Fatal co-infection by multiple pathogens in an indigenous woman with autoimmune hemolytic anemia and tuberculosis: a case report.

BACKGROUND: Tuberculosis (TB), one of the leading causes of death worldwide, has a higher incidence among indigenous people. Albeit uncommon, autoimmune hemolytic anemia (AIHA) has been deemed a risk condition to develop mycobacterial infection, as a result of the immunosuppressive treatments. TB, in turn, can be a predisposing factor for secondary infections. CASE PRESENTATION: Here we present a case of a 28-year-old indigenous woman from Colombia, previously diagnosed with AIHA and pulmonary TB. Despite various treatments, therapies and medical interventions, the patient died after severe medullary aplasia of multiple causes, including secondary myelotoxicity by immunosuppressive therapy and secondary disseminated infections, underlining infection by Staphylococcus aureus, Klebsiella pneumoniae and Candida glabrata, which were identified as drug-resistant microorganisms. Together, this led to significant clinical complications. Invasive aspergillosis was diagnosed at autopsy. CONCLUSIONS: This report presents a rarely finding of AIHA followed by TB, and highlights the great challenges of dealing with co-infections, particularly by drug resistant pathogens. It also aims to spur governments and public health authorities to focus attention in the prevention, screening and management of TB, especially among vulnerable communities, such as indigenous people.

Candida Non-albicans and Non-auris Causing Invasive Candidiasis in a Fourth-Level Hospital in Colombia: Epidemiology, Antifungal Susceptibility, and Genetic Diversity.

Increasingly common and associated with healthcare settings, Candida infections are very important, since some species of this genus can develop antifungal resistance. We contribute data on the epidemiology, antifungal susceptibility, and genetic diversity of Candida non-albicans and non-auris affecting critically ill patients in a fourth-level hospital in Colombia. Ninety-seven isolates causing invasive infections, identified by conventional methods over 18 months, were studied. Data from patients affected by these yeasts, including sex, age, comorbidities, treatment, and outcome, were analysed. The antifungal susceptibility of the isolates was determined, and the ribosomal DNA was sequenced. Candida parapsilosis, Candida tropicalis, Candida glabrata, Candida dubliniensis, and Candida guilliermondii caused 48.5% of all cases of invasive candidiasis. The species were mainly recovered from blood (50%). Patients were mostly men (53.4%), between 18 days and 93 years old, hospitalized in the ICU (70.7%). Overall mortality was 46.6%, but patients in the ICU, using antibiotics, with diabetes mellitus, or with C. glabrata infections were more likely to die. Resistant isolates were identified in C. parapsilosis, C. tropicalis, and C. glabrata. This study provides epidemiological data for the surveillance of emerging Candida species, highlighting their clinical impact, as well as the emergence of antifungal resistance and clonal dispersal.

Rare Yeasts in Latin America: Uncommon Yet Meaningful.

Systemic infections caused by rare yeasts are increasing given the rise in immunocompromised or seriously ill patients. Even though globally, the clinical significance of these emerging opportunistic yeasts is increasingly being recognized, less is known about the epidemiology of rare yeasts in Latin America. This review collects, analyzes, and contributes demographic and clinical data from 495 cases of infection caused by rare yeasts in the region. Among all cases, 32 species of rare yeasts, distributed in 12 genera, have been reported in 8 Latin American countries, with Trichosporon asahii (49.5%), Rhodotorula mucilaginosa (11.1%), and Saccharomyces cerevisiae (7.8%) the most common species found. Patients were mostly male (58.3%), from neonates to 84 years of age. Statistically, surgery and antibiotic use were associated with higher rates of Trichosporon infections, while central venous catheter, leukemia, and cancer were associated with higher rates of Rhodotorula infections. From all cases, fungemia was the predominant diagnosis (50.3%). Patients were mostly treated with amphotericin B (58.7%). Crude mortality was 40.8%, with a higher risk of death from fungemia and T. asahii infections. Culture was the main diagnostic methodology. Antifungal resistance to one or more drugs was reported in various species of rare yeasts.

Reinfection rate and disease severity of the BA.5 Omicron SARS-CoV-2 lineage compared to previously circulating variants of concern in the Canary Islands (Spain).

