Abstract The aim of this study was to evaluate the phenotypic and molecular patterns of biofilm formation in infection and colonization isolates of Acinetobacter spp. from patients who were admitted in a public hospital of Recife-PE-Brazil in 2018-2019. For the biofilm phenotypic analysis, Acinetobacter spp. isolates were evaluated by the crystal violet staining method; the search of virulence genes (bap, ompA, epsA, csuE and bfmS) was performed by PCR; and the ERIC-PCR was performed for molecular typing. Amongst the 38 Acinetobacter spp. isolates, 20 were isolated from infections and 18 from colonization. The resistance profile pointed that 86.85% (33/38) of the isolates were multidrug-resistant, being three infection isolates, and two colonization isolates resistant to polymyxin B. All the isolates were able to produce biofilm and they had at least one of the investigated virulence genes on their molecular profile, but the bap gene was found in 100% of them. No clones were detected by ERIC-PCR. There was no correlation between biofilm formation and the resistance profile of the bacteria, neither to the molecular profile of the virulence genes. Thus, the ability of Acinetobacter spp. to form biofilm is probably related to the high frequency of virulence genes.

Abstract INTRODUCTION: Pseudomonas aeruginosa, an important pathogen globally, presents several resistance mechanisms. This study aimed to investigate the presence of bla GES in clinical isolates of Pseudomonas aeruginosa obtained from various clinical specimens from patients admitted to three different hospitals in Recife, Brazil. The Guiana extended spectrum beta-lactamase (GES) enzymes are responsible for conferring broad spectrum resistance to beta-lactam drugs, including the carbapenems. METHODS: A total of 100 carbapenem-resistant P. aeruginosa isolates underwent polymerase chain reaction (PCR) testing to identify bla GES, bla KPC, bla SPM-1, bla IMP, and bla VIM. Additionally, PCR products positive for bla GES were sequenced. The clonal profiles of these same isolates were then determined by means of enterobacterial repetitive intergenic consensus (ERIC)-PCR analysis. RESULTS: PCR analysis revealed that four isolates harbored bla GES; DNA sequencing showed that two harbored bla GES-1 and two bla GES-11. Beta-lactamase genes bla SPM-1, bla IMP, bla VIM, and bla KPC were investigated; none of these genes was detected. Automated susceptibility testing methods (Vitek®2, bioMérieux) showed that the bla GES-1-positive isolates were only susceptible to polymyxin B. The patterns obtained with ERIC-PCR methods showed clonal relationship between the two isolates that harbored bla GES-11, whereas different clonal profiles were found in the isolates harboring bla GES-1. CONCLUSIONS: We detected the presence of bacterial isolates positive for two different variants of the enzyme GES in three different hospitals from Recife, Brazil. These enzymes have a great capacity for dissemination among Gram-negative bacteria and confer broad-spectrum resistance to beta-lactam antibiotics and to the carbapenems.

OBJETIVO: Testar se os indivíduos com escores z de estatura para idade entre -2 e -1 apresentam maior porcentagem de gordura corporal e, portanto, não devem ser classificados como tendo estado nutricional normal. MÉTODOS: Foram estudados 96 indivíduos (52 meninos e 44 meninas, 57% púberes). A composição corporal foi analisada por absortometria radiológica de dupla energia. RESULTADOS: O percentual de gordura abdominal em meninas pré-púberes com baixa estatura foi maior (27,4%; p = 0,01) quando comparado ao grupo com estatura normal (20,6%). Diferenças semelhantes na gordura abdominal (%) foram observadas para as meninas e meninos púberes com baixa estatura e estatura normal (37,6 e 29,8%, p = 0,01; 24,6 e 15,7%, p = 0,01, respectivamente). Os percentuais de gordura corporal total das meninas pré-púberes e dos meninos púberes com baixa estatura foram superiores (29,9 e 24,5%, p = 0,03; 26,3 e 18,1%, p = 0,01, respectivamente) aos dos grupo com estatura normal. Os grupos com estatura normal apresentaram menor circunferência da cintura. CONCLUSÃO: Adolescentes com baixa estatura leve apresentam alterações na composição corporal, indicando aumento do risco para doenças metabólicas.

