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Berengua C, Miró E, Gutiérrez C, Sánchez M, Mulero A, Ramos P, Del Cuerpo M, Torrego A, García-Cadenas I, Pajares V, Navarro F, Martino R, Rabella N. Detection of cytomegalovirus in bronchoalveolar lavage fluid from immunocompromised patients with pneumonitis by viral culture and DNA quantification. J Virol Methods 2023; 317:114743. [PMID: 37116585 DOI: 10.1016/j.jviromet.2023.114743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/26/2023] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE To compare the detection of human cytomegalovirus (HCMV) in bronchoalveolar lavage (BAL) fluid by viral culture and quantitative polymerase chain reaction (qPCR), and to establish a viral load threshold that can identify cases of HCMV replication indicative of pneumonitis. There is currently no universal viral load cut-off to differentiate between patients with and without pneumonitis, and the interpretation of qPCR results is challenging. METHODS 176 consecutive BAL samples from immunosuppressed hosts with signs and/or symptoms of respiratory infection were prospectively studied by viral culture and qPCR. RESULTS Concordant results were obtained in 81.25% of the BAL samples. The rest were discordant, as only 34% of the qPCR-positive BAL samples were positive by culture. The median HCMV load was significantly higher in culture-positive than in culture-negative BAL samples (5,038 vs 178 IU/mL). Using a cut-off value of 1,258 IU/mL of HCMV in BAL, pneumonia was diagnosed with a sensitivity of 76%, a specificity of 100%, a VPP of 100% and VPN of 98%, and HCMV was isolated in 100% of the BAL cultures. CONCLUSION We found that a qPCR-negative was a quick and reliable way of ruling out HCMV pneumonitis, but a positive result did not always indicate clinically significant replication in the lung. However, an HCMV load in BAL fluid of ≥1,258 IU/mL was always associated with disease, whereas <200 IU/mL rarely so.
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Affiliation(s)
- C Berengua
- Genetics and Microbiology Department. Universitat Autònoma de Barcelona. Spain; Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain.
| | - E Miró
- Genetics and Microbiology Department. Universitat Autònoma de Barcelona. Spain; Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - C Gutiérrez
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - M Sánchez
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - A Mulero
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - P Ramos
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - M Del Cuerpo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - A Torrego
- Pneumology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - I García-Cadenas
- Pneumology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - V Pajares
- Pneumology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - F Navarro
- Genetics and Microbiology Department. Universitat Autònoma de Barcelona. Spain; Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - R Martino
- Hematology Department. Hospital de la Santa Creu I Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
| | - N Rabella
- Genetics and Microbiology Department. Universitat Autònoma de Barcelona. Spain; Microbiology Department. Hospital de la Santa Creu i Sant Pau. Barcelona. Spain; Sant Pau Institute of Biomedical Research (IIb Sant Pau) Barcelona. Spain
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Andrés C, Del Cuerpo M, Rabella N, Piñana M, Iglesias-Cabezas MJ, González-Sánchez A, Esperalba J, Rando A, Martín MC, Fuentes F, Rubio S, Saubi N, Pumarola T, Antón A. Detection of reassortant influenza B strains from 2004 to 2015 seasons in Barcelona (Catalonia, Spain) by whole genome sequencing. Virus Res 2023; 330:199089. [PMID: 37011863 DOI: 10.1016/j.virusres.2023.199089] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Influenza B viruses (FLUBV) have segmented genomes which enables the virus to evolve by segment reassortment. Since the divergence of both FLUBV lineages, B/Victoria/2/87 (B/VIC) and B/Yamagata/16/88 (B/YAM), PB2, PB1 and HA have kept the same ancestor, while some reassortment events in the other segments have been reported worldwide. The aim of the present study was to find out reassortment episodes in FLUBV strains detected in cases attended at Vall d'hebron University Hospital and Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) from 2004 to 2015 season. METHODS From October 2004 to May 2015, respiratory tract specimens were received from patients with respiratory tract infection (RTI) suspicion. Influenza detection was carried out by either cell culture isolation, immunofluorescence or PCR-based assays. A RT-PCR was performed to distinguish both lineages by agarose gel electrophoresis. Whole genome amplification was performed using the universal primer set by Zhou et al. in 2012, and subsequently sequenced using Roche 454 GS Junior platform. Bioinformatic analysis was performed to characterise the sequences with B/Malaysia/2506/2007 and B/Florida/4/2006 corresponding sequences as reference of (B/VIC) and (B/YAM), respectively. RESULTS A total of 118 FLUBV (75 B/VIC and 43 B/YAM), from 2004-2006, 2008-2011 and 2012-2015 seasons, were studied. The whole genome of fifty-Eight B/VIC and 42 B/YAM viruses was successfully amplified. Based on HA sequences, most B/VIC viruses (37; 64%) belonged to clade 1A (B/Brisbane/60/2008) except to 11 (19%), which fell within clade 1B (B/HongKong/514/2009) and 10 (17%) to B/Malaysia/2506/2004. Nine (20%) B/YAM viruses belonged to clade 2 (B/Massachusetts/02/2012), 18 (42%) to clade 3 (B/Phuket/3073/2013) and 15 (38%) fell within Florida/4/2006. Numerous intra-lineage reassortments in PB2, PB1, NA and NS were found in 2 2010-2011 viruses. An important inter-lineage reassortment event from 2008-2009 (11), 2010-2011 (26) and 2012-2013 (3) FLUBV/VIC (clade 1) strains to FLUBV/YAM (clade 3) was found, in addition to 1 reassortant NS in 2010-2011 B/VIC virus. CONCLUSIONS Intra- and inter-lineage reassortment episodes were revealed by WGS. While PB2-PB1-HA remained in complex, NP and NS reassortant viruses were found in both lineages. Despite reassorment events are not often, the characterisation only by HA and NA sequences might be underestimating their detection.
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Affiliation(s)
- Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Margarita Del Cuerpo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Núria Rabella
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Maria Piñana
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Manuel Jesús Iglesias-Cabezas
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Alejandra González-Sánchez
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Juliana Esperalba
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Ariadna Rando
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Maria Carmen Martín
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Francisco Fuentes
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Susana Rubio
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Narcís Saubi
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Tomàs Pumarola
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en red de Enfermedades Infecciosas CIBERINFEC, Instituto Carlos III, Madrid, Spain.
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en red de Enfermedades Infecciosas CIBERINFEC, Instituto Carlos III, Madrid, Spain
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Berengua C, López M, Esteban M, Marín P, Ramos P, Cuerpo MD, Gich I, Navarro F, Miró E, Rabella N. Viral culture and immunofluorescence for the detection of SARS-CoV-2 infectivity in RT-PCR positive respiratory samples. J Clin Virol 2022; 152:105167. [PMID: 35523105 PMCID: PMC9046102 DOI: 10.1016/j.jcv.2022.105167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/06/2022] [Accepted: 04/20/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Knowing how long SARS-CoV-2-positive individuals can remain infective is crucial for the design of infection prevention and control strategies. Viral culture is the gold standard for detecting an active-replicative virus and evaluating its infectious potential. OBJECTIVE To assess the correlation of SARS-CoV-2 infectivity with the number of days from symptom onset and the Ct value, using culture as a reference method. Also, to describe a detailed protocol for SARS-CoV-2 culture and immunofluorescence confirmation based on our experience with other respiratory viruses. STUDY DESIGN 100 consecutive respiratory samples positive for SARS-CoV-2 by RT-PCR from different subjects were inoculated into VERO E6 cells. RESULTS Viral isolation was successful in 58% of samples. The median number of days from symptom onset for culture-positive samples was 2, and 15 for culture-negative samples. Six positive cultures were obtained in patients ≥14 days after symptom onset, all of whom were immunocompromised or with severe COVID-19. The mean Ct value was 12.64 units higher in culture-negative than in culture-positive samples. The probability of successfully isolating SARS-CoV-2 in samples with a Ct value <22 was 100%, decreasing to 3.1% when >27. CONCLUSIONS Our findings show a significant positive correlation between the probability of isolating SARS-CoV-2 in culture, fewer days of symptoms and a lower RT-PCR Ct value. SARS-CoV-2 infectivity lasts no more than 14 days from symptom onset in immunocompetent individuals. In contrast, in immunocompromised patients or those with severe COVID-19 infectivity may remain after 14 days. Ct value <22 always indicates infectivity.
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Affiliation(s)
- Carla Berengua
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain,Corresponding author at: Microbiology Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí Street, 89, Barcelona, 08041, Spain
| | - Marina López
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Montserrat Esteban
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Pilar Marín
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Paula Ramos
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Margarita del Cuerpo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP). Clinical Epidemiology and Public Health Department. Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Ferran Navarro
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Elisenda Miró
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
| | - Núria Rabella
- Microbiology Department. Hospital de la Santa Creu i Sant Pau. Universitat Autónoma de Barcelona (UAB). Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona. Spain
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4
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García-Arroyo L, Prim N, Del Cuerpo M, Marín P, Roig MC, Esteban M, Labeaga R, Martí N, Berengua C, Gich I, Navarro F, Rabella N. Prevalence and seasonality of viral respiratory infections in a temperate climate region: A 24-year study (1997-2020). Influenza Other Respir Viruses 2022; 16:756-766. [PMID: 35170253 PMCID: PMC9178050 DOI: 10.1111/irv.12972] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/19/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Few long‐term reports have been published on the epidemiology of respiratory viruses despite their frequent involvement in extremely common infections. The aim here was to determine the frequency and distribution of respiratory viruses in a temperate climate area (Barcelona, Spain) throughout a 24‐year period. Methods We collected data on all respiratory viruses detected from 1997 to 2020 in our institution. Clinical specimens were analyzed mainly by conventional techniques, and molecular techniques were also used. Results Of the 59,579 specimens analyzed, 21,382 (35.9%) were positive for at least one virus. The number of positive samples during cold months was significantly higher than in warm months. Respiratory virus infections were detected in patients of all ages, above all in children under 3 years of age, who were most frequently infected with the respiratory syncytial virus, whereas Influenza A virus predominated in the other groups, especially in adults. A clear demographic and seasonal pattern was established for some viruses. Circulation of other respiratory viruses during the FLUAV H1N1pdm09 and SARS‐CoV‐2 pandemics was observed. Conclusions This long‐term study provides new knowledge about the prevalence of respiratory viruses in a Mediterranean region. Throughout the study period, the frequency of some viruses remained constant, whereas others varied with the year. A clear demographic and seasonal pattern was established for some viruses. Patients suffering from severe respiratory infections should be examined for a range of respiratory viruses regardless of gender, age, or season.