ABSTRACTThe emergence of the Omicron SARS-CoV-2 variant of concern has changed the COVID-19 scenario as this variant is characterized by high transmissibility and immune evasion ability. To evaluate the impact of this variant on the Canary Islands (Spain) population, we determined the reinfection rates and disease severity associated with the Omicron sublineages and the previously circulating variants of concern. We performed a retrospective observational study on 21,745 SARS-CoV-2 viral genomes collected from December 2020 to July 2022 in the Canary Islands (Spain). We compared the reinfection rates between lineages using pairwise proportion and Fisher's exact tests. To assess disease severity, we studied the association of Alpha, Delta, BA.1, BA.2, BA.5, and other risk factors on 28-day hospital mortality using logistic regression and Cox proportional hazard models. We observed 127 bona fide reinfection cases throughout the study period. We found that BA.5 had the highest reinfection rate compared to other lineages (vs. Delta p = 2.89 × 10-25; vs. BA.1 p = 5.17 × 10-11; vs. BA.2 p = 0.002). Among the 1,094 hospitalized patients, multivariate logistic regression showed that Alpha (Odds Ratio [OR] = 0.45, 95% Confidence Interval [CI] = 0.23-0.87, p = 0.02), BA.2 (OR = 0.38, 95% CI = 0.22-0.63, p = 1.91 × 10-4), and BA.5 (OR = 0.30, 95% CI = 0.16-0.55, p = 1.05 × 10-4) had lower 28-day hospital mortality compared to Delta. These results were confirmed by using Cox proportional hazard models. Omicron lineages, and in particular BA.5, were associated with higher reinfection rates and lower disease severity (28-day hospital mortality) than previously circulating variants of concern.

Bioinformatic approaches to draft the viral genome sequence of Canary Islands cases related to the multicountry mpox virus 2022-outbreak.

On July 23, 2022, monkeypox disease (mpox) was declared a Public Emergency of International Concern (PHEIC) by the World Health Organization (WHO) due to a multicountry outbreak. In Europe, several cases of mpox virus (MPXV) infection related to this outbreak were detected in the Canary Islands (Spain). Here we describe the combination of viral DNA sequencing and bioinformatic approaches, including methods for de novo genome assembly and short- and long-read technologies, used to reconstruct the first MPXV genome isolated in the Canary Islands on the 31st of May 2022 from a male adult patient with mild symptoms. The same sequencing and bioinformatic approaches were then validated with three other positive cases of MPXV infection from the same mpox outbreak. We obtained the best results using a reference-based approach with short reads, evidencing 46-79 nucleotide variants against viral sequences from the 2018-2019 mpox outbreak and placing the viral sequences in the new B.1 sublineage of clade IIb of the MPXV classification. This study of MPXV demonstrates the potential of metagenomics sequencing for rapid and precise pathogen identification.

Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.

Tracing the trajectories of SARS-CoV-2 variants of concern between December 2020 and September 2021 in the Canary Islands (Spain).

Several variants of concern (VOCs) explain most of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic waves in Europe. We aimed to dissect the spread of the SARS-CoV-2 VOCs in the Canary Islands (Spain) between December 2020 and September 2021 at a micro-geographical level. We sequenced the viral genome of 8,224 respiratory samples collected in the archipelago. We observed that Alpha (B.1.1.7) and Delta (B.1.617.2 and sublineages) were ubiquitously present in the islands, while Beta (B.1.351) and Gamma (P.1/P.1.1) had a heterogeneous distribution and were responsible for fewer and more controlled outbreaks. This work represents the largest effort for viral genomic surveillance in the Canary Islands so far, helping the public health bodies in decision-making throughout the pandemic.

Prevalencia de parasitismo intestinal en niños de la comunidad indígena U'wa en Boyacá, Colombia / Intestinal parasitism prevalence in indigenous U'wa children in Boyacá, Colombia

