In vitro activity of delafloxacin against anaerobic bacteria compared with other antimicrobials.

The aim of this study was to describe the in vitro activity of delafloxacin against 230 anaerobic isolates and compare it with the activity of other antimicrobials used against infections caused by anaerobic microorganisms. Minimal inhibitory concentrations (MICs) were lower for delafloxacin than for all other antibiotics tested with the exception of piperacillin-tazobactam and meropenem against Gram-positive anaerobic cocci. Only two (0.8 %) isolates of Bacteroides spp. showed a MIC ≥4 µg/mL. With some exceptions, the present results show lower MICs for delafloxacin in comparison to the other antibiotics used against anaerobes.

Differences between bloodstream infections involving Gram-positive and Gram-negative anaerobes.

BACKGROUND: The objectives of this study were to describe differences between bloodstream infections involving Gram-positive (GP) and Gram-negative (GN) anaerobic bacteria. METHODS: Patients with clinically significant anaerobic bacteremia detected between October 2016 and July 2022 in a tertiary hospital in Granada (Spain) were retrospectively included. Species identification was performed by MALDI-TOF MS and/or molecular methods. The association between variables was analyzed using contingency tables, applying the chi-square test when expected frequencies were adequate and the Fisher exact test when not. Variables were gathered at the time of the first positive blood culture. RESULTS: Out of 237 cases of anaerobic bloodstream infections detected, 127 (53.6%) were GN. Crude mortality was 20.3%, corresponding to 48 patients who died of causes directly attributable to bacteremia. The presence of malignant disease (p = 0.011), abdominal and/or pelvic surgery (p = 0.001), and transplantation (p = 0.008) were significantly associated with bacteremia due to GN bacteria, while the presence of diabetes mellitus was significantly associated with bacteremia due to GP bacteria (p = 0.022). The presence of both septic shock and mortality was more frequently associated with bacteremia due to GN versus GP bacteria. CONCLUSIONS: The association of certain variables with the presence of bloodstream infections due to GP or GN anaerobic bacteria may assist in selecting the optimal empirical therapeutic approach and improving the outcome of patients with these types of infection.

Comparative evaluation of chemiluminescent immunoassay and enzyme-linked immunosorbent assays for the diagnosis of West Nile virus infections.

In August 2020, anew West Nile virus (WNV) outbreak affected 71 people with meningoencephalitis in Andalusia (Spain). Samples from these individuals were received in our laboratory, a regional Virus Referral Centre. The aim of this study was to compare the agreement, sensitivity and specificity of findings between the WNV VIRCLIA IgG and IgM assay (Vircell, Spain) and the WNV ELISA IgM and IgG assay (Euroimmun, Germany) and to compare the performance of WNV VIRCLIA IgM and Euroimmun ELISA for cerebrospinal fluid (CSF) diagnosis. The study included 24 CSF samples (paired with serum samples) and 247 serum samples from 217 patients with suspected WNV infection (1 or 2 per patient). The agreement between ELISA and CLIA tests for IgM and Ig G detection in serum was 93% (kappa index = 0.85) and 96% (kappa index = 0.89) respectively. Sensitivity values of ELISA and CLIA tests for IgM in serum samples were 96.7% and 98.9%, respectively, and specificity values were 96.4% and 95.4% respectively. Sensitivity values of ELISA and CLIA test for IgG in serum samples were 91.1% and 97%, respectively, and specificity values were 100% and 98.8% respectively. Results obtained with ELISA and CLIA tests in CSF samples showed 75% agreement between them (kappa index = 0.51). According to these findings, the WNV VIRCLIA IgM and IgG monotest offers an accurate qualitative detection of WNV in serum and CSF specimens.

Comparison of two chemiluminescent immunoassays in the detection of measles IgM antibodies.

Serological confirmation of measles is achieved by detecting the specific immunoglobulin M (IgM), and it is important to evaluate new commercial inmunoassays in order to ensure the quality of results. The objective of this study was to compare the performance of a novel automated chemiluminescent immunoassay (CLIA), Virclia IgM measles (Vircell, Spain), with that of the widely used Liaison measles IgM assay (DiaSorin, Italy). A panel of 86 sera from laboratory-confirmed cases was used for the sensitivity calculation, and 59 sera from healthy individuals and those with other viral infections were used for the specificity calculation. Sensitivity values were 96.5% for Virclia and 97.6% for Liaison; specificity values were 93.2% for Virclia and 96.6% for Liaison; neither difference was statistically significant VirClia IgM measles is a good alternative to other immunoassays for the serological confirmation of measles.

