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1.
Gac. méd. Méx ; 157(2): 160-165, mar.-abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1279096

ABSTRACT

Resumen Antecedentes y objetivo: Las enfermedades del sistema respiratorio son causa frecuente de prescripción de antibióticos. Actualmente se emplean nuevas tecnologías para su diagnóstico como el FilmArray Respiratory Panel. El objetivo de este estudio es identificar la correlación entre el diagnóstico y tratamiento de infecciones de vías respiratorias con el resultado de PCR para virus respiratorios. Material y métodos: Estudio descriptivo, transversal, retrospectivo, se incluyeron 134 pacientes atendidos en el Hospital Christus Muguerza en Saltillo, Coahuila. Para todos los casos se analizaron los resultados del panel y el tratamiento que recibieron los pacientes. Resultados: El 58 % recibió tratamiento antibiótico a su ingreso, el 13 % tratamiento combinado (antibiótico + antiviral), 27 % recibió tratamiento sintomático y el 2 % fue tratado con antiviral de primera instancia. Posterior al resultado el 38 % continuó con antibiótico, el 30 % con antibiótico y antiviral, 13.8 % se manejó con antiviral y el 18.2 % con tratamiento sintomático. Conclusión: A pesar de la alerta mundial por la resistencia a los antimicrobianos se sigue tratando a los pacientes con antibióticos, por una situación que se cree está influenciada por varios factores.


Abstract Background and objective: Respiratory system diseases represent one of the leading cause of prescription of antibiotics. At present, new technologies for the diagnosis are being used, including the FilmArray Respiratory Panel. The objective was to identify the correlation between the diagnosis and treatment of respiratory tract infections with the result of PCR for respiratory viruses. Material and methods: Descriptive, cross-sectional, restrospective study. 134 patients were included treated at the Christus Muguerza Hospital in Saltillo, Coahuila. For all cases, the positive results of this test and the treatment patients received were analyzed. Results: 58 % received antibiotic treatment at admission, 13 % received combined treatment (antibiotic + antiviral), 27 % received symptomatic treatment since their admission and 2 % whit antiviral. After receiving a positive result for respiratory viruses, 38 % continued with antibiotics, 30 % with antibiotics and antivirals, 13.8 % only managed with antivirals and 18.2% with symptomatic treatment. Conclusion: Although we are currently on global alert for resistance to antibiotics, there is a lack of awareness about the prescription of antibiotics, due to a situation which is believed to be influenced by several factors.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Antiviral Agents/therapeutic use , Respiratory Tract Infections/virology , Virus Diseases/diagnosis , Multiplex Polymerase Chain Reaction , Anti-Bacterial Agents/therapeutic use , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Virus Diseases/drug therapy , Virus Diseases/virology , Acute Disease , Cross-Sectional Studies , Retrospective Studies , Hospitals, Private , Mexico
2.
Rev. chil. infectol ; 37(4): 371-382, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138561

ABSTRACT

Resumen Introducción: Los niños que reciben trasplante de precursores hematopoyéticos (TPH) pueden presentar infecciones respiratorias virales (IRV) durante episodios febriles. Los datos sobre su evolución clínica son escasos, así como la comparación de ellos con infecciones bacterianas (IB). Objetivo: Caracterizar la evolución clínica de pacientes con IRV, en comparación con IB en niños con TPH, cursando un episodio febril. Método: Estudio prospectivo en pacientes ≤ 18 años con cáncer y TPH ingresados por fiebre en el Hospital Luis Calvo Mackenna (2016-2019). Se realizó evaluación clínica y de laboratorio: hemocultivos, RPC para patógenos respiratorios (Filmarray®), cuantificación viral y medición de citoquinas en muestra nasal (Luminex®, 38 citoquinas). Se compararon los grupos IRV, IB y los de etiología no precisada (ENP) en relación con: infección respiratoria aguda (IRA), citoquinas nasales, ingreso a UCI, necesidad de ventilación mecánica, mortalidad y suspensión de antimicrobianos. Resultados: De 56 episodios febriles, 35 fueron IRV, 12 IB y 9 de ENP. Mediana de edad fue 8,5 años, 62% masculino. Un 94% de los casos IRV presentó IRA sintomática, versus 33% en los grupos IB y ENP (p < 0,001), con IRA baja en 69% de las IRV (p < 0,001). Rinovirus (54%) y coronavirus (15%) fueron las etiologías más frecuentemente detectadas. No hubo diferencias en citoquinas nasales entre los grupos IRV e IB. Ingreso a UCI: 11% del grupo IRV, 17% de IB y 11% de ENP (p = 0,88). Requirieron ventilación mecánica sólo 2 pacientes (p = 0,37) sin fallecimiento. Tras la detección viral respiratoria por RPC, se suspendió antimicrobianos en 26% de los casos con IRV (p = 0,04). Conclusión: Las IRV son frecuentes en niños con TPH y episodios febriles. La detección viral podría optimizar y racionalizar el uso de antimicrobianos en esta población.


