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No. of bitstreams: 2 Dissertação - Tainá Carvalho Guerreiro - 2015.pdf: 1793254 bytes, checksum: b06a919b2f95dde4661fe77445d3668c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-07-08 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Streptococcus pneumoniae remains as a major cause of childhood morbidity and mortality worldwide, especially in developing countries. Nasopharyngeal colonization is the key of the development of pneumococcal diseases as well as for horizontal spread of this pathogen in the community. Children are the main reservoir of S. pneumoniae and act as vectors in the transmission chain of this microorganism. Pneumococcal conjugate vaccines protect against pneumococcal disease caused by vaccine serotypes, also contributes to the protection against colonization by the same serotypes. In 2010, PCV10 was introduced in the childhood immunization program of Brazil. This is a population-based study that was conducted immediately after the introduction of the vaccine in order to determine the carriage rate of this pathogen in children attending in day care centers in Goiania. These data may be used as a predictor for evaluating the dynamic of the circulating serotypes into the community after the vaccine introduction. Between October and November 2010, nasopharyngeal swabs were collected from 853 children ranging from 36 to 59 months attending in day care centers in Goiania. Isolation and identification of S. pneumoniae were done after the incubation step on broth-enriched for 6 h and posterior plating on blood agar. Isolates that were α-haemolytic, optochin-sensitive and soluble in bile were identified as S. pneumoniae. The isolates were serotyped by cmPCR. The database had been built with the statistical program SPSS (Chicago, IL, USA) version 18.0. The possible risk factors were assessed by multivariate Poisson regression. The level of probability of 0.05 (two-tailed) was used to determine statistical significance. The prevalence of pneumococcus carrier was 57.6% (CI95%: 54.2% - 60.9%). According to the multivariate Poisson regression analysis, children aged 36-47 months (IRR: 1.117; CI95%: 1.007-1.238; p: 0.035) and children in whose houses had four or more residents (IRR: 1.1214; CI95%: 1.078-1.368; p 0.001) were considered risk factors independently associated to pneumococcal colonization. The variable family income equal to or greater than three minimum wages was considered a protective factor independently associated to pneumococcal colonization (IRR: 0.787; CI95%: 0.627-0.990; p 0.041). The most prevalent serotypes and serogroups founded were 6A/6B/6C/6D (n=80; 16.3%), 14 (n=47; 9.6%), 23F (n=46; 9.4%), 19F (n=43; 8.8%), 15B/15C (n=30; 6.1%), 11A/11D (n=28; 5.7%), 3 (n=22; 4.5%) and 19A (n=16; 3.3%). Our results showed a high prevalence of pneumococcal colonization among the study population, indicating that colonization by this microrganism is common among children, especially in environments that favor crowding. The main serotypes/serogroups are cover by PCV10. / Streptococcus pneumoniae é o patógeno responsável pelas maiores taxas de morbidade e mortalidade em crianças, principalmente em países em desenvolvimento. A colonização da nasofaringe é a chave para o desenvolvimento das doenças pneumocócicas, bem como para a transmissão horizontal desse patógeno na comunidade. Crianças são o principal reservatório de S. pneumoniae e atuam como vetores dentro da cadeia de transmissão desse microrganismo. As vacinas pneumocócicas conjugadas (PCV) protegem contra as doenças pneumocócicas causadas pelos sorotipos vacinais, atuando também na proteção contra a colonização pelos mesmos sorotipos. Em 2010, o Brasil introduziu a PCV10 no programa de imunização infantil. Este trabalho é um estudo de base populacional que foi conduzido imediatamente após a introdução da PCV10 para determinar a taxa de portador desse patógeno em crianças não vacinadas que frequentam creches no município de Goiânia. Esses dados poderão ser utilizados como linha de base epidemiológica para avaliação da dinâmica dos sorotipos circulantes na comunidade após a introdução da vacina. Foram coletados, nos meses de outubro e novembro de 2010, 853 