Spinocerebellar Ataxia in Brazil: A Comprehensive Genotype - Phenotype Analysis.

Spinocerebellar ataxias (SCAs) are a diverse group of hereditary neurodegenerative disorders characterized by progressive degeneration of the cerebellum and other parts of the nervous system. In this study, we examined the genotype‒phenotype correlations in SCAs within the Brazilian population by leveraging a comprehensive dataset of 763 individuals from SARAH Network of Rehabilitation Hospitals. Using a retrospective, cross-sectional, observational, multicentric approach, we analysed medical records and conducted standardized molecular testing to explore epidemiological characteristics, clinical manifestations, and genetic profiles of SCAs in Brazil. Our findings revealed the predominance of SCA3, followed by SCA7 and SCA2, which aligns with global trends and reflects the specific genetic landscape of Brazil. A significant inverse relationship between the age of symptom onset and CAG repeat length in the mutated allele was observed across SCAs 2, 3, and 7. This study also highlights a trend towards paternal inheritance in SCA2 and details the distribution of CAG repeat expansions, which correlates larger expansions with earlier onset and specific symptomatology. This extensive analysis underscores the critical importance of genetic testing in the diagnosis and management of SCAs and enlightens the intricate genotype‒phenotype interplay within a genetically diverse population. Despite certain limitations, such as potential selection bias and the retrospective nature of the study, our research provides invaluable insights into the prevalence, genetic underpinnings, and clinical variability of SCAs in Brazil. We suggest a broader demographic scope and investigations into nonmotor symptoms in future studies to obtain a more comprehensive understanding of SCAs.

Oral health education for systemic sclerosis patients: A booklet report.

Purpose/objectives: Systemic sclerosis (SSc) is a rare chronic autoimmune disease characterized by vascular abnormalities and connective tissue disorders. In 2021, the multidisciplinary team of the university hospital recognized a demand for oral health information among SSc patients. This study aims to describe the development of an SSc oral health booklet and its validation by people with SSc. Methods: For the development of the booklet, the project creators employed the action research methodology involving ten stages. SSc patients evaluated the material by filling out a digital form. Results: One hundred and thirty-one people with SSc evaluated the booklet. It received an average score of 9.73 (SD: 0.80) in relevance, 9.82 (SD: 0.47) in explicitness, and 9.49 (SD: 0.93) in aesthetics. The final version was emailed to the participants and posted on social media. Innovation: This is the first booklet that deeply addresses these issues in Portuguese and constitutes a soft technology to instruct and assist patients with SSc. Conclusion: The production of high-quality educational materials on oral health for patients with SSc is necessary. The online distribution increased its reach and had great importance in the context of the COVID-19 pandemic.

Impacts of mental health in the sleep pattern of healthcare professionals during the COVID-19 pandemic in Brazil.

BACKGROUND: After >2 years of the Coronavirus Disease-19 (COVID-19) pandemic, it is well established how sleep symptoms are rising, especially among healthcare workers (HCW). The aim of this study is to evaluate what features are associated with sleep disturbances in the HCW population. METHODS: Cross-sectional and longitudinal analysis of social and clinical variables associated with sleep problems and insomnia incidence in HCW in a large, national-level cohort. The measurement of sleep problems was assessed by self-report using Jenkins Sleep Scale (JSS). A multivariate analysis was used in the cross-sectional design and generalized linear models were used in the longitudinal design. RESULTS: 10,467 HCW were analyzed in the cross-sectional analysis, 3313 participants were analyzed in the three timepoints of the study. Sex, previously diagnosed mental illness and frontline work with COVID-19 were associated with higher scores in JSS in the univariate analysis. In the multivariate analysis, only previous diagnosis of mental illness was related with sleep difficulties, especially previously diagnosed insomnia. The longitudinal analysis concluded that previous diagnosis of mental illnesses was associated with higher levels of insomnia development (OR = 11.62). The self-reported disorders found to be major risk factors were addiction (OR = 7.69), generalized anxiety disorder (OR = 3.67), social anxiety (OR = 2.21) and bipolar disorder (OR = 2.21). LIMITATIONS: Attrition bias. CONCLUSIONS: Previous diagnosis of mental illness was strongly related to insomnia development in HCW during the COVID-19 pandemic. Strategies that focus on this population are advised.

