Ehrlichia canis and Rickettsia spp. in dogs from urban areas in Paraiba state, northeastern Brazil / Ehrlichia canis e Rickettsia spp. em cães de áreas urbanas da Paraíba, nordeste do Brasil

Abstract The aims of our study was to identify Ehrlichia canis and antibodies against Rickettsia spp. belonging to the spotted fever group (SFG) in dogs sampled from Paraiba state, northeastern Brazil. Blood and serum samples collected by convenience from dogs in urban areas of five municipalities were analyzed by real-time PCR for the detection of E. canis DNA and by immunofluorescence assay test (IFAT) for the identification of antibodies against Rickettsia rickettsii, R. felis, R. parkeri, R. amblyommii and R. rhipicephali antigens. E. canis DNA was detected in 8.9% (64/719) of the blood samples, whereas 5.63% (43/763) of the serum samples were positive for at least one of the Rickettsia antigens tested by IFAT. This study showed for the first time the occurrence of E. canis and suggested the circulation of SFG Rickettsia in dogs in the study region of Paraiba state, northeastern Brazil.

Resumo Os objetivos do nosso estudo foram identificar Ehrlichia canis e anticorpos contra Rickettsia spp. pertencentes ao Grupo da Febre Maculosa (GFM) em cães amostrados no estado da Paraíba, nordeste do Brasil. As amostras de sangue e soro, coletados por conveniência, de cães em áreas urbanas de cinco municípios foram analisadas por PCR em tempo real para a detecção de DNA de E. canis e pela Reação de Imunofluorescência Indireta (RIFI) para identificação de anticorpos contra Rickettsia rickettsii, R. felis, R. parkeri, R. amblyommii e R. rhipicephali. O DNA de E. canis foi detectado em 8,9% (64/719) das amostras de sangue, enquanto que 5,63% (43/763) das amostras de soro foram positivas para pelo menos um dos antígenos de Rickettsia testados por RIFI. Este estudo mostrou pela primeira vez a ocorrência de E. canis e sugere a circulação de Rickettsia do GFM em cães na região em estudo do estado da Paraíba, Nordeste do Brasil.

Single-tube nested PCR assay with in-house DNA extraction for Mycobacterium tuberculosis detection in blood and urine

Abstract: INTRODUCTION : Molecular analyses are auxiliary tools for detecting Koch's bacilli in clinical specimens from patients with suspected tuberculosis (TB). However, there are still no efficient diagnostic tests that combine high sensitivity and specificity and yield rapid results in the detection of TB. This study evaluated single-tube nested polymerase chain reaction (STNPCR) as a molecular diagnostic test with low risk of cross contamination for detecting Mycobacterium tuberculosis in clinical samples. METHODS: Mycobacterium tuberculosis deoxyribonucleic acid (DNA) was detected in blood and urine samples by STNPCR followed by agarose gel electrophoresis. In this system, reaction tubes were not opened between the two stages of PCR (simple and nested). RESULTS: STNPCR demonstrated good accuracy in clinical samples with no cross contamination between microtubes. Sensitivity in blood and urine, analyzed in parallel, was 35%-62% for pulmonary and 41%-72% for extrapulmonary TB. The specificity of STNPCR was 100% in most analyses, depending on the type of clinical sample (blood or urine) and clinical form of disease (pulmonary or extrapulmonary). CONCLUSIONS: STNPCR was effective in detecting TB, especially the extrapulmonary form for which sensitivity was higher, and had the advantage of less invasive sample collection from patients for whom a spontaneous sputum sample was unavailable. With low risk of cross contamination, the STNPCR can be used as an adjunct to conventional methods for diagnosing TB.

Pertussis may be the cause of prolonged cough in adolescents and adults in the interepidemic period

Objective: This study was aimed to evaluate the prevalence of pertussis in adolescents and adults with cough lasting more than 14 days and less than 30 days. Methods: This is a prospective observational study in interepidemic period of pertusis. Ten public health outpatient clinics in the city of Recife, Brazil, were randomly selected for the study. The study population consisted of individuals aged 10 years and over with cough that had lasted between 14 and 30 days. Nasopharyngeal swabs were collected for culture and PCR in order to identify Bordetella pertussis. We adopted the Centers for Disease Control and Prevention in the US (CDC) definition of cases of pertussis. Results: A total of 192 individuals were identified as suspected cases. Their mean age was 40.7 years. Pertussis was confirmed in 10 of the 192 suspected cases, with an estimated prevalence of 5.21% (95% confidence interval 2.03-8.38). All cases met the clinical case definition for pertussis; one suspect had both culture and PCR positive. PCR confirmed 100% of the cases, 7/10 by PCR and 3/10 by epidemiological linkage with a case confirmed by PCR. Conclusion: During an interepidemic period, 1 in 20 cases of prolonged cough had pertussis, suggesting this is an important cause of prolonged cough in adolescents and adults. .

