Abstract Objective: The objective was to analyze the health conditions of people living on the streets, in the COVID-19 scenario, based on the contributions of the Environmental Theory. Methods: This is a theoretical-reflexive analysis. Results: Two categories were developed: The dichotomy between living on the street and the Nightingalian assumptions and; The reality of people living on the street in times of pandemic by COVID-19. The first category addressed the difference between what is experienced by people on the street and what the Nightingalian assumptions say about health conditions. The second category showed the insertion of these people in the context of prevention measures. Final considerations: It is of fundamental importance to discuss the access to prevention and health promotion strategies by these people and to promote specific actions for the reality in which they live.

Resumen Objetivo: Analizar las condiciones de salud de las personas sin hogar, en el escenario de la COVID-19, a partir de los aportes de la Teoría Ambiental. Método: Se trata de un análisis teórico-reflexivo. Resultados: Fue posible elaborar dos categorías: la dicotomía entre vivir en la calle y supuestos de Nightingale; y la realidad de las personas que viven en la calle en tiempos de pandemia por COVID-19. La primera categoría abordó la diferencia entre lo que experimenta la gente en la calle y lo que dicen las suposiciones de Nightingale sobre las condiciones de salud. La segunda categoría mostró la inserción de estas personas en el contexto de las medidas de prevención. Consideraciones finales: Es de fundamental importancia discutir el acceso a las estrategias de prevención y promoción de la salud por parte de estas personas y promover acciones específicas para la realidad en la que viven.

ABSTRACT Despite the widespread use of chlorhexidine (CHX) to prevent infection, data regarding the in vitro action of CHX against methicillin-resistant Staphylococcus aureus (MRSA) are limited. Clinical isolates from Hospital das Clinicas, Sao Paulo, Brazil, identified during 2002/2003 and 2012/2013 were studied to describe the susceptibility to CHX and mupirocin, molecular characteristics, and virulence profile of MRSA. Susceptibility test to Mupirocin was performed by the disk diffusion method and to CHX by the agar dilution technique. PCR for virulence genes, mecA gene and Staphylococcal Cassette Chromosome mec (SCCmec) types were investigated as well. Mupirocin- and CHX-resistant isolates were sequenced using the IlluminaTM plataform. Two hundred and sixteen MRSA clinical isolates were evaluated: 154 from infected and 62 from colonized patients. Resistance to mupirocin was observed in four isolates assigned as SCCmec type III and STs (ST05; ST239 and ST105) carrying mupA and blaZ, two of them co-harboring the ileS gene. Only one isolate assigned as SCCmec type III was resistant to CHX (MIC of 8.0 μg.mL-1) and harbored the qacA gene. Resistance to chlorhexidine and mupirocin were found in isolates carrying qacA and mupA in our hospital. Since these genes are plasmid-mediated, this finding draws attention to the potential spread of resistance to mupirocin in our hospital.

Resumo Objetivo: avaliar o Sistema de Vigilância da Tuberculose Drogarresistente (SV-TBDR)/Brasil. Métodos: estudo avaliativo, segundo diretrizes do Centro de Controle e Prevenção de Doenças, sobre dados nacionais do Sistema de Informação de Tratamentos Especiais de Tuberculose (SITETB) e do Sistema de Informação de Agravos de Notificação (Sinan) de 2013-2017. Resultados: a completitude média dos dados foi de 95% (escolaridade [89,1%; 5.417/6.078]; nacionalidade [94,7%; 5.754/6.078]; raça/cor da pele [99,1%; 6.023/6.078]; tipo de resistência [98,6%; 5.995/6.078]; forma clínica [100%; 6.078/6.078]; e teste para HIV [87%; 5.289/6.078]); a proporção média de casos com culturas realizadas foi de 65,7% (cultura 1 [94,8%; 5.764/6.078]; cultura 2 [69,8%; 4.241/6.078]; cultura 3 [54,7%; 3.324/6.078]; e cultura 4 [43,6%; 2.652/6.078]); em 2015, o SV-TBDR notificou 52% (1.197/2.300) dos casos multirresistentes estimados pela Organização Mundial da Saúde, 41,3% (990/2.400) em 2016 e 45,8% (1.100/2.400) em 2017. Conclusão: a baixa sensibilidade do SV-TBDR recomenda melhorias no acesso ao diagnóstico da TBDR.

