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Algunas acciones inmediatas y estratégicas debemos realizar en nuestros hospitales para lograr una mayor preservación de los tratamientos antimicrobianos, para que los mismos sean verdaderamente eficaces y nos ayuden a retrasar la aparición de cepas multirresistentes. Los Programas de Optimización de Antibióticos (PROA) nos ayudan a establecer protocolos de uso de antibiótico, cómo y cuándo se deben utilizar, a qué dosis y cuánto tiempo, cuales debemos disponer primero y cual reservar para pacientes más graves. Además de recomendar cuando es necesario incorporar nuevos antibióticos en el arsenal terapéutico, porque las bacterias siempre desencadenan mecanismos de resistencia a los antimicrobianos que van apareciendo. Debemos incluso tener un estudio de susceptibilidad de los mismo a pesar de no estar incorporado en el cuadro básico hospitalario para saber cómo responden nuestras cepas. El establecimiento de guías locales de tratamiento antimicrobiano es a través de un mejor conocimiento de la epidemiología local. Facilita la toma de decisiones del clínico en situaciones concretas, con o sin información microbiológica definitiva es una de las herramientas para el tratamiento de los pacientes que requieran intervenciones inmediatas. Por lo que, el antibiograma acumulado o el mapa microbiológico es fundamental para tomar decisiones acertadas según el objetivo terapéutico...(AU)

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The importance of Brazil for the International Trade of poultry products induces legislators and interested companies to pay special attention to complying with international standard quality requirements. One of these requirements is the suppression of the indiscriminate use of antibiotics in poultry, as in the strategy of their use as a growth promoter. To meet this demand, the study of short-chain organic acids becomes interesting and their review essential. As good examples for the issue described, short chain organic acids such as citric acid, fumaric acid, sorbic acid and malic acid are extremely important due to their antimicrobial qualities, accessibility, and international acceptance. In addition to the individual effect, the blend of acids, that is, the association of acids for the role of growth promoter or performance enhancer, combines acids that act synergistically, enhancing their qualities. This study aims to address the physicochemical characteristics, effects, and qualities of short-chain organic acids, as well as their associated effects, encouraging further work that fills the scientific gaps in empirical knowledge about these additives.(AU)

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The microorganism resistance to antibiotics has become one of the most worrying issues for science due to the difficulties related to clinical treatment and the rapid spread of diseases. Efflux pumps are classified into six groups of carrier proteins that are part of the different types of mechanisms that contribute to resistance in microorganisms, allowing their survival. The present study aimed to carry out a bibliographic review on the superfamilies of carriers in order to understand their compositions, expressions, substrates, and role in intrinsic resistance. At first, a search for manuscripts was carried out in the databases Medline, Pubmed, ScienceDirect, and Scielo, using as descriptors: efflux pump, expression, pump inhibitors and efflux superfamily. For article selection, two criteria were taken into account: for inclusion, those published between 2000 and 2020, including textbooks, and for exclusion, duplicates and academic collections. In this research, 139,615 published articles were obtained, with 312 selected articles and 7 book chapters that best met the aim. From the comprehensive analysis, it was possible to consider that the chromosomes and genetic elements can contain genes encoding efflux pumps and are responsible for multidrug resistance. Even though this is a well-explored topic in the scientific community, understanding the behavior of antibiotics as substrates that increase the expression of pump-encoding genes has challenged medicine. This review study succinctly summarizes the most relevant features of these systems, as well as their contribution to multidrug resistance.

