Posts filed under ‘FIEBRE y RASH’

Colonization of β-hemolytic streptococci in patients with erysipelas—a prospective study

European Journal of Clinical Microbiology & Infectious Diseases October 2019 V.38 N.10 P.1901–1906

Erysipelas is a common skin infection causing significant morbidity. At present there are no established procedures for bacteriological sampling.

Here we investigate the possibility of using cultures for diagnostic purposes by determining the perianal colonization with beta-hemolytic streptococci (BHS) in patients with erysipelas.

Patients with erysipelas and a control group of patients with fever without signs of skin infection were prospectively included and cultures for BHS were taken from the tonsils, the perianal area, and wounds.

BHS were grouped according to Lancefield antigen, species-determined, and emm-typed. Renewed cultures were taken after four weeks from patients with erysipelas and a positive culture for BHS. 25 patients with erysipelas and 25 with fever were included.

In the group with erysipelas, 11 patients (44%) were colonized with BHS, ten patients were colonized in the perianal area, and one patient in the throat.

In contrast, only one patient in the control group was colonized (p = 0.005 for difference). All of the patients with erysipelas colonized with BHS had an erythema located to the lower limb.

The BHS were then subjected to MALDI-TOF MS and most commonly found to be Streptococcus dysgalactiae. Renewed cultures were taken from nine of the 11 patients with BHS and three of these were still colonized.

Streptococcus dysgalactiae colonizes the perianal area in a substantial proportion of patients with erysipelas.

The possibility of using cultures from this area as a diagnostic method in patients with erysipelas seems promising.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-019-03625-9?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10096_38_10

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-019-03625-9.pdf

November 12, 2019 at 3:50 pm

Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study.

Lancet Infect Dis. September 10, 2019  pii: S1473-3099(19)30446-3.

Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study.

Lynskey NN1, Jauneikaite E2, Li HK1, Zhi X1, Turner CE3, Mosavie M4, Pearson M4, Asai M1, Lobkowicz L1, Chow JY5, Parkhill J6, Lamagni T7, Chalker VJ7, Sriskandan S8.

Author information

1 Department of Infectious Diseases and Medical Research Council Centre for Molecular Bacteriology & Infection, Imperial College London, London, UK.

2 Department of Infectious Diseases and Medical Research Council Centre for Molecular Bacteriology & Infection, Imperial College London, London, UK; Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK.

3 Molecular Biology & Biotechnology, University of Sheffield, Sheffield, UK.

4 Department of Infectious Diseases and Medical Research Council Centre for Molecular Bacteriology & Infection, Imperial College London, London, UK; Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK.

5 Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK; North-West London Health Protection Team, London Public Health England Centre, Public Health England, London, UK.

6 Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK; Wellcome Sanger Institute, Cambridge, UK.

7 Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK; National Infection Service, Public Health England, London, UK.

8 Department of Infectious Diseases and Medical Research Council Centre for Molecular Bacteriology & Infection, Imperial College London, London, UK; Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, National Institute for Health Research, Imperial College London, London, UK. Electronic address: s.sriskandan@imperial.ac.uk.

Abstract

BACKGROUND:

Since 2014, England has seen increased scarlet fever activity unprecedented in modern times. In 2016, England’s scarlet fever seasonal rise coincided with an unexpected elevation in invasive Streptococcus pyogenes infections. We describe the molecular epidemiological investigation of these events.

METHODS:

We analysed changes in S pyogenes emm genotypes, and notifications of scarlet fever and invasive disease in 2014-16 using regional (northwest London) and national (England and Wales) data. Genomes of 135 non-invasive and 552 invasive emm1 isolates from 2009-16 were analysed and compared with 2800 global emm1 sequences. Transcript and protein expression of streptococcal pyrogenic exotoxin A (SpeA; also known as scarlet fever or erythrogenic toxin A) in sequenced, non-invasive emm1 isolates was quantified by real-time PCR and western blot analyses.

