1
|
Lucas Dato A, Pacheco-Tenza MI, Borrajo Brunete E, Martínez López B, García López M, González Cuello I, Gregori Colomé J, Navarro Cots M, Saugar JM, García-Vazquez E, Ruiz-Maciá JA, Llenas-García J. Strongyloidiasis in Southern Alicante (Spain): Comparative Retrospective Study of Autochthonous and Imported Cases. Pathogens 2020; 9:pathogens9080601. [PMID: 32717912 PMCID: PMC7460300 DOI: 10.3390/pathogens9080601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Strongyloidiasis is a parasitic disease with global prevalence. In Spain, autochthonous cases are concentrated in the Mediterranean basin. We aimed to analyze clinical and epidemiological characteristics of Strongyloides stercoralis infection in Vega Baja del Segura (Spain), comparing autochthonous versus imported cases. METHODS Observational retrospective study of all strongyloidiasis cases from January 2009 to January 2019. Cases were diagnosed by stool larvae visualization, positive culture, PCR, Strongyloides serology, and/or compatible histology. RESULTS We included 36 patients (21 men) with a mean age of 60.8 years ±17.6; 15 cases were autochthonous and 21 imported 80.9% from Latin America. Autochthonous cases were associated with older age (mean 71.3 vs. 53.3 years; p = 0.002), male sex (odds ratio (OR) 5.33; 95% confidence interval (CI) 1.15-24.68; p = 0.041), and agricultural activity (OR 13.5; 95% CI 2.4-73.7; p = 0.002). Fourteen were asymptomatic, three autochthonous cases presented with hyperinfection syndrome, and two patients died. There was no difference between autochthonous versus imported origin in eosinophilia at diagnosis (93.3% vs. 75%; p = 0.207), treatment received, or clinical response (85.7% vs. 88.9% cured; p = 1). CONCLUSION In our region, imported strongyloidiasis coexists with autochthonous cases, which are mainly in older male farmers who are diagnosed at more advanced stages. Systematic screening programs are needed.
Collapse
Affiliation(s)
- Ana Lucas Dato
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Correspondence: (A.L.D.); (J.L.-G.)
| | - María Isabel Pacheco-Tenza
- Internal Medicine Department, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Emilio Borrajo Brunete
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Microbiology Department, Hospital Vega Baja, 03314 Orihuela, Spain
| | - Belén Martínez López
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - María García López
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - Inmaculada González Cuello
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - Joan Gregori Colomé
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - María Navarro Cots
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Microbiology Department, Hospital Vega Baja, 03314 Orihuela, Spain
| | - José María Saugar
- Parasitology Department, Centro Nacional de Microbiología, Instituto Carlos III, 28903 Madrid, Spain;
| | - Elisa García-Vazquez
- Infectious Diseases Unit, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
- Instituto Murciano de Investigación Biosanitaria (IMIB), Universidad de Murcia, 30120 Murcia, Spain
| | - José Antonio Ruiz-Maciá
- Pathological Department, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Jara Llenas-García
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Clinical Medicine Department, Universidad Miguel Hernández de Elche, 03202 Elche, Spain
- Correspondence: (A.L.D.); (J.L.-G.)