Resumen Objetivo: Determinar la prevalencia de parasitismo intestinal en niños menores de 15 años de la comunidad indígena U'wa, del municipio de Güicán, Boyacá. Metodología: Estudio descriptivo de corte transversal en 125 niños menores de 15 años, pertenecientes a la comunidad indígena U'wa del municipio de Güicán. Se evaluó la presencia de parásitos intestinales a partir de dos exámenes coprológicos directos. El procesamiento y análisis estadístico se realizó con el programa SPSS versión 22. Resultados: La prevalencia de parásitos fue del 72% IC 95%. Los parásitos más frecuentes fueron Blastocystis spp. 43.3%; Entamoeba histolytica/dispar 35.5%; Ascaris lumbricoides 12.2% y Giardia intestinalis con 11.1%. Los parásitos no patógenos hallados fueron Entamoeba coli 30%; Endolimax nana 24.4% y Iodamoeba butschlii 5.5%. El poliparasitismo fue de 50% y se asoció con ser menor de 7 años de edad y tener más de 4 manifestaciones clínicas. Conclusiones: Las comunidades indígenas se consideran una población vulnerable puesto que no cuentan con los servicios básicos de sanidad, tienen alta prevalencia de enfermedades infecciosas que pueden generar algunas complicaciones, especialmente en los menores de 15 años . Con este estudio se conoció la dinámica de las infecciones parasitarias en la comunidad indígena U'wa que tienen implicaciones en la salud pública y en el marco del contexto salud-enfermedad, con el fin de realizar intervenciones de manera integral en busca de mejorar el estado de salud.

Abstract Objective: To determine the prevalence of intestinal parasitism in children under 15 years of age belonging to the U'wa indigenous community in the municipality of Guican, Boyacá. Methodology: This is a descriptive cross-sectional study conducted with 125 children under the age of 15, who belong to the Uwa indigenous community of the Güican municipality. The presence of intestinal parasites was evaluated through the implementation of two direct stool tests. Statistical analysis and processing were performed with the SPSS version 22 program. Results: The prevalence of parasites was 72% 95% CI (% -%). The most frequent parasites were Blastocystis spp (43.3%), Entamoeba histolytica / dispar (35.5%), Ascaris lumbricoides (12.2%), and Giardia intestinalis (11.1%). The non-pathogenic parasites found were Entamoeba coli (30%), Endolimax nana (24.4%), and Iodamoeba bütschlii (5.5%). Polyparasitism was 50%, which was associated with being less than 7 years old and having more than 4 clinical manifestations. Conclusions: Indigenous communities are considered a vulnerable population since they do not have basic health services and they present a high prevalence of infectious diseases, especially in children under 15 years of age, which can generate some complications. This study revealed the dynamics of parasitic infections in this indigenous community, which have implications for public health and in the context of the health-disease, to carry out interventions in a comprehensive way in order to improve health status.

Prevalencia de obesidad y riesgo cardiovascular en trabajadores del área de hidrocarburos / Prevalence of obesity and cardiovascular risk in workers in the hydrocarbon area

Resumen Introducción: La enfermedad cardiovascular (infarto de miocardio, muerte cardíaca y accidente cerebrovascular fatal o no fatal) es la principal causa de muerte prematura y de discapacidad en el mundo. Es responsable de más de 17 millones de muertes anuales y afecta principalmente a la población que se ubica en los países de ingresos bajos y medios. Se estima que el 80% de la carga mundial se produce en estos países. Objetivo: Establecer la prevalencia de obesidad y riesgo cardiovascular mediante los criterios de Framingham en una población de trabajadores de la industria de producción de hidrocarburos. Método: Se desarrolló un estudio observacional descriptivo, epidemiológico, en el que se tuvo en cuenta la población de los trabajadores de la empresa Montajes JM, Cerritos CPE6, Proyecto 176, en el departamento del Meta (Puerto Gaitán). Se representaron las variables en promedio, intervalos de confianza y desviación estándar, procediendo a desarrollar un análisis por sexo para cada uno de los factores de riesgo. Resultados: En la población del programa de riesgo cardiovascular se encontró un promedio de edad de 38.11 años y un índice de masa corporal de 26.00 m2/kg. El 7.58% presentó hipertensión arterial, el 1.08% diabetes mellitus y el 24.91% tabaquismo. El riesgo cardiovascular calculado con la escala de Framingham fue del 4.48%. El índice de masa corporal, la edad y la presión arterial sistólica no son estadísticamente significativos para la valoración del riesgo con la escala Framingham. Conclusiones: La prevalencia de obesidad fue del 64.9%, en tanto que el 75% de las personas que trabajan en hidrocarburos tenían riesgo leve de enfermedad cardiovascular.

