Genotype Distribution Change After Human Papillomavirus Vaccination in Two Autonomous Communities in Spain.

Context: It has been more than 10 years since the human papillomavirus (HPV) vaccination program was initiated in most advanced countries. Thus, it seems necessary to change the uterine cervical cancer screening strategy. Molecular-based tests are considered essential in this scenario. Objective: We aimed to review the distribution of the HPV genotypes after the introduction of the vaccination program with Cervarix® and Gardasil 4® in two autonomous communities in Spain, looking for possible changes in distribution and the occurrence of a herd effect. Design: A cross-sectional study was performed in 45,362 samples that were processed in the Cantabria and Aragon communities during the period from 2002 to 2016. We compared the genotype distribution before and after the vaccination program was initiated. Results: Genotypes HPV6 and HPV11 have decreased significantly after the introduction of the vaccine. HPV16 has had a decrease, but not a significant one in the statistical analysis. However, HPV31, HPV52, and HPV45 have increased in percentage. A replacement phenomenon with other genotypes not included in the vaccine has been observed in our population. Conclusions: Continued surveillance is needed to provide further indication of any changes over time in the genotypes in circulation. This will be facilitated by monitoring the genotyping results from the new model of cervical screening using primary HPV DNA testing.

Clinical Outcome in Human T-Lymphotropic Virus Type 2 Carriers Following Organ Transplantation.

BACKGROUND: Frequent and rapid development of myelopathy has been reported in individuals with human T-lymphotropic virus type 1 (HTLV-1) infection following solid organ transplantation. There is no information regarding HTLV-2, a closely related virus that often infects injection drug users. METHODS: This study includes a retrospective analysis of all consecutive organ transplants performed during the last 2 decades at a large reference transplantation unit in Spain. All participants were tested for anti-HTLV antibodies. RESULTS: A total of 2019 individuals were tested for HTLV during the study period, including 663 potential donors and 1356 recipient candidates. Twelve (0.59%) were reactive on initial HTLV serologic screening, but only 6 (all recipients) were confirmed as positive, all for HTLV-2. Two recipients underwent liver transplantation and have remained asymptomatic despite being on tacrolimus for 4 and 8 years, respectively. Likewise, the remaining 4 HTLV-2 carriers have not developed clinical complications potentially associated with HTLV-2. CONCLUSIONS: Unlike HTLV-1 infection, HTLV-2 infection in the transplantation setting does not seem to be associated with rapid development of neurologic complications, Given the cross-seroreactivity between HTLV-1 and HTLV-2, discriminatory rapid tests are urgently needed and would reduce unnecessary organ discharge.

Seroconversión a IgG4 en un paciente con brucelosis crónica con focalidad biliar / No disponible

No disponible

Nocardiosis linfocutánea por Nocardia brasiliensis en un paciente inmunocompetente / Primary lynphocutaneus nocardiosis by Nocardia brasiliensis in an immunocompetent patient

No disponible

No disponible

Human papillomavirus (HPV) infection and intraepithelial neoplasia and invasive cancer of the uterine cervix: a case-control study in Zaragoza, Spain.

INTRODUCTION: The raw incidence of cancer of the uterine cervix is Spain is 7,8 per 100.000 inhabitants (adjusted incidence is 5.6). The incidence of this tumor is still low, but a steady increase has been seen, probably related to increasing risk factors. AIM: To determine the frequency of infection by different types of human papillomavirus (HPV) in Papanicolau smears from women with and without cancer of the uterine cervix in Spain. PATIENTS AND METHODS: A case-control study was performed in women with and without cervical cancer from Zaragoza, Spain. Pap smears from 600 cases (540 women with cervical intraepithelial neoplasms (CIN) and 60 with invasive cancer) and 1200 controls (women without those lesions) were tested by polymerase chain reaction (PCR) and typed by oligonucleotide microarray-based detection. RESULTS: HPV was detected in 93.3% of all samples with invasive cancer versus 17.5% of controls. OR for invasive cancer was 55 (95% CI 21.5-140,5). Statistically significant associations were also found for different grades of cervical dysplasia. CONCLUSION: The strong association found between HPV infection, specifically types 16 and 18 and cancer of the uterine cervix in Zaragoza, Spain, stresses the importance of ongoing efforts to institute a vaccine program with recently approved HPV vaccines in order to prevent cervical cancer in this population.

