RESUMO
OBJECTIVE: To identify the ocular pathologies that are reported as causes of low vision in children. MATERIAL AND METHODS: The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. RESULTS: 27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. CONCLUSIONS: Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population.
Assuntos
Catarata , Glaucoma , Nistagmo Patológico , Retinopatia da Prematuridade , Baixa Visão , Recém-Nascido , Humanos , Criança , Baixa Visão/etiologia , Baixa Visão/complicações , Cegueira/etiologia , Glaucoma/complicações , Catarata/complicações , Retinopatia da Prematuridade/complicaçõesRESUMO
Tuberculosis (TB) is the leading cause of death among infectious diseases worldwide. Among the estimated cases of drug-resistant TB, approximately 60% occur in the BRICS countries (Brazil, Russia, India, China and South Africa). Among Brazilian states, primary and acquired multidrug-resistant TB (MDR-TB) rates were the highest in Rio Grande do Sul (RS). This study aimed to perform molecular characterisation of MDR-TB in the State of RS, a high-burden Brazilian state. We performed molecular characterisation of MDR-TB cases in RS, defined by drug susceptibility testing, using 131 Mycobacterium tuberculosis (M.tb) DNA samples from the Central Laboratory. We carried out MIRU-VNTR 24loci, spoligotyping, sequencing of the katG, inhA and rpoB genes and RDRio sublineage identification. The most frequent families found were LAM (65.6%) and Haarlem (22.1%). RDRio deletion was observed in 42 (32%) of the M.tb isolates. Among MDR-TB cases, eight (6.1%) did not present mutations in the studied genes. In 116 (88.5%) M.tb isolates, we found mutations associated with rifampicin (RIF) resistance in rpoB gene, and in 112 isolates (85.5%), we observed mutations related to isoniazid resistance in katG and inhA genes. An insertion of 12 nucleotides (CCAGAACAACCC) at the 516 codon in the rpoB gene, possibly responsible for a decreased interaction of RIF and RNA polymerase, was found in 19/131 of the isolates, belonging mostly to LAM and Haarlem families. These results enable a better understanding of the dynamics of transmission and evolution of MDR-TB in the region.
Assuntos
Proteínas de Bactérias/genética , Farmacorresistência Bacteriana Múltipla/genética , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/genética , Adolescente , Adulto , Distribuição por Idade , Antituberculosos/uso terapêutico , Brasil/epidemiologia , Efeitos Psicossociais da Doença , RNA Polimerases Dirigidas por DNA/genética , Bases de Dados Factuais , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Feminino , Genótipo , Humanos , Incidência , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Repetições Minissatélites/genética , Mycobacterium tuberculosis/isolamento & purificação , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Adulto JovemRESUMO
This study compared the level of agreement between two commercially available rapid serological tests and the official screening test used to detect Leishmania seropositive dogs in Brazil. Ninety-five canine sera from a visceral leishmaniasis endemic area were tested by using the official immunochromatographic test (T1; rK28 antigen) based on dual path platform technology, a rapid ELISA (T2; purified Leishmania antigens) and an immunochromatographic test (T3; rK28 antigen) based on lateral flow. There was substantial agreement (Kappa 0.77; 95% confidence interval, CI, 0.62-0.91; P<0.001; observed agreement 90.5%) between T1 and T2, and a fair agreement (Kappa 0.26; 95% CI 0.08-0.43; P<0.001; observed agreement 74.7%) between T1 and T3. Sixteen dogs positive at T1 and T2 were negative at T3. T2 may be a reliable alternative to T1, while T3 could lead to an underestimation of the actual number of seropositive dogs.
