Factores de riesgo asociados a infecciones por gram positivos vs. gram negativos en neutropenicos febriles

Investigar potenciales factores de riesgo asociados a infecciones por bacterias gram positivas vs. gram negativas en los pacientes con Neutropenia febril postquimioterapia. Diseño: Conducimos un estudio analítico de casos y controles basado en pacientes hospitalizados para identificar los factores de riesgo asociados a infecciones bacterianas entre pacientes con neutropenia febril. Se recolecto la información en un cuestionario diseñado para la investigación. Pacientes: Comparamos 65 casos infectados por gram positivos con 200 controles infectados por gram negativos hospitalizados con diagnostico de Neutropenia febril postquimioterapia. Análisis: Usamos el Odds Ratio como el resumen básico estadístico para calcular variaciones en el riesgo. Principales resultados: El análisis univariado mostro que lesiones en piel ( -OR 7,2; IC 95%: 2,89-17,9, p< 0,001) y uso de catéter central ( -OR 5,8; IC 95%: 2,0-16,8, p < 0,010) fueron asociados a infecciones por gram positivos. Conclusiones: Este estudio mostro que entre pacientes con Neutropenia febril postquimioterapia las lesiones en piel y uso de catéter central están asociados al desarrollo de infección por gram positivos. Palabras claves: Neutropenia febril; factores de riesgo; infecciones bacterianas.

Human papillomavirus detection from human immunodeficiency virus-infected colombian women's paired urine and cervical samples

Infection, coinfection and type-specific human papillomavirus (HPV) distribution was evaluated in human immunodeficiency virus (HIV)-positive women from paired cervical and urine samples. Paired cervical and urine samples (n = 204) were taken from HIV-positive women for identifying HPV-DNA presence by using polymerase chain reaction (PCR) with three generic primer sets (GP5+/6+, MY09/11 and pU1M/2R). HPV-positive samples were typed for six high-risk HPV (HR-HPV) (HPV-16, -18, -31, -33, -45 and -58) and two low-risk (LR-HPV) (HPV-6/11) types. Agreement between paired sample results and diagnostic performance was evaluated. HPV infection prevalence was 70.6% in cervical and 63.2% in urine samples. HPV-16 was the most prevalent HPV type in both types of sample (66.7% in cervical samples and 62.0% in urine) followed by HPV-31(47.2%) in cervical samples and HPV-58 (35.7%) in urine samples. There was 55.4% coinfection (infection by more than one type of HPV) in cervical samples and 40.2% in urine samples. Abnormal Papanicolau smears were observed in 25.3% of the women, presenting significant association with HPV-DNA being identified in urine samples. There was poor agreement of cervical and urine sample results in generic and type-specific detection of HPV. Urine samples provided the best diagnosis when taking cytological findings as reference. In conclusion including urine samples could be a good strategy for ensuring adherence to screening programs aimed at reducing the impact of cervical cancer, since this sample is easy to obtain and showed good diagnostic performance.

Caracterización y dinámica de los patrones de infecciones únicas y múltiples para seis tipos del virus de papiloma humano de alto riesgo

El cáncer de cuello uterino (CCU) es la segunda causa de muerte por cáncer en la población femenina de Colombia con tasas de incidencia y mortalidad altas (32,9-36,4 y 18,7 casos/año/100.000 mujeres, respectivamente). El principal factor de riesgo para el desarrollo de lesiones cervicales pre-neoplásicas es la infección persistente por ciertos tipos de Virus de Papiloma Humano (VPH) conocidos como de alto riesgo (VPH-AR), asociados con ~90% de CCU a nivel mundial. Este trabajo tuvo como objetivo identificar las características de la infección por VPH en una población de mujeres socio-demográficamente heterogénea, que habitan en diferentes regiones de Colombia. Para esto, fueron incluidas 2109 mujeres provenientes de las ciudades de Chaparral, Tumaco, Leticia, Bogotá y Girardot, quienes acudieron a los programas de promoción y prevención de CCU implementados en los respectivos hospitales; cada mujer proporcionó información sociodemográfica y de conductas sexuales, además de una muestra de raspado cervical. Se determinó la presencia de VPH por la técnica de PCR, empleando tres juegos de cebadores genéricos, adicionalmente, se usaron cebadores tipo-específicos para determinar la frecuencia de seis tipos de VPH de alto riesgo (VPH-AR-16, -18, -31, -33, -45 y -58) y dos de bajo riesgo (VPH-BR-6/11). Se evaluó también la carga viral de los tipos de VPH-AR mediante PCR en tiempo real y se correlacionaron los datos de 219 mujeres a través de un seguimiento a dos años (cada 6 meses), con el fin de determinar la dinámica de los patrones de infecciones únicas y múltiples encontrados en nuestro país.

