Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS.

The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

Educational campaign versus malathion spraying for the control of Aedes aegypti in Colima, Mexico.

OBJECTIVE: To evaluate the effect of an educational campaign for reducing the breeding places of Aedes aegypti, the principal vector of dengue; and to compare its effects with the ones obtained by spraying of malathion at ultralow volume. DESIGN: Randomised community trial. SETTING: Colima city, in the State of Colima, Mexico. PARTICIPANTS: Householders of 187 houses, randomly selected from the west sector of the city. DATA: In each house, an entomological survey was done, as well as one for knowledge, attitude and practices (KAP), before the intervention and six months after. The intervention consisted of educational campaign alone (47 houses); malathion spraying at ultra low volume alone (46 houses); both treatments simultaneously (49 houses) and no intervention, or control group (45 houses). MAIN RESULTS: The global average of the positive containers by house (C+/C) was reduced from 0.97 to 0.77. A two way analysis of variance showed that this reduction was more apparent in the houses that received educational campaign (F=8.4, p<0.005) with relation to the ones that received malathion spraying (F=0.38, p>0.5), while the combination of both treatments demonstrated a discrete negative interaction (F=6.52, p<0.05). These effects were independent of climatic changes and level of knowledge about dengue, as the KAP indicator did not show any significant changes in any group (F=1.14, p>0.1). CONCLUSION: The results indicated that the educational campaign reduced the A aegypti breeding places more effectively than the use of chemicals spraying, and that the combination of both treatments can reduce its efficiency, possibly because of the false expectancy of protection that spraying creates. The KAP surveys seemed to have very limited value in evaluating quantitatively the programmes of eradication of the dengue vector.

[Factors that modify the larval indices of Aedes aegypti in Colima, Mexico]. / Factores que modifican los índices larvarios de Aedes aegypti en Colima, México.

OBJECTIVE: In order to investigate the variables that could have the greatest impact on larval indices of Aedes aegypti, the main vector of dengue, a descriptive, longitudinal study was carried out in the city of Colima, which is located in the Mexican Pacific coastal state of the same name. METHODS: A total of 187 dwellings were inspected to determine the house index (HI) and the number of positive containers per house (C+/H), during the rainy season and the dry season. The following were recorded as independent variables: the air temperature, the season, the use of ultra low volume (ULV) spraying of malathion, the Premise Condition Index (PCI), and the score on a survey of knowledge, attitudes, and practices (KAP). RESULTS: Both the multivariate logistic regression and the multivariate lineal regression showed a reduction of HI and C+/H due to the effect of the dry season. Paradoxically, the temperature seemed to have a negative correlation with the larval indices, and this effect was more pronounced during the dry season. The PCI showed the most significant correlation with HI and C+/H, independently of the other variables. The ULV sprayings showed a small negative effect on the indices, while the KAP score did not indicate any association at all. CONCLUSIONS: Some conclusions that can be drawn from this study are as follows: higher temperatures can reduce the larval indices during the dry season, the PCI can be an adequate estimator of the Ae. aegypti infestation rate, ULV spraying reduces the number of larval breeding sites, and the KAP score has little association with the larval indices.