RCAAP Repository

To talk about the constructed images of Luiz Carlos Prestes and Olga Benario is the main reason of this research. The biographies O Cavaleiro da Esperança: a vida de Luiz Carlos Prestes, written by Jorge Amado and Olga, written by Fernando Morais are the main sources that joined by other literary works from Amado and several documents complete the sources for this research. Organized in six parts including the initial and final considerations the whole text is composed by four themes. The first part reflects the representative images about Prestes and Olga in the contemporary age seen by the named Brazilian left and by the couple s daughter Anita Leocadia Prestes. Besides it includes and analyses the several historical interpretations already concluded about the characters. The second, third and fourth approach refer specially to the representations done through the biographies already mentioned. The second approach reflects at first the biographers outlook having the analyzed works as important marcs in the literary life of the writers. Furthermore, the political relevance credited to the texts due to the historical moment of their productions is also studied. Afterwards the limits between history and literature are mentioned checking the details of the biographic gender and its claiming of true narrative that in the case of the approached writers is the expression of a power project. The third theme turns into analyze about memories understanding how the subjective reasons / affectivities are streamlined at the biographies written. Finally we debate identity observing at first place that Amado and Morais hold common similarities within the literary writers and interpreters of the Brazilian national identity and afterwards analyzing the nostalgic elaborations of the characters viewing stimulate the readers to (re)elaborate the image of the identity characteristics of the Brazilian people.

Allergic rhinitis (AR) represents a global health problem and its prevalence has increased in the last years. The aim of this study is to evaluate the cytokine profile in nasal lavage fluid and the clinical alterations in children with AR after different drugs treatment. This is a prospective randomized open study; twenty-eight children aged from six to twelve years with moderate persistent AR were selected and randomly distributed in three groups of treatment during four weeks with nasal corticosteroid (mometasone), anti-leukotriene (montelukaste), and antihistamine (desloratadine). A daily symptoms score card was filled and the parent s perception of improving was verified. Samples of nasal lavage fluid, before and after treatment, was collected for measuring IL-5, IFN-&#947;, IL-10 e TGF-&#946; by immunoassay (ELISA). There are no differences in symptoms by daily score cards, although all parents referred good or excellent improvement of symptoms perception, with significant difference favorable to mometasone group (p<0.05). Only the group treated with mometasone showed a reduction in IL-5 levels. There are no differences in the levels of IFN-&#947; and TGF-&#946;, while IL-10 levels were above the detection limits. It can be concluded that the group treated with mometasone showed improvement of clinical symptoms as well as reduction in IL-5 levels in the nasal lavage fluid of children with allergic rhinitis.

Application of Taenia saginata metacestodes as alternative antigen is an important alternative for neurocysticercosis (NC) serodiagnosis. The cross reaction with Echinococcus granulosus infection occurred in homologous and heterologous antigens, and could be avoid with different purified methods. This study analyzed antigen fractions obtained from crude saline extract of T. saginata metacestodes purified by affinity chromatography with the lectin jacalin (unbound and bound fraction), concanavalin A (unbound and bound fraction), concanavalin A using jacalina unbound fraction (unbound and bound fraction) and N-acetil (unbound and bound fraction). The fraction were tested for the detection of IgG antibodies by enzyme linked immunosorbent assay (ELISA) and immunoblot for the laboratory diagnosis of human NC. The application of T. saginata metacestodes as an alternative antigen for use in ELISA and WB tests compared with the metacestodes antigen of Taenia solium in CFS samples was also analyzed. Serum samples were obtained from 142 individuals: 40 were diagnosed with NC, 62 presented Taenia sp. and other parasitic diseases and 40 were apparently healthy individuals. The CSF samples were obtained from 35 patients with definitive neurocysticercosis; and 35 patients with other neurological disorder. Among the fractions, unbound concanavalin A demonstrated statically higher sensitivity and specificity by ELISA (90% and 93.1 %, respectively). By Immunoblot, the concanavalin unbound showed 100% of sensitivity and specificity, where only serum samples from patients with NC recognized the protein of 64-68 kDa, so this antigen fraction may be used as specific antigen for diagnosis of NC. The sensitivity and specificity of ELISA using antigen obtained from T. solium applied to CSF samples results of 100%. When the tests were conducted using T. saginata metacestodes, results were 100% and 94.3%, respectively. The 47-52, 64-68 and 70 kDa antigens were recognized by only CSF samples from patients with NC. The results indicated that T. saginata metacestodes can be used as alternative antigen for NC diagnosis using LCR samples.

