RESUMO
Chikungunya virus (CHIKV) was isolated from 12 febrile humans in Yucatan, Mexico, in 2015. One patient was co-infected with dengue virus type 1. Two additional CHIKV isolates were obtained from Aedes aegypti mosquitoes collected in the homes of patients. Phylogenetic analysis showed that the CHIKV isolates belong to the Asian lineage.
Assuntos
Aedes/virologia , Febre de Chikungunya/virologia , Vírus Chikungunya/isolamento & purificação , Febre/virologia , Animais , Febre de Chikungunya/complicações , Vírus Chikungunya/classificação , Chlorocebus aethiops , Coinfecção/virologia , Dengue/complicações , Dengue/virologia , Vírus da Dengue/isolamento & purificação , México , Filogenia , Células VeroRESUMO
OBJECTIVE: To determine the effect of doxycycline treatment on cytokine levels, including tumor necrosis factor (TNF) and interleukin 6 (IL-6), and mortality in dengue patients at high risk of complication. METHODS: A group of dengue hemorrhagic fever patients (n=231) were randomized to receive either standard supportive care or supportive care in addition to oral doxycycline twice daily for 7 days. Dengue virus infection was confirmed by PCR using multiple primers. Serum samples were obtained at days 0, 3, 5 and 7 and tested for levels of TNF and IL-6. RESULTS: Doxycycline-treated group presented a 46% lower mortality than that observed in the untreated group (11.2% [13/116] vs 20.9% [24/115], respectively, p=0.05). Moreover, administration of doxycycline resulted in a significant (p<0.01) decrease in levels of TNF and IL-6 versus controls in the tests performed during follow-up (day 3, 5 and 7). Patients who died in both groups possessed significantly (p<0.01) higher levels of TNF and IL-6 compared to those who survived at all-time points. CONCLUSION: The above findings suggest that doxycycline can provide a clinical benefit to dengue patients at high risk of complications. This effect could be mediated by decreasing pro-inflammatory cytokine levels.
Assuntos
Anti-Infecciosos/uso terapêutico , Doxiciclina/uso terapêutico , Mediadores da Inflamação/sangue , Interleucina-6/sangue , Dengue Grave/tratamento farmacológico , Fator de Necrose Tumoral alfa/sangue , Administração Oral , Adulto , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/efeitos adversos , Biomarcadores/sangue , Regulação para Baixo , Doxiciclina/administração & dosagem , Doxiciclina/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , México , Modelos de Riscos Proporcionais , Fatores de Risco , Dengue Grave/sangue , Dengue Grave/diagnóstico , Dengue Grave/imunologia , Dengue Grave/mortalidade , Dengue Grave/virologia , Fatores de Tempo , Resultado do TratamentoAssuntos
Rickettsia typhi , Tifo Endêmico Transmitido por Pulgas/microbiologia , Adulto , Criança , Feminino , Humanos , Masculino , México , Rickettsia typhi/classificação , Rickettsia typhi/genética , Resultado do Tratamento , Tifo Endêmico Transmitido por Pulgas/diagnóstico , Tifo Endêmico Transmitido por Pulgas/tratamento farmacológicoRESUMO
OBJETIVO: Establecer la frecuencia y la relación del alelo CCR5-Δ32 con la infección y la progresión clínica de pacientes VIH+ y en individuos expuestos seronegativos. MATERIAL Y MÉTODOS: Se analizaron 355 muestras, 62 VIH+, 51 individuos expuestos seronegativos y 242 de la población general. Los VIH+ se subdividieron en: a) progresores normales n= 49; b) progresores lentos n= 10, y c) no progresores n= 3. RESULTADOS: Se identificó el genotipo wt/Δ32 en 17.7 por ciento de los VIH+, 13.7 por ciento de los individuos expuestos seronegativos y 6.2 por ciento en la población general. El genotipo Δ32/Δ32 se encontró en 3.9 por ciento de los individuos expuestos seronegativos. Según la progresión clínica de los VIH+, se identificó el genotipo wt/Δ32 en 10.2 por ciento de los progresores normales, 30 por ciento de los progresores lentos y en 100 por ciento de los no progresores. CONCLUSIÓN: El genotipo wt/Δ32 se observó en todos los no progresores, lo que apoya su papel en esta forma de progresión clínica en este grupo.
OBJECTIVE: CCR5-Δ32 allele frequency needs to be identified in HIV+ patients and exposed seronegative individuals in Yucatan, Mexico, to understand this mutation's relationship to infection and disease progression. MATERIAL AND METHODS: A total of 355 samples were analyzed: 62 from HIV+ patients, 51 from exposed seronegative individuals and 242 from general population. Infected patients were subdivided into a) normal progressors n= 49; b) slow progressors n= 10, and c) non-progressors n= 3. RESULTS: Genotype wt/Δ32 was identified in 17.7 percent of HIV+, 13.7 percent of exposed seronegative individuals and 6.2 percent of general population. Genotype Δ32/Δ32 was identified in 3.9 percent of exposed seronegative individuals. In infected patients, wt/Δ32 was identified in 10.2 percent of normal progressors, 30 percent of slow progressors and 100 percent of non-progressors. CONCLUSION: Genotype wt/Δ32 was observed in all non-progressing HIV+ patients, supporting its role in this group's disease development and clinical evolution.