Diagnóstico de laboratorio de las micosis invasoras por hongos filamentosos en pacientes inmunodeprimidos / Laboratory diagnosis of invasive mold infections in immunocompromised patients

Las infecciones invasoras por hongos filamentosos han aumentado durante los últimos 20 años ya que la población en riesgo se ha incrementado. El diagnóstico y el tratamiento temprano son la clave para el éxito del tratamiento. Los métodos clásicos de diagnóstico microbiológico son lentos y poco sensibles. El desarrollo de nuevas técnicas como detección de antígenos, galactomanano y (1,3)β-D-glucano y de ADN representan una mejora en el diagnóstico de este tipo de infecciones

Invasive mould infections have become more prevalent in the clinical setting during the past 20 years because of changes in the population at risk. Early diagnosis and prompt therapy are crucial for the successful outcome of these infections, but conventional methods for microbiological diagnosis are slow and lack sensitivity. Innovative techniques for detecting circulating fungal antigens, such as galactomannan and (1,3)β-D-glucan, and fungal genomic DNA may improve the diagnosis of fungal invasive infections

Inter-single-sequence-repeat-PCR typing as a new tool for identification of Microsporum canis strains.

BACKGROUND: Microsporum canis is a ubiquitous dermatophyte that commonly causes human infections. Since contact with infected animals is the usual way of infection, tracing its source is an essential preventive measure. OBJECTIVE: To type isolates of M. canis from human patients whose skin was affected, and from some animals (dogs and cats) that were closely associated to the patients. METHODS: The inter-single-sequence-repeat-PCR (ISSR-PCR) technique has been used for typing 24 isolates of M. canis. Seventeen isolates tested were from human patients, 5 from cats and 1 from a dog RESULTS: A total of 21 genotypes were identified. The same genotype was found infecting a patient and a cat that was living closely with him, but another member of the same family proved to be infected with two genotypes different from that. Clinical specimens from two patients had been contaminated with the same genotype, probably in the laboratory where the samples were handled. CONCLUSION: These results demonstrate that ISSR-PCR polymorphism is a reliable method for the identification of the M. canis strains.

Sensititre YeastOne caspofungin susceptibility testing of Candida clinical isolates: correlation with results of NCCLS M27-A2 multicenter study.

The ability of Sensititre YeastOne to discriminate isolates with reduced caspofungin susceptibility was determined against 36 Candida spp. (6 with a known FKS1 mutation). Results were compared with those of M27-A2. The MIC endpoint was 100% growth inhibition. Overall agreement (+/-2 log2) was 87.16%. Sensititre YeastOne detected strains with reduced caspofungin susceptibility.

Potential fungicidal effect of voriconazole against Candida spp.

In vitro fungistatic and fungicidal activities of voriconazole were evaluated against 114 isolates of Candida spp. MICs were determined using the NCCLS M27-A2 broth microdilution method. Minimum fungicidal concentrations (MFCs) were defined as the lowest drug concentrations that yielded < or = 5 colonies (> or = 98% killing activity). The fungicidal activity could be only evaluated against 45.6% of the isolates (52 of 114 isolates) because trailing growth occurred, and 30 of these 52 isolates (57.69%) showed MFC values < or = 1 mg/l. There was little or no fungicidal activity against C. albicans and C. tropicalis. In contrast, all C. krusei were killed by 1-2 mg/l voriconazole. In conclusion, our data show that the fungicidal effect of voriconazole against Candida spp. is species dependent.

[Genotypes of Candida dubliniensis in clinical isolates]. / Genotipos de Candida dubliniensis en aislamientos clínicos.

Amplification of specific sequences of the ITS1 and ITS2 regions and the intervening 5.8S rRNA gene has lead to the identification of four separate genotypes in Candida dubliniensis. Using primers specific for each genotype, we have studied the prevalence of these genotypes among 68 clinical isolates, mostly from Spanish patients infected by HIV. The majority of the isolates tested belonged to genotype 1 (97%), while only one isolate each from genotypes 2 (1.5%) and 3 (1.5%) were detected in the oral cavity of two patients with HIV infection.