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Kidney failure is an important cause of morbidity and mortality, frequently associated with chronic inflammation of glomeruli and immune hypersensitivity reactions. In this study we aimed to determine if there was an association between HLA alleles and end stage kidney diseases. Towards this objective, we analyzed 87 patients with an average age of 51 years and a mean of 4.5 years of hemodialysis. The main clinical diagnosis of kidney failure in this group was hypertension (38%), diabetes (25%) and glomerulopathies (23%). As a control, we utilized the HLA typing data of 17,541 voluntary marrow donors from the Brazilian national registry. HLA typing was determined by SSO kits (One Lambda, Inc.) and flow cytometry (Luminex technology). Our results demonstrated that, when compared to the normal population, there was a significant association of: 1) hypertension with HLA-A*23 (p=0.014), HLA-A*30 (p<0.001) and HLA-B*41 (p=0.016); 2) diabetes with HLA-A*23 (p=0.004), HLA-A*30 (p=0.033), HLA-B*41 (p=0.023), HLA-B*81 (p=0.020), HLADRB 1*1 (p=0.030) and HLA-DRB1*3 (p=0.013); and 3) glomerulopathies with HLA-A*32 (p<0.001), HLA-B*13 (p<0.001), HLA-B*14 (p=0.004), HLA-DRB1*4 (p=0.030), HLADRB 1*11 (p=0.008) and HLA-DRB1*15 (p<0.001). There was an association between allele frequency and protection against kidney disease in the following situations: 1) hypertension with HLA-A*3 and HLA-DRB1*4; 2) diabetes with HLA-DRB1*11; 3) glomerulopathies with HLA-DRB1*1 and HLA-DRB1*13. In conclusion, HLA alleles may be an important marker of prognosis in chronic renal disease.

Health care-associated infection is a major cause of morbidity, mortality and increase costs in hospital and hands of health care workers are important reservoirs of nosocomial transmission of Staphylococcus aureus. Although hand hygiene remains as the method of simple and effective prevention, compliance to this practice is very low. Multimodal interventions in a strategy to promote hand hygiene are used successfully in developed countries, but information is scarce in Brazilian hospitals and developing countries. The aim of this study was to evaluate the impact of an intervention on hand hygiene in the prevalence of nosocomial infection and infection and colonization by S. aureus, or both, in a university hospital in Brazil, between February 2006 and July 2008. Hand hygiene compliance was assessed by direct observation and analyzed together with the prevalence of nosocomial infections, including infection or colonization by S. aureus resistant (MRSA) and susceptible to methicillin (MSSA), before and after an educational intervention, using posters, colored stickers, and feedback of results, in the wards of Internal Medicine, Surgery, Pediatrics, ICU adult and nursery high-risk (BAR) . Cultures of the hands of health care workers were conducted to verify their contamination by S. aureus. A total of 427 opportunities for hand hygiene was observed, with compliance of about 20% in units of care with adult patients, 24% in pediatric and 43% in neonatal, frequencies not varied in post-intervention, except in the BAR when hand hygiene compliance increased significantly, with 25% decrease in rates of nosocomial infection and 50% in colonization by MRSA. In assessing the contamination of the hands of health care workers was isolated 18% of S. aureus after the care of patients infected and colonized. The research showed a combination of high rates of nosocomial infection and poor compliance to hand hygiene, even after intervention, with the exception noted in the BAR. This failure could be due, in hospitals of developing countries, the shortage of human and financial resources, weak policies of hospital management and particularly with issues relating to education and motivation of the health care workers. However the success of the intervention occurred in the neonatal unit, where the participation of leadership was more evident is a hope of obtaining better results when the approach to such complex issues.

