Margarita Baquero

Limited level of accuracy provided by available rapid diagnosis tests for malaria enhances the need for PCR-based reference laboratories.

ABSTRACT The rise of imported malaria cases and the high fatality rate in Europe make the search for new and easy diagnostic methods necessary. Rapid diagnosis tests (RDTs) are, in part, developed to cover the lack of diagnosis experience. Unfortunately, our data suggest that the accuracy of RDTs is insufficient and could increase the number of incorrect malaria diagnoses.

First Case of HIV-1 Group O Infection in Spain

A 34‐year‐old woman born in Bilbao, a northern city in Spain, was first seen at our institution in April 1995. She had maintained a monogamous sexual relation in the preceding 6 years with a 35‐year‐old male, and previously has sex only sporadically with two other persons. She as well as her three partners were Spanish‐born, and had neither a history of transfusions, nor of injecting drugs, nor were they homosexual.

Performance of OraQuick Advance® Rapid HIV-1/2 Antibody Test for detection of antibodies in oral fluid and serum/plasma in HIV-1+ subjects carrying different HIV-1 subtypes and recombinant variants

BACKGROUND Rapid, simple, low-cost, sensitive, and specific tests are needed to detect antibodies to all HIV-1 subtypes, especially in developing countries. OBJECTIVE To evaluate the performance of a rapid diagnostic test for detection of HIV-1/2 antibodies in oral fluids and sera/plasma from subjects from geographic areas infected with different HIV-1 variants. STUDY DESIGN OraQuick Rapid HIV-1/2 Diagnostic Test was evaluated in sera and oral fluids from 100 subjects from Spain and South-America. It was also assessed in 56 plasma and 39 oral fluid specimens from 56 Africans carrying HIV-1 non-B subtypes or inter-subtype recombinants defined by phylogenetic analysis at pol and gp41 coding regions. All patients were previously diagnosed as HIV-1 positive by serological tests (Abbott AxSYM HIV-1/2; Western Blot HIV-1/HIV-2 and Pepti-LAV, BIO-RAD). RESULTS OraQuick provided positive results in all 156 serum/plasma specimens regardless of the infecting HIV-1 subtype, and in 136/139 (97.8%) oral fluids. The three oral specimens (2.2%) that yielded false-negative results by OraQuick were taken from one subtype B-infected Spaniard and from two subtype D-infected Africans. The last two were also negative by Pepti-LAV using plasma samples. Ten additional sera and 32 oral fluids from HIV-negative individuals yielded negative results by OraQuick. This rapid test showed good sensitivity for detecting anti-HIV-1 antibodies in oral fluids and in serum/plasma specimens from subjects carrying different HIV-1 subtypes and recombinant variants. CONCLUSION OraQuick demonstrated its utility for detecting infections due to HIV-1 subtypes and recombinants common in developing countries.

High Prevalence of Seropositivity to a Major Allergen of Anisakis simplex, Ani s 1, in Dyspeptic Patients

ABSTRACT Finding evidence of anisakidosis requires invasive methods. We have developed a serological assay based on the detection of an immunoglobulin E (IgE) specifically directed against Ani s 1 protein, a major parasite allergen of Anisakis simplex, which has shown a high level of accuracy in the diagnosis of anisakidosis. We used this tool to determine the prevalence of anti-Ani s 1 IgE in dyspeptic patients and to investigate if its seropositivity could be related to epidemiological factors other than raw fish consumption. A total of 174 dyspeptic patients who submitted to upper digestive tract endoscopy were studied. Specific IgE against Ani s 1 was determined by immunoblotting. Quantitative information on smoking, alcohol consumption, and fish consumption as well as a history of gastric surgery was recorded. Twenty-four (13.8%) patients were seropositive for Ani s 1 protein. The seroprevalence of anti-Ani s 1 IgE increased with age in patients who were less than 62 years old (P = 0.047). Seropositivity to Ani s 1 was associated with the consumption of fish in vinegar (P < 0.001), raw fish (P = 0.001), and smoked fish (P = 0.007). There was no relationship between anti-Ani s 1 IgE seropositivity and the number of cigarettes smoked (P = 0.098) or alcohol intake (P = 0.179). Five patients had undergone previous gastric surgery, and three of those patients were seropositive for Ani s 1 (P = 0.019). In multivariate analysis, the consumption of fish in vinegar (P = 0.006), raw fish (P = 0.017), and smoked fish (P = 0.002) and a history of gastric surgery (P = 0.005) were independent factors associated with anti-Ani s 1 IgE detection. In conclusion, at present, anisakidosis might frequently be underdiagnosed, and it might have a clinical role in patients with upper dyspeptic symptoms. Uncooked-fish ingestion and previous gastric surgery were associated with seropositivity for Ani s 1 protein.