Abstract Background: Children undergoing hematopoietic stem cell transplant (HSCT) can develop respiratory viral infections (RVI) during fever episodes. There are few data about clinical outcomes in RVI and compared to bacterial infections (BI) in this population. Aim: To determine clinical outcome of RVI, compared to BI in children with HSCT. Methods: Prospective study, patients ≤ 18 years with cancer and HSCT admitted with fever at a National Bone Marrow Transplant Center (Hospital Calvo Mackenna), Chile, (April-2016 to May-2019). Clinical assessment, laboratory tests, blood cultures, nasopharyngeal sample for multiplex-PCR (Filmarray®), viral loads by PCR and cytokine panel (Luminex®, 38 cytokines) were performed. The following outcomes were evaluated: upper/lower respiratory tract disease (RTD), admission to ICU, mechanical ventilation, mortality and antimicrobial withdrawal. Results: Of 56 febrile episodes, 35 (63%) were RVI, 12 (21%) BI and 9 (16%) with unknown etiology (UE). Median of age was 8.5 years, 62% male gender. Rhinovirus (54%) and coronavirus (15%) were the more frequent detected viruses. No significant differences in cytokine levels were observed between RVI and BI. 94% of RVI patients had symptomatic RTD, versus 33% in BI and 33% in UE group (p < 0.001), with lower-RTD in 69% of RVI group (p < 0,001). Admission to ICU was 11% in RVI, 17% in BI and 11% in UE group (p = 0.88); only 2 patients required mechanical ventilation (p = 0.37) and no mortality was reported. After an RVI was detected by PCR, antimicrobials were withdrawal in 26% of patients with RVI (p: 0.04). Conclusion: RVI are frequent etiologic agents in febrile episodes of patients with HSCT. Viral detection might help to rationalize the use of antimicrobials in this population.


Subject(s)
Humans , Male , Female , Child , Respiratory Tract Infections/virology , Virus Diseases/diagnosis , Hematopoietic Stem Cell Transplantation/adverse effects , Fever/virology , Respiratory Tract Infections/diagnosis , Chile , Prospective Studies
3.
Arq. Inst. Biol ; 87: e0092020, 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1121090

ABSTRACT

Abortion and complications in reproduction are important causes of economic loss in horse breeding. Studies of its causal agents can help to identify the primary pathogens or other factors involved and define appropriate measures to reduce its occurrence. This research aimed to investigate the primary causes of equine abortion, stillbirth, and perinatal mortality in regions of Brazil. Tissue from aborted fetuses, stillbirths, neonates and foals submitted to the Biological Institute of São Paulo, Brazil, from January 2010 to July 2013 were processed for viral and bacterial isolation, polymerase chain reaction (PCR), histology, and immunohistochemistry. Bacterial infection was the primary detected cause of abortion, found in 16 of the 53 animals submitted for bacterial analysis followed by viruses analysis in 2 of 105 animals, and noninfectious causes (neonatal isoerythrolysis) in 2 of 105 animals. Fungi were found in a single sample of 53 tested. The most frequent bacteria recovered were Escherichia coli, Enterobacter aerogenes, combined E. coli and Streptococcus spp., Staphylococcus spp., and Bacillus spp. The following agents were each observed in a single sample: Arcanobacterium pyogenes, Streptococcus spp., Corynebacterium spp., Actinobacillus spp., and Rhodococcus equi. The predominant identification of fecal and other opportunistic bacteria as opposed to pathogens commonly associated with equine abortion, such as Leptospira spp. and equine herpesvirus type 1 (EHV-1), suggests the need of improving hygiene management of breeding mares to prevent bacterial infection that may cause fetal loss, stillbirth, and perinatal mortality.(AU)


Abortamento e complicações na reprodução são importantes causas de perda econômica na equideocultura. Estudos dos agentes causais podem ajudar a identificar patógenos ou outros fatores envolvidos e definir medidas apropriadas para reduzir sua ocorrência. Esta pesquisa investigou as causas primárias de aborto, natimortalidade e mortalidade perinatal em equinos de diversas regiões do Brasil. Tecidos de fetos abortados, natimortos e potros submetidos ao Instituto Biológico de São Paulo, Brasil, no período de janeiro de 2010 a julho de 2013, foram processados por meio de técnicas de isolamento viral e bacteriano, PCR, histologia e imuno-histoquímica. Infecção bacteriana foi a causa mais detectada, encontrada em 16 de 53 amostras submetidas à análise bacteriana, seguida de causa viral em 2 de 105 amostras, e causas não infecciosas (isoeritrólise neonatal) em 2 de 105 amostras. Fungo foi encontrado em uma única amostra de 53 testadas. As bactérias isoladas mais frequentemente foram Escherichia coli, Enterobacter aerogenes, E. coli associada a Streptococcus spp., Staphylococcus spp. associado a Bacillus spp. Os seguintes agentes foram observados em uma única amostra cada: Arcanobacterium pyogenes, Streptococcus spp., Corynebacterium spp., Actinobacillus spp. e Rhodococcus equi. A identificação predominante de bactérias fecais e outras bactérias oportunistas, ao invés de outros patógenos comumente associados a quadros de abortamento equino, tais como Leptospira spp. e Herpesvírus equino tipo 1, sugere a necessidade de maior atenção no manejo higiênico das éguas em reprodução, a fim de prevenir infecções bacterianas que possam causar perda fetal, natimortalidade e mortalidade perinatal.(AU)


Subject(s)
Animals , Female , Pregnancy , Bacterial Infections/complications , Abortion, Veterinary/etiology , Horses , Staphylococcus/isolation & purification , Streptococcus/isolation & purification , Bacterial Infections/diagnosis , Brazil , Virus Diseases/complications , Virus Diseases/diagnosis , Immunohistochemistry , Polymerase Chain Reaction , Cause of Death , Enterobacter aerogenes/isolation & purification , Abortion, Veterinary/mortality , Aborted Fetus , Escherichia coli/isolation & purification , Mycoses/complications , Mycoses/diagnosis
4.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 55(3): e140200, Outubro 25, 2018.
Article in English | LILACS, VETINDEX | ID: biblio-969177