Abstract Objective: to evaluate the Brazilian Drug-Resistant Tuberculosis Surveillance System (DRTB-SS). Methods: this was an evaluative study, following Centers for Disease Control and Prevention guidelines, using national data from the Special Tuberculosis Treatment Information System (SITETB), and the Notifiable Diseases Information System (SINAN), from 2013 to 2017. Results: average data completeness was 95% (schooling [89.1%; 5,417/6,078], nationality [94.7%; 5,754/6,078], race/skin color [99.1%; 6,023/6,078], type of resistance [98.6%; 5,995/6,078], clinical form [100%; 6,078/6,078], and HIV test [87%; 5,289/6,078]); average proportion of cases with sputum cultures performed was 65.7% (culture 1 [94.8%; 5,764/6,078], culture 2 [69.8%; 4,241/6,078], culture 3 [54.7%, 3,324/6,078], and culture 4 [43.6%; 2,652/6,078]); DRTB-SS reported 52% (1,197/2,300) of multi-resistant cases estimated by the World Health Organization in 2015, 41.3% (990/2,400) in 2016, and 45.8% (1,100/2,400) in 2017. Conclusion: low DRTB-SS sensitivity suggests the need for improved access to DRTB diagnosis.

Resumen Objetivo: evaluar el Sistema de Vigilancia de la Tuberculosis Drogorresistente (SV-TB -DR)/Brasil. Métodos: estudio evaluativo, según directrices del Centro de Control y Prevención de Enfermedades, sobre datos nacionales del Sistema de Información de Tratamientos Especiales de Tuberculosis (SITETB) y del Sistema Nacional de Agravamientos de Notificación (Sinan) entre 2013 y 2017. Resultados: la completitud promedio de los datos fue de 95% (escolaridad [89,1%; 5.417/6.078]; nacionalidad [94,7%; 5.754/6.078]; raza/color de la piel [99,1%; 6.023/6.078]; tipo de resistencia [98,6%; 5.995/6.078]; forma clínica [100%; 6.078/6.078]; y prueba de VIH [87%; 5.289/6.078]); la proporción promedio de los casos con cultivos realizados fue 65,7% (cultivo 1 [94,8%; 5.764/6.078]; cultivo 2 [69,8%; 4.241/6.078]; cultivo 3 [54,7%; 3.324/6.078]; y cultivo 4 [43,6%; 2.652/6.078]); el SV-TB-DR reportó en 2015 52% (1.197/2.300) de los casos multirresistentes estimados por la Organización Mundial de la Salud, 41,3% (990/2.400) en 2016 y 45,8% (1.100/2.400) en 2017. Conclusión: la baja sensibilidad del SV-TB-DR sugiere la necesidad de mejorar el acceso al diagnóstico de TB-DR.

Resumo Objetivo: avaliar o Sistema de Vigilância da Tuberculose Drogarresistente (SV-TBDR)/Brasil. Métodos: estudo avaliativo, segundo diretrizes do Centro de Controle e Prevenção de Doenças, sobre dados nacionais do Sistema de Informação de Tratamentos Especiais de Tuberculose (SITETB) e do Sistema de Informação de Agravos de Notificação (Sinan) de 2013-2017. Resultados: a completitude média dos dados foi de 95% (escolaridade [89,1%; 5.417/6.078]; nacionalidade [94,7%; 5.754/6.078]; raça/cor da pele [99,1%; 6.023/6.078]; tipo de resistência [98,6%; 5.995/6.078]; forma clínica [100%; 6.078/6.078]; e teste para HIV [87%; 5.289/6.078]); a proporção média de casos com culturas realizadas foi de 65,7% (cultura 1 [94,8%; 5.764/6.078]; cultura 2 [69,8%; 4.241/6.078]; cultura 3 [54,7%; 3.324/6.078]; e cultura 4 [43,6%; 2.652/6.078]); em 2015, o SV-TBDR notificou 52% (1.197/2.300) dos casos multirresistentes estimados pela Organização Mundial da Saúde, 41,3% (990/2.400) em 2016 e 45,8% (1.100/2.400) em 2017. Conclusão: a baixa sensibilidade do SV-TBDR recomenda melhorias no acesso ao diagnóstico da TBDR.

