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      Prevalence of potentially pathogenic free-living amoebae from Acanthamoeba and Naegleria genera in non-hospital, public, internal environments from the city of Santos, Brazil

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          Abstract

          Acanthamoeba and Naegleria species are free-living amoebae (FLA) found in a large variety of natural habitats. The prevalence of such amoebae was determined from dust samples taken from public non-hospital internal environments with good standards of cleanliness from two campuses of the same University in the city of Santos (SP), Brazil, and where young and apparently healthy people circulate. The frequency of free-living amoebae in both campuseswas 39% and 17% respectively, with predominance of the genus Acanthamoeba. On the campus with a much larger number of circulating individuals, the observed frequency of free-living amoebae was 2.29 times larger (P< 0.00005). Two trophozoite forms of Naegleria fowleri, are the only species of this genus known to cause primary amoebian meningoencephalitis, a rare and non-opportunistic infection. We assume that the high frequency of these organisms in different internal locations represents some kind of public health risk.

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          Cultivation of pathogenic and opportunistic free-living amebas.

          Free-living amebas are widely distributed in soil and water, particularly members of the genera Acanthamoeba and NAEGLERIA: Since the early 1960s, they have been recognized as opportunistic human pathogens, capable of causing infections of the central nervous system (CNS) in both immunocompetent and immunocompromised hosts. Naegleria is the causal agent of a fulminant CNS condition, primary amebic meningoencephalitis; Acanthamoeba is responsible for a more chronic and insidious infection of the CNS termed granulomatous amebic encephalitis, as well as amebic keratitis. Balamuthia sp. has been recognized in the past decade as another ameba implicated in CNS infections. Cultivation of these organisms in vitro provides the basis for a better understanding of the biology of these amebas, as well as an important means of isolating and identifying them from clinical samples. Naegleria and Acanthamoeba can be cultured axenically in cell-free media or on tissue culture cells as feeder layers and in cultures with bacteria as a food source. Balamuthia, which has yet to be isolated from the environment, will not grow on bacteria. Instead, it requires tissue culture cells as feeder layers or an enriched cell-free medium. The recent identification of another ameba, Sappinia diploidea, suggests that other free-living forms may also be involved as causal agents of human infections.
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            Urinary tract infection in diabetes.

            The aim of this article is to review recent publications relevant to understanding the interaction of urinary tract infection and diabetes mellitus, including epidemiology, pathogenesis, microbiology, and treatment. The largest number of identified reports described aspects of epidemiology, including defining the incidence and outcomes of urinary infection in patients with diabetes. In several reports, mortality and risk of hospitalization for urinary infection were not increased with diabetes, although length of hospitalization may be prolonged. Other reports quantify the increased incidence of cystitis or pyelonephritis in persons with diabetes, but remain subject to potential biases which could overestimate the occurrence in diabetic relative to non-diabetic populations. Several reports suggest that resistant bacteria are more frequently isolated from diabetic outpatients with urinary infection, but it is not clear how this is directly attributable to diabetes. There are no recent clinical trials which enhance our understanding of optimal treatment of symptomatic urinary infection, although several review articles acknowledge the appropriateness of the non-treatment of asymptomatic bacteriuria in diabetic women. Recent reports exploring diabetes and urinary tract infection provide some insights, particularly for risks of infection and outcomes, but there are no recent large advances in the knowledge base. Questions related to incidence, optimal treatment, and role of metabolic control still need to be addressed to expand the knowledge base and enhance management of this common problem.
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              The effect of thermal pollution on the distribution of Naegleria fowleri.

              The distribution in the environment of Naegleria fowleri, the causal agent of primary amoebic meningoencephalitis has been investigated in this study. N. fowleri was isolated only from a thermally polluted canal. These amoebaflagellates were not isolated from another thermally polluted canal in the neighbourhood indicating that, apart from high temperature, other factors are involved in the selective proliferation of N. fowleri. This species was absent in all other samples originating from two canals, a stream, two lakes, several reservoirs and slow sandfilters of a water supply service and also a water distribution network. Many other amoebae able to grow at 42 degrees C. were found in different places. Most of the N. fowleri strains isolated were not virulent for mice, although they showed all the characteristics of the pathogenic strains.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                bjid
                Brazilian Journal of Infectious Diseases
                Braz J Infect Dis
                Brazilian Society of Infectious Diseases (Salvador )
                1678-4391
                December 2009
                : 13
                : 6
                : 395-397
                Affiliations
                [1 ] Universidade Católica de Santos Brazil
                Article
                S1413-86702009000600001
                10.1590/S1413-86702009000600001
                4da874c4-556f-4d7d-8194-eec19d086627

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1413-8670&lng=en
                Categories
                INFECTIOUS DISEASES

                Infectious disease & Microbiology
                Free - living amoebae,Acanthamoeba spp.,Naegleria spp.,prevalence,dust from internal environments,Brazil

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