Apoena de Aguiar Ribeiro

First Report of Infection with Community-Acquired Methicillin-Resistant Staphylococcus aureus in South America

ABSTRACT Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged in the southwestern Pacific, North America, and Europe. These S. aureus isolates frequently shared some genetic characteristics, including the SCCmec type IV and lukS-lukF genes. In this paper we show that typical CA-MRSA isolates have spread to South America (Brazil).

Relaçäo entre biofilme, atividade de cárie e gengivite em crianças HIV+

A utilizacao de terapia medicamentosa em criancas infectadas pelo HIV (HIV+) vem promovendo a diminuicao na prevalencia de manifestacoes bucais em tecidos moles ao longo dos anos. Entretanto, observa-se uma constância na experiencia de carie e gengivite desta populacao, sobretudo devido a influencia cronica de alguns fatores envolvidos no processo da infeccao pelo HIV, como uso prolongado de medicamentos liquidos acucarados, dieta rica em carboidratos e repetidos episodios de internacao. Assim, o objetivo do presente estudo foi avaliar se a qualidade e quantidade de biofilme representam um fator importante na atividade da doenca carie e gengivite neste grupo em especial. Apos exame do biofilme (indice de biofilme; Ribeiro23, 2000), da atividade de carie e gengivite de 56 criancas, de 0 a 14 anos, pacientes com diagnostico definitivo de infeccao pelo HIV, observou-se que somente 7 (12,5%) nao apresentavam biofilme visivel clinicamente e 33 (58,9%) apresentavam gengivite, com, em media, 4,44 superficies com sangramento. Quanto a doenca carie, 73,2% das criancas apresentavam lesoes cariosas ativas. Verificou-se ainda a correlacao entre o indice de biofilme, o estado gengival e a atividade das lesoes cariosas (teste de correlacao de Spearman, rs = +0,57 e rs = +0,49, respectivamente). Conclui-se, que nas criancas HIV+ avaliadas, a qualidade e quantidade de biofilme sobre a superficie dental representam um importante fator na etiologia da atividade das doencas carie e gengivite, podendo e devendo este ser trabalhado para que seja possivel restabelecer a saude bucal destas criancas.

Influence of Contact Points on the Performance of Caries Detection Methods in Approximal Surfaces of Primary Molars: An in vivo Study

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D₀ = health, D1-D4 = disease; D2: D₀, D1 = health, D2-D4 = disease; D3: D₀-D2 = health, D3, D4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

Comparison of different methods for detecting methicillin resistance in MRSA isolates belonging to international lineages commonly isolated in the American continent

The aim of the present paper was to compare different methods for detecting methicillin resistance in Staphylococcus aureus. Among the isolates analyzed, 52 belonged to MRSA international lineages commonly detected in the American continent and 14 to sporadic MRSA clones. Both 30 μg‐cefoxitin disk and PBP2a had 100% sensibility/specificity when the low‐level heterogeneous isolates were tested and, thus, are highly recommended.