FINDINGS:

Coincident with national increases in scarlet fever and invasive disease notifications, emm1 S pyogenes upper respiratory tract isolates increased significantly in northwest London in the March to May period, from five (5%) of 96 isolates in 2014, to 28 (19%) of 147 isolates in 2015 (p=0·0021 vs 2014 values), to 47 (33%) of 144 in 2016 (p=0·0080 vs 2015 values). Similarly, invasive emm1 isolates collected nationally in the same period increased from 183 (31%) of 587 in 2015 to 267 (42%) of 637 in 2016 (p<0·0001). Sequences of emm1 isolates from 2009-16 showed emergence of a new emm1 lineage (designated M1UK)-with overlap of pharyngitis, scarlet fever, and invasive M1UK strains-which could be genotypically distinguished from pandemic emm1 isolates (M1global) by 27 single-nucleotide polymorphisms. Median SpeA protein concentration in supernatant was nine-times higher among M1UK isolates (190·2 ng/mL [IQR 168·9-200·4]; n=10) than M1global isolates (20·9 ng/mL [0·0-27·3]; n=10; p<0·0001). M1UK expanded nationally to represent 252 (84%) of all 299 emm1 genomes in 2016. Phylogenetic analysis of published datasets identified single M1UK isolates in Denmark and the USA.

INTERPRETATION:

A dominant new emm1 S pyogenes lineage characterised by increased SpeA production has emerged during increased S pyogenes activity in England. The expanded reservoir of M1UK and recognised invasive potential of emm1 S pyogenes provide plausible explanation for the increased incidence of invasive disease, and rationale for global surveillance.

FUNDING: UK Medical Research Council, UK National Institute for Health Research, Wellcome Trust, Rosetrees Trust, Stoneygate Trust

FULL TEXT

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30446-3/fulltext

PDF

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2819%2930446-3

 

 

Lancet Infect Dis. September 10, 2019  pii: S1473-3099(19)30494-3.

Scarlet fever changes its spots.

Brouwer S1, Lacey JA2, You Y3, Davies MR2, Walker MJ4.

Author information

1 School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia.

2 Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.

3 State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

4 School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia. Electronic address: mark.walker@uq.edu.au.

FULL TEXT

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30494-3/fulltext

PDF

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2819%2930494-3

September 26, 2019 at 9:40 am

Interventions to Reduce Measles Virus Exposures in Outpatient Health Care Facilities — New York City, 2018

MMWR Sep 13, 2019 V.68 N.36 P.794-792

Strengthening health care facility infection control is crucial to preventing infectious disease transmission.

Guidelines to prevent or minimize airborne pathogen spread in outpatient health care facilities exist (1); however, few reports describe practical implementation when engineering controls, such as recommended airborne infection isolation rooms (negative pressure rooms), are unavailable* (2).

On September 30, 2018, a person with measles, a highly contagious respiratory illness characterized by fever and rash, that is spread by airborne transmission, was detected in New York City (NYC),† and as of December 10, 42 laboratory or epidemiologically linked cases had been confirmed.

By September 3, 2019, with 654 confirmed cases, this measles outbreak had become the largest in the United States since 1992, well before endemic domestic measles transmission was declared eliminated in 2000§,¶ (3,4).

Interventions used in 15 outpatient health care facilities to attempt to prevent health care facility exposure from patients with suspected measles were evaluated….

FULL TEXT

https://www.cdc.gov/mmwr/volumes/68/wr/mm6836a2.htm?s_cid=mm6836a2_w

PDF

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6836a2-H.pdf

September 20, 2019 at 3:54 pm

ARGENTINA – Confirmación de tres nuevos casos de sarampión en niños. Alto riesgo de transmisibilidad

ACTUALIZACIÓN EPIDEMIOLÓGICA 13/0/2019 – Ministerio salud Nación

En virtud de la situación epidemiológica regional y local respecto a la confirmación de tres casos de

sarampión en niños residentes de la Ciudad Autónoma de Buenos Aires y la Provincia de Buenos Aires, la

Secretaria de Gobierno de Salud emite la siguiente actualización…..

TEXTO COMPLETO

https://www.argentina.gob.ar/sites/default/files/sarampion_13_septiembre_2019.pdf

 

– – –

September 14, 2019 at 9:39 am

Emergence of dominant toxigenic M1T1 Streptococcus pyogenes clone during increased scarlet fever activity in England: a population-based molecular epidemiological study

The Lancet Infectious Diseases September 10, 2019

Background

Since 2014, England has seen increased scarlet fever activity unprecedented in modern times. In 2016, England’s scarlet fever seasonal rise coincided with an unexpected elevation in invasive Streptococcus pyogenes infections. We describe the molecular epidemiological investigation of these events.

