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Fernández-Huerta M, Pich OQ, Espasa M. [Mycoplasma and Ureaplasma spp. in clinical practice of ano-genital infections]. Rev Esp Quimioter 2022; 35:301-303. [PMID: 35488360 PMCID: PMC9134890 DOI: 10.37201/req/005.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/28/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Affiliation(s)
- M Fernández-Huerta
- Miguel Fernández-Huerta, Servicio de Microbiología, Hospital Universitario de Navarra, Spain.
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2
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Gomila-Grange A, Espasa M, Moglia E. Cardiogenic Shock Caused by SARS-CoV-2 in a Patient with Serial Negative Nucleic Acid Amplification Tests. Case Report. ACTA ACUST UNITED AC 2020; 2:1903-1905. [PMID: 32904594 PMCID: PMC7456659 DOI: 10.1007/s42399-020-00496-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Accepted: 08/27/2020] [Indexed: 01/08/2023]
Abstract
Myocarditis is an unusual manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been associated with increased severity of disease and mortality. The diagnosis of coronavirus disease 2019 (COVID-19) is based on positivity of nucleic acid amplification tests (NAAT) of respiratory samples. We report the case of a patient with cardiogenic shock caused by SARS-CoV-2 myocarditis with serial negative upper and lower respiratory nucleic acid amplification tests. Diagnosis was made by serology (positive IgM + IgA and IgG) from patient’s serum sample of day 10 after symptoms’ initiation.
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Affiliation(s)
- Aina Gomila-Grange
- Infectious Diseases Department, Consorci Corporació Sanitària Parc Taulí, Parc Taulí 1, Sabadell, 08208 Barcelona, CP Spain
| | - M Espasa
- Microbiology Unit, Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - E Moglia
- Intensive Care Unit, Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
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Mendoza-Palomar N, Sulleiro E, Perez-Garcia I, Espiau M, Soriano-Arandes A, Martín-Nalda A, Espasa M, Zarzuela F, Soler-Palacin P. Schistosomiasis in children: review of 51 imported cases in Spain. J Travel Med 2020; 27:5671715. [PMID: 31821494 DOI: 10.1093/jtm/taz099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 11/14/2022]
Affiliation(s)
- N Mendoza-Palomar
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - E Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - I Perez-Garcia
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Espiau
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - A Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - A Martín-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - M Espasa
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - F Zarzuela
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - P Soler-Palacin
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
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Moure Z, Angheben A, Molina I, Gobbi F, Espasa M, Anselmi M, Salvador F, Tais S, Sánchez-Montalvá A, Pumarola T, Albajar-Viñas P, Sulleiro E. Serodiscordance in chronic Chagas disease diagnosis: a real problem in non-endemic countries. Clin Microbiol Infect 2016; 22:788-792. [PMID: 27317907 DOI: 10.1016/j.cmi.2016.06.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/02/2016] [Accepted: 06/06/2016] [Indexed: 11/28/2022]
Abstract
According to the WHO, chronic Chagas disease (CD) diagnosis is based on two serological techniques. To establish a definitive diagnosis, the results must be concordant. In cases of discordances, the WHO proposes repeating serology in a new sample, and if results remain inconclusive, a confirmatory test should be performed. This study, conducted at two Tropical Medicine Units in Europe over 4 years, aims to assess the diagnostic yield of TESA- (trypomastigote excreted-secreted antigens) blot as a confirmatory technique in patients with inconclusive and discordant results. Of 4939 individuals screened, 1124 (22.7%) obtained positive results and 165 (3.3%) discordant results. Serology was repeated in 88/165 sera and discrepancies were solved in 25/88 (28.4%) cases. Patients without a definitive diagnosis were classified in two different groups: Group 1, including patients with inconclusive results despite retesting (n = 63), and Group 2, including patients with discordant results not retested (n = 77). TESA-blot was performed for all of Group 1 and 39/77 of Group 2 and was positive for 33/63 (52.4%) and 21/39 (53.8%), respectively. Analysis of Group 1 results showed a moderate agreement between results of the ELISA based on native antigen and TESA-blot (κ 0.53). In contrast, a clear disagreement was observed between the ELISA based on recombinant antigens and TESA-blot (κ <0). A sizeable proportion of patients are suspected to have CD with inconclusive results or in whom re-testing is not feasible. TESA-blot was positive in half of these patients, highlighting the need for a confirmatory assay in European centres caring for exposed individuals.
