Posts filed under ‘Infecciones emergentes’

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)


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.






February 9, 2018 at 6:47 pm

Gentamicin synergises with azoles against drug-resistant Candida albicans

International Journal of Antimicrobial Agents January 2018 V.51 N.1 P.107–114

Mengjiao Lu, Cuixiang Yu, Xueyan Cui, Jinyi Shi, Lei Yuan, Shujuan Sun


  • Gentamicin (GM) synergises with azoles against planktonic cells of resistant Candida albicans.
  • GM synergises with fluconazole (FLC) against pre-formed biofilms of C. albicans.
  • GM enhanced the in vivo efficacy of FLC against resistant C. albicans.
  • GM suppresses the efflux pump of resistant C. albicans.
  • GM?+?FLC reduces phospholipase activity of resistant C. albicans.

Candida spp. are the primary opportunistic pathogens of nosocomial fungal infections, causing both superficial and life-threatening systemic infections. Combination therapy for fungal infections has attracted considerable attention, especially for those caused by drug-resistant fungi. Gentamicin (GM), an aminoglycoside antibiotic, has weak antifungal activity against Fusarium spp. The aim of this study was to investigate the interactions of GM with azoles against Candida spp. and the underlying mechanisms. In a chequerboard assay, GM was found not only to work synergistically with azoles against planktonic cells of drug-resistant Candida albicans with a fractional inhibitory concentration index (FICI) of 0.13–0.14, but also synergised with fluconazole (FLC) against C. albicans biofilms pre-formed in <12?h. Synergism of GM with FLC was also confirmed in vivo in a Galleria mellonella infection model. In addition, mechanism studies showed that GM not only suppressed the efflux pump of resistant C. albicans in a dose-dependent manner but also inhibited extracellular phospholipase activity of resistant C. albicans when combined with FLC. These findings suggest that GM enhances the efficacy of azoles against resistant C. albicans via efflux inhibition and decreased activity of extracellular phospholipase.



February 5, 2018 at 6:10 pm

Hospital sewage water: a reservoir for variants of New Delhi metallo-ß-lactamase (NDM)- and extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae

International Journal of Antimicrobial Agents January 2018 V.51 N.1 P.82–88

Shadab Parvez, Asad U. Khan


  • In Escherichia coli, coexistence of NDM-1 with CMY-6 and CMY-139 was observed.
  • In E. coli, coexistence of NDM-4 with CMY-6, CMY-42 and CMY-86 was observed.
  • In E. coli, coexistence of NDM-5 with CMY-6 and CMY-42 and of NDM-7 with CMY-6 was observed.
  • Detection of NDM-5-producing Shigella boydii and NDM-7-producing Citrobacter freundii.
  • Identification of association of NDM-4 and OXA-48 in Citrobacter braakii and Citrobacter farmeri.


New Delhi metallo-ß-lactamase (NDM)-producing Enterobacteriaceae have become a threat to public health.

Hospital sewage is generally unexplored, having the potential to harbour bacteria causing healthcare-associated infections. Hence, this study was initiated to monitor NDM-producing Enterobacteriaceae in hospital sewage water. A total of 32 isolates with blaNDM variants were detected in hospital sewage water, including 17 Escherichia coli, 8 Citrobacter freundii, 4 Shigella boydii, 2 Citrobacter braakii and 1 Citrobacter farmeri,  showing resistance to all antibiotics except colistin. All 32 isolates carried blaNDM (9 blaNDM-1, 11 blaNDM-4, 10 blaNDM-5 and 2 blaNDM-7), 24 isolates carried blaCMY variants (1 blaCMY-2, 3 blaCMY-4, 5 blaCMY-6, 11 blaCMY-42, 2 blaCMY-86 and 2 blaCMY-139), 20 isolates carried blaOXA-type (17 blaOXA-1 and 3 blaOXA-48), 19 isolates carried blaCTX-M and 9 isolates carried ampC on conjugative plasmids of IncFIA, IncFIB, IncFIC, IncP, IncY, IncHI1 and IncI1 types. In E. coli, coexistence of blaNDM-1 with blaCMY-6 and blaCMY-139, of blaNDM-4 with blaCMY-6, blaCMY-42 and blaCMY-86, of blaNDM-5 with blaCMY-6 and blaCMY-42, and of blaNDM-7 with blaCMY-6 was observed. NDM-5-producing S. boydii and NDM-7-producing C. freundii were identified as well as detection of  an association of blaNDM-4 and blaOXA-48 in C. braakii and C. farmeri. A class 1 integron was also found on a plasmid. ISAba125 and bleomycin genes were found surrounding all blaNDM variants. The emergence and dissemination of blaNDM variants in hospital sewage water is a matter of concern, creating an endemic scenario leading to the level of an outbreak.



