RESUMO
Since 2003, a lymphogranuloma venereum epidemic has been reported in The Netherlands and other European countries. This epidemic is caused by Chlamydia trachomatis serovariant L2b and has only been seen in men having sex with men. The authors investigated a woman presenting with a bubo in her right groin. The authors showed by real-time PCR that the woman was infected with C trachomatis, serovariant L2b. This is the first reported case study of a female patient with bubonic lymphogranuloma venereum caused by serovariant L2b, which was probably contracted via her bisexual male partner.
Assuntos
Chlamydia trachomatis/isolamento & purificação , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/patologia , Chlamydia trachomatis/classificação , Chlamydia trachomatis/genética , DNA Bacteriano/genética , Feminino , Genótipo , Humanos , Países Baixos , Reação em Cadeia da Polimerase em Tempo Real , Sorotipagem , Adulto JovemRESUMO
Enhanced surveillance of infections due to the pandemic A(H1N1) influenza virus, which included monitoring for antiviral resistance, was carried out in the Netherlands from late April 2009 through late May 2010. More than 1100 instances of infection with the pandemic A(H1N1) influenza virus from 2009 and 2010 [A(H1N1) 2009] distributed across this period were analyzed. Of these, 19 cases of oseltamivir-resistant virus harboring the H275Y mutation in the neuraminidase (NA) were detected. The mean 50% inhibitory concentration (IC50) levels for oseltamivir- and zanamivir-susceptible A(H1N1) 2009 viruses were 1.4-fold and 2-fold, respectively, lower than for the seasonal A(H1N1) influenza viruses from 2007/2008; for oseltamivir-resistant A(H1N1) 2009 virus the IC50 was 2.9-fold lower. Eighteen of the 19 patients with oseltamivir-resistant virus showed prolonged shedding of the virus and developed resistance while on oseltamivir therapy. Sixteen of these 18 patients had an immunodeficiency, of whom 11 had a hematologic disorder. The two other patients had another underlying disease. Six of the patients who had an underlying disease died; of these, five had received cytostatic or immunosuppressive therapy. No indications for onward transmission of resistant viruses were found. This study showed that the main association for the emergence of cases of oseltamivir-resistant A(H1N1) 2009 virus was receiving antiviral therapy and having drug-induced immunosuppression or an hematologic disorder. Except for a single case of a resistant virus not linked to oseltamivir therapy, the absence of detection of resistant variants in community specimens and in specimens from contacts of cases with resistant virus suggested that the spread of resistant A(H1N1) 2009 virus was limited. Containment may have been the cumulative result of impaired NA function, successful isolation of the patients, and prophylactic measures to limit exposure.
Assuntos
Farmacorresistência Viral , Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos , Influenza Humana/tratamento farmacológico , Influenza Humana/epidemiologia , Oseltamivir/uso terapêutico , Pandemias , Adolescente , Adulto , Idoso , Animais , Linhagem Celular , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1/classificação , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/fisiologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Mutação , Países Baixos/epidemiologia , Neuraminidase/genética , Neuraminidase/metabolismo , Filogenia , Vigilância de Evento Sentinela , Proteínas Virais/genética , Proteínas Virais/metabolismo , Adulto JovemRESUMO
Mycobacterial colonies of two different morphologies were isolated from one sputum sample of a HIV-positive patient. One morphological type was resistant to streptomycin (STR) and susceptible to isoniazid (INH), while the other isolate with different colony morphology was resistant to both of these anti-TB drugs. A mycobacterial isolate of one pus from a lymph node sample was resistant to these two anti-TB drugs, while the other isolate from another pus sample was resistant to STR but susceptible INH. IS6110 RFLP based finger printing revealed that the HIV-positive patient was infected with different strains of Mycobacterium tuberculosis. A subculture of isolates on solid medium is useful to examine mixed infection.