Cluster of Serogroup W-135 Meningococcal Disease in 3 Military Recruits

We describe a group of 3 cases of invasive meningococcal disease that occurred in a military training camp in April 2011. All three patients were hospitalized. Ultimately, two patients recovered and one died. One patient had meningitis, one patient had septicemia and meningitis, and the other had no definite septicemia or meningitis. Neisseria meningitidis serogroup W-135 was detected in the serum and cerebrospinal fluid (CSF) of all patients by real-time polymerase chain reaction. In the one case of mortality, two strains were isolated from the patient's blood and CSF. Using multilocus sequence typing analysis, these strains were identified as a novel sequence type, ST-8912. Special attention is required for the meningococcal disease in military camp because the military personnels are in high risk of contact transmission.

MULTIPLEX SYBR® GREEN-REAL TIME PCR (qPCR) ASSAY FOR THE DETECTION AND DIFFERENTIATION OF Bartonella henselae AND Bartonella clarridgeiae IN CATS / PCR em Tempo Real (qPCR) multiplex utilizando SYBR® Green para a detecção e diferenciação de Bartonella henselae e Bartonella clarridgeiae em gatos

A novel SYBR® green-real time polymerase chain reaction (qPCR) was developed to detect two Bartonella species, B. henselae and B. clarridgeiae, directly from blood samples. The test was used in blood samples obtained from cats living in animal shelters in Southern Brazil. Results were compared with those obtained by conventional PCR targeting Bartonella spp. Among the 47 samples analyzed, eight were positive using the conventional PCR and 12 were positive using qPCR. Importantly, the new qPCR detected the presence of both B. henselae and B. clarridgeiae in two samples. The results show that the qPCR described here may be a reliable tool for the screening and differentiation of two important Bartonella species.

Um novo teste baseado na reação em cadeia da polimerase em tempo real (qPCR) com SYBR ® Green foi desenvolvido para detectar duas espécies de Bartonella, B. henselae e B. clarridgeiae, diretamente em amostras de sangue. Este teste foi utilizado em amostras de sangue obtidas de gatos que vivem em abrigos de animais do sul do Brasil. Os resultados foram comparados aos obtidos pelo PCR convencional utilizado para a detecção de Bartonella spp. Das 47 amostras analisadas, oito foram positivas no PCR convencional e 12 foram positivas para qPCR. A reação de qPCR, permitiu a detecção da presença simultânea de B. henselae e B. clarridgeiae em duas destas amostras. Os resultados mostram que a qPCR aqui descrita pode ser uma ferramenta confiável para a detecção e diferenciação de duas espécies importantes de Bartonella spp.

Molecular detection of Ehrlichia canis and Anaplasma platys in dogs in southern Brazil / Detecção molecular de Ehrlichia canis e Anaplasma platys em cães do sul do Brasil

The aims of this study were to determine the occurrence of Anaplasma platys and Ehrlichia canis infection in dogs in Porto Alegre, Southern Brazil; and to investigate their association with hematological abnormalities. Serum samples from 196 dogs were first tested using dot-ELISA for antibodies against Anaplasma spp. and Ehrlichia canis. Peripheral blood samples from 199 dogs were subjected to 16S rRNA nested PCR (nPCR) for A. platys and E. canis, followed by DNA sequencing to ensure pathogen identity. A total of 19/196 samples (9.69%) were positive for Anaplasma spp. using ELISA and 28/199 (14.07%) samples were positive for A. platys by nested PCR. All the dog samples were negative for E. canis, both in anti-E. canis antibody tests and in nested PCR. There were no significant differences in hematological parameters between A. platys-PCR positive and negative dogs and Anaplasma spp. serologically positive dogs, except for basophil counts, which were higher in nPCR-positive dogs. This is the first report showing A. platys presence in dogs in Southern Brazil. In conclusion, hematological parameters may not be sufficient to diagnose A. platys infection in dogs in Southern Brazil, probably due either to low pathogenicity or to chronic infection. On the other hand, E. canis may either have very low occurrence or be absent in dogs in Porto Alegre.