A Randomized Controlled Trial Evaluating the Analgesic Effect of the Combination of Methadone With Morphine for Cancer Related Pain.

CONTEXT AND OBJECTIVES: Although opioids play an indispensable role in the management of cancer-related pain, inadequate pain relief still occurs. The primary objective of this study was to evaluate whether the combination of a low dose of methadone with morphine promotes a reduction in opioid consumption; the secondary objectives were if the association promotes lower pain intensity, and adverse effects (AEs). MATERIALS AND METHODS: A sample if 41 patients with cancer-related pain in palliative setting were included. Patients were starting the third step of the analgesic ladder, and 1 group (n=21) achieve methadone (2.5 mg/12 h) in combination with morphine/methadone, and another group (n=20) received morphine alone. Both groups could use morphine (5 mg) as needed to maintain pain intensity <4, and adjuvant in stable dose. The following outcomes were evaluated: total morphine dose, pain intensity, and AEs. RESULTS: There was no difference in the number of adjuvants, and the dose of morphine used. Pain intensity was significantly lower in the morphine/methadone group after 2 weeks, with no statistically significant difference at other timepoints. There was no difference between groups in the AEs. CONCLUSION: Low dose of methadone in combination with morphine provided faster pain control as compared with morphine alone, and although this study was not powered to show differences in AEs, we did not notice a difference.

Tratamento compensatório paciente classe III esquelética vertical com técnica Buccal Shelf / Patient class III vertical skeletal compensatory treatment with buccal shelf technique

Resumo A má oclusão de Classe III é a relação dentária baseada na relação anteroposterior entre os primeiros molares, onde o indivíduo apresenta a cúspide mesio-vestibular do primeiro molar superior ocluindo no sulco mesio-vestibular do primeiro molar inferior. A compensação ortodôntica da má oclusão de Classe III, com mini-implantes, usada como ancoragem esquelética na mecânica ortodôntica vem revolucionando o tratamento Classe III esquelética. Optou-se por camuflagem ortodôntica com tratamento ortodôntico corretivo compensador, sendo utilizado aparelho fixo pela técnica Straight Wire (Capelozza III) e mecânica de distalização e verticalização de pré-molares mandibular com fio superior .019" x .025" de aço e inferior .020" de aço, através do Buccal Shelf, mini-implante de aço inserido na região retro molar entre primeiro e segundo molar inferior. Os apinhamentos foram satisfatoriamente corrigidos com um efetivo alinhamento e nivelamento dos arcos. Verticalmente, observou-se considerável alteração, pois houve correção da mordida aberta anterior por extrusão dos incisivos criando um adequado overbite e overjet. O uso de mini-implantes extra-radiculares adaptados na região de Buccal Shelf radicular como recurso de ancoragem mostrou-se eficaz no tratamento compensador da Classe III esquelética em paciente vertical (AU)

Abstract Class III malocclusion is the dental relationship, based on the anteroposterior relationship between the first molars, in which the individual presents the mesiovestibular cusp of the first maxillary molar occluding in the mesiovestibular groove of the first mandibular molar. Orthodontic compensation of Class III malocclusion with mini-implants used as skeletal anchorage in orthodontic mechanics has been revolutionizing the Class III skeletal treatment. Orthodontic camouflage with compensating corrective orthodontic treatment was chosen, using a fixed appliance in the Straight Wire technique (Capelozza III) and distalization and verticalization mechanics of mandibular premolars with a 19×25 upper steel wire and 20 lower steel wire through the Buccal Shelf, a mini steel implant inserted in the retromolar region between the first and second mandibular molars. Crowding was satisfactorily corrected with effective arches alignment and leveling. Vertically, a considerable change was observed, as there was correction of the anterior open bite by extrusion of the incisors creating an adequate overbite and overjet. The use of extra-radicular mini-implants adapted in the root Buccal Shelf region as an anchorage resource proved to be effective in the patient Class III vertical skeletal compensatory treatment (AU)

The Yin and Yang of Tyrosine Kinase Inhibition During Experimental Polymicrobial Sepsis.

