Study on the relation of the characteristics of the capture sites with the Leptospira spp. occurrence in bats and rodents from Yucatan, Mexico.

This study aims to describe the natural Leptospira occurrence in small mammals from Yucatan, Mexico, and to explore the relation between the characteristics of the capture sites and the Leptospira occurrence. Bats and rodents were captured in five sites of Yucatan state, and from them, a kidney fragment was collected that was used in the genomic DNA extraction. Leptospira DNA was identified by PCR targeting the 16S-rRNA and LipL32 genes. Additionally, a bioinformatic analysis was carried out to know the Leptospira species and was corroborated with a phylogenetic tree. The assemblage of small mammals was compound of 82 (51.2 %) bats and 78 (48.8 %) rodents. A global frequency (bats plus rodents) of Leptospira occurrence of 21.2 % (34/160) was observed; in bats, it was 21.9 % (18/82), and in rodents, 20.5 % (16/78). The phylogenetic trees based on LipL32 gene showed that the recovered sequences most closely resemble the species L. borgpetersenii and L. noguchii. The ordination of the capture sites with tropical deciduous forests as original vegetation is more related to the abundance of Leptospira-infected rodents. The ordination of the capture sites with tropical sub-deciduous forests as original vegetation is more related to the diversity of Leptospira-infected bat species. The canonical ordering of the capture sites is by the original vegetation type and the diversity and abundance of Leptospira-infected bat and rodent species.

Assessing the impact of a 6-year health sciences enrichment program for underrepresented minority youth on healthcare workforce diversity, career path, and public health.

Background: Improving the quality of care for a diverse population requires a diverse healthcare workforce which necessitates high educational attainment among underrepresented communities. Programs aimed to address healthcare workforce diversity gaps also serve as a public health intervention by offering avenues to improve the health of local communities by providing students with the knowledge and skills to promote healthy behaviors, foster scientific literacy, and inspire future public health professionals - who in turn serve their local communities to advance health outcomes. We interviewed alumni of the New York Presbyterian Hospital Lang Youth Medical Program (LYMP), a high school health sciences mentoring and enrichment program for underrepresented minority youth in Upper Manhattan, from graduating classes between 2012 and 2021 to explore their perspectives on what aspects of the program had the most impact on their academic and career paths. Method: This is a qualitative study using in-depth, semi-structured individual interviews. All interviews were analyzed using the constant comparative method for developing grounded theory, following a convenience sampling method. Results: 106 codes were organized into 24 themes, which were further arranged into 4 topic areas: demonstrated program success, intangible program drivers, improvement opportunities, and barriers to program participation. Topic areas captured participants' perspectives on how the program is designed to foster an environment of personal, academic, and professional development; ways aspects of the program organically worked together to provide unanticipated positive facilitators; opportunities for program improvements, and external factors that influenced decision-making. Conclusion: Through this study, we found that the LYMP had a positive influence in helping participants set and achieve personal, academic, and professional goals. Alumni reported activities and experiences offered by the program that foster key youth development constructs linked to healthier and more resilient communities. Importantly, the vast majority of participants described how the synergism between program features, staff support, family involvement, and professional development and networking created an environment of achievement that went beyond the scope of the program design. Findings from this study offer a blueprint for other organizations to craft a similarly successful enrichment program that improves health outcomes, reduces health disparities, and promotes overall population health.

Highly Multiplexed Serology for Nonhuman Mammals.

Emerging infectious diseases represent a serious and ongoing threat to humans. Most emerging viruses are maintained in stable relationships with other species of animals, and their emergence within the human population results from cross-species transmission. Therefore, if we want to be prepared for the next emerging virus, we need to broadly characterize the diversity and ecology of viruses currently infecting other animals (i.e., the animal virosphere). High-throughput metagenomic sequencing has accelerated the pace of virus discovery. However, molecular assays can detect only active infections and only if virus is present within the sampled fluid or tissue at the time of collection. In contrast, serological assays measure long-lived antibody responses to infections, which can be detected within the blood, regardless of the infected tissues. Therefore, serological assays can provide a complementary approach for understanding the circulation of viruses, and while serological assays have historically been limited in scope, recent advancements allow thousands to hundreds of thousands of antigens to be assessed simultaneously using <1 µL of blood (i.e., highly multiplexed serology). The application of highly multiplexed serology for the characterization of the animal virosphere is dependent on the availability of reagents that can be used to capture or label antibodies of interest. Here, we evaluate the utility of commercial immunoglobulin-binding proteins (protein A and protein G) to enable highly multiplexed serology in 25 species of nonhuman mammals, and we describe a competitive fluorescence-linked immunosorbent assay (FLISA) that can be used as an initial screen for choosing the most appropriate capture protein for a given host species. IMPORTANCE Antibodies are generated in response to infections with viruses and other pathogens, and they help protect against future exposures. Mature antibodies are long lived, are highly specific, and can bind to their protein targets with high affinity. Thus, antibodies can also provide information about an individual's history of viral exposures, which has important applications for understanding the epidemiology and etiology of disease. In recent years, there have been large advances in the available methods for broadly characterizing antibody-binding profiles, but thus far, these have been utilized primarily with human samples only. Here, we demonstrate that commercial antibody-binding reagents can facilitate modern antibody assays for a wide variety of mammalian species, and we describe an inexpensive and fast approach for choosing the best reagent for each animal species. By studying antibody-binding profiles in captive and wild animals, we can better understand the distribution and prevalence of viruses that could spill over into humans.