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House dust mites as Dermatophagoides pteronyssinus (Dp) are considered important allergen sources for sensitization of genetically predisposed subjects. Several allergens are commonly constituted by glycoconjugates that may have affinity with lectins, such as Concanavalin A (ConA). The aim of this study was to evaluate IgE, IgG1 and IgG4 reactivity to ConA-related components from Dp extract in allergic and non-allergic subjects. ConA-bound and ConA-unbound components were obtained from Dp crude extract after fractionation on ConA-Sepharose affinity chromatography and all extracts were evaluated by ELISA and immunoblotting for detection of IgE, IgG1, and IgG4 in sera from 95 mite-sensitized patients (DP+)and 92 non-allergic (NA) subjects. In DP+ patients, IgE and IgG1 seropositivity to crude Dp extract was higher (100% and 84,2%, respectively) than to ConA-related extracts, while IgG4 seropositivity was higher to ConA-bound Dp (83,2%) as compared to other Dp extracts. Interestingly, IgG4 seropositivity to ConA-related Dp extracts, especially ConA-bound Dp, was higher in DP+ than NA subjects. Inhibition ELISA for all antibody isotypes showed a high (>80%) cross-reactivity between crude Dp and ConA-related extracts or D. farinae extract (>70%). However, partial inhibition for IgG1 (67%) and IgG4 (33%), but not for IgE, was found when using Blomia tropicalis extract. Immunoblotting revealed immunodominant bands recognized by IgE (14 and 25 kDa) and IgG4 (25 and 88 kDa) mostly in crude Dp and ConAunbound extracts, whereas IgG1 recognized bands above 78 kDa mainly in crude Dp extract. ConA-bound and ConA-unbound Dp extracts demonstrate high crossreactivity and are constituted by components that are able to induce IgE synthesis in allergic patients, and IgG1 and IgG4 in allergic and non allergic subjects.

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Cardiac surgery with cardiopulmonary bypass is considered a major cause of systemic inflammatory response, and may have important clinical implications. Analysis of the level of inflammation and myocardial injury may be useful to determine prognosis. Homocysteinemia has been related to the physiopathology of cardiovascular diseases, and may be linked to the mechanisms of oxidative stress. The aim of this study was to determine the concentration of homocysteine and other inflammation and myocardial injury markers in pediatric patients with congenital heart disease who were submitted to cardiac surgery. In addition, the relation between homocysteine and clinical and surgical variables in this group of patients was also analyzed. A total of 29 patients were prospectively studied. Serum levels of homocysteine, inflammation markers (absolute number of white blood cells and band cells and C-reactive protein) and myocardial injury markers (creatine kinases and troponin T) were assessed at three different moments: D0 preoperatively (control), D1 immediately postoperatively (upon admission to the pediatric ICU) and D2 three days after surgery. Averages of homocysteine were, respectively, 7.53  0.51 M at D0, 9.43  0.66 M at D1 and 8.12  0.60 M at D2. Variation in homocysteine levels was not related to the type of congenital heart disease. Cardiopulmonary bypass led to an increase in homocysteine levels, which was not related to duration of the procedure, cardiopulmonary bypass or aortic clamping. Levels of inflammation and myocardial injury markers also increased immediately postoperatively in response to the surgical procedure. A positive correlation was observed between homocysteine and C-reactive protein three days after surgery. In conclusion, serum levels of homocysteine, inflammation markers and myocardial injury markers increase immediately postoperatively in patients with congenital heart disease submitted to cardiac surgery. Increased homocysteine levels are related to cardiopulmonary bypass and increased C-reactive protein levels. However, increased homocysteine levels are not related to any of the other markers studied.