ABSTRACT

Several factors can affect bovine mammary gland health and although bacterial mastitis is the most studied and reported cause, viral infections may also have negative effects on bovine udder health. Viral infections can indirectly damage the papillary duct of the teat, and induce or exacerbate signs of bovine mastitis due to viral-induced immunosuppressive effects that may lead to a greater susceptibility to bacterial mastitis and even intensify the severity of established bacterial infections. Some viruses (Bovine alphaherpesvirus2, cowpox, pseudocowpox, foot-and-mouth disease, vesicular stomatitis and papillomavirus) affect the integrity of the udder skin, leading to teat lesions, favoring the entry of mastitis-causing pathogens. It is therefore possible that the association between mastitis and viruses is underestimated and may, for example, be associated with negative bacterial culture results. Few milk samples are tested for the presence of viruses, mainly because of the more laborious and expensive procedures required. Furthermore, samples for virus testing would require specific procedures in terms of collection, handling and storage. Thus, there is a knowledge gap in regard to the actual impact of viruses on bovine udder health. Despite the fact that serum anti-virus antibodies can be detected, there is not enough evidence to confirm or exclude the effect of viruses on udder health. However, any expectation of milk production from healthy animals should consider the possible impact of viral infections in mastitis development and not underestimate the importance of actions to diagnose and control the disease. Therefore, the purpose of this review is to describe the association of diagnosis and control of viral diseases and their effect on bovine udder health.(AU)


Diversos fatores podem afetar a saúde da glândula mamária bovina e embora a mastite bacteriana seja a causa mais estudada e relatada, as infecções virais também podem ter efeitos negativos sobre a saúde da glândula mamária bovina. De forma indireta as infecções virais podem danificar o ducto papilar do teto ou ainda, induzir ou agravar a mastite bovina, devido aos seus efeitos imunossupressores que podem levar a uma maior susceptibilidade para casos de mastite bacteriana e até mesmo intensificar a severidade das infecções bacterianas já estabelecidas. Alguns vírus (Alphaherpesvirus bovino 2, cowpox, pseudocowpox, febre aftosa, estomatite vesicular e papilomavírus) afetam a integridade da pele do úbere, levando a lesões no teto, favorecendo a entrada de patógenos causadores de mastite. Portanto é possível que a associação entre mastites e viroses seja subestimada e podem, por exemplo, estar associada às amostras de diagnóstico de mastite bacteriana com resultados de cultura bacteriana negativa. Além disso, as amostras de leite de vacas com mastite não são coletadas, tratadas e armazenadas adequadamente para pesquisa de vírus que requer cuidados específicos, além de um diagnóstico mais trabalhoso e caro. Desse modo, há lacunas a serem preenchidas quanto ao real impacto das viroses sobre a saúde da glândula mamária bovina. Apesar da possibilidade de detecção de anticorpos séricos contra os vírus, não existem evidências suficientes para incluir ou excluir os efeitos das viroses a saúde da glândula mamária bovina. Porém, a expectativa de produção de leite por meio de animais saudáveis deve considerar os possíveis impactos das infecções virais no desenvolvimento de mastites, não se pode, portanto, subestimar a importância de ações para o diagnóstico e controle das mesmas. Sendo assim, o propósito desta revisão é descrever as relações entre o diagnóstico de controle das doenças virais e seus potenciais impactos sobre a saúde da glândula mamária bovina.(AU)


Subject(s)
Animals , Cattle , Virus Diseases/diagnosis , Virus Diseases/veterinary , Cattle/abnormalities , Mammary Glands, Animal/abnormalities
5.
Med. infant ; 25(1): 26-31, marzo 2018. tab
Article in Spanish | LILACS | ID: biblio-883475

ABSTRACT

Introducción: El Trasplante alogénico de células progenitoras hematopoyéticas (TCPH) se asocia a una lenta recuperación de sistema inmune, lo que predispone a sus receptores a presentar múltiples complicaciones infecciosas. En este trabajo se analizan las infecciones virales de una cohorte retrospectiva. Material y métodos: se revisó la base de datos del servicio y se registraron las infecciones virales del periodo 2012-2016. Resultados: n 215. El 91% de los receptores y el 70% de los donantes eran CMV positivos antes del trasplante, el 47% de os receptores presentó reactivación de CMV y el 10% enfermedad, con una mortalidad directa del 3,1%. El 87% de los receptores y el 70% de los donantes tenían serología para EBV y el 13% tuvieron una reactivación con una carga viral > 20.000 copias/ml. El 11% de los pac tuvieron enfermedad por Herpes zoster, el 6% por Herpes 6 y el 5% por Herpes simple. Se detectó infección por adenovirus en el 25% de los pacientes, siendo el compromiso más frecuente el digestivo, seguido de la infección respiratoria baja. La mortalidad directa por adenovirus fue 5,1%. Se registraron 41 episodios de infección respiratoria aguda baja por virus respiratorios, con una mortalidad directa del 4%. El 18% de los pac tuvo cistitis hemorrágica por virus BK, con viremia asociada en el 41% de los casos. El 6% de los pacientes presentó falla hematológica asociada a Parvovirus, que un caso fue causa de la pérdida del injerto. Conclusión: las enfermedades virales son una complicación muy frecuente del TCPH y con gran peso en la mortalidad relacionada al trasplante. Los avances terapéuticos han sido menores que los alcanzados en los métodos diagnósticos (AU)


