Posts filed under ‘Epidemiología’

Urban Wild Boars and Risk of Zoonotic Streptococcus suis, Spain

Emerging Infectious Diseases June 2018 V.24 N.6

Fernández-Aguilar et al.

Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Bellaterra, Spain (X. Fernández-Aguilar, V. Aragon, N. Galofré-Milà, O. Cabezón); Universitat Autònoma de Barcelona, Bellaterra (X. Fernández-Aguilar, R. Velarde, R. Castillo-Contreras, J.R. López-Olvera, G. Mentaberre, A. Colom-Cadena, S. Lavín, O. Cabezón); Université de Montréal, St.-Hyacinthe, Québec, Canada (M. Gottschalk); Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain (J. Càmara, C. Ardanuy); CIBER de Enfermedades Respiratorias, Madrid, Spain (C. Ardanuy)

Urban wild boars (Sus scrofa) from Barcelona, Spain, harbor great diversity of Streptococcus suis strains, including strains with the cps2 gene and with the same molecular profile as local human cases. The increasing trend of potential effective contacts for S. suis transmission is of public health concern.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/24/6/17-1271_article

PDF

https://wwwnc.cdc.gov/eid/article/24/6/pdfs/17-1271.pdf

 

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May 21, 2018 at 8:40 am

Enterotoxigenic Escherichia coli blood group A interactions intensify diarrheal severity

The Journal of Clinical Investigation 2018

Pardeep Kumar, Mark Donowitz, James M. Fleckenstein

Enterotoxigenic Escherichia coli (ETEC) infections are highly prevalent in developing countries where clinical presentations range from asymptomatic colonization to severe cholera-like illness. The molecular basis for these varied presentations, that may involve strain-specific virulence features as well as host factors, have not been elucidated. We demonstrated that when challenged with ETEC strain H10407, originally isolated from a case of cholera-like illness, blood group A human volunteers developed severe diarrhea more frequently than individuals from other blood groups. Interestingly, a diverse population of ETEC strains, including H10407, secrete the EtpA adhesin molecule. As many bacterial adhesins also agglutinate red blood cells, we combined the use of glycan arrays, biolayer inferometry, and non-canonical amino acid labeling with hemagglutination studies to demonstrate that EtpA is a dominant ETEC blood group A specific lectin/hemagglutinin. Importantly, we have also shown that EtpA interacts specifically with glycans expressed on intestinal epithelial cells from blood group A individuals, and that EtpA-mediated bacterial-host interactions accelerate bacterial adhesion and effective delivery of both the heat-labile and heat-stable toxins of ETEC. Collectively, these data provide additional insight into the complex molecular basis of severe ETEC diarrheal illness that may inform rational design of vaccines to protect those at highest risk.

abstract

https://www.jci.org/articles/view/97659/pdf

PDF (CLIC en DOWNLOAD)

https://dm5migu4zj3pb.cloudfront.net/manuscripts/97000/97659/cache/97659.1-20180507184523-covered-253bed37ca4c1ab43d105aefdf7b5536.pdf

May 21, 2018 at 8:38 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

Osteoarticular infections in a tertiary care children’s hospital: Epidemiology and clinical characteristics in association with bacteremia.

Arch Argent Pediatr. 2018 Apr 1;116(2):e204-e209.

[Article in English, Spanish; Abstract available in Spanish from the publisher]

Highton E1, Pérez MG2, Cedillo Villamagua C1, Sormani MI1, Mussini MS1, Isasmendi A3, Pinheiró J3, Reijtman V3, Taicz M1, Mastroianni A3, García ME3, Rosanova MT1.

Author information

1 Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”, Ciudad Autónoma de Buenos Aires, Argentina.

2 Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”, Ciudad Autónoma de Buenos Aires, Argentina. guaperez@hotmail.com.

3 Servicio de Microbiología, Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”, Ciudad Autónoma de Buenos Aires, Argentina.

INTRODUCTION:

Osteoarticular infections are an important cause of morbidity and may present with bacteremia. The epidemiology has changed in recent years.

OBJECTIVES:

To describe the epidemiological, clinical, and evolutionary characteristics of children with osteoarticular infections and compare patients with and without bacteremia.

POPULATION AND METHODS:

Retrospective cohort. Patients younger than 18 years admitted between January 1st, 2016 and December 31st, 2016 suspected of osteoarticular infections who had undergone an arthrocentesis and/or joint biopsy were included. Clinical and laboratory characteristics were compared between patients with and without bacteremia. The Stata 10 software was used.

RESULTS:

N: 62. Patients’ median age was 59.5 months (interquartile range [IQR]: 24-84). Fever developed in 44 patients (70%). Arthritis predominated (54 patients, 87%). An etiologic agent was identified in 29 patients (47%). Staphylococcus aureus was prevalent (n: 20, 32%). Among these, 15 developed bacteremia (24%). Clindamycin was administered to 56 patients (90%) as empirical therapy. The median intravenous treatment duration was 7 days (IQR: 5-11) and the median length of stay, 7 days (IQR: 4-12). Patients with bacteremia were younger (26 months versus 60 months, p < 0.05), had a higher baseline C-reactive protein level (101 U/L versus 33 U/L, p < 0.05), a lower hemoglobin level at the time of admission (10.8 g/dL versus 12.5 g/dL, p = 0.04), and a higher frequency of fever (100% versus 57%, p < 0.05).

CONCLUSIONS:

Staphylococcus aureus was prevalent. Children with bacteremia were younger, had a higher C-reactive protein level, a lower hemoglobin level at the time of admission, and 100% presented fever.

PDF

http://www.sap.org.ar/docs/publicaciones/archivosarg/2018/v116n2a11e.pdf

 

May 18, 2018 at 8:17 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

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