Assuntos
Feminino , Humanos , Masculino , Frequência do Gene , Soropositividade para HIV/genética , /genética , Estudos Transversais , Progressão da Doença , Genótipo , Soronegatividade para HIV/genética , México , Estudos Prospectivos , /imunologiaRESUMO
OBJECTIVE: CCR5-Δ32 allele frequency needs to be identified in HIV+ patients and exposed seronegative individuals in Yucatan, Mexico, to understand this mutation's relationship to infection and disease progression. MATERIAL AND METHODS: A total of 355 samples were analyzed: 62 from HIV+ patients, 51 from exposed seronegative individuals and 242 from general population. Infected patients were subdivided into a) normal progressors n= 49; b) slow progressors n= 10, and c) non-progressors n= 3. RESULTS: Genotype wt/Δ32 was identified in 17.7% of HIV+, 13.7% of exposed seronegative individuals and 6.2% of general population. Genotype Δ32/Δ32 was identified in 3.9% of exposed seronegative individuals. In infected patients, wt/Δ32 was identified in 10.2% of normal progressors, 30% of slow progressors and 100% of non-progressors. CONCLUSION: Genotype wt/Δ32 was observed in all non-progressing HIV+ patients, supporting its role in this group's disease development and clinical evolution.
Assuntos
Frequência do Gene , Soropositividade para HIV/genética , Receptores CCR5/genética , Estudos Transversais , Progressão da Doença , Feminino , Genótipo , Soronegatividade para HIV/genética , Humanos , Masculino , México , Estudos Prospectivos , Receptores CCR5/imunologiaRESUMO
OBJECTIVE: Determine antibiotic resistance of community-acquired uropathogen Escherichia coli and infer therapeutic options. MATERIAL AND METHODS: E. coli strains isolated from urine during a one-year period were studied. Identification and susceptibility tests were performed. RESULTS: A total of 652 isolates were included from patients in two institutions, a healthcare clinic 303 (46.5%) and a hospital 349 ( 53.5%). The antimicrobials with higher resistance rates were ampicillin 67.2%, trimethoprim-sulfametoxazole 59.2%, cefazolin 35.6% and ciprofloxacin 24.7%. CONCLUSIONS: Resistance to trimethoprim-sulfamethoxazole and ciprofloxacin used for empiric treatment in community urinary infections is high, and there are few available treatment options.
Assuntos
Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/microbiologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/microbiologia , Escherichia coli/efeitos dos fármacos , Adulto , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Ampicilina/farmacologia , Antibacterianos/farmacologia , Cefazolina/farmacologia , Ciprofloxacina/farmacologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Feminino , Hospitais Privados/estatística & dados numéricos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Combinação Trimetoprima e Sulfametoxazol/farmacologiaRESUMO
OBJETIVO: Determinar la resistencia del uropatógeno comunitario más frecuente, Escherichia coli, a diversos antimicrobianos y deducir opciones de manejo empírico. MATERIAL Y MÉTODOS: Del 14 de julio de 2005 al 13 julio de 2006 se estudiaron cepas de Escherichia coli aisladas de urocultivos de pacientes que asistieron a la consulta externa de la Clínica Nova y del Hospital San José, en Monterrey, Nuevo León, México. Se identificó la bacteria y se determinó susceptibilidad a antibióticos mediante método automatizado. Se compararon los resultados entre las dos instituciones y la frecuencia de resistencia a antimicrobianos entre mujeres de entre 15 a 50 años de edad y > 50. RESULTADOS: Se analizaron 652 urocultivos: 303 (46.5 por ciento) de Clínica Nova y 349 (53.5 por ciento) del Hospital San José. Las cepas aisladas fueron resistentes a ampicilina, en 67.2 por ciento; a trimetoprim-sulfametoxazol, en 59.2 por ciento; a cefazolina, en 35.6 por ciento, y a ciprofloxacino, en 24.7 por ciento. CONCLUSIONES: La resistencia a trimetoprim-sulfametoxazol y ciprofloxacino, considerados de elección en el manejo empírico de las infecciones de vías urinarias adquiridas en la comunidad, es alta. Las opciones de manejo son pocas.