Revision sistemática: Factores asociados a colonización e infección por bacterias gram negativas resistentes a carbapenemicos

INTRODUCCIÓN: Los carbapenémicos (CP) son una de las últimas líneas de tratamiento para infecciones por microorganismos multirresistentes (MDR), especialmente Gram-negativos productores de betalactamasas de espectro extendido. Es creciente la preocupación a nivel mundial por el aumento de aislamientos resistentes a CP, en EEUU hasta 60% de las infecciones nosocomiales son causadas por bacterias MDR. En la Unión Europea, cerca de 25.000 pacientes mueren anualmente por esta causa. En Latinoamérica hay una tendencia creciente en las tasas de resistencia.OBJETIVO: Identificar y describir factores protectores o de riesgo, relacionados con colonización o infección por Gram negativos resistentes a CP en pacientes adultos hospitalizados, mediante una revisión sistemática de la literatura.MÉTODOS: Revisión sistemática de literatura, búsqueda de estudios observacionales analíticos en las bases de datos PubMed, Embase, Scopus, BVS, Scielo y búsqueda de literatura gris, publicados desde el 01/01/2004 al 15/04/2015. Se evalúo la calidad de los estudios con escala Newcastle-Ottawa y FLC Osteba. RESULTADOS: Se seleccionaron 36 estudios de alta calidad, diseño de casos y controles. Los factores de riesgo estadísticamente significativos observados son estancia en UCI OR:36.46, insuficiencia renal aguda OR:6.23, diálisis OR:10.80 ventilación mecánica OR:17.5, cateterismo vesical OR:14.3, uso de carbapenémicos OR:18,52,quinolonas OR17.30, cefepime OR:28.05, glicopéptidos OR:19.1; metronidazol OR:4.17, p:0.03, colistina OR:12.1, linezolid OR:7 CONCLUSIÓN: Pese a que hay alta heterogeneidad en las variables incluidas en los estudios, se encontró que los factores de riesgo principales para adquirir GNR-CP en pacientes hospitalizados son: antecedente de insuficiencia renal aguda y diálisis, ventilación mecánica, cateterismo vesical, estancia en UCI y uso previo de antibióticos carbapenémicos, quinolonas, cefepime, glicopéptidos, metronidazol, linezolid y colistina. No se hallaron factores protectores. factores de riesgo

Desenvolupament d'un sistema de previsió de risc d'infecció per Stemphylium vesicarium. Avaluació, validació i implementació en parcel·les experimentals en camps comercials de perera

