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Gutiérrez-Gálvez L, García-Fernández D, Barrio MD, Luna M, Torres Í, Zamora F, Navío C, Milán-Rois P, Castellanos M, Abreu M, Cantón R, Galán JC, Somoza Á, Miranda R, García-Mendiola T, Lorenzo E. Free PCR virus detection via few-layer bismuthene and tetrahedral DNA nanostructured assemblies. Talanta 2024; 269:125405. [PMID: 37984235 DOI: 10.1016/j.talanta.2023.125405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 11/22/2023]
Abstract
In this work we describe a highly sensitive method based on a biocatalyzed electrochemiluminescence approach. The system combines, for the first time, the use of few-layer bismuthene (FLB) as a platform for the oriented immobilization of tetrahedral DNA nanostructures (TDNs) specifically designed and synthetized to detect a specific SARS-CoV-2 gene sequence. In one of its vertices, these TDNs contain a DNA capture probe of the open reading frame 1 ab (ORF1ab) of the virus, available for the biorecognition of the target DNA/RNA. At the other three vertices, there are thiol groups that enable the stable anchoring/binding to the FLB surface. This novel geometry/approach enables not only the binding of the TDNs to surfaces, but also the orientation of the capture probe in a direction normal to the bismuthine surface so that it is readily accessible for binding/recognition of the specific SARS-CoV-2 sequence. The analytical signal is based on the anodic electrochemiluminescence (ECL) intensity of luminol which, in turn, arises as a result of the reaction with H2O2, generated by the enzymatic reaction of glucose oxidation, catalyzed by the biocatalytic label avidin-glucose oxidase conjugate (Av-GOx), which acts as co-reactant in the electrochemiluminescent reaction. The method exhibits a limit of detection (LOD) of 4.31 aM and a wide linear range from 14.4 aM to 1.00 μM, and its applicability was confirmed by detecting SARS-CoV-2 in nasopharyngeal samples from COVID-19 patients without the need of any amplification process.
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Affiliation(s)
- Laura Gutiérrez-Gálvez
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
| | - Daniel García-Fernández
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
| | - Melisa Del Barrio
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
| | - Mónica Luna
- Instituto de Micro y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), 28760, Tres Cantos, Madrid, Spain
| | - Íñigo Torres
- Departamento de Química Inorgánica and Condensed Matter Physics Center (IFIMAC), Universidad Autónoma de Madrid, 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - Félix Zamora
- Departamento de Química Inorgánica and Condensed Matter Physics Center (IFIMAC), Universidad Autónoma de Madrid, 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - Cristina Navío
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Paula Milán-Rois
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | | | - Melanie Abreu
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Rafael Cantón
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Álvaro Somoza
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Rodolfo Miranda
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Tania García-Mendiola
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain.
| | - Encarnación Lorenzo
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain; IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
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Campos M, Galán JC, Rodríguez-Domínguez M, Sempere JM, Llorens C, Baquero F. Membrane computing simulation of sexually transmitted bacterial infections in hotspots of individuals with various risk behaviors. Microbiol Spectr 2024; 12:e0272823. [PMID: 38197662 PMCID: PMC10845966 DOI: 10.1128/spectrum.02728-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/07/2023] [Indexed: 01/11/2024] Open
Abstract
The epidemiology of sexually transmitted infections (STIs) is complex due to the coexistence of various pathogens, the variety of transmission modes derived from sexual orientations and behaviors at different ages and genders, and sexual contact hotspots resulting in network transmission. There is also a growing proportion of recreational drug users engaged in high-risk sexual activities, as well as pharmacological self-protection routines fostering non-condom practices. The frequency of asymptomatic patients makes it difficult to develop a comprehensive approach to STI epidemiology. Modeling approaches are required to deal with such complexity. Membrane computing is a natural computing methodology for the virtual reproduction of epidemics under the influence of deterministic and stochastic events with an unprecedented level of granularity. The application of the LOIMOS program to STI epidemiology illustrates the possibility of using it to shape appropriate interventions. Under the conditions of our basic landscape, including sexual hotspots of individuals with various risk behaviors, an increase in condom use reduces STIs in a larger proportion of heterosexuals than in same-gender sexual contacts and is much more efficient for reducing Neisseria gonorrhoeae than Chlamydia and lymphogranuloma venereum infections. Amelioration from diagnostic STI screening could be instrumental in reducing N. gonorrhoeae infections, particularly in men having sex with men (MSM), and Chlamydia trachomatis infections in the heterosexual population; however, screening was less effective in decreasing lymphogranuloma venereum infections in MSM. The influence of STI epidemiology of sexual contacts between different age groups (<35 and ≥35 years) and in bisexual populations was also submitted for simulation.IMPORTANCEThe epidemiology of sexually transmitted infections (STIs) is complex and significantly influences sexual and reproductive health worldwide. Gender, age, sexual orientation, sexual behavior (including recreational drug use and physical and pharmacological protection practices), the structure of sexual contact networks, and the limited application or efficiency of diagnostic screening procedures create variable landscapes in different countries. Modeling techniques are required to deal with such complexity. We propose the use of a simulation technology based on membrane computing, mimicking in silico STI epidemics under various local conditions with an unprecedented level of detail. This approach allows us to evaluate the relative weight of the various epidemic drivers in various populations at risk and the possible outcomes of interventions in particular epidemiological landscapes.
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Affiliation(s)
- Marcelino Campos
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Valencian Research Institute for Artificial Intelligence (VRAIN), Polytechnic University of Valencia, Valencia, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
| | - José M. Sempere
- Valencian Research Institute for Artificial Intelligence (VRAIN), Polytechnic University of Valencia, Valencia, Spain
| | - Carlos Llorens
- Biotechvana, Valencia, Scientific Park University of Valencia, Paterna, Spain
| | - Fernando Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
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Mateos-Nozal J, Rodríguez-Domínguez M, San Román J, Candel FJ, Villarrubia N, Pérez-Panizo N, Segura E, Cuñarro JM, Ramírez-Arellano MVM, Rodríguez-Ramos R, Pariente-Rodríguez R, Villar LM, Ramos P, Cantón R, Cruz-Jentoft AJ, Galán JC. Factors Associated with SARS-CoV-2 Infection in Fully Vaccinated Nursing Home Residents and Workers. Viruses 2024; 16:186. [PMID: 38399962 PMCID: PMC10891794 DOI: 10.3390/v16020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Persons living or working in nursing homes faced a higher risk of SARS-CoV-2 infections during the pandemic, resulting in heightened morbidity and mortality among older adults despite robust vaccination efforts. This prospective study evaluated the humoral and cellular immunity in fully vaccinated residents and workers from two nursing homes in Madrid, Spain, from 2020 to 2021. Measurements of IgG levels were conducted in August 2020 (pre-vaccination) and June and September 2021 (post-vaccination), alongside assessments of neutralizing antibodies and cellular responses in September 2021 among the most vulnerable individuals. Follow-up extended until February 2022 to identify risk factors for SARS-CoV-2 infection or mortality, involving 267 residents (mean age 87.6 years, 81.3% women) and 302 workers (mean age 50.7 years, 82.1% women). Residents exhibited a significantly higher likelihood of experiencing COVID-19 before June 2021 compared with nursing staff (OR [95% CI], 7.2 [3.0 to 17.2], p < 0.01). Participants with a history of previous COVID-19 infection showed more significant increases in IgG levels in August 2020, June 2021 and September 2021, alongside an increased proportion of neutralizing antibodies in the most vulnerable individuals. However, IgG decay remained the same between June and September 2021 based on the previous COVID-19 status. During the Omicron variant wave, residents and staff showed a similar rate of SARS-CoV-2 infection. Notably, preceding clinical or immunological factors before receiving three vaccination doses did not demonstrate associations with COVID-19 infection or overall mortality in our participant cohort.
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Affiliation(s)
- Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Francisco Javier Candel
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Noelia Villarrubia
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Nuria Pérez-Panizo
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Esther Segura
- Residencia de Mayores Manoteras, 28050 Madrid, Spain;
| | | | | | - Rafael Rodríguez-Ramos
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Roberto Pariente-Rodríguez
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Luisa M. Villar
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | | | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfonso J. Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Martínez-García L, Orviz E, González-Alba JM, Comunión A, Puerta T, Mateo M, Sánchez-Conde M, Rodríguez-Jiménez MC, Rodríguez-Domínguez M, Bru-Gorraiz FJ, del Romero J, Cantón R, Galán JC. Rapid expansion of lymphogranuloma venereum infections with fast diversification and spread of Chlamydia trachomatis L genovariants. Microbiol Spectr 2024; 12:e0285523. [PMID: 38095475 PMCID: PMC10783107 DOI: 10.1128/spectrum.02855-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024] Open
Abstract
IMPORTANCE Numerous international organizations, including the World Health Organization, have been drawing attention to the global increase in sexually transmitted infections. Twenty years ago, lymphogranuloma venereum (LGV) was mainly considered a tropical disease; in recent decades, however, LGV has been increasingly present in high-income countries. This increase has been linked to men who have sex with men who participate in highly interconnected sexual networks, leading to a rapid spread of LGV. This study focuses on the spread of LGV, presenting the largest time series of LGV prevalence in Spain, which includes more than a thousand diagnosed cases in one large city. The number of LGV cases diagnosed was analyzed over time, and a selection of strains was subjected to molecular genotyping. The results indicate that the LGV epidemic is gradually evolving toward an increasingly complex diversification due to the selection of successful genovariants that have emerged by mutation and recombination events, suggesting that we are moving toward an unpredictable scenario.
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Affiliation(s)
- Laura Martínez-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - José María González-Alba
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | | | - Teresa Puerta
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - María Mateo
- Servicio de Microbiología, Hospital Central de la Defensa Gómez-Ulla, Madrid, Spain
| | - Matilde Sánchez-Conde
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - María Concepción Rodríguez-Jiménez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Jorge del Romero
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Cárdenas-Isasi MJ, Martínez-Yoldi MJ, Galán JC. How should we generalise the diagnosis of dengue as it spreads to more and more regions of the world? Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:1-3. [PMID: 38176844 DOI: 10.1016/j.eimce.2023.09.002] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/26/2023] [Indexed: 01/06/2024]
Affiliation(s)
- María José Cárdenas-Isasi
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Miguel J Martínez-Yoldi
- Microbiology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.
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Albóniga OE, Moreno E, Martínez-Sanz J, Vizcarra P, Ron R, Díaz-Álvarez J, Rosas Cancio-Suarez M, Sánchez-Conde M, Galán JC, Angulo S, Moreno S, Barbas C, Serrano-Villar S. Author Correction: Differential abundance of lipids and metabolites related to SARS-CoV-2 infection and susceptibility. Sci Rep 2023; 13:22513. [PMID: 38110458 PMCID: PMC10728131 DOI: 10.1038/s41598-023-47669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Affiliation(s)
- Oihane E Albóniga
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Elena Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Vizcarra
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rosas Cancio-Suarez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago Angulo
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain.
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Carretera de Colmenar Viejo, Km 9.100, 28034, Madrid, Spain.
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7
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Viñuela L, de Salazar A, Fuentes A, Serrano-Conde E, Falces-Romero I, Pinto A, Portilla I, Masiá M, Peraire J, Gómez-Sirvent JL, Sanchiz M, Iborra A, Baza B, Aguilera A, Olalla J, Espinosa N, Iribarren JA, Martínez-Velasco M, Imaz A, Montero M, Rivero M, Suarez-García I, Maciá MD, Galán JC, Perez-Elias MJ, García-Fraile LJ, Moreno C, Garcia F. Transmitted drug resistance to antiretroviral drugs in Spain during the period 2019-2021. J Med Virol 2023; 95:e29287. [PMID: 38084763 DOI: 10.1002/jmv.29287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/17/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023]
Abstract
To evaluate the prevalence of transmitted drug resistance (TDR) to nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI, NNRTI), protease inhibitors (PI), and integrase strand transfer inhibitors (INSTI) in Spain during the period 2019-2021, as well as to evaluate transmitted clinically relevant resistance (TCRR) to antiretroviral drugs. Reverse transcriptase (RT), protease (Pro), and Integrase (IN) sequences from 1824 PLWH (people living with HIV) were studied. To evaluate TDR we investigated the prevalence of surveillance drug resistance mutations (SDRM). To evaluate TCRR (any resistance level ≥ 3), and for HIV subtyping we used the Stanford v.9.4.1 HIVDB Algorithm and an in-depth phylogenetic analysis. The prevalence of NRTI SDRMs was 3.8% (95% CI, 2.8%-4.6%), 6.1% (95% CI, 5.0%-7.3%) for NNRTI, 0.9% (95% CI, 0.5%-1.4%) for PI, and 0.2% (95% CI, 0.0%-0.9%) for INSTI. The prevalence of TCRR to NRTI was 2.1% (95% CI, 1.5%-2.9%), 11.8% for NNRTI, (95% CI, 10.3%-13.5%), 0.2% (95% CI, 0.1%-0.6%) for PI, and 2.5% (95% CI, 1.5%-4.1%) for INSTI. Most of the patients were infected by subtype B (79.8%), while the majority of non-Bs were CRF02_AG (n = 109, 6%). The prevalence of INSTI and PI resistance in Spain during the period 2019-2021 is low, while NRTI resistance is moderate, and NNRTI resistance is the highest. Our results support the use of integrase inhibitors as first-line treatment in Spain. Our findings highlight the importance of ongoing surveillance of TDR to antiretroviral drugs in PLWH particularly with regard to first-line antiretroviral therapy.