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Affiliation(s)
- Z Moure
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.
| | - A Angheben
- Centre for Tropical Diseases, Hospital 'Sacro Cuore-Don Calabria', Negrar, Italy; Global Health Centre of Tuscany Region, Florence, Italy
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - F Gobbi
- Centre for Tropical Diseases, Hospital 'Sacro Cuore-Don Calabria', Negrar, Italy; Global Health Centre of Tuscany Region, Florence, Italy
| | - M Espasa
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain
| | - M Anselmi
- Centro de Epidemiologia Comunitaria y Medicina Tropical, Esmeraldas, Ecuador
| | - F Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - S Tais
- Service of Epidemiology and Laboratory for Tropical Diseases, Hospital 'Sacro Cuore-Don Calabria', Negrar, Italy
| | - A Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - T Pumarola
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain
| | - P Albajar-Viñas
- Department of HIV/AIDS, Tuberculosis, Malaria and Neglected Diseases, Control of Neglected Tropical Diseases Department, WHO, Geneva, Switzerland
| | - E Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain
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Bocanegra C, Sulleiro E, Soriano-Arandes A, Pou D, Suy A, Llurba E, Rodó C, Espasa M, Campins M, Martín A, Rodrigo C, Vázquez A, De Ory F, Sánchez-Seco MP, Pumarola T, Carreras E, Molina I. Zika virus infection in pregnant women in Barcelona, Spain. Clin Microbiol Infect 2016; 22:648-50. [PMID: 27063354 DOI: 10.1016/j.cmi.2016.03.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022]
Affiliation(s)
- C Bocanegra
- Tropical Medicine and International Health Unit, Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain.
| | - E Sulleiro
- Microbiology Department, University Hospital Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - A Soriano-Arandes
- Pediatrics Department, Tropical Medicine and International Health Unit, Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - D Pou
- Tropical Medicine and International Health Unit, Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona Spain
| | - A Suy
- Gynecology and Obstetrics Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - E Llurba
- Gynecology and Obstetrics Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - C Rodó
- Gynecology and Obstetrics Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - M Espasa
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - M Campins
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Martín
- Pediatrics Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Rodrigo
- Pediatrics Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Vázquez
- National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - F De Ory
- National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - M P Sánchez-Seco
- National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - T Pumarola
- Microbiology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - E Carreras
- Gynecology and Obstetrics Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona Spain
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Millares L, Ferrari R, Gallego M, Garcia-Nuñez M, Pérez-Brocal V, Espasa M, Pomares X, Monton C, Moya A, Monsó E. Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis 2014; 33:1101-11. [PMID: 24449346 PMCID: PMC4042013 DOI: 10.1007/s10096-013-2044-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/20/2013] [Indexed: 02/07/2023]
Abstract
The bronchial microbiome in severe COPD during stability and exacerbation in patients chronically colonised by Pseudomonas aeruginosa (PA), has not been defined. Our objective was to determine the characteristics of the bronchial microbiome of severe COPD patients colonised and not colonised by P. aeruginosa and its changes during exacerbation. COPD patients with severe disease and frequent exacerbations were categorised according to chronic colonisation by P. aeruginosa. Sputum samples were obtained in stability and exacerbation, cultured, and analysed by 16S rRNA gene amplification and pyrosequencing. Sixteen patients were included, 5 of them showing chronic colonisation by P. aeruginosa. Pseudomonas genus had significantly higher relative abundance in stable colonised patients (p = 0.019), but no significant differences in biodiversity parameters were found between the two groups (Shannon, 3 (2-4) vs 3 (2-3), p = 0.699; Chao1, 124 (77-159) vs 140 (115-163), p = 0.364). In PA-colonised patients bronchial microbiome changed to a microbiome similar to non-PA-colonised patients during exacerbations. An increase in the relative abundance over 20 % during exacerbation was found for Streptococcus, Pseudomonas, Moraxella, Haemophilus, Neisseria, Achromobacter and Corynebacterium genera, which include recognised potentially pathogenic microorganisms, in 13 patients colonised and not colonised by P. aeruginosa with paired samples. These increases were not identified by culture in 5 out of 13 participants (38.5 %). Stable COPD patients with severe disease and PA-colonised showed a similar biodiversity to non-PA-colonised patients, with a higher relative abundance of Pseudomonas genus in bronchial secretions. Exacerbation in severe COPD patients showed the same microbial pattern, independently of previous colonisation by P. aeruginosa.
