https://repositorio.ufba.br/handle/ri/20012 2026-04-17T11:51:52Z https://repositorio.ufba.br/handle/ri/43566 Título: Caracterização fenotípica e genotípica de Escherichia coli isolada de infecções urinárias e de corrente sanguínea adquiridas na comunidade Autor(es): Galvão, Vívian Santos Primeiro Orientador: Pedreira, Joice Neves Reis Abstract: INTRODUCTION: Escherichia coli is a major cause of community-acquired infections, associated with significant clinical impact and healthcare burden. The increasing prevalence of antimicrobial resistance has further complicated their management. This study compared clinical features, antimicrobial resistance, phylogenetic groups, virulence traits, and clonal profiles of E. coli isolates from community-acquired (CA) urinary tract infections (UTI) and bloodstream infections (BSI). METHODS: The isolates were obtained from two cross-sectional studies: CA-UTI isolates collected between April 2019 and January 2022, and CA-BSI isolates collected between March 2015 and May 2019. Clinical and demographic data were obtained through patient interviews and medical records. Antimicrobial susceptibility was assessed by disk diffusion or Vitek® 2 methods, following CLSI guidelines. β-lactamase genes, phylogenetic groups, and virulence factors were identified by PCR, and molecular typing was performed by MLST. RESULTS: A total of 167 E. coli isolates were analyzed, including 98 from CA-UTIs and 69 from CA-BSIs. CA-UTI mainly affected younger women (95.5%; median age 48 years), while CA-BSI predominated in elderly patients (median age 68 years), with lethality reaching 15.9%, particularly in septic shock cases. Most CA-BSI (71.2%) were secondary to prior UTI. High resistance to ampicillin (≥50%) and trimethoprim-sulfamethoxazole (>30%) was observed in both groups, while fluoroquinolone resistance was higher among CA-UTIs (33.7% vs. 18.8%). Multidrug resistant (MDR) (24.5% vs. 17.4%) and ESBL (6.1% vs. 5.8%) rates were comparable. Phylogroup B2 predominated and included the most virulent strains, whereas phylogroup A showed the greatest proportion of MDR strains. CA-BSIs isolates carried more virulence genes, particularly those related to capsules (kpsM), siderophores (iroN, iutA, and aer), P-fimbriae (papC), serum resistance (traT), and pathogenicity island PAI ICFT073. ST1193 and ST73 were the most prevalent lineages, followed by ST95 and ST131. ST1193 was mainly associated with MDR in CA-UTIs, whereas ST73 and ST95 were restricted to highly virulent strains, with ST95 significantly more frequent in CA-BSIs. CONCLUSION: CA-BSI isolates exhibited greater virulence potential compared to those from CA-UTIs, although resistance profiles were similar. The emergence and detection of high-risk clones, particularly ST1193, underscores the need for continuous molecular surveillance and resistance monitoring in community settings, with implications for clinical practice and control strategies. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2025-09-25T00:00:00Z https://repositorio.ufba.br/handle/ri/42035 Título: Candidíase vulvovaginal na população do Recôncavo Baiano: prevalência, diagnóstico e suscetibilidade à antifúngicos Autor(es): Lordêlo, Cássia Vargas Primeiro Orientador: Barros, Tânia Fraga Abstract: Vulvovaginal candidiasis is the second most common vulvovaginitis affecting women, with uncomfortable clinical complaints that can impact their quality of life. However, empirical treatment, without knowledge of the resistance profile of the fungal species that cause this community-acquired infection, has allowed albicans and non-albicans species to develop resistance to commonly used antifungals. In addition, the lack of epidemiological monitoring of fungal species and their resistance to antimicrobials may be associated with complications in clinical cases of vulvovaginal candidiasis. Furthermore, there is a lack of studies on vulvovaginal candidiasis in the Recôncavo Baiano region, allowing therapeutic approaches to be established in accordance with national and international standards. Therefore, the aim of this study was to define the epidemiological profile and clinical and laboratory aspects of vulvovaginal candidiasis in the Recôncavo Baiano region.. To this end, cervical-vaginal samples were collected from women who sought care at the Basic Health Units in the municipalities of Cruz das Almas, Sapeaçu and Governador Mangabeira, for Pap smears. Clinical data was extracted from the information described by the nursing professional, responsible for the collection, in the Cytopathological Examination Requisition. Conventional cytology slides were made and then stained using the Papanicolaou technique, while swabs containing the sample were sown on Sabouraud Dextrose Agar with chloramphenicol to isolate yeasts. Gram staining and PCR-RFLP tests were used to identify the yeast species. Antifungal tests were carried out to determine the sensitivity profile to fluconazole, itraconazole, miconazole, nystatin, clotrimazole and ketoconazole. Fisher's exact test was used to determine associations, while the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the Pap test were calculated using culture as the gold standard. The Pap test was associated with vulvovaginal candidiasis, with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 32%, 100%, 100%, 88,8% and 89,4%, respectively, when compared to the mycological culture test. C. albicans was the most isolated species (64%), followed by Nakaseomyces glabratus, C. parapsilosis, C. tropicalis, Meyerozyma guilliermondii and Pichia kudriavzevii. Pruritus and bleeding were signs and symptoms associated with vulvovaginal candidiasis when the etiological agent isolated was C. albicans. Itraconazole and miconazole were the antifungals that showed the greatest variability in the sensitivity profile, but the only case of resistance was reported by N. glabratus to itraconazole. Pap smears are an important strategy for the early diagnosis of vulvovaginal candidiasis, especially within the Unified Health System, where more complex laboratory tests are not always available. The prevalence of non-albicans species in this study demonstrates the relevance of epidemiological research to monitor