Nasopharyngeal carriage of Staphylococcus aureus among imprisoned males from Brazil without exposure to healthcare: risk factors and molecular characterization

Background: Previous studies report high prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) colonization among imprisoned populations. However, there are no data on that prevalence in Brazilian correctional institutions.Findings: We tested 302 male prisoners for nasopharyngeal colonization with Staphylococcus aureus from February 2009 through April 2010. The overall isolation rate of S. aureus was 16.5% (50/302). Men who had sex with men, users of inhalatory drugs and those with previous lung or skin diseases were more likely to be colonized with S. aureus. MRSA was isolated from 0.7% of subjects (2/302). The two Community-associated (CA)-MRSA belonged to ST5 but were unrelated based on the PFGE results. Both harbored SCCmec IV, and did not possess the Panton-Valentine Leukocidin gene.Conclusion: We found low prevalence of S. aureus and CA-MRSA among prisoners. MRSA isolates ST5 from two subjects harboured SCCmec IV and presented different PFGE patterns

PROFILE OF TYPE 2 DIABETICS INSULIN-APPLICANTS FOLLOWED IN A MULTI HEALTH CENTER, SALVADOR, BAHIA, BRAZIL

Objetivo: Descrever o perfil clínico e epidemiológico de pacientes com Diabetes Mellitus (DM) tipo 2 insulino-requerentes acompanhados por equipe multidisciplinar em um Multicentro de Saúde em Salvador-BA, Brasil. Método: Estudo epidemiológico, transversal, descritivo de pacientes atendidos em um Multicentro de Saúde no período de outubro/2017 a outubro/2019. As variáveis clínicas e sociodemográficas foram coletadas de prontuários e expressas em frequências absolutas e relativas, média e desvio padrão (DP), além de mediana e intervalo interquartílico (IIQ). Resultados: Foram avaliados 163 pacientes com média (DP) de idade de 61,2 (± 10,6) anos, com predomínio entre 51 e 60 anos (39,3%), sendo 66,3% do sexo feminino. A mediana de tempo de diagnóstico foi de 10 (3) anos e 78,8% usavam insulina há menos de 5 anos. Metade dos pacientes aceitava sua condição de diabético, 53,2% não corrigiam adequadamente os episódios hipoglicêmicos, 68,1% possuíam hemoglobina glicada acima das metas estipuladas pela Sociedade Brasileira de Diabetes e 59,9% tinham microalbuminúria. Além disso, 96,3% não praticavam exercícios físicos, 2,5% possuíam perfil alimentar apropriado, 71,0% tinham diagnóstico de Hipertensão Arterial Sistêmica, e 70,8% possuíam o valor da fração de colesterol Low Density Lipoprotein (LDL) acima da meta estabelecida pela Sociedade Brasileira de Cardiologia. Conclusão: Nesta amostra de pacientes diabéticos insulino-requerentes, a maioria dos pacientes era do sexo feminino, apresentava outras comorbidades associadas ao DM, baixa adesão às medidas higienodietéticas, elevação da hemoglobina glicada e indícios de nefropatia diabética.Objective: To describe the clinical and epidemiological profile of patients with insulin-inuming Type 2 Diabetes Mellitus followed by a multidisciplinary team in a Multicenter Health Unit in Salvador-BA, Brazil. Method: Epidemiological, cross-sectional, retrospective, descriptive study with patients treated in the Multicenter Health Unit from October/2017 to October/2019. The clinical and sociodemographic variables were collected from medical records and expressed in absolute and relative frequencies, mean and standard deviation (SD), in addition to median and interquartile range (IR). Results: We evaluated 163 patients with mean (SD) of age of 61.2 (± 10.6) years, with a predominance between 51 and 60 years (39.3%), 66.3% of which were female.The median time of diagnosis was 10 (3) years and 78.8% had been using insulin for less than 5 years. Half of the patients accepted their diabetic condition, 53.2% did not adequately correct hypoglycemic episodes, 68.1% glycated hemoglobin above the targets set by the Brazilian Diabetes Society and 59.9% had microalbuminuria. In addition, 96.3% did not exercise, 2.5% had an appropriate food profile, 71.0% were diagnosed with Systemic Arterial Hypertension, and 70.8% did not have the cholesterol fraction Low Density Lipoprotein (LDL) value in the goal established by the Brazilian Society of Cardiology. Conclusion: In this sample of insulin-applicant diabetic patients, most patients were female, had other comorbidities associated with DM, low adhering to hygienic dietary measures, elevation of glycated hemoglobin and signs of diabetic nephropathy