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Affiliation(s)
- Laura García-Arroyo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Núria Prim
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Marga Del Cuerpo
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Pilar Marín
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Maria Carme Roig
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Mnontserrat Esteban
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Rosa Labeaga
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Neus Martí
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Carla Berengua
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Clinical Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Ferran Navarro
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Núria Rabella
- Microbiology Department. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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5
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Benschop KS, Albert J, Anton A, Andrés C, Aranzamendi M, Armannsdóttir B, Bailly JL, Baldanti F, Baldvinsdóttir GE, Beard S, Berginc N, Böttcher S, Blomqvist S, Bubba L, Calvo C, Cabrerizo M, Cavallero A, Celma C, Ceriotti F, Costa I, Cottrell S, Del Cuerpo M, Dean J, Dembinski JL, Diedrich S, Diez-Domingo J, Dorenberg D, Duizer E, Dyrdak R, Fanti D, Farkas A, Feeney S, Flipse J, De Gascun C, Galli C, Georgieva I, Gifford L, Guiomar R, Hönemann M, Ikonen N, Jeannoël M, Josset L, Keeren K, López-Labrador FX, Maier M, McKenna J, Meijer A, Mengual-Chuliá B, Midgley SE, Mirand A, Montes M, Moore C, Morley U, Murk JL, Nikolaeva-Glomb L, Numanovic S, Oggioni M, Palminha P, Pariani E, Pellegrinelli L, Piralla A, Pietsch C, Piñeiro L, Rabella N, Rainetova P, Uceda Renteria SC, Romero MP, Reynders M, Roorda L, Savolainen-Kopra C, Schuffenecker I, Soynova A, Swanink CM, Ursic T, Verweij JJ, Vila J, Vuorinen T, Simmonds P, Fischer TK, Harvala H. Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34763750 PMCID: PMC8646978 DOI: 10.2807/1560-7917.es.2021.26.45.2100998] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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] [Indexed: 01/01/2023]
Abstract
We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.
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Affiliation(s)
- Kimberley Sm Benschop
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Andres Anton
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maitane Aranzamendi
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Jean-Luc Bailly
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Fausto Baldanti
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy.,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | | | - Stuart Beard
- UK Health Security Agency, Colindale, United Kingdom
| | - Natasa Berginc
- National laboratory of health, environment and food, Laboratory for public health virology, Ljubljana, Slovenia
| | - Sindy Böttcher
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Soile Blomqvist
- National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Bubba
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | - Maria Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, Enterovirus and Viral Gastroenteritis Unit/Polio National Lab, Madrid, Spain
| | - Annalisa Cavallero
- Laboratory of Microbiology, ASST Monza, San Gerardo Hospital, Monza (MB), Italy
| | | | - Ferruccio Ceriotti
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Inês Costa
- National Institute of Health (INSA), Lisbon, Portugal
| | | | - Margarita Del Cuerpo
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jonathan Dean
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | - Sabine Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Javier Diez-Domingo
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | | | - Erwin Duizer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Robert Dyrdak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Diana Fanti
- Chemical-clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Agnes Farkas
- National Public Health Center, Budapest, Hungary
| | - Susan Feeney
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Jacky Flipse
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Cristina Galli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Irina Georgieva
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | | | - Mario Hönemann
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Niina Ikonen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Marion Jeannoël
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Laurence Josset
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Kathrin Keeren
- Secretary of the commission for Polio Eradication in Germany, Robert-Koch Institute, Berlin, Germany
| | - F Xavier López-Labrador
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.,Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Melanie Maier
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - James McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Adam Meijer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Beatriz Mengual-Chuliá
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Sofie E Midgley
- The Danish WHO National Reference Laboratory for Poliovirus, Statens Serum Institut, Copenhagen, Denmark
| | - Audrey Mirand
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Milagrosa Montes
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Ursula Morley
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Jean-Luc Murk
- Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Lubomira Nikolaeva-Glomb
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Sanela Numanovic
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Massimo Oggioni
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Corinna Pietsch
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Luis Piñeiro
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | - Núria Rabella
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Sara Colonia Uceda Renteria
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - María P Romero
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | | | | | - Isabelle Schuffenecker
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Aysa Soynova
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Caroline Ma Swanink
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Tina Ursic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Jorgina Vila
- Pediatric Hospitalization Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Tytti Vuorinen
- Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
| | | | - Thea K Fischer
- Nordsjaellands Hospital, Hillerod, Denmark.,University of Sothern Denmark, Odense, Denmark
| | - Heli Harvala
- University College London (UCL), Department of infection and Immunity, London, United Kingdom.,NHS Blood and Transplant, Microbiology Services, Colindale, United Kingdom
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6
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Miro E, Del Cuerpo M, Rubio M, Berengua C, Español M, Marin P, Vela JI, Pomar V, Gutierrez C, Navarro F, Rabella N. Whole-genome analysis to describe a human adenovirus D8 conjunctivitis outbreak in a tertiary hospital. J Med Virol 2021; 93:4840-4845. [PMID: 33543795 DOI: 10.1002/jmv.26850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/07/2022]
Abstract
Conjunctivitis is a frequent ocular disorder caused by human adenoviruses (HAdVs). Only a few of the 45 HAdV-D species are associated with epidemic keratoconjunctivitis, including HAdV-D8. Nosocomial outbreaks due to HAdV-D8 have been rarely described, because keratoconjunctivitis cases are clinically diagnosed and treated without having to characterize the causative agent. Moreover, molecular typing is tedious when using classical techniques. In this study, a hospital outbreak of conjunctivitis caused by HAdV-D8 was characterized using the recently developed whole-genome sequencing (WGS) method. Of the 363 patients attending the Ophthalmology Department between July 13 and August 13, 2018, 36 may have acquired intrahospital conjunctivitis. Also, 11 of 22 samples sent to the Virology section were selected for WGS analysis. The WGS results revealed that 10 out of 11 HAdV-D8 strains were closely related. The remaining strain (Case 28) was more similar to a strain from an outbreak in Germany obtained from a public sequence database. WGS results showed that outbreak HAdV-D8 strains had a minimum percentage of identity of 94.3%. WGS is useful in a clinical setting, because it avoids carrying out viral culture or specific polymerase chain reaction sequencing. The public availability of sequence reads makes it easier to compare clusters in circulation. In conclusion, WGS can play an important role in standard routines to describe viral outbreaks.
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Affiliation(s)
- Elisenda Miro
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Margarita Del Cuerpo
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Marc Rubio
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Carla Berengua
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Montserrat Español
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Pilar Marin
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Jose I Vela
- Department of Ophthalmology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Virginia Pomar
- Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Cristina Gutierrez
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Ferran Navarro
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Núria Rabella
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
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7
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Hayes A, Nguyen D, Andersson M, Antón A, Bailly J, Beard S, Benschop KSM, Berginc N, Blomqvist S, Cunningham E, Davis D, Dembinski JL, Diedrich S, Dudman SG, Dyrdak R, Eltringham GJA, Gonzales‐Goggia S, Gunson R, Howson‐Wells HC, Jääskeläinen AJ, López‐Labrador FX, Maier M, Majumdar M, Midgley S, Mirand A, Morley U, Nordbø SA, Oikarinen S, Osman H, Papa A, Pellegrinelli L, Piralla A, Rabella N, Richter J, Smith M, Söderlund Strand A, Templeton K, Vipond B, Vuorinen T, Williams C, Wollants E, Zakikhany K, Fischer TK, Harvala H, Simmonds P. A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. J Med Virol 2020; 92:1065-1074. [PMID: 31883139 PMCID: PMC7496258 DOI: 10.1002/jmv.25659] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/24/2019] [Indexed: 12/28/2022]
Abstract
Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10-5 ). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.