changes in the distribution of C. albicans species to non-albicans species. Although antifungal drugs still appear to be active against the yeast isolates identified, changes in the sensitivity profile of non-albicans species may indicate a need to search for alternative antifungal drugs in the treatment of vulvovaginal candidiasis Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2025-03-28T00:00:00Z https://repositorio.ufba.br/handle/ri/42006 Título: Formulação microemulsionada contendo mentol: uma terapia tópica inovadora para disfunção erétil Autor(es): Jesus, Rafael Leonne Cruz Primeiro Orientador: Silva, Darizy Flávia Abstract: Introduction: Currently, erectile dysfunction is associated with cardiovascular diseases, and some hypertensive patients do not respond well to conventional therapy. Activation of TRPM8 has shown relaxation of the internal pudendal artery in rats, suggesting a potential treatment for hypertension-related erectile dysfunction. Menthol, a TRPM8 agonist, poses challenges in use due to its solubility and volatility. This study aimed to develop and evaluate the efficacy of a menthol-containing microemulsion for topical treatment of erectile dysfunction in an animal model with essential hypertension, focusing on erectile tissues. Methods: Firstly, a pseudo-ternary diagram was created to select a specific mixture of oil, surfactant, co-surfactant, and water. This mixture was enriched with menthol and thoroughly studied. The resulting microemulsion was modified with the addition of xanthan gum, and its influence was investigated alongside menthol. Transmission electron microscopy (TEM), dynamic light scattering, and small-angle X-ray scattering (SAXS) analyses revealed droplets with a smaller average diameter. Stability assays were conducted to assess the shelf life of the microemulsion system for 90 days. Studies on 10-week-old SHR and Wistar rats involved daily topical application of menthol-containing microemulsion for 21 days on the penile region, with results analyzed in tissues from the corpus cavernosum (CC), internal pudendal artery (IPA), and superior mesenteric artery (SMA). Results: The pseudo-ternary diagram was used to select a mixture of oil, surfactant, co-surfactant, and water. This mixture was enriched with menthol and thoroughly studied. The resulting microemulsion was modified with the addition of XG. Transmission electron microscopy (TEM) analyses showed droplets with an average diameter smaller than 120 nm, confirmed by dynamic light scattering and small-angle X-ray scattering (SAXS). The mixture conformation was droplet-like, as observed by SAXS and TEM. Topical treatment with menthol in SHR rats with ED significantly reduced blood pressure but did not affect body development. It decreased responsiveness to vasoconstrictors in the corpus cavernosum and increased response to vasodilators. It also altered responsiveness of the internal pudendal artery but did not affect deeper arteries like the superior mesenteric artery. Conclusion: Our data suggest that the microemulsion holds potential in treating erectile dysfunction associated with hypertension. Topical menthol treatment reduced blood pressure and improved artery responsiveness, as well as enhancing sildenafil effectiveness. We are developing an innovative menthol-based therapy with promising prospects for future interventions. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2024-05-31T00:00:00Z https://repositorio.ufba.br/handle/ri/41452 Título: Impacto das infecções maternas crônicas: associações entre a soropositividade materna para anticorpos IgG contra Toxoplasma gondii com restrição no crescimento fetal e efeitos no neurodesenvolvimento infantil Autor(es): Martinez, Victor Otero Primeiro Orientador: Menezes Filho, José Antonio Abstract: This work is part of a broader study called DSAN-12m (Socioenvironmental Determinants of Children's Neurodevelopment at 12 Months: A Longitudinal Study in the Recôncavo Baiano), which aims to investigate the socioenvironmental determinants of children's neurodevelopment at 12 months of age in a birth cohort in the Recôncavo Baiano region.In this thesis, the current state of the art regarding the relationships between maternal immune activation, chronic/latent prenatal infectious diseases, and neurodevelopment was assessed. Additionally, two original manuscripts were developed to investigate the impact of infections during pregnancy, particularly in the absence of evidence of acute disease, on fetal growth at birth and on children's neurodevelopment at 12 months of age. For better organization, the text was divided into a review manuscript, which presents the theoretical framework and systematizes publications on the thesis topic. Following this, two original manuscripts are presented, followed by final considerations to maintain the coherence of the work. The first manuscript, titled “Impact of Chronic Toxoplasmosis in Pregnancy: Association between Maternal Seropositivity for Toxoplasma gondii IgG Antibodies and Fetal Growth Restriction”, investigated the relationships between the prevalence of specific antibodies in pregnant women and fetal development alterations at birth. Notably, this manuscript was published in the journal Parasitology Research (ISSN: 1432-1955, Impact Factor: 1.8) in December 2023 (APPENDIX E). The second manuscript, titled “Impact of Chronic Toxoplasmosis in Pregnancy: Association between Maternal IgG Antibodies against Toxoplasma gondii and Neurocognitive Development Effects”, explored the association between the prevalence of specific antibodies in pregnant women and neurodevelopmental alterations in their children at 12 months of age. This manuscript is formatted according to the guidelines of Parasitology Research and will be submitted for publication after incorporating the corrections suggested by the evaluation committee. Finally, the thesis concludes with final considerations and future perspectives, integrating the results of this study with other socioenvironmental determinants that adversely affect child neurodevelopment in this birth cohort conducted in the Recôncavo Baiano, the DSAN-12m study. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Tese 2024-12-06T00:00:00Z