We investigated the cytokine profile of peripheral mononuclear cells from chronic osteomyelitis (OST) patients following in vitro stimulation with staphylococcal enterotoxin A (SEA). We demonstrate that stimulation with SEA induced prominent lymphocyte proliferation and high levels of tumour necrosis factor (TNF)-α, interleukin (IL)-4 and IL-10 secretion in both OST and non-infected individuals (NI). Even though stimulation with SEA had no impact on IL-6 production in either patient group, the baseline level of IL-6 production by cells from OST patients was always significantly less than that produced by cells from NI. After classifying the osteomyelitic episodes based on the time after the last reactivation event as "early" (1-4 months) or "late" osteomyelitis (5-12 months), we found that increased levels of TNF-α and IL-4 in combination with decreased levels of IL-6 were observed in the early episodes. By contrast, increased levels of IL-10, IL-2 and IL-6 were hallmarks of late episodes. Our data demonstrate that early osteomyelitic episodes are accompanied by an increased frequency of "high producers" of TNF-α and IL-4, whereas late events are characterised by increased frequencies of "high producers" of IL-10, IL-6 and IL-2. These findings demonstrate the distinct cytokine profiles in chronic osteomyelitis, with a distinct regulation of IL-6 production during early and late episodes.

Um surto de toxinfecção alimentar envolvendo 42 pessoas, ocorrido após a ingestão de uma refeição servida num restaurante do município de Passos, Minas Gerais, Brasil, é relatado. Trinta minutos após a ingestão dos alimentos, 31 pessoas adoeceram apresentando tontura, vômito, cólica e diarréia. Os alimentos suspeitos foram panqueca de frango, arroz, feijão, molho de tomate e pasta de grão de bico. Foram isolados na panqueca de frango contagens superiores a 2,0x10(8) UFC de estafilococos produtores de enterotoxinas A, B e D por grama do alimento. Culturas isoladas a partir da região orofaríngea, sub-ungüeal e mucosa nasal dos manipuladores de alimentos revelaram serem estes, portadores assintomáticos de cepas de S. aureus produtores de enterotoxinas A, B, C e D. Na mucosa nasal de um dos manipuladores foi isolada a cepa de S. aureus produtora de TSST-1. Os resultados obtidos indicam os manipuladores como prováveis fontes de contaminação dos alimentos.

An outbreak of staphylococcal food poisoning involving 42 people who had eaten a meal at a restaurant in the Municipality of Passos, Minas Gerais, Brazil, is reported. Thirty-one of the individuals became ill with vomiting, diarrhea and dizziness within 30 minutes after eating the meal. The foods suspected were: chicken pancake, rice, beans, tomato sauce and mashed chick-peas. Large numbers (> 2.0x10(8) CFU/g) of enterotoxigenic staphylococci were present in the chicken pancake. These strains produced enterotoxins A, B and D. Swabs from the nasal cavity and throat and from under the fingernails of food handlers were cultured for the detection of enterotoxigenic staphylococci carriers. Four out of five of them were healthy carriers of enterotoxin A, B, C and D producing Staphylococcus aureus at the sites cultured and one of them was also a nasal carrier of TSST-1 toxin producing S. aureus. These results indicate that the food handlers would have been the source of the food contamination.

Considering that the hospital infection is related to the nursing workers, we developed this study with 27 nursing professionals of a surgical center of Belo Horizonte city to identify the present microbial flora in different ranches, the enterotoxinas produced by stumps of S. aureus and the sensibility test to antimicrobiotics. The collected material was submitted to microbiological exams. We have identified workers with S.aureus; S.epidermidis; Klebsiella sp.; Proteus sp.; Enterobacter sp.; Pseudomonas and S. saprofhyticus. Of the stumps of found S.aureus, 83,3% produce toxins, TSST and enterotoxins A and B. The resistance to the antimicrobiotics was developed, mainly by stumps of S. epidermidis and S. aureus.