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Affiliation(s)
- A. Hayes
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - D. Nguyen
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - M. Andersson
- Microbiology Laboratory, John Radcliffe Hospital, Headley Way, HeadingtonOxfordUK
| | - A. Antón
- Respiratory Viruses Unit, Virology Section, Microbiology DepartmentHospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig Vall d'HebronBarcelonaSpain
| | - J.‐L. Bailly
- Université Clermont Auvergne, LMGE UMR CNRS, UFR MédecineClermont‐FerrandFrance
- CHU Clermont‐Ferrand, National Reference Center for EV and Parechovirus‐Associated LaboratoryClermont‐FerrandFrance
| | - S. Beard
- Enteric Virus Unit, Virus Reference DepartmentNational Infection Service, Public Health EnglandLondonUK
| | - K. S. M. Benschop
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - N. Berginc
- Department for Public Health VirologyNational Laboratory of Health, Environment and FoodLjubljanaSlovenia
| | - S. Blomqvist
- National Institute for Health and Welfare, MannerheimintieHelsinkiFinland
| | - E. Cunningham
- Viapath Infection Sciences, St. Thomas' HospitalLondonUK
| | - D. Davis
- Microbiology, Virology and infection Prevention & ControlGreat Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - J. L. Dembinski
- Department of VirologyNorwegian Institute of Public HealthOsloNorway
| | - S. Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch InstituteBerlinGermany
| | - S. G. Dudman
- Department of MicrobiologyOslo University Hospital Rikshospitalet, Inst. Clinical Medicine, University of OsloOsloNorway
| | - R. Dyrdak
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstituteStockholmSweden
| | - G. J. A. Eltringham
- Molecular Diagnostics Laboratory, Microbiology, Freeman HospitalNewcastle Upon TyneUK
| | - S. Gonzales‐Goggia
- Public Health England Poliovirus Reference Laboratory, National Infection Service, Public Health EnglandLondonUK
| | - R. Gunson
- West of Scotland Specialist Virology CentreGlasgow Royal InfirmaryGlasgowUK
| | - H. C. Howson‐Wells
- Nottingham University Hospitals NHS Trust, Clinical Microbiology, Queens Medical CentreNottinghamUK
| | - A. J. Jääskeläinen
- University of Helsinki and Helsinki University Hospital, HUSLAB, Virology and ImmunologyHelsinkiFinland
| | - F. X. López‐Labrador
- Virology Laboratory, Joint Units in Genomics and Health and Infection and Health, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO‐Public Health)/Universitat de València, Av. CatalunyaValènciaSpain
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
| | - M. Maier
- Institute of VirologyLeipzig University HospitalLeipzigGermany
| | - M. Majumdar
- The National Institute for Biological Standards and ControlHertfordshireUK
| | - S. Midgley
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - A. Mirand
- CHU Clermont‐Ferrand, Laboratoire de Virologie—Centre National de Référence des Entérovirus et Parechovirus, Laboratoire Associé—Clermont‐FerrandFrance
| | - U. Morley
- UCD National Virus Reference LaboratoryUniversity College Dublin, BelfieldDublinIreland
| | - S. A. Nordbø
- Department of Medical MicrobiologySt. Olavs University HospitalTrondheimNorway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - S. Oikarinen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - H. Osman
- Public Health England Birmingham Public Health Laboratory, Heartlands HospitalBirminghamUK
| | - A. Papa
- Department of MicrobiologyMedical School, Aristotle University of ThessalonikiThessalonikiGreece
| | - L. Pellegrinelli
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - A. Piralla
- Molecular Virology Unit, Microbiology and Virology DepartmentFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - N. Rabella
- Virology Section, Santa Creu i Sant Pau University HospitalBarcelonaSpain
| | - J. Richter
- Department of Molecular VirologyCyprus Institute of Neurology and GeneticsNicosiaCyprus
| | - M. Smith
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- King's College Hospital, Bessemer Wing, Denmark HillLondonUK
| | - A. Söderlund Strand
- Laboratory Medicine, Department of Clinical MicrobiologyLund University Hospital, SölvegatanLundSweden
| | - K. Templeton
- Edinburgh Specialist Virology, Royal Infirmary of EdinburghEdinburghUK
| | - B. Vipond
- Public Health England, South West Regional Laboratory, Pathology Sciences Building, Science QuarterSouthmead HospitalBristolUK
| | - T. Vuorinen
- Clinical MicrobiologyTurku University Hospital and Institute of Biomedicine University of TurkuTurkuFinland
| | | | - E. Wollants
- Clinical and Epidemiological Virology, KU Leuven, REGA Institute, Clinical and Epidemiological VirologyLeuvenBelgium
| | - K. Zakikhany
- Katherina Zakikhany‐Gilg, Public Health Agency of Sweden, Department of MicrobiologyUnit of Laboratory Surveillance of Viral Pathogens and Vaccine Preventable DiseasesStockholmSweden
| | - T. K. Fischer
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos IIIMadridSpain
- Department of Virus and Special Microbiological DiagnosticsVirus Surveillance and Research Section, Statens Serum InstitutCopenhagenDenmark
| | - H. Harvala
- NHS Blood and Transplant, ColindaleLondonUK
| | - P. Simmonds
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
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8
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Masa-Calles J, Torner N, López-Perea N, Torres de Mier MDV, Fernández-Martínez B, Cabrerizo M, Gallardo-García V, Malo C, Margolles M, Portell M, Abadía N, Blasco A, García-Hernández S, Marcos H, Rabella N, Marín C, Fuentes A, Losada I, Gutiérrez JG, Nieto A, Ortúzar VG, Cenoz MG, Arteagoitia JM, Martínez ÁB, Rivas A, Castrillejo D. Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years' experience, Spain, 1998 to 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 30482263 PMCID: PMC6341937 DOI: 10.2807/1560-7917.es.2018.23.47.1700423] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000–0.78/100,000). Two periods (P) are described: P1 (1998–2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007–2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain–Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.
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Affiliation(s)
- Josefa Masa-Calles
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Torner
- Department of Medicine, University of Barcelona, Barcelona, Spain.,Public Health Agency of Catalonia, Generalitat of Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Noemí López-Perea
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María de Viarce Torres de Mier
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Fernández-Martínez
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María Cabrerizo
- National Polio Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Carmen Malo
- Servicio de Vigilancia en Salud Pública, D.G. de Salud Pública, Departamento de Sanidad, Aragón, Spain
| | - Mario Margolles
- Servicio de Vigilancia Epidemiológica, Consejería de Sanidad, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Margarita Portell
- Servicio de Vigilancia Epidemiológica, Conselleria de Salut, Família i Bienestar Social Baleares, Spain
| | - Natividad Abadía
- Servicio de Epidemiologia y Prevención, Dirección General Salud Pública, Servicio Canario de Salud, Canarias, Spain
| | - Aniceto Blasco
- Sección de Vigilancia Epidemiológica, D.G. de Salud Pública, Cantabria, Spain
| | - Sara García-Hernández
- Servicio de Epidemiología, D.G. de Salud Pública, Consejería de Sanidad, Castilla-La Mancha, Spain
| | - Henar Marcos
- Servicio de Vigilancia Epidemiológica y Enfermedades Transmisibles, D.G. de Salud Pública, Consejería de Sanidad, Castilla y León, Spain
| | - Núria Rabella
- Microbiology Department, Hospital de la Santa Creu i Sant Pau, Microbiology & Genetics Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Celia Marín
- Servei de Vigilància i Control Epidemiològic, Conselleria de Sanitat Universal i Salut Pública, Comunitat Valenciana, Spain
| | - Amelia Fuentes
- Subdirección de Epidemiología. D.G. de Salud Pública, Servicio Extremeño de Salud, Consejería de Salud y Políticas Sociales, Extremadura, Spain
| | - Isabel Losada
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Spain
| | - Juan García Gutiérrez
- Servicio de Epidemiología, Subdirección General de Epidemiología, Dirección General de Salud Pública, Comunidad Autónoma de Madrid, Spain
| | - Alba Nieto
- Servicio de Epidemiología, Subdirección General de Epidemiología, Dirección General de Salud Pública, Comunidad Autónoma de Madrid, Spain
| | - Visitación García Ortúzar
- Servicio de Epidemiología, D. G. de Salud Pública y Adicciones, Consejería de Salud, Región de Murcia, Spain
| | - Manuel García Cenoz
- Servicio de Epidemiología y Prevención Sanitaria, Instituto de Salud Pública de Navarra, IdiSNA, Spain.,Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - José María Arteagoitia
- Servicio de vigilancia epidemiológica y vacunas, Dirección de Salud Pública y Adicciones, Departamento de Salud, País Vasco, Spain
| | - Ángela Blanco Martínez
- Sección de Vigilancia Epidemiológica y Control de Enfermedades Transmisibles, D.G de Salud Pública y Consumo, Consejería de Salud, La Rioja, Spain
| | - Ana Rivas
- Servicio de Epidemiología, Consejería de Sanidad y Consumo, Ceuta, Spain
| | - Daniel Castrillejo
- Servicio de Epidemiología, D.G. de Sanidad y Consumo, Consejería de Presidencia y Salud Pública, Melilla, Spain
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9
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Cabrerizo M, Martín Del Valle F, Muñoz-Almagro C, Launes C, Romero M, Moreno-Docón A, Menasalvas A, Reis-Iglesias L, García-Costa J, Cilla A, Megias G, Rey-Cao S, Mar Portugués M, Pena M, Del Cuerpo M, Rabella N, Aranzamendi M, Martínez-Sapiña A, Sanbonmatsu S, Otero A, Calvo C. Study of enterovirus and parechovirus infections in young children in Spain over a 3-year period. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.272] [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]
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10
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Cabrerizo M, Díaz-Cerio M, Muñoz-Almagro C, Rabella N, Tarragó D, Romero MP, Pena MJ, Calvo C, Rey-Cao S, Moreno-Docón A, Martínez-Rienda I, Otero A, Trallero G. Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain. J Med Virol 2016; 89:435-442. [PMID: 27505281 DOI: 10.1002/jmv.24658] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/28/2022]
Abstract
The epidemiology and clinical association of enterovirus (EV) and parechovirus (HPeV) infections, as well as the type-distribution-according-to-age, were determined during a 4-year study period in Spain. During 2010-2013, a total of 21,832 clinical samples were screened for EV and the detection frequency was 6.5% (1,430). Of the total EV-negative samples, only 1,873 samples from 2011 to 2013 were available for HPeV testing. HPeV was detected in 42 (2%) of them. Positive samples were genotyped using PCR and sequencing. EV infections occurred in all age groups of patients: neonates (17%), children 28 days to 2 years (29%), children 2-14 years (40%), and adults (14%). Thirty-four different EV types were identified. HPeV infections were detected exclusively in infants <8 m (70% neonates, P < 0.05). All but one HPeV were HPeV-3. Differences in type frequency detection were found according to age and clinical manifestation. Coxsackievirus (CV)-B4 (61%), CV-B5 (83%), and HPeV-3 (64%) were more frequent in neonates than in older patients (P < 0.05). Echovirus (E)-3 (60%), E-18 (47%), E-25 (62%), CV-A6 (61%), CV-A16 (72%), and EV-71 (75%) were mainly detected in children 28 days to 2 years (P < 0.05), whereas, E-6 (79%), E-20 (88%), and E-30 (85%) were predominant in children >2 years and adults (P < 0.05). Clinically, meningitis was associated with EV (P < 0.01) whereas, encephalitis was more frequent in HPeV-infected patients. CV-B types were associated with myocarditis (90%; P < 0.05) and EV species A with hand-foot-mouth-disease/atypical exanthema (88%; P < 0.05). J. Med. Virol. 89:435-442, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- María Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María Díaz-Cerio
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - David Tarragó
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - María José Pena
- Hospital Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | - Almudena Otero
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Gloria Trallero
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
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11
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García‐Arroyo L, Prim N, Martí N, Roig MC, Navarro F, Rabella N. Benefits and drawbacks of molecular techniques for diagnosis of viral respiratory infections. Experience with two multiplex PCR assays. J Med Virol 2016; 88:45-50. [PMID: 26100363 PMCID: PMC7166422 DOI: 10.1002/jmv.24298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 11/08/2022]
Abstract
Molecular techniques have represented a major step forward in the diagnosis of viral respiratory infections. They are considered highly sensitive and specific compared to conventional techniques. In this study two nucleic acid amplification tests (NAATs) were compared to conventional methods (immunofluorescence and viral culture). The aim of this work was to discuss the clinical interpretation of the results obtained by NAATs on the basis of the two-decade experience of our group and the literature. Eighty nasopharyngeal aspirates were collected from children under six years attended for acute respiratory illness at the pediatric emergency room of a third level Hospital. Both NAATs tested (Seeplex(®) and Clart(®)) showed an overall higher performance regarding sensitivity (76% and 90%, respectively). Compared to Seeplex(®), the Clart(®) system tripled the number of multiple detections (8 by Seeplex(®) vs. 25 by Clart(®)). In some specimens both NAATs detected different viruses. Given these discrepancies and the fact that detection of viral nucleic acids is not necessarily related to the current clinical syndrome, the interpretation of molecular results may not always be so straightforward. The pros and cons of NAATs should always be taken into account when giving a result.