L'estemfiliosi de la perera és una malaltia fúngica ocasionada pel fong Deuteromicet Stemphylium vesicarium. Els símptomes característics d'aquesta malaltia són lesions necròtiques en fulles i fruits, provocant el depreciament econòmic d'aquests últims. Si les condicions climàtiques són favorables aquesta malaltia pot arribar a provocar la pèrdua total de la producció. La malaltia es localitza bàsicament en la conca mediterrània, sent les zones fructícoles de Girona a Catalunya i Emilia-Romagna a Itàlia els llocs on les pèrdues de producció són més grans. Actualment l'únic mètode de control és la cobertura permanent dels òrgans de la planta amb fungicides. Per obtenir aquesta protecció és necessari realitzar aplicacions preventives amb una cadència fixa, setmanal o quinzenal, de diferents fungicides en els arbres. Aquesta cadència d'aplicació comporta que al llarg del període vegetatiu de la perera es realitzin entre 20 i 25 aplicacions de fungicida, per cadències setmanals, o entre 10 i 13 aplicacions si la cadència és quinzenal. Aquest elevat nombre de tractaments comporta uns efectes toxicològics a nivell mediambiental i per a la salut humana, un augment del cost econòmic de la producció i en alguns casos afavorir l'aparició de resistències del patogen a determinats fungicides. Molts d' aquests tractaments es realitzen sense que les condicions ambientals siguin favorables a l'inici d'infeccions del fong, i són per tant innecessàries. Amb l'objectiu d'obtenir una eina per determinar el risc d'infeccions en funció de les condicions climàtiques i realitzar d'aquesta manera els tractaments amb fungicides només quan són necessaris, es va elaborar el Sistema pel Tractament Racionalitzat de l'Estemfiliosi de la Perera (STREP). El model consisteix en relacionar quantitativament amb la severitat de la malaltia els paràmetres climàtics de durada del període d'humectació i temperatura mitjana durant aquests períodes. En aquest treball s'ha determinat l'eficàcia en el control de la malaltia per diferents fungicides aplicats de manera preventiva amb una cadència fixa en diferents finques comercials i durant varis anys. S'ha constatat que no hi ha cap producte totalment eficaç en el control de la malaltia, sent l'eficàcia obtinguda mitjana. Aquesta eficàcia de control esta en funció del nivell de pressió de la malaltia, obtenint eficàcies inferiors quan el nivell en els testimonis no tractats és elevat. En assajos en condicions controlades s'ha determinat que els fungicides analitzats aplicats de manera curativa o postinfecciosa, quan ja s'han iniciat les infeccions, presenten una eficàcia més baixa que quan s'apliquen preventivament. El tiram és el producte amb una eficàcia més elevada en la major part de les condicions experimentals. S' ha analitzat durant 5 anys, 1992-1996, en diferents plantacions de perera de Girona, la dinàmica dels paràmetres ambientals de durada deis períodes amb humectació, la temperatura mitjana de l'aire, la temperatura mitjana durant els períodes d'humectació, la durada dels períodes amb humitat relativa superior al 90% i la pluviometria. S 'ha constatat que la humectació deguda a la rosada és la principal causa d'humectació i que és un procés lent i continu. Les durades més freqüents d'humectació han estat períodes inferiors a 12 hores i les temperatures més freqüents durant aquests períodes han estat entre 11 i 21°C. S'ha determinat també que existeixen períodes amb humitat relativa elevada però sense formació de pel·lícula d'aigua i s'ha observat que ocasionalment existeixen períodes breus d'interrupció de la humectació en que poden existir humanitats relatives elevades o baixes. La capacitat predictiva del model STREP ha estat avaluada mitjançant 42 assajos en condicions naturals i controlades, determinant que en més del 95 % dels casos avaluats les prediccions de malaltia s'han correspost amb les observades, i que només en dos casos el model ha infraestimat el nivell de risc d'infecció. Demostrant així que el model STREP és fiable en les seves prediccions. S'ha estudiat l'efecte de la humitat relativa durant els períodes interromputs d'humectació i les durades d'aquests períodes, en les infeccions produïdes pel fong. S'ha constatat que el model STREP hauria d'incorporar com a períodes separats els períodes d'humectació interromputs amb relatives elevades (>98%) s'haurien de considerar com a períodes continus. Per una altra banda s'ha comprovat que els períodes amb humitats relatives elevades sense formació d'humectació en condicions naturals no són suficients per provocar l'inici d'infeccions de S. Vesicarium. S'ha utilitzat el model STREP com a eina per guiar els tractaments fungicides en diferents parcel·les de finques comercials durant dos anys. D'aquests assajos es pot concloure que utilitzant valors de risc acumulat SA:0.4 com a llindar per a realitzar els tractaments es controla la malaltia amb una eficàcia semblant als tractaments setmanals, però amb una reducció del nombre d'aplicacions necessàries entre un 25 i un 50%. Utilitzar un llindar SA:0.6 en finques amb varietats sensibles i una pressió d'inòcul del patogen elevada presenta bons resultats però inferiors als obtinguts amb tractaments setmanals, no obstant l'estalvi de tractaments ha estat molt important (50-70%). De tots aquests resultats es conclou que el model STREP és adequat per ésser utilitzat en programes pilot a escala comercial en el control racional de l'estemfiliosi de la perera. En funció d'aquests resultats es considerarà la seva implementació en Estacions d'Avisos Fitosanitaris.