Cutaneous leishmaniasis caused by Leishmania (L.) amazonensis is largely distributed throughout the country and can manifest as severe and disseminated lesions in man and other animals. During microorganism invasion phagocytes are activated and one of the signs of this activation is the phosphorylation of specific substrates by the enzyme phosphatidylinositol-3- kinase (PI3K), which is in its turn activated by a variety of extracellular signals, generating lipid products that will serve as mediator in signal transduction downstream. During parasite invasion of the host cells there is recruitment of cytoskeleton proteins to form a phagosome, followed by fusion with lysosomes to generate the phagolysosome, where the parasites will thrive. Modulation of PI3K signaling pathways by parasites are important strategies for the establishment of the infection and intracellular survival of intracellular parasites. In this study we aimed to investigate the maturation of the phagolysosome of L. (L.) amazonensis through the labeling of F-actin and LAMP-1, as well as to determine the role of PI3K on the invasion process by L. (L.) amazonensis. Murine peritoneal macrophages treated or not with wortmannin (an inhibitor of the PI3K pathway) were infected with L. (L.) amazonensis promastigotes. To validate the role of this pathway by this species of Leishmania, macrophages were transfected with GFP-PLC-&#948;-PH plasmid, which has homology with PI(4,5)P2, a component of the PI3K pathway, after which they were infected. Our results demonstrated that, during the maturation of L. (L.) amazonensis phagosomes, there was initially F-actin recruitment to the nascent phagosome/endosome, which disappeared after fusion with lysosomes, as shown by the recruitment of LAMP-1, a lysosomal marker. The processes of invasion and lysosomal fusion of L. (L.) amazonensis demonstrated a clear dependency of PI3K activity, as it was demonstrated by the inhibition of these processes by the PI3K inhibitor wortmannin.

Neurocysticercosis (NC) is a polymorphic disease and the immune response in human carrier is heterogenic. In this study, 35 primers were used for amplifications by Random Amplified Polymorphic DNA (RAPD) of Taenia solium metacestodes, from five different geographic areas in Brazil: 1) Distrito Federal (DF), Center West; 2) Barreiras (BA), Northeast and Southeast; 3) Hydro Basin of the Mosquito River (North of Minas Gerais, RM-MG), 4) São Paulo (SP) and 5) Uberaba (Minas Gerais, UB-MG). Metacestodes saline crude extracts of four populations (DF, BA, RM-MG e SP) were used for the detection of specific IgG antibodies by ELISA and Western Blotting (WB). A total of 157 serum samples of three groups, (G1): 49 NC patients; (G2): 68 patients with other helminthiasis: hydatidosis (10), taeniasis (20), strongyloidiasis (20), schistosomiasis (10) and hymenolepiasis (8); and (G3): 40 healthy individuals; were analyzed by ELISA. From these, the 98 serum samples were assayed by WB; G1 (49), G2 (39) and G3 (10). The genetic distances, in disagreement percentage, between the metacestode populations were calculated from of 15 RAPD markers and showed 49.5% (DF), 48% (BA), 38.5% (UBMG) and 28% (RM-MG and SP) of genetic distances. Six primers identified polymorphic fragments and the primers 26 (GGGTTTGGCA) and 29 (TCGCCAGCCA) allowed a better differentiation of populations. The fragments of 1000, 500 and 326 pb (pairs of bases) in the UB-MG and of 600 and 244 pb in RM-MG were amplified by primer 26. The fragments generated by primer 29 were 500, 800 and 1191 pb, 300 and 1377 pb, 1000 pb and 244 and 434 pb in SP, UB-MG, DF and BA populations, respectively. In G1, the positivity by ELISA was: 90% (DF), 69% (BA), 71% (MG) and 67% (SP). The DF extract was more antigenic than others (p=0.02). In WB, the 64-68 kDa antigens were recognized in all extracts, exclusively, in serum samples from active NC patients (p=0.001). Variation in banding pattern was detected between the extracts (p<0.05). In G2, the serum samples of hydatidosis patients presented from 70 to 90% positivity by ELISA in antigenic extracts (p<0.05); however, the bands recognition pattern in WB was different from that presented in G1 samples. The 77 kDa band was significantly identified in hydatidosis samples (p=0.0001). In conclusion, the T. solium populations analyzed showed genetic variability and antigenic differences.