Considerando que la infección del hospital se relaciona a los obreros de enfermería, nosotros desarrollamos este estudio con 27 profesionales de enfermería de un centro quirúrgico de la ciudad de Belo Horizonte para identificar el microbiota presente en diferentes ranchos, las enterotoxinas producidas por los tocones de S. aureus y la sensibilidad prueban al antimicrobiotics. El material reunido se sometió a los microbiological exámenes. Nosotros hemos identificado obreros con S.aureus; S.epidermidis; Klebsiella sp.; Proteus sp.; Enterobacter sp.; Pseudomonas y S.saprofhyticus. De los tocones de S.aureus encontró, 83,3% producen toxinas TSST y enterotoxins A y B. La resistencia al antimicrobiotics fue desarrollada, principalmente por los tocones de S.epidermidis y S.aureus.

Considerando que a infecção hospitalar está relacionada aos trabalhadores de enfermagem, realizou-se este estudo com 27 profissionais de enfermagem de um centro cirúrgico de Belo Horizonte, para identificar a microbiota presente em diferentes sítios, as enterotoxinas produzidas por cepas de S. aureus, o teste de sensibilidade a antimicrobianos. O material coletado foi submetido a exames microbiológicos. Identificou-se trabalhadores com S.aureus; S.epidermidis; Klebsiella sp.; Proteus sp.; Enterobacter sp.; Pseudomonas e S.saprofhyticus. Das cepas de S.aureus encontradas, 83,3% são produtoras de toxinas, TSST e enterotoxinas A e B. A resistência aos antimicrobianos foi desenvolvida, principalmente, por cepas de S.epidermidis e S.aureus.

Doze pessoas foram acometidas de vômito e diarréia aproximadamente 4 horas após haverem ingerido bolo recheado, servido em uma festa de aniversário, e no dia seguinte à festa. Staphylococcus aureus produtor de enterotoxina A foi isolado no bolo, fossa nasal, leito subungueal e, essencialmente, em uma ferida em fase de cicatrização, localizada na nuca da manipuladora, que dispunha de longa experiência na área de produção de alimentos. O bolo, de cerca de 6 kg, quando ainda quente, foi levado ao refrigerador, por uma hora antes de ser servido não tendo portanto, sido convenientemente resfriado. Esses dados permitiram concluir que o referido alimento foi, acidentalmente, contaminado pela manipuladora e inadequadamente resfriado antes de ser ingerido.

Twelve people became ill with vomiting and diarrhoea approximately four hours after eating cake with a cream filling at a birthday party and on the day following. The cake had been prepared by a food handler who had long experience in preparing foods for such functions. Staphylococcus aureus that produced enterotoxin A was isolated from the nose, the fingernails, and a healed infection on the neck of the food handler, and from the cake. Enterotoxin A was detected in the remaining portion of the cake. The cake, while still warm, had been refrigerated for one hour after it was prepared before it was removed for the party; it was refrigerated after the party. The cake was large (6 kg) and hence it was not adequately cooled in the hour during wich it was refrigerated before the party. The conclusion is that the cake was accidentally contaminated by the food handler and inadequately cooled before it was eaten.

Doze pessoas foram acometidas de vômito e diarréia aproximadamente 4 horas após haverem ingerido bolo recheado, servido em uma festa de aniversário, e no dia seguinte à festa. Staphylococcus aureus produtor de enterotoxina A foi isolado no bolo, fossa nasal, leito subungueal e, essencialmente, em uma ferida em fase de cicatrização, localizada na nuca da manipuladora, que dispunha de longa experiência na área de produção de alimentos. O bolo, de cerca de 6 kg, quando ainda quente, foi levado ao refrigerador, por uma hora antes de ser servido não tendo portanto, sido convenientemente resfriado. Esses dados permitiram concluir que o referido alimento foi, acidentalmente, contaminado pela manipuladora e inadequadamente resfriado antes de ser ingerido.

Twelve people became ill with vomiting and diarrhoea approximately four hours after eating cake with a cream filling at a birthday party and on the day following. The cake had been prepared by a food handler who had long experience in preparing foods for such functions. Staphylococcus aureus that produced enterotoxin A was isolated from the nose, the fingernails, and a healed infection on the neck of the food handler, and from the cake. Enterotoxin A was detected in the remaining portion of the cake. The cake, while still warm, had been refrigerated for one hour after it was prepared before it was removed for the party; it was refrigerated after the party. The cake was large (6 kg) and hence it was not adequately cooled in the hour during wich it was refrigerated before the party. The conclusion is that the cake was accidentally contaminated by the food handler and inadequately cooled before it was eaten.