Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil

ABSTRACT Objective The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

The first year of the COVID-19 pandemic in an indigenous population in Brazil: an epidemiological study

ABSTRACT This cross-sectional observational study that describes the epidemiological data of the first year of the COVID-19 pandemic in the Mato Grosso do Sul State, aimed to demonstrate the differences between indigenous and non-indigenous populations, characterize confirmed cases of COVID-19 according to risk factors related to ethnicity, comorbidities and their evolution and to verify the challenges in facing the disease in Brazil. SIVEP-Gripe and E-SUS-VE, a nationwide surveillance database in Brazil, from March 2020 to March 2021 in Mato Grosso do Sul state, were used to compare survivors and non-survivors from indigenous and non-indigenous populations and the epidemiological incidence curves of these populations. A total of 176,478, including 5,299 indigenous people, were confirmed. Among the indigenous population, 52.5% (confidence interval [CI] 51.2-53.9) were women, 38% (CI 36.7-39.4) were 20-39 years old, 56.7% were diagnosed by rapid antibody tests, 12.3% (CI 95%:11.5-13.2) had at least one comorbidity, and 5.3% (CI 95%:4.7-5.9) were hospitalized. In the non-indigenous patients, 56.8% were confirmed using RT-PCR, 4.4% (CI 95%:4.3-4.5) had at least one comorbidity, and 8.0% (CI 95%:7.9-8.2) were hospitalized. The majority of non-survivors were ≥60 years old (65.1% indigenous vs. 74.1% non-indigenous). The mortality in indigenous people was more than three times higher (11% vs. 2.9%). Indigenous people had a lower proportion of RT-PCR diagnoses; deaths were more frequent in younger patients and were less likely to be admitted to hospital. Mass vaccination may have controlled the incidence and mortality associated with COVID-19 in this population during the period of increased viral circulation.

Detection of Treponema pallidum in whole blood samples of patients with syphilis by the polymerase chain reaction

ABSTRACT Syphilis is caused by the bacterium Treponema pallidum. The diagnosis is based on clinical data and serological analysis; however, the sensitivity and specificity of such tests may vary depending on the type of test and stage of the infection. In order to overcome this premise, this study utilized the polymerase chain reaction (PCR) for the detection of T. pallidum DNA in whole blood samples of patients with syphilis. The blood samples from patients with or without symptoms of syphilis, but with positive results in enzyme-linked immunosorbent assay (ELISA), were included in this study. A venereal disease research laboratory (VDRL) test was performed for all collected sera samples. For PCR, the T. pallidum DNA was extracted from the collected blood samples and a specific primer set was designed to amplify 131 nucleotides of polA (Tp0105). The specificity of the primers was evaluated with the DNA of 17 different pathogens. From a total of 314 blood samples reactive in ELISA, 58.2% (183/314) of the samples were reactive in the VDRL test. In the PCR, 54% (168/314) of the ELISA-reactive samples were positive. In both tests (VDRL and PCR) 104 samples were positive. Of 104 positive samples for both tests, 71 were at the latent stage. Based on these results, it can be concluded that PCR with the designed set of primers can be utilized as a diagnostic method for T. pallidum detection in blood samples of patients with syphilis, especially those with latent infection. In addition, it can be utilized as a supplement for serological methods to improve the diagnosis of syphilis.

High lethality rate of carbapenem-resistant Acinetobacter baumannii in Intensive Care Units of a Brazilian hospital: An epidemiologic surveillance study

ABSTRACT Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a growing threat to public health. Methods: A 3-year retrospective study was conducted to evaluate the prevalence and lethality of multidrug-resistant (MDR) A. baumannii isolated from Brazilian patients. Results: In this study, 219 Acinetobacter baumannii isolates were identified, of which 70.8% (155/219) were isolated from patients hospitalized in intensive care units. Of these, 57.4% (n = 89/155) were assessed, of which 92.1% (82/89) were carbapenem-resistant, and 49 were classified as infected. The lethality rate was 79.6% (39/49). Conclusions: We highlight the need of an effective epidemiological surveillance measure to contain the dissemination of CRAB in the hospital environment.

Overview of polymyxin resistance in Enterobacteriaceae

ABSTRACT Polymyxin antibiotics are disfavored owing to their potential clinical toxicity, especially nephrotoxicity. However, the dry antibiotic development pipeline, together with the increasing global prevalence of infections caused by multidrug-resistant (MDR) gram-negative bacteria, have renewed clinical interest in these polypeptide antibiotics. This review highlights the current information regarding the mechanisms of resistance to polymyxins and their molecular epidemiology. Knowledge of the resistance mechanisms and epidemiology of these pathogens is critical for the development of novel antibacterial agents and rapid treatment choices.

