Margarita Bolaños-Rivero

Seroprevalence of Rickettsia typhi and Rickettsia conorii infections in the Canary Islands (Spain)

OBJECTIVE The aim of this work was to evaluate the prevalence of past infection due to Rickettsia typhi and Rickettsia conorii in the Canary Islands (Spain). METHODS A representative sample of the population of the seven islands, formed of 662 people aged between 5 and 75 years (368 females, 294 males), was analyzed. Epidemiological data were obtained by direct survey. The detection of serum IgG antibodies against both microorganisms was based on an indirect immunofluorescence test, considered positive if the titers were ≥ 1/80. RESULTS Of the analyzed population 3.9% had IgG antibodies against R. typhi and 4.4% against R. conorii. Out of these positive samples, only three were positive for both species. The seroprevalence was similar in both sexes. Positive results were found in all age groups, but a higher rate was noticed in those aged 46 years and older (p<0.05). R. typhi was found to be more prevalent in rural areas of all islands, as well as in farmers. CONCLUSIONS Our results confirm the presence of antibodies against the causative agents of murine typhus and Mediterranean spotted fever in the Canary Islands. Indirect data suggest that the detection of antibodies to R. conorii might be due to a cross-reaction between these species.

Skin and soft tissue infections (patera foot) in immigrants, Spain.

An unusual skin and soft tissue infection of the lower limbs has been observed in immigrants from sub-Saharan Africa who cross the Atlantic Ocean crowded on small fishing boats (pateras). Response to conventional treatment is usually poor. Extreme extrinsic factors (including new pathogens) may contribute to the etiology of the infection and its pathogenesis.

Shewanella spp. infections in Gran Canaria, Spain: retrospective analysis of 31 cases and a literature review

Introduction Shewanella spp. can cause severe skin and soft-tissue infections, gastrointestinal infections, otitis and bacteraemia, generally upon contact with seawater or consumption of raw seafood. Recently, a new condition termed ‘patera foot’ characterized by acute skin and soft-tissue infection has been described in irregular immigrants arriving to the Canary Islands, Spain, in rudimentary boats. Most infections are caused by a single species, Shewanella algae. The improvement of the diagnostic capabilities in clinical microbiology laboratories has resulted in a growing number of cases being reported worldwide, most of them coming from warm regions. Case presentation In this work, we reviewed the medical records of all the patients with Shewanella infections in the two university hospitals of Gran Canaria (the Canary Islands, Spain) during the period 2000–2016, resulting in the identification of 31 cases. We also conducted a literature review of Shewanella infections reported worldwide in recent years. Conclusion This case series suggests that Shewanella infections are nosocomially acquired more frequently than previously thought. In addition, the unexpectedly high proportion of multidrug-resistant isolates raises concerns.

Utilidad del diagnóstico molecular precoz de fiebre Q y rickettsiosis en pacientes con fiebre de duración intermedia

espanolLa mayor parte de los casos de fiebre de duracion intermedia (FDI) en Espana corresponden a enfermedades infecciosas (principalmente fiebre Q y rickettsiosis). En la practica clinica el diagnostico causal de estas entidades se basa en el inmunodiagnostico, con una escasa utilidad en fases precoces. Por ello, el objetivo de este trabajo fue la evaluacion de la utilidad de tecnicas moleculares en el diagnostico precoz de fiebre Q y rickettsiosis en pacientes con FDI. Se estudio mediante PCR la presencia de material genetico de Coxiella burnetii y Rickettsia spp. en muestras sanguineas de 271 pacientes con FDI. La especificidad de ambas tecnicas es elevada, permitiendo el diagnostico en casos no diagnosticados mediante deteccion de anticuerpos especificos. Estos datos sugieren que el empleo de tecnicas moleculares, con una adecuada seleccion de la muestra de estudio y el empleo de cebadores adecuados, es un elemento util en el diagnostico precoz de las principales causas de FDI, principalmente si la serologia es negativa o no es concluyente. EnglishMost cases of fever of intermediate duration (FDI) in Spain are associated with infectious diseases (mainly Q fever and rickettsia infections). In clinical practice, the causal diagnosis of these entities is based on immunodiagnostic techniques, which are of little help in the early stages. Therefore, the aim of this study was to evaluate the usefulness of molecular techniques for the early diagnosis of Q fever and rickettsia diseases in patients with FDI. A PCR method was used to detect the presence of genetic material of Coxiella burnetii and Rickettsia spp. in blood specimens from 271 patients with FDI. The specificity of both techniques is high, allowing diagnosis in cases undiagnosed by specific antibodies detection. These data suggest that the use of molecular techniques, with proper selection of the study specimen, and using appropriate primers is a useful tool in the early diagnosis of the main causes of FDI, especially if serology is negative or inconclusive.Most cases of fever of intermediate duration (FDI) in Spain are associated with infectious diseases (mainly Q fever and rickettsia infections). In clinical practice, the causal diagnosis of these entities is based on immunodiagnostic techniques, which are of little help in the early stages. Therefore, the aim of this study was to evaluate the usefulness of molecular techniques for the early diagnosis of Q fever and rickettsia diseases in patients with FDI. A PCR method was used to detect the presence of genetic material of Coxiella burnetii and Rickettsia spp. in blood specimens from 271 patients with FDI. The specificity of both techniques is high, allowing diagnosis in cases undiagnosed by specific antibodies detection. These data suggest that the use of molecular techniques, with proper selection of the study specimen, and using appropriate primers is a useful tool in the early diagnosis of the main causes of FDI, especially if serology is negative or inconclusive.

Compartmental syndrome of the upper limb due to Moraxella lacunata infection: a link to patera foot syndrome?

We report a case of compartmental syndrome of the left upper limb secondary to a severe Moraxella lacunata infection, an unusual pathogen, occurring in a young black male immigrant to the island of Gran Canaria, Spain. We propose a pathophysiological relationship with patera foot syndrome.