RESUMO
Chlamydophila pneumoniae is a cause of community-acquired pneumonia (CAP) and responsible for 1-2% of cases in paediatric patients. In Mexico, information on this microorganism is limited. The aim of this study was to detect C. pneumoniae using two genomic targets in a real-time PCR and IgM/IgG serology assays in paediatric patients with CAP at a tertiary care hospital in Mexico City and to describe their clinical characteristics, radiological features, and outcomes. A total of 154 hospitalized patients with diagnosis of CAP were included. Detection of C. pneumoniae was performed by real-time PCR of the pst and arg genes. Complete blood cell count, C-reactive protein measurement and IgM and IgG detection were performed. Clinical-epidemiological and radiological data from the patients were collected. C. pneumoniae was detected in 25 patients (16%), of whom 88% had underlying disease (P = 0.014). Forty-eight percent of the cases occurred in spring, 36% in girls, and 40% in children older than 6 years. All patients had cough, and 88% had fever. Interstitial pattern on chest-X-ray was the most frequent (68%), consolidation was observed in 32% (P = 0.002). IgM was positive in 7% and IgG in 28.6%. Thirty-six percent presented complications. Four percent died. A high proportion showed co-infection with Mycoplasma pneumoniae (64%). This is the first clinical report of C. pneumoniae as a cause of CAP in Mexican paediatric patients, using two genomic target strategy and serology. We found a frequency of 16.2% with predominance in children under 6 years of age. In addition; cough and fever were the most common symptoms. Early detection of this pathogen allows timely initiation of specific antimicrobial therapy to reduce development of complications. This study is one of the few to describe the presence of C. pneumoniae in patients with underlying diseases.
Assuntos
Chlamydophila pneumoniae , Infecções Comunitárias Adquiridas , Pneumonia por Mycoplasma , Feminino , Criança , Humanos , Pré-Escolar , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/epidemiologia , Chlamydophila pneumoniae/genética , Patologia Molecular , Tosse , México/epidemiologia , Centros de Atenção Terciária , Mycoplasma pneumoniae/genética , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/epidemiologia , Imunoglobulina G , Imunoglobulina MRESUMO
BACKGROUND: Acute respiratory infections (ARIs) represent an important cause of morbidity and mortality in children, remaining a major public health concern, especially affecting children under 5 years old from low-income countries. Unfortunately, information regarding their epidemiology is still limited in Peru. METHODS: A secondary data analysis was performed from a previous cross-sectional study conducted in children with a probable diagnosis of Pertussis from January 2010 to July 2012. All samples were analyzed via Polymerase Chain Reaction (PCR) for the following etiologies: Influenza-A, Influenza-B, RSV-A, RSV-B, Adenovirus, Parainfluenza 1 virus, Parainfluenza 2 virus, Parainfluenza 3 virus, Mycoplasma pneumoniae and Chlamydia pneumoniae. RESULTS: A total of 288 patients were included. The most common pathogen isolated was Adenovirus (49%), followed by Bordetella pertussis (41%) from our previous investigation, the most prevelant microorganisms were Mycoplasma pneumonia (26%) and Influenza-B (19.8%). Coinfections were reported in 58% of samples and the most common association was found between B. pertussis and Adenovirus (12.2%). CONCLUSIONS: There was a high prevalence of Adenovirus, Mycoplasma pneumoniae and other etiologies in patients with a probable diagnosis of pertussis. Despite the presence of persistent cough lasting at least two weeks and other clinical characteristics highly suspicious of pertussis, secondary etiologies should be considered in children under 5 years-old in order to give a proper treatment.
