Made available in DSpace on 2016-12-23T13:55:57Z (GMT). No. of bitstreams: 1 Priscila Ventorim Lisboa Ferreira.pdf: 1031724 bytes, checksum: c897be36746643eea3eee9da896e7d40 (MD5) Previous issue date: 2013-08-14 / Introdução: Diversas alterações cutâneas têm sido descritas nos pacientes transplantados renais, sendo a maior parte delas relativas aos efeitos imunossupressores diretos ou aos efeitos colaterais das drogas e podem ser agrupadas em infecções virais, bacterianas e fúngicas, lesões pré-neoplásicas e neoplásicas e iatrogênicas. Objetivos: 1- Determinar os agentes etiológicos e formas clínicas das micoses observadas nos pacientes transplantados renais estudados. 2- Correlacionar a ocorrência de micose com esquema imunossupressor. 3- Avaliar a prevalência de micoses em relação às dermatoses bacterianas e virais. Materiais e métodos: Estudo descritivo tipo corte transversal, com amostragem por conveniência, que avaliou 82 pacientes transplantados renais em regime de medicações imunossupressoras, atendidos em um hospital da Grande Vitória (ES), nos anos de 2011 e 2012. Após exame dermatológico foram realizados exames micológicos através de microscopia e cultura, quando necessários. Resultados: A casuística consistiu, na maioria, de pacientes do sexo masculino, pardos e com média de idade de 49,2 anos. O esquema imunossupressor mais frequente foi a combinação de Prednisona + Tacrolimus + Micofenolato sódico (46,3%) e foi o mais relacionado às dermatomicoses. O percentual de dermatomicoses foi de 28%, sendo 19,5% de onicomicoses, 6,1% de pitiríase versicolor e 2,4% de tineas. Com relação às dermatoses infecciosas, 7,3% apresentaram verrugas vulgares, 2,4% herpes simples e o mesmo percentual de 1,22% para molusco contagioso, erisipela e furunculose. O grupo de pacientes com transplante tardio (entre 3 e 5 anos) foi o que apresentou maior frequência de dermatomicoses. Conclusões: Os aspectos clínicos das dermatomicoses foram semelhantes, porém mais freqüentes que aqueles observados na população em geral. O percentual de dermatoses infecciosas foi similar ao da população imunocompetente / Introduction: Several cutaneous changes have been reported in renal transplant recipients, most of them due to immunosuppressive effects or side effects of the drugs and can be grouped into viral, bacterial and fungal infections, pre-neoplastic and neoplastic, and iatrogenic. Objectives: 1 - Determine the etiologic agents and clinical forms of mycoses observed in renal transplant recipients studied. 2 - Correlate the occurrence of fungal infection with immunosuppressive regimen and time of transplantation. 3 - Evaluate the frequency of bacterial and viral skin diseases. Materials and Methods: Descriptive cross-sectional study with convenience sampling, which evaluated 82 renal transplant recipients under immunosuppressive medications, treated at a hospital in Vitória (ES) in the years 2011 and 2012. After dermatological examination, skin scrapings were performed by light microscopy and mycological culture. Results: The sample consisted mostly of males and a mean age of 49.2 years. The most frequent regimen was the combination of Prednisone + Tacrolimus + Mycophenolate sodium (46.3%) and it was the most related to dermatomycoses. The frequency of dermatomycoses was 28%, with 19.5% of onychomycosis, 6.1% of pitiryasis versicolor and 2.4% of Tineas. We also found 7.3% of common warts, 2.4% of herpes simplex and the same percentage of 1.22% for molluscum contagiosum, erysipelas and furunculosis. The group of patients with late transplant (between 3 and 5 years) showed the highest frequency of dermatomycoses. Conclusions: The clinical aspects of dermatomycoses was similar but it was more frequent than that observed in the general population. The percentage of cutaneous infections was similar to that of immunocompetent population

L'environnement des stations thermales est favorable à la croissance des Legionella. La Tunisie compte de nombreux sites thermaux. Elle a par ailleurs développé une médecine traditionnelle à base de plantes. L'objectif de ce travail était de caractériser des souches de légionelles isolées de stations thermales et d'étudier le potentiel antimicrobien d'HE de plantes tunisiennes. 2 souches de L. londiniensis et 16 de L. pneumophila (sérovars 1, 4, 5, 6 et 8) ont été isolées de 3 stations thermales tunisiennes et avaient des pulsotypes différents de ceux de la base du CNRL. Les HE de 6 plantes tunisiennes ont été extraites, analysées (GC-MS) et testées contre L. pneumophila (8 souches, sérovars 1, 4, 5, 6 et 8). Les HE de Juniperus phoenicea L. (isobornéol 20,91% et 1S α-pinène 18,30%) et Thymus vulgaris (carvacrol 88,50%) étaient les plus actives (CMI <0,03 mg/mL et ≤0,07 mg/mL respectivement). L'activité de 20 HE (6 de plantes tunisiennes et 14 commerciales) a été évaluée contre 11 espèces bactériennes (6 Gram+, 5 Gram-) et 7 fongiques (4 levures, 3 filamenteux). L'HE de T. vulgaris tunisien était la plus active (Gram-: CMI ≤0,34 mg/mL ; Gram+: CMI ≤0,7 mg/mL ; levures: CMI ≤0,55 mg/mL ; moisissures: CMI=0,3 mg/mL ; dermatophytes: CMI ≤0,07 mg/mL). Elle a montré une activité très supérieure à celle de l'HE commerciale de T. vulgaris certainement due à sa composition différente. En conclusion, la présence de Legionella dans les sites étudiés doit encourager les autorités à renforcer les mesures préventives et l'efficacité antimicrobienne des HE, en particulier l'HE de T. vulgaris tunisien, suggère leur possible intérêt dans le traitement des eaux ou la conservation des aliments. / Spa environment is favorable to the growth of Legionella. Tunisia, which has many spa, has developed a traditional herbal medicine. The objective of this work was to characterize strains of Legionella isolated from 3 spas and to investigate the antimicrobial potential of EOs from Tunisian plants.2 strains of L. londiniensis and 16 of L. pneumophila (serotypes 1, 4, 5, 6 and 8) were isolated and had different pulsotypes from those of the CNRL database.EOs from six Tunisian plants were extracted, analyzed (GC-MS) and tested against L. pneumophila (8 strains, serotypes 1, 4, 5, 6 and 8). The EO of Juniperus phoenicea L. (1S isoborneol 20.91% and 18.30% α-pinene) and Thymus vulgaris (carvacrol 88.50%) were the most active (MIC <0.03 mg/mL and ≤0.07 mg/mL, respectively).The activity of 20 EOs (6 from Tunisian plants and 14 commercial ones) was evaluated against 11 bacterial species (6 Gram+, 5 Gram-) and 7 fungal species (4 yeasts, 3 filamentous). The EO of Tunisian T. vulgaris was the most active (Gram-: MIC ≤ 0.34 mg/mL, and Gram +: MIC ≤0.7 mg/mL; yeasts MIC ≤0.55 mg/mL; mold: MIC=0.3 mg/mL; dermatophytes: MIC ≤0.07 mg/mL). It showed a higher activity than the commercial EO of T. vulgaris, certainly due to their different composition.In conclusion, the presence of Legionella in the studied spas should encourage the authorities to strengthen the preventive measures. The antimicrobial efficacy of EOs, especially from Tunisian T. vulgaris, suggest their potential interest in water treatment or food storage.