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The objectives of the study were to estimate the prevalence of anti-Toxoplasma gondii antibodies in free-range chickens in Aguascalientes, Mexico, its association with certain risk factors, and the frequency of parasite DNA in the heart. Eighty-one small rural family farms were included, and blood and heart samples were taken from 150 clinically healthy, adult, free-range chickens. Serum samples were processed by indirect immunofluorescence antibody test considering a dilution of 1:16 as a positive reaction, while the DNA detection was done by PCR. The correlation between the presence of antibodies and the potential risk factors was estimated with logistic regression. The overall seroprevalence in the examined populations was 67%, with a range from 33% to 100% among municipalities, and 78% of the farms having at least one seropositive bird. The PCR test identified the presence of parasite DNA for one case only. Among the variables, the presence of cats and the presence of other animal species on the farm were the ones that had the highest values, while the presence of feral cats and the presence of noxious fauna were also identified as potential risk factors. The results indicate high soil contamination by T. gondii oocysts, which implies the active role of cats living on the farms.
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Doenças do Gato , Parasitos , Toxoplasmose Animal , Animais , Gatos , Galinhas , Estudos Soroepidemiológicos , Toxoplasmose Animal/epidemiologia , Toxoplasmose Animal/parasitologia , México/epidemiologia , DNARESUMO
The population activity of CA1 pyramidal neurons (PNs) segregates along anatomical axes with different behaviors, suggesting that CA1 PNs are functionally subspecialized based on somatic location. In dorsal CA1, spatial encoding is biased toward CA2 (CA1c) and in deep layers of the radial axis. In contrast, nonspatial coding peaks toward subiculum (CA1a) and in superficial layers. While preferential innervation by spatial vs. nonspatial input from entorhinal cortex (EC) may contribute to this specialization, it cannot fully explain the range of in vivo responses. Differences in intrinsic properties thus may play a critical role in modulating such synaptic input differences. In this study we examined the postsynaptic integrative properties of dorsal CA1 PNs in six subpopulations along the transverse (CA1c, CA1b, CA1a) and radial (deep, superficial) axes. Our results suggest that active and passive properties of deep and superficial neurons evolve over the transverse axis to promote the functional specialization of CA1c vs. CA1a as dictated by their cortical input. We also find that CA1b is not merely an intermediate mix of its neighbors, but uniquely balances low excitability with superior input integration of its mixed input, as may be required for its proposed role in sequence encoding. Thus synaptic input and intrinsic properties combine to functionally compartmentalize CA1 processing into at least three transverse axis regions defined by the processing schemes of their composite radial axis subpopulations.NEW & NOTEWORTHY There is increasing interest in CA1 pyramidal neuron heterogeneity and the functional relevance of this diversity. We find that active and passive properties evolve over the transverse and radial axes in dorsal CA1 to promote the functional specialization of CA1c and CA1a for spatial and nonspatial memory, respectively. Furthermore, CA1b is not a mean of its neighbors, but features low excitability and superior integrative capabilities, relevant to its role in nonspatial sequence encoding.
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Região CA1 Hipocampal/fisiologia , Memória/fisiologia , Células Piramidais/fisiologia , Animais , Fenômenos Eletrofisiológicos/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Memória Espacial/fisiologiaRESUMO
The most common indications for early liver retransplantation (eRe-LT) are vascular complications and primary nonfunction (PNF). These patients are usually in a critical clinical condition that can affect their chances of survival. In fact, the survival of these patients is usually lower compared with the patients undergoing a first transplant. To the best of our knowledge, no specific series of pediatric patients undergoing eRe-LT has been published to date. Therefore, the aim of this study is to report the results of eRe-LT and to analyze factors potentially related to success or failure. Our work is of a retrospective cohort study of patients who underwent eRe-LT at the Juan P. Garrahan Pediatric Hospital of Buenos Aires, Argentina, between May 1995 and December 2018 (n = 60). Re-LT was considered early when performed ≤30 days after the previous LT. A total of 40 (66.7%) patients were enrolled due to vascular causes and 20 (33.3%) were enrolled because of PNF. Of all the relisted patients, 36 underwent eRe-LT, 14 died on the waiting list, and 10 recovered without eRe-LT. A total of 23 (63.9%) patients died after eRe-LT, most of them due to infection-related complications. Survival rates at 1 and 5 years were 42.4% and 33.9%, respectively. On univariate logistic regression analysis, Pediatric End-Stage Liver Disease (PELD)/Model for End-Stage Liver Disease (MELD) scores, transplant era, and advanced life support at eRe-LT were found to be related to 60-day mortality. However, on multivariate analysis, era (odds ratio [OR], 9.3; 95% confidence interval [CI], 1.19-72.35; P = 0.033) and PELD/MELD scores (OR, 1.07; 95% CI, 1-1.14; P = 0.036) were significantly associated with 60-day patient mortality. This study found that the level of acuity before retransplant, measured by the requirement of advanced life support and the PELD/MELD score at eRe-LT, was significantly associated with the chances of post-eRe-LT patient survival.
