A diarreia ainda persiste como um problema de saúde pública, sendo uma das principais causas de mortalidade infantil nos países em desenvolvimento, principalmente em crianças abaixo de 5 anos. Este estudo teve por objetivo avaliar a etiologia das diarreias agudas em crianças de 0 a 5 anos atendidas no Hospital Universitário da USP em um estudo caso-controle. As fezes de 260 casos e 58 controles foram coletadas por suabe retal e conservadas em meio Cary-Blair até o momento da semeadura. As bactérias pesquisadas foram Escherichia coli diarreiogênicas (EPEC, EIEC, EAEC, EHEC, ETEC), Salmonella sp, Shigella sp, Yersinia enterocolitica e Campylobacter sp. Os meios de cultura utilizados para isolamento das bactérias foram Ágar SS e Ágar MacConkey. Após incubação por 24 horas a 37ºC, as bactérias foram identificadas fenotipicamente utilizando-se EPM-MILI-Citrato. Posteriormente, as bactérias enteropatogênicas foram aglutinadas com anti-soros específicos polivalentes. Para isolamento de Campylobacter sp foi utilizado Ágar Karmalli incubado a 42ºC por 48 horas em microaerofilia. Foram também pesquisados os fatores de virulência de Escherichia coli por colony-blot, utilizando sondas genéticas marcadas radioativamente. Os agentes virais pesquisados foram Rotavírus e Adenovírus em 134 crianças utilizando-se kit ROTA-VIKIA ADENO pelo método imunocromatográfico. Neste trabalho foi possível observar que a prevalência dos agentes foi: EPEC - casos: 34(13%), controles: 5(8,6%); EAEC - casos: 27(10,3%), controles: 8(13,7%); EIEC - casos: 5(1,9%); controles: 0, Shigella sonnei - casos: 7(2,7%); controles: 0, Shigella flexneri - casos: 4(1,5%), controles: 0; Salmonella - casos: 7(2,7%), controles: 1(1,7%); Campylobacter sp - casos: 4(1,5%), controles: 0; Rotavírus - casos: 21(17,3%), controles: 1(7,7%); Adenovírus - casos: 6(5%), controles: 1(7,7%) e Rotavírus + Adenovírus - casos: 2(1,7%), controles: 1(7,7%). O agente etiológico mais encontrado foi Rotavirus e se caracterizou como o único patógeno que apresentou significância estatística entre casos e controles (p<0,01). Ocorreu uma maior prevalência de EPEC atípica em relação à EPEC típica, dados concordantes com outros trabalhos. Houve predominância de Shigella sonnei em relação à Shigella flexneri, resultados divergentes encontrados em estudos anteriores. Rotavirus foi o enteropatógeno mais prevalente, sendo que nove crianças acometidas estavam desidratadas. Dez crianças tiveram infecção mista entre os agentes isolados. Em dezessete crianças do grupo controle (sem diarreia) foram encontrados agentes patogênicos, a saber: EPEC (5), EAEC (8), Salmonella (1) e Rotavirus + Adenovirus (1). / Diarrhea remains an important problem worldwide and has been characterized as one of the main causes of infant death in developing countries, especially in children under five years old. The aim of this study was to evaluate the etiology of acute diarrhea in children by case-control attended in São Paulo University Hospital. Fecal samples of 260 cases and 58 matched controls were collected by rectal swabs and conserved in Cary-Blair medium until the moment of seeding. Researched bacterial were diarrheiogenic Escherichia coli (EPEC, EIEC, EAEC, EHEC and ETEC), Salmonella sp, Shigella sp, Yersinia enterocolitica and thermophilic Campylobacter sp. Cultures for bacterium isolation were made in SS agar and MacConkey agar. After incubation at 37ºC by 24 h, bacteria were tested using biochemical tests (EPM-MILI-Citrato). For Campylobacter isolation was used Karmali agar at 42ºC by 48 h in 5% CO2. Colony-blot hybridization using specific radiolabelled DNA probes was used to identify diarrheiogenic E. coli. Rotavirus and Adenovirus were sought in 121 cases and 13 controls by ROTA-VIKIA ADENO by immunochromatographic assay. The prevalence of the pathogens were as follows: EPEC - cases: 34 (13%), controls: 5 (1,9%); EAEC - cases: 27 (10,3%), controls: 8 (13,7%); EIEC - cases: 5 (1,9%), controls: 0; Shigella sonnei - cases: 7 (2,7%), controls: 0; Shigella flexneri - cases: 4 (1,5%), controls: 0; Salmonella - cases: 7 (2,7%), controls: 1 (1,7%); Campylobacter sp - cases: 4 (1,5%), controls: 0; Rotavirus - cases: 21 (17,3%), controls - 1 (7,7%); Adenovirus - cases: 6 (5%), controls: 1 (7,7%) and Rotavirus + Adenovirus - cases: 2 (1,7%), controls: 1 (7,7%). The main etiologic agent found was Rotavirus, which was the only pathogen significant between cases and controls (p<0,01). Atypical EPEC had major prevalence comparing to typical EPEC. Shigella sonnei was more isolated than Shigella flexneri, a different result found in other studies. Ten children had mixed infection between the isolated agents. In seventeen children of the control group (without diarrhea) were found pathogens, that is: EPEC (5), EAEC (8), Salmonella (1) and Rotavirus + Adenovirus (1).

ABSTRACT In the western world colitis is a common chronic disease and in Sweden the prevalence is around 1%. If a patient has bloody diarrhea it is probably ulcerative proctocolitis or Crohn’s disease, whereas if the diarrhea is watery, it is microscopic colitis. For a diagnosis, the patient has to do a colonoscopy and a colonic biopsy sample has to be taken. The biopsy sample will be sent to a laboratory for sectioning, staining and microscopic analysis. In this study we compared the effects of short and long dehydration time of the sample before the sectioning. We also compared staining with Alcianblue/Van Gieson and Van Gieson alone. Our results showed that a short dehydration time was a milder treatment and made it easier to section the biopsy sample. The comparison of the two methods was unsuccessful because the staining with Alcianblue/Van Gieson failed.

Water and food borne Escherichia coli O157:H7 could be one of the pathogens posing high health risk to patients suffering from Acquired Immunodeficiency Syndrome (AIDS) because of its incrimination in diarrhoea cases in AIDS patients. The present study, which was conducted between March 2005 and August 2006, investigated the prevalence of E. coli O157:H7 in water, meat and meat products and vegetables and its impact on diarrhoeic conditions of confirmed and non-confirmed HIV/AIDS patients in the Amathole District in the Eastern Cape Province of South Africa. The water samples used in the study were obtained from stand pipes supplying treated drinking water to communities residing in Fort Beaufort, Alice, Dimbaza and Mdantsane whereas borehole waters were sampled from Ngwenya and Kwasaki. The meat and meat products and vegetable samples were purchased from shops, butcheries, supermarkets and open air markets in Fort Beaufort, Alice and Mdantsane. The stool swabs used in the study were obtained from HIV/AIDS and outpatient clinics at Frere Hospital in East London. A total of 180 each of water, meat and meat products and vegetable samples and another 360 stool samples were analyzed for E. coli O157:H7. Presumptive E. coli O157 was isolated from the samples by culture-based methods and confirmed using Polymerase Chain Reaction techniques. Anti-biogram as well as risk assessment were also carried out using standard methods. The viable counts of presumptive E. coli O157 for water samples ranged between 3.3 × 104 and 1.71 × 105 CFU/ml, and between 1.8 × 104 and 5.04 × 106 CFU/g for meat and meat products, whereas those for vegetables ranged between 1.3 × 103 and 1.6 × 106 CFU/g. The counts of presumptive E. coli O157 for the water and vegetable samples were not significantly different whereas those for meat and meat products were found to be significantly different (P ≤ 0.05). The prevalence rates of presumptive E coli O157 in meat and meat products was 35.55 percent (64/180), and 25.55 percent (46/180) and 21.66 percent (39/180) for