Is Infection by Dermatophilus congolensis Underdiagnosed

ABSTRACT Dermatophilus congolensis, which affects animal species, is an uncommon human infection. Few cases, mainly in tropical areas, have been reported. We describe the first human infection in Spain in a traveler returning from Central America. Diagnosis of human infection may be underestimated in people in contact with animals.

Isolation of Alloiococcus otitidis from the external ear in children

In 1989 Faden and Dryja [4] reported the isolation of unknown gram-positive cocci from middle ear fluid collected by tympanocentesis in children with persistent otitis media. They suggested these bacteria played a role in causing chronic otitis media due to their intracellular location and the presence of inflammatory cells in the effusions. Aguirre and Collins [5] proposed the name Alloiococcus otitis for this organism. A change of this name to Alloiococcus otitidis has been proposed to conform to the rules of binomial nomenclature [6]. In this report we describe the isolation of 26 strains of Alloiococcus otitidis recovered from the external ear in 21 children with or without clinical otitis media.

Molecular markers in plasmodium falciparum linked to resistance to anti-malarial drugs in samples imported from Africa over an eight-year period (2002-2010): impact of the introduction of artemisinin combination therapy

BackgroundDrug resistance is a major problem to control Plasmodium falciparum infection in endemic countries. During last decade, African countries have changed first-line treatment to artemisinin-based combinations therapy (ACT); sulphadoxine-pyrimethamine (SP) is recommended for Intermittent Preventive Therapy (IPT). Molecular markers related to P falciparum resistance were analysed for the period of transition from SP to ACT, in isolates imported from Africa.MethodsA first group of samples was taken in the period between June 2002 and June 2006 (n = 113); a second group in the period between November 2008 and August 2010 (n = 46). Several alleles were analysed by nested PCR-RFLP: 51, 59, 108, 164, in the pfdhfr gene; 436, 437, 540, 581, in the pfdhps gene; 86, 1246, in the pfmdr1 gene and 76, in the pfcrt gene. The prevalence of alleles in the groups was compared with the chi-squared or Fishers exact tests.ResultsThe pfdhfr N51I, C59R and S108N were over to 90% in the two groups; all samples had the I164. In the pfdhps, 437 G and 581 G, increased up to 80% and 10.9% (p = 0.024), respectively in the second group. The 540 G decreases (24% to 16.%) and the 436A disappears at the end of the follow-up (p = 0.004) in the second group. The 76I-pfcrt stayed over 95% in the two groups. Prevalence of 86Y-pfmdr1 decreased over eight years.ConclusionsPharmacological pressure affects the resistance strains prevalence. As for SP, the disappearance of 436A and the decrease in 540 G suggest that these mutations are not fixed. On the other hand, studies carried out after ACT introduction show there was a selection of strains carrying the SNPs N86Y, D1246Y in pfmdr1. In this work, the prevalence of pfmdr1- D1246Y is increasing, perhaps as a result of selective pressure by ACT. Continued surveillance is essential to monitor the effectiveness of treatments.

Shigellosis in Subjects with Traveler's Diarrhea Versus Domestically Acquired Diarrhea: Implications for Antimicrobial Therapy and Human Immunodeficiency Virus Surveillance.

