Avaliação funcional do equilíbrio e da sensibilidade cutânea plantar de idosos moradores na comunidade

Desequilíbrio é um dos muitos fatores de risco que aumenta a susceptibilidade de um idoso a quedas. O equilíbrio pode ser avaliado mediante testes posturais e de sensibilidade plantar. OBJETIVO: Avaliar a ocorrência de desequilíbrio e perda de sensibilidade cutânea plantar em idosos da comunidade e verificar a existência de associação entre ambas as alterações. CASUÍSTICA E MÉTODOS: Estudo transversal descritivo envolvendo 45 idosos submetidos à escala de equilíbrio de Berg (EEB) e ao teste de sensibilidade plantar com monofilamento de nylon. Foram utilizados os testes qui-quadrado e exato de Fisher e elaboradas curvas ROC para estudo da sensibilidade e especificidade da EEB. RESULTADOS: Idosos com alteração do equilíbrio e da sensibilidade cutânea foram em número de 2 e 4, respectivamente. Houve associação significativa entre queixa de desequilíbrio e perda da sensibilidade (p = 0,047) e ocorreu concordância razoável (Kappa: 0,6457) entre a EEB e o teste da sensibilidade. Verificou-se também associação significativa entre 6 dos 14 tarefas da EEB e o teste sensorial. CONCLUSÃO: Idosos vivendo com independência na comunidade, em sua maioria, apresentam equilíbrio e sensibilidade cutânea plantar normais. Quando alteradas estas funções mostram-se associadas de forma que, se os testes forem realizados conjuntamente, a precisão da avaliação do equilíbrio idoso aumenta.

Avaliação da colonização nasal por Staphylococcus spp. resistenteà oxacilina em alunos de enfermagem

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Variabilidades fenotípica e genotípica de estirpes de Staphylococcus aureus isoladas em casos de mastite subclínica bovina

Foram submetidas a PCR-Ribotipagem e aos testes de sensibilidade in vitro frente a 12 antimicrobianos 77 estirpes de Staphylococcus aureus isoladas em amostras de leite procedentes de 40 vacas da raça holandesa que apresentaram mastite subclínica, em uma propriedade rural localizada no Estado de São Paulo, Brasil. Os resultados obtidos revelaram quatro diferentes padrões de resistência a antimicrobianos, sendo observada a predominância de resistência à lincomicina entre 19 (24,7%) estirpes de S.aureus. As 58 (75,3%) estirpes restantes foram sensíveis aos 12 antimicrobianos testados. A PCR-ribotipagem revelou a ocorrência de nove padrões genotípicos distintos, além de apresentar uma capacidade discriminatória maior (D = 0,82) que a obtida nos antibiogramas (D = 0,42). Entre as 19 estirpes resistentes aos antimicrobianos, 14 (73,7%) foram agrupadas em três padrões de ribotipagem e, destas, 13 (92,9%) apresentaram resistência à eritromicina e à lincomicina, isoladamente ou em associação. O grande número de ribotipos e de padrões de resistência a antimicrobianos observados nesta propriedade demonstrou que há grande heterogeneidade genética em populações naturais de S. aureus, fato este que deve ser levado em consideração em programas de controle da mastite bovina.

Isolamento e caracterização de candida albicans e outras leveduras de águas de recreação não marinha e de materiais clínicos

Candida albicans and other yeasts from recreational water or clinical materials were isolated. Sixty-six water samples, originating from eight swimming pools and five lakes with beaches were examined for the presence of these yeasts, by a membrane filter method and 'pour plate' technique. Sixty-two clinical materials from suspected cases of candidiasis were studied in the same period. Rhodotorula sp and C. albicans were more frequently isolated from lakes and swimming pools, respectively; C. albicans and C. parapsilosis from clinical materials. From 44 samples of C. albicans, 90,9% were serotype A, and 9,1%, serotype B; C. albicans from recreational waters belong only serotype A. No difference was observed in the M.I.C. of C. albicans strains from waters and clinical materials. All strains were susceptible to the antifungal drugs tested.

Estudo sobre a resistencia aos antimicrobianos em bacterias isoladas de pacientes hospitalizados (Botucatu, 1988-1992)

Since 1988 to 1992, a study about susceptibility to antimicrobial drugs of bacterias isolated from hospitalized patients was performed. The compared susceptibility to important drugs (ampicillin, cephalotin, cefoxitin, ceftaxizime, ceftriaxone, aztreonam, gentamicin, amikacin, pefloxacin, ciprofloxacin, imipenem, oxacillin and vancomycin) was investigated in 1200 strains (300 of each specie) of the prevalent bacterias: E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and S. aureus. Minimal inhibitory concentration (MIC) was determined by agar dilution method, using from 0.05 to 256 mcg of each drug per ml of culture medium (Mueller-Hinton). Ranges of MIC, MIC(50%), MIC(90%) and the proportion of resistant strains were determined and permitted to know the 4 drugs that were found to be more active against bacterias; the CIM(90%) values are: E. coli - aztreonam (0.1 mcg/ml), pefloxacin (0.1), ceftazidime (0.25) and ceftriaxone (0.05); K. pneumoniae-aztreonam (0.25) ceftriaxone (0.25), ceftazidime (0.5) and pefloxacin (2.0); P. aeruginosa-imipenem (4.0), aztreonam (16), ceftazidime (16) and ciprofloxacin (16); S. aureus-vancomycin (1.01, ciprofloxacin (8, 0), amikacin (128) and cephalothin (128 mg/ml). The better 'in vitro' antibacterial activity observed was related to: aztreonam (77-100% of the sensitive strains), ceftazidime (50-99,7%), pefloxacin (73-99,7%), ciprofloxacin (80%), imipenem (93%) and vancomycin (100%).