Neutrophils are the first cells of our immune system to arrive at the site of inflammation. They release cytokines, e.g., chemokines, to attract further immune cells, but also actively start to phagocytose and kill pathogens. In the case of sepsis, this tightly regulated host defense mechanism can become uncontrolled and hyperactive resulting in severe organ damage. Currently, no effective therapy is available to fight sepsis; therefore, novel treatment targets that could prevent excessive inflammatory responses are warranted. Src Family tyrosine Kinases (SFK), a group of tyrosine kinases, have been shown to play a major role in regulating immune cell recruitment and host defense. Leukocytes with SFK depletion display severe spreading and migration defects along with reduced cytokine production. Thus, we investigated the effects of dasatinib, a tyrosine kinase inhibitor, with a strong inhibitory capacity on SFKs during sterile inflammation and polymicrobial sepsis in mice. We found that dasatinib-treated mice displayed diminished leukocyte adhesion and extravasation in tumor necrosis factor-α-stimulated cremaster muscle venules in vivo. In polymicrobial sepsis, sepsis severity, organ damage, and clinical outcome improved in a dose-dependent fashion pointing toward an optimal therapeutic window for dasatinib dosage during polymicrobial sepsis. Dasatinib treatment may, therefore, provide a balanced immune response by preventing an overshooting inflammatory reaction on the one side and bacterial overgrowth on the other side.

Arterial thromboembolism secondary to subaortic stenosis in a persian kitten

Background: Aortic stenosis refers to several types of anatomic and functional obstructions of the left ventricular outflow tract. In small animals, this anomaly is most commonly documented as either a congenital lesion or an obstruction that develops soon after birth. It is a hereditary disease, caused by a dominant autosomal gene and modifying genes that interfere with phenotype expression. Even though aortic thromboembolism may be a potential complication in cats with cardiac diseases, aortic stenosis is deemed rare in that species. In this paper, we report an unusual case of a Persian kitten with aortic stenosis that eventually developed arterial thromboembolism.Case: A 7-month-old Persian kitten (3.1 kg) was admitted to a Veterinary Teaching Hospital with a history of hindlimbs paralysis over the past 48 h, as well as excessive vocalization. Also, the cat presented with inappetence, adipsia, urine incontinence, and hematuria. On physical examination, we observed hypothermia and cold paws. The footpads were cyanotic and there were no palpable femoral pulses. Cardiac auscultation disclosed a regular fast pace (200 bpm) and a grade 2/6 murmur heard best over the left cardiac base, but irradiating to the contralateral hemithorax. Prothrombin time and activated partial thromboplastin time were within the normal reference range, but the complete blood count showed microcytosis, lymphopenia, and hyperproteinemia. Also, elevated alanine aminotransferase and BUN were identified. On the echocardiogram, we observed a subvalvular aortic stenosis, which resulted in concentric remodeling of the left ventricle and a mild left atrial dilation. The stenotic lesion was classified as mild. Also, the thoracic radiography unveiled cardiomegaly. The recommended therapy included atenolol(6.25 mg/cat PO, q24h), clopidogrel (18.7 mg/cat PO, q24h), enoxaparin (1 mg/kg SC, q24 h), methadone (0.2 mg/kg IM, q8h) and amoxicillin + potassium clavulanate (20 mg/kg SC, q12h).[...](AU)

