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Duquesne A, Falcón R, Galindo B, Feliciano O, Gutiérrez O, Baldoquín W, Fonseca MC, Llanes R, Sarmiento L. Diagnostic Testing Accuracy for Helicobacter pylori Infection among Adult Patients with Dyspepsia in Cuba's Primary Care Setting. Microorganisms 2023; 11:997. [PMID: 37110419 PMCID: PMC10146794 DOI: 10.3390/microorganisms11040997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Evidence of the effectiveness of the tests used to diagnose Helicobacter pylori (H. pylori) in primary healthcare is limited. This cross-sectional study aims to assess the accuracy of tests used for to diagnose H. pylori infection in primary care patients and its relationship with gastroduodenal pathologies. Over 12 months, 173 primary care patients with dyspeptic symptoms were referred for upper gastrointestinal endoscopy to obtain gastric biopsies, and venous blood was extracted from them. H. pylori infection was detected using a rapid urease test (RUT), real-time polymerase chain reaction (RT-PCR), H. pylori-IgG ELISA, and Western blot (WB). The culture and histological findings were used as the reference standard for H. pylori infection. H. pylori prevalence was 50%. There were no significant differences between men and women overall or by age group. The presence of H. pylori was associated with chronic moderate gastritis and its absence with chronic inactive gastritis, as well as the combination of gastritis and gastric lesions (p < 0.05). RUT and ELISA H. pylori -IgG tests showed the highest overall performance (accuracy 98.9% and 84.4%), followed by WB and RT-PCR (accuracy 79.3% and 73.9%). These findings support the notion that combined invasive and noninvasive methods, such as RUT and H. pylori-IgG ELISA, can be a primary diagnostic screening tool for detecting H. pylori among adult dyspeptic patients in Cuba's primary care setting.
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Affiliation(s)
- Amílcar Duquesne
- Teaching Orthopedical Hospital Fructuoso Rodríguez, Havana City 10400, Cuba
| | - Rosabel Falcón
- Department of Microbiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Belkys Galindo
- Department of Epidemiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Onelkis Feliciano
- Department of Microbiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Oderay Gutiérrez
- Department of Microbiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Waldemar Baldoquín
- Department of Epidemiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Magile C. Fonseca
- Department of Virology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Rafael Llanes
- Department of Microbiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba
| | - Luis Sarmiento
- Department of Clinical Sciences, Immunovirology Unit, Skåne University Hospital, Lund University, 21428 Malmö, Sweden
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Rodríguez N, Cuylaerts V, Sardiñas R, Gutiérrez O, Soto Y, Llanes R, De Baetselier I. Pooling triple site samples to detect sexually transmitted infections can also be implemented in Cuba by using the SacaceTM Neisseria gonorrhoeae/ Chlamydia trachomatis/ Mycoplasma genitalium/ Trichomonas vaginalis Real-TM kit. Open Forum Infect Dis 2023; 10:ofad126. [PMID: 37113590 PMCID: PMC10127532 DOI: 10.1093/ofid/ofad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Affiliation(s)
- Nadia Rodríguez
- Center for Research, Diagnosis and Reference, Institute of Tropical Medicine “Pedro Kourí” , Havana , Cuba
| | - Vicky Cuylaerts
- Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine , Antwerp , Belgium
| | - Ruxana Sardiñas
- Center for Research, Diagnosis and Reference, Institute of Tropical Medicine “Pedro Kourí” , Havana , Cuba
| | - Oderay Gutiérrez
- Center for Research, Diagnosis and Reference, Institute of Tropical Medicine “Pedro Kourí” , Havana , Cuba
| | - Yudira Soto
- Center for Research, Diagnosis and Reference, Institute of Tropical Medicine “Pedro Kourí” , Havana , Cuba
| | - Rafael Llanes
- Center for Research, Diagnosis and Reference, Institute of Tropical Medicine “Pedro Kourí” , Havana , Cuba
| | - Irith De Baetselier
- Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine , Antwerp , Belgium
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Sangrós FJ, Torrecilla J, Giráldez-García C, Carrillo L, Mancera J, Mur T, Franch J, Díez J, Goday A, Serrano R, García-Soidán FJ, Cuatrecasas G, Igual D, Moreno A, Millaruelo JM, Carramiñana F, Ruiz MA, Pérez FC, Iriarte Y, Lorenzo Á, González M, Álvarez B, Barutell L, Mayayo MS, del Castillo M, Navarro E, Malo F, Cambra A, López R, Gutiérrez MÁ, Gutiérrez L, Boente C, Mediavilla JJ, Prieto L, Mendo L, Mansilla MJ, Ortega FJ, Borras A, Sánchez LG, Obaya JC, Alonso M, García F, Gutiérrez ÁT, Hernández AM, Suárez D, Álvarez JC, Sáenz I, Martínez FJ, Casorrán A, Ripoll J, Salanova A, Marín MT, Gutiérrez F, Innerárity J, Álvarez MDM, Artola S, Bedoya MJ, Poveda S, Álvarez F, Brito MJ, Iglesias R, Paniagua F, Nogales P, Gómez Á, Rubio JF, Durán MC, Sagredo J, Gijón MT, Rollán MÁ, Pérez PP, Gamarra J, Carbonell F, García-Giralda L, Antón JJ, de la Flor M, Martínez R, Pardo JL, Ruiz A, Plana R, Macía R, Villaró M, Babace C, Torres JL, Blanco C, Jurado Á, Martín JL, Navarro J, Sanz G, Colas R, Cordero B, de Castro C, Ibáñez M, Monzón A, Porta N, Gómez MDC, Llanes R, Rodríguez JJ, Granero E, Sánchez M, Martínez J, Ezkurra P, Ávila L, de la Sen C, Rodríguez A, Buil P, Gabriel P, Roura P, Tarragó E, Mundet X, Bosch R, González JC, Bobé MI, Mata M, Ruiz I, López F, Birules M, Armengol O, de Miguel RM, Romera L, Benito B, Piulats N, Bilbeny B, Cabré JJ, Cos X, Pujol R, Seguí M, Losada C, de Santiago AM, Muñoz P, Regidor E. Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.04.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sangrós FJ, Torrecilla J, Giráldez-García C, Carrillo L, Mancera J, Mur T, Franch J, Díez J, Goday A, Serrano R, García-Soidán FJ, Cuatrecasas G, Igual D, Moreno A, Millaruelo JM, Carramiñana F, Ruiz MA, Pérez FC, Iriarte Y, Lorenzo Á, González M, Álvarez B, Barutell L, Mayayo MS, Del Castillo M, Navarro E, Malo F, Cambra A, López R, Gutiérrez MÁ, Gutiérrez L, Boente C, Mediavilla JJ, Prieto L, Mendo L, Mansilla MJ, Ortega FJ, Borras A, Sánchez LG, Obaya JC, Alonso M, García F, Gutiérrez ÁT, Hernández AM, Suárez D, Álvarez JC, Sáenz I, Martínez FJ, Casorrán A, Ripoll J, Salanova A, Marín MT, Gutiérrez F, Innerárity J, Álvarez MDM, Artola S, Bedoya MJ, Poveda S, Álvarez F, Brito MJ, Iglesias R, Paniagua F, Nogales P, Gómez Á, Rubio JF, Durán MC, Sagredo J, Gijón MT, Rollán MÁ, Pérez PP, Gamarra J, Carbonell F, García-Giralda L, Antón JJ, de la Flor M, Martínez R, Pardo JL, Ruiz A, Plana R, Macía R, Villaró M, Babace C, Torres JL, Blanco C, Jurado Á, Martín JL, Navarro J, Sanz G, Colas R, Cordero B, de Castro C, Ibáñez M, Monzón A, Porta N, Gómez MDC, Llanes R, Rodríguez JJ, Granero E, Sánchez M, Martínez J, Ezkurra P, Ávila L, de la Sen C, Rodríguez A, Buil P, Gabriel P, Roura P, Tarragó E, Mundet X, Bosch R, González JC, Bobé MI, Mata M, Ruiz I, López F, Birules M, Armengol O, de Miguel RM, Romera L, Benito B, Piulats N, Bilbeny B, Cabré JJ, Cos X, Pujol R, Seguí M, Losada C, de Santiago AM, Muñoz P, Regidor E. Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study. ACTA ACUST UNITED AC 2017; 71:170-177. [PMID: 28789915 DOI: 10.1016/j.rec.2017.04.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/06/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). METHODS Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. RESULTS Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). CONCLUSIONS Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.
