Profile of patients hospitalized with odontogenic infections in a public hospital in Belo Horizonte, Brazil

Objectives: We aimed to evaluate the profile of hospitalized patients presenting with odontogenic infections requiring intensive care and to identify predictive factors of worsening of the disease. Study Design: In this retrospective study, 119 consecutive medical records were assessed for data regarding odontogenic infections. The variables examined were age, gender, etiology, time from onset of infection to hospital admission, hospital stay, complications during hospitalization, and anatomical sites affected. Results: Most patients were female (64.7%) and the mean age of our study group was 28.3 years. Average length of hospital stay was 7.3 ± 6.3 days and the mean time from onset of infection to hospitalization was 6.9 days. Lower teeth corresponded to the initially affected site in the great majority (72.3%) of the cases and the mandibular third molar was the most commonly first infected tooth (31.9%). Post-surgical infection was involved in 21.8% of the cases. Systemic conditions were reported for 18.5% of the patients, mainly hypertension, but they were not determinant for admission. The main reasons for hospitalization were dyslalia, dysphagia, and dyspnea, either as single or associated signs (96.6%). Antimicrobial therapy was administered alone or combined with surgical drainage to 64 (53.8%) and 53 (44.5%) patients, respectively. Conclusions: Overall data generated by this investigation on the profile of severe odontogenic infection patients in our region are similar to those reported by other researchers. Conversely we found a higher prevalence of the disease among women in disagreement with previously published results. Such a kind of study may improve our knowledge relative to the disease and also reveal the regional scenario regarding severe odontogenic infections. Consequently it may contribute to the designing of strategies that may lead to a more efficient oral health care system what ultimately would culminate with the prevention of more severe outcomes from the disease

Characterization of an antagonistic peptide produced by a Bacteroides Fragilis isolate obtained from a patient with intra-abdominal infection / Caracterização de um peptido antagonístico produzido por Bacteroides Fragilis isolado obtido em um paciente com infecção intra-abdominal

The indigenous microbiota of humans is extremely rich and diverse, with special emphasis on the intestinal microbiota. As a constituent of this microbiota, it is mentioned the genus Bacteroides, whose members are Gram negative rods, obligate anaerobes, amphibionts, associated to the etiopathogenesis of important infectious diseases, such as intra-abdominal infections. Bacteroides strains have the ability to synthesize antagonistic substances that play an ecological role, especially in densely colonized habitats, giving a competitive advantage to the producing samples. The objective of this study was to evaluate the synthesis capacity of antagonistic substances by 40 samples of Bacteroides and Parabacteroides isolated from patients with intra-abdominal infections. The expression of antagonism was evaluated by the overlay diffusion method, using, as well as the test samples, 36 reference samples of Gram negative and Gram-positive bacteria. Subsequently, a production strain (Bacteroides fragilis) was used for extraction, purification and partial characterization of the detected antagonistic substance. As indicator strains, Bacteroides ovatus and Bacteroides caccae were used. The production strain was submitted to protein extraction, and the activity of the precipitated intracellular extract was detected with (NH4) 2SO4 in concentrations of 30% (C30) and 50% (C50). C30 and C50 were inactivated by proteases and high temperatures and remained active after exposure to organic solvents and a wide pH range. Both fractions presented antagonistic activity of bacteriostatic nature. The C50 extract was subjected to ion exchange chromatography, and 50 fractions were recovered. Among them, fractions 1 to 4, referring to a single peak, that were not able to bind to the column, presented antagonistic activity. Fractions from the ion exchange chromatography were applied in gel filtration chromatography. Among them, fractions 2 and 3 were able to inhibit the developing sample. These fractions were submitted to reverse phase chromatography, and 50 fractions were collected. One of them, fraction 2C, remained active against the revealing sample. Mass spectrometry, from fraction 2C obtained from reverse phase chromatography, presented ions of approximately 1300.00 Da, which generated a more intense signal. The search performed by similarity between the sequenced peptides and proteins described in the BLASTP database, from fragmentation obtained in reverse phase chromatography, resulted in 100% identity between two peptides. One of the sequenced peptides showed 100% identity to a type VII secretion protein. The search performed by similarity between the sequenced peptides and proteins described in the ANTIMICROBIAL PEPTIDE DATABASE database, from fragmentation obtained with trypsin digestion, resulted in 42% identity with a Streptomyces microcine. Together, the results indicate the production of antagonistic substances by the B. fragilis sample under study. It is plausible to assume that they play a relevant role in interbacterial relationships, as a virulence factor, in a complex environment such as intra-abdominal infection

