ABSTRACT
The combination of molecular and conventional epidemiological methods has improved the knowledge about the transmission of tuberculosis in urban populations. To examine transmission of tuberculosis in Havana, Cuba, with DNA fingerprinting, we studied 51 out of 92 Mycobacterium tuberculosis strains isolated from tuberculosis patients who resided in Havana and whose infection was culture-confirmed in the period from September 1997 to March 1998. Isolates from 28 patients (55 percent) had unique IS6110 restriction fragment length polymorphism (RFLP) patterns, while isolates from 23 others (45 percent) had identical patterns and belonged to 7 clusters. Three clusters consisting of six, five and two cases were each related to small outbreaks that occurred in a closed setting. Three other clustered cases were linked to a large outbreak that occurred in another institution. Younger patients were more correlated to clustering than older ones. The finding that 45 percent of the isolates had clustered RFLP patterns suggests that recent transmission is a key factor in the tuberculosis cases in Havana. The IS6110 RFLP typing made it possible to define the occurrence of outbreaks in two closed institutions
Subject(s)
Humans , Male , Female , Adult , Middle Aged , DNA, Bacterial , Mycobacterium tuberculosis/genetics , Polymorphism, Restriction Fragment Length , Tuberculosis/transmission , Cuba/epidemiology , Disease Outbreaks , DNA Fingerprinting , Incidence , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/epidemiology , Tuberculosis/geneticsABSTRACT
From April to July 1993; Maputo City suffered an epidemic of dysentery. We analysed stool samples from 142 consecutive children hospitalized with acute bloody diarrhoea in the pediatric infectious diseases ward of Maputo Central Hospital. The samples were analysed for known pathogenic microbial organisms. 74 (52.1) were male and 68 (47.9) female; the mean age was 2.62 years. Shigella dysenteriae type-1 was isolated in 59 (41.5) cases. The probability of isolation of shigella dysenteriae was greater when the evolution time of the illness was equal to or less than five days and the number of daily stools was six or greater at the time of sample collection. For the diagnosis of shigellosis; the presence of macroscopic blood in liquid stools showed a sensitivity of 86.2; a specificity of 82.9; a positive predictive value of 78.1; and a negative predictive value of 89.5. All Shigella spisollated were sensitive to nalidixic acid; cephalothin; kanamycin and gentamicin and resistant to tetracycline; trimethoprim; chloramphenicol; ampicillin; sulfurisoxazole; cotrimoxazole and erythromycin. There was a statistical association (p0.05) between malaria due to plasmodium falciparum and the presence of macroscopic blood in the stools
Subject(s)
Dysentery , Infant , Shigella dysenteriaeABSTRACT
Foi efectuado um estudo retrospectivo das amostras recebidas no Laboratorio de Microbiologia da Faculdade de Medicina no periodo compreendido entre Junho de 1991 e Junho de 1992; para confirmacao laboratorial do diagnostico clinico de colera. De um total de 2823 amostras analisadas; provenientes de igual numero de casos; 1399(49;5) proveniente da cidade de Maputoe 1424(50;4) da Provincia de Maputo. Corresponderam a individuos do sexo maculino; 1494(52.9) e ao sexo feminino; 1329 (47.1) resultaram positivas; 952(33.7) amostras das quais; 856(89.9) corresponderam ao serotipo Inaba e 96(10.1) ao Ogawa. Todas as estirpes isoladas foram biotipo El Tor e sensiveis in vitro a Tetraciclina; Doxiciclina; Sulfadiazina e Cloranfenicol. Em ambos os locais de estudo; as amostras positivas foram mais frequentes na estacao quente que na fria (pO.0001); e nos individuos do sexo masculino no grupo eterio de mais de 16 anos (p