Introduction: Allogeneic hematopietic stem cell transplantation (HSCT) is associated with a slow recovery of the immune system leading to multiple infectious complications. In this study viral infections are evaluated in a retrospective cohort. Material and methods: The data base of the department was reviewed recording viral infections that occurred between 2012-2016. Results: n 215; 91% of the recipients and 70% of the donors were CMV prior to the transplant; 47% of the recipients had a CMV reactivation and 10% developed the disease with a related mortality of 3.1%. Overall, 87% of the recipients and 70% of the donor had a positive serology for EBV and 13% had a reactivation with a viral load of > 20,000 copies/ml. Of the patients, 11% had Herpes zoster, 6% Herpes 6, and 5% Herpes simplex. Adenovirus infection was detected in 25% of the patients, most commonly involving the digestive tract followed by lower respiratory tract infection. Adenovirusrelated mortality was 5.1%. Forty-one acute lower respiratory tract infections due to respiratory viruses were recorded leading to a mortality of 4%. Of all the patients, 18% had BK virus-related hemorrhagic cystitis with associated viremia in 41% of the cases. Six percent of the patients had parvovirusassociated hemotologic failure leading to graft loss in one case. Conclusion: Viral diseases are a very frequent complication in HSCT with a high transplant-related mortality. Advances in therapy have lagged behind advances in diagnostic methods (AU)


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/mortality , Immunocompromised Host , Prevalence , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Virus Diseases/mortality , Cohort Studies , Retrospective Studies
7.
Arch. argent. pediatr ; 116(1): 35-41, feb. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887424

ABSTRACT

Introducción. Evaluamos el nivel de reactantes de fase aguda y la prueba LightCycler® SeptiFast para diferenciar infecciones bacterianas vs.virales. Métodos. Estudio prospectivo en niños febriles. Se analizaron recuento de leucocitos, proteína C-reactiva y procalcitonina en días 1, 3 y 7 de hospitalización. El día 1 se realizaron hemocultivo y radiografía de tórax. Se evaluaron dos grupos de niños que presentaron infecciones bacterianas o virales. Resultados. Se incluyeron 94 niños febriles. La temperatura media de la fiebre fue significativamente más alta en niños con infecciones bacterianas que con infecciones virales (p < 0,001). En 34 (72,3%) niños con infecciones bacterianas, el hemocultivo fue negativo. De ellos, 12 (35,2%) presentaron prueba SeptiFast positiva. No hubo resultados positivos en hemocultivos de niños con infecciones virales y todos tuvieron resultado negativo para la prueba SeptiFast. La media de proteína C-reactiva el primer día de hospitalización fue significativamente más alta en el grupo con infecciones bacterianas (p < 0,001) y en los días 3 y 7 junto con la procalcitonina fueron significativamente más altas en niños con infecciones bacterianas (p <0,001). La sensibilidad y especificidad de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 63,8%, 44,7%, 74,5% y 78,7%, 68,1% y 100%, respectivamente. Las áreas bajo la curva de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 0,519, 0,764 y 0,835, respectivamente. Conclusiones. Los reactantes de fase aguda, en especial procalcitonina, y la prueba LightCycler® SeptiFast podrían ayudar a diferenciar infecciones bacterianas de virales.


Introduction: This study was performed to investigate the value of acute phase reactants and LightCycler® SeptiFast test to differentiate bacterial and viral infections. Population and methods: Children with fever were enrolled to this prospective study. Peripheral white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) were studied from all patients on day 1, 3 and 7. Blood culture and chest X-ray were also obtained on day 1. Blood samples for LightCycler® SeptiFast test were obtained in all patients to use them if there was uncertain diagnosis between bacterial or viral infection. The patients were divided into two groups as bacterial and viral infection. Results: A total of 94 children with fever were enrolled. The mean value of fever was significantly higher in bacterial group than viral group (p <0.001). In bacterial infection group, 34 (72.3%) patients had negative blood culture. Of those, 12 (35.2%) had positive SeptiFast test. There were no positive blood culture in patients with viral infection group and all of them had negative SeptiFast test. The mean levels of CRP on the first day of admission were significantly higher in bacterial group than viral group (p <0.001). CRP and PCT levels of day 3 and 7 were significantly higher in bacterial group (p <0.001). The sensitivity and specificity levels of WBC, CRP and PCT were 63.8%, 44.7%, 74.5% and 78.7% ,68.1% and 100%, respectively. Conclusions: We found that acute phase reactants, especially PCT, and LightCycler® SeptiFast test may help to differentiate bacterial and viral infections.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Bacterial Infections/diagnosis , Bacterial Infections/blood , Virus Diseases/diagnosis , Virus Diseases/blood , Acute-Phase Proteins/analysis , Multiplex Polymerase Chain Reaction , Prospective Studies , Diagnosis, Differential , Real-Time Polymerase Chain Reaction
9.
Rev. pediatr. electrón ; 14(1): 9-12, 2017.
Article in Spanish | LILACS | ID: biblio-969365

ABSTRACT

La técnica de la reacción de polimerasa en cadena (PCR) en tiempo real o PCR está disponible en el Hospital Roberto del Río desde el 2015. Esta técnica rápida y muy sensible, mejora los tiempos de respuesta y facilita la toma de decisiones clínicas. Sin embargo, es importante conocer los distintos aspectos del método para hacer una correcta interpretación clínica de un resultado de PCR.


Real time polymerase chain reaction (PCR) is a rapid and sensitive technique. It improves answer time for clinical decisions. It is important to know it well for a better clinical understanding.


