José María Navarro

Viral infections of the central nervous system in Spain: A prospective study

The aim of the study was to determine the incidence of viruses causing aseptic meningitis, meningoencephalitis, and encephalitis in Spain. This was a prospective study, in collaboration with 17 Spanish hospitals, including 581 cases (CSF from all and sera from 280): meningitis (340), meningoencephalitis (91), encephalitis (76), febrile syndrome (7), other neurological disorders (32), and 35 cases without clinical information. CSF were assayed by PCR for enterovirus (EV), herpesvirus (herpes simplex [HSV], varicella‐zoster [VZV], cytomegalovirus [CMV], Epstein–Barr [EBV], and human herpes virus‐6 [HHV‐6]), mumps (MV), Toscana virus (TOSV), adenovirus (HAdV), lymphocytic choriomeningitis virus (LCMV), West Nile virus (WNV), and rabies. Serology was undertaken when methodology was available. Amongst meningitis cases, 57.1% were characterized; EV was the most frequent (76.8%), followed by VZV (10.3%) and HSV (3.1%; HSV‐1: 1.6%; HSV‐2: 1.0%, HSV non‐typed: 0.5%). Cases due to CMV, EBV, HHV‐6, MV, TOSV, HAdV, and LCMV were also detected. For meningoencephalitis, 40.7% of cases were diagnosed, HSV‐1 (43.2%) and VZV (27.0%) being the most frequent agents, while cases associated with HSV‐2, EV, CMV, MV, and LCMV were also detected. For encephalitis, 27.6% of cases were caused by HSV‐1 (71.4%), VZV (19.1%), or EV (9.5%). Other positive neurological syndromes included cerebellitis (EV and HAdV), seizures (HSV), demyelinating disease (HSV‐1 and HHV‐6), myelopathy (VZV), and polyradiculoneuritis (HSV). No rabies or WNV cases were identified. EVs are the most frequent cause of meningitis, as is HSV for meningoencephalitis and encephalitis. A significant number of cases (42.9% meningitis, 59.3% meningoencephalitis, 72.4% encephalitis) still have no etiological diagnosis. J. Med. Virol. 85:554–562, 2013.

Granada Virus: a Natural Phlebovirus Reassortant of the Sandfly Fever Naples Serocomplex with Low Seroprevalence in Humans

A new member of the phlebovirus genus, tentatively named Granada virus, was detected in sandflies collected in Spain. By showing the presence of specific neutralizing antibodies in human serum collected in Granada, we show that Granada virus infects humans. The analysis of the complete genome of Granada virus revealed that this agent is likely to be a natural reassortant of the recently described Massilia virus (donor of the long and short segments) with a yet unidentified phlebovirus (donor of the medium segment).

Infecciones por el virus de Toscana, el virus del Nilo occidental y otros arbovirus de interés en Europa

Arbovirosis, viral infection transmitted by arthropods, is a widespread health problem. Recurrent outbreaks caused by some of these viruses such as dengue or West Nile strains in regions where they do not appear frequently, justify the establishment of global control measures. Tick-borne encephalitis viruses, sand fly fever viruses (Toscana, Naples and Sicily) and occasionally West Nile and Crimean-Congo fever viruses are the most frequent causes of arbovirosis in Europe, although circulation of other potentially pathogenetic viruses such as Chikungunya has also been detected. The only native arbovirosis described in Spain is infection produced by Toscana virus, which causes aseptic, usually benign meningitis. Nevertheless, some West Nile virus-associated meningo-encephalitis cases have been described in France, Portugal and countries in the Magreb region, increasing the risk of sporadic occurrence of these processes in our country. To achieve an accurate diagnosis, high clinical suspicion is required as well as highly specific laboratory techniques, mainly based on IgM detection, RT-PCR and viral culture of CSF and/or serum.

Performance of the Sysmex UF1000i system in screening for significant bacteriuria before quantitative culture of aerobic/facultative fast-growth bacteria in a reference hospital.

To evaluate the performance of the Sysmex UF1000i automatic urine screening system in the quantitative culture of fast‐growth aerobic/facultative bacteria.