A Promising Approach to Mitigate Risks on the Existing Tailings Dams in Brazil.

Mining operations lead to the production of large quantities of mineral waste, such as fluid fine tailings whose disposal is rather challenging. In Brazil, tailings disposal is facing a critical situation due to the large accidents that took place in the last couple of years. As a response to these accidents, the Brazilian Mining Agency became stricter on licensing mining complexes and issued an interruption on activities on 56 tailings dams. In this paper, the authors propose a promising approach to minimize risks on the existing tailings dams hoping that the industry succeeds at mining avoiding social harms and environmental damages. The results presented herein showed that in situ electrical dewatering is a promising technology that offers many benefits. It can significantly increase the solids content of liquefiable tailings stratum within a short time. This leads to tailings masses possessing higher shear strength. As a consequence, this technology might well lead to safe tailing dams in Brazil bringing socio-economic and environmental benefits.

Evidencia molecular de Leptospira interrogans sensu stricto en Cavia porcellus (cuyes) destinados para el consumo humano en el municipio de Pasto, Nariño / Molecular evidence of Leptospira interrogans sensu stricto in Cavia porcellus (guinea pig) grown for human consumption in Pasto, Nariño

Introducción: La leptospirosis es una zoonosis emergente, endémica en Colombia, que afecta tanto animales domésticos como silvestres. Es considerada de riesgo laboral, ya que la transmisión al ser humano está asociada a la exposición con animales o ambientes infectados. En el departamento de Nariño, la producción de cuyes para el consumo humano se realiza en sistemas de crianza tradicionales que podrían favorecer la infección por Leptospira interrogans en esta especie. Objetivo: Detectar molecularmente la infección natural por especies patógenas del género Leptospira en cuyes que son destinados para el consumo humano en el municipio de Pasto. Materiales y métodos: Se tomaron 270 muestras de tejido renal en cuyes sacrificados en dos mataderos. Las muestras fueron analizadas mediante Reacción en Cadena de la Polimerasa (PCR) convencional y coloración diferencial de Warthin Starry (W-S). Resultados: En la evaluación de las 270 muestras, 4 (1,5%) fueron positivas para PCR y una de las muestras demostró la presencia de Leptospira bajo tinción W-S. Conclusiones: Mediante el uso de técnicas moleculares se evidenció L. interrogans en el tejido renal de Cavia porcellus. La circulación del patógeno en esta población representa un riesgo de infección para humanos y animales domésticos en contacto con estos sistemas productivos.

Introduction: Leptospirosis is an emerging zoonosis that is endemic in Colombia and affects both domestic and wild animals. It is considered an occupational risk since human transmission is associated with exposure to infected animals or environments. In the department of Nariño, the production of guinea pigs for human consumption applies traditional rearing systems that could cause animals to get infected with Leptosipira interrogans. Objective: To molecularly identify natural infection by pathogenic species of the genus Leptospira in guinea pigs used for human consumption in the municipality of Pasto (Colombia). Materials and methods: 270 kidney tissue samples were taken from guinea pigs slaughtered in two facilities. Samples were analyzed through conventional polymerase chain reaction (PCR) and Warthin Starry (W-S) differential staining. Results: While 4 (1.5%) out of the 270 samples were categorized as positive using PCR, only 1 sample showed the presence of Leptospira through W-S staining. Conclusions: Molecular techniques were useful to identify L. interrogans in kidney tissue of Cavia porcellus. Dissemination of this pathogen within this population represents an infection risk for humans and domestic animals that are in close proximity to these productive systems.

High Diversity of Leptospira Species Infecting Bats Captured in the Urabá Region (Antioquia-Colombia).

Leptospirosis is a globally distributed zoonotic disease caused by pathogenic bacteria of the genus Leptospira. This zoonotic disease affects humans, domestic animals and wild animals. Colombia is considered an endemic country for leptospirosis; Antioquia is the second department in Colombia, with the highest number of reported leptospirosis cases. Currently, many studies report bats as reservoirs of Leptospira spp. but the prevalence in these mammals is unknown. The goal of this study was to better understand the role of bats as reservoir hosts of Leptospira species and to evaluate the genetic diversity of circulating Leptospira species in Antioquia-Colombia. We captured 206 bats in the municipalities of Chigorodó (43 bats), Carepa (43 bats), Apartadó (39 bats), Turbo (40 bats), and Necoclí (41 bats) in the Urabá region (Antioquia-Colombia). Twenty bats tested positive for Leptospira spp. infection (20/206-9.70%) and the species of infected bats were Carollia perspicillata, Dermanura rava, Glossophaga soricina, Molossus molossus, Artibeus planirostris, and Uroderma convexum. These species have different feeding strategies such as frugivorous, insectivores, and nectarivores. The infecting Leptospira species identified were Leptospira borgpetersenii (3/20-15%), Leptospira alexanderi (2/20-10%), Leptospira noguchii (6/20-30%), Leptospira interrogans (3/20-15%), and Leptospira kirschneri (6/20-30%). Our results showed the importance of bats in the epidemiology, ecology, and evolution of Leptospira in this host-pathogen association. This is the first step in deciphering the role played by bats in the epidemiology of human leptospirosis in the endemic region of Urabá (Antioquia-Colombia).