water and vegetables respectively. Prevalence of presumptive E. coli O157 in the stool samples of HIV/AIDS patients was 36.39 percent (131/360), of which 56.5 percent (74/131) and 43.5 percent (57/131) were from stools of confirmed and non-confirmed HIV/AIDS patients, respectively. Molecular analysis of representative presumptive E. coli O157 indicated that 10.29 percent (4/39) of vegetables; 14.81 percent (4/27) of water and 38.46 percent (5/13) of meat and meat products carried E. coli O157:H7. Also 36 percent (9/25) and 17.24 percent (5/29) of the stool samples were positive for E. coli O157:H7. Antimicrobial susceptibility profile revealed that all of the E. coli O157:H7 isolated from water, meat and meat products and vegetables as well as those isolated from stools of confirmed and non-confirmed HIV/AIDS patients were resistant (R) to gentamycin and erythromycin. However, 75 percent (20/27) of these isolates were resistant (R) to ampicillin and tetracycline whereas approximately 25 percent (6/27) were resistant (R) to nalidixic acid, ceftriaxone, and chloramphenicol. All the isolates (27/27) were susceptible (S) to amikacin. Probability of risk of E. coli O157:H7 infection was high for confirmed HIV/AIDS patients than for the non-confirmed HIV/AIDS patients. Estimated probability of risk of E. coli O157:H7 due to ingestion of water was 1.00 for 100 confirmed and non-confirmed HIV/AIDS patients. Risk due to meat and meat products was estimated at 0.27 and 0.20 and for vegetables at 0.21 and 0.15 per 100 confirmed and non-confirmed HIV/AIDS patients. The findings of this study predicted a possible link between E. coli O157:H7 isolated from drinking water, meat and meat products and vegetables and diarrhoeic conditions in both confirmed and non-confirmed HIV/AIDS patients, and concludes that confirmed HIV/AIDS patients can be at higher risk of contracting water and food borne E. coli O157:H7 than nonconfirmed HIV/AIDS patients. It is thus recommended that proper water treatment and food handling, maximum food and water safety and sanitation as well as personal body hygiene should be maintained, in order to prevent E. coli O157:H7 infections. Education initiatives and active surveillance of E. coli O157:H7 should be taken by all the stake-holders working directly or indirectly towards ensuring enduring sound public health.

Cryptosporidiosis is an infection caused by Cryptosporidium; a protozoan parasite that infects the gastrointestinal tract. The infection is of major public health concern in both developed and developing countries. Faecal samples were collected from 160 in-patient adults, with complaint of diarrhoea, admitted at Victoria hospital in Alice, Nkonkobe Municipality. Twenty apparently healthy subjects were included as controls. All diarrhoea positive patients were interviewed to record socio-demographic information, water supply and animal contact. Initial screening was carried out by microscopy and ELISA to detect positive Cryptosporidium. Genomic DNA was extracted from microscopically positive samples and a PCR reaction was perform to amplify the (18S) SSUrRNA gene for further identification and epidemiology of Cryptosporidium. Data were analysed using Pearson‘s χ2 and Fisher‘s exact test to assess the univariate association between Cryptosporidium infection and the possible risk factors. Of the 180 subjects screened for cryptosporidial infection, Cryptosporidium antigen was detected in 122 giving an overall prevalence of 67.8 percent. In HIV-positive diarrhoea patients, prevalence increased with ages; between 31-43 (mean age 36.5 yr) and 70-82 (mean age 75.8 yr) had a higher prevalence (100 percent) of the antigen than 18-30 (mean age 23.2 yr) and 83-95 (mean age 88.8 yr) (50.0 percent) in HIV-positive diarrhoea patients (P > 0.05). In HIV-negative diarrhoea patients, prevalence was highest in