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Affiliation(s)
| | - Núria Prim
- Servei de Microbiologia, Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Neus Martí
- Servei de Microbiologia, Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Maria Carme Roig
- Servei de Microbiologia, Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Ferran Navarro
- Servei de Microbiologia, Hospital de la Santa Creu i Sant PauBarcelonaSpain
- Departament de Genètica i de MicrobiologiaUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Núria Rabella
- Servei de Microbiologia, Hospital de la Santa Creu i Sant PauBarcelonaSpain
- Departament de Genètica i de MicrobiologiaUniversitat Autònoma de BarcelonaBarcelonaSpain
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García-Cadenas I, Castillo N, Martino R, Barba P, Esquirol A, Novelli S, Orti G, Garrido A, Saavedra S, Moreno C, Granell M, Briones J, Brunet S, Navarro F, Ruiz I, Rabella N, Valcárcel D, Sierra J. Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab. Bone Marrow Transplant 2015; 50:579-84. [PMID: 25581404 DOI: 10.1038/bmt.2014.298] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/08/2014] [Accepted: 11/16/2014] [Indexed: 01/14/2023]
Abstract
We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).
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Affiliation(s)
- I García-Cadenas
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Castillo
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Martino
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Barba
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Esquirol
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Novelli
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Orti
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Garrido
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Saavedra
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Moreno
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Granell
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Briones
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Brunet
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Navarro
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Ruiz
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Rabella
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Valcárcel
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Sierra
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Prim N, Benito N, Montes G, Pomar V, Molet J, Rabella N. Human herpesvirus 1 meningoencephalitis after trigeminal neuralgia surgery. J Infect 2013; 67:79-81. [PMID: 23068448 DOI: 10.1016/j.jinf.2012.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 08/29/2012] [Accepted: 10/07/2012] [Indexed: 02/05/2023]
Abstract
We report a case of human herpesvirus 1 (HHV-1) meningoencephalitis in a patient who underwent trigeminal neuralgia surgery. Although this surgery has been reported to increase the risk of mucocutaneous HHV-1 recurrence, to our knowledge, an association between trigeminal surgery and HHV-1 encephalitis has not been previously described.
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Affiliation(s)
- Núria Prim
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, Barcelona, Spain
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14
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de Ory F, Avellón A, Echevarría JE, Sánchez-Seco MP, Trallero G, Cabrerizo M, Casas I, Pozo F, Fedele G, Vicente D, Pena MJ, Moreno A, Niubo J, Rabella N, Rubio G, Pérez-Ruiz M, Rodríguez-Iglesias M, Gimeno C, Eiros JM, Melón S, Blasco M, López-Miragaya I, Varela E, Martinez-Sapiña A, Rodríguez G, Marcos MÁ, Gegúndez MI, Cilla G, Gabilondo I, Navarro JM, Torres J, Aznar C, Castellanos A, Guisasola ME, Negredo AI, Tenorio A, Vázquez-Morón S. Viral infections of the central nervous system in Spain: a prospective study. J Med Virol 2012; 85:554-62. [PMID: 23239485 DOI: 10.1002/jmv.23470] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2012] [Indexed: 11/10/2022]
Abstract
The aim of the study was to determine the incidence of viruses causing aseptic meningitis, meningoencephalitis, and encephalitis in Spain. This was a prospective study, in collaboration with 17 Spanish hospitals, including 581 cases (CSF from all and sera from 280): meningitis (340), meningoencephalitis (91), encephalitis (76), febrile syndrome (7), other neurological disorders (32), and 35 cases without clinical information. CSF were assayed by PCR for enterovirus (EV), herpesvirus (herpes simplex [HSV], varicella-zoster [VZV], cytomegalovirus [CMV], Epstein-Barr [EBV], and human herpes virus-6 [HHV-6]), mumps (MV), Toscana virus (TOSV), adenovirus (HAdV), lymphocytic choriomeningitis virus (LCMV), West Nile virus (WNV), and rabies. Serology was undertaken when methodology was available. Amongst meningitis cases, 57.1% were characterized; EV was the most frequent (76.8%), followed by VZV (10.3%) and HSV (3.1%; HSV-1: 1.6%; HSV-2: 1.0%, HSV non-typed: 0.5%). Cases due to CMV, EBV, HHV-6, MV, TOSV, HAdV, and LCMV were also detected. For meningoencephalitis, 40.7% of cases were diagnosed, HSV-1 (43.2%) and VZV (27.0%) being the most frequent agents, while cases associated with HSV-2, EV, CMV, MV, and LCMV were also detected. For encephalitis, 27.6% of cases were caused by HSV-1 (71.4%), VZV (19.1%), or EV (9.5%). Other positive neurological syndromes included cerebellitis (EV and HAdV), seizures (HSV), demyelinating disease (HSV-1 and HHV-6), myelopathy (VZV), and polyradiculoneuritis (HSV). No rabies or WNV cases were identified. EVs are the most frequent cause of meningitis, as is HSV for meningoencephalitis and encephalitis. A significant number of cases (42.9% meningitis, 59.3% meningoencephalitis, 72.4% encephalitis) still have no etiological diagnosis.
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Affiliation(s)
- F de Ory
- National Centre for Microbiology, Majadahonda, Spain.
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15
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Trallero G, Avellon A, Otero A, De Miguel T, Pérez C, Rabella N, Rubio G, Echevarria JE, Cabrerizo M. Enteroviruses in Spain over the decade 1998-2007: virological and epidemiological studies. J Clin Virol 2009; 47:170-6. [PMID: 20007023 DOI: 10.1016/j.jcv.2009.11.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 10/08/2009] [Accepted: 11/11/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Human enteroviruses (HEV) are the commonest cause of viral meningitis as well as other pathologies, therefore HEV characterization is important both in patient management and epidemiological investigation. OBJECTIVES A 10-year study of patients with enteroviral infection was carried out in Spain to determine the underlying etiology. STUDY DESIGN HEV were fully typed by microneutralisation tests and/or molecular methods. RESULTS A collection of 86404 clinical samples were studied in several Spanish laboratories. These were collected from patients with different syndromes, mainly aseptic meningitis (AM), fever, respiratory diseases and acute flaccid paralysis. Of these, 6867 HEV were obtained. At the National Poliovirus Laboratory 2814 were serotypically characterised. Among non-polio enteroviruses, the eight main serotypes were Echovirus 30 (25%), Echovirus 6 (12.4%), Echovirus 13 (8.3%), Echovirus 11 (7.4%) and Echovirus 9 (4.7%), followed by Coxsackievirus B5 (4.2%) and Echovirus 7 and Coxsackievirus A9 (3.7%) each. In AM cases, Echovirus 30 was identified in 39% of them, followed by Echovirus 6 (14%). However, Echovirus 6 was mainly associated with respiratory disease (17%), followed by Echovirus 11 (10%). On the other hand, Echovirus 30, Echovirus 11 and Echovirus 6 contributed equally with 12% of each serotype in the cases of fever. CONCLUSIONS The present report complements previous data (Trallero et al.(13)), with the results of HEV incidence in Spain from 1998 to 2007. The surveillance described in this study provided valuable information as to which serotypes are in circulation, the emergence of new HEV and association with clinical manifestations.
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Affiliation(s)
- G Trallero
- National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Madrid, Spain.
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16
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Martino R, Piñana JL, Parody R, Valcarcel D, Sureda A, Brunet S, Briones J, Delgado J, Sánchez F, Rabella N, Sierra J. Lower respiratory tract respiratory virus infections increase the risk of invasive aspergillosis after a reduced-intensity allogeneic hematopoietic SCT. Bone Marrow Transplant 2009; 44:749-56. [PMID: 19398963 PMCID: PMC7091792 DOI: 10.1038/bmt.2009.78] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [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] [Indexed: 01/24/2023]
Abstract
We have analyzed the incidence and risk factors for the occurrence of invasive aspergillosis (IA) among 219 consecutive recipients of an allogeneic hematopoietic SCT after a reduced-intensity conditioning regimen (Allo-RIC). Twenty-seven patients developed an IA at a median of 218 days (range 24–2051) post-Allo-RIC, for a 4-year incidence of 13% (95% confidence interval 4–24%). In multivariate analysis, risk factors for developing IA were steroid therapy for moderate-to-severe graft vs host disease (GVHD) (Hazard Ratio (HR) 2.9, P=0.03), occurrence of a lower respiratory tract infection (LRTI) by a respiratory virus (RV) (HR 4.3, P<0.01) and CMV disease (HR 2.8, P=0.03). Variables that decreased survival after Allo-RIC were advanced disease phase (HR 1.9, P=0.02), steroid therapy for moderate-to-severe GVHD (HR 2.2, P<0.01), not developing chronic GVHD (HR 4.3, P<0.01), occurrence of LRTI by an RV (HR 3.4, P<0.01) and CMV disease (HR 2, P=0.01), whereas occurrence of IA had no effect on survival (P=0.5). Our results show that IA is a common infectious complication after an Allo-RIC, which occurs late post-transplant and may not have a strong effect on survival. An important observation is the possible role of LRTI by conventional RVs as risk factors for IA.
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Affiliation(s)
- R Martino
- Division of Clinical Hematology, Hospital de la Sant Creu i Sant Pau, Autonomous University of Barcelona, Sant Antoni Maria Claret 167, Barcelona, Catalunya, Spain.