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Doença Hepática Terminal , Transplante de Fígado , Argentina , Criança , Doença Hepática Terminal/diagnóstico , Doença Hepática Terminal/cirurgia , Humanos , Transplante de Fígado/efeitos adversos , Prognóstico , Reoperação , Estudos Retrospectivos , Índice de Gravidade de Doença , Listas de EsperaRESUMO
Hepatoblastoma (HB) is the most common malignant liver tumor in children. Twenty percent of the cases may remain unresectable after neoadjuvant chemotherapy and, for these patients, liver transplant (LT) is an accepted therapeutic option. To analyze the risk factors to event-free survival (EFS) that influence the clinical outcome of patients with HB receiving LT, we retrospectively analyzed 21 patients with HB who underwent LT between January 1, 2005, and May 1, 2018. Overall survival (OS) was 90%. The univariate analysis shows that the AFP level at the time of LT was associated with a higher risk of EFS. With a ROC curve analysis, we established a cutoff point value of AFP levels at 16 000 ng/dL, with a sensitivity of 71.43% and a specificity of 85.71%. Multivariate analysis showed that patients with higher values of pretransplant AFP (>16 000 ng/dL) had a significantly higher risk of EFS than those transplanted with lower levels (HR: 10.180; 95% CI: 1.54-66.97; P = .02). Efforts should be made to improve the selection of candidates for LT for unresectable HB, aiming at a better definition of chemoresistance as a risk factor of poor outcomes.
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Hepatoblastoma/cirurgia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do TratamentoRESUMO
Before PCV7 introduction, invasive pneumococcal disease (IPD) was responsible for approximately 12,000-18,000 deaths annually among children <5years in Latin America. In Peru, PCV7 was introduced in 2009. We used whole genome sequencing to deduce key features of invasive strains collected in Lima, Peru from 2006 to 2011. We sequenced 212 IPD isolates from 16 hospitals in Lima pre (2006-2009; n=133) and post (2010-2011; n=79) PCV7 introduction; 130 (61.3%) isolates were from children≤5years old. CDC's Streptococcus lab bioinformatics pipeline revealed serotypes, sequence types (STs), pilus genes, PBP types and other resistance determinants. During the pre-PCV7 period, serotype 14 was the most common serotype (24.8%), followed by 6B (20.3%), 19F (10.5%), and 23F (6.8%). Post-PCV7, the proportion of PCV7 serotype 6B decreased significantly (to 6.3%), while 19F (16.3%), 14 (15.0%), 23F (7.5%), and 19A (7.5%) were the most common serotypes; only serotypes 3 and 10A increased significantly. Overall, 82% (n=173) of all isolates carried at least one resistance determinant, including 72 (34%) isolates that carried resistance determinants against 3 or more antimicrobial classes; of these 72 isolates, 56 (78%) belonged to a PCV7 serotype. Eighty-two STs were identified, with 53 of them organized in 14 clonal complexes. ST frequencies were distributed differently pre and post-PCV7 introduction, with only 18 of the 57 STs identified in years 2006-2009 isolates also observed in years 2010-2011 isolates. The apparent expansion of a 19F/ST1421 lineage with predicted ß-lactam resistance (PBP type 13:16:20) and carrying resistance determinants against four additional antimicrobial classes was observed.
