Posts filed under ‘Infecciones en embarzadas’

Group B Streptococcus in surgical site and non-invasive bacterial infections worldwide: A systematic review and meta-analysis

International Journal of Infectious Diseases June 2019 V.83 P.116-129

Simon M. Collin, Nandini Shetty, Rebecca Guy, Victoria N. Nyaga, Ann Bull, Michael J. Richards, Tjallie I.I. van der Kooi, Mayke B.G. Koek, Mary De Almeida, Sally A. Roberts, Theresa Lamagni

Highlights

  • This review obtained data on group B Streptococcus infection from 67 countries.
  • Group B Streptococcus is implicated in a small proportion of non-invasive infections.
  • Group B Streptococcus causes 10% of caesarean section invasive surgical infections.

Objectives

The epidemiology of disease caused by group B Streptococcus (GBS; Streptococcus agalactiae) outside pregnancy and the neonatal period is poorly characterized. The aim of this study was to quantify the role of GBS as a cause of surgical site and non-invasive infections at all ages.

Methods

A systematic review (PROSPERO CRD42017068914) and meta-analysis of GBS as a proportion (%) of bacterial isolates from surgical site infection (SSI), skin/soft tissue infection (SSTI), urinary tract infection (UTI), and respiratory tract infection (RTI) was conducted.

Results

Seventy-four studies and data sources were included, covering 67 countries. In orthopaedic surgery, GBS accounted for 0.37% (95% confidence interval (CI) 0.08–1.68%), 0.87% (95% CI 0.33–2.28%), and 1.46% (95% CI 0.49–4.29%) of superficial, deep, and organ/space SSI, respectively. GBS played a more significant role as a cause of post-caesarean section SSI, detected in 2.92% (95% CI 1.51–5.55%), 1.93% (95% CI 0.97–3.81%), and 9.69% (95% CI 6.72–13.8%) of superficial, deep, and organ/space SSI. Of the SSTI isolates, 1.89% (95% CI 1.16–3.05%) were GBS. The prevalence of GBS in community and hospital UTI isolates was 1.61% (1.13–2.30%) and 0.73% (0.43–1.23%), respectively. GBS was uncommonly associated with RTI, accounting for 0.35% (95% CI 0.19–0.63%) of community and 0.27% (95% CI 0.15–0.48%) of hospital RTI isolates.

Conclusions

GBS is implicated in a small proportion of surgical site and non-invasive infections, but a substantial proportion of invasive SSI post-caesarean section.

FULL TEXT

https://www.ijidonline.com/article/S1201-9712(19)30187-0/fulltext

PDF

https://www.ijidonline.com/article/S1201-9712(19)30187-0/pdf

 

 

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June 30, 2019 at 12:21 pm

American trypanosomiasis and Chagas disease – Sexual transmission

International Journal of Infectious Diseases April 2019 V.81 N.4 P.81-84

Clever Gomes, Adriana B. Almeida, Ana C. Rosa, Perla F. Araujo, Antonio R.L. Teixeira

Highlights

  • Trypanosoma cruzi infection can be transmitted sexually from males and females to naïve mates.
  • T. cruzi parasites were detected in semen ejaculates from individuals with Chagas disease by nucleic acid techniques.
  • Semen aliquots from humans with Chagas disease instilled into the vagina of naïve female mice resulted in T. cruzi infections.
  • Breeding T. cruzi-infected male and female mice vertically transmitted the infection to progeny mice.

Objective

To contribute to the discussion on the research findings indicating the sexual transmission of American trypanosomiasis and Chagas disease in humans.

Methods

A review of the literature was performed to investigate the routes of transmission of Trypanosoma cruzi parasites and to evaluate the distribution of Chagas disease, which is now found across five continents.

Results

The epidemiological profile of American trypanosomiasis, which is still considered a neglected disease of the poor people of Latin America, has changed over time. A family-based study demonstrated that the blood protozoan T. cruzi can be transmitted sexually from infected males and females to naïve mates.

Conclusions

Evidence that Chagas disease can be transmitted sexually, coupled with the migration of individuals with Chagas disease to previously non-endemic countries and increased travel to endemic countries, has implications for public health. Improved screening of blood supplies and prenatal care are required to prevent congenital spread.

FULL TEXT

https://www.ijidonline.com/article/S1201-9712(19)30032-3/fulltext

PDF

https://www.ijidonline.com/article/S1201-9712(19)30032-3/pdf

June 30, 2019 at 12:18 pm

Listeriosis in Spain based on hospitalisation records, 1997 to 2015: need for greater awareness

Eurosuveillance

Listeriosis is an infectious disease caused by bacteria of the genus Listeria spp. L. monocytogenes is the major pathogenic species in both animals and humans. L. monocytogenes is a Gram-positive, rod-shaped organism that can grow in aerobic and anaerobic conditions [1], is widely distributed in the environment and is able to contaminate a wide variety of foods or beverages (soft cheese, deli meats, unpasteurised milk, refrigerated smoked seafood, etc.) [2]. The bacteria can multiply at refrigerator temperatures [3]; therefore, contaminated products are often kept for several days or even weeks, e.g. in the household/restaurants, and may be eaten on multiple occasions, which can complicate the identification of the incriminated food source [4].

The clinical syndromes of listeriosis include: febrile gastroenteritis, sepsis, central nervous system (CNS) involvement in the form of encephalitis, meningoencephalitis and focal infections such as pneumonia myo-endocarditis and septic arthritis, etc [5]. Invasive listeriosis most commonly affects pregnant women, neonates, elderly people and people with chronic conditions or weakened immune response [6]. Listeriosis has one of the highest case fatality rates among all food-borne infections; when it affects the CNS, the mortality rate is above 50% and neurological sequelae are present in more than 60% of survivors [2]. Listeriosis is also associated with fetal and neonatal death.

