A infecção do sítio cirúrgico (ISC) é o processo infeccioso que ocorre no local onde se deu o procedimento cirúrgico, podendo manifestar-se após 48 horas da admissão hospitalar ou até 30 dias depois do procedimento e, em caso do uso de próteses, em até um ano. A ocorrência de ISC é responsável por grande parte das infecções que ocorrem nos hospitais tanto em medicina quanto em veterinária, elevando o tempo de hospitalização, os custos do tratamento e os transtornos aos pacientes por ela acometidos. Estas infecções geralmente estão associadas a fatores que predispõe a sua ocorrência, os chamados fatores de risco. O objetivo deste estudo foi determinar a taxa de infecção do sítio cirúrgico e os seus fatores de risco, para procedimentos cirúrgicos em cães e gatos realizadas no Hospital de Clínicas Veterinárias da UFRGS no ano de 2012. Foram acompanhados sempre às terças e quintas feiras, 400 procedimentos cirúrgicos em 339 cães e gatos operados na rotina do bloco cirúrgico do HCV-UFRGS e escolhidos de forma randômica. O critério de inclusão foi, procedimentos realizados na rotina do bloco cirúrgico e o critério de exclusão foi, procedimentos de profilaxia dentária, oftálmicos, os óbitos e pacientes que não retornaram para a retirada de suturas. Os dados foram registrados em uma planilha especialmente elaborada para esta pesquisa, considerando os fatores de risco de desenvolvimento de ISC mais citados na literatura. A análise estatística foi realizada com um banco de dados dos 339 animais observados, onde constavam 37 fatores de risco (variáveis independentes) e infecção do sítio cirúrgico (variável dependente). Os fatores de risco para ISC foram identificados por regressão logística multivariável utilizando o procedimento PROC LOGISTIC no SAS® versão 9.1. Foi feito um modelo univariável e todas as variáveis com valor p < 0,20 foram selecionadas para compor o modelo multivariável que foi construído no método de seleção de Forward, e o modelo de menor AIC passou pelo método de seleção Backward até que só restassem variáveis com valor p ≤0,05. O ajuste do modelo final foi testado utilizando o teste Hosmer-Lemeshow. No modelo univariável com valor de p < 0,20 foram selecionadas 7 variáveis. O modelo multivariável final teve ajuste entre 3 variáveis: índice ASA, duração de incisão e internação prévia e o valor de AIC deste modelo foi 180,6. O teste de hipótese global (Wald) teve valor de p 0,002 e o teste de ajustamento do modelo (Hosmer-Lemeshow) teve valor de p de 0,31 significando que estava ajustado. O resultado obtido foi um índice de ISC de 8,5%. / A surgical site infection (SSI) is the infectious process that occurs at the site where the surgery took place, and can manifest itself after 48 hours of hospital admission or within 30 days after the procedure and if the use of prostheses, within one year. The occurrence of this disease is responsible for much of nosocomial infections in both medicine and in veterinary, increasing the hospitalization time, cost of treatment and the inconvenience to patients affected by it. These infections are usually associated with factors predisposing to its occurrence, so-called risk factors. The aim of this study was to determine the rate of surgical site infection and its risk factors, for surgeries in dogs and cats held at UFRGS Veterinary Hospital in 2012. Were always accompanied on Tuesdays and Thursdays, four hundred procedures were followed in 339 dogs and cats routinely operated in the surgical HCV-UFRGS and chosen randomly. The inclusion criterion was, the routine procedures performed in surgical and exclusion criterion was, dental prophylaxis procedures, ophthalmic, deaths and patients who did not return for removal of sutures. Data were recorded on a table designed especially for this study, considering the risk factors for development of SSI most often cited in the literature. Statistical analysis was performed using a database of 339 animals observed, which contained 37 risk factors (independent variables) and surgical site infection (dependent variable). Risk factors for SSI were identified by multivariate logistic regression using PROC LOGISTIC in SAS ® version 9.1. A univariate model was created and all variables with p < 0.20 were selected to compose the multivariable model. The multivariable model was built at Forward selection method, and the model with the lowest AIC passed Backward selection method until there remained only variables with p ≤ 0.05. The fit of the final model was tested using the Hosmer- Lemeshow. In the univariate model with p <0.20 were selected 7 variables. The final multivariable model was fit between the three variables: ASA index, duration of incision and previous hospitalization and the AIC value of the model was 180.6. The global hypothesis test (Wald) was p-value 0.002 and the test model adjustment (Hosmer- Lemeshow) had a p value of 0.31 signifying that was set. The result was an index of ISC 8.5%.