O objetivo deste estudo foi determinar a ocorrência de Anaplasma platys e Ehrlichia canis em cães de Porto Alegre, sul do Brasil, sua detecção molecular e associação com anormalidades hematológicas. Amostras séricas de 196 cães foram inicialmente triadas por dot-ELISA para a presença de anticorpos contra Anaplasma spp. e Ehrlichia canis. Amostras de sangue periférico de 199 cães foram submetidas à nested PCR (16S rRNA) para A. platys e E. canis, seguido de sequenciamento do DNA para confirmar a identidade do agente. Do total, 19/196 (9,69%) amostras foram positivas para Anaplasma spp. por dot-ELISA e 28/199 (14,07%) por nPCR. Todas as amostras dos cães foram negativas para E. canis no teste sorológico anti-E. canis e também na nPCR. Não houve diferença significativa nos parâmetros hematológicos, exceto a contagem de basófilos, que apresentou valores mais altos em cães positivos na nPCR para A. platys. Este é o primeiro relato da presença de A. platys no Rio Grande do Sul, e a primeira detecção molecular do agente no sul do Brasil. Em conclusão, parâmetros hematológicos não são suficientes para diagnosticar a infecção por A. platys em cães, provavelmente devido sua baixa patogenicidade ou infecção crônica. Por outro lado, E. canis parece ter ocorrência baixa ou mesmo nula em cães de Porto Alegre.

Molecular detection of feline arthropod-borne pathogens in cats in Cuiabá, state of Mato Grosso, central-western region of Brazil / Detecção molecular de patógenos transmitidos por artrópodes em gatos de Cuiabá, estado do Mato Grosso, centro-oeste do Brasil

Hemotrophic mycoplasmas (hemoplasmas), Bartonellasp., Hepatozoon sp. and Cytauxzoon felis are prominent pathogens that circulate between cats and invertebrate hosts. The present study aimed to detect the presence of DNA from hemoplasmas, Bartonella sp., Hepatozoon sp. and Cytauxzoon felis, and then confirm it by means of sequencing, in blood samples from cats in Cuiabá, MT, Brazil. From February 2009 to February 2011, blood samples with added EDTA were collected from 163 cats that were being housed in four different animal shelters in the city of Cuiabá, state of Mato Grosso, Brazil and from 15 cats that were admitted to the veterinary hospital of the Federal University of Mato Grosso (UFMT). Out of the 178 cats sampled, 15 (8.4%) were positive for hemoplasmas: four (2.2%) for Mycoplasma haemofelis, 12 (6.7%) for 'Candidatus M. haemominutum' and one (0.5%) for 'Candidatus M. turicensis'. One cat (0.5%), a patient that was attended at the veterinary hospital, was coinfected with M. haemofelis, 'Candidatus M. haemominutum' and 'Candidatus M. turicensis', based on sequencing confirmation. Four cats were positive for Bartonella spp.: three (1.7%) for B. henselae and one (0.5%) for B. clarridgeiae. None of the animals showed Cytauxzoon sp. or Hepatozoon sp. DNA in their blood samples. This study showed that cats housed in animal shelters in the city of Cuiabá, state of Mato Grosso, are exposed to hemoplasmas and Bartonella species.

Micoplasmas hemotróficos (hemoplasmas), Bartonellasp., Hepatozoon sp. e Cytauxzoon felis se destacam como importantes patógenos que circulam entre gatos e hospedeiros invertebrados. O presente estudo objetivou detectar e, posteriormente confirmar por seqüenciamento, a presença de DNA de hemoplasmas, Bartonella sp., Hepatozoon sp. e Cytauxzoon felis em amostras de sangue de gatos de Cuiabá, MT, Brasil. Entre fevereiro/2009 e fevereiro de 2011, amostras de sangue acrescidas de EDTA foram coletadas de 163 gatos mantidos em quatro diferentes abrigos na cidade de Cuiabá, estado do Mato Grosso, Brasil, e de 15 gatos atendidos no Hospital Veterinário da Universidade Federal do Mato Grosso (UFTM). Dos 178 gatos amostrados, 15 (8,4%) foram positivos para hemoplasmas: quatro (2,2%) para Mycoplasma haemofelis, 12 (6,7%) para 'Candidatus M. haemominutum' e um (0,5%) para 'Candidatus M. turicensis'. Um (0.5%) gato, atendido no Hospital Veterinário da UFMT, estava co-infectado com M. haemofelis, 'Candidatus M. haemominutum' e 'Candidatus M. turicensis', baseado na confirmação por sequenciamento. Quatro gatos mostraram-se positivos para Bartonella spp.: três (1,7%) para B. henselae e um (0.5%) para B. clarridgeiae. Todos os gatos amostrados mostraram-se negativos para Cytauxzoon sp. e Hepatozoon sp. Este estudo mostrou que gatos mantidos em abrigos na cidade de Cuiabá, estado do Mato Grosso, são expostos a hemoplasmas e espécies de Bartonella sp.

