Frequency of Staphylococcus aureus virulence genes in milk of cows and goats with mastitis / Frequência de genes fatores de virulência de Staphylococcus aureus em leite de vacas e cabras com mastite

The present study determined the frequency of Staphylococcus aureus virulence genes in 2,253 milk samples of cows (n=1000) and goats (n=1253) raised in three different geographical regions of the state Pernambuco, Brazil. The presence of genes of virulence factors associated to adhesion to host cells (fnbA, fnbB, clfA and clfB), toxinosis (sea, seb, sec, sed, seg, seh, sei, tsst, hla and hlb), and capsular polysaccharide (cap5 and cap8) was evaluated by PCR. A total of 123 and 27 S. aureus strains were isolated from cows' and goats' milk, respectively. The sec and tsst genes were detected exclusively in goats' isolates, while the seh gene was only identified in cows' isolates. The number of toxin genes per strain showed that goats' isolates are likely more toxic than bovines' isolates. The cap5 genotype predominated in both host species, especially in strains collected from cows raised in the Agreste region. The cap8 genotype is likely more virulent due to the number of virulence genes per strain. The results of the present study demonstrate that S. aureus may pose a potential threat to human health in Brazil, and, therefore, these results should support actions related to mastitis control programs.(AU)

O presente estudo determinou a frequência de genes de virulência de Staphylococcus aureus em 2253 amostras de leite, sendo de vacas n=1000 e de cabras n=1253, procedentes das três regiões geográficas do estado de Pernambuco, Brasil. A presença de genes de fatores de virulência associados à adesão às células hospedeiras (fnbA, fnbB, clfA e clfB), toxinosis (sea, seb, sec, sed, seg, seh, sei, tsst, hla e hlb) e polissacarídeo capsular (cap5 e cap8) foram avaliadas por PCR. Um total de 123 e 27 cepas de S. aureus foram isoladas do leite de vacas e cabras, respectivamente. Os genes sec e tsst foram detectados exclusivamente em isolados de cabras, enquanto o gene seh foi identificado apenas em isolados de vaca. O número de genes de toxina por cepa mostrou que os isolados de cabras são potencialmente mais tóxicos do que os isolados obtidos de bovinos. O genótipo cap5 predominou em ambas as espécies hospedeiras, especialmente em cepas coletadas de vacas criadas na região Agreste. O genótipo cap8 é potencialmente mais virulento devido ao número de genes de virulência por isolado. Os resultados do presente estudo demonstram que S. aureus pode representar uma ameaça potencial para a saúde humana no Brasil e, portanto, estes resultados devem subsidiar ações relacionadas aos programas de controle de mastite.(AU)

Mastitis in dairy goats from the state of Minas Gerais, Brazil: profiles of farms, risk factors and characterization of bactéria / Mastite em cabras de leite no estado de Minas Gerais: perfil de propriedades, fatores de risco e caracterização de bactérias

