ABSTRACT
Aims: To highlight the observed features including socio-demographic, economic and biochemical characteristics seen among uncontrolled diabetic adults that should be areas of concern or focus by healthcare providers during the management of diabetes in the country. Also to perform molecular characterization of bacterial organisms prevalent among a cross section of diabetic patients with asymptomatic bacteriauria. Study Design: This was a cross sectional prospective and descriptive study. Place and Duration of Study: Study was carried out among patients attending two noncommunicable chronic diseases health centers in Trinidad & Tobago over a 6 months period in 2012. Methodology: Following informed consent, diabetic volunteers were recruited to participate in the study. Participants fulfilled study criteria that included absence of urinary symptoms, not catheterized, no history of UTI or any form of uropathy. Blood samples were screened for Hb1Ac, serum electrolytes and urea values; urine for microscopy, culture and sensitivity. Enterobacteriaceae isolates from urine culture were subjected to screening for CTX-M, TEM, and SHV by amplification of gene fragments by conventional PCR and for KPC, and NDM and OXA48 targets by real-time PCR using Sybergreen melting curve analysis. Results: Four hundred and fourteen diabetics were surveyed. Significant (15.7%; 65/414) bacteriauria was noted in sixty five subjects. Majority, 81.5% (53/65) with positive urine cultures had high HBA1c values. Escherichia coli 48.57% (34/70) and Klebsiella pneumonia 25.7% (18/70) were the most recovered organisms, with 87.1% (61/70) from urine samples and 75.4% (49/65) from female subjects. Urine samples from males 24.6% (16/65) yielded mostly Staphylococcus epidermidis 14.3% (10/7) and Staphylococcus aureus 5.7% (4/70) respectively. All Enterobacteriaceae isolates were negative for KPC, NDM and OXA-48. Although the blaTEM and bla SHV were detected in both the E. coli and K. pneumoniae isolates as expected. Conclusion: Escherichia coli was the prevalent Enterobacteriaceae among the patients with asymptomatic bacteriauria. Poor diabetic control is significantly and strongly associated with bacteriauria that was more prevalent among female diabetics. Although none of the antimicrobial resistant targets were encountered among the Enterobacteriaceae, there is still the need to keep an eye on these targets and diabetic subjects in the country.
ABSTRACT
Salmonella infection in bird species in Jamaica was studied. This revealed that very low prevalence of salmonellosis was found (0.32 %). Salmonella Yeerongpilly (newly reported in the country) was isolated from a bird collected at a bird aviary. This study showed that there was the presence of this Salmonella serovar in a Chinese owl (Columba livia domestica) in Jamaica. There were not published reports from Caribbean Islands of the presence of this serovar. Salmonella Yeerongpilly belongs to serogroup E1 and by molecular serotyping random amplification of polymorphic DNA (RAPD) fingerprinting belongs to A20, B17 and C21. This strain was isolated in Queensland Australia in the 1960s before the successful Salmonella eradication campaign. This study suggests that a larger investigation in pet birds as Salmonella carriers should be carried out in Jamaica. Mandatory screening or quarantine of birds entering the country should be institutionalized.
Subject(s)
Animals , Bird Diseases/epidemiology , Bird Diseases/microbiology , China , Columbidae/classification , Columbidae/microbiology , Jamaica , Salmonella/classification , Salmonella/epidemiology , Salmonella Infections/epidemiologyABSTRACT
Background: Detection of red blood cells antibodies is important for the diagnosis of autoimmune hemolytic anemia, hemolytic disease of newborn, pre-transfusion testing and other problems. The aim of this study was to use Staphylococcal protein A (SpA) and Streptococcal protein G (SpG) as reagents in immunological tests for detecting red blood cells (RBC) antibodies and to compare the method with other techniques. Study Design & Methods: Sera from 60 patients, comprising forty-four anti-D positive sera from pregnant women and 16 from healthy controls were, used for the study. The anti-globulin gel test and the standard Coombs’ test were used to determine RBC antibodies in these sera and the result were compared with that of protein A and protein G tests. Results: With various degree of agglutination all 4 techniques detected the presence of RBC antibodies (anti-D) in the sera from 44 pregnant women, and tested negative for the remaining 16 sera (from healthy controls). The sensitivity and the specificity of the 4 techniques was 100%. Conclusions: This preliminary study demonstrates that both SpA and SpG tests can be used for the detection of RBC antibodies and therefore requires more study and testing before they can become useful standard tests in transfusion medicine.