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Affiliation(s)
- Laura Viñuela
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Ibs, Granada, Spain
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
| | - Adolfo de Salazar
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Ibs, Granada, Spain
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
| | - Ana Fuentes
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Ibs, Granada, Spain
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
| | - Esther Serrano-Conde
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | - Adriana Pinto
- Infectious Diseases Unit, Hospital 12 de Octubre, Madrid, Spain
| | - Irene Portilla
- Infectious Diseases Unit, Hospital General Universitario de Alicante, Alicante, Spain
| | - Mar Masiá
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain
| | - Joaquim Peraire
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
- Infectious Diseases Unit, Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Juan Luis Gómez-Sirvent
- Infectious Diseases Unit, Hospital Universitario de Canarias, Las Palmas de Gran Canaria, Spain
| | - Marta Sanchiz
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Asunción Iborra
- Clinical Microbiology Unit, Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Begoña Baza
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
- Instituto de Medicina de Laboratorio (IML), Madrid, Spain
| | - Antonio Aguilera
- Clinical Microbiology Unit, Complejo Hospitalario Universitario de Santiago, Santiago, Spain
| | - Julián Olalla
- Infectious Diseases Unit, Hospital Costa del Sol, Marbella, Spain
| | - Nuria Espinosa
- Infectious Diseases Unit, Hospital Virgen del Rocío, Seville, Spain
| | | | | | - Arkaitz Imaz
- Infectious Diseases Unit, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Marta Montero
- Infectious Diseases Unit, Hospital Universitario La Fe, Valencia, Spain
| | - María Rivero
- Infectious Diseases Unit, Hospital de Navarra, Pamplona, Spain
| | | | | | - Juan Carlos Galán
- Infectious Diseases Unit, Hospital Ramón y Cajal, Madrid, Spain
- Ciber de Epidemiologia y Salud Publica, CIBERESP, Madrid, Spain
- Insituto Ramón y Cajal de Investigación Sanitaria (IRYSCIS), Madrid, Spain
| | - Maria Jesus Perez-Elias
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
- Infectious Diseases Unit, Hospital Ramón y Cajal, Madrid, Spain
| | | | - Cristina Moreno
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Federico Garcia
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Ibs, Granada, Spain
- Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII, Madrid, Spain
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8
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Domínguez-Rodríguez S, Liz-López H, Panizo-LLedot A, Ballesteros Á, Dagan R, Greenberg D, Gutiérrez L, Rojo P, Otheo E, Galán JC, Villanueva S, García S, Mosquera P, Tagarro A, Moraleda C, Camacho D. Testing the performance, adequacy, and applicability of an artificial intelligence model for pediatric pneumonia diagnosis. Comput Methods Programs Biomed 2023; 242:107765. [PMID: 37704545 DOI: 10.1016/j.cmpb.2023.107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/07/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Community-acquired Pneumonia (CAP) is a common childhood infectious disease. Deep learning models show promise in X-ray interpretation and diagnosis, but their validation should be extended due to limitations in the current validation workflow. To extend the standard validation workflow we propose doing a pilot test with the next characteristics. First, the assumption of perfect ground truth (100% sensitive and specific) is unrealistic, as high intra and inter-observer variability have been reported. To address this, we propose using Bayesian latent class models (BLCA) to estimate accuracy during the pilot. Additionally, assessing only the performance of a model without considering its applicability and acceptance by physicians is insufficient if we hope to integrate AI systems into day-to-day clinical practice. Therefore, we propose employing explainable artificial intelligence (XAI) methods during the pilot test to involve physicians and evaluate how well a Deep Learning model is accepted and how helpful it is for routine decisions as well as analyze its limitations by assessing the etiology. This study aims to apply the proposed pilot to test a deep Convolutional Neural Network (CNN)-based model for identifying consolidation in pediatric chest-X-ray (CXR) images already validated using the standard workflow. METHODS For the standard validation workflow, a total of 5856 public CXRs and 950 private CXRs were used to train and validate the performance of the CNN model. The performance of the model was estimated assuming a perfect ground truth. For the pilot test proposed in this article, a total of 190 pediatric chest-X-ray (CXRs) images were used to test the CNN model support decision tool (SDT). The performance of the model on the pilot test was estimated using extensions of the two-test Bayesian Latent-Class model (BLCA). The sensitivity, specificity, and accuracy of the model were also assessed. The clinical characteristics of the patients were compared according to the model performance. The adequacy and applicability of the SDT was tested using XAI techniques. The adequacy of the SDT was assessed by asking two senior physicians the agreement rate with the SDT. The applicability was tested by asking three medical residents before and after using the SDT and the agreement between experts was calculated using the kappa index. RESULTS The CRXs of the pilot test were labeled by the panel of experts into consolidation (124/176, 70.4%) and no-consolidation/other infiltrates (52/176, 29.5%). A total of 31/176 (17.6%) discrepancies were found between the model and the panel of experts with a kappa index of 0.6. The sensitivity and specificity reached a median of 90.9 (95% Credible Interval (CrI), 81.2-99.9) and 77.7 (95% CrI, 63.3-98.1), respectively. The senior physicians reported a high agreement rate (70%) with the system in identifying logical consolidation patterns. The three medical residents reached a higher agreement using SDT than alone with experts (0.66±0.1 vs. 0.75±0.2). CONCLUSIONS Through the pilot test, we have successfully verified that the deep learning model was underestimated when a perfect ground truth was considered. Furthermore, by conducting adequacy and applicability tests, we can ensure that the model is able to identify logical patterns within the CXRs and that augmenting clinicians with automated preliminary read assistants could accelerate their workflows and enhance accuracy in identifying consolidation in pediatric CXR images.
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Affiliation(s)
- Sara Domínguez-Rodríguez
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Helena Liz-López
- Computer Systems Engineering Department, Universidad Politécnica de Madrid, Spain
| | - Angel Panizo-LLedot
- Computer Systems Engineering Department, Universidad Politécnica de Madrid, Spain.
| | - Álvaro Ballesteros
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Ron Dagan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - David Greenberg
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel
| | - Lourdes Gutiérrez
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Pablo Rojo
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Enrique Otheo
- Hospital Universitario Ramón y Cajal. Pediatrics Department, Madrid, Spain
| | - Juan Carlos Galán
- Hospital Universitario Ramón y Cajal, Microbiology Department, Madrid, Spain
| | - Sara Villanueva
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Sonsoles García
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo Mosquera
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alfredo Tagarro
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Fundación para la Investigación e Innovación Biomédica del Hospital Universitario Infanta Sofía y Hospital Universitario del Henares. Madrid, Spain; Pediatrics Research Group. Universidad Europea de Madrid. Pediatrics, Madrid, Spain
| | - Cinta Moraleda
- Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - David Camacho
- Computer Systems Engineering Department, Universidad Politécnica de Madrid, Spain
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9
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Martínez-Sanz J, Ponce-Alonso M, Martínez-García L, de la Cueva V, Olavarrieta L, Montero L, Pérez-Elías MJ, Galán JC. Description of mpox reinfection by whole genome sequencing. Int J Infect Dis 2023; 137:111-113. [PMID: 37884258 DOI: 10.1016/j.ijid.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
Several possible mpox reinfections have been reported, however, the debate on whether these are confirmed reinfections remains open. A 30-year-old male living with HIV and a history of single-dose mpox vaccination, first diagnosed with mpox in September 2022, presented with genital ulcers in March 2023, testing positive for mpox virus. Real-time polymerase chain reaction revealed the presence of viral DNA with cycle threshold values of 24 and 25, respectively. Whole genome sequencing and phylogenetic approach allowed us to classify these viruses as Clade IIb lineage B.1 and Clade IIb lineage B.1.4, respectively. Twelve nucleotide differences were identified. The observed difference was higher than the estimate of mutations/genome/year described. These data confirm that mpox reinfection is possible and reinforces current vaccination campaigns.
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Affiliation(s)
- Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
| | - Manuel Ponce-Alonso
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain; Department of Microbiology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Laura Martínez-García
- Department of Microbiology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Víctor de la Cueva
- Unidad Central de Apoyo Genómica Traslacional (UCA-GT), IRYCIS, Hospital Ramón y Cajal Madrid, Spain
| | - Leticia Olavarrieta
- Unidad Central de Apoyo Genómica Traslacional (UCA-GT), IRYCIS, Hospital Ramón y Cajal Madrid, Spain
| | - Laura Montero
- Directorate General of Public Health, Regional Ministry of Health of Madrid, Madrid, Spain
| | - María Jesús Pérez-Elías
- Department of Infectious Diseases, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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10
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de Salazar A, Martínez MJ, Navero-Castillejos J, Negredo A, Galán JC, Rojo Molinero E, Lagarejos E, Muñoz-Almagro C, Hernández Rodríguez Á, Lepe JA, Antón Pagarolas A, Pérez Castro S, Zamora Cintas MI, Domínguez-Gil González M, Niubó-Bosch J, Gutiérrez Arroyo A, Vazquez A, García F, Sánchez-Seco Fariñas MP. The imperative for quality control programs in Monkeypox virus DNA testing by PCR: CIBERINFEC quality control. J Med Virol 2023; 95:e29240. [PMID: 37971716 DOI: 10.1002/jmv.29240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
To evaluate molecular assays for Mpox diagnosis available in various clinical microbiology services in Spain through a quality control (QC) approach. A total of 14 centers from across Spain participated in the study. The Reference Laboratory dispatched eight serum samples and eight nucleic acid extracts to each participating center. Some samples were spiked with Mpox or Vaccinia virus to mimic positive samples for Mpox or other orthopox viruses. Participating centers provided information on the results obtained, as well as the laboratory methods used. Among the 14 participating centers seven different commercial assays were employed, with the most commonly used kit being LightMix Modular Orthopox/Monkeypox (Mpox) Virus (Roche®). Of the 12 centers conducting Mpox determinations, concordance ranged from 62.5% (n = 1) to 100% (n = 11) for eluates and from 75.0% (n = 1) to 100% (n = 10) for serum. Among the 10 centers performing Orthopoxvirus determinations, a 100% concordance was observed for eluates, while for serum, concordance ranged from 87.5% (n = 6) to 100% (n = 4). Repeatedly, 6 different centers reported a false negative in serum samples for Orthopoxvirus diagnosis, particularly in a sample with borderline Ct = 39. Conversely, one center, using the TaqMan™ Mpox Virus Microbe Detection Assay (Thermo Fisher), reported false positives in Mpox diagnosis for samples spiked with vaccinia virus due to cross-reactions. We observed a positive correlation of various diagnostic assays for Mpox used by the participating centers with the reference values. Our results highlight the significance of standardization, validation, and ongoing QC in the microbiological diagnosis of infectious diseases, which might be particularly relevant for emerging viruses.
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Affiliation(s)
- Adolfo de Salazar
- Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Miguel J Martínez
- Servicio de Microbiología, Hospital Clinic de Barcelona, Spain
- Instituto de Salud Global de Barcelona (ISGloba), Barcelona, Spain
| | | | - Anabel Negredo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Estrella Rojo Molinero
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Departamento de Microbiología, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
| | - Eduardo Lagarejos
- Servicio de Microbiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Carmen Muñoz-Almagro
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- RDI Microbiology Department, Hospital Sant Joan de Deu, Barcelona, Spain
- Departamento de Medicina, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Águeda Hernández Rodríguez
- Laboratori Clínic de la Metropolitana Nord, Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - José Antonio Lepe
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Unidad de Enfermedades Infecciosas, Microbiología y Parasitología, Hospital Universitario Virgen del Rocio, Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
| | - Andrés Antón Pagarolas
- Departamento de Microbiología, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sonia Pérez Castro
- Servicio Microbiología, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | - Marta Domínguez-Gil González
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Servicio de Microbiología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Jordi Niubó-Bosch
- Laboratori Clínic Territorial Metropolitana Sud, Departamento de Microbiología, Hospital Universitari de Bellvitge, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Ana Vazquez
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Federico García
- Servicio de Microbiología, Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - María Paz Sánchez-Seco Fariñas
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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11
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Albóniga OE, Moreno E, Martínez-Sanz J, Vizcarra P, Ron R, Díaz-Álvarez J, Rosas Cancio-Suarez M, Sánchez-Conde M, Galán JC, Angulo S, Moreno S, Barbas C, Serrano-Villar S. Differential abundance of lipids and metabolites related to SARS-CoV-2 infection and susceptibility. Sci Rep 2023; 13:15124. [PMID: 37704651 PMCID: PMC10500013 DOI: 10.1038/s41598-023-40999-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/20/2023] [Indexed: 09/15/2023] Open
Abstract
The mechanisms driving SARS-CoV-2 susceptibility remain poorly understood, especially the factors determining why unvaccinated individuals remain uninfected despite high-risk exposures. To understand lipid and metabolite profiles related with COVID-19 susceptibility and disease progression. We collected samples from an exceptional group of unvaccinated healthcare workers heavily exposed to SARS-CoV-2 but not infected ('non-susceptible') and subjects who became infected during the follow-up ('susceptible'), including non-hospitalized and hospitalized patients with different disease severity providing samples at early disease stages. Then, we analyzed their plasma metabolomic profiles using mass spectrometry coupled with liquid and gas chromatography. We show specific lipids profiles and metabolites that could explain SARS-CoV-2 susceptibility and COVID-19 severity. More importantly, non-susceptible individuals show a unique lipidomic pattern characterized by the upregulation of most lipids, especially ceramides and sphingomyelin, which could be interpreted as markers of low susceptibility to SARS-CoV-2 infection. This study strengthens the findings of other researchers about the importance of studying lipid profiles as relevant markers of SARS-CoV-2 pathogenesis.
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Affiliation(s)
- Oihane E Albóniga
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Elena Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Vizcarra
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rosas Cancio-Suarez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago Angulo
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain.
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Carretera de Colmenar Viejo, Km 9.100, 28034, Madrid, Spain.
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12
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Troyano-Hernáez P, Herrador P, Gea F, Romero-Hernández B, Reina G, Albillos A, Galán JC, Holguín Á. Impact of storage time in dried blood samples (DBS) and dried plasma samples (DPS) for point-of-care hepatitis C virus (HCV) RNA quantification and HCV core antigen detection. Microbiol Spectr 2023; 11:e0174823. [PMID: 37655908 PMCID: PMC10581200 DOI: 10.1128/spectrum.01748-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 09/02/2023] Open
Abstract
The scale-up of hepatitis C virus (HCV) diagnosis and treatment requires affordable and simple tools to improve access to care, especially in low- and middle-income settings with limited infrastructure or high-risk populations. Dried blood and plasma samples (DBS and DPS) are useful alternative for hepatitis C detection in settings lacking adequate infrastructure. We evaluated the performance of DBS and DPS vs plasma in a point-of-care HCV RNA quantitative assay (Xpert HCV Viral Load-Cepheid), and compared HCV core antigen (HCVcAg) detection by the Architect HCV core antigen assay (Abbott) in DBS vs serum. The dried samples were stored at room temperature for different storage times to reproduce the time from sampling to testing in settings with centralized diagnosis or when testing mobile populations. HCV RNA quantification in DBS and DPS presented 100% sensitivity and specificity and a high correlation for up to 3 months of storage. HCV viremia showed a mean decrease of 0.5 log10 IU/mL (DBS) and 0.3 log10 IU/mL (DPS) for storage times up to 1 month. Architect HCVcAg detection presented high sensitivity/specificity (96%/100%) in DBS tested immediately after sampling, decreasing to 86% sensitivity after 7 days of storage. However, sensitivity increased when an optimized cut-off was applied for each storage time. We conclude that DBS and DPS are suitable samples for HCV RNA detection and quantification, being DPS more reliable for shorter storage times. DBS can be also used for HCVcAg qualitative detection and the sensitivity can be increased when adjusting the cut-off values. IMPORTANCE Hepatitis C infection remains a global burden despite the effectiveness of antivirals. In the WHO roadmap to accomplish HCV elimination by 2030, HCV diagnosis is one of the main targets. However, identifying patients in resource-limited settings and high-risk populations with limited access to healthcare remains a challenge and requires innovative approaches that allow decentralized testing. The significance of our research is in verifying the good performance of dried samples for HCV diagnosis using two different diagnostics assays and considering the effect of room temperature storage in this sample format. We confirmed dried samples are an interesting alternative for HCV screening and reflex testing in resource-limited settings or high-risk populations.
