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1.
Euro Surveill ; 24(7)2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30782267

RESUMO

IntroductionEnterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions.AimOur objective was to investigate the epidemiology and clinical characteristics of the outbreak.MethodsWe carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3'-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries.ResultsMost EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported.ConclusionAn emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases.

2.
Biol Blood Marrow Transplant ; 25(5): 1022-1030, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30639821

RESUMO

The current study evaluates the clinical effect of sirolimus exposure on the occurrence of cytomegalovirus (CMV) DNAemia necessitating preemptive antiviral therapy. A total of 167 consecutive recipients of reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT) who received sirolimus- and tacrolimus-based graft-versus-host disease (GVHD) prophylaxis and whose CMV serostatus was positive for donors and/or recipients were included in this multicenter retrospective study. A parametric model with consecutive sirolimus blood levels describing the time to CMV DNAemia-RAT was developed using NONMEM version 7.4. Overall, 122 of 167 patients (73%) were allografted from an unrelated donor, and the donor CMV-serostatus was negative in 51 cases (31%). Fifty-six recipients (34%) developed CMV DNAemia necessitating preemptive therapy, with a cumulative incidence of 36% at a median follow-up of 25 months. Time to CMV DNAemia necessitating preemptive therapy was best described using a Gompertz function. CMV DNAemia necessitating preemptive therapy-predicting factors were antithymocyte globulin-based conditioning regimen (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1 to 4.1; P < .01) and sirolimus concentration (HR, .94; 95% CI, .87 to .99; P < .01). The risk of CMV DNAemia-RAT decreased by 6% for each 1 ng/mL increase in sirolimus trough concentration. In conclusion, we provide evidence on the association between sirolimus blood concentration and incidence of CMV DNAemia necessitating preemptive therapy in allo-HSCT recipients. Moreover, this study presents the first predictive model describing the time to CMV DNAemia necessitating preemptive antiviral therapy as a function of sirolimus drug concentration.

3.
Euro Surveill ; 23(47)2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30482263

RESUMO

Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000-0.78/100,000). Two periods (P) are described: P1 (1998-2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007-2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain-Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.

4.
An. pediatr. (2003. Ed. impr.) ; 88(2): 82-88, feb. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172007

RESUMO

Introducción: Los parechovirus humanos (HPeV) son virus de la familia Picornaviridae, recientemente descritos, a los que se atribuyen cuadros de fiebre sin foco (FSF), sepsis clínica, gastroenteritis, meningitis o encefalitis fundamentalmente en lactantes pequeños. Nuestro objetivo fue describir la epidemiología y las características clínicas de las infecciones por HPeV en nuestro medio. Pacientes y métodos: Estudio multicéntrico prospectivo, llevado a cabo en 12 hospitales a nivel nacional, entre 2013-2015, en niños < 3 años con FSF, sepsis clínica o patología neurológica. Se realizó determinación de HPeV mediante RT-PCR en el Centro Nacional de Microbiología en suero, heces o líquido cefalorraquídeo. Resultados: Se analizan 47 infecciones por HPeV de un total de 850 muestras (5,52%), siendo HPeV-3 el más frecuente (29 casos), con predominio en mayo y julio, con una distribución bienal. El 57% eran neonatos y solo 2 > 3 meses. Todos los pacientes presentaron fiebre, el 45% irritabilidad, el 18,6% exantema y el 14% diarrea. No se observa ninguna alteración específica en las pruebas bioquímicas. El diagnóstico final más frecuente fue FSF (61%) seguido de sepsis clínica (29%). Aunque un 29% de los niños precisaron ingreso en cuidados intensivos, solo un paciente presentó secuelas. Conclusiones: Los HPeV circulan en nuestro país, afectando fundamentalmente a lactantes < 2 meses y se asocian a FSF y sepsis clínica, con un predominio en primavera y verano. Sería de interés implementar las técnicas moleculares de diagnóstico en todos los hospitales para reconocer y manejar adecuadamente estas infecciones (AU)


