Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3560
O Doutorado Acadêmico em Doenças Tropicais iniciou em 2007 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).
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Navegando Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT por Orientadores "LIMA, Karla Valéria Batista"
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Item Acesso aberto (Open Access) Caracterização genética de micobactérias não tuberculosas isoladas de espécimes clínicos pulmonares no estado do Pará(Universidade Federal do Pará, 2012-11-29) COSTA, Ana Roberta Fusco da; LIMA, Karla Valéria Batista; http://lattes.cnpq.br/9795461154139260In recent years have been seen increased reports of nontuberculous mycobacteria (NTM) infections in the world. However, data on frequency and NTM species associated with pulmonary infections are still limited in Brazil, especially in states of Northern Brazil. The knowledge of species associated with NTM lung infections has clinical and epidemiological importance, being molecular techniques efficient tools to provide diagnostic species-specific, which is necessary for choice of appropriate therapy. This study describes the diversity of NTM isolated from respiratory specimens at the Evandro Chagas Institute between 1999 and 2011. The NTM were initially characterized by PCR-restriction analysis (PRA-hsp65) and reidentificated by sequencing of 16S rRNA, hsp65, rpoB and ITS1 targets. According to ours findings, the PRA-hsp65 method proved to be a convenient tool for identifying NTM, allowing distinction of a variety of species quickly, simply and inexpensively, as compared to the sequencing. Moreover, as suggested in this study, according to local species diversity, this method can be subject to modifications to provide greater discriminatory power. Sequence analysis of the rpoB gene of Mycobacterium avium complex (MAC) revealed that this target is not a suitable alternative for discrimination of isolates from State of Para, because it generated discrepant results with low taxonomic resolution. M. chelonae, M. avium and M. simiae complexes were the most frequent NTM. Two potential species were detected, M. paraensis sp. nov. and M. amazoniensis sp. nov., being proposed as new members of the M. simiae complex. Among the patients with NTM disease, the main characteristics found were women older than 50 years, pardo ethnic group and previous tuberculosis. Although this study does not show the real magnitude of NTM lung infections in State of Para, it describes the diversity of species and clearly reveals the importance of this group in the region, which has accounted 13.5% of mycobacterial isolates in a reference laboratory. The findings highlight the need for bacteriological confirmation of cases presumptively diagnosed as TB with primary resistance to therapy for TB.Item Acesso aberto (Open Access) Perfil epidemiológico, letalidade e caracterização molecular de Pseudomonas aeruginosa multirresistentes, produtoras de metalobetalactamases de isolados clínicos em Unidade de Terapia Intensiva na região Norte(Universidade Federal do Pará, 2014) MATOS, Eliseth Costa Oliveira de; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163; LIMA, Karla Valéria Batista; http://lattes.cnpq.br/9795461154139260The bacterial resistance is responsible for major concerns about the great problems on health systems. The proposal of this study was to determine the epidemiological, lethality and molecular characteristics of Pseudomonas aeruginosa isolated from patients admitted to the Intensive Care Unit (ICU) in a teaching hospital in city of Belem, Pará, Brazil and analyze the performance of susceptibility testing for P. aeruginosa in automated VITEK -2 to study the antimicrobial resistance. The target people of this study consisted of 54 patients with P. aeruginosa infection at the adult , pediatric and neonatal ICUs from January 2010 to March 2012. For the epidemiological research, demographic data, comorbidities, length of stay were collected. Episodes of Healthcare-associated infections were defined in accordance to Center for Disease Control and Prevention (CDC), use of invasive procedures, previous therapy and patient outcome, Jackson MacCabe score, APACHE II score and Charlson score were documented. The bacterial identification was performed by biochemical tests and VITEK-2 system. The sensitivity test was performed with the application of the method of broth microdilution , and detection of metallo-beta-lactamase by the double disc and PCR method. The test of Genotyping was made by amplification throug DiversiLab system. The P. aeruginosa was the second most common pathogen in the hospital and this occurrence was higher in the adult ICU. The respiratory infection was predominant in the adult ICU, while bloodstream infection was prevalent in pediatric and neonatal ICU. The multidrug resistance was higher in the adult ICU, the average age of patients was 28 years, with an average length of stay of 87.1 days, the diseases were potentially fatal and major risk factors for acquisition of PaMR infection were the use of mechanical ventilation and urinary catheterization. Through the meta-analysis study, we found that infections caused by MR strains showed higher mortality rate, and were twice as likely to death occurs, multidrug resistance a factor of poor prognosis in patients with infection PaMR. Four isolates producers blaSPM-1 variant was detected and genotyping figured the presence of genetic similarity greater than 97%, the changes observed may be related to selective pressure existing in the adult ICU, coupled with inadequate therapy. This study demonstrated the importance of investigations of infections with multidrug-resistant pathogens in critical care units, contributing to these data the possibility of better monitoring and control of these infections.