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Infecções Pneumocócicas/microbiologia , Vacinas Pneumocócicas , Streptococcus pneumoniae/isolamento & purificação , Sequenciamento Completo do Genoma , Adulto , Anti-Infecciosos/farmacologia , Pré-Escolar , Farmacorresistência Bacteriana , Genótipo , Humanos , Lactente , Peru , Infecções Pneumocócicas/patologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/classificação , Vacinas Pneumocócicas/genética , Sorogrupo , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/genética , Vacinas ConjugadasRESUMO
Objective To 1) describe the correlation between the zones of inhibition in 1-µg oxacillin disk diffusion (ODD) tests and penicillin and ceftriaxone minimum inhibitory concentrations (MICs) of meningeal and non-meningeal strains of Streptococcus pneumoniae and 2) evaluate the usefulness of the ODD test as a predictor of susceptibility to penicillin in S. pneumoniae and as a quick and cost-effective method easily implemented in a routine clinical laboratory setting. Methods S. pneumoniae isolates from healthy nasopharyngeal carriers less than 2 years old, obtained in a multicentric cross-sectional study conducted in various Peruvian hospitals and health centers from 2007 to 2009, were analyzed. Using Clinical and Laboratory Standards Institute (CLSI) breakpoints, the correlation between the zones of inhibition of the ODD test and the MICs of penicillin and ceftriaxone was determined. Results Of the 571 S. pneumoniae isolates, 314 (55%) showed resistance to penicillin (MIC ≥ 0.12 µg/mL) and 124 (21.7%) showed resistance to ceftriaxone (MIC ≥ 1 µg/mL). Comparison of the ODD test zones of inhibition and the penicillin MICs, using the CLSI meningeal breakpoints, showed good correlation (Cohen's kappa coefficient = 0.8239). Conclusions There was good correlation between ODD zones of inhibition and penicillin meningeal breakpoints but weak correlation between the ODD results and non-meningeal breakpoints for both penicillin and ceftriaxone. Therefore, the ODD test appears to be a useful tool for predicting penicillin resistance in cases of meningeal strains of S. pneumoniae, particularly in low- and middle- income countries, where MIC determination is not routinely available.
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Antibacterianos/farmacologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/métodos , Oxacilina/farmacologia , Resistência às Penicilinas , Streptococcus pneumoniae/efeitos dos fármacos , Ceftriaxona/farmacologia , Estudos Transversais , Humanos , PeruRESUMO
OBJECTIVE: To determine the geospatial distribution of bovine paralytic rabies cases transmitted by Desmodus rotundus in the Mexican states of Guanajuato, Querétaro, and San Luis Potosí. METHODS: This was a cross-sectional epidemiological study based on cases reported during statewide campaigns for the control of bovine paralytic rabies in Guanajuato (2008-2013), Querétaro (2005-2013) and San Luis Potosí (2001-2013). All cases were confirmed by direct immunofluorescence. Maps showing the distribution of cases by year and species were constructed using ArcMap version 10.1. To identify areas where conditions favor the appearance of cases, bioclimatic variables were combined with georeferenced cases using MaxEnt version 3.3.3. RESULTS: Of the 1037 cases recorded, 911 (87.9%) occurred in San Luis Potosí, 82 (7.9%) in Querétaro, and 44 (4.2%) in Guanajuato. Of the total number of cases, 87.4% occurred at altitudes of less than 1500 meters above sea level. In Guanajuato and Querétaro, 77.3% and 42.3% of the cases, respectively, occurred at altitudes greater than 1 500 meters above sea level. Peak incidence was recorded from December to March. The V11 antigenic variant of the virus was the most common (173 cases); it was found in all three states. In the endemic channel, the average number of cases remains within the security zone from January to March but exceeds the median value from April to June. The spatial distribution of cases shows that the disease has spread recently, which correlates with the presence of the vampire bat. CONCLUSIONS: Bovine paralytic rabies has spread to areas that were formerly free of the disease. Environmental characteristics and the altitude above sea level do not limit the appearance of cases. Constant monitoring should be conducted for early case detection. Vaccination should take place before the rainy season starts, without waiting for outbreaks to occur.