the 18-30 (mean age 23.2 yr) (87.5 percent) and least (35.7 percent) in those aged 83-95 (mean age 88.8 yr) (P > 0.05). Cryptosporidium antigen was higher in females than in males. Of 115 females (mean age 46.7yr) who participated in the study, antigen was detected in 90 (78.2 percent) against 32 (71.1 percent) of 45 males (mean age 42.6yr). None of the 20 apparently healthy control subjects was found to be infected with Cryptosporidium. Cryptosporidium was detected in 27 HIV-positive and 97 HIV-negative diarrhoea patients by any one of the techniques. Antigen detection by ELISA 14 showed the highest positivity 96 (76.8 percent) in HIV- negative and 26 (74.3 percent) in HIV- positive diarrhoea patients. PCR detected eighty-nine (71.2 percent) cases in HIV-negative and 23 (65.7 percent) in HIV-positive patients with diarrhoea. Only 13 (37.1 percent) HIV-positive and 34 (27.2 percent) HIV-negative diarrhoea patients were found positive for Cryptosporidium by modified ZN. No significant difference was observed in sensitivity of antigen detection by ELISA and PCR (96.9 percent) in HIV-negative diarrhoea patients, respectively. Specificity of the staining technique was 88.9 percent in HIV-positive and 96.6 percent in HIV-negative diarrhoea patients. No significant difference was found in specificity of antigen detection by ELISA and PCR in HIV-positive and HIV-negative diarrhoea patients, respectively. Positive predictive value of ZN staining in both HIV-positive and HIV-negative diarrhoea patients (92.3 and 96.9 percent) was statistically higher than ELISA and PCR. No significant difference was observed in negative predictive value of ZN technique for detection of Cryptosporidium between HIV-positive and HIV- negative diarrhoea patients. Differences found in prevalence rates due to water source, suggest that the high infection rates of specific groups are associated with their exposure to the contaminated water supply. The results indicate that Cryptosporidium infection is highly prevalent in adult faecal specimens in the Nkonkobe Municipality, an indication of active infection that is likely to emerge as major human pathogen in this location due to socioeconomic changes which favour transmission. However, sequencing analysis is required to differentiate between Cryptosporidium genotypes in the various outbreaks

Class of 2006 Abstract / Background: The processes’ underlying a recent rise in the rate of Clostridium difficile associated diarrhea (CDAD) at the Southern Arizona Veterans Administration Health Care System (SAVAHS) is unclear. Past changes to formulary in workhorse oral flouroquinolone from levofloxacin to gatifloxacin are under scrutiny. An infection-control component was also possible. Methods: 142 patients suspected of having CDAD had stool specimens submitted for toxin assay from late July to late Oct of 2004. A retrospective chart review was performed using the Veterans Administration Computerized Patient Record System (CPRS) to examine total antibiotic use in the three months prior to having specimens submitted for laboratory toxin analysis. A subset-analysis was performed on 100 specimens submitted for toxin analysis. Parallel culture was performed and 9 isolates of C. difficile were obtained for molecular analysis and fingerprinting. Results: Of the 142 patients sampled, 20 tested positive for C. difficile toxin with the remaining 122 patients testing negative. Antibiotic usage was categorized by total antibiotic use and gatifloxacin use. 98 patients received at least 1 antibiotic within the preceding 3 months with 44 patients receiving no antibiotic therapy of any kind. Of the 98 patients that received antibiotic therapy, 44 received gatifloxacin, however, all of these patients also received at least one other antibiotic. Of the nine isolates fingerprinted, two distinct genetic clusters were identified.