Molecular detection of Ehrlichia canis in dogs from the Pantanal of Mato Grosso State, Brazil / Detecção molecular de Ehrlichia canis em cães do Pantanal do Mato Grosso, Brasil

The present study evaluated the presence of Ehrlichia DNA in the blood samples of 320 dogs from the urban and rural areas of the municipality of Poconé, Pantanal region, Mato Grosso state, by Polymerase Chain Reaction (PCR), targeting the ehrlichial dsbgene. Risk factors for infection in dogs were also evaluated. Forty-eight (15%, 95% CI: 11.4-19.5%) dogs were positive: 25 (15.6%, 95% CI: 10.4-22.2%) from the urban area and 23 (14.4%, 95% CI: 9.3-20.8%) from the rural area (P > 0.05). Partial DNA sequence obtained from PCR products of 18 samples from the urban area and 16 samples from the rural area were 100% identical to E. canis from Brazil and the USA. This study reports the first E. canis molecular detection in dogs from the northern Pantanal region.

O presente estudo avaliou a presença de DNA de Ehrlichia spp. em 320 cães das áreas urbana e rural do município de Poconé, região do Pantanal de Mato Grosso, pela PCR visando o gene dsb. Os fatores de risco para a infecção em cães também foram avaliados. Quarenta e oito (15%, IC 95%: 11,4-19,5%) cães foram positivos, 25 (15,6%, IC 95%: 10,4-22,2%) da área urbana e 23 (14,37%, 95% CI: 9,3-20,8%) da área rural (P > 0,05). Sequências parciais de DNAs obtidos a partir de produtos da PCR de 18 amostras da área urbana e 16 da área rural foram 100% idênticas a E. canis do Brasil e EUA. Este estudo relata a primeira detecção molecular de E. canis em cães da região norte do Pantanal.

Consenso para el diagnóstico clínico y microbiológico y la prevención de la infección por Bordetella pertussis / Consensus on the clinical and microbiologic diagnosis of Bordetella pertussis, and infection prevention

La tos ferina sigue siendo responsable de una carga de enfermedad importante en el mundo. Aunque la implementación del uso de la vacuna contra esta enfermedad ha disminuido en gran medida el número de casos en la población pediátrica, se ha observado que la inmunidad inducida por la vacuna y por la infeccion natural disminuye con el tiempo lo que hace nuevamente susceptibles a adolescentes y adultos jóvenes que pueden transmitir la enfermedad a lactantes no inmunizados o con esquema de vacunación incompleto. Este documento, resultado de la reunión de un grupo internacional de expertos en la Ciudad de México, ha analizado la información médica reciente para establecer el estado actual de la epidemiología, diagnóstico, vigilancia y, especialmente, el valor de la dosis de refuerzo con dTpa en adolescentes y adultos como estrategia de prevención de tos ferina en México.

Pertussis continues to be responsible for a significant disease burden worldwide. Although immunization practices have reduced the occurrence of the disease among children, waning vaccine- and infection-induced immunity still allows the disease to affect adolescents and adults who, in turn, can transmit the disease to non-immunized or partially immunized infants. This document is the result of a meeting in Mexico City of international experts who analyzed recent medical information in order to establish the current status of the epidemiology, diagnosis and surveillance of pertussis and, especially, the value of the dTpa booster dose in adolescents and adults as a pertussis prevention strategy in Mexico.