swabs de secreção da nasofaringe em crianças entre 36 a 59 meses que frequentavam creches no município de Goiânia. Para o isolamento e identificação de S. pneumoniae as amostras foram incubadas por 6 h em caldo enriquecido e semeadas em ágar sangue. Colônias α-hemolíticas sensíveis à optoquina e à bile foram identificadas como S. pneumoniae. Os isolados foram sorotipados por PCR multiplex convencional. A base de dados foi construída com o programa estatístico SPSS (Chicago, IL, USA) versão 18.0. Os possíveis fatores de risco foram avaliados por regressão de Poisson multivariada. O nível de probabilidade de 0,05 (bi-caudal) foi utilizado para determinar a significância estatística. A prevalência de portador do pneumococo foi de 57,6% (IC95%: 54,2% - 60,9%). De acordo com a análise multivariada crianças com idade entre 36-47 meses de idade (IRR: 1,117; IC95%:1,007 – 1,238; p= 0,035) e crianças em cujos domicílios haviam quatro ou mais pessoas residentes (IRR: 1,1214; IC95%: 1,078 – 1,368; p= 0,001) foram considerados fatores de risco independentemente associados para a colonização pneumocócica. A variável renda familiar igual ou superior a três salários mínimos foi considerada um fator protetor independentemente associado para a colonização pneumocócica (IRR: 0,787; IC95%: 0,627 – 0,990; p= 0,041). Os sorotipos/sorogrupos mais prevalentes foram 6A/6B/6C/6D (n=80; 16,3%), 14 (n=47; 9,6%), 23F (n=46; 9,4%), 19F (n=43; 8,8%), 15B/15C (n=30; 6,1%), 11A/11D (n=28; 5,7%), 3 (n=22; 4,5%) e 19A (n=16; 3,3%). Nossos resultados mostraram uma alta prevalência de colonização por pneumococo entre a população estudada, indicando que a colonização por esse microrganismo é comum entre crianças, principalmente em ambientes que favorecem a aglomeração. Os principais sorotipos/sorogrupos encontrados são contemplados pela PCV10.

Regulation of adenoviral gene expression is a complex process directed by viral proteins controlling a multitude of different activities at distinct phases of the virus life cycle. This thesis discusses adenoviral regulation of transcription and splicing by two proteins expressed at the late phase: L4-22K and L4-33K. These are closely related with a common N-terminus but unique C-terminal domains. The L4-33K protein is an alternative RNA splicing factor inducing L1-IIIa mRNA splicing, while L4-22K is stimulating transcription from the major late promoter (MLP). The L4-33K protein contains a tiny RS-repeat in its unique C-terminal end that is essential for the splicing enhancer function of the protein. Here we demonstrate that the tiny RS-repeat is required for localization of the protein to the nucleus and viral replication centers. Further, we describe an auto-regulatory loop where L4-33K enhances splicing of its own intron. The preliminary characterization of the responsive RNA-element suggests that it differs from the previously defined L4-33K-responsive element activating L1-IIIa mRNA splicing. L4-22K lacks the ability to enhance L1-IIIa splicing in vivo, and here we show that the protein is defective in L1-IIIa or other late pre-mRNA splicing reactions in vitro. Interestingly, we found a novel function for the L4-22K and L4-33K proteins as regulators of E1A alternative splicing. Both proteins selectively upregulated E1A-10S mRNA accumulation in transfection experiments, by a mechanism independent of the tiny RS-repeat. Although L4-22K is reported to be an MLP transcriptional enhancer protein, here we show that L4-22K also functions as a repressor of MLP transcription. This novel activity depends on the integrity of the major late first leader 5’ splice site. The model suggests that at low concentrations L4-22K activates MLP transcription while at high concentrations L4-22K represses transcription. So far, characterizations of the L4-22K and L4-33K proteins have been limited to human adenoviruses 2 or 5 (HAdV-2/5). We expanded our experiments to include HAdV-3, HAdV-4, HAdV-9, HAdV-11 and HAdV-41. The results demonstrated that the transcription- or splicing-enhancing properties of L4-22K and L4-33K, respectively, are evolutionarily conserved and non-overlapping. Thus, the sequence-based conservation is mirrored by the functions, as expected for functionally important proteins.