Subject(s)
Humans , Respiratory Tract Infections/diagnosis , Bacterial Infections/diagnosis , Virus Diseases/diagnosis , Real-Time Polymerase Chain Reaction , Bacteria/isolation & purification , Viruses/isolation & purification
10.
Braz. j. microbiol ; 47(supl.1): 38-50, Oct.-Dec. 2016. graf
Article in English | LILACS | ID: biblio-839330

ABSTRACT

ABSTRACT Arboviruses pose a serious threat to public health worldwide, overloading the healthcare system and causing economic losses. These viruses form a very diverse group, and in Brazil, arboviruses belonging to the families Flaviviridae and Togaviridae are predominant. Unfortunately, the number of arboviruses increases in proportion with factors such as deforestation, poor sanitation, climate changes, and introduction of new viruses like Chikungunya virus and Zika virus. In Brazil, dengue is endemic, along with the presence of other arboviruses. The situation is complicated by the scarcity of diagnostic infrastructure and the absence of approved vaccines for these diseases. Disease control, thus, relies solely on vector control. Therefore, enhanced clinical knowledge and improved general awareness about these arboviruses are indispensable to tackle diagnostic inadequacies.


Subject(s)
Humans , Animals , Virus Diseases/transmission , Virus Diseases/virology , Insect Vectors/virology , Culicidae/virology , Brazil/epidemiology , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Alphavirus Infections/diagnosis , Alphavirus Infections/transmission , Alphavirus Infections/epidemiology , Alphavirus Infections/virology , Alphavirus/classification , Alphavirus/physiology , Dengue/transmission , Dengue/epidemiology , Dengue/virology , Dengue Virus/classification , Dengue Virus/physiology , Zika Virus Infection/diagnosis , Zika Virus Infection/transmission , Zika Virus Infection/epidemiology , Zika Virus Infection/virology
11.
J. pediatr. (Rio J.) ; 91(5): 442-447, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-766168

ABSTRACT

ABSTRACT OBJECTIVE: Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. METHOD: A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), transaminases (AST and ALT), blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. RESULTS: Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys) were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%), rhinorrhea (23%), and fever (63%), with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%), limited ambulation (57%), gait abnormality (40%), and muscle weakness in the lower limbs (71%), with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507 ± 9180 U/L), LDH (827 ± 598 U/L), and AST (199 ± 245 U/L), with a tendency to leukopenia (4590 ± 1420) leukocytes/mm3. The complete recovery of laboratory parameters was observed in 30 days (median), and laboratory and clinical recurrence was documented in one case after 10 months. CONCLUSION: Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.


RESUMO OBJETIVO: Descrever o perfil clínico-laboratorial, o acompanhamento e o desfecho de uma série de casos de miosite aguda viral. MÉTODO: Foi conduzida uma análise retrospectiva de casos suspeitos, em observação em unidade de emergência, e seguimento ambulatorial com o registro de sintomas de infecção respiratória, sintomas músculo-esqueléticos, determinação de enzimas musculares, creatina-fosfoquinase (CPK), desidrogenase lática (DHL), transaminases (AST e ALT), hemograma, proteína C reativa e velocidade de hemossedimentação, na fase aguda e no acompanhamento, até a normalização. RESULTADOS: Entre 2000 e 2009, 42 casos suspeitos foram identificados e 35 (27 meninos) foram incluídos. A mediana de idade foi de sete anos e o diagnóstico relatado em 89%, na primeira visita de emergência. Os sintomas respiratórios observados foram: tosse (31%), coriza (23%) e febre (63%), com duração média de 4,3 dias. Os sintomas músculo-esqueléticos foram: dor localizada nas panturrilhas (80%), deambulação limitada (57%), marcha anormal (40%) e fraqueza muscular nos membros inferiores (71%), com duração média de 3,6 dias. Observou-se elevação importante das enzimas CPK (5.507 ± 9.180) U/l, DHL (827 ± 598) U/l e AST (199 ± 245) U/l e tendência a leucopenia (4.590 ± 1.420) leucócitos/mm3. A recuperação completa dos parâmetros laboratoriais foi observada em 30 dias (mediana) e a recaída clínica e laboratorial em um caso após 10 meses. CONCLUSÃO: Os sintomas típicos com enzimas musculares elevadas após diagnóstico de influenza e o curso autolimitado foram os indícios para o diagnóstico. A elevação de enzimas musculares indica a atividade miotrópica transitória relacionada à influenza sazonal que deve ser considerada, a despeito da identificação viral, possivelmente associada com o vírus influenza ou outros vírus respiratórios.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Myositis/virology , Virus Diseases/complications , Acute Disease , C-Reactive Protein/analysis , Clinical Enzyme Tests/methods , Creatine Kinase, MB Form/blood , Creatine Kinase/blood , Influenza, Human/complications , Muscle Weakness/etiology , Myositis/diagnosis , Retrospective Studies , Sex Distribution , Time Factors , Transaminases/blood , Virus Diseases/diagnosis
12.
Rev. argent. microbiol ; 47(1): 29-35, Mar. 2015. tab
Article in Spanish | LILACS | ID: lil-757141