Assuntos
Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Coqueluche/etiologia , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/etiologia , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Pré-Escolar , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/etiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Tosse/microbiologia , Estudos Transversais , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/etiologia , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Vírus da Parainfluenza 3 Humana/genética , Vírus da Parainfluenza 3 Humana/isolamento & purificação , Peru/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Infecções Respiratórias/epidemiologia , Infecções por Respirovirus/epidemiologia , Infecções por Respirovirus/etiologia , Coqueluche/diagnóstico , Coqueluche/epidemiologiaRESUMO
ANTECEDENTES: La colangitis biliar primaria (CBP) es una enfermedad hepática inflamatoria crónica colestásica de causa desconocida. Varios patógenos virales y bacterianos han sido propuestos como factores que podrían gatillar una respuesta inmune por mimetismo molecular, o directamente estar relacionados en la persistencia del daño biliar. Existen reportes controversiales respecto al rol de en la patogenia de CBP. OBJETIVOS: Investigar marcadores de infección de séricos y en hígado de pacientes con CBP. PACIENTES Y MÉTODOS: Veinte pacientes diagnosticados con CBP y 20 pacientes control con otras enfermedades hepáticas crónicas no colestásicas fueron estudiados. Se determinaron anticuerpos séricos anti- (IgG). Se realizó detección inmunohistoquímica de antígenos de en hígado. Se extrajo DNA de hígado para amplificación de la secuencia específica de rRNA 16S de por PCR. Fueron usados controles de amplificación de DNA bacteriano y humano. Los pacientes firmaron consentimiento informado. Se realizó un metaanálisis de la diferencia de riesgo de CBP en pacientes infectados por y en un grupo control. RESULTADOS: Los anticuerpos séricos fueron positivos en 30% de los pacientes con CBP y 50% de los controles (p = NS). Antígenos de no fueron detectados en tejido hepático de pacientes con CBP ni de controles. No se amplificó ADN bacteriano en ninguna de las muestras. El metaanálisis de la diferencia de riesgo mostró gran heterogeneidad de los estudios, por lo que no se realizó una estimación de diferencia de riesgo agrupada. DISCUSIÓN: No encontramos asociación entre infección por y CBP. En la evidencia actual, un estudio presenta resultados a favor de la asociación entre y CBP y tres estudios resultados en contra.,
Primary biliary cholangitis (PBC) is a chronic cholestatic inflammatory liver disease of unknown cause. Several viral and bacterial pathogens have been proposed as factors that could either trigger an immune response by molecular mimicry or directly be involved in the persistence of biliary damage. There are conflicting reports respecting the role of in the pathogenesis of PBC. To investigate markers of infection in serum and liver tissue from patients with PBC. Twenty patients with diagnosis of PBC and 20 control patients with other non-cholestatic chronic liver diseases were studied. Serum anti- antibodies (IgG) were determined. Liver tissue was available for immunohistochemistry detection of antigens. DNA was extracted from liver tissue and a specific sequence of 16S rRNA gene was amplified by CPR. Adequate controls of bacterial and human DNA amplification were used. Informed consent was obtained from patients. A meta-analysis of risk difference of PBC in Chlamydophila pneumoniae infected patients and in the control groupwas performed. Serum antibodies were positive in 30% of patients with PBC and 50% of controls (p = NS). antigens were not detected in liver tissue neither of patients with PBC nor controls. Bacterial DNA did not amplify in any of the samples, despite good amplification of internal and external controls. Risk difference meta-analysis showed high heterogeneity between studies. Therefore, we did not estimate a pooled risk difference. Our results do not support the association between infection and PBC. In the current literature only one study shows an association between and PBC, but other three studies do not support it.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydophila/complicações , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/microbiologia , DNA Bacteriano , Imunoglobulina G , Imuno-Histoquímica , RNA Ribossômico 16S/análise , Estudos de Casos e Controles , Reação em Cadeia da Polimerase , Chlamydophila pneumoniae/genética , Fígado/microbiologia , Cirrose Hepática Biliar/etiologiaRESUMO