Abstract Objective: to evaluate the Brazilian Drug-Resistant Tuberculosis Surveillance System (DRTB-SS). Methods: this was an evaluative study, following Centers for Disease Control and Prevention guidelines, using national data from the Special Tuberculosis Treatment Information System (SITETB), and the Notifiable Diseases Information System (SINAN), from 2013 to 2017. Results: average data completeness was 95% (schooling [89.1%; 5,417/6,078], nationality [94.7%; 5,754/6,078], race/skin color [99.1%; 6,023/6,078], type of resistance [98.6%; 5,995/6,078], clinical form [100%; 6,078/6,078], and HIV test [87%; 5,289/6,078]); average proportion of cases with sputum cultures performed was 65.7% (culture 1 [94.8%; 5,764/6,078], culture 2 [69.8%; 4,241/6,078], culture 3 [54.7%, 3,324/6,078], and culture 4 [43.6%; 2,652/6,078]); DRTB-SS reported 52% (1,197/2,300) of multi-resistant cases estimated by the World Health Organization in 2015, 41.3% (990/2,400) in 2016, and 45.8% (1,100/2,400) in 2017. Conclusion: low DRTB-SS sensitivity suggests the need for improved access to DRTB diagnosis.

Resumen Objetivo: evaluar el Sistema de Vigilancia de la Tuberculosis Drogorresistente (SV-TB -DR)/Brasil. Métodos: estudio evaluativo, según directrices del Centro de Control y Prevención de Enfermedades, sobre datos nacionales del Sistema de Información de Tratamientos Especiales de Tuberculosis (SITETB) y del Sistema Nacional de Agravamientos de Notificación (Sinan) entre 2013 y 2017. Resultados: la completitud promedio de los datos fue de 95% (escolaridad [89,1%; 5.417/6.078]; nacionalidad [94,7%; 5.754/6.078]; raza/color de la piel [99,1%; 6.023/6.078]; tipo de resistencia [98,6%; 5.995/6.078]; forma clínica [100%; 6.078/6.078]; y prueba de VIH [87%; 5.289/6.078]); la proporción promedio de los casos con cultivos realizados fue 65,7% (cultivo 1 [94,8%; 5.764/6.078]; cultivo 2 [69,8%; 4.241/6.078]; cultivo 3 [54,7%; 3.324/6.078]; y cultivo 4 [43,6%; 2.652/6.078]); el SV-TB-DR reportó en 2015 52% (1.197/2.300) de los casos multirresistentes estimados por la Organización Mundial de la Salud, 41,3% (990/2.400) en 2016 y 45,8% (1.100/2.400) en 2017. Conclusión: la baja sensibilidad del SV-TB-DR sugiere la necesidad de mejorar el acceso al diagnóstico de TB-DR.

Resumo O Sistema de Informação de Agravos de Notificação (Sinan) possibilita conhecer o perfil das pessoas com tuberculose (TB) ativa em um país continental como o Brasil. Disponível em todos os municípios e estados, o sistema permite contínua consolidação dos dados, avaliação e monitoramento das ações relacionadas ao controle da doença no país. O objetivo deste estudo foi apresentar as especificidades do Sinan-Net referentes à TB, entre elas a tela de acompanhamento, a rotina de vinculação e o boletim de acompanhamento. Adicionalmente, são descritas as principais variáveis e indicadores, os desafios e limitações do sistema.

Abstract The Notifiable Diseases Information System (SINAN) enables knowledge of the profile of people with active tuberculosis (TB) in a country of continental dimensions such as Brazil. Available in all Brazilian municipalities and states, the system enables continuous consolidation of data, evaluation and monitoring of actions related to TB control in the country. The purpose of this paper is to present the specificities of SINAN-Net related to TB, including the follow-up screen, the record linkage and the follow-up report. Additionally, we describe the main variables and indicators and the challenges and limitations of the system.