ABSTRACT

Las infecciones respiratorias agudas producen una importante morbimortalidad y comúnmente son causadas por virus. En Argentina, los programas de vigilancia epidemiológica se basan en la detección de antígenos virales por inmunofluorescencia (IF), aunque es bien conocido que los métodos moleculares son más sensibles. El panel respiratorio (PR) FilmArray (PR-FilmArray) es un equipo comercial automatizado de PCR múltiples que detecta 17 virus respiratorios y 3 bacterias, en un sistema cerrado que requiere 5 min de procesamiento y una 1 h de instrumentación. Se evaluó un total de 315 muestras respiratorias de niños menores de 6 años con infecciones respiratorias agudas por IF para 8 virus respiratorios y por RT-PCR para rinovirus. Posteriormente, estas muestras se estudiaron con el PR-FilmArray. La frecuencia de positividad al considerar los 9 virus estudiados por IF y RT-PCR fue del 75 %; por PR-FilmArray fue del 92 %. El porcentaje de acuerdo positivo entre ambas metodologías fue del 70,5 % y el de acuerdo negativo fue del 99,6 % (intervalo de confianza 95 %: 65,5-75,1 y 99,2-99,8, respectivamente). El PR-FilmArray permitió obtener un mayor diagnóstico positivo (97 %) y detectó otros virus, como los coronavirus NL63, 229E, OC43 y HKU1 (10 %) y los bocavirus (18 %). Además, permitió identificar coinfecciones múltiples (39 %) con 2, 3, 4 y hasta 5 virus. Actualmente, la IF continúa siendo el método más utilizado en los países latinoamericanos para el diagnóstico de virus respiratorios por su bajo costo, por su capacidad para procesar un alto número de muestras simultáneamente y porque los resultados de los virus más frecuentes están disponibles en 5 h. Sin embargo, la futura incorporación de métodos moleculares aumentaría notablemente la capacidad diagnóstica.


Acute respiratory infections, which are commonly caused by viruses, are an important cause of morbidity and mortality in children. In Argentina, national surveillance programs for the detection of respiratory viruses are usually performed by using immunofluorescence (IF) assays, although it is well known that molecular methods are more sensitive. An automated multiplex PCR device, the FilmArray-Respiratory Panel (FilmArray-RP), can detect 17 viral and 3 bacterial pathogens in a closed system that requires only 5 min of hands-on time and 1 h of instrumentation time. A total of 315 respiratory samples from children under 6 years of age suffering from acute respiratory infections, were studied by IF for 8 respiratory viruses and by RT-PCR for rhinoviruses. Later, these samples were tested by the FilmArray-RP. The positivity frequency obtained for the 9 viruses tested was 75 % by IF/RT-PCR and 92 % by the FilmArray-RP. The positive and negative percent agreement between both methods was 70.5 % whereas the negative percent agreement was 99.6 % (95 % confidence interval:65.5-75.1 and 99.2-99.8 respectively). The FilmArray-RP allowed a higher positive diagnosis (97 %) and detected other viruses such as coronavirus NL63, 229E, OC43, HKU1 (10 %) and bocavirus (18 %). In addition, this method identified multiple coinfections (39 %) with 2, 3, 4 and up to 5 different viruses. At present, IF is still the most frequently used method in most Latin American countries for respiratory viruses diagnosis due to its low cost, its capability to process a high number of samples simultaneously and the fast determination of results for the most frequent viruses, which are available within 5 h. However, the coming incorporation of molecular methods in routine procedures will significantly increase the diagnostic yield of these infections.


Subject(s)
Child , Humans , Multiplex Polymerase Chain Reaction , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , Virus Diseases/diagnosis , Retrospective Studies
13.
Article in English | WPRIM | ID: wpr-58265

ABSTRACT

BACKGROUND/AIMS: Infections are major causes of both early and late death after lung transplantation (LT). The development of prophylaxis strategies has altered the epidemiology of post-LT infections; however, recent epidemiological data are limited. We evaluated infections after LT at our institution by time of occurrence, site of infections, and microbiologic etiologies. METHODS: All consecutive patients undergoing lung or heart-lung transplantation between October 2008 and August 2014 at our institution were enrolled. Cases of infections after LT were initially identified from the prospective registry database, which was followed by a detailed review of the patients' medical records. RESULTS: A total of 108 episodes of post-LT infections (56 bacterial, 43 viral, and nine fungal infections) were observed in 34 LT recipients. Within 1 month after LT, the most common bacterial infections were catheter-related bloodstream infections (42%). Pneumonia was the most common site of bacterial infection in the 2- to 6-month period (28%) and after 6 months (47%). Cytomegalovirus was the most common viral infection within 1 month (75%) and in the 2- to 6-month period (80%). Respiratory viruses were the most common viruses after 6 months (48%). Catheter-related candidemia was the most common fungal infection. Invasive pulmonary aspergillosis developed after 6 months. Survival rates at the first and third years were 79% and 73%, respectively. CONCLUSIONS: Although this study was performed in a single center, we provide valuable and recent detailed epidemiology data for post-LT infections. A further multicenter study is required to properly evaluate the epidemiology of post-LT infections in Korea.


Subject(s)
Adult , Bacterial Infections/diagnosis , Catheter-Related Infections/microbiology , Cytomegalovirus Infections/virology , Female , Heart-Lung Transplantation/adverse effects , Humans , Kaplan-Meier Estimate , Lung Transplantation/adverse effects , Male , Medical Records , Middle Aged , Mycoses/diagnosis , Pneumonia, Bacterial/microbiology , Registries , Republic of Korea/epidemiology , Risk Factors , Time Factors , Treatment Outcome , Virus Diseases/diagnosis
14.
Med. interna (Caracas) ; 31(1): 8-15, 2015. ilus, mapas
Article in Spanish | LILACS | ID: lil-772203

