Staphylococcus aureus growth delay after exposure to low fluencies of blue light (470 nm) / Atraso no crescimento de Staphylococcus aureus após exposição à baixas fluências de luz azul (470 nm)

Antibiotic resistance is one of the greatest challenges to treat bacterial infections worldwide, leading to increase in medical expenses, prolonged hospital stay and increased mortality. The use of blue light has been suggested as an innovative alternative to overcome this problem. In this study we analyzed the antibacterial effect of blue light using low emission parameters on Staphylococcus aureus cultures. In vitro bacterial cultures were used in two experimental approaches. The first approach included single or fractionated blue light application provided by LED emitters (470 nm), with the following fluencies: 16.29, 27.16 and 54.32 J/cm2. For the second approach a power LED (470 nm) was used to deliver 54.32 J/cm2 fractionated in 3 applications. Our results demonstrated that bacterial cultures exposed to fractionated blue light radiation exhibited significantly smaller sizes colonies than the control group after 24 h incubation, however the affected bacteria were able to adapt and continue to proliferate after prolonged incubation time. We could conclude that the hypothetical clinical use of low fluencies of blue light as an antibacterial treatment is risky, since its action is not definitive and proves to be ineffective at least for the strain used in this study.

A resistência a antibióticos é um dos maiores desafios para o tratamento de infecções bacterianas em todo o mundo, levando ao aumento de despesas médicas, prolongamento da internação hospitalar e aumento da mortalidade. O uso da luz azul tem sido sugerido como uma alternativa inovadora para superar esse problema. Neste estudo, analisamos o efeito antibacteriano da luz azul usando parâmetros de baixa emissão em culturas de Staphylococcus aureus. Culturas bacterianas foram usadas em duas abordagens experimentais in vitro. A primeira abordagem incluiu o uso da aplicação única ou fracionada de luz azul fornecida por emissores de LED (470 nm), com as seguintes fluências: 16,29, 27,16 e 54,32 J/cm2. Para a segunda abordagem, um LED de potência (470 nm) foi usado para fornecer 54,32 J/cm2 fracionado em 3 aplicações. Nossos resultados demonstraram que as culturas bacterianas expostas à radiação de luz azul fracionada exibiram colônias de tamanhos significativamente menores do que o grupo controle após 24 h de incubação, no entanto, as bactérias afetadas foram capazes de se adaptar e continuar a proliferar após um tempo prolongado de incubação. Podemos concluir que o uso clínico hipotético de baixas fluências de luz azul como tratamento antibacteriano é arriscado, pois sua ação não é definitiva e mostra-se ineficaz, pelo menos para a cepa utilizada neste estudo.

Individual variation is the key to the development of a vaccine against Staphylococcus aureus: a comparative study between mice lineages

Bacterial infections occur worldwide and are a major public health problem. Among pathogens, Staphylococcus aureus is the main causative agent of bacterial diseases in the world. This study aimed to evaluate which components of the immune system could act protectively against a S. aureus infection in intradermally immunized mice. C57BL/6 and A/j mice were immunized intradermally with S. aureus inactivated by heat and then challenged with viable strains in an air pouch model. At 6, 12, and 24 h after the challenge, euthanasia was performed, and the cellular profile of the inflammatory infiltrate, cytokines, and the bacterial load were evaluated in the air pouch lavages. Immunized mice demonstrated that the intradermal immunization with S. aureus promoted protection in C57BL/6 mice by reducing the bacterial, which was correlated with increased serum concentration of IgG antibodies (IgG1 and IgG2a) against S. aureus. The increase in IgG2a antibody levels was correlated with a decrease of bacterial load in intradermally immunized C57BL/6 mice, along with production of IL-17A at the inflammation site, as well as IgG1consumption. Similar results were not found in the A/j lineage. In conclusion, a vaccine against S. aureus should focus more on the individual characteristics of the host because it is a determinant factor for the success of the immunization.