Database Survey of Anti-Inflammatory Plants in South America: A Review

Inflammation is a complex event linked to tissue damage whether by bacteria, physical trauma, chemical, heat or any other phenomenon. This physiological response is coordinated largely by a variety of chemical mediators that are released from the epithelium, the immunocytes and nerves of the lamina propria. However, if the factor that triggers the inflammation persists, the inflammation can become relentless, leading to an intensification of the lesion. The present work is a literature survey of plant extracts from the South American continent that have been reported to show anti-inflammatory activity. This review refers to 63 bacterial families of which the following stood out: Asteraceae, Fabaceae, Euphorbiaceae, Apocynaceae and Celastraceae, with their countries, parts used, types of extract used, model bioassays, organisms tested and their activity

Staphylococcus aureus: resistência de virulência e tipagem de MRSA pelas técnicas de MLST e spa typing

Staphylococcus aureus is distinguished by its high pathogenicity and frequency, allowing that this agent is capable of producing diseases in both healthy individuals and immunocompromised due to its easy dissemination. The aim of this work was to characterize the distribution of clones of S. aureus sensitive and resistant (MSSA/MRSA) in 50 isolates from patients with skin infections of Section of Dermatology of the University Hospital of the Botucatu Medical School Hospital of the (FMB), 50 isolates of elderly residents of nursing homes of Bauru and 50 isolates from inmates of Detention Center of Avare. The isolates of S. aureus were subjected to the technique of E-test for determination of Minimum Inhibitory Concentration (MIC). To determine the virulence profile and oxacillin resistance in 150 isolates of S. aureus was used Polymerase Chain Reaction (PCR) for the detection of mecA gene, staphylococcal cassette chromosome mec (SCCmec), genes encoding enterotoxins (sea, seb and sec-1), exfoliative toxins A and B (eta e etb), toxic shock syndrome toxin 1 (tst), Panton-Valentine leukocidin (lukS-PV and lukF-PV), alpha and delta hemolysin (hla and hld) and biofilm (icaA and icaD). The clonal profile of MRSA and MSSA isolates were characterized by Pulsed Field Gel Electrophoresis (PFGE), and MRSA clones were subjected to molecular typing Multilocus Sequence Typing (MLST) and spa typing. The results revealed a higher prevalence of MRSA in institutional settings, besides having MIC90 64μg/mL for oxacillin and MIC90 > 256 mg/mL for clindamycin. Of the 150 samples of S. aureus studied, 20 (13.3%) were mecA carriers, being detected seven isolates harboring SCCmec type IV nine carrying the SCCmec type II, only one isolate carrying the SCCmec type I and 3 isolates were not typed by the protocol used. Among the virulence factors, enterotoxin A was the most prevalent in all sources. Is important to note, 10% of isolates from Center Resocialization ...Staphylococcus aureus se destaca por sua patogenicidade e alta frequência, permitindo que este agente seja capaz de produzir doenças tanto em indivíduos sadios quanto em imunocomprometidos por sua fácil disseminação. O objetivo deste trabalho foi caracterizar a distribuição de clones de S. aureus sensíveis e resistentes à meticilina (MSSA/MRSA) em 50 isolados provenientes de pacientes com infecções de pele da Seção de Dermatologia do Hospital das Clínicas da Faculdade de Medicina (FMB) de Botucatu, 50 isolados de idosos de Instituições de Longa Permanência (ILP) de Bauru e 50 isolados provenientes de detentos do Centro de Ressocialização (CR) de Avaré. Os isolados de S. aureus foram submetidos à técnica de E-test para determinação da Concentração Inibitória Mínima (CIM). Para determinação do perfil de virulência e resistência à oxacilina nos 150 isolados de S. aureus foram realizadas reações em cadeia da polimerase (PCR) para a detecção dos genes mecA, cassete cromossômico estafilocócio mec (SCCmec), genes codificadores das enterotoxinas (sea, seb e sec-1), toxinas esfoliativas A e B (eta e etb), toxina 1 da síndrome do choque tóxico (tst), leucocidina de Panton-Valentine (lukS-PV e lukF-PV), hemolisinas alfa e delta (hla e hld) e biofilme (icaA e icaD). O perfil clonal dos isolados MSSA e MRSA foi caracterizado por Pulsed Field Gel Electrophoresis (PFGE), e os clones de MRSA foram submetidos a tipagem molecular por Multilocus Sequence Typing (MLST) e spa typing. Os resultados revelaram maior prevalência de MRSA nas instituições de longa permanência, além de apresentarem CIM90 64μg/mL para oxacilina e CIM90 > 256 μg/mL para clindamicina. Das 150 amostras de S.aureus ..