Resumen El Sistema de Información de Agravamientos de Notificación (Sinan) posibilita conocer el perfil de las personas con tuberculosis (TB) activa en un país continental como Brasil. Disponible en todos los municipios y estados, el sistema posibilita una continua consolidación de los datos, evaluación y monitoreo de las acciones relacionadas al control de la enfermedad en el país. El objetivo de este trabajo es presentar las especificidades del Sinan-Net con relación a la TB, entre ellas la pantalla de acompañamiento, la rutina de vinculación y el boletín de acompañamiento. Adicionalmente, describimos las principales variables e indicadores y los desafíos y limitaciones del sistema.

Resumo O Sistema de Informação de Agravos de Notificação (Sinan) possibilita conhecer o perfil das pessoas com tuberculose (TB) ativa em um país continental como o Brasil. Disponível em todos os municípios e estados, o sistema permite contínua consolidação dos dados, avaliação e monitoramento das ações relacionadas ao controle da doença no país. O objetivo deste estudo foi apresentar as especificidades do Sinan-Net referentes à TB, entre elas a tela de acompanhamento, a rotina de vinculação e o boletim de acompanhamento. Adicionalmente, são descritas as principais variáveis e indicadores, os desafios e limitações do sistema.

Abstract The Notifiable Diseases Information System (SINAN) enables knowledge of the profile of people with active tuberculosis (TB) in a country of continental dimensions such as Brazil. Available in all Brazilian municipalities and states, the system enables continuous consolidation of data, evaluation and monitoring of actions related to TB control in the country. The purpose of this paper is to present the specificities of SINAN-Net related to TB, including the follow-up screen, the record linkage and the follow-up report. Additionally, we describe the main variables and indicators and the challenges and limitations of the system.

Resumen El Sistema de Información de Agravamientos de Notificación (Sinan) posibilita conocer el perfil de las personas con tuberculosis (TB) activa en un país continental como Brasil. Disponible en todos los municipios y estados, el sistema posibilita una continua consolidación de los datos, evaluación y monitoreo de las acciones relacionadas al control de la enfermedad en el país. El objetivo de este trabajo es presentar las especificidades del Sinan-Net con relación a la TB, entre ellas la pantalla de acompañamiento, la rutina de vinculación y el boletín de acompañamiento. Adicionalmente, describimos las principales variables e indicadores y los desafíos y limitaciones del sistema.

BACKGROUND Dengue virus (DENV) has circulated in Brazil for over 30 years. During this time, one serotype has cyclically replaced the other, until recently, when all four distinct serotypes began to circulate together. Persistent circulation of DENV for long time periods makes sequential infections throughout a person’s life possible. After primary DENV infection, life-long immunity is developed for the infecting serotype. Since DENV and Zika virus (ZIKV) are antigenically similar, the possibility of cross-reactions has attracted attention and has been demonstrated in vitro. OBJECTIVE The aim of this study was to investigate whether immune-sera from DENV and ZIKV infected patients would cross-react in vitro with other Flaviviridae family members. METHODS Cross-reaction of the studied samples with yellow fever virus (YFV), West Nile virus (WNV), Rocio virus (ROCV), Saint Louis virus (SLEV) and Ilheus virus (ILHV) has been investigated by plaque reduction neutralisation test (PRNT) and the antibody-dependent enhancement (ADE) by flow-cytometry. FINDINGS Antibodies against ZIKV and DENV virus cross-reacted with other flaviviruses either neutralising or enhancing the infection. Thus, viral entrance into FcRFcɣRII-expressing cells were influenced by the cross-reactive antibodies. ZIKV or DENV immune sera enhanced cellular infection by WNV, ILHV, ROCV and SLEV. Finally, DENV immune sera presented higher neutralising activity for YFV and SLEV. While ZIKV immune sera neutralised WNV, ILHV and ROCV with high frequencies of positivity. MAIN CONCLUSIONS The co-circulation of those viruses in the same area represents a risk for the development of severe infections if they spread throughout the country. Successive flavivirus infections may have an impact on disease pathogenesis, as well as on the development of safe vaccine strategies.

