Azizedite Guedes Gonçalves

The potential use of propolis as a cariostatic agent and its actions on mutans group streptococci

Propolis is a resinous substance made by bees. It possesses many biological activities, and many studies have reported its potential application in the control of dental caries. However, variability in the chemical composition of propolis is a potential problem in its quality control, especially since propolis has already been incorporated into products for oral use. Therefore, a critical analysis of the available data on propolis is warranted. The present review discusses the in vitro and in vivo studies published in the period between 1978 and 2008 regarding the effects of propolis on Streptococcus mutans growth, bacterial adherence, glucosyltransferase activity, and caries indicators. Several investigations carried out with crude propolis extracts, isolated fractions, and purified compounds showed reductions in Streptococcus mutans counts and interference with their adhesion capacity and glucosyltransferase activity, which are considered major properties in the establishment of the cariogenic process. Data from in vivo studies have demonstrated reductions in Streptococcus mutans counts in saliva, the plaque index, and insoluble polysaccharide formation. These findings indicate that propolis and/or its compounds are promising cariostatic agents. However, the variation in the chemical composition of propolis due to its geographical distribution is a significant drawback to its routine clinical use. Thus, further studies are needed to establish the quality and safety control criteria for propolis in order for it to be used in accordance with its proposed activity.

Conhecimentos e atitudes da população sobre dengue no Município de São Luís, Maranhão, Brasil, 2004

A sample survey with 843 interviews in Sao Luis, Maranhao State, Brazil was conducted to assess community knowledge and concepts regarding dengue. The populations understanding and its socioeconomic, health, and environmental conditions were evaluated. Potential vector breeding sites were found in all the areas surveyed. Media (TV, radio, etc.) were the most important source of public information on the disease. However, a gap was observed between knowledge and attitudes towards vector prevention. Strategies are also needed to involve the population in more effective prevention of vector proliferation, thus helping control the disease in Sao Luis.

Extended-spectrum β-lactamase-producing enterobacteriaceae in community-acquired urinary tract infections in São Luís, Brazil

The number of ESBL-producing Enterobacteriaceae in community-acquired urinary tract infections worldwide is probably underestimated because of the technical difficulties encountered with their detection. In this study, out of 5,672 urine samples analyzed, 916 were positive for uropathogens, 472 of them being enterobacteria of which 7.6% produced β-lactamases. Analysis of the isolated from 36 patients showed a high level of antibiotic resistance, with 52.7% and 80.5% of isolates expressing blaTEM and blaCTX-M, respectively.

The use of glucan as immunostimulant in the treatment of a severe case of chromoblastomycosis.

We report the case of an alternative treatment for a patient with a severe form of chromoblastomycosis that responded poorly to the traditional antifungal therapy. We hereby show, in this study, the improvement of lesions after treatment with itraconazole associated with an intramuscular administration of glucan. We observed that the regression of lesions was associated with an improvement of the cellular immune response. This favourable response that we observed suggests that the therapeutic regimen we used might be an option for the treatment of patients with a severe form of chromoblastomycosis.

Nosocomial infection and characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae in Northeast Brazil

INTRODUCTION Extended spectrum β-lactamases (ESBLs) are enzymes that degrade β-lactam antibiotics and have been reported to be an important cause of nosocomial infection in worldwide. METHODS During 2009, 659 enterobacteria strains were isolated from different clinical specimens and tested for ESBL production. The disk approximation test, combined disk method and addition of clavulanic acid were used for phenotypic detection of the ESBL-producing strains and PCR for detection of the bla(TEM) and bla(CTX-M) genes. RESULTS Among the isolates, 125 were ESBL producers. The bla(CTX-M) and bla(TEM) genes were detected in 90.4% and 75% of the strains, respectively. Most strains were isolated from urine. Klebsiella pneumoniae was the most prevalent organism. Microorganisms presented high resistance to the antibiotics. CONCLUSIONS These results support the need for extending ESBL detection methods to different pathogens of the Enterobacteriaceae family because these methods are only currently standardized by the CLSI for Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. Carbapenems were the antibiotic class of choice for the treatment of infections caused by ESBL-producing Enterobacteriaceae.

Fonsecaea pedrosoi infection induces differential modulation of costimulatory molecules and cytokines in monocytes from patients with severe and mild forms of chromoblastomycosis

The host defense mechanism in chromoblastomycosis has not been thoroughly investigated. It has been suggested that cell‐mediated immunity in patients with long‐standing chromoblastomycosis is somehow impaired. As a result, these individuals became unable to develop an efficient immune reaction. Many studies have shown that monocyte‐derived macrophages exhibit critical activities in immunity to microorganisms. Moreover, the ability of cells from the monocytic lineage to process and present antigens, to produce cytokines, and to provide costimulatory signals confirms their pivotal role in the initiation of specific immune responses. In the present study, it was observed that monocytes from patients with a severe form of disease had a higher production of IL‐10 and a lower expression of HLA‐DR and costimulatory molecules when stimulated with specific antigen or LPS. Immune modulation with recombinant IL‐12 or anti‐IL‐10 can restore the antigen‐specific Th1‐type immune response in chromoblastomycosis patients by up‐regulating HLA‐DR and costimulatory molecules in monocytes. Therefore, our data show that monocytes from patients with different clinical forms of chromoblastomycosis present distinct phenotypic and functional profiles. This observation suggests possible mechanisms that control the T cell response and influence their role in the development of pathology.