Territorialização e redes na sociedade contemporânea: religião e cuidado no espaço público

-Nesta pesquisa trabalhamos o conceito de territorialização para compreender as condições e possibilidades de acesso à variedade de recursos decuidado que se encontram disponibilizados em um determinado contexto social. A partir do trabalho de observação e de entrevistas feitas com osprofissionais e os usuários da Unidade Básica de Saúde do Bairro de Santa Luzia, Juiz de Fora – MG, intentamos entender as redes de cuidadoatravés das quais se operacionaliza a territorialização.Essas redes sociais são espaços em que se encontram tanto o formato territorialização-dominação da UBS, quanto as diferentes articulaçõesintersticiais realizadas como válvula de escape por parte dos usuários. Entendidas como um recurso metodológico, elas nos permitem entender asnovas configurações que o social assume. Entendemos o social como um tipo de conexão que coloca em relação coisas não sociais, produzindosempre novas percepções acerca do que constituem os vínculos entre os humanos. Portanto, é nesse espaço-conexão em rede que se produz aterritorialização, ou melhor, que o conceito territorialização é metaforizado em vários tipos de territorialização: 1. a própria delimitação do espaçogeográfico adscrito pela UBS; 2. o âmbito familiar e 3. os espaços de interação por onde circulam os sujeitos/usuários. Em tais espaçosterritorializados podemos perceber as relações entre diferentes experiências terapêuticas e a Estratégia de Saúde da Família, no que diz respeito aosvariados graus de receptividade da ESF e as articulações diversas entre o cuidado profissional e as terapêuticas populares e/ou religiosas

SHIFT IN HUMAN ROTAVIRUS DISTRIBUTION IN BELO HORIZONTE, BRAZIL DETECTED BY RIBONUCLEIC ACID ELECTROPHORESIS

Rotavirus has been considered the main agent of infectious diarrhea especially among younger children. We addressed the prevalence of rotavirus-associated diarrhea and the diversity of circulating electropherotypes by immunochromatography and RNA electrophoresis. Stool samples were taken from 391 children (267 with diarrhea) from the lower socioeconomic stratum who sought treatment in the Hospital Infantil João Paulo II/Belo Horizonte, during 2005 and 2006. Rotavirus was detected in 79/20.2% of subjects, 64/24.0% with diarrhea and 15/12.1% with no diarrhea. The virus was strongly associated with diarrhea (p = 0.003). A total of 76/19.4% and 69/17.6% rotavirus-positive children were identified by immunochromatography and electrophoresis, respectively. Rotavirus-associated diarrhea was more frequently detected in dry months (p < 0.001) and almost exclusively in children aged up to three years. Long profile strains prevailed (54/78.3%) but a shift toward short electropherotype was identified. Despite the decrease seen in 2006, rotavirus infection is still very common in our area. Although viral RNA electrophoresis is useful as a typing method, it should not be used exclusively in the diagnosis of rotavirus infection. We confirmed a shift from long to short profile strains, as already described for other South American countries

Prevalência baixa de adenovírus em crianças com diarreia em Belo Horizonte-MG Low prevalence of adenoviruses in children with acute diarrhea in Belo Horizonte-MG