ABSTRACT
OBJECTIVE: To compare the QuantiFERON®-TB Gold (QFT-G) assay and tuberculin skin test (TST) in screening/diagnosis of latent tuberculosis infection (LTBI) among individuals in Trinidad & Tobago at high risk for TB. METHODS: A total of 560 individuals (TB patient contacts, HIV patients, health care workers, prison inmates, and TB patients [controls]) were recruited for the study. Blood was drawn and processed using the QFT-G assay, followed by immediate administration of TST solution on subjects' forearm. Data were analyzed with Epi InfoTM 3.5.1 software. Results were compared across the target groups using the chi-square test (P < 0.05). RESULTS: The QFT-G assay detected LTBI in 51 percent of the subjects (with most positive results occurring among the control group) whereas the TST detected it in 39.4 percent (P = 0.001). Overall, the QFT-G assay detected LTBI more frequently than the TST among all subjects except the control group, where detection favored the TST. The QFT-G assay produced indeterminate and nonreactive results in some HIV patients but required less turnaround time than the TST (23.3 h versus 70.2 h; P < 0.0001). The TST cost less per subject than the QFT-G assay (US $3.70 versus US $18.60; P = 0.0008). CONCLUSIONS: The QFT-G assay cost more but had a higher detection rate among most target groups and required less turnaround time than the TST. However, its sensitivity was lower among immunocompromised subjects. Therefore, the QFT-G assay should be used with caution for LBTI screening/diagnosis in resource-poor, high-HIV prevalence settings such as Trinidad & Tobago.
OBJETIVO: Comparar la prueba QuantiFERON®-TB Gold (QFT-G) con la prueba cutánea de la tuberculina (PPD) para el tamizaje y diagnóstico de la infección tuberculosa latente (ITBL) en personas con alto riesgo de tuberculosis en Trinidad y Tabago. MÉTODOS: Para el estudio, se reclutó un total de 560 individuos (personas en contacto con pacientes de tuberculosis, pacientes con VIH, trabajadores de la salud, presidiarios y pacientes de tuberculosis [grupo testigo]). Las muestras de sangre se extrajeron y procesaron utilizando la prueba QFT-G, seguida de la aplicación inmediata de la solución de PPD en el antebrazo de las personas. Los datos se analizaron con el software Epi InfoTM 3.5.1. Los resultados obtenidos en los grupos destinatarios se compararon utilizando la prueba de la ji al cuadrado (P < 0,05). RESULTADOS: La prueba QFT-G detectó la infección tuberculosa latente en 51 por ciento de los individuos (la mayoría de los resultados positivos se presentaron en el grupo testigo) mientras que la prueba PPD la detectó en 39,4 por ciento (P = 0,001). En términos generales, la prueba QFT-G detectó la infección tuberculosa latente con mayor frecuencia que la PPD en todos los individuos, excepto en aquellos del grupo testigo, donde el índice de detección favoreció a la PPD. La prueba QFT-G produjo resultados indeterminados y no reactivos en algunos pacientes con VIH, pero requirió menos tiempo de respuesta que la PPD (23,3 h contra 70,2 h; P < 0.0001). La prueba PPD tuvo un costo menor por individuo que la QFT-G (US$3,70 en comparación con US$18,60; P = 0.0008). CONCLUSIONES: La prueba QFT-G tuvo un costo más elevado, pero la tasa de detección fue más alta en la mayoría de los grupos destinatarios y el tiempo de respuesta fue más rápido en comparación con la PPD. Sin embargo, la sensibilidad de la prueba QFT-G fue inferior entre los individuos inmunodeficientes. Por consiguiente, se deben tomar las precauciones necesarias para utilizar la prueba QFT-G en el tamizaje y diagnóstico de ITBL en entornos de escasos recursos y alta prevalencia de VIH como Trinidad y Tabago.