Abstract Introduction: Cardiovascular disease is one of the main causes of premature death and disability worldwide (myocardial infarction, cardiac death and fatal or non-fatal stroke) is responsible for more than 17 million annual deaths, in patients of low- and middle-income countries, it is estimated that 80% of the global burden occurs in these countries. Objective: To establish the prevalence of obesity and cardiovascular risk, evaluated using the Framingham criteria in a population of workers in the hydrocarbon production industry. Method: An observational, descriptive, epidemiological study was carried out of a population of workers of the company Montajes JM, Cerritos CPE6 Project 176, in Puerto Gaitan in the department of Meta, Colombia. The variables in average, standard deviation and confidence intervals were described, with a comparative analysis of risk factors by sex. Results: In the population of the cardiovascular risk program, an average age of 38.11 years old and a body mass index of 26.00 m2/kg were found. 7.58% presented high blood pressure, 1.08% diabetes mellitus and 24.91% were found to smoke. The cardiovascular risk calculated with the Framingham scale was found to be 4.48%. Body mass index, age and systolic blood pressure were not statistically significant for the risk assessment using the Framingham scales. Conclusions: The prevalence of obesity in the group of workers in the hydrocarbon drilling industry was 64.9% and 75% had a slight risk of cardiovascular disease.

Bryozoan diversity on a whale bone: an uncommon substrate from the continental shelf off NW Spain.

Carcasses and bones of whales are interesting yet poorly understood habitats for invertebrates and microbial communities. Nevertheless, bryozoans have never before been reported in this particular habitat at the present day. Here, we present the first study on a bryozoan community colonizing a whale bone from the continental shelf off NW Spain at 128 m depth. Thirty-three species of bryozoans were identified, representing 50% of the known bryozoan diversity from this area and depth range. Despite this high biodiversity, no potential whale-fall specialists were detected: all the species are already known in the area, with several being more frequent in shallower or deeper waters. Our results support the hypothesis that the number of specialist taxa on whale-fall habitats decreases drastically on whale remains at depths of less than 260 m. These results also support the theory that whale-falls can serve as intermediate habitats where no other suitable substrate is present, facilitating habitat colonization. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12526-021-01189-6.

Social Robot Navigation Tasks: Combining Machine Learning Techniques and Social Force Model.

Social robot navigation in public spaces, buildings or private houses is a difficult problem that is not well solved due to environmental constraints (buildings, static objects etc.), pedestrians and other mobile vehicles. Moreover, robots have to move in a human-aware manner-that is, robots have to navigate in such a way that people feel safe and comfortable. In this work, we present two navigation tasks, social robot navigation and robot accompaniment, which combine machine learning techniques with the Social Force Model (SFM) allowing human-aware social navigation. The robots in both approaches use data from different sensors to capture the environment knowledge as well as information from pedestrian motion. The two navigation tasks make use of the SFM, which is a general framework in which human motion behaviors can be expressed through a set of functions depending on the pedestrians' relative and absolute positions and velocities. Additionally, in both social navigation tasks, the robot's motion behavior is learned using machine learning techniques: in the first case using supervised deep learning techniques and, in the second case, using Reinforcement Learning (RL). The machine learning techniques are combined with the SFM to create navigation models that behave in a social manner when the robot is navigating in an environment with pedestrians or accompanying a person. The validation of the systems was performed with a large set of simulations and real-life experiments with a new humanoid robot denominated IVO and with an aerial robot. The experiments show that the combination of SFM and machine learning can solve human-aware robot navigation in complex dynamic environments.

Impact and Management of COVID-19 Among Healthcare Workers in Two Acute Care Hospitals and Two Associated Long-term Care Centres in Barcelona, Spain.

OBJECTIVE: To describe the characteristics of COVID-19-related episodes in healthcare workers (HCW) of two hospitals. METHODS: Prospective study of HCW with COVID-like symptoms and/or who were close contacts of confirmed COVID-19. The percentage of positive PCRs among those with symptoms was calculated, and symptom's positive predictive value and negative predictive value. The characteristics of contacts were described, as well as the secondary clinical attack rate. RESULTS: We registered 1222 episodes of HCW with COVID-like symptoms; 340 (27.8%) had a positive PCR. In 885 episodes, a HCW was a close contact of a confirmed case. In 45.5% of these, the HCW had contact with another HCW. The secondary clinical attack rate of contacts of HCW was 14.5%. CONCLUSION: We found a high prevalence of disease and transmission between HCW during the first wave of the SARS-CoV-2 pandemic.

Increasing SARS-CoV-2 RT-qPCR testing capacity by sample pooling.

