Heteroresistance, defined as the occurrence of apparently homogeneous subpopulations of microbial cells showing different levels of antimicrobial susceptibility is a problem that has been associated with therapeutical failure in cryptococcosis. The purpose of the study was an investigation on the level of heteroresistance to fluconazole (LHF) as observed in clinical and environmental C. neoformans/C. gattii complex species isolates from Amazonas State (AM), Brazil. A total of 45 isolates and 9 type strains was analyzed. The assessments comprised testing for minimal inhibitory concentrations (MICs), for LHFs, for the strains’ capacity of adaptation to high fluconazole (FLC) concentrations above the LHF, and for the stability of the heteroresistance phenomenon. The mean MICs for clinical isolates of C. gattii (6.4 µg/mL) were higher than those observed for environmental C. gattii strains (1.7 µg/mL) and clinical (3.7 µg/mL) as well as environmental (1.5 µg/mL) C. neoformans isolates. The phenomenon of heteroresistance to FLC was recorded for all isolates. On average, the LHF (8–256 µg/mL) of the isolates was 16 times higher than the FLC MICs (0.5–16 µg/mL) and a proportion of 85% isolates showed LHFs ≥16 µg/mL, 40% even ≥32 µg/mL. According to the adaptation assay, a considerable number of isolates (58%) showed the capacity of adaptation to MICs even higher than the initially recorded LHF. After the adaptation experiment, the adaptative-LHF values (8–512 µg/mL) were about 60 times higher than the original MIC values. After nine subsequent passages in drug-free broth, the isolates had their adaptative-LHF reduced. However, the LHF did not revert to the initially measured level. Our findings challenge the clinical interpretation of the antifungal MIC testing and motivate future studies correlating the levels of heteroresistance and parameters like LHF and adaptative-LHF with cryptococcosis-associated morbidity and mortality.

Introduction: Salmonella enterica serovar Panama belongs to the D1 serogroup and is frequently associated with nontyphoidal salmonellosis in humans. This study aimed to characterize isolates collected from Northeast Brazil by phenotypic and molecular methods. Methods: Forty four S. Panama strains were examined for antimicrobial susceptibility, virulence genes, and pulsed field gel electrophoresis (PFGE) types. Results: All strains were susceptible to antibiotics (except for streptomycin), presented classical virulence factors, and could be clustered into four groups and 18 pulsotypes. Conclusions: This work calls for continuous surveillance for the emergence of antibiotic resistance and new clones in a geographical area.

This study of depression assessment aims to demonstrate the process of joint calibration and transfer standards between the internationally recognized BDI and EBADEP-A, a new instrument recently validated in Brazil. In addition to the illustration of methodological procedures, our study is intended to contribute to the elaboration of normative references for the latter instrument as an assessment of depression symptoms. We included 1666 participants divided into subgroups of patients and nonpatients. The respondents answered the EBADEP-A and the Brazilian version of BDI. Data were analyzed using the Rasch-Andrich Rating Scale Model. We performed concurrent calibration of items of both instruments. Next, for each instrument we performed calibration with item parameters fixed based on prior analysis. Based on that, norms of the BDI were transfered to EBADEP-A. This procedure can be applied to any test that measures the same construct. This procedure produces a scale on the same metric. Keywords IRT; psychological assessment; humor disorders; psychometric properties; depression RESUMEN Este estudio de evaluación de la depresión tiene como objetivo demostrar el proceso de calibración y transferencia conjunta entre el BDI y el EBADEP-A, un nuevo instrumento validado en Brasil. Además de la ilustración de los procedimientos metodológicos, este estudio pretende contribuir a la elaboración de referencias normativas para este último instrumento como una evaluación de los síntomas de depresión. Se

Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.

No abstract