Asthma is a common chronic disorder which may be increasing in prevalence. However, little is known of its distribution and determinants. The European Community Respiratory Health Survey (ECRHS) is a multicentre survey of the prevalence, determinants and management of asthma. This paper presents a descriptive account of the variation in self-reported attacks of asthma and asthma symptoms across Europe, and in part fulfils the first aim of the study. A screening questionnaire, including seven questions relating to the 12 month prevalence of symptoms of asthma, was distributed to representative samples of 20-44 year old men and women in 48 centers, predominantly in Western Europe. The median response rate to the questionnaire was 75% but, after removing from the denominator those who were the wrong age, were known to have moved out of the area, or had died, it was 78% (range 54-100). The prevalence of all symptoms varied widely. Although these were generally lower in northern, central and southern Europe and higher in the British Isles, New Zealand, Australia and the United States, there were wide variations even within some countries. Centres with a high prevalence of self-reported attacks of asthma also reported high prevalences of nasal allergies and of waking at night with breathlessness. The use of asthma medication was more common where wheeze and asthma attacks were more frequent. In most centres in The Netherlands, Sweden, New Zealand and the United Kingdom over 80% of those with a diagnosis of asthma were currently using asthma medication. In Italy, France and Spain the rate was generally less than 70%. These data are the best evidence to date that geographical differences in asthma prevalence exist, are substantial and are not an artefact of the use of noncomparable methods.

An increasing incidence of nosocomial infections caused by non-multiresistant methicillin-resistant Staphylococcus aureus (nMMRSA) has been reported worldwide. The present study genotyped nMMRSA isolates obtained from hospitals in two cities in Brazil. The hospital isolates displayed pulsed-field gel electrophoresis (PFGE) patterns that were similar to those of the USA100 (ST5-SCCmecII) and USA 800 (ST5-SCCmecIV) strains, which are related to the New York/Japan and paediatric clones, respectively. Carriage of SCCmecIV and the classification by multilocus sequence typing (MLST) of a representative of this PFGE pattern in clonal complex 5 (CC5) confirmed the genetic relationship of the Brazilian isolates with USA800. The USA800-related Brazilian isolates were responsible for severe nosocomial infections in compromised adults and elderly patients in Brazil. A higher growth rate, an ability to form biofilm on inert polystyrene surfaces and the presence of the egc locus may have contributed, at least in part, to the fitness of these organisms as global nosocomial pathogens.

RESUMO:No presente estudo objetivou-se avaliar a atividade antimicrobiana e sinérgica de 4 frações das folhas de Schinopsis brasiliensis Engl (F1', F2', F1" e F2") frente às cepas Staphylococcus aureus MRSA multirresistentes. Os métodos utilizados foram poços de difusão em ágar, concentração mínima inibitória (CMI) -diluição em ágar, e bioautografia. Nos resultados bioautográficos observou-se três halos de inibição relacionados, no mínimo, à quatro constituintes ativos; sendo dois deles isolados das folhas (galato de metila e ácido gálico). A F2" (200µg/mL) apresentou halos de inibição de 16 e 19mm frente as cepas de S. aureus multirresistente e Klebsiella pneumoniae, e CMI 100µg/mL, respectivamente. Quanto as análises das associações das frações F1" ou F2" (25 e 50µg/mL) com a tetraciclina e oxacilina, mostraram ações aditiva e sinérgica para a F2" (50µg/mL), embora não suficiente para que a CMI atingisse valores inferiores a 2 e 4µg/mL, necessário para serem classificadas como cepas sensíveis a oxacilina e tetraciclina, respectivamente. "Assim, conclui-se que a F2" das folhas de S. brasiliensis apresentou potencial antimicrobiano frente às cepas de S. aureus MRSA multirresistentes e que as associações das frações com os antibióticos testados não apresentaram benefícios não justificando o uso concomitante. Palavras-chave: Schinopsis brasiliensis, Staphylococcus aureus, Atividade antimicrobiana, Multidroga-Resistente.ABSTRACT: Antimicrobial and synergic activity of fractions from the leaves of Schinopsis brasiliensis Engl. against Staphylococcus aureus multiresistant clones. The aim of this study was to evaluate the antimicrobial and synergic activity of 4 leaf fractions of Schinopsis brasiliensis Engl (F1', F2', F1" and F2") against multidrug-resistant Staphylococcus aureus strains. The used methods were agar well diffusion, minimum inhibitory concentration (MIC) -agar dilution, and bioautography. The bioautographic results showed three inhibition zones that corresponded to at least four active compounds, two of which (methyl gallate and gallic acid) have already been isolated from leaves. The F2" (200µg/mL) fraction showed inhibition zones of 16 mm and 19 mm against S. aureus multidrug-resistant and Klebsiella pneumoniae strains and a MIC value of 100µg/mL, respectively. The analyses of associations of fraction F1" or F2" (25 and 50µg/mL) with tetracycline and oxacillin showed additive and synergistic action for F2" (50µg/mL), although it was not enough to decrease the MIC values to less than 2 and 4µg/ mL, necessary to classify the strains as susceptible to oxacillin and tetracycline, respectively. Thus, it was concluded that F2" from the leaves of S. brasiliensis showed antimicrobial potential against multidrug-resistant MRSA strains, and the associations of the fractions with the tested antibiotics showed no benefits, not justifying their concomitant use.

