SciELO Brasil - Scientific Electronic Library Online
SciELO (Scientific Electronic Library Online) is an electronic library covering a selected collection of Brazilian scientific journals. The objective of the site is to implement an electronic virtual library, providing full access to a collection of serial titles, a collection of issues from individual serial titles, as well as to the full text of articles. The project envisages the development of a common methodology for the preparation, storage, dissemination and evaluation of scientific literature in electronic format.
Methicillin-resistant Staphylococcus lugdunensis carrying SCCmec type V misidentified as MRSA - Pereira,Eliezer Menezes; Schuenck,Ricardo Pinto; Nouér,Simone Aranha; Santos,Kátia Regina Netto dos
Staphylococcus lugdunensis is a rare cause of severe infections and clinical manifestations are similar to those related to S. aureus infection. We describe a hospital-acquired bacteremia due to methicillin-resistant Staphylococcus lugdunensis, misidentified as methicillin-resistant S. aureus. The oxacillin MIC was 16 µg/mL and the mecA gene and SCCmec type V were determined by PCR. Although treatment had been appropriated, the patient died after rapid progressive respiratory failure and another nosocomial sepsis. It is important not only to identify S. lugdunensis in view of its clinical course, but also to determine its susceptibility to oxacillin by detecting the mecA gene or...
Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum - Morais,Orlando Oliveira de; Porto,Cláudia; Coutinho,Anglya Samara Silva Leite; Reis,Carmélia Matos Santiago; Teixeira,Marcus de Melo; Gomes,Ciro Martins
Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially...
Fatal adenoviral necrotizing bronchiolitis case in a post-cardiac surgery intensive care unit - Castelli,Jussara Bianchi; Siciliano,Rinaldo F; Vieira,Ricardo D; Aiello,Vera D; Strabelli,Tânia MV
We report a case of a 67 year-old-male patient admitted to the intensive care unit in the post-coronary bypass surgery period who presented cardiogenic shock, acute renal failure and three episodes of sepsis, the latter with pulmonary distress at the 30th post-operative day. The patient expired within five days in spite of treatment with vancomycin, imipenem, colistimethate and amphotericin B. At autopsy severe adenovirus pneumonia was found. Viral pulmonary infections following cardiovascular surgery are uncommon. We highlight the importance of etiological diagnosis to a correct treatment approach.
Polyoma BK virus: an emerging opportunistic infectious agent of the human central nervous system - Silva,Rodrigo Lopes da
BK virus, a double-stranded DNA virus, is a member of the Polyomaviridae family which is known to infect humans. Clinical evidence of disease is mostly encountered in immunosuppressed individuals such as AIDS patients or those who undergo renal or bone marrow transplantation where complications associated with BKV infection manifest commonly as a polyomavirus nephropathy or hemorrhagic cystitis, respectively. Recent evidence suggests that in addition to the JC virus (the other member of the same family known to be strongly neurotropic and responsible for the progressive multifocal leukoencephalopathy), BK virus can infect and cause clinically relevant disease in the human central...
Seroepidemiological survey of transmissible infectious diseases in a portuguese prison establishment - Marques,Nuno Miguel da Silva; Margalho,Renata; Melo,Maria João; Cunha,José Gabriel Saraiva da; Meliço-Silvestre,António Abel
A cross-sectional study was conducted in 151 (71.6%) of 211 male inmates of a regional Portuguese prison in order to establish the seroprevalence for viral hepatitis (HAV, HBV, HCV), human immunodeficiency virus (HIV), syphilis and herpes simplex virus (HSV-1 and HSV-2) and to analyze some psychosocial and criminal characteristics. Mean age was 34 years. Anti-HAV was positive in 69.5% (n = 105) and in 34.4% (n = 52) for anti-HCV. One (0.7%) person had HBsAg and 29 (19.2%) had laboratory markers of past HBV infection. Non-immune inmates for HBV were 40.4% (n = 61). Syphilis was diagnosed in 6.0% (n...
Seroprevalence of hepatitis A immunity among brazilian adult patients with liver cirrhosis: is HAV vaccination necessary? - Oliveira,Luiz Carlos Marques de; Comácio,Samantha Martins; Santos,Júlia de Fátima Gonçalves
BACKGROUND: Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations. OBJECTIVE: To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil. METHODS: Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated....