Rotavírus (RV) é um importante patógeno viral que causa diarreia em leitões e indivíduos jovens de várias outras espécies animais. RV dos grupos A, B, C e E foram descritos como causa de diarreia em suínos. Este estudo reúne achados histopatológicos, imunohistoquímicos e de reação em cadeia da polimerase com transcriptase reversa (RT-PCR) presentes em quatro surtos de diarreia causados por RV de um e de múltiplos grupos na região sul do Brasil. Vacinação para RV não era aplicada em nenhuma das granjas estudadas. Necropsia, exames histológicos e imuni-histoquímicos foram realizados em 34 suínos de maternidade que apresentavam diarreia severa, além disso, realizou-se cultivo bacteriano e RT-PCR para RV dos grupos A, B e C, vírus da gastroenterite transmissível (TGEV), vírus da diarreia epidêmica dos suínos (PEDV), sapovírus (SaV), norovírus (NoV) e kobuvírus (Aichi vírus C) em 30 dessas amostras. Desidratação e conteúdo pastoso a líquido no cólon foram observados em todos os suínos. Exame histológico revelou atrofia de vilosidades em 29 casos, vacuolização de enterócitos em 27 casos e debris celulares na lâmina própria em 20 casos. Houve marcação imunohistoquímica positiva em 21 casos. RT-PCR foi positiva para RV em 20 casos e RV do grupo C foi o mais frequentemente detectado, presente em 17 amostras. Cultivo e isolamento de Escherichia coli ocorreu em todos os casos e quatro destes foram de E. coli α-hemolítica. Em 15 amostras houve isolamento de Clostridium sp. Sapovirus foi detectado em oito amostras, duas amostras foram positivas para norovírus e detectou-se kobuvírus em 11 animais. Os achados histológicos foram consistentes com infecção por RV e a imuno-histoquímica revelou dois padrões de marcação para o agente no intestino delgado. Os resultados de RT-PCR mostraram que o RV do grupo C foi o principal agente detectado neste estudo. O isolamento de E. coli e a detecção de SaV os destacou como agentes associados à infecção por RV. A detecção de kobuvírus o enfatiza como um novo candidato em associação com RV. / Rotavirus is an important viral pathogen causing diarrhea in piglets and other animal species worldwide. Groups A, B, C and E have been described causing diarrhea in swine. This study reunites histopathological, immunohistochemical and reverse transcriptase polymerase chain reaction (RT-PCR) findings present in four outbreaks of diarrhea caused by single and multiple groups of rotavirus in the south of Brazil. None of the herds studied applied vaccination against rotavirus. Necropsy, histological examination and immunohistochemistry were performed in 34 nursing piglets that presented severe diarrhea, bacterial culture and reverse transcriptase polymerase chain reaction (RT-PCR) for rotavirus from groups A, B and C, transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), sapovirus (SaV), norovirus (NoV) and kobuvirus (Aichi virus C) were carried out in 30 of the animals necropsied. Additionally, RT-PCR was performed in fecal pools from two outbreaks. Dehydration and fluid to pasty contents were observed in the colon of all 34 swine examined. Histological examination revealed villus atrophy in 29 cases, vacuolation of enterocytes in 27 cases and necrotic debris in the lamina propria of 20 cases. IHC was positive in 21 samples. RT-PCR was positive for rotavirus in 20 samples and group C rotavirus was the most frequently detected, present in 17 samples. Escherichia coli was isolated from all cases, and in four cases, it was α-hemolytic. Clostridium sp. was isolated from 15 samples. Sapovirus was detected in eight samples, samples from two animals were positive for norovirus and kobuvirus was detected from 11 samples. Histological findings were consistent with rotavirus infection and immunohistochemistry revealed two patterns of staining for rotavirus in the small intestine. RT-PCR results have shown group C rotavirus as the main agent detected in this study. The isolation of Escherichia coli and the detection of sapovirus highlighted them as possible agents associated to rotavirus infection. Kobuvirus detection has emphasized it as a new candidate in the association with rotavirus.