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Affiliation(s)
- L. Millares
- Fundació Parc Taulí, Sabadell, Spain
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Fundació Institut d’Investigació Germans Trias i Pujol, Badalona, Spain
| | - R. Ferrari
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - M. Gallego
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - M. Garcia-Nuñez
- Fundació Parc Taulí, Sabadell, Spain
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Fundació Institut d’Investigació Germans Trias i Pujol, Badalona, Spain
| | - V. Pérez-Brocal
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - M. Espasa
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - X. Pomares
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - C. Monton
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - A. Moya
- Genomics and Health Area, Centro Superior de Investigación en Salud Pública—Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (CSISP-FISABIO), Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Genetics, Institut Cavanilles de Biodiversitat i Biologia Evolutiva, (ICBiBE) Universitat de València, Valencia, Spain
| | - E. Monsó
- CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
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Vilella M, Larramona H, Bosque M, Costa J, Espasa M, Valdesoiro L, Asensio O, Domingo X, Guijarro E. 143 Seasonality of Pseudomonas aeruginosa isolation in patients with cystic fibrosis. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60279-4] [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: 11/25/2022]
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Sigaúque B, Roca A, Sanz S, Oliveiras I, Martínez M, Mandomando I, Vallès X, Espasa M, Abacassamo F, Sacarlal J, Macete E, Nhacolo A, Aponte J, Levine M, Alonso P. Acute bacterial meningitis among children, in Manhiça, a rural area in Southern Mozambique. Acta Trop 2008; 105:21-7. [PMID: 17959132 DOI: 10.1016/j.actatropica.2007.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Revised: 01/03/2007] [Accepted: 01/05/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Acute bacterial meningitis (ABM) is one of the most severe diseases in Sub-Saharan Africa. Although data for the continent is very limited, more than one million cases are estimated per year, with mortality and life-long sequelae occurring in 50% of these cases. METHODS As part of the clinical management of children admitted to the Manhiça District Hospital, information on cases of ABM was recorded. We analysed data from June 1998 to November 2003. RESULTS During the study period, 475 cerebrospinal-fluid (CSF) samples were collected from 20,173 children <15 years of age admitted to hospital. Culture results confirmed 71 (15%) cases of ABM. The most prevalent bacterial aetiologies were Streptotoccus pneumoniae (pneumococcus, n=31), Haemophilus influenzae (n=13) and Neisseria meningitis (n=8). Other important bacteria were Streptococcus sp. (n=7), Salmonella sp. (n=4) and Staphylococcus aureus (n=3). Crude incidence rates of ABM and pneumococcal meningitis were 20/100,000 and 10/100,000 children-year-at-risk, respectively. Incidences were more than three times higher in the <1 year age group. Overall case fatality rate was 36%, and was highest for H. influenzae and pneumococcal meningitis (55% and 45%, respectively, p=0.044). Pneumococcal susceptibility was 81% for oxacillin and 93% for chloramphenicol. For H. influenzae isolates, susceptibility was 54% for ampicillin and 62% for chloramphenicol. CONCLUSIONS S. pneumoniae and H. influenzae are the main aetiologies responsible for the high burden of morbidity and mortality associated with ABM in rural Mozambique. These findings are important to evaluate treatment guidelines and potential impact of control measures.
