ABSTRACT
BACKGROUND: Microscopy continues to be the mainstay for the evaluation of parasitaemia in malaria but requires laboratory support and microbiological experience. Other fast and simple methods are necessary. METHODS: A retrospective observational study of imported malaria treated from July-2007 to December-2020 was carried out to evaluate the association between the degree of parasitaemia and both rapid diagnostic tests (RDT) reactivity patterns and haematological parameters. Plasmodium falciparum monoinfections diagnosed by peripheral blood smear and/or polymerase chain reaction (PCR),which also had a positive RDT result in the same blood sample, were included in the study. RESULTS: A total of 273 patients were included. Most of them were male (n = 256; 93.8%) and visiting friends and relatives (VFR) travellers (n = 252; 92.3%). Patients with plasmodial lactate dehydrogenase (pLDH) or aldolase and histidine-rich protein 2 (HRP-2) co-reactivity (Pan/Pf pattern) had a parasitaemia range between 0 and 37% while those with just HRP-2 reactivity (P. falciparum pattern) had ranges between 0 and 1%. Not a single case of P. falciparum pattern was found for parasitaemia ranges greater than 1%, showing a negative predictive value of 100% for high parasitaemia. All the correlations between haematological parameters and parasitaemia resulted to be weak, with a maximum rho coefficient of -0.35 for lymphocytes and platelets, and of 0.40 for neutrophils-to-lymphocytes count ratio. Multivariate predictive models were constructed reflecting a poor predictive capacity. CONCLUSIONS: The reactivity pattern of RDT allows a rapid semi-quantitative assessment of P. falciparum parasitaemia in travellers with imported malaria, discriminating patients with lower parasite loads. Haematological parameters were not able to estimate parasitaemia with sufficient precision.
Subject(s)
Malaria, Falciparum , Malaria , Humans , Male , Female , Rapid Diagnostic Tests , Reagent Kits, Diagnostic , Sensitivity and Specificity , Malaria, Falciparum/diagnosis , Malaria, Falciparum/parasitology , Malaria/parasitology , Plasmodium falciparum , Parasitemia/diagnosis , Diagnostic Tests, Routine/methods , Antigens, Protozoan , Protozoan ProteinsABSTRACT
Schistosomiasis is a neglected tropical disease despite of being a major public health problem affecting nearly 240 million people in the world. Due to the migratory flow from endemic countries to Western countries, an increasing number of cases is being diagnosed in non-endemic areas, generally in migrants or people visiting these areas. Serology is the recommended method for screening and diagnosis of schistosomiasis in migrants from endemic regions. However, serological techniques have a highly variable sensitivity. The aim of this study was to evaluate retrospectively the sensitivity of three different serological tests used in real clinical practice for the screening and diagnosis of imported schistosomiasis in sub-Saharan migrant patients, using the detection of schistosome eggs in urine, faeces or tissues as the gold standard. We evaluated three different serological techniques in 405 sub-Saharan patients with confirmed schistosomiasis treated between 2004 and 2022: an enzyme-linked immunosorbent assay (ELISA), an indirect haemagglutination assay (IHA) and an immunochromatographic test (ICT). The overall sensitivity values obtained with the different techniques were: 44.4% for IHA, 71.2% for ELISA and 94.7% for ICT, respectively. According to species, ICT showed the highest sensitivity (S. haematobium: 94%, S. mansoni: 93.3%; and S. intercalatum/guineensis: 100%). In conclusion, our study shows that Schistosoma ICT has the best performance in real clinical practice, when compared to ELISA and IHA, in both S. mansoni and S. haematobium infections.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Endophthalmitis/microbiology , Listeriosis/complications , Listeria monocytogenes/pathogenicity , Liver Cirrhosis/complications , Hepatitis C, Chronic/drug therapy , Antiviral Agents/adverse effectsABSTRACT
INTRODUCCIÓN: El objetivo fue la detección en urocultivos de Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii y Morganella morganii (grupo CESPM) para el estudio de su perfil de sensibilidad a los antibióticos. MÉTODOS: Entre 2006 y 2016 se analizaron todos los aislados de enterobacterias del grupo CESPM de urocultivos de centros de atención primaria o del complejo hospitalario Virgen de las Nieves (Granada). Se estudió la sensibilidad a aminoglucósidos, fosfomicina, nitrofurantoína, quinolonas, piperacilina/tazobactam, cefepime, imipenem y trimetoprim/sulfametoxazol, según normas del CLSI. RESULTADOS: Se estudiaron 736 aislamientos (30,57% E. cloacae; 23,50% M. morganii; 20,38% K. aerogenes; 10,32% C. freundii; 8,83% S. marcescens y 6,38% P. stuartii). Se observó una disminución significativa de la sensibilidad. Para gentamicina, ciprofloxacino, imipenem y cefepime presentaron sensibilidad superior al 80%. CONCLUSIÓN: E. cloacae, M. morganii y K. aerogenes fueron las especies más frecuentemente aisladas. Cefepime e imipenem siguen siendo una buena alternativa terapéutica empírica por su actividad in vitro
INTRODUCTION: The objective of this study was to analyse the susceptibility to antibiotic of Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii and Morganella morganii (CESPM group), detected in urine cultures. METHODS: Between 2006 and 2016 we analyzed CESPM group Enterobacteria isolated from urine cultures from both primary health-care centers and Hospital Virgen de las Nieves (Granada). We studied the susceptibility to aminoglycosides, fosfomycin, nitrofurantoin, quinolones, piperacillin/tazobactam, cefepime, imipenem and trimethoprim/sulfamethoxazole following CLSI interpretation criteria. RESULTS: A total of 736 isolates were studied: 30.57% E. cloacae, 23.50% M. morganii, 20.38% K. aerogenes, 10.32% C. freundii, 8.83% S. marcescens and 6.38% P. stuartii. A significant decrease in the antibiotic susceptibility was observed. Gentamicin, ciprofloxacin, imipenem and cefepime showed susceptibility over 80%. CONCLUSIONS: E. cloacae, M. morganii and K. aerogenes were the most common isolates. Cefepime and imipenem are still a good empiric therapeutic alternative given its activity in vitro
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Enterobacter/drug effects , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , Bacterial Infections/microbiology , Enterobacter/isolation & purification , Enterobacter/classification , Microbial Sensitivity Tests , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Mycoplasma genitalium/genetics , Mutation/genetics , Molecular Diagnostic Techniques/methods , Macrolides/pharmacology , Drug Resistance, Microbial/genetics , Polymerase Chain ReactionABSTRACT
INTRODUCTION: The objective of this study was to analyse the susceptibility to antibiotic of Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii and Morganella morganii (CESPM group), detected in urine cultures. METHODS: Between 2006 and 2016 we analyzed CESPM group Enterobacteria isolated from urine cultures from both primary health-care centers and Hospital Virgen de las Nieves (Granada). We studied the susceptibility to aminoglycosides, fosfomycin, nitrofurantoin, quinolones, piperacillin/tazobactam, cefepime, imipenem and trimethoprim/sulfamethoxazole following CLSI interpretation criteria. RESULTS: A total of 736 isolates were studied: 30.57% E. cloacae, 23.50% M. morganii, 20.38% K. aerogenes, 10.32% C. freundii, 8.83% S. marcescens and 6.38% P. stuartii. A significant decrease in the antibiotic susceptibility was observed. Gentamicin, ciprofloxacin, imipenem and cefepime showed susceptibility over 80%. CONCLUSIONS: E. cloacae, M. morganii and K. aerogenes were the most common isolates. Cefepime and imipenem are still a good empiric therapeutic alternative given its activity in vitro.