BACKGROUND: The etiology of myxomatous mitral valve degeneration (MVD) is not fully understood and may depend on time or environmental factors for which the interaction of infectious agents has not been documented. The purpose of the study is to analyze the effect of Mycoplasma pneumoniae (Mp), Chlamydophila pneumoniae (Cp) and Borrelia burgdorferi (Bb) on myxomatous mitral valve degeneration pathogenesis and establish whether increased in inflammation and collagen degradation in myxomatous mitral valve degeneration etiopathogenesis. METHODS: An immunohistochemical test was performed to detect the inflammatory cells (CD20, CD45, CD68) and Mp, Bb and MMP9 antigens in two groups. The in situ hybridization was performed to detect Chlamydophila pneumoniae and the bacteria study was performed using transmission electron microscopy. Group 1 (n = 20), surgical specimen composed by myxomatous mitral valve degeneration, and group 2 (n = 20), autopsy specimen composed by normal mitral valve. The data were analyzed using SigmaStat version 20 (SPSS Inc., Chicago, IL, USA). The groups were compared using Student's t test, Mann-Whitney test. A correlation analysis was performed using Spearman's correlation test. P values lower than 0.05 were considered statistically significant. RESULTS: By immunohistochemistry, there was a higher inflammatory cells/mm2 for CD20 and CD45 in group 1, and CD68 in group 2. Higher number of Mp and Cp antigens was observed in group 1 and more Bb antigens was detected in group 2. The group 1 exhibited a positive correlation between the Bb and MVD percentage, between CD45 and Mp, and between MMP9 with Mp. These correlations were not observed in the group 2. Electron microscopy revealed the presence of structures compatible with microorganisms that feature Borrelia and Mycoplasma characteristics. CONCLUSIONS: The presence of infectious agents, inflammatory cells and collagenases in mitral valves appear to contribute to the pathogenesis of MVD. Mycoplasma pneumoniae was strongly related with myxomatous mitral valve degeneration. Despite of low percentage of Borrelia burgdorferi in MD group, this agent was correlated with myxomatous degeneration and this may occour due synergistic actions between these infectious agents likely contribute to collagen degradation.
Assuntos
Borrelia burgdorferi/patogenicidade , Chlamydophila pneumoniae/patogenicidade , Valva Mitral/microbiologia , Valva Mitral/patologia , Mycoplasma pneumoniae/patogenicidade , Idoso , Estudos de Casos e Controles , Chicago , Chlamydophila pneumoniae/genética , Colágeno/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Metaloproteinase 9 da Matriz/metabolismo , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/patologia , Miocardite/microbiologia , Miocardite/patologia , Fatores de RiscoRESUMO
In this study, genetic diversity of Chlamydia pneumoniae was investigated and the relationships between sequences amplified of different sources, clinical conditions and geographical regions of central Argentina were established. Samples amplified were similar to human C. pneumoniae patterns and show the high clonality of the population.
Assuntos
Chlamydophila pneumoniae/genética , Animais , Argentina , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Bactérias/genética , Infecções por Chlamydia/microbiologia , Chlamydophila pneumoniae/isolamento & purificação , Chlamydophila pneumoniae/patogenicidade , Humanos , FilogeniaRESUMO
In the central area of Argentina, the epidemiological and molecular characteristics of Chlamydophila pneumoniae infections in reptiles are still unknown. A nested polymerase chain reaction of the rpoB gene was used to detect C. pneumoniae in cloacal swab samples from 19 reptiles at a recreational area. Eleven (57.89%) reptiles were positive; the sequencing and phylogenetic analysis confirmed the presence of this bacterium. Neither C. pneumoniae DNA in the caregivers pharynges nor IgM antibodies anti-C. pneumoniae in their serum samples were detected; however, caregivers presented very high titers of IgG anti-C. pneumoniae. The detection of C. pneumoniae DNA in reptiles demonstrated the circulation of this agent in the recreational area and could be responsible for the exacerbated immune response of the personnel handling the reptiles, which suggests a potential zoonotic cycle. This is the first report of the detection of C. pneumoniae in reptiles in Argentina.