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Macete E, Aponte JJ, Guinovart C, Sacarlal J, Ofori-Anyinam O, Mandomando I, Espasa M, Bevilacqua C, Leach A, Dubois MC, Heppner DG, Tello L, Milman J, Cohen J, Dubovsky F, Tornieporth N, Thompson R, Alonso PL. Safety and immunogenicity of the RTS,S/AS02A candidate malaria vaccine in children aged 1-4 in Mozambique. Trop Med Int Health 2007; 12:37-46. [PMID: 17207146 DOI: 10.1111/j.1365-3156.2006.01754.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The development of a malaria vaccine remains a public health priority for sub-Saharan Africa. RTS,S/AS02A candidate malaria vaccine has been shown to be safe and immunogenic in previous studies in adults and staggered dose-escalation studies in children in The Gambia. However, genetic features and the intensity of malaria transmission may modify the safety and immune response of a vaccine. OBJECTIVE We carried out a phase I, double-blind randomized controlled trial in 60 children aged 1-4 in Mozambique to evaluate the safety, reactogenicity and immunogenicity of the paediatric vaccine dose (fixed 25 microg RTS,S in 0.25 ml) of RTS,S/AS02A, prior to undertaking a planned larger phase IIb proof-of-concept of efficacy study in the same population. METHOD Children were randomized to receive either RTS,S/AS02A or Engerix-B vaccine. Monitoring of safety and reactogenicity included detailed clinical and laboratory analyses and assessment of adverse events (AEs). RESULTS The RTS,S/AS02A was found to be safe and well tolerated. Serious adverse events were balanced between both groups and none was related to vaccination. The frequency of adverse events reported with RTS, S/AS02A was comparable to previous studies in children. Grade 3 AEs were infrequent (one case of pain, one of fever in each group and some swelling greater than 20 mm in diameter), transient and resolved without sequelae. RTS,S/AS02A was highly immunogenic for anti-circumsporozoite protein antibody response and induced a strong anti-hepatitis-B surface antigen response.
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Affiliation(s)
- E Macete
- Centro de Investigação em Saúde da Manhiça (CISM), Manhiça, Mozambique
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10
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Roca A, Sigaúque B, Quintó L, Mandomando I, Vallès X, Espasa M, Abacassamo F, Sacarlal J, Macete E, Nhacolo A, Levine M, Alonso P. Invasive pneumococcal disease in children<5 years of age in rural Mozambique. Trop Med Int Health 2006; 11:1422-31. [PMID: 16930265 DOI: 10.1111/j.1365-3156.2006.01697.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To estimate the incidence and epidemiological characteristics of invasive pneumococcal disease (IPD) in children<5 years of age living in a rural area of southern Mozambique. METHODS As part of the clinical management of children admitted to Manhiça District Hospital, prospective surveillance for invasive bacterial disease was conducted from June 2001 to May 2003. The level of antibiotic resistance of the isolates was also analysed. RESULTS Pneumococcus was the most commonly isolated bacterium, accounting for 212 episodes. The estimated crude incidence rate of IPD in the study area among children<5 years of age was 416/100,000 per child-year at risk. The youngest age group (<3 months) had the highest incidence (779/100,000). Cases were detected during both rainy and dry seasons. The most common clinical diagnosis was pneumonia, made in 146/212 (69%) of the episodes of IPD. The overall case fatality rate was 10%, being highest among children with pneumococcal meningitis (5/9=56%). Pneumococcal isolates were highly susceptible to penicillin (86% susceptible and 14% with intermediate resistance) and chloramphenicol (98% susceptible). In contrast, up to 37% of the isolates tested were non-susceptible to cotrimoxazole. CONCLUSIONS Incidence rates of IPD and associated mortality shown in this study highlight the need for pneumococcal vaccines in rural Africa, which must be effective in infants and young children.