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Raiva/epidemiologia , Animais , Bovinos , Quirópteros , Estudos Transversais , Humanos , México/epidemiologia , Vírus da RaivaRESUMO
Synaptic spine loss is an early pathophysiologic hallmark of Alzheimer disease (AD) that precedes overt loss of dendritic architecture and frank neurodegeneration. While spine loss signifies a decreased engagement of postsynaptic neurons by presynaptic targets, the degree to which loss of spines and their passive components impacts the excitability of postsynaptic neurons and responses to surviving synaptic inputs is unclear. Using passive multicompartmental models of CA1 pyramidal neurons (PNs), implicated in early AD, we find that spine loss alone drives a boosting of remaining inputs to their proximal and distal dendrites, targeted by CA3 and entorhinal cortex (EC), respectively. This boosting effect is higher in distal versus proximal dendrites and can be mediated by spine loss restricted to the distal compartment, enough to impact synaptic input integration and somatodendritic backpropagation. This has particular relevance to very early stages of AD in which pathophysiology extends from EC to CA1.
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The perforant path (PP) carries direct inputs from entorhinal cortex to CA1 pyramidal neurons (PNs), with an impact dependent on PN position across transverse (CA1a-CA1c) and radial (superficial/deep) axes. It remains unclear how aging and Alzheimer disease (AD) affect PP input, despite its critical role in memory and early AD. Applying ex vivo recordings and two-photon microscopy in slices from mice up to 30 months old, we interrogated PP responses across PN subpopulations and compared them to Schaffer collateral and intrinsic excitability changes. We found that aging uniquely impacts PP excitatory responses, abolishing transverse and radial differences via a mechanism independent of presynaptic and membrane excitability change. This is amplified in aged 3xTg-AD mice, with further weakening of PP inputs to CA1a superficial PNs associated with distal dendritic spine loss. This demonstrates a unique feature of aging-related circuit dysfunction, with mechanistic implications related to memory impairment and synaptic vulnerability.
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BACKGROUND AND PURPOSE: The purpose of this study is to evaluate the feasibility of using 3-dimensional (3D) ultra-short echo time (UTE) radial imaging method for measurement of the permeability of the blood-brain barrier (BBB) to gadolinium-based contrast agent. In this study, we propose to use the golden-angle radial sparse parallel (GRASP) method with 3D center-out trajectories for UTE, hence named as 3D UTE-GRASP. We first examined the feasibility of using 3D UTE-GRASP dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for differentiating subtle BBB disruptions induced by focused ultrasound (FUS). Then, we examined the BBB permeability changes in Alzheimer's disease (AD) pathology using Alzheimer's disease transgenic mice (5xFAD) at different ages. METHODS: For FUS experiments, we used four Sprague Dawley rats at similar ages where we compared BBB permeability of each rat receiving the FUS sonication with different acoustic power (0.4-1.0 MPa). For AD transgenic mice experiments, we included three 5xFAD mice (6, 12, and 16 months old) and three wild-type mice (4, 8, and 12 months old). RESULTS: The result from FUS experiments showed a progressive increase in BBB permeability with increase of acoustic power (p < .05), demonstrating the sensitivity of DCE-MRI method for detecting subtle changes in BBB disruption. Our AD transgenic mice experiments suggest an early BBB disruption in 5xFAD mice, which is further impaired with aging. CONCLUSION: The results in this study substantiate the feasibility of using the proposed 3D UTE-GRASP method for detecting subtle BBB permeability changes expected in neurodegenerative diseases, such as AD.