ABSTRACT: The Zona da Mata of Minas Gerais has a specialized goat milk production chain. Goat milk is superior in quality compared with milk of other domestic species, and the demand for milk and milk products for the public has increased. Data on dairy goat breeding in Minas Gerais are scarce and relatively old, and this lack of information has limited the implementation of prophylactic measures, especially for mastitis, which represents the biggest sanitary problem for dairy herds. The objective of this work was to characterize mastitis and bacteria associated with it in milking goats in the Zona da Mata of Minas Gerais. It also causes socioeconomic problems and market issues for dairy goat farming. A total of 539 lactating goats were examined and 268 individual samples (one for teat) were collected from animals positive for strip cup test and/or the California Mastitis Test (CMT). Microbiological cultures were carried out on blood agar medium and the bacteria were subjected to phenotypic, genotypic and antimicrobial susceptibility tests. The prevalence of subclinical mastitis was 28.0% and the clinical prevalence was 2.8%. Bacterial multiplication was obtained in 62% of samples. One hundred eighty seven total bacteria were identified. The most common species identified was Staphylococcus aureus (60%), followed Staphylococcus epidermidis (9.1%,), Escherichia coli (6.9%), Staphylococcus saprophyticus (5.9%) e Staphylococcus caprae (4.3%). Bacteria of the genus Staphylococcus presented a profile of resistance to antimicrobials belonging to the beta-lactam class (penicillin, ampicillin and oxacillin) in addition to tetracycline, in contrast to the other antimicrobials tested. Twelve percent of multidrug resistence (MDR) was found in five microregions. Among the bacteria with the highest prevalence of MDR, 38.5% were E. coli and 10.6% were S. aureus. The producers of the Zona da Mata of Minas Gerais are technicians who work with specialized dairy breeds and practise good management. However, some measures related to prophylaxis and control of diseases, such as vaccination, have low adherence or are not performed due to a lack of veterinary assistance. This is the first study focusing on this region, which is highly prominent in goat milk production in Brazil. It provides important information that can help in the implementation of measures for the prophylaxis and control of diseases, and for maintenance of a constant supply of products in sufficient quantities and of a quality suitable for the consumer population.

RESUMO: A Zona da Mata de Minas Gerais possui uma cadeia especializada de produção de leite de cabra. O leite de cabra é superior em qualidade em comparação com o leite de outras espécies domésticas, e a demanda por leite e produtos lácteos do público tem aumentado. Os dados sobre o sistema de criação de cabras leiteiras em Minas Gerais são escassos e relativamente antigos, e essa falta de informação limita a implementação de medidas profiláticas, especialmente para a mastite, que representa o maior problema sanitário nos rebanhos leiteiros. Isso também causa problemas socioeconômicos e problemas de mercado para a criação de cabras leiteiras. O objetivo deste trabalho foi caracterizar a mastite e as bactérias associadas em cabras leiteiras na Zona da Mata de Minas Gerais. Um total de 539 cabras em lactação foi examinado e 268 amostras individuais (uma por teto) foram coletadas de animais positivos no teste da caneca de fundo escuro e/ou Califórnia Mastitis test (CMT). As culturas microbiológicas foram realizadas em meio Agar sangue e as bactérias foram submetidas a testes fenotípicos, genotípicos e testes de susceptibilidade antimicrobiana. A prevalência de mastite subclínica foi de 28,0% e a prevalência clínica foi de 2,8%. A multiplicação bacteriana foi obtida em 62,0% das amostras. Cento e oitenta e sete bactérias foram identificadas. As espécies mais identificadas foram: Staphylococcus aureus (60,4%), seguida de Staphylococcus epidermidis (9.1%,), Escherichia coli (6.9%), Staphylococcus saprophyticus (5.9%) e Staphylococcus caprae (4,3%) em ordem decrescente. As bactérias do gênero Staphylococcus apresentaram um perfil de resistência aos antimicrobianos pertencentes à classe de beta-lactâmicos - penicilina, ampicilina e oxacilina - além da tetraciclina, em contraste com os outros antimicrobianos testados. Doze por cento dos isolados apresentaram resistência múltipla a antibióticos (MDR) e foram encontrados em cinco microrregiões. Entre as bactérias com maior prevalência de MDR, 38,5% foram E. coli e 10,6% S. aureus. Os produtores da Zona da Mata de Minas Gerais são tecnificados, trabalham com raças leiteiras especializadas praticam e possuem bom manejo. No entanto, algumas medidas relacionadas à profilaxia e ao controle das doenças, como a vacinação, têm baixa adesão ou não são realizadas por falta de assistência veterinária. Este é o primeiro estudo com foco nesta região, que possui grande relevância na produção de leite de cabra no Brasil, fornecendo informações importantes que podem auxiliar na implementação de medidas de profilaxia e controle das doenças, e na manutenção de um fornecimento constante de produtos em quantidade e qualidade suficientemente adequada para a população consumidora.