Arterial thromboembolism secondary to subaortic stenosis in a persian kitten

Background: Aortic stenosis refers to several types of anatomic and functional obstructions of the left ventricular outflow tract. In small animals, this anomaly is most commonly documented as either a congenital lesion or an obstruction that develops soon after birth. It is a hereditary disease, caused by a dominant autosomal gene and modifying genes that interfere with phenotype expression. Even though aortic thromboembolism may be a potential complication in cats with cardiac diseases, aortic stenosis is deemed rare in that species. In this paper, we report an unusual case of a Persian kitten with aortic stenosis that eventually developed arterial thromboembolism.Case: A 7-month-old Persian kitten (3.1 kg) was admitted to a Veterinary Teaching Hospital with a history of hindlimbs paralysis over the past 48 h, as well as excessive vocalization. Also, the cat presented with inappetence, adipsia, urine incontinence, and hematuria. On physical examination, we observed hypothermia and cold paws. The footpads were cyanotic and there were no palpable femoral pulses. Cardiac auscultation disclosed a regular fast pace (200 bpm) and a grade 2/6 murmur heard best over the left cardiac base, but irradiating to the contralateral hemithorax. Prothrombin time and activated partial thromboplastin time were within the normal reference range, but the complete blood count showed microcytosis, lymphopenia, and hyperproteinemia. Also, elevated alanine aminotransferase and BUN were identified. On the echocardiogram, we observed a subvalvular aortic stenosis, which resulted in concentric remodeling of the left ventricle and a mild left atrial dilation. The stenotic lesion was classified as mild. Also, the thoracic radiography unveiled cardiomegaly. The recommended therapy included atenolol(6.25 mg/cat PO, q24h), clopidogrel (18.7 mg/cat PO, q24h), enoxaparin (1 mg/kg SC, q24 h), methadone (0.2 mg/kg IM, q8h) and amoxicillin + potassium clavulanate (20 mg/kg SC, q12h).[...]

Changes in weight and body fat after use of tetracycline and Lactobacillus gasseri in rats

ABSTRACT Recent studies have shown a role of intestinal microbiota in obesity. The consumption of antibiotics in the last 70 years has led to changes in intestinal microbiota, which has led to weight gain and body fat accumulation. To evaluate the possibility of weight gain induced by antibiotics and the possible protective effect of probiotics, we divided 45 animals (Rattus norvegicus) into groups and administered the following treatments over two weeks: tetracycline, tetracycline + Lactobacillus gasseri, and NaCl. The animals were weighed over the course of 8 weeks, and at the end of the treatment period, they were measured and subjected to bioelectrical impedance analysis. The results show that the group receiving tetracycline alone had a higher body mass index (p=0.030), a greater Lee index (p=0.008), and a lower body water percentage than the control group, indicating a greater accumulation of body fat. The group receiving the probiotics with tetracycline presented similar results to the control group, indicating a possible protective effect of body fat accumulation in the group receiving tetracycline alone. The results show that tetracycline increased the concentration of body fat, and the use of probiotics was associated with an ability to protect the animals from the pro-obesity effect.

Obesity and the use of antibiotics and probiotics in rats.

BACKGROUND: Obesity has become a major public health challenge in recent years. Recent studies suggest that alterations of the gut microbiota by antibiotics could play an important role in obesity. METHODS: We investigated this topic using 60 Wistar rats, which were divided into 3 experimental groups: rats treated with amoxicillin, rats treated with amoxicillin plus Saccharomyces boulardii and controls. Treatments were administered over the course of 2 weeks. Tetrapolar bioelectric impedance analysis and anthropometric evaluations were conducted. RESULTS: The body mass index was significantly lower for the animals in the control group (p = 0.034). The same result was observed for the Lee index: the control group had a lower index than the 2 groups that received antibiotic treatment (p = 0.0019). The total body water data demonstrated that the control group had the greatest amount of body water (279.1 g, p = 0.0243). CONCLUSIONS: The groups treated with the antibiotic exhibited a greater accumulation of body fat than the control group.

Patch tests / Testes de contato

Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field.

Os testes de contato foram introduzidos, como ferramenta diagnóstica, no final do século XIX. Desde então passaram por diversos aprimoramentos tornando-os o que são hoje. Eles são utilizados na investigação diagnóstica das dermatites de contato em diferentes partes do mundo. Devem ser aplicados com a utilização de baterias ou séries previamente estudadas e padronizadas. A metodologia é simples, mas requer treinamento adequado para sua interpretação e bom aproveitamento dos resultados obtidos. Apesar de ser utilizado há mais de um século, necessita de aprimoramentos como todas as outras técnicas utilizadas para investigação diagnóstica na área médica.