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17
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Guirado L, Rabella N, Díaz JM, Facundo C, Maderuelo A, Margall N, Silva I, García-Maset R, Calabia J, Giménez I, Garra N, Solà R, Ballarín JA. [Prophylactic and pre-emptive therapy for cytomegalovirus infection in kidney transplant patients using oral valganciclovir]. Nefrologia 2008; 28:293-300. [PMID: 18590496] [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: 05/26/2023] Open
Abstract
UNLABELLED Prophylactic and pre-emptive therapy with oral valganciclovir for cytomegalovirus infection in renal transplant recipients. BACKGROUND Cytomegalovirus infection is a very important health problem in solid organ transplant recipients (SOT). Once-daily valganciclovir has been shown to be as clinically effective and well tolerated as oral ganciclovir tid in the prevention of CMV infection in high risk SOT recipients. METHODS The aim of the present study was to evaluate the incidence and severity of CMV disease in 150 renal transplant recipients that received either prophylactic [high risk group (HR), N = 66] or pre-emptive [low risk group (LR), N = 84] therapy with oral valganciclovir (900 mg/day vo) for three months according to their basal risk. Patients were monitored for signs and symptoms of CMV disease and CMV plasma viral load was assessed weekly. RESULTS A total of 31 patients (47%) of the HR and 26 patients (31%) of the LR presented a positive CMV PCR result. Twelve patients (14.3%) in the LR that had a high viral load (CMV PCR > 1,000 copies/mL) but remained asymptomatic received pre-emptive therapy. Four patients (4.7%) in the LR, after an average time of 35 days after transplant and two patients (4.5%) in the HR, after prophylactic treatment was completed, developed CMV disease. The disease was mild-moderate in most of the cases. Those patients that developed CMV disease responded to treatment with iv ganciclovir for 14 days followed by treatment with oral valganciclovir for up to three months. CONCLUSION Prophylactic treatment with oral valganciclovir for CMV prevention is only required in high risk solid organ transplant recipients.
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Affiliation(s)
- L Guirado
- Servicio de Nefrología, Fundació Puigvert, Barcelona.
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18
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Parody R, Rabella N, Martino R, Otegui M, del Cuerpo M, Coll P, Sierra J. Upper and lower respiratory tract infections by human enterovirus and rhinovirus in adult patients with hematological malignancies. Am J Hematol 2007; 82:807-11. [PMID: 17563077 DOI: 10.1002/ajh.20974] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [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: 11/06/2022]
Abstract
The impact of human enterovirus (HEV) and human rhinovirus (HRV) respiratory tract infections in adult patients with hematological malignancies has been infrequently reported. We retrospectively studied 31 patients with an upper or lower respiratory tract infection (URTI/LRTI) by HEV (n = 18) or HRV (n = 15). At onset, a LRTI was present in 6 (33%) and 2 (13%) episodes of HEV and HRV infections, respectively, with or without an URTI. Progression to LRTI (pneumonia) from prior URTI was seen in 1 (6%) and 2 (13%) HEV and HRV infections, respectively. The presence of lymphocytopenia (<0.5 x 10(9)/l) was higher in LRTI by HEV: 4/5 (80%) versus 2/10 (20%) by HRV. Eight of 18 (44%) patients with immunosuppression versus 3/14 (21%) patients with no immunosuppression at the onset of respiratory infection developed a LRTI. Thirteen per cent of patients had associated respiratory infections from bacteria, aspergillus, or CMV. Pulmonary aspergillosis was diagnosed in 20% of HRV infections. Three of 11 patients (27%) with a LRTI died, but pulmonary copathogens were also involved in all cases. In conclusion, HEV and HRV can be associated with LRTI in immunocompromised patients, although their direct impact on mortality is uncertain.
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Affiliation(s)
- R Parody
- Department of Clinical Hematology, Autonomous University, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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19
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Solà R, Rabella N, Guirado LL, Díaz JM, Facundo C, García R. Relation between pp65 antigenemia, RT-PCR and viruria for cytomegalovirus detection in kidney transplant recipients. Transplant Proc 2006; 37:3768-9. [PMID: 16386533 DOI: 10.1016/j.transproceed.2005.09.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION We compared the efficiency of detection using pp65 antigenemia, reverse transcription-polymerase chain reaction (RT-PCR), and viruria for the diagnosis of cytomegalovirus (CMV) infections after kidney transplantation. PATIENTS AND METHODS We evaluated 40 renal transplant recipients between weeks 5 and 12 after transplantation, including 179 blood and 181 urine specimens. RESULTS All positive samples by antigenemia were also positive by PCR. However, in 52 cases only PCR was positive (kappa = 0.134 [P < .001]). Viruria was positive in 66 cases, but only 26 were CMV PCR positive. In 34 cases, viruria was negative and PCR positive (P = .192). CONCLUSION Detection of DNA in serum is a more sensitive method than antigenemia for the diagnosis of CMV infection. Viruria was not related to the presence of CMV in blood.
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Affiliation(s)
- R Solà
- Unitat de Transplantament Renal, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain.
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20
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Williams JV, Martino R, Rabella N, Otegui M, Parody R, Heck JM, Crowe JE. A prospective study comparing human metapneumovirus with other respiratory viruses in adults with hematologic malignancies and respiratory tract infections. J Infect Dis 2005; 192:1061-5. [PMID: 16107960 PMCID: PMC1483060 DOI: 10.1086/432732] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Accepted: 04/18/2005] [Indexed: 11/03/2022] Open
Abstract
Human metapneumovirus (hMPV) is a recently described paramyxovirus associated with upper and lower respiratory-tract infection (URI and LRI, respectively). We conducted a prospective study of URI and LRI in adults with hematologic malignancies during a 4-year period. We retrospectively tested samples by reverse-transcription polymerase chain reaction for hMPV and analyzed clinical data. Twenty-two (9%) of 251 episodes of respiratory infection tested positive for hMPV. Sixteen (73%) of the illnesses occurred in hematopoietic stem-cell transplant recipients. Nine patients with hMPV developed LRI; 3 of these patients died. hMPV is a common cause of respiratory infections in adults with hematologic malignancies, with associated morbidity and mortality.
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Affiliation(s)
- John V Williams
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2581, USA.
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21
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Monmany J, Rabella N, Margall N, Domingo P, Gich I, Vázquez G. Unmasking influenza virus infection in patients attended to in the emergency department. Infection 2004; 32:89-97. [PMID: 15057573 PMCID: PMC7099985 DOI: 10.1007/s15010-004-3088-y] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2003] [Accepted: 12/01/2003] [Indexed: 11/27/2022]
Abstract
Background: Infection by the influenza virus may pass undetected in
many adult patients attended to in the emergency department
because its diagnosis usually relies on clinical manifestations,
which can be distorted by symptoms of a preexisting disease,
superposed complications or nontypical manifestations of
influenza virus infection (confusing symptoms). Patients and
Methods: We performed this observational, prospective study with an
antigen detection test by indirect immunofluorescence assay
(IFA) to estimate the presence of influenza virus infection in
such patients. No confirmatory test was performed to validate a
positive or negative IFA result. Then we compared those who were
antigen positive to those who were negative and also analyzed
those who were positive classified by age, comorbidity and
clinical presentation. We also evaluated the use of medical and
hospital resources and vaccination status. Posterior pharynx
swab specimens from 136 consecutive adult patients, 74 women and
62 men with a mean age of 68.7 ± 17.9 (range: 18–97) years
attended to in the emergency department of a university hospital
in Barcelona during the 1999–2000 influenza epidemic were
examined. Tested patients presented either a classical influenza
syndrome, a deterioration of a previous condition or any abrupt
onset of symptoms without an obvious cause. Results: Influenza A virus antigen was detected in 99 (72.8%) of
the 136 patients included in the study. Confusing symptoms were
present in 86 patients with laboratoryconfirmed influenza and 40
of them lacked influenza syndrome. Prostration, aching and fever
out of proportion to catarrhal symptoms (disproportionate
prostration) and cough were independent predictors for this
diagnosis (OR = 5.14; 95% CI: 1.98–13.35, p = 0.001 and OR =
4.40, 95% CI, 1.65–11.75, p = 0.03, respectively). Among the 99
patients who tested positive, 72 were ≥ 65 years of age. This
older positive group compared to the 27 also positive < 65
(non-old) had a tendency to show symptoms mediated by cytokines
less frequently: malaise was present in 76.4% of the older
positive patients vs 92.6% in the non-old positive ones, p =
0.07. The equivalent percentages for muscle ache were: 56.9% vs
77.8%, p = 0.06; for dysthermia: 54.2% vs 70.4%, p = 0.08; for
headache: 35.2% vs 66.7%, p = 0.005, and for disproportionate
prostration: 47.2% vs 66.7%, p = 0.08. Cough was more frequent
in the older positive group: 94.4% vs 77.8%, p = 0.02. Older
positive patients were also hospitalized and received
antibiotics more frequently than the non-old positive ones:
65.3% vs 40.7%, p = 0.03 and 81.9% vs 63.0%, p = 0.046,
respectively. Hospitalization was independently correlated with
the presence of complications (OR = 4.5, 95% IC 1.27–15.95, p =
0.02). Patients with the highest comorbidity, evaluated with the
Charlson scale, were more inadequately vaccinated than those
with moderate or low comorbidity. Conclusion: Influenza virus infection has a great and underestimated
impact in the emergency department during influenza epidemics.
High frequency of confusing symptoms, which overcome classical
influenza syndrome in adult people with comorbidity, may explain
this effect. Disproportionate prostration and cough are symptoms
that independently predict its diagnosis in the global adult
population, whereas in the elderly, fever and cough should
arouse this suspicion whether or not they present classic
symptoms. In our setting, individuals with high comorbidity are
inadequately vaccinated.
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Affiliation(s)
- J Monmany
- Department of Internal Medicine, Hospital of Santa Creu and Sant Pau, Autonomous University of Barcelona, Sant Antoni Maria Claret 167, E-08025, Barcelona, Spain.
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Martino R, Rámila E, Rabella N, Muñoz JM, Peyret M, Portos JM, Laborda R, Sierra J. Respiratory virus infections in adults with hematologic malignancies: a prospective study. Clin Infect Dis 2003; 36:1-8. [PMID: 12491194 PMCID: PMC7202548 DOI: 10.1086/344899] [Citation(s) in RCA: 60] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2002] [Accepted: 08/30/2002] [Indexed: 11/30/2022] Open
Abstract
During a 2-year period, 157 consecutive episodes of respiratory virus infections that occurred in 130 patients with upper or lower respiratory tract infection were analyzed for respiratory viruses. A respiratory virus was identified in 75 episodes (48%), and several viruses were found in 13 episodes: there were a total of 56 influenza A virus infections, 14 respiratory syncytial virus infections, 8 adenovirus infections, 8 infections with parainfluenza virus types 1 or 3, and 7 enterovirus infections. On multivariate analysis, the only variable that predicted progression to pneumonia in patients with an upper respiratory tract infection was the presence of respiratory syncytial virus, whereas lymphocytopenia had a nonsignificant trend. Also, among the 38 patients who had pneumonia at any time during the episode, both respiratory syncytial virus and lymphocytopenia were commonly found. For both epidemiological and therapeutic considerations, frequent screening for respiratory viruses should be incorporated into the routine diagnostic study of patients with hematologic malignancies.
