend the analysis elements, including the pre-analysis of the work performed.

Bacterial microbiota present in the gallbladder of cattle and antimicrobial resistance of Staphylococcus isolates / Microbiota bacteriana presente na vesícula biliar de bovinos e resistência antimicrobiana de isolados de Staphyloccocus

Pathogenic microorganisms can reside transiently or permanently in the gallbladder of cattle. Thus, during slaughter, more attention should be given to the gastrointestinal tract, especially to the accessory organ, the gallbladder. The main aim of this study was to characterize the bacterial microbiota present in bile and gallbladder epithelium of cattle slaughtered in a slaughtering plant under sanitary conditions and to evaluate the antimicrobial resistance in strains of the genus Staphylococcus. Thirty intact gallbladders were collected and the in bile and epithelium were researched for the presence of Aerobic Mesophilic Heterotrophic Bacteria (AMHB), Staphylococcus spp., total Enterobacteriaceae, Enterococcus spp. and Salmonella spp.The frequency of isolation of the microorganism mentioned above were, respectively: 23.02 percent, 14.39 percent, 13.67 percent, 24.46 percent, 0 percent and 24.46 percent. Concerning both gallbladder environments, the frequency of isolation of the microorganisms in the epithelium was 64.03 percent, and in the bile 35.97 percent, with no statistical difference, but with significant difference between the population averages. In antimicrobial susceptibility testing, strains of Staphylococcus from both bile and gallbladder epithelium showed sensitivity to the antimicrobials: penicillin G, ceftriaxone, chloramphenicol and gentamicin. The observation that the gallbladder supports a high frequency of microorganisms brings us to the possible fact that cattle might be a persistent carrier of pathogens of great importance to public health...

Microrganismos patogênicos podem residir temporariamente ou permanentemente na vesícula biliar de bovinos. Assim, durante o abate, maior atenção deve ser dada ao trato gastrointestinal, especialmente para o órgão acessório, a vesícula biliar. O principal objetivo deste estudo foi caracterizar a microbiota bacteriana presente na bile e no epitélio de vesículas biliares de bovinos abatidos em matadouro frigorífico sob inspeção sanitária e avaliar a resistência antimicrobiana de estirpes do gênero Staphyloccocus. Foram coletadas 30 vesículas biliares íntegras e foi pesquisada na bile e no epitélio do órgão a presença de bactérias heterotróficas aeróbias mesófilas (BHAM), Staphylococcus spp. e Enterobacteriaceae totais, Escherichia coli, Enterococcus spp. e Salmonella spp. A frequência de isolamento dos microrganismos citados acima foi, respectivamente: 23,02 por cento, 14,39 por cento, 13,67 por cento, 24,46 por cento, 0por cento e 24,46 por cento. Em relação aos dois ambientes da vesícula, a frequência de isolamento dos microrganismos no epitélio foi de 64,03 por cento, e na bile 35,97 por cento, não sendo diferente estatisticamente, mas com diferença significativa entre as médias populacionais.No teste de susceptibilidade aos antimicrobianos, as estirpes de Staphylococcus isoladas a partir da bile e do epitélio da vesícula biliar apresentaram sensibilidade a: penicilina G, ceftriaxona, cloranfenicol e gentamicina. A observação de que a vesícula biliar comporta microrganismos em elevadas frequências atenta para o fato de que o bovino possa ser um portador persistente de patógenos de grande importância em saúde pública...

Determinación fenotípica de staphylococcus aureus resistente a meticilina en trabajadores de UCI de tres centros de atención medica en Tunja (Colombia) / Phenotypic determination of Staphylococcus aureus resitant to methicillin from workers belonging to three ICU of medical care centers in Tunja (Colombia)

El presente estudio tuvo como propósito determinar fenotípicamente la portación de Staphylococcus aureus resistente a meticilina (SARM) en trabajadores de la salud que laboran en Unidades de Cuidados Intensivos (UCI) de tres centros de atención médica en Tunja (Colombia). A los sujetos en estudio (84) se les practicó un hisopado nasal con el fin de aislar cepas de SARM. Las muestras se inocularon en agar manitol-salado, las cepas fermentadoras de manitol se identificaron por medio de pruebas morfológicas (Gram) y bioquímicas tales como catalasa, coagulasa y DNAsa. Para determinar su resistencia a la meticilina se realizó la prueba de susceptibilidad usando el método de difusión con disco de cefoxitina de 30µg, según el protocolo M02-A11 del CLSI. Se usaron las cepas de Staphylococcus aureus ATCC 43300 como control de resistencia y ATCC 33862 como control de sensibilidad. Una encuesta fue realizada con el fin de determinar posibles factores de riesgo que pudieran estar asociados con la presencia portadores asintomáticos del microorganismo. Del estudio se obtuvo que la prevalencia de SARM fue del 1,2%, los factores asociados a la portación nasal son: ser médico (p=0,025) y la ausencia de lavado de manos después de procesos invasivos (p=0,003). Podría concluirse que aunque la portación nasal asintomática de SARM en este estudio fue baja, el solo hallazgo de una cepa de SARM representa un peligro potencial para los usuarios de las UCI, debido al riesgo de transmisión y la posible generación de infecciones multiresistentes que empeoran el pronóstico del paciente.

