Posts filed under ‘Infecciones emergentes’

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens.

Measles Virus Infection Negatively Affects Host Immune Status

New evidence shows that measles infection decreases the breadth and titers of preexisting antibodies to a wide variety of pathogens

SOURCE

Science. November 1, 2019 V.366 N.6465 P.599-606.

Mina MJ1,2,3, Kula T4,2, Leng Y4, Li M2, de Vries RD5, Knip M6,7, Siljander H6,7, Rewers M8, Choy DF9, Wilson MS9, Larman HB10, Nelson AN11, Griffin DE11, de Swart RL5, Elledge SJ1,2,12.

Author information

1 Division of Genetics, Brigham and Women’s Hospital, Howard Hughes Medical Institute, Boston, MA 02115, USA. selledge@genetics.med.harvard.edu  mmina@hsph.harvard.edu

2 Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.

3 Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA.

4 Division of Genetics, Brigham and Women’s Hospital, Howard Hughes Medical Institute, Boston, MA 02115, USA.

5 Department of Viroscience, Postgraduate School of Molecular Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 CN, Rotterdam, Netherlands.

6 Children’s Hospital, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland.

7 Research Program for Clinical and Molecular Metabolism, University of Helsinki, 00014 Helsinki, Finland.

8 Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Denver, CO 80045, USA.

9 Genentech Inc., South San Francisco, CA 94080, USA.

10 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

11 W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

12Program in Virology, Harvard Medical School, Boston, MA 02115, USA.

Abstract

Measles virus is directly responsible for more than 100,000 deaths yearly. Epidemiological studies have associated measles with increased morbidity and mortality for years after infection, but the reasons why are poorly understood. Measles virus infects immune cells, causing acute immune suppression. To identify and quantify long-term effects of measles on the immune system, we used VirScan, an assay that tracks antibodies to thousands of pathogen epitopes in blood. We studied 77 unvaccinated children before and 2 months after natural measles virus infection. Measles caused elimination of 11 to 73% of the antibody repertoire across individuals. Recovery of antibodies was detected after natural reexposure to pathogens. Notably, these immune system effects were not observed in infants vaccinated against MMR (measles, mumps, and rubella), but were confirmed in measles-infected macaques. The reduction in humoral immune memory after measles infection generates potential vulnerability to future infections, underscoring the need for widespread vaccination.

FULL TEXT

https://science.sciencemag.org/content/366/6465/599.long

PDF

https://science.sciencemag.org/content/sci/366/6465/599.full.pdf

November 18, 2019 at 7:04 pm

Control and Elimination of Extensively Drug-Resistant Acinetobacter baumanii in an Intensive Care Unit

Emerging Infectious Diseases November 2019 V.25 N.10 P.1928-1931

We decreased antimicrobial drug consumption in an intensive care unit in Lebanon by changing to colistin monotherapy for extensively drug-resistant Acinetobacter baumanii infections.

We saw a 78% decrease of A. baumanii in sputum and near-elimination of blaoxa-23-carrying sequence type 2 clone over the 1-year study.

Non–A. baumanii multidrug-resistant infections remained stable.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/25/10/18-1626_article

PDF (CLIC en PDF)

November 13, 2019 at 7:02 am

Real-world efficacy of bezlotoxumab for prevention of recurrent Clostridium difficile infection: a retrospective study of 46 patients in five university hospitals in Finland

European Journal of Clinical Microbiology & Infectious Diseases October 2019 V.38 N.10 P.1947–1952

Reports on real-world experience on efficacy of bezlotoxumab (BEZ) has been lacking thus far. We retrospectively studied the efficacy and safety of BEZ in preventing the recurrence of Clostridium difficile infection (CDI) in five university hospitals in Finland. Seventy-three percent of our 46 patients remained free of recurrence in the following 3 months and the performance remained as 71% effective also among immunocompromised patients. In severe CDI, BEZ prevented recurrence in 63% of cases. From our study patients, 78% had three or more known risk factors for recurrence of CDI. Eight of our patients were waiting for fecal microbiota transplantation but after stopping the antibiotics that were continued to prevent recurrence of CDI and after receiving BEZ, all remained free of recurrence and did not need the procedure. Success with BEZ as an adjunctive treatment in preventing recurrence of CDI in high-risk patients may be rated as high. Among a subgroup of our patients, those already evaluated to be in need of fecal microbiota transplantation, BEZ seems to be an alternative option.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-019-03630-y?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%2Fs10096-019-03630-y.pdf

November 12, 2019 at 3:45 pm

Risk factors for acquisition of carbapenem-resistance during treatment with carbapenem in the intensive care unit: a prospective study

European Journal of Clinical Microbiology & Infectious Diseases V.38 N.11 P.2077–2085

François Labaste, Julia Grossac, Fanny Vardon Bounes, Jean-Marie Conil, Stéphanie Ruiz, Thierry Seguin, Marion Grare, Olivier Fourcade, Vincent Minville & Bernard Georges

The emergence of carbapenemases in gram-negative aerobes is worrying.

The aim of this prospective study was to estimate the incidence of acquisition of carbapenem-resistance during treatment in ICU and to identify the risk factors. This was a prospective, observational, cohort study.

This study was conducted at intensive care unit, academic medical center, Toulouse Rangueil University Hospital. Patients were included if they received antibiotic treatment with carbapenem for more than 48 h.

Biological samples were taken in accordance with current practice in the unit. The main endpoint was the occurrence of bacterial resistance to carbapenems occurring between the onset of treatment and the patient’s exit from the ICU. Uni- and multi-variate analyses were carried out.

Of the 364 patients admitted to the unit between May and November 2014, 78 were included in our study and 16 (20.51%) developed resistance.

The two main risk factors were a length of stay in ICU of more than 29 days (HR = 3.61, p = 0.01) and the presence of Pseudomonas aeruginosa in the samples taken before the start of treatment (HR = 5.31, p = 0.002).

No resistance due to carbapenemase production was observed in this study. The prescription of carbapenems in the ICU setting must adhere to the expert guidelines.

In light of our results, special attention must be paid to patients whose stay in intensive care is prolonged, and those in whom Pseudomonas aeruginosa is isolated from bacteriological samples taken before the beginning of antibiotic therapy.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-019-03644-6?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10096_38_11

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-019-03644-6.pdf

November 12, 2019 at 8:42 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

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

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