Congenital human toxoplasmosis caused by non-clonal Toxoplasma gondii genotypes in Argentina.

Toxoplasmosis, a worldwide distributed zoonosis, can be transmitted congenitally affecting fetuses and developing variable clinical signs. Different Toxoplasma gondii genotypes and infective dose are related factors with different clinical manifestations. Several studies indicate that atypical strains could produce more severe clinical manifestations compared to typical strains. Umbilical cord blood (n = 37) and placenta (n = 19) were collected at birth from women with acute T. gondii infection and processed for isolation by mice bioassay. Six isolates were obtained and identified as TgHm14-4Arg, TgHm15-02Arg, TgHm16-01Arg, TgHm16-02Arg, TgHm17-01Arg and TgHm17-02Arg. Three genotypes described previously on Toxo-DB were identified: #138 identified in chickens from Brazil, #182 isolated from eared doves from Brazil, #14 from wallaby kangaroos and chickens from Argentina, chickens from Brazil, Colombia, Chile and Venezuela, cats and dogs from Brazil and Colombia and also coyotes from USA indicating worldwide distribution of these genotypes. Two new allele combinations were obtained showing high genotypes diversity in Argentina. Four of the isolates (TgHm14-4Arg, TgHm15-02Arg, TgHm16-01Arg, TgHm16-02Arg) and two of them (TgHm17-01Arg, TgHm17-02Arg) produced chronic and acute infections in mice, respectively. Until now, seven T. gondii isolates have been obtained from humans in Argentina, and all were atypical or non-clonal genotypes. The identification of atypical strains causing congenital toxoplasmosis and circulating in our region, make important to perform the serological screenings according Argentine Consensus of Toxoplasmosis and to apply and monitoring treatments earlier in pregnancy. To achieve this aim, it is necessary to inform general population about T. gondii infection, diagnostics and control measures. These results should serve to generate awareness about congenital toxoplasmosis in South America.

[Prevalence of anti-Toxoplasma gondii antibodies in blood donors in Buenos Aires city, from 1967 to 2017]. / Prevalencia de anticuerpos anti-Toxoplasma gondii en hemodonantes en la ciudad de Buenos Aires, desde 1967 a 2017.

A prevalence study of antibodies anti Toxoplasma gondii in voluntary blood donors who attended the hemotherapy service at the Hospital Alemán during the first four months of the years 1997, 2007 and 2017 was carried out and the results were compared to the study carried out in 1967. The sera where processed with the Sabin Feldman Dye Test. The global average seroprevalence in 1967 was 67.0% (CI95%, 64.4%-69.6%); in 1997, 35.0% (CI95%, 33.3%-38.3%); in 2007, 31.9% (CI95%, 29.6%-34.2%) and in 2017, 21.2% (CI95%, 19.0%-23.3%). In the fifty years covered by the study the decline in prevalence was 45.8%, which represents an average annual decline of 0.9%.The decline was statistically significant between 1967 and 1997, and between 2007 and 2017. The four studies demonstrate that infection prevalence increased depending on age. The infection rate for 1967 was 1.0% per year and declined in the next studies to 0.8% in 1997, 0.8% in 2007, and 0.5% in 2017. Donors from the last study responded to a survey that showed a statistically significant correlation between seroprevalence of Toxoplasma gondii antibodies and lack of tap water, unfinished secondary studies or residence in the western or southern part of the Buenos Aires metropolitan area. No significant association was found with having a cat as a pet, the consumption of undercooked meat or the practice of gardening.

Prevalencia de anticuerpos anti Toxoplasma gondii en hemodonantes en la ciudad de Buenos Aires, desde 1967 a 2017 / Prevalence of anti-Toxoplasma gondii antibodies in blood donors in Buenos Aires city, from 1967 to 2017

Se estudió la prevalencia de anticuerpos anti Toxoplasma gondii a los dadores voluntarios de sangre que concurrieron durante el primer cuatrimestre de los años 1997, 2007 y 2017 al Servicio de Hemoterapia del Hospital Alemán de Buenos Aires y se compararon los resultados con el estudio efectuado en el año 1967. Los sueros fueron procesados con el Sabin Feldman Dye Test. La seroprevalencia promedio en 1967 fue 67.0% (IC95%, 64.4%-69.6%), en 1997, 35% (IC95%, 33.3%-38.3%), en 2007, 31.9 % (IC95%, 29.6%-34.2%) y en 2017, 21.2% (IC95%, 19.0%-23.3%). En los cincuenta años que abarca el estudio la disminución de la prevalencia fue de 45.8%, que representa una declinación anual promedio del 0.9%. El descenso fue estadísticamente significativo entre los años 1967 y 1997 y entre 2007 y 2017. En los cuatro estudios se observó un incremento de la prevalencia de infección en función de la edad. La tasa de infección calculada para el año 1967 fue 1.0% y disminuyó en los estudios posteriores, a 0.8% en 1997, 0.7% en 2007 y 0.5% en 2017. Los donantes del último estudio respondieron una encuesta que mostró una correlación estadísticamente significativa entre seroprevalencia de anticuerpos anti-Toxoplasma gondii y la carencia de agua corriente, estudios secundarios no concluidos o la residencia en zona oeste o sur del conurbano bonaerense. No se encontró una asociación significativa con tener un gato como mascota, consumo de carne poco cocida o práctica de jardinería.

