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Cámara-Checa A, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Tamargo J, Gómez R, Caballero R, Delpón E. Reply to Benndorff and DiFrancesco: Reliable human HCN4 single-channel recordings using the cell-attached configuration in expression systems. Proc Natl Acad Sci U S A 2024; 121:e2402992121. [PMID: 38588416 PMCID: PMC11032473 DOI: 10.1073/pnas.2402992121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Anabel Cámara-Checa
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Marcos Rubio-Alarcón
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Dago
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Teresa Crespo-García
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Josu Rapún
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Juan Tamargo
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
| | - Ricardo Gómez
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Ricardo Caballero
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Eva Delpón
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
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Cámara-Checa A, Perin F, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Cebrián J, Gómez R, Bermúdez-Jiménez F, Monserrat L, Tamargo J, Caballero R, Jiménez-Jáimez J, Delpón E. A gain-of-function HCN4 mutant in the HCN domain is responsible for inappropriate sinus tachycardia in a Spanish family. Proc Natl Acad Sci U S A 2023; 120:e2305135120. [PMID: 38032931 DOI: 10.1073/pnas.2305135120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
In a family with inappropriate sinus tachycardia (IST), we identified a mutation (p.V240M) of the hyperpolarization-activated cyclic nucleotide-gated type 4 (HCN4) channel, which contributes to the pacemaker current (If) in human sinoatrial node cells. Here, we clinically study fifteen family members and functionally analyze the p.V240M variant. Macroscopic (IHCN4) and single-channel currents were recorded using patch-clamp in cells expressing human native (WT) and/or p.V240M HCN4 channels. All p.V240M mutation carriers exhibited IST that was accompanied by cardiomyopathy in adults. IHCN4 generated by p.V240M channels either alone or in combination with WT was significantly greater than that generated by WT channels alone. The variant, which lies in the N-terminal HCN domain, increased the single-channel conductance and opening frequency and probability of HCN4 channels. Conversely, it did not modify the channel sensitivity for cAMP and ivabradine or the level of expression at the membrane. Treatment with ivabradine based on functional data reversed the IST and the cardiomyopathy of the carriers. In computer simulations, the p.V240M gain-of-function variant increases If and beating rate and thus explains the IST of the carriers. The results demonstrate the importance of the unique HCN domain in HCN4, which stabilizes the channels in the closed state.
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Affiliation(s)
- Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francesca Perin
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Ricardo Gómez
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francisco Bermúdez-Jiménez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid 28029, Spain
| | - Lorenzo Monserrat
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
- Health in Code Sociedad Limitada, A Coruña 15008, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Juan Jiménez-Jáimez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
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Dago M, Crespo-García T, Cámara-Checa A, Rapún J, Rubio-Alarcón M, Marín M, Tamargo J, Caballero R, Delpón E. Empagliflozin and Dapagliflozin Increase Na + and Inward Rectifier K + Current Densities in Human Cardiomyocytes Derived from Induced Pluripotent Stem Cells (hiPSC-CMs). Cells 2022; 11:3707. [PMID: 36496967 PMCID: PMC9738206 DOI: 10.3390/cells11233707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
Dapagliflozin (dapa) and empagliflozin (empa) are sodium-glucose cotransporter-2 inhibitors (SGLT2is) that reduce morbidity and mortality in heart failure (HF) patients. Sodium and inward rectifier K+ currents (INa and IK1), carried by Nav1.5 and Kir2.1 channels, respectively, are responsible for cardiac excitability, conduction velocity, and refractoriness. In HF patients, Nav1.5 and Kir2.1 expression are reduced, enhancing risk of arrhythmia. Incubation with dapa or empa (24-h,1 µM) significantly increased INa and IK1 densities recorded in human-induced pluripotent stem cell-cardiomyocytes (hiPSC-CMs) using patch-clamp techniques. Dapa and empa, respectively, shifted to more hyperpolarized potentials the INa activation and inactivation curves. Identical effects were observed in Chinese hamster ovary (CHO) cells that were incubated with dapa or empa and transiently expressed human Nav1.5 channels. Conversely, empa but not dapa significantly increased human Kir2.1 currents in CHO cells. Dapa and empa effects on INa and IK1 were also apparent in Ca-calmodulin kinase II-silenced CHO cells. Cariporide, a Na+/H+ exchanger type 1 (NHE1) inhibitor, did not increase INa or IK1 in hiPSC-CMs. Dapa and empa at therapeutic concentrations increased INa and IK1 in healthy human cardiomyocytes. These SGLT2is could represent a new class of drugs with a novel and long-pursued antiarrhythmic mechanism of action.
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Affiliation(s)
- María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Crespo-García T, Rubio-Alarcón M, Cámara-Checa A, Dago M, Rapún J, Nieto-Marín P, Marín M, Cebrián J, Tamargo J, Delpón E, Caballero R. A Cantú syndrome mutation produces dual effects on KATP channels by disrupting ankyrin B regulation. J Gen Physiol 2022; 155:213613. [PMID: 36287534 PMCID: PMC9614705 DOI: 10.1085/jgp.202112995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 02/01/2023] Open
Abstract
ATP-sensitive potassium (KATP) channels composed of Kir6.x and sulfonylurea receptor (SURs) subunits couple cellular metabolism to electrical activity. Cantú syndrome (CS) is a rare disease caused by mutations in the genes encoding Kir6.1 (KCNJ8) and SUR2A (ABCC9) that produce KATP channel hyperactivity due to a reduced channel block by physiological ATP concentrations. We functionally characterized the p.S1054Y SUR2A mutation identified in two CS carriers, who exhibited a mild phenotype although the mutation was predicted as highly pathogenic. We recorded macroscopic and single-channel currents in CHO and HEK-293 cells and measured the membrane expression of the channel subunits by biotinylation assays in HEK-293 cells. The mutation increased basal whole-cell current density and at the single-channel level, it augmented opening frequency, slope conductance, and open probability (Po), and promoted the appearance of multiple conductance levels. p.S1054Y also reduced Kir6.2 and SUR2A expression specifically at the membrane. Overexpression of ankyrin B (AnkB) prevented these gain- and loss-of-function effects, as well as the p.S1054Y-induced reduction of ATP inhibition of currents measured in inside-out macropatches. Yeast two-hybrid assays suggested that SUR2A WT and AnkB interact, while p.S1054Y interaction with AnkB is decreased. The p.E322K Kir6.2 mutation, which prevents AnkB binding to Kir6.2, produced similar biophysical alterations than p.S1054Y. Our results are the first demonstration of a CS mutation whose functional consequences involve the disruption of AnkB effects on KATP channels providing a novel mechanism by which CS mutations can reduce ATP block. Furthermore, they may help explain the mild phenotype associated with this mutation.
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Affiliation(s)
- Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain,Correspondence to Eva Delpón:
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
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Estévez A, Machado M, Valerio M, Sánchez C, Marín M, Adán I, Bouza E, Hualde AM, Pinilla B, Muñoz P. Endocarditis polimicrobiana, ¿una entidad real? Análisis de nuestra cohorte de endocarditis HGUGM 2008-2020. Cirugía Cardiovascular 2022. [DOI: 10.1016/j.circv.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Márquez DF, Garzón ME, Renna NF, Baroni M, Berger A, Caruso G, Ferretti V, Sabio R, König F, Marín M, Romero CA. [Argentine registry of office blood pressure monitoring. RAMPAC study]. Hipertens Riesgo Vasc 2022; 39:62-68. [PMID: 35305932 DOI: 10.1016/j.hipert.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/21/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hypertension (HTN) is the leading cause of mortality and disability in the world. In Argentina, almost 44% of hypertensives do not know about their condition and this may be due to the low rate of blood pressure (BP) measurements during the office visit. Our hypothesis is that the measurement and electronic recording of BP (BPMR) is not a routine practice in Argentina. OBJECTIVE To describe the rate of office BP measurement in Argentina. METHODS This is a retrospective, multicentre, point prevalence study. We analysed all office visits on 9/19/2019 at 9 medical institutions in 6 provinces of Argentina. RESULTS Two thousand and eighty-two office visits were analysed. The patients' mean age was 52.1 years (18-103), 1790 (59.7%) were female, and 702 (36.1%) were hypertensives. BP was measured in 420 visits (14.1%; 95% CI 12.8-15.4). In a multivariate logistic regression model, history of HTN (OR 1.91, P<.001) and previous cardiovascular event (OR 1.76, P<.001) were associated with more odds of BPMR. The presence of cancer was associated with fewer odds of BPMR (OR .51, P<.01). Cardiology measured BP up to 49.5% (144/291 visits), followed by internal medicine 30% (152/507 visits). CONCLUSION BPMR during office visits is deficient in Argentina and represents a missed healthcare opportunity. Different strategies are needed to detect hypertensive patients and reduce cardiovascular events.
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Affiliation(s)
- D F Márquez
- Unidad de Hipertensión Arterial, Hospital San Bernardo, Salta, Argentina; Instituto de NefroUrología y Nutrición de Salta, Salta, Argentina
| | - M E Garzón
- Servicio de Clínica Médica, Hospital Ferreyra, Córdoba, Argentina; Servicio de Clínica Médica, Hospital Privado, Córdoba, Argentina
| | - N F Renna
- Departamento de Cardiología, Hospital Español, Mendoza, Argentina
| | - M Baroni
- Facultad de Ciencias Médicas, Universidad Nacional de Cuyo-Mendoza, Servicio de Cardiología, Instituto Modelo de Cardiología, Córdoba, Argentina
| | - A Berger
- Servicio de Clínica Médica, Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - G Caruso
- Servicio de Clínica Médica, Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - V Ferretti
- Servicio de Clínica Médica, Sanatorio Norte, Rosario, Argentina
| | - R Sabio
- Hospital de Alta Complejidad, SAMIC-El Calafate, Santa Cruz, Argentina
| | - F König
- Unidad de Hipertensión Arterial, Hospital San Bernardo, Salta, Argentina
| | - M Marín
- Unidad de Hipertensión Arterial, Hospital Italiano de San Justo, Buenos Aires, Argentina
| | - C A Romero
- Servicio de Clínica Médica, Hospital Privado, Córdoba, Argentina; Emory University School of Medicine, Renal Division, Atlanta, EE. UU..