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Affiliation(s)
- F Javier Sangrós
- Atención Primaria, Centro de Salud Torrero-La Paz, Zaragoza, Spain
| | - Jesús Torrecilla
- Atención Primaria, Centro de Salud Bombarda-Monsalud, Zaragoza, Spain
| | - Carolina Giráldez-García
- Servicio de Medicina Preventiva, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain; Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, Spain.
| | - Lourdes Carrillo
- Atención Primaria, Centro de Salud La Victoria de Acentejo, La Victoria de Acentejo, Santa Cruz de Tenerife, Spain
| | - José Mancera
- Atención Primaria, Centro de Salud Ciudad Jardín, Málaga, Spain
| | - Teresa Mur
- Atención Primaria, Centro de Atención Primaria Terrassa Sud, Terrassa, Barcelona, Spain
| | - Josep Franch
- Equipo de Atención Primaria, Centro de Salud Raval Sud, Barcelona, Spain
| | - Javier Díez
- Atención Primaria, Centro de Salud Tafalla, Tafalla, Navarra, Spain
| | - Albert Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Rosario Serrano
- Atención Primaria, Centro de Salud Martín de Vargas, Madrid, Spain
| | | | | | - Dimas Igual
- Atención Primaria, Centro de Salud Manuel Encinas, Cáceres, Spain
| | - Ana Moreno
- Atención Primaria, Centro de Salud San Roque, Badajoz, Spain
| | | | | | | | | | - Yon Iriarte
- Atención Primaria, Centro de Salud Aizarnazabal-Getaria, Guipúzcua, Spain
| | - Ángela Lorenzo
- Atención Primaria, Centro de Salud Alcalá de Guadaira, Madrid, Spain
| | - María González
- Atención Primaria, Centro de Salud Alcantarilla-Sangonera, Alcantarilla, Murcia, Spain
| | - Beatriz Álvarez
- Atención Primaria, Centro de Salud Andrés Mellado, Madrid, Spain
| | - Lourdes Barutell
- Atención Primaria, Centro de Salud Andrés Mellado, Madrid, Spain
| | - M Soledad Mayayo
- Atención Primaria, Centro de Salud Martín de Vargas, Madrid, Spain
| | | | - Emma Navarro
- Atención Primaria, Centro de Salud Añaza, Añaza, Santa Cruz de Tenerife, Spain
| | - Fernando Malo
- Atención Primaria, Centro de Salud Ares, Ares, A Coruña, Spain
| | - Ainhoa Cambra
- Atención Primaria, Centro de Salud Arrabal, Zaragoza, Spain
| | - Riánsares López
- Atención Primaria, Centro de Salud Artilleros, Madrid, Spain
| | | | - Luisa Gutiérrez
- Atención Primaria, Centro de Salud Errenteria-Beraun, Rentería, Guipúzcoa, Spain
| | - Carmen Boente
- Atención Primaria, Centro de Salud Porriño, Porriño, Pontevedra, Spain
| | | | - Luis Prieto
- Atención Primaria, Centro de Salud Cáceres-La Mejostilla, Cáceres, Spain
| | - Luis Mendo
- Atención Primaria, Centro de Salud Cadreita, Cadreita, Navarra, Spain
| | - M José Mansilla
- Atención Primaria, Centro de Salud Martín de Vargas, Madrid, Spain
| | | | - Antonia Borras
- Atención Primaria, Centro de Salud Canal Salat, Ciutadella, Balearic Islands, Spain
| | - L Gabriel Sánchez
- Atención Primaria, Centro de Salud Carballeda, Mombuey, Zamora, Spain
| | - J Carlos Obaya
- Atención Primaria, Centro de Salud Chopera, Alcobendas, Madrid, Spain
| | - Margarita Alonso
- Atención Primaria, Centro de Salud La Eria, Oviedo, Asturias, Spain
| | - Francisco García
- Atención Primaria, Centro de Salud Don Benito Este, Badajoz, Spain
| | | | - Ana M Hernández
- Atención Primaria, Centro de Salud El Calero, Las Palmas, Spain
| | - Dulce Suárez
- Atención Primaria, Centro de Salud El Calero, Las Palmas, Spain
| | | | - Isabel Sáenz
- Atención Primaria, Centro de Salud Espronceda, Madrid, Spain
| | | | - Ana Casorrán
- Atención Primaria, Centro de Salud Fuente de San Luis, Valencia, Spain
| | - Jazmín Ripoll
- Atención Primaria, Centro de Salud Fuente de San Luis, Valencia, Spain
| | | | - M Teresa Marín
- Atención Primaria, Centro de Salud General Ricardos, Madrid, Spain
| | - Félix Gutiérrez
- Atención Primaria, Centro de Salud Bombarda-Monsalud, Zaragoza, Spain
| | - Jaime Innerárity
- Atención Primaria, Centro de Salud Hereza, Leganés, Madrid, Spain
| | | | - Sara Artola
- Atención Primaria, Centro de Salud Hereza, Leganés, Madrid, Spain
| | - M Jesús Bedoya
- Atención Primaria, Centro de Salud Hereza, Leganés, Madrid, Spain
| | - Santiago Poveda
- Atención Primaria, Centro de Salud Jumilla, Jumilla, Murcia, Spain
| | - Fernando Álvarez
- Atención Primaria, Centro de Salud La Calzada II, Gijón, Asturias, Spain
| | - M Jesús Brito
- Atención Primaria, Centro de Salud La Matanza, Santa Cruz de Tenerife, Spain
| | - Rosario Iglesias
- Atención Primaria, Centro de Salud Pedro Lain Entralgo, Alcorcón, Madrid, Spain
| | | | - Pedro Nogales
- Atención Primaria, Centro de Salud Las Águilas, Madrid, Spain
| | - Ángel Gómez
- Atención Primaria, Centro de Salud Lasarte, Lasarte-Oria, Guipúzcoa, Spain
| | - José Félix Rubio
- Atención Primaria, Centro de Salud Lasarte, Lasarte-Oria, Guipúzcoa, Spain
| | - M Carmen Durán
- Atención Primaria, Centro de Salud Lavadores, Vigo, Pontevedra, Spain
| | - Julio Sagredo
- Atención Primaria, Centro de Salud Los Rosales, Madrid, Spain
| | - M Teresa Gijón
- Atención Primaria, Centro de Salud Los Yébenes, Madrid, Spain
| | | | - Pedro P Pérez
- Atención Primaria, Centro de Salud Mallen, Sevilla, Spain
| | - Javier Gamarra
- Atención Primaria, Centro de Salud Medina del Campo Rural, Medina del Campo, Valladolid, Spain
| | | | | | - J Joaquín Antón
- Atención Primaria, Centro de Salud Murcia Centro, Murcia, Spain
| | - Manuel de la Flor
- Atención Primaria, Centro de Salud Nuestra Señora de Gracia, Carmona, Sevilla, Spain
| | - Rosario Martínez
- Atención Primaria, Centro de Salud Oñati, Oñati, Guipúzcoa, Spain
| | - José Luis Pardo
- Atención Primaria, Centro de Salud Orihuela I, Orihuela, Alicante, Spain
| | - Antonio Ruiz
- Atención Primaria, Centro de Salud Pinto, Pinto, Madrid, Spain
| | - Raquel Plana
- Atención Primaria, Centro de Salud Ponteareas, Ponteareas, Pontevedra, Spain
| | - Ramón Macía
- Atención Primaria, Centro de Salud Roces Montevil, Gijón, Asturias, Spain
| | - Mercè Villaró