OBJECTIVE: To determine the impact of transferring a pediatric population to mechanical ventilator dependency units (MVDUs) or to home mechanical ventilation (HMV) on bed availability in the pediatric intensive care unit (ICU). METHODS: This is a longitudinal, retrospective study of hospitalized children who required prolonged mechanical ventilation at the MVDU located at the Hospital Auxiliar de Suzano, a secondary public hospital in São Paulo, Brazil. We calculated the number of days patients spent at MVDU and on HMV, and analyzed their survival rates with Kaplan-Meier estimator. RESULTS: Forty-one patients were admitted to the MVDU in 7.3 years. Median length of stay in this unit was 239 days (interquartile range = 102-479). Of these patients, 22 came from the ICU, where their transfer made available 8,643 bed-days (a mean of 14 new patients per month). HMV of eight patients made 4,022 bed-days available in the hospital in 4 years (a mean of 12 new patients per month in the ICU). Survival rates of patients at home were not significantly different from those observed in hospitalized patients. CONCLUSION: A hospital unit for mechanical ventilator-dependent patients and HMV can improve bed availability in ICUs. Survival rates of patients who receive HMV are not significantly different from those of patients who remain hospitalized.

Staphylococcus aureus is the main human pathogen that colonizes individuals in general population. The objective of the study was evaluate the epidemiological and sensitivity profile of S. aureus lineage, isolated in health care workers (HCW) of a University Hospital in Pernambuco state, Brazil. Biological samples of hands and nasal cavities were sown in agar sheep blood. Colonies under suspicion of being S. aureus were identified using Gram staining, catalase test and coagulase, mannitol-salty agar fermentation and DNAse agar. The resistance to mupirocin was analyzed through the Kirby Bauer technique. In relation to methicillin and vancomycin the determination was by the minimum inhibitory concentration method (E-test). From the 202 HCW evaluated, 52 were colonized by S. aureus (25,7%). The factors associated to the colonization by S. aureus were: age-group, professional category, use of individual protection equipments (frequency and numbers). All S. aureus isolate lineages were sensitive to mupirocin and vancomycin, and three of them were identified as methicillin-resistant. The prevalence of MSSA and MRSA among HCW was considered low and was below the results described in the literature. The isolate S. aureus lineages have shown low resistance profile.

A monitoração de vários interferentes nos resultados das análises clínicas laboratoriais originados do sistema de transporte de amostras biológicas de um posto de coleta para o local da fase analítica propriamente dita é de extrema importância. Com o objetivo de avaliar a estabilidade dos bioanalitos durante o transporte, os autores, neste trabalho, monitoraram a temperatura das caixas térmicas. Através de dispositivos medidores de temperatura (chips) introduzidos no interior de cada caixa térmica, observou-se que elas permaneceram climatizadas em torno de 13º a 23ºC, simulando a temperatura ambiente por todo o percurso e tempo necessários. Compararam-se os resultados de análises clínicas laboratoriais das amostras biológicas sem transporte realizadas no laboratório de origem da coleta (Jundiaí) com os das mesmas amostras biológicas com transporte realizado na central em São Paulo. Inicialmente foram estudados os principais parâmetros bioquímicos e a coagulação do sangue, além da urinálise com bacteriologia. A análise estatística foi de concordância entre as duas médias através do coeficiente de correlação intraclasse e também pela técnica de Bland-Altman, na qual se observou que, entre os 29 analíticos estudados, 23 (79,3%) apresentaram concordância boa a excelente; cinco (17,2%), moderada a boa; e uma (3,5%), fraca a moderada. Quanto às uroculturas, elas apresentaram 88% de concordância, portanto boa a excelente, e a urina I apresentou 94% de concordância na hematúria e 87,5% na leucocitúria, também boa a excelente. Os dados obtidos pelas correlações dos resultados das amostras e dos gráficos de temperatura emitidos pelos dispositivos registradores representaram indicadores de validação do sistema de transporte e das análises laboratoriais em até 16 horas após coleta do material, simulando um posto muito distante.

The results obtained from biological sample analysis may be affected by several factors, among them, the conditions of samples transportation from the site of collection to the central laboratory.The aim of this paper was to verify the stability of the samples submitted to the transportation process (from Jundiaí to São Paulo) by comparing the results of 29 clinical laboratory parameters (including microbiology tests) on the same samples submitted or not to transportation. First, we verified the temperature inside a transportation box, during the routine the from Jundiaí to São Paulo, by introducing a special chip able to register it continuously. We observed that the temperature inside the box was kept between 13ºC and 23ºC (similar to room temperature). After that, samples were collected in Jundiaí and divided in two aliquots; one to be analysed at the laboratory in São Paulo. The methodology, apparatus and reagents used on the samples analysis were the same at both laboratories. The statistical analysis showed concordance between both averages trough correlation coefficient "intra-class" and by the "Blan-Altman methods". It was observed that among the 29 parameters: 23 (79,3%) showed good to excellent. On the data from urinalysis we observed a good to excellent concordance in the urocult (88.0%), and as well in the urine I analysis. The data obtained by the correlation between the laboratory results and the graphics of temperature registered by chip are strong indicative of validation of our laboratorial analysis and transportation system, up to 16 hours sample collection.