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INTRODUCTION: Microorganisms of clinical importance frequently develop resistance to drug therapy, now a growing problem. The experience with Mycobacterium tuberculosis is a representative example of increasing multi-drug resistance. To avoid reaching a crisis in which patients could be left without adequate treatment, a new strategy is needed. Anti-microbial therapy has historically targeted the mechanisms rather than origin of drug resistance, thus allowing microorganisms to adapt and survive. AREAS COVERED: This contribution analyses the historical development (1943-2020) of the evolution of multi-drug resistance by M. tuberculosis strains in light of Darwin's and Lamarck's theories of evolution. EXPERT OPINION: Regarding the molecular origin of microbial drug resistance, genetic mutations and epigenetic modifications are known to participate. The analysis of the history of drug resistance by M. tuberculosis evidences a gradual development of resistance to some antibiotics, undoubtedly due to random mutations together with natural selection based on environmental pressures (e.g., antibiotics), representing Darwin's idea. More rapid adaptation of M. tuberculosis to new antibiotic treatments has also occurred, probably because of heritable acquired characteristics, evidencing Lamarck's proposal. Therefore, microbial infections should be treated with an antibiotic producing null or low mutagenic activity along with a resistance inhibitor, preferably in a single medication.

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Female genital tract infections have a high incidence among different age groups and represent an important impact on public health. Among them, vaginitis refers to inflammation of the vulva and/or vagina due to the presence of pathogens that cause trichomoniasis, bacterial vaginosis, and vulvovaginal candidiasis. Several discomforts are associated with these infections, as well as pregnancy complications and the facilitation of HIV transmission and acquisition. The increasing resistance of microorganisms to drugs used in therapy is remarkable, since women report the recurrence of these infections and associated comorbidities. Different resistant mechanisms already described for the drugs used in the therapy against Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis, as well as aspects related to pathogenesis and treatment, are discussed in this review. This study aims to contribute to drug design, avoiding therapy ineffectiveness due to drug resistance. Effective alternative therapies to treat vaginitis will reduce the recurrence of infections and, consequently, the high costs generated in the health system, improving women's well-being.

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The emergence of antibiotic resistance drives an essential race against time to reveal new molecular structures capable of addressing this alarming global health problem. Snake venoms are natural catalogs of multifunctional toxins and privileged frameworks, which serve as potential templates for the inspiration of novel treatment strategies for combating antibiotic resistant bacteria. Phospholipases A2 (PLA2 s) are one of the main classes of antibacterial biomolecules, with recognized therapeutic value, found in these valuable secretions. Recently, a number of biomimetic oligopeptides based on small fragments of primary structure from PLA2 toxins has emerged as a meaningful opportunity to overcome multidrug-resistant clinical isolates. Thus, this review will highlight the biochemical and structural properties of antibacterial PLA2 s and peptides thereof, as well as their possible molecular mechanisms of action and key roles in development of effective therapeutic strategies. Chemical strategies possibly useful to convert antibacterial peptides from PLA2 s to efficient drugs will be equally addressed.

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Desde 1928, los antibióticos eran las primeras armas contra los microoganismos. En 1998 apareció una bacteria resistente que permitió el incremento de las enfermedades infecciosas. Cuanto más expuesta esté una población bacteriana a un antibiótico, las bacterias que sobrevivan se harán más resistentes, aún para defenderse de futuros antibióticos. Pero su empleo está justificado como método de profilaxis en pacientes médicamente comprometidos. En principio, debe indicarse medicación local para reducir la carga microbiana. El proifesional debe saber cuándo recetar un antibiótico y no olvidar que éste es un coadyuvante del tratamiento, ya que es el propio sistema inmune del paciente el que realiza la curación.

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Neonatal diarrhea determines significant changes in feed conversion, causing productivity loss in caprine herds. The antimicrobial resistance in bacteria is characterized as an important public healthissue; therefore, Escherichia coli may be characterized as an important pathogen due to expressingvirulence mechanisms responsible for significant clinical conditions in humans and animals. Thepresent study evaluated the presence of E. coli among 117 caprine fecal samples and analyzed theisolates for antimicrobial resistance. Suggestive colonies were submitted to biochemical screeningfollowed by genotypic group determination and phylogenetic analysis; further, the sampleswere submitted to antimicrobials susceptibility test. E. coli, Salmonella spp, Shigella sonnei andEnterobacter aerogenes were identified. E. coli isolates were phylogenetically classified as B2 (9/39),D (19/39), B1 (7/39) e A (4/29) groups. The analysis of the isolates also revealed the presence of K99(04/39) and Stx (02/39) virulence factors. Antimicrobial susceptibility test revealed sensitive isolatesto Chloramphenicol, Streptomycin, Amoxicillin and Ciprofloxacin, being all resistant to Lincomycin,Vancomycin and Penicillin. The results support the need of establishing restricted protocols forantimicrobial use, a fundamental procedure for health improvement in Brazilian caprine herds.