Assuntos
Infecções por Chlamydophila/veterinária , Chlamydophila pneumoniae/isolamento & purificação , Reservatórios de Doenças/microbiologia , Répteis/microbiologia , Criação de Animais Domésticos , Animais , Anticorpos Antibacterianos/sangue , Argentina/epidemiologia , Boidae/microbiologia , Bothrops/microbiologia , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/microbiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/imunologia , Cloaca/microbiologia , DNA Bacteriano/análise , DNA Bacteriano/genética , Elapidae/microbiologia , Humanos , Dados de Sequência Molecular , Exposição Ocupacional , Faringe/microbiologia , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Tartarugas/microbiologia , ZoonosesRESUMO
In the central area of Argentina, the epidemiological and molecular characteristics of Chlamydophila pneumoniae infections in reptiles are still unknown. A nested polymerase chain reaction of the rpoB gene was used to detect C. pneumoniae in cloacal swab samples from 19 reptiles at a recreational area. Eleven (57.89
) reptiles were positive; the sequencing and phylogenetic analysis confirmed the presence of this bacterium. Neither C. pneumoniae DNA in the caregivers pharynges nor IgM antibodies anti-C. pneumoniae in their serum samples were detected; however, caregivers presented very high titers of IgG anti-C. pneumoniae. The detection of C. pneumoniae DNA in reptiles demonstrated the circulation of this agent in the recreational area and could be responsible for the exacerbated immune response of the personnel handling the reptiles, which suggests a potential zoonotic cycle. This is the first report of the detection of C. pneumoniae in reptiles in Argentina.
Assuntos
Infecções por Chlamydophila/veterinária , Chlamydophila pneumoniae/isolamento & purificação , Reservatórios de Doenças/microbiologia , Répteis/microbiologia , Criação de Animais Domésticos , Animais , Anticorpos Antibacterianos/sangue , Argentina/epidemiologia , Boidae/microbiologia , Bothrops/microbiologia , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/microbiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/imunologia , Cloaca/microbiologia , DNA Bacteriano/análise , DNA Bacteriano/genética , Elapidae/microbiologia , Humanos , Dados de Sequência Molecular , Exposição Ocupacional , Faringe/microbiologia , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Tartarugas/microbiologia , ZoonosesRESUMO
OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD). METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP) were included in this study. Patients were admitted to the HC UNICAMP and stratified into three groups: in group 1, we selected patients with severe chronic periodontitis (31 men and 19 women, mean age 55.1 +/- 11.29 years old); the group 2 with mild chronic periodontitis (40 men and 28 women, mean age 54.8 +/- 10.37 years old) and group 3 represented by the toothless (43 men and 20 women, mean age 67.5 +/- 8.55 years old). Blood samples were collected to measure the lipid profiles, hematological and blood glucose levels. In addition, biopsies of seventeen coronary arteries with atherosclerosis and an equal number of internal mammary arteries without atherosclerotic degeneration in group 1 were investigated. Statistical analysis by analysis of variance (ANOVA) and Scheffé test for multiple comparisons was performed. RESULTS: Triglyceride and LDL levels were elevated in group 1 than in group 2. HDL were reduced by 20% in group 1 and remained reduced by 8% in toothless. Blood glucose was higher in group 1. DNA of periodontal bacteria was detected in 58.8% of the coronary arteries. CONCLUSIONS: Patients with (AIHD) and severe chronic periodontitis may have altered lipid profile, as well as microorganisms associated with CP can permeate into coronary vessels.
