A revista Hansenologia Internationalis apresenta uma conversa com o enfermeiro, epidemiologista e professor titular da Universidade Federal de Minas Gerais (UFMG), Francisco Carlos Félix Lana, um dos principais nomes da pesquisa em hanseníase no Brasil. Fundador do Núcleo de Estudos e Pesquisas em Hanseníase (NEPHANS/UFMG) e com mais de quatro décadas de dedicação à saúde coletiva, o entrevistado resgata os marcos de sua trajetória profissional, desde o primeiro contato com a doença na Atenção Primária até sua atuação pioneira na implantação da Poliquimioterapia (PQT) em Minas Gerais. Ao longo do texto, o pesquisador aborda a aplicação inovadora da análise espacial e de marcadores sorológicos para compreender os territórios de vulnerabilidade e os determinantes sociais que perpetuam a cadeia de transmissão da doença. Além de destacar o papel central e estratégico da enfermagem no cuidado longitudinal, o especialista reflete sobre os rumos para o alcance das metas de eliminação da hanseníase, a importância da descentralização do diagnóstico, a urgência da quimioprofilaxia no Sistema Único de Saúde (SUS) e o legado construído na formação de gerações de cientistas no país.
Chronic ulcers are wounds characterized by impaired tissue repair, often resulting from multifactorial causes such as underlying diseases or trauma. These lesions frequently harbor microorganisms capable of forming biofilms and exhibiting antimicrobial resistance, thereby worsening the clinical condition and limiting the effectiveness of therapeutic interventions. To characterize bacterial biofilm formation in chronic lower-limb ulcers of patients treated at the outpatient wound clinic of the Instituto Lauro de Souza Lima, Bauru, Sao Paulo, Brazil, using microbiological, molecular, and histopathological techniques, and to investigate its association with clinical and sociodemographic parameters. Phenotypic and molecular biofilm production was evaluated in microbial isolates obtained from chronic lower-limb ulcers collected by swab and biopsy. Tissue samples were subjected to histopathological analysis using Hematoxylin and Eosin (H&E) and Periodic Acid-Schiff (PAS) staining to assess tissue morphology and detect microbial biofilms. Clinical signs and sociodemographic variables were recorded at two distinct time points to monitor patient outcomes. Samples from 33 patients (mean age 63.8 years, predominantly male, with low educational level) yielded 107 bacterial isolates. Maceration (94%) and ochre dermatitis (82%) were the most prevalent inflammatory signs. Biofilm production by Staphylococcus spp. was significantly associated with the presence of slough (adjusted p = 0.0012). Phenotypic biofilm detection was observed in 59.8% of isolates using Congo red agar and in 67.3% using the polystyrene microplate assay, with higher production among Gram-positive bacteria. Molecular analysis confirmed these findings, revealing a high prevalence of the icaD gene in Staphylococcus spp. (93%) and the pelF gene in Pseudomonas aeruginosa (87%). Polymicrobial samples predominantly exhibited strong biofilm adherence. Comparison between the two clinical assessments demonstrated statistically significant differences in pain levels, wound temperature, and ulcer area, indicating partial clinical progression despite the persistence of certain inflammatory features. Chronic ulcers have a multifactorial etiology, with microbial biofilms playing a central role in delayed healing. These findings underscore the need for integrated therapeutic approaches targeting both microbial and host-related factors.
Leprosy represents a public health concern; its diagnosis remains clinical. Recently, the Brazilian public health system/SUS incorporated the leprosy-specific IgM anti-PGL-I rapid test Fast ML Flow Hanseníase (MLFH/Bioclin, Brazil; originally ML Flow) to aid leprosy contacts surveillance and diagnosis. Anti-PGL-I antibody levels correlate with bacterial load. This multicenter study evaluated MLFH performance in confirmed leprosy cases from four Brazilian reference centers. MLFH results were compared to anti-PGL-I ELISA, bacilloscopy/BI and analyzed in indeterminate/I, pure neuritic/PN and in Ridley Jopling/RJ categories (tuberculoid/TT, borderline-tuberculoid/BT, borderline/BB, borderline-lepromatous/BL, lepromatous/LL). Leprosy patients’ serum samples (N = 158; 95 multibacillary/MB, 63 paucibacillary/PB) were evaluated. Additionally, 20 previously tested leprosy samples were distributed to each center to assess MLFH repeatability, inter-center and inter-operator reproducibility. Higher MLFH seropositivity (84.8
Leprosy is a chronic infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis. The treatment typically involves multidrug therapy comprising dapsone, clofazimine, and rifampicin for 6-12 months. TB47 is a new inhibitor of the mycobacterial electron transport chain (ETC), disrupting ATP production in bacteria. This study investigated the in vitro and in vivo antimicrobial effects of TB47 on M. leprae. In vitro assays employed IDE8 tick cells infected with M. leprae, showing that after 30 days of infection, 5 ng/mL of TB47 treatment significantly impaired bacillary growth. For in vivo assays, BALB/c mice were infected with M. leprae and subjected to different treatments with varying doses of TB47 combined or not with clofazimine. Treatments were administered weekly for 90 days (13 times). The effects were assessed immediately after treatment, as well as at 120 and 210 days post-treatment. Results showed that 100 and 10 mg/kg of TB47 combined with 5 mg/kg clofazimine exhibited a bactericidal effect on M. leprae in all time points evaluated, in contrast with clofazimine monotherapy, for which the bactericidal effect was observed only 210 days post-treatment. TB47 monotherapy had a bacteriostatic effect immediately after treatment, but replication resumed at later evaluation points. Histopathological evaluation supported these findings. Combining dose-dependent TB47 with clofazimine showed an additive bacteriostatic and bactericidal effect on M. leprae, suggesting an advantageous pharmacokinetic and pharmacodynamic profile. Further research into mycobacterial ETC inhibitors could significantly impact leprosy management by providing more effective and shorter treatment options.