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Affiliation(s)
- Paloma Troyano-Hernáez
- Microbiology Department, HIV-1 Molecular Epidemiology Laboratory, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS) and RITIP-CoRISpe, Madrid, Spain
| | - Pedro Herrador
- Microbiology Department, HIV-1 Molecular Epidemiology Laboratory, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS) and RITIP-CoRISpe, Madrid, Spain
- Microbiology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
| | - Francisco Gea
- Gastroenterology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
| | - Beatriz Romero-Hernández
- Microbiology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
- Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
- ISTUN, Institute of Tropical Health, Universidad de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Agustín Albillos
- Gastroenterology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
- Biomedical Research Center on Liver and Digestive Diseases (CIBEREHD), Madrid, Spain
- University of Alcalá, Madrid, Spain
| | - Juan Carlos Galán
- Microbiology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
- Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - África Holguín
- Microbiology Department, HIV-1 Molecular Epidemiology Laboratory, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS) and RITIP-CoRISpe, Madrid, Spain
- Microbiology Department, Ramón y Cajal University Hospital-Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
- Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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13
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García-Ruiz de Morales AG, Martínez-Sanz J, Vivancos-Gallego MJ, Sánchez-Conde M, Vélez-Díaz-Pallarés M, Romero-Hernández B, Vázquez MDG, de Luque CMC, González-Sarria A, Galán JC, Rodríguez FG, Moreno S, Pérez-Elías MJ. HIV and HCV screening by non-infectious diseases physicians: can we improve testing and hidden infection rates? Front Public Health 2023; 11:1136988. [PMID: 37435522 PMCID: PMC10332317 DOI: 10.3389/fpubh.2023.1136988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Background Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diagnoses. Methods This interventional study consisted of a 1-h training session on HIV and HCV epidemiology and testing guidelines for non-ID physicians. Pre-and post-session questionnaires compared the knowledge of the guidelines and attitudes toward screening before and after the session. Rates of screening and diagnoses were compared in three 6 months periods: before, immediately after, and 24 months ±4 after the session. Results A total of 345 physicians from 31 departments participated in these sessions. Before the session, 19.9% (28% medical, 8% surgical) and 17.9% (30% medical, 2.7% surgical) were aware of HIV and HCV testing guidelines, respectively. The willingness to routinely test increased from 5.6 to 22%, whereas not ordering tests decreased from 34.1 to 2.4%. HIV screening rates significantly increased by 20% after the session (7.7 vs. 9.3 tests per 103 patients; p < 0.001), and the effect persisted until the long-term period. The HIV diagnosis rate increased globally (3.6 vs. 5.2 HIV diagnoses per 105 patients; p = 0.157), mainly because of medical services (4.7 vs. 7.7 per 105 patients; p = 0.082). The HCV screening rate increased significantly immediately and in the long term only in medical services (15.7 and 13.6%, respectively). The new active HCV infection rates increased immediately and declined steeply thereafter. Conclusion A short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination.
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Affiliation(s)
- Alejandro G García-Ruiz de Morales
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - María J Vivancos-Gallego
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Vélez-Díaz-Pallarés
- Department of Pharmacy, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain
| | - Beatriz Romero-Hernández
- Department of Microbiology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | | | - Ander González-Sarria
- Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Gea Rodríguez
- Department of Gastroenterology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - María Jesús Pérez-Elías
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain
- CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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14
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Vázquez-Morón S, Iglesias-Caballero M, Lepe JA, Garcia F, Melón S, Marimon JM, García de Viedma D, Folgueira MD, Galán JC, López-Causapé C, Benito-Ruesca R, Alcoba-Florez J, Gonzalez Candelas F, Toro MD, Fajardo M, Ezpeleta C, Lázaro F, Pérez Castro S, Cuesta I, Zaballos A, Pozo F, Casas I. Enhancing SARS-CoV-2 Surveillance through Regular Genomic Sequencing in Spain: The RELECOV Network. Int J Mol Sci 2023; 24:ijms24108573. [PMID: 37239920 DOI: 10.3390/ijms24108573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Millions of SARS-CoV-2 whole genome sequences have been generated to date. However, good quality data and adequate surveillance systems are required to contribute to meaningful surveillance in public health. In this context, the network of Spanish laboratories for coronavirus (RELECOV) was created with the main goal of promoting actions to speed up the detection, analyses, and evaluation of SARS-CoV-2 at a national level, partially structured and financed by an ECDC-HERA-Incubator action (ECDC/GRANT/2021/024). A SARS-CoV-2 sequencing quality control assessment (QCA) was developed to evaluate the network's technical capacity. QCA full panel results showed a lower hit rate for lineage assignment compared to that obtained for variants. Genomic data comprising 48,578 viral genomes were studied and evaluated to monitor SARS-CoV-2. The developed network actions showed a 36% increase in sharing viral sequences. In addition, analysis of lineage/sublineage-defining mutations to track the virus showed characteristic mutation profiles for the Delta and Omicron variants. Further, phylogenetic analyses strongly correlated with different variant clusters, obtaining a robust reference tree. The RELECOV network has made it possible to improve and enhance the genomic surveillance of SARS-CoV-2 in Spain. It has provided and evaluated genomic tools for viral genome monitoring and characterization that make it possible to increase knowledge efficiently and quickly, promoting the genomic surveillance of SARS-CoV-2 in Spain.
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Affiliation(s)
- Sonia Vázquez-Morón
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
| | - María Iglesias-Caballero
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - José Antonio Lepe
- Microbiology Service, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain
| | - Federico Garcia
- Microbiology Service, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria Ibs. Granada, 18016 Granada, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), ISCIII, 28029 Madrid, Spain
| | - Santiago Melón
- Microbiology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - José M Marimon
- Microbiology Service, Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, 20014 Donostia-San Sebastian, Spain
| | - Darío García de Viedma
- Microbiology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
| | - Maria Dolores Folgueira
- Microbiology Department, Hospital Universitario 12 de Octubre, Biomedical Research Institute imas12, 28041 Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Juan Carlos Galán
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
- Microbiology Service, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Carla López-Causapé
- Microbiology Service, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Rafael Benito-Ruesca
- Microbiology Service, Hospital Clínico Universitario Lozano Blesa, Departamento de Microbiología, Facultad de Medicina, Instituto de Investigación Sanitaria de Aragón, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Julia Alcoba-Florez
- Microbiology Service, Hospital Universitario Ntra. Sra de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Fernando Gonzalez Candelas
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), 46020 Valencia, Spain
| | - María de Toro
- Plataforma de Genómica y Bioinformática, Centro de Investigación Biomédica de La Rioja (CIBIR), 26006 Logroño, Spain
| | - Miguel Fajardo
- Microbiology Service, Hospital Universitario de Badajoz, 06080 Badajoz, Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra and Navarra De Servicios Y Tecnologías S A (NASERTIC), 31008 Pamplona, Spain
| | - Fernando Lázaro
- Microbiology Service, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Sonia Pérez Castro
- Microbiology Service, Complexo Hospitalario Universitario de Vigo, 36204 Vigo, Spain
| | - Isabel Cuesta
- Bioinformatics Unit, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Angel Zaballos
- Genomics Unit, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Francisco Pozo
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
| | - Inmaculada Casas
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
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15
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Hernández-Aguado JJ, de La Fuente-Valero J, Ramírez Mena M, Ortega-Medina L, Vidart Aragón JA, Galán JC. Comparative pilot study about HPV test with partial genotyping in primary screening versus other strategies for cervical cancer population screening, CRYGEN 16/18 study. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:262-268. [PMID: 35963773 DOI: 10.1016/j.eimce.2022.08.001] [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] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The early detection of cervical cancer requires the implementation of molecular screening programmes for human papillomavirus (HPV). However, there are discrepancies in the optimization of screening protocols. The performance of 10 primary screening strategies based on molecular, cytological or combined techniques is now evaluated. MATERIAL AND METHODS A blind, prospective, and interventional study was designed in 1.977 35-year-old women. The molecular determination was carried out by the Cobas 4800 HPV platform. Cytological analysis were performed on the same samples without knowledge of the result of the molecular assay. All women in whom HPV-16/HPV-18 was detected or presented cytological alteration together with detection of other high-risk genotypes (HPVhr) were referred to colposcopy. RESULTS The molecular assay detected the presence of HPVhr genotypes in 12.5% of the women, while only 8.1% of the cytologies were pathological. Among the patients referred to colposcopy, in 19.5% high-grade lesions were observed, being HPV-16 present in 65.3% of them. In six of these high-grade lesions (associated with HPV-16 in all cases), cytology was reported as normal. The follow-up one year later, of women with normal cytology and HPVhr detection a HSIL/CIN2+ lesion was detected (associated to HPV-33). In the comparative study with other strategies, the protocol called CRYGEN 16/18 yielded the best balance of sensitivity and specificity with the least referral to colposcopy. CONCLUSIONS Performing molecular detection of HPVhr with partial first-line genotyping of at least HPV-16, with direct referral to colposcopy, increases the detection rate of HSIL/CIN2+ lesions.
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Affiliation(s)
| | | | - Mar Ramírez Mena
- Servicio de Ginecología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Luis Ortega-Medina
- Servicio de Anatomía Patológica, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain; CIBER Epidemiología Salud Pública (CIBERESP), Madrid, Spain.
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16
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Sanchez T, Mavragani A, Álamo E, Pérez-Panizo N, Mousa A, Dacal E, Lin L, Vladimirov A, Cuadrado D, Mateos-Nozal J, Galán JC, Romero-Hernandez B, Cantón R, Luengo-Oroz M, Rodriguez-Dominguez M. A Smartphone-Based Platform Assisted by Artificial Intelligence for Reading and Reporting Rapid Diagnostic Tests: Evaluation Study in SARS-CoV-2 Lateral Flow Immunoassays. JMIR Public Health Surveill 2022; 8:e38533. [PMID: 36265136 PMCID: PMC9840096 DOI: 10.2196/38533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/16/2022] [Accepted: 10/13/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Rapid diagnostic tests (RDTs) are being widely used to manage COVID-19 pandemic. However, many results remain unreported or unconfirmed, altering a correct epidemiological surveillance. OBJECTIVE Our aim was to evaluate an artificial intelligence-based smartphone app, connected to a cloud web platform, to automatically and objectively read RDT results and assess its impact on COVID-19 pandemic management. METHODS Overall, 252 human sera were used to inoculate a total of 1165 RDTs for training and validation purposes. We then conducted two field studies to assess the performance on real-world scenarios by testing 172 antibody RDTs at two nursing homes and 96 antigen RDTs at one hospital emergency department. RESULTS Field studies demonstrated high levels of sensitivity (100%) and specificity (94.4%, CI 92.8%-96.1%) for reading IgG band of COVID-19 antibody RDTs compared to visual readings from health workers. Sensitivity of detecting IgM test bands was 100%, and specificity was 95.8% (CI 94.3%-97.3%). All COVID-19 antigen RDTs were correctly read by the app. CONCLUSIONS The proposed reading system is automatic, reducing variability and uncertainty associated with RDTs interpretation and can be used to read different RDT brands. The web platform serves as a real-time epidemiological tracking tool and facilitates reporting of positive RDTs to relevant health authorities.
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Affiliation(s)
| | | | | | - Nuria Pérez-Panizo
- Servicio de Geriatría, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | | | - Lin Lin
- Spotlab, Madrid, Spain.,Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Romero-Hernandez
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Mario Rodriguez-Dominguez
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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17
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Martínez-García L, González-Alba JM, Puerta T, Comunión A, Rodríguez-Jiménez MC, Orviz E, Sánchez-Conde M, Rodríguez-Domínguez M, Cantón R, Galán JC. Specific high-resolution scheme to improve understanding of the spatio-temporal dispersion of lymphogranuloma venereum epidemic. Front Microbiol 2022; 13:1056216. [PMID: 36605505 PMCID: PMC9808035 DOI: 10.3389/fmicb.2022.1056216] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Lymphogranuloma venereum (LGV) is already endemic in vulnerable populations in several European countries; however, molecular epidemiology data with improved accuracy are necessary to better understand LGV epidemic in these countries. Current strategies to study the molecular epidemiology of LGV cases involve schemes based on a few genetic fragments of Chlamydia trachomatis, which have demonstrated limited discriminatory power for LGV. Therefore, this study aimed to propose a new combination of molecular markers based on the most variable genes of L-genotype genomes to improve the characterization of the current LGV epidemic in Madrid, Spain. Methods Four genes were selected according to their diversity index (CTLon_0054, CTLon_0087, CTLon_0243 and CTLon_0301) for use in combination with ompA. In silico and experimental studies were performed to compare the previously described multilocus sequence typing (MLST) schemes with our proposal. Moreover, the proposed scheme was applied (n = 68) to analyze the spatio-temporal spread of the LGV cases. Results Our proposal demonstrated higher diversity allowing the identification of three main groups compared to the previously published MLST based on hypervariable genes wherein only a single sequence type was identified. The temporal analysis showed that the major cluster was progressively diversifying, revealing a very active transmission chain. Furthermore, an L2b genome identical to that of the origin of the epidemic was detected, suggesting reintroductions or a low screening rate in vulnerable populations. The spatial distribution suggests that the selection and spread of new variants occurs from the central district to the peripheral regions. Discussion The scheme proposed in this study has proven to be useful for appropriate discrimination of LGV strains. This study, to our knowledge for the first time, demonstrates a spatio-temporal spread that increases our understanding and identifies areas with special susceptibility for maintenance of the endemic situation of LGV.
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Affiliation(s)
- Laura Martínez-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José María González-Alba
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | | | - María Concepción Rodríguez-Jiménez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Matilde Sánchez-Conde
- Servicio de Enfermedades Infecciosas. Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,*Correspondence: Juan Carlos Galán,
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18
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Pérez-Mies B, Caniego-Casas T, Bardi T, Carretero-Barrio I, Benito A, García-Cosío M, González-García I, Pizarro D, Rosas M, Cristóbal E, Ruano Y, Garrido MC, Rigual-Bobillo J, de Pablo R, Galán JC, Pestaña D, Palacios J. Progression to lung fibrosis in severe COVID-19 patients: A morphological and transcriptomic study in postmortem samples. Front Med (Lausanne) 2022; 9:976759. [PMID: 36405615 PMCID: PMC9669577 DOI: 10.3389/fmed.2022.976759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/17/2022] [Indexed: 09/02/2023] Open
Abstract
The development of lung fibrosis is a major concern in patients recovered from severe COVID-19 pneumonia. This study aimed to document the evolution of diffuse alveolar damage (DAD) to the fibrosing pattern and define the transcriptional programs involved. Morphological, immunohistochemical and transcriptional analysis were performed in lung samples obtained from autopsy of 33 severe COVID-19 patients (median illness duration: 36 days). Normal lung and idiopathic pulmonary fibrosis (IPF) were used for comparison. Twenty-seven patients with DAD and disease evolution of more than 2 weeks had fibrosis. Pathways and genes related with collagen biosynthesis and extracellular matrix (ECM) biosynthesis and degradation, myofibroblastic differentiation and epithelial to mesenchymal transition (EMT) were overexpressed in COVID-19. This pattern had similarities with that observed in IPF. By immunohistochemistry, pathological fibroblasts (pFBs), with CTHRC1 and SPARC expression, increased in areas of proliferative DAD and decreased in areas of mature fibrosis. Immunohistochemical analysis demonstrated constitutive expression of cadherin-11 in normal epithelial cells and a similar pattern of cadherin and catenin expression in epithelial cells from both normal and COVID-19 samples. Transcriptomic analysis revealed downregulation of the Hippo pathway, concordant with the observation of YAP overexpression in hyperplastic alveolar epithelial cells. Progression to fibrosis in severe COVID-19 is associated with overexpression of fibrogenic pathways and increased in CTHRC1- and SPARC-positive pFBs. Whereas the Hippo pathway seemed to be implicated in the response to epithelial cell damage, EMT was not a major process implicated in COVID-19 mediated lung fibrosis.