Catéteres recubiertos con quitosan / Catheters coated with chitosan

Introducción: Los catéteres venosos centrales son fundamentales en el tratamiento de pacientes en estado crítico con patologías agudas o crónicas. Los catéteres venosos centrales son utilizados para fines diagnósticos y terapéuticos. A pesar de buscar un beneficio para el paciente, este no está exento riesgos significativos durante su utilización, aumentando la morbimortalidad. 1,2En la argentina aproximadamente un tercio del total de las bacteriemias nosocomiales tienen origen en los catéteres venosos (considerada como una de las causas más frecuente de bacteriemia nosocomial). Las infecciones asociadas a catéteres son las terceras en frecuencia entre las infecciones nosocomiales asociadas a dispositivos biomédicos, con un 16%; seguida a la infección del tracto urinario asociada a la sonda vesical con el 31% y la neumonía asociada a asistencia respiratoria mecánica con el 27%. Como consecuencia las bacteriemias nosocomiales se incrementa los costos de atención, extienden la internación hospitalaria y aumentan la morbimortalidad de los pacientes.3 Material y Método: Entre los meses de agosto y septiembre del año 2018, se realizó una búsqueda bibliográfica recurriendo a escritura científica, lectura crítica a base de fuentes de información como revistas científicas digitales, búsquedas avanzadas con filtros selectivos en Pubmed, y archivos de revisiones, revisiones sistemáticas y nuevas investigaciones. La búsqueda en Internet se llevó a cabo con la utilización lenguaje MeSH combinando términos como, catéteres recubiertos, infección asociada a catéteres, biomateriales mediante operadores booleanos en idioma inglés, español. Se realizó la lectura crítica y análisis de los artículos estudiados. Conclusión: Esta nueva investigación concluye que el revestimiento de los catéteres venosos centrales con un agente antimicrobiano eficiente y no tóxicas contra células humanas como el quitosan hace de este polímero un candidato potencial para otras aplicaciones en la prevención de infecciones crónicas y nosocomiales asociadas a dispositivos médicos. Los recubrimientos con quitosan se probaron con éxito en depósitos empleados en la investigación como poderosos agentes antimicrobianos para evitar el desarrollo y la diseminación de Infección por S. aureus que muestra alta citocompatibilidad y baja citotoxicidad.

Introduction: Central venous catheters are fundamental in the treatment of patients in critical condition with acute or chronic pathologies. Central venous catheters are used for diagnostic and therapeutic purposes. Despite seeking a benefit for the patient, this is not without significant risks during its use, increasing morbidity and mortality. 1,2In Argentina about one third of all nosocomial bacteremia originates from venous catheters (considered one of the most frequent causes of nosocomial bacteremia). Catheter-associated infections are the third in frequency among nosocomial infections associated with biomedical devices, with 16%; followed by urinary tract infection associated with the bladder catheter with 31% and pneumonia associated with mechanical ventilation with 27%. As a consequence, nosocomial bacteremia increases the costs of care, extends hospitalization and increases the morbidity and mortality of patients.3 Material and Method: Between the months of August and September of the year 2018, a bibliographic search was carried out using scientific writing, critical reading based on information sources such as digital scientific journals, advanced searches with selective filters in Pubmed, and review files. , systematic reviews and new investigations. The Internet search was carried out with the use of MeSH language, combining terms such as coated catheters, infection associated with catheters, biomaterials through Boolean operators in English, Spanish. The critical reading and analysis of the articles studied was carried out. Conclusion: This new research concludes that the coating of central venous catheters with an efficient and non-toxic antimicrobial agent against human cells such as chitosan makes this polymer a potential candidate for other applications in the prevention of chronic and nosocomial infections associated with medical devices. . Chitosan coatings were successfully tested in deposits used in the research as powerful antimicrobial agents to prevent the development and spread of S. aureus infection showing high cytocompatibility and low cytotoxicity.

Tipologia de manejo de ordenha: análise de fatores de risco para a mastite subclínica / Typology of milking management: analysis of risk factors for subclinical mastitis

Apesar do volume de leite produzido, a qualidade da matéria-prima é um dos maiores entraves ao desenvolvimento tecnológico e à consolidação da indústria de laticínios no Brasil. Dentre os entraves, toma destaque a contagem de células somáticas do leite, que é o indicador mais usado em programas de controle e prevenção da mastite em todo o mundo. Com objetivo de identificar características no manejo de ordenha e quantificar fatores de risco que elevam a mastite subclínica e seus principais agentes causadores, realizou-se coleta de dados in loco em propriedades leiteiras na região Oeste do Paraná, coletas que consistiam na aplicação de dois questionários guia semi-estruturados, acompanhamento de uma ordenha e coleta de leite de três vacas que apresentassem o teste de CMT positivo. Com a utilização do método estatístico de análise de correspondência múltipla (ACM) chegou-se a um montante de 12 variáveis a serem estudadas e a formação das dimensões 1 e 2 com 28,54% e 21,06% da variância explicada respectivamente. Com a análise de classificação hierárquica ascendente permitiu reduzir o universo inicial de 112 vacas para quatro grupos homogêneos de produção (G1, G2, G3, G4). As características de manejo de ordenha: tipo de ordenha, secagem dos tetos antes da ordenha, tratamento para casos de mastite clínica, higiene das mãos do ordenhador e treinamento dos ordenadores foram identificados como fatores de risco para mastite subclínica com isolamento do agente Staphylococcus coagulase negativo, o qual foi o agente mais prevalente nos isolamentos microbiológicos das amostras de leite com mastite subclínica.(AU)