Tuberculosis de mama: reporte de un caso / Breast tuberculosis: a case report

RESUMEN Presentamos caso de mastitis en mujer de 45 años sin antecedentes de infección en otras regiones corporales. Presentó cuadro clínico, estudios de imágenes y baciloscopia inespecíficos, sin embargo, mediante muestras histológicas obtenidas por punción aspirativa se encontró células epiteliodes gigantes, necrosis y formaciones granulomatosas, lo cual justificó el pensamiento clínico en tuberculosis. En ausencia de evidencias confirmatorias de lesión en otros tejidos, la existencia de mastitis de evolución tórpida es un indicativo clínico para sospechar tuberculosis mamaria, pues usualmente las características del proceso suelen plantear diagnósticos erróneos con otras entidades tumorales de la mama como cáncer. La tuberculosis en mama, representa una rara enfermedad cuyo diagnóstico es difícil por las bajas evidencias clínicas, microbiológicas y la inespecificidad de los resultados imagenológicos, por lo que la sospecha de su real posibilidad diagnóstica es una condición primordial para su determinación, aun cuando no se confirme el agente causal.

ABSTRACT We present a case of mastitis in a 45-year-old woman with no history of infection in other areas of the body, with unspecific clinical picture, imaging studies, and bacilloscopy. However, histological samples obtained by aspiration showed giant epithelial cells, necrosis, and granulomatous formations, which justified a clinical inclination toward tuberculosis. In the absence of confirmatory evidence of any lesions in other tissues, the existence of mastitis of torpid evolution is a clinical indication to suspect mammary tuberculosis, since the characteristics of the process usually lead to erroneous diagnoses with other breast tumors such as cancer. Tuberculosis in the breast is a rare disease with a difficult diagnosis due to the low clinical and microbiological evidence and the lack of specificity of the imaging results, so the suspicion of its real diagnostic possibility is a fundamental condition for its determination, even when the causal agent is not confirmed.

Mammary botryomycosis: two concomitant cases in mares: case report / Botriomicose mamária: dois casos concomitantes em éguas: relato de caso

Mammary disorders in mares are rare and usually only one animal per paddock is affected. In this report, two mares with 7 and 9 years old, were concomitantly diagnosis of chronic pyogranulomatous mastitis, associated with the Splendore-Hoeppli reaction, indicative of botryomycosis a rare, chronic suppurative disease with microabscess formation, characterized by in vivo formation of eosinophilic materials around microorganisms or biologically inert material. Various bacteria can cause botryomycosis in horses, and the most frequently isolated one is Staphylococcussp., particularly S. aureus. This report confirms the role of Staphylococcus sp.; however, specifically S. hyicus and S. cohnii that prior to the current report, had not been associated with cases of botryomycosis.(AU)

Enfermidades mamárias em éguas são raras e, normalmente, apenas um animal é afetado. Neste relato, duas éguas, de sete e nove anos, foram diagnosticadas concomitantemente com mastite crônica piogranulomatosa, associada com reação de Splendore - Hoeppli, indicativa de botriomicose, uma doença crônica supurativa rara, com formação de microabscessos caracterizados pela presença de material eosinofílico em torno dos microrganismos ou de material biologicamente inerte. Várias bactérias podem causar botriomicose em cavalos, sendo Staphylococcus sp., particularmente S. aureus, as mais frequentemente isoladas. Este relato confirma o papel do Staphylococcus sp, no entanto este é o primeiro relato em que S. hyicus e S. cohnii foram identificados em lesões relacionadas à botriomicose.(AU)

Comparative analysis of agr groups and virulence genes among subclinical and clinical mastitis Staphylococcus aureus isolates from sheep flocks of the Northeast of Brazil

