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[PMID]: 29447196 [Au] Autor: Verani JR; Massora S; Acácio S; Dos Santos RT; Vubil D; Pimenta F; Moura I; Whitney CG; Costa MH; Macete E; Matsinhe MB; Carvalho MDG; Sigaúque B [Ad] Endereço: Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America. [Ti] Título: Nasopharyngeal carriage of Streptococcus pneumoniae among HIV-infected and -uninfected children <5 years of age before introduction of pneumococcal conjugate vaccine in Mozambique. [So] Source: PLoS One;13(2):e0191113, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça. A single nasopharyngeal swab was obtained and cultured following enrichment in Todd Hewitt broth with yeast extract and rabbit serum. Pneumococcal isolates were serotyped by Quellung reaction and multiplex polymerase chain reaction. Factors associated with pneumococcal carriage were examined using logistic regression. Overall pneumococcal carriage prevalence was 80.5% (585/727), with similar prevalences among HIV-infected (81.5%, 339/416) and HIV-uninfected (79.1%, 246/311) children, and across age strata. Among HIV-infected, after adjusting for recent antibiotic use and hospitalization, there was no significant association between study site and colonization: Maputo (74.8%, 92/123), Nampula (83.7%, 82/98), Manhiça (84.6%, 165/195). Among HIV-uninfected, report of having been born to an HIV-infected mother was not associated with colonization. Among 601 pneumococcal isolates from 585 children, serotypes 19F (13.5%), 23F (13.1%), 6A (9.2%), 6B (6.2%) and 19A (5.2%) were most common. The proportion of serotypes included in the 10- and 13-valent vaccines was 44.9% and 61.7%, respectively, with no significant differences by HIV status or age group. Overall 36.9% (n = 268) of children were colonized with a PCV10 serotype and 49.7% (n = 361) with a PCV13 serotype. Pneumococcal carriage was common, with little variation by geographic region, age, or HIV status. PCV10 was introduced in April 2013; ongoing carriage studies will examine the benefits of PCV10 among HIV-infected and-uninfected children. [Mh] Termos MeSH primário: Infecções Pneumocócicas/imunologia Vacinas Pneumocócicas/administração & dosagem Vacinas Pneumocócicas/uso terapêutico [Mh] Termos MeSH secundário: Portador Sadio/epidemiologia Pré-Escolar Feminino Infecções por HIV/imunologia Infecções por HIV/microbiologia Seres Humanos Lactente Recém-Nascido Masculino Testes de Sensibilidade Microbiana/métodos Moçambique/epidemiologia Nasofaringe/imunologia Infecções Pneumocócicas/fisiopatologia Prevalência População Rural Sorogrupo Streptococcus pneumoniae/imunologia Streptococcus pneumoniae/patogenicidade Vacinas Conjugadas/administração & dosagem Vacinas Conjugadas/uso terapêutico [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (10-valent pneumococcal conjugate vaccine); 0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180216 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191113

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[PMID]: 28454768 [Au] Autor: Kotkowski K; Ellison RT; Barysauskas C; Barton B; Allison J; Mack D; Finberg RW; Reznek M [Ad] Endereço: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: kevin.kotkowski@umassmemorial.org. [Ti] Título: Association of hospital contact precaution policies with emergency department admission time. [So] Source: J Hosp Infect;96(3):244-249, 2017 Jul. [Is] ISSN: 1532-2939 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Contact precautions are a widely accepted strategy to reduce in-hospital transmission of meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). However, these practices may have unintended deleterious effects on patients. AIM: To evaluate the effect of a modification in hospital-wide contact precaution practices on emergency department (ED) admission times. METHODS: During the study period, the hospital changed its contact precaution policy from requiring contact precautions for all patients with a history of MRSA or VRE to only those who presented with clinical conditions likely to contaminate the environment with pathogens. An interrupted time series analysis of ED admission times for adults for one year preceding and one year following this change was performed at a two-campus hospital. The main outcome was admission time, defined as time from decision to admit to arrival in an inpatient bed, for patients with MRSA or VRE compared with all other patients. The in-hospital MRSA and VRE acquisition rates were evaluated over the same period and have been published previously. FINDINGS: At one campus, admission time decreased immediately by 161min for MRSA patients (P=0.008) and 135min for VRE patients (P=0.003), and both continued to decrease over the duration of the study. There was no significant change in admission time at the second campus. CONCLUSIONS: Modifying contact precaution requirements for MRSA and VRE may be associated with improved ED admission time without significantly altering in-hospital MRSA and VRE acquisition. [Mh] Termos MeSH primário: Infecção Hospitalar/prevenção & controle Medicina de Emergência/métodos Infecções por Bactérias Gram-Positivas/diagnóstico Controle de Infecções/métodos Staphylococcus aureus Resistente à Meticilina/isolamento & purificação Admissão do Paciente Enterococos Resistentes à Vancomicina/isolamento & purificação [Mh] Termos MeSH secundário: Adulto Portador Sadio/diagnóstico Serviço Hospitalar de Emergência Hospitais Seres Humanos Política Organizacional Estudos Retrospectivos Fatores de Tempo [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170430 [St] Status: MEDLINE

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[PMID]: 28449969 [Au] Autor: Le Doare K; Faal A; Jaiteh M; Sarfo F; Taylor S; Warburton F; Humphries H; Birt J; Jarju S; Darboe S; Clarke E; Antonio M; Foster-Nyarko E; Heath PT; Gorringe A; Kampmann B [Ad] Endereço: Centre for International Child Health, Imperial College London, Norfolk Place, London W2 1PG, UK,; Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0TE, UK; Vaccines & Immunity Theme, MRC Unit The Gambia, Atlantic Road, Fajara, Gambia [Ti] Título: Association between functional antibody against Group B Streptococcus and maternal and infant colonization in a Gambian cohort. [So] Source: Vaccine;35(22):2970-2978, 2017 05 19. [Is] ISSN: 1873-2518 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: Vertical transmission of Group B Streptococcus (GBS) is a prerequisite for early-onset disease and a consequence of maternal GBS colonization. Disease protection is associated with maternally-derived anti-GBS antibody. Using a novel antibody-mediated C3b/iC3b deposition flow cytometry assay which correlates with opsonic killing we developed a model to assess the impact of maternally-derived functional anti-GBS antibody on infant GBS colonization from birth to day 60-89 of life. METHODS: Rectovaginal swabs and cord blood (birth) and infant nasopharyngeal/rectal swabs (birth, day 6 and day 60-89) were obtained from 750 mother/infant pairs. Antibody-mediated C3b/iC3b deposition with cord and infant sera was measured by flow cytometry. RESULTS: We established that as maternally-derived anti-GBS functional antibody increases, infant colonization decreases at birth and up to three months of life, the critical time window for the development of GBS disease. Further, we observed a serotype (ST)-dependent threshold above which no infant was colonized at birth. Functional antibody above the upper 95th confidence interval for the geometric mean concentration was associated with absence of infant GBS colonization at birth for STII (p<0.001), STIII (p=0.01) and STV (p<0.001). Increased functional antibody was also associated with clearance of GBS between birth and day 60-89. CONCLUSIONS: Higher concentrations of maternally-derived antibody-mediated complement deposition are associated with a decreased risk of GBS colonization in infants up to day 60-89 of life. Our findings are of relevance to establish thresholds for protection following vaccination of pregnant women with future GBS vaccines. [Mh] Termos MeSH primário: Anticorpos Antibacterianos/imunologia Imunidade Materno-Adquirida Transmissão Vertical de Doença Infecciosa Infecções Estreptocócicas/imunologia Streptococcus/crescimento & desenvolvimento Streptococcus/imunologia [Mh] Termos MeSH secundário: Adulto Anticorpos Antibacterianos/sangue Portador Sadio Criança Pré-Escolar Estudos de Coortes Complemento C3b/imunologia Feminino Sangue Fetal/imunologia Citometria de Fluxo Gâmbia/epidemiologia Seres Humanos Técnicas Imunológicas Lactente Recém-Nascido Estudos Longitudinais Mães Nasofaringe/microbiologia Proteínas Opsonizantes Gravidez Complicações Infecciosas na Gravidez/microbiologia Infecções Estreptocócicas/epidemiologia Infecções Estreptocócicas/transmissão Streptococcus/classificação Streptococcus/isolamento & purificação Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Antibodies, Bacterial); 0 (Opsonin Proteins); 80295-43-8 (Complement C3b) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE

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[PMID]: 28741237 [Au] Autor: Zhand S; Tabarraei A; Nazari A; Moradi A [Ad] Endereço: Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. [Ti] Título: Cytotoxic T lymphocytes and CD4 epitope mutations in the pre-core/core region of hepatitis B virus in chronic hepatitis B carriers in Northeast Iran. [So] Source: Indian J Gastroenterol;36(4):253-257, 2017 Jul. [Is] ISSN: 0975-0711 [Cp] País de publicação: India [La] Idioma: eng [Ab] Resumo: BACKGROUNDS: Hepatitis B virus (HBV) is vulnerable to many various mutations. Those within epitopes recognized by sensitized T cells may influence the re-emergence of the virus. This study was designed to investigate the mutation in immune epitope regions of HBV pre-core/core among chronic HBV patients of Golestan province, Northeast Iran. METHODS: In 120 chronic HBV carriers, HBV DNA was extracted from blood plasma samples and PCR was done using specific primers. Direct sequencing and alignment of the pre-core/core region were applied using reference sequence from Gene Bank database (Accession Number AB033559). RESULTS: The study showed 27 inferred amino acid substitutions, 9 of which (33.3%) were in CD4 and 2 (7.4%) in cytotoxic T lymphocytes' (CTL) epitopes and 16 other mutations (59.2%) were observed in other regions. CONCLUSIONS: CTL escape mutations were not commonly observed in pre-core/core sequences of chronic HBV carriers in the locale of study. It can be concluded that most of the inferred amino acid substitutions occur in different immune epitopes other than CTL and CD4. [Mh] Termos MeSH primário: Antígenos CD4/genética Portador Sadio/virologia Epitopos/genética Vírus da Hepatite B/genética Vírus da Hepatite B/imunologia Hepatite B Crônica/virologia Mutação Puntual Linfócitos T Citotóxicos/imunologia [Mh] Termos MeSH secundário: Substituição de Aminoácidos Portador Sadio/imunologia Epitopos/química Epitopos/imunologia Hepatite B Crônica/imunologia Seres Humanos Irã (Geográfico) [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (CD4 Antigens); 0 (Epitopes) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180228 [Lr] Data última revisão: 180228 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170726 [St] Status: MEDLINE [do] DOI: 10.1007/s12664-017-0767-z

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[PMID]: 29173242 [Au] Autor: Minter A; Diggle PJ; Costa F; Childs J; Ko AI; Begon M [Ad] Endereço: Institute of Integrative Biology, The University of Liverpool,Liverpool,UK. [Ti] Título: Evidence of multiple intraspecific transmission routes for Leptospira acquisition in Norway rats (Rattus norvegicus). [So] Source: Epidemiol Infect;145(16):3438-3448, 2017 12. [Is] ISSN: 1469-4409 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Infectious diseases frequently have multiple potential routes of intraspecific transmission of pathogens within wildlife and other populations. For pathogens causing zoonotic diseases, knowing whether these transmission routes occur in the wild and their relative importance, is critical for understanding maintenance, improving control measures and ultimately preventing human disease. The Norway rat (Rattus norvegicus) is the primary reservoir of leptospirosis in the urban slums of Salvador, Brazil. There is biological evidence for potentially three different transmission routes of leptospire infection occurring in the rodent population. Using newly obtained prevalence data from rodents trapped at an urban slum field site, we present changes in cumulative risk of infection in relation to age-dependent transmission routes to infer which intra-specific transmission routes occur in the wild. We found that a significant proportion of animals leave the nest with infection and that the risk of infection increases throughout the lifetime of Norway rats. We did not observe a significant effect of sexual maturity on the risk of infection. In conclusion, our results suggest that vertical and environmental transmission of leptospirosis both occur in wild populations of Norway rats. [Mh] Termos MeSH primário: Leptospira Leptospirose Doenças dos Roedores [Mh] Termos MeSH secundário: Envelhecimento Animais Peso Corporal Brasil/epidemiologia Portador Sadio/epidemiologia Portador Sadio/transmissão Portador Sadio/veterinária Feminino Transmissão Vertical de Doença Infecciosa Leptospirose/epidemiologia Leptospirose/transmissão Leptospirose/veterinária Masculino Prevalência Ratos Doenças dos Roedores/epidemiologia Doenças dos Roedores/transmissão Análise de Sobrevida [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 180215 [Lr] Data última revisão: 180215 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE [do] DOI: 10.1017/S0950268817002539