Introduction: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. Patients and methods: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5.52%), with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Results: Out of 850 specimens examined, 47 were positive (5.52%) for HPeV, with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Conclusions: HPeV circulates in our country, mainly during spring and summer, and affects young infants with a FUO and clinical sepsis. Molecular diagnostic techniques in all hospitals could help in improving the management of patients with these infections (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Parechovirus/patogenicidade , Infecções por Picornaviridae/epidemiologia , Estudos Prospectivos , Sepse/epidemiologia , Meningites Bacterianas/epidemiologia , Gastroenterite/epidemiologia , Encefalite/epidemiologia
5.
An Pediatr (Barc) ; 88(2): 82-88, 2018 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-28365283

RESUMO

INTRODUCTION: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. PATIENTS AND METHODS: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5.52%), with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. RESULTS: Out of 850 specimens examined, 47 were positive (5.52%) for HPeV, with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae CONCLUSIONS: HPeV circulates in our country, mainly during spring and summer, and affects young infants with a FUO and clinical sepsis. Molecular diagnostic techniques in all hospitals could help in improving the management of patients with these infections.

7.
J Med Virol ; 89(3): 435-442, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27505281

RESUMO

The epidemiology and clinical association of enterovirus (EV) and parechovirus (HPeV) infections, as well as the type-distribution-according-to-age, were determined during a 4-year study period in Spain. During 2010-2013, a total of 21,832 clinical samples were screened for EV and the detection frequency was 6.5% (1,430). Of the total EV-negative samples, only 1,873 samples from 2011 to 2013 were available for HPeV testing. HPeV was detected in 42 (2%) of them. Positive samples were genotyped using PCR and sequencing. EV infections occurred in all age groups of patients: neonates (17%), children 28 days to 2 years (29%), children 2-14 years (40%), and adults (14%). Thirty-four different EV types were identified. HPeV infections were detected exclusively in infants <8 m (70% neonates, P < 0.05). All but one HPeV were HPeV-3. Differences in type frequency detection were found according to age and clinical manifestation. Coxsackievirus (CV)-B4 (61%), CV-B5 (83%), and HPeV-3 (64%) were more frequent in neonates than in older patients (P < 0.05). Echovirus (E)-3 (60%), E-18 (47%), E-25 (62%), CV-A6 (61%), CV-A16 (72%), and EV-71 (75%) were mainly detected in children 28 days to 2 years (P < 0.05), whereas, E-6 (79%), E-20 (88%), and E-30 (85%) were predominant in children >2 years and adults (P < 0.05). Clinically, meningitis was associated with EV (P < 0.01) whereas, encephalitis was more frequent in HPeV-infected patients. CV-B types were associated with myocarditis (90%; P < 0.05) and EV species A with hand-foot-mouth-disease/atypical exanthema (88%; P < 0.05). J. Med. Virol. 89:435-442, 2017. © 2016 Wiley Periodicals, Inc.


Assuntos
Infecções por Enterovirus/epidemiologia , Enterovirus/classificação , Enterovirus/genética , Genótipo , Parechovirus/classificação , Parechovirus/genética , Infecções por Picornaviridae/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Enterovirus/isolamento & purificação , Infecções por Enterovirus/patologia , Infecções por Enterovirus/virologia , Feminino , Técnicas de Genotipagem , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Parechovirus/isolamento & purificação , Infecções por Picornaviridae/patologia , Infecções por Picornaviridae/virologia , Reação em Cadeia da Polimerase , Prevalência , Análise de Sequência de DNA , Espanha/epidemiologia , Adulto Jovem
8.
Arch Virol ; 161(5): 1365-70, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26898312

RESUMO

Epidemiological and clinical characteristics of coxsackievirus B3 infections in Spain were investigated. This enterovirus (EV) type was detected mainly in young children (<6 months) and was associated with neurological (78 %) and respiratory diseases (10 %) but also with myo/pericarditis (10 %). Two myocarditis cases were fatal. Phylogenetic analysis of the VP1 region showed that genotype III circulated in the country between 2004 and 2008 and was replaced by genotype V in 2010. Furthermore, phylogenetic analysis of the 3D region indicated that recombination events have occurred and contributed to the genetic evolution of this EV type.