Staphylococcus aureus is one of the most frequent mastitis causative agents in small ruminants. The expression of most virulence genes of S. aureus is controlled by an accessory gene regulator (agr)locus. This study aimed to ascertain the prevalence of the different agr groups and to evaluate the occurrence of encoding genes for cytotoxin, adhesins and toxins with superantigen activity in S. aureus isolates from milk of ewes with clinical and subclinical mastitis in sheep flocks raised for meat production The agr groups I and II were identified in both cases of clinical and subclinical mastitis. Neither the arg groups III and IV nor negative agr were found. The presence of cflA gene was identified in 100% of the isolates. The frequency of hla and lukE-D genes was high -77.3 and 82.8%, respectively and all isolates from clinical mastitis presented these genes. The sec gene, either associated to tst gene or not, was identified only in isolates from subclinical mastitis. None of the following genes were identified: bbp, ebpS, cna, fnbB, icaA, icaD, bap, hlg, lukM-lukF-PV and se-a-b-d-e.

Perfil da contagem de células somáticas na infecção intramamária em búfalas na região Nordeste do Brasil / Somatic cell count profile in intramammary infection of buffaloes from the Brazilian Northeast

Objetivou-se com esse estudo avaliar o perfil de células somáticas na mastite subclínica em búfalas leiteiras no Nordeste do Brasil. Foram analisadas 1896 amostras de leite de 474 búfalas procedentes de quatro propriedades de exploração leiteira nos Estados de Pernambuco, Alagoas, Bahia e Ceará. A secreção láctea de cada teto foi submetida ao Califórnia Mastitis Test (CMT) e as amostras positivas, a partir de duas cruzes foram coletadas para realização da contagem de células somáticas (CCS) e exame microbiológico. Observou-se que as amostras positivas no exame microbiológico apresentaram CCS entre 280.000 a 401.000 cel/mL com mediana de 328.000 cel/mL. Conclui-se que valores de CCS acima de 280.000 cel/mL é um indicativo de infecção da glândula mamária, contudo o exame microbiológico do leite é o melhor método para diagnóstico da mastite subclínica em búfalas. A observação dos Staphylococcus coagulase negativa exercendo influência na elevação da CCS deve ser objeto de outros estudos para elucidar a patogenicidade desse grupo de microrganismos na mastite de búfalas.

The aim of this study was to evaluate the somatic cell profile in the subclinical mastitis in dairy buffaloes in the Brazilian Northeastern. One thousand eight hundred ninety six milk samples from 474 buffaloes proceeding from four dairy farms located in the states of Pernambuco, Alagoas, Bahia and Ceará were analyzed. The lactic secretion was submitted to the California Mastitis Test (CMT) and the positive samples, from two crosses on were collected for the somatic cell count (SCC) and microbiologic exam. It was observed that the positive samples at the microbiologic exam presented SCC between 280,000 and 401,000 cells/mL with median of 328,000 cells/mL. It was concluded that SCC values above 280,000 cells/mL is an indication of mammary gland infection, however, the microbiologic exam of the milk is the best method for the diagnostic of subclinical mastitis in buffaloes. The observation of Staphylococcus coagulase-negative exerting influence in the SCC elevation must be subject of further studies in order to elucidate the pathogenicity of this group of microorganisms in mastitis of buffaloes.

Tuberculous mastitis presenting as breast abscess

Tuberculous mastitis is a rare clinical entity and usually affects women from the Indian sub-continent and Africa. It often mimics breast carcinoma and pyogenic breast abscess clinically and radiologically, may both co-exist. Routine laboratory investigations are not helpful in its diagnosis. Fine needle aspiration cytology [FNAC] / biopsy are essential for diagnosis and tuberculosis culture when positive may be very useful to guide antimicrobial therapy. Antitubercular drugs in combination with aspiration or surgical drainage are usually associated with an excellent outcome

Antimicrobial susceptibility of coagulase-negative staphylococci isolated from meat-producing ewes with mastitis / Susceptibilidade antimicrobiana de cepas de estafilococcos coagulase-negativa isolados de ovinos de corte com mastite

