ABSTRACT
Polymorphisms in the CAMP gene (cathelicidin) have not been tested in tuberculosis susceptibility. We tested polymorphisms rs9844812 (HIF-1α::ARNT binding site) and rs56122065 (CAMP) plus rs1800972 (DEFB1). SNP rs1800972 was associated with extrapulmonary tuberculosis (EPTB) in a codominant model (genotype CG, P = 0.037, OR 4.82; 95% CI: 0.92-47.42; statistical power, 82%), but not PTB (P = 0.101) in a Mexican population.
Subject(s)
Antimicrobial Cationic Peptides/genetics , Genetic Predisposition to Disease , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Polymorphism, Genetic , Tuberculosis/genetics , 5' Untranslated Regions , Alleles , Amino Acid Sequence , Antimicrobial Cationic Peptides/chemistry , Aryl Hydrocarbon Receptor Nuclear Translocator/genetics , Aryl Hydrocarbon Receptor Nuclear Translocator/metabolism , Base Sequence , Binding Sites , Case-Control Studies , Exons , Gene Frequency , Genotype , Humans , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Molecular Sequence Data , Nucleotide Motifs , Polymorphism, Single Nucleotide , Position-Specific Scoring Matrices , Promoter Regions, Genetic , Protein Binding , Tuberculosis/metabolism , Tuberculosis, Pulmonary/genetics , Tuberculosis, Pulmonary/metabolism , beta-Defensins/genetics , CathelicidinsABSTRACT
BACKGROUND: Cytomegalovirus (CMV) infection is a common cause of morbidity, graft loss, and mortality among kidney recipients due to its direct and indirect influences on organs and systems, namely, immunomodulation, which favors the appearance of opportunistic infections, vasculopathy, and decreased graft and patient survival. In Mexico the dimensions of this infection are unknown in kidney transplant recipients. We evaluated the incidence and predictive factors for CMV infection among renal transplant recipients of the Mexican Institute of Social Security in Guadalajara. METHODS: This prospective cohort analysis of patients >or=16 years of age of both genders, included transplantations from May 2006 to July 2007. Two hundred twenty-five patients were followed over 6 months to evaluate CMV infection or disease. We evaluated demographic, clinical, and paraclinical aspects, such as total lymphocyte count and quantitative CMV polymerase chain reactions (PCR). RESULTS: The overall incidence of CMV infection was 17.8%. CMV infections were associated with lymphopenia (relative risk [RR] 14.75; confidence interval [CI] 95%, 3.46-62.77), serostatus D+/R- (RR 5.53; CI 95%, 2.18-14.05), and fever (RR 4.57; CI 95%, 1.50-13.95). Receiver-operating characteristic (ROC) curves for lymphopenia versus PCR showed a sensitivity of 27% and a specificity of 98%. CONCLUSION: In our study, lymphopenia, serostatus D+/R-, and fever were good predictors of CMV infections among renal transplant recipients.
Subject(s)
Cytomegalovirus Infections/epidemiology , Kidney Transplantation/adverse effects , Postoperative Complications/epidemiology , Adolescent , Adult , Antiviral Agents/therapeutic use , Cohort Studies , Cytomegalovirus/genetics , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/physiopathology , DNA, Viral/genetics , Female , Fever/virology , Humans , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/immunology , Lymphocyte Count , Male , Polymerase Chain Reaction , Predictive Value of Tests , Probability , ROC Curve , Risk , Young AdultABSTRACT
BACKGROUND: Pseudomonas aeruginosa is a common cause of nosocomial infections, particularly in intensive care units (ICUs). The aim of this study was to characterize P. aeruginosa clinical isolates by comparing antimicrobial susceptibility patterns with the presence of plasmids and to establish the clonal relatedness by pulsed-field gel electrophoresis (PFGE) typing. METHODS: The patients included those with isolation of P. aeruginosa hospitalized for more than 48 h in the ICU from April to May 1998. Environmental and staff cultures were obtained simultaneously. Minimal inhibitory concentrations, plasmid DNA profiles, and PFGE genomic patterns of enzyme restriction chromosomal DNA were compared. RESULTS: Sixty P. aeruginosa isolates were obtained from 197 clinical specimens, 178 environmental samples, and 47 hand cultures of personnel. Antimicrobial resistance was as follows: tobramycin 100%; ticarcillin, cefotaxime, ceftriaxone, ceftazidime, and gentamicin 80%; cefepime 60%; amikacin, ticarcillin/clavulanate, imipenem, and meropenem 40%; piperacillin and norfloxacin 20%; carbenicillin 12%, and ciprofloxacin 0%. Plasmids were detected in 11 isolates (18%). PFGE typing showed that 23 isolates belonged to a common clone (pattern A), identified from five patients, two nurses, and 10 environmental samples. Ten isolates were grouped in four clusters and 27 isolates had unrelated genomic patterns. There was no relationship among DNA genomic patterns, plasmid profiles, and susceptibility patterns. CONCLUSIONS: PFGE demonstrated the existence of a common clone in a critical care area. Reinforcement of infection control measures is needed to avoid horizontal transmission and severe infections.