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Affiliation(s)
- Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
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Rabella N, Otegui M, Labeaga R, Rodríguez P, Margall N, Gurguí M, Prats G. Antiviral susceptibility of Herpes simplex viruses and its clinical correlates: a single center's experience. Clin Infect Dis 2002; 34:1055-60. [PMID: 11914993 DOI: 10.1086/339490] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2001] [Revised: 11/27/2001] [Indexed: 11/03/2022] Open
Abstract
The in vitro susceptibility to acyclovir of 204 herpes simplex virus isolates from 165 immunocompromised patients treated at our hospital was determined by the cytopathic effect reduction assay. Approximately 95% of herpes simplex virus 1 and 73% of herpes simplex virus 2 isolates were inhibited by acyclovir at concentrations of <2 microgram/mL. From 8 patients (5%), an isolate with low susceptibility to acyclovir (50% inhibitory dose, >3 microgram/mL) was recovered. Medical records of 83 patients were reviewed. Lesions resolved in most of the patients, independent of treatment. Treatment failures were not always associated with isolation of an in vitro-resistant virus. On the contrary, when a virus with low susceptibility to acyclovir was isolated, resolution of the lesion was the rule. In 9 of 10 patients with subsequent recurrent episodes of disease, the susceptibility of the viruses isolated was similar to that of the first episode. Routine susceptibility testing in our geographic area is not encouraged because of the low incidence of acyclovir-resistant herpes simplex viruses.
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Affiliation(s)
- N Rabella
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
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Guirado L, Herreros MA, Muñoz JM, Rabella N, Facundo C, Agraz I, Díaz M, Diaz JM, Durán F, Solà R. Use of cytomegalovirus antigenemia as a marker for preemptive treatment. Transplant Proc 2002; 34:67-8. [PMID: 11959188 DOI: 10.1016/s0041-1345(01)02668-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- L Guirado
- Renal Transplantation Unit, Puigvert Foundation, Barcelona, Spain
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Otegui M, Rabella N, Labeaga R, Herrero M, Margall N, Muñoz JM, Prats G. [Clinical utility of susceptibility testing of herpes simplex virus to acyclovir]. Rev Esp Quimioter 2001; 14:351-7. [PMID: 11856981] [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: 02/23/2023]
Abstract
In vitro susceptibility to acyclovir of 96 strains of herpes simplex virus isolated from 80 immunocompromised patients attended in our hospital was studied by the cytopathic effect reduction assay. Ninety-eight percent (61/62) of herpes simplex virus 1 strains and 91% (31/34) of herpes simplex virus 2 strains were inhibited by acyclovir concentrations lower than 3 mg/l. In 5% of the patients herpes simplex strains resistant to acyclovir (ID(50) >3 mg/l) were isolated. Ninety-eight percent of the lesions caused by herpes simplex viruses susceptible to acyclovir (ID(50) <3 mg/l) resolved independently of treatment. In two cases, the cytopathic effect reduction assay was not able to predict treatment failure and persistance of the lesions was not always associated with isolation of a resistant strain in vitro. In four cases, isolation of a strain resistant to acyclovir was not indicative of treatment failure. In conclusion, we believe there is no need to routinely test susceptibility of herpes simplex viruses to acyclovir and that susceptibility testing should be indicated only in patients in whom lesions persist and other causes have been ruled out.
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Affiliation(s)
- M Otegui
- Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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26
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Otegui M, Rabella N, Labeaga R, Herrero M, Margall R, Muñoz JM, Prats G. [In vitro susceptibility to ganciclovir and foscarnet of cytomegaloviruses]. Rev Esp Quimioter 2001; 14:155-64. [PMID: 11704769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Ganciclovir is the drug of choice for the treatment of acute cytomegalovirus infections. This antiviral agent is a nucleoside analog of guanine whose activity is dependent upon its intracellular phosphorylation to the triphosphate derivative. Foscarnet is used to treat immunosuppressed patients such as organ transplant recipients and AIDS patients with cytomegalovirus who do not tolerate or develop resistance to ganciclovir. Foscarnet is a pyrophosphate analog that directly inhibits viral DNA polymerase. Resistant isolates have been recovered from immunocompromised patients treated with both anticytomegalovirus compounds. The aims of this study were to prepare a plaque reduction assay to study the in vitro susceptibility of cytomegalovirus to ganciclovir and foscarnet, and to apply it to the knowledge of in vitro susceptibility values of cytomegalovirus isolated from clinical samples. Eighty isolates from patients who had never been treated with ganciclovir or foscarnet were tested for antiviral susceptibility. The plaque reduction assay took 6-8 weeks. The results are expressed as ID(50) (inhibitory dose 50), and the ID(50) values of ganciclovir were between 2.14 and 13.49 microM. The ID(50) for ganciclovir was higher that 12 microM in only two cases (2%). The molecular study of the DNA of these did not show any mutation in the UL97 gene. The ID(50) values of foscarnet were between 46.65 and 460.22 microM. In 78 cases (98%) foscarnet ID(50) was lower than 400 microM. These results were comparable with those obtained by other authors. To summarize, the frequency of cytomegalovirus strains resistant in vitro to ganciclovir and foscarnet in previously untreated patients was low and when it was present it did not involve therapeutic failure since the patients progressed favorably.
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Affiliation(s)
- M Otegui
- Servicio de Microbiología, Hospital de la Sta. Creu i St. Pau, Barcelona, Spain
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27
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Negredo E, Domingo P, Sambeat MA, Rabella N, Vázquez G. Effect of pneumococcal vaccine on plasma HIV-1 RNA of stable patients undergoing effective highly active antiretroviral therapy. Eur J Clin Microbiol Infect Dis 2001; 20:287-8. [PMID: 11399023 DOI: 10.1007/s100960100470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- E Negredo
- Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
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28
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Español I, Gallego A, Enríquez J, Rabella N, Lerma E, Hernández A, Pujol-Moix N. Thrombocytopenia associated with liver cirrhosis and hepatitis C viral infection: role of thrombopoietin. Hepatogastroenterology 2000; 47:1404-6. [PMID: 11100362] [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: 02/18/2023]
Abstract
BACKGROUND/AIMS Thrombocytopenia in chronic liver diseases has traditionally been considered a consequence of platelet pooling and destruction in spleen. We tried to evaluate the influence of thrombopoietin, the physiological regulator of thrombopoiesis, on the origin of this thrombocytopenia. METHODOLOGY We determined serum thrombopoietin levels by ELISA in thrombocytopenic patients with liver cirrhosis (n = 32) and with chronic hepatitis C viral infection (n = 23). A group of 43 healthy subjects was used as a control. RESULTS Liver cirrhosis patients presented slightly, but not significantly, lower serum thrombopoietin levels (104 +/- 56 pg/mL) than controls (121 +/- 58 pg/mL) or patients infected with chronic hepatitis C virus (125 +/- 40 pg/mL). No correlations were found between serum thrombopoietin concentrations and liver tests or hematological parameters. CONCLUSIONS We conclude that low thrombopoietin production may play a role, along with hypersplenism, in the development of thrombocytopenia in patients with liver cirrhosis. Normal thrombopoietin levels exclude a defect in thrombopoietin production as a possible etiology for the thrombocytopenia in patients with chronic hepatitis C viral infection. However, a direct viral megakaryocyte infection or an immune mechanism could explain this thrombocytopenia, according to the thrombopoietin levels detected.
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Affiliation(s)
- I Español
- Departament d'Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
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Negredo E, Domingo P, Sambeat MA, Rabella N, Vázquez G. Influence of coinfection with hepatitis viruses on human immunodeficiency plasma viral load. Arch Intern Med 1999; 159:2367-8. [PMID: 10547181 DOI: 10.1001/archinte.159.19.2367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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30
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Español I, Muñiz-Diaz E, Margall N, Rabella N, Sambeat MA, Hernández A, Pujol-Moix N. Serum thrombopoietin levels in thrombocytopenic and non-thrombocytopenic patients with human immunodeficiency virus (HIV-1) infection. Eur J Haematol 1999; 63:245-50. [PMID: 10530413 DOI: 10.1111/j.1600-0609.1999.tb01885.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 12/16/2022]
Abstract
HIV-1 seropositive patients often exhibit thrombocytopenia, considered of multifactorial aetiology. Thrombopoietin (TPO), a recently isolated cytokine, is the main regulator of megakaryocyte and platelet production. The objective of this study was to analyse serum TPO levels in thrombocytopenic and non-thrombocytopenic HIV-1 infected patients. Serum TPO levels were measured by ELISA in 43 healthy individuals and in 88 HIV-1 infected patients: 68 thrombocytopenics and 20 non-thrombocytopenics. Thrombocytopenic HIV-1 infected patients showed higher TPO concentrations (263 +/- 342 pg/ml) than non-thrombocytopenics (191 +/- 86 pg/ml); levels in both groups were significantly higher than those of healthy controls (121 +/- 58 pg/ml). Two subgroups of thrombocytopenic patients, the autoimmune thrombocytopenic purpura (AITP) group and the mild thrombocytopenic group, presented TPO levels similar to those of non-thrombocytopenics. Patients exhibiting pancytopenia showed the highest TPO concentrations. However, there was no correlation between TPO levels and platelet counts in any group of HIV-1 infected patients. TPO levels in HIV-1 seropositive patients were slightly increased and the differences in TPO levels between thrombocytopenic and non-thrombocytopenic patients were generally small. The finding of mildly increased TPO levels along with the recently described recovery of thrombocytopenia following recombinant TPO administration confirms the implication of ineffective platelet production in the origin of HIV-associated thrombocytopenia.