As concentrações de nutrientes das folhas e do sedimento e a capacidade de acumulação de elementos químicos dos tecidos foliares das espécies Avicennia germinans (L.) Stearn., Avicennia schaueriana Staft & Leechm., Laguncularia racemosa (L.) Gaertn. f. e Rhizophora mangle L. foram analisadas em quatro estações de estudo no manguezal do estuário do Rio São Mateus, no Estado do Espírito Santo. De modo geral, os elementos determinados no sedimento seguiram a ordem: Mg > Ca > Fe > K > Mn > P > Zn > Cu, apresentando variações inter e intraespecíficas. No tecido foliar, as espécies de Avicennia apresentaram maiores teores de N, K e Mg e menores concentrações de Ca. Rhizophora mangle exibiu maior concentração de Mn e Laguncularia racemosa, maior teor de Fe em relação às demais espécies. Os resultados demonstraram que a concentração de nutrientes do sedimento refletiu a influência da granulometria neste compartimento. O acúmulo de nutrientes nas folhas variou de acordo com a espécie e estação de estudo, mas não refletiu as concentrações do sedimento. Os dados confirmaram o papel do manguezal como barreira biogeoquímica ao trânsito de metais pesados. Entretanto, torna-se desejável uma amostragem periódica para um melhor entendimento da dinâmica de nutrientes.

We analyzed nutrient concentrations in leaves and sediments, and element accumulation capacity in foliar tissues of Avicennia germinans (L.) Stearn., Avicennia schaueriana Staft & Leechm., Laguncularia racemosa (L.) Gaertn. f. and Rhizophora mangle L. in four sites along the São Mateus River estuary mangrove, Espírito Santo State, SE-Brazil. In sediment, elements decrease following the sequence: Mg > Ca > Fe > K > Mn > P > Zn > Cu and showed inter and intraespecific variation. Avicennia leaves showed the greatest N, K and Mg concentrations and lowest Ca concentrations. Rhizophora mangle presented the greatest Mn concentration, and Laguncularia racemosa the greatest Fe level. Sediment nutrient concentrations reflected the influence of granulometry in this compartment. Nutrient accumulation in leaves varied according to species and study site but it was not correlated with sediment concentrations. Results confirmed the mangrove role as a biogeochemistry barrier blocking heavy metal up to tropical coastal areas. However, it is necessary periodic sampling so that it can be possible a better understanding of the nutrient dynamic.

Um projeto piloto para o controle da filariose bancroftiana foi desenvolvido em duas áreas do Recife, com índices iniciais de prevalência de microfilaremia de 10%. Nas duas áreas, foi aplicado tratamento em massa com doses baixas de dietilcarbamazina. Em uma das áreas, esse tratamento foi associado ao controle do vetor, integrando medidas físicas, como o uso de camadas flutuantes de esferas de poliestireno, ao tratamento periódico dos criadouros com a bactéria entomopatógena Bacillus sphaericus. Como resultado, a densidade populacional do vetor, da ordem de sessenta a 120 Culex/quarto/noite antes das intervenções, foi drasticamente reduzida, mantendo-se, durante dois anos, em valores entre quatro e 16 Culex/quarto/noite. Neste contexto, as ações para envolver a comunidade escolar local no controle do vetor resultaram na realização de atividades curriculares e extraclasses, culminando com a participação efetiva de grupos de alunos ("Vigilantes de Vetores") na aplicação das medidas de controle e na divulgação de conhecimentos básicos sobre a biologia do Culex quinquefasciatus. O entusiástico envolvimento de professores e alunos mostrou ser a escola um espaço aberto à participação em programas desta natureza.

A pilot study for the control of Bancroftian filariasis transmission was developed in two areas of Recife, Brazil, where microfilaraemic prevalence was 10% in 1991. Mass treatment with diethylcarbamazine (DEC) using low and spaced doses was employed in both areas. In one such instance, DEC therapy was associated with vector control using physical measures and periodic treatment of Culex breeding sites with the entomopathogen Bacillus sphaericus. The vector population density, reaching 60 120 Culex/room /night before the intervention, was drastically reduced to 4 16 Culex/room/night, and maintained at this level for more than two years. Actions to engage the local school community in the vector control process were implemented, and as a consequence several classroom and extracurricular activities were put into practice, culminating with the effective participation of a team of students called the "Vector Vigilantes", in the application of control measures against the vector. The enthusiastic involvement of schoolteachers and students pointed to schools as a place amenable to programs such as this.

