Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 11 de 11
Filtrar
1.
JAC Antimicrob Resist ; 6(4): dlae098, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39005591

RESUMEN

Background: Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population. Methods: Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included. Results: In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%. Conclusion: Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.

2.
Nat Commun ; 15(1): 3083, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600104

RESUMEN

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection in young children and the second leading cause of infant death worldwide. While global circulation has been extensively studied for respiratory viruses such as seasonal influenza, and more recently also in great detail for SARS-CoV-2, a lack of global multi-annual sampling of complete RSV genomes limits our understanding of RSV molecular epidemiology. Here, we capitalise on the genomic surveillance by the INFORM-RSV study and apply phylodynamic approaches to uncover how selection and neutral epidemiological processes shape RSV diversity. Using complete viral genome sequences, we show similar patterns of site-specific diversifying selection among RSVA and RSVB and recover the imprint of non-neutral epidemic processes on their genealogies. Using a phylogeographic approach, we provide evidence for air travel governing the global patterns of RSVA and RSVB spread, which results in a considerable degree of phylogenetic mixing across countries. Our findings highlight the potential of systematic global RSV genomic surveillance for transforming our understanding of global RSV spread.


Asunto(s)
Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Infecciones del Sistema Respiratorio , Lactante , Niño , Humanos , Preescolar , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/genética , Filogenia , Virus Sincitial Respiratorio Humano/genética , Genómica , Infecciones del Sistema Respiratorio/epidemiología
3.
Sex Transm Dis ; 51(1): 11-14, 2024 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-37889942

RESUMEN

BACKGROUND: Congenital syphilis (CS) remains a major public health problem, and its incidence is increasing worldwide. METHODS: Retrospective, observational, and descriptive study of cases with CS and their mothers at a tertiary-level hospital in Mexico from 2017 to 2022. Medical records of patients with CS and a structured collection of epidemiological, clinical, and laboratory data were analyzed and classified in the Centers for Disease Control scenarios as confirmed, probable, less probable, or unlikely. RESULTS: One hundred eighty cases were diagnosed with a compatible definition of congenital syphilis, and we identified 43 (21.21%) confirmed proven. Among those proven cases, 15.6% had hematological, 13.3% skin, 12.2% liver, 6.7% pulmonary, 6.6% neurological, 5.8% eye, 5.6% bone, and 0.6% hearing involvements. According to the clinical stages of maternal syphilis, 119 (66.1%) were in the late latent phase, 49 (27.2%) in the early latent phase, 7 (3.9%) in the secondary stage, and 5 (2.8%) in the primary stage. Mothers with tertiary syphilis were not detected. CONCLUSION: Regardless of negative antenatal screening, health care workers should consider the diagnosis of congenital syphilis. Infants are still undiagnosed at birth, and only a tiny percentage exhibits symptoms. The wide range of clinical manifestations of this preventable infection can be misdiagnosed for various other diseases, causing diagnostic delays that can have serious consequences.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Sífilis Congénita , Sífilis , Femenino , Humanos , Recién Nacido , Embarazo , Hospitales , Incidencia , México/epidemiología , Relaciones Madre-Hijo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Estudios Retrospectivos , Sífilis/diagnóstico , Sífilis/epidemiología , Sífilis/complicaciones , Sífilis Congénita/diagnóstico , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control
4.
Am J Trop Med Hyg ; 109(6): 1270-1273, 2023 12 06.
Artículo en Inglés | MEDLINE | ID: mdl-37931306

RESUMEN

Acinetobacter baumannii poses a significant threat to public health due to the high rate of multidrug-resistant strains. However, information on the molecular characterization of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections in children is scarce. This study aimed to describe the molecular characterization of carbapenem-resistant A. baumannii infections in children from a hospital in Mexico. A retrospective study was conducted during the period 2017-2022. Clinical and demographic data were collected from the clinical records. Mass spectrometry was used for the identification of the strains. To confirm A. baumannii strains, a polymerase chain reaction (PCR) method was applied using a gyrB sequence. The carbapenemase-encoding resistance genes were detected by PCR. Six cases of CRAB were documented, including five in neonates. The median intensive care unit stay was 20 days, and all cases had an invasive medical device. Half of the patients had at least one medical condition. A high prevalence of coresistance was observed in most of the antibiotic groups. Three of the six strains coharbored carbapenemase genes: blaOXA-51, blaOXA-24, and blaIMP. Mortality was reported in two neonate patients. The present study shows a high rate of coharboring blaOXA-51, blaOXA-24, and blaIMP-1, which has a direct impact on therapeutic decisions. Implementation of antimicrobial stewardship programs is urgent to stop the spread of this microorganism.