MICROBIOLOGICAL ANALYSES OF WATER FROM HEMODIALYSIS SERVICES IN SÃO LUÍS, MARANHÃO, BRAZIL

A necessidade de um controle rigoroso no servico de hemodialise tornou-se algo de extrema importância para garantir uma melhor qualidade de vida aos pacientes submetidos a este tratamento, uma vez que, a falta de controle de qualidade da agua, tem levado a obito varios pacientes. Este estudo teve como objetivo avaliar as caracteristicas fisico-quimicas e bacteriologicas da agua utilizada pelos servicos de hemodialise em hospitais da cidade de Sao Luis. A metodologia utilizada para as analises bacteriologicas foi: metodo da membrana filtrante para determinacao de coliformes totais, metodo Cult-Dipcombi-ttc-agar para bacterias heterotroficas e metodo limulus amebocyte lysate para endotoxinas. Foram analisadas dezoito amostras de agua em tres unidades hospitalares, sendo seis amostras provenientes de cada servico de hemodialise, colhidas diretamente dos pontos pre e pos-tratamento. Quanto a presenca de microrganismos na agua utilizada pelos servicos de hemodialise, observou-se positividade nas unidades hospitalares B e C. Nao foi encontrada contaminacao por bacterias heterotroficas nas amostras examinadas no pre-tratamento, entretanto a contaminacao por endotoxinas foi em 100% das amostras. Nas amostras pos-tratamento encontrou-se para bacterias heterotroficas 66,6% e endotoxinas 33,3%. Os microrganismos identificados na unidade hospitalar B foram: Burkholderia cepacia, Alcaligenes xilosoxidans, Pseudomonas aeruginosa e Stenotrophomonas maltophilia. Na unidade C, foram identificados: Flavimonas oryzihabitans, Ralstonia pickettii e Burkholderia cepacia. Houve uma correlacao significativa entre a presenca de endotoxinas e caracteristicas fisico-quimicas da agua tais como: turbidez e condutividade. Estes dados revelaram que duas das tres unidades hospitalares avaliadas necessitam rever o controle do sistema de agua de hemodialise.

Immunomodulatory and Antimicrobial Activity of Babassu Mesocarp Improves the Survival in Lethal Sepsis

Attalea speciosa syn Orbignya phalerata Mart. (babassu) has been used in the treatment of inflammatory and infectious diseases. Aim of the study. To investigate the antimicrobial and immunological activity of babassu mesocarp extract (EE). Material and Methods. The in vitro antimicrobial activity was evaluated by disk diffusion assay and by determination of the minimum inhibitory concentration (MIC) to Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus (MRSA). The flavonoids and phenolic acids content were determined by chromatography. The in vivo assays were performed in Swiss mice submitted to sepsis by cecal ligation and puncture (CLP). The mice received EE subcutaneously (125 or 250 mg/Kg), 6 hours after the CLP. The number of lymphoid cells was quantified and the cytokines production was determined by ELISA after 12 h. Results. EE was effective as antimicrobial to E. faecalis, S. aureus, and MRSA. EE is rich in phenolic acids, a class of compounds with antimicrobial and immunological activity. An increased survival can be observed in those groups, possibly due to a significant inhibition of TNF-α and IL-6. Conclusions. The EE showed specific antimicrobial activity in vitro and an important antiseptic effect in vivo possibly due to the antimicrobial and immunomodulatory activity.

Phenotypic detection of metallo-β-lactamases in Pseudomonas aeruginosa and Acinetobacter baumannii isolated from hospitalized patients in São Luis, State of Maranhão, Brazil

INTRODUCTION Acquired metallo-β-lactamases (MβL) are emerging determinants of resistance in Pseudomonas aeruginosa and Acinetobacter baumannii. The objectives of this study were to phenotypically detect MβL in imipenem-resistant P. aeruginosa and A. baumannii, to investigate the association between MβL-positive strains and hospitals, and to compare the resistance profiles of MβL-producing and non-MβL-producing strains. METHODS The approximation disk and combined disk assay methods were used in this study. RESULTS A total of 18 (38.3%) P. aeruginosa isolates and 1 (5.6%) A. baumannii isolate tested positive for the presence of MβL. CONCLUSIONS These results demonstrate the need for strict surveillance and for the adoption of preventive measures to reduce the spread of infection and potential outbreaks of disease caused by MβL-producing microorganisms.

Systemic lupus erythematosus in the elderly.

The authors report two clinical cases of systemic lupus erythematosus, both in patients over 65 years of age. The discussion includes a brief overview of recent publications on this condition in geriatric patients. Some aspects of systemic lupus in elderly persons are suggested and commented on.