Abstract INTRODUCTION: High endemic levels of pulmonary tuberculosis in prisons result from overcrowding, limited access to healthcare, delayed diagnosis, sustained transmission owing to poor control measures, and multidrug resistance. This study evaluated locally implemented measures for early pulmonary tuberculosis diagnosis and evaluated resistance to anti-tuberculosis drugs. METHODS: This transversal study employed data from the Mato Grosso do Sul State Tuberculosis Control Program obtained from 35 correctional facilities in 16 counties for 2 periods (2007-2010 and 2011-2014). RESULTS: Statewide prevalence (per 100,000) was 480.0 in 2007 and 972.9 in 2014. The following indicators showed improvement: alcohol-acid-fast bacillus testing (from 82.7% to 92.9%); cultures performed (55.0% to 81.8%); drug susceptibility testing of positive cultures (71.6% to 62.4%); and overall drug susceptibility testing coverage (36.6% to 47.4%). Primary and acquired resistance rates for 2007-2014 were 21.1% and 30.0%, respectively. Primary and acquired multidrug resistance rates were 0.3% and 1.3%, respectively. CONCLUSIONS: Prevalence rates increased, and laboratory indicators improved as a result of capacity building and coordination of technical teams and other individuals providing healthcare to inmates. Resistance rates were high, thereby negatively affecting disease control.

BACKGROUND Lymphatic filariasis (LF) is a parasitic disease caused mainly by the Wuchereria bancrofti worm and that affects up to 120 million people worldwide. LF is the second cause of chronic global deformity, responsible for 15 million people with lymphedema (elephantiasis) and 25 million men with scrotal hydrocele. Its diagnosis is still associated with numerous difficulties, such as the sample collection periods (microfilaria nocturnal periodicity) and limited diagnostic kits. OBJECTIVES The aim of this work was to evaluate two recombinant antigens (Wb14 and WbT) as part of an enzyme-linked immunosorbent assay (ELISA) based antibody capture tests for LF. METHODS The recombinant antigens rWb14 and rWbT were expressed in Escherichia coli BL21 and an antibody capture ELISA was performed. For this, sera were used from microfilaremic individuals with W. bancrofti (MF), chronic pathology (CP), individuals infected with Strongyloides (SP) and healthy controls from endemic (EN) and non-endemic (NE) areas. FINDINGS Both tests showed similar results, with 90% sensitivity and 96.6% specificity. In comparison with the BM14 ELISA commercial test, the Wb14 and WbT antigens performed with identical sensitivity but greater specificity. Reduced positivity with the CP suggested a potential to monitor cure. This was not confirmed, however, when sera from individuals up to seven years after treatment were assayed. MAIN CONCLUSIONS The Wb14 and WbT ELISAs were considered efficient and promising diagnostic tests. Due to the importance of antibody capture analysis to evaluate the Global Program to Eliminate Lymphatic Filariasis (GPELF), the tests proposed here appear as great alternatives to the available commercial system.

RESUMO Objetivo Estimar as taxas de resistência às drogas entre casos de tuberculose pulmonar (TBP) para o estado de Mato Grosso do Sul, Brasil, e especificamente para a região da fronteira com Paraguai e Bolívia, além de identificar fatores de risco associados. Métodos O presente estudo epidemiológico, transversal, enfocou os casos de TBP registrados de janeiro de 2007 a dezembro de 2010 no Sistema de Informação de Agravos de Notificação da Secretaria de Estado de Saúde com resultados do teste de suscetibilidade a rifampicina, isoniazida, etambutol e estreptomicina. Definiram-se como variáveis dependentes o desenvolvimento de resistência a uma única droga e a qualquer combinação de drogas. As variáveis independentes foram ser caso novo ou tratado, residência em região de fronteira ou outra região, presença ou ausência de diabetes e história de alcoolismo. Resultados Foram identificados 789 casos de TBP com teste de suscetibilidade. As características associadas à resistência foram: caso tratado (P=0,0001), região de fronteira (P=0,0142), alcoolismo (P=0,0451) e diabetes (P=0,0708). As taxas de resistência combinada, primária e adquirida no estado foram de 16,3%, 10,6% e 39,0%, e na fronteira, de 22,3%, 19,2% e 37,5%. As taxas de resistência a múltiplas drogas combinada, primária e adquirida no estado foram de 1,8%, 0,6% e 6,3%, e na fronteira, de 3,1%, 1,2% e 12,5%. Conclusões O estado deve, na região de fronteira, realizar cultura em todos os sintomáticos respiratórios, investigar o padrão de resistência nos casos confirmados, adotar o tratamento diretamente observado nos casos de TBP e desencadear ações de saúde conjuntas com os países fronteiriços. Em todo o estado, é necessário monitorar os níveis de resistência adquirida, ampliar a investigação de resistência para todos os casos tratados e adotar o tratamento diretamente observado prioritariamente entre pacientes com alcoolismo e diabetes.

