Electropherotypes of rotaviral RNA from cases of infantile diarrhea in Uruguay.

Electropherotypes of human rotavirus isolates from infants with acute diarrhea belonging to two populations with different clinical features were determined. Thirteen electropherotypes were identified in total 69 isolates; 46 (66.6%) isolates had long RNA migration patterns and 23 (33.3%) isolates had short migration pattern. One of the long-pattern electropherotypes (47.82% of the total electropherotypes) was predominant. It was detected in both populations almost throughout the whole period of the study, while other electropherotypes were found only occasionally. The co-circulation of long and short electropherotypes was not frequent.

Etiology of children's diarrhea in Montevideo, Uruguay: associated pathogens and unusual isolates.

We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.

[Epidemiological study of hepatitis A and E viruses in different populations in Uruguay]. / Estudio epidemiológico de los virus de la hepatitis A y E en diferentes poblaciones del Uruguay.

The hepatitis A and E virus (HAV and HEV) share the fecal-oral mechanism. Hepatitis A is an endemo-epidemic disease in Uruguay but no data on the epidemiologic pattern of the HEV is available. The aims of this study were to update the epidemiologic behavior of the HAV in Montevideo and demonstrate the circulation of the HEV in Uruguay. Two hundred fourteen patients who consulted in the Policlínica de Nutrición y Digestivo were studied, 185 (86%) of whom were anti HAV (HAVAB, Abbot) positive. 81.8% (117/143) of those residents in Montevideo and 95.7% (68/71) of those who were from the inland were anti-HAV positive. From the Montevideo population 55.8% cases under the age of 40 years were anti-HAV positive and occurred in 97.6% of those older (p < 0.001). Considering the health care conditions of the positive patients in Montevideo, 95.6% (43/45) had septic chambers and 75.5% (74/98) disposed of toilet facilities (p < 0.001). It is concluded that although the global prevalence has been maintained since 1982, there is a change in the epidemiologic pattern with greater risk of infection in patients under the age of 40 years proceeding from areas without toilet facilities. The prevalence of total antibodies for HEV (EIA, Abbot) was 2.8% in this population. An association was observed with HAV in 2.2% (4/185). Moreover, a sample of 252 blood donors from the National Blood Service was analyzed with 5 being found to be anti HEV positive, with only 3 (1.2%) being confirmed in the Center for Disease Control in the United States. Although no definitive conclusions may be drawn from the present study, from an epidemiologic point of view, it has been shown that there is evidence of the circulation of HEV in Uruguay, in both the out patient and in blood donor populations.

Frecuencia de las infecciones mixtas en la etiología de la neumonía y de la otitis media aguda / Frecuency of mixed infections in pneumonia and otitis media etiology

El empleo simultáneo de técnicas de diagnóstico para bacterias, virus, Mycoplasma pneumoniae y Chlamydia trachomatis permitió identificar infecciones mixtas en procesos respiratorios agudos de niños menores de 5 años. Se logró reconocer la frecuencia relativa de estas infecciones y el porcentaje de los diferentes agentes implicados en la etiología de la neumonía adquirida en la comunidad así como en la otitis media aguda supurada. Entre 1987 y 1990 se captaron 541 pacientes con neumonía, determinándose la etiología en 63.7 por ciento de los casos. De esos 9.3 por ciento correspondió a una infección mixta. La mayor frecuencia relativa demostrada correspondió al aislamiento de una bacteria de la sangre y a la presencia de un virus en el aspirado nasofaringeo. En segundo lugar lo ocuparon las dobles infecciones virales. A pesar de que el virus respiratorio sincicial es por lejos el virus más frecuente, proporcionalmente se asoció menos a una bacteria que los adenovirus o los virus parainfluenza. De 62 exudados ópticos procesados, se diagnosticó un patógeno en 50 (80.6 por ciento). En 34 por ciento de las etiologías se asociaron 2 o más agentes. Se pudo concluir que las infecciones concomitantes por más de un patógeno ocurren no sólo en inmunodeprimidos sino que se hallan implicados en procesos respiratorios agudos de población general, y que su reconocimiento se logra empleando simultáneamente diversas técnicas y disponiendo de reactivos que posibiliten cubrir un espectro amplio de diferentes patógenos respiratorios

Identification of viruses in a study of acute respiratory tract infection in children from Uruguay.

For the purpose of identifying viral agents associated with acute respiratory tract infections (ARI) in children less than 5 years old, a longitudinal community study was undertaken in Montevideo, Uruguay, from May 1985 to December 1987. This report includes results obtained by cell culture and immunofluorescence techniques for detection of respiratory syncytial virus (RSV), influenza A and B viruses, parainfluenza 1 and 3 viruses, and adenovirus. Two populations were studied: children visited at home by pediatricians (group 1) and children with an ARI episode who attended an outpatient clinic (group 2). Nasopharyngeal aspirates were obtained at the time of an ARI episode: 858 from group 1 and 488 from group 2. Viruses were identified in 15.3% of group 1 specimens and in 17.6% of group 2 specimens. RSV was the most frequently recovered agent, accounting for 67.9% and 58.1%, respectively, of all viruses detected. The sensitivity and specificity of RSV isolation by cell culture are compared with detection by indirect immunofluorescence.