New evidence for the antiquity of the intestinal parasite Trichuris (whipworm) in Europe

The whipworm, Trichuris trichiura L., is one of the most common human intestinal parasites worldwide, yet little is known of its origin and global spread. Archaeological records for this nematode have all been of Neolithic or later date, suggesting a possible association between the spread of pastoral farming and human acquisition of whipworm. This paper reports the discovery of eggs of the genus Trichuris in late Mesolithic deposits from south Wales, indicating that whipworm was present in Europe before the arrival of agriculture. This raises the possibility that human infection by Trichuris arose through contact with wild animals in parts of the landscape frequented by both human and animal groups.

Comparative effect of root-knot nematode on severity of Verticillium and Fusarium wilt in cotton

The effect of root-knot nematode (RKN) (Meloidogyne incognita) on Verticillium dahliae and Fusarium oxysporum f.sp. vasinfectum in cotton (Gossypium hirsutum) was investigated. Two different inoculation methods were used, one in which inoculum was added to the soil, so that nematode and fungal inoculum were in close proximity; the other, inoculation into the stem, whereby the two inocula were spatially separated. Invasion of the roots by RKN enhanced disease severity, as measured by the height of vascular browning in the stem, following inoculation with either wilt pathogen. The effect of RKN on Fusarium wilt was more pronounced than that on Verticillium wilt. Nematode-enhanced infection by F. oxysporum is a well known effect but there are few reports of enhanced infection by Verticillium due to RKN. Relative resistance of a number of cotton cultivars to both wilt diseases, as measured by height of vascular browning, was similar to the known field performance of the cultivars. The use of vascular browning as an estimate of disease severity was therefore validated.

Differences in infectivity of Pasteuria penetrans isolates produced on different populations of Meloidogyne

The level of Pasteuria penetrans spore attachment on juveniles of Meloidogyne javanica, M. incognita and M. arenaria was greater when the nematodes were exposed to spores of a population that had been multiplied on a mixture of these Meloidogyne species than where Pasteuria was multiplied on a single nematode population. When tomato plants were inoculated with M. javanica, M. incognita and M. arenaria juveniles encumbered with spores produced on different Meloidogyne species, tile incidence of root galling and productivity of egg-masses were less, and this was also reflected in increased infection of females of M. javanica, M. incognita and M. arenaria compared to the infection by Pasteuria populations produced on single nematode species and therefore assumed to have a narrower genetic base.

Mutations in H5N1 influenza virus hemagglutinin that confer binding to human tracheal airway epithelium

The emergence in 2009 of a swine-origin H1N1 influenza virus as the first pandemic of the 21st Century is a timely reminder of the international public health impact of influenza viruses, even those associated with mild disease. The widespread distribution of highly pathogenic H5N1 influenza virus in the avian population has spawned concern that it may give rise to a human influenza pandemic. The mortality rate associated with occasional human infection by H5N1 virus approximates 60%, suggesting that an H5N1 pandemic would be devastating to global health and economy. To date, the H5N1 virus has not acquired the propensity to transmit efficiently between humans. The reasons behind this are unclear, especially given the high mutation rate associated with influenza virus replication. Here we used a panel of recombinant H5 hemagglutinin (HA) variants to demonstrate the potential for H5 HA to bind human airway epithelium, the predominant target tissue for influenza virus infection and spread. While parental H5 HA exhibited limited binding to human tracheal epithelium, introduction of selected mutations converted the binding profile to that of a current human influenza strain HA. Strikingly, these amino-acid changes required multiple simultaneous mutations in the genomes of naturally occurring H5 isolates. Moreover, H5 HAs bearing intermediate sequences failed to bind airway tissues and likely represent mutations that are an evolutionary "dead end." We conclude that, although genetic changes that adapt H5 to human airways can be demonstrated, they may not readily arise during natural virus replication. This genetic barrier limits the likelihood that current H5 viruses will originate a human pandemic.