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Doença de Alzheimer , Barreira Hematoencefálica , Meios de Contraste , Estudos de Viabilidade , Imageamento por Ressonância Magnética , Camundongos Transgênicos , Ratos Sprague-Dawley , Barreira Hematoencefálica/diagnóstico por imagem , Animais , Camundongos , Imageamento por Ressonância Magnética/métodos , Ratos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/metabolismo , Permeabilidade Capilar/fisiologia , Imageamento Tridimensional/métodosRESUMO
BACKGROUND: The Pneumococcal conjugate vaccine (PCV) has decreased cases of invasive pneumococcal disease (IPD) worldwide. However, the impact of PCVs introduction may be affected by the serotype distribution in a specific context. METHODS: Cross-sectional multicenter passive surveillance study of IPD cases in pediatric patients hospitalized in Lima, Peru between 2016 and 2019 (after PCV13 introduction) to determine the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae. Serotyping was performed by a sequential multiplex PCR and confirmed by whole genome sequencing. RESULTS: Eighty-five S. pneumoniae isolates were recovered (4.07/100,000 among children <60 months of age). Serotype 19A was the most common (49.4%). Children infected with serotype 19A in comparison with children infected with other serotypes were younger, had a lower rate of meningitis and higher rates of pneumonia, complicated pneumonia and antimicrobial resistance; 28.6% of patients with serotype 19A have received at least one dose of PCV13 vs. 62.8% of patients with other serotypes. Using MIC-breakpoints, 81.2% (56/69) of non-meningitis strains and 31.2% (5/16) of meningitis strains were susceptible to penicillin; 18.8% (3/16) of meningitis strains had intermediate resistance to ceftriaxone. Resistance to azithromycin was 78.8% (67/85). Serotype 19A frequency increased over time in the same study population, from 4.2% (4/96) in 2006-2008, to 8.6% (5/58) in 2009-2011, to 49.4% (42/85) in the current study (2016-2019) (p < 0.001). CONCLUSIONS: After PCV13 introduction in Peru, serotype 19A remains the most prevalent; however, the vaccination coverage is still not optimal. Therefore, additonal surveillance studies are needed to determine the remaining IPD burden.
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Anti-Infecciosos , Meningite , Infecções Pneumocócicas , Pneumonia , Criança , Humanos , Lactente , Streptococcus pneumoniae , Sorogrupo , Vacinas Conjugadas , Criança Hospitalizada , Peru/epidemiologia , Estudos Transversais , Vacinas Pneumocócicas , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , SorotipagemRESUMO
Rabies is a zoonotic disease that affects livestock worldwide. The distribution of rabies is highly correlated with the distribution of the vampire bat Desmodus rotundus, the main vector of the disease. In this study, climatic, topographic, livestock population, vampire distribution and urban and rural zones were used to estimate the risk for presentation of cases of rabies in Mexico by co- Kriging interpolation. The highest risk for the presentation of cases is in the endemic areas of the disease, i.e. the States of Yucatán, Chiapas, Campeche, Quintana Roo, Tabasco, Veracruz, San Luis Potosí, Nayarit and Baja California Sur. A transition zone for cases was identified across northern Mexico, involving the States of Sonora, Sinaloa, Chihuahua, and Durango. The variables topography, vampire distribution, bovine population and rural zones are the most important to explain the risk of cases in livestock. This study provides robust estimates of risk and spread of rabies based on geostatistical methods. The information presented should be useful for authorities responsible of public and animal health when they plan and establish strategies preventing the spread of rabies into rabies-free regions of México.
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Quirópteros , Raiva , Animais , Bovinos , Raiva/epidemiologia , Raiva/veterinária , México/epidemiologia , Fatores de Risco , Meio Ambiente , GadoRESUMO
OBJECTIVE: To determinate the frequency of Streptococcus pneumoniae nasopharyngeal carriers, serotypes and antimicrobial resistance in healthy children in Lima, Peru, post-PCV13 introduction and to compare the results with a similar study conducted between 2006 and 2008 before PCV7 introduction (pre-PCV7). METHODS: A cross-sectional multicenter study was conducted between January 2018 and August 2019 in 1000 healthy children under two years of age. We use standard microbiological methods to determinate S. pneumoniae from nasopharyngeal swab, Kirby Bauer and minimum inhibitory concentration methods to determinate antimicrobial susceptibility and whole genomic sequencing to determinate pneumococcal serotypes. RESULTS: The pneumococcal carriage rate was 20.8 % vs. 31.1 % in pre-PCV7 (p < 0.001). The most frequent serotypes were 15C, 19A and 6C (12.4 %, 10.9 % and 10.9 % respectively). The carriage of PCV13 serotypes after PCV13 introduction decreased from 59.1 % (before PCV7 introduction) to 18.7 % (p < 0.001). Penicillin resistance was 75.5 %, TMP/SMX 75.5 % and azithromycin 50.0 %, using disk diffusion. Penicillin resistance rates using MIC breakpoint for meningitis (MIC ≥ 0.12) increased from 60.4 % to 74.5 % (p = 0.001). CONCLUSION: The introduction of PCV13 in the immunization program in Peru has decreased the pneumococcal nasopharyngeal carriage and the frequency of PCV13 serotypes; however, there has been an increase in non-PCV13 serotypes and antimicrobial resistance.