| |
Collapse
|
2
|
Muadica AS, Balasegaram S, Beebeejaun K, Köster PC, Bailo B, Hernández-de-Mingo M, Dashti A, Dacal E, Saugar JM, Fuentes I, Carmena D. Risk associations for intestinal parasites in symptomatic and asymptomatic schoolchildren in central Mozambique. Clin Microbiol Infect 2020; 27:624-629. [PMID: 32505583 DOI: 10.1016/j.cmi.2020.05.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Chronic infections by enteric parasites including protist and helminthic species produce long-term sequelae on the health status of infected children. This study assesses potential associations linked with enteric parasite infections in symptomatic and asymptomatic children in Zambézia province, Mozambique. METHODS In this prospective cross-sectional study, stool samples and epidemiological questionnaires on demographics and risk associations were collected from symptomatic children (n = 286) from clinical settings and asymptomatic (n = 807) children from 17 schools and creches aged 3‒14 years. We detected enteric parasites using PCR-based methods. We calculated prevalence (adjusted for age, sex, house construction, drinking water, and latrine use) and odds ratios (ORs) for risk associations with logistic regression, after adjusting for district, neighbourhood and symptoms. RESULTS Numbers and adjusted prevalence (95% confidence intervals in parentheses) for the symptomatic and asymptomatic populations were Giardia duodenalis 120, 52% (22-82), 339, 42% (25-59); followed by Strongyloides stercoralis 52, 14% (9‒20), 180, 20% (15-25). Risk associations for G. duodenalis included drinking untreated river/spring water, OR 2.91 (1.80-4.70); contact with ducks, OR 14.96 (2.93‒76.31); dogs, OR 1.92 (1.04-3.52); cats, OR 1.73 (1.16-2.59), and a relative with diarrhoea, OR 2.59 (1.54‒4.37). Risk associations for S. stercoralis included having no latrine, OR 2.41 (1.44-4.02); drinking well water, OR 1.82 (1.02-3.25), and increasing age, OR 1.11 (1.04-1.20). CONCLUSIONS We found a high prevalence of intestinal parasites regardless of the children's symptoms. Drinking well or river water, domestic animals, and latrine absence were contributing factors of human infections.
Collapse
Affiliation(s)
- A S Muadica
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain; Departamento de Ciências e Tecnologia, Universidade Licungo, Quelimane, Zambézia, Mozambique
| | - S Balasegaram
- Field Epidemiology Services, National Infection Service, Public Health England, London, UK
| | - K Beebeejaun
- Field Epidemiology Services, National Infection Service, Public Health England, London, UK
| | - P C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - B Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - M Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - A Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - E Dacal
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - J M Saugar
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - I Fuentes
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - D Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain.
| |
Collapse
|
3
|
Sanchez-Thevenet P, Carmena D, Adell-Aledón M, Dacal E, Arias E, Saugar JM, Rodríguez E, Dea-Ayuela MA. High Prevalence and Diversity of Zoonotic and Other Intestinal Parasites in Dogs from Eastern Spain. Vector Borne Zoonotic Dis 2019; 19:915-922. [DOI: 10.1089/vbz.2019.2468] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Paula Sanchez-Thevenet
- Department of Medicine, Cardenal Herrera-CEU University, CEU Universities, Castellón, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - Manuel Adell-Aledón
- Department of Medicine, Cardenal Herrera-CEU University, CEU Universities, Castellón, Spain
| | - Elena Dacal
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - Eva Arias
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - José María Saugar
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - Esperanza Rodríguez
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | | |
Collapse
|
4
|
Gandasegui J, Fernández-Soto P, Dacal E, Rodríguez E, Saugar JM, Yepes E, Aznar-Ruiz-de-Alegría ML, Espasa M, Ninda A, Bocanegra C, Salvador F, Sulleiro E, Moreno M, Vicente B, López-Abán J, Muro A. Field and laboratory comparative evaluation of a LAMP assay for the diagnosis of urogenital schistosomiasis in Cubal, Central Angola. Trop Med Int Health 2018; 23:992-1001. [PMID: 29920859 DOI: 10.1111/tmi.13117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the performance of Rapid-Heat LAMPellet assay in field conditions for diagnosis of urogenital schistosomiasis in an endemic area in Cubal, Angola, and to assess the reproducibility in a reference laboratory. METHODS A total of 172 urine samples from school-age children were tested for microhaematuria, microscopic detection of Schistosoma haematobium eggs and LAMP for DNA detection. Urine samples were stored in a basic equipped laboratory. Field-LAMP tests were performed with and without prior DNA extraction from urine samples, and the results were read by turbidity and by colour change. When field procedures were finished, samples were sent to a reference laboratory to be reanalysed by LAMP. RESULTS A total of 83 of 172 (48.3%) were positive for microhaematuria, 87/172 (50.6%) were microscopy-positive for S. haematobium eggs detection, and 127/172 (73.8%) showed LAMP-positive results for detecting S. haematobium using purified DNA and 109/172 (63.4%) without prior DNA extraction. MacNemar's test showed a statistical significant relation between LAMP results and microscopy-detected S. haematobium infections and microhaematuria (P < 0.001 in both cases), respectively. When samples of purified DNA were reanalysed in a reference laboratory in Spain using the same LAMP methodology, the overall reproducibility achieved 72.1%. CONCLUSIONS The ease of use, simplicity and feasibility demonstrated by LAMP assay in field conditions together with the acceptable level of reproducibility achieved in a reference laboratory support the use of LAMP assay as an effective test for molecular diagnosis of urogenital schistosomiasis in endemic remote areas.
