Sepsis secondary to complicated skin and soft tissue infection caused by Ignatzschineria indica. First case report in Latin America.

INTRODUCTION: Ignatzschineria is a recently recognized genus associated with larvae infestation Members of this genus are pathogens infrequently implicated in human disease. During the last decade, fewer than 10 cases of infection with Ignatzchineria species have been reported around the world. Bacteria of the genera Ignatzchineria and Wohlfahrtiimonas have been isolated from larvae of the parasitic fly Wohlfahrtia magnifica, which is found in Europe, Asia and North Africa, and is associated with myiasis in several animal species, but rarely in humans. CASE PRESENTATION: We report the first case of sepsis associated with complicated skin and soft tissue infection caused by I. indica in Latin America. CONCLUSION: The clinical and molecular findings in our report add information to the accumulating data on emerging pathogens of this type, their geographic distribution, the correlation between the emergence of infectious diseases and social and economic inequalities, as well as the effects of global climate changes on potentially unusual distribution of vectors. We consider that fly larvae should be regarded as a potential source of specific arthropod-borne bacterial systemic infections.

Universal versus selective screening for the detection, control and prognosis of gestational diabetes mellitus in Argentina.

In all, 1,702 unselected pregnant women from the city of La Plata were tested for gestational diabetes mellitus (GDM) and evaluated to determine GDM prevalence and risk factors. In women with GDM, we evaluated compliance with guidelines for GDM management, and perinatal complications attributable to GDM. GDM prevalence was 5.8%, and its risk factors were pre-gestational obesity, previous hyperglycaemia, age > 30 years, previous GDM (and its surrogate markers). In primi-gravida (PG) subjects, GDM was equally prevalent in the presence (4.2%) or absence (4.0%) of risk factors. In multi-gravida (MG) women, although risk factors doubled the prevalence of GDM (8.6%), in the absence of risk factors GDM prevalence was similar to that of PG women (3.9%). Half of all women with GDM received inadequate post-diagnosis obstetric control, and this induced a fourfold increase in infant perinatal complications. In conclusion, all non-hyperglycaemic 24-28-week pregnant women should be tested for GDM, although particular attention must be paid to MG women with risk factors.