Background: S. pneumoniae is a major cause of meningitis, pneumonia and sepsis in children. In 2006 universal pneumococcal vaccination was recommended in Germany for all children up to their second birthday. We have compared the prevalence and outcome of IPD at a single hospital before and after the introduction of vaccination. Findings: 55 cases of IPD were identified over an 11 year period. Almost half of the patients were younger than 2 years of age. Most of the children were affected by pneumonia. The second highest incidence seen was for meningitis and sepsis. 17 patients exhibited additional complications. Significant pre-existing and predisposing disorders, such as IRAK 4 defect, ALPS or SLE were identified in 4 patients. Complete recovery was seen in 78% of affected children; 11% had a fatal outcome and 11% suffered from long term complications. Only 31% overall had been vaccinated. The most common serotype was 14. Serotypes not covered by any of the current vaccines were also found. Antibiotic treatment commenced with cephalosporins in over 90%. Conclusion: Frequency of IPD in our hospital did not decrease after initiation of the pneumococcal vaccination. This might be due to vaccinations not being administered satisfactorily as well as to poor education about the need of the vaccination. Pre-existing diseases must be monitored and treated accordingly and rare deficiencies taken into account when IPD takes a foudroyant course. In addition, antibiotic stewardship has been initiated at this hospital centre as a consequence of the high cephalosporin use detected in this study.

Alpacas were first introduced into South Africa during the year 2000. They are valuable because of the fine quality wool they produce which has much better insulation properties than that of merino wool fibres. Alpacas are also used to act as guards of sheep herds against predators. During 2008, blood samples from an alpaca that died acutely with severe lung oedema, respiratory distress and froth exuding from the nose were received at Elsenburg Veterinary Laboratory. The alpaca was from a herd of 23 alpacas of a British veterinarian in the Montagu district in the western Cape. Virus isolation attempts on the blood produced infrequent embryo mortalities. Embryonated chicken egg (ECE) material was send to the Virology Department at the Onderstepoort Veterinary Institute (OVI). A bluetongue virus (BTV) PCR performed at the diagnostic PCR laboratory at OVI on the ECE material was positive. Further intra-venous (IV) inoculations in ECE produced embryo mortalities on two consecutive days, the 8th and 9th November. The dead embryos were harvested separately and named and treated as two separate virus samples, Alp8 and Alp9 which were further passaged on baby hamster kidney (BHK) cells. The BTV virus neutralisation tests (VNT) performed at the Office International des Epizooties (OIE) Laboratory on both Alp8 and Alp9 were negative. Because of the close serological relationship between BTV and epizootic haemorrhagic disease virus (EHDV), an EHDV VNT was also performed and was also negative. In the light of the negative VNT and the positive BTV PCR results, more in-depth molecular analyses were performed. RNA was purified from tissue culture material and agarose gel electrophoresis (AGE) performed. Both Alp8 and Alp9 had a typical orbiviral electrophoretic profile, but their respective profiles were different. A sequence-independent reverse transcriptase PCR amplification method generated ample complementary DNA (cDNA) of both samples for sequencing. Sanger sequencing was used to partially sequence genome segments 5 (NS1) and 2 (VP2). BLAST analysis of the partial information of the genome segments 5 (NS1) of Alp8 confirmed it as being a BTV and Alp9 as being an EHDV. BLAST analysis of the deduced amino acid sequence generated of VP2 of both Alp8 and Alp9 established that these samples were possibly new serotypes of BTV and EHDV respectively. The complete genome of both Alp8 and Alp9 was sequenced with next generation 454 Pyrosequencing. This confirmed the partial sequencing results. BLAST analysis of the complete sequence of S2 (VP2) of Alp8 showed that it has 73 % nucleotide and 77 % deduced amino acid identity to BTV15. In contrast the nucleic acid sequence of genome segment S2 (VP2) of Alp9 had no nucleotide sequence identity to any virus, but its deduced amino acid sequence had 71 % amino acid identity to EHDV2. Hyper immune guinea pig (GP) serum prepared against the putative new BT (Alp8) and EHD (Alp9) virus serotypes were tested for serological cross-reactivity against the 24 OIE reference antigen strains of BTV and the 8 OIE reference antigen strains of EHDV. Alp8 had a neutralising antibody (NAb) titre of > 32 against BTV15. Alp9 did not cross react with any of the OIE BTV and EHDV strains. Six out of the remaining 22 alpacas on the farm had NAbs to a greater or lesser extend against Alp8 (BTV) and Alp9 (EHDV) viruses, which confirmed that the viruses were also present in other alpacas in the herd. Very few cases of EHDV in alpacas have ever been reported in literature. A small scale pilot vector susceptibility study showed that vector competence of C. imicola for both Alp8 and Alp9 was low, below 2 %. The fact that neutralising antibodies to Alp8 and Alp9 were detected in other alpacas in the herd raises the question as to whether there are other Culicoides species circulating in the area that could vector the viruses. In conclusion, the results from the serological and virological analyses as well as the nucleic acid sequence data of the genomes of two virus samples, Alp8 and Alp9, from an alpaca that died in the Montagu district in the western Cape identified Alp9 as a definite new serotype of EHDV and Alp8 as a possible new serotype of BTV most closely related to BTV15. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