Collapse
Affiliation(s)
- Javier Gandasegui
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| | - Elena Dacal
- Department of Parasitology, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| | - Esperanza Rodríguez
- Department of Parasitology, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| | - José María Saugar
- Department of Parasitology, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| | - Edward Yepes
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| | | | - Mateu Espasa
- Microbiology Department, University Hospital Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | | | - Cristina Bocanegra
- Special Program for Infectious Diseases Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, University Hospital Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | | | - Belén Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| | - Julio López-Abán
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Faculty of Pharmacy, Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), University of Salamanca, Salamanca, Spain
| |
Collapse
|
5
|
Fernández-Soto P, Sánchez-Hernández A, Gandasegui J, Bajo Santos C, López-Abán J, Saugar JM, Rodríguez E, Vicente B, Muro A. Strong-LAMP: A LAMP Assay for Strongyloides spp. Detection in Stool and Urine Samples. Towards the Diagnosis of Human Strongyloidiasis Starting from a Rodent Model. PLoS Negl Trop Dis 2016; 10:e0004836. [PMID: 27415764 PMCID: PMC4945066 DOI: 10.1371/journal.pntd.0004836] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/19/2016] [Indexed: 11/28/2022] Open
Abstract
Background Strongyloides stercoralis, the chief causative agent of human strongyloidiasis, is a nematode globally distributed but mainly endemic in tropical and subtropical regions. Chronic infection is often clinically asymptomatic but it can result in severe hyperinfection syndrome or disseminated strongyloidiasis in immunocompromised patients. There is a great diversity of techniques used in diagnosing the disease, but definitive diagnosis is accomplished by parasitological examination of stool samples for morphological identification of parasite. Until now, no molecular method has been tested in urine samples as an alternative to stool samples for diagnosing strongyloidiasis. This study aimed to evaluate the use of a new molecular LAMP assay in a well-established Wistar rat experimental infection model using both stool and, for the first time, urine samples. The LAMP assay was also clinically evaluated in patients´ stool samples. Methodology/Principal Findings Stool and urine samples were obtained daily during a 28-day period from rats infected subcutaneously with different infective third-stage larvae doses of S. venezuelensis. The dynamics of parasite infection was determined by daily counting the number of eggs per gram of feces from day 1 to 28 post-infection. A set of primers for LAMP assay based on a DNA partial sequence in the 18S rRNA gene from S. venezuelensis was designed. The set up LAMP assay (namely, Strong-LAMP) allowed the sensitive detection of S. venezuelensis DNA in both stool and urine samples obtained from each infection group of rats and was also effective in S. stercoralis DNA amplification in patients´ stool samples with previously confirmed strongyloidiasis by parasitological and real-time PCR tests. Conclusions/Significance Our Strong-LAMP assay is an useful molecular tool in research of a strongyloidiasis experimental infection model in both stool and urine samples. After further validation, the Strong-LAMP could also be potentially applied for effective diagnosis of strongyloidiasis in a clinical setting. Human strongyloidiasis, a soil-transmitted infection