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[PMID]: 28449953 [Au] Autor: Rezende TFT; Doi AM; Quiles MG; Pignatari ACC; Manfrendi S; Grothe C; Taminato M; Barbosa DA [Ad] Endereço: Special Clinical Microbiology Laboratory (LEMC/ALERTA), Federal University of São Paulo/UNIFESP/Brazil, São Paulo, Brazil. Electronic address: thaisftr_@hotmail.com. [Ti] Título: Detection of colonization by carbapenem-resistant organisms by real-time polymerase chain reaction from rectal swabs in patients with chronic renal disease. [So] Source: J Hosp Infect;96(2):123-128, 2017 Jun. [Is] ISSN: 1532-2939 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Carbapenem-resistant organism (CRO) colonization is a serious problem that increases the risk of infection and contributes to dissemination of antimicrobial resistance in healthcare-associated environments. The risk of acquisition and dissemination of CRO is high in chronic renal failure patients and the surveillance culture is recommended as a component of infection control programmes. AIM: To assess colonization by CRO, comparing phenotypic and molecular-based methods of diagnostics, in rectal swabs in a large population of chronic renal failure patients. METHODS: A total of 1092 rectal swabs (ESwab™) were collected at two different times from 546 chronic kidney disease (CKD) patients from a specialized tertiary care university centre. They were divided into three groups: conservative treatment (N = 129), dialysis (N = 217), and transplanted patients (N = 200). A chromogenic (CHROMagar™) KPC agar and the multiplex real-time polymerase chain reaction (qPCR) targeting carbapenemase-encoding genes were tested as phenotypic and molecular screening for carbapenemase production. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and conventional PCR were also performed on the isolates grown on chromogenic agar. FINDINGS: Among the 1092 samples, 150 (13.7%) were identified as CRO producers according to chromogenic agar. Only 26 (2.4%) were confirmed as KPC by conventional PCR. According to qPCR direct from swab, 31 (2.8%) were positive for KPC, 39 (3.6%) for GES, and three (0.3%) for SPM with kappa index of 0.256. CONCLUSION: The qPCR technique provides faster results when compared to culture method and enables rapid implementation of control measures and interventions to reduce the spread of CRO in healthcare settings, especially among CKD patients. [Mh] Termos MeSH primário: Proteínas de Bactérias/genética Bactérias Gram-Negativas/isolamento & purificação Infecções por Bactérias Gram-Negativas/diagnóstico Reação em Cadeia da Polimerase em Tempo Real/métodos Reto/microbiologia Insuficiência Renal Crônica/complicações Resistência beta-Lactâmica beta-Lactamases/genética [Mh] Termos MeSH secundário: Proteínas de Bactérias/análise Técnicas Bacteriológicas/métodos Portador Sadio/diagnóstico Portador Sadio/microbiologia Infecções por Bactérias Gram-Negativas/microbiologia Hospitais Universitários Seres Humanos Técnicas de Diagnóstico Molecular/métodos Fatores de Tempo beta-Lactamases/análise [Pt] Tipo de publicação: COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Bacterial Proteins); EC 3.5.2.6 (beta-Lactamases); EC 3.5.2.6 (carbapenemase) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE

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[PMID]: 29307521 [Au] Autor: Han W; Ni Q; Liu K; Yao Y; Zhao D; Liu X; Chen Y [Ad] Endereço: Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China; Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, 79 Qingchun Road, Hangzhou 310003, China. [Ti] Título: Decreased CD122 on CD56 NK associated with its impairment in asymptomatic chronic HBV carriers with high levels of HBV DNA, HBsAg and HBeAg. [So] Source: Life Sci;195:53-60, 2018 Feb 15. [Is] ISSN: 1879-0631 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: AIMS: NK cells play important roles in inhibiting HBV replication and preventing HBV infection. However, NK-cell dysfunction has not been fully studied in asymptomatic chronic HBV carriers (ASC). This study aims to assess decreased expression of CD122 associated with impaired NK cells and the restoration of NK cells with IL-2 and IL-15 stimulation. MAIN METHODS: The experiments were performed by flow cytometer, cytotoxicity assay, ELISA and western blotting. KEY FINDINGS: The reduced CD122 on CD56 NK cells and CD56 NK cells is associated with high levels of HBV DNA, HBsAg or HBeAg in ASCs, in which CD56 NK-cell impairment is observed. Moreover, decreased IFN-γ and degranulation and low cytotoxicity by CD56 NK cells after CD122 blockade were revealed. IL-2 and/or IL-15 can restore impaired CD56 NK cells, together with increased p-STAT5, which can be reversed by CD122 blockade. Additionally, IL-2 or IL-15 can enhance IFN-α2-activated CD56 NK-cell immune responses via up-regulating interferon alpha and beta receptor subunit 2 (IFNAR2). SIGNIFICANCE: Down-regulated CD122 on CD56 NK cell in ASCs with