The antimicrobial activity of dry methanol and ethyl acetate extracts for the leaves, bark of the stem, peel of the root, flower, fruit and seed of Caesalpinia pyramidalis Tull. (catingueira) was performed against seventeen isolates of Staphylococcus aureus MRSA multiresistant strains, which included two isolates of S. aureus MSSA and two ATCC strains. The antimicrobial activity was tested by the agar diffusion method and the Minimum Inhibitory Concentration (MIC) was determined. The dry methanol extract of the root showed good antimicrobial activity with a MIC of less than 0.5 mg.mL . The dry ethyl acetate extracts exhibited lower antimicrobial activity, which might be explained by solubility problems and less diffusion in the agar medium. Results of the bioautographies also confirmed inhibition halos corresponding to the active substances present in the leaves, as well as in the flower of C. pyramidalis. The phytochemical study of the leaves, bark of the stem, peel of the root, flower and fruit of extracts from C. pyramidalis confirmed the presence of a number of known antimicrobial agents including ursolic acid, quercetin, catechin, ellagic acid, sitosterol, flavonoids, proanthocyanidins and gallic acid. A determinação da atividade antimicrobiana dos extratos metanólicos e em acetato de etila da folha, casca do caule, casca da raiz, flor, fruto e semente de Caesalpinia pyramidalis Tull. foi realizada frente a dezessete isolados de Staphylococcus aureus MRSA multirresistentes, dois isolados de S. aureus MSSA e duas cepas padrão, pelas técnicas de poço/difusão em ágar e determinação das CMI pelo método de diluição em agar/multiinoculador de Stears. O extrato metanólico de casca da raiz indicou uma boa atividade, com CMI inferior a 0.5 mg.mL -1 . Os extratos secos por extração em acetato de etila apresentaram menor atividade que se poderia explicar por problemas de solubilidade e menor difusão no meio de cultura em ágar. Resultados das bioautografias confirmaram zonas de inibição correspondente às substâncias ativas presente na folha, como também na flor da C. pyramidalis. No estudo fitoquímico das folhas, casca da caule, casca da raiz, flor e fruto dos extratos de C. pyramidalis evidenciou-se a presença de vários constituintes com reconhecida atividade antimicrobiana, entre estes o ácido ursólico, quercetina, catequina, ácido elágico, sitosterol, flavonóides, proantocianidinas e ácido gálico. Entre todos os metabólitos citados, somente o ultimo não observamos, por CCD, na casca da raiz de C. pyramidalis. Unitermos

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