The endogenous flora of the skin and some mucous membranes are well known, however, we were unable to find descriptions about normal esophageal flora in literature. We believe that knowledge about normal esophageal flora is important for therapeutic implications. We compiled data on 30 patients without infection of the oropharynx or esophagus who were admitted for an endoscopy of the upper digestive tract to determine normal esophageal flora. The samples were collected by injecting 10 ml of 0.9% physiological solution into the esophagus and oropharynx and removing it by suction. Esophageal samples from 30 patients and oropharingeal samples from 10 of these patients were collected. We identified mixed flora being Streptococcus viridans the most frequent microorganism found. Where samples from both the esophagus and oropharynx were collected, three occurrences of this same microorganism were found. We concluded that the isolation frequency of germs in the esophagus by the method used was high and the most frequently found germ was S. viridans. There is therefore a possible correlation between the flora from the oropharynx and the esophagus.

A protective herd effect has been described after susceptible populations of children are vaccinated with conjugate Haemophilus influenzae type b (Hib). Hib carriage was studied in children aged 6-24 months attending day care centers in two cities in southern Brazil (Curitiba and Porto Alegre). In Curitiba, routine immunization with Hib polyribosylribitol phosphate polysaccharide-tetanus toxoid conjugate vaccine (PRP-T) in combination with diphtheria-tetanus toxoids-pertussis vaccine (PRP-T/DTP) has been offered since September 1996; DTP vaccine alone is routinely given in Porto Alegre. Children in Porto Alegre (n=643) were 8 times less likely to have received adequate Hib vaccination and 4 times more likely to be Hib carriers than children in Curitiba (n=647; i.e., point prevalence of oropharyngeal colonization, 4.8% vs. 1.2%). Point prevalence of carriage with non-type b or other nontypeable Hi was similar in children of both cities. There was a vaccination effect on carriage rates in children who received a primary 3-dose series, independent of the booster dose, suggesting that a booster may be unnecessary to induce population protection.

Purpose:To ascertain if the polymerization reaction also contributes additionally to the antibacterial effects of two commonly used cyanoacrylate tissue adhesives.Materials and Methods:Fresh liquid ethyl-cyanoacrylate (EC) and N-butyl-cyanoacrylate (BC) adhesives were applied onto 6-mm sterile filter paper discs. In the first group, the adhesive-soaked discs were immediately placed onto confluent monolayer cultures of bacteria, allowing the polymerization reaction to proceed while in culture. In the second group, the adhesive-soaked disc was allowed to first polymerize prior to being placed onto the bacterial cultures. Four types of bacteria were studied: Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. Immediately after the discs were applied, the cultures were incubated at 35° C for 24 h. Bacterial inhibitory halos were measured in the cultures at the end of the incubation period.Results:For EC, exposure of the bacteria to the cyanoacrylate polymerization reaction increased the bacterial inhibitory halos in Streptococcus pneumonia, Staphylococcus aureus and Escherichia coli. For BC, it increased the bacterial inhibitory halos in Staphylococcus aureus and Streptococcus pneumoniae. No inhibitory halos were observed in Pseudomonas aeruginosa. The bactericidal effect was higher in actively polymerizing EC, compared to previously polymerized EC in Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coli; however, no such differences were observed for BC.Conclusions:The polymerization reaction may also be an important factor in the antibacterial properties of EC and BC.

We evaluated the performance of several methods for the detection of methicillin resistance in Staphylococcus aureus using 101 clinical S. aureus isolates from pediatric patients in a tertiary hospital in Brazil; 50 isolates were mecA-positive and 51 were mecA-negative. The Etest and oxacillin agar screening plates were 100% sensitive and specific for mecA presence. Oxacillin and cefoxitin disks gave sensitivities of 96 and 92%, respectively, and 98% specificity. Alterations of CLSI cefoxitin breakpoints increased sensitivity to 98%, without decreasing specificity. Our results highlight the importance of a continuing evaluation of the recommended microbiological methods by different laboratories and in different settings. If necessary, laboratories should use a second test before reporting a strain as susceptible, especially when testing strains isolated from invasive or serious infections. With the new (2007) CLSI breakpoints, the cefoxitin-disk test appears to be a good option for the detection of methicillin resistance in S. aureus.

No abstract

FUNDAMENTO: Leveduras do gênero Candida determinam colonização, infecções superficiais e infecções sistêmicas em imunodeprimidos. As várias apresentações da doença levam à necessidade de utilizar diferentes métodos diagnósticos e tratamentos. OBJETIVOS: Diferenciar as espécies de Candida e correlacioná-las com as regiões anatômicas. Avaliar a susceptibilidade a cetoconazol, fluconazol, itraconazol e anfotericina B. MÉTODOS: Foram avaliados 100 pacientes imunocompetentes com candidíase cutânea ou mucosa atendidos na Santa Casa de S. Paulo entre maio de 1999 e julho de 2001. Correlacionou-se a região acometida e a espécie de Candida, isolada através técnica CHROMagar Candida®. Avaliou-se a susceptibilidade das espécies a cetoconazol, fluconazol, itraconazol e anfotericina B, através do Etest®. RESULTADOS: C. albicans foi isolada em 76,0% dos materiais, C. krusei em 19% e C. tropicalis em 1%. Não houve correlação significante entre a região acometida e as espécies. A maioria das amostras mostrou susceptibilidade aos antifúngicos. CONCLUSÃO: C. albicans foi a espécie mais observada. A maioria das amostras de Candida mostrou-se susceptível aos antifúngicos.

We concluded that Spiritist "passe" effectively inhibited growth in bacterial cultures compared to LOH with intention or no LOH. Further studies comparing different intentions and types of LOH in cultures of cells and microorganisms are warranted.

Staphylococcus aureus (S. aureus) is one of the most frequent causes of hospital acquired infections. With the increase in multiple drug resistant strains, natural products such as propolis are a stratagem for new product discovery. The aims of this study were: to determine the in vitro antimicrobial activity of an ethanol extract of propolis; to define the MIC50 and MIC90 (Minimal Inhibitory Concentration – MIC) against 210 strains of S. aureus; to characterize a crude sample of propolis and the respective ethanol extract as to the presence of predetermined chemical markers. The agar dilution method was used to define the MIC and the high performance liquid chromatography (HPLC) method was used to characterize the samples of propolis. MIC results ranged from 710 to 2,850 µg/mL. The MIC50 and MIC90 for the 210 strains as well as the individual analysis of American Type Culture Collection (ATCC) strains of Methicillin-susceptible Staphylococcus aureus (MSSA) and Methicillin-resistant Staphylococcus aureus (MRSA) were both 1,420 µg/mL. Based on the chromatographic analysis of the crude sample and ethanol extracted propolis, it was concluded that propolis was a mixture of the BRP (SP/MG) and BRP (PR) types. The results obtained confirm an antimicrobial activity in relation to the strains of the S. aureus tested.