An increase of sexually transmitted shigellosis is currently being reported in developed countries. In addition, travel-related shigellosis can introduce resistant strains that could be disseminated within this new scenario. Epidemiological features and antimicrobial susceptibility of shigellosis depending on where infection was acquired were investigated. From 2008 to 2013, subjects with shigellosis were studied. Patients were classified according to acquisition of Shigella as travelers diarrhea (TD) or domestically acquired diarrhea (DAD). Ninety cases of shigellosis were identified: 76 corresponding to the TD group and 14 to the DAD group. In the DAD group, most of patients were human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), being shigellosis associated to male sex (P = 0.007) and HIV infection (P < 0.0001). S. sonnei (47.8%) and S. flexneri (42.2%) were the predominant species. The highest resistance was detected for trimethoprim/sulfamethoxazole (SXT) (81.8%), followed by ampicillin (AMP) (37.8%) and ciprofloxacin (CIP) (23.3%). Resistant Shigella strains were more frequent in subjects with TD than those with DAD, although only for CIP the difference was significant (P = 0.034). Continuous monitoring of patients with shigellosis is necessary to control the spread of resistant Shigella strains and for effective therapy. Men with shigellosis who have not traveled to an endemic area should be screened for HIV infection.

Correlation between serological and genetic methods for typing hepatitis C virus.

Nucleotide sequencing and phylogenetic analysis of hepatitis C virus (HCV) have provided evidence for the existence of at least 9 major genotypes of HCV, some of which can be further divided into subtypes [ 1, 2 ]. These viral types and subtypes seem to differ in their geographic distribution, pathogenicity and response to treatment [ 1–4 ]. Current methodologies for determining HCV genotypes are complex, expensive and time‐consuming, being impractical for routine use in most clinical settings. Their reliability may be further compromised if viral RNA is lost in the serum or plasma specimen through storage or improper laboratory handling or if it is absent in the blood circulation at the time of sample collection.

Relación entre detección de anticuerpos anti-CagA, sensibilidad antibiótica y úlcera péptica en pacientes con infección por Helicobacter pylori

Introduccion El proposito de este estudio fue determinar si la presencia de anticuerpos frente a las proteinas de virulencia CagA y VacA de Helicobacter pylori se asociaba con una mayor sensibilidad a los antibioticos, y su relevancia clinica en los pacientes con dispepsia. Metodos Se estudiaron 98 pacientes adultos con infeccion por H. pylori que acudieron a realizarse una endoscopia gastrica por sus sintomas dispepticos. La determinacion de anticuerpos anti-CagA y anti-VacA se realizo mediante Western-blot (Helicoblot 2.0). Se estudio la concentracion minima inhibitoria a amoxicilina, metronidazol, claritromicina y tetraciclina mediante E-test. Resultados Fueron diagnosticados de dispepsia ulcerosa 39 pacientes y 59 de dispepsia no ulcerosa. Presentaron anticuerpos anti-CagA 63 pacientes y 52 anti-VacA que en ambos casos se asociaron significativamente con la presencia de dispepsia ulcerosa (p = 0,034 y p = 0,029, respectivamente). Se detectaron un 38,8% de cepas resistentes a metronidazol y un 10,3% a claritromicina. No se observaron resistencias a amoxicilina ni a tetraciclina. La sensibilidad a claritromicina fue mas frecuente en pacientes con dispepsia ulcerosa frente a los sujetos con dispepsia no ulcerosa (p = 0,046). Los pacientes con anticuerpos anti-CagA presentaron las cepas mas sensibles a los antibioticos, siendo para la claritromicina la diferencia estadisticamente significativa (p Conclusio La deteccion de anticuerpos anti-CagA se asocio con una mayor sensibilidad a los antibioticos en pacientes con dispepsia ulcerosa y no ulcerosa, por lo que su deteccion podria ser un marcador de buen pronostico de exito terapeutico.