Aseptic meningitis caused by Leptospira spp diagnosed by polymerase chain reaction

Leptospirosis is a zoonotic disease caused by the pathogenic Leptospira spp. The clinical presentations are diverse, ranging from undifferentiated fever to fulminant disease including meningeal forms. The neurological leptospirosis forms are usually neglected. The aim of this study was to investigate leptospirosis as the cause of aseptic meningitis using different diagnostic techniques including the polymerase chain reaction (PCR). Thirty-nine cerebrospinal fluid (CSF) samples from patients presenting with meningeal abnormalities, predominance of lymphocytes and negative results by traditional microbiological tests were processed by leptospiral culture, anti-leptospiral antibody response and PCR. Leptospira spp DNA was detected in 23 (58.97 percent) of the CSF samples. Anti-leptospiral antibodies were found in 13 (33.33 percent) CSF samples. Twelve CSF samples were positive by PCR assay and negative by microscopic agglutination test (MAT) assay. Two CSF samples were positive by MAT and negative by PCR. The positive and negative agreement between both tests was 11 and 14, respectively. CSF samples from six cases of unknown diagnosis were positive by PCR assay. Eight cases showed positive results using PCR and MAT. Leptospirosis could be detected by PCR assay from the 3rd-26th day after illness onset. The sensitivity of the PCR was assessed with confirmed cases of leptospirosis (by MAT) and found to be 89.5 percent. All CSFs were negative by culture. PCR was found to be a powerful tool for diagnosing meningitis cases of leptospirosis. We recommend that it may be used as a supplementary diagnostic tool, especially in the early stages of the disease, when other diagnostic techniques such as serology are not sensitive.

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats in the south of Brazil: a molecular study

Bartonella spp are the causative agent of cat scratch disease in humans. Cats are the natural reservoir of these bacteria and may infect humans through scratches, bites or fleas. Blood samples from 47 cats aged up to 12 months were collected for this study. All animals were lodged in municipal animal shelters in the Vale do Sinos region, Rio Grande do Sul, Brazil. Bartonella spp were detected by genus-specific polymerase chain reaction (PCR) and when the PCR was positive, the species were determined by DNA sequencing. A Giemsa-stained blood smear was also examined for the presence of intraerythrocytic elements suggestive of Bartonella spp infection. Phylogenetic analysis was also performed for all positive samples. Using molecular detection methods, Bartonella spp were detected in 17.02 percent (8/47) of the samples. In seven out of eight samples confirmed to be positive for Bartonella spp, blood smear examination revealed the presence of intraerythrocytic elements suggestive of Bartonella spp. Phylogenetic analysis characterized positive samples as Bartonella henselae (5) or Bartonella clarridgeiae (3). To the best of our knowledge, this is the first molecular study demonstrating the presence of Bartonella spp in cats from the Southern Region of Brazil.

Ehrlichia canis morulae and DNA detection in whole blood and spleen aspiration samples / Detecção de mórulas e DNA de Ehrlichia canis em sangue e em aspirado de baço em cães naturalmente infectados

The aim of this study was to compare the detection of Ehrlichia canis morulae and DNA by nPCR in whole blood and spleen aspiration. The sample included 40 dogs showing thrombocytopenia associated to clinical signs suggestive of canine ehrlichiosis. Morulae detection showed that in 35 of the dogs studied, 17 had morulae in spleen tissue, and two in buffy coat smears. E. canis DNA was detected in 29/40 blood samples. We verified that morulae detection is more efficient in cytological preparations from spleen aspiration. On the other hand, nPCR on spleen and blood samples were equally efficient for disease diagnosis.

O objetivo desse estudo foi comparar a pesquisa de mórulas de Ehrlichia canis e a nPCR em sangue total e em aspirado de baço. Selecionaram-se 40 cães apresentando trombocitopenia associada a sinais e sintomas sugestivos de erliquiose canina. A pesquisa de mórula mostrou que dentre 35 amostras, 17 apresentaram mórulas nas preparações do baço, e duas nos esfregaços feitos a partir da papa leucocitária. O DNA de Ehrlichia canis foi detectado em 29 de 40 amostras de baço e em 30 de 40 no sangue. No presente estudo observou-se que a pesquisa de mórula é mais eficiente nas preparações citológicas obtidas da punção aspirativa do baço e que tanto a nPCR de baço quanto a de sangue foram eficientes no diagnóstico da doença.