Assuntos
Anticorpos Antiprotozoários/sangue , Doenças do Cão/diagnóstico , Ensaio de Imunoadsorção Enzimática/veterinária , Leishmania infantum , Leishmaniose Visceral/veterinária , Animais , Antígenos de Protozoários/imunologia , Brasil , Cromatografia de Afinidade , Doenças do Cão/epidemiologia , Cães , Ensaio de Imunoadsorção Enzimática/métodos , Leishmania infantum/imunologia , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Sensibilidade e Especificidade , Testes Sorológicos/veterináriaRESUMO
Las infecciones por levaduras tienen gran importancia debido a su relativa alta frecuencia e incremento de la resistencia a los antifúngicos, especialmente a los derivados azólicos y, en particular, al fluconazol. El objetivo del estudio fue determinar la concentración inhibitoria mínima (CIM) del fluconazol y anfotericina B de aislados de Candida de pacientes ambulatorios y hospitalizados en Paraguay de mayo del 2010 a agosto del 2011, aplicando criterios nuevos y antiguos para el fluconazolYeast infections are very important because of their relatively high frequency and increased resistance to antifungal agents, especially to azole derivatives, and in particular, to fluconazole. The objective of this study was to determine the minimum inhibitory concentration (MIC) of fluconazole and amphotericin B in Candida isolates in clinically significant samples from hospitalized patients in Paraguay from May 2010 to August 2011 using the old and new criteria for fluconazole. The MICs of the antifungals were determined by the microdilution method (M27 A-2) according to CLSI recommendations. Fifty isolates were evaluated, being C. albicans the predominant species (40%) followed by C. parapsilosis and C. glabrata in equal proportion (20%), C. tropicalis (16%) and C. krusei (4%). Using the old cutoff, five isolates were resistant to . La CIM de los anti-fúngicos se determinó por el método de microdilución según la CLSI. Fueron incluidos 50 aislados de Candida, resultando predominante C. albicans (40%) seguido de C. parapsilosis y C. glabrata en igual proporción (20%), C. tropicales (16%) y C. krusei (4%). Con el antiguo criterio, cinco aislados resultaron resistentes al fluconazol (10%), dos fueron C. krusei con resistencia natural, dos C. tropicalis y uno C. albicans. Tres aislados tuvieron sensibilidad dosis dependiente (SDD), uno de cada especie de C. tropicales, C. parasilopsis y C. glabrata. Con el nuevo criterio, la resistencia aumentó a siete aislados (14%), dos...
Yeast infections areveryimportantbecause of their relatively high frequency andincreased resistance to antifungal agents, especiallytoazole derivatives, and inparticular, to fluconazole. Theobjective of thisstudy was to determine the minimuminhibitory concentration (MIC) of fluconazole and amphotericin B inCandidaisolatesinclinically significant samples from hospitalized patients in Paraguay from May 2010 toAugust 2011 using the old and new criteria for fluconazole. The MICs of the antifungalswere determined by the microdilution method (M27 A-2) according to CLSIrecommendations. Fifty isolates were evaluated,beingC. albicansthe predominantspecies (40%) followed byC. parapsilosisandC. glabratain equal proportion (20%),C.tropicalis(16%) andC. krusei(4%).Usingthe old cutoff,five isolates were resistant to fluconazole (10%), two naturally resistant isolates (C. krusei), twoC. tropicalisand oneC. albicans.ThreeC. glabrataand one isolates of each species ofC. tropicales, C.parasilopsisyC. glabratashowed sensitivity dose dependent (SDD). With the new cutoff,the number of resistant isolates increased to seven (14%), of which two were SDD basedon the old criteria. NineC. glabrataand twoC. albicans,previouslyclassified as sensitive,changedto SDD. All isolates were susceptible to amphotericin B. With the newcutoffpoints,important variations were observed in the isolates susceptibility profiles,particularly inC. glabrata,supportingtheneedof species identification,permanentsurveillance ofthe isolatesresistancetoanti-fungalsand correlationof the sensitivityresultswith theclinicalresponseto treatment.
Assuntos
Anfotericina B , Candida , FluconazolRESUMO
El Streptococcus pyogenes o estreptococo beta-hemolítico (EBH) grupo A es la causa másfrecuente de faringitis bacteriana; su importancia radica en las secuelas no supurativasque puede desencadenar como la fiebre reumática aguda y la glomerulonefritis agudapost-estreptocócica. Casos de faringitis por grupos de EBH diferentes al grupo A,específicamente los del grupo C y G están documentados, pero su papel no estácompletamente claro. El objetivo de este estudio retrospectivo fue determinar lafrecuencia de serogrupos de EBH aislados de hisopados faríngeos de niños y adultos confaringitis, que acudieron al departamento de Microbiología del Laboratorio San Roque enAsunción-Paraguay, entre junio de 2006 a junio de 2007. Las muestras de hisopadosfaríngeos fueron cultivadas en agar sangre de carnero al 5 por ciento e incubadas por 48h a 35ºCen atmósfera de 5 por ciento de CO2 y las colonias beta-hemolíticas identificadas por métodosmicrobiológicos convencionales. De los 303 cultivos, 42 (13,9 por ciento) resultaron positivos paraEBH, de estos 25 (8,3 por ciento) fueron identificados como EBHA, 4 (1,3 por ciento) EBHC y 13 (4,3 por ciento)EBHG. La frecuencia relativa de los serogrupos fue de 59,5 por ciento del grupo A, 9,5 por ciento del grupoC y 31 por ciento del grupo G. Teniendo en cuenta que el 40,5 por ciento de los aislamientos de EBH eradiferente al grupo A, no debería considerarse al EBHA como único estreptococo patógenode la faringe, por lo tanto se debería identificar e informar todos los serogrupos en formarutinaria para un correcto diagnóstico y tratamiento, como una medida para prevenir laslesiones no supurativas que las infecciones por estos serogrupos pueden desencadenar.
