Evolução na vigilância laboratorial do Haemophilus influenzae nas meningites e pneumonias bacterianas, por PCR em tempo real, no Estado de São Paulo (2010-2019)

Autores

  • Maria Gisele Gonçalves Instituto Adolfo Lutz
  • Fábio Takenori Higa Instituto Adolfo Lutz
  • Fábio Takenori Higa Instituto Adolfo Lutz
  • Lucila Okuyama Fukasawa Instituto Adolfo Lutz
  • Layla Degaulle Alves Barros Instituto Adolfo Lutz
  • Maristela Marques Salgado Instituto Adolfo Lutz

Palavras-chave:

h.influenzae, Meningites bacterianas, Pneumonias bacterianas, PCR em tempo real, Diagnóstico

Resumo

Haemophilus influenzae (Hi) é um importante patógeno causador de meningites (MB) e pneumonias bacterianas (PB), principalmente em países onde a imunoprevenção é precária ou inexistente. O Hi é classificado em tipáveis (sorotipos a, b, c, d, e, f) e não tipáveis (HiNt), de acordo com a presença ou ausência da cápsula polissacarídica, respectivamente. A cápsula é o principal fator de virulência dos Hi e o gene bexA, responsável pela sua expressão, é comumente empregado na detecção molecular e vigilância das MB e PB causadas por Hi. Em 2010, o Instituto Adolfo Lutz (IAL) implantou a PCR em tempo real (qPCR) empregando esse alvo genético para a detecção de Hi. Entretanto, relatos de falha na detecção de alguns Hi encapsulados e HiNt motivaram a substituição do gene alvo para essa bactéria. Desta forma, em agosto de 2012, o IAL fez a substituição do bexA pelo alvo genético hpd no ensaio de qPCR, permitindo a detecção de Hi tipáveis e não tipáveis. Neste estudo, avaliamos o impacto da substituição do alvo genético na vigilância das MB e PB analisando o emprego do alvo genético bexA, no período de 2010 a julho de 2012, em comparação com o emprego do hpd, de agosto de 2012 a 2019. Esta substituição promoveu a melhoria na detecção de variantes não vacinais de Hi nas MB e PB em 37% e 23%, respectivamente, com predomínio de Hia e HiNt, contribuindo para o aprimoramento da vigilância laboratorial...(AU)

Métricas

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2022-01-31

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Gisele Gonçalves M, Takenori Higa F, Takenori Higa F, Okuyama Fukasawa L, Degaulle Alves Barros L, Marques Salgado M. Evolução na vigilância laboratorial do Haemophilus influenzae nas meningites e pneumonias bacterianas, por PCR em tempo real, no Estado de São Paulo (2010-2019). Bepa [Internet]. 31º de janeiro de 2022 [citado 28º de setembro de 2022];19:1-16. Disponível em: https://periodicos.saude.sp.gov.br/BEPA182/article/view/37293

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