Evaluación de una técnica de PCR en tiempo real para determinar colonización por Streptococcusagalactiae en mujeres gestantes de Medellín que consultan en Dinamica IPS / Evaluation of a real-time PCR technique to determine colonization by Streptococcus agalactiae in pregnant women of Medellín who consult in Dinamica IPS

Objetivo: Evaluar una técnica de PCR en tiempo real para determinar colonización por Streptococcus agalactiae en mujeres gestantes de Medellín. Materiales Y Métodos: Se realizó un estudio descriptivo prospectivo, en 150 mujeres gestantes, seleccionadas de forma aleatoria, en una IPS en el periodo comprendido entre Enero-Julio 2016. Criterio de inclusión: Ser gestante entre la semana 35-37, declaración voluntaria de participación en el estudio y de exclusión el uso de antibióticos. A las pacientes, se les tomó muestra con hisopo de lintroito vaginal y de la región anal. Las muestras se procesaron para qPCR, cultivo en caldo selectivo con posterior siembra en agar sangre de carnero y medio cromogénico para S. agalactiae STRB (ChromIDTMStrepto,BioMérieuxSA.). Resultados: La prevalencia de colonización por S. agalactiae en las gestantes fue de 20,9% y 22,3% en agar sangre y agar cromogénico STRB respectivamente, mientras que mediante PCR en tiempo real la prevalencia fue de 36%. Al comparar la qPCR con la prueba de oro se encontró: sensibilidad 79,31% (ICdel95%:0,61-0,90), especificidad 75,45% (IC del 95%: 0,66-0,82), valor predictivo positivo 46% (IC del 95%:0,32-0,59) y negativo 93,2% (IC del 95%: 0,86-0,96). Discusión: Elempleo de la qPCR permitió aumentar la sensibilidad y la oportunidad diagnostica (Eltiempo requerido empleando elcultivo fue de 24-48 Horas y por qPCR 6 horas) ,impactando la reducción de riesgos de transmisión neonata lde S.agalactiae, lo cualpodría representar una Disminución en días de estancia y costos hospitalarios por una infección prevenible.

Materials and Methods: A prospective and descriptive study was conducted in 150 pregnant women, randomly selected, at an IPS between January and July 2016. Inclusion criteria: gestation period week 35-37, voluntary declaration of participation in the study. Exclusion criteria: the use of antibiotics. Samples were taken from the vaginal introitus and the anal region using a hyssop and processed for qPCR as well as the gold standard test [selective broth culture with subsequent culture in blood agar and chromogenic medium for S. agalactiae STRB (ChromIDTMStrepto, BioMérieux SA)]. Results: The prevalence of colonization by S. agalactiae in pregnant women was 20.9% and 22.3% in blood agar and chromogenic agar STRB respectively, where as using qPCR the prevalence was 36.0%. The time required using the culture was 24-48h compared to 6h for qPCR. Our data comparing qPCR with the gold standard test showed: sensitivity 79.31% (95% CI: 0.61-0.90), specificity 75.45% (95% CI: 0.66-0.82), positive predictive value 46.0% (95% CI: 0.32-0.59) and negative 93.2%(95% CI: 0.86-0.96). Discussion: The use of the qPCR increased the sensitivity and the diagnostic opportunity (4x to 8x faster using qPCR), which can lead to a decrease in the risk of neonatal transmission of S. agalactiae and result in a reduction in the length of hospital stay and costs induced by a preventable infection.

Age-specific seroprevalence of human papillomavirus 16, 18, 31, and 58 in women of a rural town of Colombia.

OBJECTIVE: The study's objective was to estimate human papillomavirus (HPV) genotype-specific seroprevalence to determine population HPV exposure and inform vaccine policy. METHODS: This study is a cross-sectional prevalence survey of 878 women of Pueblorrico, a rural town of Colombia. A standardized questionnaire was used to obtain information on demographic characteristics, sexual and reproductive history, and smoking habits. Seropositivity to HPV-16, -18, -31, and -58 was determined by virus-like particles in an enzyme-linked immunosorbent assay. RESULTS: Overall seropositivity to any HPV genotype was 27.9%. The combined seroprevalence of women 15 to 19 and 20 to 24 years old was 35.4% (95% confidence interval [CI], 25.9-46.2) and 36.0% (95% CI, 27.7-45.3), respectively. Seroprevalence for HPV-16 was 17% (95% CI, 14.6-19.6); for HPV-18, 9.8% (95% CI, 8.0-11.9); for HPV-31, 11.4% (95% CI, 9.5-13.7); and for HPV 58, 12.5% (95% CI, 10.5-14.9). Higher HPV seropositivity was associated with the lifetime number of occasional sexual partners (odds ratio, 3.05; 95% CI, 1.26-7.37) and having more than 2 regular sexual partners (odds ratio, 3.00; 95% CI, 1.21-7.45) in women younger than 44 and older than 45 years old, respectively. Use of oral contraceptives and tobacco/cigarettes was significantly associated with reduced HPV seropositivity in women older than 45 but not in women younger than 44 years old. CONCLUSIONS: Human papillomavirus seropositivity is associated with measures of sexual behavior, particularly a greater lifetime number of sexual partners. Hormonal and tobacco/cigarette use may be factors influencing the HPV seropositivity in women older than 45 years old.

Prevalence of specific herpes simplex virus-2 antibodies and associated factors in women of a rural town of Colombia.

