Revisitingmolecular serotyping of Streptococcus pneumonia

Submitted by Nuzia Santos ([email protected]) on 2016-07-06T11:40:35Z No. of bitstreams: 1 ve_Dhian_Camargo_ Revisitingmolecular_CPqRR_2015.pdf: 1647355 bytes, checksum: d446af4ae8ae1cdd1b0e0853582ff5ec (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2016-07-06T11:43:26Z (GMT) No. of bitstreams: 1 ve_Dhian_Camargo_ Revisitingmolecular_CPqRR_2015.pdf: 1647355 bytes, checksum: d446af4ae8ae1cdd1b0e0853582ff5ec (MD5)Made available in DSpace on 2016-07-06T11:43:26Z (GMT). No. of bitstreams: 1 ve_Dhian_Camargo_ Revisitingmolecular_CPqRR_2015.pdf: 1647355 bytes, checksum: d446af4ae8ae1cdd1b0e0853582ff5ec (MD5) Previous issue date: 2015Made available in DSpace on 2016-07-14T19:10:31Z (GMT). No. of bitstreams: 3 ve_Dhian_Camargo_ Revisitingmolecular_CPqRR_2015.pdf.txt: 41150 bytes, checksum: 677ee69411513ac8a87f484354a4dac8 (MD5) ve_Dhian_Camargo_ Revisitingmolecular_CPqRR_2015.pdf: 1647355 bytes, checksum: d446af4ae8ae1cdd1b0e0853582ff5ec (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Belo Horizonte, MG, Brasil / Fundação Ezequiel Dias. Serviço de Bactérias e Doenças de Fungos. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Grupo de Biologia e Genômica Computacional. Belo Horizonte, MG, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Centro de Excelência em Bioinformática. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Grupo de Biologia e Genômica Computacional. Belo Horizonte, MG, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Centro de Excelência em Bioinformática. Belo Horizonte, MG, Brasil.Fundação Ezequiel Dias. Serviço de Bactérias e Doenças de Fungos. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Belo Horizonte, MG, Brasil.Background: Ninety-two Streptococcus pneumoniae serotypes have been described so far, but the pneumococcal conjugate vaccine introduced in the Brazilian basic vaccination schedule in 2010 covers only the ten most prevalent in the country. Pneumococcal serotype-shifting after massive immunization is a major concern and monitoring this phenomenon requires efficient and accessible serotyping methods. Pneumococcal serotyping based on antisera produced in animals is laborious and restricted to a few reference laboratories. Alternatively, molecular serotyping methods assess polymorphisms in the cps gene cluster, which encodes key enzymes for capsular polysaccharides synthesis in pneumococci. In one such approach, cps-RFLP, the PCR amplified cps loci are digested with an endonuclease, generating serotype-specific fingerprints on agarose gel electrophoresis. Methods: In this work, in silico and in vitro approaches were combined to demonstrate that XhoII is the most discriminating endonuclease for cps-RFLP, and to build a database of serotype-specific fingerprints that accommodates the genetic diversity within the cps locus of 92 known pneumococci serotypes. Results: The expected specificity of cps-RFLP using XhoII was 76% for serotyping and 100% for serogrouping. The database of cps-RFLP fingerprints was integrated to Molecular Serotyping Tool (MST), a previously published web-based software for molecular serotyping. In addition, 43 isolates representing 29 serotypes prevalent in the state of Minas Gerais, Brazil, from 2007 to 2013, were examined in vitro; 11 serotypes (nine serogroups) matched the respective in silico patterns calculated for reference strains. The remaining experimental patterns, despite their resemblance to their expected in silico patterns, did not reach the threshold of similarity score to be considered a match and were then added to the database. Conclusion: The cps-RFLP method with XhoII outperformed the antisera-based and other molecular serotyping methods in regard of the expected specificity. In order to accommodate the genetic variability of the pneumococci cps loci, the database of cps-RFLP patterns will be progressively expanded to include new variant in vitro patterns. The cps-RFLP method with endonuclease XhoII coupled with MST for computer-assisted interpretation of results may represent a relevant contribution to the real time detection of changes in regional pneumococci population diversity in response to mass immunization programs

