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Ferrés M, Martínez-Valdebenito C, Henriquez C, Marco C, Angulo J, Barrera A, Palma C, Barriga Pinto G, Cuiza A, Ferreira L, Rioseco ML, Calvo M, Fritz R, Bravo S, Bruhn A, Graf J, Llancaqueo A, Rivera G, Cerda C, Tischler N, Valdivieso F, Vial P, Mertz G, Vial C, Le Corre N. Viral shedding and viraemia of Andes virus during acute hantavirus infection: a prospective study. Lancet Infect Dis 2024:S1473-3099(24)00142-7. [PMID: 38582089 DOI: 10.1016/s1473-3099(24)00142-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/29/2024] [Accepted: 02/19/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Andes virus (ANDV) is a zoonotic Orthohantavirus leading to hantavirus cardiopulmonary syndrome. Although most transmissions occur through environmental exposure to rodent faeces and urine, rare person-to-person transmission has been documented, mainly for close contacts. This study investigates the presence and infectivity of ANDV in body fluids from confirmed cases and the duration of viraemia. METHODS In this prospective study, 131 participants with confirmed ANDV infection were enrolled in Chile in a prospective study between 2008 and 2022. Clinical samples (buffy coat, plasma, gingival crevicular fluid [GCF], saliva, nasopharyngeal swabs [NPS], and urine) were collected weekly for 3 weeks together with clinical and epidemiological data. Samples were categorised as acute or convalescent (up to and after 16 days following onset of symptoms). Infectivity of positive fluids was assessed after the culture of samples on Vero E6 cells and use of flow cytometry assays to determine the production of ANDV nucleoprotein. FINDINGS ANDV RNA was detected in 100% of buffy coats during acute phase, declining to 95% by day 17, and to 93% between days 23-29. ANDV RNA in GCF and saliva decreased from 30% and 12%, respectively, during the acute phase, to 12% and 11% during the convalescent phase. Successful infectivity assays of RT-qPCR-positive fluids, including GCF, saliva, NPS, and urine, were observed in 18 (42%) of 43 samples obtained during the acute phase of infection. After re-culture, the capacity to infect Vero E6 cells was maintained in 16 (89%) of 18 samples. Severity was associated with the presence of ANDV RNA in one or more fluids besides blood (odds ratio 2·58 [95% CI 1·42-5·18]). INTERPRETATION ANDV infection is a systemic and viraemic infection, that affects various organs. The presence of infectious particles in body fluids contributes to our understanding of potential mechanisms for person-to-person transmission, supporting the development of preventive strategies. Detection of ANDV RNA in additional fluids at hospital admission is a predictor of disease severity. FUNDING None. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile.
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Carolina Henriquez
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Marco
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jenniffer Angulo
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Aldo Barrera
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Palma
- Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
| | - Gonzalo Barriga Pinto
- Laboratory of Emerging Viruses, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Analia Cuiza
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - María Luisa Rioseco
- Hospital Regional de Puerto Montt, Universidad San Sebastián, Sede Patagonía, Puerto Montt, Chile
| | - Mario Calvo
- Hospital Regional de Valdivia, Valdivia, Chile
| | | | - Sebastián Bravo
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro Bruhn
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | | | | | - Nicole Tischler
- Fundación Ciencia & Vida, Universidad San Sebastián, Facultad de Medicina y Ciencia, Laboratorio de Virología Molecular, Santiago, Chile
| | | | - Pablo Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría, Clínica Alemana de Santiago, Chile
| | | | - Cecilia Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Santiago, Chile
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Ampuero M, Martínez-Valdebenito C, Ferrés M, Soto-Rifo R, Gaggero A. Monkeypox Virus in Wastewater Samples from Santiago Metropolitan Region, Chile. Emerg Infect Dis 2023; 29:2358-2361. [PMID: 37877805 PMCID: PMC10617339 DOI: 10.3201/eid2911.230096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Sewage surveillance provides useful epidemiologic and public health information on viral infections at the population level. We detected monkeypox virus DNA from sewage samples covering 85% of the population in Santiago Metropolitan Region Chile. We also isolated infective viruses from those samples. Wastewater surveillance could complement clinical surveillance for monkeypox virus.
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3
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Vial PA, Ferrés M, Vial C, Klingström J, Ahlm C, López R, Le Corre N, Mertz GJ. Hantavirus in humans: a review of clinical aspects and management. Lancet Infect Dis 2023; 23:e371-e382. [PMID: 37105214 DOI: 10.1016/s1473-3099(23)00128-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 04/29/2023]
Abstract
Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions. Transmission to humans occurs by exposure to infected rodents in endemic areas; however, Andes hantavirus is unique in that it can be transmitted from person to person. As hantaviruses target endothelial cells, they can affect diverse organ systems; increased vascular permeability is central to pathogenesis. The main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas. HCPS and HFRS are separate clinical entities, but they share several features and have many overlapping symptoms, signs, and pathogenic alterations. For HCPS in particular, clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing or algorithms for presumptive diagnosis, and prompt transfer to a facility with critical care units. No specific effective antiviral treatment is available.
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Affiliation(s)
- Pablo A Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría Clínica Alemana de Santiago, Santiago, Chile.
| | - Marcela Ferrés
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Jonas Klingström
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - René López
- Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Paciente Crítico Clínica Alemana, Santiago, Chile
| | - Nicole Le Corre
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gregory J Mertz
- Department of Internal Medicine, UNM Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
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4
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Mondaca S, Walbaum B, Le Corre N, Ferrés M, Valdés A, Martínez-Valdebenito C, Ruiz-Tagle C, Macanas-Pirard P, Ross P, Cisternas B, Pérez P, Cabrera O, Cerda V, Ormazábal I, Barrera A, Prado ME, Venegas MI, Palma S, Broekhuizen R, Kalergis AM, Bueno SM, Espinoza MA, Balcells ME, Nervi B. Influence of SARS-CoV-2 mRNA Vaccine Booster among Cancer Patients on Active Treatment Previously Immunized with Inactivated versus mRNA Vaccines: A Prospective Cohort Study. Vaccines (Basel) 2023; 11:1193. [PMID: 37515009 PMCID: PMC10384024 DOI: 10.3390/vaccines11071193] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/22/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
Cancer patients on chemotherapy have a lower immune response to SARS-CoV-2 vaccines. Therefore, through a prospective cohort study of patients with solid tumors receiving chemotherapy, we aimed to determine the immunogenicity of an mRNA vaccine booster (BNT162b2) among patients previously immunized with an inactivated (CoronaVac) or homologous (BNT162b2) SARS-CoV-2 vaccine. The primary outcome was the proportion of patients with anti-SARS-CoV-2 neutralizing antibody (NAb) seropositivity at 8-12 weeks post-booster. The secondary end points included IgG antibody (TAb) seropositivity and specific T-cell responses. A total of 109 patients were included. Eighty-four (77%) had heterologous vaccine schedules (two doses of CoronaVac followed by the BNT162b2 booster) and twenty-five had (23%) homologous vaccine schedules (three doses of BNT162b2). IgG antibody positivity for the homologous and heterologous regimen were 100% and 96% (p = 0.338), whereas NAb positivity reached 100% and 92% (p = 0.13), respectively. Absolute NAb positivity and Tab levels were associated with the homologous schedule (with a beta coefficient of 0.26 with p = 0.027 and a geometric mean ratio 1.41 with p = 0.044, respectively). Both the homologous and heterologous vaccine regimens elicited a strong humoral and cellular response after the BNT162b2 booster. The homologous regimen was associated with higher NAb positivity and Tab levels after adjusting for relevant covariates.
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Affiliation(s)
- Sebastián Mondaca
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Benjamín Walbaum
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Nicole Le Corre
- Laboratorio de Infectología y Virología Molecular, Red de Salud UC Christus, Santiago 8330024, Chile
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Marcela Ferrés
- Laboratorio de Infectología y Virología Molecular, Red de Salud UC Christus, Santiago 8330024, Chile
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Alejandro Valdés
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Constanza Martínez-Valdebenito
- Laboratorio de Infectología y Virología Molecular, Red de Salud UC Christus, Santiago 8330024, Chile
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Cinthya Ruiz-Tagle
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Patricia Macanas-Pirard
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Center for Cancer Prevention and Control, CECAN, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Patricio Ross
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Betzabé Cisternas
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Patricia Pérez
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Olivia Cabrera
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Valentina Cerda
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Ivana Ormazábal
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Aldo Barrera
- Laboratorio de Infectología y Virología Molecular, Red de Salud UC Christus, Santiago 8330024, Chile
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - María E Prado
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - María I Venegas
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Silvia Palma
- Instituto de Cáncer, Red de Salud UC-Christus, Santiago 8330032, Chile
| | - Richard Broekhuizen
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Center for Cancer Prevention and Control, CECAN, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Alexis M Kalergis
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330032, Chile
| | - Susan M Bueno
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Manuel A Espinoza
- Center for Cancer Prevention and Control, CECAN, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330032, Chile
| | - M Elvira Balcells
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
| | - Bruno Nervi
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
- Center for Cancer Prevention and Control, CECAN, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile
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Dib M, Le Corre N, Ortiz C, García D, Ferrés M, Martinez-Valdebenito C, Ruiz-Tagle C, Ojeda MJ, Espinoza MA, Jara A, Arab JP, Rabagliati R, Vizcaya C, Ceballos ME, Sarmiento M, Mondaca S, Viñuela M, Pastore A, Szwarcfiter V, Galdames E, Barrera A, Castro P, Gálvez NMS, Soto JA, Bueno SM, Kalergis AM, Nervi B, Balcells ME. SARS-CoV-2 vaccine booster in solid organ transplant recipients previously immunised with inactivated versus mRNA vaccines: A prospective cohort study. The Lancet Regional Health - Americas 2022; 16:100371. [PMID: 36185969 PMCID: PMC9503242 DOI: 10.1016/j.lana.2022.100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Methods Findings Interpretation Funding
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Bertrand PJ, Vázquez Y, Beckhaus AA, González LA, Contreras AM, Ferrés M, Padilla O, Riedel CA, Kalergis AM, Bueno SM. Identification of biomarkers for disease severity in nasopharyngeal secretions of infants with upper or lower respiratory tract viral infections. Clin Exp Immunol 2022; 210:68-78. [PMID: 36036806 PMCID: PMC9585550 DOI: 10.1093/cei/uxac083] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/08/2022] [Accepted: 08/24/2022] [Indexed: 01/25/2023] Open
Abstract
Lower respiratory tract infections (LRTIs) produced by viruses are the most frequent cause of morbidity and mortality in children younger than 5 years of age. The immune response triggered by viral infection can induce a strong inflammation in the airways and cytokines could be considered as biomarkers for disease severity as these molecules modulate the inflammatory response that defines the outcome of patients. Aiming to predict the severity of disease during respiratory tract infections, we conducted a 1-year follow-up observational study in infants who presented upper or lower respiratory tract infections caused by seasonal respiratory viruses. At the time of enrollment, nasopharyngeal swabs (NPS) were obtained from infants to measure mRNA expression and protein levels of IL-3, IL-8, IL-33, and thymic stromal lymphopoietin. While all cytokines significantly increased their protein levels in infants with upper and lower respiratory tract infections as compared to control infants, IL-33 and IL-8 showed a significant increase in respiratory syncytial virus (RSV)-infected patients with LRTI as compared to patients with upper respiratory tract infection. We also found higher viral loads of RSV-positive samples with a greater IL-8 response at the beginning of the symptoms. Data obtained in this study suggest that both IL-8 and IL-33 could be used as biomarkers for clinical severity for infants suffering from LRTIs caused by the RSV.