- Atención Primaria, Centro de Atención Primaria Terrassa Sud, Terrassa, Barcelona, Spain
| | - Carmen Babace
- Atención Primaria, Centro de Salud Rodríguez Paterna, Logroño, La Rioja, Spain
| | - José Luis Torres
- Atención Primaria, Centro de Salud Rodríguez Paterna, Logroño, La Rioja, Spain
| | | | - Ángeles Jurado
- Atención Primaria, Centro de Salud Salvador Caballero, Granada, Spain
| | - José Luis Martín
- Atención Primaria, Centro de Salud Salvador Caballero, Granada, Spain
| | - Jorge Navarro
- Atención Primaria, Centro de Salud Salvador Pau, Valencia, Spain
| | - Gloria Sanz
- Atención Primaria, Centro de Salud San José Centro, Zaragoza, Spain
| | - Rafael Colas
- Atención Primaria, Centro de Salud Santoña, Santoña, Cantabria, Spain
| | - Blanca Cordero
- Atención Primaria, Centro de Salud Santa María de Benquerencia, Toledo, Spain
| | - Cristina de Castro
- Atención Primaria, Centro de Salud Santa María de Benquerencia, Toledo, Spain
| | | | - Alicia Monzón
- Atención Primaria, Centro de Salud Vecindario, Vecindario, Las Palmas, Spain
| | - Nuria Porta
- Atención Primaria, Centro de Atención Primaria Terrassa Sud, Terrassa, Barcelona, Spain
| | | | - Rafael Llanes
- Atención Primaria, Centro de Salud Villanueva de la Cañada, Villanueva de la Cañada, Madrid, Spain
| | - J José Rodríguez
- Atención Primaria, Centro de Salud Villaviciosa de Odón, Villaviciosa de Odón, Madrid, Spain
| | - Esteban Granero
- Atención Primaria, Centro de Salud Vista Alegre Murcia, Murcia, Spain
| | - Manuel Sánchez
- Atención Primaria, Centro de Salud Vista Alegre Murcia, Murcia, Spain
| | - Juan Martínez
- Atención Primaria, Centro de Salud Yecla, Yecla, Murcia, Spain
| | - Patxi Ezkurra
- Atención Primaria, Centro de Salud Zumaia, Zumaia, Guipúzcoa, Spain
| | - Luis Ávila
- Atención Primaria, Consultorio Almáchar, Almáchar, Málaga, Spain
| | | | - Antonio Rodríguez
- Equipo de Atención Primaria, Centro de Salud Anglès, Anglès, Girona, Spain
| | - Pilar Buil
- Equipo de Atención Primaria, Centro de Salud Azpilagaña, Pamplona, Navarra, Spain
| | - Paula Gabriel
- Equipo de Atención Primaria, Centro de Salud Badia del Vallès, Badia del Vallès, Barcelona, Spain
| | - Pilar Roura
- Equipo de Atención Primaria, Centro de Salud Badia del Vallès, Badia del Vallès, Barcelona, Spain
| | - Eduard Tarragó
- Equipo de Atención Primaria, Centro de Salud Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Mundet
- Equipo de Atención Primaria, Centro de Salud El Carmel, Barcelona, Spain
| | - Remei Bosch
- Equipo de Atención Primaria, Centro de Salud Girona 2, Girona, Spain
| | - J Carles González
- Equipo de Atención Primaria, Centro de Salud Girona 3, Girona, Spain
| | - M Isabel Bobé
- Equipo de Atención Primaria, Centro de Salud La Mina, Barcelona, Spain
| | - Manel Mata
- Equipo de Atención Primaria, Centro de Salud La Mina, Barcelona, Spain
| | - Irene Ruiz
- Equipo de Atención Primaria, Centro de Salud La Torrassa, Barcelona, Spain
| | - Flora López
- Equipo de Atención Primaria, Centro de Salud Martorell, Martorell, Barcelona, Spain
| | - Marti Birules
- Equipo de Atención Primaria, Centro de Salud Poblenou, Barcelona, Spain
| | - Oriol Armengol
- Equipo de Atención Primaria, Centro de Salud Poblenou, Barcelona, Spain
| | - Rosa Mar de Miguel
- Equipo de Atención Primaria, Centro de Salud Pubillas Casas, Esplugues de Llobregat, Barcelona, Spain
| | - Laura Romera
- Equipo de Atención Primaria, Centro de Salud Raval Nord, Barcelona, Spain
| | - Belén Benito
- Equipo de Atención Primaria, Centro de Salud Raval Sud, Barcelona, Spain
| | - Neus Piulats
- Equipo de Atención Primaria, Centro de Salud Raval Sud, Barcelona, Spain
| | - Beatriz Bilbeny
- Equipo de Atención Primaria, Centro de Salud Raval Sud, Barcelona, Spain
| | - J José Cabré
- Equipo de Atención Primaria, Centro de Salud Reus-1, Reus, Tarragona, Spain
| | - Xavier Cos
- Equipo de Atención Primaria, Centro de Salud Sant Martí de Provençals, Barcelona, Spain
| | - Ramón Pujol
- Equipo de Atención Primaria, Centro de Salud Tremp, Tremp, Lleida, Spain
| | - Mateu Seguí
- Atención Primaria, Unidad Básica de Salud de Es Castell, Es Castell, Balearic Islands, Spain
| | - Carmen Losada
- Unidad de Gestión Clínica, Centro de Salud Adoratrices, Huelva, Spain
| | - A María de Santiago
- Unidad Docente de Atención Familiar y Comunitaria, Servicio de Salud de Castilla-La Mancha, Guadalajara, Spain
| | - Pedro Muñoz
- Unidad Docente de Medicina Familiar y Comunitaria, Gerencia de Atención Primaria, Santander, Cantabria, Spain
| | - Enrique Regidor
- Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Abstract
Over 700,000 cases of cholera were reported in Haiti between October 2010 and February 2015. In November 2011, the Cuban Medical Team serving in Haiti established a laboratory-supported sentinel surveillance system for cholera in 10 public hospitals (one in each of Haiti's 10 departments), to estimate the proportion of hospitalized patients with cholera and detect emergence of new Vibrio cholerae serotypes. Each month, the first ten stool samples collected from patients admitted with acute watery diarrhea were studied in all hospitals involved. Surveillance system findings from November 1, 2011, to October 30, 2012 showed that acute watery diarrhea was caused by V. cholerae serogroup O1 in 45.9% (210/458) of patients: Serotype Ogawa was found in 98.6% of this isolates (207/210) and serotype Inaba in 1.4% (3/210), indicating low circulation level of the latter in Haiti. Continuing laboratory sentinel surveillance of V. cholerae is needed to monitor the spread of the disease and prevent and contain outbreaks, particularly of new serotypes. It is important to ensure that these findings are systematically integrated with data available to MSPP from other surveillance sources. KEYWORDS Vibrio cholerae, serotype Inaba, serotype Ogawa, epidemiological surveillance, medical cooperation, Haiti, Cuba.
