Margarita Bolaños

Murine Typhus with Renal Involvement in Canary Islands, Spain

Murine typhus and “murine-thypus-like” disease are reemerging infectious diseases. In Canary Islands (Spain), a rather distinct clinical pattern characterized by higher incidence of complications, especially renal damage (including acute failure and urinalysis abnormalities), is apparent and highly suggestive. It could be related to different strains of Rickettsia typhi or other cross-reactive species.

Human Rickettsia felis Infection, Canary Islands, Spain

We report the first cases of human infection by Rickettsia felis in the Canary Islands. Antibodies against R. felis were found in 5 adsorbed serum samples from 44 patients with clinically suspected rickettsiosis by Western blot serology. Fleas from 1 patients dog were positive for R. felis by polymerase chain reaction.

Fiebre Q en Gran Canaria. Aportación de 40 nuevos casos

IntroducciOn Describir las caracteristicas clinicas y epidemiologicas de la fiebre Q en la zona sur de la isla de Gran Canaria. Metodos Se realizo un analisis retrospectivo de los casos diagnosticados de fiebre Q en el Servicio de Microbiologia del Hospital Universitario Insular de Gran Canaria entre los anos 1998 y 2000. Para la deteccion de anticuerpos frente a antigenos de fase II de Coxiella burnetii se empleo una tecnica de inmunofluorescencia indirecta. El diagnostico de fiebre Q aguda se realizo cuando se detectaron titulos de inmunoglobulina G (IgG) _ 1:320 e IgM _ 1:80 o cuando se demostro seroconversion. Resultados Durante el periodo de estudio se diagnosticaron serologicamente 59 casos de fiebre Q aguda (incidencia anual de 5 casos/100.000 habitantes). La seroprevalencia (IgG _ 1:80) encontrada en los pacientes a los que se les solicitaba serologia de fiebre Q y durante este periodo fue del 23,9%. Se dispuso de datos clinicos y epidemiologicos en 40 pacientes, siendo todos los casos esporadicos; el 57% de ellos fueron hospitalizados. La edad media fue de 40,6 _ 13,3 anos (intervalo, 20-74), mas frecuente en varones (85%) y procedentes del medio rural (67,5%). El 65% de los casos se produjeron de abril a julio. La manifestacion clinica mas frecuente fue un sindrome febril con elevacion de las enzimas hepaticas (87,5%). La forma neumonica fue rara (solo 3 casos). Conclusiones La fiebre Q se manifiesta fundamentalmente en nuestra zona como un sindrome febril agudo con afectacion hepatica subclinica. Esto, y la escasez de formas neumonicas y cronicas sugieren la implicacion de cepas de C. burnetii diferentes a las de otras zonas geograficas.

Molecular method for the characterization of Coxiella burnetii from clinical and environmental samples: variability of genotypes in Spain

BackgroundCoxiella burnetii is a highly clonal microorganism which is difficult to culture, requiring BSL3 conditions for its propagation. This leads to a scarce availability of isolates worldwide. On the other hand, published methods of characterization have delineated up to 8 different genomic groups and 36 genotypes. However, all these methodologies, with the exception of one that exhibited limited discriminatory power (3 genotypes), rely on performing between 10 and 20 PCR amplifications or sequencing long fragments of DNA, which make their direct application to clinical samples impracticable and leads to a scarce accessibility of data on the circulation of C. burnetii genotypes.ResultsTo assess the variability of this organism in Spain, we have developed a novel method that consists of a multiplex (8 targets) PCR and hybridization with specific probes that reproduce the previous classification of this organism into 8 genomic groups, and up to 16 genotypes. It allows for a direct characterization from clinical and environmental samples in a single run, which will help in the study of the different genotypes circulating in wild and domestic cycles as well as from sporadic human cases and outbreaks. The method has been validated with reference isolates. A high variability of C. burnetii has been found in Spain among 90 samples tested, detecting 10 different genotypes, being those adaA negative associated with acute Q fever cases presenting as fever of intermediate duration with liver involvement and with chronic cases. Genotypes infecting humans are also found in sheep, goats, rats, wild boar and ticks, and the only genotype found in cattle has never been found among our clinical samples.ConclusionsThis newly developed methodology has permitted to demonstrate that C. burnetii is highly variable in Spain. With the data presented here, cattle seem not to participate in the transmission of C. burnetii to humans in the samples studied, while sheep, goats, wild boar, rats and ticks share genotypes with the human population.

Seroprevalence of infection by Coxiella burnetii in Canary Islands (Spain).

Objectives: The aims of our study were: (i) to know the seroprevalence of Coxiella burnetii infection in the Canary Islands, (ii) to evaluate its epidemiologic features and (iii) to compare the rates of seroprevalence using two different cut-offs (1:20 and 1:80) for the diagnosis of past infection. Methods: We analysed a representative sample of the canarian population. 662 sera were tested. For the detection of IgG and IgM antibodies against C. burnetii phase II antigens an immuofluorescence assay was used. The serologic screening for IgG detection begun with a 1:20 dilution. A titer of IgG ≥ 1:80 along with a negative IgM were used as criteria for previous infection. Results: At an IgG antibody titer against C. burnetii of 1:80 as diagnostic for past infection, the observed global seroprevalence was 21.5%. If the cut-off used was 1:20, the observed prevalence increased up to 35.8% (p = 0.001). Significantly different seroprevalence rates were obtained at these different cut-offs when results were analysed for groups of age and socioeconomic status, but not for either the island of origin or for farmers. Conclusion: Our results strongly suggest that Coxiella burnetii infection is endemic in all the Canary Islands. Although it is more frequent in males above 30 years old, it do affect people of all ages, and thus it should be borne in mind in the face of any acute febrile syndrome.

Streptococcus bovis Bacteremia from a Venous Access Port in a Patient with AIDS

We report the first case of S. bovis bacteremia related to endoluminal colonization of a venous access port in a setting of advanced HIV infection, neutropenia and co-infection with HBV. The patient had no bowel abnormalities. The clinical picture was mild and was resolved by removal of the device.

Absceso glúteo por Streptococcus pneumoniae

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