Posts filed under ‘Biología Molecular’

Clinical and epidemiological features of chronic Trypanosoma cruzi infection in patients with HIV/AIDS in Buenos Aires, Argentina

International Journal of Infectious Diseases February 2018 V.67 P.118–121

Andrés Guillermo Benchetrit, Marisa Fernández, Amadeo Javier Bava, Marcelo Corti, Norma Porteiro, Liliana Martínez Peralta

Highlights

  • Chagas disease reactivation is an AIDS-defining illness with a high mortality rate.
  • Besides the vector-borne route, other means of T. cruzi infection acquisition must be assessed.
  • HIV-infected patients with lower CD4 T-cell counts are at higher risk of Chagas disease reactivation.
  • Severely immunecompromised patients infected with T. cruzi may have negative serological assay results.
  • Direct parasitological techniques should be performed in the diagnosis of patients for whom there is a suspicion of T. cruzi reactivation.

Objectives

Trypanosoma cruzi reactivation in HIV patients is considered an opportunistic infection, usually with a fatal outcome. The aim of this study was to describe the epidemiological and clinical features of T. cruzi infection in HIV patients and to compare these findings between patients with and without Chagas disease reactivation.

Methods

The medical records of T. cruzi–HIV co-infected patients treated at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were reviewed retrospectively. Epidemiological and clinical features were assessed and compared between patients with and without Chagas disease reactivation.

Results

The medical records of 80 T. cruzi–HIV co-infected patients were reviewed. The most likely route of T. cruzi infection was vector-borne (32/80 patients), followed by intravenous drug use (12/80). Nine of 80 patients had reactivation. Patients without reactivation had a significantly higher CD4 T-cell count at diagnosis of T. cruzi infection (144 cells/μl vs. 30 cells/μl, p = 0.026). Chagas disease serology was negative in two of nine patients with reactivation.

Conclusions

Serological assays for T. cruzi infection may be negative in severely immunocompromised patients. Direct parasitological techniques should be performed in the diagnosis of patients for whom there is a suspicion of T. cruzi reactivation. HIV patients with a lower CD4 count are at higher risk of reactivation.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30309-0/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30309-0/pdf

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February 18, 2018 at 4:05 pm

Seroprevalence and risk factors of Hepatitis E infection in Jordan’s population: First report

International Journal of Infectious Diseases January 2018 V.66 P.121–125

Mohammad M. Obaidat, Amira A. Roess

Highlights

  • Seroprevalce, risk factors and zoonotic potential of HEV were studied.
  • HEV antibodies occurs at high prevalence (30.9%) overall in Jordan.
  • HEV infection associates with age and eating undercooked meat.
  • Owning camels increased the odds of HEV seropositivity.

Objectives

Hepatitis E virus (HEV) is hyperendemic in many countries, but data on this virus are not available in Jordan. This study determined the seroprevalence, risk factors and zoonotic potential of HEV in a Jordanian population.

Methods

A total of 450 sera samples from 8 different governorates were tested for HEV-IgG. A pre-tested and validated questionnaire was used to collect risk factor data including animal interaction and environmental exposures.

Results

The overall seroprevalence was 30.9%. Eating undercooked meat was significantly associated with HEV seropositivity (OR = 2.06, 95%CI 1.04–4.06) after controlling for age, gender, travel history and source of water. Age was also associated with HEV seropositivity; the youngest (≤14 years of age) and oldest age groups (60 and 80 years of age) had the highest prevalence (45.5% and 53.2%, respectively), compared to those between 20 to 29 years of age and 30 to 39 years of age (20.2 and 15.2%, respectively), although the small sample size among the youngest group tempers this association. There was evidence of a marginal association between owning camels and an increased odds of HEV seropositivity. Place of residence and source of drinking water were not associated with infection.

