Desenvolvimento de um instrumento de avaliação da vulnerabilidade de pacientes imunodeprimidos a infecções zoonóticas a partir de animais de estimação.

Os animais de estimação podem ser fonte de infecções, principalmente para seres humanos imunocomprometidos, em especial, pacientes portadores do vírus HIV. Considerando que o contato com animais pode prover benefícios emocionais, profissionais da área da saúde, em particular médicos e médicos veterinários, devem estar conscientes do papel potencial destes animais na transmissão de doenças de forma a preconizar medidas profiláticas para que esta transmissão não ocorra. As circunstâncias que favorecem a transmissão de doenças a partir dos animais de estimação ainda não são totalmente conhecidas, principalmente na realidade brasileira. Faltam estudos com o objetivo de investigar o risco de doenças de origem zoonótica decorrentes do contato com estes animais, hoje também chamados de animais pet. Ademais, ressente-se da falta de um instrumento devidamente elaborado e validado com a finalidade de captar as informações necessárias para a realização de estudos deste tipo ou mesmo para servir como ferramenta de rastreio de situações de vulnerabilidade de pacientes imunodeprimidos com vistas ao aconselhamento sobre medidas de prevenção. Desta maneira, o objetivo deste estudo é elaborar um instrumento para averiguar a vulnerabilidade de pacientes imunodeprimidos a infecções zoonóticas a partir de animais de estimação. Inicialmente, foram mapeados os animais de estimação mais encontrados no ambiente doméstico e as principais infecções que podem ser transmitidas a partir deles. Selecionaram-se, então, os possíveis mecanismos de transmissão a serem abordados. Dentre as espécies de animais de estimação elencadas, os cães, gatos, aves, répteis e os pequenos roedores foram os selecionados para a confecção deste instrumento. As infecções selecionadas foram: Salmonelose; Criptosporidíase; Giardíase; Dermatofitoses, Esporotricose, Bartonelose; Ancilostomíase; Toxocaríase; Psitacose; Toxoplasmose; Escabiose; Campilobacteriose; Criptococose e Histoplasmose. Considerando as diferentes formas de transmissão de cada infecção foram identificados os possíveis atos e comportamentos no contato com animais de estimação, bem como características destes animais, que poderiam aumentar a probabilidade de transmissão. O instrumento desenvolvido foi composto de uma primeira parte abarcando os critérios de elegibilidade, e de outra envolvendo o escopo principal do instrumento. Como as características de contato e as infecções variam de acordo com a espécie de animal, o instrumento abordou cada um dos cinco grupos de animais separadamente. O instrumento aqui proposto concerne à etapa inicial de um processo de desenvolvimento formal para utilização em futuras pesquisas sobre o papel dos animais de estimação na transmissão de infecções para pacientes imunodeprimidos. Estudos que explorem a confiabilidade e validade do instrumento proposto, assim como sua aceitabilidade, são necessários antes que seu uso seja recomendado.

Infecções por corinebactérias não diftéricas em cateter venoso central de pacientes oncológicos pediátricos

Estudo descritivo retrospectivo realizado no Instituto Nacional do Câncer José Alencar Gomes da Silva, INCA/HCI-Rio de Janeiro, Brasil, (INCA- HCI-RJ), avaliou infecções por Corynebacterium sp. com ênfase nos pacientes pediátricos em tratamento nos setores onco-hematológico pediátrico e seus acessos venosos. Os resultados permitiram a elaboração de dois artigos. No Artigo 1 - Foram analisadas as bacteremias causadas por espécies de corinebactérias não produtoras de toxina diftérica, observadas em dois períodos, com intervalo de sete anos (2003/2004 e 2012/2013), totalizando 62 pacientes. No Artigo 2 - Foi realizada investigação clínica e epidemiológica de 24 casos de infecção por Corynebacterium sp. em amostras de sangue de cateter e/ou periférica, em menores de 18 anos em tratamento onco-hematopediátrico, em dois períodos, com intervalo de oito anos (2003/2004 e 2013/2014). Nos dois artigos foram avaliados aspectos clínico-epidemiológicos, tratamentos realizados, conduta em cada paciente e avaliação da susceptibilidade aos antimicrobianos das cepas isoladas. Os tumores sólidos tiveram maior prevalência em ambas análises. No primeiro artigo, as infecções por corinebactérias tiveram relação com os pacientes usuários de cateter venoso central. Após estes primeiros resultados, foi desenhado um segundo estudo retrospectivo com abordagem em pacientes pediátricos em tratamento. Cerca de 83,3% destes pacientes eram portadores de cateter venoso central de longa permanência (CVCLP). A análise microbiológica permitiu a observação da incidência de novas espécies de corinebactérias, algumas multirresistentes, além da evolução dos padrões de susceptibilidade aos antimicrobianos, com aumento da resistência a alguns dos agentes utilizados na rotina de tratamento para infecções por este grupo. Em ambos estudos C. amycolatum foi a espécie predominante. Apesar de terem sido identificadas cepas multirresistentes, todas as cepas isoladas apresentaram susceptibilidade a vancomicina (artigos 1 e 2). O uso de vancomicina permitiu preservação dos dispositivos venosos com estabilização do quadro clínico, na maioria dos casos. Na avaliação retrospectiva do segundo estudo proposto 40% dos CVCLP foram preservados, a análise comparativa dos períodos estudados revelou uma evolução na preservação de dispositivos venosos mediante o tratamento antimicrobiano orientado nos casos de infecção por Corynebacterium. A integração da equipe multidisciplinar, desde a identificação dos casos clínicos, manuseio das amostras, identificação laboratorial e os resultados, bem como na proposta de tratamento promoveu uma melhoria significativa na assistência aos pacientes e contribuiu para o sucesso terapêutico observado neste trabalho. O reconhecimento das corinebactérias como importantes agentes associados a infecções em pacientes oncológicos pediátricos pelos profissionais de saúde contribuiu para a elaboração de estratégias específicas e, conseqüentemente, para melhorias nas condutas e protocolos, bem como na terapêutica aplicada às infecções por estes agentes.