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Rubio-Alarcón M, Cámara-Checa A, Dago M, Crespo-García T, Nieto-Marín P, Marín M, Merino JL, Toquero J, Salguero-Bodes R, Tamargo J, Cebrián J, Delpón E, Caballero R. Zfhx3 Transcription Factor Represses the Expression of SCN5A Gene and Decreases Sodium Current Density (I Na). Int J Mol Sci 2021; 22:ijms222313031. [PMID: 34884836 PMCID: PMC8657907 DOI: 10.3390/ijms222313031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 02/02/2023] Open
Abstract
The ZFHX3 and SCN5A genes encode the zinc finger homeobox 3 (Zfhx3) transcription factor (TF) and the human cardiac Na+ channel (Nav1.5), respectively. The effects of Zfhx3 on the expression of the Nav1.5 channel, and in cardiac excitability, are currently unknown. Additionally, we identified three Zfhx3 variants in probands diagnosed with familial atrial fibrillation (p.M1260T) and Brugada Syndrome (p.V949I and p.Q2564R). Here, we analyzed the effects of native (WT) and mutated Zfhx3 on Na+ current (INa) recorded in HL-1 cardiomyocytes. ZFHX3 mRNA can be detected in human atrial and ventricular samples. In HL-1 cardiomyocytes, transfection of Zfhx3 strongly reduced peak INa density, while the silencing of endogenous expression augmented it (from −65.9 ± 8.9 to −104.6 ± 10.8 pA/pF; n ≥ 8, p < 0.05). Zfhx3 significantly reduced the transcriptional activity of human SCN5A, PITX2, TBX5, and NKX25 minimal promoters. Consequently, the mRNA and/or protein expression levels of Nav1.5 and Tbx5 were diminished (n ≥ 6, p < 0.05). Zfhx3 also increased the expression of Nedd4-2 ubiquitin-protein ligase, enhancing Nav1.5 proteasomal degradation. p.V949I, p.M1260T, and p.Q2564R Zfhx3 produced similar effects on INa density and time- and voltage-dependent properties in WT. WT Zfhx3 inhibits INa as a result of a direct repressor effect on the SCN5A promoter, the modulation of Tbx5 increasing on the INa, and the increased expression of Nedd4-2. We propose that this TF participates in the control of cardiac excitability in human adult cardiac tissue.
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Affiliation(s)
- Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - José Luis Merino
- Department of Cardiology, Hospital Universitario La Paz, Instituto de Investigación Sanitaria la Paz, CIBERCV, 28046 Madrid, Spain;
| | - Jorge Toquero
- Department of Cardiology, Hospital Universitario Puerta de Hierro, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, CIBERCV, Majadahonda, 28222 Madrid, Spain;
| | - Rafael Salguero-Bodes
- Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, CIBERCV, 28041 Madrid, Spain;
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
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8
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Mencía-Gutiérrez A, Martín-Maldonado B, Pastor-Tiburón N, Moraleda V, González F, García-Peña FJ, Pérez-Cobo I, Revuelta L, Marín M. Prevalence and antimicrobial resistance of Campylobacter from wild birds of prey in Spain. Comp Immunol Microbiol Infect Dis 2021; 79:101712. [PMID: 34688167 DOI: 10.1016/j.cimid.2021.101712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/27/2021] [Revised: 09/18/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
Wild birds have been identified as a relevant reservoir of Campylobacter spp., therefore, a potential source of infection in humans and domestic animals. The objective of this study was to determine the occurrence of Campylobacter spp. on birds of prey in Spain. In addition, antibiotic resistance profiles of the isolates were evaluated. A total of 689 specimens of 28 raptor species were analyzed, with a resulting individual prevalence of 7.5%. C. jejuni was the most frequently isolated species (88.5%), followed by C. coli and C. lari (3.8% each). The occurrence of Campylobacter was significantly higher (p < 0.05) in nocturnal birds of prey (15.3%), in spring season (12.2%) and in carnivorous species (9.4%). Isolates displayed a remarkable resistance to nalidixic acid (69.9%), ciprofloxacin (69.9%), and tetracycline (55.6%), and a low resistance to streptomycin (6.7%). Our findings highlight the importance of birds of prey as reservoirs of Campylobacter strains and their significant role as carriers of antimicrobial resistance.
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Affiliation(s)
- Aida Mencía-Gutiérrez
- Department of Animal Physiology, Faculty of Veterinary Sciences, Complutense University of Madrid, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain.
| | - Bárbara Martín-Maldonado
- Grupo de Rehabilitación de la Fauna Autóctona y su Hábitat (GREFA), Monte del Pilar, Majadahonda, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain
| | - Natalia Pastor-Tiburón
- Grupo de Rehabilitación de la Fauna Autóctona y su Hábitat (GREFA), Monte del Pilar, Majadahonda, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain
| | - Virginia Moraleda
- Grupo de Rehabilitación de la Fauna Autóctona y su Hábitat (GREFA), Monte del Pilar, Majadahonda, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain
| | - Fernando González
- Grupo de Rehabilitación de la Fauna Autóctona y su Hábitat (GREFA), Monte del Pilar, Majadahonda, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain
| | | | - Iratxe Pérez-Cobo
- Laboratorio Central de Veterinaria (Ministerio de Agricultura, Pesca y Alimentación), Algete, Spain
| | - Luis Revuelta
- Department of Animal Physiology, Faculty of Veterinary Sciences, Complutense University of Madrid, Madrid, Spain; Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain
| | - María Marín
- Grupo de Estudio de la Medicina y Conservación de la Fauna Silvestre (GEMAS), Spain; Department of Nutrition and Food Science, Faculty of Veterinary Sciences, Complutense University of Madrid, Madrid, Spain
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9
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Vallecillos A, Marín M, Bortoletti M, López J, Afonso JM, Ramis G, Arizcun M, María-Dolores E, Armero E. Genetic Analysis of the Fatty Acid Profile in Gilthead Seabream ( Sparus aurata L.). Animals (Basel) 2021; 11:ani11102889. [PMID: 34679910 PMCID: PMC8532642 DOI: 10.3390/ani11102889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/30/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Humans require essential fatty acids in their diet and marine fish are a source of them, especially omega3 fatty acids that present high benefits on diverse vascular diseases and the immune system. Breeding programs in gilthead seabream usually include growth as the first criterion in the selection process of the fish. However, that could lead to fish with a higher fillet fat content and a fatty acid profile with a lower polyunsaturated fatty acids percentage. Fillet fat content and its fatty acids profile have been revealed as heritable traits. Therefore, further studies to go deeper in the selection process are advisable. Abstract The gilthead seabream is one of the most valuable species in the Mediterranean basin both for fisheries and aquaculture. Marine fish, such as gilthead seabream, are a source of n3 polyunsaturated fatty acids, highly appreciated for human food owing to their benefits on the cardiovascular and immune systems. The aim of the present study was to estimate heritability for fatty acid (FA) profile in fillet gilthead seabream to be considered as a strategy of a selective breeding program. Total of 399 fish, from a broodstock Mediterranean Sea, were analysed for growth, flesh composition and FA profile. Heritabilities for growth traits, and flesh composition (fat, protein, and moisture content) were medium. Heritability was moderate for 14:0, 16:0 and 18:1n9 and for sum of monounsaturated FA and n6/n3 ratio, and it was low for 20:1n11 and 22:6n3 and the ratio unsaturated/saturated FA. Breeding programs in gilthead seabream usually include growth as the first criterion in the selection process of the fish. However, other quality traits, such as fillet fat content and its fatty acids profile should be considered, since they are very important traits for the consumer, from a nutritional point of view and the benefits for the health.
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Affiliation(s)
- Antonio Vallecillos
- Department of Agronomic Engineering, Technical University of Cartagena, Paseo Alfonso XIII 48, 30202 Cartagena, Spain; (A.V.); (M.M.); (J.L.); (E.M.-D.)
| | - María Marín
- Department of Agronomic Engineering, Technical University of Cartagena, Paseo Alfonso XIII 48, 30202 Cartagena, Spain; (A.V.); (M.M.); (J.L.); (E.M.-D.)
| | - Martina Bortoletti
- Department of Comparative Biomedicine and Food Science (BCA), University of Padova, Viale dell’Universitá 16, 35020 Legnaro, Italy;
| | - Javier López
- Department of Agronomic Engineering, Technical University of Cartagena, Paseo Alfonso XIII 48, 30202 Cartagena, Spain; (A.V.); (M.M.); (J.L.); (E.M.-D.)
| | - Juan M. Afonso
- Institute of Sustainable Aquaculture and Marine Ecosystems (GIA-ECOAQUA), Carretera de Taliarte s/n, 35214 Telde, Spain;
| | - Guillermo Ramis
- Department of Animal Production, University of Murcia, Avenida Teniente Flomesta 5, 30860 Murcia, Spain;
| | - Marta Arizcun
- Spanish Institute of Oceanography, Oceanographic Center of Murcia, Carretera de la Azohía s/n, 30860 Puerto de Mazarrón, Spain;
| | - Emilio María-Dolores
- Department of Agronomic Engineering, Technical University of Cartagena, Paseo Alfonso XIII 48, 30202 Cartagena, Spain; (A.V.); (M.M.); (J.L.); (E.M.-D.)
| | - Eva Armero
- Department of Agronomic Engineering, Technical University of Cartagena, Paseo Alfonso XIII 48, 30202 Cartagena, Spain; (A.V.); (M.M.); (J.L.); (E.M.-D.)