Multidrug-resistant Acinetobacter baumannii outbreaks: a global problem in healthcare settings

Abstract INTRODUCTION: The increase in the prevalence of multidrug-resistant Acinetobacter baumannii infections in hospital settings has rapidly emerged worldwide as a serious health problem. METHODS: This review synthetizes the epidemiology of multidrug-resistant A. baumannii, highlighting resistance mechanisms. CONCLUSIONS: Understanding the genetic mechanisms of resistance as well as the associated risk factors is critical to develop and implement adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting.

Antibacterial activity of Cinnamomum cassia L. essential oil in a carbapenem- and polymyxin-resistant Klebsiella aerogenes strain

Abstract INTRODUCTION: Essential oils can serve as novel sources of antibiotics for multidrug-resistant bacteria. METHODS: The multidrug-resistance profile of a Klebsiella aerogenes strain was assessed by PCR and sequencing. The antibacterial activity of Cinnamomum cassia essential oil (CCeo) against K. aerogenes was assessed by broth microdilution and time-kill methods. RESULTS: K. aerogenes showed high antibiotic resistance. The genes bla KPC-2, ampC, bla CTX-M-15, bla OXA-1, and bla TEM were present. CCeo exhibited an inhibitory effect with a minimum inhibitory concentration of 17.57 μg/mL. CONCLUSIONS: The antibacterial activity of CCeo makes it a potential candidate for treating carbapenem- and polymyxin-resistant K. aerogenes strains.

Comparison of Treponema pallidum genomes for the prediction of resistance genes

Syphilis is a sexually transmitted infection caused by Treponema pallidum, which is highly prevalent in several countries,including Brazil. The use of bioinformatics’ tools for the identification of resistance genes is an important practice for thestudy of microorganisms, such as T. pallidum. In this study, the complete genomes of 43 strains of T. pallidum, isolatedfrom different countries, were analyzed. A total of 41,514 sequences were obtained, and compared against prokaryoteresistance gene databases using BLASTn, BLASTx and RGI for gene alignment and prediction. From the alignments, itwas possible to identify antibiotic resistance genes for each strain. The genes identified in each comparison were groupedaccording to the antibiotic category in which they show resistance to. The antibiotic-resistant genes related to drugs used totreat syphilis were grouped separately. The in silico tools used have shown to be effective in identifying resistance genes ingenomes of T. pallidum strains. Due to the lack of research and accurate information regarding the antibiotic resistancegenes in T. pallidum, this study serves as a basis for studies in molecular biology whose aim is the identification of thesegenes, besides being a reference to help in the control and treatment of this infection.

Origanum vulgare L. essential oil inhibits the growth of carbapenem-resistant gram-negative bacteria

Abstract INTRODUCTION: Plant products are sources for drug development against multidrug resistant bacteria. METHODS The antimicrobial activity of Origanum vulgare L. essential oil (OVeo) against carbapenem-resistant strains was assessed by disk-diffusion, microdilution (REMA-Resazurin Microtiter Assay), and time kill assays. RESULTS Carbapenemase production was confirmed for all strains. OVeo exhibited a minimum inhibitory concentration of 0.059% v/v for Klebsiella pneumoniae and Serratia marcescens, and of 0.015 % v/v for Acinetobacter baumannii. A decrease in cell count was observed after a 4 h treatment. CONCLUSIONS OVeo antimicrobial effect was rapid and consistent, making it a candidate for developing alternative therapeutic options against carbapenem-resistant strains.

Descriptive analysis of syphilis cases reported in Mato Grosso do Sul, Brazil identifies failure in treatment

Abstract INTRODUCTION: Syphilis infection remains an alarming public health problem worldwide. METHODS: This study analyzed syphilis cases listed in the Information System on Diseases of Compulsory Declaration (SINAN) of Mato Grosso do Sul state in Brazil between January 2013 and December 2014. RESULTS: Most of the evaluated syphilis cases would have been preventable through public education, particularly congenital syphilis in children of previously diagnosed mothers and infection by untreated sexual partners. CONCLUSIONS: The incidence rate of syphilis could be reduced by improving prevention through counselling on the risk of infection, improving access to condoms, and increasing the frequency of diagnostic tests.