Despite the produced milk volume, its quality is one of the barriers for technological development and consolidation of the dairy industry in Brazil. Among the barriers is the milk somatic cell count, which is the indicator used in most control programs and prevention of mastitis. In order to identify characteristics in the management of milking and to quantify risk factors that increase subclinical mastitis and its main bacterial agents, data were collected in situ on dairy farms in western Paraná. The data collection consisted in the application of two questionnaires, in accompanying a milking procedure, and in collection of CMT positive milk samples from three cows. Using the statistical method of multiple correspondence analysis (MCA) we came to a total of 12 variables to be studied, and to the formation of dimension 1 and 2 with respectively 28.54% and 21.06% of the explained variance. With the hierarchical ascending classification analysis it was possible to reduce the initial population of 112 cows to produce four homogeneous groups (G1, G2, G3, G4). The milking handling characteristics, as type of milking, drying teats before milking, treatment for cases of clinical mastitis, milker's hand hygiene and as training of officers, were identified as risk factors for subclinical mastitis with isolation of a coagulase negative Staphylococcus, which was the most prevalent agent in milk samples of subclinical mastitis.(AU)

Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: a systematic review and meta-analysis

Abstract Globally, methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections. Healthcare workers (HCWs), patients and the environment may act as reservoirs for the spread of MRSA to patients and other HCWs. Screening and eradication of MRSA colonization is an effective method of reducing the MRSA infection rate. There are limited data on the prevalence of MRSA among Iranian HCWs. We performed a systematic search by using different electronic databases including Medline (via PubMed), Embase, Web of Science, and Iranian Databases (from January 2000 to July 2016). Meta-analysis was performed using the Comprehensive Meta-Analysis (Biostat V2.2) software. The meta-analyses showed that the prevalence of S. aureus and MRSA among HCWs were 22.7% [95% confidence interval (CI): 19.3-26.6] and 32.8% (95% CI: 26.0-40.4) respectively. The high rate of nasal MRSA carriage among Iranian HCWs has been attributed to poor compliance to hand hygiene, injudicious use of antibiotics, and ineffective infection control and prevention measures. The rational use of antibiotics plus strict infection control are the main pillars for controlling multidrug resistant microorganisms such as MRSA in the hospital setting. These measurements should be applied nationally.

Silibinin improves palmitate-induced insulin resistance in C2C12 myotubes by attenuating IRS-1/PI3K/Akt pathway inhibition

The present study investigated the effect of silibinin, the principal potential anti-inflammatory flavonoid contained in silymarin, a mixture of flavonolignans extracted from Silybum marianum seeds, on palmitate-induced insulin resistance in C2C12 myotubes and its potential molecular mechanisms. Silibinin prevented the decrease of insulin-stimulated 2-NBDG (2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxy-D-glucose) uptake and the downregulation of glutamate transporter type 4 (GLUT4) translocation in C2C12 myotubes induced by palmitate. Meanwhile, silibinin suppressed the palmitate-induced decrease of insulin-stimulated Akt Ser473 phosphorylation, which was reversed by wortmannin, a specific inhibitor of phosphatidylinositol-3-kinase (PI3K). We also found that palmitate downregulated insulin-stimulated Tyr632 phosphorylation of insulin receptor substrate 1 (IRS-1) and up-regulated IRS-1 Ser307 phosphorylation. These effects were rebalanced by silibinin. Considering several serine/threonine kinases reported to phosphorylate IRS-1 at Ser307, treatment with silibinin downregulated the phosphorylation of both c-Jun N-terminal kinase (JNK) and nuclear factor-κB kinase β (IKKβ), which was increased by palmitate in C2C12 myotubes mediating inflammatory status, whereas the phosphorylation of PKC-θ was not significantly modulated by silibinin. Collectively, the results indicated that silibinin prevented inhibition of the IRS-1/PI3K/Akt pathway, thus ameliorating palmitate-induced insulin resistance in C2C12 myotubes.

The family's role as a support network for people living with HIV/AIDS: a review of Brazilian research into the theme / A família como rede de apoio às pessoas que vivem com HIV/AIDS: uma revisão na literatura brasileira

The study of HIV transmission and the implementation of AIDS prevention actions recognize the importance of social networks in the transmission of the disease, the adherence to treatment and the quality of life of those infected. For this relevance there was a review of articles on social support networks to people living with HIV /AIDS available in the Virtual Health Library (VHL) were published in Brazil between 2002 and 2012. In this study 31 articles were used from journals covering the following áreas: Nursing (n = 15), Psychology (n = 6) and Science Health / Biomedica (n = 6), were included, which some principal authors were affiliated to higher education public institutions (n = 17). In relation to the methodology used, priority wasgiven to conducting: qualitative research (n = 18), cross-sectional studies (n = 19) and studies that involved talking to people living with HIV/AIDS (n = 13). Particular importance was placed on analytic categories related to: adherence to treatment (n = 6), the family (n = 4), vulnerability (n = 3) and support from social networks (n = 5). Within this paper we argue for more investments into studies that focus on the family, carers and their households, as well as deepening the theoretical study of the themes discussed and the use of developed theories for the analysis of Social Networks.