Antigenic characterization of respiratory syncytial virus associated with acute respiratory infections in Uruguayan children from 1985 to 1987.

The occurrence of subgroup A and B strains of respiratory syncytial virus (RSV) was studied during three epidemic years, 1985 to 1987, in Uruguay. A set of monoclonal antibodies was selected according to their reactivity with local RSV isolates and used for the typing of RSV directly in nasopharyngeal cells by indirect immunofluorescence. Of 77 specimens, 69 could be typed as belonging to subgroup A or B, 5 could not be typed with the restricted set of monoclonal antibodies employed, and 3 reacted with both subgroup-specific antibodies. In 1985 and 1986 subgroup A predominated, accounting for 65.7% of all typed specimens, but in 1987 subgroup B surpassed subgroup A, accounting for 82.4% of the samples.

Comparación entre la inmunoflurescencia y el ensayo inmunoenzimático para el diagnóstico rápido del virus respiratorio sincicial en secreciones nasofaríngeas / Rapid detection of respiratory syncytial virus antigens in nasopharyngeal secretions: comparison of immunofluorescence and enzyme immunoassay

Un ensayo inmunoenzimático comercial Abboutt-RSV-EIA fue evaluado comprarándolo con la inmunofluorescencia indirecta. Aspirados nasofaríngeos de 95 niños con infección respiratoria aguda baja fueron procesados por inmunofluorescencia y por enzimoinmunoensayo para revelar la presencia de antígenos del virus respiratorio sincicial. De los 60 materiales positivos por inmunofluorescencia, 46 también lo fueron por enzimoinmunoensayo (sensibilidad 78,7%); de 35 negativos, 34 fueron también negativos por el Abbout-RSV-EIA (especificidad 97,1%). Según los resultados presentados, la evaluada es aceptable como una alternativa para el diagnóstico rápido de VRS en lugares donde no se cuente con otros recursos

Comparación entre la inmunoflurescencia y el ensayo inmunoenzimático para el diagnóstico rápido del virus respiratorio sincicial en secreciones nasofaríngeas / Rapid detection of respiratory syncytial virus antigens in nasopharyngeal secretions: comparison of immunofluorescence and enzyme immunoassay

Un ensayo inmunoenzimático comercial Abboutt-RSV-EIA fue evaluado comprarándolo con la inmunofluorescencia indirecta. Aspirados nasofaríngeos de 95 niños con infección respiratoria aguda baja fueron procesados por inmunofluorescencia y por enzimoinmunoensayo para revelar la presencia de antígenos del virus respiratorio sincicial. De los 60 materiales positivos por inmunofluorescencia, 46 también lo fueron por enzimoinmunoensayo (sensibilidad 78,7%); de 35 negativos, 34 fueron también negativos por el Abbout-RSV-EIA (especificidad 97,1%). Según los resultados presentados, la evaluada es aceptable como una alternativa para el diagnóstico rápido de VRS en lugares donde no se cuente con otros recursos (AU)

[Comparison between immunofluorescence and immunoenzymatic assay for the rapid diagnosis of the respiratory syncytial virus in nasopharyngeal secretions]. / Comparación entre la inmunofluorescencia y el ensayo inmunoenzimático para el diagnóstico rápido del virus respiratorio sincicial en secreciones nasofaríngeas.

An enzyme immunoassay, RSV-EIA Abbot, was evaluated by comparison with indirect immunofluorescence. Nasopharyngeal secretions obtained from 95 infants and young children with acute respiratory infections were examined for the presence of respiratory syncytial virus antigens with both methods. Specimens were stored at -70 degrees C before being tested by EIA. Out of 60 samples positive by indirect immunofluorescence, 46 were also positive by RSV-EIA (sensitivity 78.7%) and 34 out of 35 immunofluorescence negative specimens were negative by RSV-EIA (specificity 97.1%). Therefore, the EIA appears to be an acceptable test for the rapid detection of RSV as an alternative for indirect immunofluorescence.

Comparación entre la inmunofluorescencia y el ensayo inmunoenzimático para el diagnóstico rápido del virus respiratorio sincicial en secreciones nasofaríngeas. / [Comparison between immunofluorescence and immunoenzymatic assay for the rapid diagnosis of the respiratory syncytial virus in nasopharyngeal secretions]

An enzyme immunoassay, RSV-EIA Abbot, was evaluated by comparison with indirect immunofluorescence. Nasopharyngeal secretions obtained from 95 infants and young children with acute respiratory infections were examined for the presence of respiratory syncytial virus antigens with both methods. Specimens were stored at -70 degrees C before being tested by EIA. Out of 60 samples positive by indirect immunofluorescence, 46 were also positive by RSV-EIA (sensitivity 78.7

) and 34 out of 35 immunofluorescence negative specimens were negative by RSV-EIA (specificity 97.1

). Therefore, the EIA appears to be an acceptable test for the rapid detection of RSV as an alternative for indirect immunofluorescence.