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Affiliation(s)
- A Roca
- Centre de Salut Internacional, Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
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Coll P, Aragón LM, Alcaide F, Espasa M, Garrigó M, González J, Manterola JM, Orús P, Salvadó M. Molecular analysis of isoniazid and rifampin resistance in Mycobacterium tuberculosis isolates recovered from Barcelona. Microb Drug Resist 2005; 11:107-14. [PMID: 15910223 DOI: 10.1089/mdr.2005.11.107] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We studied the presence of mutations in the whole katG gene and specific regions of the oxyR-ahpC and mabA-inhA regulatory region in 61 Mycobacterium tuberculosis isoniazid-resistant isolates. An 81-bp region of the rpoB gene was also sequenced in 17 rifampin-resistant strains. Alterations in the katG gene were detected in 55% of the isolates. Mutation in codon 315 was the most prevalent (32%). Strains showed a high level of resistance, and most maintained a substantial catalase-peroxidase activity. Three strains with an isoniazid MIC of >or=32 microg/ml lacked catalase-peroxidase activity. Two of them had deletions in the catalytic domain of the KatG protein. One strain with deletion and three strains with mutations in the C-terminal domain showed low-level resistance and conserved the catalase-peroxidase activity. Mutations in the mabA-inhA regulatory region were identified in 32% of the isolates. All had low-level resistance, and the vast majority conserved catalase-peroxidase activity. Seventeen percent of the isoniazid-resistant isolates had no detectable alterations at the studied loci. Resistance to rifampin was associated with mutations in the 81-bp of the rpoB gene in all cases. IS6110 analysis indicated that recent transmission contributed substantially to the emergence of isoniazid- resistant tuberculosis in Barcelona through short transmission chains. A rapid genotypic assay, including the 315-katG codon and the -15 nucleotide of the mabA-inhA regulatory region, may cover 62% of isoniazid- resistant strains in Barcelona. In contrast, the targeting of the 81-bp region of rpoB would detect all our rifampin-resistant isolates.
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Affiliation(s)
- Pere Coll
- Servei de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona.
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12
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Tudó G, González-Martín J, Obama R, Rodríguez JM, Franco JR, Espasa M, Simarro PP, Escaramis G, Ascaso C, García A, Jiménez De Anta MT. Molecular epidemiology of tuberculosis in the Bata and Malabo districts of Equatorial Guinea. Int J Tuberc Lung Dis 2004; 8:1458-63. [PMID: 15636492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
SETTING Bata and Malabo districts, Equatorial Guinea, 1 March 1999 to 28 February 2001. OBJECTIVE To study the molecular epidemiology of tuberculosis (TB). RESULTS During the study period, 429 patients were diagnosed with TB in the Bata and Malabo districts. A positive culture was obtained in 206 (48%) TB patients, with RFLP analysis being performed in 185 (89.8%). Ninety-two different patterns were identified. Single patterns were found in 71 strains (38.3%) and the remaining 114 strains (61.6%) were classified into 21 clusters (of 2 to 25 patients). In addition, 37 of the typing strains were resistant to one or more anti-tuberculosis drugs, and 30 were included in clusters (81%), with 21 low level isoniazid (MIC < or = 1 microg/ml) resistance strains in the same cluster. Statistical analysis showed that resistance to anti-tuberculosis drugs (OR 3.1; 95% CI 1.2-7.6; P = 0.014), and positive smear results (4+ grade smear) (OR 4.3; 95% CI 1.5-12; P = 0.005), were significantly more frequent among patients with clustered strains. No epidemiological links were related to clustering. CONCLUSIONS The level of clustering (61.6%) observed suggests a high degree of recent transmission and a predominance of determined patterns of Mycobacterium tuberculosis strains among the population of Equatorial Guinea.