Endophytic microbial diversity in coffee cherries of Coffea arabica from southeastern Brazil.

The microbiota associated with coffee plants may play a critical role in the final expression of coffee quality. However, the microbial diversity in coffee cherries is still poorly characterized. Here, we investigated the endophytic diversity in cherries of Coffea arabica by using culture-independent approaches to identify the associated microbes, ultimately to better understand their ecology and potential role in determining coffee quality. Group-specific 16S rRNA and 26S rRNA genes polymerase chain reaction - denaturing gradient gel electrophoresis and clone library sequencing showed that the endophytic community is composed of members of the 3 domains of life. Bacterial sequences showing high similarity with cultured and uncultured bacteria belonged to the Betaproteobacteria, Gammaproteobacteria, and Firmicutes phyla. Phylogenetic analyses of cloned sequences from Firmicutes revealed that most sequences fell into 3 major genera: Bacillus, Staphylococcus, and Paenibacillus. Archaeal sequences revealed the presence of operational taxonomic units belonging to Euryarchaeota and Crenarchaeota phyla. Sequences from endophytic yeast were not recovered, but various distinct sequences showing high identity with filamentous fungi were found. There was no obvious correlation between the microbial composition and cultivar or geographic location of the coffee plant. To the best of our knowledge, this is the first report demonstrating internal tissue colonization of plant fruits by members of the Archaea domain. The finding of archaeal small-subunit rRNA in coffee cherries, although not sufficient to indicate their role as active endophytes, certainly expands our perspectives toward considering members of this domain as potential endophytic microbes.

Patch tests.

Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field.

Análise da diversidade da microbiota intestinal de ratos submetidos à ressecção da valva ileocecal e criação de esfíncter artificial / Analysis of the diversity of the intestinal microbiota of rats subjected to resection of the ileocecalvalve and creation of artificial sphincter

OBJETIVO: analisar através de biologia molecular a diversidade da microbiota da junção ileocecal antes e após a ressecção da válvula ileocecal e reconstrução do trânsito com e sem a criação de "neoesfíncter". MÉTODOS: Os animais foram distribuídos em dois grupos: Grupo A (n=7) com ressecção da válvula ileocecal e anastomose ileocólica término-terminal em plano único, e Grupo B (n=7) com ressecção da válvula ileocecal e anastomose ileocólica término-terminal em plano único e confecção do esfíncter artificial. Reoperados com 20 dias coletou-se novamente conteúdo intraluminar do íleo e do cólon. Das amostras coletadas, extraiu-se DNA para reação de PCR-DGGE. Os padrões de bandas eletroforéticas , gerados na reação, foram submetidos ao programa Bionumerics para análise da similaridade e da diversidade da microbiota. RESULTADOS: a diversidade da microbiota foi maior e em mais amostras do íleo do que as do cólon. O grupo com a válvula apresentou os maiores valores e variações no cólon de 2,11 a 2,93. Em três animais de cada grupo estabeleceu-se comparação da similaridade e não se assemelharam ao controle. CONCLUSÃO: a ressecção da válvula ileocecal levou à mudanças da microbiota ileal e, com a criação de novo esfíncter, as variações foram maiores.

OBJECTIVE: To analyze, through molecular biology, the diversity of the intestinal microbiota before and after resection of the ileocecal junction and reconstruction of intestinal transit with and without the creation of a neosphincter. METHODS: Fourteen Wistar rats were divided into two groups: Group A (n = 7), submitted to resection of the ileocecal valve and end-to-end, single-layer ileocolic anastomosis; and Group B (n = 7) with resection of the ileocecal valve and end-to-end, single-layer ileocolic anastomosis followed by construction of an artificial sphincter. Intraluminal contents were collected from both groups. The animals were reoperated 20 days after the first procedure, with new collection of intraluminal contents of the ileum and colon. From the samples collected, DNA was extracted for PCR-DGGE. The electrophoretic banding patterns generated in the reaction were analyzed for similarities and diversities of the microbiota. RESULTS: The diversity of microorganisms was larger and in more samples when collected from the ileum than from the colon. The group with the neosphincter showed the highest variation in the colon, from 2.11 to 2.93. In three animals from each group was established comparing the similarity and not resembled the control. CONCLUSION: ileocecal resection led to changes in ileal microbiota and, with the creation of new sphincter, the changes were even greater.