Antifungal activity of propolis on different species of Candida

Propolis is a resinous material collected by bees from the buds or other parts of plants. It is known for its biological properties, having antibacterial, antifungal and healing properties. The antifungal activity of propolis was studied in sensitivity tests on 80 strains of Candida yeasts: 20 strains of Candida albicans, 20 strains of Candida tropicalis, 20 strains of Candida krusei and 15 strains of Candida guilliermondii. The yeasts showed a clear antifungal activity with the following order of sensitivity: C. albicans > C. tropicalis > C. krusei > C. guilliermondii. Patients with full dentures who used a hydroalcoholic propolis extract showed a decrease in the number of Candida.

Ocorrência e determinação do perfil de sensibilidade às drogas das cepas de Staphylococcus aureus isoladas de fossas nasais e orofaringe dos servidores hospitalares

Staphylococcus aureus is a very important hospital and community pathogen. This species is related to supurative disease, systemic and widespread metastatic lesions. The ability of S. aureus to develop resistance to antibiotics, more recently to methicillin, associates this bacteria with epidemic outbreaks of severe nosocomial infection. The source of staphylococcal infection is a patient with a staphylococcal lesion or a career member of the hospital staff. We aimed to detect the frequency of S. aureus isolated from anterior nares and oral cavities among the hospital staff in Bauru - SP, and to determine the antibiotic susceptibility of the isolates. Within 213 of the staff members analyzed. S. aureus was found in 94 (44.13%) of careers, with 47 (50%) of nasal carriers, 23 (24.4%) of oral carriers and 24 (25.5%) of both carriers. The biochemical characteristics analyzed for the species identification were similar to S. aureus ATCC 29213. All strains identified as S. aureus showed varied sensibility to the antimicrobial agents tested. No vancomicin resistant strains and only 8 (8.5%) strains with oxacilin resistance were found.

Padrão de sensibilidade aos antimicrobianos de bacilos gram-negativos não fermentadores isolados de materiais clínicos de pacientes em Presidente Prudente - SP

The aim of this study was the assessment of isolation frequency and antimicrobial susceptibility pattern of nonfermenting Gram-negative bacilli. Ninety eight strains of nonfermenting Gram-negative bacilli, isolated from several clinical materials of patients admited at the Dr. Domingos Leonardo Cerávolo University Hospital and at Dr. Odilo Antunes Siqueira State Hospital, as well as from every outpatient; assisted at Laboratory of Clinical Analysis of Unoeste University, Presidente Prudente, São Paulo, in the period of October 1999 to April 2001 were analyzed. The most frequent species were Pseudomonas aeruginosa (65.3%) and Acinetobacter baumannii (23.5%). The frequency of the other isolated species was smaller than 2.5%. In the antimicrobial susceptibility tests, the two species more prevalent showed high resistance. The antibiotic most active in vitro was the imipenem, with 79.6% in microdiluition method, and 76.6% in diffusion method, for Pseudomonas aeruginosa strains and 100.0% in both microdiluition and diffusion methods, for Acinetobacter baumannii. The cephalosporins of third generation, the ciprofloxacin and the aminoglycosides, presented percentage of susceptibility varying from 22.4 to 69.7%. These results bring implications to the emergency use of the antimicrobial agents in the treatment of patients with severe infection.

Pheno and genotyping of Staphylococcus aureus, isolated from bovine milk samples from São Paulo State, Brazil

In the present study, 87 Staphylococcus aureus isolates obtained from milk samples of 87 cows with mastitis in 6 different municipal districts of 2 regions of São Paulo State, Brazil, were compared pheno and genotypically. Pulsed-field gel electrophoresis (PFGE) analysis of the strains was performed, and PCR was carried out to detect genes for a number of staphylococcal cell surface proteins, exoproteins, and 3 classes of agr genes. Nine distinct S. aureus lineages (LA-LI) were identified by PFGE. The lineages LA and LE, which accounted together for 63 strains (72.2%), were prevalent and had been collected from all of the 6 municipal districts, indicating a broad geographic distribution of these lineages; LB, LC, LD, LF, LG, LH, and LI, however, were isolated sporadically and accounted for 24 strains (27.8%). Some characteristics, like penicillin resistance and the presence of cap8 and agr class II genes, were associated with the prevalent lineages (LA and LE), and penicillin susceptibility and the presence of cna and cap5 genes were associated with sporadic lineages. According to the present results, some S. aureus lineages possess a combination of genes that confer the propensity to cause and disseminate infection, and only a limited number of clones are responsible for the cases of bovine mastitis on the various farms. © 2004 NRC Canada.