Orientador: Domingos da Silva Leite / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-07T11:06:07Z (GMT). No. of bitstreams: 1 Valadares_GeorgioFreesz_D.pdf: 5633139 bytes, checksum: eb53d324f81f52cd2327efa730c3e888 (MD5) Previous issue date: 2006 / Resumo: Infecções por Escherichia coli são freqüentes em animais domésticos, afetando principalmente animais recém nascidos e no período do pós-desmame, sendo responsáveis por importantes danos econômicos na suinocultura e pecuária de bovinos e ovinos. A instalação da bactéria ao hospedeiro se dá através da colonização, processo mediado por proteínas denominadas adesinas, que se encontram distribuídas por toda a superfície bacteriana. Estas apresentam uma grande variedade morfológica e são coletivamente chamadas de Fatores de Colonização (FCs). Neste trabalho identificamos um novo fator de colonização (FC O25) presente em cepas de Escherichia coli isoladas de casos de colibacilose neonatal bovina, que apresenta semelhanças antigênicas com os FCs F4(K88), CS31A e F41 sem, contudo, apresentar identidade genética com estes fatores em ensaios de PCR. Baseados nessas homologias, investigamos a hipótese do FC O25 pertencer a esta família de FCs. Estudamos a seqüência do gene que compõe a subunidade principal do FC O25 com base em semelhanças com genes dos fatores de colonização homólogos e encontramos o FC O25 presente em 35 das 41 cepas em estudo. Verificamos que a proteína FC O25 apresenta 49,7% de homologia com a proteína FaeG (F4), 35,4% com ClpG (CS31A) e 29,4% com FimF41. Com ferramentas de bioinformática determinamos a relação filogenética entre essas proteínas e a estrutura secundária do FC O25. Os estudos de extração de DNA genômico e plasmidial indicaram que o gene FC O25 deve estar localizado no cromossomo bacteriano. Este foi clonado no vetor de expressão pET-151, inserido na linhagem de E.coli BL21[DE3]-Star e a proteína do FC O25 foi obtida e purificada e antissoro policlonal monoespecífico foi obtido em coelho. A proteína do FC O25 purificada foi submetida a ensaios de Western Blotting frente a antissoros anti os FCs F4, F41 e CS31A e verificamos reconhecimento da proteína em diferentes graus. A cepa CG1905-B foi utilizada em ensaios de microscopia eletrônica de transmissão com marcação por anticorpos conjugados com ouro e verificamos que a estrutura do FC O25 é do tipo fibrilar assemelhando-se à estrutura do CS31A. Em ensaios de adesão a linhagens de células eucarióticas in vitro observamos adesão às células Caco-2 (carcinoma de cólon humano) e que esta adesão era inibida pelo antissoro anti-FC O25. Os resultados sugerem que o FC O25 pode ser importante para a patogenicidade das E. coli bovinas no Brasil, uma vez que encontramos uma associação deste com outros fatores de colonização e, sobretudo com toxinas relacionadas com a patogenia em bovinos, evidenciando novas relações entre mecanismos de virulência que merecem novas investigações, além da própria elucidação completa da estrutura do operon FC O25 / Abstract: Infections from Escherichia coli are frequent in domestic animals, affecting mainly newborn animals in the post weaning period, being thus responsible for important economic losses in the cattle, porcine and lamb herds. The establishment of the bacterium in the host is made by colonization and it is a process mediated by proteins called adhesins that are distributed along the bacterial surface. They present a great morphological variety and are called Colonization factors (CFs). Our objective in this work was to identify the new colonization factor (CF O25) in Escherichia coli strains isolated from bovine neonatal colibacillosis, this CF O25 presents antigenic similarities with the FCs F4(K88), CS31A and F41 without, however, present genetic identity to these factors in PCR assays. Based in these homologies, we investigated the hypothesis of the NFC be a member of this "family" of CFs. So we studied the sequence of the CF O25¿s main subunit gene and its similarities with the genes of the homologous CFs (F4, F41 and CS31A) in polymerase chain reaction (PCR) assays. We found the CF O25 in 35 of the 41 studied strains. Through DNA sequencing, we verified that CF O25 protein presents 49.7% of homology with FaeG protein (F4), 35.4% with ClpG (CS31A) and 29.4% with FimF41. Using bioinformatics tools we determined the phylogenetic relationships between these proteins and the secondary structure of the CF O25. The genomic and plasmid DNA extraction assays indicates that the CF O25 gene is located in