A prevalence study of antibodies anti Toxoplasma gondii in voluntary blood donors who attended the hemotherapy service at the Hospital Alemán during the first four months of the years 1997, 2007 and 2017 was carried out and the results were compared to the study carried out in 1967. The sera where processed with the Sabin Feldman Dye Test. The global average seroprevalence in 1967 was 67.0% (CI95%, 64.4%-69.6%); in 1997, 35.0% (CI95%, 33.3%-38.3%); in 2007, 31.9% (CI95%, 29.6%-34.2%) and in 2017, 21.2% (CI95%, 19.0%-23.3%). In the fifty years covered by the study the decline in prevalence was 45.8%, which represents an average annual decline of 0.9%.The decline was statistically significant between 1967 and 1997, and between 2007 and 2017. The four studies demonstrate that infection prevalence increased depending on age. The infection rate for 1967 was 1.0% per year and declined in the next studies to 0.8% in 1997, 0.8% in 2007, and 0.5% in 2017. Donors from the last study responded to a survey that showed a statistically significant correlation between seroprevalence of Toxoplasma gondii antibodies and lack of tap water, unfinished secondary studies or residence in the western or southern part of the Buenos Aires metropolitan area. No significant association was found with having a cat as a pet, the consumption of undercooked meat or the practice of gardening.

First isolation and molecular characterization of Toxoplasma gondii from a human placenta in Argentina.

Blood sample and placenta were taken from a 37-week pregnant woman; serologic results indicated acute toxoplasmosis. Placenta was inoculated into mice. Seropositive mice were sacrificed and tissue cysts from brain were inoculated into new mice. Specific DNA was detected by PCR, and the isolate was characterized as Type II by nPCR-RFLP for nSAG2, SAG3, BTUB, GRA6, c29-2, c22-8, L358, PK1 and Apico markers. This is the first isolation and molecular characterization of Toxoplasma gondii from humans in Argentina.

Ten-year persistence of antibody to hepatitis B surface antigen in healthcare workers vaccinated against hepatitis B virus, and response to booster vaccination.

This study estimated the number of HCWs with protective antibody levels 5 and 10 years after HBV vaccination. Kaplan-Meier probabilities of protective levels were 0.95 at 60 days after vaccination, 0.87 at 5 years, and 0.79 at 10 years. Those without protective levels displayed good response 7 and 30 days after a booster.

La batalla de los biofilms / The battles of biofilms

Ciertos microorganismos adhieren a las superficies de materiales inertes, biomédicos, domésticos o industriales, se organizan en colonias y viven en comunidades protegidas. Se define coimo biofilm a una colonia de microorganismos, generalmente bacterias, envueltos en una matriz, adheridos entre sí y a una superficie.....Los biofilms de mayor interés médico son los que se forman en la placa dentaria, la enfermedad periodontal, infecciones prostáticas, litiasis renal, catéter venoso central, infecciones urinarias asociadas a sonda vesical, implantes permanentes como stents en la vía biliar y prótesis de todo tipo

La batalla de los biofilms / The battles of biofilms

Ciertos microorganismos adhieren a las superficies de materiales inertes, biomédicos, domésticos o industriales, se organizan en colonias y viven en comunidades protegidas. Se define coimo biofilm a una colonia de microorganismos, generalmente bacterias, envueltos en una matriz, adheridos entre sí y a una superficie.....Los biofilms de mayor interés médico son los que se forman en la placa dentaria, la enfermedad periodontal, infecciones prostáticas, litiasis renal, catéter venoso central, infecciones urinarias asociadas a sonda vesical, implantes permanentes como stents en la vía biliar y prótesis de todo tipo

Sacroileitis bacteriana. Hallazgos clínicos y evolutivos en 9 casosBacterial sacroileitis / Clinical findinds and clinical course in 9 cases

Since septic sacroileitis is one of the less frequent localizations among joint infections, we decided to review 9 cases in a retrospective study of 5 females and 4 males, aged between 22 and 60 years old. None had a clinically predisposing condition. The initiating factor was gynecologic-obstetric in 4 women, the irruption of the skin barrier in 3 cases and finally in one case the infection reached the joint through the psoas muscle. Fever and lumbar pain were present in all cases and allowed diagnostic orientation. Radiologic and centellographic alterations were useful for clinical confirmation. An articular biopsypunction was performed in 4 cases, while in the other 5 cases the clinical and radiologic features and the bacteriologic positivity in the blood cultures were enough criteria for diagnosis. The bacteriologic findings were Staphylococcus aureus (4 cases), Streptococcus group A beta hemolítico (1 case), Staphylococcus coagulase negative (1 case), Streptococcus agalactiae (1 case), Proteus mirabilis (2 cases). Eight out of 9 patients were treated with a B-lactamic and aminoglycoside association. One patient received her treatment per os, with quinolones. Six patients recovered, 2 died and one needed to be sent to another hospital.