Artritis tuberculosa sobre prótesis de rodilla: descripción de un caso y revisión de la literatura / Tuberculous prosthetic knee joint infection: a case report and literature review

Introducción. La infección protésica tardía se presenta a partir del segundo mes tras la cirugía en el contexto de una diseminación hematógena desde otro foco. La infección protésica por micobacterias es una complicación rara cuyo manejo clínico no está estandarizado. Caso. Paciente de 77 años sin antecedentes personales de interés salvo diabetes y un recambio protésico de rodilla derecha por gonartrosis tres años antes. Acude a urgencias del hospital por un cuadro de unos 6 meses de evolución de intenso dolor en rodilla derecha de tipo mecánico con signos inflamatorios pero sin fiebre asociada. A los 5 días de su reingreso y presentando empeoramiento clínico se informa del crecimiento de Mycobacterium tuberculosis en la primera muestra de aspirado de rodilla y se instaura tratamiento antituberculoso durante 9 meses. Las imágenes de resonancia magnética nuclear confirmaron también el diagnóstico de espondilitis tuberculosa en el contexto clínico de la paciente. Tras la intervención quirúrgica se seguía aislando en el cultivo de las muestras intraoperatorias M. tuberculosis y por ello la paciente recibió de nuevo otra tanda de 9 meses con antituberculosos. La evolución al año de seguimiento fue aceptable, aunque unos meses después la paciente falleció por causas cardiovasculares. En la revisión bibliográfica se encontraron 15 publicaciones con un total de 17 casos clínicos en los últimos 25 años de infección protésica por M. tuberculosis. Conclusión. La artritis protésica tuberculosa, aunque es una presentación infrecuente, debe tenerse presente, especialmente en aquellos pacientes con condiciones predisponentes y con antecedentes de infección tuberculosa (AU)

Introduction. Prosthetic late infection occurs in the second month after surgery in the context of haematogenous spread from another source. Prosthetic mycobacterial infection is a rare complication whose clinical management is not standardized. Case. Patient of 77 years with no personal history except for diabetes and a prosthetic replacement of right knee with osteoarthritis three years ago. Patient goes to hospital emergency box for 6 months pain in the right knee with mechanical inflammatory signs but no fever associated. After their return within 5 days and clinical worsening is reporting growth of Mycobacterium tuberculosis in knee aspirate and antitubercular treatment is established for 9 months. Nuclear magnetic resonance imaging studies also confirmed the diagnosis of tuberculosis spondylitis in the clinical context of the patients. After surgery, M. tuberculosis was again isolated from intraoperative samples and therefore the patient received another batch of treatment for 9 months. After a year of monitoring, the development was acceptable but few months later, the patient died for cardiovascular causes. In the literature review, 15 publications with a total of 17 clinical cases of prosthetic infection by M. tuberculosis were found from 1980 to 2014. Conclusion. Prosthetic tuberculous arthritis, although it is a rare presentation, it should be noted, especially in patients with predisposing conditions with a history of tuberculosis infection (AU)

Preliminary evaluation of a new kit for differentiation of Mycobacterium tuberculosis complex species using Speed-Oligo MTBC.

We present the first evaluation of a novel molecular assay, the Speed-Oligo Mycobacterium tuberculosis complex (SO-MTBC), which is based on PCR combined with a dipstick for the differentiation of M. tuberculosis complex (MTBC) members. The results of this assay were compared with findings obtained using the Genotype MTBC assay. In this study, 189 strains of MTBC isolates from 2011 to 2014 were evaluated to determine the MTBC species. Most (174, 92 %) of the strains were identified as M. tuberculosissensu stricto, 7 (3.7 %) as Mycobacteriumbovis, 5 (2.6 %) as M. bovis bacillus Calmette-Guérin, 2 (1.1 %) as Mycobacteriumafricanum and 1 (0.5 %) as Mycobacteriumcaprae; no strains belonged to Mycobacteriummicroti and Mycobacteriumcanettii subsp. The concordance κ coefficient obtained was 0.96 with the results of the Genotype MTBC assay. SO-MTBC may represent a fast and easy-to-use alternative for differentiating among MTBC subspecies in laboratories with standard equipment.

Molecular characterization and antimicrobial susceptibility of hemolytic Streptococcus agalactiae from post-menopausal women.