A infecção do sítio cirúrgico (ISC) é o processo infeccioso que ocorre no local onde se deu o procedimento cirúrgico, podendo manifestar-se após 48 horas da admissão hospitalar ou até 30 dias depois do procedimento e, em caso do uso de próteses, em até um ano. A ocorrência de ISC é responsável por grande parte das infecções que ocorrem nos hospitais tanto em medicina quanto em veterinária, elevando o tempo de hospitalização, os custos do tratamento e os transtornos aos pacientes por ela acometidos. Estas infecções geralmente estão associadas a fatores que predispõe a sua ocorrência, os chamados fatores de risco. O objetivo deste estudo foi determinar a taxa de infecção do sítio cirúrgico e os seus fatores de risco, para procedimentos cirúrgicos em cães e gatos realizadas no Hospital de Clínicas Veterinárias da UFRGS no ano de 2012. Foram acompanhados sempre às terças e quintas feiras, 400 procedimentos cirúrgicos em 339 cães e gatos operados na rotina do bloco cirúrgico do HCV-UFRGS e escolhidos de forma randômica. O critério de inclusão foi, procedimentos realizados na rotina do bloco cirúrgico e o critério de exclusão foi, procedimentos de profilaxia dentária, oftálmicos, os óbitos e pacientes que não retornaram para a retirada de suturas. Os dados foram registrados em uma planilha especialmente elaborada para esta pesquisa, considerando os fatores de risco de desenvolvimento de ISC mais citados na literatura. A análise estatística foi realizada com um banco de dados dos 339 animais observados, onde constavam 37 fatores de risco (variáveis independentes) e infecção do sítio cirúrgico (variável dependente). Os fatores de risco para ISC foram identificados por regressão logística multivariável utilizando o procedimento PROC LOGISTIC no SAS® versão 9.1. Foi feito um modelo univariável e todas as variáveis com valor p < 0,20 foram selecionadas para compor o modelo multivariável que foi construído no método de seleção de Forward, e o modelo de menor AIC passou pelo método de seleção Backward até que só restassem variáveis com valor p ≤0,05. O ajuste do modelo final foi testado utilizando o teste Hosmer-Lemeshow. No modelo univariável com valor de p < 0,20 foram selecionadas 7 variáveis. O modelo multivariável final teve ajuste entre 3 variáveis: índice ASA, duração de incisão e internação prévia e o valor de AIC deste modelo foi 180,6. O teste de hipótese global (Wald) teve valor de p 0,002 e o teste de ajustamento do modelo (Hosmer-Lemeshow) teve valor de p de 0,31 significando que estava ajustado. O resultado obtido foi um índice de ISC de 8,5%. / A surgical site infection (SSI) is the infectious process that occurs at the site where the surgery took place, and can manifest itself after 48 hours of hospital admission or within 30 days after the procedure and if the use of prostheses, within one year. The occurrence of this disease is responsible for much of nosocomial infections in both medicine and in veterinary, increasing the hospitalization time, cost of treatment and the inconvenience to patients affected by it. These infections are usually associated with factors predisposing to its occurrence, so-called risk factors. The aim of this study was to determine the rate of surgical site infection and its risk factors, for surgeries in dogs and cats held at UFRGS Veterinary Hospital in 2012. Were always accompanied on Tuesdays and Thursdays, four hundred procedures were followed in 339 dogs and cats routinely operated in the surgical HCV-UFRGS and chosen randomly. The inclusion criterion was, the routine procedures performed in surgical and exclusion criterion was, dental prophylaxis procedures, ophthalmic, deaths and patients who did not return for removal of sutures. Data were recorded on a table designed especially for this study, considering the risk factors for development of SSI most often cited in the literature. Statistical analysis was performed using a database of 339 animals observed, which contained 37 risk factors (independent variables) and surgical site infection (dependent variable). Risk factors for SSI were identified by multivariate logistic regression using PROC LOGISTIC in SAS ® version 9.1. A univariate model was created and all variables with p < 0.20 were selected to compose the multivariable model. The multivariable model was built at Forward selection method, and the model with the lowest AIC passed Backward selection method until there remained only variables with p ≤ 0.05. The fit of the final model was tested using the Hosmer- Lemeshow. In the univariate model with p <0.20 were selected 7 variables. The final multivariable model was fit between the three variables: ASA index, duration of incision and previous hospitalization and the AIC value of the model was 180.6. The global hypothesis test (Wald) was p-value 0.002 and the test model adjustment (Hosmer- Lemeshow) had a p value of 0.31 signifying that was set. The result was an index of ISC 8.5%.