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Affiliation(s)
- Rafael Llanes
- Pedro Kourí Tropical Medicine Institute, Havana, Cuba.
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Llanes R, Somarriba L, Velázquez B, Núñez FA, Villafranca CM. Low prevalence of Vibrio cholerae O1 versus moderate prevalence of intestinal parasites in food-handlers working with health care personnel in Haiti. Pathog Glob Health 2016; 110:30-2. [PMID: 27077312 DOI: 10.1080/20477724.2016.1141471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Food-handlers with poor personal hygiene working in food-service establishments could be potential sources of infection due to pathogenic organisms. In May 2011, a cross-sectional study was undertaken to determine the prevalence of bacteria and intestinal parasites among food-handlers working with Cuban health personnel in Haiti. Stool specimens were collected from 56 food-handlers and samples were examined using standard procedures. Of the food handlers, 26.8% had one bacterial or intestinal parasite. The most prevalent species of organism found were Blastocystis spp. (9%), followed by Vibrio cholerae O1 serotype Ogawa, Aeromonas spp. and Giardia intestinalis, each one with 4%. The prevalence of intestinal parasites was 19.7%. Five out of 56 food handlers had diarrhea at the time the study was conducted. It was found that there was a lower prevalence of V. cholerae O1 serotype Ogawa in comparison to intestinal parasites. The study highlights the importance of the precautions that must be taken in cholera-affected countries by medical teams and their organizations, with emphasis on the preparation, processing, and serving of meals. The recommendation is to intensify continuing education programs, periodical laboratory examinations to detect carriers and food-handlers reporting sick, and to observe strict adherence to hygienic food-handling practices. In addition, food handlers with diarrhea should refrain from preparation or delivery of food.
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Affiliation(s)
- Rafael Llanes
- a Tropical Medicine Institute Pedro Kouri (IPK) , PO Box 601, Marianao 13, Havana , Cuba.,b Cuban Medical Brigade in Haiti , Delmas 83, Post Code HT 6120 , Port au Prince , Haiti
| | - Lorenzo Somarriba
- b Cuban Medical Brigade in Haiti , Delmas 83, Post Code HT 6120 , Port au Prince , Haiti
| | - Beltran Velázquez
- b Cuban Medical Brigade in Haiti , Delmas 83, Post Code HT 6120 , Port au Prince , Haiti
| | - Fidel A Núñez
- a Tropical Medicine Institute Pedro Kouri (IPK) , PO Box 601, Marianao 13, Havana , Cuba
| | - Caridad M Villafranca
- b Cuban Medical Brigade in Haiti , Delmas 83, Post Code HT 6120 , Port au Prince , Haiti
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Llanes R, Somarriba L, Pedroso P, Mariscal E, Fuster C, Zayas Y. Did the cholera epidemic in Haiti really start in the Artibonite Department? J Infect Dev Ctries 2013; 7:753-5. [PMID: 24129629 DOI: 10.3855/jidc.3311] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 02/26/2013] [Accepted: 03/12/2013] [Indexed: 10/31/2022] Open
Abstract
This item has no abstract. Follow the links below to access the full text.
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Affiliation(s)
- Rafael Llanes
- Cuban Medical Brigade in Haiti, Port au Prince, Haiti.
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Wada A, Wong PF, Hojo H, Hasegawa M, Ichinose A, Llanes R, Kubo Y, Senba M, Ichinose Y. Alarin but not its alternative-splicing form, GALP (Galanin-like peptide) has antimicrobial activity. Biochem Biophys Res Commun 2013; 434:223-7. [PMID: 23537644 DOI: 10.1016/j.bbrc.2013.03.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 03/17/2013] [Indexed: 12/17/2022]
Abstract
Alarin is an alternative-splicing form of GALP (galanin-like peptide). It shares only 5 conserved amino acids at the N-terminal region with GALP which is involved in a diverse range of normal brain functions. This study seeks to investigate whether alarin has additional functions due to its differences from GALP. Here, we have shown using a radial diffusion assay that alarin but not GALP inhibited the growth of Escherichia coli (strain ML-35). The conserved N-terminal region, however, remained essential for the antimicrobial activity of alarin as truncated peptides showed reduced killing effect. Moreover, alarin inhibited the growth of E. coli in a similar potency as human cathelicidin LL-37, a well-studied antimicrobial peptide. Electron microscopy further showed that alarin induced bacterial membrane blebbing but unlike LL-37, it did not cause hemolysis of erythrocytes. In addition, alarin is only active against the gram-negative bacteria, E. coli but not the gram-positive bacteria, Staphylococcus aureus. Thus, these data suggest that alarin has potentials as an antimicrobial and should be considered for the development in human therapeutics.
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Affiliation(s)
- Akihiro Wada
- Department of Bacteriology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 8528523, Japan.
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Llanes R, Velázquez B, Reyes Z, Somarriba L. Co-infection with Cyclospora cayetanensis and Salmonella typhi in a patient with HIV infection and chronic diarrhoea. Pathog Glob Health 2013; 107:38-9. [PMID: 23432863 DOI: 10.1179/2047773212y.0000000065] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A 45-year-old-Haitian male patient with fever, abdominal cramping, chronic diarrhoea and weight loss of about 3 kg was investigated. Stool examination revealed Salmonella typhi and Cyclospora cayetanensis. The HIV test was positive with a CD4 count of 130 cells/mm(3). We provided the first report of co-infection Cyclospora cayetanensis and Salmonella typhi in a HIV patient with chronic diarrhoea. The patient was treated with oral ciprofloxacin, 500 mg, twice daily for two weeks, with a good clinical outcome.
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Affiliation(s)
- Rafael Llanes
- Brigada Médica Cubana en Haití. Puerto Príncipe, Departamento Oeste, Haití.
