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A cross-sectional study on the clinical and immunological spectrum of human Leishmania (L.) infantum chagasi infection in the Brazilian Amazon region

CRESCENTE, Jose Angelo B.; SILVEIRA, Fernando T.; LAINSON, Ralph; GOMES, Claudia M. C.; LAURENTI, Marcia D.; CORBETT, Carlos E. P.
Fonte: ELSEVIER SCIENCE INC Publicador: ELSEVIER SCIENCE INC
Tipo: Artigo de Revista Científica
Português
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The objectives of this study were to identify individuals with symptomatic and/or asymptomatic infection due to Leishmania (L.) infantum chagasi; to study the two types of infection, both clinically and immunologically, and to determine the prevalence rate of infection at the beginning of the study. This was a cross-sectional study with a cohort of 946 individuals, of both genders, from the age of 1 year, living in the municipality of Barcarena, PA, Brazil, an area endemic for American visceral leishmaniasis (AVL). The leishmanin skin test (LST) and the indirect fluorescent test (IFAT), were used for the diagnosis of infection. One hundred and twenty cases of infection were diagnosed, with a prevalence rate of 12.6%; eight cases showed high seroreactivity (1280-10240, IgG) in IFAT and no LST reaction; four of these cases were typical AVL and four had subclinical oligosymptomatic infection. Using two immunological methods with a clinical examination of the infected individuals enabled the identification of five clinical-immunological profiles which may promote a better understanding of the interaction between L. (L.) i. chagasi and the human immune response: asymptomatic infection (AI) 73.4%; subclinical resistant infection (SRI) 15%; subclinicat oligosymptomatic infection (SOI) 3%; symptomatic infection (AVL) 3% and indeterminate initial infection (III) 5%. (C) 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.; Instituto Evandro Chagas (Secretaria de Vigilancia em Saude...

Infecções hospitalares em pacientes submetidos a transplante de fígado: fatores de risco relacionados ao doador; Hospital Infection in liver transplantation

Freire, Maristela Pinheiro
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 05/03/2007 Português
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As infecções após transplante de fígado são uma importante causa de morbidade e mortalidade. O risco de transmissão de infecção pelo doador é descrito, principalmente quando esta infecção não é detectada ou tratada. O diagnóstico das infecções no doador é difícil e pouco disponível, portanto dados indiretos destas infecções podem ser úteis na escolha ou descarte do órgão, principalmente considerando-se a escassez de órgãos disponíveis para transplante. O objetivo deste estudo é Identificar os fatores de risco relacionados ao doador e ao receptor para infecção hospitalar bacteriana e fúngica (IH) em pacientes submetidos a transplante de fígado, no primeiro mês após o transplante. Foram avaliados os pacientes submetidos a transplante de fígado no Hospital das Clínicas da Faculdade de Medicina da USP, no período de janeiro de 2002 a junho de 2005. Os critérios de exclusão foram: óbito com menos de 48 horas, transplante intervivos, retransplante em menos de 5 dias e receptor de transplante dominó. Foram avaliados fatores de risco relacionados ao doador e ao receptor. A análise univariada foi feita por X2 e teste exato de Fisher para variáveis dicotômicas, e teste de Mann-Whitney para variáveis ordenadas. A análise multivariada foi realizada por regressão logística tipo stepwise. No período foram realizados 130 transplantes; desses 30 foram excluídos...

Procalcitonina (PCT) como indicador de infecção grave em adultos neutropênicos febris; Procalcitonin (PCT) as a marker of severe systemic infection in febrile neutropenia

Massaro, Karin Schmidt Rodrigues
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 07/12/2007 Português
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Introdução: Neutropenia febril é uma emergência médica que demanda um diagnóstico precoce e administração de antibióticos o mais breve possível. A procalcitonina (PCT) é um marcador inflamatório que vem sendo utilizado como um indicador de infecção bacteriana grave. A detecção precoce do quadro séptico é difícil, principalmente numa população heterogênea como no caso dos neutropênicos febris. A possibilidade de um único exame laboratorial poder identificar precocemente os quadros de sepse contribuiria de forma significativa para melhorar o prognóstico destes pacientes. Objetivo: Avaliar os níveis de PCT como marcador de infecção sistêmica comparados aos níveis de proteína C-reativa (PCR) em pacientes neutropênicos febris. Métodos: Foram estudadas amostras de 65 pacientes com a finalidade de determinar as concentrações séricas de PCT, PCR e outros parâmetros hematológicos em três momentos diferentes: antes da febre, no momento da febre e 72 após o término da febre. Os pacientes foram divididos inicialmente em quatro grupos: com infecção sistêmica comprovada laboratorial ou clinicamente (I), com febre de origem indeterminada - FOI- (II), com infecção localizada (III) e com infecção fúngica confirmada (IV). Posteriormente...

Estudo seccional sobre o espectro clínico e imunológico da infecção humana por Leishmania (L.) i. chagasi na Amazônia brasileira; A cross study on the clinical and immunological spectrum of human Leishmania (L.) i. chagasi infection in the Brazilian amazon

Crescente, José Angelo Barletta
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 07/08/2008 Português
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A dinâmica da leishmaniose visceral humana na Amazônia brasileira é pouco conhecida e nos últimos anos tem aumentado a incidência da doença principalmente no Estado do Pará. Os objetivos do estudo foram: I) identificar indivíduos com infecção sintomática e/ou assintomática por Leishmania (L.) infantum chagasi, II) estudar os dois tipos de infecção, tanto clínica quanto imunologicamente, e III) estudar a taxa de prevalência da infecção. O estudo foi de corte transversal com 946 indivíduos de ambos os sexos, com idade a partir de 1 ano, vivendo em área endêmica de leishmaniose visceral americana (LVA), município de Barcarena, Pará, Brasil. Para o diagnóstico da infecção, foram usadas a reação dérmica de hipersensibilidade retardada (Reação Intradérmica de Montenegro) - RIM e a Reação de Imunofluorêscencia Indireta (RIFI). Foram diagnosticados 120 casos de infecção com taxa de prevalência de 12.6%; 8 casos mostraram alta soro-reatividade (1.280 a 120.240) IgG utilizando-se o teste da RIFI e nenhuma reação na RIM; 4 casos foram típicos de LVA e outros 4 casos de infecção subclínica oligossintomática. Os dois métodos imunológicos usados simultaneamente com o exame clínico permitiram a identificação de 5 perfis clínico-imunológicos: Infecção Assintomática (IA) 73...

A transfusão sanguínea no perioperatório e a ocorrência da infecção de sítio cirúrgico; Perioperative blood transfusion and the occurrence of surgical site infection.

Mantoani, Camila Cristina
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 24/08/2012 Português
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Trata-se de uma revisão integrativa da literatura com objetivo de identificar e analisar as evidências oriundas de estudos primários que abordaram a relação entre a transfusão sanguínea e a ocorrência da infecção de sítio cirúrgico, em pacientes adultos submetidos à cirurgia eletiva. A busca foi realizada em abril de 2012 nas bases de dados PUBMED/ MEDLINE, CINAHL, LILACS e Biblioteca Cochrane e utilizou-se o limite dos estudos indexados nos últimos 10 anos. Para a busca nas bases de dados eletrônicas foram utilizadas combinações entre os descritores controlados transfusão sanguínea, transfusão de componentes sanguíneos, cirurgia eletiva e infecção de ferida cirúrgica e os não-controlados infusão sanguínea, procedimento cirúrgico eletivo, cirurgia de não urgência e infecção de sítio cirúrgico, as quais resultaram na identificação de 2195 referências, dentre essas, 2112 foram excluídas devido a ausência em relação ao tema a partir da leitura de título e resumo. Assim, 73 estudos mostraram-se elegíveis e foram lidos na íntegra, dentre os quais, 50 estudos não foram selecionados e cita-se como motivo de exclusão para cinco estudos, que não analisavam a relação da infecção de sítio cirúrgico e a transfusão sanguínea...

Sítio de inserção do cateter venoso no paciente queimado e ocorrência de infecção: revisão sistemática de literatura; Sites of venous catheter insertion in burn patients and occurrence of infection: systematic review of the literature.

Silva, Caroline Lopes Ciofi
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 05/11/2012 Português
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Pacientes queimados possuem alto risco de infecção e desenvolvimento de sepse relacionado a diversos fatores, entre eles a presença de dispositivos invasivos, como os cateteres venosos indispensáveis para o tratamento desses pacientes. O objetivo desse estudo foi identificar e avaliar as evidências disponíveis na literatura, por meio de revisão sistemática, sobre possível associação entre o sítio de inserção do cateter venoso em pacientes queimados e o aumento da ocorrência de infecção relacionada ao cateter. Analisaram-se as seguintes bases de dados: MEDLINE, LILACS, CINAHL, EMBASE, Web of Science e The Cochrane Library. Utilizaram-se os descritores controlados e não-controlados adaptados para cada base de dados e, para a combinação desses, utilizou-se o operador boleano AND. As buscas ocorreram entre os meses de outubro e dezembro de 2011. Após leitura dos títulos, resumos e textos na íntegra, considerando-se os critérios de inclusão e exclusão previamente definidos, selecionou-se nove estudos. Utilizou-se um roteiro elaborado e validado para coleta dos dados e avaliação crítica dos estudos. A síntese dos dados ocorreu de forma descritiva. Os estudos foram classificados segundo duas categorias temáticas: infecção relacionada ao cateter e inserção do cateter através da queimadura ou em área próxima à queimadura; e infecção relacionada ao cateter e sítios anatômicos de inserção do cateter venoso. Na primeira categoria...

Prevalência de infecção nosocomial em unidades de terapia intensiva do Rio Grande do Sul; The prevalence of nosocomial infection in intensive care units in the state of Rio Grande do Sul

Lisboa, Thiago Costa; Faria, Mário de Barros; Höher, Jorge Amilton; Borges, Luis A. A.; Gomez, Jussara; Schifelbain, Luciele Medianeira Oliveira; Dias, Fernando Suparregui; Lisboa, João Carlos; Friedman, Gilberto
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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JUSTIFICATIVA E OBJETIVOS: Determinar a prevalência de infecções adquiridas em UTI e os fatores de risco para estas infecções, identificar os organismos infectantes mais prevalentes, avaliar a relação entre infecção adquirida na UTI e mortalidade. MÉTODO: Estudo de prevalência de um dia. Participaram do estudo 16 UTI do estado do Rio Grande do Sul, excluindo unidades coronarianas ou pediátricas. Todos os pacientes com idade maior que 12 anos, ocupando um leito de UTI por um período de 24h, foram incluídos. As 16 UTI coletaram dados de 174 pacientes. Principais desfechos: taxas de infecção adquirida na UTI, padrões de resistência dos patógenos isolados e fatores potenciais de risco para infecção adquirida na UTI e mortalidade. RESULTADOS: Um total de 122 pacientes (71%) estava infectado, e 51 (29%) adquiriram infecção na UTI. Pneumonia (58,2%), infecção do trato respiratório inferior (22,9%), infecção do trato urinário (18%) foram os tipos mais freqüentes de infecção. Os microorganismos mais relatados foram stafilococos aureus (42% [64% resistentes a oxacilina]) e pseudomonas aeruginosa (31%). Seis fatores de risco foram identificados para infecção adquirida na UTI: cateter urinário, acesso vascular central...

Diagnostico molecular da infecção ativa por citomegalovirus humano (HCMV) em pacientes submetidos a transplante pela reação em cadeia da polimerase (tipo "Nested PCR") : comparação entre leucocitos do sangue periferico e soro; Molecular diagnostic of active human cytomegalovirus infection in patient urdergoing transplanation by nested polymerase chain reaction : comparison between peripheral blood leucocytes and serum

Paula Durante Andrade
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 19/02/2009 Português
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O Citomegalovírus Humano (HCMV) é o principal causador de complicações pós-transplante. Métodos específicos que permitam identificar, precocemente, os pacientes com risco de desenvolvimento de doença, para os quais tratamento é indicado, têm sido requeridos, a fim de que poucos pacientes sejam desnecessariamente tratados e para a efetiva instituição terapêutica. A "Nested-PCR", dupla Reação em Cadeia da Polimerase, é um teste comumente utilizado no diagnóstico da infecção ativa por HCMV, contudo, quando realizada em leucócitos do sangue periférico, devido à sua alta sensibilidade, não apresenta boa correlação com o desenvolvimento de doença por HCMV. A detecção do DNA do HCMV no soro, pela PCR, tem sido associada com o desenvolvimento de doença por HCMV. Neste estudo, nós aplicamos a "Nested-PCR" em leucócitos do sangue periférico (denominada "L-PCR"), o método Convencional do Laboratório, e em soro ("sPCR"), para o diagnóstico da infecção ativa por HCMV, a fim de estabelecermos a correlação dos resultados obtidos, de ambos os métodos, com o desenvolvimento de infecção sintomática. Com este propósito, nós avaliamos, prospectivamente, amostras de 37 pacientes, 20 submetidos a transplante renal...

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients.

Duarte, Helena; Santos, Carla; Capelas, Manuel Luís; Fonseca, Jorge
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia
Tipo: Artigo de Revista Científica
Publicado em /12/2012 Português
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CONTEXT: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. OBJECTIVES: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. METHODS: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. RESULTS: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age...

Additional Risk factors for infection by multidrug-resistant pathogens in healthcare associated infection: a large cohort study

Cardoso, T.; Ribeiro, O.; Aragão, I.; Costa-Pereira, A.; Sarmento, A.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 26/12/2012 Português
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BACKGROUND: There is a lack of consensus regarding the definition of risk factors for healthcare-associated infection (HCAI). The purpose of this study was to identify additional risk factors for HCAI, which are not included in the current definition of HCAI, associated with infection by multidrug-resistant (MDR) pathogens, in all hospitalized infected patients from the community. METHODS: This 1-year prospective cohort study included all patients with infection admitted to a large, tertiary care, university hospital. Risk factors not included in the HCAI definition, and independently associated with MDR pathogen infection, namely MDR Gram-negative (MDR-GN) and ESKAPE microorganisms (vancomycin-resistant Enterococcus faecium, methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species, carbapenem-hydrolyzing Klebsiella pneumonia and MDR Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species), were identified by logistic regression among patients admitted from the community (either with community-acquired or HCAI). RESULTS: There were 1035 patients with infection, 718 from the community. Of these, 439 (61%) had microbiologic documentation; 123 were MDR (28%). Among MDR: 104 (85%) had MDR-GN and 41 (33%) had an ESKAPE infection. Independent risk factors associated with MDR and MDR-GN infection were: age (adjusted odds ratio (OR) = 1.7 and 1.5...

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Duarte, Helena; Santos, Carla; Capelas, Manuel Luís; Fonseca, Jorge
Fonte: IBEPEGE Publicador: IBEPEGE
Tipo: Artigo de Revista Científica
Publicado em /10/2012 Português
Relevância na Pesquisa
36.13%
"Context - Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. Objectives - The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. Methods - Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. Results - A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age...

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Duarte,Helena; Santos,Carla; Capelas,Manuel Luís; Fonseca,Jorge
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE; Colégio Brasileiro de Cirurgia Digestiva - CBCD; Sociedade Brasileira de Motilidade Digestiva - SBMD; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE; Colégio Brasileiro de Cirurgia Digestiva - CBCD; Sociedade Brasileira de Motilidade Digestiva - SBMD; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2012 Português
Relevância na Pesquisa
36.13%
CONTEXT: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. OBJECTIVES: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. METHODS: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. RESULTS: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age...

Prevalence rates of infection in intensive care units of a tertiary teaching hospital

Toufen Junior,Carlos; Hovnanian,André Luiz Dresler; Franca,Suelene Aires; Carvalho,Carlos Roberto Ribeiro
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 Português
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OBJECTIVE: To determine the prevalence rates of infections among intensive care unit patients, the predominant infecting organisms, and their resistance patterns. To identify the related factors for intensive care unit-acquired infection and mortality rates. DESIGN: A 1-day point-prevalence study. SETTING:A total of 19 intensive care units at the Hospital das Clínicas - University of São Paulo, School of Medicine (HC-FMUSP), a teaching and tertiary hospital, were eligible to participate in the study. PATIENTS: All patients over 16 years old occupying an intensive care unit bed over a 24-hour period. The 19 intensive care unit s provided 126 patient case reports. MAIN OUTCOME MEASURES: Rates of infection, antimicrobial use, microbiological isolates resistance patterns, potential related factors for intensive care unit-acquired infection, and death rates. RESULTS: A total of 126 patients were studied. Eighty-seven patients (69%) received antimicrobials on the day of study, 72 (57%) for treatment, and 15 (12%) for prophylaxis. Community-acquired infection occurred in 15 patients (20.8%), non- intensive care unit nosocomial infection in 24 (33.3%), and intensive care unit-acquired infection in 22 patients (30.6%). Eleven patients (15.3%) had no defined type. The most frequently reported infections were respiratory (58.5%). The most frequently isolated bacteria were Enterobacteriaceae (33.8%)...

Low and high-dose intradermal infection with Leishmania majorand Leishmania amazonensis in C57BL/6 mice

Côrtes,Denise Fonseca; Carneiro,Matheus Batista Heitor; Santos,Liliane Martins; Souza,Talita Correia de Oliveira; Maioli,Tatiane Uceli; Duz,Ana Luiza C; Ramos-Jorge,Maria Letícia; Afonso,Luis Carlos Crocco; Carneiro,Claudia; Vieira,Leda Quercia
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2010 Português
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A model of skin infection with Leishmania amazonensiswith low doses of parasites is compared to infection with high doses of L. amazonensis and low and high doses of Leishmania major. C57BL/6 mice were infected with 10³ or 10(6) parasites in the ear and the outcome of infection was assessed. The appearance of lesions in mice infected with 10³ parasites was delayed compared to mice infected with 10(6) Leishmania and parasites were detectable at the infection site before lesions became apparent. Mice infected with L. amazonensisdisplayed persistent lesions, whereas infection with L. major spontaneously healed in all groups, although lymphocytes persisted at the site of infection after healing. Macrophages persisted only in L. amazonensis-infected mice. High-dose L. amazonensis-infected mice produced lower levels of IFN-? and TNF than mice infected with L. major. No correlation between the persistence of parasites and IL-10 levels and the production of nitric oxide or urea by macrophages was found. We conclude that infection with low doses of L. amazonensisin the dermis changes the course of infection by delaying the appearance of lesions. However, low-dose infection does not change the outcomes of susceptibility and cytokine production described for subcutaneous infection with high numbers of parasites.

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Ferrari,T.C.A.; Xavier,M.A.P.; Vidigal,P.V.T.; Amaral,N.S.; Diniz,P.A.; Resende,A.P.; Miranda,D.M.; Faria,A.C.; Lima,A.S.; Faria,L.C.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 Português
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Estimates of occult hepatitis B virus (HBV) infection prevalence varies among different studies depending on the prevalence of HBV infection in the study population and on the sensitivity of the assay used to detect HBV DNA. We investigated the prevalence of occult HBV infection in cirrhotic patients undergoing liver transplantation in a Brazilian referral center. Frozen liver samples from 68 adults were analyzed using a nested polymerase chain reaction assay for HBV DNA. The specificity of the amplified HBV sequences was confirmed by direct sequencing of the amplicons. The patient population comprised 49 (72.1%) males and 19 (27.9%) females with a median age of 53 years (range=18-67 years). Occult HBV infection was diagnosed in three (4.4%) patients. The etiologies of the underlying chronic liver disease in these cases were alcohol abuse, HBV infection, and cryptogenic cirrhosis. Two of the patients with cryptic HBV infection also presented hepatocellular carcinoma. Markers of previous HBV infection were available in two patients with occult HBV infection and were negative in both. In conclusion, using a sensitive nested polymerase chain reaction assay to detect HBV DNA in frozen liver tissue, we found a low prevalence of occult HBV infection in cirrhotic patients undergoing liver transplant...

Infection profile of patients undergoing autologous bone marrow transplantation in a Brazilian institution

Santos,Kelli Borges; Hallack Neto,Abrahão Elias; Silva,Girlene Alves; Atalla,Angelo; Abreu,Marcus Matta; Ribeiro,Luiz Cláudio
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
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CONTEXT AND OBJECTIVE: Hematopoietic stem cell transplantation (HSCT) has been widely used for treating oncological and hematological diseases. Although HSCT has helped to improve patient survival, the risk of developing infection during hospitalization is an important cause of morbidity and mortality. This study aimed to analyze the infection profile during hospitalization and the associated risk factors among patients undergoing autologous HSCT at the University Hospital, Universidade Federal de Juiz de Fora. DESIGN AND SETTING: This was a cross-sectional study on patients undergoing autologous HSCT at a public university hospital. METHODS: Patients with febrile neutropenia between 2004 and 2009 were retrospectively evaluated regarding their infection profile and associated risk factors. RESULTS: Infection occurred in 57.2% of 112 patients with febrile neutropenia. The main source of infection was the central venous catheter (25.9%). Infection was chiefly due to Gram-positive bacteria, although Gram-negative-related infections were more severe and caused a higher death rate. Sex, age, skin color, nutritional status and underlying disease were not associated with the development of infection. Patients with severe mucositis (Grades III and IV) had a higher infection rate (P < 0.001). Patients who developed pulmonary complications during hospitalization had higher infection rates (P = 0.002). Infection was the main cause of death (57.1%) in the study sample. CONCLUSION: Strategies aimed at reducing infection-related mortality rates among patients undergoing autologous HSCT are necessary.

Differential Response of Respiratory Dendritic Cell Subsets to Influenza Virus Infection?

Hao, Xueli; Kim, Taeg S.; Braciale, Thomas J.
Fonte: American Society for Microbiology (ASM) Publicador: American Society for Microbiology (ASM)
Tipo: text
Português
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Dendritic cells (DC) are believed to play an important role in the initiation of innate and adaptive immune responses to infection, including respiratory tract infections, where respiratory DC (RDC) perform this role. In this report, we examined the susceptibilities of isolated murine RDC to influenza virus infection in vitro and the effect of the multiplicity of infection (MOI) on costimulatory ligand upregulation and inflammatory cytokine/chemokine production after infection. We found that the efficiency of influenza virus infection of RDC increased with increasing MOIs. Furthermore, distinct subpopulations of RDC differed in their susceptibilities to influenza virus infection and in the magnitude/tempo of costimulatory ligand expression. Additional characterization of the CD11c-positive (CD11c+) RDC revealed that the identifiable subsets of RDC differed in susceptibility to infection, with CD11c+ CD103+ DC exhibiting the greatest susceptibility, CD11c+ CD11bhi DC exhibiting intermediate susceptibility, and CD11c+ B220+ plasmacytoid DC (pDC) exhibiting the least susceptibility to infection. A companion analysis of the in vivo susceptibilities of these RDC subsets to influenza virus revealed a corresponding infection pattern. The three RDC subsets displayed different patterns of cytokine/chemokine production in response to influenza virus infection in vitro: pDC were the predominant producers of most cytokines examined...

Blocking of integrins inhibits HIV-1 infection of human cervical mucosa immune cells with free and complement-opsonized virions

Tjomsland, Veronica; Ellegård, Rada; Kjölhede, Preben; Wodlin, Ninni Borendal; Hinkula, Jorma; Lifson, Jeffrey D; Larsson, Marie
Fonte: BlackWell Publishing Ltd Publicador: BlackWell Publishing Ltd
Tipo: text
Português
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The initial interaction between HIV-1 and the host occurs at the mucosa during sexual intercourse. In cervical mucosa, HIV-1 exists both as free and opsonized virions and this might influence initial infection. We used cervical explants to study HIV-1 transmission, the effects of opsonization on infectivity, and how infection can be prevented. Complement opsonization enhanced HIV-1 infection of dendritic cells (DCs) compared with that by free HIV-1, but this increased infection was not observed with CD4+ T cells. Blockage of the ?4-, ?7-, and ?1-integrins significantly inhibited HIV-1 infection of both DCs and CD4+ T cells. We found a greater impairment of HIV-1 infection in DCs for complement-opsonized virions compared with that of free virions when ?M/?2- and ?4-integrins were blocked. Blocking the C-type lectin receptor macrophage mannose receptor (MMR) inhibited infection of emigrating DCs but had no effect on CD4+ T-cell infection. We show that blocking of integrins decreases the HIV-1 infection of both mucosal DCs and CD4+ T cells emigrating from the cervical tissues. These findings may provide the basis of novel microbicidal strategies that may help limit or prevent initial infection of the cervical mucosa, thereby reducing or averting systemic HIV-1 infection.

Systematic Review of Emergency Department Central Venous and Arterial Catheter Infection

LeMaster, Christopher H.; Agrawal, Ashish T.; Hou, Peter Chuanyi; Schuur, Jeremiah D
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Português
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Background: There is an extensive critical care literature for central venous catheter and arterial line infection, duration of catheterization, and compliance with infection control procedures. The emergency medicine literature, however, contains very little data on central venous catheters and arterial lines. As emergency medicine practice continues to incorporate greater numbers of critical care procedures such as central venous catheter placement, infection control is becoming a greater issue. Aims: We performed a systematic review of studies reporting baseline data of ED-placed central venous catheters and arterial lines using multiple search methods. Methods: Two reviewers independently assessed included studies using explicit criteria, including the use of EDplaced invasive lines, the presence of central line-associated bloodstream infection, and excluded case reports and review articles. Finding significant heterogeneity among studies, we performed a qualitative assessment. Results: Our search produced 504 abstracts, of which 15 studies were evaluated, and 4 studies were excluded because of quality issues leaving 11 cohort studies. Four studies calculated infection rates, ranging 0–24.1/1,000 catheter-days for central line-associated and 0–32.8/1...

Prevalence of early-onset neonatal infection among newborns of mothers with bacterial infection or colonization: a systematic review and meta-analysis

Chan, Grace J; Lee, Anne CC; Baqui, Abdullah H; Tan, Jingwen; Black, Robert E
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
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Background: Although neonatal infections cause a significant proportion of deaths in the first week of life, little is known about the burden of neonatal disease originating from maternal infection or colonization globally. This paper describes the prevalence of vertical transmission – the percentage of newborns with neonatal infection among newborns exposed to maternal infection. Methods: We searched Pubmed, Embase, Scopus, Web of Science, Cochrane Library, and WHO Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection. Studies that measured prevalence of bacterial vertical transmission were included. Random effects meta-analyses were used to pool data to calculate prevalence estimates of vertical transmission. Results: 122 studies met the inclusion criteria. Only seven studies (5.7%) were from very high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of infection (lab-confirmed, clinical signs), colonization, and risk factors of infection. The prevalence of early onset neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 17.2% (95%CI 6.5-27.9). The prevalence of neonatal lab-confirmed infection among newborns of colonized mothers was 0% (95% CI 0.0-0.0). The prevalence of neonatal surface colonization among newborns of colonized mothers ranged from 30.9-45.5% depending on the organism. The prevalence of neonatal lab-confirmed infection among newborns of mothers with risk factors (premature rupture of membranes...