Inflamação sistêmica causada pela periodontite crônica em pacientes vítimas de ataque cardíaco isquêmico agudo / Systemic inflammation caused by chronic periodontite in patients victims of acute ischemic heart attack

OBJETIVO: Processos inflamatórios e infecciosos mediados por bactérias em sítios distantes têm sido descritos como fator de risco à doença coronariana isquêmica aguda (DCIA). MÉTODOS: Cento e oitenta e um pacientes com DCIA, com e sem periodontites crônicas, foram incluídos neste estudo. Os pacientes foram admitidos no HC da UNICAMP e estratificados em três grupos: grupo 1 - pacientes com periodontite crônica grave (31 homens e 19 mulheres; média de idade 55,1 ± 11,29 anos); grupo 2 - pacientes com periodontite crônica leve (40 homens e 28 mulheres; média de idade 54,8 ± 10,37 anos); grupo 3 - pacientes desdentados (43 homens e 20 mulheres; média de idade 67,5 ± 8,55 anos). Amostras sanguíneas foram coletadas para mensurar os perfis lipídico, hematológico e glicêmico. Além disso, biópsias de 17 artérias coronárias com aterosclerose e igual número de artérias mamárias internas sem degeneração aterosclerótica no grupo 1 foram investigadas. Para análise estatística utilizou-se a análise de variância (ANOVA) e o teste de Scheffé para comparações múltiplas. RESULTADOS: Triglicérides e LDL estavam elevados no grupo 1 em relação ao grupo 2. O HDL apresentou-se reduzido em 20 por cento dos pacientes do grupo 1, e em 8 por cento nos desdentados. A glicemia estava elevada no grupo 1. DNA de bactérias periodontais foram detectados em 58,8 por cento das artérias coronárias. CONCLUSÕES: Pacientes com DCIA e periodontite crônica grave podem apresentar perfil lipídico alterado, como também microorganismos associados com as periodontites crônicas graves podem permear dentro de vasos coronarianos.

OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD). METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP) were included in this study. Patients were admitted to the HC UNICAMP and stratified into three groups: in group 1, we selected patients with severe chronic periodontitis (31 men and 19 women, mean age 55.1 ± 11.29 years old); the group 2 with mild chronic periodontitis (40 men and 28 women, mean age 54.8 ± 10.37 years old) and group 3 represented by the toothless (43 men and 20 women, mean age 67.5 ± 8.55 years old). Blood samples were collected to measure the lipid profiles, hematological and blood glucose levels. In addition, biopsies of seventeen coronary arteries with atherosclerosis and an equal number of internal mammary arteries without atherosclerotic degeneration in group 1 were investigated. Statistical analysis by analysis of variance (ANOVA) and Scheffé test for multiple comparisons was performed. RESULTS: Triglyceride and LDL levels were elevated in group 1 than in group 2. HDL were reduced by 20 percent in group 1 and remained reduced by 8 percent in toothless. Blood glucose was higher in group 1. DNA of periodontal bacteria was detected in 58.8 percent of the coronary arteries. CONCLUSIONS: Patients with (AIHD) and severe chronic periodontitis may have altered lipid profile, as well as microorganisms associated with CP can permeate into coronary vessels.

Molecular diagnosis of Anaplasmataceae organisms in dogs with clinical and microscopical signs of ehrlichiosis / Diagnóstico molecular de agentes da família Anaplasmataceae em cães com sinais clínicos e microscópios de erliquiose

Ehrlichioses are important emerging zoonotic tick-borne diseases that can affect both animals and humans. Clinical manifestations of ehrlichiosis caused by different members of Anaplasmataceae in dogs are similar to each other and to other diseases showing systemic manifestation. The observation of inclusions in white blood cells and in platelets cannot be used to confirm the Anaplasmataceae etiologic agent of the disease. In this work we assessed the presence of Anaplasmataceae agents in 51 dogs from two different cities (Jaboticabal and Campo Grande) showing clinical and microscopical diagnosis of ehrlichiosis, by using molecular techniques. Anaplasmataceae DNA were amplified in 46/51 (90.2 percent) of the blood samples; 22 (40 percent) samples from Jaboticabal and 10 (18.2 percent) from Campo Grande were positive for E. canis nPCR. Anaplasma platys DNA was amplified in 2 samples from Jaboticabal and in 11 from Campo Grande. Phylogenetic analysis of E. canis and A. platys DNA confirmed the infection agent and showed that PCR is the most reliable method to diagnose ehrlichial infection.