mainly caused by Strongyloides stercoralis, is one of the most neglected among the so-called neglected tropical diseases (NTDs). The difficult diagnosis lead to an underreporting of infection rates. Strongyloidiasis can easily be misdiagnosed because many infections remain asymptomatic and the lack of sensitivity of the conventional fecal-based techniques for morphologically identification of infective larvae in feces. Although serologic tests are useful, a limitation in standardization to avoid cross-reactions still remains. There is an urgent need to improve more sensitive and specific diagnostic tests, particularly in immunocompromised patients or candidates to immunosuppressive treatments. Several molecular approaches for Strongyloides spp. DNA detection have already been assayed, but they have a very limited use in routine diagnostic, particularly in endemic areas. In addition, all molecular approaches for Strongyloides spp. DNA detection have always been mainly assayed for stool samples and no other more advantageous biological samples, such as urine, have been investigated for molecular purposes. In this study we have developed, for the first time, a molecular assay using LAMP methodology as a simple, sensible and robust method for the detection of S. venezuelensis DNA in a well-established Wistar rats experimental infection in both stool and urine samples. The LAMP assay was also successfully evaluated in patients´ stool samples. Our LAMP assay (Strong-LAMP) is an useful molecular tool in a strongyloidiasis experimental infection model and could be a potential field-friendly diagnostic test in a clinical setting, following further validation.
Collapse
Affiliation(s)
- Pedro Fernández-Soto
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Alicia Sánchez-Hernández
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Javier Gandasegui
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Cristina Bajo Santos
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Julio López-Abán
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - José María Saugar
- Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Esperanza Rodríguez
- Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Vicente
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Antonio Muro
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| |
Collapse
|
6
|
Gómez-Junyent J, Paredes-Zapata D, de las Parras ER, González-Costello J, Ruiz-Arranz Á, Cañizares R, Saugar JM, Muñoz J. Real-Time Polymerase Chain Reaction in Stool Detects Transmission of Strongyloides stercoralis from an Infected Donor to Solid Organ Transplant Recipients. Am J Trop Med Hyg 2016; 94:897-9. [PMID: 26880781 DOI: 10.4269/ajtmh.15-0610] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/09/2015] [Indexed: 11/07/2022] Open
Abstract
Solid organ transplant recipients can acquire Strongyloides stercoralis from an infected donor. The diagnosis of S. stercoralis in immunocompromised individuals may be challenging due to a lower sensitivity of available parasitological and serological methods, compared with immunocompetent individuals. Recently, a real-time polymerase chain reaction (RT-PCR) in stool has been developed for S. stercoralis diagnosis. We report two cases of S. stercoralis infection transmitted by a donor to two solid organ transplant recipients, who were diagnosed with RT-PCR in stool. This test could play an important role inS. stercoralis diagnosis in immunosuppressed patients, facilitating rapid treatment initiation and reducing the risk of severe strongyloidiasis. Adherence to current recommendations of screening among donors and recipients from endemic areas is also urgently needed.