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In the present work it was studied: the morphological and ultrastructural characteristics of mast cells located in the peritoneal cavity of BALB/c and C57BL/6 mice and morphological and ultrastructural alterations of these mast cells after 24 and 48 hours of infection with RH strain of T. gondii; the number of the mast cells, neutrophils, macrophages and lymphocytes from peritoneal cavity of BALB/c and C57BL/6 mice after 24 and 48 hours of infection with RH strain of T. gondii, by optical microscopy; the morphological characteristics of mast cells located in the small intestine of BALB/c and C57BL/6 mice; and the morphological and quantitative features of mast cells located in the small intestine of BALB/c and C57BL/6 mice after 8 days of infection with ME-49 strain of T. gondii and/or treated with 48/80 compound; the histopathological changes of the small intestine BALB/c and C57BL/6 mice after 8 days of infection with ME-49 strain of T. gondii and tissue parasitism in this organ, liver and brain from BALB/c and C57BL/6 mice after 8 days of infection with ME-49 strain of T. gondii and/ or treated with 48/80 compound, by immunohistochemistry. The light and transmission electron microscopy analysis revealed that the mast cells from the peritoneal exsudate of BALB/c and C57BL/6 mice, presented similar characteristics like shape, cytoplasmic granules quantity and feature. Similarity, mast cells from the peritoneal exsudate of BALB/c and C57BL/6 T. gondii infected mice, presented similar characteristics between both lineages of mice. The light microscopy analysis showed an increased number of mast cells, neutrophil and macrophage in peritoneal exsudate of BALB/c mice after 24 hours of infection with RH strain of T. gondii, these influx didn t occurr in C57BL/6 lineage. The number of mast cells in the small intestine from BALB/c mice was superior than the number of mast cells observed in the small intestine from C57BL/c mice. The number of parasitized field in the small intestine was superior in C57BL/6 mice. These results reveals the role of the mast cells in the mechanisms of regulation of the inflammatory response against T. gondii and may be related with their sensitivity or resistance of the both mice lineage, BALB/c and C57BL/6. After comparison between mice lineage, BALB/c and C57BL/6, it was observed that the lymphocytes number was statistically significant after 24 and 48 hours of PBS inoculation in C57BL/6 mice s peritoneal exsudate. The light microscopy analysis from the different regions of the small intestine, duodenum, proximal jejunum, distal jejunum and ileum, of BALB/c and C57BL/6 mice showed that mast cells were found, preferentially, in the submucosa and muscle stratum. By light microscopy, mast cells from the small intestine of BALB/c and C57BL/6 mice after 8 days of infection with ME-49 strain of T. gondii, presented different characteristics in the quantity and shape of the cytoplasmic granules. The number of mast cells from the small intestine of BALB/c and C57BL/6 after 8 days of infection with ME-49 strain of T. gondii, presented superior in BALB/c mice. The mast cells were, preferentially, located in the duodenum form BALB/c and C57BL/6 mice infected or not infected. The histopathology analysis, after 8 days of infection with ME-49 strain of T. gondii, showed an inflammatory infiltrated more intense in the small intestine from C57BL/6 mice. T. gondii was found in the small intestine, liver and brain from BALB/c and C57BL/6 mice after 8 days of infection with ME-49 strain of T. gondii, and/or treated with 48/80 compound by immunohistochemistry. In the small intestine of BALB/c mice the number of mast cells doesn t change after 8 days of infection with ME-49 strain of T. gondii, and after 12 days of treatment with 48/80 compound.