Listeria monocytogenes é um patógeno intracelular facultativo responsável por listeriose, uma doença de origem alimentar. Dentre os 13 sorotipos de L. monocytogenes existentes, o sorotipo 4b é o mais freqüentemente isolado de humanos, enquanto os sorotipos 1/2a, 1/2b e 1/2c são mais freqüentes em alimentos e amostras ambientais. O estudo da variabilidade de virulência de quatro cepas de L. monocytogenes recentemente isoladas (1/2B - alimento; 1/2C e 4BENV - ambiente de processamento de alimento; 4BCLIN - sangue), além de duas outras cepas de casos de listeriose (P14 e P14A), foi o objetivo deste trabalho. Avaliou-se a capacidade de invasão, proliferação intracelular, citotoxicidade, disseminação intercelular, polimerização de filamentos de actina e transcrição gênica dos genes de virulência actA, plcA e plcB das cepas em modelos celulares eucarióticos MDBK, HeLa e L929. A cepa de origem alimentar 1/2B apresentou características de invasão, taxa de multiplicação (IGC), assim como a disseminação intercelular, semelhantes às cepas clínicas P14 e 4BCLIN em células HeLa. As cepas de origem ambiental (1/2C e 4BENV), apesar da baixa capacidade de invasão em todas linhagens celulares empregadas, apresentaram IGC superior às demais cepas estudadas e disseminação intercelular superior ou similar às cepas clínicas, dependendo da célula eucariótica. As cepas de origem clínica 4BCLIN, P14, P14A tiveram maiores porcentagens de invasão nas linhagens MDBK e L929, porém, em relação à população intracelular (UFC/mL), as cepas 4BCLIN e P14A foram superiores às demais. Estas últimas também foram citotóxicas às células HeLa, induzindo à liberação de LDH e à morte por necrose. Já as cepas de origem alimentar, ambiental e a cepa clínica P14 não foram citotóxicas às células HeLa e MDBK. Em relação à polimerização dos filamentos de actina não houve diferença estatística entre as cepas. Todos os genes de virulência estudados apresentaram maior número de transcritos para as cepas de origem não clínica (1/2B, 1/2C e 4BENV). Sendo assim, todas as cepas de L. monocytogenes estudadas possuem potencial patogênico, por apresentar pelo menos duas características relacionadas à virulência da espécie. Alimentos possivelmente contaminados com estas cepas representam risco à saúde pública. / Listeria monocytogenes is a facultative intracellular pathogen responsible for listeriose, a foodborne disease. Amongst the 13 serotypes of L. monocytogenes, the serotype 4b is more frequently isolated from clinical samples while the serotypes 1/2a, 1/2b and 1/2c are associated with food and food processing environment. The study of the virulence variability of four L. monocytogenes strains recently isolated (1/2B - food; 1/2C and 4BENV - food processing environment; 4BCLIN blood), as well as two strains of listeriosis (P14 and P14A) was the aim of this work. Eukaryotic cellular models HeLa, MDBK and L929 were used to evaluate the invasion capacity, intracellular proliferation, cytotoxicity, intercellular dissemination and polymerization of actin tails of L. monocytogenes strains. Gene transcription of the virulence genes actA, plcA and plcB was also conducted. The food isolate 1/2B presented invasion characteristics, multiplication index (IGC), as well as the intercellular dissemination, similar to the clinical strains P14 and 4BCLIN in HeLa cells. Environmental strains (1/2C and 4BENV), although showing a low capacity of invasion in all cellular models, had the highest IGC comparing to the other isolates. They also showed similar to or higher intercellular dissemination than the clinical ones, depending on the cell line used. The clinical strains 4BCLIN, P14, P14A presented greater invasion capacity in MDBK and L929 cells than all other isolates. However, in relation to the intracellular population (CFU/mL) the isolates 4BCLIN and P14A showed superior results. These strains were also cytotoxic to HeLa cells, inducing LDH release and death due to necrosis. The food, environmental and P14 isolates were not cytotoxic to HeLa and MDBK cells. There was no statistical difference in actin tail polymerization between the strains. The non-clinical isolates (1/2B, 1/2C and 4BENV) presented higher number of transcripts for than the clinical ones. In conclusion, all L. monocytogenes strains studied showed pathogenic potential, based on expression of at least two characteristics related to the virulence of the species. The presence of these strains in food represents public health risk.