Collapse
Affiliation(s)
- Joan Gómez-Junyent
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - David Paredes-Zapata
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Esperanza Rodríguez de las Parras
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - José González-Costello
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Ángel Ruiz-Arranz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Rosario Cañizares
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - José María Saugar
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - José Muñoz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Donation and Transplant Coordination Section, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Department of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda, Madrid, Spain; Department of Cardiology, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain; Department of Intensive Care, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Salvador F, Sulleiro E, Sánchez-Montalvá A, Saugar JM, Rodríguez E, Pahissa A, Molina I. Usefulness of Strongyloides stercoralis serology in the management of patients with eosinophilia. Am J Trop Med Hyg 2014; 90:830-4. [PMID: 24615124 DOI: 10.4269/ajtmh.13-0678] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Strongyloides stercoralis infection is being increasingly diagnosed out of endemic areas. The aim of this study is to evaluate the usefulness of S. stercoralis serology for the management of probable strongyloidiasis in patients presenting with eosinophilia. Overall, 147 patients were included, 89 (60.5%) patients had a positive S. stercoralis serology. Strongyloides stercoralis larvae were detected only in 15 (10.2%) patients. Twenty-eight patients had human immunodeficiency virus infection. Eighty patients received ivermectin 200 mcg/Kg/day for 2 days, and follow-up 6 months after treatment could be performed in 32 patients: 26 (81.3%) patients reached the response to treatment criteria (negative serology 6 months after treatment or when by enzyme-linked immunosorbent assay the optical density ratio of post-treatment to pre-treatment decreased to 0.6), and 11 (34.4%) patients fulfilled the cure criteria (negative serology 6 months after treatment). Strongyloides stercoralis serology is a useful diagnostic tool both in the diagnosis of probable strongyloidiasis and follow-up after treatment.
Collapse
Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron Teaching Hospital, Barcelona, Spain, PROSICS Barcelona; Department of Microbiology, Vall d'Hebron Teaching Hospital, Barcelona, Spain, PROSICS Barcelona; Department of Parasitology, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | | | | | | |
Collapse
|
8
|
Hornillos V, Saugar JM, de la Torre BG, Andreu D, Rivas L, Acuña AU, Amat-Guerri F. Synthesis of 16-mercaptohexadecylphosphocholine, a miltefosine analog with leishmanicidal activity. Bioorg Med Chem Lett 2006; 16:5190-3. [PMID: 16870434 DOI: 10.1016/j.bmcl.2006.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Revised: 07/05/2006] [Accepted: 07/05/2006] [Indexed: 11/20/2022]
Abstract
The alkylphosphocholine miltefosine (n-hexadecylphosphocholine, MT) has been introduced recently as a very effective drug for the oral treatment of human leishmaniasis. However, the parasiticidal mechanism of MT at a molecular level is far from being understood. Here we report the synthesis and biological characterization of 16-mercaptohexadecylphosphocholine, a thiol analog of MT which was designed to facilitate the search of MT interacting targets within the parasite by a variety of analytical methods. This analog presents the same leishmanicidal effect as the parent drug against Leishmania donovani promastigotes and Leishmania pifanoi axenic amastigotes, and has been used to develop an affinity chromatography method to attempt the isolation of putative Leishmania proteins that bind to the phosphocholine part of the molecule.
Collapse
Affiliation(s)
- Valentín Hornillos