- Correspondence: ; Tel.: +34-968-325-538; Fax: +34-968-325-433
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10
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Rodriguez-Manfredi JA, de la Torre Juárez M, Alonso A, Apéstigue V, Arruego I, Atienza T, Banfield D, Boland J, Carrera MA, Castañer L, Ceballos J, Chen-Chen H, Cobos A, Conrad PG, Cordoba E, del Río-Gaztelurrutia T, de Vicente-Retortillo A, Domínguez-Pumar M, Espejo S, Fairen AG, Fernández-Palma A, Ferrándiz R, Ferri F, Fischer E, García-Manchado A, García-Villadangos M, Genzer M, Giménez S, Gómez-Elvira J, Gómez F, Guzewich SD, Harri AM, Hernández CD, Hieta M, Hueso R, Jaakonaho I, Jiménez JJ, Jiménez V, Larman A, Leiter R, Lepinette A, Lemmon MT, López G, Madsen SN, Mäkinen T, Marín M, Martín-Soler J, Martínez G, Molina A, Mora-Sotomayor L, Moreno-Álvarez JF, Navarro S, Newman CE, Ortega C, Parrondo MC, Peinado V, Peña A, Pérez-Grande I, Pérez-Hoyos S, Pla-García J, Polkko J, Postigo M, Prieto-Ballesteros O, Rafkin SCR, Ramos M, Richardson MI, Romeral J, Romero C, Runyon KD, Saiz-Lopez A, Sánchez-Lavega A, Sard I, Schofield JT, Sebastian E, Smith MD, Sullivan RJ, Tamppari LK, Thompson AD, Toledo D, Torrero F, Torres J, Urquí R, Velasco T, Viúdez-Moreiras D, Zurita S. The Mars Environmental Dynamics Analyzer, MEDA. A Suite of Environmental Sensors for the Mars 2020 Mission. Space Sci Rev 2021; 217:48. [PMID: 34776548 PMCID: PMC8550605 DOI: 10.1007/s11214-021-00816-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 05/16/2023]
Abstract
NASA's Mars 2020 (M2020) rover mission includes a suite of sensors to monitor current environmental conditions near the surface of Mars and to constrain bulk aerosol properties from changes in atmospheric radiation at the surface. The Mars Environmental Dynamics Analyzer (MEDA) consists of a set of meteorological sensors including wind sensor, a barometer, a relative humidity sensor, a set of 5 thermocouples to measure atmospheric temperature at ∼1.5 m and ∼0.5 m above the surface, a set of thermopiles to characterize the thermal IR brightness temperatures of the surface and the lower atmosphere. MEDA adds a radiation and dust sensor to monitor the optical atmospheric properties that can be used to infer bulk aerosol physical properties such as particle size distribution, non-sphericity, and concentration. The MEDA package and its scientific purpose are described in this document as well as how it responded to the calibration tests and how it helps prepare for the human exploration of Mars. A comparison is also presented to previous environmental monitoring payloads landed on Mars on the Viking, Pathfinder, Phoenix, MSL, and InSight spacecraft.
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Affiliation(s)
| | | | | | - V. Apéstigue
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - I. Arruego
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - T. Atienza
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - D. Banfield
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY USA
| | - J. Boland
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | | | - L. Castañer
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - J. Ceballos
- Instituto de Microelectrónica de Sevilla (US-CSIC), Seville, Spain
| | - H. Chen-Chen
- Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - A. Cobos
- CRISA-Airbus, Tres Cantos, Spain
| | | | - E. Cordoba
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | | | | | | | - S. Espejo
- Instituto de Microelectrónica de Sevilla (US-CSIC), Seville, Spain
| | - A. G. Fairen
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - R. Ferrándiz
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - F. Ferri
- Università degli Studi di Padova, Padova, Italy
| | - E. Fischer
- University of Michigan, Ann Arbor, MI USA
| | | | | | - M. Genzer
- Finnish Meteorological Institute, Helsinki, Finland
| | - S. Giménez
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - J. Gómez-Elvira
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - F. Gómez
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - A.-M. Harri
- Finnish Meteorological Institute, Helsinki, Finland
| | - C. D. Hernández
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - M. Hieta
- Finnish Meteorological Institute, Helsinki, Finland
| | - R. Hueso
- Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - I. Jaakonaho
- Finnish Meteorological Institute, Helsinki, Finland
| | - J. J. Jiménez
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - V. Jiménez
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - A. Larman
- Added-Value-Solutions, Elgoibar, Spain
| | - R. Leiter
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - A. Lepinette
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - G. López
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - S. N. Madsen
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - T. Mäkinen
- Finnish Meteorological Institute, Helsinki, Finland
| | - M. Marín
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - G. Martínez
- Lunar and Planetary Institute, Houston, TX USA
| | - A. Molina
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - S. Navarro
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - C. Ortega
- Added-Value-Solutions, Elgoibar, Spain
| | - M. C. Parrondo
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - V. Peinado
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - A. Peña
- CRISA-Airbus, Tres Cantos, Spain
| | | | | | | | - J. Polkko
- Finnish Meteorological Institute, Helsinki, Finland
| | - M. Postigo
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - M. Ramos
- Universidad de Alcalá, Alcalá de Henares, Spain
| | | | - J. Romeral
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - C. Romero
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - A. Saiz-Lopez
- Dept. of Atmospheric Chemistry and Climate, Institute of Physical Chemistry Rocasolano, CSIC, Madrid, Spain
| | | | - I. Sard
- Added-Value-Solutions, Elgoibar, Spain
| | - J. T. Schofield
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - E. Sebastian
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - M. D. Smith
- NASA Goddard Space Flight Center, Greenbelt, MD USA
| | - R. J. Sullivan
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY USA
| | - L. K. Tamppari
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - A. D. Thompson
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - D. Toledo
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | | | - J. Torres
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - R. Urquí
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - S. Zurita
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
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Luque L, Rodrigo T, García-García JM, Casals M, Millet JP, Caylà J, Orcau A, Agüero R, Alcázar J, Altet N, Altube L, Álvarez F, Anibarro L, Barrón M, Bermúdez P, Bikuña E, Blanquer R, Borderías L, Bustamante A, Calpe J, Caminero J, Cañas F, Casas F, Casas X, Cases E, Castejón N, Castrodeza R, Cebrián J, Cervera A, Ciruelos J, Delgado A, De Souza M, Díaz D, Domínguez M, Fernández B, Gallardo J, Gallego M, Clemente MG, García C, García F, Garros F, Gort A, Guerediaga A, Gullón J, Hidalgo C, Iglesias M, Jiménez G, Jiménez M, Kindelan J, Laparra J, López I, Lera R, Lloret T, Marín M, Lacasa XM, Martínez E, Martínez A, Medina J, Melero C, Milà C, Millet J, Mir I, Molina F, Morales C, Morales M, Moreno A, Moreno V, Muñoz A, Muñoz C, Muñoz J, Muñoz L, Oribe M, Parra I, Penas A, Pérez J, Rivas P, Rodríguez J, Ruiz-Manzano J, Sala J, Sandel D, Sánchez M, Sánchez M, Sánchez P, Santamaría I, Sanz F, Serrano A, Somoza M, Tabernero E, Trujillo E, Valencia E, Valiño P, Vargas A, Vidal I, Vidal R, Villanueva M, Villar A, Vizcaya M, Zabaleta M, Zubillaga G. Factors Associated With Extrapulmonary Tuberculosis in Spain and Its Distribution in Immigrant Population. Open Respiratory Archives 2020. [DOI: 10.1016/j.opresp.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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12
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Reigadas E, Bouza E, Olmedo M, Vázquez-Cuesta S, Villar-Gómara L, Alcalá L, Marín M, Rodríguez-Fernández S, Valerio M, Muñoz P. Faecal microbiota transplantation for recurrent Clostridioides difficile infection: experience with lyophilized oral capsules. J Hosp Infect 2019; 105:319-324. [PMID: 31883938 DOI: 10.1016/j.jhin.2019.12.022] [Citation(s) in RCA: 14] [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: 10/07/2019] [Accepted: 12/18/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Faecal microbiota transplantation (FMT) is a highly effective approach for refractory and recurrent Clostridioides difficile infection (CDI). Despite its excellent efficacy, FMT is not yet a routine procedure in most centres. There is very little experience with FMT based on lyophilized capsules, and data from European institutions are lacking. This article describes our experience with FMT to treat recurrent CDI using lyophilized oral capsules. METHODS A prospectively recorded single-centre case series of patients with recurrent CDI who underwent FMT between January 2018 and May 2019 were analysed. The primary outcome was defined as resolution of CDI without recurrences over a two-month period. Overall resolution was defined as resolution of diarrhoea without recurrence of CDI within two months after a further cycle of FMT. The FMT process involved oral ingestion of four or five lyophilized capsules in a single dose. All stool donors were rigorously screened. FINDINGS FMT was performed in 32 patients. Primary cure was achieved in 81.3% of patients, and the overall cure rate was 87.5%. FMT via lyophilized capsules was well tolerated. No FMT procedure-related adverse events and no further complications were observed for lyophilized-capsule FMT. CONCLUSIONS This initial clinical experience suggests that FMT based on oral lyophilized preparations is a safe, well-tolerated, and highly effective treatment for recurrent CDI. Administration of oral lyophilized capsules seems feasible in hospital routine and will enable FMT to be more widely used.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Olmedo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - S Vázquez-Cuesta