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Affiliation(s)
- Belén Pérez-Mies
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Tamara Caniego-Casas
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Tommaso Bardi
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Department of Anesthesiology and Surgical Critical Care, Hospital Ramón y Cajal, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Amparo Benito
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Irene González-García
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - David Pizarro
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rosas
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Eva Cristóbal
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Yolanda Ruano
- Department of Pathology, Medical School, Universidad Complutense, Instituto i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - María Concepción Garrido
- Department of Pathology, Medical School, Universidad Complutense, Instituto i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan Rigual-Bobillo
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Department of Respiratory, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Raúl de Pablo
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
- Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Clinical Microbiology Unit, Hospital Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Pestaña
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
- Department of Anesthesiology and Surgical Critical Care, Hospital Ramón y Cajal, Madrid, Spain
| | - José Palacios
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
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19
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Moraleda C, Domínguez-Rodríguez S, Mesa JM, García-Sánchez P, de la Serna M, Alonso-Cadenas JA, Bermejo A, Sabrido G, Martínez-Campos L, González-Posada AF, Illán-Ramos M, Cobos-Carrascosa E, Ballesteros Á, Galán JC, Llorente F, Aguilera-Alonso D, Jiménez AB, Catalán P, Dahdouh E, Navarro I, Fernández-Garoz B, Mendoza P, Pérez-Jorge C, Cabezas-Fernández T, Blázquez-Gamero D, Rivas G, Gonzalez-Donapetry P, Sáez E, Fernández-Pinero J, Lucas-Fernández J, Pérez-Ramírez E, Merino P, Miragaya S, Lorente J, Iglesias I, Tagarro A. Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population. Arch Dis Child 2022; 107:1051-1058. [PMID: 35688603 PMCID: PMC9240444 DOI: 10.1136/archdischild-2021-323712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/12/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. DESIGN Cross-sectional multicentre diagnostic study. SETTING Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. PATIENTS Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. MAIN OUTCOME Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. RESULTS 1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. CONCLUSIONS RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.
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Affiliation(s)
- Cinta Moraleda
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre. Pediatric Research and Clinical Trials Unit (UPIC). RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Sara Domínguez-Rodríguez
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Juan Miguel Mesa
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | - Paula García-Sánchez
- Emergency Pediatric Department. Instituto Investigación Hospital La Paz (IDIPaz), Hospital Universitario La Paz, Madrid, Spain
| | - María de la Serna
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | - José Antonio Alonso-Cadenas
- Emergency Pediatric Department. Instituto Investigación La Princesa, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Amanda Bermejo
- Pediatric Department, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - Gema Sabrido
- Pediatric Department, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Leticia Martínez-Campos
- Pediatric Infectious Diseases, Materno Infantil. Hospital Universitario Torrecárdenas, Almeria, Spain
| | | | - Marta Illán-Ramos
- Pediatrics Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Elena Cobos-Carrascosa
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Álvaro Ballesteros
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Juan Carlos Galán
- Microbiology Department, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Francisco Llorente
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - David Aguilera-Alonso
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario Gregorio Marañón. Unidad de Investigación Maternoinfantil Fundación Familia Alonso (UDIMIFFA), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM). CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ana Belén Jiménez
- Pediatrics Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiologia Clinica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Elias Dahdouh
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz. IdiPAZ, Madrid, Spain
| | - Ignacio Navarro
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | | | - Pablo Mendoza
- Microbiology Department, Hospital Universitario de Móstoles, Mostoles, Madrid, Spain
| | - Concepción Pérez-Jorge
- Microbiology Department, Hospital Universitario Rey Juan Carlos, Mostoles, Madrid, Spain
| | | | - Daniel Blázquez-Gamero
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre. Pediatric Research and Clinical Trials Unit (UPIC). RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Gonzalo Rivas
- Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Elena Sáez
- Microbiology Department, UR Salud. Hospital Universitario Infanta Sofía. Paediatrics Research Group, San Sebastian de los Reyes, Madrid, Spain
| | | | - Jesús Lucas-Fernández
- Microbiology Department, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisa Pérez-Ramírez
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - Paloma Merino
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Sandra Miragaya
- Clinic Analysis Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Jorge Lorente
- Emergency Pediatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Irene Iglesias
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - Alfredo Tagarro
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
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20
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Vivancos-Gallego MJ, Sánchez-Conde M, Rodríguez-Domínguez M, Fernandez-Gonzalez P, Martínez-García L, Garcia-Mouronte E, Martínez-Sanz J, Moreno-Zamora AM, Casado JL, Ron R, Galán JC, Pérez-Elías MJ, Moreno S. Human Monkeypox in People With HIV: Transmission, Clinical Features, and Outcome. Open Forum Infect Dis 2022; 9:ofac557. [PMID: 36381620 PMCID: PMC9664972 DOI: 10.1093/ofid/ofac557] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/18/2022] [Indexed: 07/30/2023] Open
Abstract
We describe the first 25 persons with HIV diagnosed with human monkeypox virus (MPXV) in our hospital in an ongoing outbreak in Spain. Proctitis was the predominant finding in 52%, and MPXV DNA was detected in rectal swabs from 90%. Proctitis and demonstration of MPXV in rectal swabs support the sexual transmission of MPXV.
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Affiliation(s)
- María Jesús Vivancos-Gallego
- Correspondence: Maria J. Vivancos-Gallego, MD, PhD, Department of Infectious Diseases, Hospital U. Ramón y Cajal, Carretera de Colmenar, Km, 9,100, 28034 Madrid, Spain ()
| | | | - Mario Rodríguez-Domínguez
- Department of Microbiology, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERESP, Madrid, Spain
| | | | - Laura Martínez-García
- Department of Microbiology, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERESP, Madrid, Spain
| | | | - Javier Martínez-Sanz
- Department of Infectious Diseases, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERINFEC, Madrid, Spain
| | - Ana María Moreno-Zamora
- Department of Infectious Diseases, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERINFEC, Madrid, Spain
| | - Jose Luis Casado
- Department of Infectious Diseases, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERINFEC, Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERINFEC, Madrid, Spain
| | - Juan Carlos Galán
- Department of Microbiology, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERESP, Madrid, Spain
| | - María Jesús Pérez-Elías
- Department of Infectious Diseases, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
- CIBERINFEC, Madrid, Spain
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21
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Rodríguez-Domínguez M, Casabona J, Galán JC. A challenging future in the sexually transmitted infection diagnostics landscape: Chlamydia trachomatis as model. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:470-472. [PMID: 36336377 DOI: 10.1016/j.eimce.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Casabona
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut Català d'Oncologia, Badalona, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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22
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Pina-Coronado C, Martínez-Sobrino Á, Gutiérrez-Gálvez L, Del Caño R, Martínez-Periñán E, García-Nieto D, Rodríguez-Peña M, Luna M, Milán-Rois P, Castellanos M, Abreu M, Cantón R, Galán JC, Pineda T, Pariente F, Somoza Á, García-Mendiola T, Miranda R, Lorenzo E. Methylene Blue functionalized carbon nanodots combined with different shape gold nanostructures for sensitive and selective SARS-CoV-2 sensing. Sens Actuators B Chem 2022; 369:132217. [PMID: 35755181 PMCID: PMC9212675 DOI: 10.1016/j.snb.2022.132217] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/17/2022] [Accepted: 06/12/2022] [Indexed: 05/20/2023]
Abstract
The development of DNA-sensing platforms based on new synthetized Methylene Blue functionalized carbon nanodots combined with different shape gold nanostructures (AuNs), as a new pathway to develop a selective and sensitive methodology for SARS-CoV-2 detection is presented. A mixture of gold nanoparticles and gold nanotriangles have been synthetized to modify disposable electrodes that act as an enhanced nanostructured electrochemical surface for DNA probe immobilization. On the other hand, modified carbon nanodots prepared a la carte to contain Methylene Blue (MB-CDs) are used as electrochemical indicators of the hybridization event. These MB-CDs, due to their structure, are able to interact differently with double and single-stranded DNA molecules. Based on this strategy, target sequences of the SARS-CoV-2 virus have been detected in a straightforward way and rapidly with a detection limit of 2.00 aM. Moreover, this platform allows the detection of the SARS-CoV-2 sequence in the presence of other viruses, and also a single nucleotide polymorphism (SNPs). The developed approach has been tested directly on RNA obtained from nasopharyngeal samples from COVID-19 patients, avoiding any amplification process. The results agree well with those obtained by RT-qPCR or reverse transcription quantitative polymerase chain reaction technique.
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Affiliation(s)
- Clara Pina-Coronado
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Álvaro Martínez-Sobrino
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Laura Gutiérrez-Gálvez
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Rafael Del Caño
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
- Departamento de Química Física y Termodinámica Aplicada e Instituto Universitario de Nanoquímica, Universidad de Córdoba, Córdoba 14014, Spain
| | - Emiliano Martínez-Periñán
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Daniel García-Nieto
- Instituto de Micro y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, Madrid 28760, Spain
| | - Micaela Rodríguez-Peña
- Instituto de Micro y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, Madrid 28760, Spain
| | - M Luna
- Instituto de Micro y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, Madrid 28760, Spain
| | - Paula Milán-Rois
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
| | | | - Melanie Abreu
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid 28034, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid 28034, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid 28034, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Teresa Pineda
- Departamento de Química Física y Termodinámica Aplicada e Instituto Universitario de Nanoquímica, Universidad de Córdoba, Córdoba 14014, Spain
| | - Félix Pariente
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Álvaro Somoza
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
| | - Tania García-Mendiola
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
- Institute for Advanced Research in Chemical Sciences (IAdChem), Ciudad Universitaria de Cantoblanco, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Rodolfo Miranda
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
| | - Encarnación Lorenzo
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, Madrid 28049, Spain
- Institute for Advanced Research in Chemical Sciences (IAdChem), Ciudad Universitaria de Cantoblanco, Universidad Autónoma de Madrid, Madrid 28049, Spain
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
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23
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Kaci K, Del Caño R, Luna M, Milán-Rois P, Castellanos M, Abreu M, Cantón R, Galán JC, Somoza Á, Miranda R, González de Rivera G, García-Mendiola T, Lorenzo E. Paving the way to point of care (POC) devices for SARS-CoV-2 detection. Talanta 2022; 247:123542. [PMID: 35609482 PMCID: PMC9116970 DOI: 10.1016/j.talanta.2022.123542] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 01/12/2023]
Abstract
In this work we present a powerful, affordable, and portable biosensor to develop Point of care (POC) SARS-CoV-2 virus detection. It is constructed from a fast, low cost, portable and electronically automatized potentiostat that controls the potential applied to a disposable screen-printed electrochemical platform and the current response. The potentiostat was designed to get the best signal-to-noise ratio, a very simple user interface offering the possibility to be used by any device (computer, mobile phone or tablet), to have a small and portable size, and a cheap manufacturing cost. Furthermore, the device includes as main components, a data acquisition board, a controller board and a hybridization chamber with a final size of 10 × 8 × 4 cm. The device has been tested by detecting specific SARS-CoV-2 virus sequences, reaching a detection limit of 22.1 fM. Results agree well with those obtained using a conventional potentiostat, which validate the device and pave the way to the development of POC biosensors. In this sense, the device has finally applied to directly detect the presence of the virus in nasopharyngeal samples of COVID-19 patients and results confirm its utility for the rapid detection infected samples avoiding any amplification process.
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Affiliation(s)
- Karim Kaci
- HCTLab - Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - Rafael Del Caño
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, 28049, Madrid, Spain; Departamento de Química Física y Termodinámica Aplicada e Instituto Universitario de Nanoquímica, Universidad de Córdoba, 14014, Córdoba, Spain
| | - Mónica Luna
- Instituto de Micro y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, 28760, Madrid, Spain
| | - Paula Milán-Rois
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | | | - Melanie Abreu
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Álvaro Somoza
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Rodolfo Miranda
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | | | - Tania García-Mendiola
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain.
| | - Encarnación Lorenzo
- Departamento de Química Analítica y Análisis Instrumental, Universidad Autónoma de Madrid, 28049, Madrid, Spain; IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, 28049, Madrid, Spain
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24
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Romero-Hernández B, Martínez-García L, Rodríguez-Dominguez M, Martínez-Sanz J, Vélez-Díaz-Pallarés M, Pérez Mies B, Muriel A, Gea F, Pérez-Elías MJ, Galán JC. The Negative Impact of COVID-19 in HCV, HIV, and HPV Surveillance Programs During the Different Pandemic Waves. Front Public Health 2022; 10:880435. [PMID: 35937266 PMCID: PMC9353175 DOI: 10.3389/fpubh.2022.880435] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has been a worldwide stress test for health systems. 2 years have elapsed since the description of the first cases of pneumonia of unknown origin. This study quantifies the impact of COVID-19 in the screening program of chronic viral infections such as human papillomavirus (HPV), human immunodeficiency virus (HIV), and hepatitis C virus (HCV) along the six different pandemic waves in our population. Each wave had particular epidemiological, biological, or clinical patterns.MethodsWe analyzed the number of samples for screening of these viruses from March 2020 to February 2022, the new infections detected in the pandemic period compared to the previous year, the time elapsed between diagnosis and linking to treatment and follow-up of patients, and the percentage of late HIV diagnosis. Moreover, we used the origin of the samples as a marker for quantifying the restoration of activity in primary care.ResultsDuring the first pandemic year, the number of samples received was reduced by 26.7, 22.6, and 22.5% for molecular detection of HPV or serological HCV and HIV status respectively. The highest decrease was observed during the first wave with 70, 40, and 26.7% for HPV, HCV, and HIV. As expected, new diagnoses also decreased by 35.4, 58.2, and 40.5% for HPV, HCV, and HIV respectively during the first year of the pandemic. In the second year of the pandemic, the number of samples remained below pre-pandemic period levels for HCV (−3.6%) and HIV (−9.3%) but was slightly higher for HPV (8.0%). The new diagnoses in the second year of the pandemic were −16.1, −46.8, and −18.6% for HPV, HCV, and HIV respectively.ConclusionsUndoubtedly, an important number of new HPV, HCV, and HIV infections were lost during the COVID-19 pandemic, and surveillance programs were disrupted as a consequence of collapse of the health system. It is a priority to reinforce these surveillance programs as soon as possible in order to detect undiagnosed cases before the associated morbidity-mortality increases. New pandemic waves could increase the risk of reversing the achievements made over the last few decades.
