RESUMO
Whole-genome characterisation in clinical microbiology enables to detect trends in infection dynamics and disease transmission. Here, we report a case of bacteraemia due to Campylobacter fetus subsp. fetus in a rural worker under cancer treatment that was diagnosed with cellulitis; the patient was treated with antibiotics and recovered. The routine typing methods were not able to identify the microorganism causing the infection, so it was further analysed by molecular methods and whole-genome sequencing. The multi-locus sequence typing (MLST) revealed the presence of the bovine-associated ST-4 genotype. Whole-genome comparisons with other C. fetus strains revealed an inconsistent phylogenetic position based on the core genome, discordant with previous ST-4 strains. To the best of our knowledge, this is the first C. fetus subsp. fetus carrying the ST-4 isolated from humans and represents a probable case of zoonotic transmission from cattle.
Assuntos
Bacteriemia/diagnóstico , Infecções por Campylobacter/diagnóstico , Campylobacter fetus/isolamento & purificação , Genótipo , Tipagem de Sequências Multilocus , Exposição Ocupacional , Zoonoses/diagnóstico , Animais , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Campylobacter fetus/classificação , Campylobacter fetus/genética , Bovinos , Análise por Conglomerados , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Neoplasias/complicações , Filogenia , População Rural , Análise de Sequência de DNA , Homologia de Sequência , Resultado do Tratamento , Zoonoses/tratamento farmacológico , Zoonoses/microbiologiaRESUMO
Haematopoietic cell transplant activity in the 28 countries comprising Latin America is poorly defined. We conducted a voluntary survey of members of the Latin American Bone Marrow Transplantation Group regarding transplant activity 2009-2012. Collated responses were compared with data of transplant rates from the Worldwide Network for Blood and Marrow Transplantation for other geographic regions. Several socio-economic variables were analysed to determine correlations with transplant rates. In total, 94 teams from 12 countries reported 11 519 transplants including 7033 autotransplants and 4486 allotransplants. Annual activity increased from 2517 transplants in 2009 to 3263 in 2012, a 30% increase. Median transplants rate (transplant per million inhabitants) in 2012 was 64 (autotransplants, median 40; allotransplants, median 24). This rate is substantially lower than that in North America and European regions (482 and 378) but higher than that in the Eastern Mediterranean and Asia Pacific regions (30 and 45). However, the Latin America transplant rate is 5-8-fold lower than that in America and Europe, suggesting a need to increase transplant availability. Transplant team density in Latin America (teams per million population; 1.8) is 3-4-fold lower than that in North America (6.2) or Europe (7.6). Within Latin America, there is substantial diversity in transplant rates by country partially explained by diverse socio-economic variables including per capita gross national income, health expenditure and physician density. These data should help inform future health-care policy in Latin America.
Assuntos
Transplante de Células-Tronco Hematopoéticas/tendências , Atenção à Saúde/estatística & dados numéricos , Atenção à Saúde/tendências , Previsões , Saúde Global/estatística & dados numéricos , Saúde Global/tendências , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , Humanos , América Latina , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
El enfrentamiento guerrillas - autodefensas - organismos armados del Estado ha ocasionado incontable número de muertos, amenazados, secuestrados, desaparecidos, desplazados y flagrantes violaciones a los derechos humanos y el Derecho Internacional Humanitario. La mayor parte de la población y el territorio del departamento se encuentra bajo esta situación. Lo que ha estado sucediendo ultimamente es la eliminación por parte de las autodefensas de todo militante o simpatizante de la guerrilla y esta ha respondido con acciones terroristas que sacrifican personas inocentes. Las autodefensas de Cordoba y Urabá han crecido en hombres, han expandido su influencia al Chocó, la Costa Atlántica y otras partes del pais, han fortalecido su presencia en lugares "conquistados" y hacen parte de las Autodefensas Unidas de Colombia. Se han constituído sin lugar a dudas en voceros a tener en cuenta en cualquier propuesta de paz. Las autodefensas son, al parecer, un proyecto económico, social y político, fácilmente desbordable por la concepción dogmática y fanática que los guía, la tendencia a la venganza, el abuso de las armas en manos de líderes y jóvenes combatientes sin formación adecuada y el hecho de creer que pueden decidir sin fórmula de juicio quien tiene la verdad y quien puede o no vivir. La dinámica del conflicto es tal que individualidades o sectores de la llamada sociedad civil cada día se involucran mas en las acciones de los actores armados