Natural infection with Trypanosoma cruzi in bats captured in Campeche and Yucatán, México. / Infección natural con Trypanosoma cruzi en murciélagos capturados en Campeche y Yucatán, México

INTRODUCTION: Bats have been reported as hosts of the Trypanosoma cruzi protozoan, the etiologic agent of American trypanosomiasis, an endemic zoonotic disease in México. OBJECTIVE: To describe T. cruzi infection in bats from the states of Campeche and Yucatán, México. MATERIALS AND METHODS: Captures were made from March to November, 2017, at three sites in Yucatán and one in Campeche. Up to four mist nets on two consecutive nights were used for the capture. The bats' species were identified and euthanasia was performed to collect kidney and heart samples for total DNA extraction. Trypanosoma cruzi infection was detected by conventional PCR with the amplification of a fragment belonging to the T. cruzi DNA nuclear. RESULTS: Eighty-six bats belonging to five families (Vespertilionidae, Noctilionidae, Mormoopidae, Phyllostomidae, and Molossidae) and 13 species (Rhogeessa aeneus, Noctilio leporinus, Pteronotus davyi, P. parnellii, Artibeus jamaicensis, A. lituratus, A. phaeotis, Glossophaga soricina, Carollia sowelli, Chiroderma villosum, Uroderma bilobatum, Sturnira parvidens, and Molossus rufus) were captured. Infection frequency by PCR was 30,2% (26/86) detected only in the renal tissue. The infected species were P. parnellii, G. soricina, A. lituratus, A. jamaicensis, S. parvidens, C. villosum, and R. aeneus. CONCLUSIONS: Our results confirmed the participation of several bat species as hosts in the T. cruzi transmission cycle in the region. Further studies are necessary to establish the importance of these animals in the zoonotic transmission of T. cruzi.

Introducción. Los murciélagos se han reportado como huéspedes del protozoario Trypanosoma cruzi, agente etiológico de la tripanosomiasis americana, enfermedad zoonótica endémica en México. Objetivo. Describir la infección con T. cruzi en murciélagos capturados en los estados de Campeche y Yucatán, México. Materiales y métodos. Se realizaron capturas de marzo a noviembre de 2017 en tres sitios de Yucatán y uno de Campeche. Para la captura se emplearon hasta cuatro redes de niebla por dos noches consecutivas. Se identificó la especie de los murciélagos capturados y se les practicó la eutanasia para recolectar muestras de riñón y corazón, utilizadas posteriormente en la extracción de ADN total. La infección con T. cruzi se detectó por la amplificación con PCR convencional de un fragmento perteneciente al ADN nuclear de T. cruzi. Resultados. Se capturaron 86 murciélagos pertenecientes a cinco familias (Vespertilionidae, Noctilionidae, Mormoopidae, Phyllostomidae, Molossidae) y 13 especies (Rhogeessa aeneus, Noctilio leporinus, Pteronotus davyi, P. parnellii, Artibeus jamaicensis, A. lituratus, A. phaeotis, Glossophaga soricina, Carollia sowelli, Chiroderma villosum, Uroderma bilobatum, Sturnira parvidens y Molossus rufus). La PCR mostró una frecuencia de infección de 30,2 % (26/86), detectada únicamente en tejido renal. Las especies infectadas fueron P. parnellii, G. soricina, A. lituratus, A. jamaicensis, S. parvidens, C. villosum y R. aeneus. Conclusiones. Los resultados confirmaron la participación de varias especies de murciélagos como huéspedes en el ciclo de transmisión de T. cruzi en la región. Es necesario realizar más estudios para determinar la importancia de estos animales en la transmisión zoonótica de T. cruzi.

Development and characterization of two equine formulations towards SARS-CoV-2 proteins for the potential treatment of COVID-19.

