Posts filed under ‘Biología Molecular’

Westward Spread of Highly Pathogenic Avian Influenza A(H7N9) Virus among Humans, China

Emerging Infectious Diseases June 2018 V.24 N.6   

Yang et al.

Beijing Normal University, Beijing, China (Q. Yang, X. Tong, H. Tian); Shaanxi Provincial Centre for Disease Control and Prevention, Xi’an, China (W. Shi, L. Zhang, Y. Xu, J. Xu, S. Li, F. Liu, P. Yu); Xianyang Centre for Disease Control and Prevention, Xianyang, China (J. Zhang); Baoji Centre for Disease Control and Prevention, Baoji, China (K. Hu); Xi’an Centre for Disease Control and Prevention, Xi’an (C. Ma); Chinese Center for Disease Control and Prevention, Beijing (X. Zhao, X. Li); Chinese Academy of Forestry, Beijing (G. Zhang); University of Oxford, Oxford, UK (O.G. Pybus)

We report infection of humans with highly pathogenic avian influenza A(H7N9) virus in Shaanxi, China, in May 2017. We obtained complete genomes for samples from 5 patients and from live poultry markets or farms in 4 cities. Results indicate that H7N9 is spreading westward from southern and eastern China.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/17-1135_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/17-1135.pdf

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May 22, 2018 at 7:41 am

Pulmonary Infections with Nontuberculous Mycobacteria, Catalonia, Spain, 1994–2014

Emerging Infectious Diseases June 2018 V.24 N.6

Santin et al.

Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, Spain (M. Santin, P. Malchair, L. Gonzalez-Luquero, M.D. Grijota-Camino, J. Dorca, F. Alcaide); University of Barcelona, Barcelona, Spain (M. Santin, J. Dorca, F. Alcaide); Agency of Public Health of Catalonia, Barcelona (I. Barrabeig); Consorci del Laboratory Intercomarcal de l’Alt Penedès, l’Anoia i el Garraf, Vilafranca del Penedès, Spain (M.A. Benitez); Hospital Moisés Broggi, Sant Joan Despí, Spain (J. Sabria, C. Cañete); Hospital de Viladecans, Viladecans, Spain (M. Palau-Benavent, J.A. Lloret-Queraltó)

In Spain, systematic reporting of pulmonary infections with nontuberculous mycobacteria is not mandatory. Therefore, to determine trends, we retrospectively identified cases for January 1994–December 2014 in Catalonia. Over the 21 years, prevalence increased and was associated with being male. Mycobacterium avium complex and M. abscessus prevalence increased; M. kansasii prevalence decreased.

En España, la notificación sistemática de infecciones pulmonares por micobacterias no tuberculosas no es obligatoria. Por lo tanto, para determinar las tendencias, identificamos casos de enero de 1994 a diciembre de 2014 de forma retrospectiva en Cataluña. Durante los 21 años, la prevalencia aumentó y se asoció con ser hombre. El complejo Mycobacterium avium y la prevalencia de M. abscessus aumentaron; La prevalencia de M. kansasii disminuyó.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/17-2095_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/17-2095.pdf

May 22, 2018 at 7:40 am

Zooanthroponotic Transmission of Drug-Resistant Pseudomonas aeruginosa, Brazil

Emerging Infectious Diseases Journal June 2018 V.24 N.6

R. Fernandes et al.

Universidade de São Paulo, São Paulo, Brazil (M.R. Fernandes, F.P. Sellera, Q. Moura, M.P.N. Carvalho, L. Cerdeira, N. Lincopan); Centro Universitário Monte Serrat, Santos, São Paulo (P.N. Rosato)

We recovered VIM-2 carbapenemase-producing Pseudomonas aeruginosa isolates from an infected dog, its owner, and the domestic environment. Genomic investigation revealed household transmission of the high-risk hospital clone sequence type 233 in the human–animal–environment interface. Results suggest zooanthroponotic transmission of VIM-2–producing P. aeruginosa in the household following the patient’s hospital discharge.

TRAD

Recuperamos VIM-2 cepas de PAE productoras de carbapenemasas de un perro infectado, su dueño y el entorno doméstico. La investigación genómica reveló la transmisión domiciliaria de la secuencia clon hospitalaria de alto riesgo tipo 233 en la interfaz humano-animal-ambiente.