Erliquioses são importantes enfermidades emergentes transmitidas por carrapatos que podem afetar os animais e o homem. Em cães, as manifestações clínicas da erliquiose causada por diferentes membros da Família Anaplasmataceae são similares entre si e entre outras enfermidades de manifestação sistêmica. A observação de inclusões em leucócitos e plaquetas não pode ser utilizada para diagnosticar o agente etiológico pertencente à Família Anaplasmataceae. O presente trabalho objetivou detectar, por meio de técnicas moleculares, a presença de agentes da Família Anaplasmataceae em 51 cães de duas diferentes cidades (Jaboticabal, SP e Campo Grande, MS) apresentando sinais clínicos e microscópios sugestivos de erliquiose. DNA de agentes da Família Anaplasmataceae foi amplificado em 46/51 (90,2 por cento) das amostras de sangue; 22 (40 por cento) amostras de Jaboticabal e 10 (18,2 por cento) amostras de Campo Grande foram positivas na nested PCR para E. canis. DNA de Anaplasma platys foi amplificado em duas amostras de Jaboticabal e em 11 de Campo Grande. Análise filogenética dos DNAs de E. canis e A. platys das amostras confirmou o agente etiológico e mostrou que a PCR é o método mais confiável no diagnóstico das infecções por agentes da Família Anaplasmataceae.

Experimental infection of dogs with a Brazilian strain of Rickettsia rickettsii: clinical and laboratory findings

The bacterium Rickettsia rickettsii is the etiological agent of an acute, severe disease called Rocky Mountain spotted fever in the United States or Brazilian spotted fever (BSF) in Brazil. In addition to these two countries, the disease has also been reported to affect humans in Mexico, Costa Rica, Panama, Colombia and Argentina. Like humans, dogs are also susceptible to R. rickettsii infection. However, despite the wide distribution of R. rickettsii in the Western Hemisphere, reports of R. rickettsii-induced illness in dogs has been restricted to the United States. The present study evaluated the pathogenicity for dogs of a South American strain of R. rickettsii. Three groups of dogs were evaluated: group 1 (G1) was inoculated ip with R. rickettsii; group 2 (G2) was infested by R. rickettsii-infected ticks; and the control group (G3) was infested by uninfected ticks. During the study, no clinical abnormalities, Rickettsia DNA or R. rickettsii-reactive antibodies were detected in G3. In contrast, all G1 and G2 dogs developed signs of rickettsial infection, i.e., fever, lethargy, anorexia, ocular lesions, thrombocytopenia, anemia and detectable levels of Rickettsia DNA and R. rickettsii-reactive antibodies in their blood. Rickettsemia started 3-8 days after inoculation or tick infestation and lasted for 3-13 days. Our results indicate that a Brazilian strain of R. rickettsii is pathogenic for dogs, suggesting that canine clinical illness due to R. rickettsii has been unreported in Brazil and possibly in the other South American countries where BSF has been reported among humans.

Evaluation of a nested-PCR assay for Streptococcus pneumoniae detection in pediatric patients with community-acquired pneumonia / Evaluación de una PCR anidada en pacientes pediátricos para diagnóstico de neumonía neumocócica adquirida en la comunidad

The aim of the present work was to evaluate the usefulness of a simplified method for DNA extraction coupled to a nested-PCR protocol, based on the amplification of pneumolysin gene fragments for the diagnosis of pneumococcal pneumonia in pediatric patients with clinical and radiological evidence of bacterial infection. Bacterial DNA was extracted from sera by boiling and used without further purification in the PCR for the pneumolysin gene. None toxic reagents were used and the necessary steps to obtain the DNA were left at a minimum; furthermore, it overcomes the use of expensive commercial kits for DNA purification. The total procedure can be completed the same day of sampling and, most important, it avoids the use of sophisticated technology. Both in vitro analytical specificity and sensitivity (10 CFU/ml) of the assay were similar to those previously reported. When clinical samples were tested, the rate of positivity was shown to be 83.3% and 71% in pediatric patients with positive (group a) and negative blood cultures (group b), respectively. In group a, DNA detection was successful in samples from children without treatment or with less than 48 h of antibiotic therapy. None amplification was obtained from sera patients with viral infection or in samples from healthy controls. The application of the strategy described in this paper substantially seems to improve the diagnostic process in a determinate group: blood culture-negative children with pneumonia.