Interaction of severe acute respiratory syndrome-coronavirus and NL63 coronavirus spike proteins with angiotensin converting enzyme-2

Although in different groups, the coronaviruses severe acute respiratory syndrome-coronavirus (SARS-CoV) and NL63 use the same receptor, angiotensin converting enzyme (ACE)-2, for entry into the host cell. Despite this common receptor, the consequence of entry is very different; severe respiratory distress in the case of SARS-CoV but frequently only a mild respiratory infection for NL63. Using a wholly recombinant system, we have investigated the ability of each virus receptor-binding protein, spike or S protein, to bind to ACE-2 in solution and on the cell surface. In both assays, we find that the NL63 S protein has a weaker interaction with ACE-2 than the SARS-CoV S protein, particularly in solution binding, but the residues required for contact are similar. We also confirm that the ACE-2-binding site of NL63 S lies between residues 190 and 739. A lower-affinity interaction with ACE-2 might partly explain the different pathological consequences of infection by SARS-CoV and NL63.

Endoparasitism in colonial hosts: patterns and processes

This study begins to redress our lack of knowledge of the interactions between colonial hosts and their parasites by focusing on a novel host-parasite system. Investigations of freshwater bryozoan populations revealed that infection by myxozoan parasites is widespread. Covert infections were detected in all 5 populations studied and were often at high prevalence while overt infections were observed in only 1. Infections were persistent in populations subject to temporal sampling. Negative effects of infection were identified but virulence was low. Infection did not induce mortality in the environmental conditions studied. However, the production of statoblasts (dormant propagules) was greatly reduced in bryozoans with overt infections in comparison to uninfected bryozoans. Overtly-infected bryozoans also grew more slowly and had low fission rates relative to colonies lacking overt infection. Bryozoans with covert infections were smaller than uninfected bryozoans. High levels of vertical transmission were achieved through colony fission and the infection of statoblasts. Increased fission rates may be a strategy for hosts to escape from parasites but the parasite can also exploit the fragmentation of colonial hosts to gain vertical transmission and dispersal. Our study provides evidence that opportunities and constraints for host-parasite co-evolution can be highly dependent on organismal body plans and that low virulence may be associated with exploitation of colonial hosts by endoparasites.

Generation of candidate human influenza vaccine strains in cell culture: rehearsing the European response to an H7N1 pandemic threat

Background: Although H5N1 avian influenza viruses pose the most obvious imminent pandemic threat, there have been several recent zoonotic incidents involving transmission of H7 viruses to humans. Vaccines are the primary public health defense against pandemics, but reliance on embryonated chickens eggs to propagate vaccine and logistic problems posed by the use of new technology may slow our ability to respond rapidly in a pandemic situation. Objectives: We sought to generate an H7 candidate vaccine virus suitable for administration to humans whose generation and amplification avoided the use of eggs. Methods: We generated a suitable H7 vaccine virus by reverse genetics. This virus, known as RD3, comprises the internal genes of A/Puerto Rico/8/34 with surface antigens of the highly pathogenic avian strain A/Chicken/Italy/13474/99 (H7N1). The multi-basic amino acid site in the HA gene, associated with high pathogenicity in chickens, was removed. Results: The HA modification did not alter the antigenicity of the virus and the resultant single basic motif was stably retained following several passages in Vero and PER. C6 cells. RD3 was attenuated for growth in embryonated eggs, chickens, and ferrets. RD3 induced an antibody response in infected animals reactive against both the homologous virus and other H7 influenza viruses associated with recent infection by H7 viruses in humans. Conclusions: This is the first report of a candidate H7 vaccine virus for use in humans generated by reverse genetics and propagated entirely in mammalian tissue culture. The vaccine has potential use against a wide range of H7 strains.