Carriers of Methicillin-Resistant Staphylococcus aureus (MRSA) in healthcare workers of intensive care units (ICUs) belonging to three medical centers in Tunja (Colombia) were phenotypically determined. All subjects under study (84) we performed a nasal swab in order to isolate strains of MRSA. Samples were inoculated onto mannitol salt agar; mannitol-fermenting strains were identified by morphological evidence (Gram) and biochemical such as catalase, coagulase and DNase. To determine their resistance to methicillin was performed a susceptibility test using disk diffusion method with 30 μg cefoxitin disc, according to CLSI M02-A11 protocol. Staphylococcus aureus strains ATCC 43300 and ATCC resistance control and sensitivity control 33 862 were used. A survey was conducted in order to determine possible risk factors that might be associated with the presence of asymptomatic carriers of MRSA. Prevalence of MRSA was 1.2%, factors associated with nasal carriage are: to be a physician (p = 0.025) and the absence of handwashing after invasive procedures (p=0,003). Although asymptomatic nasal carriage of MRSA in this study was low, the finding of a single MRSA strain represents a potential hazard to users of the ICU, due to risk of transmission and possible generation of multi-resistant infections that worsen prognosis of users.

Detección de portadores del rasgo drepanocítico en una muestra de población de Maracay y su zona metropolitana / Detection of sickle cell trait carriers in a population sample of Maracay and its Metropolitan area

La Anemia drepanocítica es una enfermedad genética con patrón de herencia autosómico recesivo, caracterizada por la presencia de eritrocitos en forma de hoz, los cuales no pueden pasar eficientemente por los capilares provocando vaso-oclusión, daños en tejidos y crisis dolorosas. En el Estado Aragua se ha reportado una frecuencia relativamente alta de pacientes drepanocíticos y portadores del rasgo drepanocítico, quienes pueden ser sintomáticos en condiciones de hipoxia. El objetivo del trabajo consistió en detectar portadores del rasgo drepanocítico en una muestra de 200 individuos sin relación de parentesco y sin síntomas de anemia drepanocítica, habitantes de Maracay y su zona Metropolitana, estado Aragua; para dar información genético-patológica pertinente a los portadores y sus familias. Una vez obtenido el consentimiento informado, se tomó una muestra de sangre para detectar células drepanocíticas mediante la prueba de Metabisulfito de Sodio y el diagnóstico se confirmó con un ensayo de Reacción en Cadena de la Polimerasa y posterior digestión con la enzima Bsu 36 I. Se encontraron 13 portadores del rasgo drepanocítico (6,5%). Al incluir 20 familiares de 6 de estos portadores sanos, se obtuvo una frecuencia de 45%. Se dio información genético-patológica al grupo familiar, con énfasis en la prevención a la exposición de factores de riesgo y la prevención de la producción del nacimiento de homocigotos afectados. Estos resultados alertan sobre la necesidad de establecer programas de detección y educación de portadores del rasgo drepanocítico para prevenir complicaciones de salud en estas personas.

The sickle cell disease is a genetic disease, with autosomal recessive inheritance pattern, characterized by the presence of sickleshaped red blood cells, which cannot pass efficiently through the capillaries causing vaso-occlusion, tissue damage and painful crisis. In Aragua State it has been reported a relatively high frequency of sickle cell patients and healthy carriers of sickle cell trait, who may be symptomatic under conditions of hypoxia. The aim of this study was to detect carriers of sickle cell trait in a sample of 200 nonrelated individuals without symptoms of sickle cell disease, habitants of Maracay and its metropolitan area, Aragua state, to provide genetic-pathological information relevant to families of healthy carriers identified. After obtaining informed consent, a sample of peripheral blood was taken to detect sickle cell through sodium metabisulfite test, the diagnosis was confirmed by a Polymerase Chain Reaction test and subsequent digestion by Bsu 36 I enzyme. Thirteen carriers of sickle cell trait were found, (6.5%). By including 20 relatives of 6 healthy carriers a frequency of 45% was obtained. Pathological genetic information to the family was provided with emphasis on prevention of exposure to risk factors and prevention of production of homozygous affected birth. These results highlight the need to establish detection and education of sickle cell trait carriers to prevent health complications in these individuals.