Identification of a predominant genotype of Mycobacterium tuberculosis in Brazilian indigenous population

After nearly a century of vaccination and six decades of drug therapy, tuberculosis (TB) kills more people annually than any other infectious disease. Substantial challenges to disease eradication remain among vulnerable and underserved populations. The Guarani-Kaiowá people are an indigenous population in Paraguay and the Brazilian state of Mato Grosso do Sul. This community, marginalized in Brazilian society, experiences severe poverty. Like other South American indigenous populations, their TB prevalence is high, but the disease has remained largely unstudied in their communities. Herein, Mycobacterium tuberculosis isolates from local clinics were whole genome sequenced, and a population genetic framework was generated. Phylogenetics show M. tuberculosis isolates in the Guarani-Kaiowá people cluster away from selected reference strains, suggesting divergence. Most cluster in a single group, further characterized as M. tuberculosis sublineage 4.3.3. Closer analysis of SNPs showed numerous variants across the genome, including in drug resistance-associated genes, and with many unique changes fixed in each group. We report that local M. tuberculosis strains have acquired unique polymorphisms in the Guarani-Kaiowá people, and drug resistance characterization is urgently needed to inform public health to ensure proper care and avoid further evolution and spread of drug-resistant TB

Immunogenicity of a 23-valent pneumococcal polysaccharide vaccine in Brazilian elderly

Serum antibodies specific for the capsular polysaccharides of Streptococcus pneumoniae provide protection against invasive pneumococcal infection. In Brazil, this vaccine has been used for people over 65 years with clinical risk to develop pneumococcal infection since 1999. We evaluated the immune response of 102 elderly subjects (75.5 percent females and 24.5 percent males) with a mean age of 71 years, and 19 young healthy adults (63.2 percent females and 36.8 percent males) with a mean age of 27 years. The elderly study group consisted of outpatients who received follow-up care in the Geriatric Department of General Hospital, Faculty of Medicine, University of São Paulo. None had acute illness at the time of vaccination. Both groups were immunized with one intra-deltoid injection with 0.5 ml of a 23-valent pneumococcal polysaccharide vaccine. The total IgG specific antibody concentrations to capsular polysaccharides 1, 3, 5, 6B, 8, and 14 were determined against pre- and 1-month post-vaccination sera. All samples were analyzed according to the second-generation pneumococcal polysaccharide ELISA protocol. We observed that the pneumococcal polysaccharide vaccine evoked consistent antibody increase for serotypes 1, 5, 6B, 8, and 14 (geometric mean concentration increase of 2.46 in the elderly and 2.84 in the young adults). Otherwise, we observed no increase in antibody concentration for serotype 3 in both groups.

Septicemia por Salmonella typhimurium - sensibilidade antibiotica e correlacao entre hemocultura e coprocultura. / Salmonella typhimurium septicemia - antibiotic sensitivity and correlation between hemoculture and coproculture

Os autores apresentam os aspectos referentes a sensibilidade aos antimicrobianos de S. typhimurium isolado de 56 criancas portadoras de septicemia. E discutida, tambem a importancia da correlacao hemocultura/ coprocultura. A sensibilidade aos antibioticos no presente estudo mostra padrao diferente do observado na literatura, com grande resistencia aos agentes classicamente utilizados, como ampicilina, cloranfenicol, sulfas e gentamicina. A polimixina E e a amikacina foram os agentes mais eficazes na experiencia dos autores. Enfatiza-se o valor da coprocultura, a elevada positividade da hemocultura e a origem intra-hospitalar da patologia

Pneumonia por :Haemophilus influenzae" em crianca: analise de 25 casos. / Pneumonia due to Haemophilus influenzae in children: analysis of 25 cases

Os autores apresentam 25 criancas portadoras de pneumonia por Haemophilus influenzae (isolado no sangue e liquido pleural ou material de aspirado pulmonar). A idade dos pacientes oscilou de tres meses a 7 anos: 70% tinha menos de dois anos. Os antibioticos mais ativos nesta casuistica foram o Cloranfenicol (96%) e o Colistin (84%). Em 11 pacientes houve complicacoes pleuropulmonares: nesses, a evolucao, ainda que boa, foi arrastada. Tendo em vista a inespecificidade do quadro clinico e a especificidade do tratamento, os autores chamam a atencao para a importancia do diagnostico etiologico das pneumopatias