Conclusion

This is the first study to report HEV seroprevalence in Jordan and shows that HEV exposure is high in Jordan. Surveillance for acute and chronic Hepatitis E is needed to estimate the frequency of the actual disease.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30297-7/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30297-7/pdf

February 10, 2018 at 9:14 am

First case of New Delhi metallo-β-lactamase in Klebsiella pneumoniae from Ecuador: An update for South America

International Journal of Infectious Diseases December 2017 V.65 N. P.119–121

Daniel Romero-Alvarez, Jorge Reyes, Viviana Quezada, Carolina Satán, Nelson Cevallos, Sofía Barrera, Gabriel Trueba, Luis E. Escobar, José E. Villacís

Highlights

  • The New Delhi metallo-β-lactamase (NDM) resistance plasmid has autochthonous circulation in Ecuador.
  • A Klebsiella pneumoniae ST147 harboring the NDM-1 gene in an IncA/C plasmid is described for the first time in Quito, Ecuador.
  • The circulation of NDM in South America has been addressed mainly by Brazil and Colombia.

Objectives

To describe a clinical case of Klebsiella pneumoniae harboring a New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America.

Methods

The modified Hodge test, carbapenem inactivation method, imipenem–EDTA disk method (synergy), and Rapidec Carba NP test were used to identify antibiotic resistance mechanisms. The presence of resistance genes was explored with a conjugation assay, and molecular confirmation of NDM was performed by PCR and DNA sequencing. Plasmid characterization was conducted by PCR-based replicon typing. A literature review was performed in Google Scholar and PubMed to identify reports from South America.

Results

An HIV-infected patient, who had never traveled abroad, developed a bloodstream infection caused by K. pneumoniae ST147 harboring the NDM-1 resistance gene in a plasmid from the IncA/C group. Local circulation of NDM has also been described in other South American countries, in particular in Colombia and Brazil, although published scientific records were not found for other countries.

Conclusions

This report presents the first evidence of autochthonous circulation of the NDM-1 resistance gene harbored by an IncA/C plasmid isolated from a K. pneumoniae ST147 in Ecuador. Efforts should be implemented to monitor and characterize the spatial and temporal distribution of NDM in Ecuador and other countries of South America.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30268-0/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30268-0/pdf

February 10, 2018 at 9:09 am

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015

Emerg Infect Dis. 2018 V.24 N.2 P.201-209

Adriana E. KajonComments to Author , Daryl M. Lamson, Camden R. Bair, Xiaoyan Lu, Marie L. Landry, Marilyn Menegus2, Dean D. Erdman, and Kirsten St. George

Author affiliations: Lovelace Respiratory Research Institute, Albuquerque, New Mexico, USA (A.E. Kajon, C.R. Bair); New York State Department of Health, Albany, New York, USA (D.M. Lamson, K. St. George); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (X. Lu, D.D. Erdman); Yale University School of Medicine, New Haven, Connecticut, USA (M.L. Landry); University of Rochester Medical Center, Rochester, New York, USA (M. Menegus)

Abstract

Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011–2015.

Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities.

HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases.

Two novel a-like variants were recovered from students enrolled at a college in Tompkins County, New York, USA, and a prototype-like variant distinguishable from the vaccine strain was isolated from an 18-year-old woman visiting a physician’s office in Ulster County, New York, USA, with symptoms of influenza-like illness. Our data suggest that HAdV-4 might be an underestimated causative agent of ARD among civilian adults.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/2/17-1407_article

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-1407.pdf

 

 

February 9, 2018 at 6:47 pm

Emerging group C and group G streptococcal endocarditis: A Canadian perspective

International Journal of Infectious Diseases December 2017 V.65 N. P.128–132

Sylvain A. Lother, Davinder S. Jassal, Philippe Lagacé-Wiens, Yoav Keynan

Objectives

The aim of this study was to determine the incidence of infective endocarditis (IE) in patients with bacteremia caused by group C and group G streptococci (GCGS) and to characterize the burden of disease, clinical characteristics, and outcomes through a case series of patients with GCGS IE.

Methods

Individuals with blood cultures growing GCGS in Manitoba, Canada, between January 2012 and December 2015 were included. Clinical and echocardiographic parameters were collected retrospectively. IE was suspected or confirmed according to the modified Duke criteria.

Results

Two hundred and nine bacteremic events occurred in 198 patients. Transthoracic echocardiography (TTE) was performed in 33%. Suspected or confirmed IE occurred in 6% of all patients and in 18% of those with TTE. Native valve infection was more common than prosthetic valve and device-related infections (75%, 17%, and 8%, respectively). Metastatic infection was observed in 64%, primarily to the lungs (57%), skin (43%), osteoarticular system (29%), and central nervous system (29%). Sepsis occurred in 58% and streptococcal toxic shock syndrome in 50% of those with IE, with overall mortality of 17%.