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Affiliation(s)
- Pablo J Bertrand
- Departamento de Enfermedades Respiratorias Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yaneisi Vázquez
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea A Beckhaus
- Departamento de Enfermedades Respiratorias Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Liliana A González
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana María Contreras
- Laboratorio de Infectología y Virología Molecular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Laboratorio de Infectología y Virología Molecular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Oslando Padilla
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia A Riedel
- Millennium Institute on Immunology and Immunotherapy, Departamento de Ciencias Biológicas, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Alexis M Kalergis
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Susan M Bueno
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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7
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Díaz LA, García-Salum T, Fuentes-López E, Reyes D, Ortiz J, Chahuan J, Levican J, Almonacid LI, Valenzuela GH, Serrano E, Budnik S, Gandara V, Gallardo A, Seydewitz MF, Ferrés M, Cofré C, Álvarez M, Pavez C, Candia R, Monrroy H, Espino A, Rada G, Ortiz L, Valderrama S, Salinas E, Toro A, Ortega M, Pizarro M, Medina RA, Riquelme A. High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort study. Gastroenterología y Hepatología (English Edition) 2022; 45. [PMCID: PMC9574026 DOI: 10.1016/j.gastre.2021.12.006] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- Luis Antonio Díaz
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tamara García-Salum
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Reyes
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Ortiz
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Chahuan
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Levican
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonardo I. Almonacid
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo H. Valenzuela
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eileen Serrano
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sigall Budnik
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Gandara
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Gallardo
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Marcela Ferrés
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Colomba Cofré
- Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Álvarez
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Pavez
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto Candia
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hugo Monrroy
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alberto Espino
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile,Epistemonikos Foundation, Santiago, Chile
| | - Luis Ortiz
- Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Valderrama
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Erick Salinas
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adriana Toro
- Pediatric Service, Clínica UC San Carlos, Red Salud UC Christus, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcos Ortega
- Department of Intensive Care Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Respiratory Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Margarita Pizarro
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael A. Medina
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Corresponding authors
| | - Arnoldo Riquelme
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Corresponding authors
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8
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Acevedo ML, Gaete-Argel A, Alonso-Palomares L, de Oca MM, Bustamante A, Gaggero A, Paredes F, Cortes CP, Pantano S, Martínez-Valdebenito C, Angulo J, Le Corre N, Ferrés M, Navarrete MA, Valiente-Echeverría F, Soto-Rifo R. Differential neutralizing antibody responses elicited by CoronaVac and BNT162b2 against SARS-CoV-2 Lambda in Chile. Nat Microbiol 2022; 7:524-529. [PMID: 35365787 DOI: 10.1038/s41564-022-01092-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/23/2022] [Indexed: 01/21/2023]
Abstract
SARS-CoV-2 variant Lambda was dominant in several South American countries, including Chile. To ascertain the efficacy of local vaccination efforts, we used pseudotyped viruses to characterize the neutralization capacity of antibodies elicited by CoronaVac (n = 53) and BNT162b2 (n = 56) in healthcare workers from Clínica Santa María and the Faculty of Medicine at Universidad de Chile, as well as in convalescent plasma from individuals infected during the first wave visiting the Hospital Clínico at Pontificia Universidad Católica (n = 30). We observed that BNT162b2 elicits higher neutralizing antibody titres than CoronaVac, with differences ranging from 7.4-fold for the ancestral spike (Wuhan-Hu-1) to 8.2-fold for the Lambda spike and 13-fold for the Delta spike. Compared with the ancestral virus, neutralization against D614G, Alpha, Gamma, Lambda and Delta variants was reduced by between 0.93- and 4.22-fold for CoronaVac, 1.04- and 2.38-fold for BNT162b2, and 1.26- and 2.67-fold for convalescent plasma. Comparative analyses among the spike structures of the different variants suggest that mutations in the spike protein from the Lambda variant, including the 246-252 deletion in an antigenic supersite at the N-terminal domain loop and L452Q/F490S within the receptor-binding domain, may account for immune escape. Interestingly, analyses using pseudotyped and whole viruses showed increased entry rates into HEK293T-ACE2 cells, but reduced replication rates in Vero-E6 cells for the Lambda variant when compared with the Alpha, Gamma and Delta variants. Our data show that inactivated virus and messenger RNA vaccines elicit different levels of neutralizing antibodies with different potency to neutralize SARS-CoV-2 variants, including the variant of interest Lambda.
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Affiliation(s)
- Mónica L Acevedo
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile.,Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
| | - Aracelly Gaete-Argel
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Luis Alonso-Palomares
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | | | - Andrés Bustamante
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Aldo Gaggero
- Laboratorio de Virología Ambiental, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Fabio Paredes
- Departamento de Epidemiología, Ministerio de Salud de Chile, Santiago, Chile
| | - Claudia P Cortes
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Clínica Santa María, Santiago, Chile.,Departamento de Medicina Centro, Universidad de Chile, Santiago, Chile
| | - Sergio Pantano
- Biomolecular Simulations Group, Instituto Pasteur de Montevideo, Montevideo, Uruguay
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jenniffer Angulo
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Fernando Valiente-Echeverría
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile. .,Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.
| | - Ricardo Soto-Rifo
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile. .,Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.
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9
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Balcells ME, Le Corre N, Durán J, Ceballos ME, Vizcaya C, Mondaca S, Dib M, Rabagliati R, Sarmiento M, Burgos PI, Espinoza M, Ferrés M, Martinez-Valdebenito C, Ruiz-Tagle C, Ortiz C, Ross P, Budnik S, Solari S, Vizcaya MDLÁ, Lembach H, Berrios-Rojas R, Melo-González F, Ríos M, Kalergis AM, Bueno SM, Nervi B. Reduced immune response to inactivated SARS-CoV-2 vaccine in a cohort of immunocompromised patients in Chile. Clin Infect Dis 2022; 75:e594-e602. [PMID: 35255140 PMCID: PMC8903589 DOI: 10.1093/cid/ciac167] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Indexed: 12/22/2022] Open
Abstract
Background Inactivated SARS-CoV-2 vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with five different immunocompromising conditions and 67 controls, receiving two doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Chile. Neutralizing antibodies (NAb) positivity, total anti-SARS-CoV-2 IgG antibodies (TAb) concentration, and T cell response were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% (p<0.0001) and 5.7% (p<0.0001) in the solid organ transplant (SOT) group, 41.5% (p<0.0001) and 19.2% (p<0.0001) in the autoimmune rheumatic diseases group, 43.3% (p=0.0002) and 21.4% (p=0.0013) in the cancer patients with solid tumors group, 45.5% (p<0.0001) and 28.7% (p=0.0006) in the HIV infected group, 64.3% (p=n.s.) and 56.6% (p=n.s.) in the hematopoietic stem cell transplantation (HSCT) group, respectively. TAb seropositivity was also lower for the SOT (20.6%, p<0.0001), rheumatic diseases (61%, p=0.0001) and HIV groups (70.9%, p=0.0032), compared to control group (92.3%). On the other hand, the number of IFN-y Spot Forming T Cells specific for SARS-CoV-2 tended to be lower but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest a boosting vaccination strategy should be considered in these vulnerable patients.
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Affiliation(s)
- M Elvira Balcells
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Nicole Le Corre
- Departamento de Inmunología e Infectología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile.,Laboratorio de Infectología y Virología Molecular, Red de Salud UC-CHRISTUS
| | - Josefina Durán
- Departamento de Reumatología e Inmunología Clínica, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - María Elena Ceballos
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Cecilia Vizcaya
- Departamento de Inmunología e Infectología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Sebastián Mondaca
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Martín Dib
- Programa de trasplante, Departamento de Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Ricardo Rabagliati
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Mauricio Sarmiento
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Paula I Burgos
- Departamento de Reumatología e Inmunología Clínica, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Manuel Espinoza
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Marcela Ferrés
- Departamento de Inmunología e Infectología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile.,Laboratorio de Infectología y Virología Molecular, Red de Salud UC-CHRISTUS
| | - Constanza Martinez-Valdebenito
- Departamento de Inmunología e Infectología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile.,Laboratorio de Infectología y Virología Molecular, Red de Salud UC-CHRISTUS
| | - Cinthya Ruiz-Tagle
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Catalina Ortiz
- Programa de trasplante, Departamento de Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Patricio Ross
- Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Sigall Budnik
- Departamento de Reumatología e Inmunología Clínica, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Sandra Solari
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | | | - Hans Lembach
- Unidad de Trasplantes, Hospital Clínico Universidad de Chile, Facultad de Medicina, Universidad de Chile
| | - Roslye Berrios-Rojas
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile
| | - Felipe Melo-González
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile
| | - Mariana Ríos
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile
| | - Alexis M Kalergis
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile.,Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile
| | - Susan M Bueno
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.,Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile
| | - Bruno Nervi
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile
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10
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Angulo J, Martinez-Valdebenito C, Pardo-Roa C, Almonacid LI, Fuentes-Luppichini E, Contreras AM, Maldonado C, Le Corre N, Melo F, Medina RA, Ferrés M. Assessment of Mutations Associated With Genomic Variants of SARS-CoV-2: RT-qPCR as a Rapid and Affordable Tool to Monitoring Known Circulating Variants in Chile, 2021. Front Med (Lausanne) 2022; 9:841073. [PMID: 35280916 PMCID: PMC8914012 DOI: 10.3389/fmed.2022.841073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Since the first report of SARS-CoV-2 infection in humans, the virus has mutated to develop new viral variants with higher infection rates and more resistance to neutralization by antibodies elicited after natural SARS-CoV-2 infection or by vaccines. Therefore, rapid identification of viral variants circulating in the population is crucial for epidemiological assessment and efforts to contain the resurgence of the pandemic. Between January and November 2021, we performed a large variant RT-qPCR-based screening of mutations in the spike protein of 1851 SARS-CoV-2-positive samples derived from outpatients from the UC-Christus Health Network in Chile. In a portion of samples (n = 636), we validated our RT-qPCR-pipeline by WGS, obtaining a 99.2% concordance. Our results indicate that from January to March 2021 there was a dominance of non-identifiable variants by the RT-qPCR-based screening; however, throughout WGS we were able to identify the Lambda (C.37) variant of interest (VOI). From March to July, we observed the rapid emergence of mutations associated with the Gamma variant (P.1), which was quickly replaced by the appearance of a combination of samples harboring mutations associated with the Delta variant (B.1.617.2), which predominated until the end of the study. Our results highlight the applicability of cost-effective RT-qPCR-based screening of mutations associated with known variants of concern (VOC), VOI and variants under monitoring (VUM) of SARS-CoV-2, being a rapid and reliable tool that complements WGS-based surveillance.
