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1</a>&#41;&#46; Atualmente&#44; o g&#234;nero tem 45 esp&#233;cies e subesp&#233;cies&#44; das quais pelo menos 17 s&#227;o capazes de infectar seres humanos&#46; A maioria dessas bact&#233;rias &#233; transmitida por artr&#243;podes hemat&#243;fagos&#44; e alguns de seus reservat&#243;rios s&#227;o animais dom&#233;sticos&#44; principalmente c&#227;es e gatos&#46; Embora sejam bact&#233;rias negligenciadas&#44; o n&#250;mero de estudos sobre a infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; est&#225; aumentando&#44; assim como o reconhecimento de sua import&#226;ncia&#46; Esses agentes t&#234;m sido relacionados a um amplo espectro de manifesta&#231;&#245;es cl&#237;nicas&#44; que varia de infec&#231;&#227;o assintom&#225;tica a condi&#231;&#245;es com risco de morte&#44; como endocardite&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">N&#227;o existem testes diagn&#243;sticos com sensibilidade e especificidade suficientemente altas&#46; 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estudantes ou funcion&#225;rios da Unicamp&#44; maiores de 18 anos que negaram sintomas cl&#237;nicos&#44; n&#227;o eram gestantes e que concordaram em participar do estudo&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As amostras foram processadas como resumido na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46; As culturas de enriquecimento l&#237;quido e as culturas s&#243;lidas foram realizadas como descrito anteriormente&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> A partir do sangue total e de amostras das culturas&#44; o DNA foi extra&#237;do usando o QIAmp DNA mini <span class="elsevierStyleItalic">kit</span> &#40;Qiagen&#174;&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Do DNA obtido foram realizadas PCRs convencionais espec&#237;ficas para g&#234;nero &#40;regi&#227;o ITS&#41; e PCRs espec&#237;ficas para a esp&#233;cie <span class="elsevierStyleItalic">Bartonella henselae</span>&#58; PCR de dupla amplifica&#231;&#227;o &#40;<span class="elsevierStyleItalic">nested</span>&#41; para a regi&#227;o <span class="elsevierStyleItalic">ftsZ</span> e PCR em tempo real para a regi&#227;o <span class="elsevierStyleItalic">gltA</span>&#46; A qualidade do DNA extra&#237;do e a aus&#234;ncia de inibidores de amplifica&#231;&#227;o foram testadas por meio de PCR convencional para o gene GAPDH&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O DNA de <span class="elsevierStyleItalic">B&#46; henselae</span> foi detectado em 20&#37; &#40;6&#47;30&#41; dos pacientes com Ps e em 10&#37; &#40;3&#47;30&#41; dos volunt&#225;rios saud&#225;veis que negaram os sintomas no momento da coleta da amostra sangu&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; O teste exato de Fischer n&#227;o mostrou diferen&#231;a estat&#237;stica entre os dois grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;23&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">A Ps &#233; uma doen&#231;a multifatorial&#44; inflamat&#243;ria e imunomediada&#46; Embora n&#227;o exista consenso sobre os mecanismos exatos de a&#231;&#227;o em sua patog&#234;nese&#44; existem fortes ind&#237;cios de que fatores externos&#44; como superant&#237;genos&#44; tenham grande capacidade de estimular a resposta inflamat&#243;ria da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Os microrganismos t&#234;m sido associados &#224; Ps &#40;incluindo estreptococos &#946;&#8208;hemol&#237;ticos&#44; <span class="elsevierStyleItalic">Staphylococcus aureus&#44; Porphyromonas gingivalis&#44; Candida albicans&#44; Chlamydia psittaci</span>&#44; v&#237;rus da imunodefici&#234;ncia humana e v&#237;rus da hepatite C&#41;&#44; mas h&#225; evid&#234;ncias limitadas de que a terapia antimicrobiana apresente algum benef&#237;cio direto na preven&#231;&#227;o de crises&#46; A Ps est&#225; associada&#44; independentemente&#44; a um risco aumentado de infec&#231;&#245;es graves&#44; o que &#233; intensificado pelo uso de tratamentos imunomoduladores&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">A infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi documentada em 3&#44;2&#37; numa amostra com 500 doadores de sangue usando uma &#250;nica PCR convencional espec&#237;fica para o g&#234;nero&#44; a partir de amostras de cultura l&#237;quida e s&#243;lida&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi detectada em pacientes com Ps e artrite psori&#225;sica &#40;PsA&#41;&#46; Um paciente com Ps apresentou a doen&#231;a da arranhadura do gato durante o tratamento com adalimumabe&#46; Outro paciente com PsA apresentou linfadenopatia mesent&#233;rica e abscessos espl&#234;nicos&#46; A infec&#231;&#227;o sintom&#225;tica por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi detectada em outros pacientes que recebiam tratamento com imunobiol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Um em cada cinco pacientes com Ps e um em cada 10 volunt&#225;rios saud&#225;veis apresentaram infec&#231;&#227;o por <span class="elsevierStyleItalic">B&#46; henselae</span>&#46; Embora n&#227;o haja diferen&#231;a estat&#237;stica com rela&#231;&#227;o ao grupo controle&#44; essas informa&#231;&#245;es s&#227;o importantes para considerar a alta preval&#234;ncia da infec&#231;&#227;o nos pacientes com Ps e mesmo no grupo controle&#46; &#201; preciso aten&#231;&#227;o em qualquer paciente que necessite de tratamento imunobiol&#243;gico ou outros medicamentos imunossupressores e que apresente poss&#237;veis express&#245;es da infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46;&#44; como febre de origem indeterminada&#44; hepatite criptog&#234;nica&#44; linfonodomegalia&#44; endocardite&#44; sepse&#44; rea&#231;&#245;es granulomatosas ou angioproliferativas&#46; Mais estudos s&#227;o necess&#225;rios para avaliar se a infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; pode agravar a express&#227;o da Ps e os riscos dessa infec&#231;&#227;o associada a tratamentos imunossupressores&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0065" class="elsevierStylePara elsevierViewall">Bolsa de Doutorado CNPq 170501&#47;2018&#8208;3 &#40;Santos&#44; LS&#41;&#59; Bolsa de P&#243;s&#8208;doutorado Fapesp 2018&#47;12565&#8208;6 &#40;Drummond&#44; MR&#41;&#59; Bolsa de Produtividade CNPq 301900&#47;2015&#8208;9 &#40;Velho&#44; PENF&#41; e Fundo de Apoio &#224; Dermatologia &#40;Funaderm&#41;&#47;Sociedade Brasileira de Dermatologia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0070" class="elsevierStylePara elsevierViewall">Luciene Silva dos Santos&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Marina Rovani Drummond&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Renata Ferreira Magalh&#227;es&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Marilene Neves da Silva&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Patricia Andreia Rodrigues Ferreira&#58; Concep&#231;&#227;o e planejamento do estudo&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Paulo Eduardo Neves Ferreira Velho&#58; An&#225;lise estat&#237;stica&#44; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0100" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado na Faculdade de Ci&#234;ncias M&#233;dicas&#44; Universidade Estadual de Campinas&#44; Campinas&#44; SP&#44; Brasil&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCR sangue total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCR em tempo realcultura l&#237;quida&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">PS16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#43;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">PS18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#43;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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Carta ‐ Investigação
Prevalência da infecção por Bartonella spp. em pacientes com psoríase
Luciene Silva dos Santosa, Marina Rovani Drummonda, Renata Ferreira Magalhãesb, Marilene Neves da Silvaa, Patricia Andreia Rodrigues Ferreirab, Paulo Eduardo Neves Ferreira Velhob,
Corresponding author
pvelho@unicamp.br

Autor para correspondência.