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Anti-Infecciosos , Infecções Pneumocócicas , Humanos , Criança , Lactente , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Sorogrupo , Estudos Transversais , Peru/epidemiologia , Portador Sadio/microbiologia , Streptococcus pneumoniae/genética , Nasofaringe/microbiologia , Resistência às Penicilinas , Vacinas Pneumocócicas , Vacinas ConjugadasRESUMO
CONTEXT AND PURPOSE: This work aimed to study the seroprevalence of natural infection by T. gondii in different population segments of dogs from Aguascalientes, Mexico as well as its possible association with some risk factors. METHODS: The study included 210 clinically healthy dogs from three population segments: rural, stray and pet. A blood serum sample was collected on a single occasion and processed by indirect immunofluorescence considering a dilution of 1:16 as a positive reaction; the association between the presence of antibodies and the potential risk factors was estimated with logistic regression. RESULTS: The overall prevalence of anti-T. gondii antibodies in the studied population was 59% (123/210; CI 95% 51-65) being different between population segments, in rural dogs 74% (59/80; CI 95% 62-82), in stray dogs 60% (48/80; CI 95% 48-70) and in pet dogs 32% (16/50; CI 95% 19-46), the titers of the positive sera were in a range of 1:16-1:128. In rural dogs the seroprevalence according to the municipality was in a range of 55% to 100% finding positive dogs in all the studied municipalities. The zootechnical function of guarding the property in rural dogs was identified as a risk factor (OR 2.4), while in pet dogs it was living with cats (OR 7) as well as sharing the drinking water container (OR 4); in stray dogs it was not possible to identify any risk factor. CONCLUSIONS: This study documents the wide presence of anti-T. gondii antibodies in the population groups examined, this being more important in rural dogs.
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Doenças do Cão , Toxoplasma , Toxoplasmose Animal , Animais , Cães , Estudos Soroepidemiológicos , México/epidemiologia , Anticorpos Antiprotozoários , Doenças do Cão/epidemiologia , Fatores de RiscoRESUMO
Giardia is a protozoan that affects humans as well as a wide range of domestic species. It is distributed worldwide, and the highest frequency is seen in developing countries. Due to the potential for domestic cats to be carriers of this parasite and subsequently transmit the infection to humans, it is important to know the risk of transmission. For this reason, the objective of this study was to determine the frequency of this parasite in the cat population of the city of Santiago de Queretaro, Mexico, and identify the assemblages present to determine the role this host plays in public health, this being the first study of its type to be performed in the country. This was a cross-sectional study during which 200 fecal samples were collected from cats of both sexes and varying ages and strata of origin. The samples were analyzed by microscopy following the flotation technique, having obtained a general frequency of 25%. Giardia cysts were found at higher frequency in pasty stools. The assemblages found were zoonotic, specifically assemblage A, which suggests that the cat poses an important risk for the dissemination of the parasite to humans, making it an important public health problem.