O estudo da transmissão do HIV e a implementação de ações de prevenção da AIDS reconhece a importância das redes sociais na contaminação, adesão ao tratamento e qualidade de vida das pessoas infectadas. Por tal relevância, realizou-se uma revisão de artigos sobre redes sociais de apoio às pessoas que vivem com HIV/ AIDS, disponíveis na Biblioteca Virtual em Saúde (BVS) e publicados no Brasil no período de 2002 a 2012. Encontraram-se 31 artigos em revistas de Enfermagem (n = 15), Psicologia (n = 6) e Ciências da Saúde/Biomédicas (n = 6), produzidos por primeiros autores associados a Instituições de Ensino Superior públicas (n = 17). Quanto à metodologia, priorizou-se o método qualitativo (n = 18), estudos transversais (n = 19) e a participação exclusiva de pessoas que vivem com HIV/AIDS (n = 13). Houve predomínio de categorias analíticas relacionadas à adesão ao tratamento (n = 6), família (n = 4), vulnerabilidade (n = 3) e apoio/suporte social/ rede de apoio (n = 5). Discute-se a necessidade de investimento em estudos que privilegiem familiares e cuidadores como participantes e seus domicílios como lócus de investigação, bem como maior aprofundamento teórico nos estudos das temáticas abordadas e utilização de teorias desenvolvidas para análise de Redes Sociais.

Association of high-density lipoprotein and apolipoprotein E genetic variants with age-related macular degeneration / Associação de lipoproteína de alta densidade e variantes genéticas da apolipoproteína E com degeneração macular relacionada à idade

Purpose: This study aimed to evaluate the association of age-related macular degeneration (AMD) with apolipoprotein E (APOE) variants and serum lipid profiles, including levels and fractions of total serum cholesterol (TC), low-density lipoprotein cholesterol (LDLc), and high-density lipoprotein cholesterol (HDLc), and triglycerides (TG). Methods: Genotyping of APOE-HhaI was performed in 134 patients (study group, SG) and 164 individuals without AMD (control group, CG), aged 50-89 years. Lipid profiles were analyzed in a subgroup of 30 subjects of both groups, matched according to age and sex. The significance level was set at P<0.05. Results: APOE E3/E3 was more prevalent (SG=74.6%; CG=77.4%), with no difference between both groups (P=0.667). The same result was observed for risk genotypes (APOE E -/2: SG=7.4%; CG=10.3%, P=0.624). Serum levels of TC, LDLc, and TG revealed similar median values between SG (193.5, 116, and 155 mg/dL, respectively) and CG (207.5, 120, and 123.5 mg/dL, respectively; P >0.05). For HDLc, a higher median value was observed in SG (53.3 mg/dL) versus CG (42.5 mg/dL; P=0.016). Logistic regression analysis showed the same value, and the HDLc/TC ratio was -11.423 (P=0.014), as also confirmed by an increase in HDLc in SG. The association between lipid profiles and apolipoprotein E genotypes was similar in both groups (P>0.05). Conclusion: APOE-HhaI is not associated with AMD. However, an increase in serum HDLc level appears to exert a protective effect against the disease, irrespective of the genetic variants of apoE. .

Objetivo: Este estudo teve como objetivo avaliar a associação de degeneração macular relacionada à idade (DMRI) com variantes de alipoproteína E (APOE) e perfil lipídico sérico, incluindo níveis séricos de colesterol total (TC) e frações de proteínas relacionadas a receptor de LDL (LDLc) e HDL colesterol (HDLc), e triglicérides (TG). Métodos: Realizouse genotipagem de APOE-HhaI em 134 pacientes (grupo de estudo SG) e 164 indivíduos sem a doença (grupo controle CG), na faixa etária entre 5089 anos. O perfil lipídico sérico foi analisado em um subgrupo de 30 indivíduos de ambos os grupos, pareados por idade e sexo. Admitiuse nível de significância para valorP<0,05. Resultados: APOE E3/E3 prevaleceu (SG=74,6%; CG=77,4%), sem diferença entre os grupos (P=0,667), o mesmo ocorreu para genótipos de risco (APOE /E2: SG=7,4%; CG=10,3%,P=0,624).Níveis séricos de TC, LDLc e TG mostraram medianas semelhantes entre SG (193,5; 116; 155 mg/dL, respectivamente) e CG (207,5; 120; 123,5 mg/dL respectivamente; P>0,05). Para HDLc notouse valor de mediana elevado em SG (53,3 mg/dL) versus CG (42,5 mg/dL; P=0,016), constatado também na análise de regressão logística, cuja razão HDLc/TC mostrou coeficiente 11,423 (P=0,014), confirmando acréscimo de HDLc em SG. A relação entre perfil lipídico sérico e genótipos de APOE mostrou semelhança entre os grupos (P>0,05). Conclusão: APOE-HhaI não se associa a DMRI, no entanto, o acréscimo no nível sérico de HDLc parece ter efeito protetor contra a doença, independente de variantes genéticas da apoE. .