A infecção do sítio cirúrgico (ISC) é o processo infeccioso que ocorre no local onde se deu o procedimento cirúrgico, podendo manifestar-se após 48 horas da admissão hospitalar ou até 30 dias depois do procedimento e, em caso do uso de próteses, em até um ano. A ocorrência de ISC é responsável por grande parte das infecções que ocorrem nos hospitais tanto em medicina quanto em veterinária, elevando o tempo de hospitalização, os custos do tratamento e os transtornos aos pacientes por ela acometidos. Estas infecções geralmente estão associadas a fatores que predispõe a sua ocorrência, os chamados fatores de risco. O objetivo deste estudo foi determinar a taxa de infecção do sítio cirúrgico e os seus fatores de risco, para procedimentos cirúrgicos em cães e gatos realizadas no Hospital de Clínicas Veterinárias da UFRGS no ano de 2012. Foram acompanhados sempre às terças e quintas feiras, 400 procedimentos cirúrgicos em 339 cães e gatos operados na rotina do bloco cirúrgico do HCV-UFRGS e escolhidos de forma randômica. O critério de inclusão foi, procedimentos realizados na rotina do bloco cirúrgico e o critério de exclusão foi, procedimentos de profilaxia dentária, oftálmicos, os óbitos e pacientes que não retornaram para a retirada de suturas. Os dados foram registrados em uma planilha especialmente elaborada para esta pesquisa, considerando os fatores de risco de desenvolvimento de ISC mais citados na literatura. A análise estatística foi realizada com um banco de dados dos 339 animais observados, onde constavam 37 fatores de risco (variáveis independentes) e infecção do sítio cirúrgico (variável dependente). Os fatores de risco para ISC foram identificados por regressão logística multivariável utilizando o procedimento PROC LOGISTIC no SAS® versão 9.1. Foi feito um modelo univariável e todas as variáveis com valor p < 0,20 foram selecionadas para compor o modelo multivariável que foi construído no método de seleção de Forward, e o modelo de menor AIC passou pelo método de seleção Backward até que só restassem variáveis com valor p ≤0,05. O ajuste do modelo final foi testado utilizando o teste Hosmer-Lemeshow. No modelo univariável com valor de p < 0,20 foram selecionadas 7 variáveis. O modelo multivariável final teve ajuste entre 3 variáveis: índice ASA, duração de incisão e internação prévia e o valor de AIC deste modelo foi 180,6. O teste de hipótese global (Wald) teve valor de p 0,002 e o teste de ajustamento do modelo (Hosmer-Lemeshow) teve valor de p de 0,31 significando que estava ajustado. O resultado obtido foi um índice de ISC de 8,5%. / A surgical site infection (SSI) is the infectious process that occurs at the site where the surgery took place, and can manifest itself after 48 hours of hospital admission or within 30 days after the procedure and if the use of prostheses, within one year. The occurrence of this disease is responsible for much of nosocomial infections in both medicine and in veterinary, increasing the hospitalization time, cost of treatment and the inconvenience to patients affected by it. These infections are usually associated with factors predisposing to its occurrence, so-called risk factors. The aim of this study was to determine the rate of surgical site infection and its risk factors, for surgeries in dogs and cats held at UFRGS Veterinary Hospital in 2012. Were always accompanied on Tuesdays and Thursdays, four hundred procedures were followed in 339 dogs and cats routinely operated in the surgical HCV-UFRGS and chosen randomly. The inclusion criterion was, the routine procedures performed in surgical and exclusion criterion was, dental prophylaxis procedures, ophthalmic, deaths and patients who did not return for removal of sutures. Data were recorded on a table designed especially for this study, considering the risk factors for development of SSI most often cited in the literature. Statistical analysis was performed using a database of 339 animals observed, which contained 37 risk factors (independent variables) and surgical site infection (dependent variable). Risk factors for SSI were identified by multivariate logistic regression using PROC LOGISTIC in SAS ® version 9.1. A univariate model was created and all variables with p < 0.20 were selected to compose the multivariable model. The