In the current global emergency due to SARS-CoV-2 outbreak, passive immunotherapy emerges as a promising treatment for COVID-19. Among animal-derived products, equine formulations are still the cornerstone therapy for treating envenomations due to animal bites and stings. Therefore, drawing upon decades of experience in manufacturing snake antivenom, we developed and preclinically evaluated two anti-SARS-CoV-2 polyclonal equine formulations as potential alternative therapy for COVID-19. We immunized two groups of horses with either S1 (anti-S1) or a mixture of S1, N, and SEM mosaic (anti-Mix) viral recombinant proteins. Horses reached a maximum anti-viral antibody level at 7 weeks following priming, and showed no major adverse acute or chronic clinical alterations. Two whole-IgG formulations were prepared via hyperimmune plasma precipitation with caprylic acid and then formulated for parenteral use. Both preparations had similar physicochemical and microbiological quality and showed ELISA immunoreactivity towards S1 protein and the receptor binding domain (RBD). The anti-Mix formulation also presented immunoreactivity against N protein. Due to high anti-S1 and anti-RBD antibody content, final products exhibited high in vitro neutralizing capacity of SARS-CoV-2 infection, 80 times higher than a pool of human convalescent plasma. Pre-clinical quality profiles were similar among both products, but clinical efficacy and safety must be tested in clinical trials. The technological strategy we describe here can be adapted by other producers, particularly in low- and middle-income countries.

Natural infection with Trypanosoma cruzi in bats captured in Campeche and Yucatán, México / Infección natural con Trypanosoma cruzi en murciélagos capturados en Campeche y Yucatán, México

Abstract | Introduction: Bats have been reported as hosts of the Trypanosoma cruzi protozoan, the etiologic agent of American trypanosomiasis, an endemic zoonotic disease in México. Objective: To describe T. cruzi infection in bats from the states of Campeche and Yucatán, México. Materials and methods: Captures were made from March to November, 2017 at three sites in Yucatán and one in Campeche. Up to four mist nets on two consecutive nights were used for the capture. The bats' species were identified and euthanasia was performed to collect kidney and heart samples for total DNA extraction. Trypanosoma cruzi infection was detected by conventional PCR with the amplification of a fragment belonging to the T. cruzi DNA nuclear. Results: Eighty-six bats belonging to five families (Vespertilionidae, Noctilionidae, Mormoopidae, Phyllostomidae, and Molossidae) and 13 species (Rhogeessa aeneus, Noctilio leporinus, Pteronotus davyi, P. parnellii, Artibeus jamaicensis, A. lituratus, A. phaeotis, Glossophaga soricina, Carollia sowelli, Chiroderma villosum, Uroderma bilobatum, Sturnira parvidens, and Molossus rufus) were captured. Infection frequency by PCR was 30,2% (26/86) detected only in the renal tissue. The infected species were P. parnellii, G. soricina, A. lituratus, A. jamaicensis, S. parvidens, C. villosum, and R. aeneus. Conclusions: Our results confirmed the participation of several bat species as hosts in the T. cruzi transmission cycle in the region. Further studies are necessary to establish the importance of these animals in the zoonotic transmission of T. cruzi.

Resumen | Introducción. Los murciélagos se han reportado como huéspedes del protozoario Trypanosoma cruzi, agente etiológico de la tripanosomiasis americana, enfermedad zoonótica endémica en México. Objetivo. Describir la infección con T. cruzi en murciélagos capturados en los estados de Campeche y Yucatán, México. Materiales y métodos. Se realizaron capturas de marzo a noviembre de 2017 en tres sitios de Yucatán y uno de Campeche. Para la captura se emplearon hasta cuatro redes de niebla por dos noches consecutivas. Se identificó la especie de los murciélagos capturados y se les practicó la eutanasia para recolectar muestras de riñón y corazón, utilizadas posteriormente en la extracción de ADN total. La infección con T. cruzi se detectó por la amplificación con PCR convencional de un fragmento perteneciente al ADN nuclear de T. cruzi. Resultados. Se capturaron 86 murciélagos pertenecientes a cinco familias (Vespertilionidae, Noctilionidae, Mormoopidae, Phyllostomidae, Molossidae) y 13 especies (Rhogeessa aeneus, Noctilio leporinus, Pteronotus davyi, P. parnellii, Artibeus jamaicensis, A. lituratus, A. phaeotis, Glossophaga soricina, Carollia sowelli, Chiroderma villosum, Uroderma bilobatum, Sturnira parvidens y Molossus rufus). La PCR mostró una frecuencia de infección de 30,2 % (26/86), detectada únicamente en tejido renal. Las especies infectadas fueron P. parnellii, G. soricina, A. lituratus, A. jamaicensis, S. parvidens, C. villosum y R. aeneus. Conclusiones. Los resultados confirmaron la participación de varias especies de murciélagos como huéspedes en el ciclo de transmisión de T. cruzi en la región. Es necesario realizar más estudios para determinar la importancia de estos animales en la transmisión zoonótica de T. cruzi.

West Nile and Zika viruses in bats from a suburban area of Merida, Yucatan, Mexico.

Infections with viruses of the Flavivirus genus were explored in 22 bats (Artibeus jamaicensis) from Merida, Yucatan, Mexico. The detection of the viral genus was performed by RT-PCR, and infections with dengue (DENV 1-4), West Nile (WNV) and Zika (ZIKV) viruses were subsequently explored. Sequences from positive products were analysed using the BLAST algorithm to determine identity. In 7 (31.8%) and 2 (9.1%) bats, WNV and ZIKV were identified, respectively. The bioinformatic analysis showed 98%-100% coverage and identity for both viruses. Molecular evidence of WNV and ZIKV natural infection in bats from Yucatan, Mexico, is presented.