El objetivo del presente trabajo fue evaluar la utilidad de un método simplificado para extracción de ADN, acoplado a un protocolo de PCR anidada, basada en la amplificación de fragmentos del gen de la neumolisina para el diagnóstico de neumonía neumocócica en niños con evidencias clínicas y radiológicas de infección bacteriana. El ADN bacteriano fue extraído del suero por calentamiento y utilizado en la PCR para el gen de la neumolisina sin purificación posterior. Para la obtención de ADN no se utilizan reactivos tóxicos ni costosos "kits" comerciales. El procedimiento completo puede ser realizado en el día y lo que es más importante, evita el uso de tecnología sofisticada. La especificidad analítica in vitro y la sensibilidad (10 UFC/ml) del ensayo fueron similares a lo hallado en publicaciones anteriores. El porcentaje de muestras positivas fue del 83,3% y del 71% en los pacientes con hemocultivos positivos (grupo a) y negativos (grupo b), respectivamente. En el grupo a, sólo se obtuvieron resultados positivos mediante la PCR anidada en los pacientes no tratados o con menos de 48 hs de tratamiento antibiótico. No se obtuvieron señales de amplificación en los sueros de los pacientes con infecciones virales ni en las muestras del grupo control. La aplicación de la estrategia descripta incrementa la posibilidad diagnóstica de neumonía neumocócica en niños con hemocultivos negativos.

Polymerase chain reaction in rapid diagnosis of neonatal sepsis.

In a prospective study a total of hundred neonates who fulfilled the American College of Obstetrics and Gynecology's (ACOG) criteria for probable sepsis admitted to NICU of tertiary care armed forces hospital were investigated for evidence of sepsis. The investigation protocol included sepsis screen, blood culture and 1 mL of venous blood for molecular analysis by polymerase chain reaction (PCR) for bacterial DNA component encoding 16 s RNA in all cases. 100 newborns with probable sepsis were studied to evaluate the molecular diagnosis of sepsis using PCR amplification of 16 S RNA in newborns with risk factors for sepsis or those who have clinical evidence of sepsis. We compared the results of PCR with blood culture and other markers of sepsis screen (total leucocyte count (TLC), absolute neutrophil count (ANC), immature/total neutrophil count ratio (I/T ratio), peripheral blood smear, micro ESR and C reactive protein (CRP). Controls consisted of 30 normal healthy newborns with no overt evidence of sepsis. Sepsis screen was positive in 24 (24%) of cases in study group with sensitivity and specificity of 100% and 83.5% respectively. Blood culture was positive in 09(9%t) with sensitivity of 69.2% and specificity of 100%. PCR was positive in 13(13%) of cases (9% are both blood culture and sepsis screen positive and 4% are positive by sepsis screen); the sensitivity of PCR was 100% and specificity was 95.6%. Blood culture is the most reliable method for diagnosis of neonatal sepsis. Polymerase chain reaction is useful and superior to blood culture for early diagnosis of sepsis in neonates.

Rapid detection of Haemophilus influenzae type b in Bangladeshi children with pneumonia and meningitis by PCR and analysis of antimicrobial resistance.

A polymerase chain reaction (PCR) assay with primers from 'bexA' gene was compared with culture for the detection of Haemophilus influenzae type b (Hib) in clinical samples from children with pneumonia and meningitis. Of 200 sera (180 from pneumonia, 20 from non-pneumonia patients) tested by PCR (serum-PCR), Hib was detected in 15 of 16 blood culture-positive and in 6 blood culture-negative pneumonia cases. When compared with the results of blood culture, serum-PCR had sensitivity, specificity, and accuracy index of 93.7%, 96.7%, and 96.5% respectively. Of 120 cerebrospinal fluid (CSF) samples from meningitis patients tested by culture and PCR (CSF-PCR), the latter method could detect Hib in all 15 culture-positive and in 8 of 105 culture-negative cases, showing sensitivity, specificity, and accuracy index of 100%, 92.4%, and 94.4% respectively. The PCR result was available within a day. Antimicrobial susceptibility of Hib was determined by the disc-diffusion method. High rate of resistance to ampicillin (54.8%), chloramphenicol (48.4%), and co-trimoxazole (80.6%) was observed among 31 invasive Hib isolates with resistance to all 3 drugs (multiresistance) in 48.4% of the isolates. All the Hib isolates were susceptible to ceftriaxone. The study has shown that PCR is a rapid, sensitive and specific diagnostic test for Hib from clinical samples, and a combination of culture and PCR is necessary for the detection of Hib infections to the maximum extent for case management to reduce morbidity, mortality, and complications of the invasive Hib infections. A high prevalence of multiresistant Hib strains is a matter of concern.