Asunto(s)
Acinetobacter baumannii , Sepsis , Recién Nacido , Humanos , Niño , Acinetobacter baumannii/genética , Estudios Retrospectivos , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/genética , Proteínas Bacterianas/genética , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico
5.
J Pediatric Infect Dis Soc ; 12(7): 431-435, 2023 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-37392402

RESUMEN

BACKGROUND: Acinetobacter baumannii has emerged as a threat to public health due to the high prevalence of multidrug-resistant isolates. Information regarding the clinical and molecular characterization of carbapenem-resistant A. baumannii (CRAB) infections in children is scarce. Our study aimed to describe the clinical and molecular characteristics of CRAB infections in children from a third-level center in Mexico. METHODS: Consecutive cases of CRAB infections were documented during 2017-2022. Clinical and demographic data were collected from clinical records. Mass spectrometry was used for the identification of the isolates. The identification of A. baumannii strains was confirmed by conducting a polymerase chain reaction (PCR) assay targeting the gyrB sequence. In addition, the carbapenemase-encoding resistance genes were detected by PCR. RESULTS: Twenty-one cases of CRAB infections were documented: 76% female and 62% were neonates. The median hospital length of stay at the time of positive culture was 37 days (interquartile range, 13-54). Sixty-four percent of the isolates were recovered from bronchial secretions. A co-resistance rate greater than 60% was observed for most groups of antibiotics. All carbapenem-resistant isolates carried blaOXA-24 genes. BlaIMP genes were detected in half of the cases, with all strains co-harboring blaOXA-24 genes. CONCLUSIONS: The present study demonstrated a high proportion of CRAB infections in the neonatal population, a high prevalence of co-resistance to antibiotics, and a high rate of isolates carrying blaOXA-24 and blaIMP genes. CRAB is a significant concern due to the mortality rate and the lack of therapeutic alternatives; implementing infection prevention and control programs is urgent to stop the spread of carbapenem-resistant A. baumannii.


Asunto(s)
Acinetobacter baumannii , Recién Nacido , Humanos , Femenino , Niño , Masculino , Epidemiología Molecular , México/epidemiología , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/genética , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Hospitales , Farmacorresistencia Bacteriana Múltiple/genética
9.
Pediatr Infect Dis J ; 41(2): 140-144, 2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-34609106

RESUMEN

INTRODUCTION: Although most cases of coccidioidomycosis are subclinical or self-limited respiratory disease, 1% lead to extrathoracic dissemination and become fatal, especially in patients with an associated immunodeficiency. Up to 30%-50% of patients with defects in cell-mediated immunity, those with AIDS and recipients of solid-organ transplants, may develop disseminated coccidioidomycosis (DC). Within the primary immunodeficiencies, an uncommon group is caused by C-terminal NFKB2 pathogenic variants. MATERIALS AND METHODS: We performed a literature search of core databases. Written informed consent for the study and for publication was obtained. CASE PRESENTATION: A 7-year-old Mexican girl, eldest of 3 sisters, no relevant family history, and a history of recurrent upper respiratory infections and alopecia totalis was admitted with DC involving pulmonary, soft tissue, skin, bone and joint compromise. The immunodeficiency assessment showed low IgM and NK cells. We found an NFKB2 de novo heterozygous nonsense mutation of c.2611C>T (p.Gln871*). She was treated with liposomal amphotericin B and itraconazole with surgical debridement. The clinical phenotype of this primary immunodeficiency is characterized by antibody deficiency and associated broncho-pulmonary predisposition to infection, but moreover also opportunistic infections and autoimmunity, most recognizable alopecia and adrenocorticotropic hormone-deficiency. After 1 year of her discharge, she continues under surveillance with antifungal therapy with itraconazole and replacement intravenous immunoglobulin until today. CONCLUSION: This is the first case report of DC in a patient with an NFKB2 pathogenic variant and it illustrates the importance of screening for primary immunodeficiencies in patients with disseminated fungal infections.


Asunto(s)
Coccidioidomicosis , Subunidad p52 de NF-kappa B/genética , Infecciones Oportunistas , Enfermedades de Inmunodeficiencia Primaria , Alopecia , Antifúngicos/uso terapéutico , Niño , Coccidioidomicosis/complicaciones , Coccidioidomicosis/diagnóstico , Coccidioidomicosis/tratamiento farmacológico , Coccidioidomicosis/patología , Codón sin Sentido/genética , Femenino , Humanos , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/patología , Enfermedades de Inmunodeficiencia Primaria/complicaciones , Cuero Cabelludo/patología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...