Macular dystrophy associated with Kjellin’s syndrome: a case report / Distrofia macular associada à síndrome de Kjellin: um relato de caso

Hereditary spastic paraplegia (HSP) is characterized by weakness and spasticity of the lower extremities. Kjellin’s syndrome is a rare syndrome associated with HSP. The syndrome is characterized by the presence of bilateral retinal flecks, similar to the findings in Stargardt disease and fundus flavimaculatus. We report the case of a 34-year-old male who presented with complete features of Kjellin’s syndrome, with typical retinal findings observed on multimodal imaging (spectral domain optical coherence tomography [SD-OCT], near-infrared reflectance and autofluorescence imaging). The ophthalmological changes at early stages of the disease may not impair visual acuity. Therefore, the detection of central retinal degeneration requires thorough fundus examination.

A paralisia espástica hereditária (HSP) é caracterizada por fraqueza e espasticidade das extremidades inferiores. A síndrome de Kjellin é uma rara associação de HSP com a presença de flecks retinianos similares aos encontrados em pacientes com doença de Stargardt ou fundus flavimaculatus. Descrevemos os achados em imagens multimodais da retina (tomografia de coerência óptica de domínio espectral [SD-OCT], reflectância próxima ao infravermelho e autofluorescência) em um paciente de 34 anos que apresenta conjunto completo de sinais e sintomas da síndrome de Kjellin. As alterações retinianas em estágios iniciais da doença podem aparecer, mesmo sem redução da acuidade visual, e por isso, para detecção da degeneração central da retina, é necessário exame minucioso do fundo de olho.

Impression cytology in the evaluation of ocular surface tumors: review article / Citologia de impressão na avaliação de tumores da superfície ocular: artigo de revisão

Impression cytology (IC) has been widely used as a method for evaluating the ocular surface and superficial cells layers in the diagnosis and follow-up after treatment of several ocular surface tumors of both epithelial and melanocytic origin. Information regarding this can be found in the English-language literature since 1992. Using either cellulose acetate or Biopore membranes for specimen collection, a high correlation has been found between IC and tissue histology. Compared with exfoliative cytology with spatula, IC is less traumatic to the patient’s eye, provides a precise location of the area being studied, and allows accurate observation of the cells the way they exist in vivo. The additional advantage of IC is the preservation of limbal stem cells responsible for continuous corneal epithelium renewal; these can be affected after incisional or excisional biopsy at the corneoscleral limbus, which is the most frequent site of appearance of tumors in the stratified epithelium. Treatment for ocular surface squamous neoplasia has historically included surgery, but nonsurgical interventions have also been adopted. Hence, in certain cases, ophthalmologists may prefer interventions less invasive than surgical biopsy such as of impression cytology for both initial diagnosis and therapeutic monitoring of treatment for ocular surface lesions. Nevertheless, it should be considered that IC may be less helpful if the results conflict with the clinical picture or if the clinical diagnosis is uncertain and results are negative. In such cases, surgical biopsy is required for accurate diagnosis. The purpose of this review is to examine the published literature on the utilization of IC for the diagnosis and management of ocular surface tumors and to discuss the requirement for further investigation on the subject.

A citologia de impressão (CI) tem sido amplamente utilizada como um método de avaliação da superfície ocular e das camadas de células superficiais no diagnóstico e no seguimento após tratamento de vários tumores da superfície ocular de origem epitelial ou melanocítica. As informações podem sem encontradas na literatura em língua inglesa desde 1992. Utilizando-se de membranas de acetato de celulose ou Biopore na coleta dos espécimes, uma alta correlação tem sido encontrada entre a CI e a histologia do tecido. Comparando-se com a citologia esfoliativa, a citologia de impressão é menos traumática para o olho do paciente, fornece uma localização precisa da área estudada e permite ver as células da forma como elas organizam-se in vivo. A vantagem adicional da citologia de impressão é a preservação das células- tronco germinativas responsáveis pela renovação contínua do epitélio da córnea. Elas podem ser afetadas após biópsia cirúrgica na região do limbo que é o sítio mais frequentemente acometido pelos tumores do epitélio estratificado. O tratamento para a neoplasia escamosa da superfície ocular tem sido historicamente a cirurgia, mas intervenções não cirúrgicas também foram adotadas. Por esta razão, em certos casos, oftalmologistas podem recorrer a formas menos invasivas que a biópsia cirúrgica (como a citologia de impressão) tanto para o diagnóstico inicial quanto para o monitoramento terapêutico das lesões da superfície ocular. No entanto, deve-se ter em mente que a citologia de impressão deixa de ser útil quando seu resultado não coincide com o quadro clínico ou quando o diagnóstico clínico é incerto e o resultado da citologia de impressão negativo. Nesses casos, a biópsia cirúrgica deve ser realizada para o diagnóstico. O objetivo desta revisão é examinar a literatura sobre a utilização da citologia de impressão no diagnóstico e tratamento dos tumores da superfície ocular bem como discutir a necessidade de uma investigação mais aprofundada sobre o assunto.