Worldwide, listeriosis is an emerging infection of public health concern [7]. In Europe, human listeriosis peaked in incidence during the 1980s, showed a general decline during the 1990s and stabilised in the 2000s [8]. More recent data show an increasing trend since 2008 [9]. This increase seems to be related to the ageing of the population and the increase in life expectancy of immunocompromised patients, but also to changes in the ways food is produced, stored, distributed and consumed around the world [10]. Although listeriosis is often a sporadic disease [11], large food-borne outbreaks have occurred during the last decade in Europe and the United States (US) [12]. In South Africa, an outbreak with more than 1,024 laboratory-confirmed listeriosis cases, as at 2 May 2018, has been ongoing since the start of 2017, with a 28.6% case fatality rate [13].

In Spain, food safety criteria (FSC) for L. monocytogenes follow European Commission (EC) regulations [14,15]. Before 2015, when it was added to the list of mandatory notifiable diseases, regions could voluntarily report listeriosis to the Microbiological Information System (Sistema de Información Microbiológica, SIM) [16]. Using the centralised hospital discharge database (Conjunto Mínimo Básico de Datos, CMBD), we aimed to describe the epidemiology of listeriosis in Spain from 1997–2015.

FULL TEXT

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.21.1800271

PDF (CLIC en DOWNLOAD PDF)

June 21, 2019 at 7:49 am

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019. 366 pag

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019.  366 pag

Developed by the HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission – A Working Group of the Office of AIDS Research Advisory Council (OARAC)

What’s New in the Guidelines

Text, references, and appendices were updated to include new data and publications where relevant.

The sections that address infant feeding now include links to a new section that was added on March 27, 2018, titled Guidance for Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed.

Major content changes are summarized below; all changes are highlighted throughout the guidelines.

PDF

http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf

January 8, 2019 at 8:08 am

Identification of Epstein-Barr Virus in the Human Placenta and Its Pathologic Characteristics.

J Korean Med Sci. December 2017 V.32 N.12 P.1959-1966.   

Kim Y1,2, Kim HS3, Park JS3, Kim CJ4, Kim WH5.

1 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

2 Laboratory of Epigenetics, Cancer Research Institute, Seoul National University, Seoul, Korea.

3 Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

4 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

5 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. woohokim@snu.ac.kr

Abstract

Epstein-Barr virus (EBV), a common pathogen in humans, is suspected as the cause of multiple pregnancy-related pathologies including depression, preeclampsia, and stillbirth. Moreover, transmission of EBV through the placenta has been reported. However, the focus of EBV infection within the placenta has remained unknown to date. In this study, we proved the expression of latent EBV genes in the endometrial glandular epithelial cells of the placenta and investigated the cytological characteristics of these cells. Sixty-eight placentas were obtained from pregnant women. Tissue microarray was constructed. EBV latent genes including EBV-encoding RNA-1 (EBER1), Epstein-Barr virus nuclear antigen 1 (EBNA1), late membrane antigen (LMP1), and RPMS1 were detected with silver in situ hybridization and/or mRNA in situ hybridization. Nuclear features of EBV-positive cells in EBV-infected placenta were compared with those of EBV-negative cells via image analysis. Sixteen placentas (23.5%) showed positive expression of all 4 EBV latent genes; only the glandular epithelial cells of the decidua showed EBV gene expression. EBV infection status was not significantly correlated with maternal, fetal, or placental factors. The nuclei of EBV-positive cells were significantly larger, longer, and round-shaped than those of EBV-negative cells regardless of EBV-infection status of the placenta. For the first time, evidence of EBV gene expression has been shown in placental tissues. Furthermore, we have characterized its cytological features, allowing screening of EBV infection through microscopic examination.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680494/pdf/jkms-32-1959.pdf

November 9, 2018 at 7:06 am

Epstein-Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia.

AJP Rep. January 2017 V.7 N.1 P.e5-e7.

Staley SA1, Smid MC2, Dotters-Katz SK2, Stringer EM2.

1 Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Abstract

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks’ gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein-Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303016/pdf/10-1055-s-0036-1597265.pdf

November 9, 2018 at 7:05 am

Maternal depressive symptoms related to Epstein-Barr virus reactivation in late pregnancy.

Sci Rep. October 31, 2013 V.3 P.3096.

Zhu P1, Chen YJ, Hao JH, Ge JF, Huang K, Tao RX, Jiang XM, Tao FB.

1 1] Department of Maternal and Child Health, School of Public Health, Anhui Medical University, Hefei, China [2].

Abstract

We examined the relationship between maternal depressive symptoms in late pregnancy and Epstein-Barr virus reactivation before delivery. In this prospective observational study, prevalence of Epstein-Barr virus reactivation within one week before delivery was compared between 163 pregnant women with depressive symptoms at 33 to 34 weeks of gestation and a computer-generated control group of 163 pregnant healthy women without depressive symptoms. Depressive symptoms at 33 to 34 weeks of gestation were significantly related to the prevalence of Epstein-Barr virus reactivation before delivery after adjustment for potential confounders (adjusted OR = 2.74, 95%CI: 1.23-6.08). Compared to that in the control group, the prevalence of Epstein-Barr virus reactivation was higher in women with depressive symptoms accompanied by higher negative coping (24.2% compared with 7.9%; adjusted OR = 3.67, 95%CI: 1.47-9.16). Maternal depressive symptoms in late pregnancy are associated with Epstein-Barr virus reactivation, and this association could be moderated by maternal coping style.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813936/pdf/srep03096.pdf

November 9, 2018 at 7:04 am

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