Assuntos
Periodontite Crônica/complicações , Isquemia Miocárdica/microbiologia , Doença Aguda , Idoso , Análise de Variância , Glicemia/análise , Estudos de Casos e Controles , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Periodontite Crônica/sangue , Vasos Coronários/microbiologia , Vasos Coronários/patologia , DNA Bacteriano/sangue , Feminino , Humanos , Lipídeos/sangue , Masculino , Artéria Torácica Interna/microbiologia , Artéria Torácica Interna/patologia , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Isquemia Miocárdica/patologiaRESUMO
OBJETIVO: Processos inflamatórios e infecciosos mediados por bactérias em sítios distantes têm sido descritos como fator de risco à doença coronariana isquêmica aguda (DCIA). MÉTODOS: Cento e oitenta e um pacientes com DCIA, com e sem periodontites crônicas, foram incluídos neste estudo. Os pacientes foram admitidos no HC da UNICAMP e estratificados em três grupos: grupo 1 - pacientes com periodontite crônica grave (31 homens e 19 mulheres; média de idade 55,1 ± 11,29 anos); grupo 2 - pacientes com periodontite crônica leve (40 homens e 28 mulheres; média de idade 54,8 ± 10,37 anos); grupo 3 - pacientes desdentados (43 homens e 20 mulheres; média de idade 67,5 ± 8,55 anos). Amostras sanguíneas foram coletadas para mensurar os perfis lipídico, hematológico e glicêmico. Além disso, biópsias de 17 artérias coronárias com aterosclerose e igual número de artérias mamárias internas sem degeneração aterosclerótica no grupo 1 foram investigadas. Para análise estatística utilizou-se a análise de variância (ANOVA) e o teste de Scheffé para comparações múltiplas. RESULTADOS: Triglicérides e LDL estavam elevados no grupo 1 em relação ao grupo 2. O HDL apresentou-se reduzido em 20 por cento dos pacientes do grupo 1, e em 8 por cento nos desdentados. A glicemia estava elevada no grupo 1. DNA de bactérias periodontais foram detectados em 58,8 por cento das artérias coronárias. CONCLUSÕES: Pacientes com DCIA e periodontite crônica grave podem apresentar perfil lipídico alterado, como também microorganismos associados com as periodontites crônicas graves podem permear dentro de vasos coronarianos.
OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD). METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP) were included in this study. Patients were admitted to the HC UNICAMP and stratified into three groups: in group 1, we selected patients with severe chronic periodontitis (31 men and 19 women, mean age 55.1 ± 11.29 years old); the group 2 with mild chronic periodontitis (40 men and 28 women, mean age 54.8 ± 10.37 years old) and group 3 represented by the toothless (43 men and 20 women, mean age 67.5 ± 8.55 years old). Blood samples were collected to measure the lipid profiles, hematological and blood glucose levels. In addition, biopsies of seventeen coronary arteries with atherosclerosis and an equal number of internal mammary arteries without atherosclerotic degeneration in group 1 were investigated. Statistical analysis by analysis of variance (ANOVA) and Scheffé test for multiple comparisons was performed. RESULTS: Triglyceride and LDL levels were elevated in group 1 than in group 2. HDL were reduced by 20 percent in group 1 and remained reduced by 8 percent in toothless. Blood glucose was higher in group 1. DNA of periodontal bacteria was detected in 58.8 percent of the coronary arteries. CONCLUSIONS: Patients with (AIHD) and severe chronic periodontitis may have altered lipid profile, as well as microorganisms associated with CP can permeate into coronary vessels.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite Crônica/complicações , Isquemia Miocárdica/microbiologia , Doença Aguda , Análise de Variância , Glicemia/análise , Estudos de Casos e Controles , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Periodontite Crônica/sangue , Vasos Coronários/microbiologia , Vasos Coronários/patologia , DNA Bacteriano/sangue , Lipídeos/sangue , Artéria Torácica Interna/microbiologia , Artéria Torácica Interna/patologia , Isquemia Miocárdica/sangue , Isquemia Miocárdica/patologiaRESUMO
OBJECTIVE: To investigate the possible relationship between atherothrombotic stroke and Chlamydia pneumoniae. METHOD: 150 patients with carotid atherothrombosis were enrolled. The casuistic was divided in three groups: ischemic stroke (IS): 65 patients; transient ischemic attack (TIA): 26 patients; and control: 59. The IS or TIA onset was up to 30 days from the beginning of the study. Carotid atheromatoses was diagnosed by Doppler-ultrasonography. Patients with cardioembolic risk or non-atherothrombotic origin were excluded. Comparisons were done between the three groups, and within each group according to the different age sub-groups, to the main arteries affected, and to the atherogenic risk factors. Bacteria detection was done using polimerase chain reaction. RESULTS: Only one patient tested positive for C. pneumoniae belonging to the control group. CONCLUSION: These results do not suggest that C. pneumoniae participated in the onset of IS or TIA or that it has a role in carotid plaque destabilization.