Isolation of Salmonella larochelle for the first time in India

The isolation of a new serotype, S. larochelle (6, 7: eh:1, 2), is reported in this communication. This serotype has not so far been reported from any source in this country. The serotype was isolated on November 27th, 1979 at Bombay from a market sample of frozen frog legs intended for domestic consumption.

Studies on isolation of salmonella from sea foods 1. Comparison of enrichment and selective media for recovery of salmonellae from fish

Three enrichment broths and six plating media were compared for efficiency of detection Salmonella in the presence of numbers of Coliforms (10super(5)/ml) and proteus (10super(3)/ml) from artificially inoculated fish samples. Recovery experiments Salmonella anatum, S. typhimurium and S. enteritidis indicated that the two enrichment broths Dulcitol Selinite (DSE) and Selinite Cystine (SC) were equally efficient. Further, the viability of Salmonella, inoculated into fish muscle and kept at 4°C for 48 hours, was found to be not affected by the low temperature storage. Selective plating media like Xylose Lysine Deoxycholate agar (XLD), Brilliant Green Sulphadiazine agar (BGS) and Brilliant Green agar (BG) were found to be superior in performance to Salmonella-Shigella agar: (SS) and Bismuth Sui phite agar (BiS).

Isolation of Salmonella roan for the first time in India

The isolation of Salmonella roan for the first time in India is reported.

Rapapport's broth, a better enrichment medium in the identification of Salmonella from processed frog legs

Live clams (Villorita cyprinoides) collected from their natural beds were packed in different ways like dry pack, tray pack, in oxygenated water (wet pack) and depurated samples in wet pack. It was found that the packaging in l kg lots in 200 gauge polythene bags with oxygen at a temperature of 20°C could keep them live for 4 days. In tray pack without oxygen and water they can be kept alive for 3 days at 20°C. Temperature seems to be the critical factor in the transportation of live clams. At room temperature both dry and wet pack can be kept for 24 h only. Depuration technique does not appear to be useful in prolonging the storage life of clams in live condition as percentage mortality is more at 48 h both at 20°C and room temperature compared to the non-depurated samples.

Isolation of Salmonella braenderup (6, 7:e, h:e, n, z (sub15)) from Mussel meat

A brief account is given of the morphology, biochemistry and serology of Salmonella braenderup isolated from mussel meat, obtained from fish markets in Calicut, India. Possible implications regarding human salmonellosis are also considered.

Isolation of Salmonella agona (4, 12:f, g, 5:-) from commercial frozen boiled clam meat

Details are given of the morphological, biochemical and serological characteristics of a specimen of Salmonella agona isolated from a sample of frozen boiled clam meat (Villorita cyprinoides) processed in a factory at Cochin. Possible association of this serotype with human salmonellosis is considered briefly.

Incidence and low temperature survival of Salmonella in fishery products

Salmonella was isolated from 12% of PD shrimps, 10% of HL shrimps, 14% of PUD shrimps, 17% of lobsters, 14% of cuttle fish, 25% of cat fish and 20% of seer fish (all frozen) tested. One percent of the fish meal, 4% of dried non-penaeid prawn and 23% of sea beach sand showed incidence of the organism. Salmonella was also isolated from 2 and 4% of the swab samples of utensil surfaces and the floor surface of the processing hall respectively as well as from 1% of the process water tested. All the serotypes of Salmonella tested were resistant to freezing at -40°C, but during subsequent storage at -20°C, there was some difference between the serotypes with regard to their viability, S. paratyphi B being the most resistant which survived up to 9 months while S. saintpaul the least resistant having survival up to 5 months only.