massive viral antigens and high viremia is associated with its impairment, which can be restored by IL-2 and/or IL-15, or combined with IFN-α2. [Mh] Termos MeSH primário: Antígeno CD56/biossíntese DNA Viral/biossíntese Antígenos de Superfície da Hepatite B/sangue Antígenos E da Hepatite B/sangue Vírus da Hepatite B/metabolismo Hepatite B/metabolismo Subunidade beta de Receptor de Interleucina-2/biossíntese Células Matadoras Naturais/metabolismo [Mh] Termos MeSH secundário: Adulto Antígeno CD56/genética Portador Sadio DNA Viral/genética Feminino Vírus da Hepatite B/genética Seres Humanos Interferon gama/biossíntese Interleucina-15/farmacologia Interleucina-2/farmacologia Subunidade beta de Receptor de Interleucina-2/genética Masculino Receptor de Interferon alfa e beta/biossíntese Receptor de Interferon alfa e beta/genética Fator de Transcrição STAT5/biossíntese Fator de Transcrição STAT5/genética Viremia/sangue Viremia/virologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (CD56 Antigen); 0 (DNA, Viral); 0 (Hepatitis B Surface Antigens); 0 (Hepatitis B e Antigens); 0 (IFNAR2 protein, human); 0 (Interleukin-15); 0 (Interleukin-2); 0 (Interleukin-2 Receptor beta Subunit); 0 (STAT5 Transcription Factor); 156986-95-7 (Receptor, Interferon alpha-beta); 82115-62-6 (Interferon-gamma) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180208 [Lr] Data última revisão: 180208 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180109 [St] Status: MEDLINE

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[PMID]: 29304069 [Au] Autor: Kwetkat A; Pfister W; Pansow D; Pletz MW; Sieber CC; Hoyer H [Ad] Endereço: Department of Geriatric Medicine, Jena University Hospital, Jena, Thuringia, Germany. [Ti] Título: Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment. [So] Source: PLoS One;13(1):e0190716, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: From April 2013 to February 2014 we performed a multicentre prospective cross-sectional study in 541 German nursing home residents. We determined pharyngeal carriage of Streptococcus pneumoniae (primary objective) and other bacteria (secondary objective) in naso- and oropharyngeal swabs by culture-based standard procedures and explored the influence of multimorbidity and functional status on bacterial carriage. METHODS: Socio-demographic data, vaccination status, multimorbidity, nutrition and functional status defined by Comprehensive Geriatric Assessment were evaluated. We estimated carriage rates with 95% confidence intervals (CI) and explored potential risk factors by logistic regression analysis. RESULTS: Pneumococcal post-serotyping carriage rate was 0.8% (95%CI 0.2-1.9%; 4/526). Serotyping revealed serotypes 4, 7F, 23B and 23F and S. pseudopneumoniae in two other cases. Odds of carriage were higher in men (Odds ratio OR 5.3 (95%CI 0.9-29.4)), in malnourished residents (OR 4.6 (0.8-25.7)), residents living in shared rooms (OR 3.0 (0.5-16.5)) or having contact with schoolchildren (OR 2.0 (0.2-17.6)). The most frequent pathogen was Staphylococcus aureus (prevalence 29.5% (25.6-33.6%)) with meticillin-resistant Staphylococcus aureus prevalence of 1.1%. Gram-negative bacteria (GNB) were found in 22.5% (19.0-26.3%) with a prevalence of extended-spectrum beta lactamase (ESBL) producing bacteria of 0.8%. Odds of S. aureus carriage were higher for immobility (OR 1.84 (1.15-2.93)) and cognitive impairment (OR 1.54 (0.98-2.40)). Odds of GNB carriage were higher in residents with more severe comorbidity (OR 1.13 (1.00-1.28)) and malnutrition (OR 1.54 (0.81-2.91)). CONCLUSIONS: Given the observed data, at least long-term carriage of S. pneumoniae in nursing home residents seems to be rare and rather unlikely to cause nursing home acquired pneumonia. The low rate of colonization with multi drug resistant (MDR) bacteria confirms that nursing home residency is not a risk factor for MDR pneumonia in Germany. For individual risk assessment in this susceptible population, immobility and malnutrition should be considered as signs of functional impairment as well as comorbidity. [Mh] Termos MeSH primário: Portador Sadio/epidemiologia Portador Sadio/microbiologia Nariz/microbiologia Casas de Saúde Orofaringe/microbiologia [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Estudos Transversais Escherichia coli Feminino Alemanha Seres Humanos Modelos Logísticos Masculino Multimorbidade Prevalência Estudos Prospectivos Fatores de Risco Staphylococcus aureus [Pt] Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180205 [Lr] Data última revisão: 180205 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180106 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0190716