Impact of macrolide therapy on mortality of HIV-infected patients with community-acquired pneumonia in a tertiary teaching hospital - Mello,Claudia Figueiredo; Negra,Marinella Della
BACKGROUND: Bacterial pneumonia is one of the main causes of morbidity and mortality in patients infected by the human immunodeficiency virus (HIV). The main objective of this study was to evaluate the effect of macrolide therapy in combination with a beta-lactam based empiric regimen for inpatients with community-acquired pneumonia and HIV. METHODS: This is a retrospective cohort study of hospitalized patients. Adult patients who had received treatment with ceftriaxone or ceftriaxone plus clarithromycin were included. RESULTS: 76 patients met the inclusion criteria. Among baseline characteristics analyzed, only respiratory rate showed significant difference: patients who had received clarithromycin were more likely...
Lopinavir/ritonavir dosing during pregnancy in Brazil and maternal/infant laboratory abnormalities - Peixoto,Mario Ferreira; Pilotto,José Henrique; Stoszek,Sonia Karolina; Kreitchmann,Regis; Mussi-Pinhata,Marisa Márcia; Melo,Victor Hugo; João,Esaú Custodio; Ceriotto,Mariana; Souza,Ricardo da Silva de; Read,Jennifer
OBJECTIVES: To describe laboratory abnormalities among HIV-infected women and their infants with standard and increased lopinavir/ritonavir (LPV/r) dosing during the third trimester of pregnancy. METHODS: We evaluated data on pregnant women from NISDI cohorts (2002-2009) enrolled in Brazil, who received at least 28 days of LPV/r during the third pregnancy trimester and gave birth to singleton infants. RESULTS: 164 women received LPV/r standard dosing [(798/198 or 800/200 mg/day) (Group 1)] and 70 increased dosing [(> 800/200 mg/day) (Group 2)]. Group 1 was more likely to have advanced clinical disease and to use ARVs for treatment, and less likely to have...
Physician adherence to guidelines for tuberculosis and HIV care in Rio de Janeiro, Brazil - Saraceni,Valeria; Pacheco,Antonio Guilherme; Golub,Jonathan E; Vellozo,Vitoria; King,Bonnie S; Cavalcante,Solange C; Eldred,Lois; Chaisson,Richard E; Durovni,Betina
BACKGROUND: Tuberculosis is the most common opportunistic infection among HIV-infected patients in Brazil. Brazil's national policy for HIV care recommends screening for latent tuberculosis (TB) and implementing isoniazid preventive therapy (IPT). OBJECTIVES: We compared physician adherence to TB screening and other prevention and care policies among HIV primary care clinics in Rio de Janeiro City. METHODS: Data on performance of CD4 counts, viral load testing, tuberculin skin testing (TST) and IPT were abstracted from patient charts at 29 HIV clinics in Rio de Janeiro as part of the TB/HIV in Rio (THRio) study. Data on use of pneumocystis jiroveci pneumonia...
Prevalence and factors associated with darunavir resistance mutations in multi-experienced HIV-1-infected patients failing other protease inhibitors in a referral teaching center in Brazil - Vidal,Jose E; Freitas,Angela C; Song,Alice TW; Campos,Silvia V; Dalben,Mirian; Hernandez,Adrian V
Information about resistance profile of darunavir (DRV) is scarce in Brazil. Our objectives were to estimate the prevalence of DRV resistance mutations in patients failing protease inhibitors (PI) and to identify factors associated with having more DRV resistance mutations. All HIV-infected patients failing PI-based regimens with genotyping performed between 2007 and 2008 in a referral teaching center in São Paulo, Brazil, were included. DRV-specific resistance mutations listed by December 2008 IAS-USA panel update were considered. Two Poisson regression models were constructed to assess factors related to the presence of more DRV resistance mutations. A total of 171 HIV-infected patients with...
Candida species isolated from the vaginal mucosa of HIV-infected women in Salvador, Bahia, Brazil - Oliveira,Paula Matos; Mascarenhas,Rita Elizabeth; Lacroix,Claire; Ferrer,Suzana Ramos; Oliveira,Rone Peterson C; Cravo,Elaine Andrade; Alves,André P Ribeiro; Grassi,Maria Fernanda Rios
BACKGROUND: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in...
TNF -308G > a promoter polymorphism (rs1800629) and outcome from critical illness - Paskulin,Diego D'Ávila; Fallavena,Paulo RV; Paludo,Francis JO; Borges,Thiago J; Picanço,Juliane B; Dias,Fernando S; Alho,Clarice Sampaio
BACKGROUND: The susceptibility to adverse outcome from critical illness (occurrence of sepsis, septic shock, organ dysfunction/failure, and mortality) varies dramatically due to different degrees of inflammatory response. An over expression of tumor necrosis factor alpha (TNF-α) can lead to the progression of the inflammatory condition. OBJECTIVE: We assessed the relationship of the genotype distribution of -308G >A TNF-α polymorphism with regard to the development of sepsis, septic shock, higher organ dysfunction or mortality in critically ill patients. METHODS: Observational, hospital-based cohort study of 520 critically ill Caucasian patients from southern Brazil admitted to the general ICU of São Lucas Hospital,...
