RESUMO
PURPOSE: Fascioliasis is a worldwide distributed trematodiasis considered a neglected disease. Diagnosis in humans has been traditionally based on parasitological and immunological techniques. Recently we reported the use of the PCR in stool samples for the individual diagnosis. The purpose of this study was to evaluate human fascioliasis by a combination of diagnostic methods in an area where the disease is highly endemic in animals. METHODS: We studied all the inhabitants (N = 240) of Tatón village, Argentina, by Fasciola hepatica rproCL1-ELISA. Among them, we continued the study with 13 cases that had at least two positive serological tests, who performed a questionnaire, physical examination, abdominal ultrasonography, and collection of blood and faeces. Blood/serum samples were used for Fh rproCL1-ELISA and liver function tests. Faeces were used for parasitological analysis and PCR of a repetitive fragment of Fasciola sp. RESULTS: Among the 13 patients, 9 presented symptoms of biliary colic. All patients repeated positive serology. F. hepatica eggs were not detected. PCR was positive in 11 cases. CONCLUSION: This is the first report employing an approach based on the combination of methods for the evaluation of human fascioliasis in an endemic area, which includes molecular tools with a high value in detecting low infections.
Assuntos
Fasciola hepatica , Fasciolíase , Animais , Antígenos de Helmintos , Argentina , Ensaio de Imunoadsorção Enzimática , Fezes , Humanos , Reação em Cadeia da Polimerase , Sensibilidade e EspecificidadeAssuntos
beta-Lactamases , Prevalência , Doenças Musculoesqueléticas , Enterobacteriaceae , InfecçõesRESUMO
Fasciola hepatica is a trematode showing genetic variation among isolates from different regions of the world. The objective of this work was to characterize for the first time F. hepatica isolates circulating in different regions of Argentina. Twenty-two adult flukes were collected from naturally infected bovine livers in different areas from Argentina and used for DNA extraction. We carried out PCR amplification and sequence analysis of the ribosomal internal transcribed spacer 1 (ITS1), mitochondrial nicotinamide adenine dinucleotide dehydrogenase subunits 4 and 5 (nad4 and nad5) and mitochondrial cytochrome c oxidase subunit I (cox1) genes as genetic markers. Phylogenies were reconstructed using maximum parsimony algorithm. A total of 6 haplotypes were found for cox1, 4 haplotypes for nad4 and 3 haplotypes for nad5. The sequenced ITS1 fragment was identical in all samples. The analyzed cox1 gene fragment is the most variable marker and is recommended for future analyses. No geographic association was found in the Argentinean samples.
Assuntos
DNA de Helmintos/genética , DNA Mitocondrial/genética , Fasciola hepatica/genética , Marcadores Genéticos , Animais , Argentina , FilogeniaRESUMO
We report a Serratia marcescens outbreak occurred in the NICU of a pediatric hospital in Guayaquil, Ecuador. Nine cases of infection were detected, from which septicemia was developed in 55.5%. The index case was a newborn derived from another institution with septic arthritis caused by the outbreak strain. The infection rate was 17.6% and mortality rate was 33.3%. All isolates were resistant to aminoglycosides and susceptible to third generation cephalosporins and carbapenems. Clonality analysis by pulsed-field gel electrophoresis (PFGE) revealed the presence of two closely related clones confirming the horizontal spread. Measures were taken by the committee such as: strengthening the hand hygiene, patient hygiene and cohort studies of gastrointestinal colonization, which allowed the control of the outbreak.