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[PMID]: 29267378 [Au] Autor: Jochems SP; Weiser JN; Malley R; Ferreira DM [Ad] Endereço: Department of Clinicial Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom. [Ti] Título: The immunological mechanisms that control pneumococcal carriage. [So] Source: PLoS Pathog;13(12):e1006665, 2017 12. [Is] ISSN: 1553-7374 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Colonization of the human nasopharynx by pneumococcus is extremely common and is both the primary reservoir for transmission and a prerequisite for disease. Current vaccines targeting the polysaccharide capsule effectively prevent colonization, conferring herd protection within vaccinated communities. However, these vaccines cover only a subset of all circulating pneumococcal strains, and serotype replacement has been observed. Given the success of pneumococcal conjugate vaccine (PCV) in preventing colonization in unvaccinated adults within vaccinated communities, reducing nasopharyngeal colonization has become an outcome of interest for novel vaccines. Here, we discuss the immunological mechanisms that control nasopharyngeal colonization, with an emphasis on findings from human studies. Increased understanding of these immunological mechanisms is required to identify correlates of protection against colonization that will facilitate the early testing and design of novel vaccines. [Mh] Termos MeSH primário: Infecções Pneumocócicas/imunologia Vacinas Pneumocócicas/imunologia [Mh] Termos MeSH secundário: Portador Sadio/imunologia Seres Humanos Nasofaringe/microbiologia Vacinas Conjugadas/imunologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW [Nm] Nome de substância: 0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180111 [Lr] Data última revisão: 180111 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171222 [St] Status: MEDLINE [do] DOI: 10.1371/journal.ppat.1006665

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[PMID]: 28459219 [Au] Autor: Li M; Li J; Xia Z; Xiao N; Jiang W; Wen Y [Ad] Endereço: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Shanghai, China. li_mei76@163.com. [Ti] Título: A combined strategy for screening a clustered mobile population returning from highly endemic areas for Plasmodium falciparum. [So] Source: J Infect Dev Ctries;11(4):287-293, 2017 Apr 30. [Is] ISSN: 1972-2680 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Early and accurate diagnosis of imported malaria cases in clusters is crucial for protecting the health of patients and local populations, especially confirmed parasitic persons who are asymptomatic. METHODOLOGY: A total of 226 gold miners who had stayed in highly endemic areas of Ghana for more than six months and returned in clusters were selected randomly. Blood samples from them were tested with microscopy, nest polymerase chain reaction, and rapid diagnostic test (RDT). The sensitivity, specificity, predictive values, agreement rate, and Youden's index of each of three diagnostic methods were calculated and compared with the defined gold standard. A quick and efficient way to respond to screening such a clustered mobile population was predicted and analyzed by evaluating two assumed results of combining microscopy and RDT with or without symptoms of illness. RESULTS: The rate of the carriers of malaria parasites in the populations of gold miners was 19.47%, including 39 P. falciparum. Among the three diagnostic methods, the microscopy method showed the highest specificity, while the RDT method showed the highest sensitivity but the lowest specificity in detecting P. falciparum. The assumed results of combining RDT and microscopy with symptoms showed the best results among all the test results in screening P. falciparum. CONCLUSIONS: It was too complex and difficult to catch all parasite carriers in a short period of time among populations with such a complicated situation as that in Shanglin County. A strategy of combing microscopy and RDT for diagnosis is highly recommended. [Mh] Termos MeSH primário: Doenças Assintomáticas Portador Sadio/diagnóstico Doenças Transmissíveis Importadas/diagnóstico Testes Diagnósticos de Rotina/métodos Malária Falciparum/diagnóstico Programas de Rastreamento/métodos [Mh] Termos MeSH secundário: China Gana Seres Humanos Imunocromatografia/métodos Microscopia/métodos Reação em Cadeia da Polimerase/métodos Valor Preditivo dos Testes Sensibilidade e Especificidade [Pt] Tipo de publicação: COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180109 [Lr] Data última revisão: 180109 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170502 [St] Status: MEDLINE [do] DOI: 10.3855/jidc.8394

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