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Affiliation(s)
- I Español
- Department d'Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
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31
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González Y, Martino R, Rabella N, Labeaga R, Badell I, Sierra J. Community respiratory virus infections in patients with hematologic malignancies. Haematologica 1999; 84:820-3. [PMID: 10477456] [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: 02/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The main difficulty of PCR-based clonality studies for B-cell lymphoproliferative disorders (B-LPD) is discrimination between monoclonal and polyclonal PCR products, especially when there is a high background of polyclonal B cells in the tumor sample. Actually, PCR-based methods for clonality assessment require additional analysis of the PCR products in order to discern between monoclonal and polyclonal samples. Heteroduplex analysis represents an attractive approach since it is easy to perform and avoids the use of radioactive substrates or expensive equipment. DESIGN AND METHODS We studied the sensitivity and specificity of heteroduplex PCR analysis for monoclonal detection in samples from 90 B-cell non Hodgkin's lymphoma (B-NHL) patients and in 28 individuals without neoplastic B-cell disorders (negative controls). Furthermore, in 42 B-NHL and in the same 28 negative controls, we compared heteroduplex analysis vs the classical PCR technique. We also compared ethidium bromide (EtBr) vs. silver nitrate (AgNO(3)) staining as well as agarose vs. polyacrylamide gel electrophoresis (PAGE). RESULTS Using two pair consensus primers sited at VH (FR3 and FR2) and at JH, 91% of B-NHL samples displayed monoclonal products after heteroduplex PCR analysis using PAGE and AgNO(3) staining. Moreover, no polyclonal sample showed a monoclonal PCR product. By contrast, false positive results were obtained when using agarose (5/28) and PAGE without heteroduplex analysis: 2/28 and 8/28 with EtBr and AgNO(3) staining, respectively. In addition, false negative results only appeared with EtBr staining: 13/42 in agarose, 4/42 in PAGE without heteroduplex analysis and 7/42 in PAGE after heteroduplex analysis. INTERPRETATION AND CONCLUSIONS We conclude that AgNO(3) stained PAGE after heteroduplex analysis is the most suitable strategy for detecting monoclonal rearrangements in B-NHL samples because it does not produce false-positive results and the risk of false-negative results is very low.
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Affiliation(s)
- Y González
- Service of Hematology, University Hospital of Salamanca, Paseo de San Vicente, 58-182, Salamanca, 37007, Spain.
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Rabella N, Rodriguez P, Labeaga R, Otegui M, Mercader M, Gurguí M, Prats G. Conventional respiratory viruses recovered from immunocompromised patients: clinical considerations. Clin Infect Dis 1999; 28:1043-8. [PMID: 10452632 DOI: 10.1086/514738] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [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: 11/03/2022] Open
Abstract
Lower respiratory tract infection is the most common complication in the immunocompromised patient. From January 1991 to December 1995, 785 consecutive patients with suspected respiratory tract infections were studied. One hundred ninety-nine viruses were isolated from 182 (23%) of 785 bronchoalveolar lavage fluid specimens. Cytomegalovirus was isolated from 131 patients, herpes simplex virus was recovered from 31, and conventional respiratory viruses (CRVs) were recovered from 36. There were 9 influenza A viruses, 2 influenza B viruses, 7 parainfluenza viruses, 5 respiratory syncytial viruses, 5 adenoviruses, 6 enteroviruses, and 3 rhinoviruses. We identified 22 patients from whom a CRV was the only microorganism recovered; 13 patients developed pneumonia, 10 had acute respiratory failure, 5 required support with mechanical ventilation, and 5 (23%) died. In conclusion, CRVs are frequent causes of respiratory illnesses and are associated with high rates of morbidity and mortality among immunocompromised patients.
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Affiliation(s)
- N Rabella
- Servei de Microbiologia, Unitat de Malalties Infeccioses, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
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Abstract
In recent years, it has been recognised that the community respiratory viruses are a frequent cause of upper and lower respiratory tract infections in immunocompromised hosts such as bone marrow transplant recipients. By contrast, infections by non-polio enteroviruses have rarely been reported after stem cell transplantation. We present four cases of acute respiratory illness with enterovirus isolated as the sole pathogen from bronchoalveolar lavage. All four patients developed pneumonia and three died of progressive pneumonia, which reflects the severity of this complication. We conclude that enteroviral pulmonary infections may be a cause of severe pneumonia in immunocompromised hosts.
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Affiliation(s)
- Y González
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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34
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Barnadas MA, Margall N, Rabella N, Alegre M, Baselga E, Randazzo L, de Moragas JM. [Mucocutaneous manifestations in acute HIV infection. 3 case reports]. An Med Interna 1998; 15:650-3. [PMID: 9972600] [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: 02/10/2023]
Abstract
We report three patients who developed a generalized rash with oral, genital or perianal ulcerations as a result of acute infection due to HIV. The primary infection was diagnosed by seroconversion (by means of EIA and Western blot techniques). Definitive diagnosis was established on days 52, 85 and 97 after the appearance of the rash. The p24 protein of the HIV was only detected in the early phase of the disorder in the two cases in which this study was carried out.
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Affiliation(s)
- M A Barnadas
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona
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Manteiga R, Martino R, Sureda A, Labeaga R, Brunet S, Sierra J, Rabella N. Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience. Bone Marrow Transplant 1998; 22:899-904. [PMID: 9827819 DOI: 10.1038/sj.bmt.1701439] [Citation(s) in RCA: 39] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The optimal prophylactic strategy for cytomegalovirus (CMV) disease after allogeneic hematopoietic stem cell transplantation has not yet been established. The aim of this study was to analyze our single-center experience with a uniform protocol of CMV antigenemia-guided pre-emptive treatment with ganciclovir (GCV) after allografting. Fifty-two consecutive adult patients, 48 of them transplanted from HLA-identical matched related donors were included. T cell-depleted marrow or peripheral blood were used in 21 cases. After engraftment, weekly blood samples were tested for CMV pp65 antigenemia and viremia (conventional cultures) until day +100. GCV was started if CMV antigenemia and/or CMV viremia were detected. CMV infection (CMV-I) was found in 19 patients (37%). Seven patients suffered from CMV disease (CMV-D), three colitis and four pneumonias. There was one death directly related to CMV-D and three further cases died from refractory GVHD with CMV-D. Only one patient developed CMV pneumonia without any previous positive antigenemia and/or viremia. Multivariate analysis identified grades II-IV acute GVHD (P = 0.02) and peripheral blood stem cell transplantation (P = 0.03) to be risk factors for developing CMV-I. In conclusion, this monitoring protocol allowed early treatment of CMV-I without progression to CMV-D. Pre-emptive therapy had the additional advantage of avoiding GCV administration in most of our allograft recipients.
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Affiliation(s)
- R Manteiga
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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36
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Rodés A, Vall M, Casabona J, Nuez M, Rabella N, Mitrani L. [Prevalence of human immunodeficiency virus infection and behaviors associated with its transmission among parenteral drug users selected on the street]. Med Clin (Barc) 1998; 111:372-7. [PMID: 9833239] [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: 02/09/2023]
Abstract
BACKGROUND To estimate the prevalence of HIV infection and the associated risk behaviours among intravenous drug users not receiving treatment for their drug dependence. PATIENTS AND METHODS A cross-sectional study of 200 intravenous drug users recruited from the streets of Barcelona in 1993. Information about the socio-demographic aspects and behaviours was obtained through a personal interview using a standardised questionnaire which was carried out by three ex-drug users. Saliva samples were used to determine anti HIV antibodies. RESULTS The prevalence of HIV infection was 51%. 57% borrowed used syringes, 65% lended their syringes, and 41% practised back of frontloading. 85% if those who shared syringes always cleaned them, however 59% only used water. 78% had heterosexual relations, in 33% of the cases with a non-injecting sexual partner. 65% always used condoms with sexual clients although only 26% always used them with stable sexual partners and 36% with casual sexual partners. 78% had performed the HIV test and among those who knew they were seropositive, 40% had received some kind of health control in the last 6 months. Not having a legal income, injecting speedball or barbiturates, unknowing self HIV negative status and practicing forms of indirect sharing were found to be independently associated with syringe sharing. CONCLUSIONS The high prevalence of HIV infection and associated risk behaviours highlights the need to increase and adapt the prevention efforts and investigation to this group. Social marginalization and poliuse of drugs should be addressed in HIV prevention programs.
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Affiliation(s)
- A Rodés
- Centro de Estudios Epidemiológicos sobre el Sida de Cataluña, Hospital Universitario Germans Triaś i Pujol, Badalona.
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Muñoz L, Balmaña J, Martino R, Sureda A, Rabella N, Brunet S. [Abdominal pain as the initial symptom of visceral varicella zoster infection in hematopoietic stem cell transplant recipients]. Med Clin (Barc) 1998; 111:19-22. [PMID: 9666431] [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: 02/08/2023]
Abstract
Varicella zoster virus (VZV) infections are an important cause of morbidity after stem cell transplantation (SCT), with no differences in their overall incidence between allogeneic and autologous transplants. We report four patients who developed a disseminated VZV infection with visceral involvement after an allogeneic (n = 3) or autologous (n = 1) SCT. In all 4 cases, the initial symptom was severe abdominal pain which preceded the appearance of the classical herpetic vesicular skin lesions from two to four days in three cases, while one never developed skin lesions. The interval from the transplant to the infection ranged from 5 to 13 months, and all three allogeneic SCT received a T-cell depleted graft, although two suffered from chronic GVHD. All patients had clinical, radiologic and/or biochemical findings indicative of gastrointestinal or visceral involvement. An extensive bibliography review of this specific form of presentation of disseminated VZV infection is presented. The interval from the abdominal pain to the development of the skin lesions has ranged from one to 10 days, and this has led to a delay in the initiation of specific antiviral therapy in many cases, including our only fatal case. We conclude that an abdominal pain of unknown origin in this particular clinical setting should always be regarded as a possible prodromal phase of a disseminated VZV infection.
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Affiliation(s)
- L Muñoz
- Unidad de Hematología Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona
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38
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Negredo E, Domingo P, Rabella N, López-Contreras J, Fontanet A, Orellana I. Prevalence of parvovirus B19 infection among patients with human immunodeficiency virus infection in Barcelona, Spain. Arch Intern Med 1998; 158:680-1. [PMID: 9521236 DOI: 10.1001/archinte.158.6.680-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Barnadas MA, Alegre M, Baselga E, Randazzo L, Margall N, Rabella N, Curell R, de Moragas JM. Histopathological changes of primary HIV infection. Description of three cases and review of the literature. J Cutan Pathol 1997; 24:507-10. [PMID: 9331897 DOI: 10.1111/j.1600-0560.1997.tb01325.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The histopathological changes observed in the cutaneous rash of three patients who suffered the acute phase of HIV infection are described. In all three patients a perivascular and interstitial inflammatory infiltrate was present in the upper and mid-reticular dermis. In one biopsy isolated areas of epidermal necrosis were observed and in the two other biopsies a perifollicular inflammatory infiltrate was detected with perforation in one case. Furthermore, a periductal infiltrate was observed in one of these biopsies.