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Affiliation(s)
- Beatriz Romero-Hernández
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Martínez-García
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mario Rodríguez-Dominguez
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Javier Martínez-Sanz
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Madrid, Spain
| | | | - Belen Pérez Mies
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A. Muriel
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Universidad de Alcalá, Madrid, Spain
| | - Francisco Gea
- Liver Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBER of Liver and Digestive Diseases (CIBEREHD), Madrid, Spain
| | - María Jesús Pérez-Elías
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Juan Carlos Galán
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- *Correspondence: Juan Carlos Galán
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Ruz-Caracuel I, Pian-Arias H, Corral Í, Carretero-Barrio I, Bueno-Sacristán D, Pérez-Mies B, García-Cosío M, Caniego-Casas T, Pizarro D, García-Narros MI, Piris-Villaespesa M, Pestaña D, de Pablo R, Galán JC, Masjuan J, Palacios J. Neuropathological findings in fatal COVID-19 and their associated neurological clinical manifestations. Pathology 2022; 54:738-745. [PMID: 35691726 PMCID: PMC9182090 DOI: 10.1016/j.pathol.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 12/19/2022]
Abstract
Severe cases of Coronavirus Disease 2019 (COVID-19) can present with multiple neurological symptoms. The available neuropathological studies have described different lesions; the most frequent was the presence of neuroinflammation and vascular-related lesions. The objective of this study was to report the neuropathological studies performed in a medical institution, with abundant long intensive care unit stays, and their associated clinical manifestations. This is a retrospective monocentric case series study based on the neuropathological reports of 13 autopsies with a wide range of illness duration (13–108 days). A neuroinflammatory score was calculated based on the quantification of CD8- and CD68-positive cells in representative areas of the central nervous system. This score was correlated afterwards with illness duration and parameters related to systemic inflammation. Widespread microglial and cytotoxic T-cell activation was found in all patients. There was no correlation between the neuroinflammatory score and the duration of the illness; nor with parameters of systemic inflammation such as the peak of IL-6 or the HScore (a parameter of systemic macrophage activation syndrome). Two patients had global hypoxic ischaemic damage and five patients had subacute infarcts. One patient had many more brain vascular microthrombi compared to the others and multiple subacute pituitary infarcts. SARS-CoV-2 RNA was not detected with qRT-PCR. The proportion of brain lesions in severe COVID-19 patients could be related to illness duration. In our series, with abundant long hospitalisation stays, neuroinflammation was present in all patients and was more prominent between day 34 and day 45 after onset of symptoms. Clinical correlation showed that two patients with the highest neuroinflammatory scores had severe encephalopathies that were not attributable to any other cause. The second most frequent lesions were related to vascular pathology.
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Affiliation(s)
| | - Héctor Pian-Arias
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Íñigo Corral
- Neurology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain
| | | | - Belén Pérez-Mies
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain
| | - Tamara Caniego-Casas
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; CIBERONC, Madrid, Spain
| | - David Pizarro
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | | | | | - David Pestaña
- Universidad de Alcalá de Henares, Madrid, Spain; Anesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl de Pablo
- Universidad de Alcalá de Henares, Madrid, Spain; Department of Intensive Care Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Juan Carlos Galán
- Clinical Microbiology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; CIBERESP, Madrid, Spain
| | - Jaime Masjuan
- Neurology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain.
| | - José Palacios
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain.
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26
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Rodríguez Díaz C, Lafuente-Gómez N, Coutinho C, Pardo D, Alarcón-Iniesta H, López-Valls M, Coloma R, Milán-Rois P, Domenech M, Abreu M, Cantón R, Galán JC, Bocanegra R, Campos LA, Miranda R, Castellanos M, Somoza Á. Development of colorimetric sensors based on gold nanoparticles for SARS-CoV-2 RdRp, E and S genes detection. Talanta 2022; 243:123393. [PMID: 35325745 PMCID: PMC8923713 DOI: 10.1016/j.talanta.2022.123393] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/20/2022]
Abstract
We present a fast, reliable and easy to scale-up colorimetric sensor based on gold nanoparticles (AuNPs) to detect the sequences coding for the RdRp, E, and S proteins of SARS-CoV-2. The optimization of the system (so-called “the sensor”) includes the evaluation of different sizes of nanoparticles, sequences of oligonucleotides and buffers. It is stable for months without any noticeable decrease in its activity, allowing the detection of SARS-CoV-2 sequences by the naked eye in 15 min. The efficiency and selectivity of detection, in terms of significative colorimetric changes in the solution upon target recognition, are qualitatively (visually) and quantitatively (absorbance measurements) assessed using synthetic samples and samples derived from infected cells and patients. Furthermore, an easy and affordable amplification approach is implemented to increase the system's sensitivity for detecting high and medium viral loads (≥103 - 104 viral RNA copies/μl) in patient samples. The whole process (amplification and detection) takes 2.5 h. Due to the ease of use, stability and minimum equipment requirements, the proposed approach can be a valuable tool for the detection of SARS-CoV-2 at facilities with limited resources.
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27
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Muñoz-Chimeno M, Bartúren S, García-Lugo MA, Morago L, Rodríguez Á, Galán JC, Pérez-Rivilla A, Rodríguez M, Millán R, Del Álamo M, Alonso R, Molina L, Aguinaga A, Avellón A. Hepatitis E virus genotype 3 microbiological surveillance by the Spanish Reference Laboratory: geographic distribution and phylogenetic analysis of subtypes from 2009 to 2019. Euro Surveill 2022; 27. [PMID: 35686567 PMCID: PMC9198656 DOI: 10.2807/1560-7917.es.2022.27.23.2100542] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Hepatitis E virus genotype 3 (HEV-3) is widely distributed throughout Europe, with incidence of infections increasing in many countries. Belgium, Bulgaria, France, Germany, Italy, the Netherlands and the United Kingdom have reported the distribution of HEV-3 subtypes in cohorts of patients with hepatic disease. Aim To describe the distribution of the HEV-3 subtypes in Spain at national and autonomous community (AC) levels between 2009 and 2019. The study was also extended to Andorra. Methods Of 5,197 samples received by the National Reference Laboratory during the study, 409 were HEV-RNA-positive. Among these, 294 (71.9%) were further typed based on an ORF2 sequence fragment, or, for a subset of 74, based on the full-coding genome sequence. Results HEV-3 was detected in 291 samples. The dominant subtype in Spain was HEV-3f (88.3%; 257/291), which occurred in all ACs, with no change in detection level over time. Within this subtype, three subclusters were characterised: HEV-3f-B, HEV-3f-A1 and HEV-3f-A2. The second most common HEV subtype was the recently described HEV-3m (7%; 21/291), with two subclusters identified: HEV-3m-A, which has been known since 2010, and HEV-3m-B, since 2014. The third most encountered subtype was HEV-3c (4.1%; 12/291), with a frequency not increasing over time, unlike observations in some European countries. Conclusion The importance of the surveillance of HEV-3 subtype and subcluster circulation is yet to be assessed. This surveillance together with the comprehensive epidemiological characterisation of clinical cases, could support the identification of sources of transmission and the establishment of control measures nationally and internationally.
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Affiliation(s)
- Milagros Muñoz-Chimeno
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Silvia Bartúren
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | | | - Lucia Morago
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Álvaro Rodríguez
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Juan Carlos Galán
- CIBERESP, Madrid, Spain.,Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Mercedes Rodríguez
- Hospital Universitario Central de Asturias, Grupo de Microbiología Traslacional (ISPA) Oviedo, Asturias, Spain
| | - Rosario Millán
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Roberto Alonso
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Laura Molina
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Ana Avellón
- CIBERESP, Madrid, Spain.,Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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28
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Rodríguez-Domínguez M, Casabona J, Galán JC. A challenging future in the sexually transmitted infection diagnostics landscape: Chlamydia trachomatis as model. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Galán JC, Cantón R. New variants in SARS-CoV-2: What are we learning from the Omicron variant? Arch Bronconeumol 2022; 58 Suppl 1:3-5. [PMID: 35491286 PMCID: PMC9012506 DOI: 10.1016/j.arbres.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022]
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30
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López-Pintor JM, Martínez-García L, Maruri A, Menéndez B, Puerta T, Rodríguez C, González-Alba JM, Rodríguez-Domínguez M, Galán JC. Quantification of plasmid copy number as surrogate marker of virulence among different invasive and non-invasive genotypes of Chlamydia trachomatis. Diagn Microbiol Infect Dis 2022; 102:115610. [DOI: 10.1016/j.diagmicrobio.2021.115610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 02/04/2023]
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31
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Del Caño R, García-Mendiola T, García-Nieto D, Álvaro R, Luna M, Iniesta HA, Coloma R, Diaz CR, Milán-Rois P, Castellanos M, Abreu M, Cantón R, Galán JC, Pineda T, Pariente F, Miranda R, Somoza Á, Lorenzo E. Amplification-free detection of SARS-CoV-2 using gold nanotriangles functionalized with oligonucleotides. Mikrochim Acta 2022; 189:171. [PMID: 35364748 PMCID: PMC8974806 DOI: 10.1007/s00604-022-05272-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 01/24/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022]
Abstract
Gold nanotriangles (AuNTs) functionalized with dithiolated oligonucleotides have been employed to develop an amplification-free electrochemical biosensor for SARS-CoV-2 in patient samples. Gold nanotriangles, prepared through a seed-mediated growth method and exhaustively characterized by different techniques, serve as an improved electrochemical platform and for DNA probe immobilization. Azure A is used as an electrochemical indicator of the hybridization event. The biosensor detects either single stranded DNA or RNA sequences of SARS-CoV-2 of different lengths, with a low detection limit of 22.2 fM. In addition, it allows to detect point mutations in SARS-CoV-2 genome with the aim to detect more infective SARS-CoV-2 variants such as Alpha, Beta, Gamma, Delta, and Omicron. Results obtained with the biosensor in nasopharyngeal swab samples from COVID-19 patients show the possibility to clearly discriminate between non-infected and infected patient samples as well as patient samples with different viral load. Furthermore, the results correlate well with those obtained by the gold standard technique RT-qPCR, with the advantage of avoiding the amplification process and the need of sophisticated equipment.
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Affiliation(s)
- Rafael Del Caño
- Departamento de Química Analítica, Universidad Autónoma de Madrid, 28049, Madrid, Spain.,Departamento de Química Física Y Termodinámica Aplicada e Instituto Universitario de Nanoquímica, Universidad de Córdoba, 14014, Córdoba, Spain
| | - Tania García-Mendiola
- Departamento de Química Analítica, Universidad Autónoma de Madrid, 28049, Madrid, Spain. .,Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain.
| | - Daniel García-Nieto
- Instituto de Micro Y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, 28760, Madrid, Spain
| | - Raquel Álvaro
- Instituto de Micro Y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, 28760, Madrid, Spain
| | - Mónica Luna
- Instituto de Micro Y Nanotecnología IMN-CNM, CSIC (CEI UAM+CSIC), Isaac Newton 8, Tres Cantos, 28760, Madrid, Spain
| | | | - Rocío Coloma
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Ciro Rodríguez Diaz
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Paula Milán-Rois
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | | | - Melanie Abreu
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBER) en Epidemiología Y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Pineda
- Departamento de Química Física Y Termodinámica Aplicada e Instituto Universitario de Nanoquímica, Universidad de Córdoba, 14014, Córdoba, Spain
| | - Félix Pariente
- Departamento de Química Analítica, Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - Rodolfo Miranda
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Álvaro Somoza
- IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Encarnación Lorenzo
- Departamento de Química Analítica, Universidad Autónoma de Madrid, 28049, Madrid, Spain. .,Institute for Advanced Research in Chemical Sciences (IAdChem), Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain. .,IMDEA-Nanociencia, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain.
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32
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Aranaz-Andrés JM, Chávez ACF, Laso AM, Abreu M, Núñez PM, Galán JC, Moreno RC. Analysis of the diagnostic accuracy of rapid antigenic tests for detection of SARS-CoV-2 in hospital outbreak situation. Eur J Clin Microbiol Infect Dis 2022; 41:305-312. [PMID: 34792699 PMCID: PMC8600491 DOI: 10.1007/s10096-021-04346-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022]
Abstract
The reverse transcriptase polymerase chain reaction (RT-PCR) continues to be the reference diagnostic method for the confirmation of COVID-19 cases; however, rapid antigen detection tests (RADT) have recently been developed. The purpose of the study is to assess the performance of rapid antigen-based COVID-19 testing in the context of hospital outbreaks. This was an observational, cross-sectional study. The study period was from October 2020 to January 2021. The "Panbio COVID-19 AG" RADT (Abbott) was performed and TaqPath COVID-19 test RT-PCR. The samples were obtained from hospitalised patients in suspected outbreak situations at the Ramón y Cajal Hospital. A hospital outbreak was defined as the presence of 3 or more epidemiologically linked cases. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the RADT were calculated using RT-PCR as a reference. A total of 17 hospital outbreaks were detected in 11 hospital units during the study period, in which 34 RT-PCR and RADT screenings were performed. We obtained 541 samples, which were analysed with RT-PCR and a further 541 analysed with RADT. Six RADT tests gave conflicting results with the RT-PCR, 5 of them with a negative RADT and positive RT-PCR and one with positive RADT and a negative RT-PCR. The sensitivity of the RADT was 83.3% (65.3-94.4%) and the specificity was 99.8% (98.9-100%). The PPV was 96.2% (80.4-99.9%) and the NPV was 99% (97.7-99.7%). The RADT shows good diagnostic performance in patients on non-COVID-19 hospital wards, in the context of an outbreak.
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Affiliation(s)
- Jesús María Aranaz-Andrés
- Preventive Medicine and Public Health, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Universidad Internacional de La Rioja (UNIR), Logroño, Spain
| | - Abelardo Claudio Fernández Chávez
- Preventive Medicine and Public Health, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Amaranta McGee Laso
- Preventive Medicine and Public Health, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
| | - Melanie Abreu
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Paloma Moreno Núñez
- Preventive Medicine and Public Health, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán
- CIBER Epidemiología Y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Cantón Moreno
- Servicio de Microbiología, Hospital Universitario Ramón Y Cajal and Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
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33
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Baquero F, Martínez JL, Novais Â, Rodríguez-Beltrán J, Martínez-García L, Coque TM, Galán JC. Allogenous Selection of Mutational Collateral Resistance: Old Drugs Select for New Resistance Within Antibiotic Families. Front Microbiol 2021; 12:757833. [PMID: 34745065 PMCID: PMC8569428 DOI: 10.3389/fmicb.2021.757833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/05/2021] [Indexed: 11/22/2022] Open
Abstract
Allogeneous selection occurs when an antibiotic selects for resistance to more advanced members of the same family. The mechanisms of allogenous selection are (a) collateral expansion, when the antibiotic expands the gene and gene-containing bacterial populations favoring the emergence of other mutations, inactivating the more advanced antibiotics; (b) collateral selection, when the old antibiotic selects its own resistance but also resistance to more modern drugs; (c) collateral hyper-resistance, when resistance to the old antibiotic selects in higher degree for populations resistant to other antibiotics of the family than to itself; and (d) collateral evolution, when the simultaneous or sequential use of antibiotics of the same family selects for new mutational combinations with novel phenotypes in this family, generally with higher activity (higher inactivation of the antibiotic substrates) or broader spectrum (more antibiotics of the family are inactivated). Note that in some cases, collateral selection derives from collateral evolution. In this article, examples of allogenous selection are provided for the major families of antibiotics. Improvements in minimal inhibitory concentrations with the newest drugs do not necessarily exclude “old” antibiotics of the same family of retaining some selective power for resistance to the newest agents. If this were true, the use of older members of the same drug family would facilitate the emergence of mutational resistance to the younger drugs of the family, which is frequently based on previously established resistance traits. The extensive use of old drugs (particularly in low-income countries and in farming) might be significant for the emergence and selection of resistance to the novel members of the family, becoming a growing source of variation and selection of resistance to the whole family. In terms of future research, it could be advisable to focus antimicrobial drug discovery more on the identification of new targets and new (unique) classes of antimicrobial agents, than on the perpetual chemical exploitation of classic existing ones.
