Purpose Pseudomonas aeruginosa appears as the main pathogen in cystic fibrosis (CF) involved in recurrent pneumonia and pulmonary exacerbations. The type III secretion system (T3SS) is one of its main determinants of virulence and is associated with poor clinical progression and increased mortality. This study determined the relationship of clinical features of patients with CF and P. aeruginosa T3SS virulotypes. Materials and Methods From January 2018 to March 2019, P. aeruginosa were isolated from sputum and/or oropharyngeal swabs. T3SS markers ( exoS, exoU, exoT and exoY ) were detected by PCR. Clinical severity according to Shwachman-Kulckycki score and spirometry data were associated with T3SS virulotypes. Results A total of 49 patients had positive cultures for P. aeruginosa . T3SS virulence-related markers were detected as follows: exoS 97.9% (n=48), exoU 63.2% (n=31), exoT 95.9% (n=47) and exoY 97.9% (n=48). The prevalence of exoS + /exoU + virulotype was higher than previously reported in CF settings, being detected in 61.2% of the evaluated isolates, present in 70% of intermittent infections and with a significantly higher frequency in cases of exacerbations. The presence of exoU in chronic infection was not associated with poor clinical results. In chronic infections, the exoS + /exoU − virulotype prevailed (77.8%) and was associated to worse clinical results according to the Shwachman-Kulckycki score and spirometric. Conclusion Our findings revealed a high prevalence of the atypical exoS + /exoU + virulotype among P. aeruginosa isolates from patients with CF, which was associated with intermittent infection and early clinical alterations, while the exoS + /exoU − virulotype was associated with chronic infection and worse clinical results. Finally, the presented data highlight the relevance of T3SS virulence markers in the clinical progression and disease severity in CF patients.

ObjectivesWe assessed the prevalence of SARS-CoV-2 infection, personal protective equipment (PPE) shortages and occurrence of biological accidents among front-line healthcare workers (HCW).Design, setting and participantsUsing respondent-driven sampling, the study recruited distinct categories of HCW attending suspected or confirmed patients with COVID-19 from May 2020 to February 2021, in the Recife metropolitan area, Northeast Brazil.Outcome measuresThe criterion to assess SARS-CoV-2 infection among HCW was a positive self-reported PCR test.ResultsWe analysed 1525 HCW: 527 physicians, 471 registered nurses, 263 nursing assistants and 264 physical therapists. Women predominated in all categories (81.1%; 95% CI: 77.8% to 84.1%). Nurses were older with more comorbidities (hypertension and overweight/obesity) than the other staff. The overall prevalence of SARS-CoV-2 infection was 61.8% (95% CI: 55.7% to 67.5%) after adjustment for the cluster random effect, weighted by network, and the reference population size. Risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56; 95% CI: 1.42 to 4.61), not always using all recommended PPE while assisting patients with COVID-19 (OR adj: 2.15; 95% CI: 1.02 to 4.53) and reporting a splash of biological fluid/respiratory secretion in the eyes (OR adj: 3.37; 95% CI: 1.10 to 10.34).ConclusionsThis study shows the high frequency of SARS-CoV2 infection among HCW presumably due to workplace exposures. In our setting, nursing assistant comprised the most vulnerable category. Our findings highlight the need for improving healthcare facility environments, specific training and supervision to cope with public health emergencies.

The stigma perceived by men who have sex with men (MSM) and people living with HIV (PLHIV) may negatively impact their physical and mental well-being, testing and healthcare seeking, adherence to treatment and social insertion of individuals. In the present review, stigma-related aspects on MSM behavior and perceptions on HIV/AIDS are discussed. An integrative literature review was performed, including experimental and non-experimental studies. The presence of stigma and discrimination against MSM and PLHIV still remains, especially in association with HIV infection and ethnic aspects. Identifying the impact of stigma on infection dynamics and mental health of individuals remains necessary and urgent.

A leishmaniose tegumentar americana (LTA) é uma doença infecciosa não contagiosa causada por diferentes protozoários do gênero Leishmania e transmitida pela picada do flebótomo fêmea infectada. Apesar de todos os esforços realizados, a LTA ainda representa um grave problema de saúde pública no Brasil. Objetivo: Analisar a distribuição espaço-temporal da incidência da Leishmaniose Tegumentar Americana no município de Bragança -PA no período de 2012 a 2016. Método: Trata-se de um estudo transversal, prospectivo, descritivo, de base populacional com abordagem quantitativa e sem coleta de material biológico. Resultado e Discussão: Durante o período de estudo foram encontrados cento e sessenta e três (163) casos novos de LTA distribuídos nas diversas localidades do município de Bragança-PA. Segundo a série temporal dos casos de LTA no período de estudo a distribuição dos casos não foi homogênea ao longo dos anos. O

Aim: Serratia marcescens is pathogen associated with nosocomial outbreaks among immunocompromised individuals. Molecular typing methods are useful tools for determining genetic relationships among bacterial isolates. The present study reports the analysis of the clonal relationships among S. marcescens isolates from an outbreak occurred in the neonatal unit (NU) at a referral public hospital of Belém, Pará, Brazilian Amazon, using PFGE and rep-PCR.Material and Methods: Thirty isolates were obtained from referral hospital in the Brazilian Amazon. The molecular typing of isolates was performed using pulsed field gel electrophoresis (PFGE) and semiautomated rep-PCR in the DiversiLab System®.Results: Results revealed that by PFGE there was the formation of three main clusters containing three, 13 and nine isolates. The DiversiLab rep-PCR analysis identified an agreement of 80.64% (25 of the 31 strains) compared to PFGE. Conclusions:The semiautomated rep-PCR was similarly efficient as the PFGE for S. marcescens, demonstrating to be as efficient tool for outbreaks investigation.