Aspectos de la respuesta inmune innata en las infecciones intramamarias causadas por Staphylococcus aureus en bovinos / Aspects of the innate immune response to intramammary Staphylococcus aureus infections in cattle

Staphylococcus aureus es el principal agente causante de mastitis bovina en Argentina y en el mundo. Esta bacteria ocasiona infecciones crónicas que generan importantes pérdidas a los productores y la industria lechera. El objetivo de este artículo es caracterizar los mecanismos que intervienen en la infección causada por S. aureus en la glándula mamaria bovina, evaluando dos aspectos diferentes del proceso infeccioso: por un lado, lo vinculado con la respuesta inmune innata por parte del hospedador, y por otro, la capacidad de la bacteria para evadir el sistema inmune e interactuar con diferentes tipos celulares. La exploración de la interacción de S. aureus con el sistema inmune de la glándula mamaria bovina permitirá identificar blancos para delinear nuevas alternativas preventivas o curativas, que contribuyan a evitar o eliminar las infecciones causadas por este organismo

Staphylococcus aureus is the pathogen most frequently isolated from bovine mastitis worldwide, causing chronic intramammary infections that limit profitable dairying. The objective of this article is to characterize the mechanisms involved in S. aureus mammary gland infections considering two different aspects of the infectious process; on the one hand, the aspects involved in the host innate immune response and on the other hand, the capacity of this organism to evade the immune system and interact with different cell types. The exploration of S. aureus interactions with the immune response of bovine mammary gland will help identify targets to outline new preventive or curative alternatives for intramammary infections caused by this organism

Infecções multirresistentes por Staphylococcus aureus: Tratamento e profilaxia / Multidrug-resistant Staphylococcus aureus infections: treatment and prophylaxis

O gênero Staphylococcus constitui-se por bactérias esféricas, chamadas de cocos, sendo que à microscopia apresentam-se agrupadas em "cachos de uva". O Staphylococcus aureus, apesar de fazer parte da microbiota humana normal, constitui-se como a espécie de bactéria mais virulenta e uma das responsáveis por infecções hospitalares e/ou adquiridas na comunidade, devido à sua disseminação intra-hospitalar sem dificuldades, somada à extraordinária capacidade de adquirir resistência a alguns antimicrobianos. A necessidade de controle das infecções causadas por S. aureus ganha ênfase devido à extensão do número de ocorrências de infecções hospitalares e à imprescindibilidade do controle dos surtos. Portanto, a resistência adquirida aos antimicrobianos se torna preocupante pelo seu uso clínico indiscriminado...

The Staphylococcus genus is constituted by spherical bacteria, called cocci, and microscopy are shown grouped into "clusters of grapes". S. aureus, despite being part of the normal human microbiota was established as the most virulent species of bacteria and one of those responsible for hospital and/or community-acquired infections due to their hospital spread smoothly added to the extraordinary ability to acquire resistance to certain antibiotics. The need for the control of infections caused by S. aureus gains emphasis due to the extension of the number of occurrences of nosocomial infections and the indispensability of the control of outbreaks. Therefore, the acquired resistance to antimicrobials is very worrying for their widespread clinical use...

Estágio sanduiche na Noruega: relato de experiência / Sandwich stage in Norway: experience report

O Programa de Doutorado no Brasil com Estágio no Exterior, conhecido como Doutorado Sanduíche, visa a contribuir para intercâmbios dos cursos de Pós-Graduação no País com seus congêneres no exterior. O objetivo deste artigo foi relatar a experiência vivida durante o estágio realizado na Noruega, em unidades hospitalares, laboratórios de microbiologia, órgãos federais e serviços de saúde de Oslo e Região Metropolitana. Foram desenvolvidas atividades de vigilância epidemiológica, técnicas laboratoriais de identificação e tipagem molecular de Staphylococcus aureus e políticas públicas e institucionais de prevenção e controle dessas bactérias, quando multirresistentes. O estágio, além de subsidiar e fortalecer a análise dos dados do projeto da tese, permitiu refletir sobre a importância de políticas públicas e diretrizes definidas, e fornecer condições para ações de prevenção e controle de agravos, tendo a saúde e o bem-estar da pessoa como valores de Estado.