Comparison of the bacterial Enhancin-like proteins from Yersinia and Bacillus spp. with a baculovirus Enhancin

Enhancins are a class of metalloproteases found in some baculoviruses that enhance viral infection by degrading the peritrophic, membrane (PM) of the insect midgut. However, sequencing has revealed enhancin-like genes with 24-25% homology to viral enhancins, in the genomes of Yersinia pestis and Bacillus anthracis. AcMNPV does not encode enhancin therefore recombinant AcMNPV budded viruses (BVs) and polyhedra inclusion bodies (PIBs) were generated expressing the bacterial Enhancins. Bacterial Enhancins were found to be cytotoxic when compared to viral enhancin, however, larval bioassays suggested that the bacterial Enhancins did not enhance infection in the same way as viral Enhancin. This suggests that the bacterial Enhancins may have evolved a distinct biochemical function. (c) 2005 Elsevier Inc. All rights reserved.

Effects of straw and silicon soil amendments on some foliar and stem-base diseases in pot-grown winter wheat

Four foliar and two stem-base pathogens were inoculated onto wheat plants grown in different substrates in pot experiments. Soils from four different UK locations were each treated in three ways: (i) straw incorporated in the field at 10 t ha−1 several months previously; (ii) silicon fertilization at 100 mg L−1 during the experiment; and (iii) no amendments. A sand and vermiculite mix was used with and without silicon amendment. The silicon treatment increased plant silica concentrations in all experiments, but incorporating straw was not associated with raised plant silica concentrations. Blumeria graminis and Puccinia recondita were inoculated by shaking infected plants over the test plants, followed by suitable humid periods. The silicon treatment reduced powdery mildew (B. graminis) substantially in sand and vermiculite and in two of the soils, but there were no effects on the slight infection by brown rust (P. recondita). Phaeosphaeria nodorum and Mycosphaerella graminicola were inoculated as conidial suspensions. Leaf spot caused by P. nodorum was reduced in silicon-amended sand and vermiculite; soil was not tested. Symptoms of septoria leaf blotch caused by M. graminicola were reduced by silicon amendment in a severely infected sand and vermiculite experiment but not in soil or a slightly infected sand and vermiculite experiment. Oculimacula yallundae (eyespot) and Fusarium culmorum (brown foot rot) were inoculated as agar plugs on the stem base. Severity of O. yallundae was reduced by silicon amendment of two of the soils but not sand and vermiculite; brown foot rot symptoms caused by F. culmorum were unaffected by silicon amendment. The straw treatment reduced severity of powdery mildew but did not detectably affect the other pathogens. Both straw and silicon treatments appeared to increase plant resistance to all diseases only under high disease pressure.

Baculovirus superinfection: a probable restriction factor on the surface display of proteins for library screening

In addition to the expression of recombinant proteins, baculoviruses have been developed as a platform for the display of complex eukaryotic proteins on the surface of virus particles or infected insect cells. Surface display has been used extensively for antigen presentation and targeted gene delivery but is also a candidate for the display of protein libraries for molecular screening. However, although baculovirus gene libraries can be efficiently expressed and displayed on the surface of insect cells, target gene selection is inefficient probably due to super-infection which gives rise to cells expressing more than one protein. In this report baculovirus superinfection of Sf9 cells has been investigated by the use of two recombinant multiple nucleopolyhedrovirus carrying green or red fluorescent proteins under the control of both early and late promoters (vAcBacGFP and vAcBacDsRed). The reporter gene expression was detected 8 hours after the infection of vAcBacGFP and cells in early and late phases of infection could be distinguished by the fluorescence intensity of the expressed protein. Simultaneous infection with vAcBacGFP and vAcBacDsRed viruses each at 0.5 MOI resulted in 80% of infected cells coexpressing the two fluorescent proteins at 48 hours post infection (hpi), and subsequent infection with the two viruses resulted in similar co-infection rate. Most Sf9 cells were re-infectable within the first several hours post infection, but the reinfection rate then decreased to a very low level by 16 hpi. Our data demonstrate that Sf9 cells were easily super-infectable during baculovirus infection, and super-infection could occur simultaneously at the time of the primary infection or subsequently during secondary infection by progeny viruses. The efficiency of super-infection may explain the difficulties of baculovirus display library screening but would benefit the production of complex proteins requiring co-expression of multiple polypeptides.