INTRODUÇÃO: Diversos microrganismos são reconhecidos como agentes de diarreia aguda, entre eles, os adenovírus, cuja associação com a doença apresenta variações geográficas e é pouco conhecida no Brasil. OBJETIVOS: Investigar a presença de adenovírus em fezes de crianças com diarreia aguda e sem diarreia, em Belo Horizonte-MG, e estudar os fatores epidemiológicos associados à adenovirose intestinal. MATERIAL E MÉTODOS: O teste imunocromatográfico qualitativo (kit VIKIA® Rota-Adeno, bioMérieux) foi utilizado para pesquisa de antígenos de adenovírus em amostras fecais obtidas de 268 crianças com diarreia aguda e 124 sem diarreia, em 2005 e 2006, no Hospital Infantil João Paulo II, Belo Horizonte-MG. Dados laboratoriais, clínicos e epidemiológicos foram registrados em banco de dados (SPSS Statistical package, IBM). RESULTADOS: Adenovírus foi detectado nas fezes de 16 crianças (4,1%): 12 (4,5%) com diarreia e quatro (3,2%) sem diarreia. A virose foi mais comum em meninas e a distribuição etária da infecção foi homogênea. Entre as 16 crianças com infecção pelo vírus, 11 (68,8%) tinham até 12 meses de idade. Entretanto, diferença significativa não foi observada para os parâmetros analisados. Distribuição sazonal da infecção por adenovírus não foi detectada. CONCLUSÃO: Nossos dados demonstram que a prevalência da adenovirose é baixa na população pediátrica no nosso meio.<br>INTRODUCTION: Several microorganisms, among them enteric adenovirus, are widely recognized as etiological agents of acute diarrhea. The association between adenovirus and the disease varies among geographical regions and is poorly known in Brazil. OBJECTIVES: To investigate the presence of adenovirus in stool samples from children with and without diarrhea in Belo Horizonte-MG. To study factors associated with enteric adenovirus infection. MATERIAL AND METHOD: A qualitative immunochromatographic assay (kit VIKIA® Rota-Adeno, bioMérieux) was performed to detect adenovirus antigens in stool samples from 268 children with acute diarrhea and 124 without diarrhea at Hospital Infantil João Paulo II from January/2005 to December/2006. Clinical, laboratory, and epidemiologic data were recorded in SPSS database (SPSS Statistical package, IBM). RESULTS: Adenovirus was detected in 16 samples (4.1%): 12 of them (4.5%) were from children with acute diarrhea and 4 of them (3.2%) from children without diarrhea. The viral infection was more prevalent among girls and the age distribution was homogenous. Among the 16 children infected by adenovirus,11 (68.8%) were younger than 12 months old. However, no significant statistical difference was observed within the analyzed parameters. There was no seasonal distribution of adenovirus infection. CONCLUSION: Our data demonstrate that the prevalence of enteric adenovirus infection is low among children with diarrhea in Belo Horizonte-MG

Reutilización del detergente enzimático en el procesamiento de gastroscopios: una fuente potencial de trasmisión de microorganismos