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Affiliation(s)
- Jenniffer Angulo
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
| | - Constanza Martinez-Valdebenito
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
| | - Catalina Pardo-Roa
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Interdisciplinary Rehabilitation Register – COVID-19 Working Group, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonardo I. Almonacid
- Molecular Bioinformatics Laboratory, Department of Molecular Genetics and Microbiology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Ana Maria Contreras
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
| | - Constanza Maldonado
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
| | - Francisco Melo
- Molecular Bioinformatics Laboratory, Department of Molecular Genetics and Microbiology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael A. Medina
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Interdisciplinary Rehabilitation Register – COVID-19 Working Group, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Marcela Ferrés
- Departamento de Enfermedades Infeciosas e Inmmunologia Pediatricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Infectious Disease and Molecular Virology Laboratory, Red Salud UC-Christus, Santiago, Chile
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11
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Perret P. C, Abarca K, Solari S, Aguilera P, García-Huidobro D, Olivares F, Palma C, Contreras AM, Martínez-Valdebenito C, Ferrés M. Detección del SARS-CoV-2 mediante RT-qPCR utilizando saliva en pacientes ambulatorios con estudio de COVID-19. Rev Chilena Infectol 2022. [DOI: 10.4067/s0716-10182022000400372] [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: 11/26/2022] Open
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12
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Díaz LA, García-Salum T, Fuentes-López E, Reyes D, Ortiz J, Chahuan J, Levican J, Almonacid LI, Valenzuela GH, Serrano E, Budnik S, Gandara V, Gallardo A, Seydewitz MF, Ferrés M, Cofré C, Álvarez M, Pavez C, Candia R, Monrroy H, Espino A, Rada G, Ortiz L, Valderrama S, Salinas E, Toro A, Ortega M, Pizarro M, Medina RA, Riquelme A. High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A Systematic Review and Cohort Study. Gastroenterología y Hepatología 2022; 45:593-604. [PMID: 35077722 PMCID: PMC8783395 DOI: 10.1016/j.gastrohep.2021.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/02/2021] [Accepted: 12/29/2021] [Indexed: 10/25/2022]
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13
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Izquierdo G, Sandoval A, Abarzúa F, Yamamoto M, Rodríguez JG, Silva M, Torres JP, Aravena M, Fuentes D, Reyes A, Conca N, Cofré F, Delpiano L, Hernández M, Twele L, Labraña Y, Ferrés M, Ribalta G, Chuang A, Ortega X, Oliva B, Baltra E. Recomendaciones para el diagnóstico y manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido. Rev Chilena Infectol 2021; 38:824-856. [DOI: 10.4067/s0716-10182021000600824] [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] [Received: 10/18/2021] [Indexed: 11/17/2022] Open
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14
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Le-Corre N, Pérez R, Vizcaya C, Martínez-Valdebenito C, López T, Monge M, Alarcón R, Moller F, Martínez MT, Massardo JM, Ferrés M. Relevance of codetection of respiratory viruses in the severity of acute respiratory infection in hospitalized children. Andes Pediatr 2021; 92:349-358. [PMID: 34479240 DOI: 10.32641/andespediatr.v92i3.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/16/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Multiplex polymerase chain reaction (PCR) allows simultaneous detection of respiratory viruses, raising questions about their relevance in the clinical feature. OBJECTIVE To evaluate the contribution of clinical, epidemiological, and virological factors in the clinical course of children hospitalized due to ARI with viral co-detection. PATIENTS AND METHOD Pediatric patients ≤ 15 years old, hospitalized due to ARI at the UC-CHRISTUS Health Network Clinical Hospital between June and October 2014, and who presented a positive respiratory molecular panel test, were included. Respiratory samples (nasopharyngeal swab, tracheal aspiration, or bronchoalveolar lavage) with positive panel tests by Seeplex® RV15 OneStep ACE Detection Seegene® technique, were analyzed with a second technique (xTAG-RVP-FASTv2 Luminex®, USA), which allows simultaneous and semi-quantitative detection of 17 respiratory viruses. Clinical and epidemiological records were collected. RESULTS One virus was identified in 42/57 children (74%) and two or more in 15/57 (26%). Intensive care unit (ICU) hospi talization was significantly more frequent in patients with viral co-detection (OR = 5,5; IC 95%: 1,5 19,6). The most frequently detected viruses were rhinovirus/enterovirus (HRV/EV) (29%) and res piratory syncytial virus (RSV) (25%), and the most common co-detection was HRV/EV-RSV (33%). In x-rays, patients with HRV/EV infection presented interstitial images more frequently, while RSV was associated with condensations (p = 0.002). For HRV/EV, median fluorescence intensity (MFI, semi-quantification) were 1788 and 2456 in co-detection and single agent, respectively (p = 0.022). Children with HRV/EV co-detection had a longer hospital stay compared to isolated identification (5 versus 3 days, p = 0,028). CONCLUSION In children hospitalized due to ARI, viral co-detection is frequent and associated with more ICU hospitalizations. Our study highlights the presence of HRV/ EV in viral co-detection and longer length of stay. More studies are needed to define the relevance of viral co-detection in hospitalized pediatric patients.
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Affiliation(s)
- Nicole Le-Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Regina Pérez
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vizcaya
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Tania López
- Hospital Clínico, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Monge
- Hospital Clínico, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Francesca Moller
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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15
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López R, Espinoza M, Graf J, Mertz G, Ferrés M, Calvo M, Vial C, Vial PA. Proteinuria in Hantavirus Cardiopulmonary Syndrome: A Frequent Finding Linked To Mortality. Int J Infect Dis 2021; 110:466-468. [PMID: 34271201 DOI: 10.1016/j.ijid.2021.07.026] [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: 04/22/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To determine the relative frequency and prognosis value of proteinuria in hantavirus cardiopulmonary syndrome (HCPS) due to Andes virus. METHODS This observational analytical study prospectively obtained data from patients admitted to 12 health centers in nine Chilean cities between 2001 and 2018. Only patients with confirmed Andes virus HCPS and laboratory characterization that included qualitative proteinuria determination at admission were considered. RESULTS The database involved 175 patients, 95 of them had a measurement of urine protein at the time of hospital admission. They were mainly male (71%) and the median age was 35 [22-47] years. Median duration of the febrile prodromal time was 5 [4-7] days. Hospital length of stay and hospital mortality rate were 10 [7-14] days and 21.1%, respectively. Seventy-three patients (77%) were identified with proteinuria at admission, which was associated with increased mortality rate (26% versus 5%, p=0.036) and the relative risk was 1.3 [1.1-1.6], p=0.002. CONCLUSIONS Proteinuria is a frequent finding in patients with HCPS, which is associated with a higher mortality rate.
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Affiliation(s)
- René López
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile; Escuela de Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Mauricio Espinoza
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile; Escuela de Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Jerónimo Graf
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile; Escuela de Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Gregory Mertz
- University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Marcela Ferrés
- Departamento Enfermedades Infecciosas e Inmunología Pediátrica, Laboratorio Infectología y Virología Molecular, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mario Calvo
- Instituto de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Cecilia Vial
- Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Pablo A Vial
- Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría, Clínica Alemana de Santiago, Santiago, Chile.
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Ferrés M, Martínez-Valdebenito C, Angulo J, Henríquez C, Vera-Otárola J, Vergara MJ, Pérez J, Fernández J, Sotomayor V, Valdés MF, González-Candia D, Tischler ND, Vial C, Vial P, Mertz G, Le Corre N. Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile 1. Emerg Infect Dis 2021; 26:1885-1888. [PMID: 32687024 PMCID: PMC7392419 DOI: 10.3201/eid2608.200204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Andes virus (ANDV) is the only hantavirus transmitted between humans through close contact. We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission.
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17
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Balcells ME, Rojas L, Le Corre N, Martínez-Valdebenito C, Ceballos ME, Ferrés M, Chang M, Vizcaya C, Mondaca S, Huete Á, Castro R, Sarmiento M, Villarroel L, Pizarro A, Ross P, Santander J, Lara B, Ferrada M, Vargas-Salas S, Beltrán-Pavez C, Soto-Rifo R, Valiente-Echeverría F, Caglevic C, Mahave M, Selman C, Gazitúa R, Briones JL, Villarroel-Espindola F, Balmaceda C, Espinoza MA, Pereira J, Nervi B. Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial. PLoS Med 2021; 18:e1003415. [PMID: 33657114 PMCID: PMC7929568 DOI: 10.1371/journal.pmed.1003415] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Convalescent plasma (CP), despite limited evidence on its efficacy, is being widely used as a compassionate therapy for hospitalized patients with COVID-19. We aimed to evaluate the efficacy and safety of early CP therapy in COVID-19 progression. METHODS AND FINDINGS The study was an open-label, single-center randomized clinical trial performed in an academic medical center in Santiago, Chile, from May 10, 2020, to July 18, 2020, with final follow-up until August 17, 2020. The trial included patients hospitalized within the first 7 days of COVID-19 symptom onset, presenting risk factors for illness progression and not on mechanical ventilation. The intervention consisted of immediate CP (early plasma group) versus no CP unless developing prespecified criteria of deterioration (deferred plasma group). Additional standard treatment was allowed in both arms. The primary outcome was a composite of mechanical ventilation, hospitalization for >14 days, or death. The key secondary outcomes included time to respiratory failure, days of mechanical ventilation, hospital length of stay, mortality at 30 days, and SARS-CoV-2 real-time PCR clearance rate. Of 58 randomized patients (mean age, 65.8 years; 50% male), 57 (98.3%) completed the trial. A total of 13 (43.3%) participants from the deferred group received plasma based on clinical aggravation. We failed to find benefit in the primary outcome (32.1% versus 33.3%, odds ratio [OR] 0.95, 95% CI 0.32-2.84, p > 0.999) in the early versus deferred CP group. The in-hospital mortality rate was 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17 p = 0.246), mechanical ventilation 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17, p = 0.246), and prolonged hospitalization 21.4% versus 30.0% (OR 0.64, 95% CI, 0.19-2.10, p = 0.554) in the early versus deferred CP group, respectively. The viral clearance rate on day 3 (26% versus 8%, p = 0.204) and day 7 (38% versus 19%, p = 0.374) did not differ between groups. Two patients experienced serious adverse events within 6 hours after plasma transfusion. The main limitation of this study is the lack of statistical power to detect a smaller but clinically relevant therapeutic effect of CP, as well as not having confirmed neutralizing antibodies in donor before plasma infusion. CONCLUSIONS In the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration. TRIAL REGISTRATION NCT04375098.
