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- ItemAcesso aberto (Open Access)Água para o consumo humano da rede de abastecimento público ofertada às unidades escolares da região metropolitana da Baixada Santista: qualidade, ações, fragilidades e potencialidades(Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Pereira, Tatiana Caldas [UNIFESP]; Stedefeldt, Elke [UNIFESP]; http://lattes.cnpq.br/5590674723055512; http://lattes.cnpq.br/4204960461897439; Universidade Federal de São PauloA água é um bem essencial para a sobrevivência de todosos seres vivos e sua disponibilidade e qualidade um problema global. As doenças de veiculação hídrica são responsáveis por surtos epidemiológicos e um problema de Saúde Pública. A qualidade da água reflete o seu processo de tratamento, armazenamento e as condições de infraestrutura utilizadas para sua distribuição. Fatores intrínsecos ao tratamento, como pH e desinfecção,e fatores ambientais podem influenciar a qualidade da água. No Estado de São Paulo, em 1992, foi criado o Programa de Vigilância da Qualidade da Água para Consumo Humano (PROÁGUA) com o objetivo de vigiar a água da rede de abastecimento público em todos os municípios do Estado. Dentre as ações realizadas no PROÁGUA são coletadas amostras de água em pontos críticos e não críticos de forma a contemplar todo o universo do município. As amostras são coletadas pela VISA Municipal e encaminhadas para o Laboratório de Saúde Pública para a avaliação dos parâmetros básicos: pesquisa de coliformes totais, pesquisa de Escherichia coli, cloro residual livre, turbidez, fluoreto e cor aparente. O objetivo do presente estudo foi avaliar a qualidade microbiológica da água para consumo humano do sistema de abastecimento público ofertada às unidades escolares participantes do PROÁGUA da Região Metropolitana da Baixada Santista (RMBS) e analisar as ações adotadas pela Vigilância Sanitária dos municípios frente ao Programa. Para tanto, foi realizado um estudo transversal e descritivo com duas abordagens, quantitativa e qualitativa. A abordagem quantitativa foi realizada a partir de dados secundários obtidos do sistema de gerenciamento de amostras laboratoriais – GAL. Os dados caracterizam-se por 3.725 amostras de água coletadas no cavalete de entrada hídrica das escolas municipais e estaduais, no período de 2016 a 2018. Os resultados obtidos demonstraram que a água disponibilizada às unidades escolares da RMBS estava segura quanto ao parâmetro microbiológico de pesquisa de Escherichia coli. Na abordagem qualitativa, foram realizadas entrevistas semiestruturadas com os profissionais de Vigilância Sanitária Municipal que atuam no PROÁGUA. A partir do corpusdas respostas das entrevistasfoi realizada a análise de conteúdo do tipo temática não apriorística. Foi verificado que são realizadas ações previstas no Programa, mas existe a necessidade deprocedimentos sistematizados de forma histórica para a verificação dos resultados das análises de água a fim de melhorar o alcance dos resultados esperados no desenvolvimento do PROÁGUA.
- ItemSomente MetadadadosDesenvolvimento de imunossensor para a detecção da bactéria Escherichia coli O104:H4(Universidade Federal de São Paulo (UNIFESP), 2020-10-29) Gomes, Elen Rute Lira [UNIFESP]; Moraes, Marli Leite De [UNIFESP]; Universidade Federal de São PauloEscherichia coli serotype O104:H4 produces Shiga toxin, which causes Uremic Hemolytic Syndrome (HUS), characterized by the destruction of red blood cells, that over a long period, it leads to renal failure. The fast and efficient identification of this bacterium is essential to prevent the progress of the infection and worsening of the symptoms, therefore, the biosensors development is a promising alternative, ensuring a fast, cheap and easy diagnosis. In this work, immunosensors were studied to detect E. coli O104:H4 through anti-E coli O104:H4 monoclonal antibody immobilized on polyethyleneimine polymer (PEI) in nanostructured Layer-by-layer films. The antibody immobilization on the PEI was monitored by fluorescence spectroscopy and cyclic voltammetry and the film morphology was obtained by atomic force microscopy. The detection was performed with the film deposited on a screen printed carbon electrode for electrochemical measurements, in different concentrations of inactivated E. coli O104:H4 and the numbers of layers deposited PEI/anti-E. coli. Films containing only PEI were used as controls and samples of different strains of E. coli and S. aureus were analyzed to verify the specificity and selectivity of the immunosensor. The interaction of the PEI/anti-E. coli film with different E. coli concentrations caused an increase in current, with a + 0.30 V, observed in voltammograms. For films containing 1 and 2 PEI/anti-E. coli bilayers this variation was greater when compared with 3 and 5 bilayers. The voltammograms data of the different strains were investigated through the principal component analysis (PCA), the results showed the ability of the system to distinguish E. coli from S. aureus, and among E. coli strains, except for E. coli 1219264. The PEI/anti-E. coli immunosensors containing 1 and 2 bilayers showed good reproducibility, specificity and selectivity, and the immunosensor with 1 bilayer was able to detect concentrations from 2.8 μg/mL of the inactivated bacteria. Thus, the immunosensor investigated in this work showed the feasibility of its application as a prototype for the E. coli detection.