The Doctoral Program in Brazil, with the Internship Abroad known as the Sandwich Ph.D., aims to contribute to exchanges of graduate courses in the country with counterparts abroad. The objective of this article was to report the lived experience during an internship in Norway, in hospital units, microbiology laboratories, federal agencies and health services in Oslo and the metropolitan region. Activities were developed for epidemiological surveillance, laboratory techniques for identification and molecular typing of Staphylococcus aureus, and public and institutional policies for prevention and control of these bacteria, when multiresistant. The Sandwich stage in addition to supporting and strengthening the analysis of project data of the thesis, permitted the reflection on the importance of established public policies and guidelines, and conditions provided for prevention and control of diseases, and health and welfare of the person as values of the state.

El Programa de Doctorado en el Brasil con Prácticas en el Exterior, conocido como Doctorado Sandwich, visa contribuir a los intercambios de los cursos de Postgrado en el País con sus congéneres en el exterior. El objetivo de este artículo fue relatar la experiencia vivida durante las prácticas realizadas en Noruega, en unidades hospitalarias, laboratorios de microbiologia, órganos federales y servicios de salud de Oslo y Región Metropolitana. Se desarrollaron actividades de vigilancia epidemiológica, técnicas de laboratorio de identificación y tipaje molecular de Staphylococcus aureus y políticas públicas e institucionales de prevención y control de esas bacterias, multiresistentes. La práctica, además de ofrecer subsídios y fortalecer al análisis de los datos del proyecto de la tesis, permitió reflexionar sobre la importancia de las políticas públicas y directivas definidas, y dar las condiciones para acciones de prevención y control de agravios, teniendo a la salud y al bienestar de la persona como valores de Estado.

Lessons to learn with the methicillin-resistant Staphylococcus aureus control in Norway

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Norway is low, compared to other European and American countries. The health system includes mandatory case reporting and has written guidelines for prevention and control. This communication describes the national public policies related to MRSA obtained from documents and academic experience gained during a doctoral fellowship in Oslo, Norway. The painstaking procedures used for investigating suspected cases, including health professionals, decolonization and case monitoring, could be important tools to be used by countries with a high prevalence of MRSA.

Colonization of nursing professionals by Staphylococcus aureus / A colonização dos profissionais de enfermagem por Staphylococcus aureus / La colonización de los profesionales de enfermería por Staphylococcus aureus

This cross-sectional study aimed to investigate the presence of Staphylococcus aureus in the saliva of the nursing team of a teaching hospital in the interior of São Paulo State. Three saliva samples were collected from 351 individuals with an interval of two months between each collection. All ethical aspects were considered. In 867 (82.3 percent) cultures there was no identification of Staphylococcus aureus in the saliva, in 88 (17.7 percent) cultures Staphylococcus aureus was isolated, 26 (2.5 percent) of which were resistant to methicillin. The prevalence of professionals colonized by Staphylococcus aureus was 41.0 percent (144/351), of which 7.1 percent (25/351) were characterized as methicillin-resistant Staphylococcus aureus. Transient carriers represented 81.2 percent and persistent carriers 18.8 percent. Resistance to mupirocin was 73.1 percent of MRSA and 9.3 percent of MSSA. The results demonstrate that it is the nurse and nursing technician that are the professional categories most susceptible to MRSA. Broader discussion on the thematic and interventions are needed.

Este é um estudo transversal e teve como objetivo investigar a presença de Staphylococcus aureus na saliva da equipe de enfermagem de um hospital escola, do interior paulista. Foram coletadas três amostras da saliva de 351 indivíduos, com intervalo de dois meses. Todos os aspectos éticos foram contemplados. Em 867 (82,3 por cento) culturas não houve identificação de Staphylococcus aureus na saliva, em 88 (17,7 por cento) culturas foi isolado Staphylococcus aureus, sendo 26 (2,5 por cento) resistentes à meticilina. A prevalência de profissionais colonizados por Staphylococcus aureus foi de 41,0 por cento (144/351), dos quais 7,1 por cento (25/351) foram caracterizados como Staphylococcus aureus resistentes à meticilina. Os carreadores transitórios representaram 81,2 por cento e os persistentes 18,8 por cento. A resistência à mupirocina foi de 73,1 por cento entre os resistentes à meticilina e 9,3 por cento nos sensíveis à meticilina. Os resultados evidenciaram que enfermeiras e os técnicos de enfermagem representam as categorias profissionais mais suscetíveis ao MRSA. Discussão mais ampla sobre a temática e intervenções se fazem necessárias.