Traditionally, bacterial culture has been used for bacterial detection, allowing study of living microorganisms. Molecular methods are rapid and allow simultaneous identification of numerous species and uncultivated phylotypes. The objective of this doctoral thesis was to investigate the role of the oral microbiota, including poorly characterized and uncultivated bacteria, in dental caries and periodontitis, by comprehensive molecular, clinical, and statistical methods. The microbiota of 275 pre-school children (75 with caries and 200 caries-free) was examined by whole genomic DNA probes, 16S rDNA cloning and sequencing, and PCR. Streptococcus mutans, exhibiting a combined association with Streptococcus sobrinus, was significantly associated with Early Childhood Caries (ECC). Plaque from children with Severe Early Childhood Caries (S-ECC) was diverse with 138 identified and 107 unidentified taxa, which possibly included novel phylotypes. Other species/phylotypes associated with childhood caries included Lactobacillus gasseri (p<0.01), Lactobacillus fermentum, Actinomyces israelii, and Actinomyces odontolyticus (all p<0.05, ECC), Veillonella parvula (p<0.01), Veillonella atypica (p<0.05), and Veillonella sp. HOT-780 (p<0.01, S-ECC). Lactobacillus acidophilus and Lactobacillus reuteri, both used as probiotic therapy species, were detected more frequently in caries-free children than those with ECC. Fastidious periodontal species, including Parvimonas micra, Aggregatibacter actinomycetemcomitans, Eubacterium brachy, Filifactor alocis (all p <0.05), and Porphyromonas gingivalis (p<0.01), were also more frequently detected in children with dental caries than in caries-free children. Other variables associated with ECC were race, dental visit, snacking (all p<0.05), and visible dental plaque (p<0.01). The oral microbiota of early periodontitis in young adults (N=141) was analyzed by whole genomic and oligonucleotide DNA probes, and PCR. Species detected more frequently in early periodontitis than periodontal health included Treponema denticola, F. alocis, Porphyromonas endodontalis, Bacteroidetes sp. HOT-274 (oral clone AU126), and A. odontolyticus (p<0.01) by oligonucleotide DNA probes, and P. gingivalis (p<0.001) and T. forsythia (p=0.03) by PCR. Subgingival samples exhibited a higher prevalence of periodontitis-associated species than samples from tongue surface, including A. actinomycetemcomitans, T. denticola, T. forsythia (all p<0.05), and uncultivated TM7, Treponema, and Actinobaculum clones (all p<0.05). P. gingivalis (p<0.01) by PCR was associated with periodontal disease progression. Early periodontitis was associated with older age (p=0.01), male gender (p=0.04), and cigarette smoking (p=0.05). The role of bacterial subgroups in periodontitis was examined by studying the serotypeability of 313 genotyped clinical A. actinomycetemcomitans isolates (189 subjects). A total of 95 strains (30 subjects) remained non-serotypeable, although PCR revealed presence of the serotype- specific genes. The absence of the immunodominant serotype-specific antigen was confirmed by immunoblot assays. No major DNA rearrangement in the studied serotype-specific gene clusters was found. In summary, detection of previously cultured species and uncultivated phylotypes revealed the diversity of the oral microbiota in dental diseases and health already early in life. Bacterial species have insufficiently characterized subgroups that may have attributes to evade the host response. Molecular approaches used in this study enable comprehensive, culture-independent characterization of the oral microbiome that may in the future lead to identification of diagnostic bacterial profiles for dental diseases.

