Diphetria in a vaccinated adult in Rio de Janeiro, Brazil

In 1999, a case of diphtheria in a 32-year-old woman was reported. The patient developed a sore throat immediately after participating of a five-day meeting with European workers in Rio de Janeiro. Her history included complete pediatric immunization (DTP) and three doses of adult formulation tetanus and diphtheria toxoid (dT) two years earlier. Clinical diagnosis of diphtheria was not made until microbiologic examination of specimens confirmed toxigenicity of Corynebacterium diphtheriae var. gravis, a biotype currently found circulating within Europe where diphtheria remains epidemic. This case reinforces the potential susceptibility of Brazilian adults to epidemic diphtheria in the vaccine era.

Isolation of Pseudomonas cepacia in cystic fibrosis patient

Pulmonary infection on cystic fibrosis (CF) patients are associated with a limited qualitative number of microorganisms. During the colonization process, Staphylococcus aureus usually preceedes Pseudomonas aeruginosa. This latter is at first non-mucoid, being replaced or associated to a mucoid morphotype which is rare in other diseases. In 1980, Pseudomonas cepacia appeared as an important agent in CF pulmonary infections with a mean frequency of about 6.1% isolations in different parts of the world. The primus colonization mainly occurs in the presence of pre-existent tissue lesions and the clinical progress of the disease is variable. In some patients it can be fulminant; in others it can cause a gradual and slow decrease in their pulmonary functions. The concern with this germ isolation is justified by its antibiotic multiple resistence and the possibility of direct transmission from a colonized patient to a non-colonized one. We reported the first case of P. cepacia infection in a CF patient in our area. The microbiological attendance to this patient had been made from 1986 to 1991 and the first positive culture appeared in 1988. The sensitivity profile showed that the primus colonization strain was sensitive to 9 of 17 tested antibiotics, however in the last culture the strain was resistent to all antibiotics. These data corroborate the need for monitoring the bacterial flora on CF patients respiratory system

Comportamento bioquímico de amostras de Streptococcus beta hemolítico / Biochemical behavior of beta hemolytic Streptococcus strains

Avaliamos o comportamento de 165 amostras de Steptococcus beta hemolítico grupadas sorologicamente, frente às provas fisilógicas recomendadas para a sua identificaçäo presuntiva (teste de sensibilidade à bacitracina, teste CAMP, hidrólise do hipurato de sódio, teste da bile esculina e tolerância ao caldo hipercloretado). O teste de sensibilidade à bacitracina mostrou-se altamente sensível para a identificaçäo presuntiva do grupo A (100%), embora tenha fornecido resultados falso-positivos para os grupos B (23,2%), C (100%) e G (58,8%). O teste CAMP identificou 97,5% das amostras do grupo B, tendo sido observado um percentual de 13,5% de provas positivas para o grupo A. Näo houve falso-positivos para o teste de hipurato de sódio, que identificou 84,2% dos Sterptococcus do grupo b., todos os grupos foram negativos para o teste da bile esculina, enquanto 23,2% das amostras do grupo B foram tolerantes ao calcio hipercloretado. Pela análise do emprego simultâneo dos testes mencionados, verificamos que apenas para as amostras de Streptococcus do grupo B, com determinadaos padröes de comportamento, foi possível a identificaçäo definitiva . Para os demais grupos torna-se necessário a utilizaçäo de testes fisiológicos adicinonais ou a grupagem sorológica para o diagnóstico de certeza