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Affiliation(s)
- María Elvira Balcells
- Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Rojas
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Program of Pharmacology and Toxicology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Diagnostic Virology Laboratory, Red de Salud UC CHRISTUS, Santiago, Chile
| | - Constanza Martínez-Valdebenito
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Diagnostic Virology Laboratory, Red de Salud UC CHRISTUS, Santiago, Chile
| | - María Elena Ceballos
- Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Diagnostic Virology Laboratory, Red de Salud UC CHRISTUS, Santiago, Chile
| | - Mayling Chang
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vizcaya
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Mondaca
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Álvaro Huete
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ricardo Castro
- Department of Intensive Care Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Sarmiento
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Villarroel
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Pizarro
- Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Ross
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Santander
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bárbara Lara
- Emergency Medicine Section, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrada
- Clinical Research Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Vargas-Salas
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Beltrán-Pavez
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Ricardo Soto-Rifo
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Fernando Valiente-Echeverría
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- HIV/AIDS Work Group, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | | | - Mauricio Mahave
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - Carolina Selman
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - Raimundo Gazitúa
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | | | - Franz Villarroel-Espindola
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
- Translational Medicine Research Laboratory, Fundación Arturo López Pérez, Santiago, Chile
| | - Carlos Balmaceda
- Health Technology Assessment Unit, Clinical Research Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel A. Espinoza
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Pereira
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bruno Nervi
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Beltrán-Pavez C, Riquelme-Barrios S, Oyarzún-Arrau A, Gaete-Argel A, González-Stegmaier R, Cereceda-Solis K, Aguirre A, Travisany D, Palma-Vejares R, Barriga GP, Gaggero A, Martínez-Valdebenito C, Corre NL, Ferrés M, Balcells ME, Fernandez J, Ramírez E, Villarroel F, Valiente-Echeverría F, Soto-Rifo R. Insights into neutralizing antibody responses in individuals exposed to SARS-CoV-2 in Chile. Sci Adv 2021; 7:eabe6855. [PMID: 33579701 PMCID: PMC7880587 DOI: 10.1126/sciadv.abe6855] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/23/2020] [Indexed: 05/08/2023]
Abstract
Chile has one of the worst numbers worldwide in terms of SARS-CoV-2 positive cases and COVID-19-related deaths per million inhabitants; thus, characterization of neutralizing antibody (NAb) responses in the general population is critical to understanding of immunity at the local level. Given our inability to perform massive classical neutralization assays due to the scarce availability of BSL-3 facilities in the country, we developed and fully characterized an HIV-based SARS-CoV-2 pseudotype, which was used in a 96-well plate format to investigate NAb responses in samples from individuals exposed to SARS-CoV-2 or treated with convalescent plasma. We also identified samples with decreased or enhanced neutralization activity against the D614G spike variant compared with the wild type, indicating the relevance of this variant in host immunity. The data presented here represent the first insights into NAb responses in individuals from Chile, serving as a guide for future studies in the country.
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Affiliation(s)
- Carolina Beltrán-Pavez
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Sebastián Riquelme-Barrios
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Aarón Oyarzún-Arrau
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Aracelly Gaete-Argel
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | | | - Karina Cereceda-Solis
- Translational Medicine Laboratory, Fundación Arturo López Pérez Cancer Center, Santiago, Chile
| | - Adam Aguirre
- Translational Medicine Laboratory, Fundación Arturo López Pérez Cancer Center, Santiago, Chile
| | - Dante Travisany
- Centro de Modelamiento Matemático UMI-CNRS 2807, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile and Fondap Center for Genome Regulation, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
- INRIA Chile Research Center, Santiago, Chile
| | - Ricardo Palma-Vejares
- Centro de Modelamiento Matemático UMI-CNRS 2807, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile and Fondap Center for Genome Regulation, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
| | - Gonzalo P Barriga
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Emerging Viruses, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Aldo Gaggero
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Environmental Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Infectología y Virología Molecular, Laboratorio de Bioseguridad Nivel 3, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Elvira Balcells
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Fernandez
- Subdepartamento de Genética Molecular, Instituto de Salud Pública, Santiago, Chile
| | - Eugenio Ramírez
- Sección Virus Oncogénicos, Subdepartamento de Enfermedades Virales, Instituto de Salud Pública, Santiago, Chile
| | - Franz Villarroel
- Translational Medicine Laboratory, Fundación Arturo López Pérez Cancer Center, Santiago, Chile
| | - Fernando Valiente-Echeverría
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Ricardo Soto-Rifo
- SARS-CoV-2 Research Group, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
- Laboratory of Molecular and Cellular Virology, Virology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Alvarez JC, Alvarez J, Tinoco J, Mellado P, Miranda H, Ferrés M, Forero J, Álvarez C. Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections. Cureus 2020; 12:e11583. [PMID: 33364107 PMCID: PMC7749804 DOI: 10.7759/cureus.11583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Varicella-zoster virus (VZV) and herpes zoster cause infections of the central nervous system (CNS) manifesting as meningitis or encephalitis. As compared to enterovirus (EV) and herpes simplex virus 1 (HSV-1) and 2 (HSV-2), it is not often tested in CNS infections due to VZV and herpes zoster. There is a certain tendency to think that the findings in the cerebrospinal fluid in infections of the CNS by viruses are comparable among themselves. The exact proportion of patients with VZV primary and reactivation infection who present with lesions prior to or concomitant to its involvement in the CNS is unknown. It is also not known about the risk factors that lead to the reactivation of VZV and CNS involvement. Objective To describe the clinical characteristics and laboratory results of patients with a positive VZV polymerase chain reaction (PCR) and neurological signs and symptoms. Methods A retrospective and descriptive study was performed at the Hospital Universitario de la Pontificia Universidad Católica de Chile (Hospital Clínico UC CHRISTUS) from September 2012 to July 2014. The following parameters were recorded: neurological signs and symptoms, PCR for VZV in cerebrospinal fluid (CSF), comorbidities, personal medical history, cutaneous lesions, CSF characteristics, CNS imaging, electroencephalography (EEG), treatment, mortality, and neurological sequelae. Adult patients with meningitis, encephalitis, or meningoencephalitis due to VZV diagnosed with PCR were included. Results Out of 70 CSF samples analyzed in the previously mentioned period, 21 cases were VZV positive, 16 cases that had clinical information available were included. The mean age with VZV CNS reactivation was 47 years (range 19-80 years). Five patients (31.25%) were immunocompromised: three had human immunodeficiency virus (HIV), one had kidney transplantation, and one had primary immunodeficiency. Clinical presentation was meningitis in 11 patients (68.75%) and encephalitis in five patients (31.25%). Pleocytosis in CSF was observed in all the samples. The five immunocompromised patients had cutaneous lesions. All patients received antiviral treatment. Therapy duration was from 10 up to 21 days. The clinical course was positive in most patients and the mean hospitalization time was 15 days (range 5-60 days). No mortality was observed. Conclusions VZV is a worldwide virus and a common cause of CNS infection. The rising incidence is probably due to a better diagnostic method and a frequent clinical suspicion even in the absence of cutaneous lesions, except in immunocompromised cases, as it was observed in the present study. CNS infection presented as a wide spectrum of clinical manifestations with possible neurological sequelae. There was a reduction in neurological morbidity with antiviral therapy. Nonetheless, both the incidence and the morbidity of CNS VZV infection are expected to be diminished by varicella and herpes zoster vaccination. Additionally, there was no increase in mortality in these patients.
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Affiliation(s)
- Jose C Alvarez
- Internal Medicine, University of Antioquia, Medellin, COL
| | - Jorge Alvarez
- Infectious Disease, Faculty of Medicine, Pontifical Catholic University of Chile, Cali, COL
| | - Javier Tinoco
- Infectious Diseases, Pontifical Catholic University of Chile, Cali, COL
| | | | - Hector Miranda
- Neurology, Pontifical Catholic University of Chile, Cali, COL
| | - Marcela Ferrés
- Infectious Disease, Pontifical Catholic University of Chile, Cali, COL
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20
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Martinez-Valdebenito C, Andaur C, Angulo J, Henriquez C, Ferrés M, Le Corre N. Characterization of Oral Immunity in Cases and Close Household Contacts Exposed to Andes Orthohantavirus (ANDV). Front Cell Infect Microbiol 2020; 10:557273. [PMID: 33224896 PMCID: PMC7670062 DOI: 10.3389/fcimb.2020.557273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/29/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Andes orthohantavirus (ANDV) is the sole etiologic agent of Hantavirus Cardiopulmonary Syndrome in Chile and, until now, the only Hantavirus known to be transmitted by person-to-person route. The main risk of person-to-person transmission is to be a sexual partner of an index case, and deep kissing the main mechanism of infection. Experimental reports suggest that ANDV infection can be inhibited by some saliva components. Therefore, some host factors like saliva quality, could help to explain why some individuals do not become infected even though their exposure to the virus is high. Aim: To compare some saliva components, such cytokines and mucins, between ANDV-infected cases (exposed-sick), their close household contacts (exposed-not sick) and healthy control not exposed. Methods: Sixty-nine confirmed ANDV-infected cases, 76 close household contacts exposed to ANDV but not infected (CHC) and 39 healthy control not exposed (HCNE). The following components were measured in saliva: secretory immunoglobulin A (sIgA) by ELISA; cytokines (IL1β, IL12p70, TNFα, INFy, IL10, IL6, VEGF, IP10, and IL8) by Multiplex Assay and mucins MUC7 and MUC5B by Western Blotting. Results: Among infected cases, CHC and HCNE analyzed 74, 45, and 33% were men, respectively (p ≤ 0.05). The average age for cases, CHC and HCNE was 37.7, 28.7, and 32 years, respectively (p ≤ 0.05). The average concentration of sIgA in infected cases was 4.846 mg/mL, higher than for CHC group, 0.333 mg/mL (p ≤ 0.05). For cytokines, significant differences were found comparing all groups for IFNy, IL12p70, and IL8. Among CHC group, there was a higher frequency of detection of MUC7 isoform (62.6%; 31/49) compared to ANDV-infected cases (40.5%; 17/42) (p < 0.05). Similarly, presence of MUC5B was higher among CHC groups (62.16%; 46/74) than in ANDV-infected cases (44.4%; 28/63) (p < 0.05). Conclusions: Three salivary components showed differences between infected cases and close household contacts (sIgA, cytokines, and mucins). These differences can be explained by the acute state of the disease in the ANDV-infected cases group. However, the differences in MUC5B and isoforms of MUC7 are not entirely explainable by the infection itself. This work represents a novel description of salivary components in the context of ANDV infection.
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Affiliation(s)
- Constanza Martinez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile
| | - Camila Andaur
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile
| | - Jenniffer Angulo
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile.,Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Santiago, Chile
| | - Carolina Henriquez
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratorio de Infectología y Virología Molecular, Red Salud UC Christus, Santiago, Chile
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21
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Villalobos C, Ceballos ME, Ferrés M, Palma C. Drug resistance mutations in proviral DNA of HIV-infected patients with low level of viremia. J Clin Virol 2020; 132:104657. [PMID: 33049643 DOI: 10.1016/j.jcv.2020.104657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/27/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Camila Villalobos
- Infectious Diseases Department, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile; Infectious Diseases Service, Hospital Naval Almirante Nef, Chile.
| | - María Elena Ceballos
- Infectious Diseases Department, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
| | - Marcela Ferrés
- Pediatric Infectious Diseases and Inmunology Department, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile; Infectology and Molecular Virology Laboratory, Red Salud UC CHRISTUS, Chile.
| | - Carlos Palma
- Infectology and Molecular Virology Laboratory, Red Salud UC CHRISTUS, Chile.
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22
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Wozniak A, Cerda A, Ibarra-Henríquez C, Sebastian V, Armijo G, Lamig L, Miranda C, Lagos M, Solari S, Guzmán AM, Quiroga T, Hitschfeld S, Riveras E, Ferrés M, Gutiérrez RA, García P. A simple RNA preparation method for SARS-CoV-2 detection by RT-qPCR. Sci Rep 2020; 10:16608. [PMID: 33024174 PMCID: PMC7538882 DOI: 10.1038/s41598-020-73616-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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: 05/07/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022] Open
Abstract
The technique RT-qPCR for viral RNA detection is the current worldwide strategy used for early detection of the novel coronavirus SARS-CoV-2. RNA extraction is a key pre-analytical step in RT-qPCR, often achieved using commercial kits. However, the magnitude of the COVID-19 pandemic is causing disruptions to the global supply chains used by many diagnostic laboratories to procure the commercial kits required for RNA extraction. Shortage in these essential reagents is even more acute in developing countries with no means to produce kits locally. We sought to find an alternative procedure to replace commercial kits using common reagents found in molecular biology laboratories. Here we report a method for RNA extraction that takes about 40 min to complete ten samples, and is not more laborious than current commercial RNA extraction kits. We demonstrate that this method can be used to process nasopharyngeal swab samples and yields RT-qPCR results comparable to those obtained with commercial kits. Most importantly, this procedure can be easily implemented in any molecular diagnostic laboratory. Frequent testing is crucial for individual patient management as well as for public health decision making in this pandemic. Implementation of this method could maintain crucial testing going despite commercial kit shortages.