Avaliou-se a sensibilidade antimicrobiana in vitro de 121 cepas de estafilococos coagulase-negativa isolada de leite de ovelhas Santa Inês, aos fármacos: penicilina, amoxicilina, ampicilina, estreptomicina, oxaciclina, neomicina, cefalotina, gentamicina e sulfonamida. A resistência à sulfonamida foi a mais frequente (27,3 por cento), seguida pela estreptomicina (14,0 por cento) e pela oxaciclina (14,0 por cento), enquanto da gentamicina (1,6 por cento) foi a menos frequente. Todas as cepas foram sensíveis a pelo menos um antimicrobiano, e 20,3 por cento das cepas apresentaram resistência múltipla. Os resultados mostram a importância de Staphylococci coagulase-negativas como agentes causadores de mastite em ovinos, e o perfil de resistência múltipla indica a importância da determinação da resistência à oxaciclina como indicador da presença de ilhas de patogenicidade que contêm fatores de virulência e resistência a outros antimicrobianos que contribuem para a sobrevivência da bactéria ao tratamento.

role of anaerobic bacteria in the dairy cattle mastitis

One hundred and ten milk samples were collected from 35 dairy cows with recurrent mastitis and 75 apparently healthy ones. The field application of California Mastitis Test [CMT] on the apparently healthy cows indicated 60% [45 out of 75 cows] with sub-clinical mastitis. The estimation of SCC recorded 31.8% [35 samples] above Ixl0[6] cell/ml, 40.9% [45 samples] were ranged between 4xl0[5] to Ixl0[5] cell/ml and 27.3% [30 samples] were less than 4xl0[5] cell/ml. The bacteriological examination revealed 10% facultative anaerobic bacteria from normal milk samples, while both facultative and obligatory anaerobic bacteria were 62.2% from sub-clinical and 100% from clinical mastitic milk samples. The highly effective antibiotics on the isolated bacteria in the laboratory were florofenicol, tetradelta, gentamicin, amoxicillin-clavulanate, refampicin and metronidazol

Mycobacterium tuberculosis breast infection mimicking pyogenic abscesses in Kuwait

To present 2 cases of primary breast abscesses caused by Mycobacterium tuberculosis mimicking pyogenic abscesses in healthy young females. Two young non-lactating Indonesian and Indian women, aged 27 and 29 years old, respectively, presented with breast abscesses caused by M. tuberculosis. The breasts presented as huge, swollen, hot, tender masses with a discharge at the subareolar site. Surgical drainage revealed deep abscess with copious amount of pus, samples of which were positive for acid-fast bacilli [AFB] and later confirmed as M. tuberculosis by positive cultures in Becton Dickinson BBL Migit and BACTEC 12B media. The initial therapies with clindamycin were changed to 4 anti-tuberculous drugs as soon as the smears showed the presence of AFB. The patients were discharged a week later, but both were lost to follow-up. Mammary tuberculosis should be considered in the differential diagnosis of breast lesion, especially in patients from endemic areas

Contagem de células somáticas e isolamento de agentes causadores de mastite em búfalas (Bubalus bubalis) / Somatic cell count and mastitis causing pathogens isolation in water buffaloes (Bubalus bubalis)

The research was accomplished in eight dairy water buffalo herds, randomically choosen in Região do Alto São Francisco, State of Minas Gerais, Brazil. Information was collected from March to November, 2003 during 270 days of observation. In order to determine the somatic cell count (SCC) in presence or absence of microbial isolation, 1,393 samples were collected from 285 lactating females and microbiological exams and SCC were done. Samples obtained from udders without evidence of clinical or subclinical inflammation showed infection for a great variety of microbial mastitis pathogens. The low SCC did not necessarily indicate the absence of intramammary infection, suggesting that SCC patterns used for bovine cannot be appropriate in order to control mastitis in buffalo herds.