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Affiliation(s)
- G Tudó
- Servei de Microbiologia, Centre de Diagnòstic Biomèdic, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Tudó G, González J, Obama R, Rodríguez JM, Franco JR, Espasa M, Simarro PR, Escaramís G, Ascaso C, García A, Jiménez de Anta MT. Study of resistance to anti-tuberculosis drugs in five districts of Equatorial Guinea: rates, risk factors, genotyping of gene mutations and molecular epidemiology. Int J Tuberc Lung Dis 2004; 8:15-22. [PMID: 14974741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
SETTING Five districts in Equatorial Guinea, March 1999 to February 2001. OBJECTIVES To determine tuberculosis drug resistance among new and previously treated cases, the risk factors associated with resistance, and the mutations associated with isoniazid and rifampicin (katG, inhA and rpoB genes) resistance, and to genotype resistant strains. RESULTS A positive culture identified as Mycobacterium tuberculosis complex was obtained in 240/499 patients. Susceptibility testing was performed in 236 strains. The overall resistance rate in new cases was 16.9% compared to 41.6% in previously treated cases. Isoniazid resistance was the most frequent (respectively 12.5% and 16.6%) in the two groups, while multidrug resistance was observed in 1.7% and 25% of new and previously treated cases, respectively. Female sex was statistically associated with resistance in new cases. Of 41 isoniazid-resistant strains, 33 (80.5%) had mutations in the inhA gene; none had mutations in the katG gene and eight had no mutations in either gene. All strains had low-level isoniazid resistance. Of eight strains resistant to rifampicin, six had mutations in the rpoB gene. Genotyping defined seven clusters. CONCLUSIONS Moderate resistance was found in new cases. Low-level isoniazid resistance predominated among mutations in the inhA gene, with a high percentage of clustering in resistant strains.
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Affiliation(s)
- G Tudó
- Hospital Clinic de Barcelona, Servei de Microbiologia, Barcelona, Spain
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14
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Marco F, Danés C, Almela M, Jurado A, Mensa J, de la Bellacasa JP, Espasa M, Martínez JA, Jiménez de Anta MT. Trends in frequency and in vitro susceptibilities to antifungal agents, including voriconazole and anidulafungin, of Candida bloodstream isolates. Results from a six-year study (1996-2001). Diagn Microbiol Infect Dis 2003; 46:259-64. [PMID: 12944017 DOI: 10.1016/s0732-8893(03)00086-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The frequency of isolation and antifungal susceptibility patterns to established and two new antifungal agents were determined for 218 Candida spp isolates causing bloodstream infection from 1996 to 2001. Overall, 41.7% of the candidemias were due to C. albicans, followed by C. parapsilosis (22%), C. tropicalis (16.1%), C. glabrata (11.9%), C. krusei (6%) and miscellaneous Candida spp (2.3%). Isolates of C. albicans C. parapsilosis and C. tropicalis (80% of isolates) were highly susceptible to fluconazole (94 to 100% at </= 8 microg/ml) and voriconazole (97 to 100% at </= 1 microg/ml). By comparison with the newer agents itraconazole was less active (77 to 97% at </=0.12 microg/ml). Only 77% and 15% of C. glabrata isolates were inhibited by fluconazole at </= 8 microg/ml and itraconazole at </=0.12 microg/ml, respectively. Voriconazole showed a remarkable in vitro potency against C. glabrata as well as C. krusei isolates (100% at </= 1 microg/ml). Anidulafungin was very active against Candida spp isolates (MIC90: </= 0.5 microg/ml), except C. parapsilosis (MIC90: 4 microg/ml) and two C. guilliermondii isolates (MIC: >/= 32 microg/ml).
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Affiliation(s)
- F Marco
- Serveis de Microbiologia i Infeccions, Hospital Clínic, IDIBAPS, Facultat de Medicina, Universitat de Barcelona, Spain.