Objetivo: evaluar la potencial contaminación del detergente enzimático a partir de su reutilización e identificar el perfil microbiológico en la solución utilizada en la limpieza de aparatos endoscópicos gastrointestinales. Método: estudio transversal realizado a partir del análisis microbiológico de 76 alícuotas de 19 diferentes soluciones de detergente enzimático utilizadas en la limpieza de aparatos endoscópicos. Las alícuotas fueron homogeneizadas y sometidas a filtración en membrana Millipore® 0,45µm, la identificación presumida de los microorganismos fue realizada por métodos bioquímico-fisiológicos conforme grupos bacterianos específicos previamente establecidos y que presentan importancia clínica y epidemiológica. Resultados: los valores medios, así como la desviación estándar y la mediana, de la carga microbiana del detergente enzimático fueron crecientes a medida que la solución fue reutilizada. Hubo diferencia significativa entre las medias después del primer uso y después de la quinta reutilización. Fueron identificados 97 microorganismos, con predominio de los géneros&nbsp;Staphylococcus&nbsp;coagulase negativa,&nbsp;Pseudomonas spp, Klebsiella spp, Enterobacter spp, y de la especie&nbsp;Escherichia coli. Conclusión: la reutilización de la solución de detergente enzimático constituye un riesgo al procesamiento seguro de los aparatos endoscópicos, evidenciado por su contaminación con microorganismos que presentan potencial patogénico, ya que el detergente enzimático no posee propiedad bactericida y puede contribuir como fuente importante para brotes en pacientes sometidos a esos procedimientos.Objetivo: avaliar a potencial contaminação do detergente enzimático a partir de seu reuso e identificar o perfil microbiológico na solução utilizada na limpeza de aparelhos endoscópicos gastrointestinais. Método: estudo transversal realizado a partir da análise microbiológica de 76 alíquotas de 19 diferentes soluções de detergente enzimático utilizadas na limpeza de aparelhos endoscópicos. As alíquotas foram homogeneizadas, submetidas a filtração em membrana Millipore® 0,45µm e a identificação presuntiva dos microrganismos foi realizada por métodos bioquímico-fisiológico conforme grupos bacterianos específicos previamente estabelecidos e que apresentam importância clínica e epidemiológica. Resultados: Os valores médios, assim como o desvio-padrão e a mediana, da carga microbiana do detergente enzimático foram crescentes à medida que a solução foi reutilizada. Houve diferença significativa entre as médias de após primeiro uso e após quinto reuso. Foram identificados 97 microrganismos, com predomínio dos gêneros Staphylococcus coagulase negativa, Pseudomonas spp., Klebsiella spp., Enterobacter spp., e da espécie Escherichia coli. Conclusão: O reuso da solução de detergente enzimático constitui um risco ao processamento seguro dos aparelhos endoscópios, evidenciado pela sua contaminação com microrganismos que apresentam potencial patogênico, uma vez que o detergente enzimático não possui propriedade bactericida e pode contribuir como fonte importante para surtos em pacientes submetidos a tais procedimentos.Objective: to evaluate the potential contamination of enzymatic detergent from its reuse and to identify the microbiological profile in the solution used to clean gastrointestinal endoscopic devices. Method: cross-sectional study based on microbiological analysis of 76 aliquots of 19 different enzymatic detergent solutions used to clean endoscopic devices. The aliquots were homogenized, subjected to Millipore® 0.45 µm membrane filtration and the presumptive identification of microorganisms was performed by biochemical-physiological methods according to previously established specific bacterial groups that are of clinical and epidemiological relevance. Results: the mean values, as well as the standard deviation and the median, of the enzymatic detergent microbial load increased as the solution was reused. There was a significant difference between the means of after first use and after fifth reuse. A total of 97 microorganisms were identified, with predominance of the coagulase-negative&nbsp;Staphylococcus, Pseudomonas&nbsp;spp.,&nbsp;Klebsiella&nbsp;spp.,&nbsp;Enterobacter&nbsp;spp. genus, and&nbsp;Escherichia coli&nbsp;species. Conclusion: the reuse of the enzymatic detergent solution is a risk to the safe processing of endoscopic devices, evidenced by its contamination with pathogenic potential microorganisms, since the enzymatic detergent has no bactericidal property and can contribute as an important source for outbreaks in patients under such procedures

Prevalence of Salmonella enterica in children aged less than 5 years with acute diarrhea and controls in Teresina-PI

We investigated the prevalence of Salmonella enterica (SE) among children (n = 400/250 with diarrhea) in Teresina-PI from 2004 to 2007. SE Newport was isolated from two samples and O-C2-C3-ND, Enteritidis, and Muenchen serological variants were isolated from one sample each. SE infection was more prevalent among children aged less than six months. Increased fecal volume, 3-10 evacuations/day, vomit and fever were reported for all cases. Resistance to nalidixic acid (NAL) and sulphamethoxazole-trimethoprim (SXT) was ubiquitous. Our data substantiate the need for monitoring SE infections worldwide and the emergence of antimicrobial resistance

Shigella in Brazilian children with acute diarrhoea: prevalence, antimicrobial resistance and virulence genes

Diarrhoeal disease is still considered a major cause of morbidity and mortality among children. Among diarrhoeagenic agents, Shigella should be highlighted due to its prevalence and the severity of the associated disease. Here, we assessed Shigella prevalence, drug susceptibility and virulence factors. Faeces from 157 children with diarrhoea who sought treatment at the Children's Hospital João Paulo II, a reference children´s hospital in Belo Horizonte, state of Minas Gerais, Brazil, were cultured and drug susceptibility of the Shigella isolates was determined by the disk diffusion technique. Shigella virulence markers were identified by polymerase chain reaction. The bacterium was recovered from 10.8% of the children (88.2% Shigella sonnei). The ipaH, iuc, sen and ial genes were detected in strains isolated from all shigellosis patients; set1A was only detected in Shigella flexneri. Additionally, patients were infected by Shigella strains of different ial, sat, sen and set1A genotypes. Compared to previous studies, we observed a marked shift in the distribution of species from S. flexneri to S. sonnei and high rates of trimethoprim/sulfamethoxazole resistance