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Villar-Gómara
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - S Rodríguez-Fernández
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Valerio
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
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13
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Reigadas E, Alcalá L, Marín M, Martin A, Muñoz P, Bouza E. Prediction of poor outcome in Clostridioides difficile infection: A multicentre external validation of the toxin B amplification cycle. Anaerobe 2019; 61:102079. [PMID: 31356959 DOI: 10.1016/j.anaerobe.2019.102079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 02/08/2023]
Abstract
Classification of patients according to their risk of poor outcomes in Clostridioides difficile infection (CDI) would enable implementation of costly new treatment options in a subset of patients at higher risk of poor outcome. In a previous study, we found that low toxin B amplification cycle thresholds (Ct) were independently associated with poor outcome CDI. Our objective was to perform a multicentre external validation of a PCR-toxin B Ct as a marker of poor outcome CDI. We carried out a multicentre study (14 hospitals) in which the characteristics and outcome of patients with CDI were evaluated. A subanalysis of the results of the amplification curve of real-time PCR gene toxin B (XpertTM C. difficile) was performed. A total of 223 patients were included. The median age was 73.0 years, 50.2% were female, and the median Charlson index was 3.0. The comparison of poor outcome and non-poor outcome CDI episodes revealed, respectively, the following results: median age (years), 77.0 vs 72.0 (p = 0.009); patients from nursing homes, 24.4% vs 10.8% (p = 0.039); median leukocytes (cells/μl), 10,740.0 vs 8795.0 (p = 0.026); and median PCR-toxin B Ct, 23.3 vs 25.4 (p = 0.004). Multivariate analysis showed that a PCR-toxin B Ct cut-off <23.5 was significantly and independently associated with poor outcome CDI (p = 0.002; OR, 3.371; 95%CI, 1.565-7.264). This variable correctly classified 68.5% of patients. The use of this microbiological marker could facilitate early selection of patients who are at higher risk of poor outcome and are more likely to benefit from newer and more costly therapeutic options.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Martin
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
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Rejili M, Msaddak A, Filali I, Benabderrahim MA, Mars M, Marín M. New chromosomal lineages within Microvirga and Bradyrhizobium genera nodulate Lupinus angustifolius growing on different Tunisian soils. FEMS Microbiol Ecol 2019; 95:5537381. [DOI: 10.1093/femsec/fiz118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 07/17/2019] [Indexed: 11/13/2022] Open
Abstract
ABSTRACTThirty-one rhizobial isolates nodulating native Lupinus angustifolius (blue lupine) plants growing in Northern Tunisian soils were isolated and analysed using different chromosomal and symbiotic gene markers. Phylogenetic analyses based on recA partial sequences grouped them into at least five groups: four of them within the genus Bradyrhizobium (26 isolates) and one into the genus Microvirga (5 isolates). Representative strains were analysed by multilocus sequence analysis of three housekeeping genes rrs-recA-glnII and rrs-gyrB-dnaK for Bradyrhizobium and Microvirga isolates, respectively. Based on this analysis, eight isolates clustered with the previously described strains Bradyrhizobium lupini USDA3051 and Bradyrhizobium canariense BTA-1. However, five of the isolates clustered separately and may constitute a new species within the Bradyrhizobium genus. The remaining five isolates were closely related to the strain Microvirga sp. LmiM8 and may constitute a new Microvirga species. The analysis of the nodC gene showed that all Bradyrhizobium strains nodulating blue lupine belong to the symbiovar genistearum, whereas the Microvirga isolates are associated with the symbiovar mediterranense. The results of this study support that the L. angustifolius root nodule symbionts isolated in Northern Tunisia belong mostly to the B. canariense/B. lupini lineages. However, new clades of Bradyrhizobium and Microvirga have been identified as L. angustifolius endosymbionts.
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Affiliation(s)
- M Rejili
- Laboratory of Biodiversity and Valorization of Arid Areas Bioresources (BVBAA) – Faculty of Sciences of Gabes, University of Gabes, Erriadh, Zrig 6072, Gabes, Tunisia
| | - A Msaddak
- Laboratory of Biodiversity and Valorization of Arid Areas Bioresources (BVBAA) – Faculty of Sciences of Gabes, University of Gabes, Erriadh, Zrig 6072, Gabes, Tunisia
| | - I Filali
- College of Computer and Information Sciences, Princess Nourah bint Abdulrahman University, Riyadh PO Box 84428, Saudi Arabia
| | - M A Benabderrahim
- Arid and Oases Cropping Laboratory, Arid Area Institute, Gabes 6051, Tunisia
| | - M Mars
- Laboratory of Biodiversity and Valorization of Arid Areas Bioresources (BVBAA) – Faculty of Sciences of Gabes, University of Gabes, Erriadh, Zrig 6072, Gabes, Tunisia
| | - M Marín
- Institute of Genetics, Ludwig Maximilians University of Munich (LMU), Grosshaderner Str. 2–4, D-82152 Martinsried, Germany
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Martín V, Cárdenas N, Ocaña S, Marín M, Arroyo R, Beltrán D, Badiola C, Fernández L, Rodríguez JM. Rectal and Vaginal Eradication of Streptococcus agalactiae (GBS) in Pregnant Women by Using Lactobacillus salivarius CECT 9145, A Target-specific Probiotic Strain. Nutrients 2019; 11:E810. [PMID: 30974819 PMCID: PMC6521265 DOI: 10.3390/nu11040810] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 12/14/2022] Open
Abstract
Streptococcus agalactiae (Group B Streptococci, GBS) can cause severe neonatal sepsis. The recto-vaginal GBS screening of pregnant women and intrapartum antibiotic prophylaxis (IAP) to positive ones is one of the main preventive options. However, such a strategy has some limitations and there is a need for alternative approaches. Initially, the vaginal microbiota of 30 non-pregnant and 24 pregnant women, including the assessment of GBS colonization, was studied. Among the Lactobacillus isolates, 10 Lactobacillus salivarius strains were selected for further characterization. In vitro characterization revealed that L. salivarius CECT 9145 was the best candidate for GBS eradication. Its efficacy to eradicate GBS from the intestinal and vaginal tracts of pregnant women was evaluated in a pilot trial involving 57 healthy pregnant women. All the volunteers in the probiotic group (n = 25) were GBS-positive and consumed ~9 log10 cfu of L. salivarius CECT 9145 daily from week 26 to week 38. At the end of the trial (week 38), 72% and 68% of the women in this group were GBS-negative in the rectal and vaginal samples, respectively. L. salivarius CECT 9145 seems to be an efficient method to reduce the number of GBS-positive women during pregnancy, decreasing the number of women receiving IAP during delivery.
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Affiliation(s)
- Virginia Martín
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain.
| | - Nivia Cárdenas
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain.
| | - Sara Ocaña
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain.
- Unidad de Reproducción, Fundación Hospital Alcorcón, 28922 Alcorcón, Spain.
| | - María Marín
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain.
| | - Rebeca Arroyo
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain.
| | - David Beltrán
- Centro de Diagnóstico Médico, Ayuntamiento de Madrid, 28006 Madrid, Spain.
| | - Carlos Badiola
- Laboratorios Casen Recordati S.L., Vía de las Dos Castillas, 33, 28224 Pozuelo de Alarcón, Madrid, Spain.
| | - Leónides Fernández
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain.
| | - Juan M Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain.
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Delucchi A, Marín M, Páez O, Bendersky M, Rodríguez P. Principales conclusiones del Consenso Argentino de Hipertensión Arterial. Hipertensión y Riesgo Vascular 2019; 36:96-109. [DOI: 10.1016/j.hipert.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/28/2018] [Accepted: 01/07/2019] [Indexed: 01/13/2023]
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17
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Quintanilla-Bordás C, Castro-Izaguirre E, Carcelén-Gadea M, Marín M. The first reported case of drug-induced hemolytic anemia caused by dimethyl fumarate in a patient with multiple sclerosis. Transfusion 2019; 59:1648-1650. [PMID: 30702749 DOI: 10.1111/trf.15151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/22/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Drug-induced hemolytic anemia is a rare and potentially fatal complication of drug treatment. Specific laboratory tests are crucial to confirm the diagnosis. CASE REPORT A 38-year-old woman on treatment with dimethyl fumarate for multiple sclerosis presented with a 7-day history of weakness and fatigue. Laboratory tests revealed profound hemolytic anemia with hemoglobin levels of 4.7 g/dL (reference, 12.5-16.0), decreased haptoglobin, increased reticulocyte count, and increased indirect bilirubin. A first direct antiglobulin test was negative. The patient was started on prednisone 1 mg/kg/day, and dimethyl fumarate was withdrawn. A blood sample was drawn on Day 7 and sent to a reference laboratory. A direct antiglobulin test performed 7 days later was positive. Furthermore, an indirect antiglobulin test was positive only in the presence of the drug. RESULTS The patient did not receive a blood transfusion, recovered clinically during the following days, and was discharged on Day 7. On Day 36, the patient's RBCs had normalized. She was changed to another disease-modifying treatment for her multiple sclerosis, and at 10-month follow-up she remained stable without any notable adverse effects. CONCLUSION This case describes the first report of a dimethyl fumarate-induced hemolytic anemia. Laboratory results should always be interpreted within the clinical context. Specific laboratory expertise is often needed, given the complexity of the field.