Identification of São Paulo metallo-beta-lactamase-1-producing Pseudomonas aeruginosa in the Central-West region of Brazil: a case study

Abstract: Metallo-beta-lactamase production is an important mechanism for carbapenem resistance of Pseudomonas aeruginosa , which represents an emerging public health challenge. We report the case of a patient admitted to an intensive care unit, with sepsis caused by multidrug-resistant São Paulo Metallo-beta-lactamase-1-producing P. aeruginosa . This is the first case of infection by this pathogenic strain in the State of Mato Grosso do Sul, Brazil. Thus, infection control measures are required for preventing future spread and outbreaks.

Estudo multicêntrico da prevalência de tuberculose e HIV na população carcerária do Estado do Mato Grosso do Sul / Multicenter study of the prevalence of tuberculosis and HIV in the prison population of the State of Mato Grosso do Sul

INTRODUÇÃO: Estudos anteriores relataram maior prevalência de Tuberculose e HIV entre os prisioneiros do que na população geral no Brasil, mas existem dados limitados disponíveis para facilitar o desenvolvimento de intervenções efetivas neste cenário de alta transmissão. O objetivo deste estudo foi avaliar a prevalência e os fatores de risco associados à Tuberculose e ao HIV. METODOLOGIA: Realizado questionário para a amostra de detentos de 12 prisões em Mato Grosso do Sul (Brasil), prova tuberculínica, coletado sangue para teste de HIVe duas amostras de escarro para baciloscopia e cultura de participantes que relataram tosse de qualquer duração, de Janeiro a Dezembro de2013. RESUILTADOS: Foram recrutados 3.380 detentos, dos quais 2.861(84,6%) eram homens de 8 prisões e 519 (15,4%) eram mulheres de4 prisões. Entre os 1.020 (30%) indivíduos que relataram tosse, 691(68%) coletaram escarro e foram identificados 31 casos de tuberculose ativa, com uma prevalência de 917 por 100.000 detentos. A prevalência de tuberculose latente foi de 22,5% e 11,7% para homens e mulheres,respectivamente. Dos participantes, 55 (1,63%) são soropositivos: 45(1,58%) homens e 10 mulheres (1,93%). CONCLUSÕES: Observou-se que a prevalência de tuberculose ativa e HIV são mais elevadas entre detentos do que na população geral, o que indica um alto risco de infecção e transmissão dentro dessas configurações. Para melhorar o controle da tuberculose nas prisões é necessária a detecção de casos de TB ativa em presídios através da triagem frequente e detecção de casos passiva e ativa.

BACKGROUND: Prior studies have reported higher Tuberculosis and HIVprevalence among prisoners than the general population in Brazil, yet there are limited data available to facilitate the development of effectiveinterventions in this high-transmission setting. The aim of this study wasto evaluate the prevalence and risk factors associated with TB and HIV. METHODS: We administered a questionnaire and tuberculin skin test (TST)to a population-based sample of inmates from 12 prisons in Mato Grasso do Sul (Brazil) and collected sera for HIV testing and two sputum samplesfor smear microscopy and culture from participants reporting a cough ofany duration, from January to December 2013. RESULTS: We recruited 3,380inmates, of which 2,861 (84.6%) were males from 8 prisons, and 519(15.4%) were females from 4 prisons. Among the 1,020 (30%) subjectswho reported a cough, we obtained sputum from 691 (68%) and identified31 cases of active TB for a prevalence of 917 per 100,000 prisoners. The prevalences of LTBI were 22.5% and 11.7% for male and female prisoners, respectively. Of these participants, 55 (1.63%) tested HIV-positive: 45(1.58%) men and 10 women (1.93%). It is observed that the prevalence ofTB and HIV are higher in prisons than in urban populations, indicating ahigh risk of infection and transmission within these settings. CONCLUSIONS: It is observed that the prevalence of Tuberculose and HIV are higher inprisons than in urban populations, indicating a high risk of infection andtransmission within these settings. For enhancing TB control in prisons is necessary case detection for active TB in prison facilities through frequent screening and passive and active case-finding of inmates.

An improved method for characterization of the mutation associated to porcine stress syndrome by PCR amplification followed by restriction analysis / Um método melhorado para caracterização da mutação associada à síndrome do estresse suíno por amplificação por PCR seguido de análise de restrição

A mutation in the gene coding for the ryanodine receptor 1 (RYR1), also known as halothane (hal) gene or swine stress gene, is associated to the porcine stress syndrome (PSS). Detection of the mutation is normally accomplished by PCR amplification of an 81bp fragment of the hal gene, followed by digestion with the HhaI restriction endonuclease. Wild-type allele (N) is cut in two fragments, whereas the mutant allele (n) is not digested by the restriction enzyme. Electrophoresis of the digested DNA on agarose gel and ethidium bromide staining allows the reading of the result. The correct interpretation is difficult due to the small size of the DNA fragments. In this study we designed a new set of primers for amplification of a 144bp fragment that facilitates the reading of the result. In addition, we optimized the PCR reaction to allow amplification from a single hair bulb, added directly into the PCR mix without previous treatment. This improved method was used to genotype 165 sows and boars used in a breeding program. Forty-nine percent of the animals had the NN genotype, whereas 50% were Nn and only 1% was nn.