Assuntos
Infecções por Coxsackievirus/epidemiologia , Enterovirus Humano B/genética , Infecções por Coxsackievirus/patologia , Infecções por Coxsackievirus/virologia , Humanos , Lactente , Recém-Nascido , Epidemiologia Molecular , Filogenia , Espanha/epidemiologia
9.
J Med Virol ; 88(1): 45-50, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26100363

RESUMO

Molecular techniques have represented a major step forward in the diagnosis of viral respiratory infections. They are considered highly sensitive and specific compared to conventional techniques. In this study two nucleic acid amplification tests (NAATs) were compared to conventional methods (immunofluorescence and viral culture). The aim of this work was to discuss the clinical interpretation of the results obtained by NAATs on the basis of the two-decade experience of our group and the literature. Eighty nasopharyngeal aspirates were collected from children under six years attended for acute respiratory illness at the pediatric emergency room of a third level Hospital. Both NAATs tested (Seeplex(®) and Clart(®)) showed an overall higher performance regarding sensitivity (76% and 90%, respectively). Compared to Seeplex(®), the Clart(®) system tripled the number of multiple detections (8 by Seeplex(®) vs. 25 by Clart(®)). In some specimens both NAATs detected different viruses. Given these discrepancies and the fact that detection of viral nucleic acids is not necessarily related to the current clinical syndrome, the interpretation of molecular results may not always be so straightforward. The pros and cons of NAATs should always be taken into account when giving a result.


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Infecções Respiratórias/diagnóstico , Vírus/classificação , Vírus/isolamento & purificação , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Nasofaringe/virologia , Infecções Respiratórias/virologia , Sensibilidade e Especificidade , Vírus/genética
10.
Eur J Pediatr ; 174(11): 1511-6, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25982340

RESUMO

UNLABELLED: Human parechoviruses (HPeV) have been recently recognized as important viral agents in paediatric infections. The aims of this study were to investigate the HPeV infection prevalence in infants <1 month in Spain and, secondly, to analyse the clinical and epidemiological characteristics of the infected patients compared with those infected by enterovirus (EV). Infants <1 month with neurological or systemic symptoms were included in a multicentre prospective study. EV and HPeV detection by RT-PCR and genotyping were performed in cerebrospinal fluids (CSF), sera or throat swabs. Out of the total of 84 infants studied during 2013, 32 were EV positive (38 %) and 9 HPeV positive (11 %). HPeV-3 was identified in eight cases and HPeV-5 in one. Mean age of HPeV-positive patients was 18 days. Diagnoses were fever without source (FWS) (67 %), clinical sepsis (22 %) and encephalitis (11 %). Leukocytes in blood and CSF were normal. Pleocytosis (p = 0.03) and meningitis (p = 0.001) were significantly more frequent in patients with EV infections than with HPeV. CONCLUSIONS: Although HPeV-3 infections were detected less frequently than EV, they still account for approximately 10 % of the cases analysed in infants younger than 1 month. HPeV-3 was mainly associated with FWS and without leukocytosis and pleocytosis in CSF. In these cases, HPeV screening is desirable to identify the aetiologic agent and prevent unnecessary treatment and prolonged hospitalization.


Assuntos
Encefalite Viral/epidemiologia , Infecções por Enterovirus/epidemiologia , Enterovirus/isolamento & purificação , Parechovirus/isolamento & purificação , Infecções por Picornaviridae/epidemiologia , Viremia/epidemiologia , Encefalite Viral/diagnóstico , Encefalite Viral/virologia , Enterovirus/genética , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/virologia , Feminino , Genótipo , Humanos , Recém-Nascido , Masculino , Parechovirus/genética , Infecções por Picornaviridae/diagnóstico , Infecções por Picornaviridae/virologia , Prevalência , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Espanha/epidemiologia , Viremia/diagnóstico , Viremia/virologia
11.
J Virol Methods ; 208: 125-8, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25152526