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Affiliation(s)
- Carlos Quintanilla-Bordás
- Department of Neurology, Consorci Hospital General Universitari de Valencia, Neurology, Valencia, Spain
| | - Emma Castro-Izaguirre
- Centro de Transfusión de la Comunidad Valenciana, Conselleria de Sanitat, Valencia, Spain
| | - María Carcelén-Gadea
- Department of Neurology, Consorci Hospital General Universitari de Valencia, Neurology, Valencia, Spain
| | - María Marín
- Department of Hematology, Consorci Hospital General Universitari de Valencia, Valencia, Spain
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Acosta F, Pérez-Lago L, Ruiz Serrano M, Marín M, Kohl T, Lozano N, Niemann S, Valerio M, Olmedo M, Pérez-Granda M, Pérez Pérez M, Bouza E, Muñoz P, García de Viedma D. Fast update of undetected Mycobacterium chimaera infections to reveal unsuspected cases. J Hosp Infect 2018; 100:451-455. [DOI: 10.1016/j.jhin.2018.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
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19
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Marín M, Ruiz A, Iglesias C, Quiroga L, Cercenado E, Martín-Rabadán P, Bouza E, Rodríguez-Sánchez B. Identification of Nocardia species from clinical isolates using MALDI-TOF mass spectrometry. Clin Microbiol Infect 2018; 24:1342.e5-1342.e8. [PMID: 29933050 DOI: 10.1016/j.cmi.2018.06.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/10/2018] [Accepted: 06/09/2018] [Indexed: 11/18/2022]
Abstract
The identification of Nocardia isolates still represents a challenge for matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) despite its acceptance for most bacterial and fungal isolates. In this study we evaluate the identification of Nocardia isolates using direct spotting and an updated database. Overall, 82 Nocardia isolates belonging to 13 species were identified by DNA sequence analysis of the 16S rRNA and secA1 genes. Nine of these well-characterized isolates from 6 Nocardia species were used to create an in-house library. The remaining 73 isolates were directly spotted on the target plate and on-plate protein extraction was performed. The protein spectra obtained were analyzed by MALDI-TOF MS using the BDAL database (Bruker Daltonics) updated with 6,903 MSPs or the combination of this commercial database and our in-house library. As a result, the use of the commercial database alone and in combination with the in-house library yielded 94.5% and 95.9% of correct species-level identifications, respectively, No isolate was misidentified at the genus level with either database. Besides, the use of the in-house library allowed the species-level identification of a N. otitidiscaviarum isolate that could only be identified at the genus-level with a score value <1.6 using the commercial database. In conclusion, the implementation of the direct spotting method and the in-house database provided a high rate of correct species assignment of Nocardia isolates despite the low number of isolates added. Further addition of well-characterized Nocardia isolates may ensure the rapid, accurate and inexpensive identification of most isolates encountered in the routine of the microbiology laboratory.
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Affiliation(s)
- M Marín
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - A Ruiz
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - C Iglesias
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - L Quiroga
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - E Cercenado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - P Martín-Rabadán
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Belén Rodríguez-Sánchez
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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20
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Marín M, Gudiol C, Castet F, Oliva M, Peiró I, Royo-Cebrecos C, Carratalà J, Mesia R. Bloodstream infection in patients with head and neck cancer: a major challenge in the cetuximab era. Clin Transl Oncol 2018; 21:187-196. [PMID: 29948973 DOI: 10.1007/s12094-018-1905-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/28/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE To assess the impact of bloodstream infection (BSI) in patients with head and neck cancer (HNC) in the cetuximab era. METHODS We prospectively analysed the epidemiology, microbiology and outcomes of 51 BSI episodes occurring in 48 patients with HNC (2006-2017). We performed a retrospective matched-cohort study (1:2) to determine the risk factors for BSI. Finally, we compared patients who died with those who survived to identify risk factors for mortality. RESULTS The most frequent HNC localization was the oropharynx (43%), and pneumonia was the most frequent source (25%). Gram-positive BSI occurred in 55% cases, mainly due to Streptococcus pneumoniae (21%), and among Gram-negatives, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most frequent. Hypoalbuminemia (OR 8.4; 95% CI, 3.5-19.9), previous chemotherapy (OR, 3.2; 95% CI, 1.3-7.4) and cetuximab therapy (OR, 2.8; 95% CI, 1.6-6.7) were significant risk factors for BSI. Patients with BSI had a higher overall case-fatality rate than patients without BSI (OR, 4.4; 95% CI, 1.7-11.8). Hypoalbuminemia was an independent risk factor for the early (7 day) and overall (30 day) case-fatalities, with ORs of 0.8 (95% CI, 0.6-0.9) and 0.8 (95% CI, 0.7-0.97), respectively. The presence of comorbidities (OR, 7; 95% CI, 1.4-34) was also an independent risk factor for overall case-fatality. CONCLUSIONS BSI causes high mortality in patients with HNC and is most often secondary to pneumonia. It occurs mainly among patients with hypoalbuminemia who receive treatment with cetuximab or chemotherapy. The development of BSI in patients with HNC impairs their outcome, especially in the presence of hypoalbuminemia and comorbidities.
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Affiliation(s)
- M Marín
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain
| | - C Gudiol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain. .,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain. .,REIPI (Spanish Network for Research in Infectious Diseases), Barcelona, Spain. .,Department of Medicine, University of Barcelona, Barcelona, Spain.
| | - F Castet
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain
| | - M Oliva
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain
| | - I Peiró
- IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain.,Clinical Nutrition Unit, Catalan Institute of Oncology (ICO), L'Hospitalet, Barcelona, Spain
| | - C Royo-Cebrecos
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain.,REIPI (Spanish Network for Research in Infectious Diseases), Barcelona, Spain
| | - J Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain.,REIPI (Spanish Network for Research in Infectious Diseases), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - R Mesia
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet, Barcelona, Spain.,IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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Mediano P, Fernández L, Jiménez E, Arroyo R, Espinosa-Martos I, Rodríguez JM, Marín M. Response to the Letter to the Editor by Cullinane & Amir. J Hum Lact 2017; 33:817-818. [PMID: 28817349 DOI: 10.1177/0890334417726059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Reigadas E, Muñoz-Pacheco P, Vázquez-Cuesta S, Alcalá L, Marín M, Martin A, Bouza E. Rifaximin-resistant Clostridium difficile strains isolated from symptomatic patients. Anaerobe 2017; 48:269-272. [PMID: 28988773 DOI: 10.1016/j.anaerobe.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 07/28/2017] [Revised: 09/14/2017] [Accepted: 10/05/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rifaximin has been proposed as an alternative treatment for specific cases of Clostridium difficile infection (CDI) and intestinal decontamination. Rifaximin-resistant C. difficile has occasionally been reported. Antibiotic susceptibility testing relies on anaerobic agar dilution (reference method), which is cumbersome and not routinely used. There is no commercial test for detection of resistance to rifaximin. OBJECTIVES To assess resistance to rifaximin by C. difficile and to evaluate the correlation between the results of the rifampicin E-test and susceptibility to rifaximin. METHODS We compared the in vitro susceptibility of clinical CDI isolates to rifaximin over a 6-month period using the agar dilution method with susceptibility to rifampicin using the E-test. All isolates were characterized using PCR-ribotyping. Clinical data were recorded prospectively. RESULTS We recovered 276 consecutive C. difficile isolates and found that 32.2% of episodes were caused by rifaximin-resistant strains. The MICs for rifaximin ranged from <0.0009-256 mg/L, with a geometric mean (GM) of 0.256 mg/L, an MIC50/90 of 0.015/>256 mg/L. Rifaximin and rifampicin MICs were comparable, and all strains classed as resistant by agar dilution were correctly classified as resistant by E-test. The most common ribotypes were 001 (37.2%), 078/126 (14.3%), and 014 (12.0%). Ribotype 001 exhibited the highest MICs for rifaximin. CONCLUSIONS Resistance to rifaximin was common; resistance rates were higher in ribotype 001 strains. Susceptibility to rifaximin determined by agar dilution correlated with susceptibility to rifampicin determined using the E-test, including rifaximin-resistant strains. Our results suggest that the rifampicin E-test is a valid method for the prediction of rifaximin-resistant C. difficile.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - P Muñoz-Pacheco
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - S Vázquez-Cuesta
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Martin
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
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Martinez Vila C, Fernández-Morales LA, Oliveres H, Marín M, Ribera P, Pardo JC, Dalmau E, Segui MA. Fulvestrant plus LHRH analogues in male with synchronous breast and prostate cancer. Ann Oncol 2017; 28:2027-2028. [PMID: 28444131 DOI: 10.1093/annonc/mdx198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- C Martinez Vila
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | | | - H Oliveres
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - M Marín
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - P Ribera
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - J C Pardo
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - E Dalmau
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - M A Segui
- Department of Oncology, Corporacio Sanitaria Parc Tauli, Sabadell, Spain
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Jiménez E, Arroyo R, Cárdenas N, Marín M, Serrano P, Fernández L, Rodríguez JM. Mammary candidiasis: A medical condition without scientific evidence? PLoS One 2017; 12:e0181071. [PMID: 28704470 PMCID: PMC5509296 DOI: 10.1371/journal.pone.0181071] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 06/26/2017] [Indexed: 01/10/2023] Open
Abstract
Many physicians, midwives and lactation consultants still believe that yeasts (particularly Candida spp.) play an important role as an agent of nipple and breast pain despite the absolute absence of scientific proofs to establish such association. In this context, the objective of this study was to investigate the microorganisms involved in sore nipples and/or painful "shooting" breastfeeding by using a variety of microscopy techniques, as well as culture-dependent and-independent identification methods. Initially, 60 women (30 diagnosed as suffering "mammary candidiasis" and 30 with no painful breastfeeding) were recruited to elucidate the role of their pumps on the milk microbial profiles. After realizing the bias introduced by using such devices, manual expression was selected as the collection method for the microbiological analysis of milk samples provided by 529 women with symptoms compatible with "mammary candidiasis". Nipple swabs and nipple biopsy samples were also collected from the participating women. Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal. In contrast, our results strongly support that coagulase-negative staphylococci and streptococci (mainly from the mitis and salivarius groups) are the agents responsible for such cases. As a consequence, and following the recommendations of the US Library of Medicine for the nomenclature of infectious diseases, the term "mammary candidiasis" or "nipple thrush" should be avoided when referring to such condition and replaced by "subacute mastitis".