Assistência Farmacêutica no Sistema Único de Saúde: da Política Nacional de Medicamentos à Atenção Básica à Saúde Pharmaceutical Assistance in the Basic Units of Health: from the National Drug Policy to the Basic Attention to Health

Este artigo é um estudo de revisão teórica que discute a Assistência Farmacêutica no Sistema Único de Saúde, resgatando-se brevemente a história da Política Nacional de Medicamentos, os mecanismos de financiamento no processo de descentralização da saúde e a Assistência Farmacêutica na Atenção Básica à Saúde. A ampliação do acesso da população ao sistema de saúde exigiu mudanças na distribuição de medicamentos, de maneira a aumentar a cobertura e ao mesmo tempo minimizar custos. Identificam-se avanços no arcabouço jurídico e institucional: descentralização da gestão das ações da assistência farmacêutica; ampliação do acesso da população aos medicamentos essenciais; e estruturação da assistência farmacêutica nos municípios. No entanto, persistem ações prioritárias em relação ao financiamento e cobertura populacional, em detrimento da qualidade dos processos. Conclui-se que em muitos municípios brasileiros ocorrem baixa disponibilidade e descontinuidade da oferta de medicamentos essenciais; dispensação por trabalhadores sem qualificação; condições inadequadas de armazenamento que comprometem a qualidade dos medicamentos; prescrição de medicamentos que não pertencem à Relação Nacional de Medicamentos Essenciais; e problemas relacionados ao acesso dos usuários à farmacoterapia.<br>This study of theoretical revision discuss the Pharmaceutical Assistance in the Basic Units of Health, rescuing briefly the history of the National Drug Policy, the mechanisms of financing in the process of health decentralization and Pharmaceutical Assistance on the Basic Attention to Health. The expansion of the population access to the health system has demanded changes on drug distribution in order to increase the coverage and at the same time to reduce costs. It was identified advances in legal and institutional structures: the management decentralization of actions on pharmaceutical assistance; the expansion of the population access to essential medicines; and the establishment of the pharmaceutical assistance in some cities. However, it still persists priority actions in relation to the financing and population coverage, in detriment of quality processes. The conclusion is that, many Brazilian cities has low availability and discontinuity of essential medicine offer; dispensation by workers without qualification; inadequate conditions of storage that compromise the quality of medicines; medicine prescription that does not belong to the National Reference of Essential Medicines; and problems related to the access of users to the pharmacotherapy

Epidemiology and evolution of Zika virus in Minas Gerais, Southeast Brazil

Autochthonous Zika virus (ZIKV) transmission in Brazil was first identified in April 2015 in Brazil, with the first ZIKV-associated microcephaly cases detected in October 2015. Despite efforts on understanding ZIKV transmission in Brazil, little is known about the virus epidemiology and genetic diversity in Minas Gerais (MG), the second most populous state in the country. We report molecular and genomic findings from the main public health laboratory in MG. Until January 2020, 26,817 ZIKV suspected infections and 86 congenital syndrome cases were reported in MG state. We tested 8552 ZIKV and microcephaly suspected cases. Ten genomes were generated on-site directly from clinical samples. A total of 1723 confirmed cases were detected in Minas Gerais, with two main epidemic waves; the first and larger epidemic wave peaked in March 2016, with the second smaller wave that peaked in March 2017. Dated molecular clock analysis revealed that multiple introductions occurred in Minas Gerais between 2014 and 2015, suggesting that the virus was circulating unnoticed for at least 16 months before the first confirmed laboratory case that we retrospectively identified in December 2015. Our findings highlight the importance of continued genomic surveillance strategies combined with traditional epidemiology to assist public health laboratories in monitoring and understanding the diversity of circulating arboviruses, which might help attenuate the public health impact of infectious diseases