RESUMO

Human enteroviruses (EVs) and parechoviruses (HPeVs) are important etiological agents causing infections such as meningitis, encephalitis and sepsis-like disease in neonates and young children. We have developed a real-time RT-PCR for simultaneous detection of EV and HPeV in clinical samples. Primers and probe sets were designed from the conserved 5'-noncoding region of the genomes. The sensitivity, specificity and reproducibility of the technique were measured using a set of 25 EV and 6 HPeV types. All EVs but no HPeVs were detected with the EV primers-probe set. The HPeV primers-probe set detected only the 6 HPeV types. The lower detection limit was found to be 4 and 40CCID50/ml for HPeV and EV respectively, demonstrating high sensitivity of the technique for both viruses. The threshold cycle values were highly reproducible on repeat testing of positive controls among assay runs. The assay was evaluated in 53 clinical samples of suspected meningitis, sepsis or febrile syndromes from children under 3 years. In 11 of these (21%) EVs were detected, while 4, i.e. 7.5%, were HPeV positive. Molecular typing was carried out for 73% of the viruses. In summary, the RT-PCR method developed demonstrated effectively both EV and HPeV detection, which can cause similar clinical symptoms in infants.


Assuntos
Enterovirus/isolamento & purificação , Técnicas de Diagnóstico Molecular/métodos , Parechovirus/isolamento & purificação , Infecções por Picornaviridae/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Pré-Escolar , Primers do DNA/genética , Enterovirus/classificação , Enterovirus/genética , Humanos , Lactente , Sondas de Oligonucleotídeos/genética , Parechovirus/classificação , Parechovirus/genética , Infecções por Picornaviridae/virologia , RNA não Traduzido/genética , RNA Viral/genética , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
12.
J Med Virol ; 85(1): 116-20, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23124895

RESUMO

Cell culture is still the gold standard for the diagnosis of human enteroviruses (HEVs) although molecular techniques are required for detection of some serotypes. Due to the diversity of HEVs, a single cell line is not susceptible to all serotypes, and several lines are required to optimize the isolation of HEVs. In this study, the results of HEV isolation during the last 25 years are reported. A total of 1,192 HEVs were isolated and isolation rates varied depending on the cell line used. MRC5 cells yielded the best results (70.7%), followed by A549 cells (52.6%), RD cells (37.5%), and HEp-2 cells (29.7%). A total of 521 HEVs were characterized, and HEV-B was the most frequent species (81%). Polioviruses (PV) and HEV-A were isolated less frequently (17% and 1%, respectively). None of the cell lines detected all the enteroviruses. MRC5 cells were the most susceptible for isolation of echoviruses (85.7%) and PVs (85.4%), whereas HEp2 was the most susceptible for Coxsackieviruses B (82.6%). Some serotypes were isolated in one cell line only. 40.5% of echoviruses were isolated in MRC5 cells whereas 42.3% and 23.9% of Coxsackieviruses B were isolated in RD cells and HEp2 cells, respectively. Although A549 cells did not achieve the best performance for any enterovirus serotypes, they isolated 52.6% of the total HEVs. In view of these results, MRC5 cells, A549 cells, and RD cells should be combined to optimize isolation of HEVs.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/virologia , Enterovirus/crescimento & desenvolvimento , Enterovirus/isolamento & purificação , Virologia/métodos , Animais , Técnicas de Cultura de Células/métodos , Linhagem Celular , Humanos
13.
J Infect ; 67(1): 79-81, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23068448

RESUMO

We report a case of human herpesvirus 1 (HHV-1) meningoencephalitis in a patient who underwent trigeminal neuralgia surgery. Although this surgery has been reported to increase the risk of mucocutaneous HHV-1 recurrence, to our knowledge, an association between trigeminal surgery and HHV-1 encephalitis has not been previously described.


Assuntos
Herpes Simples/diagnóstico , Herpesvirus Humano 1/isolamento & purificação , Meningoencefalite/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Neuralgia do Trigêmeo/cirurgia , Idoso , Líquido Cefalorraquidiano/virologia , DNA Viral/líquido cefalorraquidiano , Herpes Simples/patologia , Herpes Simples/virologia , Humanos , Masculino , Meningoencefalite/patologia , Meningoencefalite/virologia , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/virologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-22745532