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Affiliation(s)
- Esther Jiménez
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Rebeca Arroyo
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Nivia Cárdenas
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - María Marín
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Pilar Serrano
- Unidadde Endocrinología y Nutrición, Hospital Virgen del Rocío, Seville, Spain
| | - Leonides Fernández
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Juan M. Rodríguez
- Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
- * E-mail:
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Marín M, Arroyo R, Espinosa-Martos I, Fernández L, Rodríguez JM. Identification of Emerging Human Mastitis Pathogens by MALDI-TOF and Assessment of Their Antibiotic Resistance Patterns. Front Microbiol 2017; 8:1258. [PMID: 28747897 PMCID: PMC5506187 DOI: 10.3389/fmicb.2017.01258] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 05/03/2017] [Accepted: 06/23/2017] [Indexed: 12/29/2022] Open
Abstract
Lactational mastitis constitutes one of the main causes of undesired weaning, depriving the mother–infant pair from the benefits of breastfeeding; therefore, this condition should be considered a relevant public health issue. The role of specific microorganisms remains unclear since human milk cultures and antibiotic susceptibility testing (AST) are not routinely performed, despite the fact that this would be key to ensure an early and effective diagnosis and treatment. The objective of this study was to describe the culturable microbial diversity in 647 milk samples from breastfeeding women with clinical symptoms of mastitis by Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) VITEK MS technology and to analyze the antimicrobial susceptibility profiles of a collection of isolates from these samples by the VITEK 2 AST system. Staphylococcus epidermidis was the most common species isolated from mastitis samples (87.6%), while Staphylococcus aureus was detected in 22.1%. Streptococci constituted the second (68.6%) most prevalent bacterial group, with Streptococcus mitis/oralis, Streptococcus salivarius, and Streptococcus parasanguinis detected with frequencies of 40.8, 36.8, and 14.4%, respectively. The antibiotic susceptibility profiles of 642 staphylococcal isolates indicated a remarkable resistance to benzylpenicillin (88.3%) and erythromycin (67.3%) with differences between species. A high percentage of Staphylococcus isolates were resistant to at least one antibiotic (Staphylococcus hominis, 100%; S. epidermidis, 98.2%; S. aureus, 92.9%; Staphylococcus lugdunensis, 90.5%) and the percentage of multidrug-resistance (MDR) isolates was noticeable (S. hominis, 81%; S. epidermidis, 64.4%; S. aureus, 11.5%; S. lugdunensis, 10.5%). In relation to streptococcal isolates (n = 524), AST revealed high or moderate percentages of resistance to erythromycin (68.7%), benzylpenicillin (63.7%), ampicillin (51.5%), and tetracycline (30.8%). Antibiotic resistance to at least one antibiotic was detected in 97.6% of S. parasanguinis, 92.6% of S. salivarius, 83.3% of S. mitis/oralis, and 72.4% of Streptococcus vestibularis isolates. A significant number of MDR streptococcal isolates was also found (S. parasanguinis, 51.2%; S. salivarius, 39.3%; S. mitis/oralis, 34.6%; and S. vestibularis, 19%). The results highlight the important role of coagulase-negative staphylococci and streptococci as human mastitis-causing agents. Moreover, the high rates of antimicrobial resistance among these microorganisms must be contemplated as an issue of clinical relevance in relation to treatment options.
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Affiliation(s)
- María Marín
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de MadridMadrid, Spain
| | | | | | - Leónides Fernández
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de MadridMadrid, Spain
| | - Juan M Rodríguez
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de MadridMadrid, Spain
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Mediano P, Fernández L, Jiménez E, Arroyo R, Espinosa-Martos I, Rodríguez JM, Marín M. Microbial Diversity in Milk of Women With Mastitis: Potential Role of Coagulase-Negative Staphylococci, Viridans Group Streptococci, and Corynebacteria. J Hum Lact 2017; 33:309-318. [PMID: 28418794 DOI: 10.1177/0890334417692968] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lactational mastitis constitutes a significant cause of premature weaning. However, its etiology, linked to the presence of pathogenic microorganisms, has been scarcely reported. Research aim: The aim of this study was to describe the microbial diversity in milk samples from women suffering from lactational mastitis and to identify more accurately a collection of isolates belonging to coagulase-negative staphylococci, streptococci, and coryneform bacteria. METHODS This is a cross-sectional descriptive one-group study. A total of 5,009 isolates from 1,849 mastitis milk samples was identified by culture, biochemical, and/or molecular methods at the species or genus level. A more precise identification of a collection of 211 isolates was carried out by 16S rRNA gene sequencing. RESULTS Mean total bacterial count in milk samples was 4.11 log10 colony-forming units/ml, 95% confidence interval [4.08, 4.15]. Staphylococcus epidermidis was the most common species being isolated from 91.56% of the samples, whereas Staphylococcus aureus was detected in 29.74%. Streptococci and corynebacteria constituted the second (70.20%) and third (16.60%) most prevalent bacterial groups, respectively, found in this study. In contrast, Candida spp. was present in only 0.54% of the samples. Sequencing of the 16S rRNA gene revealed a high diversity of bacterial species among identified isolates. CONCLUSION Many coagulase-negative staphylococci, viridans group streptococci, and corynebacteria, usually dismissed as contaminant bacteria, may play an important role as etiologic agents of mastitis. Proper diagnosis of mastitis should be established after performing microbiological testing of milk based on standardized procedures. A reliable analysis must identify the mastitis-causing pathogen(s) at the species level and its(their) concentration(s).
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Affiliation(s)
- Pilar Mediano
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Leonides Fernández
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Esther Jiménez
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Rebeca Arroyo
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Irene Espinosa-Martos
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain.,2 Probisearch SL, Tres Cantos, Madrid, Spain
| | - Juan M Rodríguez
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - María Marín
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
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Reigadas E, Alcalá L, Marín M, Martín A, Bouza E. C. difficile PCR-ribotype 023 might go undetected when using ChromId C. difficile agar. Anaerobe 2017; 44:34-35. [PMID: 28108388 DOI: 10.1016/j.anaerobe.2017.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/16/2016] [Revised: 01/10/2017] [Accepted: 01/14/2017] [Indexed: 01/05/2023]
Abstract
We compared the performance of the new chromogenic medium ChromID C. difficile with that of CLO agar. ChromID C. difficile agar is a sensitive medium that can accelerate the presumptive identification of C. difficile, however ribotype 023 might go undetected when using this chromogenic medium.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Martín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
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Vena A, Muñoz P, Valerio M, Rodríguez-Creixéms M, Marín M, Martínez Jiménez M, Martínez Sellés M, Rodríguez Abella H, Bouza E. 11. Endocarditis fúngica: aún muchas controversias pendientes. Cirugía Cardiovascular 2017. [DOI: 10.1016/j.circv.2016.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Barbosa E, Marín M, Giraldo CE, Uribe S, Freitas A. Corrigendum. Neotropical Biodiversity 2017. [DOI: 10.1080/23766808.2017.1383668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Martín V, Mediano P, Del Campo R, Rodríguez JM, Marín M. Streptococcal Diversity of Human Milk and Comparison of Different Methods for the Taxonomic Identification of Streptococci. J Hum Lact 2016; 32:NP84-NP94. [PMID: 26261225 DOI: 10.1177/0890334415597901] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The genus Streptococcus is 1 of the dominant bacterial groups in human milk, but the taxonomic identification of some species remains difficult. OBJECTIVE The objective of this study was to investigate the discriminatory ability of different methods to identify streptococcal species in order to perform an assessment of the streptococcal diversity of human milk microbiota as accurately as possible. METHODS The identification of 105 streptococcal strains from human milk was performed by 16S rRNA, tuf, and sodA gene sequencing, phylogenetic analysis, and Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) mass spectrometry. RESULTS Streptococcus salivarius, Streptococcus mitis, and Streptococcus parasanguinis were the streptococcal dominant species in the human milk microbiota. Sequencing of housekeeping genes allowed the classification of 96.2% (16S rRNA), 84.8% ( sodA), and 88.6% ( tuf) of the isolates. Phylogenetic analysis showed 3 main streptococcal clusters corresponding with the mitis (73 isolates), salivarius (29), mutans (1)-pyogenic (2) groups, but many of the mitis group isolates (36) could not be assigned to any species. The application of the MALDI-TOF Bruker Biotyper system resulted in the identification of 56 isolates (53.33%) at the species level, but it could not discriminate between S pneumoniae and S mitis isolates, in contrast to the Vitek-MS system. CONCLUSION There was a good agreement among the different methods assessed in this study to identify those isolates of the salivarius, mutans, and pyogenic groups, whereas unambiguous discrimination could not be achieved concerning some species of the mitis group ( S mitis, S pneumoniae, S pseudopneumoniae, S oralis).