Assuntos
Faringite , StreptococcusRESUMO
Mycobacterium abscessus es una de las micobacterias de crecimiento rápido asociadas a infecciones localizadas de heridas post traumáticas y quirúrgicas, infecciones crónicas pulmonares e infecciones cutáneas diseminadas en pacientes inmunosuprimidos. Raramente han sido descritos infecciones en región parotídea por micobacterias de crecimiento rápido. Aquí se reporta el caso de una infección en lóbulo superficial de la glándula parótida de pacientesin compromiso inmune, sin cirugías previas ni traumas aparentes, causado por Mycobacterium abscessus. Estas micobacterias deben ser consideradas en el momento de realizar el diagnóstico tanto clínico como laboratorial, ya que son bacterias emergentes y pueden presentarse de manera inusual, de modo a no demorar el diagnóstico del agente etiológico, debido a que requieren prolongada antibioticoterapia y son bastante resistentes a los antibióticos, especialmente el M. abscessus, que es una de las más resistentes
Mycobacterium abscessus is one of the fast-growing mycobacteria associated to localized infections of post-traumatic injuries, surgical wounds, pulmonary chronic infections and disseminated cutaneous infections in immunosupressed patients. Fast-growing mycobacteria infections of the parotid region have been rarely described. We report the case of a Mycobacterium abscessus infection of the superficial lobe of the parotid gland without immune compromise, previous surgeries or apparent trauma. Thesemycobacteria should be considered at the time of clinical and laboratory diagnosis, as they are emerging bacteria and could present in an unusual manner, in order not to delay the diagnosis of the etiological agent because they require long antibiotic therapy and are pretty resistant to antibiotics specially M. abscessus which is one of the most resistant
Assuntos
Humanos , Feminino , Idoso , Região Parotídea , Infecções por Mycobacterium não Tuberculosas , Mycobacterium abscessus , MycobacteriumRESUMO
El rotavirus (RV) es el principal agente viral causante de diarrea aguda en niños menores de 5 años y es responsable de aproximadamente el 6% de las muertes en este grupo etáreo, lo que conlleva la necesidad de utilizar métodos de diagnósticos rápidos y confiables. El objetivo del estudio es evaluar la sensibilidad y especificidad del método inmunocromatográfico (ICG), en el que se basan muchos kits comerciales utilizados para el diagnóstico de rotavirus grupo A, tomando como referencia el método de electroforesis en gel de poliacrilamida (PAGE). Se seleccionaron muestras de heces de 317 pacientes con diarrea aguda que concurrieron a un laboratorio privado de mayo a noviembre del 2006, con pedido de análisis de rotavirus y todos los datos de los pacientes fueron manejados de manera confidencial Se utilizaron kits de las marcas comerciales Operón simple (n=154) o SD Bioline rotavirus (n=163), siguiendo estrictamente las instrucciones del fabricante. Las muestras fueron conservadas en frío y remitidas al IICS para la realización de los estudios moleculares. La sensibilidad obtenida por el método ICG fue de 97,8% y la especificidad de 84%. La concordancia absoluta fue del 90%. Las muestras que dieron resultados discrepantes entre ICG y PAGE, fueron confirmadas por nRT-PCR, resultados que coincidieron con los obtenidos por PAGE. La sensibilidad del método ICG es muy buena, si bien la especificidad es moderada el método puede ser utilizado como screening para el diagnóstico rápido de rotavirus y sería aconsejable utilizar métodos más específicos como los moleculares para estudios epidemiológicos.