Alpacas were first introduced into South Africa during the year 2000. They are valuable because of the fine quality wool they produce which has much better insulation properties than that of merino wool fibres. Alpacas are also used to act as guards of sheep herds against predators. During 2008, blood samples from an alpaca that died acutely with severe lung oedema, respiratory distress and froth exuding from the nose were received at Elsenburg Veterinary Laboratory. The alpaca was from a herd of 23 alpacas of a British veterinarian in the Montagu district in the western Cape. Virus isolation attempts on the blood produced infrequent embryo mortalities. Embryonated chicken egg (ECE) material was send to the Virology Department at the Onderstepoort Veterinary Institute (OVI). A bluetongue virus (BTV) PCR performed at the diagnostic PCR laboratory at OVI on the ECE material was positive. Further intra-venous (IV) inoculations in ECE produced embryo mortalities on two consecutive days, the 8th and 9th November. The dead embryos were harvested separately and named and treated as two separate virus samples, Alp8 and Alp9 which were further passaged on baby hamster kidney (BHK) cells. The BTV virus neutralisation tests (VNT) performed at the Office International des Epizooties (OIE) Laboratory on both Alp8 and Alp9 were negative. Because of the close serological relationship between BTV and epizootic haemorrhagic disease virus (EHDV), an EHDV VNT was also performed and was also negative. In the light of the negative VNT and the positive BTV PCR results, more in-depth molecular analyses were performed. RNA was purified from tissue culture material and agarose gel electrophoresis (AGE) performed. Both Alp8 and Alp9 had a typical orbiviral electrophoretic profile, but their respective profiles were different. A sequence-independent reverse transcriptase PCR amplification method generated ample complementary DNA (cDNA) of both samples for sequencing. Sanger sequencing was used to partially sequence genome segments 5 (NS1) and 2 (VP2). BLAST analysis of the partial information of the genome segments 5 (NS1) of Alp8 confirmed it as being a BTV and Alp9 as being an EHDV. BLAST analysis of the deduced amino acid sequence generated of VP2 of both Alp8 and Alp9 established that these samples were possibly new serotypes of BTV and EHDV respectively. The complete genome of both Alp8 and Alp9 was sequenced with next generation 454 Pyrosequencing. This confirmed the partial sequencing results. BLAST analysis of the complete sequence of S2 (VP2) of Alp8 showed that it has 73 % nucleotide and 77 % deduced amino acid identity to BTV15. In contrast the nucleic acid sequence of genome segment S2 (VP2) of Alp9 had no nucleotide sequence identity to any virus, but its deduced amino acid sequence had 71 % amino acid identity to EHDV2. Hyper immune guinea pig (GP) serum prepared against the putative new BT (Alp8) and EHD (Alp9) virus serotypes were tested for serological cross-reactivity against the 24 OIE reference antigen strains of BTV and the 8 OIE reference antigen strains of EHDV. Alp8 had a neutralising antibody (NAb) titre of > 32 against BTV15. Alp9 did not cross react with any of the OIE BTV and EHDV strains. Six out of the remaining 22 alpacas on the farm had NAbs to a greater or lesser extend against Alp8 (BTV) and Alp9 (EHDV) viruses, which confirmed that the viruses were also present in other alpacas in the herd. Very few cases of EHDV in alpacas have ever been reported in literature. A small scale pilot vector susceptibility study showed that vector competence of C. imicola for both Alp8 and Alp9 was low, below 2 %. The fact that neutralising antibodies to Alp8 and Alp9 were detected in other alpacas in the herd raises the question as to whether there are other Culicoides species circulating in the area that could vector the viruses. In conclusion, the results from the serological and virological analyses as well as the nucleic acid sequence data of the genomes of two virus samples, Alp8 and Alp9, from an alpaca that died in the Montagu district in the western Cape identified Alp9 as a definite new serotype of EHDV and Alp8 as a possible new serotype of BTV most closely related to BTV15. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014

Listeria monocytogenes é um patógeno intracelular facultativo responsável por listeriose, uma doença de origem alimentar. Dentre os 13 sorotipos de L. monocytogenes existentes, o sorotipo 4b é o mais freqüentemente isolado de humanos, enquanto os sorotipos 1/2a, 1/2b e 1/2c são mais freqüentes em alimentos e amostras ambientais. O estudo da variabilidade de virulência de quatro cepas de L. monocytogenes recentemente isoladas (1/2B - alimento; 1/2C e 4BENV - ambiente de processamento de alimento; 4BCLIN - sangue), além de duas outras cepas de casos de listeriose (P14 e P14A), foi o objetivo deste trabalho. Avaliou-se a capacidade de invasão, proliferação intracelular, citotoxicidade, disseminação intercelular, polimerização de filamentos de actina e transcrição gênica dos genes de virulência actA, plcA e plcB das cepas em modelos celulares eucarióticos MDBK, HeLa e L929. A cepa de origem