Meningitis por el virus Toscana en España: descripción de 17 casos

Fundamento Y Objetivo Hemos analizado los datos clinicos y epidemiologicos de los primeros 17 casos de meningitis por el virus Toscana en Espana. Pacientes Y Metodo Se procesaron 724 muestras de liquido cefalorraquideo de pacientes con sospecha de meningitis aseptica para aislamiento de virus en cultivo celular, y se analizaron las historias clinicas de los pacientes con aislamiento del virus Toscana Resultados Se aislo el virus Toscana en el liquido cefalorraquideo de 17 pacientes (7% de los aislamientos virales). El primer caso se diagnostico en junio de 1988 y el ultimo en agosto de 2002. La edad media fue de 27 anos (intervalo, 10–64 anos). La mayoria de los pacientes procedian del medio rural (n = 11; 64,7%). Los sintomas predominantes fueron la cefalea (holocraneal o focalizada), que se presento en todos los pacientes, y fiebre moderada, que aparecio en el 76,5%, con una duracion media de 48 h (intervalo, 18 h-5 dias). La rigidez de nuca se presento en 9 enfermos (53%). Todos los casos se presentaron en los meses comprendidos entre junio y octubre, con predominio en el mes de agosto (53%). La evolucion fue buena en todos los casos, con un tiempo medio de duracion de la enfermedad de 7 dias (intervalo, 3–10 dias) Conclusiones El virus Toscana debe considerarse entre los agentes causantes de meningitis linfocitaria en Espana

C-reactive protein as a prognostic indicator in acute brucellosis

Pre- and post-treatment measurements of C-reactive protein (CRP) in 85 patients with acute brucellosis were useful in predicting the diseases evolution and response to treatment. A positive value for CRP (greater than 1 microgram/dl) was significantly associated with an unfavorable course, with a negative predictive value of 0.95.

Evaluation of three rapid enzyme immunoassays and cell culture for detection of respiratory syncytial virus

Three rapid enzyme immunoassay techniques for the detection of respiratory syncytial virus antigen (Becton Dickinson Directigen RSV, Abbott RSV Testpack and Abbott RSV EIA) and cell culture were evaluated in a total of 250 nasal washings. The sensitivity and specificity were 62 % and 76 % respectively for Directigen, 64 % and 86 % for RSV Testpack, and 76 % and 81 % for RSV EIA, taking cell culture as the reference method. Agreement between cell culture and EIA techniques was 79 % (70 positive and 128 negative results). All three EIA techniques gave positive results in 69 samples (52 positive and 17 negative in the cell culture). In 121 samples all three EIA techniques gave negative results (103 negative and 18 positive in the cell culture). Using the cell culture technique 46 strains other than respiratory syncytial virus were isolated.

EVALUATION OF IMMUNOFLUORESCENCE, TWO ENZYME IMMUNOASSAYS AND THE SHELL-VIAL ASSAY FOR DETECTION OF RESPIRATORY SYNCYTIAL VIRUS

yzoites. The highest values below the threshold for negative sera could be related to the low sensitivity of IIF and DAT (7 and 4 IUlml) and the high sensitivity of IEIA. The presence of naturally occurring antibodies to Toxoplasma gondii may be an alternative explanation. Indeed, Potasman et al. (7) found on Western blotting that sera of some uninfected individuals react with a 30 kD band which might correspond to P30.

Sysmex UF-1000i performance for screening yeasts in urine

We tested the capacity of the Sysmex UF‐1000i system to detect yeasts in urine by screening a total of 22 132 urine samples received for culture in our microbiology laboratory during 1 year. We also analyzed different dilutions of previously filtered urine inoculated with a strain of Candida albicans. With clinical samples, a single cut‐off point of 50 yeast‐like cells (YLCs)/μL detected candiduria ≥10 000 colony forming units (CFU)/mL and >100 000 CFU/mL with a sensitivity of 87.3%/95.4%, a specificity of 97%, a negative predictive value of 95.9%, and a positive predictive value of 9.3%/5.7%. With the simulated samples, a linear relationship was observed between the dilution factor and the number of cells detected by UF‐1000i. This instrument appears to be able to reliably rule out candiduria of a magnitude of at least 10 000 CFU/mL and facilitate urine sample screening, thereby providing fast results. The Sysmex UF1000i system can be adapted for candiduria screening by the use of an appropriate YLCs/μL cut‐off point that takes account of the prevalence of candiduria in the population.

Comparison between urine culture profile and morphology classification using fluorescence parameters of the sysmex uf‐1000i urine flow cytometer

To determine the usefulness of the fluorescence parameters generated by Sysmex UF‐1000i flow cytometer for the rapid diagnosis of urinary tract infection by bacilli or cocci.