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Llanes R, Millán LM, Escobar MP, Gala A, Capó V, Feliciano O, Gutiérrez O, Llop A, Ponce F, Pérez-Pérez GI. Low prevalence of Helicobacter pylori among symptomatic children from a hospital in Havana, Cuba. J Trop Pediatr 2012; 58:231-4. [PMID: 21752863 DOI: 10.1093/tropej/fmr060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aims of this study were to assess the prevalence of Helicobacter pylori infection and to introduce a new algorithm to improve its diagnosis in Cuban symptomatic children. One hundred and thirty-three consecutive children with upper gastrointestinal symptoms were studied. Patients were endoscoped and antral biopsies were obtained for rapid urease test (RUT), culture and histology. Prevalence of H. pylori infection was 30.8%. No statistical differences were found concerning demographic, socio-economic factors or chief clinical complaints, between H. pylori-positive and negative children, except for haematemesis, which was significantly higher in infected children (p = 0.003). Histologically, there was statistical association between moderate chronic gastritis in infected children (p = 0.04). Culture and RUT had the highest specificity and sensitivity, respectively. The prevalence of H. pylori infection in Cuban symptomatic children is similar to the one observed in developed countries. Culture and RUT is a useful combination to diagnose H. pylori infection in paediatric patients.
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Affiliation(s)
- Rafael Llanes
- Department of Bacteriology, Tropical Medicine Institute Pedro Kourí (IPK), Autopista Novia Mediodía Km 6 ½, Havana, Cuba.
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Llanes R, Feliciano O, Guzmán D, Gutiérrez O, Valdés L, Llop A, Gala A, Holton J. Use of a single biopsy specimen for diagnosing Helicobacter pylori infection by culture and two different PCR methods: report from Cuba. Trop Gastroenterol 2010; 31:111-112. [PMID: 20862986] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Rafael Llanes
- Dept of Microbiology, Institute of Tropical Medicine Pedro Kouri (IPK), Marianao, Havana, Cuba.
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Llanes R, Soria C, Nagashima S, Kobayashi N, Gala A, Guzmán D, Feliciano O, Valdés L, Gutiérrez O, Fernández H, Llop A, Wada A. Phenotypic and genetic characterization of antimicrobial profiles of Helicobacter pylori strains in Cuba. J Health Popul Nutr 2010; 28:124-129. [PMID: 20411674 PMCID: PMC2980873 DOI: 10.3329/jhpn.v28i2.4881] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The study evaluated the antibiotic resistance patterns of Helicobacter pylori strains against metronidazole and clarithromycin in a hospital in Havana, Cuba. Eighty-five percent, 22.5%, and 10% of 40 H. pylori strains investigated were resistant to metronidazole, ciprofloxacin, and clarithromycin respectively but all were susceptible to amoxicillin and tetracycline. RdxA truncation was found only in metronidazole-resistant strains. In such strains, reported are eight and two novel mutations in the rdxA and frxA genes respectively. Two-point mutations in the 23S rRNA genes of clarithromycin-resistant strains were detected. A high prevalence of metronidazole resistance was found in Cuban H. pylori strains. Mutations in the rdxA gene may contribute more significantly than frxA gene to the high level of resistance to metronidazole. This study supports the need to continue monitoring the antibiotic susceptibility in H. pylori in Cuba to guide the treatment of such infection.
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Affiliation(s)
- Rafael Llanes
- Microbiology, Clinical and Epidemiology Branch, Institute Pedro Kouri, Havana, Cuba.
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Wada A, Hasegawa M, Wong PF, Shirai E, Shirai N, Tan LJ, Llanes R, Hojo H, Yamasaki E, Ichinose A, Ichinose Y, Senba M. Direct binding of gangliosides to Helicobacter pylori vacuolating cytotoxin (VacA) neutralizes its toxin activity. Glycobiology 2010; 20:668-78. [PMID: 20118071 DOI: 10.1093/glycob/cwq014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Gangliosides are target receptors for bacterial entry, yet those present in human milk exhibit a protective role against bacterial infection. Here, we show that treatment with ganglioside mixture at a concentration of 100 microg/mL resulted in significant inhibition of the vacuole formation activity of Helicobacter pylori vacuolating cytotoxin (VacA) in gastric epithelial cancer AZ-521 cells. All gangliosides (GM1, GM2, GM3, GD1a, GD1b, GD3 and GT1b) examined showed good neutralizing capacity against VacA. A pull-down assay was performed using lyso-GM1 coupled to Sepharose as the tagged polysaccharide polymer to capture VacA from H. pylori culture supernatant. GM1-VacA complexes were successfully precipitated, suggesting that GM1 binds directly to VacA. The hydrodynamic binding of lyso-GM1 and VacA measured by fluorescence correlation spectroscopy had a K(d) value of 190 nM. VacA also bound to lyso-GM1 at pH 2 corresponding to the physiological pH of human stomach. Collectively, these results showed that direct binding of H. pylori VacA to free gangliosides neutralizes the toxin activity of VacA. These findings offer an alternative insight into the role of gangliosides in VacA toxicity and the pathogenesis of H. pylori.
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Affiliation(s)
- Akihiro Wada
- Department of Bacteriology, Nagasaki University, Nagasaki, Japan.
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Pérez AE, Dickinson FO, Banderas F, Serrano T, Llanes R, Guzmán D, Díaz P, Alvarez A, Guirola M, Caballero E, Canaan-Haden L, Guillén G. Safety and preliminary immunogenicity of MenC/P64k, a meningococcal serogroup C conjugate vaccine with a new recombinant carrier. ACTA ACUST UNITED AC 2006; 46:386-92. [PMID: 16553812 DOI: 10.1111/j.1574-695x.2006.00047.x] [Citation(s) in RCA: 7] [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: 11/30/2022]
Abstract
This study reports the preliminary assessment of the safety and immunogenicity of the first serogroup C conjugate vaccine candidate that includes meningococcal P64k recombinant protein as the carrier (MenC/P64k). Twenty volunteers were recruited for a double-blind, randomized, controlled phase I clinical trial, receiving a single dose of MenC/P64k (study group) and a single dose of the commercial polysaccharide vaccine AC (control group). Only mild reactions were observed. No statistical differences were detected between the antipolysaccharide C IgG responses of both groups as well as between bactericidal serum titre (P > 0.05). The MenC/P64k vaccine was found to have a good safety profile, to be well tolerated and immunogenic.
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Quiñones D, Llanes R, Toraño G, Pérez M. Nasopharyngeal colonization by Moraxella catarrhalis and study of antimicrobial susceptibility in healthy children from Cuban day-care centers. Arch Med Res 2005; 36:80-2. [PMID: 15778001 DOI: 10.1016/j.arcmed.2004.09.001] [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] [Received: 01/30/2004] [Accepted: 09/02/2004] [Indexed: 10/25/2022]
Abstract
The prevalence of nasopharyngeal carriage of Moraxella catarrhalis was determined for the first time in Cuba. One-hundred fifty healthy children attending three day-care centers in the municipality of Marianao, Havana City were studied. The percentage of recovering bacteria in nasal and pharyngeal swabs was compared. Antimicrobial susceptibilities to ampicillin, trimethoprim-sulfamethoxazole, tetracycline, cefotaxime, ceftriaxone, chloramphenicol, erythromycin, azithromycin, amoxicillin/clavulanate, and norfloxacin were determined by the disk diffusion method according to recommendations of the National Committee for Clinical Laboratory Standards. Sixty-five percent of the children studied carried Moraxella catarrhalis. The nasal cavity was the main isolation site for this organism (81% of positive cultures). Most strains were highly susceptible to the antimicrobial agents tested, except to ampicillin (53.6% resistance). This study provides evidence of the need for continued surveillance of antimicrobial susceptibility of Moraxella catarrhali, in order to determine optimal empiric therapy for community-acquired respiratory tract infections produced by this pathogen.