ABSTRACT Objective To estimate the rate of drug resistance among pulmonary tuberculosis (PTB) cases in the state of Mato Grosso do Sul, Brazil, and specifically in the border areas with Paraguay and Bolivia, as well as to identify associated risk factors. Method The present cross-sectional, epidemiological study focused on PTB cases recorded between January 2007 and December 2010 in the State Reportable Disease Information System with results of susceptibility tests to rifampicin, isoniazid, ethambutol, and streptomycin. Dependent variables were development of resistance to a single drug or any combination of drugs. Independent variables were being a new or treated case, living in border areas, presence/absence of diabetes, and history of alcoholism. Results There were 789 TBP cases with susceptibility testing. The following characteristics were associated with resistance: treated case (P = 0.0001), border region (P = 0.0142), alcoholism (P = 0.0451), and diabetes (P = 0.0708). The rates of combined, primary, and acquired resistance for the state were 16.3%, 10.6%, and 39.0%, vs. 22.3%, 19.2%, and 37.5% for the border region. The rates of combined, primary, and acquired multidrug resistance for the state were 1.8%, 0.6%, and 6.3%, vs. 3.1%, 1.2%, and 12.5% for the border region. Conclusions In the border region, the state should investigate drug resistance in all patients with respiratory symptoms, determine the pattern of resistance in confirmed cases, adopt directly observed treatment for cases of PTB, and develop health actions together with neighboring countries. Across the state, the levels of acquired resistance should be monitored, with investigation of resistance in all treated cases and implementation of directly observed treatment especially among patients with diabetes or alcoholism.

Dengue is an acute febrile disease caused by the mosquito-borne dengue virus (DENV) that according to clinical manifestations can be classified as asymptomatic, mild or severe dengue. Severe dengue cases have been associated with an unbalanced immune response characterised by an over secretion of inflammatory cytokines. In the present study we measured type I interferon (IFN-I) transcript and circulating levels in primary and secondary DENV infected patients. We observed that dengue fever (DF) and dengue haemorrhagic fever (DHF) patients express IFN-I differently. While DF and DHF patients express interferon-α similarly (52,71 ± 7,40 and 49,05 ± 7,70, respectively), IFN- β were associated with primary DHF patients. On the other hand, secondary DHF patients were not able to secrete large amounts of IFN- β which in turn may have influenced the high-level of viraemia. Our results suggest that, in patients from our cohort, infection by DENV serotype 3 elicits an innate response characterised by higher levels of IFN- β in the DHF patients with primary infection, which could contribute to control infection evidenced by the low-level of viraemia in these patients. The present findings may contribute to shed light in the role of innate immune response in dengue pathogenesis.

Resumo Casos de dengue têm aumentado em grupos etários mais jovens no Brasil. Anticorpos antidengue maternos podem exercer efeito protetor nos primeiros meses de vida, mas seu declínio pode aumentar o risco de dengue grave. Uma coorte de nascimento prospectiva foi estabelecida na cidade do Recife, Pernambuco, Brasil, entre 2011-2012, para determinar a incidência de infecção sorotipo-específica do dengue e cinética dos anticorpos antidengue materno-transferidos nos primeiros anos de vida. Este artigo descreve o desenho, os métodos e resultados preliminares deste estudo de coorte. Trezentas e cinquenta e quatro crianças foram acompanhadas clínico e laboratorialmente por dois anos, com 15% de perdas de seguimento. A taxa global de novas infecções foi de aproximadamente 10% na coorte de crianças no primeiro ano de seguimento. Informações sobre a força de infecção sorotipo-específica do dengue nos primeiros anos de vida, bem como a avaliação da cinética de anticorpos materno-transferidos poderão contribuir para a compreensão da etiopatogenia da doença.