Los resultados sugieren la transmisión zooantroprópica de P.AE productora de VIM-2 en el hogar después del alta hospitalaria del paciente.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/18-0335_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/18-0335.pdf

 

May 19, 2018 at 10:34 am

Genomic Epidemiology of Global Carbapenemase-Producing Enterobacter spp., 2008–2014

Emerging Infectious Diseases Journal June 2018 V.24 N.6

Peirano, Yasufumi Matsumura1, Mark D. Adams2, Patricia Bradford, Mary Motyl, Liang Chen, Barry N. Kreiswirth, and Johann D.D. Pitou

University of Calgary, Calgary, Alberta, Canada (G. Peirano, J.D.D. Pitout); Kyoto University Graduate School of Medicine, Kyoto, Japan (Y. Matsumura); J. Craig Venter Institute, La Jolla, California, USA (M.D. Adams); AstraZeneca Pharmaceuticals LP, Waltham, Massachusetts, USA (P. Bradford); Merck & Co., Inc., Rahway, New Jersey, USA (M. Motyl); Rutgers University, Newark, New Jersey, USA (L. Chen, B.N. Kreiswirth); University of Pretoria, Pretoria, South Africa (J.D.D. Pitout)

We performed whole-genome sequencing on 170 clinical carbapenemase-producing Enterobacter spp. isolates collected globally during 2008–2014. The most common carbapenemase was VIM, followed by New Delhi metallo-β-lactamase (NDM), Klebsiella pneumoniae carbapenemase, oxacillin 48, and IMP. The isolates were of predominantly 2 species (E. xiangfangensis and E. hormaechei subsp. steigerwaltii) and 4 global clones (sequence type [ST] 114, ST93, ST90, and ST78) with different clades within ST114 and ST90. Particular genetic structures surrounding carbapenemase genes were circulating locally in various institutions within the same or between different STs in Greece, Guatemala, Italy, Spain, Serbia, and Vietnam. We found a common NDM genetic structure (NDM-GE-U.S.), previously described on pNDM-U.S. from Klebsiella pneumoniae ATCC BAA-214, in 14 different clones obtained from 6 countries spanning 4 continents. Our study highlights the importance of surveillance programs using whole-genome sequencing in providing insight into the molecular epidemiology of carbapenemase-producing Enterobacter spp.

TRAD

Realizamos la secuenciación del genoma completo en 170 Enterobacter spp. productoras de carbapenemasas clínicas. aislados recogidos a nivel mundial durante 2008-2014.

La carbapenemasa más común fue VIM, seguida de metalo-β-lactamasa (NDM) de Nueva Delhi, carbapenemasas de Klebsiella pneumoniae, oxacilina 48 e IMP.

Los aislamientos fueron predominantemente de 2 especies (E. xiangfangensis y E. hormaechei subsp steigerwaltii) y 4 clones globales (secuencia tipo [ST] 114, ST93, ST90 y ST78) con diferentes clados dentro de ST114 y ST90. Las estructuras genéticas particulares que rodean los genes de la carbapenemasa circulaban localmente en varias instituciones dentro de la misma o entre diferentes ST en Grecia, Guatemala, Italia, España, Serbia y Vietnam.

Encontramos una estructura genética NDM común (NDM-GE-U.S.), descrita previamente en pNDM-U.S. de K pneumoniae ATCC BAA-214, en 14 clones diferentes obtenidos de 6 países que abarcan 4 continentes.

Nuestro estudio resalta la importancia de los programas de vigilancia que usan la secuenciación del genoma completo para proporcionar información sobre la epidemiología molecular de Enterobacter spp. que produce carbapenemasas.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/17-1648_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/17-1648.pdf

May 19, 2018 at 10:33 am

Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids

Ann Rheum Dis. May 2018 V.77 N.5 P.644-649.

Park JW1, Curtis JR2, Moon J1, Song YW1, Kim S3,4, Lee EB1.

Author information

1 Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

2 Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

3 Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

4 Seoul Kidney Clinic, Seoul, Republic of Korea.

Abstract

OBJECTIVES:

To investigate the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) as primary prophylaxis for pneumocystis pneumonia (PCP) in patients with rheumatic diseases receiving high-dose steroids.

METHODS:

The study included 1522 treatment episodes with prolonged (≥4 weeks) high-dose (≥30 mg/day prednisone) steroids in 1092 patients over a 12-year period. Of these, 262 treatment episodes involved TMP-SMX (prophylaxis group) while other episodes involved no prophylaxis (control group). Differences in 1-year PCP incidence and its mortality between the two groups were estimated using Cox regression. To minimise baseline imbalance, propensity score matching was performed and efficacy outcome was mainly assessed in the postmatched population (n=235 in both groups).

RESULTS:

During a total of 1474.4 person-years, 30 PCP cases occurred with a mortality rate of 36.7%. One non-fatal case occurred in the prophylaxis group. TMP-SMX significantly reduced the 1-year PCP incidence (adjusted HR=0.07(95% CI 0.01 to 0.53)) and related mortality (adjusted HR=0.08 (95% CI 0.0006 to 0.71)) in the postmatched population. The result of the same analysis performed in the whole population was consistent with that of the primary analysis. Incidence rate of adverse drug reactions (ADR) related to TMP-SMX was 21.2 (14.8-29.3)/100 person-years. Only two serious ADRs (including one Stevens-Johnson syndrome case) occurred. The number needed to treat for preventing one PCP (52 (33-124)) was lower than the number needed to harm for serious ADR (131 (55-∞)).