multivariable model was built at Forward selection method, and the model with the lowest AIC passed Backward selection method until there remained only variables with p ≤ 0.05. The fit of the final model was tested using the Hosmer- Lemeshow. In the univariate model with p <0.20 were selected 7 variables. The final multivariable model was fit between the three variables: ASA index, duration of incision and previous hospitalization and the AIC value of the model was 180.6. The global hypothesis test (Wald) was p-value 0.002 and the test model adjustment (Hosmer- Lemeshow) had a p value of 0.31 signifying that was set. The result was an index of ISC 8.5%.

Les protozooses digestives restent une des premières causes de morbidité, de malnutrition et de mortalité dans le monde. Cependant, la biologie de certains protozoaires entériques comme Blastocystis est mal connue et il reste négligé par les autorités sanitaires. Ce parasite colonise le tractus intestinal de l’Homme et de nombreux animaux. Son principal mode de transmission est la voie oro-fécale et sa prévalence peut dépasser 50% dans les pays en développement. Il présente une large diversité génétique avec 17 sous-types (STs) identifiés à ce jour. Un large faisceau de données récentes suggère que l’infection à Blastocystis est associée à une variété de troubles gastro-intestinaux et de l’urticaire.Dans le cadre de ma thèse, des études épidémiologiques ont été menées dans différents pays (Liban, Sénégal, France) afin de déterminer la prévalence de ce parasite dans la population humaine et identifier des facteurs de risque d’infection. En parallèle, à travers une enquête dans des zoos français, des réservoirs animaux de transmission zoonotique du parasite ont été proposés. D’autre part, les mécanismes impliqués dans la colonisation de l’hôte par Blastocystis ont été étudiés.Dans le cadre des enquêtes épidémiologiques, le parasite a été recherché dans les selles par PCR en temps réel et l’amplicon obtenu séquencé pour le sous-typage. La première étude menée au Liban a montré une prévalence de 19% dans la population générale mais cette prévalence atteint 60% dans une population d’écoliers vivant dans la même région. Une prévalence de 100% a été obtenue dans une cohorte d’enfants sénégalais. Ces fortes prévalences s’expliquent par des conditions d’hygiènes très précaires. Le ST3 était prédominant dans ces deux pays suivi des ST1 et ST2. Dans une étude multicentrique menée en France, une prévalence globale de 18,3% a été obtenue avec une prédominance du ST3 suivi des ST1, ST4 et ST2. Cette distribution est aussi celle observée dans une majorité de pays européens. Dans l’étude française, des variables (voyage récent, âge, saison) ont été identifiés comme des facteurs de risque de transmission du parasite. Le contact avec des animaux peut représenter un autre facteur de risque du fait du potentiel zoonotique du parasite. Dans une large étude épidémiologique réalisée dans deux zoos français sur plus de 160 espèces animales, la prévalence globale de Blastocystis dépasse 30% avec des variations importantes selon les groupes d’animaux. En comparant la distribution des STs entre l’Homme et les différents groupes d’animaux, les primates, les artiodactyles (bovins et cochons) et les oiseaux représenteraient les principaux réservoirs potentiels d’infection pour l’Homme.Une association entre l’infection à Blastocystis et l’appendicite a été mise en évidence chez une enfant au Maroc confirmant la pathogénie et le potentiel invasif et inflammatoire du parasite. De plus, 26 autres membres de sa famille ont présenté des symptômes digestifs suggérant une épidémie de blastocystose d’origine hydrique. L’hypothèse d’une relation entre ST de Blastocystis et pouvoir pathogène a été émise d’où l’intérêt d’une étude de génomique comparative afin d’identifier des facteurs de virulence pouvant être spécifiques d’un ST. A ce jour, aucune différence n’a pu être mise en évidence entre le génome de ST4 séquencé durant ma thèse et celui de ST7 disponible dans les bases de données alors qu’ils présentent une virulence différente in vitro. Enfin, l’impact de la colonisation par Blastocystis sur la composition du microbiote intestinal humain a été évalué. Une approche par séquençage à haut-débit a permis de comparer