The rotavirus (RV) is the major causative agent of acute viral diarrhea in children under 5 years old and is responsible for approximately 6% of the deaths in this age group making necessary the use of quick and reliable diagnosis methods. The aim of this study is to evaluate the sensibility and specificity of the immunochromatographic method (ICG) on which many commercial kits used for the diagnosis of A rotavirus group are based taking as a reference the polyacrylamide gel electrophoresis (PAGE). Feces samples were collected from 317 patients with acute that attended a private laboratory from May to November, 2006 for rotavirus analysis. All the information of the patients was managed confidentially. Kits of the commercial brands simple Operón (n=154) or SD Bioline rotavirus (n=163) were used strictly following the instructions of the manufacturers. Samples were maintained in cold and sent to the IICS for the performance of the molecular studies. The sensibility obtained by the method ICG was 97.8%, the specificity was 84% and the absolute concordance was 90 %. The samples that gave discrepant results between ICG and PAGE were confirmed by nRT-PCR that provided results similar to those obtained by PAGE. The sensibility of the ICG method is very good and though the specificity is moderated it can be used as screening for the quick diagnosis of rotavirus and it would be advisable to use more specific methods, as the molecular ones, for epidemiological studies.
Assuntos
RotavirusRESUMO
Mycobacterium abscessus es una de las micobacterias de crecimiento rápido asociadas a infecciones localizadas de heridas post traumáticas y quirúrgicas, infecciones crónicas pulmonares e infecciones cutáneas diseminadas en pacientes inmunosuprimidos.Raramente han sido descritos infecciones en región parotídea por micobacterias de crecimiento rápido. Aquí se reporta el caso de una infección en lóbulo superficial de la glándula parótida de paciente sin compromiso inmune, sin cirugías previas ni traumasaparentes, causado por Mycobacterium abscessus. Estas micobacterias deben ser consideradas en el momento de realizar el diagnóstico tanto clínico como laboratorial, ya que son bacterias emergentes y pueden presentarse de manera inusual, de modo a nodemorar el diagnóstico del agente etiológico, debido a que requieren prolongada antibioticoterapia y son bastante resistentes a los antibióticos, especialmente el M. abscessus, que es una de las más resistentes.
Mycobacterium abscessus is one of the fast-growing mycobacteria associated to localized infections of post-traumatic injuries, surgical wounds, pulmonary chronic infections and disseminated cutaneous infections in immunosupressed patients. Fast-growing mycobacteria infections of the parotid region have been rarely described. We report the case of a Mycobacterium abscessus infection of the superficial lobe of the parotid gland without immune compromise, previous surgeries or apparent trauma. These mycobacteria should be considered at the time of clinical and laboratory diagnosis, as they are emerging bacteria and could present in an unusual manner, in order not to delaythe diagnosis of the etiological agent because they require long antibiotic therapy and are pretty resistant to antibiotics specially M. abscessus which is one of the most resistant.
Assuntos
Infecções por Mycobacterium , Mycobacterium , Bactérias , Região ParotídeaRESUMO
Las fluoroquinolonas constituyen un grupo de antibióticos, ampliamente utilizado en infeccionesdel tracto urinario (ITU), por su excelente actividad frente a las enterobacterias y por su vía deeliminación. El objetivo de este estudio es determinar la resistencia a las fluoroquinolonas:ciprofloxacina, levofloxacina y gatifloxacina en bacilos gramnegativos aislados de ITU. Se incluyeronen el estudio todos los bacilos gramnegativos, aislados de pacientes adultos con ITU, queconcurrieron en forma consecutiva al laboratorio San Roque, desde junio de 2005 a marzo de 2006.Para determinar la resistencia, se utilizó el método de difusión en agar siguiendo normasestandarizadas del NCCLS. De las 380 cepas aisladas el 81,7% correspondió a Escherichia coli,11,6% Klebsiella pneumoniae, 3,4% Proteus mirabilis, 1% Enterobacter aerógenes, 0,8%Enterobacter cloacae, 0,5% Citrobacter koseri, 0,5% Citrobacter freundii y 0,5% Klebsiella oxytoca.El 17,6% de todos los aislamientos, fue resistente a todas las fluoroquinolonas ensayadas (58cepas de E. coli, 7 cepas de K. pneumoniae y 2 de E. cloacae). La resistencia de E. coli a las tresfluoroquinolonas fue del 18,7%, y de K. pneumoniae 15,9%. Una cepa de E. coli, sensible agatifloxacina, presentó sensibilidad intermedia a ciprofloxacina y levofloxacina. Las tresfluoroquinolonas testadas presentaron igual actividad frente a bacilos gramnegativos, aislados deITU. Esta resistencia es relativamente alta, debido a que la resistencia a un antibiótico a serutilizado en forma empírica, no debe superar el 20%