Uma mutação no gene que codifica o receptor ryanodine 1 (RYR1), também conhecido como gene do halotano (hal) ou gene do estresse suíno, está associada à Síndrome do Estresse Suíno (PSS). A mutação é geralmente detectada por PCR, a partir da amplificação de um fragmento de 81pb do gene hal, seguida por digestão com a endonuclease de restrição HhaI. O alelo normal (N) é cortado em dois fragmentos, enquanto que o alelo mutado (n) não é digerido pela enzima de restrição. A eletroforese do DNA digerido em gel de agarose corado com brometo de etídio permite a leitura do resultado. A interpretação correta é difícil devido ao pequeno tamanho dos fragmentos. Neste estudo, foi projetado um novo par de iniciadores para a amplificação de um fragmento de 144pb, o que facilita a leitura do resultado. Adicionalmente, foi otimizada a reação de PCR para permitir a amplificação a partir de um único bulbo capilar, acrescentado diretamente na mistura de PCR, sem tratamento prévio. Esse método foi usado para genotipar 165 reprodutores utilizados em granjas produtoras de matrizes. Quarenta e nove porcento dos animais apresentaram genótipo NN, 50% Nn e apenas 1% nn.

Desenvolvimento e avaliação de novas estratégias de imunização contra colibacilose suína / Development and evaluation of new strategies for immunization against swine colibacillosis

Colibacilose suína causada por Escherichia coli enterotoxigênica continua sendo um dos principais problemas sanitários na criação de suínos. A tecnologia do DNA recombinante proporciona a possibilidade de desenvolvimento de novas estratégias de imunização. Neste trabalho é descrito o desenvolvimento de uma vacina de subunidade através da produção e purificação da proteína FaeC da fímbria de E. coli K88. O gene que codifica este antígeno foi amplificado por PCR e clonado em um vetor de expressão em E. coli, fusionado a uma cauda de histidinas. A proteína recombinante expressa por esta bactéria foi purificada, e depois de quantificada foi utilizada para imunizar camundongos. Paralelamente a isso, o mesmo gene foi clonado no vetor de expressão em célula eucariótica, introduzindo a seqüência de Kozak para favorecer a tradução deste gene em células musculares. O plasmídio resultante, denominado pUP310, foi produzido em larga escala e também utilizado na imunização de camundongos. A resposta imune induzida por ambas formas de imunizações foi monitorada por ELISA, onde o antígeno utilizado foi a proteína FaeC purificada. Houve indução de resposta imune nos camundongos inoculados com pUP310 e FaeC purificada. Foi possível detectar anticorpos anti-FaeC 42 dias após a primeira inoculação e este título foi aumentando, sendo ainda detectável 7 meses após a primeira inoculação. Conclui-se que pUP310 e FaeC recombinante são candidatos potenciais para imunização de suínos contra E. coli K88.

Um protocolo de "nested-PCR" para detecção do vírus da anemia das galinhas / A nested-PCR protocol for detection of the chicken anemia virus

Este trabalho descreve o estabelecimento de um pro!tocolo de nested-PCR para a detecção do vírus da anemia das galinhas (CAV, chicken anemia virus), agente causador da anemia infecciosa das galinhas. Para a extração de DNA a partir de amostras clínicas um método baseado no uso de tiocianato de guanidina mostrou-se mais sensível e prático, do que os demais avaliados. Para a PCR inicial foi selecionado um par de primers que amplifica uma região de 664 pares de bases (pb) do gene VP1. Para a nested-PCR propriamente dita, foi selecionado um segundo par que amplifica uma região interna de 520 pb. A especificidade dos primers foi avaliada utilizando amostras de lotes controlados para CAV. Outras trinta amostras vírus e bactérias, causadoras de doenças em aves, não geraram produto de amplificação. A sensibilidade do teste foi determinada a partir de diluições seriadas de uma amostra vacinal de CAV. A nested-PCR mostrou ser mais sensível do que a PCR e foi capaz de detectar pelo menos 0,16 TCID50 por cento da cepa vacinal. Além disso, detectou DNA viral em tecidos, soro e cama aviária de lotes com e sem sinais clínicos. Conclui-se que, como técnica para a detecção do CAV, o protocolo de nested-PCR aqui descrito, é mais sensível, rápido e menos trabalhoso do que o isolamento viral em cultivo celular.