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15
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Torres-Rodríguez JM, Ribas-Forcadell E, Gascón J, López-Jodra O, Espasa M. [Diagnostic usefulness of the intradermal test with histoplamin in non-endemic areas of histoplasmosis]. Rev Iberoam Micol 2000; 17:97-101. [PMID: 15762801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The histoplasmosis in Spain is an imported disease presenting in most of case diagnostic difficulties. In this paper, the intradermal skin test with Histoplasma capsulatum antigen as diagnostic method in immunocompetent patients with clinical and radiological signs compatible with histoplasmosis after being visited Central and South American endemic counties, in which this mycosis is endemic. Nine Spanish patients coming from different countries of Latin America with fever and acute respiratory symptoms compatible with histoplasmosis were studied. Other nine accompanying subjects and five controls were also evaluated. Patients underwent mycological cultures and and serological tests for H. capsulatum. Intradermal test with 1% histoplasmine were done in all patients. Serology and skin tests tests were also performed in accompanying people. Intradermal were done in healthy controls. Skin test with histoplasmine were positive in seven of the nine patients. Six of these showed precipitating antibodies against the same antigen. H. capsulatum was only isolated from bone marrow biopsy samples in one patient. The seven patients were given itraconazole by oral route and all symptoms improved after 2 and 4 weeks. In five accompanying subjects the skin test were also positive so that a subclinical histoplasmosis was diagnosed. In the remaining patients and healthy accompanying subjects histoplasmosis infection was excluded. In non endemic geographical areas of histoplasmosis intradermal skin test with histoplasmin when used in immunocompetent individuals is an easy and reliable method for the diagnosis of this mycosis as well as for epidemiological studies.
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Torres-Rodríguez JM, Ribas-Forcadell E, Gascón J, Espasa M. [Diagnostic value of intradermoreaction with histoplasmin in non-endemic areas of histoplasmosis]. Med Clin (Barc) 1999; 113:37-8. [PMID: 10422078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Torres-Rodríguez JM, Mendez R, López-Jodra O, Morera Y, Espasa M, Jimenez T, Lagunas C. In vitro susceptibilities of clinical yeast isolates to the new antifungal eberconazole compared with their susceptibilities to clotrimazole and ketoconazole. Antimicrob Agents Chemother 1999; 43:1258-9. [PMID: 10223946 PMCID: PMC89253 DOI: 10.1128/aac.43.5.1258] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The antifungal activity of eberconazole, a new imidazole derivative, against 124 clinical isolates of Candida comprising eight different species and to 34 isolates of Cryptococcus neoformans was compared to those of clotrimazole and ketoconazole. MICs of eberconazole, determined by the National Committee for Clinical Laboratory Standards standardized microbroth method, were equal to or lower than those of other azoles, especially for Candida krusei and Candida glabrata, which are usually resistant to triazoles.
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Affiliation(s)
- J M Torres-Rodríguez
- Experimental and Clinical Mycology Research Group (GREMEC), IMIM, Autonomous University of Barcelona, Barcelona, Spain.
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Gómez-Martínez J, Marco F, Mensa J, Espasa M, Martínez JA, Jiménez de Anta MT. [In vitro activity of fluoroquinolones and oral beta lactam antibiotics against clinical isolates of Escherichia coli]. Rev Esp Quimioter 1999; 12:54-7. [PMID: 10209063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We studied the in vitro activity of amoxicillin-clavulanic acid, cefprozil, cefuroxime, cefpodoxime, ceftibuten, cefixime, ciprofloxacin and sparfloxacin against 400 strains of Escherichia coli. The strains were obtained from urine cultures from patients with community acquired urinary tract infection who were treated in our hospital in 1997 and 1998. Among the six betalactams, ceftibuten and cefixime were the most active in vitro with MIC90 of 0.5 mg/l. Both antimicrobials were 2- and 16-fold more active than cefpodoxime (MIC90 1 mg/l) and cefprozil (MIC90 8 mg/l), respectively. However, overall, the four cephalosporins inhibited between 95% and 99% of isolates. Cefuroxime and amoxicillin-clavulanic acid showed less activity with a MIC90 of 16 mg/l. The percentage of fluoroquinolone-resistant strains was 24% with a similar activity to ciprofloxacin (MIC90 32 mg/l) and sparfloxacin (MIC90 64 mg/l).
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Affiliation(s)
- J Gómez-Martínez
- Servicio de Microbiología, Institut d'Investigacions Biomèdiques August Pí i Sunyer (IDIBAPS), Hospital Clínic, Barcelona
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