Comunicamos un brote nosocomial por Serratia marcescens en una Unidad de Cuidados Intensivos en un hospital pediátrico de Guayaquil, Ecuador. Se detectaron nueve casos de infección, manifestándose en 55,5% de los casos como sepsis. El caso índice correspondió a un neonato derivado de otra institución con artritis séptica. La tasa de ataque fue 17,6% (n: 51) y la mortalidad 33,3%. Todos los aislados presentaron resistencia a las cefalosporinas y aminoglucósidos y sensibilidad a carbapenémicos. El análisis de clonalidad reveló la presencia de dos clones estrechamente relacionados, confirmando la diseminación horizontal. Las medidas de control de brote fueron: reforzamiento de higiene de manos, cohorte de los pacientes y búsqueda de colonización gastrointestinal.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Serratia marcescens/isolamento & purificação , Unidades de Terapia Intensiva Neonatal , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Serratia/epidemiologia , Serratia marcescens/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Infecção Hospitalar/microbiologia , Infecções por Serratia/microbiologia , Equador/epidemiologiaRESUMO
BACKGROUND: In South America, fascioliasis stands out due to the human endemic areas in many countries. In Argentina, human endemic areas have recently been detected. Lymnaeid vectors were studied in two human endemic localities of Catamarca province: Locality A beside Taton and Rio Grande villages; Locality B close to Recreo town. METHODS: Lymnaeids were characterised by the complete sequences of rDNA ITS-2 and ITS-1 and fragments of the mtDNA 16S and cox1. Shell morphometry was studied with the aid of a computer image analysis system. Climate analyses were made by nearest neighbour interpolation from FAO data. Koeppen & Budyko climate classifications were used. De Martonne aridity index and Gorczynski continentality index were obtained. Lymnaeid distribution was assessed in environmental studies. RESULTS: DNA sequences demonstrated the presence of Lymnaea neotropica and L. viator in Locality A and of L. neotropica in Locality B. Two and four new haplotypes were found in L. neotropica and L. viator, respectively. For interspecific differentiation, ITS-1 and 16S showed the highest and lowest resolution, respectively. For intraspecific analyses, cox1 was the best marker and ITS-1 the worst. Shell intraspecific variability overlapped in both species, except maximum length which was greater in L. viator. The desertic-arid conditions surrounding Locality A, the semiaridity-aridity surrounding Locality B, and the very low yearly precipitation in both localities, are very different from the typical fascioliasis transmission foci. Lymnaeids are confined to lateral river side floodings and small man-made irrigation systems. Water availability only depends on the rivers flowing from neighbouring mountains. All disease transmission factors are concentrated in small areas where humans and animals go for water supply, vegetable cultures and livestock farming. CONCLUSIONS: The unusually high number of DNA haplotypes and the extreme climate unsuitable for F. hepatica and lymnaeid development, demonstrate that the transmission foci are isolated. Seasonal transmission may depend on the timely overlap of appropriate temperature and river water availability. Lymnaeids and F. hepatica have probably reached these localities by livestock introduction. DNA differences regarding other populations of L. neotropica and L. viator in Argentina suggest an introduction independent from the spreading movements which allowed these two lymnaeids to expand throughout the country.
Assuntos
Vetores de Doenças , Fasciola hepatica/fisiologia , Fasciolíase/transmissão , Lymnaea/classificação , Animais , Argentina , Ciclo-Oxigenase 1/genética , DNA Mitocondrial/química , DNA Mitocondrial/genética , DNA Ribossômico/química , DNA Ribossômico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Meio Ambiente , Fasciolíase/parasitologia , Feminino , Haplótipos , Humanos , Lymnaea/genética , Lymnaea/parasitologia , Masculino , Filogenia , Análise de Sequência de DNARESUMO
We report a Serratia marcescens outbreak occurred in the NICU of a pediatric hospital in Guayaquil, Ecuador. Nine cases of infection were detected, from which septicemia was developed in 55.5%. The index case was a newborn derived from another institution with septic arthritis caused by the outbreak strain. The infection rate was 17.6% and mortality rate was 33.3%. All isolates were resistant to aminoglycosides and susceptible to third generation cephalosporins and carbapenems. Clonality analysis by pulsed-field gel electrophoresis (PFGE) revealed the presence of two closely related clones confirming the horizontal spread. Measures were taken by the committee such as: strengthening the hand hygiene, patient hygiene and cohort studies of gastrointestinal colonization, which allowed the control of the outbreak.
Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Unidades de Terapia Intensiva Neonatal , Infecções por Serratia/epidemiologia , Serratia marcescens/isolamento & purificação , Infecção Hospitalar/microbiologia , Equador/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Infecções por Serratia/microbiologia , Serratia marcescens/efeitos dos fármacosRESUMO
The study evaluated the antibiotic resistance patterns of Helicobacter pylori strains against metronidazole and clarithromycin in a hospital in Havana, Cuba. Eighty-five percent, 22.5%, and 10% of 40 H. pylori strains investigated were resistant to metronidazole, ciprofloxacin, and clarithromycin respectively but all were susceptible to amoxicillin and tetracycline. RdxA truncation was found only in metronidazole-resistant strains. In such strains, reported are eight and two novel mutations in the rdxA and frxA genes respectively. Two-point mutations in the 23S rRNA genes of clarithromycin-resistant strains were detected. A high prevalence of metronidazole resistance was found in Cuban H. pylori strains. Mutations in the rdxA gene may contribute more significantly than frxA gene to the high level of resistance to metronidazole. This study supports the need to continue monitoring the antibiotic susceptibility in H. pylori in Cuba to guide the treatment of such infection.