Background
In Latin America, Brazil harbors the most cases of human visceral leishmaniasis (HVL). Since the early 1980s, the disease has spread to the urban centers of the north, and now the south and west of Brazil; it reached São Paulo state in the southeast in 1996, and Presidente Prudente in the western region in 2010. Our aim was to describe the spatiotemporal analysis and environmental risk factors associated with the dispersion of VL in Presidente Prudente, an urban setting with recent transmission.
Methods
An entomological survey was carried out from 2009 to 2015. A canine visceral leishmaniasis (CVL) serosurvey was performed from 2010 to 2015 using enzyme-linked immunosorbent assays (ELISA), a dual-path platform CVL rapid test, and indirect fluorescent antibodies (IFAT). Data from HVL cases were obtained from the Municipal Surveillance Epidemiology Center from 2013 to 2017. Data on water drainage and forest fragments were obtained from public platforms and irregular solid-waste deposits were determined by monthly inspections of the urban area. Kernel density maps of the distribution of CVL were constructed.
Results
From 2009 to 2015,
Lutzomyia longipalpis
sand flies were found in all seven areas of Presidente Prudente. From 2010 to 2015, 40,309 dogs were serologically screened and 638 showed positive results, i.e. a prevalence rate of 1.6%. From 2013 to 2017, six human cases were diagnosed with a mortality rate of 33.3%. In 2015, 56 points of irregular solid-waste deposits were identified, predominantly in the neighborhoods. Three different hotspots of CVL showed an increased distribution of vectors, seropositive dogs, irregular solid-waste deposits, forest fragments and water drainage.
Conclusions
The use of tools that analyze the spatial distribution of vectors, canine and human VL as environmental risk factors were essential to identifying the areas most vulnerable to the spread or maintenance of VL. The results may help public health authorities in planning prevention and control measures to avoid expansion and future outbreaks.
Staphylococcus aureuscan cause a variety of infections, especially nosocomial. Its importance lies in the combination of virulence, invasiveness and antibiotic resistance constituting therapeutic challenges. This study aimed to assess the genotype and phenotypic resistance profiles of samples of S. aureusisolated from hospitalized patients in a Brazilian teaching hospital. We evaluated 1078 samples obtained from surveillance cultures and clinical S.aureusin hospitalized patients. To assess the phenotypic resistance profile was used disk diffusion method according to CLSIcriteria, 2011. For the determination of genotypic resistance was the presence of the mecAgene by polymerase chain reaction -PCR. Of the 1078 samples tested phenotypically, it was observed that 75.1% of the samples were Methicillin Resistant Staphylococcus aureus(MRSA), and of these, 98.4% were resistant to oxacillin and 100%, cefoxitin. To determine genotype was performed for the PCR amplification of the mecAgene. Of the 443 samples tested for the mecA336 samples were positive (75.8%). Of these samples, 85.7% showed resistance phenotype oxacillin and cefoxitin 88.4%. Due to the high rate of MRSA, concludes the need for investment in research, rational use of antimicrobials and creation of reference laboratories for verification of antimicrobial resistance
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.