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Affiliation(s)
- Fernando Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research (IRYCIS), Network Center for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José L Martínez
- Department of Microbial Biotechnology, National Center for Biotechnology (CNB-CSIC), Madrid, Spain
| | - Ângela Novais
- UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Jerónimo Rodríguez-Beltrán
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research (IRYCIS), Network Center for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Martínez-García
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research (IRYCIS), Network Center for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Teresa M Coque
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research (IRYCIS), Network Center for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Institute for Health Research (IRYCIS), Network Center for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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34
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Ferrer-Gómez A, Pian-Arias H, Carretero-Barrio I, Navarro-Cantero A, Pestaña D, de Pablo R, Zamorano JL, Galán JC, Pérez-Mies B, Ruz-Caracuel I, Palacios J. Late Cardiac Pathology in Severe Covid-19. A Postmortem Series of 30 Patients. Front Cardiovasc Med 2021; 8:748396. [PMID: 34722679 PMCID: PMC8555828 DOI: 10.3389/fcvm.2021.748396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/22/2021] [Indexed: 01/08/2023] Open
Abstract
The role of SARS-CoV-2 as a direct cause in the cardiac lesions in patients with severe COVID-19 remains to be established. Our objective is to report the pathological findings in cardiac samples of 30 patients who died after a prolonged hospital stay due to Sars-Cov-2 infection. We performed macroscopic, histological and immunohistochemical analysis of the hearts of 30 patients; and detected Sars-Cov-2 RNA by RT-PCR in the cardiac tissue samples. The median age of our cohort was 69.5 years and 76.6% were male. The median time between symptoms onset and death was 36.5 days. The main comorbidities were arterial hypertension (13 patients, 43.3%), dyslipidemia (11 patients, 36.7%), cardiovascular conditions (8 patients, 26.7%), and obesity (8 patients, 26.7%). Cardiovascular conditions included ischemic cardiopathy in 4 patients (13.3%), hypertrophic cardiomyopathy in 2 patients (6.7%) and valve replacement and chronic heart failure in one patient each (3.3%). At autopsy, the most frequent histopathological findings were coronary artery atherosclerosis (8 patients, 26.7%), left ventricular hypertrophy (4 patients, 13.3%), chronic epicardial inflammation (3 patients, 10%) and adipose metaplasia (2 patients, 6.7%). Two patients showed focal myocarditis, one due to invasive aspergillosis. One additional patient showed senile amyloidosis. Sars-Cov-2 RNA was detected in the heart of only one out of 30 patients, who had the shortest disease evolution of the series (9 days). However, no relevant cardiac histological alterations were identified. In present series, cardiac pathology was only modest in most patients with severe COVID-19. At present, the contribution of a direct effect of SARS-CoV-2 on cardiac lesions remains to be established.
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Affiliation(s)
- Ana Ferrer-Gómez
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Héctor Pian-Arias
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Antonia Navarro-Cantero
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - David Pestaña
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Anaesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Raúl de Pablo
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Medical Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - José Luis Zamorano
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Ruz-Caracuel
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - José Palacios
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
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Campos M, Sempere JM, Galán JC, Moya A, Llorens C, de-Los-Angeles C, Baquero-Artigao F, Cantón R, Baquero F. Simulating the impact of non-pharmaceutical interventions limiting transmission in COVID-19 epidemics using a membrane computing model. ACTA ACUST UNITED AC 2021; 2:uqab011. [PMID: 34642663 PMCID: PMC8499911 DOI: 10.1093/femsml/uqab011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
Epidemics caused by microbial organisms are part of the natural phenomena of increasing biological complexity. The heterogeneity and constant variability of hosts, in terms of age, immunological status, family structure, lifestyle, work activities, social and leisure habits, daily division of time and other demographic characteristics make it extremely difficult to predict the evolution of epidemics. Such prediction is, however, critical for implementing intervention measures in due time and with appropriate intensity. General conclusions should be precluded, given that local parameters dominate the flow of local epidemics. Membrane computing models allows us to reproduce the objects (viruses and hosts) and their interactions (stochastic but also with defined probabilities) with an unprecedented level of detail. Our LOIMOS model helps reproduce the demographics and social aspects of a hypothetical town of 10 320 inhabitants in an average European country where COVID-19 is imported from the outside. The above-mentioned characteristics of hosts and their lifestyle are minutely considered. For the data in the Hospital and the ICU we took advantage of the observations at the Nursery Intensive Care Unit of the Consortium University General Hospital, Valencia, Spain (included as author). The dynamics of the epidemics are reproduced and include the effects on viral transmission of innate and acquired immunity at various ages. The model predicts the consequences of delaying the adoption of non-pharmaceutical interventions (between 15 and 45 days after the first reported cases) and the effect of those interventions on infection and mortality rates (reducing transmission by 20, 50 and 80%) in immunological response groups. The lockdown for the elderly population as a single intervention appears to be effective. This modeling exercise exemplifies the application of membrane computing for designing appropriate multilateral interventions in epidemic situations.
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Affiliation(s)
- M Campos
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - J M Sempere
- Valencian Research Institute for Artificial Intelligence (VRAIN), Universitat Politècnica de Valencia, Camí de Vera s/n, 46022 Valencia, Spain
| | - J C Galán
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - A Moya
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, M-607, km 9,1. 28034 Madrid, Spain
| | - C Llorens
- Biotechvana, Valencia, CEEI Building, Valencia Technological Park., C. agustín Escardino 9, 46980, Paterna, Valencia, Spain
| | - C de-Los-Angeles
- Nursery Unit, Intensive Care Unit and Pain Therapy, Consortium University General Hospital (CHGUV)., Av. Tres Cruces 2, 46014 Valencia, Spain
| | - F Baquero-Artigao
- Department of Infectious Diseases and Tropical Pediatrics, La Paz University Hospital., Av. Monforte de Lemos 2D, 28029 Madrid, Spain
| | - R Cantón
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - F Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
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36
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Hernández-Aguado JJ, de La Fuente-Valero J, Ramírez Mena M, Ortega-Medina L, Vidart Aragón JA, Galán JC. Comparative pilot study about HPV test with partial genotyping in primary screening versus other strategies for cervical cancer population screening, CRYGEN 16/18 study. Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00231-7. [PMID: 34404547 DOI: 10.1016/j.eimc.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The early detection of cervical cancer requires the implementation of molecular screening programs for human papillomavirus (HPV). However, there are discrepancies in the optimization of screening protocols. The performance of 10 primary screening strategies based on molecular, cytological or combined techniques is now evaluated. MATERIAL AND METHODS A blind, prospective, and interventional study was designed in 1977 35-year-old women. The molecular determination was carried out by the Cobas 4800 HPV platform. Cytological analysis was performed on the same samples without knowledge of the result of the molecular assay. All women in whom HPV-16/HPV-18 was detected or presented cytological alteration together with detection of other high-risk genotypes (HPVhr) were referred to colposcopy. RESULTS The molecular assay detected the presence of HPVhr genotypes in 12.5% of the women, while only 8.1% of the cytologies were pathological. Among the patients referred to colposcopy, in 19.5% high-grade lesions were observed, being HPV-16 present in 65.3% of them. In six of these high-grade lesions (associated with HPV-16 in all cases), cytology was reported as normal. The follow-up one year later, of women with normal cytology and HPVhr detection a HSIL/CIN2+ lesion was detected (associated to HPV-33). In the comparative study with other strategies, the protocol called CRYGEN 16/18 yielded the best balance of sensitivity and specificity with the least referral to colposcopy. CONCLUSIONS Performing molecular detection of HPVhr with partial first-line genotyping of at least HPV-16, with direct referral to colposcopy, increases the detection rate of HSIL/CIN2+ lesions.
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Affiliation(s)
| | | | - Mar Ramírez Mena
- Servicio de Ginecología, Hospital Universitario Clínico San Carlos, Madrid, España
| | - Luis Ortega-Medina
- Servicio de Anatomía Patológica, Hospital Universitario Clínico San Carlos, Madrid, España
| | | | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, España; CIBER Epidemiología Salud Pública (CIBERESP), Madrid, España.
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37
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Seth-Smith HMB, Bénard A, Bruisten SM, Versteeg B, Herrmann B, Kok J, Carter I, Peuchant O, Bébéar C, Lewis DA, Puerta T, Keše D, Balla E, Zákoucká H, Rob F, Morré SA, de Barbeyrac B, Galán JC, de Vries HJC, Thomson NR, Goldenberger D, Egli A. Ongoing evolution of Chlamydia trachomatis lymphogranuloma venereum: exploring the genomic diversity of circulating strains. Microb Genom 2021; 7. [PMID: 34184981 PMCID: PMC8461462 DOI: 10.1099/mgen.0.000599] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lymphogranuloma venereum (LGV), the invasive infection of the sexually transmissible infection (STI) Chlamydia trachomatis, is caused by strains from the LGV biovar, most commonly represented by ompA-genotypes L2b and L2. We investigated the diversity in LGV samples across an international collection over seven years using typing and genome sequencing. LGV-positive samples (n=321) from eight countries collected between 2011 and 2017 (Spain n=97, Netherlands n=67, Switzerland n=64, Australia n=53, Sweden n=37, Hungary n=31, Czechia n=30, Slovenia n=10) were genotyped for pmpH and ompA variants. All were found to contain the 9 bp insertion in the pmpH gene, previously associated with ompA-genotype L2b. However, analysis of the ompA gene shows ompA-genotype L2b (n=83), ompA-genotype L2 (n=180) and several variants of these (n=52; 12 variant types), as well as other/mixed ompA-genotypes (n=6). To elucidate the genomic diversity, whole genome sequencing (WGS) was performed from selected samples using SureSelect target enrichment, resulting in 42 genomes, covering a diversity of ompA-genotypes and representing most of the countries sampled. A phylogeny of these data clearly shows that these ompA-genotypes derive from an ompA-genotype L2b ancestor, carrying up to eight SNPs per isolate. SNPs within ompA are overrepresented among genomic changes in these samples, each of which results in an amino acid change in the variable domains of OmpA (major outer membrane protein, MOMP). A reversion to ompA-genotype L2 with the L2b genomic backbone is commonly seen. The wide diversity of ompA-genotypes found in these recent LGV samples indicates that this gene is under immunological selection. Our results suggest that the ompA-genotype L2b genomic backbone is the dominant strain circulating and evolving particularly in men who have sex with men (MSM) populations.
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Affiliation(s)
- Helena M B Seth-Smith
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Angèle Bénard
- Present address: Healthcare Systems Research Group, VHIR, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Wellcome Trust Sanger Institute, Cambridge, UK
| | - Sylvia M Bruisten
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AII), Location Academic Medical Centre, Amsterdam, The Netherlands
| | - Bart Versteeg
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Björn Herrmann
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Olivia Peuchant
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - Cécile Bébéar
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - David A Lewis
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Teresa Puerta
- Unidad de ITS/VIH, Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Darja Keše
- University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
| | - Eszter Balla
- Bacterial STI Reference Laboratory, National Public Health Center (former National Center for Epidemiology), Budapest, Hungary
| | - Hana Zákoucká
- National Reference Laboratory for Diagnostics of Syphilis and Chlamydia Infections, National Institute of Public Health, Srobarova 48, 100 42, Prague 10, Czech Republic
| | - Filip Rob
- Department of Dermatovenereology, Second Faculty of Medicine, Charles University and Hospital Bulovka, Budinova 2, 180 81, Prague 8, Czech Republic
| | - Servaas A Morré
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, The Netherlands
| | - Bertille de Barbeyrac
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. CIBER en Epidemiología y Salud Pública (CIBERESP)
| | - Henry J C de Vries
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AII), Location Academic Medical Centre, Amsterdam, The Netherlands
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute, Cambridge, UK.,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Goldenberger
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
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Martínez-García L, Rodríguez-Domínguez M, Lejarraga C, Rodríguez-Jiménez MC, González-Alba JM, Puerta T, Sánchez-Conde M, Hermida JM, Romero-Hernández B, Galán JC. The silent epidemic of lymphogranuloma venereum inside the COVID-19 pandemic in Madrid, Spain, March 2020 to February 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 33960288 PMCID: PMC8103729 DOI: 10.2807/1560-7917.es.2021.26.18.2100422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Despite social distancing measures implemented in Madrid to prevent the propagation of SARS-CoV-2, a significant increase (57.1%; 28.5 to 38.5 cases/month) in cases of lymphogranuloma venereum was detected during the COVID-19 pandemic. This unusual scenario might have accelerated a shift in Chlamydia trachomatis (CT) epidemiology towards a higher proportion of L genotypes compared with non-L genotypes in CT-positive samples. Our data underscore the importance of surveillance of sexually transmitted infections during the pandemic, in particular among vulnerable populations.
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Affiliation(s)
- Laura Martínez-García
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Clara Lejarraga
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - María Concepción Rodríguez-Jiménez
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José María González-Alba
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Matilde Sánchez-Conde
- Servicio de Enfermedades Infecciosas. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José Manuel Hermida
- Servicio de Enfermedades Infecciosas. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Beatriz Romero-Hernández
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
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39
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Rodríguez-Domínguez M, Romero-Hernández B, Marcos-Mencía D, Fernandez-Escribano M, Ferré-Masferrer M, Galán JC, Cantón R. SARS-CoV-2 antibodies and utility of point of care testing in Health Care Workers from a spanish University Hospital in Madrid. Clin Microbiol Infect 2021; 27:1067-1068. [PMID: 33813128 PMCID: PMC8015375 DOI: 10.1016/j.cmi.2021.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Beatriz Romero-Hernández
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Daniel Marcos-Mencía
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | | | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Spain
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40
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Pérez-Mies B, Gómez-Rojo M, Carretero-Barrio I, Bardi T, Benito A, García-Cosío M, Caballero Á, de Pablo R, Galán JC, Pestaña D, Palacios J. Pulmonary vascular proliferation in patients with severe COVID-19: an autopsy study. Thorax 2021; 76:1044-1046. [PMID: 33758071 PMCID: PMC7992389 DOI: 10.1136/thoraxjnl-2020-216714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
Diffuse alveolar damage and thrombi are the most common lung histopathological lesions reported in patients with severe COVID-19. Although some studies have suggested increased pulmonary angiogenesis, the presence of vascular proliferation in COVID-19 lungs has not been well characterised. Glomeruloid-like microscopic foci and/or coalescent vascular proliferations measuring up to 2 cm were present in the lung of 14 out of 16 autopsied patients. These lesions expressed CD31, CD34 and vascular endothelial cadherin. Platelet-derived growth factor receptor-β immunohistochemistry and dual immunostaining for CD34/smooth muscle actin demonstrated the presence of pericytes. These vascular alterations may contribute to the severe and refractory hypoxaemia that is common in patients with severe COVID-19.