alimentar 1/2B apresentou características de invasão, taxa de multiplicação (IGC), assim como a disseminação intercelular, semelhantes às cepas clínicas P14 e 4BCLIN em células HeLa. As cepas de origem ambiental (1/2C e 4BENV), apesar da baixa capacidade de invasão em todas linhagens celulares empregadas, apresentaram IGC superior às demais cepas estudadas e disseminação intercelular superior ou similar às cepas clínicas, dependendo da célula eucariótica. As cepas de origem clínica 4BCLIN, P14, P14A tiveram maiores porcentagens de invasão nas linhagens MDBK e L929, porém, em relação à população intracelular (UFC/mL), as cepas 4BCLIN e P14A foram superiores às demais. Estas últimas também foram citotóxicas às células HeLa, induzindo à liberação de LDH e à morte por necrose. Já as cepas de origem alimentar, ambiental e a cepa clínica P14 não foram citotóxicas às células HeLa e MDBK. Em relação à polimerização dos filamentos de actina não houve diferença estatística entre as cepas. Todos os genes de virulência estudados apresentaram maior número de transcritos para as cepas de origem não clínica (1/2B, 1/2C e 4BENV). Sendo assim, todas as cepas de L. monocytogenes estudadas possuem potencial patogênico, por apresentar pelo menos duas características relacionadas à virulência da espécie. Alimentos possivelmente contaminados com estas cepas representam risco à saúde pública. / Listeria monocytogenes is a facultative intracellular pathogen responsible for listeriose, a foodborne disease. Amongst the 13 serotypes of L. monocytogenes, the serotype 4b is more frequently isolated from clinical samples while the serotypes 1/2a, 1/2b and 1/2c are associated with food and food processing environment. The study of the virulence variability of four L. monocytogenes strains recently isolated (1/2B - food; 1/2C and 4BENV - food processing environment; 4BCLIN blood), as well as two strains of listeriosis (P14 and P14A) was the aim of this work. Eukaryotic cellular models HeLa, MDBK and L929 were used to evaluate the invasion capacity, intracellular proliferation, cytotoxicity, intercellular dissemination and polymerization of actin tails of L. monocytogenes strains. Gene transcription of the virulence genes actA, plcA and plcB was also conducted. The food isolate 1/2B presented invasion characteristics, multiplication index (IGC), as well as the intercellular dissemination, similar to the clinical strains P14 and 4BCLIN in HeLa cells. Environmental strains (1/2C and 4BENV), although showing a low capacity of invasion in all cellular models, had the highest IGC comparing to the other isolates. They also showed similar to or higher intercellular dissemination than the clinical ones, depending on the cell line used. The clinical strains 4BCLIN, P14, P14A presented greater invasion capacity in MDBK and L929 cells than all other isolates. However, in relation to the intracellular population (CFU/mL) the isolates 4BCLIN and P14A showed superior results. These strains were also cytotoxic to HeLa cells, inducing LDH release and death due to necrosis. The food, environmental and P14 isolates were not cytotoxic to HeLa and MDBK cells. There was no statistical difference in actin tail polymerization between the strains. The non-clinical isolates (1/2B, 1/2C and 4BENV) presented higher number of transcripts for than the clinical ones. In conclusion, all L. monocytogenes strains studied showed pathogenic potential, based on expression of at least two characteristics related to the virulence of the species. The presence of these strains in food represents public health risk.

Background: S. pneumoniae is a major cause of meningitis, pneumonia and sepsis in children. In 2006 universal pneumococcal vaccination was recommended in Germany for all children up to their second birthday. We have compared the prevalence and outcome of IPD at a single hospital before and after the introduction of vaccination. Findings: 55 cases of IPD were identified over an 11 year period. Almost half of the patients were younger than 2 years of age. Most of the children were affected by pneumonia. The second highest incidence seen was for meningitis and sepsis. 17 patients exhibited additional complications. Significant pre-existing and predisposing disorders, such as IRAK 4 defect, ALPS or SLE were identified in 4 patients. Complete recovery was seen in 78% of affected children; 11% had a fatal outcome and 11% suffered from long term complications. Only 31% overall had been vaccinated. The most common serotype was 14. Serotypes not covered by any of the current vaccines were also found. Antibiotic treatment commenced with cephalosporins in over 90%. Conclusion: Frequency of IPD in our hospital did not decrease after initiation of the pneumococcal vaccination. This might be due to vaccinations not being administered satisfactorily as well as to poor education about the need of the vaccination. Pre-existing diseases must be monitored and treated accordingly and rare deficiencies taken into account when IPD takes a foudroyant course. In addition, antibiotic stewardship has been initiated at this hospital centre as a consequence of the high cephalosporin use detected in this study.