- Instituto de Química Orgánica, CSIC, Juan de la Cierva 3, 28006 Madrid, Spain
| | | | | | | | | | | | | |
Collapse
|
9
|
Saugar JM, Rodríguez-Hernández MJ, de la Torre BG, Pachón-Ibañez ME, Fernández-Reyes M, Andreu D, Pachón J, Rivas L. Activity of cecropin A-melittin hybrid peptides against colistin-resistant clinical strains of Acinetobacter baumannii: molecular basis for the differential mechanisms of action. Antimicrob Agents Chemother 2006; 50:1251-6. [PMID: 16569836 PMCID: PMC1426946 DOI: 10.1128/aac.50.4.1251-1256.2006] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acinetobacter baumannii has successfully developed resistance against all common antibiotics, including colistin (polymyxin E), the last universally active drug against this pathogen. The possible widespread distribution of colistin-resistant A. baumannii strains may create an alarming clinical situation. In a previous work, we reported differences in lethal mechanisms between polymyxin B (PXB) and the cecropin A-melittin (CA-M) hybrid peptide CA(1-8)M(1-18) (KWKLFKKIGIGAVLKVLTTGLPALIS-NH2) on colistin-susceptible strains (J. M. Saugar, T. Alarcón, S. López-Hernández, M. López-Brea, D. Andreu, and L. Rivas, Antimicrob. Agents Chemother. 46:875-878, 2002). We now demonstrate that CA(1-8)M(1-18) and three short analogues, namely CA(1-7)M(2-9) (KWKLFKKIGAVLKVL-NH2), its Nalpha-octanoyl derivative (Oct-KWKLFKKIGAVLKVL-NH2), and CA(1-7)M(5-9) (KWKLLKKIGAVLKVL-NH2) are active against two colistin-resistant clinical strains. In vitro, resistance to colistin sulfate was targeted to the outer membrane, as spheroplasts were equally lysed by a given peptide, regardless of their respective level of colistin resistance. The CA-M hybrids were more efficient than colistin in displacing lipopolysaccharide-bound dansyl-polymyxin B from colistin-resistant but not from colistin-susceptible strains. Similar improved performance of the CA-M hybrids in permeation of the inner membrane was observed, regardless of the resistance pattern of the strain. These results argue in favor of a possible use of CA-M peptides, and by extension other antimicrobial peptides with similar features, as alternative chemotherapy in colistin-resistant Acinetobacter infections.
Collapse
Affiliation(s)
- José María Saugar
- Centro de Investigaciones Biológicas (CSIC), Madrid, and Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
The emergence of membrane-active antimicrobial peptides as new alternatives against pathogens with multiantibiotic resistance requires the design of better analogues. Among the different physicochemical parameters involved in the optimization of linear antimicrobial peptides, positional hydrophobicity has recently been incorporated. This takes into consideration the concept of the topological distribution of hydrophobic residues throughout the sequence rather than the classical concept of hydrophobicity as a global parameter of the peptide, calculated as the summation of the individual hydrophobicities of the residues. In order to assess the contribution of this parameter to the leishmanicidal mechanisms of magainin 2 analogues, the activities of two of these analogues, MG-H1 (GIKKFLHIIWKFIKAFVGEIMNS) and MG-H2 (IIKKFLHSIWKFGKAFVGEIMNI), which have similar charges, amino acid compositions, and hydrophobicities but different positional hydrophobicities, against Leishmania donovani promastigotes were assayed (T. Tachi, R. F. Epand, R. M. Epand, and K. Matsuzaki, Biochemistry 41:10723-10731, 2002). The activities were compared with that of the parental peptide, F5W-magainin 2 (GIGKWLHSAKKFGKAFVGEIMNS). The three peptides were active at micromolar concentrations, in the order MG-H2 > MG-H1 > F5W-magainin 2. These activities differ from their hemolytic and bactericidal activities. The results demonstrate that positional hydrophobicity, which reflects the presence of short stretches of sequences rich in hydrophobic amino acids, plays an important role in the activities of leishmanicidal peptides.