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Affiliation(s)
- Belén Pérez-Mies
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,CIBERONC, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - María Gómez-Rojo
- Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | | | - Tommaso Bardi
- Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Amparo Benito
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - Álvaro Caballero
- Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Raul de Pablo
- Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain.,Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,Clinical Microbiology Unit, Hospital Ramón y Cajal, Madrid, Spain.,CIBERESP, Madrid, Spain
| | - David Pestaña
- Universidad de Alcala de Henares, Madrid, Spain.,Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Jose Palacios
- Pathology, Hospital Ramón y Cajal, Madrid, Spain .,Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,CIBERONC, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
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41
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Abstract
Niches are spaces for the biological units of selection, from cells to complex communities. In a broad sense, "species" are biological units of individuation. Niches do not exist without individual organisms, and every organism has a niche. We use "niche" in the Hutchinsonian sense as an abstraction of a multidimensional environmental space characterized by a variety of conditions, both biotic and abiotic, whose quantitative ranges determine the positive or negative growth rates of the microbial individual, typically a species, but also parts of the communities of species contained in this space. Microbial organisms ("species") constantly diversify, and such diversification (radiation) depends on the possibility of opening up unexploited or insufficiently exploited niches. Niche exploitation frequently implies "niche construction," as the colonized niche evolves with time, giving rise to new potential subniches, thereby influencing the selection of a series of new variants in the progeny. The evolution of niches and organisms is the result of reciprocal interacting processes that form a single unified process. Centrifugal microbial diversification expands the limits of the species' niches while a centripetal or cohesive process occurs simultaneously, mediated by horizontal gene transfers and recombinatorial events, condensing all of the information recovered during the diversifying specialization into "novel organisms" (possible future species), thereby creating a more complex niche, where the selfishness of the new organism(s) establishes a "homeostatic power" limiting the niche's variation. Once the niche's full carrying capacity has been reached, reproductive isolation occurs, as no foreign organisms can outcompete the established population/community, thereby facilitating speciation. In the case of individualization-speciation of the microbiota, its contribution to the animal' gut structure is a type of "niche construction," the result of crosstalk between the niche (host) and microorganism(s). Lastly, there is a parallelism between the hierarchy of niches and that of microbial individuals. The increasing anthropogenic effects on the biosphere (such as globalization) might reduce the diversity of niches and bacterial individuals, with the potential emergence of highly transmissible multispecialists (which are eventually deleterious) resulting from the homogenization of the microbiosphere, a possibility that should be explored and prevented.
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Affiliation(s)
- Fernando Baquero
- Division of Biology and Evolution of Microorganisms, Department of Microbiology, Ramón y Cajal Institute for Health Research (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain
| | - Teresa M Coque
- Division of Biology and Evolution of Microorganisms, Department of Microbiology, Ramón y Cajal Institute for Health Research (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain
| | - Juan Carlos Galán
- Division of Biology and Evolution of Microorganisms, Department of Microbiology, Ramón y Cajal Institute for Health Research (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain
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Aranaz-Andrés JM, McGee-Laso A, Galán JC, Cantón R, Mira J. Activities and Perceived Risk of Transmission and Spread of SARS-CoV-2 among Specialists and Residents in a Third Level University Hospital in Spain. Int J Environ Res Public Health 2021; 18:2838. [PMID: 33802207 PMCID: PMC7998370 DOI: 10.3390/ijerph18062838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/26/2021] [Accepted: 03/08/2021] [Indexed: 12/20/2022]
Abstract
This study aims to identify factors related with SARS-CoV-2 infection in physicians and internal residents during the SARS-CoV-2 pandemic at a tertiary hospital in Spain, through a cross- sectional descriptive perception study with analytical components through two questionnaires directed at professionals working at the Ramon y Cajal University Hospital between February and April 2020. In total, 167 professionals formed the study group, and 156 professionals comprised the comparison group. Seventy percent of the professionals perceived a shortage of personal protective equipment (PPE), while 40% perceived a shortage of hand sanitiser, although more than 70% said they used it properly. Soap was more available and had a higher percentage of correct use (73.6-79.5%) (p > 0.05). Hand hygiene was optimal in >70% of professionals according to all five WHO measurements. In the adjusted model (OR; CI95%), belonging to a high-risk specialty (4.45; 1.66-11.91) and the use of public transportation (3.27; 1.87-5.73) remained risk factors. Protective factors were changes of uniform (0.53; 0.32-0.90), sanitation of personal objects before the workday (0.55; 0.31-0.97), and the disinfection of shared material (0.34; 0.19-0.58). We cannot confirm that a shortage or misuse of PPE is a factor in the spread of SARS-CoV-2. Fears and assessments are similar in both groups, but we cannot causally relate them to the spread of infection. The perception of the area of risk is different in both groups, suggesting that more information and education for healthcare workers is needed.
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Affiliation(s)
- Jesús María Aranaz-Andrés
- Servicio de Medicina Preventiva y Salud Pública, Hosital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Internacional de la Rioja, 26006 Logroño, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain
| | - Amaranta McGee-Laso
- Servicio de Medicina Preventiva y Salud Pública, Hosital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.C.G.); (R.C.)
- Centro de Investigación Biomédica en Red (CIBER) in Epidemiology and Publich Health, 28029 Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.C.G.); (R.C.)
- Red Española de Investigación en Patología en Enfermedades Infecciosas (REIPI), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Alicante, Spain;
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Viedma E, Dahdouh E, González-Alba JM, González-Bodi S, Martínez-García L, Lázaro-Perona F, Recio R, Rodríguez-Tejedor M, Folgueira MD, Cantón R, Delgado R, García-Rodríguez J, Galán JC, Mingorance J. Genomic Epidemiology of SARS-CoV-2 in Madrid, Spain, during the First Wave of the Pandemic: Fast Spread and Early Dominance by D614G Variants. Microorganisms 2021; 9:microorganisms9020454. [PMID: 33671631 PMCID: PMC7926973 DOI: 10.3390/microorganisms9020454] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 02/03/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/18/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in Madrid, Spain, on 25 February 2020. It increased in frequency very fast and by the end of May more than 70,000 cases had been confirmed by reverse transcription-polymerase chain reaction (RT-PCR). To study the lineages and the diversity of the viral population during this first epidemic wave in Madrid we sequenced 224 SARS-CoV-2 viral genomes collected from three hospitals from February to May 2020. All the known major lineages were found in this set of samples, though B.1 and B.1.5 were the most frequent ones, accounting for more than 60% of the sequences. In parallel with the B lineages and sublineages, the D614G mutation in the Spike protein sequence was detected soon after the detection of the first coronavirus disease 19 (COVID-19) case in Madrid and in two weeks became dominant, being found in 80% of the samples and remaining at this level during all the study periods. The lineage composition of the viral population found in Madrid was more similar to the European population than to the publicly available Spanish data, underlining the role of Madrid as a national and international transport hub. In agreement with this, phylodynamic analysis suggested multiple independent entries before the national lockdown and air transportation restrictions.
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Affiliation(s)
- Esther Viedma
- Servicio de Microbiología, Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre (imas12), 28009 Madrid, Spain; (E.V.); (S.G.-B.); (R.R.); (M.D.F.); (R.D.)
| | - Elias Dahdouh
- Servicio de Microbiología, Hospital Universitario La Paz and Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (E.D.); (F.L.-P.); (M.R.-T.); (J.G.-R.)
| | - José María González-Alba
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.M.G.-A.); (L.M.-G.); (R.C.)
| | - Sara González-Bodi
- Servicio de Microbiología, Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre (imas12), 28009 Madrid, Spain; (E.V.); (S.G.-B.); (R.R.); (M.D.F.); (R.D.)
| | - Laura Martínez-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.M.G.-A.); (L.M.-G.); (R.C.)
- Centro de Investigación Biomédica en Red (CIBER) in Epidemiology and Publich Health, 28029 Madrid, Spain
| | - Fernando Lázaro-Perona
- Servicio de Microbiología, Hospital Universitario La Paz and Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (E.D.); (F.L.-P.); (M.R.-T.); (J.G.-R.)
| | - Raúl Recio
- Servicio de Microbiología, Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre (imas12), 28009 Madrid, Spain; (E.V.); (S.G.-B.); (R.R.); (M.D.F.); (R.D.)
| | - María Rodríguez-Tejedor
- Servicio de Microbiología, Hospital Universitario La Paz and Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (E.D.); (F.L.-P.); (M.R.-T.); (J.G.-R.)
| | - María Dolores Folgueira
- Servicio de Microbiología, Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre (imas12), 28009 Madrid, Spain; (E.V.); (S.G.-B.); (R.R.); (M.D.F.); (R.D.)
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.M.G.-A.); (L.M.-G.); (R.C.)
- Red Española de Investigación en Patología Infecciosa (REIPI), 28009 Madrid, Spain
| | - Rafael Delgado
- Servicio de Microbiología, Hospital Universitario 12 de Octubre and Instituto de Investigación Hospital 12 de Octubre (imas12), 28009 Madrid, Spain; (E.V.); (S.G.-B.); (R.R.); (M.D.F.); (R.D.)
| | - Julio García-Rodríguez
- Servicio de Microbiología, Hospital Universitario La Paz and Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (E.D.); (F.L.-P.); (M.R.-T.); (J.G.-R.)
- Red Española de Investigación en Patología Infecciosa (REIPI), 28009 Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (J.M.G.-A.); (L.M.-G.); (R.C.)
- Centro de Investigación Biomédica en Red (CIBER) in Epidemiology and Publich Health, 28029 Madrid, Spain
- Correspondence: (J.C.G.); (J.M.)
| | - Jesús Mingorance
- Servicio de Microbiología, Hospital Universitario La Paz and Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (E.D.); (F.L.-P.); (M.R.-T.); (J.G.-R.)
- Red Española de Investigación en Patología Infecciosa (REIPI), 28009 Madrid, Spain
- Correspondence: (J.C.G.); (J.M.)
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Merino P, Guinea J, Muñoz-Gallego I, González-Donapetry P, Galán JC, Antona N, Cilla G, Hernáez-Crespo S, Díaz-de Tuesta JL, Gual-de Torrella A, González-Romo F, Escribano P, Sánchez-Castellano MÁ, Sota-Busselo M, Delgado-Iribarren A, García J, Cantón R, Muñoz P, Folgueira MD, Cuenca-Estrella M, Oteo-Iglesias J. Multicenter evaluation of the Panbio™ COVID-19 rapid antigen-detection test for the diagnosis of SARS-CoV-2 infection. Clin Microbiol Infect 2021; 27:S1198-743X(21)00076-8. [PMID: 33601009 PMCID: PMC7884234 DOI: 10.1016/j.cmi.2021.02.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The standard RT-PCR assay for coronavirus disease 2019 (COVID-19) is laborious and time-consuming, limiting testing availability. Rapid antigen-detection tests are faster and less expensive; however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the performance of the Panbio™ COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab specimens. METHODS This prospective multicentre study was carried out in ten Spanish university hospitals and included individuals with clinical symptoms or epidemiological criteria of COVID-19. Only individuals with ≤7 days from the onset of symptoms or from exposure to a confirmed case of COVID-19 were included. Two nasopharyngeal samples were taken to perform the PanbioRT as a point-of-care test and a diagnostic RT-PCR test. RESULTS Among the 958 patients studied, 325 (90.5%) had true-positive results. The overall sensitivity and specificity for the PanbioRT were 90.5% (95%CI 87.5-93.6) and 98.8% (95%CI 98-99.7), respectively. Sensitivity in participants who had a threshold cycle (CT) < 25 for the RT-PCR test was 99.5% (95%CI 98.4-100), and in participants with ≤5 days of the clinical course it was 91.8% (95%CI 88.8-94.8). Agreement between techniques was 95.7% (κ score 0.90; 95%CI 0.88-0.93). CONCLUSIONS The PanbioRT performs well clinically, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. The results must be interpreted based on the local epidemiological context.
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Affiliation(s)
- Paloma Merino
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Jesús Guinea
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Irene Muñoz-Gallego
- Clinical Microbiology Department, Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | - Juan Carlos Galán
- Microbiology Department, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Investigación en Salud Pública (CIBERESP), Madrid, Spain
| | - Nerea Antona
- Osakidetza Basque Health Service, Hospital Universitario Cruces, Microbiology Department, Barakaldo, Spain
| | - Gustavo Cilla
- Health Research Institute, Biodonostia, San Sebastián, Spain; Osakidetza Basque Health Service, Hospital Universitario Donostia, Microbiology Department, San Sebastián, Spain
| | - Silvia Hernáez-Crespo
- Osakidetza Basque Health Service, Hospital Universitario Araba, Microbiology Department, Vitoria, Spain
| | - José Luis Díaz-de Tuesta
- Osakidetza Basque Health Service, Hospital Universitario Basurto, Microbiology Department, Bilbao, Spain
| | - Ana Gual-de Torrella
- Osakidetza Basque Health Service, Hospital Universitario Galdakao-Usansolo, Microbiology Department, Galdakao, Spain
| | - Fernando González-Romo
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Pilar Escribano
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Mercedes Sota-Busselo
- Osakidetza Basque Health Service, Hospital Universitario Donostia, Clinical Management Unit of Gipuzkoa Laboratories, San Sebastián, Spain
| | - Alberto Delgado-Iribarren
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Julio García
- Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Rafael Cantón
- Microbiology Department, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Spain
| | - Patricia Muñoz
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - María Dolores Folgueira
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain; Clinical Microbiology Department, Hospital Universitario Doce de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Imas12, Madrid, Spain
| | | | - Jesús Oteo-Iglesias
- Osakidetza Basque Health Service, Hospital Universitario Donostia, Clinical Management Unit of Gipuzkoa Laboratories, San Sebastián, Spain; National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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Rubio-Garrido M, González-Alba JM, Reina G, Ndarabu A, Barquín D, Carlos S, Galán JC, Holguín Á. Current and historic HIV-1 molecular epidemiology in paediatric and adult population from Kinshasa in the Democratic Republic of Congo. Sci Rep 2020; 10:18461. [PMID: 33116151 PMCID: PMC7595211 DOI: 10.1038/s41598-020-74558-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/30/2020] [Indexed: 12/22/2022] Open
Abstract
HIV-1 diversity may impact monitoring and vaccine development. We describe the most recent data of HIV-1 variants and their temporal trends in the Democratic Republic of Congo (DRC) from 1976 to 2018 and in Kinshasa from 1983–2018. HIV-1 pol sequencing from dried blood collected in Kinshasa during 2016–2018 was done in 340 HIV-infected children/adolescents/adults to identify HIV-1 variants by phylogenetic reconstructions. Recombination events and transmission clusters were also analyzed. Variant distribution and genetic diversity were compared to historical available pol sequences from the DRC in Los Alamos Database (LANL). We characterized 165 HIV-1 pol variants circulating in Kinshasa (2016–2018) and compared them with 2641 LANL sequences from the DRC (1976–2012) and Kinshasa (1983–2008). During 2016–2018 the main subtypes were A (26.7%), G (9.7%) and C (7.3%). Recombinants accounted for a third of infections (12.7%/23.6% Circulant/Unique Recombinant Forms). We identified the first CRF47_BF reported in Africa and four transmission clusters. A significant increase of subtype A and sub-subtype F1 and a significant reduction of sub-subtype A1 and subtype D were observed in Kinshasa during 2016–2018 compared to variants circulating in the city from 1983 to 2008. We provide unique and updated information related to HIV-1 variants currently circulating in Kinshasa, reporting the temporal trends of subtypes/CRF/URF during 43 years in the DRC, and providing the most extensive data on children/adolescents.
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Affiliation(s)
- Marina Rubio-Garrido
- HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBEREsp-RITIP, 28034, Madrid, Spain
| | - José María González-Alba
- Virology Section, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBEREsp, 28034, Madrid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, Navarra Institute for Health Research (IdiSNA), Institute of Tropical Health, Universidad de Navarra (ISTUN), 31008, Pamplona, Spain.
| | - Adolphe Ndarabu
- Monkole Hospital, Kinshasa, Democratic Republic of the Congo
| | - David Barquín
- Microbiology Department, Clínica Universidad de Navarra, Navarra Institute for Health Research (IdiSNA), Institute of Tropical Health, Universidad de Navarra (ISTUN), 31008, Pamplona, Spain
| | - Silvia Carlos
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdiSNA), Institute of Tropical Health, Universidad de Navarra (ISTUN), Pamplona, 31008, Spain
| | - Juan Carlos Galán
- Virology Section, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBEREsp, 28034, Madrid, Spain
| | - África Holguín
- HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBEREsp-RITIP, 28034, Madrid, Spain.