Toxoplasma gondii and Neospora caninum are two closely related apicomplexan parasites, even though phylogenetic, ultrastructural, antigenic and biological differences have been already described. Seroepidemiological studies have demonstrated that T. gondii infection is often in domestic and sylvatic canids, whereas N. caninum infection is less common, but it is epidemiologically relevant because dogs and coyotes are their definitive hosts. This thesis is consisted of five studies on T. gondii and N. caninum infection in dogs (Canis familiaris) and maned wolves (Chrysocyon brachyurus) conducted in the Immunoparasitology Laboratory, Federal University of Uberlândia, with emphasis on seroepidemiology and immunodiagnosis. Different antigen preparations and various serological tests, such as indirect hemagglutination test (IHAT), indirect fluorescence antibody test (IFAT), immunoenzymatic test (ELISA), immunoblotting and immunoprecipitation were developed and employed in different dog and maned wolf populations. The first study established the optimal cut off titers in IFAT (1:16) and ELISA (1:64) for the detection of IgG antibodies to T. gondii in dogs by using the twograph receiver-operating characteristic (TG-ROC) curve and considering the reactivity to the major surface antigen SAG1 as infection marker. The second study developed a capture IgMELISA using heterologous antibodies (anti-human IgM) and showed a transient IgM profile in canine acute toxoplasmosis, whereas the kinetics of IgG antibodies to T. gondii in dogs revealed an early and long-time immune response. T. gondii was demonstrated by mouse bioassay and immunohistochemical assay only from dogs with fatal toxoplasmosis. The third study showed that seropositivity to N. caninum (6.7%) was lower than to T. gondii (36%) in dogs with clinical symptoms, including animals with co-infection (3.1%). The fourth study established the optimal cut off titers in IFAT (1:50) and ELISA (1:200) for the detection of IgG antibodies to N. caninum in dogs by using TG-ROC curve, but ELISA showed low specificity. Immunodominant antigens of N. caninum, especially those below 35 kDa, were weakly inhibited by T. gondii antigens in inhibition immunoblotting, indicating that they are more species-specific antigens. The fifth study showed the occurrence of antibodies to N. caninum in maned wolves (8,5%), even though in lower proportion as compared to T. gondii (74.6%), by using homologous (anti-wolf IgG), heterologous (anti-dog IgG) or affinity (Protein A) conjugates in ELISA or IFAT. Altogether, it can be concluded that the diagnosis of T. gondii infection in dogs should be based on the combination of serological tests, particularly IFAT and ELISA, with emphasis in the determination of antibody titers and classes, such as specific IgM, which was efficiently detected by capture IgM-ELISA using heterologous antibodies. N. caninum infection can be present in dogs from Uberlândia city and should be considered in the differential clinical diagnosis with T. gondii in dogs presenting clinical signs, by using preferentially IFAT and immunoblotting to detect immunodominant antigens. The occurrence of antibodies to T. gondii and N. caninum in maned wolves could be evaluated by homologous, heterologous and affinity conjugates, indicating a relevant exposure of this species to T. gondii and, in lower extension, to N. caninum.

