Banca de DEFESA: ANDRE ALENCAR MOREIRA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : ANDRE ALENCAR MOREIRA
DATE: 28/05/2024
TIME: 09:00
LOCAL: Sala de Videoconferência - FAMED
TITLE:

Characterization of the Bacterial Microbiota at the Margins of Ulcers in Patients with
Cutaneous Leishmaniasis at a Reference Service in Cariri, Ceará".

KEY WORDS:

Cutaneous Leishmaniasis; Cutaneous Bacterial Infection; Coinfection; Inflammation;
Healing; Treatment

PAGES: 87
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Cutaneous leishmaniasis (CL), a disease of the skin and mucous membranes caused by different
species of protozoa in the genus Leishmania, is contagious but not transmissible. Leishmania ssp.
is an obligatory intracellular parasite that infects the cells of the mononuclear phagocytic system.
It exists in two primary forms: a flagellate or promastigote, which is found in the digestive tube
of the insect vector, and an aflagellate or amastigote, which is observed in the tissues of
vertebrate hosts. The vectors of the CL are commonly referred to as phlebotomine sandflies,
including species such as Lutzomyia longipalpis, Lutzomyia intermedia, and Lutzomyia whitmani,
among others, which vary based on the geographical area. Bacterial coinfection frequently occurs
in CL lesions. The objective of this study is to analyze and describe the microbiological makeup
of the area surrounding skin ulcers in individuals with CL. This study is characterized by its
observational, analytical, prospective, and transversal nature. Microbiota samples were obtained
by swabbing the injuries of patients diagnosed with CL at the Clinical School of the Faculty of
Medicine of the Federal University of Cariri between January and March 2024. The study
examined the variables associated with epidemiological, clinical, and microbial data on lesions
and the corresponding area of the body for comparison. Analyzed data using absolute and relative
frequencies for categorical variables and centrality metrics for continuous variables, such as

average and standard deviation. The survey's key variables were analyzed using the Kruskal-
Wallis and Mann-Whitney tests, which involved comparing averages. The statistical analyses

were conducted at a significance threshold of α = 0.05. The study revealed that most of 

individuals affected by LC were men (61%) between the ages of 38 and 47 (20.5%), residing in
rural areas (70.7%), with incomplete elementary education (46.3%), and earning an income
between 1 to 5 minimum wages (80.5%). The lesions were most seen in the lower left limbs
(47.5%) in both males and females. Regarding the culture of ulcerative lesions, Staphylococcus
aureus was the most common (22.7%). Furthermore, it was noted that 11.3% of patients
exhibited a rise in the same bacterial species (Staphylococcus) in both the culture of the affected
area and the control culture. An assessment was conducted on the intricacy of Cutaneous
leishmaniasis with particular emphasis on the impact of bacterial coinfection. The presence of
bacteria alongside Leishmania spp. in skin lesions exacerbates the challenges associated with
identification and therapy, impeding the healing process, and potentially resulting in
consequences. The findings suggest a correlation between lesion problems and the colonization
of opportunistic bacteria, which is impacted by the inflammation caused by Leishmania. The
presence of low oxygen levels in the lesions promotes the continued existence of the infection.
Research has found a high occurrence of S. aureus infections in the periphery of skin ulcers in
individuals with Leishmania ssp. Simultaneous infection Leishmania ssp. and S. aureus
exacerbate the inflammatory response, leading to more severe lesions. CL primarily impacts
males, resulting in frequent injuries to both the upper and lower extremities. In conclusion, the
initial findings indicated that the lesions induced by CL may exhibit an opportunistic colonization
by commensal bacteria of the human epithelium, hence facilitating the emergence of subsequent
infections. Therefore, it is possible to develop novel therapeutic approaches that not only focus
on combating Leishmania but also target the opportunistic microbiota. This can help reduce the
likelihood of difficulties in the clinical condition of patients. These findings emphasize the
significance of taking secondary infections into account while treating CL. To enhance patient
outcomes and minimize difficulties, healthcare providers can effectively target both leishmania
and opportunistic microorganisms.

COMMITTEE MEMBERS:
Presidente - CLAUDIO GLEIDISTON LIMA DA SILVA
Externo à Instituição - LUIS RAFAEL LEITE SAMPAIO
Interna - MARIA DO SOCORRO VIEIRA DOS SANTOS
Externa à Instituição - RACQUEL OLIVEIRA DA SILVA SOUZA