Tuberculosis of the breast: a cytomorphological study of nine cases

To determine the role of FNAC with histological confirmation in the diagnosis of tuberculous mastitis, and to highlights its importance by determination of frequency, clinical history, clinical presentation and laboratory investigations in our setup. A retrospective case series from Jan. 1997 to Dec. 2006. Department of Pathology, Nawabshah Medical College, Nawabshah. Nine patients with mammary tuberculosis. The data was collected from patients files and other record, and the results tabulated. All were married multiparous women, aged 18-42 years, belonging to poor socio-economical class. One was pregnant, while three were lactating mothers. Associated pulmonary tuberculosis was present in three cases. Previous history of tuberculosis was present in one case, though five patients had a family history of tuberculosis. Lump in the breast, with or without ulceration/ abscess/ discharging sinus was the clinical presentation of all the cases, as was low grade fever and pain. All patients had anemia and weight loss, though axillary lymphadenopathy was seen in five cases. ESR was raised in all the cases and the Mantoux test was positive. The glutaraldehyde test was positive, though it was performed in three cases only. AFB were seen in one case only. The diagnosis was made on FNAC by the presence of chronic granulomatous inflammation having caseating epithelioid granulomas and Langhan's type of giant cells. The cytological diagnosis was confirmed by histopathologicaI findings of excisional biopsy specimen in all the cases. The present study highlights the importance of tuberculous mastitis; its frequency being 2.3% in breast diseases. FNAC is an important initial diagnostic tool in patients having tuberculous mastitis, specially in the rural areas. It is safe, rapid, simple, cost effective and accurate, the accuracy being 100%

Breast tuberculosis: diagnosis, clinical features & management.

The significance of breast tuberculosis is due to rare occurrence and mistaken identity with breast cancer and pyogenic breast abscess. Breast tuberculosis was scarcely reported even from endemic areas until lately when several reports have come up from South Africa and India. The incidence of tubercular mastitis although decreasing in the West, could show a resurgence with the global pandemic of AIDS. Breast tuberculosis has no defined clinical features. Radiological imaging is not diagnostic. Diagnosis is based on identification of typical histological features or the tubercle bacilli under microscopy or culture. Antitubercular therapy for 6 months with or without minimal surgical intervention forms the mainstay of treatment today. Over the years since the first description of tubercular mastitis in 1829, the incidence, clinical presentation, diagnostic and treatment methodology of breast tuberculosis has gradually changed. This review discusses the important issues relating to the diagnosis, clinical features, and management of breast tuberculosis.

Mastitis por Mycobacterium fortuitum en una paciente HIV negativa / Mastitis due to Mycobacterium fortuitum in an HIV negative patient

A case of a 39 year old HIV negative female patient with a Mycobacterium fortuitum mastitis without previous pathogenic history is reported. She was treated on the bases of drug-susceptibility testing and bibliographic empirical evidence with kanamycin, doxicicline, ciprofloxacin and trimetoprim-sulfametoxazol. A complete remission of her lesions was obtained after 15 months of treatment. Lesions due to this rapidly growing mycobacterium, diagnosis and treatment are commented.

Se presenta el caso de una paciente HIV negativa de 39 años con una mastitis por Mycobacterium fortuitum, sin antecedentes patogénicos previos. Fue tratada en base a las pruebas de susceptibilidad a antibióticos y quimioterápicos y a la evidencia empírica citada por la bibliografía, con kanamicina, doxiciclina, ciprofloxacina y trimetoprima-sulfametoxazol. Se obtuvo la remisión completa de sus lesiones luego de 15 meses de tratamiento. Se comenta la capacidad de producir lesiones de esta micobacteria de crecimiento rápido, su diagnóstico y tratamiento

Experimental pathogenicity evaluation of Mycoplasma canadense from bovine mastitis in vitro and in vivo laboratory models.