RESUMO

PURPOSE: Respiratory infection is the most common cause for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). The aim of this work was to study the etiology of the respiratory infection in order to assess the usefulness of the clinical and analytical parameters used for COPD identification. PATIENTS AND METHODS: We included 132 patients over a period of 2 years. The etiology of the respiratory infection was studied by conventional sputum, paired serology tests for atypical bacteria, and viral diagnostic techniques (immunochromatography, immunofluorescence, cell culture, and molecular biology techniques). We grouped the patients into four groups based on the pathogens isolated (bacterial versus. viral, known etiology versus unknown etiology) and compared the groups. RESULTS: A pathogen was identified in 48 patients. The pathogen was identified through sputum culture in 34 patients, seroconversion in three patients, and a positive result from viral techniques in 14 patients. No significant differences in identifying etiology were observed in the clinical and analytical parameters within the different groups. The most cost-effective tests were the sputum test and the polymerase chain reaction. CONCLUSION: Based on our experience, clinical and analytical parameters are not useful for the etiological identification of COPD exacerbations. Diagnosing COPD exacerbation is difficult, with the conventional sputum test for bacterial etiology and molecular biology techniques for viral etiology providing the most profitability. Further studies are necessary to identify respiratory syndromes or analytical parameters that can be used to identify the etiology of new AE-COPD cases without the laborious diagnostic techniques.


Assuntos
Doença Pulmonar Obstrutiva Crônica/microbiologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/virologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Escarro/microbiologia , Escarro/virologia , Irrigação Terapêutica
15.
Arch Virol ; 157(3): 551-4, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22193975

RESUMO

Enterovirus 99 is a recently described genotype of virus belonging to the species Human enterovirus C. So far, only a few sequences of this enterovirus type have been available. In 2010, during Spanish enterovirus surveillance, an enterovirus 99 strain was found in an acute flaccid paralysis patient. The virus was detected and typed in the clinical samples using molecular methods. Phylogenetic analysis in the 3Dpol region revealed recombination events with other species-C enteroviruses. This is the first finding of this unusual type in Spain.


Assuntos
Enterovirus Humano C/classificação , Enterovirus Humano C/isolamento & purificação , Infecções por Enterovirus/virologia , Pré-Escolar , Análise por Conglomerados , Enterovirus Humano C/genética , Infecções por Enterovirus/complicações , Feminino , Genótipo , Humanos , Dados de Sequência Molecular , Paralisia/virologia , Filogenia , RNA Viral/genética , Recombinação Genética , Análise de Sequência de DNA , Espanha , Proteínas Virais/genética
17.
Biol Blood Marrow Transplant ; 11(10): 781-96, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16182179

RESUMO

Respiratory viruses (RVs) are known to be major causes of morbidity and mortality in recipients of hematopoietic stem cell transplants (HSCTs), but prospective long-term studies are lacking. We prospectively screened all adult HSCT recipients (172 allogeneic [alloHSCT] and 240 autologous [autoHSCT]) who underwent transplantation during a 4-year period (1999 to 2003) for the development of a first episode of symptomatic upper respiratory tract infections and/or lower respiratory tract infections (LRTI) by an RV. RVs studied were influenza A and B viruses (n=39), human respiratory syncytial virus (n=19), human adenoviruses (n=11), human parainfluenza viruses 1 to 3 (n=8), human enteroviruses (n=5), human rhinoviruses (n=3), and the recently discovered human metapneumoviruses (n=19). During the study, 51 and 32 cases of RV symptomatic infections were identified of alloHSCT and autoHSCT recipients (2-year incidence, 29% and 14%, respectively). Risk factors for progression of upper respiratory tract infection to LRTI included severe (<0.2x10(9)/L) and moderate (<0.2x10(9)/L) lymphocytopenia in alloHSCT (P=.02) and autoHSCT (P=.03). Death from LRTI was attributed to an RV in 8 alloHSCT recipients. Symptomatic RV had no effect on 2-year outcomes, with the possible exception of influenza A and B virus infections in autoHSCT: these were associated with nonrelapse mortality (P=.02). In conclusion, this prospective trial allows an estimation of the minimum incidence of a first RV infection in adult HSCT recipients and identifies risk factors for acquisition of an RV infection and progression to LRTI; this should aid in the design of future studies. In addition, human metapneumovirus should be added to the potentially serious causes of RV infections in HSCT.