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Affiliation(s)
- Dianelys Quiñones
- Reference National Laboratory of Bacterial Respiratory Infections, Department of Bacteriology-Mycology, Tropical Medicine Institute Pedro Kourí, Havana City, Cuba.
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Llanes R, Domínguez C, Prat A, Rodríguez C, Valdés EA, Gutiérrez O, Guzmán D. Evaluation of the BIOCEN GC agar medium base in antimicrobial susceptibility testing of Neisseria gonorrhoeae. Arch Med Res 2005; 36:344-9. [PMID: 15950072 DOI: 10.1016/j.arcmed.2005.03.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Revised: 12/16/2003] [Accepted: 12/14/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Since 1995, the Cuban Reference Laboratory for Neisseria has been monitoring the antibiotic susceptibility of gonococci, following the methodology of the National Committee for Clinical Laboratory Standards, which uses GC agar medium base supplemented with 1% Vitox. We evaluated three lots of GC agar medium base produced by BIOCEN, Cuba, in antibiotic susceptibility testing of reference and wild strains of gonococci. METHODS The susceptibilities to five antibiotics were evaluated five times on three lots of GC agar medium base from BIOCEN. Four and one gonococcal reference strains were tested by MIC dilution and disc diffusion methods, respectively. Later, the antimicrobial susceptibilities of ten wild Neisseria gonorrhoeae strains were tested in triplicate. As internal control, a GC agar medium from Difco was used. RESULTS All antibiotic MICs obtained on four lots of GC agar medium from different manufacturers fell within the proposed quality control limits for reference strains analyzed. The disc diffusion data for the reference strain of N. gonorrhoeae ATCC 49226 to five antibiotics provided essentially identical results in all lots of GC agar medium base. For wild strains of gonococci, identical modal MIC values and zone size diameters within a 3-mm range were observed in all the antibiotics tested. CONCLUSIONS Excellent agreement in susceptibility testing methods among different lots of GC agar medium base from BIOCEN and Difco was obtained for all reference and wild gonococcal strains and antibiotics tested. We proposed that GC medium from BIOCEN can be used in antimicrobial susceptibility testing of N. gonorrhoeae by MIC dilution and disc diffusion tests.
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Affiliation(s)
- Rafael Llanes
- Department of Bacteriology, Tropical Medicine Institute Pedro Kourí (IPK), La Habana, Cuba.
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Obregón AM, Llanes R, Fernández C, Hernández I, Rodriguez J. [Development of a method to determine the minimum inhibitory concentration in reference strains from leptospiras]. Rev Cubana Med Trop 2005; 57:11-16. [PMID: 17966469] [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: 05/25/2023]
Abstract
A method to determine the minimum inhibitory concentration for leptospiras was developed, since there is not a standard method to measure it at the international level. Reference strains from the pathogenic complex L. interrogans and L. biflexa were used against penicillin, cyprofloxacine, chloramphenicol, rifampicine and tetracycline. The minimum inhibitory concentration was defined as the lowest concentration of antibiotic where it was observed the inhibition of the bacterial mobility by direct examination in dark field. Ranges for penicillin were from 0.095 to 152 microg/mL, for tetracycline from 0.156 to 3.13 microg/mL, for chloramphenicol, from 0.08 to 12.52 microg/mL, for rifampicine from 0.08 to 1.56 microg/mL, and for cyprofloxacine from 0.15 to 2.4 microg/mL. The antibiotics that showed the lowest values were cyprofloxacine, rifampicine and tetracycline, whereas the most elevated value was obtained against chloramphenicol and penicillin. The strains from the serogroups circulating more frequently in Cuba were used in this research. This study will allow in a near future to determine the antimicrobial susceptibility in autochthonous strains isolated from patients with Leptospirosis at the national level.
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Ogushi KI, Wada A, Niidome T, Okuda T, Llanes R, Nakayama M, Nishi Y, Kurazono H, Smith KD, Aderem A, Moss J, Hirayama T. Gangliosides act as co-receptors for Salmonella enteritidis FliC and promote FliC induction of human beta-defensin-2 expression in Caco-2 cells. J Biol Chem 2004; 279:12213-9. [PMID: 14707135 DOI: 10.1074/jbc.m307944200] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Antimicrobial peptides such as defensins are crucial for host defense at mucosal surfaces. We reported previously that Salmonella enteritidis flagellin (FliC) induced human beta-defensin-2 (hBD-2) mRNA expression in Caco-2 cells via NF-kappaB activation (Ogushi, K., Wada, A., Niidome, T., Mori, N., Oishi, K., Nagatake, T., Takahashi, A., Asakura, H., Makino, S., Hojo, H., Nakahara, Y., Ohsaki, M., Hatakeyama, T., Aoyagi, H., Kurazono, H., Moss, J., and Hirayama, T. (2001) J. Biol. Chem. 276, 30521-30526). In this study, we examined the role of ganglioside as co-receptors with Toll-like receptor 5 (TLR5) on FliC induction of hBD-2 expression in Caco-2 cells. Exogenous gangliosides suppressed FliC induction of hBD-2 promoter activity and binding of FliC to Caco-2 cells. Incorporation of exogenous ganglioside GD1a into Caco-2 cell membranes increased the effect of FliC on hBD-2 promoter activity. In support of a role for endogenous gangliosides, incubation of Caco-2 cells with dl-threo-2-hexadecanoylamino-3-morpholino-1-phenylpropanol, a glucosylceramide synthase inhibitor, reduced FliC induction of hBD-2 promoter activity. GD1a-loaded CHO-K1-expressing TLR5 cells had a higher potential for hBD-2 induction following FliC stimulation than GD1a-loaded CHO-K1 cells not expressing TLR5. FliC increased phosphorylation of mitogen-activated protein kinase, p38, and ERK1/2. Exogenous gangliosides GD1a, GD1b, and GT1b each suppressed FliC induction of p38 and ERK1/2 phosphorylation. Furthermore, FliC did not enhance luciferase activity in Caco-2 cells transfected with a plasmid containing a mutated activator protein 1-binding site. These results suggest that gangliosides act as co-receptors with TLR5 for FliC and promote hBD-2 expression via mitogen-activated protein kinase.
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Affiliation(s)
- Ken-ichi Ogushi
- Department of Bacteriology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
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Llanes R, González M, Martínez I, Sosa J, Guzmán D, Gutiérrez O, Llop A, Sánchez L. Evaluation of four methods for detecting the beta-lactamase activity in Neisseria gonorrhoeae isolated in Cuba. Mem Inst Oswaldo Cruz 2003; 98:1089-91. [PMID: 15049095 DOI: 10.1590/s0074-02762003000800020] [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: 11/22/2022] Open
Abstract
Four methods (chromogenic, acidimetric, inhibition, and iodometric) for demonstration of the beta-lactamase production by 70 isolates of Neisseria gonorrhoeae, were evaluated in Cuba. There was 100% correlation between all beta-lactamase methods and the standardized penicillin dilution susceptibility test for penicillinase-non-producing N. gonorrhoeae. For penicillinase-producing N. gonorrhoeae strains, there was a perfect correlation between the chromogenic method and penicillin susceptibility testing, but one and two strains failed to give a positive result for beta-lactamase with the inhibition/acidimetric and the iodometric methods, respectively. There was a high concordance between the chromogenic method, considered as gold standard and the rest of penicillinase tests evaluated: Kappa Index (KI) = 0.98 for inhibition/acidimetric methods and KI = 0.97 for the iodometric method. The four methods evaluated were accurate, reproducible, easily readable, economical, and ease to use for screening primary isolates of N. gonorrhoeae in Cuba. We recommended the use of the inhibition method, when testing the penicillinase activity in gonococcal isolates in provincial and municipal reference laboratories.