Mycoplasma canadense, a clinical isolate from milk of a mastitic buffalo, was experimentally tested for its pathogenic potential in hamster tracheal ring and rabbit fallopian tube explant organ cultures (in vitro) and rat and rabbit mammary gland (in vivo) models. The activity percentage reduction in M. canadense infected hamster tracheal rings was 99.1% in comparison to 16.4% in control rings. Mycoplasma canadense, also induced complete ciliostasis at 11-day post-infection in rabbit fallopian tube explants. Histopathological lesions in these infected organ cultures were loss of cilia, desquamation or denudation of epithelium, infiltration of inflammatory cells and proliferation of macrophages as well as oedema in lamina propria. At the end of the experiments, M. canadense organisms were reisolated in pure colonies from the infected but not the control organ cultures. In the rat and rabbit mammary glands, M. canadense organisms persisted upto 6-day and 7-day postinfection, respectively and caused histopathological changes suggestive of subacute to chronic mastitis during the experimental period. The results indicate that the tested M. canadense clinical isolate was virulent.

Primary tuberculosis of the male breast: a case report

A case of tuberculosis of the breast is reported in a 37-year-old man. Clinically the lesion was considered as a malignant tumor, or gynecomastia. Histological examination of the breast lesion revealed numerous caseating and non-caseating granulomas. Special [Ziel-Neelson's] stains revealed a large number of acid-fast bacilli. The patient showed satisfactory progress after anti-tuberculous therapy

Experimental mastitogenicity of Mycoplasma capricolum subsp. capripneumoniae for rabbit mammary glands.

Mycoplasma capricolum subsp. capripneumoniae of cow-udder origin was tested in rabbit mammary-glands for its mastitogenic capability. Establishment of mycoplasma organisms and presence of histopathological lesions in mammary glands were the parameters for describing mastitogenic potential. The reisolation of injected Mycoplasma capricolum subsp. capripneumoniae organisms in the pure form from the infected glands along with the occurrence of histopathological changes were suggestive of mastitis during the entire 8-days period of observation. Rabbit mammary-gland is recommended as a potential in vivo experimental laboratory model to screen the mastitogenic potential of mycoplasmas of animal-udder origin.

Tuberculose mamária: relato de caso / Tuberculous mastitis: a case report

É relatado um caso de mastite tuberculosa em uma paciente de 72 anos. O quadro clínico constituiu-se de um nódulo de 6 x 6 cm, sem sinais flogísticos. Com suspeita clínica de carcinoma, a paciente foi submetida à tumorectomia. O exame anátomopatológico revelou processo granulomatoso crônico, tendo sido demonstrada a presença do bacilo álcool-ácido-resistente. A mastite tuberculosa é abordada sob os pontos de vista etiopatogênico, taxinômico, clínico e terapêutico.

Staphylococci in breast milk from women with and with and without mastitis

Verificou-se a presença de Staphylococci em leite materno procedente de 19 mulheres, nove consideradas sadias e dez apresentando sintomas clínicos de mastite. Staphylococci foram detectados em todas as amostras de leite, com contagens variando de 10² a 10 a quarta ufc/mL e revelando uma significativa variedade de colônias atípicas e típicas, estas últimas observadas em todas as placas de ágar Baird-Parker, exceto em uma amostra. Staphylococcus aureus, coagulase e termonuclease positivos e fermentadores de manitol em anaerobiose, estavam presentes em 13 amostras. Várias estirpes näo apresentaram uma ou duas,outras evidenciaram todas e uma näo apresentou nenhuma das características bioquímicas citadas. De um total de 19 cepas, 8 sintetizavam quantidade detectáveis de enenterotoxinas pelo método de imunodifusäo em gel e algumas mostraram-se produtoras de pequenas quantidades de enterotoxinas e de toxina da síndrome do choque tóxico, conforme detectado através do método de aglutinaçäo reversa passiva em latex