PURPOSE: Streptococcus agalactiae (Group B streptococcus, GBS) is increasingly recognized as a pathogen in adult populations, including the elderly. Appropriate treatment involves antibiotics. An alternative to this strategy would be the administration of a polysaccharide vaccine therefore the capsular serotypes and molecular characterization of circulating strains needs to be known. Few studies have been conducted in this population. METHODS: One hundred and seven GBS isolates collected from vagino-rectal swabs from 600 post-menopausal women were analysed for their capsular type, antimicrobial resistance and genetic relatedness (multilocus sequence typing, MLST). RESULTS: The colonization rate was 17.8%. Capsular type III was predominant (34.6%), followed by type V (22.4%). The most frequent sequence type (ST) was 19 (23.3%), followed by 23 (18.7%), 1 (16.8%) and 17 (12.1%). Isolates were assembled into three phylogenetic groups from ST-19, ST-23 and ST-17 founders. All isolates were susceptible to penicillin, whereas resistance to erythromycin and clindamycin was recorded in 23.4% and 20.6% of isolates, respectively. CONCLUSIONS: In our setting, the GBS colonization rate in postmenopausal women is similar to that reported in others populations studied. The population structure of these isolates is highly diverse and contains different STs. These data can contribute to the future development of a polysaccharide vaccine for preventing GBS infection in older adults.

Potential Relevance of Melatonin Against Some Infectious Agents: A Review and Assessment of Recent Research.

Melatonin, a tryptophan-derived neurohormone found in animals, plants, and microbes, participates in various biological and physiological functions. Among other properties, numerous in vitro or in vivo studies have reported its therapeutic potential against many parasites, bacteria and viruses. In this concern, melatonin was found to be effective against many parasites such as Plasmodium, Toxoplasma gondii, and Trypansoma cruzi, via various mechanisms such as modulation of calcium level and/or host immune system. Likewise, a recent investigation has reported in vitro activity of melatonin against Leishmania infantum promastigotes which is the causative agent of fascinating visceral Leishmaniasis. This review was initially undertaken to summarize some facts about certain physiological and therapeutic effects of melatonin. It also reviews the effects and action mechanisms of melatonin in bacterial and viral infection besides biology of different parasites which may provide a promising strategy for control of many diseases of public health importance.

Serotipos y patrones de resistencia antibiótica en aislados betahemolíticos deStreptococcus agalactiae de madres colonizadas y recién nacidos con enfermedad invasiva / Serotypes and antibiotic resistance patterns in beta-hemolytic Streptococcus agalactiae isolates in colonized mothers and newborns with invasive disease

INTRODUCCIÓN: Las actuales medidas de prevención frente a la enfermedad neonatal causada por Streptococcus agalactiae, estreptococo del grupoB (EGB), son la realización de un cribado prenatal y la administración de profilaxis antibiótica intraparto con antimicrobianos adecuados. Una alternativa a esta estrategia sería la administración de una vacuna polisacarídica, por lo que es necesario conocer la distribución de serotipos capsulares de las cepas circulantes. MÉTODOS: Se estudiaron 188 cepas procedentes de gestantes del área sanitaria norte de Granada portadoras vaginorrectales de EGB y 24 de recién nacidos con enfermedad neonatal enviadas al laboratorio desde distintos hospitales andaluces. Se realizó antibiograma frente a penicilina, eritromicina y clindamicina siguiendo las normas del Clinical and Laboratory Standards Institute (CLSI), y se determinó su serotipo capsular mediante 2 métodos: aglutinación con partículas de látex y métodos moleculares. RESULTADOS: De las 188 cepas de S.agalactiae pertenecientes a mujeres embarazadas, se obtuvo una concordancia en los resultados del 80,8% entre ambas técnicas. Se detectó resistencia a eritromicina y clindamicina en el 16,5 y el 10,1% de cepas, respectivamente. En las cepas neonatales, en el 95,8% de los aislados los resultados obtenidos por ambas técnicas fueron coincidentes. Las tasas de resistencia frente a eritromicina y clindamicina fueron del 8,3 y del 4,1%, respectivamente. En ambos grupos de aislados el serotipo más frecuente fue el III y el más relacionado con resistencia frente a antimicrobianos, el V. CONCLUSIÓN: Se deberían realizar más estudios epidemiológicos que permitan continuar con una vigilancia de los serotipos causantes de enfermedad invasiva así como sus patrones de sensibilidad antibiótica utilizando métodos sensibles y específicos

