Comportamento da tuberculose humana no Rio Grande do Norte e pesquisa de Mycobacterium spp. em quijos de coalho comercializados no Município de Caicó - RN, Brasil.

Abstract

Tuberculosis (TB) is one of the leading causes of human death and is one of the main death´s culprit by a single infectious agent. The region of the Americas represents 3% of the world's disease, of which 33% are attributed to Brazil, what is one of the 22 countries prioritized by WHO, who together represent 80% of the world's occurrence by this microrganism. One of the forms of the disease on humans is zoonotic tuberculosis, which is caused by Mycobacterium bovis, and its main route of transmission to population is through the consumption of milk and dairy products (cheeses and yoghurts) prepared without the adoption of Good Agricultural Practices (GAPs) and Manufacturing (GMPs). In the first chapter, the behavior of human tuberculosis in the state of Rio Grande do Norte, Brazil, from 2008 to 2017, is analyzed through descriptive and retrospective studies, evaluating the annual incidence of tuberculosis in the State and occurrence of their clinical forms. The primary data obtained from the Tuberculosis Program in Rio Grande do Norte - SUVIGE / SESAP-RN were used; and secondary data collected from Sinan / Ministry of Health. As a result, there was a divergence between the incidence coefficients calculated with the primary data from those published in Epidemiological Bulletins: 37.1 to 27.0, per group of 100 thousand inhabitants; in addition, the disease showed a linear growth trend in Rio Grande do Norte. It is recommended that comprehensive measures be taken to protect the population and the environment associated with strengthening health services so that the goals proposed in the End TB program can be achieved, be they control and / or eradication. The following chapter evaluated the microbiological quality of the Coalho cheese marketed in the municipality of Caicó-RN, by investigating the presence of Mycobaterium spp. through bacterial culture and molecular diagnosis. Fifty samples of Coalho cheese randomly from local commerce were analyzed: 35 were made from raw milk (artisanal) and 15 with pasteurized (industrialized) milk, from which materials were extracted and submitted to processes: to obtain DNA; cultivation (Stonebrink); conventional PCR for M. bovis; and finally, nested-PCR for Mycobacterium spp. In the laboratory research, it was not possible to isolate tuberculous mycobacteria from cheeses studied. However, the growth of non-tuberculous mycobacteria (NTM) in culture medium was detected in two samples (4%), which showed hsp65 identity of: Mycobacterium lehmanii (sequence ID: KY933786.1, value-e: 2e-133, identities: 312/363 [86%]); and Mycobacterium rutilum (sequence ID: LT629971.1, value-e: 3e-108, identities: 331/371 [89%]), considerated as indicative of environmental contamination. Knowing more about the characteristics of the MNT and considering them as emerging microorganisms and ubiquitous, it is suggested that more attention be given to the cheese production chain, both in good agricultural practices (GAPs) and in good food manufacturing practices (GMPs).