Assuntos
Neoplasias Hematológicas/complicações , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Adulto , Idoso , Saúde da Família , Feminino , Neoplasias Hematológicas/terapia , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Fatores de Risco , Fatores de Tempo , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento , Vírus/isolamento & purificação
18.
J Infect Dis ; 192(6): 1061-5, 2005 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-16107960

RESUMO

Human metapneumovirus (hMPV) is a recently described paramyxovirus associated with upper and lower respiratory-tract infection (URI and LRI, respectively). We conducted a prospective study of URI and LRI in adults with hematologic malignancies during a 4-year period. We retrospectively tested samples by reverse-transcription polymerase chain reaction for hMPV and analyzed clinical data. Twenty-two (9%) of 251 episodes of respiratory infection tested positive for hMPV. Sixteen (73%) of the illnesses occurred in hematopoietic stem-cell transplant recipients. Nine patients with hMPV developed LRI; 3 of these patients died. hMPV is a common cause of respiratory infections in adults with hematologic malignancies, with associated morbidity and mortality.


Assuntos
Neoplasias Hematológicas/complicações , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/virologia , Infecções Respiratórias/virologia , Adulto , Idoso , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Paramyxoviridae/complicações , Infecções por Paramyxoviridae/mortalidade , Estudos Prospectivos , Infecções Respiratórias/complicações , Infecções Respiratórias/mortalidade
19.
Clin Infect Dis ; 36(1): 1-8, 2003 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-12491194

RESUMO

During a 2-year period, 157 consecutive episodes of respiratory virus infections that occurred in 130 patients with upper or lower respiratory tract infection were analyzed for respiratory viruses. A respiratory virus was identified in 75 episodes (48%), and several viruses were found in 13 episodes: there were a total of 56 influenza A virus infections, 14 respiratory syncytial virus infections, 8 adenovirus infections, 8 infections with parainfluenza virus types 1 or 3, and 7 enterovirus infections. On multivariate analysis, the only variable that predicted progression to pneumonia in patients with an upper respiratory tract infection was the presence of respiratory syncytial virus, whereas lymphocytopenia had a nonsignificant trend. Also, among the 38 patients who had pneumonia at any time during the episode, both respiratory syncytial virus and lymphocytopenia were commonly found. For both epidemiological and therapeutic considerations, frequent screening for respiratory viruses should be incorporated into the routine diagnostic study of patients with hematologic malignancies.


Assuntos
Neoplasias Hematológicas/complicações , Infecções Respiratórias/virologia , Adenoviridae/isolamento & purificação , Adulto , Idoso , Progressão da Doença , Feminino , Seguimentos , Neoplasias Hematológicas/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Vírus da Parainfluenza 1 Humana/isolamento & purificação , Estudos Prospectivos , Vírus Sinciciais Respiratórios/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Fatores de Risco
20.
Pediatr Infect Dis J ; 21(3): 196-200, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12005081

RESUMO

BACKGROUND: Outbreaks of nosocomial influenza virus infections have been described rarely during childhood and even less so in the neonatal period. METHODS: We report 30 neonates admitted to 2 neonatal intensive care units with nosocomial influenza A virus infection, which occurred in 2 outbreaks during 1999. Risk factors for infection were evaluated, and control measures were adopted. Virus was detected by indirect immunofluorescence antibody screen. Any infant with nasopharyngeal aspirate positive for influenza A virus was considered infected. RESULTS: Of 95 infants screened 30 were positive for influenza A virus (31.5%). Mean birth weight was 1622 g, and mean gestational age was 31 weeks in the infected group. In the noninfected group mean birth weight was 2594 g and mean gestational age was 36.4 weeks. Low birth weight, short gestational age, twin pregnancy and mechanical ventilation were identified as risk factors for infection. Clinical symptoms were seen in 22, and 8 were asymptomatic. Clinical features were predominantly respiratory and digestive. The outcome was favorable in all cases. CONCLUSIONS: Infection by influenza virus has to be considered as a possible cause of nosocomial infection in the neonatal period. Control measures and prevention are important.


Assuntos
Surtos de Doenças , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/virologia , Vírus da Influenza A/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Unidades de Terapia Intensiva Neonatal , Peso ao Nascer , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/fisiopatologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Recém-Nascido/fisiopatologia , Doenças do Recém-Nascido/prevenção & controle , Influenza Humana/fisiopatologia , Influenza Humana/prevenção & controle , Masculino , Gravidez , Respiração Artificial , Fatores de Risco , Espanha/epidemiologia , Gêmeos
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