- ItemAcesso aberto (Open Access)The gut at war: the consequences of enteropathogenic Escherichia coli infection as a factor of diarrhea and malnutrition(Associação Paulista de Medicina - APM, 2000-01-06) Fagundes-neto, Ulysses [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Diarrheal disease is still the most prevalent and important public health problem in developing countries, despite advances in knowledge, understanding, and management that have occurred over recent years. Diarrhea is the leading cause of death in children under 5 years of age. The impact of diarrheal diseases is more severe in the earliest periods of life, when taking into account both the numbers of episodes per year and hospital admission rates. This narrative review focuses on one of the major driving forces that attack the host, namely the enteropathogenic Escherichia coli (EPEC) and the consequences that generate malnutrition in an early phase of life. EPEC serotypes form dense microcolonies on the surface of tissue-culture cells in a pattern known as localized adherence (LA). When EPEC strains adhere to epithelial cells in vitro or in vivo they cause characteristic changes known as Attaching and Effacement (A/E) lesions. Surface abnormalities of the small intestinal mucosa shown by scanning electron microscopy in infants with persistent diarrhea, although non-specific, are intense enough to justify the severity of the clinical aspects displayed in a very young phase in life. Decrease in number and height of microvilli, blunting of borders of enterocytes, loss of the glycocalyx, shortening of villi and presence of a mucus pseudomembrane coating the mucosal surface were the abnormalities observed in the majority of patients. These ultrastructural derangements may be due to an association of the enteric enteropathogenic agent that triggers the diarrheic process and the onset of food intolerance responsible for perpetuation of diarrhea. An aggressive therapeutic approach based on appropriate nutritional support, especially the utilization of human milk and/or lactose-free protein hydrolyzate-based formulas and the adequate correction of the fecal losses, is required to allow complete recovery from the damage caused by this devastating enteropathogenic agent.
- ItemAcesso aberto (Open Access)Infecção neonatal por Streptococcus agalactiae do grupo B e Escherichia coli(Universidade Federal de São Paulo (UNIFESP), 2020-10-29) Longo, Maria Cristina Barbosa [UNIFESP]; Taminato, Monica [UNIFESP]; http://lattes.cnpq.br/3626639720691828; http://lattes.cnpq.br/4139508415633817; Universidade Federal de São PauloNeonatal sepsis is a major public health issue worldwide and is among the leading causes of morbidity and mortality in neonates, particularly in developing countries. It is an important component in increasing neonatal mortality rates and can lead to serious complications such as morbidity, with long-term impacts for those who survive despite relatively low numbers of cases in this population. Objectives: to verify mortality for early neonatal sepsis and what are the risk factors for neonatal sepsis caused by Streptococcus agalactiae of group B and Escherichia coli and the mortality and prevalence of microorganisms in an intensive care unit in a school hospital. Method: Observational study conducted between 2007 and 2017 with neonates with the diagnosis of clinical and/or laboratory sepsis admitted to the Neonatal Intensive Care Unit of Hospital São Paulo and search for evidence on the main risk factors for infection and neonatal sepsis with a Systematic Review and Meta-analysis, according to the recommendations of Cochrane Collaboration. Results: The results of this work will be presented in the form of two articles. In Article 1 16 were selected to compose the present study. The main risk factors for neonatal infection with GBS and E.Coli are low birth weight and prematurity. In the meta-analysis chart we identified the higher mortality for E.coli and/or GBS sepsis cases, with Odds ratio 3.54 (P < 0.00001). In article 2 181 neonates were included, 36 were excluded from the study because they did not have the complete data in the electronic records. The blood culture positivity rate was 15(10.3%) and there was no positive sample. The mortality rate was 22%. The most prevalent microorganisms were the coagulase-negative Staphylococcus (CONs) with 6(50%), Streptococcus agalactiae with 2(16.6%). Conclusion: In article 1, sepsis by E. Coli presented higher mortality. It was evident that premature and low birth weight newborns have more susceptibility to acquire infection and later sepsis caused by E. Coli and GBS. In article 2, the most prevalent microorganisms found in the study were CONs and GBS among the gram positive and gram negative E.coli bacteria, requiring in addition to specific measures for the prevention of GBS, prevention strategies for the other types of microorganisms that cause infection. In both studies it became evident that more nationwide studies are needed to investigate the etiologies of neonatal sepsis, to map and monitor its local epidemiology in order to carry out public policies with specific measures aimed at this public.