OBJECTIVES: Limited testing capacity has characterized the ongoing coronavirus disease 2019 (COVID-19) pandemic in Spain, hampering timely control of outbreaks and opportunities to reduce the escalation of community transmission. This study investigated the potential to use sample pooling, followed by one-step retrotranscription and real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) to increase testing capacity for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). METHODS: Various pool sizes (five, 10 and 15 samples) were evaluated prior to RNA extraction followed by standard RT-qPCR for the diagnosis of COVID-19. The pool size achieving reproducible results with individual sample testing was subsequently used to assess nasopharyngeal samples in a tertiary hospital in August 2020. RESULTS: A pool size of five samples had higher sensitivity compared with pool sizes of 10 and 15 samples, showing a mean cycle threshold (Ct) shift of 3.5 [standard deviation (SD) 2.2] between the pooled test and positive samples in the pool. Next, a pool size of five was used to test a total of 895 pools (4475 prospective samples) using two different RT-qPCR kits. The Real Accurate Quadruplex corona-plus PCR Kit (PathoFinder) reported the lowest mean Ct shift [2.2 (SD 2.4)] between the pool and individual samples. This strategy enables detection of individual positive samples in positive pools with Ct of 16.7-39.4. CONCLUSIONS: Grouping samples into pools of five for RT-qPCR resulted in an increase in SARS-CoV-2 testing capacity with minimal loss of sensitivity compared with testing each sample individually.

Implementation Science to Address Health Disparities During the Coronavirus Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic is disproportionally affecting racial and ethnic minorities. In the United States, data show African American, Hispanic, and Native American populations are overrepresented among COVID-19 cases and deaths. As we speed through the discovery and translation of approaches to fight COVID-19, these disparities are likely to increase. Implementation science can help address disparities by guiding the equitable development and deployment of preventive interventions, testing, and, eventually, treatment and vaccines. In this study, we discuss three ways in which implementation science can inform these efforts: (1) quantify and understand disparities; (2) design equitable interventions; and (3) test, refine, and retest interventions.

Watersiporidae (Bryozoa) in Iberian waters: an update on alien and native species.

Species of the genus Watersipora comprise an important invasive fouling group but are difficult to identify up to species level. This problem, in conjunction with the recent re-description of several member species, requires the revision of previous records and newly collected material in order to more precisely determine their actual presence and distribution. Here, we revise the identity and distribution of alien and native species of Watersiporidae in Iberian waters based on newly collected material, historical collections, and bibliographic data. Four species of Watersipora are now known from here. Watersipora cucullata is the only native species, present in the Spanish Mediterranean. Watersipora subatra seems to have been introduced relatively recently in Iberian and European Atlantic waters and has been expanding to other Atlantic localities. Watersipora arcuata was collected for the first time in Europe at the SW Spanish Atlantic coast in 1990 and recently in Mediterranean marinas. Watersipora souleorum is known in Iberian waters from two localities in the Gulf of Cadiz and in Gibraltar. With the recent redescription of the genus Watersipora, W. complanata is no longer a member. A new watersiporid genus, Terwasipora gen. nov., is described for this species. In Iberian waters, T. complanata comb. nov. is considered a native species, frequent and abundant in shallow waters along the Atlantic coast.

New species and new records of bryozoans from Galicia (NW Spain).

Although the bryozoological fauna of Galicia (NW Spain) is probably the best known of the whole Iberian Peninsula, and perhaps one of the better known in Europe, new studies continue to provide new knowledge. A new species, Schizotheca galaica sp. nov., is described. Eleven species are newly recorded in Galicia: Aetea longicollis, Parellisina curvirostris, Copidozoum planum, Glabrilaria corbula, Haplopoma sciaphilum, Schizomavella (Schizomavella) mamillata, Fenestrulina asturiasensis, Fenestrulina barrosoi, Buffonellaria muriella, Schizotheca divisa and Dentiporella saldanhai; two of them (B. muriella and S. divisa) are also reported for the first time in Iberian waters; four others (Antarctothoa galaica, F. asturiasensis, F. barrosoi and D. saldanhai) are reported for the first time since their original descriptions, and SEM images of A. longicollis and F. asturiasensis are provided for the first time. Moreover, the range of geographical distribution of some species is expanded: the record of S. divisa is the southernmost to date, while the records of S. mamillata, F. barrosoi and D. saldanhai are the most northerly to date. The presence of other four species in Galician waters is confirmed and we document the permanence and range extension of two species recently introduced into our waters (Tricellaria inopinata and A. galaica). urn:lsid:zoobank.org:pub:F8D0ABEF-026E-4FC8-A947-6484249519FA.