Methods

We analysed changes in S pyogenes emm genotypes, and notifications of scarlet fever and invasive disease in 2014–16 using regional (northwest London) and national (England and Wales) data. Genomes of 135 non-invasive and 552 invasive emm1 isolates from 2009–16 were analysed and compared with 2800 global emm1 sequences. Transcript and protein expression of streptococcal pyrogenic exotoxin A (SpeA; also known as scarlet fever or erythrogenic toxin A) in sequenced, non-invasive emm1 isolates was quantified by real-time PCR and western blot analyses.

Findings

Coincident with national increases in scarlet fever and invasive disease notifications, emm1 S pyogenes upper respiratory tract isolates increased significantly in northwest London in the March to May period, from five (5%) of 96 isolates in 2014, to 28 (19%) of 147 isolates in 2015 (p=0·0021 vs 2014 values), to 47 (33%) of 144 in 2016 (p=0·0080 vs 2015 values). Similarly, invasive emm1 isolates collected nationally in the same period increased from 183 (31%) of 587 in 2015 to 267 (42%) of 637 in 2016 (p<0·0001). Sequences of emm1 isolates from 2009–16 showed emergence of a new emm1 lineage (designated M1UK)—with overlap of pharyngitis, scarlet fever, and invasive M1UK strains—which could be genotypically distinguished from pandemic emm1 isolates (M1global) by 27 single-nucleotide polymorphisms. Median SpeA protein concentration in supernatant was nine-times higher among M1UK isolates (190·2 ng/mL [IQR 168·9–200·4]; n=10) than M1global isolates (20·9 ng/mL [0·0–27·3]; n=10; p<0·0001). M1UK expanded nationally to represent 252 (84%) of all 299 emm1 genomes in 2016. Phylogenetic analysis of published datasets identified single M1UK isolates in Denmark and the USA.

Interpretation

A dominant new emm1 S pyogenes lineage characterised by increased SpeA production has emerged during increased S pyogenes activity in England. The expanded reservoir of M1UK and recognised invasive potential of emm1 S pyogenes provide plausible explanation for the increased incidence of invasive disease, and rationale for global surveillance.

Funding

UK Medical Research Council, UK National Institute for Health Research, Wellcome Trust, Rosetrees Trust, Stoneygate Trust.

FULL TEXT

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30446-3/fulltext

PDF

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2819%2930446-3

September 13, 2019 at 7:30 am

Sep. 11, 2019 Confirmación de dos casos de sarampión en viajeros. Alto riesgo de transmisibilidad Ministerio Salud Argentina

ACTUALIZACION EPIDEMIOLOGICA

En virtud de la situación del brote de sarampión en Brasil y otros países de la región y el mundo, y la confirmación de dos casos en turistas extranjeros arribados a España provenientes de Argentina con diagnóstico de sarampión, la Secretaria de Gobierno de Salud emite la siguiente actualización …

Boletín completo

https://www.argentina.gob.ar/sites/default/files/sarampion_alerta-11-09-2019.pdf

September 12, 2019 at 7:54 am

Confirmación de caso de sarampión en Ciudad de Buenos Aires con antecedente de viaje a Brasil

ALERTA EPIDEMIOLÓGICA 4/Septiembre/2019 – SE 36

En virtud de la situación de brote de sarampión en Brasil y otros países de la región y el mundo, y la confirmación de un caso en un ciudadano argentino con antecedente de viaje, la Secretaría de Gobierno de Salud emite el presente alerta:

SITUACIÓN ACTUAL

Se confirmó un caso de sarampión en un hombre de 44 años residente en la Ciudad de Buenos Aires, atendido en efector privado, con antecedente de viaje a Brasil, que comenzó con fiebre el día 10 de agosto, agregando exantema cuatro días después. El caso se confirmó por serología (IgM positiva en suero) y seroconversión de IgG, así como RT-PCR positiva en orina. Las muestras fueron procesadas por el efector privado y se confirmaron en el Laboratorio Nacional de Referencia ANLIS Carlos G. Malbrán. Se encuentran en desarrollo las pruebas para identificación de genotipo y linaje viral. La fuente de infección está en investigación. Se iniciaron acciones de prevención y control en los contactos del caso, quienes se encuentran en seguimiento…

ARTICULO COMPLETO

https://www.argentina.gob.ar/sites/default/files/2019-09-04-alerta-sarampion.pdf

September 9, 2019 at 3:10 pm

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