the bacterial chromosome. The CF O25 gene was cloned in the pET-151 expression vector, inserted in the E.coli BL21[DE3]-Star strain and the CF O25 protein was over expressed, purified and monospecific antiserum was obtained in rabbits. The purified CF O25 protein was submitted to Western Blotting assays with antissera against the FCs F4, F41 and CS31A and we verified recognition of the CF O25 in different degrees. The CG1905-B strain was used in the assays of electronic transmission microscopy using immunogold. The structure of the PCF is fibrillar resembling it the structure of the CS31A. This strain also was submitted the assays of adhesion to the eukaryotic culture cells and we observed adhesion to the Caco-2 cells (human colon carcinoma), this adhesion could be inhibited by anti-CFO25 antiserum. Our results suggest that the CF O25 can be important for the bovine pathogenicity of E. coli in Brazil, since we found CF O25 associated with other colonization factors and toxins, related with patogenicity in bovines, evidencing new relationships between virulence mechanisms that deserve new investigations, as well the elucidation of the complete structure of CF O25 operon / Doutorado / Microbiologia / Doutor em Genetica e Biologia Molecular

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-21T14:17:15Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertacao_versaofinal.pdf: 1059482 bytes, checksum: c0a9d49ea4461e5f4da07fbfdfd5c83a (MD5) / Made available in DSpace on 2017-07-21T14:17:15Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertacao_versaofinal.pdf: 1059482 bytes, checksum: c0a9d49ea4461e5f4da07fbfdfd5c83a (MD5) Previous issue date: 2015-03-02 / CNPQ / Uma parte considerável da população rural nos países em desenvolvimento vive em um ambientedeescassezdeágua,responsávelporaltastaxasdemortalidadeinfantildevidoàsdoenças relacionadasàáguacontaminada. Aliteraturaexistenteteminvestigadooimpactodemelhorias nosistemadeágua(englobandooefeitodaexpansãodarededeabastecimentodeágua,qualidadedaáguaetratamentodeesgoto)sobreasaúdeinfantileoimpactodechoquesdechuvaem áreas secas. O presente estudo contribui para este debate por inferir o efeito causal isolado de expansãodaofertadeáguasobreamortalidadeinfantilpordoençasdiarreicas,particularmente para as zonas semiáridas, explorando um programa que distribui cisternas entre os municípios situadosnosemiáridomaisdensamentepovoadodomundo. Aoexploraravariaçãoexógenana intervençãodoprogramanosmunicípios,juntamentecomotempodetaldecisão,verificou-se queoprogramateveumimpactosignificativosobreataxademortalidadeinfantilpordoenças diarreicasparaafaixaetáriade0a4anos. / Aconsiderablepartofruralpopulationindevelopingcountrieslivesinawaterscarceenvironment,responsibleforhighratesofchildmortalityduetounsafewaterrelateddiseases. Previous literaturehasinvestigatedtheimpactoninfanthealthofwatersystemimprovements(confoundingtheeffectofwatersupplynetworkexpansion,waterqualityandsewagetreatment)andthe impactofrainfallshocksindryareas. Thepresentstudycontributestothisdebatebyinferring theisolatedcausaleffectofwatersupplyexpansiononinfantmortalityfromdiarrhealdiseases, particularly for semiarid zones, as it exploits a program that distributes cisterns among municipalities placed on the most densely populated semiarid zone in the world. By exploring exogenousvariationinmunicipalitiesprogramintervention,alongwiththetimingofsuchdecision,ithasbeenobservedthattheprogramhadasignificantimpactontheinfantmortalityrate fromdiarrhealdiseasesinthegroupof0to4yearso

Intimina é o principal fator de virulência envolvido na lesão attaching/effacing em E. coli enteropatogênica (EPEC) e E. coli enterohemorrágica (EHEC), que são responsáveis pela diarreia infantil e colite hemorrágica/síndrome hemolítico-urêmica, respectivamente. Nos países em desenvolvimento, o diagnóstico desses patógenos ou é demorado e caro, ou não é realizado em laboratórios de rotina. No entanto, a detecção é essencial para definição do tratamento da infecção. O objetivo do presente trabalho foi definir o vetor de expressão mais apropriado e avaliar a sensibilidade e especificidade do scFv-intimina obtido. O gene scFv-intimina anteriormente obtido foi clonado nos vetores de expressão pAE e pSMT3, transformados em uma E. coli BL21 (DE3). A expressão foi induzida com 1 mM de IPTG. Em ambos os vetores, a proteína expressa foi direcionada para o citoplasma bacteriano, dessa forma a construção pAE-scFv-intimina foi utilizada na obtenção do anticorpo recombinante. Após cromatografia de afinidade