Molecular detection of Coxiella-like endosymbionts and absence of Coxiella burnetii in Amblyomma mixtum from Veracruz, Mexico.

Ticks are obligate ectoparasites associated with a wide range of vertebrate hosts, including domestic animals. Moreover, ticks are capable of transmitting many pathogens such as Coxiella. To date, Coxiella burnetii, the etiological agent of coxiellosis or Q fever, is the only valid species of the genera. Nevertheless, a wide range of agents denominated Coxiella-like have been detected in recent studies, mainly associated with ticks. The pathogenicity of these Coxiella-like agents is controversial as some of them can infect both birds and humans. In Mexico, knowledge about Q fever is scarce and limited to historical serological records, and there is an overall lack of molecular proof of any agent of the genus Coxiella circulating in the country. Therefore, the aim of this study was to detect the presence of Coxiella in ticks associated with cattle in all 10 regions of Veracruz, Mexico. To accomplish this objective, first, we identified ticks collected from cattle and horses in Veracruz. Then, for Coxiella detection, DNA extraction from ticks and PCR amplification of the 16S-rDNA of Coxiella was performed. Finally, we performed a phylogenetic reconstruction to determine the Coxiella lineages detected. From the 10 regions sampled we collected 888 ticks grouped in 180 pools, and only five Amblyomma mixtum from the locality of Castán, and one from Los Angeles from Tuxpan were found positive, which represents a frequency of 20% for each locality. This study represents the first attempt at molecular detection of Coxiella in ticks associated with cattle in the state of Veracruz, the major livestock producer in the country. The findings of the present study are relevant as they establish a precedent regarding the circulation of Coxiella-like agents, as well as the absence in three municipalities of the state of Veracruz of C. burnetii, an abortive agent of livestock importance.

Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections: a South Texas Ambulatory Research Network (STARNet) study.

OBJECTIVE: To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus skin and soft tissue infections (SSTIs). METHODS: This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have "moderate or complicated" SSTIs if they had a lesion ≥5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. RESULTS: Overall, treatment failure occurred in 21% of patients (21 of 98) at a mean additional cost of $1,933.71 per patient. In a subgroup analysis of patients who received incision and drainage, those with moderate or complicated SSTIs had higher rates of treatment failure than those with mild or uncomplicated SSTIs (36% vs. 10%; P=.04). CONCLUSIONS: One in 5 patients presenting to a primary care clinic for a methicillin-resistant S. aureus SSTI will likely require additional interventions at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting.

Prevalencia de trastorno por déficit de atención e hiperactividad en niños y niñas con retraso mental de Bucaramanga, Colombia / Prevalence of attention deficit and hyperactivity disorder among children with mental retardation from the city of Bucaramanga, Colombia

Antecedentes: En niños y niñas con retraso mental (RM) son frecuentes los síntomas de desatención, hiperactividad e impulsividad. Sin embargo, no se conoce la prevalencia de trastorno por déficit de atención e hiperactividad (TDAH) en niños y niñas con RM. Objetivo: Determinar la prevalencia TDAH en pacientes con RM de consulta externa de un hospital psiquiátrico de Bucaramanga. Métodos: Estudio descriptivo. Se incluyeron pacientes entre 6 y 12 años con RM (coeficiente intelectual inferior a 70). Para identificar TDAH se realizó una entrevista semiestructurada según los criterios del DSM-IV para TDAH. Resultados: Fueron evaluados 34 pacientes. El 58.8% varones. El 53% correspondían a RM leve y el 47% a RM moderado. 19 (55.9%) pacientes presentaban TDAH, independiente del sexo y de la severidad del RM. Conclusiones: El TDAH es muy frecuente en niños y niñas con RM y se encuentra con igual frecuencia en niños y niñas con RM leve y moderado.

Background: Attention deficit and hyperactivity symptoms are common among children with mental retardation (MR). However, there is little information about the prevalence of attention deficit and hyperactivity disorder (ADHD) among patients with MR. Objective: to Establish the ADHD prevalence among children from the out patient department of a psychiatric hospital of the city of Bucaramanga, Colombia. Method: Descriptive study. Children ages 6 to 12 with intellectual coefficient below 70 were included. ADHD was evaluated by DSM-IV semi-structured interview for attention deficit hyperactivity disorder. Results: Thirty-four children were evaluated. 20 (58.9%) of them were male; 18 children (52.9%) had mild MR and 16 children (47.1%) moderate MR. We found that 19 (55.9%) of them, met the ADHD criteria, regardless of gender of MR severity. Conclusions: ADHD is frequent among children with MR, regardless of gender or the severity of their MR.