Collapse
Affiliation(s)
- Esther Guerrero
- Centro de Investigaciones Biológicas (CSIC), E-28040, Madrid, Spain
| | | | | | | |
Collapse
|
11
|
Luque-Ortega JR, Martínez S, Saugar JM, Izquierdo LR, Abad T, Luis JG, Piñero J, Valladares B, Rivas L. Fungus-elicited metabolites from plants as an enriched source for new leishmanicidal agents: antifungal phenyl-phenalenone phytoalexins from the banana plant (Musa acuminata) target mitochondria of Leishmania donovani promastigotes. Antimicrob Agents Chemother 2004; 48:1534-40. [PMID: 15105102 PMCID: PMC400542 DOI: 10.1128/aac.48.5.1534-1540.2004] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two antifungal phenyl-phenalenone phytoalexins isolated from the banana plant (Musa acuminata) elicited with the fungus Fusarium oxysporum, together with a methoxy derivative of one of them and two epoxide precursors of their chemical synthesis, were tested for leishmanicidal activity on Leishmania donovani promastigotes and L. infantum amastigotes. Drugs inhibited proliferation of both forms of the parasite with a 50% lethal concentration range between 10.3 and 68.7 micro g/ml. Their lethal mechanism was found linked to the respiratory chain by a systematic approach, including electron microscopy, measurement of the oxygen consumption rate on digitonin-permeabilized promastigotes, and enzymatic assays on a mitochondrial enriched fraction. Whereas the whole set of compounds inhibited the activity of fumarate reductase in the mitochondrial fraction (50% effective concentration [EC(50)] between 33.3 and 78.8 micro g/ml) and on purified enzyme (EC(50) = 53.3 to 115 micro g/ml), inhibition for succinate dehydrogenase was only observed for the two phytoalexins with the highest leishmanicidal activity: anigorufone and its natural analogue 2-methoxy-9-phenyl-phenalen-1-one (EC(50) = 33.5 and 59.6 micro g/ml, respectively). These results provided a new structural motif, phenyl-phenalenone, as a new lead for leishmanicidal activity, and support the use of plant extracts enriched in antifungal phytoalexins, synthesized under fungal challenge, as a more rational and effective strategy to screen for new plant leishmanicidal drugs.
Collapse
|
12
|
Saugar JM, Alarcón T, López-Hernández S, López-Brea M, Andreu D, Rivas L. Activities of polymyxin B and cecropin A-,melittin peptide CA(1-8)M(1-18) against a multiresistant strain of Acinetobacter baumannii. Antimicrob Agents Chemother 2002; 46:875-8. [PMID: 11850277 PMCID: PMC127505 DOI: 10.1128/aac.46.3.875-878.2002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Polymyxin B (PXB) and the cecropin A-melittin hybrid CA(1-8)M(1-18) (KWKLFKKIGIGAVLKVLTTGLPALIS-NH2) were compared for antibiotic activity on reference and multiresistant Acinetobacter baumannii strains. Significant differences for both peptides were observed on their inner membrane interaction and inhibition by environmental factors, supporting the use of CA(1-8)M(1-18) as a potential alternative to PXB against ACINETOBACTER:
Collapse
|
13
|
Alarcón T, López-Hernández S, Andreu D, Saugar JM, Rivas L, López-Brea M. In vitro activity of CA(1-8)M(1-18), a synthetic cecropin A-melittin hybrid peptide, against multiresistant Acinetobacter baumannii strains. Rev Esp Quimioter 2001; 14:184-90. [PMID: 11704773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The in vitro antibiotic activity of CA(1-8)M(1-18), a synthetic cecropin A-melittin hybrid peptide, was determined by broth microdilution on 20 clinical Acinetobacter baumannii isolates with different resistance profiles. The MIC(50), MIC(90) and ranges were 4 mg/l, 4 mg/l and 2-8 mg/l, respectively, and were independent of resistance pattern. Different assay parameters such as microplate plastic (polystyrene or polypropylene), addition of supplements (5-10% fetal calf serum or 5% horse blood), inoculum size (10(5), 10(6), 10(7) and 10(8) CFU/ml) or incubation period (24 or 48 h) were studied. MIC was independent of the first two parameters, although the MIC values increased both with inoculum size or incubation period. Killing curves were obtained both for a standard strain and a multiresistant isolate over a 45.7-2.8 mg/l (16-1 mM) peptide range, using an initial inoculum of 10(5)-10(6) CFU/ml and 10(9)-10(10) CFU/ml. A concentration of 45.7 mg/l was required for complete killing. Accordingly, CA(1-8)M(1-18) showed good in vitro activity against the A. baumannii strains tested irrespective of the resistance to classical antibiotics, and could be a future candidate for multiresistant A. baumannii infections, although further cytotoxicity and pharmacological studies will be needed.
Collapse
Affiliation(s)
- T Alarcón
- Servicio de Microbiología, Hospital Universitario de la Princesa, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|