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Streptococcus pneumoniae upper respiratory infections and pneumonia are often treated with macrolides, but recently macrolide resistance is becoming an increasingly important problem. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the National Immunization Program of Peru in 2015. This study aimed to evaluate the temporal evolution of macrolide resistance in S. pneumoniae isolates collected in five cross-sectional studies conducted before and after this vaccine introduction, from 2006 to 2019 in Lima, Peru. A total of 521 and 242 S. pneumoniae isolates recovered from nasopharyngeal swabs from healthy carrier children < 2 years old (2 carriage studies) and samples from normally sterile body areas from pediatric patients with invasive pneumococcal disease (IPD) (3 IPD studies), respectively, were included in this study. Phenotypic macrolide resistance was detected using the Kirby-Bauer method and/or MIC test. We found a significant increase in macrolide resistance over time, from 33.5% to 50.0% in carriage studies, and from 24.8% to 37.5% and 70.8% in IPD studies. Macrolide resistance genes [erm(B) and mef(A/E)] were screened using PCR. In carriage studies, we detected a significant decrease in the frequency of mef(A/E) genes among macrolide-resistant S. pneumoniae strains (from 66.7% to 50.0%) after introduction of PCV13. The most common mechanism of macrolide-resistant among IPD strains was the presence of erm(B) (96.0%, 95.2% and 85.1% in the 3 IPD studies respectively). Macrolide resistance was more common in serotype 19A strains (80% and 90% among carriage and IPD strains, respectively) vs. non-serotype 19A (35.5% and 34.4% among carriage and IPD strains, respectively). In conclusion, S. pneumoniae macrolide resistance rates are very high among Peruvian children. Future studies are needed in order to evaluate macrolide resistance trends among pneumococcal strains, especially now after the COVID-19 pandemic, since azithromycin was vastly used as empiric treatment of COVID-19 in Peru.
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COVID-19 , Infecções Pneumocócicas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Farmacorresistência Bacteriana , Humanos , Lactente , Macrolídeos/farmacologia , Pandemias , Peru/epidemiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Sorogrupo , Streptococcus pneumoniae , Vacinas ConjugadasRESUMO
Bovine tuberculosis (bTB) is a disease of cattle that represents a risk to public health and causes severe economic losses to the livestock industry. Recently, one of the strategies recommended for reducing the prevalence of the disease in animals is the use of the BCG vaccine, alone or in combination with proteins. It has been shown that the vaccine elicits a strong immune response, downsizes the number of animals with visible lesions, and reduces the rate of infection as well as the bacillary count. This paper, based on scientific evidence, makes suggestions about some practical vaccination alternatives that can be used in infected herds to reduce bTB prevalence, considering BCG strains, vaccine doses, routes of application, and age of the animals. Our conclusion is that vaccination is a promising alternative to be included in current control programs in underdeveloped countries to reduce the disease burden.
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The spatio-temporal epidemiology of rabies has related the influence of environmental factors and anthropogenic changes on the movements of the hematophagous bat Desmodus rotundus. In Mexico, D. rotundus is the main transmitter of the rabies virus for different livestock species, modifying annually the fluctuation of the number of cases of rabies and its dissemination in subtropical areas and regions considered free of the disease. The purpose of this study was to perform a descriptive analysis of the distribution of cases of rabies in Mexico, and to perform a time-series analysis to evaluate stationarity and to predict the number of cases for the following year. A total of 3,469 cases were reported in the period of interest, of which the 89.1% occurred in cattle, 4.3% in horses, 1.5% in sheep, 0.6% in goats, 0.01% in pig, 3.1% in vampire bats, 0.3% in cervids, 0.2% in skunks, 0.1% in insectivorous bats, 0.1% in foxes, 0.1% in buffaloes, and 0.02% in coatis; 0.5% were not identified. The most frequent antigenic variants reported were AgV11, AgV5, and AgV3, associated with D. rotundus. The distribution of cases in bats correlates with the distribution of cases in domestic and wild animals; however, cases were observed in wild species in non-endemic areas of Mexico, like the State of Chihuahua. The additive model used in the time-series analysis showed a seasonal pattern with a peak of cases at the beginning of each year, from January to March. The model showed a good predicting value; the Pearson correlation coefficient R2 was 0.705. The highest probability for the occurrence of rabies cases in the different species estimated by Ordinary Kriging was in the coast of the Gulf of Mexico, involving the states of Tamaulipas, Veracruz, Tabasco, Chiapas, and Yucatan. This study confirms that rabies in domestic and wild species is endemic in tropical and subtropical areas-however, cases have been observed in new geographic areas-and provides useful information to support actions to stop the spread of the rabies virus or the reservoir, and for planning vaccination strategies considering time and place.