Decline of hepatitis C infection in hemodialysis patients in Central Brazil: a ten years of surveillance

Hepatitis C virus (HCV) has been a significant problem for hemodialysis patients. However this infection has declined in regions where the screening for anti-HCV in blood banks and hemodialysis-specific infection control measures were adopted. In Brazil, these measures were implemented in 1993 and 1996, respectively. In addition, all studied units have implemented isolation of anti-HCV positive patients since 2000. In order to evaluate the impact of these policies in the HCV infection prevalence, accumulated incidence, and risk factors in hemodialysis population of Goiânia City, Central Brazil, all patients were interviewed and serum samples tested for HCV antibodies in 1993, 1996, 1999, and 2002. In the first six years (1993-1999), anti-HCV prevalence increased from 28.2 to 37.2%, however a b decrease in positivity was detected between 1999 and 2002 (37.8 vs 16.5%) when the measures were fully implemented. Also, a decrease of the anti-HCV accumulated incidence in cohorts of susceptible individuals during 1993-2002 (71%), 1996-2002 (34.2%), and 1999-2002 (11.7%) was found. Analysis of risk factors showed that length of time on hemodialysis, blood transfusion before screening for anti-HCV and treatment in multiple units were statistically associated with anti-HCV (p < 0.05). Our study showed a significant decline of hepatitis C infection in hemodialysis patients of Central Brazil, ratifying the importance of public health strategies for control and prevention of hepatitis C in the hemodialysis units.

Líquens e outros organismos epifílicos em Conchocarpus macrophyllus J.C. Mikan no Parque Estadual do Rio Doce, Minas Gerais, Brasil

Organismos epifílicos em C. macrophyllus foram encontrados em duas parcelas amostradas em julho de 1996, em duas áreas com diferentes graus de perturbação pelo fogo, no Parque Estadual do Rio Doce, MG. Quatorze espécies epifílicas foram encontradas incluindo: 11 líquens, uma alga, uma hepática e um fungo. Os líquens totalizaram 81,8% das espécies na área menos perturbada e 72,7% na mais perturbada. A espécie mais abundante foi Porina epiphylla, que ocorreu em 80,8% dos forófitos da primeira área e em 97% dos forófitos da segunda. O número de folhas cobertas em cada forófito, o grau de cobertura em cada folha e a altura dos forófitos foram significativamente diferentes entre as duas áreas, enquanto que a área foliar e o número de folhas por forófito não o foram. Embora diferenças significativas não tenham sido encontradas na composição específica do epifilo entre as duas áreas, a maior ocorrência de folhas cobertas pelo epifilo pode estar associada à perturbação. A penetração de luz, intensificada pelas clareiras, pode ter aumentado o crescimento em altura do forófito e a colonização das folhas pelos organismos epifílicos.

Antimicrobial resistance among invasive Haemophilus influenzae strains: results of a Brazilian study carried out from 1996 through 2000

A total of 1712 strains of Haemophilus influenzae isolated from patients with invasive diseases were obtained from ten Brazilian states from 1996 to 2000. ß-Lactamase production was assessed and the minimum inhibitory concentrations (MIC) of ampicillin, chloramphenicol, ceftriaxone and rifampin were determined using a method for broth microdilution of Haemophilus test medium. The prevalence of strains producing ß-lactamase ranged from 6.6 to 57.7%, with an overall prevalence of 18.4%. High frequency of ß-lactamase-mediated ampicillin resistance was observed in Distrito Federal (25%), São Paulo (21.7%) and Paraná (18.5%). Of the 1712 strains analyzed, none was ß-lactamase negative, ampicillin resistant. A total of 16.8% of the strains were resistant to chloramphenicol, and 13.8% of these also presented resistance to ampicillin, and only 3.0% were resistant to chloramphenicol alone. All strains were susceptible to ceftriaxone and rifampin and the MIC90 were 0.015 µg/ml and 0.25 µg/ml, respectively. Ceftriaxone is the drug of choice for empirical treatment of bacterial meningitis in pediatric patients who have not been screened for drug susceptibility. The emergence of drug resistance is a serious challenge for the management of invasive H. influenzae disease, which emphasizes the fundamental role of laboratory-based surveillance for antimicrobial resistance.