Genetic Determinants of Methicillin Resistance and Virulence among Staphylococcus aureus Isolates Recovered from Clinical and Surveillance Cultures in a Brazilian Teaching Hospital

Aims. To quantify the presence of SCCmec types and virulence genes among Staphylococcus aureus colonizing and infecting patients from a teaching hospital. Methods. We analyzed 225 and 84 S. aureus isolates recovered from surveillance and clinical cultures, respectively. Strains were studied for the presence and type of SCCmec, as well as for several virulence genes. Univariate and multivariable analysis were performed in order to identify predictors of invasiveness (defined as isolation from clinical cultures). Results. The presence of SCCmec types III (OR, 2.19, 95% CI, 1.08-4.45) and IV (OR, 5.28 95% CI, 1.35-20.63) and of genes coding for exfoliative toxin B (etb, OR, 6.38, 95% CI, 1.48-27.46) and Panton-Valentine leukocidin (pvl, OR, 2.38, 95% CI, 1.16-4.86) was independently associated with invasiveness. Conclusions. SCCmec types III and IV and virulence genes are associated with greater invasiveness of S. aureus. Patients colonized with methicillin-resistant S. aureus, as well as with strains harboring etb or pvl, may be prone to develop invasive disease. Infection-preventing strategies should be more intensively applied to this group

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology

Abstract Background Methicillin-resistant Staphylococcus aureus poses a threat to elderly living in nursing homes. Studies focusing on the epidemiology of colonization may help in the design of infection control strategies. Objective To identify factors associated with MRSA colonization and the dissemination of clones among nursing home residents. Methods Nasal swabs were collected from 300 persons from nine nursing homes in the city of Bauru, Brazil. Resistance to methicillin was identified through amplification of the mecA gene. Strain typing (Pulsed-Field Gel Electrophoresis) and characterization of the Staphylococcal Chromosome Cassette (SCC) mec was performed. Univariate and multivariable models were used to identify predictors of overall S. aureus and MRSA carriage. Results Rates of S. aureus and MRSA colonization were 17.7 and 3.7%, respectively. Age and recent admission to a hospital were independently associated with colonization with S. aureus. MRSA colonization was associated with living in small (< 15 residents) and medium-sized (15–49 residents) facilities, as well as with recent hospitalization. Most MRSA strains carried SCCmec types II or IV, and there was evidence of clonal spread within and among different facilities. Conclusions MRSA may be introduced in nursing homes form hospitals or arise from the community setting. Screening for asymptomatic colonization may identify persons with greater risk for infection, and is advised for residents discharged from acute care hospitals

Experiencias de personas hospitalizadas en proceso de punción de venas periféricas

Objective: To understand the representational components, the origins of the participants' experiences with venipuncture process, their perceptions and (im)explicit markers of care demands according to Neuman. Methods: Social Procedural Representation research, conducted with hospitalized adults with punctured veins in a hospital in Minas Gerais. Sample of 149 people with full selection. Individual interviews recorded using clipping and collage of comic books' technique. Content analysis applied NVivo and Neuman's theory. Results: Most participants were female age ≥ 50 years. Experiences contemplated own accounts, with third parties, families and professionals, perceived as dialogic, expressing feelings/behaviours, values, information/knowledge and representational objects, with those with families less significant due to the focus on care. Conclusion: Selected comic books' speech fragments and images demonstrate exposure to stressors (intrapersonal, interpersonal and extra personal), presenting gaps in the demands of nursing care when integrating relational, cognitive/specialized and instrumental technologies.Objetivo: Compreender os componentes representacionais, as origens das experiências dos participantes com o processo de punção de veias periféricas, suas percepções e marcadores implícitos e explícitos de demandas de cuidado segundo concepção de Neuman. Métodos: Pesquisa de Representação Social Processual realizada com adultos que tiveram veias puncionadas internados num hospital de Minas Gerais. Amostra de 149 pessoas de seleção completa. Entrevistas individuais gravadas usando técnica de recorte e colagem de gibi. Na análise de conteúdo, aplicaram-se NVivo e teoria de Neuman. Resultados: Predominaram mulheres em idade ≥ 50 anos. Experiências contemplaram relatos próprios, com terceiros, familiares e profissionais, percebidas como dialógicas, expressando sentimentos/comportamentos, valores, informações/conhecimentos e objetos representacionais, sendo aquelas com familiares pouco expressivas devido ao enfoque sobre acolhimento. Conclusão: Fragmentos de discurso e imagens de gibi selecionados demonstram exposição a estressores (intrapessoais, extrapessoais e interpessoais), caracterizando lacunas nas demandas de cuidados de enfermagem quando se integram tecnologias relacionais, cognitivas/especializadas e instrumentais