Influence of a high-fat diet on gut microbiota, intestinal permeability and metabolic endotoxaemia.

Lipopolysaccharide (LPS) may play an important role in chronic diseases through the activation of inflammatory responses. The type of diet consumed is of major concern for the prevention and treatment of these diseases. Evidence from animal and human studies has shown that LPS can diffuse from the gut to the circulatory system in response to the intake of high amounts of fat. The method by which LPS move into the circulatory system is either through direct diffusion due to intestinal paracellular permeability or through absorption by enterocytes during chylomicron secretion. Considering the impact of metabolic diseases on public health and the association between these diseases and the levels of LPS in the circulatory system, this review will mainly discuss the current knowledge about high-fat diets and subclinical inflammation. It will also describe the new evidence that correlates gut microbiota, intestinal permeability and alkaline phosphatase activity with increased blood LPS levels and the biological effects of this increase, such as insulin resistance. Although the majority of the studies published so far have assessed the effects of dietary fat, additional studies are necessary to deepen the understanding of how the amount, the quality and the structure of the fat may affect endotoxaemia. The potential of food combinations to reduce the negative effects of fat intake should also be considered in future studies. In these studies, the effects of flavonoids, prebiotics and probiotics on endotoxaemia should be investigated. Thus, it is essential to identify dietetic strategies capable of minimising endotoxaemia and its postprandial inflammatory effects.

First occurrence of blaOXA-58 in Acinetobacter baumannii isolated from a clinical sample in Southern Brazil

This is the first report of an Acinetobacter baumannii from clinical origin carrying the blaOXA-58 gene in Brazil. The isolate included in this study was from a patient during an outbreak in Porto Alegre, RS, Southern Brazil, in 2007. It was resistant to most of the beta-lactams tested, it has also the blaOXA-65 gene and the ISAba1 sequence located upstream to both blaOXA genes detected and it has a MIC of imipenem of 64 ìg/mL.

First occurrence of bla OXA-58 in Acinetobacter baumannii isolated from a clinical sample in Southern Brazil.

This is the first report of an Acinetobacter baumannii from clinical origin carrying the bla OXA-58 gene in Brazil. The isolate included in this study was from a patient during an outbreak in Porto Alegre, RS, Southern Brazil, in 2007. It was resistant to most of the beta-lactams tested, it has also the bla OXA-65 gene and the ISAbal sequence located upstream to both bla OXA genes detected and it has a MIC of imipenem of 64 µg/mL.

Analysis of the diversity of the intestinal microbiota of rats subjected to resection of the ileocecal valve and creation of artificial sphincter.

OBJECTIVE: To analyze, through molecular biology, the diversity of the intestinal microbiota before and after resection of the ileocecal junction and reconstruction of intestinal transit with and without the creation of a neosphincter. METHODS: Fourteen Wistar rats were divided into two groups: Group A (n = 7), submitted to resection of the ileocecal valve and end-to-end, single-layer ileocolic anastomosis; and Group B (n = 7) with resection of the ileocecal valve and end-to-end, single-layer ileocolic anastomosis followed by construction of an artificial sphincter. Intraluminal contents were collected from both groups. The animals were reoperated 20 days after the first procedure, with new collection of intraluminal contents of the ileum and colon. From the samples collected, DNA was extracted for PCR-DGGE. The electrophoretic banding patterns generated in the reaction were analyzed for similarities and diversities of the microbiota. RESULTS: The diversity of microorganisms was larger and in more samples when collected from the ileum than from the colon. The group with the neosphincter showed the highest variation in the colon, from 2.11 to 2.93. In three animals from each group was established comparing the similarity and not resembled the control. CONCLUSION: ileocecal resection led to changes in ileal microbiota and, with the creation of new sphincter, the changes were even greater.