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Affiliation(s)
- Aniela Wozniak
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
| | - Ariel Cerda
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Catalina Ibarra-Henríquez
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Valentina Sebastian
- Laboratorio de Microbiología. Servicio de Laboratorios Clínicos. Red de Salud UC-CHRISTUS, Santiago, Chile
| | - Grace Armijo
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Liliana Lamig
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Carolina Miranda
- Laboratorio de Microbiología. Servicio de Laboratorios Clínicos. Red de Salud UC-CHRISTUS, Santiago, Chile
| | - Marcela Lagos
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
| | - Sandra Solari
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
| | - Ana María Guzmán
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
| | - Teresa Quiroga
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
| | - Susan Hitschfeld
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Eleodoro Riveras
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile
| | - Marcela Ferrés
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile
- Departamento Enfermedades Infecciosas e Inmunología Pediátrica, Escuela Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo A Gutiérrez
- Department Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O`Higgins 340, Santiago, Chile.
| | - Patricia García
- Department Clinical Laboratories, School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686, Santiago, Chile.
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Díaz LA, García-Salum T, Fuentes-López E, Ferrés M, Medina RA, Riquelme A. Symptom Profiles and Risk Factors for Hospitalization in Patients With SARS-CoV-2 and COVID-19: A Large Cohort From South America. Gastroenterology 2020; 159:1148-1150. [PMID: 32437750 PMCID: PMC7207141 DOI: 10.1053/j.gastro.2020.05.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/05/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Luis Antonio Díaz
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tamara García-Salum
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael A. Medina
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Rafael A. Medina, PhD, Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Arnoldo Riquelme
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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24
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Cerda C, Martínez-Valdebenito C, Barriga F, Contreras M, Vidal M, Moreno R, Claverie X, Contreras P, Huenuman L, García T, Rathnasighe R, Medina R, Ferrés M, Le Corre N. [Humoral immune response induced by influenza vaccine in children with acute lymphoblastic leukemia]. Rev Chilena Infectol 2020; 37:138-146. [PMID: 32730479 DOI: 10.4067/s0716-10182020000200138] [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: 11/06/2019] [Accepted: 01/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. AIM To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. METHOD Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. RESULTS 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. DISCUSSION Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.
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Affiliation(s)
- Carolina Cerda
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Barriga
- Unidad Hemato-Oncología Pediátrica, División de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Contreras
- Servicio Hemato-Oncología Pediátrico, Red Salud UC-Christus, Santiago, Chile
| | - Marcela Vidal
- Servicio Hemato-Oncología Pediátrico, Red Salud UC-Christus, Santiago, Chile
| | - Rosa Moreno
- Unidad Hemato-Oncología Pediátrica, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Ximena Claverie
- Unidad Hemato-Oncología Pediátrica, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Paola Contreras
- Unidad Hemato-Oncología Pediátrica, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Lesly Huenuman
- Unidad Hemato-Oncología Pediátrica, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Tamara García
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Raveen Rathnasighe
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael Medina
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
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25
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Domínguez G, González Coloma F, Oyarzún D, Ferrés M, Martínez-Valdebenito C, Henríquez C, Lavarra E. [Epuyen lessons: one year after the outbreak of Hanta virus]. Rev Med Chil 2020; 148:416-418. [PMID: 32730391 DOI: 10.4067/s0034-98872020000300416] [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: 11/17/2022]
Affiliation(s)
- Gaspar Domínguez
- Servicio de Salud del Reloncaví, Hospital de Palena, Palena, Región de Los Lagos, Chile
| | | | - Daniela Oyarzún
- Servicio de Salud del Reloncaví, Hospital de Palena, Palena, Región de Los Lagos, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Región Metropolitana, Chile
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Región Metropolitana, Chile
| | - Carolina Henríquez
- Departamento de Enfermedades Infecciosas, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Región Metropolitana, Chile
| | - Enzo Lavarra
- Hospital Zonal de Esquel, Provincia del Chubut, Argentina
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26
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Reyes F, Ferrés M, Vial P, Vollrath V, Camponovo R, Montecinos L, Hirsch T, Valenzuela P, Perret C. [Interactive, semi-automatized and open source computational model applied to respiratory viruses surveillance]. Rev Chilena Infectol 2020; 37:69-75. [PMID: 32730403 DOI: 10.4067/s0716-10182020000100069] [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: 09/10/2019] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
Acute respiratory infections (ARI) are an important cause of morbidity and mortality worldwide, affecting mainly children and the elderly. They are associated with a high economic burden, increased number of medical visits and hospitalizations. The surveillance of the circulation of respiratory viruses can reduce the health care associated costs, and to optimize the health response. A platform based on R and its package Shiny was designed, to create an interactive and friendly web interface for gathering, analysis and publication of the data. The data from the Chilean metropolitan respiratory viruses surveillance network, available since 2006, was uploaded into the platform. Using this platform, the researcher spends less than 1 minute to upload the data, and the analysis and publication is immediate, available to be seen by any user with a device connected to Internet, who can choose the variables to be displayed. With a very low cost, in a short time, and using the R programming language, it was possible to create a simple, and interactive platform, considerably decreasing the upload and analysis time, and increasing the impact and availability of this surveillance.
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Affiliation(s)
- Felipe Reyes
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Chile
| | | | | | - Luisa Montecinos
- Laboratorio de Microbiología y Medicina Molecular, Hospital de Enfermedades Infecciosas Dr. Lucio Córdova, Chile
| | - Tamara Hirsch
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Patricia Valenzuela
- Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Cecilia Perret
- Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
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Gutiérrez V, Cerda J, Le Corre N, Medina R, Ferrés M. [Clinical and epidemiological characterization of healthcare acquired influenza in critical ill patients]. Rev Chilena Infectol 2020; 36:274-282. [PMID: 31859745 DOI: 10.4067/s0716-10182019000300274] [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: 06/19/2018] [Accepted: 03/28/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Healthcare-associated infections (HAIs) increase morbidity and mortality. During 2014, at the Hospital Clinico Red de Salud UC Christus (RS-UCCH) it was estimated that 15% of respiratory viral infections were acquired during hospitalization and influenza A was more frequent. AIMS Clinical and epidemiological characterization of HAIs due to influenza virus in patients hospitalized in critical care units (CCU) and special care. METHODS Descriptive study. We included patients hospitalized in CCU and special care with hospital acquired influenza during 2014-2017. HAI due to influenza was defined as: symptom onset and/or positive influenza PCR after ≥ 48 hours of hospital admission, without previous respiratory symptoms or previous negative influenza test study. RESULTS 22 patients were identified, median age was 74 years. Influenza was acquired average on day 13. Influenza A was detected in 77% and 27% had respiratory co-infection. Thirteen (59%) were hospitalized in CCU, only 2 (15%) due to lung problems. Comorbidity was present in 86% and decompensation in 50%. Only 41% received influenza vaccine. The associated lethality was 18%. CONCLUSIONS HAI due to influenza occurred in chronic, older and unvaccinated patients. Education about HAIs and continuous high vaccination coverage must be reinforced.
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Affiliation(s)
- Valentina Gutiérrez
- Enfermedades Infecciosas del Niño, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Cerda
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Laboratorio de Infectología y Virología Molecular, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael Medina
- Laboratorio de Virología Molecula, Departamento de Enfermedades Infecciosas e Inmunología Pediátricar, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Laboratorio de Infectología y Virología Molecular, Pontificia Universidad Católica de Chile, Santiago, Chile
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Astudillo P, Angulo J, Pino K, de Carvalho JB, de Morais GL, Perez S, de Vasconcelos ATR, Ferrés M, López-Lastra M. Correlation between female sex, IL28B genotype, and the clinical severity of bronchiolitis in pediatric patients. Pediatr Res 2020; 87:785-795. [PMID: 31645053 PMCID: PMC7086532 DOI: 10.1038/s41390-019-0623-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/08/2019] [Accepted: 10/11/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNPs) that impact on the differential expression of interleukin 28B (IL28B) are implicated in the progression of viral-induced diseases. In this prospective longitudinal cohort study, we evaluated the association between IL28B SNPs rs12979860 and rs8099917 and the clinical outcome of bronchiolitis in pediatric patients. METHODS A total of 682 infants suffering from bronchiolitis, categorized based on the final clinical outcome as mild or severe, were genotyped for IL28B SNPs rs12979860 and rs8099917. RESULTS When infants were categorized exclusively based on the final clinical outcome, no association was established between IL28B SNPs and the severity of bronchiolitis. However, when stratified by sex, the homozygotes for the minor alleles of rs12979860 (T) and rs8099917 (G) were associated with a mild disease in girls but not in boys. CONCLUSION SNPs rs12979860 and rs8099917 correlate with the severity of bronchiolitis and display a sex bias, where GG rs8099917 and TT rs12979860 genotypes are associated with a mild disease in girls but not in boys. These findings suggest that innate immunity and female sex links with the outcome of the diseases induced by respiratory viruses, such as RSV.
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Affiliation(s)
- Patricio Astudillo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Karla Pino
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Joseane Biso de Carvalho
- Laboratory of Bioinformatics, National Laboratory for Scientific Computing, Petrópolis, Rio de Janeiro, Brazil
| | - Guilherme Loss de Morais
- Laboratory of Bioinformatics, National Laboratory for Scientific Computing, Petrópolis, Rio de Janeiro, Brazil
| | - Sebastián Perez
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Marcela Ferrés
- Laboratorio de Infectología, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo López-Lastra
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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29
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Ferrés M, Lafourcade M, Gambra P, Cerón I, Payá E, Oddó D. [Support of the laboratory of microbiology and pathological anatomy in the diagnosis and management of infections in cancer patients and transplantation of hematopoietic stem cell transplant receptors]. Rev Chilena Infectol 2019; 36:145-166. [PMID: 31344152 DOI: 10.4067/s0716-10182019000200145] [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] [Indexed: 11/17/2022] Open
Abstract
The confrontation of the differential and etiological diagnosis of the infectious diseases of cancer patients, including hematopoietic stem cells transplant (HSCT) recipients, must correspond to an informed, timely decision that directly affects medical behavior that determines a better survival and quality of life for patients. The main goal of this work was to contribute to the management of these patients developing a useful tool for the clinician to make these decisions. For that, infections were grouped by compromised systems, differentiating the possible etiological agents in bacteria, viruses, fungi and parasites, highlighting the relevant diagnostic tests, mentioning the recommended techniques together with the optimal sample type for proper processing. In addition, under each group of techniques we added the item "level of requirement" to suggest what, in the opinion of the authors and the existing evidence, must be mandatory to have at local level or can be derivable to another laboratory.