A diarreia neonatal determina alterações significativas na conversão alimentar, resultando na queda daprodutividade de caprinos. A resistência antimicrobiana em bactérias caracteriza-se como importanteproblema de saúde pública, assim, a Escherichia coli pode ser caracterizada como importantepatógeno por expressar mecanismos de virulência responsáveis por significativas afecções clínicasem seres humanos e animais. O presente estudo avaliou a presença de E. coli em 117 amostrasfecais de caprinos e analisou a resistência antimicrobiana dos isolados. Colônias sugestivas foramsubmetidas a testes bioquímicos, seguido de determinação do grupo genotípico e análise filogenética;posteriormente foram submetidas à prova de suscetibilidade a antimicrobianos. Foram identificadosisolados de E. coli, Salmonella spp, Shigella sonnei e Enterobacter aerogenes. Isolados de E. coliforam classificados filogeneticamente em B2 (9/39), D (19/39), B1 (7/39) e A (4/29). Os fatores devirulência identificados foram K99 (04/39) e Stx (02/39). À prova de suscetibilidade antimicrobiana,os isolados foram sensíveis a Cloranfenicol, Estreptomicina, Amoxicilina e Ciprofloxacina, sendotodos resistentes à Lincomicina, Vancomicina e Penicilina. Os resultados reforçam a necessidade deestabelecimento de protocolos criteriosos para o uso de antimicrobianos, medida fundamental para oaprimoramento da sanidade dos rebanhos caprinos brasileiros.

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Neonatal diarrhea determines significant changes in feed conversion, causing productivity loss in caprine herds. The antimicrobial resistance in bacteria is characterized as an important public healthissue; therefore, Escherichia coli may be characterized as an important pathogen due to expressingvirulence mechanisms responsible for significant clinical conditions in humans and animals. Thepresent study evaluated the presence of E. coli among 117 caprine fecal samples and analyzed theisolates for antimicrobial resistance. Suggestive colonies were submitted to biochemical screeningfollowed by genotypic group determination and phylogenetic analysis; further, the sampleswere submitted to antimicrobials susceptibility test. E. coli, Salmonella spp, Shigella sonnei andEnterobacter aerogenes were identified. E. coli isolates were phylogenetically classified as B2 (9/39),D (19/39), B1 (7/39) e A (4/29) groups. The analysis of the isolates also revealed the presence of K99(04/39) and Stx (02/39) virulence factors. Antimicrobial susceptibility test revealed sensitive isolatesto Chloramphenicol, Streptomycin, Amoxicillin and Ciprofloxacin, being all resistant to Lincomycin,Vancomycin and Penicillin. The results support the need of establishing restricted protocols forantimicrobial use, a fundamental procedure for health improvement in Brazilian caprine herds.(AU)

A diarreia neonatal determina alterações significativas na conversão alimentar, resultando na queda daprodutividade de caprinos. A resistência antimicrobiana em bactérias caracteriza-se como importanteproblema de saúde pública, assim, a Escherichia coli pode ser caracterizada como importantepatógeno por expressar mecanismos de virulência responsáveis por significativas afecções clínicasem seres humanos e animais. O presente estudo avaliou a presença de E. coli em 117 amostrasfecais de caprinos e analisou a resistência antimicrobiana dos isolados. Colônias sugestivas foramsubmetidas a testes bioquímicos, seguido de determinação do grupo genotípico e análise filogenética;posteriormente foram submetidas à prova de suscetibilidade a antimicrobianos. Foram identificadosisolados de E. coli, Salmonella spp, Shigella sonnei e Enterobacter aerogenes. Isolados de E. coliforam classificados filogeneticamente em B2 (9/39), D (19/39), B1 (7/39) e A (4/29). Os fatores devirulência identificados foram K99 (04/39) e Stx (02/39). À prova de suscetibilidade antimicrobiana,os isolados foram sensíveis a Cloranfenicol, Estreptomicina, Amoxicilina e Ciprofloxacina, sendotodos resistentes à Lincomicina, Vancomicina e Penicilina. Os resultados reforçam a necessidade deestabelecimento de protocolos criteriosos para o uso de antimicrobianos, medida fundamental para oaprimoramento da sanidade dos rebanhos caprinos brasileiros.(AU)