First occurrence of blaOXA-58 in Acinetobacter baumannii isolated from a clinical sample in Southern Brazil

This is the first report of an Acinetobacter baumannii from clinical origin carrying the blaOXA-58 gene in Brazil. The isolate included in this study was from a patient during an outbreak in Porto Alegre, RS, Southern Brazil, in 2007. It was resistant to most of the beta-lactams tested, it has also the blaOXA-65 gene and the ISAba1 sequence located upstream to both blaOXA genes detected and it has a MIC of imipenem of 64 g/mL.

Molecular characterization of clinical multiresistant isolates of Acinetobacter sp. from hospitals in Porto Alegre, State of Rio Grande do Sul, Brazil / Caracterização molecular de isolados clínicos Acinetobacter sp. multirresistentes em hospitais de Porto Alegre, Estado do Rio Grande do Sul, Brasil

INTRODUCTION: Hospitals around the world have presented multiresistant Acinetobacter sp. outbreaks. The spread of these isolates that harbor an increasing variety of resistance genes makes the treatment of these infections and their control within the hospital environment more difficult. This study aimed to evaluate the occurrence and dissemination of Acinetobacter sp. multiresistant isolates and to identify acquired resistance genes. METHODS: We analyzed 274 clinical isolates of Acinetobacter sp. from five hospitals in Porto Alegre, RS, Brazil. We evaluated the susceptibility to antimicrobial, acquired resistance genes from Ambler's classes B and D, and performed molecular typing of the isolates using enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) technique. RESULTS: A high (68 percent) percentage of multiresistant isolates of Acinetobacter sp. was observed, and 69 percent were resistant to carbapenems. We identified 84 percent of isolates belonging to species A. baumannii because they presented the gene blaOXA-51. The gene blaOXA-23 was detected in 62 percent of the isolates, and among these, 98 percent were resistant to carbapenems. Using the ERIC-PCR technique, we identified clones of Acinetobacter sp. spread among the four hospitals analyzed during the sampling period. CONCLUSIONS: The data indicate the dissemination of Acinetobacter sp. isolates among hospitals and their permanence in the hospital after one year.

INTRODUÇÃO: Hospitais no mundo todo têm apresentado surtos de Acinetobacter sp. multirresistentes. A disseminação destes isolados com uma variedade cada vez maior de genes de resistência torna difícil o tratamento destas infecções e seu controle dentro do ambiente hospitalar. Este trabalho teve como objetivo avaliar a ocorrência e disseminação de isolados de Acinetobacter sp. multirresistentes e identificar genes de resistência adquirida. MÉTODOS: Foram avaliados 274 isolados clínicos de Acinetobacter sp. obtidos de cinco hospitais da Cidade de Porto Alegre, RS, Brasil. Avaliamos o perfil de suscetibilidade a antimicrobianos, genes de resistência adquirida das classes B e D de Ambler e realizamos a tipificação molecular dos isolados utilizando a técnica de enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). RESULTADOS: Encontramos uma alta (68 por cento) porcentagem de isolados de Acinetobacter sp. multirresistentes e 69 por cento dos isolados apresentaram resistência aos carbapenêmicos. Foram identificados 84 por cento de isolados pertencentes a espécie A. baumannii, pois apresentaram o gene blaOXA-51. Em 62 por cento dos isolados, foi detectado o gene blaOXA-23, sendo que 98 por cento destes isolados foram resistentes aos carbapenêmicos. Através da tipificação molecular pela técnica de ERIC-PCR identificamos clones de Acinetobacter sp. disseminados entre quatro dos hospitais analisados e nos anos de 2006 e 2007. CONCLUSÕES: Os dados obtidos indicam a disseminação de isolados de Acinetobacter sp. entre hospitais assim como sua permanência no ambiente hospitalar após um ano.