Global tuberculosis research and its future prospects.

Tuberculosis is the infectious disease that causes the most deaths each year in the world. Around 25% of the population is estimated to be infected with, Mycobacterium tuberculosis, the bacteria that gives rise to the disease, and more than one and a half million people die each year from this cause. A rigorous bibliometric analysis has been developed around tuberculosis disease, and the most remarkable results are presented in this paper. It is observed that interest in tuberculosis is growing, and the control of its spread has become one of the main health priorities in the world, with the United States, the United Kingdom, and India, leading the research in this area. On the other hand, it has been observed that there are two main health concerns around the tuberculosis: drug-resistant tuberculosis and co-infection with HIV. Finally, conclusions are offered, playing a frontline role in science policy decisions and research performance evaluations.

Typing and antimicrobial susceptibility of 134 Neisseria gonorrhoeae strains from Southern Spain.

OBJECTIVE: Last guidelines have recommended the introduction of dual antimicrobial therapy in order to avoid treatment failure. In the present report, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was performed. METHODS: Gonococcal isolates were tested for susceptibility according to the recommendations of both CLSI and EUCAST. A total of 134 isolates were typed by the NG-MAST technique. RESULTS: Seventy-two different N. gonorrhoeae types were found, and the most frequent types obtained were ST 1407, ST 14958, ST 7192, ST 13251 and ST 5405. If CLSI/EUCAST criteria were applied, a ST 9807 type was found nonsusceptible to ceftriaxone and cefixime (MIC 0.5 mg/L), and a ST 12800 type was found nonsusceptible only to cefixime (MIC 0.25 mg/L). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25 mg/L) and three isolates were resistant to ceftriaxone (MIC 0.19, 0.16 and 0.25 mg/L, respectively). The majority of strains were resistant to ciprofloxacin (68.6%), and all N. gonorrhoeae strains were susceptible to spectinomycin; 9.7% of isolates were resistant to azithromycin. CONCLUSIONS: Molecular typing may be a useful tool to predict antimicrobial resistance. High rates of resistance to penicillin, tetracycline and ciprofloxacin were found in this area. It is highly recommended to carry out antimicrobial susceptibility in all gonorrhoea cases and to identify treatment failures to verify emerging resistance.

Clinical and epidemiological characteristics of intestinal parasite infection by Blastocystis hominis. / Características clínicas y epidemiológicas de la parasitación intestinal por Blastocystis hominis.

OBJECTIVES: Blastocystis hominis (B. hominis) is one of the most common intestinal parasites isolated in humans. The parasite can cause gastrointestinal symptoms or, in most cases, remain asymptomatic. There are issues concerning the parasite's pathogenic character. The aim of this study was to analyse the clinical and epidemiological characteristics of the parasite infection by B. hominis, with or without other parasitic co-infections. PATIENTS AND METHODS: An observational retrospective study was conducted of B. hominis isolates in faeces from October 2004 to March 2016 in a tropical medicine unit. We reviewed all patients with a parasite infection, exclusively or not by B. hominis. RESULTS: We studied 3070 patients, 570 (18%) of whom were diagnosed with B. hominis infection, which was the only isolate in 245 (43%) of the 570 patients. A total of 325 (57%) patients presented other parasitic co-infections (Entamoeba histolytic or Entamoeba dispar, Strongyloides stercoralis, hookworm and Schistosoma spp.). The main symptom was abdominal pain (41.8%). In 31.2% of cases, the parasite was detected in the imported diseases screening of asymptomatic patients. Of those who underwent treatment with metronidazole, 78.2% improved. The parasite was neutralised in 82.6% of the patients. CONCLUSIONS: Parasite infection by B. hominis is one of the most common diseases in our tropical medicine unit. Most patients are asymptomatic, or their symptoms can be attributed to other parasite infections. In those cases in which symptoms persist without being able to attribute them to other causes, a specific treatment is recommended.

Hepatitis B and Schistosoma co-infection in a non-endemic area.

Schistosomiasis is related to the development of liver fibrosis and portal hypertension. Chronic co-infection with HBV and Schistosoma has been associated in endemic areas with a higher risk for a more severe liver disease. However, no studies have assessed the real importance of this co-infection in non-endemic regions. This is a retrospective observational study of Sub-Saharan immigrants attending between October 2004 and February 2014. Patients with chronic HBV infection with and without evidence of schistosomal infection were compared. Epidemiological, analytical, and microbiological data were analysed. Likelihood of liver fibrosis based on APRI and FIB-4 indexes was established. A total of 507 patients were included in the study, 170 (33.5 %) of them harbouring evidence of schistosome infection. No differences were found in transaminase, GGT, and ALP levels. In fibrosis tests, a higher proportion of patients with HVB and S. mansoni detection reached possible fibrosis scores (F > 2) when compared to patients without schistosomiasis: 17.4 vs 14.2 % and 4.3 % vs 4.2 % (using high sensitivity and high specificity cut-offs respectively), although differences were not statistically significant (p = 0.69, p = 0.96). For possible cirrhosis (F4) score, similar results were observed: 4.3 % of co-infected patients vs 2.1 % of mono-infected ones, p = 0.46. According to these datas, in non-endemic regions the degree of hepatic fibrosis in patients with chronic hepatitis B is not substantially modified by schistosome co-infection.

Viral hepatitis and immigration: A challenge for the healthcare system.

BACKGROUND: Viral hepatitis is a significant health problem in African countries. The increase in the immigrant population from this continent represents a challenge for the Spanish healthcare system. MATERIAL AND METHODS: A descriptive study was conducted on the prevalence of the serological markers of hepatitis B (HBV), C (HCV) and D (HDV) in African immigrants treated in a specialised doctor's office. RESULTS: The study included 2518 patients (87.7% Sub-Saharan natives), with a mean age of 31.3 years. Some 78.8% of the patients had a positive infection marker for HBV, and 638 patients (25.3%) were diagnosed with active hepatitis B (HBsAg +). In 19 cases, antibodies against HDV were detected (4 cases with detection of the viral genome). Sixty-eight patients had antibodies against HCV, 26 of whom had a positive viral load. CONCLUSIONS: The high prevalence of viral hepatitis in immigrants, especially HBV infection, represents a significant change in the profile of patients treated in Spain and requires measures aimed at early diagnosis and transmission prevention.