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Affiliation(s)
- Marcela Ferrés
- Departamento de Enfermedades Infecciosas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Pilar Gambra
- Unidad de Infectología adultos, Clínica Santa María, Santiago, Chile
| | - Inés Cerón
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ernesto Payá
- Departamento de pediatría, Hospital Dr. Exequiel González Cortés, Universidad de Chile, Santiago, Chile
| | - David Oddó
- Departamento de Anatomía Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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30
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Delama I, Mondaca R, Aguayo I, Roldán A, Ferrés M, Fica A. Infectious endocarditis by Bartonella species. Report of two cases. Rev Med Chil 2019; 147:1340-1345. [DOI: 10.4067/s0034-98872019001001340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/30/2019] [Indexed: 11/17/2022]
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Torres-Pérez F, Palma RE, Boric-Bargetto D, Vial C, Ferrés M, Vial PA, Martínez-Valdebenito C, Pavletic C, Parra A, Marquet PA, Mertz GJ. A 19 Year Analysis of Small Mammals Associated with Human Hantavirus Cases in Chile. Viruses 2019; 11:v11090848. [PMID: 31547341 PMCID: PMC6784195 DOI: 10.3390/v11090848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/26/2019] [Revised: 09/07/2019] [Accepted: 09/09/2019] [Indexed: 12/13/2022] Open
Abstract
Small mammals present in areas where hantavirus cardiopulmonary syndrome (HCPS) cases had occurred in central and southern Chile were captured and analyzed to evaluate the abundance of rodents and seroprevalence rates of antibodies to Andes orthohantavirus (ANDV). Sampling areas ranged from the Coquimbo to Aysén regions (30–45° S approx.) regions. Ninety-two sites in peridomestic and countryside areas were evaluated in 19 years of sampling. An antibody against ANDV was detected by strip immunoassay in 58 of 1847 specimens captured using Sherman traps. Of the eleven species of rodents sampled, Abrothrix olivacea, Oligoryzomys longicaudatus and Abrothrix hirta were the most frequently trapped. O. longicaudatus had the highest seropositivity rate, and by logistic regression analysis, O. longicaudatus of at least 60 g had 80% or higher probability to be seropositive. Sex, age and wounds were significantly related to seropositivity only for O. longicaudatus. Across administrative regions, the highest seropositivity was found in the El Maule region (34.8–36.2° S), and the highest number of HCPS cases was registered in the Aysén region. Our results highlight the importance of long term and geographically extended studies, particularly for highly fluctuating pathogens and their reservoirs, to understand the implications of the dynamics and transmission of zoonotic diseases in human populations.
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Affiliation(s)
- Fernando Torres-Pérez
- Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso 2373223, Chile.
| | - R Eduardo Palma
- Laboratorio de Biología Evolutiva, Departamento de Ecología, Pontificia Universidad Católica de Chile; Santiago 8331150, Chile.
| | - Dusan Boric-Bargetto
- Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso 2373223, Chile.
| | - Cecilia Vial
- Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile.
| | - Marcela Ferrés
- Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Pablo A Vial
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile.
| | - Constanza Martínez-Valdebenito
- Laboratorio de Infectología y Virología Molecular, Red Salud UC-Christus, Departamento de Enfermedades Infecciosas e Inmunología Pediátricas, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Carlos Pavletic
- Oficina de Zoonosis y Control de Vectores, División de Políticas Publicas Saludables y Promoción, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago 8320064, Chile.
| | - Alonso Parra
- Oficina de Zoonosis y Control de Vectores, División de Políticas Publicas Saludables y Promoción, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago 8320064, Chile.
| | - Pablo A Marquet
- Departamento de Ecología, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile.
| | - Gregory J Mertz
- Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque 87131, New Mexico.
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López R, Vial C, Graf J, Calvo M, Ferrés M, Mertz G, Cuiza A, Agüero B, Aguilera D, Araya D, Pailamilla I, Paratori F, Torres-Torres V, Vial PA. Platelet Count in Patients with Mild Disease at Admission is Associated with Progression to Severe Hantavirus Cardiopulmonary Syndrome. Viruses 2019; 11:v11080693. [PMID: 31366116 PMCID: PMC6724000 DOI: 10.3390/v11080693] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Hantavirus cardiopulmonary syndrome (HCPS) has a mortality up to 35–40% and its treatment is mainly supportive. A variable to predict progression from mild to severe disease is unavailable. This study was performed in patients with documented infection by Andes orthohantavirus, and the aim was to find a simple variable to predict progression to moderate/severe HCPS in patients with mild disease at admission. Methods: We performed a retrospective analysis of 175 patients between 2001 and 2018. Patients were categorized into mild, moderate, and severe disease according to organ failure and advanced support need at hospital admission (e.g., mechanical ventilation, vasopressors). Progression to moderate/severe disease was defined accordingly. Clinical and laboratory variables associated with progression were explored. Results: Forty patients with mild disease were identified; 14 of them progressed to moderate/severe disease. Only platelet count was different between those who progressed versus those that did not (37 (34–58) vs. 83 (64–177) K/mm3, p < 0.001). A ROC curve analysis showed an AUC = 0.889 (0.78–1.0) p < 0.001, with a platelet count greater than 115K /mm3 ruling out progression to moderate/severe disease. Conclusions: In patients with mild disease at presentation, platelet count could help to define priority of evacuation to tertiary care centers.
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Affiliation(s)
- René López
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago 7650567, Chile
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Cecilia Vial
- Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7590943, Chile
| | - Jerónimo Graf
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago 7650567, Chile
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Mario Calvo
- Instituto de Medicina, Universidad Austral de Chile, Valdivia 5110566, Chile
| | - Marcela Ferrés
- Departamento Enfermedades Infecciosas e Inmunología Pediátrica, Laboratorio Infectología y Virología Molecular, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8331500, Chile
| | - Gregory Mertz
- University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Analía Cuiza
- Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago 7590943, Chile
| | - Begonia Agüero
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Dante Aguilera
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Diego Araya
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Ignacia Pailamilla
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Flavia Paratori
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Víctor Torres-Torres
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile
| | - Pablo A Vial
- Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile.
- Departamento de Pediatría, Clínica Alemana de Santiago, Santiago 7650567, Chile.
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Martínez-Valdebenito C, Angulo J, Le Corre N, Marco C, Vial C, Miquel JF, Cerda J, Mertz G, Vial P, Lopez-Lastra M, Ferrés M. A Single-Nucleotide Polymorphism of α Vβ₃ Integrin Is Associated with the Andes Virus Infection Susceptibility. Viruses 2019; 11:v11020169. [PMID: 30791508 PMCID: PMC6409546 DOI: 10.3390/v11020169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/22/2019] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 01/06/2023] Open
Abstract
The AndesOrthohantavirus (ANDV), which causes the hantavirus cardiopulmonary syndrome, enters cells via integrins, and a change from leucine to proline at residue 33 in the PSI domain (L33P), impairs ANDV recognition. We assessed the association between this human polymorphism and ANDV infection. We defined susceptible and protective genotypes as “TT” (coding leucine) and “CC” (coding proline), respectively. TT was present at a rate of 89.2% (66/74) among the first cohort of ANDV cases and at 60% (63/105) among exposed close-household contacts, who remained uninfected (p < 0.05). The protective genotype (CC) was absent in all 85 ANDV cases, in both cohorts, and was present at 11.4% of the exposed close-household contacts who remained uninfected. Logistic regression modeling for risk of infection had an OR of 6.2–12.6 (p < 0.05) in the presence of TT and well-known ANDV risk activities. Moreover, an OR of 7.3 was obtained when the TT condition was analyzed for two groups exposed to the same environmental risk. Host genetic background was found to have an important role in ANDV infection susceptibility, in the studied population.
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Affiliation(s)
- Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Santiago 8330024, Chile.
| | - Nicole Le Corre
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Claudia Marco
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Cecilia Vial
- Facultad de Medicina, Center for Genetics and Genomics, Clínica Alemana Universidad del Desarrollo, Santiago 7650568, Chile.
| | - Juan Francisco Miquel
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Jaime Cerda
- Facultad de Medicina Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Gregory Mertz
- University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.
| | - Pablo Vial
- Departamento de Pediatria, Facultad de Medicina, Clínica Alemana Santiago, Universidad del Desarrollo, Santiago 7650568, Chile.
| | - Marcelo Lopez-Lastra
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Santiago 8330024, Chile.
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunologia Pediatricas, División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
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Le-Corre N, Barría S, López T, Martínez-Valdebenito C, Contreras AM, Ferrés M. [Parotiditis in Chile: clinical and molecular characterization of two cases in a highly vaccinated population]. Rev Chilena Infectol 2018; 35:198-203. [PMID: 29912260 DOI: 10.4067/s0716-10182018000200198] [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: 11/02/2017] [Accepted: 02/27/2018] [Indexed: 11/17/2022] Open
Abstract
Mumps virus usually produces a benign infection characterized by increased parotid volume which, prior to vaccination, mainly affected children and adolescents. After the introduction of measles, mumps and rubella (MMR) vaccine, mumps incidence decreased dramatically. This intervention also produced a change in its clinical presentation, moving to young adult patients, with an increased risk of complications. We report two clinical mumps cases in young adults with different clinical presentations. In both cases, serologic assays were assessed and, in one case, a polymerase chain reaction (PCR) was performed in order to confirm the diagnosis. The isolated virus was characterized and identifed as G genotype, the same genotype observed during outbreaks in United States and Europe, and different to the vaccinal strain. Mumps virus is currently circulating in Chile and it is important to be aware of possible outbreaks. Viral diagnosis can be difficult, particularly in populations with high vaccination coverage. Therefore, the access to etiologic study through PCR and serology becomes more relevant in order to optimize clinical management and secondary prevention measures.
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Affiliation(s)
- Nicole Le-Corre
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Sebastián Barría
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Tania López
- Hospital Clínico Pontificia Universidad Católica de Chile, Chile
| | - Constanza Martínez-Valdebenito
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Ana M Contreras
- Laboratorio de Infectología y Virología Molecular, Hospital Clínico Pontificia Universidad Católica de Chile, Chile
| | - Marcela Ferrés
- Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
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Urzúa S, Ferrés M, García P, Sánchez A, Luco M. [Strategies to reduce infections and antibiotic use and its effects in a neonatal care unit]. Rev Chilena Infectol 2017. [PMID: 28632822 DOI: 10.4067/s0716-10182017000200001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Late onset sepsis (LOS) remains an important cause of morbidity and mortality in neonatal intensive care units (NICU). The empirical use of vancomycin and other broad spectrum antibiotics is very frequent and is associated with the emergence of resistant agents, infection by gram-negative bacilli (GNB), fungal infections and increased morbidity and mortality. OBJECTIVE To evaluate the impact of 5 intervention protocols designed to reduce infections and promote the rational use of antibiotics (AB) in a single NICU. PATIENTS AND METHOD Retrospective analysis included all hospitalized patients before (year 2012) and after interventions (August 2013 through July 2014). All episodes of positive cultures (blood, urine, tracheal and spinal fluid) were considered as late onset infections. RESULTS After intervention, a significant decrease of late onset infections was observed from 14.3 to 8.5 per 1,000 live births (p < 0.01); with a decrease in LOS from 5.7 to 2.9 per 1,000 live births, although no significant. There was a decrease in vancomycin and 3rd generation cephalosporin use without Candida spp infections in the intervention period. Mortality rates and length of hospital stay were similar in both study periods. CONCLUSION After interventions, there was an important reduction in overall late onset infections and AB related costs.