Abstract Dengue cases have increased in younger age groups in Brazil. Maternal anti-dengue antibodies can have a protective effect in the first months of life, but their decline can increase the risk of severe dengue. A prospective birth cohort was established in 2011-2012 in the city of Recife, Pernambuco State, Brazil, to determine the incidence of serotype-specific dengue infection and the kinetics of transferred maternal anti-dengue antibodies in the first years of life. This article describes the design, methods and preliminary results of this cohort study. 354 children underwent clinical and laboratory monitoring for two years, with 15% losses to follow-up. The overall rate of new infections was approximately 10% in the first year of follow-up. Information on the force of serotype-specific dengue infection and the evaluation of transferred maternal antibodies can contribute to understanding dengue etiopathogenesis.

Resumen Los casos de dengue han aumentado en los grupos de edad más jóvenes en Brasil. Los anticuerpos antidengue maternos pueden ejercer un efecto protector en los primeros meses de vida, pero su decremento puede aumentar el riesgo de dengue grave. Una cohorte de nacimientos prospectiva se estableció en la ciudad de Recife, Pernambuco, Brasil, entre 2011-2012, para determinar la incidencia de infección serotipo-específica de dengue y la cinética de los anticuerpos antidengue materno-transferidos durante los primeros años de vida. Este artículo describe el diseño, los métodos y resultados preliminares de este estudio de cohorte. 354 niños fueron acompañados clínicamente y en laboratorio durante dos años, con un 15% de pérdidas en el seguimiento. La tasa global de nuevas infecciones fue de aproximadamente un 10% en la cohorte de niños durante el primer año de seguimiento. La información sobre la fuerza de infección serotipo-específica del dengue en los primeros años de vida, así como la evaluación de la cinética de los anticuerpos materno-transferidos, podrá contribuir a la comprensión de la etiopatogenia de la enfermedad.

Resumo Casos de dengue têm aumentado em grupos etários mais jovens no Brasil. Anticorpos antidengue maternos podem exercer efeito protetor nos primeiros meses de vida, mas seu declínio pode aumentar o risco de dengue grave. Uma coorte de nascimento prospectiva foi estabelecida na cidade do Recife, Pernambuco, Brasil, entre 2011-2012, para determinar a incidência de infecção sorotipo-específica do dengue e cinética dos anticorpos antidengue materno-transferidos nos primeiros anos de vida. Este artigo descreve o desenho, os métodos e resultados preliminares deste estudo de coorte. Trezentas e cinquenta e quatro crianças foram acompanhadas clínico e laboratorialmente por dois anos, com 15% de perdas de seguimento. A taxa global de novas infecções foi de aproximadamente 10% na coorte de crianças no primeiro ano de seguimento. Informações sobre a força de infecção sorotipo-específica do dengue nos primeiros anos de vida, bem como a avaliação da cinética de anticorpos materno-transferidos poderão contribuir para a compreensão da etiopatogenia da doença.

Abstract Dengue cases have increased in younger age groups in Brazil. Maternal anti-dengue antibodies can have a protective effect in the first months of life, but their decline can increase the risk of severe dengue. A prospective birth cohort was established in 2011-2012 in the city of Recife, Pernambuco State, Brazil, to determine the incidence of serotype-specific dengue infection and the kinetics of transferred maternal anti-dengue antibodies in the first years of life. This article describes the design, methods and preliminary results of this cohort study. 354 children underwent clinical and laboratory monitoring for two years, with 15% losses to follow-up. The overall rate of new infections was approximately 10% in the first year of follow-up. Information on the force of serotype-specific dengue infection and the evaluation of transferred maternal antibodies can contribute to understanding dengue etiopathogenesis.

Resumen Los casos de dengue han aumentado en los grupos de edad más jóvenes en Brasil. Los anticuerpos antidengue maternos pueden ejercer un efecto protector en los primeros meses de vida, pero su decremento puede aumentar el riesgo de dengue grave. Una cohorte de nacimientos prospectiva se estableció en la ciudad de Recife, Pernambuco, Brasil, entre 2011-2012, para determinar la incidencia de infección serotipo-específica de dengue y la cinética de los anticuerpos antidengue materno-transferidos durante los primeros años de vida. Este artículo describe el diseño, los métodos y resultados preliminares de este estudio de cohorte. 354 niños fueron acompañados clínicamente y en laboratorio durante dos años, con un 15% de pérdidas en el seguimiento. La tasa global de nuevas infecciones fue de aproximadamente un 10% en la cohorte de niños durante el primer año de seguimiento. La información sobre la fuerza de infección serotipo-específica del dengue en los primeros años de vida, así como la evaluación de la cinética de los anticuerpos materno-transferidos, podrá contribuir a la comprensión de la etiopatogenia de la enfermedad.