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Affiliation(s)
- Rafael Llanes
- Departmento de Bacteriología, Instituto de Medicina Tropical Pedro Kourí, Apdo Postal 601, Marianao 13, Ciudad de La Habana, Cuba.
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Fernández Molina C, Latino MA, Zamora Martínez Y, Pellecchia M, Neve V, Llanes R, Macfarlane R, Balbo L. [Development of a multiple PCR method for the identification of Ureaplasma parvum and Ureaplasma urealyticum]. Rev Argent Microbiol 2003; 35:138-42. [PMID: 14587375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Ureaplasma parvum and Ureaplasma urealyticum, also known as biovar parvum and biovar T960, respectively, could be associated with several disorders in men, women, and mainly, in newborn children with under weight. Several methods have been developed in order to identify the species or biovars of ureaplasmas. We developed a Multiplex-PCR method using the UPS-UPSA and UUS2-UUA2 primers, specific for U. parvum and U. urealyticum, respectively. This Multiplex-PCR method was used to identify cultures of clinical positive samples to Ureaplasma spp. by the "MYCOFAST Evolution-2" Kit. Of 56 positive cultures to Ureaplasma spp. from newborn children, 70% were U. parvum and 30% U. urealyticum; in 76 positive samples in women, 83% corresponded to U. parvum and 17% to U. urealyticum, while in 63 positive samples of men, 76% identified U. parvum and 24% U. urealyticum. The PCR-multiplex method showed specificity for the identification of the biovars or species of ureaplasmas of clinical interest.
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Affiliation(s)
- C Fernández Molina
- Instituto de Medicina Tropical Pedro Kourí, A.P. 601, Mariano 13, La Lisa, Ciudad de La Habana, Cuba.
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Sosa J, Ramirez-Arcos S, Ruben M, Li H, Llanes R, Llop A, Dillon JAR. High percentages of resistance to tetracycline and penicillin and reduced susceptibility to azithromycin characterize the majority of strain types of Neisseria gonorrhoeae isolates in Cuba, 1995-1998. Sex Transm Dis 2003; 30:443-8. [PMID: 12916137 DOI: 10.1097/00007435-200305000-00012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In many regions the susceptibility of Neisseria gonorrhoeae isolates to antimicrobial agents is rarely tested. The Gonococcal Antimicrobial Surveillance Program (GASP) in Cuba was established as part of a larger regional GASP program to facilitate the collection and reporting of antimicrobial susceptibility data for N gonorrhoeae isolates. GOAL The goal was to retrospectively determine the antimicrobial susceptibility and molecular epidemiology of 91 isolates of N gonorrhoeae isolated from 11 centers in Cuba. STUDY DESIGN Isolates of N gonorrhoeae were collected and presumptively identified from 11 Cuban provincial health centers. They were then forwarded to the National Laboratory of Pathogenic Neisseria Havana for confirmatory identification and were subsequently analyzed at the Center for GASP in Ottawa. Isolates were tested for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, and azithromycin by the agar dilution method. To establish baseline data for molecular epidemiologic profiles, the auxotype (A), serovar (S), plasmid content (P), and TetM type of the isolates were determined. Certain A/S/P classes were further analyzed by pulsed field gel electrophoresis (PFGE). RESULTS High percentages of the 91 N gonorrhoeae isolates were resistant to penicillin (68%) and tetracycline (83.5%), with 56% being penicillinase-producing (PPNG) and 64% carrying plasmid-mediated tetracycline resistance (TRNG; 50% were PP/TRNG). An additional 14% of the isolates carried chromosomal resistance (CMRNG) to either tetracycline or penicillin or both antibiotics. All isolates were susceptible to spectinomycin, ceftriaxone, and ciprofloxacin. However, nine isolates were resistant to azithromycin (MIC, > or = 1.0 microgram/ml), and 43 other isolates displayed reduced susceptibility to this antibiotic (MIC, 0.25-0.5 microgram/ml). Although a total of 21 different A/S classes were identified, most of the isolates (61) belonged to three A/S classes: NR/IA-6 (35 isolates), NR/IB-1 (15 isolates), and P/IA-6 (11 isolates). Thirty-two of 45 PP/TRNG were A/S class NR/IA-6, and nine of the P/IA-6 isolates were TRNG. By contrast, most of A/S class NR/IB-1 (8) were CMRNG. PFGE analysis following digestion with NheI or SpeI further clustered the isolates into separate groups. CONCLUSIONS This study demonstrates high percentages of N gonorrhoeae isolates with penicillin and tetracycline resistance in Cuba. As has been noted in other studies in the Caribbean region and Latin America, resistance and reduced susceptibility to azithromycin are developing as emerging problems. Since penicillin and tetracycline continue to be widely used for the treatment of gonococcal infections in Cuba, this study indicates the importance of antimicrobial susceptibility surveillance so that effective antibiotics may be recommended for treatment of gonococcal infections.
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Affiliation(s)
- Jorge Sosa
- Instituto de Medicina Tropical Pedro Kourí, Havana, Cuba
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Llanes R, Sosa J, Guzmán D, Llop A, Valdés EA, Martínez I, Palma S, Lantero MI. Antimicrobial susceptibility of Neisseria gonorrhoeae in Cuba (1995-1999): implications for treatment of gonorrhea. Sex Transm Dis 2003; 30:10-4. [PMID: 12514435 DOI: 10.1097/00007435-200301000-00003] [Citation(s) in RCA: 9] [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: 11/25/2022]
Abstract
BACKGROUND Antibiotic-resistant strains of Neisseria gonorrhoeae, especially those resistant to penicillin and tetracycline, have spread with remarkable rapidity in many Caribbean countries. GOAL The goal of the study was to survey the antibiotic susceptibilities of N gonorrhoeae strains isolated from 1995 to 1999 in Cuba and to discuss the impact of antimicrobial resistance on the management of gonorrhea in the country. STUDY DESIGN Susceptibility of the strains to penicillin, tetracycline, cefuroxime, ceftriaxone, ciprofloxacin, spectinomycin, and azithromycin were determined by an agar dilution method. RESULTS Penicillin and tetracycline resistance was noted in 60.8% and 54.2%, respectively, of the N gonorrhoeae strains tested. A total of 63.35 (76/120) of the N gonorrhoeae strains exhibited plasmid-mediated resistance to penicillin, tetracycline, or both. Strains with chromosomally mediated resistance to these antibiotics accounted for 10% (12/120) of the strains. The strains were susceptible to ceftriaxone, cefuroxime, spectinomycin, and ciprofloxacin. One strain's ciprofloxacin MIC was 0.125 mircog/ml. Of the 52 strains tested, 23.1% displayed intermediate resistance to azithromycin. CONCLUSIONS N gonorrhoeae strains exhibited a high frequency of resistance and multiresistance to penicillin and tetracycline. Therefore, these antibiotics should no longer be used to treat gonococcal infections in Cuba and should be substituted with effective drugs such as third-generation cephalosporins, spectinomycin, and fluoroquinolones. The detection of intermediate resistance to azithromycin and ciprofloxacin underlines the importance of periodic surveillance for susceptibility of N gonorrhoeae strains to antimicrobials agents used as primary therapy for gonorrhea.