Um projeto piloto para o controle da filariose bancroftiana foi desenvolvido em duas áreas do Recife, com índices iniciais de prevalência de microfilaremia de 10%. Nas duas áreas, foi aplicado tratamento em massa com doses baixas de dietilcarbamazina. Em uma das áreas, esse tratamento foi associado ao controle do vetor, integrando medidas físicas, como o uso de camadas flutuantes de esferas de poliestireno, ao tratamento periódico dos criadouros com a bactéria entomopatógena Bacillus sphaericus. Como resultado, a densidade populacional do vetor, da ordem de sessenta a 120 Culex/quarto/noite antes das intervenções, foi drasticamente reduzida, mantendo-se, durante dois anos, em valores entre quatro e 16 Culex/quarto/noite. Neste contexto, as ações para envolver a comunidade escolar local no controle do vetor resultaram na realização de atividades curriculares e extraclasses, culminando com a participação efetiva de grupos de alunos ("Vigilantes de Vetores") na aplicação das medidas de controle e na divulgação de conhecimentos básicos sobre a biologia do Culex quinquefasciatus. O entusiástico envolvimento de professores e alunos mostrou ser a escola um espaço aberto à participação em programas desta natureza.

A pilot study for the control of Bancroftian filariasis transmission was developed in two areas of Recife, Brazil, where microfilaraemic prevalence was 10% in 1991. Mass treatment with diethylcarbamazine (DEC) using low and spaced doses was employed in both areas. In one such instance, DEC therapy was associated with vector control using physical measures and periodic treatment of Culex breeding sites with the entomopathogen Bacillus sphaericus. The vector population density, reaching 60 120 Culex/room /night before the intervention, was drastically reduced to 4 16 Culex/room/night, and maintained at this level for more than two years. Actions to engage the local school community in the vector control process were implemented, and as a consequence several classroom and extracurricular activities were put into practice, culminating with the effective participation of a team of students called the "Vector Vigilantes", in the application of control measures against the vector. The enthusiastic involvement of schoolteachers and students pointed to schools as a place amenable to programs such as this.

Com o objetivo de conhecer p estabelecimento e duração do aleitamento materno total e exclusivo em comunidades rurais do Semi-Árido Baiano, Brasil, foram estudadas 226 crianças de O a 2 anos de idade, filhas de pequenos produtores rurais que vivem numa das regiões mais secas do nordeste brasileiro, de pobreza absoluta. Os dados referem-se a todas as crianças da família que à data do estudo tinham até 2 anos de idade. Os dados foram coletados por meio de formulários aplicados às mães ou responsáveis pelo menor, no período de 1988 a 1989. A tábua de vida foi o recurso estatístico utilizado para o cálculo da duração mediana do evento. Das 226 crianças que integraram o estudo, 91,6 iniciaram a amamentação ao peito. A duração mediana do aleitamento total foi de 90,28 dias e o aleitamento exclusivo apresentou duração mediana de 0,1 dia. Ainda que o estabelecimento da amamentação ao peito possa ser considerado alto, a duração mediana do aleitamento total foi extrememente curta, e o aleitamento exclusivo foi desprezível.

A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breastfeeding presented a median duration of 0.1 day. Through the establishment of breast-feeding can be considered high, the median duration of total breast-feeding is extremely short and that of exclusive breast-feeding insignificant.

Com o objetivo de conhecer p estabelecimento e duração do aleitamento materno total e exclusivo em comunidades rurais do Semi-Árido Baiano, Brasil, foram estudadas 226 crianças de O a 2 anos de idade, filhas de pequenos produtores rurais que vivem numa das regiões mais secas do nordeste brasileiro, de pobreza absoluta. Os dados referem-se a todas as crianças da família que à data do estudo tinham até 2 anos de idade. Os dados foram coletados por meio de formulários aplicados às mães ou responsáveis pelo menor, no período de 1988 a 1989. A tábua de vida foi o recurso estatístico utilizado para o cálculo da duração mediana do evento. Das 226 crianças que integraram o estudo, 91,6 iniciaram a amamentação ao peito. A duração mediana do aleitamento total foi de 90,28 dias e o aleitamento exclusivo apresentou duração mediana de 0,1 dia. Ainda que o estabelecimento da amamentação ao peito possa ser considerado alto, a duração mediana do aleitamento total foi extrememente curta, e o aleitamento exclusivo foi desprezível.

A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breastfeeding presented a median duration of 0.1 day. Through the establishment of breast-feeding can be considered high, the median duration of total breast-feeding is extremely short and that of exclusive breast-feeding insignificant.