Epidemiologia e susceptibilidade aos antibióticos em isolados de S. aureus meticilina-resistentes

É sabido que num mesmo país a prevalência de S. aureus meticilina-resistentes (SAMR) varia substancialmente de um hospital para outro. De modo a compreender a epidemiologia e a resistência aos antibióticos dos isolados SAMR no Hospital S. Teotónio – Viseu, conduzimos um estudo retrospectivo (2000-2001) através da análise da base de dados do laboratório (MODULAB IZASA), que permite obter dados demográficos acerca dos pacientes, e padrões de resistência dos isolados de S. aureus. A identificação das estirpes foi efectuada com o sistema Vitek (bioMérieux, Marcy L’étoile, France) e galerias BBL+ (Beckton Dickinson, Cockeysville, Maryland, USA). Para a susceptibilidade antimicrobiana recorreu-se ao sistema Vitek e ao método de difusão de disco (Kirby-Bauer). Foram seguidas as guidelines interpretativas da NCCLS. Do total de 300 isolados de S. aureus estudados, 110 (37%) provieram de exsudados purulentos, 109 (36.1%) do tracto respiratório, 52 (17.3%) de sangue e 16 (5.3%) de pontas de catéter. A resistência global à meticilina foi de 46.7% (140/300). As amostras mais comuns a partir das quais se isolaram SAMR foram as secreções respiratórias (54.2%), seguidas pelos exsudatos purulentos (24.2%), hemoculturas (12.1%) e pontas de catéter (7.1%). Nos isolados invasivos a resistência à meticilina foi de 32.7%. As taxas de resistência dos SAMR a outros antibióticos foram as seguintes: 96.3% resistentes à ciprofloxacina, 92.7% à eritromicina, 91.7% à gentamicina, 86.3% à tetraciclina, 75% ao trimethoprimsulfamethoxazole e 54.8% à clindamicina. A taxa de multirresistência foi de 87%. Os isolados SAMR exibem altos níveis de resistência à maioria dos antibióticos, excepto à teicoplanina e vancomicina, que continuam a ser as principais armas terapêuticas nas infecções por SAMR, apesar do uso substancial de glicopéptidos ao longo de muitos anos. Concluímos que a prevalência de isolados SAMR é elevada (46.7%) no Hospital S. Teotónio, o que se correlaciona com um estudo anterior de hospitais portugueses (48-50%), e com resultados de países mediterrâneos como Espanha, Itália e França (30-50%). Contudo, contrasta fortemente com os países do norte da Europa como Alemanha, Suécia, Holanda e Dinamarca (<5%). Estes dados serão úteis para a nossa comissão de controlo da infecção

Let there be light...

“Let there be light...” is a project in the scope of the International Year of Light 2015 (IYL 2015) targeted at children of the first school grade. Basically, it comprises nine recreational - scientific workshops that last for approximately 90 minutes. Each workshop is dedicated to a different topic, namely: bioluminescence, mineral observation, the rainbow, light-shadow contrast, battery production, just to name a few, and is designed, in differ- ent approaches, by a distinct team of scientists familiar to the scientific area focused. The activity starts with the dramatized storytelling of a children’s story related to the scientific subject and performed by the team of the public library expert in this area. This moment takes place in an almost magical environment opening the door to the science topic light-related that would be focused later on. In the third part of the workshop, the children are invited to produce plastic works (e.g. drawings, constructions and models) inspired in what they have learned, and that are to be collected in a public exhibition held at the same institution at the end of the project. In the present work, besides the description of the experience, you can find the critical analysis of the activity and the evaluation of the action by all the actors involved (project team and children/teachers that attended the workshops).info:eu-repo/semantics/publishedVersio

Ochratoxin A in Portugal: A Review to Assess Human Exposure

In Portugal, the climate, dietary habits, and food contamination levels present the characteristics for higher population susceptibility to ochratoxin A (OTA), one of the known mycotoxins with the greatest public health and agro-economic importance. In this review, following a brief historical insight on OTA research, a summary of the available data on OTA occurrence in food (cereals, bread, wine, meat) and biological fluids (blood, urine) is made. With this data, an estimation of intake is made to ascertain and update the risk exposure estimation of the Portuguese population, in comparison to previous studies and other populations

Structural and non-coding variants increase the diagnostic yield of clinical whole genome sequencing for rare diseases

BACKGROUND: Whole genome sequencing is increasingly being used for the diagnosis of patients with rare diseases. However, the diagnostic yields of many studies, particularly those conducted in a healthcare setting, are often disappointingly low, at 25-30%. This is in part because although entire genomes are sequenced, analysis is often confined to in silico gene panels or coding regions of the genome.METHODS: We undertook WGS on a cohort of 122 unrelated rare disease patients and their relatives (300 genomes) who had been pre-screened by gene panels or arrays. Patients were recruited from a broad spectrum of clinical specialties. We applied a bioinformatics pipeline that would allow comprehensive analysis of all variant types. We combined established bioinformatics tools for phenotypic and genomic analysis with our novel algorithms (SVRare, ALTSPLICE and GREEN-DB) to detect and annotate structural, splice site and non-coding variants.RESULTS: Our diagnostic yield was 43/122 cases (35%), although 47/122 cases (39%) were considered solved when considering novel candidate genes with supporting functional data into account. Structural, splice site and deep intronic variants contributed to 20/47 (43%) of our solved cases. Five genes that are novel, or were novel at the time of discovery, were identified, whilst a further three genes are putative novel disease genes with evidence of causality. We identified variants of uncertain significance in a further fourteen candidate genes. The phenotypic spectrum associated with RMND1 was expanded to include polymicrogyria. Two patients with secondary findings in FBN1 and KCNQ1 were confirmed to have previously unidentified Marfan and long QT syndromes, respectively, and were referred for further clinical interventions. Clinical diagnoses were changed in six patients and treatment adjustments made for eight individuals, which for five patients was considered life-saving.CONCLUSIONS: Genome sequencing is increasingly being considered as a first-line genetic test in routine clinical settings and can make a substantial contribution to rapidly identifying a causal aetiology for many patients, shortening their diagnostic odyssey. We have demonstrated that structural, splice site and intronic variants make a significant contribution to diagnostic yield and that comprehensive analysis of the entire genome is essential to maximise the value of clinical genome sequencing.</p