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Affiliation(s)
- Soledad Urzúa
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricia García
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Amparo Sánchez
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Matías Luco
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Angulo J, Martínez-Valdebenito C, Marco C, Galeno H, Villagra E, Vera L, Lagos N, Becerra N, Mora J, Bermúdez A, Díaz J, Ferrés M, López-Lastra M. Serum levels of interleukin-6 are linked to the severity of the disease caused by Andes Virus. PLoS Negl Trop Dis 2017; 11:e0005757. [PMID: 28708900 PMCID: PMC5529019 DOI: 10.1371/journal.pntd.0005757] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 03/03/2017] [Revised: 07/26/2017] [Accepted: 06/29/2017] [Indexed: 12/16/2022] Open
Abstract
Andes virus (ANDV) is the etiological agent of hantavirus cardiopulmonary syndrome in Chile. In this study, we evaluated the profile of the pro-inflammatory cytokines IL-1β, IL-12p70, IL-21, TNF-α, IFN-γ, IL-10 and IL-6 in serum samples of ANDV-infected patients at the time of hospitalization. The mean levels of circulating cytokines were determined by a Bead-Based Multiplex assay coupled with Luminex detection technology, in order to compare 43 serum samples of healthy controls and 43 samples of ANDV-infected patients that had been categorized according to the severity of disease. When compared to the controls, no significant differences in IL-1β concentration were observed in ANDV-infected patients (p = 0.9672), whereas levels of IL-12p70 and IL-21 were significantly lower in infected cases (p = <0.0001). Significantly elevated levels of TNF-α, IFN-γ, IL-10, and IL-6 were detected in ANDV-infected individuals (p = <0.0001, 0.0036, <0.0001, <0.0001, respectively). Notably, IL-6 levels were significantly higher (40-fold) in the 22 patients with severe symptoms compared to the 21 individuals with mild symptoms (p = <0.0001). Using multivariate regression models, we show that IL-6 levels has a crude OR of 14.4 (CI: 3.3–63.1). In conclusion, the serum level of IL-6 is a significant predictor of the severity of the clinical outcome of ANDV-induced disease. Andes virus (ANDV) causes hantavirus cardiopulmonary syndrome (HCPS) that is characterized by the development of vascular leakage syndrome, eventually leading to massive pulmonary edema, shock and, in many cases, death. To date, no FDA-approved immunotherapeutics, specific antivirals, or vaccines are available for use against HCPS. Patient survival rates hinge largely on early virus diagnosis, hospital admission and aggressive pulmonary and hemodynamic support in an intensive care unit. Individual host factors associated with the outcome of an ANDV infection are poorly known, and such knowledge could allow the disease progression of hospitalized patients to be predicted, resulting in individualized treatment. In this study, we show that serum levels of IL-6 at the time of hospitalization in ANDV-infected patients are associated with the severity of the clinical outcome of ANDV-induced disease. Therefore, these finding suggest that determining IL-6 levels at the time of admission to the hospital could be useful to predict the progression of ANDV-induced disease.
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Affiliation(s)
- Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Constanza Martínez-Valdebenito
- Laboratorio de Infectología, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Marco
- Laboratorio de Infectología, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Héctor Galeno
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Eliecer Villagra
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Lilian Vera
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Natalia Lagos
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Natalia Becerra
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Judith Mora
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Andrea Bermúdez
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Janepsy Díaz
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Marcela Ferrés
- Laboratorio de Infectología, Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo López-Lastra
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia (IMII), Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
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Retamal J, Becker P, González R, Ferrés M, Cerda J, Riquelme MI, Pérez R, Clavería C. Infección del sitio quirúrgico en niños sometidos a cirugía cardíaca con cierre esternal diferido: Estudio de casos y controles. Rev Chilena Infectol 2016; 33:495-500. [DOI: 10.4067/s0716-10182016000500001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/05/2016] [Indexed: 11/17/2022] Open
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Gutiérrez V, Martínez-Valdebenito C, Montecinos L, Alarcón R, Gárate C, Ferrés M. Parechovirus como agente etiológico de meningitis y/o sepsis viral en lactantes. Rev Chilena Infectol 2016; 33:380-388. [DOI: 10.4067/s0716-10182016000400002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/17/2016] [Indexed: 11/17/2022] Open
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Sandoval C, Barrera A, Ferrés M, Cerda J, Retamal J, García-Sastre A, Medina RA, Hirsch T. Infection in Health Personnel with High and Low Levels of Exposure in a Hospital Setting during the H1N1 2009 Influenza A Pandemic. PLoS One 2016; 11:e0147271. [PMID: 26799564 PMCID: PMC4723060 DOI: 10.1371/journal.pone.0147271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/13/2014] [Accepted: 12/31/2015] [Indexed: 11/13/2022] Open
Abstract
A novel H1N1 influenza A virus caused the first pandemic of the 21st century in 2009. Hospitals had an increased demand of health consultations, that made it difficult to estimate the incidence of infection in hospital personnel due to asymptomatic presentations and the under notification of cases. To estimate and compare the rate of exposure of high versus low risk health personnel to 2009 pandemic H1N1 (H1N1pdm2009) influenza A virus in a University Hospital in Chile, we performed a comparative and prospective study. Serum samples were obtained from 117 individuals that worked in the emergency room (ER) and the operating room (OR) during the peak of the pandemic. Antibody titers were determined by the hemagglutination inhibition (HI) assay. Of the samples analyzed, 65% were workers at the ER and 35% at the OR. Of the total number of the subjects tested, 29.1% were seropositive. One out of 3 (36.8%) workers at the ER had positive HI titers, meanwhile only 1 out of 7 (14.6%) workers from the OR was seropositive to the virus. The possibility of being infected in the ER as compared to the OR was 3.4 times greater (OR 3.4; CI 95%, 1.27–9.1), and the individuals of the ER had almost twice as much antibody titers against H1N1pdm2009 than the personnel in the OR, suggesting the potential of more than one exposure to the virus. Of the 34 seropositive subjects, 12 (35.3%) did not develop influenza like illness, including 2 non-clinical personnel involved in direct contact with patients at the ER. Considering the estimated population attack rate in Chile of 13%, both groups presented a higher exposure and seropositive rate than the general population, with ER personnel showing greater risk of infection and a significantly higher level of antibodies. This data provide a strong rationale to design improved control measures aimed at all the hospital personnel, including those coming into contact with the patients prior to triage, to prevent the propagation and transmission of respiratory viruses, particularly during a pandemic outbreak.
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Affiliation(s)
- Carmen Sandoval
- Departmento de Enfermedades Infecciosas e Inmulogia Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Aldo Barrera
- Laboratory of Infectious Diseases and Molecular Virology, Centro de Investigaciones Médicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Ferrés
- Departmento de Enfermedades Infecciosas e Inmulogia Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory of Infectious Diseases and Molecular Virology, Centro de Investigaciones Médicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Cerda
- Departmento de Enfermedades Infecciosas e Inmulogia Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Public Health Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Retamal
- Departmento de Enfermedades Infecciosas e Inmulogia Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adolfo García-Sastre
- Department of Microbiology and Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Rafael A. Medina
- Departmento de Enfermedades Infecciosas e Inmulogia Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory of Infectious Diseases and Molecular Virology, Centro de Investigaciones Médicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Microbiology and Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Instituto Milenio en Inmunología e Inmunoterapia, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail: ; (TH); (RAM)
| | - Tamara Hirsch
- Hospital Clínico, Emergency Room, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Pediatría, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail: ; (TH); (RAM)
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Angulo J, Pino K, Echeverría-Chagas N, Marco C, Martínez-Valdebenito C, Galeno H, Villagra E, Vera L, Lagos N, Becerra N, Mora J, Bermúdez A, Cárcamo M, Díaz J, Miquel JF, Ferrés M, López-Lastra M. Association of Single-Nucleotide Polymorphisms in IL28B, but Not TNF-α, With Severity of Disease Caused by Andes Virus. Clin Infect Dis 2015; 61:e62-9. [PMID: 26394672 PMCID: PMC4657541 DOI: 10.1093/cid/civ830] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 05/31/2015] [Accepted: 09/04/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Andes virus (ANDV) is the sole etiologic agent of hantavirus cardiopulmonary syndrome (HCPS) in Chile, with a fatality rate of about 35%. Individual host factors affecting ANDV infection outcome are poorly understood. In this case-control genetic association analysis, we explored the link between single-nucleotide polymorphisms (SNPs) rs12979860, rs8099917 and rs1800629 and the clinical outcome of ANDV-induced disease. The SNPs rs12979860 and rs8099917 are known to play a role in the differential expression of the interleukin 28B gene (IL28B), whereas SNP rs1800629 is implicated in the expression of tumor necrosis factor α gene (TNF-α). METHODS A total of 238 samples from confirmed ANDV-infected patients collected between 2006 and 2014, and categorized according to the severity of the disease, were genotyped for SNPs rs12979860, rs8099917, and rs1800629. RESULTS Analysis of IL28B SNPs rs12979860 and rs8099917 revealed a link between homozygosity of the minor alleles (TT and GG, respectively), displaying a mild disease progression, whereas heterozygosity or homozygosity for the major alleles (CT/CC and TG/TT, respectively) in both IL28B SNPs is associated with severe disease. No association with the clinical outcome of HCPS was observed for TNF-α SNP rs1800629 (TNF -308G>A). CONCLUSIONS The IL28B SNPs rs12979860 and rs8099917, but not TNF-α SNP rs1800629, are associated with the clinical outcome of ANDV-induced disease, suggesting a possible link between IL28B expression and ANDV pathogenesis.
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Affiliation(s)
- Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia
| | - Karla Pino
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia
| | - Natalia Echeverría-Chagas
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Claudia Marco
- Laboratorio de Infectología, Centro de Investigaciones Médicas, Escuela de Medicina, División de Pediatría
| | | | - Héctor Galeno
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Eliecer Villagra
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Lilian Vera
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Natalia Lagos
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Natalia Becerra
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Judith Mora
- Subdepartamento de Virología Clínica, Departamento Laboratorio Biomédico Nacional y de Referencia
| | - Andrea Bermúdez
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago
| | - Marcela Cárcamo
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago
| | - Janepsy Díaz
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago
| | - Juan Francisco Miquel
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile
| | - Marcela Ferrés
- Laboratorio de Infectología, Centro de Investigaciones Médicas, Escuela de Medicina, División de Pediatría
| | - Marcelo López-Lastra
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia
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Martinez-Valdebenito C, Calvo M, Vial C, Mansilla R, Marco C, Palma RE, Vial PA, Valdivieso F, Mertz G, Ferrés M. Person-to-person household and nosocomial transmission of andes hantavirus, Southern Chile, 2011. Emerg Infect Dis 2015; 20:1629-36. [PMID: 25272189 PMCID: PMC4193174 DOI: 10.3201/eid2010.140353] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Four persons became ill after exposure to a patient infected with the virus; 2 cases involved hospital transmission. Andes hantavirus (ANDV) causes hantavirus cardiopulmonary syndrome in Chile and is the only hantavirus for which person-to-person transmission has been proven. We describe an outbreak of 5 human cases of ANDV infection in which symptoms developed in 2 household contacts and 2 health care workers after exposure to the index case-patient. Results of an epidemiologic investigation and sequence analysis of the virus isolates support person-to-person transmission of ANDV for the 4 secondary case-patients, including nosocomial transmission for the 2 health care workers. Health care personnel who have direct contact with ANDV case-patients or their body fluids should take precautions to prevent transmission of the virus. In addition, because the incubation period of ANDV after environmental exposure is longer than that for person-to-person exposure, all persons exposed to a confirmed ANDV case-patient or with possible environmental exposure to the virus should be monitored for 42 days for clinical symptoms.