February 5, 2018 at 6:08 pm

In Vitro Activity of the Siderophore Cephalosporin, Cefiderocol, against Carbapenem-Nonsusceptible and Multidrug-Resistant Isolates of Gram-Negative Bacilli Collected Worldwide in 2014 to 2016

Agents and Chemotherapy February 2018 V.62 N.2

Meredith A. Hackel, Masakatsu Tsuji, Yoshinori Yamano, Roger Echols, James A. Karlowsky and Daniel F. Sahm

aInternational Health Management Associates, Inc., Schaumburg, Illinois, USA

bDrug Discovery and Disease Research Laboratory, Shionogi & Co., Ltd., Osaka, Japan

cPharmaceutical Research Division, Shionogi & Co., Ltd., Osaka, Japan

dClinical Development and Medical Affairs, ID3C, LLC, Easton, Connecticut, USA

eDepartment of Medical Microbiology, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

The in vitro activity of the investigational siderophore cephalosporin, cefiderocol (formerly S-649266), was determined against a 2014–2016, 52-country, worldwide collection of clinical isolates of carbapenem-nonsusceptible Enterobacteriaceae (n = 1,022), multidrug-resistant (MDR) Acinetobacter baumannii (n = 368), MDR Pseudomonas aeruginosa (n = 262), Stenotrophomonas maltophilia (n = 217), and Burkholderia cepacia (n = 4) using the Clinical and Laboratory Standards Institute (CLSI) standard broth microdilution method.

Iron-depleted cation-adjusted Mueller-Hinton broth (ID-CAMHB), prepared according to a recently approved (2017), but not yet published, CLSI protocol, was used to test cefiderocol; all other antimicrobial agents were tested using CAMHB.

The concentration of cefiderocol inhibiting 90% (MIC90) of isolates of carbapenem-nonsusceptible Enterobacteriaceae was 4 μg/ml; cefiderocol MICs ranged from 0.004 to 32 μg/ml, and 97.0% (991/1,022) of isolates demonstrated cefiderocol MICs of ≤4 μg/ml.

The MIC90s for cefiderocol for MDR A. baumannii, MDR P. aeruginosa, and S. maltophilia were 8, 1, and 0.25 μg/ml, respectively, with 89.7% (330/368), 99.2% (260/262), and 100% (217/217) of isolates demonstrating cefiderocol MICs of ≤4 μg/ml. Cefiderocol MICs for B. cepacia ranged from 0.004 to 8 μg/ml.

We conclude that cefiderocol demonstrated potent in vitro activity against a 2014–2016, worldwide collection of clinical isolates of carbapenem-nonsusceptible Enterobacteriaceae, MDR A. baumannii, MDR P. aeruginosa, S. maltophilia, and B. cepacia isolates as 96.2% of all (1,801/1,873) isolates tested had cefiderocol MICs of ≤4 μg/ml.




January 27, 2018 at 3:08 pm

The Utility of Multiplex Molecular Tests for Enteric Pathogens: a Micro-Comic Strip

Journal of Clinical Microbiology February 2018 V.56 N.2


Alexander J. McAdam

aDepartment of Laboratory Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

There are several FDA-approved multiplex molecular tests available for detection of enteric pathogens in stool (1–8).