Effect of the Kozak sequence on seroconversion of mice immunized with a DNA vaccine against swine colibacilosis

A diarréia neonatal em suínos causada por Escherichia coli produtora de enterotoxinas (ETEC) é responsável por alta mortalidade e baixa taxa de crescimento de leitões. A habilidade de tais cepas causar doença é dependente principalmente da capacidade de E. coli aderir-se a mucosa do intestino delgado, que é mediada por fímbrias. Neste estudo o gene faeC, que codifica a subunidade menor da fímbria de E. coli K88ab, foi clonado no vetor de expressão em eucariotos pcDNA3, associado ou não à seqüência de KozaK. DNA plasmidial das duas versões da vacina foi inoculado em camundongos via intra-muscular, em duas doses, nos dias 0 e 21. Os animais que receberam a vacina de DNA contendo o faeC associado a seqüência de Kozak apresentaram soroconversões significativamente maiores (p<0,05) que os vacinados com pcDNA3/faeC sem a seqüência de Kozak.

Leptospirosis diagnosis using Nested-PCR

A leptospirose constitui um problema sanitário de importância mundial. Esta doença caracteriza-se por apresentar sintomas muito parecidos com os de outras doenças como a dengue e a gripe e, clinicamente é difícil de distingui-las. Técnicas de diagnóstico da leptospirose atualmente disponíveis apresentam baixa sensibilidade e ou especificidade. Por isso, tem havido um grande esforço no sentido de desenvolver testes rápidos e eficientes, baseados em técnicas de biologia molecular. Este trabalho objetivou a avaliação e otimização do Nested-PCR, para o diagnóstico de leptospirose. Para isso foi desenhado um par de primers que amplifica uma região de 264 pb do gene LipL32. A sensibilidade e especificidade do teste foram avaliadas utilizando 7 sorovares saprófitas e 35 sorovares patogênicos. Este PCR mostrou-se específico para leptospiras patogênicas, porém a sensibilidade não foi muito alta. Com o objetivo de melhorar a sensibilidade do teste , foi desenhado outro par de primers que amplifica uma região de 183 pb do gene LipL32, interna a de 264 pb para a realização do Nested-PCR. Nesta reação foi utilizado como DNA molde o produto da primeira amplificação. O Nested-PCR mostrou-se mais sensível que o PCR normal, pois foi capaz de detectar um baixo número de células bacterianas.

Effect of the Kozak sequence on seroconversion of mice immunized with a DNA vaccine against swine colibacilosis

The neonatal diarrhea in swine caused by enterotoxigenic Escherichia coli (ETEC) is responsible for high mortality and low growth rate in pigs and it is mainly dependent on the capacity of E. coli to attach to the surface of the small intestine, a property mediated by fimbria. In this study the faeC gene, which codes for the minor fimbrial subunit of E. coli K88ab, was cloned in the eukaryotic expression vector pcDNA3, associated or not to the Kozak sequence. Plasmid DNA of the two versions of the vaccine candidate was inoculated in mice by the intramuscular route, in two doses, at 0 and 21 days. The animals that received the DNA vaccine containing faeC associated to the Kozak sequence presented seroconversion significantly higher (P 0.05) than the one vaccinated with pcDNA3/faeC without the Kozak sequence.

A diarréia neonatal em suínos causada por Escherichia coli produtora de enterotoxinas (ETEC) é responsável por alta mortalidade e baixa taxa de crescimento de leitões. A habilidade de tais cepas causar doença é dependente principalmente da capacidade de E. coli aderir-se a mucosa do intestino delgado, que é mediada por fímbrias. Neste estudo o gene faeC, que codifica a subunidade menor da fímbria de E. coli K88ab, foi clonado no vetor de expressão em eucariotos pcDNA3, associado ou não à seqüência de KozaK. DNA plasmidial das duas versões da vacina foi inoculado em camundongos via intra-muscular, em duas doses, nos dias 0 e 21. Os animais que receberam a vacina de DNA contendo o faeC associado a seqüência de Kozak apresentaram soroconversões significativamente maiores (p 0,05) que os vacinados com pcDNA3/faeC sem a seqüência de Kozak.