ABSTRACT

Una nueva enfermedad amenaza a las Américas, se trata de la infección por el virus Zika (VZIK), perteneciente a la familia Flaviviridae, genero flavivirus, trasmitida por mosquitos del género Aedes. El VZIK fue aislado en abril de 1947 en Uganda en el bosque Zika. La primera infección en un ser humano fue en Nigeria en 1954. Se trasmite fundamentalmente por vectores del género Aedes, también vía vertical, y un solo caso por relación sexual. Es considerada una enfermedad emergente; previo al año 2007, los casos reportados eran esporádicos, y luego se han descrito dos brotes de importancia, uno en 2012 en Yap, Micronesia y los años 2013, 2014, 2015, se han producido epidemias en la Polinesia francesa, Isla de Pascua, las Islas Cook y Nueva Caledonia. Con excepción del brote en la isla de Pascua el año 2014, la enfermedad en las Américas era totalmente desconocida; recientemente se ha descrito un brote en el norte de Brasil, dado que los vectores trasmisores de la enfermedad se encuentran ampliamente distribuidos en la región y se proveen epidemias de mayor magnitud en un periodo de tiempo cercano. Clínicamente es similar al dengue y la chikungunya, se caracteriza por mialgias, cefalea, artralgias principalmente de manos y pies, conjuntivitis no purulenta, las complicaciones hemorrágicas y neurológicas son raras. La mayoría de las infecciones son asintomáticas, y no se han reportado fallecimientos. El método recomendado para su diagnóstico es el PCR en tiempo real, durante los primeros 3-5 días durante la viremia, la serología IgM y IgG puede dar reacción cruzada con otros flavivirus como el dengue. Los Ministerios de Salud deben activar sus “Sistemas devigilancia” para detectar precozmente la introducción del virus, sensibilizar a los profesionales de la salud, el control de los vectores es fundamental


A new disease threatens the Americas, it is an infection caused by the Zika (VZIK) virus, which belongs to the Flaviviridae family, genus flavivirus. The VZIK was isolated in April 1947 in Uganda in the Zika forest and the the first infected human was in Nigeria in 1954. It is primarily transmitted by vectors of the genus Aedes, by vertical transmission, potentially through blood and only one case of sexual intercourse. It is considered an emerging disease; before 2007 reported cases were sporadic, two major outbreaks have been reported, one in 2012 in Yap, Micronesia and in the years 2013, 2014 and 2015 outbreaks had occurred in French Polynesia, Pascua Island (Chile), the Cook Islands and New Caledonia. Except for the VZIK outbreak at the Pascua Island in 2014, this disease was completely unknown in the Americas. Recently an outbreak has been reported in northern Brazil, because transmitters vectors, Aedes aegypti and A. albopictus, are widely distributed in the region, and outbreaks of greater magnitude are expected in a short period of time. The disease is similar to Dengue and Chikungunya, is characterized by myalgia, headache and hands and feet arthralgiae, non purulent, hemorrhagic and neurological complications are rare. It is believed that most of the cases are asymptomatic and until now no deaths have been reported. The recommended method for diagnosis is the real-time PCR of the first 3–5 days during viremia; the IgM and IgG serology have crossed reaction with other flaviviruses as dengue. Ministries of Health must activate their "monitoring systems" for early detection of virus introducion and alert health professionals and general population about this emerging disease. The Americas could be affected by three diseases with similar clinical spectrum of dengue, chikungunya and now VZIK infection, which are transmitted by the Aedes mosquito, hence the vector control is essential in the fight against these diseases


Subject(s)
Humans , Male , Female , Disease Outbreaks/prevention & control , Densovirinae , Virus Diseases/diagnosis , Virus Diseases/pathology , Central America , Latin America , North America , South America
15.
J. pediatr. (Rio J.) ; 90(4): 370-376, Jul-Aug/2014. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: lil-720885

ABSTRACT

OBJECTIVE: to estimate the prevalence of infection by respiratory viruses in pediatric patients with cancer and acute respiratory infection (ARI) and/or fever. METHODS: cross-sectional study, from January 2011 to December 2012. The secretions of nasopharyngeal aspirates were analyzed in children younger than 21 years with acute respiratory infections. Patients were treated at the Grupo em Defesa da Criança Com Câncer (Grendacc) and University Hospital (HU), Jundiaí, SP. The rapid test was used for detection of influenza virus (Kit Biotrin, Inc. Ireland), and real-time multiplex polymerase chain reaction (FTD, Respiratory pathogens, multiplex Fast Trade Kit, Malta) for detection of influenza virus (H1N1, B), rhinovirus, parainfluenza virus, adenovirus, respiratory syncytial virus, human parechovirus, bocavirus, metapneumovirus, and human coronavirus. The prevalence of viral infection was estimated and association tests were used (χ2 or Fisher's exact test). RESULTS: 104 samples of nasopharyngeal aspirate and blood were analyzed. The median age was 12 ± 5.2 years, 51% males, 68% whites, 32% had repeated ARIs, 32% prior antibiotic use, 19.8% cough, and 8% contact with ARIs. A total of 94.3% were in good general status. Acute lymphocytic leukemia (42.3%) was the most prevalent neoplasia. Respiratory viruses were detected in 50 samples: rhinoviruses (23.1%), respiratory syncytial virus AB (8.7%), and coronavirus (6.8%). Co-detection occurred in 19% of cases with 2 viruses and in 3% of those with 3 viruses, and was more frequent between rhinovirus and coronavirus 43. Fever in neutropenic patients was observed in 13%, of which four (30.7) were positive for viruses. There were no deaths. CONCLUSIONS: the prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co-detection was frequent in patients with cancer and ARIs. .