These tests allow for rapid detection of a variety of enteric pathogens; however, it can be challenging for laboratory directors to decide what pathogens to report and whether to continue to perform other tests for pathogens included in these tests (9, 10).

How might laboratory directors approach implementation of these tests?

Read the comic strip to find out.



January 24, 2018 at 3:58 pm

Development and Validation of a Real-Time PCR Assay for Rapid Detection of Candida auris from Surveillance Samples

Journal of Clinical Microbiology February 2018 V.56 N.2

Leach, Y. Zhu and S. Chaturvedi

aMycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA

bDepartment of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, USA

Candida auris is an emerging multidrug-resistant yeast causing invasive health care-associated infection with high mortality worldwide.

Rapid identification of C. auris is of primary importance for the implementation of public health measures to control the spread of infection.

To achieve these goals, we developed and validated a TaqMan-based real-time PCR assay targeting the internal transcribed spacer 2 (ITS2) region of the ribosomal gene.

The assay was highly specific, reproducible, and sensitive, with the detection limit of 1 C. auris CFU/PCR.

The performance of the C. auris real-time PCR assay was evaluated by using 623 surveillance samples, including 365 patient swabs and 258 environmental sponges.

Real-time PCR yielded positive results from 49 swab and 58 sponge samples, with 89% and 100% clinical sensitivity with regard to their respective culture-positive results.

The real-time PCR also detected C. auris DNA from 1% and 12% of swab and sponge samples with culture-negative results, indicating the presence of dead or culture-impaired C. auris.

The real-time PCR yielded results within 4 h of sample processing, compared to 4 to 14 days for culture, reducing turnaround time significantly.

The new real-time PCR assay allows for accurate and rapid screening of C. auris and can increase effective control and prevention of this emerging multidrug-resistant fungal pathogen in health care facilities.



January 24, 2018 at 3:55 pm

Use of Pristinamycin for Macrolide-Resistant Mycoplasma genitalium Infection

Emerging Infectious Diseases February 2018 V.24 N.2

Tim R.H., Jørgen S. Jensen, Christopher K. Fairley, Mieken Grant, Jennifer A. Danielewski, Jenny Su, Gerald L. Murray, Eric P.F. Chow, Karen Worthington, Suzanne M. Garland, Sepehr N. Tabrizi, and Catriona S. Bradshaw

Author affiliations: Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia (T.R.H. Read, C.K. Fairley, M. Grant, E.P.F. Chow, K. Worthington, C.S. Bradshaw); Monash University, Melbourne, Victoria, Australia (T.R.H. Read, C.K. Fairley, G.L. Murray, E.P.F. Chow, C.S. Bradshaw); Statens Serum Institut, Copenhagen, Denmark (J.S. Jensen); Murdoch Children’s Research Institute, Parkville, Victoria, Australia (J.A. Danielewski, J. Su, G.L. Murray, S.M. Garland, S.N. Tabrizi); Royal Women’s Hospital, Parkville (J.A. Danielewski, J. Su, G.L. Murray, S.M. Garland, S.N. Tabrizi); University of Melbourne, Parkville (S.M. Garland, S.N. Tabrizi, C.S. Bradshaw)

High levels of macrolide resistance and increasing fluoroquinolone resistance are found in Mycoplasma genitalium in many countries.

We evaluated pristinamycin for macrolide-resistant M. genitalium in a sexual health center in Australia.

Microbiologic cure was determined by M. genitalium–specific 16S PCR 14–90 days after treatment began. Of 114 persons treated with pristinamycin, infection was cured in 85 (75%).

This percentage did not change when pristinamycin was given at daily doses of 2 g or 4 g or at 3 g combined with 200 mg doxycycline.

In infections with higher pretreatment bacterial load, treatment was twice as likely to fail for each 1 log10 increase in bacterial load. Gastrointestinal side effects occurred in 7% of patients.

Pristinamycin at maximum oral dose, or combined with doxycycline, cured 75% of macrolide-resistant M. genitalium infections.

Pristinamycin is well-tolerated and remains an option where fluoroquinolones have failed or cannot be used.



January 23, 2018 at 8:01 am

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