Sacroileitis bacteriana. Hallazgos clínicos y evolutivos en 9 casosBacterial sacroileitis / Clinical findinds and clinical course in 9 cases

Since septic sacroileitis is one of the less frequent localizations among joint infections, we decided to review 9 cases in a retrospective study of 5 females and 4 males, aged between 22 and 60 years old. None had a clinically predisposing condition. The initiating factor was gynecologic-obstetric in 4 women, the irruption of the skin barrier in 3 cases and finally in one case the infection reached the joint through the psoas muscle. Fever and lumbar pain were present in all cases and allowed diagnostic orientation. Radiologic and centellographic alterations were useful for clinical confirmation. An articular biopsypunction was performed in 4 cases, while in the other 5 cases the clinical and radiologic features and the bacteriologic positivity in the blood cultures were enough criteria for diagnosis. The bacteriologic findings were Staphylococcus aureus (4 cases), Streptococcus group A beta hemolítico (1 case), Staphylococcus coagulase negative (1 case), Streptococcus agalactiae (1 case), Proteus mirabilis (2 cases). Eight out of 9 patients were treated with a B-lactamic and aminoglycoside association. One patient received her treatment per os, with quinolones. Six patients recovered, 2 died and one needed to be sent to another hospital.(Au)

Sarcoma de Kaposi en adultos jóvenes sin evidencia de infección por HIV / Kaposi's sarcoma in middle age males without evidence of HIV infection

El sarcoma de Kaposi (SK) es una entidad que ha aumentado significativamente en la última década debido al surgimiento del SIDA. La evolución y pronóstico en estos pacientes se diferencia a la del SK clásico. Ultimamente se ha informado acerca de su observación en pacientes con serología negativa para el HIV, pero con factores de riesgo para contraer dicho virus. Presentamos acá dos pacientes jóvenes SK, diagnosticados en nuestro hospital en el último año, con serologia negativa para HIV, y sin conductas admitidas de riesgo para SIDA. El primer paciente debutó con un síndrome nefrótico. Luego del tratamento del mismo presentó cuadro de impregnación general, fiebre y adenopatías. La anatomia patológica de una de ellas reveló SK asociado a enfermedad de Castleman. Se realizaron estudios serológicos para HIV en repetidas ocasiones, que resultaron negativos. El segundo paciente ingresó al hospital por una sepsis a Proteus mirabilis y falleció a las 48 hs. La serología para HIV habia sido negativa. Exámenes post-mortem del hígado y de una tumoración que presentaba en rodilla revelaron SK. Nos ha resultado difícil incluir a estos pacientes en algunas de las variantes de SK descriptas habitualmente

Sarcoma de Kaposi en adultos jóvenes sin evidencia de infección por HIV / Kaposis sarcoma in middle age males without evidence of HIV infection

El sarcoma de Kaposi (SK) es una entidad que ha aumentado significativamente en la última década debido al surgimiento del SIDA. La evolución y pronóstico en estos pacientes se diferencia a la del SK clásico. Ultimamente se ha informado acerca de su observación en pacientes con serología negativa para el HIV, pero con factores de riesgo para contraer dicho virus. Presentamos acá dos pacientes jóvenes SK, diagnosticados en nuestro hospital en el último año, con serologia negativa para HIV, y sin conductas admitidas de riesgo para SIDA. El primer paciente debutó con un síndrome nefrótico. Luego del tratamento del mismo presentó cuadro de impregnación general, fiebre y adenopatías. La anatomia patológica de una de ellas reveló SK asociado a enfermedad de Castleman. Se realizaron estudios serológicos para HIV en repetidas ocasiones, que resultaron negativos. El segundo paciente ingresó al hospital por una sepsis a Proteus mirabilis y falleció a las 48 hs. La serología para HIV habia sido negativa. Exámenes post-mortem del hígado y de una tumoración que presentaba en rodilla revelaron SK. Nos ha resultado difícil incluir a estos pacientes en algunas de las variantes de SK descriptas habitualmente (AU)

Flebitis superficial supurada por Candida albicans / Superficial suppurated phlebitis caused by Candida albicans

Se presenta un caso de flebitis superficial supurada por Candida albicans. La vena había sido utilizada para hidratar al paciente a través de una venopuntura. En el material que se obtuvo de los múltiples abscesos ubicados en el trayecto de dicha vena, se observaron levaduras que luego fueron identificadas por cultivo como Candida albicans. El estudo bacteriológico del mismo material fue negativo. La serología mostró antigenemia negativa con presencia de anticuerpos. Los hemo y urocultivos fueron negativos para hongos

Flebitis superficial supurada por Candida albicans / Superficial suppurated phlebitis caused by Candida albicans

Se presenta un caso de flebitis superficial supurada por Candida albicans. La vena había sido utilizada para hidratar al paciente a través de una venopuntura. En el material que se obtuvo de los múltiples abscesos ubicados en el trayecto de dicha vena, se observaron levaduras que luego fueron identificadas por cultivo como Candida albicans. El estudo bacteriológico del mismo material fue negativo. La serología mostró antigenemia negativa con presencia de anticuerpos. Los hemo y urocultivos fueron negativos para hongos (AU)