Toxoplasma gondii infection in Colombia with a review of hosts and their ecogeographic distribution.

Toxoplasma gondii is one of the most prevalent zoonotic protozoan parasites among warm-blooded animal populations (humans included) around the world, causing multiple clinic manifestations including death in the most severe cases of infection. Due to the versatile life cycle of T. gondii and its diversity of potential hosts, there is a common perception that natural areas and wildlife are highly prevalent reservoirs for the parasite; however, information and reports of the parasite on wildlife populations in Colombia are scarce. Using PRC-based detection analyses of the B1 gene, we evaluated the presence of T. gondii in 49 native small mammal species (10% of the mammal species of Colombia) from 4 different undisturbed natural habitats. Additionally, to understand the ecogeographical distribution of the parasite in Colombia, we developed a literature search of infection reports including information on the host species, density of records and occurrence patterns (using landcover and ecoregions) in natural, rural and urban areas. Our literature review showed a total of 8,103 reports of T. gondii for Colombia of which 86% were related to humans, and 14% to non-human mammals and other categories, with just a single report associated to wildlife; additionally, 82% of all reports were associated to urban areas whereas only 18% to rural sites. Based on the negative results for the presence of T. gondii in our PCR-based analyses and our literature search, we suggest that T. gondii has a synanthropic distribution in Colombia occurring in ecoregions as variable as the xeric scrubs in the northern lowlands and humid montane Andean forests, also we show a lack of information on the parasite relationship with wildlife, a concerning fact given that zoonoses are the leading mechanism for the emergence of infectious diseases.

Correction to: A Nonsense N -Terminus NFKB2 Mutation Leading to Haploinsufficiency in a Patient with a Predominantly Antibody Deficiency.

Due to typesetting mistake, the caption of Figure 2 was mistakenly replaced with the caption of Figure 3.

A Nonsense N -Terminus NFKB2 Mutation Leading to Haploinsufficiency in a Patient with a Predominantly Antibody Deficiency.

The noncanonical NF-κB pathway is implicated in diverse biological and immunological processes. Monoallelic C-terminus loss-of-function and gain-of-function mutations of NFKB2 have been recently identified as a cause of immunodeficiency manifesting with common variable immunodeficiency (CVID) or combined immunodeficiency (CID) phenotypes. Herein we report a family carrying a heterozygous nonsense mutation in NFKB2 (c.809G > A, p.W270*). This variant is associated with increased mRNA decay and no mutant NFKB2 protein expression, leading to NFKB2 haploinsufficiency. Our findings demonstrate that bona fide NFKB2 haploinsufficiency, likely caused by mutant mRNA decay and protein instability leading to the transcription and expression of only the wild-type allele, is associated with clinical immunodeficiency, although with incomplete clinical penetrance. Abnormal B cell development, hypogammaglobulinemia, poor antibody response, and abnormal noncanonical (but normal canonical) NF-κB pathway signaling are the immunologic hallmarks of this disease. This adds a third allelic variant to the pathophysiology of NFKB2-mediated immunodeficiency disorders.

Leptospira patógena en murciélagos de Campeche y Yucatán, México / Pathogenic Leptospira in bats from Campeche and Yucatán, Mexico

RESUMEN Objetivo. Reportar la infección con Leptospira en ríñones de murciélagos de Campeche y Yucatán, México, a través de la amplificación por PCR de dos fragmentos distintos del gen 16S RNA ribosomal. Materiales y métodos. Se realizaron capturas en un sitio de Campeche y dos de Yucatán. A los murciélagos capturados se les aplicó la eutanasia y se les realizó una necropsia para recolectar tejido renal que se usó en la extracción de ADN total. Se realizaron dos PCR convencionales para la amplificación de los fragmentos de 16S RNA ribosomal. Se obtuvieron las secuencias de algunos productos positivos y se analizaron con herramientas bioinformáticas para identificar la especie infectante de Leptospira. Resultados. Se capturaron 69 murciélagos pertenecientes a cuatro familias y a ocho especies distintas. La familia con mayor diversidad fue Phyllostomidae con cinco especies. La especie con mayor frecuencia de captura fue Artibeusjamaicensis (41, 59.4%). Las PCR arrojaron una frecuencia global de infección de 21.7%. Las especies infectadas fueron A. jamaicensis, Pteronotus parnellii y Chiroderma villosum. El análisis bioinformático arrojó un 99.0% de identidad para Leptospira noguchii, Leptospira borgpetersenii y Leptospira santarosai. Conclusiones. Algunas especies de murciélagos de Yucatán y Campeche son portadores renales de leptospiras patógenas, por lo que podrían participar en el ciclo silvestre de transmisión en la región. La frecuencia de infección encontrada en los riñones de los murciélagos utilizados es mayor en comparación con aquellas obtenidas en otros reservorios de Yucatán y Campeche. Nuevas especies de murciélagos son reportadas como portadores de Leptospira para México.