OBJETIVO: estimar a prevalência da infecção pelos vírus respiratórios em pacientes pediátricos com câncer e infecção respiratória aguda (IRA) e/ou febre. MÉTODOS: estudo transversal, de janeiro de 2011 a dezembro de 2012. Foram analisadas secreções de aspirado da nasofaringe de menores de 21 anos, com quadro respiratório agudo, atendidos nos hospitais Grendacc e HU, Jundiaí, SP. Foi aplicado o teste rápido para detecção dos vírus influenza (Kit Biotrin(r)) e a reação em cadeia da polimerase multiplex em tempo real (Kit multiplex/Fast Trade(r)) para detecção dos vírus: influenza (A, H1N1, B), rinovírus, parainfluenza, adenovírus respiratório, vírus respiratório sincicial, parechovírus, bocavírus, metapneumovírus humano e coronavírus humano. Foi estimada a prevalência de infecção viral e usados testes de associação (χ2 ou teste exato de Fisher). RESULTADOS: foram analisadas 104 amostras de aspirado de nasofaringe e sangue. A mediana para a idade foi 12±5,2 anos; masculino (51%); cor branca (68%); IVAS de repetição (32%); uso prévio de antibiótico (32%); tosse (19,8%); e contato com IVAS (8%). Apresentavam-se em bom estado geral 94,3% dos pacientes. A leucemia linfocítica aguda (42,3%) foi mais prevalente. Foram detectados vírus respiratórios em 50% das amostras: rinovírus (23,1%), vírus sincicial respiratório A/B (8,7%) e coronavírus (6,8%). Ocorreu codetecção em 19% entre dois vírus, e de 3% entre três vírus, sendo a mais frequente entre rinovírus e coronavírus 43. Febre em neutropênicos foi de 13%, sendo quatro (30,7%) com vírus positivo. Não houve óbitos. CONCLUSÕES: a prevalência de vírus respiratórios ...


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Neoplasms/complications , Respiratory Tract Infections/complications , Virus Diseases/complications , Acute Disease , Cross-Sectional Studies , Fever/complications , Nasopharynx , Neoplasms/drug therapy , Prevalence , Respiratory Syncytial Viruses/isolation & purification , Respiratory Tract Infections/diagnosis , Rhinovirus/isolation & purification , Virus Diseases/diagnosis , Virus Diseases/epidemiology
18.
Salvador; s.n; 2014. 91 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: biblio-1000921

ABSTRACT

A prevalência de HTLV- 1 no Brasil é diversa, dependendo tanto da região geográfica quanto do grupo analisado. Um estudo populacional realizado em Salvador detectou prevalência de 1,76%, além de maior prevalência em mulheres e associação com menores níveis de escolaridade e renda. Como a via mais frequente de transmissão vertical do HTLV-1 é a amamentação e considerando a maior prevalência nas mulheres, é muito importante a realização de exames de triagem para HTLV-1 como parte do prénatal. Até o momento, não existem estudos publicados sobre a soroprevalência do HTLV-1 em gestantes na região sul da Bahia. No presente estudo, as gestantes foram selecionadas em dois centros de referência regionais de saúde do sul da Bahia. Um total de 2.766 gestantes atendidas na sala de pré-parto entre novembro de 2008 e maio de 2010 foram analisados. Um questionário foi aplicado, e todas as amostras de plasma reagentes foram testadas em duplicata e confirmadas por Western blot e PCR. Além disso, mulheres positivas foram contactadas e visitadas. Os membros da família que estavam presentes durante a visita foram convidados a serem testados para o HTLV...


The prevalence of HTLV-1 in Brazil is diverse, depending on both the geographic region and the group analyzed. A study conducted on general population revealed that the prevalence in Salvador was 1.76%. Besides, it was also found that the prevalence was higher amongst women and that the virus was associated with lower education and lower income. As the most frequent pathway of vertical transmission of HTLV-1 is breast-feeding, and considering the higher prevalence in women, it is very important to perform screening examinations for anti-HTLV-1...


Subject(s)
Humans , Pregnancy/immunology , Pregnancy/blood , Deltaretrovirus Infections/diagnosis , Deltaretrovirus Infections/immunology , Deltaretrovirus Infections/prevention & control , Virus Diseases/diagnosis , Virus Diseases/immunology
19.
Article in English | WPRIM | ID: wpr-193130

ABSTRACT

BACKGROUND: The dramatic increase in use of the IgG test for toxoplasma, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV) [TORCH] has led to the requirement for a high-efficiency method that can be used in the clinical laboratory. This study aimed to compare the results of BGI-Array ELISA TORCH IgG (BGI-GBI, China) screening method to those of Virion/Serion TORCH IgG ELISA (Virion/Serion, Germany). METHODS: Serum specimens (n=400) submitted for routine IgG testing by Virion/Serion ELISA were also tested using the BGI-Array ELISA method. The agreements of these two kinds of method were analyzed by kappa-coefficients calculation. RESULTS: Following repeat testing, the BGI-Array ELISA TORCH IgG assays demonstrated agreements of 99.5% (398/400 specimens), 98% (392/400 specimens), 99% (396/400 specimens), and 99.5% (398/400 specimens), respectively. The BGI-Array ELISA IgG assays provided results comparable to Virion/Serion ELISA results, with kappa-coefficients showing near-perfect agreement for the HSV (kappa=0.87), rubella (kappa=0.92) and CMV (kappa=0.93) and substantial agreement for the toxoplasma (kappa=0.80) IgG assays. The use of the BGI-Array ELISA TORCH IgG assays could reduce the turnaround time (1.5 hr vs. 5 hr by Virion/Serion ELISA for 100 specimens) and were easy to use. CONCLUSIONS: BGI-Array ELISA TORCH IgG shows a good agreement with Virion/Serion ELISA methods and is suitable for clinical application.


Subject(s)
Antibodies, Viral/blood , Cytomegalovirus/immunology , Enzyme-Linked Immunosorbent Assay , Humans , Immunoglobulin G/analysis , Protozoan Infections/diagnosis , Reagent Kits, Diagnostic , Rubella virus/immunology , Sensitivity and Specificity , Simplexvirus/immunology , Toxoplasma/immunology , Virion/immunology , Virus Diseases/diagnosis
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