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Affiliation(s)
- Virginia Martín
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Pilar Mediano
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Rosa Del Campo
- 2 Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juan M Rodríguez
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - María Marín
- 1 Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
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Reigadas E, Alcalá L, Marín M, Pelaéz T, Martin A, Iglesias C, Bouza E. In vitro activity of surotomycin against contemporary clinical isolates of toxigenic Clostridium difficile strains obtained in Spain. J Antimicrob Chemother 2016; 71:3319. [PMID: 27402007 DOI: 10.1093/jac/dkw267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Reigadas E, Alcalá L, Valerio M, Marín M, Martin A, Bouza E. Toxin B PCR cycle threshold as a predictor of poor outcome of Clostridium difficile infection: a derivation and validation cohort study. J Antimicrob Chemother 2016; 71:1380-5. [PMID: 26869691 DOI: 10.1093/jac/dkv497] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/19/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Prediction of patients with poor outcome is necessary in order to plan the proper management of Clostridium difficile infection (CDI); however, clinical criteria are insufficient. In a previous study, we observed that high toxigenic C. difficile cfu stool counts at diagnosis were associated with a poor outcome. Our objective was to investigate the role of the PCR toxin B amplification cycle threshold (Ct) in the prediction of CDI poor outcome and to derive and validate a high-risk prediction rule using this marker. METHODS We prospectively included patients with CDI (derivation cohort, January 2013 to June 2014; and validation cohort, December 2014 to May 2015), who were followed for at least 2 months after their last episode/recurrence. All samples were tested with Xpert™ C. difficile. RESULTS For the derivation cohort (n = 129) toxin B Ct was independently associated with poor outcome (P < 0.001). The receiver operating characteristic (ROC) curve yielded an AUC of 0.816. Using a cut-off of <23.5 cycles for high risk of poor outcome, the diagnostic accuracy was 81.4%, the sensitivity was 46.5% (95% CI 32.5-61.1) and the specificity was 98.8% (95% CI 93.7-99.8). For the validation cohort (n = 170), the diagnostic accuracy was 81.8%, the sensitivity was 88.4% (95% CI 75.5-94.9) and the specificity was 79.5% (95% CI 71.7-85.6). The ROC curve yielded an AUC of 0.857. CONCLUSIONS Low toxin B Ct values from samples collected at the initial moment of diagnosis appears to be a strong marker for poor outcome. This available test may identify, at an early stage, patients who are at higher risk of a poor outcome CDI.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Valerio
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Martin
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
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Reigadas E, Alcalá L, Marín M, Muñoz-Pacheco P, Catalán P, Martin A, Bouza E. Clinical significance of direct cytotoxicity and toxigenic culture in Clostridium difficile infection. Anaerobe 2016; 37:38-42. [DOI: 10.1016/j.anaerobe.2015.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 02/07/2023]
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Vallejo J, Marín M, Sánchez L, Saldarriaga A. Clear cell hipernefroma in horseshoe kidney – mandibular metastases. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Reigadas E, Alcalá L, Marín M, Pelaéz T, Martin A, Iglesias C, Bouza E. In vitro activity of surotomycin against contemporary clinical isolates of toxigenic Clostridium difficile strains obtained in Spain. J Antimicrob Chemother 2015; 70:2311-5. [PMID: 25876881 DOI: 10.1093/jac/dkv092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 11/17/2014] [Accepted: 03/18/2015] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhoea in developed countries. Metronidazole and vancomycin are the mainstay of treatment, although they are associated with treatment failure and recurrence. Novel agents have emerged to address these shortcomings. We investigated the in vitro activity of a novel agent, surotomycin (formerly CB-183,315), and seven other antimicrobial agents against clinical C. difficile isolates. METHODS Antimicrobial susceptibility to surotomycin, fidaxomicin, metronidazole, vancomycin, clindamycin, rifaximin, moxifloxacin and tigecycline was determined for 100 contemporary clinical isolates of C. difficile collected in 2013. MICs were determined by agar dilution according to CLSI procedures. In addition, 10 strains with reduced susceptibility to metronidazole (n = 6) and vancomycin (n = 4) were also tested. Strains were PCR ribotyped. RESULTS The MICs of surotomycin for the 100 isolates ranged from ≤0.06 to 2 mg/L, with a geometric mean (GM) of 0.31 mg/L and an MIC50/90 of 0.25/0.5 mg/L. The MIC range of surotomycin was 0.25-1 mg/L (GM = 0.45 mg/L) for isolates with reduced metronidazole susceptibility and 0.125-0.5 mg/L (GM = 0.25 mg/L) for isolates with reduced vancomycin susceptibility. The three most common ribotypes were 001 (31.0%), 014/020 (17.0%) and 078/126 (17.0%). Ribotype 014/020 exhibited the lowest MICs of surotomycin (GM = 0.22 mg/L); the highest MICs were for ribotype 078/126 (GM = 0.72 mg/L). CONCLUSIONS Surotomycin exhibited potent in vitro activity against all the isolates tested, including those with elevated metronidazole and vancomycin MICs. The potential role of this agent in the treatment of CDI requires further clinical evaluation.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - T Pelaéz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Martin
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - C Iglesias
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
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Dávila Fajardo CL, Díaz Villamarín X, Morón Romero R, Gonzalez Medina M, Marín M, Cabeza Barrera J. CP-014 Parenteral nutrition, is standarization acceptable? Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bouza E, Rodríguez-Créixems M, Alcalá L, Marín M, De Egea V, Braojos F, Muñoz P, Reigadas E. Is Clostridium difficile infection an increasingly common severe disease in adult intensive care units? A 10-year experience. J Crit Care 2015; 30:543-9. [PMID: 25791766 DOI: 10.1016/j.jcrc.2015.02.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 10/22/2014] [Revised: 01/29/2015] [Accepted: 02/20/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE Despite the high concentration of patients with known risk factors for Clostridium difficile infection (CDI) in intensive care units (ICUs), data on ICU patients are scarce. The aim of this study was describe the incidence, clinical characteristics, and evolution of CDI in critically ill patients. MATERIALS AND METHODS From 2003 to 2012, adult patients admitted to an ICU (A-ICU) and positive for CDI were included and classified as follows: pre-ICU, if the positive sample was obtained within ±3 days of ICU admission; in-ICU, if obtained after 3 days of ICU admission and up to 3 days after ICU discharge. RESULTS We recorded 4095 CDI episodes, of which 328 were A-ICU (8%). Episodes of A-ICU decreased from 19.4 to 8.7 per 10000 ICU days of stay (P < .0001). Most A-ICU CDIs (66.3%) were mild to moderate. Pre-ICU episodes accounted for 16.2% and were more severe complicated than in-ICU episodes (11% vs 0%; P = .020). Overall mortality was 28.6%, and CDI-attributable mortality was only 3%. CONCLUSION The incidence of A-ICU CDI has decreased steadily over the last 10 years. A significant proportion of A-ICU CDI episodes are pre-ICU and are more severe than in-ICU CDI episodes. Most episodes of A-ICU CDI were nonsevere, with low associated mortality.
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Affiliation(s)
- E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain.
| | - M Rodríguez-Créixems
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain
| | - V De Egea
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain
| | - F Braojos
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Palma de Mallorca, Spain
| | - E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio, Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio, Marañón, Madrid, Spain.
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Marín M, Gudiol C, Ardanuy C, Garcia-Vidal C, Jimenez L, Domingo-Domenech E, Pérez FJ, Carratalà J. Factors influencing mortality in neutropenic patients with haematologic malignancies or solid tumours with bloodstream infection. Clin Microbiol Infect 2015; 21:583-90. [PMID: 25680311 DOI: 10.1016/j.cmi.2015.01.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 10/09/2014] [Revised: 01/09/2015] [Accepted: 01/30/2015] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to identify factors influencing mortality in neutropenic patients with haematologic malignancies or solid tumours with bloodstream infection (BSI). All episodes of BSI occurring in adult neutropenic patients with haematologic malignancies or solid tumours were prospectively recorded from January 2006 to December 2013. We analysed the factors influencing mortality in both groups of patients. We documented 602 consecutive episodes of BSI; 510 occurred in patients with haematologic malignancies and 92 in patients with solid tumours. The overall case-fatality rates were 12% and 36%, respectively. Independent risk factors associated with a higher case-fatality rate in patients with haematologic malignancies were: intensive care unit admission (odds ratio (OR), 15.2; 95% confidence interval (CI), 5.4-42.7), advanced neoplasm (OR, 8.7; 95% CI, 2.9-25.7), corticosteroid therapy (OR, 7.0; 95% CI, 3-16.4), multidrug-resistant Gram-negative BSI (OR, 3.8; 95% CI, 1.2-11.8) and a Multinational Association for Supportive Care in Cancer risk score of <21 (OR, 3.1; 95% CI, 1.3-7.4). By contrast, coagulase-negative staphylococci BSI (OR, 0.04; 95% CI, 0.004-0.5) and empirical antibiotic combination therapy (OR, 0.1; 95% CI, 0.05-0.3) were found to be protective. Independent risk factors for overall case-fatality rate in patients with solid tumours were: shock at presentation (OR, 14.3; 95% CI, 3.2-63.8), corticosteroid therapy (OR, 10; 95% CI, 2.3-44) and advanced neoplasm (OR, 7.8; 95% CI, 1.4-41.4). Prognostic factors identified in this study may help to detect those patients at higher risk of death in each group. Medical intervention addressing some of these factors might improve the outcome of BSI in neutropenic patients with haematologic malignancies or solid tumours.
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Affiliation(s)
- M Marín
- Oncology Department, Institut Català d'Oncologia-ICO, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain.
| | - C Gudiol
- Infectious Disease Service, IDIBELL, Hospital Universitari de Bellvitge, Spain; Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos IIII, Madrid, Spain
| | - C Ardanuy
- Microbiology Department, IDIBELL, Hospital Universitari de Bellvitge, Spain
| | - C Garcia-Vidal
- Infectious Disease Service, IDIBELL, Hospital Universitari de Bellvitge, Spain; Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos IIII, Madrid, Spain
| | - L Jimenez
- Oncology Department, Institut Català d'Oncologia-ICO, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - E Domingo-Domenech
- Hematology Department, Institut Català d'Oncologia-ICO, IDIBELL, University of Barcelona, Barcelona, Spain
| | - F J Pérez
- Clinical Research Unit, Institut Català d'Oncologia-ICO, IDIBELL, University of Barcelona, Barcelona, Spain
| | - J Carratalà
- Infectious Disease Service, IDIBELL, Hospital Universitari de Bellvitge, Spain; Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos IIII, Madrid, Spain
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Abstract
The use of culture-dependent and -independent techniques to study the human milk microbiota and microbiome has revealed a complex ecosystem with a much greater diversity than previously anticipated. The potential role of the milk microbiome appears to have implications not only for short- and long-term infant health but also for mammary health. In fact, mammary disbiosis, which may be triggered by a variety of host, microbial and medical factors, often leads to acute, subacute or subclinical mastitis, a condition that represents the first medical cause for undesired weaning. Multiresistance to antibiotics, together with formation of biofilms and mechanisms for evasion of the host immune response, is a common feature among the bacterial agents involved. This explains why this condition uses to be elusive to antibiotic therapy and why the development of new strategies for mastitis management based on probiotics is particularly appealing. In fact, selected lactobacilli strains isolated from breast milk have already shown a high efficacy for treatment.