Cost-effectiveness of telbivudine versus lamivudine for chronic hepatitis B - Wiens,Astrid; Venson,Rafael; Correr,Cassyano Januário; Pontarolo,Roberto
BACKGROUND AND AIM: Chronic hepatitis B is a highly prevalent disease worldwide, leading to serious consequences if not properly treated. Six treatment options for chronic hepatitis B are currently provided by the Brazilian public health system. Telbivudine is a nucleoside analogue that is neither included in the Brazilian clinical protocol nor in the therapeutic guidelines for chronic hepatitis B. OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of telbivudine for the viewpoint of the Brazilian public system, comparing it to lamivudine. METHODS: A Markov model was used to project lifetime complications and costs of treatment with lamivudine...
Respiratory virus infections among hospitalized patients with suspected influenza A H1N1 2009 virus during the first pandemic wave in Brazil - Watanabe,Aripuanã Sakurada Aranha; Carraro,Emerson; Moreira,Luciana; Camargo,Clarice; Sinohara,Juliana; Puerari,Diane; Guatura,Sandra; Granato,Celso; Bellei,Nancy
INTRODUCTION: During the first pandemic wave of the influenza A H1N1 2009 virus, morbidity was particularly high in Brazil. Hospitalizations resulting from severe respiratory disease due to suspected influenza-like illness created an opportunity to identify other respiratory viruses causing lower respiratory infections. OBJECTIVE: The purpose of this study was to assess viral etiologies among samples collected during the first pandemic wave of H1N1 2009 from hospitalized patients with suspected cases in a Brazilian Sentinel Hospital. PATIENTS AND METHODS: Viral etiologies were investigated in samples from 98 children and 61 adults with fever, cough and dyspnea who were admitted to São...
Rotavirus infection in a tertiary hospital: laboratory diagnosis and impact of immunization on pediatric hospitalization - Pereira,Luciane Aparecida; Raboni,Sonia Mara; Nogueira,Meri B; Vidal,Luine R; Almeida,Sergio Monteiro de; Debur,Maria C; Cruz,Cristina
BACKGROUND AND OBJECTIVES: Rotavirus (RV) is the main etiological agent of diarrhea in childhood; its laboratory diagnosis is crucial to guide the clinical management and prevention of its spread. RV immunization was introduced in Brazilian 6-month-old children in 2006. The present study was aimed to evaluate three methodologies used for human RV detection in stool samples obtained from patients hospitalized due to gastroenteritis in a teaching hospital and report the impact of RV immunization in hospitalization by diarrhea. METHODS: 293 stool samples collected in the 2001-2008 period were analyzed by enzyme immunoassay (EIA), latex agglutination (LA) and polyacrylamide gel electrophoresis...
Diagnosis and quantitative detection of HSV DNA in samples from patients with suspected herpes simplex encephalitis - Ziyaeyan,Mazyar; Alborzi,Abdolvahab; Haghighi,Afshin Borhani; Jamalidoust,Marziyeh; Moeini,Mahsa; Pourabbas,Bahman
Diagnosis of herpes simplex encephalitis (HSE) is based on the detection of herpes simplex virus (HSV) DNA in patients' CSF samples. HSV DNA quantitation has the potential for estimating the effects of antiviral therapy. The aim of this study was to diagnose HSV DNA in HSE suspected patients and the quantitative analysis of its genome using real-time PCR to assess the value of the viral load in the course of antiviral treatment. The CSF samples were collected from 236 consecutive HSE suspected patients from November 2004 to May 2008. Upon DNA extraction, the samples were analyzed by Real-Time PCR assay....
Comparison of different primes for PCR-based diagnosis of cutaneous leishmaniasis - Oliveira,Diego Molina de; Lonardoni,Maria Valdrinez Campana; Teodoro,Ueslei; Silveira,Thais Gomes Verzignassi
OBJECTIVE: The objective of this study was to analyze different primers that are commonly used in epidemiological studies for the detection of Leishmania DNA by PCR, and to compare them to the conventional direct parasite search for American cutaneous leishmaniasis (ACL) diagnosis. MATERIAL AND METHODS: Five pairs of primers, four of them derived from Leishmania kDNA sequences (MP3H-MP1L; B1-B2; LBF1-LBR1; 13A-13B), and one derived from the SL RNA (mini-exon) gene repeat (LU5A-LB3C), reported previously, were used. RESULTS: The MP3H-MP1L primers were the best at amplifying the DNA, detecting 2 fg of Leishmania spp. DNA. The 13A-13B primers presented the worst...