Se trata de un estudio transversal que tuvo como objetivo investigar la presencia de Staphylococcus aureus en la saliva del equipo de enfermería de un hospital escuela del interior del estado de Sao Paulo. Fueron recolectadas tres muestras de saliva de 351 individuos con intervalo de dos meses. Todos los aspectos éticos fueron contemplados. En 867 (82,3 por ciento) culturas no hubo identificación de Staphylococcus aureus en la saliva, en 88 (17,7 por ciento) culturas fue aislado Staphylococcus aureus, siendo 26 (2,5 por ciento) resistentes a la meticilina. La prevalencia de profesionales colonizados por Staphylococcus aureus fue de 41,0 por ciento (144/351), de los cuales 7,1 por ciento (25/351) fueron caracterizados como Staphylococcus aureus resistentes a la meticilina. Los portadores transitorios representaron 81,2 por ciento y los persistentes 18,8 por ciento. La resistencia a la mupirocina fue de 73,1 por ciento entre los resistentes a la meticilina y 9,3 por ciento en los sensibles a la meticilina. Los resultados evidenciaron que son las enfermeras y los técnicos de enfermería las categorías profesionales más susceptibles al MRSA. Es necesario realizar una discusión más amplia sobre la temática e las intervenciones.

Frequency of oral mucositis and microbiological analysis in children with acute lymphoblastic leukemia treated with 0.12 percent chlorhexidine gluconate

In view of the morbidity potential of oral complications in patients with leukemia, this study evaluated the clinical and microbiological alterations that occur in the oral mucosa of children with acute lymphoblastic leukemia (ALL) undergoing antineoplastic chemotherapy and prophylactic administration of 0.12 percent chlorhexidine gluconate. The sample consisted of 17 children aged 2 to 12 years that underwent clinical examination of the oral mucosa for the detection of oral lesions. In addition, biological material was collected from labial and buccal mucosa for microbiological analysis. Oral mucositis was observed in only 5 (29.4 percent) patients. Microbiological analysis revealed a reduced number of potentially pathogenic microorganisms, such as coagulase-negative staphylococci (47 percent), Candida albicans (35.3 percent), Klebsiella pneumoniae (5.9 percent), enteropathogenic Escherichia coli (5.9 percent), and Stenotrophomonas maltophilia (5.9 percent). Patients with oral mucositis showed a higher frequency of coagulase-negative staphylococci (80 percent) when compared with patients with normal oral mucosa (33.3 percent). In conclusion, the results of the present study suggest that the prophylactic use of 0.12 percent chlorhexidine gluconate reduces the frequency of oral mucositis and oral pathogens in children with ALL. In addition, the present findings suggest a possible relationship between coagulase-negative staphylococci and the development of oral mucositis.

Tendo em vista o potencial de morbidade das complicações orais em pacientes com leucemia, este estudo avaliou as alterações clínicas e microbiológicas que ocorrem na mucosa bucal de crianças com leucemia linfoblástica aguda (LLA), submetidas à quimioterapia antineoplásica e administração profilática do gluconato de clorexidina 0,12 por cento. A amostra foi constituída de 17 crianças de 2 a 12 anos, as quais foram submetidas a exame clínico da mucosa oral para a detecção de lesões bucais. Além disso, foi coletado material biológico das mucosas labial e jugal para análises microbiológicas. A mucosite oral foi observada em apenas 5 (29,4 por cento) pacientes. A análise microbiológica revelou a presença de um número reduzido de microorganismos potencialmente patogênicos, como estafilococos coagulase-negativos (47 por cento), Candida albicans (35,3 por cento), Klebsiella pneumoniae (5,9 por cento), Escherichia coli enteropatogênica (5,9 por cento) e Stenotrophomonas maltophilia (5,9 por cento). Pacientes com mucosite oral apresentaram uma maior freqüência de estafilococos coagulase-negativos (80 por cento) quando comparados aos pacientes que exibiam mucosa oral normal (33,3 por cento). Em conclusão, os resultados do presente estudo sugerem que o uso profilático do gluconato de clorexidina 0,12 por cento reduz a freqüência de mucosite oral e de patógenos orais em crianças com LLA. Além disso, os presentes achados sugerem uma possível relação entre estafilococos coagulase-negativos e o desenvolvimento de mucosite oral.

Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America

Surveillance systems monitoring the spread and divergence of methicillin-resistant Staphylococcus aureus (MRSA) strains are critical if preventive and therapeutic measures targeting MRSA infection are to be employed optimally. Surveillance provides information on the spread of MRSA, on the emergence of new strains within hospitals and communities, on the antibiotic resistance profile and virulence of strains, and on the risk factors associated with infection. These data help clinicians to provide appropriate empiric treatment of infections circulating in their region, leading to improved patient outcomes. While information on MRSA epidemiology in Latin America is growing, significant gaps exist in the available data, especially in local areas where fewer resources are available for characterizing and reporting MRSA strains. Here, we describe current knowledge of healthcare- and community-associated MRSA epidemiology in the region, and provide recommendations for future development of surveillance systems with a view to providing robust data at regional, national and local levels.

Prevention strategies for methicillin-resistant S taphylococcus aureus (MRSA) in Latin America

After the first reports of the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting.