By 2002, dengue virus serotype 1 (DENV-1) and DENV-2 had circulated for more than a decade in Brazil. In 2002, the introduction of DENV-3 in the state of Bahia produced a massive epidemic and the first cases of dengue hemorrhagic fever. Based on the standardized frequency, timing and location of viral isolations by the state's Central Laboratory, DENV-3 probably entered Bahia through its capital, Salvador, and then rapidly disseminated to other cities, following the main roads. A linear regression model that included traffic flow, distance from the capital and DENV-1 circulation (r² = 0.24, p = 0.001) supported this hypothesis. This pattern was not seen for serotypes already in circulation and was not seen for DENV-3 in the following year. Human population density was another important factor in the intensity of viral circulation. Neither DENV-1 nor DENV-2 fit this model for 2001 or 2003. Since the vector has limited flight range and vector densities fail to correlate with intensity of viral circulation, this distribution represents the movement of infected people and to some extent mosquitoes. This pattern may mimic person-to-person spread of a new infection.

Um estudo prospectivo, sobre a sensibilidade antimicrobiana da flora bacteriana em úlceras cutâneas leishmanióticas, foi realizado em pacientes portadores de leishmaniose tegumentar, em Corte de Pedra, Bahia. Foram estudados 84 pacientes, principalmente adolescentes e adultos dedicados à lavoura, apresentando lesão cutânea única. Staphylococcus aureus predominou (83%) nas culturas, sendo sensível à maioria dos antibióticos testados. Flora bacteriana mista esteve presente na úlcera em 37 (44,1%) pacientes. Entre as bactérias Gram-negativas isoladas, foram mais freqüentes Enterobacter sp (13,1%), Proteus sp (8,3%), Pseudomonas aeruginosa (7,1%) e Klebsiella sp (7,1%), sendo sensíveis principalmente à ciprofloxacina, aminoglicosídeos, cefalosporinas de terceira geração e carbapenêmicos.

A prospective study regarding aspects of antimicrobial susceptibility aspects was realized among patients with tegumentary leishmaniasis in Corte de Pedra, Bahia. Cases were composed mainly of adolescent and adult farmer patients with single lesions. Staphylococcus aureus predominated (83%) in the culteres with susceptibility to the majority of antibiotics. A mixed bacterial flora in ulcers was encountered in 37 (44,1%) patients. Among the gram-negative bacteria isolated, Enterobacter sp (13.1%), Proteus sp (8.3%), Pseudomonas aeruginosa (7.1%) and Klebsiella sp (7.1%) were mainly found with susceptibility to ciprofloxacin, aminoglycosides, third generation cephalosporin and carbapenems.

Em um estudo prospectivo para avaliar a influência da infecção bacteriana secundária na evolução da leishmaniose cutânea, em Corte de Pedra (Bahia), obteve-se o isolamento de Corynebacterium diphtheriae em 7(8,3%) de 84 pacientes portadores de úlceras, avaliados. Devido ao pequeno número de pacientes com a presença da bactéria na úlcera, não foi possível concluir se Corynebacterium diphtheriae comporta-se apenas como colonizante, nem sobre a sua influência no processo de cicatrização da úlcera leishmaniótica.

In a prospective study to evaluate the influence of secondary bacterial infection on the evaluation of cutaneous leishmaniasis, in Corte de Pedra (Bahia), we isolated Corynebacterium diphtheriae in 7 (8.3%) out of 84 patients with ulcers studied. Due to the small number of patients with the presence of the bacteria in the ulcer, we could not conclude whether Corynebacterium diphtheriae behaves only as a colonizer nor its influence on the healing of the leishmaniotic ulcer.

Foram avaliados 84 pacientes leishmanióticos com o objetivo de verificar a prevalência de infecção bacteriana secundária das úlceras cutâneas e de estudar sua relação com a cicatrização das lesões. A infecção secundária foi diagnosticada mediante cultura bacteriana aeróbica de amostra de tecido da lesão. Todos os pacientes receberam tratamento antimonial durante 20 dias e fizeram lavagem da úlcera com água e sabão comum. A casuística foi composta principalmente de adolescentes e de adultos dedicados à lavoura, apresentando lesão única. Em 47,6%, as úlceras estudadas estavam localizadas nas pernas e nos pés. Verificou-se infecção secundária em 45/83 (54,2%), sendo mais freqüente nas lesões localizadas abaixo dos joelhos. O Staphylococcus aureus predominou (88,9%). A reepitelização completa das úlceras, avaliada em 79 pacientes um mês após o fim do tratamento, não foi influenciada pela infecção secundária.

In order to study the prevalence of secondary bacterial infection in ulcerated lesions and its relationship to the healing process, 84 leishmaniotic patients were evaluated. Diagnosis of the secondary infection was made by bacterial aerobic culture of peripheral tissue specimen of the ulcer. All patients received antimonial therapy during 20 days and washed their ulcers with common soap. Cases were composed mainly of adolescent and adult farmer patients with single lesions. The evaluated ulcers were encountered on legs and feet in 47.6%. Secondary bacterial infection was found in 45/83 (54.2%), and was more frequent in lesions located below the knee. Staphylococcus aureus predominated (89%). The ulcers' healing process, evaluated in 79 patients one month after finishing treatment, was not influenced by the secondary bacterial infection.