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Affiliation(s)
- M A Barnadas
- Department of Dermatology, Hospital de la Sta, Barcelona, Spain
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41
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Prats G, Llovet T, Muñoz C, Solé R, Mirelis B, Izquierdo C, Rodríguez P, Sabanés ME, Rabella N, Pericas R, Sánchez F, Margall N, Navarro F, Coll P. [Etiology of enteritis in a university general hospital in Barcelona (1992-1995)]. Enferm Infecc Microbiol Clin 1997; 15:349-56. [PMID: 9410046] [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: 02/05/2023]
Abstract
BACKGROUND The aim of the study was to describe the etiology of enteropathogenic agents over a four-year period (1992-1995) in a University Hospital in Barcelona. METHODS We studied 12,793 stool samples, 4519 were obtained from patients under 15 years and 8274 were obtained from patients over 14 years. The specimens were examined for bacteriological, parasitological and virological enteropathogens. RESULTS In 3380 specimens of 12,793 stool samples studied were identified an enteropathogen (26.4%). Polymicrobial associations were observed in the 6.8% of the cases. Pathogens were identified in 45% of children samples and 16.3% of adults samples. The etiological enteritis agents more frequently detected in the paediatric patients were Campylobacter (13.5%), rotavirus (11.3%) and Salmonella (10.2%); and Salmonella (4.9%), Campylobacter (3.1%) and Giardia intestinalis (2.1%) in adults. Cryptosporidium (13.5%) was the most frequent cause of gastrointestinal tract infections in HIV-infected subjects. In the children with stools positives, the presence of red and white blood cells were more frequent than the adults with stools positives (73% versus 26.6%). CONCLUSIONS The enteropathogenic agents such as Campylobacter, Salmonella, and Giardia were the most frequent cause of gastroenteritis in our environment. In the children, rotavirus infections predominated during the cold months. The most frequent cause of gastroenteritis in HIV-infected patients was Cryptosporidium followed by Campylobacter.
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Affiliation(s)
- G Prats
- Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona
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Rabella N, Pérez JL, Pumarola T. [The virology laboratory in cytomegalovirus infection. Current possibilities]. Enferm Infecc Microbiol Clin 1997; 15 Suppl 2:69-76. [PMID: 9312301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- N Rabella
- Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona
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43
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Barraquer P, Rabella N, Labeaga R, Mercader M, Prats G. [Diagnosis of infections caused by varicella zoster virus]. Enferm Infecc Microbiol Clin 1996; 14:277-8. [PMID: 9044653] [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: 02/03/2023]
MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Cell Line
- Chickenpox/diagnosis
- Chickenpox/virology
- Child
- Child, Preschool
- Diagnosis, Differential
- Female
- Fluorescent Antibody Technique, Direct
- Herpes Zoster/diagnosis
- Herpes Zoster/virology
- Herpesviridae Infections/diagnosis
- Herpesviridae Infections/virology
- Herpesvirus 3, Human/growth & development
- Herpesvirus 3, Human/immunology
- Herpesvirus 3, Human/isolation & purification
- Humans
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Skin Diseases, Viral/diagnosis
- Skin Diseases, Viral/virology
- Virus Cultivation
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44
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López-Navidad A, Domingo P, López-Talavera JC, Rabella N, Verger G. Epstein-Barr virus infection associated with interstitial nephritis and chronic fatigue. Scand J Infect Dis 1996; 28:185-7. [PMID: 8792488 DOI: 10.3109/00365549609049073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Severe renal disease in the setting of Epstein-Barr virus (EBV) infection is exceedingly rare. We report here the case of a 22-year-old man with acute EBV infection associated with severe interstitial nephritis. The patient developed chronic fatigue and chronic renal failure with a serological profile typical of primary EBV infection. Clinical improvement with anti-EBNA seroconversion occurred after acyclovir therapy. Our patient illustrates that chronic fatigue with major organ dysfunction and a serological profile of primary infection can be seen in chronic EBV infection. In such a case, acyclovir may prove beneficial.
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Affiliation(s)
- A López-Navidad
- Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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45
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Vall Mayans M, Casabona J, Rabella N, De Miniac D. Testing of saliva and serum for HIV in high-risk populations. Ad Hoc Group for the Comparative Saliva and Serum Study. Eur J Clin Microbiol Infect Dis 1995; 14:710-3. [PMID: 8565992 DOI: 10.1007/bf01690881] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 01/31/2023]
Abstract
Paired samples of saliva and serum from 286 high-risk subjects were tested for HIV using two commercial enzyme immunoassays following the same WHO testing strategy supplemented with a Western blot technique. Agreement between HIV testing in both sample types was 98.9% (95% confidence interval: 97.7-100). The sensitivity of an EIA (Wellcozyme GACELISA) alone for saliva was 100% (133/133) and the specificity 98.7% (151/153). These results support previous data showing that in some situations saliva might be an effective alternative to serum for HIV testing.
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Affiliation(s)
- M Vall Mayans
- AIDS Programme, Department of Health, Generalitat de Catalunya, Barcelona, Spain
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46
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López-Contreras J, Ris J, Domingo P, Puig M, Rabella N, Nolla J. Disseminated cytomegalovirus infection in an immunocompetent adult successfully treated with ganciclovir. Scand J Infect Dis 1995; 27:523-5. [PMID: 8588148 DOI: 10.3109/00365549509047059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report the case of a previously healthy man who suffered a disseminated cytomegalovirus infection. He presented with prolonged fever, weight loss of 8 kg, anicteric hepatitis, upper digestive tract bleeding from gastric ulcers, acute polyneuritis and bilateral retinitis. Immunodeficiency was not detected either during admission or during a 3-year follow-up period. The patient was treated with ganciclovir (5 mg/kg BID) during 4 weeks with a favourable clinical outcome. To our knowledge, this is the first reported case with such characteristics.
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Affiliation(s)
- J López-Contreras
- Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain
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47
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Vallejo A, Casado C, Cantó C, Varela JM, Barge T, Rabella N, Herrera I, García Sáiz A. [Isolation, sequencing and ultrastructure of HTLV-I and HTLV-II retroviruses. Presence of the HTLV-II subtype b among Spanish intravenous drug addicts]. Med Clin (Barc) 1994; 103:730-6. [PMID: 7799679] [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: 01/27/2023]
Abstract
BACKGROUND Six cases of HTLV-I/II infection were selected for isolation and characterization of these retrovirus. METHODS Detection of anti-HTLV antibodies was carried out by enzyme immunoassay (EIA), immunofluorescence (IFI), and Western blot (WB). Analysis of proviral DNA was performed by PCR. Viral culture and partial sequencing of the pol and pX genes were carried out. Electron microscopy morphologically characterized the viral particles. RESULTS Serologic study demonstrated four cases of HTLV-II, one of HTLV-I, and one non-typeable HTLV infections. This last case was confirmed as positive for HTLV-II by PCR. Five new HTLV-II and one HTLV-I infected cell lines have been established by co-culture. Electron microscopy allowed morphologic characterization of the viral particles found in the infected cells. The sequence of the five strains of HTLV-II was identical demonstrating a divergence of 0.49% in the pX region and of 4.5% in the pol region compared with the HTLV-II Mo prototype. Comparison of these sequences with those corresponding to different strains of HTLV-II isolates from American Indians (subtypes b) suggest that these Spanish strains are more closely related with the subtype b than with the subtype a (HTLV-II Mo). Genetic variability study did not reveal any change in the sequence of these stains suggesting that the variability of these retroviruses in very infrequent in the regions studied. The analysis of the pol region of the HTLV-I strain demonstrated a divergence of 3.4% with respect to the sequence of the ATK-1 prototype (Japan) and of 1.7% of the strain HS-35 (Caribbean) showing a greater relation with the Caribbean strains than with those from Japan. CONCLUSIONS The presence of HTLV-II subtype has been confirmed among intravenous drug addicts in Spain. Isolation and characterization of the HTLV-I strain demonstrated that this also circulating around Spain despite its South American origin.
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Affiliation(s)
- A Vallejo
- Servicio de Diagnóstico, Centro Nacional de Biología Celular y Retrovirus, Instituto de Salud Carlos III, Majadahonda, Madrid
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48
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Margall N, Matias-Guiu X, Chillon M, Coll P, Alejo M, Nunes V, Quilez M, Rabella N, Prats G, Prat J. Detection of human papillomavirus 16 and 18 DNA in epithelial lesions of the lower genital tract by in situ hybridization and polymerase chain reaction: cervical scrapes are not substitutes for biopsies. J Clin Microbiol 1993; 31:924-30. [PMID: 8385153 PMCID: PMC263588 DOI: 10.1128/jcm.31.4.924-930.1993] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Human papillomavirus (HPV) types 16 and 18 in 66 women with histologically documented lesions of the genital tract and 64 control cohorts were investigated. The efficacies of in situ hybridization and polymerase chain reaction (PCR) in detecting HPV 16 and 18 DNA were analyzed. In order to assess the usefulness of replacing biopsies with cervical scrapes, the two samples were compared by PCR. The prevalence rates of HPV infection by PCR were 59.1 and 10.9% in patients and controls, respectively. PCR was three times more sensitive than in situ hybridization (52.6 versus 17.8%). However, the need to improve PCR sensitivity by subsequent dot blot hybridization reduced one of the main advantages of PCR, i.e., expeditious diagnosis. Cervical scrapes were less sensitive than biopsies (13.6 versus 53%), although with four (6.1%) patients with intraepithelial neoplasias, HPV DNA was identified only by means of cervical scraping. We conclude that obtaining biopsy specimens and cervical scraping are complementary sampling procedures.
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Affiliation(s)
- N Margall
- Serveis de Microbiologia, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain
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Sánchez I, Rabella N, Margall N, Prats G. [Comparison of electron microscopy and latex for the detection of enteric adenoviruses]. Enferm Infecc Microbiol Clin 1992; 10:436-7. [PMID: 1333285] [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: 12/26/2022]
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50
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Rabella N. [Diagnosis of cytomegalovirus infections]. Med Clin (Barc) 1990; 95:18-20. [PMID: 2172671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N Rabella
- Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona
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