ABSTRACT Objective. To report the infection with Leptospira in the kidneys of bats from Campeche and Yucatán, Mexico, through the amplification by PCR of two different 16S RNA ribosomal gene fragments. Materials and methods. Bat captures were carried out at one site in Campeche and two sites in Yucatán. Euthanasia was applied to the captured bats and a necropsy was performed to collect a renal tissue sample that was used in the total DNA extraction. Two different conventional PCR were performed for the amplification of the 16S RNA ribosomal gene fragments. Some sequences from positive products were obtained and analyzed with bioinformatics tools to identify the infectious species of Leptospira. Results. Sixty-nine bats belonging to four families and eight different species were captured. The family with the greatest diversity was Phyllostomidae with five species. The most captured species was Artibeus jamaicensis (41, 59.4%). Both PCR showed a global infection frequency of 21.7%. The infected species were A. jamaicensis, Pteronotus parnellii, and Chiroderma villosum. The bioinformatic analysis of the positive products yielded a 99.0% identity for Leptospira noguchii, Leptospira borgpetersenii, and Leptospira santarosai. Conclusions. Some bat species of Yucatán and Campeche, Mexico, are renal carriers of pathogenic Leptospira, therefore participating in the transmission cycle in the region. The frequency of infection found in the renal tissue of the captured bats is higher than the one obtained from other reservoirs captured in Yucatán and Campeche. New species of bats are reported as renal Leptospira carriers in Mexico.

New molecular target for the phylogenetic identification of Leptospira species directly from clinical samples: an alternative gene to 16S rRNA.

INTRODUCTION: Phylogenetic analysis of the 16S ribosomal gene initial region is used to identify Leptospira isolates at the species level from clinical samples. Unfortunately, this method cannot differentiate between some intermediates and saprophytic species. METHODS: We used comparative genomic analysis between 35 Leptospira species to find new molecular targets for Leptospira species identification. RESULTS: We proposed the use of the rpoC gene, encoding the DNA-directed RNA polymerase ß-subunit, for identifying 35 Leptospira species. CONCLUSIONS: The rpoC gene can be a molecular target to identify the main species of the Leptospira genus directly from clinical samples.

Deficiencia selectiva de inmunoglobulina A: manifestaciones clínicas, hallazgos de laboratorio y diagnóstico preciso / Selective Immunoglobulin A deficiency: clinical manifestations, laboratory findings and accurate diagnosis

Resumen La inmunoglobulina A (IgA) es el isotipo de anticuerpo más abundante en los humanos y fundamentalmente participa en la defensa contra las infecciones y el desarrollo de la tolerancia inmune en las mucosas. La deficiencia de IgA es la inmunodeficiencia más frecuente en humanos, pero comúnmente es asintomática y transitoria. Para diagnosticarla, se cuantifica la concentración de IgA en sangre y se evalúa la magnitud de su disminución. De acuerdo con esta evaluación se clasifica en deficiencia parcial (DPIgA) o deficiencia total (DTIgA). Adicionalmente, si solo se afectan los niveles de IgA sin alteraciones de otras inmunoglobulinas séricas como IgM e IgG o subclases de inmunoglobulina G, entonces se denomina como deficiencia selectiva de IgA (DSIgA). La deficiencia selectiva de IgA es de mayor relevancia clínica y considerada un error innato de la inmunidad, aunque su etiología aún es desconocida y clínicamente se asocia a infecciones de los tractos respiratorio y gastrointestinal, alergias y manifestaciones autoinmunes. Se realizó una búsqueda de artículos científicos en PubMed, Scopus, SciELO y Redalyc sobre la deficiencia selectiva de inmunoglobulina A, con el objetivo de realizar una revisión temática sobre las manifestaciones clínicas, el diagnóstico y el adecuado manejo clínico de los pacientes con esta inmunodeficiencia. Se propone un nuevo algoritmo clínico con el objetivo de mejorar el diagnóstico y brindar un adecuado manejo clínico de los pacientes con esta inmunodeficiencia. Un paciente con deficiencia selectiva de IgA se caracteriza por infecciones recurrentes de los tractos gastrointestinal y respiratorio, en asociación con manifestaciones alérgicas y autoinmunes en individuos mayores de cuatro años, con niveles de IgA sérica menores de 7 mg/dL y con niveles normales de IgG e IgM, y en quienes se hayan descartado defectos relacionados con los linfocitos T u otras causas de hipogammaglobulinemia. Con respecto al manejo clínico, se deben ajustar los esquemas de vacunación e implementar profilaxis antibiótica en las infecciones graves y recurrentes. Para mejorar el pronóstico se debe realizar una atención del paciente por un equipo médico interdisciplinario y un seguimiento continuo por un prolongado periodo de tiempo.