INTRODUCTION: Current preventive measures against neonatal disease caused by Streptococcus agalactiae (GBS) are prenatal screening and intrapartum antibiotic prophylaxis with appropriate antimicrobials. An alternative to this strategy would be the administration of a polysaccharide vaccine as the distribution of capsular serotypes of circulating strains needs to be known. METHODS: A study was made of 188 strains from pregnant women carrying GBS and 24 newborns with neonatal disease. Susceptibility testing was performed with penicillin, erythromycin and clindamycin following CLSI standards, and capsular serotype was determined by two methods: latex agglutination and PCR. RESULTS: Of the 188 strains of S.agalactiae from the pregnant women, there was 80.8% agreement in the results between the two techniques. Resistant to erythromycin and clindamycin was found in 16.5% and 10.1%, respectively. For neonatal strains, 95.8% of the results obtained by the two techniques were identical. The rates of resistance to erythromycin and clindamycin were 8.3% and 4.1%, respectively. In both groups, most frequently isolated serotype was III, and the most related to antimicrobial resistance serotype was V. CONCLUSIÓN: Epidemiological studies are necessary to continue surveillance of serotypes causing invasive disease and its antibiotic sensitivity patterns using sensitive and specific methods

[Serotypes and antibiotic resistance patterns in beta-hemolytic Streptococcus agalactiae isolates in colonized mothers and newborns with invasive disease]. / Serotipos y patrones de resistencia antibiótica en aislados betahemolíticos de Streptococcus agalactiae de madres colonizadas y recién nacidos con enfermedad invasiva.

INTRODUCTION: Current preventive measures against neonatal disease caused by Streptococcus agalactiae (GBS) are prenatal screening and intrapartum antibiotic prophylaxis with appropriate antimicrobials. An alternative to this strategy would be the administration of a polysaccharide vaccine as the distribution of capsular serotypes of circulating strains needs to be known. METHODS: A study was made of 188 strains from pregnant women carrying GBS and 24 newborns with neonatal disease. Susceptibility testing was performed with penicillin, erythromycin and clindamycin following CLSI standards, and capsular serotype was determined by two methods: latex agglutination and PCR. RESULTS: Of the 188 strains of S.agalactiae from the pregnant women, there was 80.8% agreement in the results between the two techniques. Resistant to erythromycin and clindamycin was found in 16.5% and 10.1%, respectively. For neonatal strains, 95.8% of the results obtained by the two techniques were identical. The rates of resistance to erythromycin and clindamycin were 8.3% and 4.1%, respectively. In both groups, most frequently isolated serotype was iii, and the most related to antimicrobial resistance serotype was v. CONCLUSION: Epidemiological studies are necessary to continue surveillance of serotypes causing invasive disease and its antibiotic sensitivity patterns using sensitive and specific methods.

Diagnosis of leishmaniasis.

Leishmaniasis is a clinically heterogeneous syndrome caused by intracellular protozoan parasites of the genus Leishmania. The clinical spectrum of leishmaniasis encompasses subclinical (not apparent), localized (skin lesion), and disseminated (cutaneous, mucocutaneous, and visceral) infection. This spectrum of manifestations depends on the immune status of the host, on the parasite, and on immunoinflammatory responses. Visceral leishmaniasis causes high morbidity and mortality in the developing world. Reliable laboratory methods become mandatory for accurate diagnosis, especially in immunocompromised patients such as those infected with HIV. In this article, we review the current state of the diagnostic tools for leishmaniasis, especially  the serological test.

Evaluation of the rapid RIDAQUICK Campylobacter® test in a general hospital.

The study objective was to evaluate the effectiveness of the new rapid immunochromatographic test RIDAQUICK Campylobacter® (r-biopharm AG, Darmstadt, Germany) for the qualitative detection of Campylobacter antigens in pathologic feces from primary and specialist care patients. Three hundred feces samples were studied from patients with diarrhea, 50.6% from adults and 49.4% from children, which were received by our microbiology laboratory for coproculture. Campylobacter culture results, with or without PCR data, served as reference values for the comparative evaluation of RIDAQUICK Campylobacter® findings. Campylobacter was detected in 12.3% of samples. The diagnostic accuracy values of the RidaQuick Campylobacter® versus culture were: sensitivity of 87%, specificity of 97%, and positive and negative predictive values of 77% and 98%, respectively. RIDAQUICK Campylobacter® is a rapid test for the diagnosis of enteritis due to Campylobacter and could be an option for the clinical diagnosis of one of the main causes of bacterial enteritis in resource-limited settings.

Clarifying the structure of granadaene: total synthesis of related analogue [2]-granadaene and confirmation of its absolute stereochemistry.