les compositions des microbiotes de patients infectés ou non par Blastocystis montrant une diversité bactérienne plus élevée chez les patients colonisés par le parasite. Ces données suggèrent que la colonisation par Blastocystis ne serait pas associée à une dysbiose intestinale généralement observée dans les maladies infectieuses intestinales. / Digestive protozoan infections are a major cause of morbidity, malnutrition and mortality worldwide. However, the biology of some enteric protozoa as Blastocystis is not well known and these microorganisms remain still neglected by the health authorities. Briefly, this parasite colonizes the intestinal tract of humans and various animals. Its main mode of transmission is the fecal-oral route and its prevalence can exceed 50% in developing countries. It exhibits a large genetic diversity with 17 subtypes (STs) identified to date. Recent data suggest that infection with Blastocystis is associated with a variety of gastrointestinal disorders and urticaria. As part of my thesis, epidemiological studies have been conducted in different countries (Lebanon, Senegal, France) to determine the prevalence of this parasite in the human population and identify risk factors for infection. In parallel, through a survey in French zoos, animal reservoirs of zoonotic transmission of Blastocystis have been proposed. Moreover, mechanisms involved in the colonization of the host by the parasite were studied.As part of, epidemiological, the parasite was identified in faecal samples by real-time PCR and the resulting amplicon was sequenced for subtyping. The first study conducted in Lebanon in the Tripoli area showed a prevalence of 19% in the general population but this prevalence reached 60% in a population of school children living in the same region. A prevalence of 100% was obtained in a cohort of Senegalese children. The high prevalence observed in these countries can be explained by poor hygiene conditions in connection with the faecal peril. In terms of distribution of STs, the ST3 was predominant in both countries followed by ST1 and ST2. In a multicenter study conducted in France, an overall prevalence of 18.3% was obtained with a predominance of ST3, followed by ST1, ST2 and ST4. This distribution is quite similar to that observed in most European countries. In the French study, parasite prevalence was significantly higher in summer than in winter. Other variables such as a recent trip and age have been identified as risk factors for transmission of the parasite. The contact with animals may represent another risk factor because of the zoonotic potential of the parasite. In a large epidemiological study conducted in two French zoos and including over 160 animal species, the overall prevalence of Blastocystis exceeds 30% with significant variations between animal groups. By comparing the distribution of STs between humans and different groups of animals, primates, artiodactyls (cattle and pigs) and birds represent major potential reservoirs of infection for humans.An association between infection with Blastocystis and appendicitis was demonstrated in a child in Morocco confirming the pathogenicity and invasive and inflammatory potential of the parasite. In addition, 26 other family members presented digestive symptoms suggesting waterborne outbreak of blastocystosis. The hypothesis of a relationship between Blastocystis ST and pathogenicity was suggested hence the interest of a comparative genomics study to identify virulence factors that may be present or absent for some STs. No difference was found between the ST4 genome sequenced during my thesis and the ST7 genome available in the database while these STs have different virulence in vitro. Finally, the unknown impact of colonization by Blastocystis on the composition of the human intestinal microbiota was evaluated. The compositions of the bacterial microbiota of 96 patients infected or not by Blastocystis were obtained by high-throughput sequencing and compared. A higher bacterial diversity was found in colonized patients compared to non-infected patients. These data suggest that colonization by Blastocystis would not be associated with dysbiosis generally observed in intestinal infectious diseases but rather to a healthy intestinal microbiota.