Abstract Immunoglobulin A (IgA) is the most abundant antibody isotype in humans and participates in protection against infections and the development of immune tolerance in mucous membranes. IgA deficiency is the most common immunodeficiency in humans, but it is commonly asymptomatic and transient. To diagnose it, the concentration of IgA in blood is quantified and the magnitude of its decrease is evaluated. According to this evaluation, it is classified as partial deficiency (DPIgA) or total deficiency (DTIgA). Additionally, if only IgA levels are affected without alterations in other serum immunoglobulins such as IgM and IgG or subclasses of IgG, then it is referred to as selective IgA deficiency (DSIgA). Selective IgA deficiency is of greater clinical relevance and considered an innate immunity error, although its etiology is still unknown. This immunodeficiency is clinically associated with respiratory and gas- trointestinal tract infections, allergies and autoimmune manifestations. A search of scientific articles was conducted in bibliographic databases PubMed, Scopus, SciELO and Redalyc on selective immunoglobulin A deficiency. Our objective was to perform a review on clinical manifestations, diagnosis, and appropriate clinical management of patients with this immunodeficiency. A new clinical algorithm is proposed in order to improve the diagnosis and provide adequate clinical management of patients with this immunodeficiency. A patient with selective IgA deficiency is characterized by recurrent infections of the gastrointestinal and respiratory tracts, in association with allergic and autoimmune manifestations in individuals older than four years. Serum IgA levels are less than 7 mg/dL, with normal levels of IgG and IgM, and defects related to T lymphocytes or other causes of hypogammaglobulinemia have been ruled out. Regarding clinical management, vaccination schedules should be adjusted and antibiotic prophylaxis should be implemented in severe and recurrent infections. Additionally, to improve prognosis, patient care should be performed by an interdisciplinary medical team and continuous monitoring for a prolonged period of time.

New molecular target for the phylogenetic identification of Leptospira species directly from clinical samples: an alternative gene to 16S rRNA

Abstract INTRODUCTION: Phylogenetic analysis of the 16S ribosomal gene initial region is used to identify Leptospira isolates at the species level from clinical samples. Unfortunately, this method cannot differentiate between some intermediates and saprophytic species. METHODS: We used comparative genomic analysis between 35 Leptospira species to find new molecular targets for Leptospira species identification. RESULTS: We proposed the use of the rpoC gene, encoding the DNA-directed RNA polymerase β-subunit, for identifying 35 Leptospira species. CONCLUSIONS: The rpoC gene can be a molecular target to identify the main species of the Leptospira genus directly from clinical samples.

Infección con Toxoplasma gondii (Eucoccidiorida: Sarcocystidae) en murciélagos de Campeche y Yucatán, México

Toxoplasma gondii es un protozoario parásito reconocido como el agente causal de la toxoplasmosis, enfermedad zoonótica que afecta a humanos y animales domésticos o silvestres. En México, representa un problema de salud pública y veterinaria, sobre todo en regiones con climas tropicales y subtropicales. Los murciélagos han sido identificados como hospederos accidentales en el ciclo de transmisión; no obstante, en México no existe información previa; por lo tanto, el objetivo del presente estudio es reportar la infección con T. gondii en murciélagos capturados en sitios de los estados de Campeche y Yucatán, México. Se capturaron murciélagos en dos sitios de Yucatán y uno de Campeche, ubicados en la Península de Yucatán. Se recolectaron riñones, bazo e hígado y se emplearon en la extracción de ADN total. La infección con T. gondii se detectó a través de la amplificación de un fragmento del gen B1, utilizando PCR anidada. Los productos positivos fueron purificados y enviados a secuenciación para su posterior análisis de alineamiento; adicionalmente, se construyó un árbol filogenético. Se analizaron un total de 69 murciélagos pertenecientes a ocho especies distintas: 41 (59.4 %, 41/69) Artibeus jamaicensis; seis (8.7 %, 6/69) Pteronotus parnellii; seis (8.7 %, 6/69) Noctilio leporinus; seis (8.7 %, 6/69) Chiroderma villosum; cuatro (5.8 %, 4/69) Glossophaga soricina; dos (2.9 %, 2/69) Carollia sowelli; dos (2.89 %, 2/69) Artibeus lituratus y dos (2.9%, 2/69) Rhogeessa aeneus. La PCR anidada identificó ocho (11.6 %, 8/69) murciélagos positivos a la infección: seis (75 %, 6/8) A. jamaicensis, capturados en X'matkuil y Panabá, un (12.5 %, 1/8) G. soricina y un (12.5 %, 1/8) C. villosum, ambos capturados en Panabá. El análisis de alineamiento arrojó 99-100 % para cobertura y 97-99 % para identidad respecto a secuencias de T. gondii. Nuestros resultados aportan al entendimiento del ciclo de transmisión de T. gondii en la región; sin embargo, son necesarias investigaciones futuras para determinar los genotipos circulantes, ya que estudios anteriores han demostrado que estos animales pueden estar infectados con genotipos identificados en otros animales domésticos o silvestres e incluso en humanos.