Streptococcus agalactiae is an important agent in the infection of neonates in the first world. One of the most extended methods for its identification is based on the detection of a characteristic red pigment in the patient samples, named [12]-granadaene (1). In this article, we present a modular and flexible approach to simple analogues of this ornithine rhamno-polyene 1 and the elucidation of the most important features of its structure: the absolute configuration at C-27, the stereochemistry of the anomeric center and the link of the amino acid ornithine to the rest of the structure.

Diagnóstico de infección congénita / Diagnosis of congenital infection

El diagnóstico de la infección congénita está basado en: a) serología materna; b) estudio microbiológico del líquido amniótico y sangre fetal, y c) serología en el neonato y detección del agente etiológico por cultivo o PCR. La infección congénita por citomegalovirus, virus herpes simple, virus varicela-zóster, Toxoplasma gondii y erythrovirus B19 suele ser el resultado de la infección primaria en la madre. Por lo tanto, la detección de anticuerpos IgG antes del embarazo permite descartar las infecciones por estos agentes. El diagnóstico serológico definitivo de infección aguda en la embarazada requiere la demostración de seroconversión. En tales casos, debe realizarse el estudio de infección congénita intrauterina en muestras de líquido amniótico y sangre fetal.Las infecciones por citomegalovirus, virus de la rubéola y T. gondii pueden diagnosticarse por detección de IgM en sangre fetal. Sin embargo, la PCR en líquido amniótico ha desplazado a las técnicas convencionales en el diagnóstico de estas infecciones. En el recién nacido, el diagnóstico puede confirmarse mediante detección de IgM específica.Erythrovirus B19 puede detectarse por PCR en líquido amniótico o sangre fetal.En la infección congénita por el virus varicela-zóster, la persistencia de IgG después del nacimiento permite establecer el diagnóstico.La detección directa del virus herpes simple en vesículas o muestras orofaríngeas es la técnica de elección para el diagnóstico de infección congénita por este agente(AU)

In general, congenital diagnosis is based on: a) maternal serologic assays; b) microbiologic study of amniotic fluid or fetal blood sampling; and c) serology in children and microorganism detection by polymerase chain reaction (PCR) or culture.Congenital infections due to cytomegalovirus, herpes simplex, varicella, B19 erythrovirus and toxoplasmosis are usually the result of primary infection in the mother. Therefore, when IgG antibodies are detected before pregnancy, these infections are ruled out. Definitive serologic diagnosis of acute infection in pregnant women requires the demonstration of seroconversion (i.e., from seronegative to seropositive). In these cases, amniotic fluid or fetal blood sampling should be performed to determine the presence of intrauterine congenital infection.Cytomegalovirus, rubella and toxoplasmosis can be diagnosed by detection of specific IgM antibodies in fetal blood. However, PCR in amniotic fluid has replaced conventional prenatal diagnostic techniques, including fetal blood sampling, in the diagnosis of these infections. In the newborn, these infections may be confirmed by measuring IgM specific antibodies.B19 erythrovirus can be detected by PCR in amniotic fluid or fetal blood. Congenital varicella-zoster infection may be diagnosed on the basis of persistence of IgG antibodies after birth. Definitive diagnosis of herpes simplex virus infection requires viral isolation. Swabs or scraping from clinical specimens can be inoculated into susceptible cell lines for isolation(AU)

[Diagnosis of congenital infection]. / Diagnóstico de infección congénita.

In general, congenital diagnosis is based on: a) maternal serologic assays; b) microbiologic study of amniotic fluid or fetal blood sampling; and c) serology in children and microorganism detection by polymerase chain reaction (PCR) or culture. Congenital infections due to cytomegalovirus, herpes simplex, varicella, B19 erythrovirus and toxoplasmosis are usually the result of primary infection in the mother. Therefore, when IgG antibodies are detected before pregnancy, these infections are ruled out. Definitive serologic diagnosis of acute infection in pregnant women requires the demonstration of seroconversion (i.e., from seronegative to seropositive). In these cases, amniotic fluid or fetal blood sampling should be performed to determine the presence of intrauterine congenital infection. Cytomegalovirus, rubella and toxoplasmosis can be diagnosed by detection of specific IgM antibodies in fetal blood. However, PCR in amniotic fluid has replaced conventional prenatal diagnostic techniques, including fetal blood sampling, in the diagnosis of these infections. In the newborn, these infections may be confirmed by measuring IgM specific antibodies. B19 erythrovirus can be detected by PCR in amniotic fluid or fetal blood. Congenital varicella-zoster infection may be diagnosed on the basis of persistence of IgG antibodies after birth. Definitive diagnosis of herpes simplex virus infection requires viral isolation. Swabs or scraping from clinical specimens can be inoculated into susceptible cell lines for isolation.