Importância de Yersinia enterocolitica em microbiologia médica

Y. enterocolitica is a human invasive enteropathogen which causes a number of intestinal and extraintestinal clinical symptoms of various degrees of severity, ranging from mild gastroenteritis to mesenteric lymphadenitis, which mimics appendicitis and in rare cases can evolve to septicemia. Infection by Y. enterocolitica can also lead to post-infection immunological sequelae including arthritis, erythema nodosum and glomerulonephritis. Pathogenic Y. enterocolitica strains have traditionally been linked to specific biotypes and serogroups and associated to a variety of phenotypic characteristics related to virulence. Molecular genetics studies have pointed to the importance of the pYV virulence plasmid, which encodes various virulence genes, as well that of specific chromosomal virulence genes, in determining the pathogenesis of this bacterium. Intestinal infections by Y. enterocolitica are mostly self-limiting and usually do not need an antibiotic treatment. The occurrence of this microorganism is not as frequently described in Brazil as it is in other countries, such as Japan, USA and many European countries. This review focuses on the general characteristics, pathogenesis, clinical symptoms, virulence characteristics, treatment and antibiotic susceptibility of Yersinia enterocolitica strains isolated in Brazil and around the world.

Multidrug-resistant urinary tract isolates of Escherichia coli from Ribeirão Preto, São Paulo, Brazil

Multiple resistances to antimicrobial drugs arising in Escherichia coli isolates may complicate therapeutic management of urinary tract infection (UTI) by this organism. In order to assess the multidrug resistance (MDR) among urinary E. coli isolates, we have tested 11 antimicrobial drugs against 67 isolates from outpatients attended in a tertiary-care teaching hospital and of 78 isolates from a municipal health unit, respectively in Ribeirão Preto, State of São Paulo, Brazil. Seventy-six percent and 22% of the isolates from the tertiary-care hospital and the municipal unit, respectively, were resistant to three or more different classes of agents, and were considered to present MDR. Among the isolates from the hospital patients, 73.0%, 65.0%, 58.0%, 58.0% and 31.0% were resistant to tetracycline, ampicillin, cephalothin, trimethoprim-sulfamethoxazole (TMP/SMX) and norfloxacin, respectively; resistance from the municipal unit patients were 31.0%, 37.0%, 8.0%, 29.0% and 12.0% respectively, to the same drugs. The predominant phenotype among the MDR isolates presented is ampicillin, TMP/SMX and tetracycline resistance. The high prevalence of drug resistance among UTI patients calls for continuous surveillance to assure effective control of this infection. © 2007 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved.

Plesiomonas shigelloides: Um enteropatógeno emergente?

Plesiomonas shigelloides is a Gram-negative rod-shaped bacterium, of the family Enterobacteriaceae, which has been isolated from freshwater and salt water, freshwater fish, shellfish and many species of animals. Most human P. shigelloides infections are suspected to be waterborne. The organism can be found in untreated water used as drinking water, in recreational water, or in water used to rinse food that is consumed without cooking or heating. The ingestion of P. shigelloides does not always cause illness in the host animal, and the organism may be present temporarily as a transient, noninfectious member of the intestinal flora. It has been isolated from the stools of patients with diarrhea,but it is also sometimes isolated from healthy individuals. P. shigelloides has been implicated in gastroenteritis, usually a self-limiting disease characterized by fever, chills, abdominal pain, nausea, diarrhea or vomiting; in severe cases the diarrhea may be yellowish-green, foamy and tinged with blood. The bacteria may also cause extra-intestinal infection. Furthermore, it can produce toxins and may be invasive. The evidence in favor of considering P. shigelloides as an enteropathogen is not totally convincing. Although it has been isolated from patients with diarrhea and incriminated in some outbreaks involving contaminated water and food, it was not possible, in many P. shigelloides samples associated with gastrointestinal infections, to identify a definite mechanism of virulence.

Comparative study of disk diffusion and microdilution methods for evaluation of antifungal activity of natural compounds against medical yeasts Candida spp and Cryptococcus sp

Antifungal activity of natural products has been tested by adapting methods designed for synthetic drugs. In this study, two methods for the determination of antifungal activity of natural products, agar diffusion and broth microdilution, the CLSI reference methods for synthetic drugs, are compared and discussed. The microdilution method was more sensitive. The minimal inhibitory concentrations (MIC) of crude extracts, fractions and pure substances from different species of the plant families Piperaceae, Rubiaceae, Clusiaceae, Fabaceae and Lauraceae, from the Biota project, were determined. Antifungal activities against Candida albicans, C.krusei, C.parapsilosis and Cryptococcus neoformans were produced by several samples.