Toxoplasma gondii is a protozoan parasite recognized as the causative agent of toxoplasmosis, a zoonotic disease that affects humans and domestic or wild animals. In Mexico, it represents a public and animal health problem, especially in regions with tropical and subtropical climates. Bats have been reported as accidental hosts in the transmission cycle; however, there is no preceding information in Mexico. Therefore, the aim of the present study is to report the T. gondii infection in bats captured in sites of Campeche and Yucatan states, Mexico. Bats were captured in two sites in Yucatan (X'matkuil and Panaba) and one in Campeche (Hampolol), located in the Yucatan Peninsula. Kidneys, spleen, and liver were collected and used in the total DNA extraction. Toxoplasma gondii infection was detected through the amplification of a B1 gene fragment, using nested PCR. The positive PCR products were purified and sent to sequencing for a posterior sequence identity analysis. Additionally, a phylogenetic tree was made. A total of 69 bats belonging to eight different species were processed: 41 (59.4 %, 41/69) Artibeus jamaicensis; six (8.7 %, 6/69) Pteronotus parnellii; six (8.7 %, 6/69) Noctilio leporinus; six (8.7 %, 6/69) Chiroderma villosum; four (5.8 %, 4/69) Glossophaga soricina; two (2.9 %, 2/69) Carollia sowelli; two (2.89 %, 2/69) Artibeus lituratus; and two (2.9 %, 2/69) Rhogeessa aeneus. The nested PCR identified eight (11.6 %, 8/69) infected bats: six (75 %, 6/8) A. jamaicensis, captured in X'matkuil and Panaba, one (12.5 %, 1/8) G. soricina, and one (12.5 %, 1/8) C. villosum, both captured in Panaba. The alignment analysis yielded 99-100 % for cover and 97-99 % for identity to T. gondii sequences. Our results contribute to the understanding of the T. gondii transmission cycle in the region; however, future research is needed to determine circulating genotypes, as previous studies have demonstrated that these animals might be infected with identified genotypes in other domestic or wild animals and even in humans.

Feasibility and Outcomes of an Electronic Health Record Intervention to Improve Hypertension Management in Immigrant-serving Primary Care Practices.

BACKGROUND: South Asians experience a disproportionate burden of high blood pressure (BP) in the United States, arguably the most preventable risk factor for cardiovascular disease. OBJECTIVE: We report 12-month results of an electronic health record (EHR)-based intervention, as a component of a larger project, "Implementing Million Hearts for Provider and Community Transformation." The EHR intervention included launching hypertension patient registries and implementing culturally tailored alerts and order sets to improve hypertension control among patients treated in 14 New York City practices located in predominantly South Asian immigrant neighborhoods. DESIGN: Using a modified stepped-wedge quasi-experimental study design, practice-level EHR data were extracted, and individual-level data were obtained on a subset of patients insured by a Medicaid insurer via their data warehouse. The primary aggregate outcome was change in proportion of hypertensive patients with controlled BP; individual-level outcomes included average systolic BP (SBP) and diastolic BP (DBP) at last clinic visit. Qualitative interviews were conducted to assess intervention feasibility. MEASURES: Hypertension was defined as having at least 1 hypertension ICD-9/10 code. Well-controlled hypertension was defined as SBP<140 and DBP<90 mm Hg. RESULTS: Postintervention, we observed a significant improvement in hypertension control at the practice level, adjusting for age and sex patient composition (adjusted relative risk, 1.09; 95% confidence interval, 1.04-1.14). Among the subset of Medicaid patients, we observed a significant reduction in average SBP and DBP adjusting for time, age, and sex, by 1.71 and 1.13 mm Hg, respectively (P<0.05). Providers reported feeling supported and satisfied with EHR components. CONCLUSIONS: EHR initiatives in practices serving immigrants and minorities may enhance practice capabilities to improve hypertension control.

Brotes emergentes de leptospirosis del Amazonas colombiano / Emerging leptospirosis outbreaks in the Colombian Department of Amazonas

Se describe por primera vez una serie de nueve casos con clínica indicativa de leptospirosis en el municipio Puerto Nariño en el departamento Amazonas, Colombia. Se muestran evidencias serológicas de exposición con Rickettsia del grupo de las fiebres manchadas. Los casos fueron clínicamente considerados como síndrome febril de origen desconocido. Se descartó infección por dengue y malaria. El diagnóstico de Leptospira se realizó mediante el método de reacción en cadena de la polimerasa en tiempo real. Igualmente, se detectó la presencia de anticuerpos contra rickettsias del grupo de las fiebres manchadas por inmunofluorescencia Indirecta. Finalmente, se realiza revisión del tema(AU)

A description is provided for the first time of a series of nine cases with a clinical examination suggestive of leptospirosis in the municipality of Puerto Nariño, Department of Amazonas, Colombia. Serological evidence is presented of exposure to Rickettsia, spotted fever group. The cases were clinically considered as febrile syndrome of unknown origin. Infection with dengue or malaria was ruled out. Diagnosis of leptospirosis was achieved by real-time polymerase chain reaction. Additionally, indirect immunofluorescence detected the presence of antibodies against rickettsia, spotted fever group. Finally, a review was conducted about the topic(AU)