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OBJECTIVES: to adapt and validate the Inventory of Family Protective Factors (IFPF) for the Portuguese culture. This instrument assesses protective factors that contribute to family resilience. Studies addressing resilience are embedded within the salutogenic paradigm, i.e. it addresses protective factors of individuals or groups without underestimating risk factors or vulnerability. METHOD: in order to assess the IFPF's linguistic and conceptual equivalence, the instrument was translated, retro-translated and the think-aloud protocol was used. We then verified the instrument's sensitiveness, reliability and validity of results to assess its psychometric characteristics. A factor analysis was performed of the principal components with varimax rotation of the scale's items and Cronbach's alpha coefficient was calculated for each dimension. A total of 85 families with disabled children, selected through simple random sampling, self-administered the instrument. RESULTS: the IFPF presents psychometric characteristics that are appropriate for the Portuguese population (Cronbach's alpha = .90). CONCLUSION: the IFPF was adapted and validated for the Portuguese culture and is an instrument to be used in studies intended to assess protective factors of family resilience. .

OBJETIVOS: adaptar e validar o Inventory of Family Protective Factors para a cultura portuguesa. Esse instrumento avalia os fatores protetores que contribuem para a resiliência familiar. Os estudos sobre resiliência inserem-se no paradigma salutogênico, abordando os fatores protetores dos indivíduos, ou grupos, sem subestimar os fatores de risco ou vulnerabilidade. MÉTODO: para avaliar a equivalência linguística e conceitual do Inventory of Family Protective Factors realizou-se a tradução, retroversão e reflexão falada; para aferir as características psicométricas do instrumento, verificou-se a sensibilidade, confiabilidade e a validade dos resultados. Foi realizada uma análise fatorial de componentes principais com rotação Varimax dos itens da escala e calculou-se o coeficiente alfa de Cronbach para cada dimensão. Através de uma amostragem aleatória simples, aplicou-se esse instrumento a 85 famílias de crianças com necessidades especiais que o autopreencheram. RESULTADOS: o Inventory of Family Protective Factors apresenta características psicométricas adequadas para a população portuguesa (alfa de Cronbach de .90). CONCLUSÃO: o Inventory of Family Protective Factors foi adaptado e validado para a cultura portuguesa. Considera-se que se trata de um instrumento útil para estudos nos quais há a proposta de avaliar os fatores protetores da resiliência familiar. .

OBJETIVOS: adaptar y validar el Inventory of Family Protective Factors (IFPF) para la cultura portuguesa. Este instrumento evalúa los factores protectores que contribuyen para la resiliencia familiar. Los estudios sobre resiliencia se insieren en el paradigma salutogénico, abordando los factores protectores de los individuos o grupos, sin subestimar los factores de riesgo o vulnerabilidad. MÉTODO: para evaluar la equivalencia lingüística y conceptual del IFPF realizamos la traducción, retrotraducción y reflexión hablada; para evaluar las características psicométricas del instrumento verificamos la sensibilidad, confiabilidad y la validez de los resultados. Realizamos un análisis factorial de los componentes principales con rotación varimax de los ítems de la escala y calculamos el coeficiente Alpha de Cronbach para cada dimensión. A través de un muestreo aleatorio simple, aplicamos este instrumento a 85 familias de niños con necesidades especiales que lo autollenaron. RESULTADOS: el IFPF presenta características psicométricas adecuadas para la población portuguesa (alfa de Cronbach de 0,90). CONCLUSIÓN: el IFPF fue adaptado y validado para la cultura portuguesa. Consideramos que se trata de un instrumento útil para estudios que se propongan evaluar los factores protectores de la resiliencia familiar. .

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