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Previous issue date: 2013 / Fundação Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde / Haemophilus influenzae pode ser encontrado, normalmente, na microbiota do trato respiratório, do trato gênito-urinário e da cavidade oral. Porém, essa espécie inclui um dos mais importantes patógenos bacterianos em infecções principalmente pediátricas. As cepas de Hi podem ser capsuladas, variando de a-f, ou não capsuladas (não tipáveis - NT). O tipo capsular b foi o mais frequente em infecções graves infantis até a utilização da vacina conjugada contra Hib, sendo ainda considerado patogênico. No Brasil, essa vacina foi introduzida no Programa Nacional de Imunização do Ministério da Saúde em agosto de 1999, e como em outros países, promoveu uma acentuada diminuição em doenças causadas por esse agente. No entanto, estudos realizados na era pós-vacinal têm mostrado que a incidência de doenças invasivas causadas por H. influenzae não b e NT têm aumentado, inclusive no Brasil. O objetivo desse trabalho foi obter informações sobre as cepas de Hi circulantes no município do Rio de Janeiro. Utilizou-se 96 amostras de quadros infeciosos (46 invasivas e 50 não invasivas), isoladas no período pós-vacinal (2000-2012). Em relação à idade, dos 54 pacientes que tiveram esse dado, 32 tiveram doenças invasivas e 22 não invasivas. Em doenças invasivas, houve o predomínio de crianças < 5 anos. Enquanto que nas não invasivas os adultos > 70 anos predominaram. Entre as cepas obtidas, 15 foram capsuladas e 81 não capsuladas. A maioria das cepas capsuladas foi proveniente de sítios invasivos, cuja faixa etária predominante foi de < 5 anos. O tipo capsular mais isolado foi o b, seguido do a e f. As cepas Hib, predominaram no início do período de estudo, enquanto os outros sorotipos predominaram no final. No presente trabalho, não encontramos cepas mutantes deficientes de cápsula tanto Hib-, quanto Hia- / Haemophilus influenzae can be found usually in the microbiota of the respiratory tract, genitourinary tract and oral cavity. However, this species includes one of the most important bacterial pathogens mainly in pediatric infections. The strains can be capsulated Hi, (serotypes a-f), or not capsulated (nontypeable - NT). The type b capsular was the most frequent serious infection in children until the use of conjugate vaccine against Hib and is still considered pathogenic. In Brazil, this vaccine was introduced in the National Immunization Program of the Ministry of Health in August 1999, and as in other countries, promoted a significant decrease of disease caused by this agent. However, studies during the post-vaccine period have shown that the incidence of invasive disease caused by H. influenzae b and NT have increased, including in Brazil. The aim of this study was to obtain information on the Hi strains circulating in the municipality of Rio de Janeiro. We used 96 samples (46 invasive and 50 noninvasive), isolated during the post-vaccination period (2000-2012). Concerning the age of the 54 patients who had this data, 32 had invasive and 22 noninvasive disease. In invasive disease, there was a predominance of children <5 years. While in the noninvasive group, adults > 70 years predominated. Among the strains obtained, 15 were capsulated and 81 non-capsulated. Most capsulated strains originated from invasive sites whose predominant age group was <5 years. The most frequent capsular type was b, followed by a and f. Hib strains predominated at the beginning of the study period, while the other serotypes prevailed in the end. In this study, we did not found mutant strains deficient in both capsule Hib- and Hia-. NT strains accounted for the vast majority of isolates in this study, 32 strains isolated from invasive sites and 49 sites noninvasive, and were obtained from patients of all age groups. The capsulated strains were predominantly biotype I and II, while non-typeable strains were most II and III. In this study, only the NT strains were resistant to two drugs: ampicillin and trimethoprim - sulfamethoxazole. These were mostly non-invasive. Thus, none of the capsulated isolates were resistant. The PFGE patterns for the 96 strains were quite different, however eight NT strains belonged to the same genotype. Capsulated strains of the same serotype were similar, getting most isolates grouped in the same cluster. We therefore conclude that it is necessary to monitor the Hi strains circulating in Rio de Janeiro, because of the geographic and economic importance of this municipality. Such conduct should be extended to the whole country in order to understand the possible changes of serotypes today, which will certainly guide for the design of new vaccines, improvement of existing ones and the use of antibiotics, resulting in a public health impact.
| Identifer | oai:union.ndltd.org:IBICT/oai:www.arca.fiocruz.br:icict/11149 |
| Date | January 2013 |
| Creators | Caldeira, Nathalia Gonçalves Santos |
| Contributors | Romão, Celia Maria Carvalho Araújo Pereira, Neves, Felipe Piedade Gonçalves, Branquinho, Maria Regina, Almeida, Antonio Eugenio Castro Cardoso de, Almeida, Antonio Eugenio Castro Cardoso de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da FIOCRUZ, instname:Fundação Oswaldo Cruz, instacron:FIOCRUZ |
| Rights | info:eu-repo/semantics/openAccess |
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