ao níquel o scFv-intimina foi empregado no ensaio de imunofluorescência indireta para definir um teste de ensaio rápido e confiável, analisando-se 199 isolados de E. coli e isolados de outras Enterobactérias, dos quais 132 resultaram em isolados eae-positivos e 67 isolados eae-negativos. O teste de imunofluorescência mostrou a detecção de 132 isolados eae-positivos (100% de sensibilidade) e a não detecção de 67 isolados eae-negativos (100% especificidade). Assim, o ensaio de imunofluorescência é um método eficaz e rápido, e o scFv-intimina é uma excelente ferramenta para o imunodiagnóstico de EPEC e EHEC. / Intimin is the main virulence factor involved in the attaching/effacing lesion of enteropathogenic E. coli (EPEC) and enterohemorrhagic E. coli (EHEC), which are responsible for infantile diarrhea and hemorrhagic colitis/hemolytic uremic syndrome, respectively. In developing countries, their diagnosis is either time-consuming and expensive or is not done in the routine laboratory. Nevertheless, their detection is essential in defining the infection treatment. The aim of the study was to define the most suitable expression vector and evaluate the sensitivity and specificity of the scFv-intimin obtained. The scFv-intimin gene previously obtained was cloned into pAE and pSMT3 expression vectors and transformed into an E. coli BL21 (DE3) strain. Expression was induced with 1 mM IPTG. In both vectors, recombinant protein was expressed as inclusion bodies, so pAE was chosen as the expression vector for nickel affinity chromatography. Once purified, scFv-intimin was employed in an indirect immunofluorescence assay to define a rapid and reliable assay testing 199 E. coli strains and other Enterobacteriaceae isolates, of which 132 isolates were eae-positive and 67 isolates were eae-negative. The immunofluorescence assay showed the detection of 132 eae-positive isolates (100% sensitive) and no detection in the 67 eae-negative isolates (100% specific). Thus, immunofluorescence is an effective and rapid method and scFv-intimin an excellent tool for the immunodiagnosis of EPEC and EHEC.

E. coli pertencentes ao sorogrupo O111 são incluem amostras com diferentes fatores de virulência que são responsáveis por gastroenterites por todo o mundo e surtos de diarreia com sangue e síndrome hemolítico-urêmica em países desenvolvidos. Resultados obtidos anteriormente mostraram que o LPS O111 é um bom candidato a antígeno para a formulação de uma vacina contra E. coli O111. Desta forma, o polissacarídeo O111 foi conjugado com proteínas arreadoras. Coelhos foram imunizados pela via subcutânea com o conjugado O111-citocromo c incorporado em sílica SBA-15 como adjuvante, os resultados mostraram que os anticorpos obtidos foram capazes de reconhecer e inibir a adesão de todas as categorias de E. coli pertencentes ao sorogrupo O111. O veículo carreador de antígeno, VaxcineTM , foi incorporado no conjugado O111-EtxB e camundongos foram imunizados pela via oral, o que resultou em resposta imune sistêmica e de mucosa contra o LPS O111. Os anticorpos obtidos foram capazes de reconhecer amostras de todas as categorias de E. coli O111. Os dados obtidos neste trabalho sugerem que a utilização do polissacarídeo O111 em uma formulação conjugada é capaz de prevenir surtos de diarreia causada por E. coli O111 independente do seu mecanismo de virulência. / The E. coli serogroup O111 include samples with different virulence factors that are responsible for enteritis throughout the world and for outbreaks of bloody diarrhea and hemolytic uremic syndrome in developed countries. Previous results obtained have shown that O111 LPS is a good candidate antigen for the development of a vaccine against E. coli O111. Therefore, the polysaccharide was conjugated with carrier proteins. Rabbits were immunized subcutaneously with the O111-cytochrome c conjugate incorporated in silica SBA-15 as an adjuvant, the results obtained show that the antibodies were able to recognize and inhibit the adhesion of all types of E. coli belonging to serogroup O111. The antigen delivery vehicle, VaxcineTM was incorporated into the O111-EtxB conjugate, and mice were immunized by gavage, resulting in systemic and mucosal immune response against O111 LPS. These antibodies were able to recognize all categories of E. coli O111. The results presented in this work indicate that an oral conjugated vaccine that targets the O111 antigen has the potencial to prevent diarrhea by O111 E. coli strains, regardless their mechanism of virulence.