Paracoccidioidomycosis is one of the most prevalent systemic mycosis in Latin America, including Brazil. It is caused by chronic infection with Paracoccidioides brasiliensis, a thermally dimorphic fungus. Calomys callosus, Rengger 1830 (Rodentia, Cricetidae), is a wild rodent found in Central Brazil and has been shown to be susceptible to experimental infection with P. brasiliensis. The objective of this work was to study the clinicopathological aspects of this experimental infection in Calomys. callosus infected with 0.6 x 105 yeast isolated from P. brasiliensis (strain Pb18) and to compare it with two others susceptible animals: A / Sn and B10.A mice. For this, five animals from each group were sacrificed at 7, 15, 30, 60, 90 and 120 days post inoculation (d.p.i.). Samples of the lung, liver and spleen were processed for mycological examination to determine the number of counts of colony forming units (CFU) as well as for histopathological examination using hematoxilyn and eosin (H&E), reticulin Gomori, trichromic (Masson), and Grocott´s stains. Blood samples from each mice were collected from orbital venous plexus and used to detect IgG and IgM specific anti-P. brasiliensis by ELISA. To determine of survival post-infection, others eight animals from each group was used. The mortality rate was higher in C. callosus than A / Sn and B10.A mice, being all deaths occurring up to 118 d.p.i. IgM levels tended to rise in all groups, but in B10.A mice and Calomys callosus groups, the level of IgG was significantly elevated during the all experimental period. Granulomatous lesions were observed in the roots of all animal groups and all granulomas were composed by Langhans giant cells, epithelioid cells, macrophages, lymphocytes, plasma cells, eosinophils, and necrosis. In C. callosus, the development of granulomas in lung was observed with 15 d.p.i. and exhibited extensive necrosis, especially at the end of the experiment. The presence of granulomas in liver was detected with seven d.p.i. in all animals, but the extensive necrosis was observed especially in samples of Calomys callosus. Similar pattern was also observed in spleen samples. In addition, in Calomys callosus the granulomatous lesions were more extensive in lung and spleen than in liver. The assessment of differential deposition of collagen showed that in Calomys callosus and B10.A the lesions were predominantly composed by collagen type III, although in B10.A animals a predominance of collagen type I was observed without, however, exceed the levels observed for collagen type III at the end of the experiment. On the other hand, the levels of collagen were lower in A / Sn mice than Calomys callosus and B10.A. and, apparently, it was not identified in the lung. On the other hand, in this group was observed a tendency to increase the deposition of collagen type I in the liver at the end of experiment. Callomys callosus showed a higher number of CFU in the three organs studied, especially in the lungs. The proportion of viable fungi in liver, lung and spleen was always higher in Calomys callosus than A / Sn and B10.A and tend to increase in liver and lung during the infection progression with the presence of budding fungi. Conclusions: Ours results indicate that the experimental infection by Paracoccidioides brasiliensis (Pb18) was more aggressive and widespread in Calomys callosus than A/Sn and B10, especially in the lung. So, Calomys callosus can be considered as an alternative animal model in studies of paracoccidioidomycosis infection.

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Bloodstream infections associated/related to central vascular catheters (CVC) at Neonatal Intensive Care Units (NICUs) are frequent, severe and costly. The aim of this research was to evaluate the incidence of bloodstream infection related / associated with different types of CVC and to investigate the pathogenesis of these infections in critical newborns hospitalized in the NICU at the Uberlândia University Hospital. The study was conducted between April/2006 and April/2008. 318 neonates were investigated using CVC followed-up through epidemiologic vigilance National Healthcare Safety Network . Blood specimens were obtained from peripheral puncture. Hemocultures were performed by the automatic commercial system Bactec/ Alert (Vitek System). Additionally, were realized cultures of nostril, skin of CVC insertion site, hub and CVC tip. The ethical approval was obtained from the Ethics Committee of Uberlândia Federal University according to the Health Ministry demands under No. 022/06. The incidence of CVC-associated/related to BSI was 13.0 and 2.1 per 1000 days CVC, respectively. The umbilical catheter (40.6%) and PICC (39.6%) CVCs were used more frequently in times average usage of 5.3 and 13.6 days, respectively. Staphylococcus epidermidis was the most common microorganism (60.0%) in bloodstream infection related CVC, followed by Staphylococcus aureus (30.0%) and Enterococcus faecalis (10.0%). The umbilical catheter was associated with 50.0% of infections related to use of this device. In total, 39.0% and 22.0% of samples from the CVC tip and blood, respectively, showed biofilm production. Approximately 83.0% and 67.0% of blood samples and tip, respectively, isolated cases of CVC-related bloodstream infection were resistant to oxacillin and producing biofilms. The mecA gene was detected in 50.0% of strains of S. epidermidis isolated from blood and CVC tip of the patients with CVC-related infection, and the gene icaAD was detected in the 33.3% and 50.0% of strains isolated from blood and CVC tip, respectively. There was agreement among the clones of S. epidermidis recovered from blood and CVC tip in only one patient, without definition of origin where skin, nostril or hub , due to negative cultures of these places. There is evidence that the pathogenesis of bloodstream infection related to CVC in neonates differs from that reported in adults, and their best knowledge will certainly allow the adoption of practices to prevent and control these infections.