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Barriga J, Cerda J, Abarca K, Ferrés M, Fajuri P, Riquelme M, Carrillo D, Clavería C. [Nosocomial infections after cardiac surgery in infants and children with congenital heart disease]. Rev Chilena Infectol 2015; 31:16-20. [PMID: 24740769 DOI: 10.4067/s0716-10182014000100002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 12/18/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Nosocomial infections generate high morbidity and mortality in children undergoing cardiac surgery. OBJECTIVE To determine risk factors for nosocomial infections in children after congenital heart surgery. METHODS A retrospective case-control study, in patients younger than 15 years undergoing surgery for congenital heart disease from January 2007 to December 2011 admitted to the Pediatric Critical Patient Unit (UPC-P) in a university hospital. For cases, the information was analyzed from the first episode of infection. RESULTS 39 patients who develop infections and 39 controls who did not develop infection were enrolled. The median age of cases was 2 months. We identified a number of factors associated with the occurrence of infections, highlighting in univariate analysis: age, weight, univentricular heart physiology, complexity of the surgical procedure according to RACHS-1 and cardiopulmonary bypass (CPB) time ≥ 200 minutes. Multivariate analysis identified CPB time ≥ 200 minutes as the major risk factor, with an OR of 11.57 (CI: 1.04 to 128.5). CONCLUSION CPB time ≥ 200 minutes was the mayor risk factor associated with the development of nosocomial infections.
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Figueiredo LTM, Souza WMD, Ferrés M, Enria DA. Hantaviruses and cardiopulmonary syndrome in South America. Virus Res 2014; 187:43-54. [DOI: 10.1016/j.virusres.2014.01.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/15/2014] [Indexed: 12/12/2022]
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Ferrer P, Tello M, Montecinos L, Tordecilla R, Rodríguez C, Beltrán C, Guzmán MA, Ferrés M, Pérez CM, Afani A. Prevalence of R5 and X4 HIV variants in antiretroviral treatment experienced patients with virologic failure. J Clin Virol 2014; 60:290-4. [PMID: 24793966 DOI: 10.1016/j.jcv.2014.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 12/02/2013] [Revised: 04/01/2014] [Accepted: 04/06/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Antiretroviral therapy (ART) inhibits virus replication. Nevertheless, ART has the disadvantage of generate selective resistance and adverse events. Coreceptor antagonists are a family of antiretroviral drugs that are used with the prior knowledge of patients HIV tropism. OBJECTIVES The purpose of this work was to estimate the prevalence of R5 and X4 variants among Chilean patients under antiretroviral therapy and virological failure and investigate variables such as plasma viral load (pVL) and CD4 cell count in the population studied. STUDY DESIGN HIV RNA or proviral DNA was extracted from 454 consecutives patients and tropism testing was performed using a genotypic method performed with Geno2pheno setting a cutoff value for FPR 5.75%. RESULTS Among 454 individuals analyzed, 299 (66%) harbouring exclusively R5 variants. They not displayed a better clinical profile than individuals harbouring X4 strains (22%). For R5 patients the median of pVL and CD4 cell count were 268,000copies/mL, and 223cells/μL respectively. For X4 samples the values were 368,000copies/mL and 214cells/μL [P>0.05]). Only, 53 patients (12%) could not be analyzed and were categorized as non-reportable. CONCLUSIONS The genotypic method confirmed that R5 strains were more prevalent despite the fact that patients were treatment-experienced for several years. The genotypic strategy proved to be a faster and cost-effective option as compared to phenotypic assays. According to our results, two of every three patients under antiretroviral therapy and with virologic failure harbour R5 strains, and may be candidates for use of a CCR5 antagonist.
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Affiliation(s)
- P Ferrer
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - M Tello
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.
| | - L Montecinos
- Laboratorio de Infectología y Virología Molecular, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago, Chile.
| | - R Tordecilla
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - C Rodríguez
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - C Beltrán
- Departamento de Infectología, Complejo Asistencial Barros Luco. Facultad de Medicina, Universidad de Santiago de Chile, and Chilean AIDS Cohort (ChiAC), Santiago, Chile.
| | - M A Guzmán
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - M Ferrés
- Laboratorio de Infectología y Virología Molecular, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago, Chile.
| | - C M Pérez
- Laboratorio de Infectología y Virología Molecular, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago, Chile.
| | - A Afani
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
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Ceballos ME, Vizcaya C, Pavez D, Cerda J, Martínez-Valdebenito C, Montecinos L, Ferrés M. Detección precoz de infección por citomegalovirus en pacientes sometidos a trasplante alogéneico de precursores hematopoyéticos por reacción de polimerasa en cadena cuantitativa en tiempo real. Rev Chilena Infectol 2014; 31:153-9. [DOI: 10.4067/s0716-10182014000200005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 03/11/2014] [Indexed: 11/17/2022] Open
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Ferrer P, Montecinos L, Tello M, Tordecilla R, Rodríguez C, Ferrés M, Pérez CM, Beltrán C, Guzmán MA, Afani A. HIV-1 tropism: a comparison between RNA and proviral DNA in routine clinical samples from Chilean patients. Virol J 2013; 10:318. [PMID: 24165156 PMCID: PMC4231446 DOI: 10.1186/1743-422x-10-318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/14/2013] [Indexed: 11/10/2022] Open
Abstract
Background HIV in Chile has a notification rate of 0.01%. Coreceptor antagonists are a family of antiretroviral drugs that are used with the prior knowledge of patients HIV-1 tropism. Viral RNA-based tropism detection requires a plasma viral load ≥1000 copies/mL, while proviral DNA-based detection can be performed regardless of plasma viral load. This test is useful in patients with low or undetectable viral loads and would benefit with a proper therapy. The aim of this study was to determine the correlation between HIV RNA and proviral genotypic DNA tropism tests. Findings Forty three Chilean patients were examined using population-based V3 sequencing, and a geno2pheno false-positive rate (FPR) cutoff values of 5, 5.75, 10 and 20%. With cutoff 5.75% a concordance of 88.4% in tropism prediction was found after a simultaneous comparison between HIV tropism assessment by RNA and DNA. In total, five discrepancies (11.6%) were found, 3 patients were RNA-R5/DNA-X4 and two were RNA-X4/DNA-R5. Proviral DNA enabled the prediction of tropism in patients with a low or undetectable viral load. For cutoff 5 and 5.75% genotypic testing using proviral DNA showed a similar sensitivity for X4 as RNA. We found that the highest sensitivity for detecting the X4 strain occurred with proviral DNA and cutoff of 10 and 20%. Viral loads were higher among X4 strain carriers than among R5 strain carriers (p < 0.05). Conclusions A high degree of concordance was found between tropism testing with RNA and testing with proviral DNA. Our results suggest that proviral DNA-based genotypic tropism testing is a useful option for patients with low or undetectable viral load who require a different therapy.
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Affiliation(s)
- Pablo Ferrer
- Laboratorio de Medicina Molecular, Hospital Clínico Universidad de Chile, Santiago, Chile.
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Gómez RS, Mora JE, Cortés CM, Riedel CA, Ferrés M, Bueno SM, Kalergis AM. Respiratory syncytial virus detection in cells and clinical samples by using three new monoclonal antibodies. J Med Virol 2013; 86:1256-66. [PMID: 24150877 DOI: 10.1002/jmv.23807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/11/2022]
Abstract
Acute respiratory infections caused by the respiratory syncytial virus (RSV) are important health burdens that affect infants worldwide. RSV is also an important cause of morbidity and disease in adults, which causes enormous economic losses. At the present time, RSV infection is diagnosed by immunofluorescence, test pack and/or PCR, obtaining better results with PCR than with any other technique. The production of new monoclonal antibodies (mAbs) capable of detecting RSV in clinical samples is necessary to generate better and faster diagnosis tools for RSV. In this study, three new mAbs, directed against the RSV N and M2-1 proteins, were evaluated for the detection of RSV in clinical samples. Nasopharyngeal swabs were obtained from: 27 RSV-positive patients; 15 human metapneumovirus (hMPV)-positive patients; and 6 healthy controls. To evaluate RSV presence in these samples, clinical samples and RSV-infected cells were tested by Enzyme-Linked ImmunoSorbent Assay (ELISA), flow cytometry, immunofluorescence, and dot-blot assays. Specificity and sensitivity were determined for each mAb by using purified RSV antigens and antigens from different viruses. Infected cells and clinical samples tested with the three new mAbs resulted positive by immunofluorescence, ELISA, flow cytometry, and dot blot. No false positives were obtained in samples infected with other respiratory virus (hMPV) or from healthy controls. These results suggest that these new anti-RSV mAbs can be considered for the rapid and reliable detection of RSV on infected cells and clinical specimens by multiple immunological approaches.
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Affiliation(s)
- Roberto S Gómez
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile; INSERM U1064, Nantes, France
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Ajenjo MC, Zambrano A, Eugenin MI, Achurra P, Zalaquett R, Irarrázaval MJ, De la Cerda G, Fernández P, Barañao M, Fuentealba P, Ferrés M, García P, Pérez C, Labarca J. Reducción de incidencia de neumonía asociada a ventilación mecánica post cirugía cardíaca: experiencia de 13 años de vigilancia epidemiológica en un hospital universitario. Rev Chilena Infectol 2013; 30:129-34. [DOI: 10.4067/s0716-10182013000200002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 03/04/2013] [Indexed: 11/17/2022] Open
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Abarca K, Winter M, Marsac D, Palma C, Contreras AM, Ferrés M. Exactitud y utilidad diagnóstica de la IgM en infecciones por Bartonella henselae. Rev Chilena Infectol 2013; 30:125-8. [DOI: 10.4067/s0716-10182013000200001] [Citation(s) in RCA: 9] [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: 07/11/2012] [Accepted: 01/05/2013] [Indexed: 11/17/2022] Open
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Ferrés M, Nervi B, Ramírez P. [Prophylaxis against cytomegalovirus infection in pediatric and adult patients undergoing solid organ and hematopoietic stem cells transplantation]. Rev Chilena Infectol 2013; 29 Suppl 1:S23-8. [PMID: 23282552 DOI: 10.4067/s0716-10182012000500004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CMV is one of the main infectious problems for SOT and HSCT. The severity of the complications are mainly associated with the type of transplant and immune status against the virus of the transplant donor and the transplant recipient. It is important to prevent exposure, using safe blood transfusion CMV seronegative donors (B1) and/or use of blood leucocytes-depleted by filtration (Al). In addition to preventing exposure, there are two widely used prevention strategies: universal prophylaxis with antiviral therapy or "pre-emptive" strategy based on the use of antivirals only to the early detection of CMV replication in blood. The first option is most used in the SOT management, especially for those identified as the high risk group of CMV disease: R (+), with D (+) or D (-) (Al), where the recommended drug is ganciclovir or valganciclovir . The second approach is preferable for HSCT, which recommends weekly monitoring for CMV viral load from day 10 to 100 post transplant (A3). This strategy requires having a viral laboratory support (A2). The selected antiviral in the case of pre emptive therapy is intravenous ganciclovir (A1).
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Affiliation(s)
- Marcela Ferrés
- Laboratorio de Infectología y Virología Molecular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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