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de Salazar A, Aguilera A, Trastoy R, Fuentes A, Alados JC, Causse M, Galán JC, Moreno A, Trigo M, Pérez-Ruiz M, Roldán C, Pena MJ, Bernal S, Serrano-Conde E, Barbeito G, Torres E, Riazzo C, Cortes-Cuevas JL, Chueca N, Coira A, Sanchez-Calvo JM, Marfil E, Becerra F, Gude MJ, Pallarés Á, Pérez Del Molino ML, García F. Sample pooling for SARS-CoV-2 RT-PCR screening. Clin Microbiol Infect 2020; 26:1687.e1-1687.e5. [PMID: 32919074 PMCID: PMC7481316 DOI: 10.1016/j.cmi.2020.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/21/2022]
Abstract
Objective To evaluate the efficacy of sample pooling compared to the individual analysis for the diagnosis of coronavirus disease 2019 (COVID-19) by using different commercial platforms for nucleic acid extraction and amplification. Methods A total of 3519 nasopharyngeal samples received at nine Spanish clinical microbiology laboratories were processed individually and in pools (342 pools of ten samples and 11 pools of nine samples) according to the existing methodology in place at each centre. Results We found that 253 pools (2519 samples) were negative and 99 pools (990 samples) were positive; with 241 positive samples (6.85%), our pooling strategy would have saved 2167 PCR tests. For 29 pools (made out of 290 samples), we found discordant results when compared to their correspondent individual samples, as follows: in 22 of 29 pools (28 samples), minor discordances were found; for seven pools (7 samples), we found major discordances. Sensitivity, specificity and positive and negative predictive values for pooling were 97.10% (95% confidence interval (CI), 94.11–98.82), 100%, 100% and 99.79% (95% CI, 99.56–99.90) respectively; accuracy was 99.80% (95% CI, 99.59–99.92), and the kappa concordant coefficient was 0.984. The dilution of samples in our pooling strategy resulted in a median loss of 2.87 (95% CI, 2.46–3.28) cycle threshold (Ct) for E gene, 3.36 (95% CI, 2.89–3.85) Ct for the RdRP gene and 2.99 (95% CI, 2.56–3.43) Ct for the N gene. Conclusions We found a high efficiency of pooling strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA testing across different RNA extraction and amplification platforms, with excellent performance in terms of sensitivity, specificity and positive and negative predictive values.
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Affiliation(s)
- Adolfo de Salazar
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Antonio Aguilera
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Santiago Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | - Rocio Trastoy
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Santiago Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | - Ana Fuentes
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Juan Carlos Alados
- Clinical Microbiology Unit, Hospital Universitario de Jerez, Cádiz, Spain
| | - Manuel Causse
- Clinical Microbiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Juan Carlos Galán
- Clinical Microbiology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antonio Moreno
- Clinical Microbiology Unit, Hospital Universitario Lucus Augusti de Lugo, Lugo, Spain
| | - Matilde Trigo
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Mercedes Pérez-Ruiz
- Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain; Clinical Microbiology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Carolina Roldán
- Clinical Microbiology Unit, Hospital Universitario de Jae, Jaen, Spain
| | - Maria José Pena
- Clinical Microbiology Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de GC, Gran Canaria, Spain
| | - Samuel Bernal
- Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - Esther Serrano-Conde
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Gema Barbeito
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Santiago Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | - Eva Torres
- Clinical Microbiology Unit, Hospital Universitario de Jerez, Cádiz, Spain
| | - Cristina Riazzo
- Clinical Microbiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - Natalia Chueca
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | - Amparo Coira
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Santiago Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | | | - Eduardo Marfil
- Clinical Microbiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Federico Becerra
- Clinical Microbiology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - María José Gude
- Clinical Microbiology Unit, Hospital Universitario Lucus Augusti de Lugo, Lugo, Spain
| | - Ángeles Pallarés
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - María Luisa Pérez Del Molino
- Clinical Microbiology Unit, Complexo Hospitalario Universitario de Santiago Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | - Federico García
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain.
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47
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Beltrán-Corbellini Á, Chico-García JL, Martínez-Poles J, Rodríguez-Jorge F, Natera-Villalba E, Gómez-Corral J, Gómez-López A, Monreal E, Parra-Díaz P, Cortés-Cuevas JL, Galán JC, Fragola-Arnau C, Porta-Etessam J, Masjuan J, Alonso-Cánovas A. Acute-onset smell and taste disorders in the context of COVID-19: a pilot multicentre polymerase chain reaction based case-control study. Eur J Neurol 2020; 27:1738-1741. [PMID: 32320508 PMCID: PMC7264557 DOI: 10.1111/ene.14273] [Citation(s) in RCA: 229] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/27/2022]
Abstract
Background and purpose Specific respiratory tract infections, including COVID‐19, may cause smell and/or taste disorders (STDs) with increased frequency. The aim was to determine whether new‐onset STDs are more frequent amongst COVID‐19 patients than influenza patients. Method This was a case–control study including hospitalized patients of two tertiary care centres. Consecutive patients positive for COVID‐19 polymerase chain reaction (cases) and patients positive for influenza polymerase chain reaction (historical control sample) were assessed during specific periods, employing a self‐reported STD questionnaire. Results Seventy‐nine cases and 40 controls were included. No significant differences were found in basal features between the two groups. New‐onset STDs were significantly more frequent amongst cases (31, 39.2%) than in the control group (5, 12.5 %) [adjusted odds ratio 21.4 (2.77–165.4, P = 0.003)]. COVID‐19 patients with new‐onset STDs were significantly younger than COVID‐19 patients without STDs (52.6 ± 17.2 vs. 67.4 ± 15.1, P < 0.001). Amongst COVID‐19 patients who presented STDs, 22 (70.9%) recalled an acute onset and it was an initial manifestation in 11 (35.5%). Twenty‐five (80.6%) presented smell disorders (mostly anosmia, 14, 45.2%) and 28 (90.3%) taste disorders (mostly ageusia, 14, 45.2%). Only four (12.9 %) reported concomitant nasal obstruction. The mean duration of STD was 7.5 ± 3.2 days and 12 patients (40%) manifested complete recovery after 7.4 ± 2.3 days of onset. Conclusion New‐onset STDs were significantly more frequent amongst COVID‐19 patients than influenza patients; they usually had an acute onset and were commonly an initial manifestation. The use of STD assessment in anamnesis as a hint for COVID‐19 and to support individuals’ self‐isolation in the current epidemic context is suggested.
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Affiliation(s)
| | - J L Chico-García
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - J Martínez-Poles
- Department of Neurology, Hospital La Luz, Madrid, Spain.,Neurological Disorders Study Group, Institute for Sanitary and Biomedical Research Clínico San Carlos (IdISSC), University Hospital Clínico San Carlos, Madrid, Spain
| | - F Rodríguez-Jorge
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - E Natera-Villalba
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - J Gómez-Corral
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - A Gómez-López
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - E Monreal
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - P Parra-Díaz
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - J L Cortés-Cuevas
- Department of Clinical Microbiology, University Hospital Ramón y Cajal, Madrid, Spain
| | - J C Galán
- Department of Clinical Microbiology, University Hospital Ramón y Cajal, Madrid, Spain
| | - C Fragola-Arnau
- Department of Otorhinolaryngology, University Hospital Ramón y Cajal, Madrid, Spain
| | - J Porta-Etessam
- Neurological Disorders Study Group, Institute for Sanitary and Biomedical Research Clínico San Carlos (IdISSC), University Hospital Clínico San Carlos, Madrid, Spain.,Department of Neurology, University Hospital Clínico San Carlos, Madrid, Spain
| | - J Masjuan
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
| | - A Alonso-Cánovas
- Department of Neurology, University Hospital Ramón y Cajal, Madrid, Spain
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48
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Pérez-Losada M, Arenas M, Galán JC, Bracho MA, Hillung J, García-González N, González-Candelas F. High-throughput sequencing (HTS) for the analysis of viral populations. Infect Genet Evol 2020; 80:104208. [PMID: 32001386 DOI: 10.1016/j.meegid.2020.104208] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/21/2020] [Accepted: 01/24/2020] [Indexed: 12/12/2022]
Abstract
The development of High-Throughput Sequencing (HTS) technologies is having a major impact on the genomic analysis of viral populations. Current HTS platforms can capture nucleic acid variation across millions of genes for both selected amplicons and full viral genomes. HTS has already facilitated the discovery of new viruses, hinted new taxonomic classifications and provided a deeper and broader understanding of their diversity, population and genetic structure. Hence, HTS has already replaced standard Sanger sequencing in basic and applied research fields, but the next step is its implementation as a routine technology for the analysis of viruses in clinical settings. The most likely application of this implementation will be the analysis of viral genomics, because the huge population sizes, high mutation rates and very fast replacement of viral populations have demonstrated the limited information obtained with Sanger technology. In this review, we describe new technologies and provide guidelines for the high-throughput sequencing and genetic and evolutionary analyses of viral populations and metaviromes, including software applications. With the development of new HTS technologies, new and refurbished molecular and bioinformatic tools are also constantly being developed to process and integrate HTS data. These allow assembling viral genomes and inferring viral population diversity and dynamics. Finally, we also present several applications of these approaches to the analysis of viral clinical samples including transmission clusters and outbreak characterization.
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Affiliation(s)
- Marcos Pérez-Losada
- Computational Biology Institute, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus Agrário de Vairão, Vairão 4485-661, Portugal
| | - Miguel Arenas
- Department of Biochemistry, Genetics and Immunology, University of Vigo, 36310 Vigo, Spain; Biomedical Research Center (CINBIO), University of Vigo, 36310 Vigo, Spain.
| | - Juan Carlos Galán
- Microbiology Service, Hospital Ramón y Cajal, Madrid, Spain; CIBER in Epidemiology and Public Health, Spain.
| | - Mª Alma Bracho
- CIBER in Epidemiology and Public Health, Spain; Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Valencia, Spain.
| | - Julia Hillung
- Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Valencia, Spain; Institute for Integrative Systems Biology (I2SysBio), CSIC-University of Valencia, Valencia, Spain.
| | - Neris García-González
- Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Valencia, Spain; Institute for Integrative Systems Biology (I2SysBio), CSIC-University of Valencia, Valencia, Spain.
| | - Fernando González-Candelas
- CIBER in Epidemiology and Public Health, Spain; Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Valencia, Spain; Institute for Integrative Systems Biology (I2SysBio), CSIC-University of Valencia, Valencia, Spain.
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49
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Gonzalez-Alba JM, Baquero F, Cantón R, Galán JC. Stratified reconstruction of ancestral Escherichia coli diversification. BMC Genomics 2019; 20:936. [PMID: 31805853 PMCID: PMC6896753 DOI: 10.1186/s12864-019-6346-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 06/24/2019] [Accepted: 11/28/2019] [Indexed: 12/15/2022] Open
Abstract
Background Phylogenetic analyses of the bacterial genomes based on the simple classification in core- genes and accessory genes pools could offer an incomplete view of the evolutionary processes, of which some are still unresolved. A combined strategy based on stratified phylogeny and ancient molecular polymorphisms is proposed to infer detailed evolutionary reconstructions by using a large number of whole genomes. This strategy, based on the highest number of genomes available in public databases, was evaluated for improving knowledge of the ancient diversification of E. coli. This staggered evolutionary scenario was also used to investigate whether the diversification of the ancient E. coli lineages could be associated with particular lifestyles and adaptive strategies. Results Phylogenetic reconstructions, exploiting 6220 available genomes in Genbank, established the E. coli core genome in 1023 genes, representing about 20% of the complete genome. The combined strategy using stratified phylogeny plus molecular polymorphisms inferred three ancient lineages (D, EB1A and FGB2). Lineage D was the closest to E. coli root. A staggered diversification could also be proposed in EB1A and FGB2 lineages and the phylogroups into these lineages. Several molecular markers suggest that each lineage had different adaptive trajectories. The analysis of gained and lost genes in the main lineages showed that functions of carbohydrates utilization (uptake of and metabolism) were gained principally in EB1A lineage, whereas loss of environmental-adaptive functions in FGB2 lineage were observed, but this lineage showed higher accumulated mutations and ancient recombination events. The population structure of E. coli was re-evaluated including up to 7561 new sequenced genomes, showing a more complex population structure of E. coli, as a new phylogroup, phylogroup I, was proposed. Conclusions A staggered reconstruction of E. coli phylogeny is proposed, indicating evolution from three ancestral lineages to reach all main known phylogroups. New phylogroups were confirmed, suggesting an increasingly complex population structure of E. coli. However these new phylogroups represent < 1% of the global E. coli population. A few key evolutionary forces have driven the diversification of the two main E. coli lineages, metabolic flexibility in one of them and colonization-virulence in the other.
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Affiliation(s)
- José Maria Gonzalez-Alba
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Baquero
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Unidad de Resistencia a Antibióticos y Virulencia Bacteriana, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. .,CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Unidad de Resistencia a Antibióticos y Virulencia Bacteriana, Madrid, Spain.
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50
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Barragán-Prada H, Ruiz-Hueso P, Tedim AP, González-Candelas F, Galán JC, Cantón R, Morosini MI. Emergence and dissemination of colistin-resistant Klebsiella pneumoniae isolates expressing OXA-48 plus CTX-M-15 in patients not previously treated with colistin in a Spanish university hospital. Diagn Microbiol Infect Dis 2018; 93:147-153. [PMID: 30266401 DOI: 10.1016/j.diagmicrobio.2018.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/28/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
Dissemination of multidrug-resistant Klebsiella pneumoniae in the hospital environment represents a primary target of resistance containment and stewardship programs. At present, polymyxins, mostly in combination, exemplify a last-resort alternative. Colistin-resistant K. pneumoniae isolates harboring OXA-48 plus CTX-M-15 (n = 21) with the simultaneous colistin-susceptible counterparts (n = 9) were recovered from 14 hospitalized patients (January 2014-January 2015) admitted in different wards. In most cases, patients had not previously received colistin. Genetic relatedness experiments demonstrated that 93% (28/30) of isolates belonged to the ST11 high-risk clone. Heteroresistance and the fitness cost of colistin resistance were addressed in susceptible and resistant isolates as well as in in vitro-obtained stable mutants, and results appeared to be strain dependent. Whole genome sequencing demonstrated molecular changes in pmrA, pmrB, and mgrB genes. Plasmid-mediated colistin resistance genes were not found. Colistin resistance in multidrug-resistant K. pneumoniae isolates should be continuously monitored to detect its potential emergence, even in patients not previously exposed to colistin.
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Affiliation(s)
- Hugo Barragán-Prada
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Paula Ruiz-Hueso
- Unidad Mixta "Infección y Salud Pública" FISABIO-Instituto de Biología Integrativa de Sistemas (I2SysBio), Universitat de València, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana P Tedim
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando González-Candelas
- Unidad Mixta "Infección y Salud Pública" FISABIO-Instituto de Biología Integrativa de Sistemas (I2SysBio), Universitat de València, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos los III, Madrid, Spain.
| | - María-Isabel Morosini
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos los III, Madrid, Spain
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