OBJECTIVE: Determine antibiotic resistance of community-acquired uropathogen Escherichia coli and infer therapeutic options. MATERIAL AND METHODS: E. coli strains isolated from urine during a one-year period were studied. Identification and susceptibility tests were performed. RESULTS: A total of 652 isolates were included from patients in two institutions, a healthcare clinic 303 (46.5 percent) and a hospital 349 ( 53.5 percent). The antimicrobials with higher resistance rates were ampicillin 67.2 percent, trimethoprim-sulfametoxazole 59.2 percent, cefazolin 35.6 percent and ciprofloxacin 24.7 percent. CONCLUSIONS: Resistance to trimethoprim-sulfamethoxazole and ciprofloxacin used for empiric treatment in community urinary infections is high, and there are few available treatment options.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/microbiologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/microbiologia , Escherichia coli/efeitos dos fármacos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Ampicilina/farmacologia , Antibacterianos/farmacologia , Cefazolina/farmacologia , Ciprofloxacina/farmacologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Escherichia coli/genética , Hospitais Privados/estatística & dados numéricos , México/epidemiologia , Combinação Trimetoprima e Sulfametoxazol/farmacologiaRESUMO
OBJECTIVE: To determine the prevalence of iron-deficiency anaemia among rural pregnant women in Valladolid, Yucatan, Mexico. MATERIALS AND METHODS: A descriptive study was carried out from March to May 2006. A clinical-epidemiological survey, a complete blood count test and a ferritin test were applied to a non-random sample conformed by 51 rural pregnant women. RESULTS: Thirty five point two percent of the 51 pregnant women studied presented anaemia, which was more frequent during the second and third trimester, 25.6% of which were adolescents. Abnormal iron profile was found in 41% of the women, 30% (9/51) presented iron-deficiency anaemia which was more frequent in the third trimester. The women with iron-deficiency anaemia had had an average of four pregnancies. No significant difference was found between multiparity and anaemia (square Chi, p = 9.29). CONCLUSIONS: The prevalence of iron-deficient anaemia was 17.64% in this group, more frequent during the third trimester. The hematological alterations were more frequent in multipara women. In a quarter of the sample, pregnancy occurred during adolescence; two events that need greater amounts of iron. The creation of nutritional programs since childhood and the incorporation of ferritin in prenatal care is fundamental for the adequate development and security of both mother and child.
Assuntos
Anemia Ferropriva/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Adolescente , Adulto , Feminino , Humanos , México/epidemiologia , Gravidez , Prevalência , Saúde da População Rural , Adulto JovemRESUMO
We determined abundance of Aedes aegypti mosquitoes and presence of dengue virus (DENV) in females collected from premises of laboratory-confirmed dengue patients over a 12-month period (March 2007 to February 2008) in Merida, Mexico. Backpack aspiration from 880 premises produced 1,836 females and 1,292 males indoors (predominantly from bedrooms) and 102 females and 108 males from patios/backyards. The mean weekly indoor catch rate per home peaked at 7.8 females in late August. Outdoor abundances of larvae or pupae were not predictive of female abundance inside the home. DENV-infected Ae. aegypti females were recovered from 34 premises. Collection of DENV-infected females from homes of dengue patients up to 27 days after the onset of symptoms (median, 14 days) shows the usefulness of indoor insecticide application in homes of suspected dengue patients to prevent their homes from becoming sources for dispersal of DENV by persons visiting and being bitten by infected mosquitoes.
Assuntos
Aedes/fisiologia , Aedes/virologia , Vírus da Dengue/isolamento & purificação , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Dengue/epidemiologia , Feminino , Habitação , Humanos , Lactente , Masculino , México/epidemiologia , Controle de Mosquitos , Densidade Demográfica , Chuva , Estações do Ano , Temperatura , Fatores de TempoRESUMO
OBJECTIVE: To determine the prevalence of secondary effects on lipid metabolism as a result of highly active antiretroviral therapy (HAART), as well as the impact of different types of antiretroviral regimens on lipids and glucose in a group of patients in Yucatan, Mexico. MATERIAL AND METHODS: A cross-sectional study was conducted. A questionnaire created for this study was administered to each patient and total cholesterol, triglycerides and fasting glucose values were determined. The presence of hyperlipidemia and alterations in glucose were determined as well as their relation to the epidemiological variables obtained from the questionnaire. RESULTS: A total of 211 subjects were studied [36 (17%) of which were women and 175 (83%) men]. Ninety-two patients (44%) were found to have hyperlipidemia. Of these, 43 (20%) had hypercholesterolemia (HC) and 82 (39%) hypertriglyceridaemia (HT). The presence of combined HC and HT was observed in 30 (14%) patients. Nineteen (9%) patients had alterations in glucose, six (3%) diabetes mellitus and 13 (6%) impaired glucose tolerance. The variables associated with the presence of hyperlipidemia were: levels of lymphocytes CD4 >350 cells/microl (OR = 2.79 1.08-7.27, p = 0.03), male gender (OR = 3.6 1.4-9.12, p = 0.006) and the use of nucleoside-reverse transcriptase inhibitors (NRTI) (OR = 3.1 1.2-8.1, p = 0.01). CONCLUSIONS: Patients with HIV infection who receive HAART have an increased risk of presenting hyperlipidemia. In this group of patients the presence of hyperlipidemia and impaired glucose tolerance was significant. Unlike what has been indicated in most published reports, the alterations of lipids were associated more frequently with INTR use, for which it is concluded that the pathogeny of these alterations is not unique, that it is probable that concurrent effects exist between different antiretroviral drug families and that other host factors are involved in the pathogenic mechanism of these alterations.