There is lack of age-specific seroprevalence surveys and identification of factors associated with herpes simplex virus type-2 seropositivity (HSV-2) in rural populations in Colombia. A random sample of 869 women was interviewed about socio-demographic aspects, sexual and reproductive history. Antibodies to HSV-2 were determined by a specific type immunoenzymatic technique (ELISA). Participants had a mean age of 38±16.1 years, 67% were married, 60% monogamous and 47% reported use of condoms. HSV-2 seroprevalence was 19.1% (95% CI: 16.6-21.9) and it was strongly associated with increasing age (Ptrend<0.001). In the logistic regression analysis, women who reported between two or three lifetime sexual partners (OR=2.4; 95% CI: 1.5-3.7), >31 years of sexual activity with regular or occasional sexual partners (OR=4.3; 95% CI: 1.2-15.7) and not using condoms with regular sexual partners (OR=2.1; 95% CI: 1.4-3.3) were more likely to be HSV-2 seropositive. The overall seroprevalence rate of women of Pueblorrico, Colombia, is lower than that reported in other Latin American countries especially in women>45 years. The difference may be explained by higher prevalence of condom use in this population or lower exposure to herpes infection in male as well as females in the past.

[Prevalence of epithelial squamous cell abnormalities and associated factors in women of a rural town of Colombia]. / Prevalencia de anormalidades de células epiteliales y factoresasociados en mujeres de un municipio rural colombiano.

INTRODUCTION: In spite of implementation of cytology-based cervical cancer screening in Colombia, mortality rates remain stable. The description of factors associated to cervical pre-neoplasic lesions is needed to establish strategies for mortality prevention. OBJECTIVE: The prevalence of epithelial squamous cell abnormalities was determined to explore the association of cytology abnormalities with described risk factors. MATERIALS AND METHODS: This population-based, cross-sectional study included 739 women randomly selected by age. A validated face-to-face questionnaire and conventional cervical cytology were used to collect the information. To establish the association between cervical abnormalities and some qualitative variables, the independent chi squared test was used. We also calculated prevalence ratio with their 95% confidence intervals. A logistic regression model was used to explore variables that potentially explain cytology abnormalities. RESULTS: The prevalence of squamous cell abnormality was 15.8%. Among women with abnormal cytology, 10% presented atypical squamous cells of undetermined significance, 3.9% low grade squamous intra-epithelial lesion and 1.9% high grade squamous intra-epithelial lesion. The adjusted logistical regression analysis showed that history of sexual transmitted disease, two or more sexual partners during entire life and previous abnormal cytology were associated with cytology abnormalities. CONCLUSION: The relation of epithelial squamous cell abnormalities with sexual behavior history reflexes the link between human papiloma virus infection and cervical cancer pre-neoplasic lesions. The frequency of use and knowledge about the purpose of cytology were factors that suggested other diagnostic limitations such as quality of cervical cytology or barriers to access health care. These latter factors may be the underlying basis for the high cervical cancer mortality rates.

Prevalencia de anormalidades de células epiteliales y factores asociados en mujeres de un municipio rural colombiano / Prevalence of epithelial squamous cell abnormalities and associated factors in women of a rural town of Colombia

Introducción. A pesar de la existencia de los programas de tamización basados en la citología, las tasas de cáncer de cuello uterino permanecen estables en Colombia. La descripción de los factores asociados a las lesiones precursoras de cáncer de cuello uterino es necesaria para establecer estrategias para su prevención.Objetivo. Determinar la prevalencia de las anormalidades de células epiteliales escamosas y su asociación con los factores de riesgo descritos. Materiales y métodos. Estudio transversal de población en 739 mujeres, seleccionadas en forma aleatoria. La información se recolectó mediante la citología y un cuestionario previamente validado. La medida de asociación fue la razón de prevalencia con su respectivo intervalo de confianza del 95 por ciento. Las variables de confusión fueron controladas en un modelo de regresión logística multivariado. Resultados.La prevalencia del evento fue de 15,8 por ciento. Entre las mujeres con citología anormal, 10 por ciento presentó células escamosas atípicas de significado indeterminado; 3,9 por ciento, lesión escamosa intraepitelial de bajo grado, y 1,9 por ciento, lesión escamosa intraepitelial de alto grado. La regresión logística ajustada sugiere que los antecedentes de enfermedades de transmisión sexual, una citología anormal y tener dos o más parejas regulares/ocasionales durante la vida se asocian con la presencia del evento. Conclusiones. La relación de anormalidades de células escamosas con conducta sexual refleja la asociación entre el virus del papiloma humano y lesiones preneoplásicas de cáncer de cuello uterino. El uso frecuente y el adecuado conocimiento sobre la citología, sugiere que aspectos tales como las dificultades con la calidad de la citología o el acceso al diagnóstico y tratamiento, pudieran explicar las altas tasas de cáncer de cuello uterino.

Clinical, histopathological and virological findings in patients with focal epithelial hyperplasia from Colombia.

BACKGROUND: Focal epithelial hyperplasia (FEH) is a rare oral HPV-related disease, highly prevalent in certain ethnic communities. A previous study found 7.5% prevalence among school children from the Indian community Embera-Chami in Colombia. OBJECTIVE: To determine the prevalence and Human Papillomavirus (HPVs)-type in children with FEH. MATERIALS AND METHODS: One hundred and thirty-eight students were screened. All FEH samples were HPV-tested by two PCR-based systems. RESULTS: We identified 18 FEH cases. beta-globin amplification was obtained in 15 cases and nine were HPV-55-positive by the HPV-PCR-hybridization method. Nine cases (50%) were HPV-13-positive by the GP5+/GP6+-based method. Twelve cases (80%) were HPV-positive by one or the other method. Forty-four percent and 88% of interviewed parents reported family histories of FEH and toothbrush sharing, respectively. CONCLUSIONS: Human Papillomavirus-DNA was identified in the majority of FEH cases and HPV-13 was the only genotype involved. Frequent familiar infection suggests interfamiliar transmission, genetic predisposition or infection susceptibility among family members.