On the pattern of Salmonella serotypes in fishery products, froglegs and processing environments

Thirty four different serotypes of Salmonella have been isolated from aquatic products. The number of serotypes from frozen froglegs were 22. Only four serotypes were isolated from frozen shrimps. S. weltevreden predominates in frozen shrimps and fish. S. roan and S. larochelle were isolated for the first time in India. Isolation of six rare serotypes of Salmonella has also been reported.

Reliability of Escherichia coli and faecal streptococci as indicators of Salmonella in frozen fishery products

The results obtained in the present study suggest that Escherichia coli and faecal streptococci are of little value as indicators of the possible presence of Salmonella in frozen fishery products.

餐洗剂对小鼠骨髓细胞SCE形成和Salmonella typhimurium基因回复突变的 影响

研究了四种餐洗剂及其主要成分LABS、Dispersol D、Alkanolamide的潜在 诱变活性。结果 表明四种牌号餐洗剂在高浓度时能诱发SCE形成。除TL牌餐洗剂 加入S9代谢激活系统后未见 诱变作用外, 其他三种餐洗剂和三种主要成分都表 现出致HisG46和HisD3052基因回复突变的能力。表3参16

The bacterial cytoskeleton modulates motility, type 3 secretion, and colonization in Salmonella.

Although there have been great advances in our understanding of the bacterial cytoskeleton, major gaps remain in our knowledge of its importance to virulence. In this study we have explored the contribution of the bacterial cytoskeleton to the ability of Salmonella to express and assemble virulence factors and cause disease. The bacterial actin-like protein MreB polymerises into helical filaments and interacts with other cytoskeletal elements including MreC to control cell-shape. As mreB appears to be an essential gene, we have constructed a viable ΔmreC depletion mutant in Salmonella. Using a broad range of independent biochemical, fluorescence and phenotypic screens we provide evidence that the Salmonella pathogenicity island-1 type three secretion system (SPI1-T3SS) and flagella systems are down-regulated in the absence of MreC. In contrast the SPI-2 T3SS appears to remain functional. The phenotypes have been further validated using a chemical genetic approach to disrupt the functionality of MreB. Although the fitness of ΔmreC is reduced in vivo, we observed that this defect does not completely abrogate the ability of Salmonella to cause disease systemically. By forcing on expression of flagella and SPI-1 T3SS in trans with the master regulators FlhDC and HilA, it is clear that the cytoskeleton is dispensable for the assembly of these structures but essential for their expression. As two-component systems are involved in sensing and adapting to environmental and cell surface signals, we have constructed and screened a panel of such mutants and identified the sensor kinase RcsC as a key phenotypic regulator in ΔmreC. Further genetic analysis revealed the importance of the Rcs two-component system in modulating the expression of these virulence factors. Collectively, these results suggest that expression of virulence genes might be directly coordinated with cytoskeletal integrity, and this regulation is mediated by the two-component system sensor kinase RcsC.

Attenuated Salmonella Typhimurium lacking the pathogenicity island-2 type 3 secretion system grow to high bacterial numbers inside phagocytes in mice.

Intracellular replication within specialized vacuoles and cell-to-cell spread in the tissue are essential for the virulence of Salmonella enterica. By observing infection dynamics at the single-cell level in vivo, we have discovered that the Salmonella pathogenicity island 2 (SPI-2) type 3 secretory system (T3SS) is dispensable for growth to high intracellular densities. This challenges the concept that intracellular replication absolutely requires proteins delivered by SPI-2 T3SS, which has been derived largely by inference from in vitro cell experiments and from unrefined measurement of net growth in mouse organs. Furthermore, we infer from our data that the SPI-2 T3SS mediates exit from infected cells, with consequent formation of new infection foci resulting in bacterial spread in the tissues. This suggests a new role for SPI-2 in vivo as a mediator of bacterial spread in the body. In addition, we demonstrate that very similar net growth rates of attenuated salmonellae in organs can be derived from very different underlying intracellular growth dynamics.

Quantification of the effects of antibodies on the extra- and intracellular dynamics of Salmonella enterica.

Antibodies are known to be essential in controlling Salmonella infection, but their exact role remains elusive. We recently developed an in vitro model to investigate the relative efficiency of four different human immunoglobulin G (IgG) subclasses in modulating the interaction of the bacteria with human phagocytes. Our results indicated that different IgG subclasses affect the efficacy of Salmonella uptake by human phagocytes. In this study, we aim to quantify the effects of IgG on intracellular dynamics of infection by combining distributions of bacterial numbers per phagocyte observed by fluorescence microscopy with a mathematical model that simulates the in vitro dynamics. We then use maximum likelihood to estimate the model parameters and compare them across IgG subclasses. The analysis reveals heterogeneity in the division rates of the bacteria, strongly suggesting that a subpopulation of intracellular Salmonella, while visible under the microscope, is not dividing. Clear differences in the observed distributions among the four IgG subclasses are best explained by variations in phagocytosis and intracellular dynamics. We propose and compare potential factors affecting the replication and death of bacteria within phagocytes, and we discuss these results in the light of recent findings on dormancy of Salmonella.