Conclusions

IE from GCGS bacteremia is common and is frequently associated with severe disease, embolic events, and mortality. In the appropriate clinical context, GCGS bacteremic events should prompt investigation for IE.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30274-6/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30274-6/pdf

February 9, 2018 at 1:25 pm

 Clinical evaluation of early acquisition of Staphylococcus aureus carriage by newborns

International Journal of Infectious Diseases November 2017 V.64 N. P.9–14

Ayala Maayan-Metzger, Tzipora Strauss, Carmit Rubin, Hanaa Jaber, Mordechai Dulitzky,

Aylana Reiss-Mandel, Eyal Leshem, Galia Rahav, Gili Regev-Yochay

Abstract

Background

Little is known about neonatal Staphylococcus aureus carriage. Sites and clinical outcomes of S. aureus colonization during the first month of life were evaluated in this study.

Methods

A cohort of 279 infants born at term to 277 mothers was included. Maternal S. aureus colonization status was examined before labor. Newborns were screened for nasal, auricular, umbilical, and rectal colonization, one to three times within 100 h after birth, and infants of carrier mothers were re-screened at 1 month. Medical data were recorded from the medical charts at discharge and at the 1-month follow-up interview.

Results

Overall 43 out of 279 (15.4%) infants acquired S. aureus within the first days of life. The only two predictors of S. aureus carriage in the postnatal period were maternal S. aureus carriage (odds ratio 7.905, 95% confidence interval 3.182–19.638) and maternal antibiotic treatment during labor (odds ratio 0.121, 95% confidence interval 0.016–0.949). Among colonized children, the nose (56%) and rectum (40%) were more frequently colonized, while ear (26%) and umbilicus (16%) colonization were less common. Co-colonization at two sites was rare (4%), but always predicted carriage at 1 month of age. Maternal and neonatal characteristics, including neonatal outcomes, were similar between S. aureus carrier and non-carrier infants during the first month of life.

Conclusions

Maternal carriage is the major predictor of neonatal S. aureus carriage. The nose and rectum are the main sites of neonatal carriage. S. aureus carriage was not associated with neonatal complications throughout the first month of life. The long-term significance of early S. aureus carriage is yet to be determined.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30219-9/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30219-9/pdf

February 9, 2018 at 1:20 pm

Hepatitis E virus infection as a promoting factor for hepatocellular carcinoma in Cameroon: Preliminary Observations

International Journal of Infectious Diseases November 2017 V.64 N. P.4–8

Marie Amougou Atsama, Paul Jean Adrien Atangana, Dominique Noah Noah, Paul Fewou Moundipa, Pascal Pineau, Richard Njouom

Abstract

Objectives

To determine the seroprevalence of hepatitis E virus (HEV) infection in patients with chronic hepatitis and/or hepatocellular carcinoma (HCC) and to assess its potential consequences for disease progression.

Methods

We conducted a prospective case-control study on patients with HCC hepatitis B or C related and non-HCC patients including patients with CLD and patients without clinical evidence of liver disease. Anti-HEV IgG and IgM were tested by ELISA using commercially available kits. Liver damage was assessed by alanine aminotransferase, aspartate aminotransferase, platelets and prothrombin measurements.

Results

We observed a significant anti-HEV IgG carriage in HCC patients compared to non-HCC subjects with CLD (41.8% vs 12.6%; P = 9.1 E-6; OR = 4.8, 95%CI: 2.3-10.6). HCC patients with HEV infection display more profound alterations of circulating liver enzymes, platelets count and prothrombin time than HCC patients without sero-reactivity to HEV.

Conclusion

Overall, this study indicates a high prevalence of HEV infection in Cameroonian patients with CLD and HCC. These data suggest either that patients with liver tumors are more susceptible to hepeviral infection or that, in a tropical context, HEV might promote the progression of liver diseases towards tumor.

abstract

http://www.ijidonline.com/article/S1201-9712(17)30216-3/fulltext

PDF

http://www.ijidonline.com/article/S1201-9712(17)30216-3/pdf

February 9, 2018 at 1:17 pm

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