RESUMO Objetivou-se caracterizar fenotípica e genotipicamente isolados clínicos de enterobactérias resistentes aos carbapenêmicos (CRE) provenientes do Hospital Universitário de Santa Maria (RS). Entre os isolados clínicos submetidos ao teste modificado de Hodge (MHT), 62,5% apresentaram positividade, indicando possível produção de carbapenemase. A reação em cadeia da polimerase (PCR) demonstrou que o blaKPC foi o gene mais encontrado (31%), seguido de blaIMP (12,5%). O uso conjunto de distintas metodologias faz-se necessário para identificar a resistência aos carbapenêmicos produzida pelas enterobactérias, de modo a auxiliar o controle de infecção prevenindo a disseminação desses microrganismos.

ABSTRACT The present study aimed to genotypically and phenotypically characterize clinical isolates of carbapenem-resistant Enterobacteriaceae collected from inpatients at the University Hospital of Santa Maria, during seven months. Among the clinical isolates subjected to the modified Hodge test (MHT), 62.5% were positive, indicating possible production of carbapenemase. Polymerase chain reaction (PCR) demonstrated that blaKPC was the most frequently found gene (31%), followed by blaIMP (12.5%). Combined use of the methods is needed to identify carbapenem resistance in enterobacteria to prevent their spread and control the infections caused by these organisms.

Este estudo investigou o efeito da exposição aguda do zinco (Zn) na histologia do fígado e testículos de lambari do rabo-amarelo (Astyanax aff. Bimaculatus). A exposição consistiu de seis concentrações de Zn, 0, 3, 5, 10, 15 e 20 mg/L por 96 horas de exposição. Fragmentos de fígado e testículos foram processados rotineiramente para inclusão em resina plástica a base de glicol metacrilato. Fragmentos de ossos, músculos, fígado e testículos foram desidratados e digeridos para quantificar os níveis teciduais da absorção de Zn. A exposição aguda a concentrações de acima de 10mg/L produziu alterações estruturais no fígado e gônada. As alterações encontradas no fígado foram: congestão vascular, diminuição do volume celular; deslocamento do núcleo dos hepatócitos, necrose; desarranjo na estrutura do cordonal; infiltrado leucocitário e vacuolização. As alterações encontradas nas gônadas foram ruptura de cisto, retardo no desenvolvimento das células da linhagem germinativa, núcleo picnótico, aglomerado de celular, deslocamento da parede do cisto e vacuolização. As alterações histológicas observadas foram compatíveis com o aumento da concentração de Zn no ambiente, comprometendo as funções hepáticas e reprodutivas, devido ao aumento no número de hepatócitos e redução na produção de espermatozoides.

This study investigated the effect of acute exposition to zinc (Zn) on histology of the liver and testes of yellow tail lambari (Astyanax aff. bimaculatus). The exposure consisted of six concentrations of Zn (0, 3, 5, 10, 15, and 20 mg/L) for 96 hours of exposure. Fragments of liver and testis were routinely processed and embedded in plastic resin based on glycol methacrylate. Fragments of bones, muscles, liver and testis were dehydrated and digested to quantify the absorption levels of Zn in the tissue. Acute exposure to concentrations above 10mg/L has produced structural changes in the liver and gonads. The changes found in the liver were vascular congestion; decrease of cellular volume; displacement of the hepatocyte nucleus; necrosis; disarrangement of cordon structure; leukocyte infiltrate and vacuolization. The changes found in the gonads were ruptured cyst, delayed development of germ cells, pyknotic nucleus, cell cluster, displacement of cyst wall and vacuolization. The histological changes observed were compatible with the increasing concentration of zinc in environment, compromising liver and reproductive functions, because there was an increase in relative frequency of hepatocytes and reduced sperm production