a Laboratório de Pesquisa Aplicada em Dermatologia e Infecção por Bartonella, Faculdade de Medicina, Universidade Estadual de Campinas, Campinas, SP, Brasil
b Disciplina de Dermatologia, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
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1</a>&#41;&#46; Atualmente&#44; o g&#234;nero tem 45 esp&#233;cies e subesp&#233;cies&#44; das quais pelo menos 17 s&#227;o capazes de infectar seres humanos&#46; A maioria dessas bact&#233;rias &#233; transmitida por artr&#243;podes hemat&#243;fagos&#44; e alguns de seus reservat&#243;rios s&#227;o animais dom&#233;sticos&#44; principalmente c&#227;es e gatos&#46; Embora sejam bact&#233;rias negligenciadas&#44; o n&#250;mero de estudos sobre a infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; est&#225; aumentando&#44; assim como o reconhecimento de sua import&#226;ncia&#46; Esses agentes t&#234;m sido relacionados a um amplo espectro de manifesta&#231;&#245;es cl&#237;nicas&#44; que varia de infec&#231;&#227;o assintom&#225;tica a condi&#231;&#245;es com risco de morte&#44; como endocardite&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">N&#227;o existem testes diagn&#243;sticos com sensibilidade e especificidade suficientemente altas&#46; 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estudantes ou funcion&#225;rios da Unicamp&#44; maiores de 18 anos que negaram sintomas cl&#237;nicos&#44; n&#227;o eram gestantes e que concordaram em participar do estudo&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">As amostras foram processadas como resumido na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46; As culturas de enriquecimento l&#237;quido e as culturas s&#243;lidas foram realizadas como descrito anteriormente&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> A partir do sangue total e de amostras das culturas&#44; o DNA foi extra&#237;do usando o QIAmp DNA mini <span class="elsevierStyleItalic">kit</span> &#40;Qiagen&#174;&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Do DNA obtido foram realizadas PCRs convencionais espec&#237;ficas para g&#234;nero &#40;regi&#227;o ITS&#41; e PCRs espec&#237;ficas para a esp&#233;cie <span class="elsevierStyleItalic">Bartonella henselae</span>&#58; PCR de dupla amplifica&#231;&#227;o &#40;<span class="elsevierStyleItalic">nested</span>&#41; para a regi&#227;o <span class="elsevierStyleItalic">ftsZ</span> e PCR em tempo real para a regi&#227;o <span class="elsevierStyleItalic">gltA</span>&#46; A qualidade do DNA extra&#237;do e a aus&#234;ncia de inibidores de amplifica&#231;&#227;o foram testadas por meio de PCR convencional para o gene GAPDH&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O DNA de <span class="elsevierStyleItalic">B&#46; henselae</span> foi detectado em 20&#37; &#40;6&#47;30&#41; dos pacientes com Ps e em 10&#37; &#40;3&#47;30&#41; dos volunt&#225;rios saud&#225;veis que negaram os sintomas no momento da coleta da amostra sangu&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; O teste exato de Fischer n&#227;o mostrou diferen&#231;a estat&#237;stica entre os dois grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;23&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">A Ps &#233; uma doen&#231;a multifatorial&#44; inflamat&#243;ria e imunomediada&#46; Embora n&#227;o exista consenso sobre os mecanismos exatos de a&#231;&#227;o em sua patog&#234;nese&#44; existem fortes ind&#237;cios de que fatores externos&#44; como superant&#237;genos&#44; tenham grande capacidade de estimular a resposta inflamat&#243;ria da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Os microrganismos t&#234;m sido associados &#224; Ps &#40;incluindo estreptococos &#946;&#8208;hemol&#237;ticos&#44; <span class="elsevierStyleItalic">Staphylococcus aureus&#44; Porphyromonas gingivalis&#44; Candida albicans&#44; Chlamydia psittaci</span>&#44; v&#237;rus da imunodefici&#234;ncia humana e v&#237;rus da hepatite C&#41;&#44; mas h&#225; evid&#234;ncias limitadas de que a terapia antimicrobiana apresente algum benef&#237;cio direto na preven&#231;&#227;o de crises&#46; A Ps est&#225; associada&#44; independentemente&#44; a um risco aumentado de infec&#231;&#245;es graves&#44; o que &#233; intensificado pelo uso de tratamentos imunomoduladores&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">A infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi documentada em 3&#44;2&#37; numa amostra com 500 doadores de sangue usando uma &#250;nica PCR convencional espec&#237;fica para o g&#234;nero&#44; a partir de amostras de cultura l&#237;quida e s&#243;lida&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi detectada em pacientes com Ps e artrite psori&#225;sica &#40;PsA&#41;&#46; Um paciente com Ps apresentou a doen&#231;a da arranhadura do gato durante o tratamento com adalimumabe&#46; Outro paciente com PsA apresentou linfadenopatia mesent&#233;rica e abscessos espl&#234;nicos&#46; A infec&#231;&#227;o sintom&#225;tica por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; foi detectada em outros pacientes que recebiam tratamento com imunobiol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Um em cada cinco pacientes com Ps e um em cada 10 volunt&#225;rios saud&#225;veis apresentaram infec&#231;&#227;o por <span class="elsevierStyleItalic">B&#46; henselae</span>&#46; Embora n&#227;o haja diferen&#231;a estat&#237;stica com rela&#231;&#227;o ao grupo controle&#44; essas informa&#231;&#245;es s&#227;o importantes para considerar a alta preval&#234;ncia da infec&#231;&#227;o nos pacientes com Ps e mesmo no grupo controle&#46; &#201; preciso aten&#231;&#227;o em qualquer paciente que necessite de tratamento imunobiol&#243;gico ou outros medicamentos imunossupressores e que apresente poss&#237;veis express&#245;es da infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46;&#44; como febre de origem indeterminada&#44; hepatite criptog&#234;nica&#44; linfonodomegalia&#44; endocardite&#44; sepse&#44; rea&#231;&#245;es granulomatosas ou angioproliferativas&#46; Mais estudos s&#227;o necess&#225;rios para avaliar se a infec&#231;&#227;o por <span class="elsevierStyleItalic">Bartonella</span> sp&#46; pode agravar a express&#227;o da Ps e os riscos dessa infec&#231;&#227;o associada a tratamentos imunossupressores&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0065" class="elsevierStylePara elsevierViewall">Bolsa de Doutorado CNPq 170501&#47;2018&#8208;3 &#40;Santos&#44; LS&#41;&#59; Bolsa de P&#243;s&#8208;doutorado Fapesp 2018&#47;12565&#8208;6 &#40;Drummond&#44; MR&#41;&#59; Bolsa de Produtividade CNPq 301900&#47;2015&#8208;9 &#40;Velho&#44; PENF&#41; e Fundo de Apoio &#224; Dermatologia &#40;Funaderm&#41;&#47;Sociedade Brasileira de Dermatologia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0070" class="elsevierStylePara elsevierViewall">Luciene Silva dos Santos&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Marina Rovani Drummond&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Renata Ferreira Magalh&#227;es&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Marilene Neves da Silva&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Patricia Andreia Rodrigues Ferreira&#58; Concep&#231;&#227;o e planejamento do estudo&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Paulo Eduardo Neves Ferreira Velho&#58; An&#225;lise estat&#237;stica&#44; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0100" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado na Faculdade de Ci&#234;ncias M&#233;dicas&#44; Universidade Estadual de Campinas&#44; Campinas&#44; SP&#44; Brasil&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCR sangue total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCR em tempo realcultura l&#237;quida&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">PS16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#43;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">PS18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#43;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#8722;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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Article information
ISSN: 26662752
Original language: Portuguese
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2021 June 38 60 98
2021 May 75 90 165
2021 April 211 280 491
2021 March 156 100 256
2021 February 44 32 76
2021 January 25 25 50
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