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Affiliation(s)
- L Fernández
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
| | - R Arroyo
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - I Espinosa
- Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
| | - M Marín
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - E Jiménez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
| | - J M Rodríguez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain Probisearch SL, C/ Santiago Grisolía 2, 28760 Tres Cantos, Spain
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Reigadas E, Alcalá L, Marín M, Burillo A, Muñoz P, Bouza E. Missed diagnosis of Clostridium difficile infection; a prospective evaluation of unselected stool samples. J Infect 2014; 70:264-72. [PMID: 25452039 DOI: 10.1016/j.jinf.2014.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 06/13/2014] [Revised: 09/25/2014] [Accepted: 10/19/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhoea in developed countries, however a high proportion of CDI episodes go undiagnosed, either because physicians do not request identification of toxigenic C. difficile or microbiologists do not perform the appropriate tests. OBJECTIVE To investigate the clinical characteristics of patients with CDI within a non-selected population and to determine risk factors for clinical underdiagnosis. METHODS We conducted a prospective study in which systematic testing for toxigenic C. difficile on all diarrhoeic stool samples was performed regardless of the clinician's request. Patients aged >2 years positive for toxigenic C. difficile and diarrhoea were enrolled (Jan-June 2013) and monitored at least 2 months after their last episode. RESULTS We identified 204 cases of CDI, of which three-quarters were healthcare-associated. Most cases were mild to moderate (83.8%), the recurrence rate was 16.2%, and CDI-related mortality was low (2.5%). A significant proportion (12.7%) of CDI cases would have been missed owing to lack of clinical suspicion. Community-acquired cases and young age were risk factors for clinical underdiagnosis. CONCLUSION Our data support the introduction of a systematic search for toxigenic C. difficile in all diarrhoeic stools from inpatients and outpatients older than 2 years.
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Affiliation(s)
- E Reigadas
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - L Alcalá
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - A Burillo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
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Rodríguez-Sánchez B, Sánchez-Carrillo C, Ruiz A, Marín M, Cercenado E, Rodríguez-Créixems M, Bouza E. Direct identification of pathogens from positive blood cultures using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2014; 20:O421-7. [DOI: 10.1111/1469-0691.12455] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/06/2013] [Accepted: 11/11/2013] [Indexed: 11/27/2022]
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Marín M, Suni M. CARACTERIZACIÓN ANATÓMICA DEL DESARROLLO DE LA RAÍZ RESERVANTE DE CAMOTES PERUANOS (IPOMOEA BATATAS (L.) LAM., CONVOLVULACEAE). Rev peru biol 2014. [DOI: 10.15381/rpb.v7i2.6812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mediano P, Fernández L, Rodríguez JM, Marín M. Case-control study of risk factors for infectious mastitis in Spanish breastfeeding women. BMC Pregnancy Childbirth 2014; 14:195. [PMID: 24902596 PMCID: PMC4063223 DOI: 10.1186/1471-2393-14-195] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 05/29/2014] [Indexed: 01/30/2023] Open
Abstract
Background The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis. Methods We conducted a case–control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors. Results The variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224). Conclusions Valuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition.
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Affiliation(s)
| | | | | | - María Marín
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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Zafrilla G, Iglesias A, Marín M, Torralba L, Dorado-Morales P, Racero JL, Alcaina JJ, Morales LJ, Martínez L, Collantes M, Gómez L, Vilanova C, Porcar M. Towards light-mediated sensing of bacterial comfort. Lett Appl Microbiol 2014; 59:127-32. [PMID: 24785827 DOI: 10.1111/lam.12255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/29/2013] [Revised: 02/25/2014] [Accepted: 03/19/2014] [Indexed: 11/29/2022]
Abstract
UNLABELLED Bacterial comfort is central to biotechnological applications. Here, we report the characterization of different sensoring systems, the first step within a broader synthetic biology-inspired light-mediated strategy to determine Escherichia coli perception of environmental factors critical to bacterial performance. We did so by directly 'asking' bacterial cultures with light-encoded questions corresponding to the excitation wavelength of fluorescent proteins placed under the control of environment-sensitive promoters. We built four genetic constructions with fluorescent proteins responding to glucose, temperature, oxygen and nitrogen; and a fifth construction allowing UV-induced expression of heterologous genes. Our engineered strains proved able to give feedback in response to key environmental factors and to express heterologous proteins upon light induction. This light-based dialoguing strategy reported here is the first effort towards developing a human-bacteria interphase with both fundamental and applied implications. SIGNIFICANCE AND IMPACT OF THE STUDY The results we present here are at the core of a larger synthetic biology research effort aiming at establishing a dialogue with bacteria. The framework is to convert the human voice into electric pulses, these into light pulses exciting bacterial fluorescent proteins, and convert light-emission back into electric pulses, which will be finally transformed into synthetic voice messages. We report here the first results of the project, in the form of light-based determination of key parameters for bacterial comfort. The ultimate goal of this strategy is to combine different engineered populations to have a combined feedback from the pool.
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Affiliation(s)
- G Zafrilla
- Universitat de València (Cavanilles Institute of Biodiversity and Evolutionary Biology), Valencia, Spain
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Cerón I, Muñoz P, Marín M, Segado A, Roda J, Valerio M, Bouza E. Efficacy of daptomycin in the treatment of enterococcal endocarditis: a 5 year comparison with conventional therapy. J Antimicrob Chemother 2014; 69:1669-74. [PMID: 24532682 DOI: 10.1093/jac/dku004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 11/14/2022] Open
Abstract
OBJECTIVES Enterococcus spp. account for 10% of infective endocarditis (IE). Although daptomycin is a bactericidal drug with in vitro activity against Enterococcus, there is little experience of its use in IE. We analysed the effectiveness of daptomycin in the treatment of enterococcal IE (EIE). METHODS This was a retrospective descriptive study comparing the efficacy of daptomycin versus ampicillin/ceftriaxone versus conventional antibiotic regimens (ampicillin or vancomycin ± gentamicin) in EIE. RESULTS From January 2007 to December 2011, 6 patients with EIE treated with daptomycin monotherapy were compared with 21 patients treated with ampicillin/ceftriaxone and 5 patients treated with ampicillin or vancomycin ± gentamicin. The three groups had similar epidemiological and clinical characteristics. Daptomycin indications were allergy to β-lactams (n = 3), therapy simplification (n = 2), renal failure (n = 2) and Enterococcus faecium resistant to ampicillin/gentamicin (n = 1). Daptomycin MICs ranged from 1 to 2 mg/L and the doses were 6-10 mg/kg/day intravenously. Daptomycin patients had longer duration of bacteraemia (6 versus 1 day, P < 0.01) and greater need of therapy switch due to complications (66.7% versus 0%, P < 0.01). There were no differences regarding duration of hospital stay or mortality. CONCLUSIONS Daptomycin-treated patients more frequently required a therapeutic change due to worse microbiological and clinical response, although mortality was not increased. Our findings do not support the use of daptomycin as single therapy in the treatment of EIE. Its role in combined strategies should be further investigated.
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Affiliation(s)
- I Cerón
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain CIBERES, Palma de Mallorca, Spain Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - M Marín
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain CIBERES, Palma de Mallorca, Spain Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - A Segado
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Roda
- Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M Valerio
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
| | - E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain CIBERES, Palma de Mallorca, Spain Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
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Rico M, Martínez E, Pellejero S, Arias F, Eito C, Mora I, Errasti M, Barrado M, Marín M, Mañeru F, Domínguez M. Stereotactic body radiation therapy for lung tumours: Initial experience of a centre. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Verdura E, Marín M, Ballesteros D, Ramos I, Sanz-Fuentenebro J. 1999 – Continuation (C-ECT) and maintenance (M-ECT) electroconvulsive therapy as an alternative treatment to pharmacotherapy: a review. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76935-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Graciano R, Marín M, Londinsky M. Opciones de cobertura para defectos en codo. Cir plást iberolatinoam 2012. [DOI: 10.4321/s0376-78922012000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Oliveira L, Lisboa B, Lopez I, Marín M, Carraro D, Coudry R. 495 P72R and PIN3 TP53 Polymorphisms and Colorectal Cancer Risk. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71165-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Alcalá L, Martín A, Marín M, Sánchez-Somolinos M, Catalán P, Peláez T, Bouza E. The undiagnosed cases of Clostridium difficile infection in a whole nation: where is the problem? Clin Microbiol Infect 2012; 18:E204-13. [PMID: 22563775 DOI: 10.1111/j.1469-0691.2012.03883.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Underdiagnosis of Clostridium difficile infection (CDI) because of lack of clinical suspicion or the use of non-sensitive diagnostic techniques is a known problem whose real magnitude has not yet been quantified. In order to estimate the extent of this underdiagnosis, we performed C. difficile cultures on all unformed stool specimens sent-irrespective of the type of request-to a series of laboratories in Spain on a single day. The specimens were cultured, and isolates were characterized at a central reference laboratory. A total of 807 specimens from 730 patients aged ≥ 2 years were selected from 118 laboratories covering 75.4% of the Spanish population. The estimated rate of hospital-acquired CDI was 2.4 episodes per 1000 admissions or 3.8 episodes per 10,000 patient-days. Only half of the episodes occurred in patients hospitalized for >2 days. Two of every three episodes went undiagnosed or were misdiagnosed, owing to non-sensitive diagnostic tests (19.0%) or lack of clinical suspicion and request (47.6%; mostly young people or non-hospitalized patients). The main ribotypes were 014/020 (20.5%), 001 (18.2%), and 126/078 (18.2%). No ribotype 027 strains were detected. Strains were fully susceptible to metronidazole and vancomycin. CDI was underdiagnosed in diarrhoeic stools in a high proportion of episodes, owing to the use of non-sensitive techniques or lack of clinical suspicion, particularly in people aged <65 years or patients with community-acquired diarrhoea. C. difficile toxins should be routinely sought in unformed stools of any origin sent for microbiological diagnosis. The ribotype 027 clone has not yet disseminated in Spain.
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Affiliation(s)
- L Alcalá
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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