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Affiliation(s)
- Rafael Llanes
- Microbiology Branch, Tropical Medicine Institute Pedro Kourí, Havana, Cuba.
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Llanes R, Zamora A, Nápoles M, Guevara A, Sosa J, Guzmán D, Llop A, Lantero MI. Antimicrobial resistance of Neisseria gonorrhoeae in the municipality of Morón, Cuba: emergence of isolates with intermediate resistance to fluoroquinolones. J Antimicrob Chemother 2003; 51:191-2. [PMID: 12493815 DOI: 10.1093/jac/dkg043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sosa J, Llanes R, Guzmán D, Quintana I, Flores M, Gutiérrez O. Typing and susceptibility to penicillin of Neisseria meningitidis isolated from patients in Cuba (1993-1999). Mem Inst Oswaldo Cruz 2001; 96:523-5. [PMID: 11391426 DOI: 10.1590/s0074-02762001000400014] [Citation(s) in RCA: 10] [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: 11/22/2022] Open
Abstract
The susceptibility to penicillin of 111 Neisseria meningitidis strains was assessed by the agar-dilution procedure and serosubtypes were determined by a whole-cell enzyme-linked immunoassay using monoclonal antibodies reagents. Thirty-five isolates showed reduced sensitivity to penicillin (MIC > or = 0.1 mg/l and < or = 1 mg/l) and no resistant strains were detected. The most common phenotype was B:4:P1.15 (77.5%) and a rising trend of non-typeable and non-subtypeable strains was detected. The increase in levels of minimal inhibitory concentrations of meningococci to penicillin gives cause for concern and the increase in non-typeable and non-subtypeable isolation demand the use of molecular biology techniques for their typing.
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Affiliation(s)
- J Sosa
- Instituto de Medicina Tropical 'Pedro Kourí', Ciudad de La Habana, Cuba.
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Abstract
BACKGROUND AND OBJECTIVES The Cuban Ministry of Public Health plans to implement the syndromic approach to sexually transmitted diseases in persons with urethral or vaginal syndrome in Cuba using 500 mg ciprofloxacin as therapy. Although the emergence of clinical isolates of Neisseria gonorrhoeae with decreased susceptibility to ciprofloxacin have been sporadically detected in Cuba, there has been no report of isolates that exhibited significant resistance to this drug. This is the first report of the isolation of a N gonorrhoeae strain resistant to ciprofloxacin in Cuba. STUDY DESIGN Case report. CONCLUSIONS This case emphasizes the need for awareness regarding the potential emergence of a clinically significant resistance of N gonorrhoeae in Cuba. There is a need for continued antimicrobial susceptibility surveillance of Cuban isolates to ciprofloxacin and other fluoroquinolones.
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Affiliation(s)
- R Llanes
- National Reference Laboratory for Neisseria, Tropical Medicine Institute, Pedro Kouri, Havana, Cuba
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Sosa J, Llanes R, Rodríguez W, Gutiérrez Y, Guzmán D. Characterization of Neisseria gonorrhoeae strains isolated from patients with conjunctivitis. Mem Inst Oswaldo Cruz 2000; 95:853-4. [PMID: 11080773 DOI: 10.1590/s0074-02762000000600018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The conjunctivitis produced by Neisseria gonorrhoeae is the less frequently reported clinical form of gonococcal infection. We aim to phenotypically characterize N. gonorrhoeae isolated from conjunctivae sites. A total of six cases of this disease were notified in the Camagüey province, Cuba. All the strains isolated were penicillin-producing, showed the serogroup WI and exhibited the same antimicrobial susceptibility pattern and plasmid profile (2.6-3. 2-24.5). The results contribute to the characterization of N. gonorrhoeae strains circulating in our environment.
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Affiliation(s)
- J Sosa
- Instituto de Medicina Tropical Pedro Kourí, Habana, Cuba.
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Azahares Romero LE, Cuello M, Callis AH, Llanes R, Estrada L, Pérez MF, Collada I, Sierra G. [Utilization of different microbiological markers in the study of Haemophilus influenzae]. Rev Argent Microbiol 1996; 28:111-7. [PMID: 9026820] [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: 02/03/2023] Open
Abstract
The present study includes 178 Haemophilus influenzae strains isolated in different pediatric hospitals from Havana, Cuba, during 1991-1994, associated to divers infections (meningitis, respiratory sepsis, primary bacteremia). A combination of various typing and subtyping methods was used as epidemiological markers: serotyping (slide agglutination with diagnostical serum a-f and latex agglutination), biotyping according to Killian's procedures (by determination of indole production, urease and ornithine decarboxylase activity), subtyping by fermentative profiles according to Roberts' methods (glucose, maltose, xylose and fructose) and outer membrane protein profile subtyping (vesicles extraction by a modified Barenkamp's method, analysis by lineal and gradient SDS-PAGE and assessment according to our own classification system). Serotype b was identified in 89.3%, biotype I was the most frequent (79.1%), other biotypes (II, III, IV and V) were also identified. Fermentative profile D (glucose, maltose, xylose and fructose positive) was the most frequent (52.8%) while profile G (glucose, maltose, xylose positive and fructose negative) represented 20.2%. Other known profiles were present. PA2 (33.7%) was the most frequent OMP subtype. Even though 11 different protein subtypes were found, the 77.5% of the strains were located in only three OMP electrophoretic subtypes (PA2, PC1, LA2).
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Affiliation(s)
- L E Azahares Romero
- Departamento de Investigaciones Meningeas Bacterianas, Instituto Finlay, La Habana, Cuba
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Llanes R, Azahares LE, Pérez MF, Martínez I, Patton AS. [Antimicrobial resistance in Haemophilus influenzae in the city of Havana, Cuba]. Rev Argent Microbiol 1996; 28:17-21. [PMID: 8815456] [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: 02/02/2023] Open
Abstract
Fifty five Haemophilus influenzae strains were studied to determine their resistance to different antimicrobial drugs. They were isolated in Habana City, Cuba, during June 1992 to May 1993, from invasive and non invasive infections. An agar dilution method, according to NCCLS guidelines, was employed. We observed that 49%, 47.3% and 27.3% were resistant to ampicillin, tetracycline and chloramphenicol, respectively. beta-lactamase production was demonstrated in 22 strains (40%). There was neither resistance to ceftriaxone, cefotaxime nor rifampicin. 36.4% of the strains were multiresistant, being described 7 different resistance patterns. The rate of resistance to the drugs was substantially higher among serotype b than among non type b strains.
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Affiliation(s)
- R Llanes
- Instituto Pedro Kourí (IPK), La Habana, Cuba
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