Archive for February 18, 2017

REVISION – Proteómica en enfermedades infecciosas

Enf Infecciosas & Microb Clínica Abril 2016 V.34 N.4 P.253-60

Sara Quero, Noemí Párraga-Niño, Marian García-Núñez, Miquel Sabrià

a Unitat de Malalties Infeccioses, Fundació Institut d’Investigació Germans Trias i Pujol, Badalona, Barcelona, España

b Universitat Autònoma de Barcelona, Cerdanyola, Barcelona, España

c CIBER de Enfermedades Respiratorias, Bunyola, Illes Balears, España

d Unitat de Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España

Las enfermedades infecciosas tienen gran incidencia en la población, provocando un impacto en la salud mundial. La primera técnica aplicada al diagnóstico de las infecciones es el cultivo de los microorganismos in vitro, el cual es costoso y con un resultado tardío.

En las últimas décadas los esfuerzos se han centrado en la aplicabilidad de las ciencias «ómicas», destacando el avance proporcionado por las técnicas proteómicas en el campo de las enfermedades infecciosas.

La presente revisión expone el manejo, el procesamiento y el análisis de las muestras biológicas para su estudio proteómico.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90451761&pident_usuario=0&pcontactid=&pident_revista=28&ty=114&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=es&fichero=28v34n04a90451761pdf001.pdf

 

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February 18, 2017 at 8:59 pm

REVISION – Fiebre del Zika

Enf Infecciosas & Microb Clínica Abril 2016 V.34 N.4 P.247-52

Pablo Martínez de Salazar, Anna Suy, Adrián Sánchez-Montalvá, Carlota Rodó, Fernando Salvador, Israel Molina

a Microbiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Spain

b IS Global and the Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain

c Obstetrics and Gynaecology Department, Maternal fetal Medicine Unit, Vall d’Hebron University Hospital, Spain

d Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Spain

La fiebre del Zika es una enfermedad sistémica causada por un arbovirus que se ha convertido recientemente en un problema de salud pública de importancia mundial después de su propagación a través de las Américas.

Esta revisión describe el conocimiento actual sobre la epidemiología del virus Zika, sus vías de transmisión, manifestaciones clínicas, las técnicas de diagnóstico y las estrategias actuales de gestión, prevención y control.

También profundiza en la asociación entre la infección y las complicaciones atribuidas al virus Zika, como la microcefalia o el síndrome de Guillem-Barré.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90451760&pident_usuario=0&pcontactid=&pident_revista=28&ty=113&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v34n04a90451760pdf001.pdf

February 18, 2017 at 8:58 pm

Comprehensive Molecular Testing for Respiratory Pathogens in Community-Acquired Pneumonia.

Clin Infect Dis. 2016 Apr 1;62(7):817-23.

Gadsby NJ1, Russell CD2, McHugh MP1, Mark H1, Conway Morris A3, Laurenson IF1, Hill AT4, Templeton KE1.

Author information

1Medical Microbiology, Department of Laboratory Medicine, Royal Infirmary of Edinburgh.

2Medical Microbiology, Department of Laboratory Medicine, Royal Infirmary of Edinburgh College of Medicine and Veterinary Medicine, University of Edinburgh.

3Department of Anaesthesia, University of Cambridge.

4Respiratory Medicine, Royal Infirmary of Edinburgh, United Kingdom.

Abstract

BACKGROUND:

The frequent lack of a microbiological diagnosis in community-acquired pneumonia (CAP) impairs pathogen-directed antimicrobial therapy. This study assessed the use of comprehensive multibacterial, multiviral molecular testing, including quantification, in adults hospitalized with CAP.

METHODS:

Clinical and laboratory data were collected for 323 adults with radiologically-confirmed CAP admitted to 2 UK tertiary care hospitals. Sputum (96%) or endotracheal aspirate (4%) specimens were cultured as per routine practice and also tested with fast multiplex real-time polymerase-chain reaction (PCR) assays for 26 respiratory bacteria and viruses. Bacterial loads were also calculated for 8 bacterial pathogens. Appropriate pathogen-directed therapy was retrospectively assessed using national guidelines adapted for local antimicrobial susceptibility patterns.

RESULTS:

Comprehensive molecular testing of single lower respiratory tract (LRT) specimens achieved pathogen detection in 87% of CAP patients compared with 39% with culture-based methods. Haemophilus influenzae and Streptococcus pneumoniae were the main agents detected, along with a wide variety of typical and atypical pathogens. Viruses were present in 30% of cases; 82% of these were codetections with bacteria. Most (85%) patients had received antimicrobials in the 72 hours before admission. Of these, 78% had a bacterial pathogen detected by PCR but only 32% were culture-positive (P < .0001). Molecular testing had the potential to enable de-escalation in number and/or spectrum of antimicrobials in 77% of patients.

CONCLUSIONS:

Comprehensive molecular testing significantly improves pathogen detection in CAP, particularly in antimicrobial-exposed patients, and requires only a single LRT specimen. It also has the potential to enable early de-escalation from broad-spectrum empirical antimicrobials to pathogen-directed therapy.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4787606/pdf/civ1214.pdf

 

February 18, 2017 at 8:43 am

Guidelines for management of community-acquired pneumonia in adults.

Medicina (B Aires). 2015;75(4):245-57.

[Article in Spanish]

Lopardo G1, Basombrío A, Clara L, Desse J, De Vedia L, Di Libero E, Gañete M, López Furst MJ, Mykietiuk A, Nemirovsky C, Osuna C, Pensotti C, Scapellato P.

Author information

1Sociedad Argentina de Infectología, Buenos Aires, Argentina. E-mail: glopardo@intramed.net

Abstract

Community-acquired pneumonia in adults is a common cause of morbidity and mortality particularly in the elderly and in patients with comorbidities. Most episodes are of bacterial origin, Streptococcus pneumoniae is the most frequently isolated pathogen. Epidemiological surveillance provides information about changes in microorganisms and their susceptibility. In recent years there has been an increase in cases caused by community-acquired meticillin resistant Staphylococcus aureus and Legionella sp. The chest radiograph is essential as a diagnostic tool. CURB-65 score and pulse oximetry allow stratifying patients into those who require outpatient care, general hospital room or admission to intensive care unit. Diagnostic studies and empirical antimicrobial therapy are also based on this stratification. The use of biomarkers such as procalcitonin or C-reactive protein is not part of the initial evaluation because its use has not been shown to modify the initial approach. We recommend treatment with amoxicillin for outpatients under 65 year old and without comorbidities, for patients 65 years or more or with comorbidities amoxicillin-clavulanic/sulbactam, for patients hospitalized in general ward ampicillin-sulbactam with or without the addition of clarithromycin, and for patients admitted to intensive care unit ampicillin-sulbactam plus clarithromycin. Suggested treatment duration is 5 to 7 days for outpatients and 7 to 10 for those who are hospitalized. During the influenza season addition of oseltamivir for hospitalized patients and for those with comorbidities is suggested.

PDF

http://www.medicinabuenosaires.com/PMID/26339883.pdf

February 18, 2017 at 8:42 am


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