CONCLUSION:

TMP-SMX prophylaxis significantly reduces the PCP incidence with a favourable safety profile in patients with rheumatic disease receiving prolonged, high-dose steroids.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909751/pdf/annrheumdis-2017-211796.pdf

May 10, 2018 at 8:42 am

Differential Contributions of Specimen Types, Culturing, and 16S rRNA Sequencing in Diagnosis of PJI.

Journal of Clincal Microbiology May 2018 V.56 N.5

Lone Heimann Larsena,b, Vesal Khalidc, Yijuan Xub,d, Trine Rolighed Thomsenb,d and Henrik C. Schønheydera,e the PRIS Study Group

aDepartment of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

bCenter for Microbial Communities, Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark

cDepartment of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark

dBiotech, Danish Technological Institute, Aarhus, Denmark

eDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark

Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark

Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark

Danish Technological Institute, Biotech, Aarhus, Denmark

Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark

Department of Health Science and Technology, Faculty of Medicine, Aalborg University

Prosthetic joint failure is mainly caused by infection, aseptic failure (AF), and mechanical problems. Infection detection has been improved with modified culture methods and molecular diagnostics. However, comparisons between modified and conventional microbiology methods are difficult due to variations in specimen sampling. In this prospective, multidisciplinary study of hip or knee prosthetic failures, we assessed the contributions of different specimen types, extended culture incubations, and 16S rRNA sequencing for diagnosing prosthetic joint infections (PJI). Project specimens included joint fluid (JF), bone biopsy specimens (BB), soft-tissue biopsy specimens (STB), and swabs (SW) from the prosthesis, collected in situ, and sonication fluid collected from prosthetic components (PC). Specimens were cultured for 6 (conventional) or 14 days, and 16S rRNA sequencing was performed at study completion. Of the 156 patients enrolled, 111 underwent 114 surgical revisions (cases) due to indications of either PJI (n = 43) or AF (n = 71). Conventional tissue biopsy cultures confirmed PJI in 28/43 (65%) cases and refuted AF in 3/71 (4%) cases; one case was not evaluable. Based on these results, minor diagnostic adjustments were made. Fourteen-day cultures of JF, STB, and PC specimens confirmed PJI in 39/42 (93%) cases, and 16S rRNA sequencing confirmed PJI in 33/42 (83%) cases. One PJI case was confirmed with 16S rRNA sequencing alone and five with cultures of project specimens alone. These findings indicated that JF, STB, and PC specimen cultures qualified as an optimal diagnostic set. The contribution of sequencing to diagnosis of PJI may depend on patient selection; this hypothesis requires further investigation.

PDF

http://jcm.asm.org/content/56/5/e01351-17.full.pdf+html

May 9, 2018 at 3:39 pm

REVIEW – Emerging infections—an increasingly important topic: review by the Emerging Infections Task Force

Clinical Microbiology and Infection April 2018 V.24 N.4 P.369-375

Petersen, N. Petrosillo, M. Koopmans, the ESCMID Emerging Infections Task Force Expert Panel

Objetivos

Este artículo revisa las tendencias en infecciones emergentes y la necesidad de una mayor vigilancia clínica y de laboratorio.

Métodos

Se han revisado los factores que contribuyeron a la aparición de brotes recientes. Se revisaron los principales brotes conocidos durante las últimas dos décadas.

Resultados

Identificamos al menos cuatro causas principales de infecciones emergentes: (i) aumento de la densidad de la población humana; (ii) el estrés de la expansión de las tierras de cultivo en el medio ambiente; (iii) globalización del mercado y la fabricación de alimentos; (iv) contaminación ambiental. Los factores que crean nuevas oportunidades para infecciones emergentes incluyen: (i) crecimiento de la población; (ii) propagación en instalaciones de atención médica; (iii) una población que envejece; (iv) viajes internacionales; (v) cambiar y expandir los hábitats de vectores.

Conclusiones

Las infecciones emergentes son impredecibles. En esta revisión, argumentamos que para descubrir nuevas tendencias en enfermedades infecciosas, los médicos deben buscar lo inusual e inesperado y garantizar diagnósticos adecuados y que la vigilancia sindrómica debe ser respaldada por servicios de laboratorio altamente especializados. El modelado matemático no ha sido capaz de predecir los brotes. Se necesita más énfasis en la biología de la evolución. El EID rara vez se destaca por ser inusual, y la presión continua sobre los presupuestos de atención médica obliga a los médicos y los laboratorios a priorizar su diagnóstico hasta condiciones comunes y tratables. La Sociedad Europea de Enfermedades Infecciosas y Microbiología Clínica, ESCMID, ha establecido un Grupo de Trabajo sobre Infecciones Emergentes, EITaF, para fortalecer las actividades de la sociedad sobre infecciones emergentes y garantizar que las infecciones emergentes se incluyan en las consideraciones diagnósticas diferenciales en la práctica clínica diaria.

PDF

http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30641-9/pdf

April 24, 2018 at 7:54 am

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