RESUMEN
The Dutch virus-typing network VIRO-TypeNed reported an increase in ECHOvirus 6 (E-6) infections with neurological symptoms in the Netherlands between June and August 2016. Of the 31 cases detected from January through August 2016, 15 presented with neurological symptoms. Ten of 15 neurological cases were detected in the same province and the identified viruses were genetically related. This report is to alert medical and public health professionals of the circulation of E-6 associated with neurological symptoms.
Asunto(s)
Brotes de Enfermedades , Echovirus 6 Humano/aislamiento & purificación , Infecciones por Echovirus/epidemiología , Meningitis Aséptica/epidemiología , Meningitis Aséptica/virología , Vigilancia de la Población/métodos , Salud Pública , Adolescente , Adulto , Líquido Cefalorraquídeo/virología , Niño , Preescolar , Sistemas de Información en Laboratorio Clínico , Echovirus 6 Humano/genética , Infecciones por Echovirus/diagnóstico , Infecciones por Echovirus/virología , Humanos , Persona de Mediana Edad , Países Bajos/epidemiología , Filogenia , Adulto JovenRESUMEN
Clostridium difficile is an important cause of antibiotic-associated diarrhoea. The simultaneous presence of different strains in individual faecal samples has not yet been established, but is important for epidemiological studies. Recurrences of Clostridium difficile-associated diarrhoea (CDAD) are observed in 15-20 % of patients and have been reported as relapses or reinfections with a new strain. In a period of 1 year, 28 faecal samples from 23 patients with a first episode of CDAD were collected at the Leiden University Medical Centre. In addition, 52 faecal samples from 23 patients, from three different hospitals, with one (n = 19), two (n = 2) or three (n = 2) recurrences were studied. PCR-ribotyping was applied as the standard typing method for the isolates. The toxinogenic and clindamycin-resistance profiles of the isolates was determined by PCR. Of 23 patients with a first episode of CDAD, two (8.7 %) harboured two different types, with no differences in toxinogenicity or clindamycin resistance, within one faecal sample. One of these 23 patients showed two types in three faecal samples from the same episode. Of the 23 patients with recurrences, six (26 %) showed a different strain type isolated in a recurrent episode. The number of cases of multiple C. difficile strains in faecal samples from patients with a first episode of CDAD did not differ significantly from the number of different strains present in recurrent episodes (chi-square test, P < or = 0.2). This observation limits the application of typing methods for studying the epidemiology of CDAD.