Crioglobulinas: características y metodología de estudio. Recomendación (2014) / Cryoglobulins: features and methodology of study. Recommendation (2014)

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[Implication of ermX genes in macrolide- and telithromycin-resistance in Corynebacterium jeikeium and Corynebacterium amycolatum]. / Implicacion de los genes ermX en la resistencia a los macrolidos y la telitromicina de Corynebacterium jeikeium y Corynebacterium amycolatum.

The activity of seven macrolides, clindamycin and telithromycin against clinical isolates of Corynebacterium spp. was studied. Of these, 36 isolates were identified as C. jeikeium and 57 as C. amycolatum. The frequency of resistance to erythromycin and other macrolides as well as clindamycin was high, with CMI(90) >256 microg/ml. Telithromycin showed the best activity, with 52.3% of C. amycolatum and 70% of C. jeikeium erythromycin-resistant strains susceptible to this ketolide. All strains had the MLSb constitutive phenotype. The ermX gene was present in all erythromycin-resistant strains, and in C. amycolatum was 100% homologous with that of C. striatum and C. diphtheriae.

Implicación de los genes ermX en la resistencia a los macrólidos y la telitromicina de Corynebacterium jeikeium y Corynebacterium amycolatum / Implication of ermX genes in macrolide- and telithromycin- resistance in Corynebacterium jeikeium and Corynebacterium amycolatum

Se ha estudiado la actividad de siete macrólidos, clindamicina y telitromicina frente a aislamientos clínicos del género Corynebacterium. Deéstos, 36 pertenecían a la especie C. jeikeium y 57 a C. amycolatum. Todos los macrólidos estudiados y la clindamicina presentaron escasaactividad, con CMI90 >256 mg/l. La telitromicina presentó mejor actividad, siendo sensibles un 52,3% de C. amycolatum y un 70% de C.jeikeium resistentes a la eritromicina. El fenotipo de resistencia fue de tipo MLSb constitutivo en todos los aislamientos. El gen ermX fue detectadoen el 100% de las cepas resistentes a eritromicina, presentando una homología, en el caso de C. amycolatum, de un 100% con elde C. striatum y C. diptheriae

The activity of seven macrolides, clindamycin and telithromycin against clinical isolates of Corynebacterium spp. was studied. Of these, 36isolates were identified as C. jeikeium and 57 as C. amycolatum. The frequency of resistance to erythromycin and other macrolides as wellas clindamycin was high, with CMI90 >256 ìg/ml. Telithromycin showed the best activity, with 52.3% of C. amycolatum and 70% of C. jeikeiumerythromycin-resistant strains susceptible to this ketolide. All strains had the MLSb constitutive phenotype. The ermX gene was presentin all erythromycin-resistant strains, and in C. amycolatum was 100% homologous with that of C. striatum and C. diphtheriae

Seroconversion and duration of immunity after vaccination against group C meningococcal infection in young children.

An increase in the incidence of group C meningococcal disease was observed in the Murcia Region (Spain) during 1996-1997. In September 1997, a massive vaccination campaign was implemented among the population aged 18 months to 19 years. The aim of this study was to assess the seroconversion rate of children aged 18-59 months and the persistence of immune response 1 year after vaccination. A total of 296 children were included. Blood samples were obtained before vaccination and 1 month and 1 year after vaccination. Three point seven percent of the children had bactericidal antibody titres of >/=1:8 before vaccination. One month after vaccination seroconversion was 63.7%, with a growing trend related to age at vaccination (p<0.0001). The increase in antibody titres was shown to be quantitatively greater above the age of 36 months (p<0.0001). One year after vaccination only 4.3% of the children who initially seroconverted still had bactericidal activity. Seroconversion in children under 5 increases with age but antibodies decline rapidly in the year following vaccination.

[High titers of rheumatoid factor: clinical significance]. / Factor reumatoide a títulos elevados: significado clínico.

UNLABELLED: Rheumatoid factor (RF) is one of the most characteristic laboratory parameters in rheumatoid arthritis (RA), and its specificity for this disease increases when the titer is high. We investigated the diagnoses associated with high titers of RF and whether they are associated with a poor prognosis of RA. PATIENTS AND METHODS: Patients with RF titers higher than 300 IU/ml were studied (nephelometry) during a three-year period in a general hospital. Patients with RA were compared with other group of patients with RA and RF lower than 300 IU/ml regarding functional capacity, presence of nodules, HLA-DR4 and radiologic status, in a retrospective cohort study. RESULTS: RF was quantitated in 2,181 patients and was higher than 300 IU/ml in 79 cases; 63 among patients in this group (80%) had RA, and the remaining patients inflammatory diseases of the connective tissue (four patients), palindromic rheumatism (two), liver disease (two), infection (one) and neoplasm (one). In two cases the diagnosis was arthrosis and in one case arthralgia of unknown origin. RA with RF higher than 300 IU/ml had a higher frequency of rheumatoid nodules than RA with RF lower than 300 IU/ml (p = 0.01; RR: 2.26; 95% CI: 1.18-4.35). The index of functional capacity and rate of HLA-DR4 and erosions was similar in both RA groups. CONCLUSIONS: In a patient with a high RF titer, RA should be first ruled out, followed by other inflammatory diseases, collagenosis and liver diseases. The likelihood of finding a healthy patient with arthrosis or soft tissue rheumatism was very low. In RA, rheumatoid nodules were significantly associated with RF with titers higher than 300 IU/ml.

[Evaluation of Mycobacterium fortuitum acyltrehaloses in the serologic diagnosis of pulmonary tuberculosis]. / Evaluación de aciltrehalosas de Mycobacterium fortuitum en el diagnóstico serológico de tuberculosis pulmonar.

BACKGROUND: Several glycolipids of Mycobacterium tuberculosis are antigenic and their use in the serodiagnosis of pulmonary tuberculosis has been postulated. Acyltrehaloses (SL-IV) are among the strongest antigenic glycolipids of M. tuberculosis; similar compounds have been found in M. fortuitum. The aim of the present study was to evaluate the usefulness of the acyltrehaloses of M. fortuitum in the serodiagnosis of pulmonary tuberculosis. METHODS: Two glycolipids, identified as triacyl- (TAT-MF) and diacyl- (DAT-MF) trehaloses, were studied by an ELISA method. Two independent analyses were carried out. In the first one, IgG and IgM were determined in sera from patients with pulmonary tuberculosis (84-24 bacteriologically not confirmed--), healthy individuals (46) and patients with respiratory pathologies other than pulmonary tuberculosis (38), using TAT-MF. In the second one, IgG was determined in sera from pulmonary tuberculosis patients (34) and from healthy individuals (20), using DAT-MF. RESULTS: The sensitivity of the IgG ELISA using TAT-MF varied, according to the cut-off point, between 79.8 and 39.3%; the specificity values ranged between 83.3 and 98.8%. In sera from bacteriologically not confirmed pulmonary tuberculosis patients the sensitivity was 87.5-45.8%. The sensitivity for IgM was very low using TAM-MF (10.7-2.3%), with specificity values ranging from 77.4 to 100%. The sensitivity and specificity values of IgG using DAT-MF were, respectively, 34.3-9.3% and 90-100%. CONCLUSIONS: The IgG ELISA using TAT-MF has similar values of sensitivity and specificity to those reported for the acyltrehaloses of M. tuberculosis, although this antigen, by itself, can not be used in the serodiagnosis of pulmonary tuberculosis. DAT-MF has no value in the serodiagnosis of pulmonary tuberculosis.