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Hurtado I.,CIBER ISCIII | Garcia de Olalla P.,Servei dEpidemiologia | Albiach D.,Colectivo Lambda de Valencia | Martin M.,Unitat dEpidemiologia i Estadistica | And 2 more authors.
Gaceta Sanitaria | Year: 2010

An intervention in venues for interaction used by men who have sex with men in Valencia (Spain) was performed to prevent human immunodeficiency virus (HIV) infection or avoid delay in diagnosis and to facilitate contact with the health circuit. Information was provided on prevention and a rapid test for HIV and syphilis was performed. We contacted 500 men and the intervention was performed in 171; 37% of the subjects in saunas and one in four of those in prostitution apartments had never been tested. The prevalence of HIV was 1.6% (n=2) in the saunas, and 11% (n=5) in the apartments (n=5). For syphilis, these percentages were 5% and 2.3% respectively. The intervention revealed the existence of highly exposed population groups with low compliance and facilitated access to the health system in these groups. © 2008 SESPAS.


Rodriguez-Guardado A.,Tropical Medicine Unit | Gonzalez M.L.,Hepatology Unit | Rodriguez M.,Hospital Universitario Central Of Asturias | Flores-Chavez M.,Institute Salud Carlos III | And 2 more authors.
Clinical Microbiology and Infection | Year: 2015

The shortage of suitable organ donors for transplantation has stimulated the use of organs from donors with transmissible infections such as Chagas disease in noninfected recipients. A case is described of liver transplantation from an anti- Trypanosoma cruzi-positive donor to a noninfected recipient who showed favorable evolution despite not having undergone preemptive therapy. © 2015 European Society of Clinical Microbiology and Infectious Diseases.


PubMed | Institute Salud Carlos III, Tropical Medicine Unit, Hepatology Unit, Hospital Universitario Central Of Asturias and Center for International Health Research
Type: Case Reports | Journal: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases | Year: 2015

The shortage of suitable organ donors for transplantation has stimulated the use of organs from donors with transmissible infections such as Chagas disease in noninfected recipients. A case is described of liver transplantation from an anti-Trypanosoma cruzi-positive donor to a noninfected recipient who showed favorable evolution despite not having undergone preemptive therapy.


Pinazo M.-J.,Hospital Clinic | Munoz J.,Hospital Clinic | Posada E.,Hospital Clinic | Lopez-Chejade P.,University of Barcelona | And 5 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2010

Chagas' disease is an emerging public health problem in areas where the disease is not endemic. Treatment with benznidazole has shown efficacy in the acute stage of the disease, but its efficacy in the chronic stage remains controversial, and unwanted side effects are more frequent and severe in adults than in children. This study describes the profile of side effects of benznidazole in a cohort of Trypanosoma cruzi-infected patients in a European country. Copyright © 2010, American Society for Microbiology. All Rights Reserved.


Zboromyrska Y.,University of Barcelona | Hurtado J.C.,University of Barcelona | Salvador P.,University of Barcelona | Alvarez-Martinez M.J.,University of Barcelona | And 9 more authors.
Clinical Microbiology and Infection | Year: 2014

Traveller's diarrhoea (TD) is the most common illness reported in international travellers. TD is caused by a wide range of pathogens, including bacteria, viruses and parasites. Multiplex PCR assays can be especially useful for studying the aetiology of TD. The first objective of this study was to evaluate the utility of the commercially available multiplex PCR (xTAG® Gastrointestinal Pathogen Panel (GPP)) for the diagnosis of TD. A total of 185 stool specimens obtained from 174 patients were processed using the GPP assay. This test detected 86 pathogens in 67 stool samples (67/185, 36.2%). Sixteen pathogens out of 86 were also detected by routine testing. The remaining pathogens (n = 70) required further confirmation by alternative techniques. Finally, 60 out of 70 pathogens were confirmed. The second objective of this study was to analyse the aetiology of TD based on the results obtained by the GPP test and routine methods. The primary pathogens causing TD were Shigella (24.2%) followed by enterotoxigenic Escherichia coli (ETEC) (23.2%), enteroaggregative E. coli (14.7%) and Giardia (13.7%). Significant regional differences were observed for ETEC with 19.4% of TD cases acquired in Africa, 11.3% in Asia and none in South Central (SC) America (p 0.01), Giardia was found in 1.5% of cases among those who had travelled to Africa, 14.1% of those who had travelled to Asia and 3% of those who had travelled to SC America (p 0.01). In conclusion, the GPP test improved the detection of enteropathogens and allowed better assessment of the aetiology of TD. © 2014 European Society of Clinical Microbiology and Infectious Diseases.


Pinazo M.,University of Barcelona | Tassies D.,Hospital Clinic | Munoz J.,University of Barcelona | Fisa R.,University of Barcelona | And 6 more authors.
Thrombosis and Haemostasis | Year: 2011

There is a current controversy over the hypothesis that a number of thromboembolic events could be related to hypercoagulable state in patients with chronic Chagas disease. This study was designed to determine whether a prothrombotic state existed in chronic Trypanosoma cruzi-infected patients and, if so, to describe its evolution after treatment with Benznidazole. Twenty-five patients with chronic Chagas disease and 18 controls were evaluated. The markers used were prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin, plasminogen, protein C, total protein S, free protein S, factor VIII, D-dimer, activated factor VIIa, tissue-type plasminogen activator inhibitor- 1, prothrombin fragment 1+2 (F 1+2), plasmin-antiplasmin complexes, soluble P-selectin and endogenous thrombin potential (ETP). Despite statistically significant differences between cases and controls in several markers, only ETP (which quantifies the ability of plasma to generate thrombin when activated through tissue factor addition) (p<0.0001) and F 1+2 (a marker of thrombin generation in vivo) (p<0.0001) showed values outside the normal levels in patients compared with controls. Similar results were obtained in these markers six months after treatment in the cohort of cases (p<0.0008 and p<0.004, respectively). These results may be relevant in clinical practice. Though current treatment for Chagas disease is still controversial, if it were considered as a thromboembolic risk factor the antiparasitic treatment strategy could be reinforced. The results also support further research on haemostasis parameters as candidates for early surrogate bio-markers of cure or progression of Chagas disease. © Schattauer 2011.


Madrid L.,Hospital Infantil Virgen Del Rocio | Madrid L.,University of Barcelona | Madrid L.,Center for International Health Research | Noguera-Julian A.,University of Barcelona | And 10 more authors.
AIDS | Year: 2014

A cross-sectional study of 77 chronic HIV-infected children revealed higher levels of biomarkers of inflammation (ultrasensitive C-reactive protein, D-dimer and b-2-microglobulin), immune activation (HLA-DRRCD38R CD4R and CD8R T cells) and microbial translocation [lipopolysaccaride (LPS), microbial 16S rDNA and sCD14] than 32 healthy controls. Immune activation was higher in viremic children, but microbial translocation occurred independently of viraemia and T cell activation. Our results do not support a relevant role of microbial translocation in T cell activation in chronic HIV-infected children, proposing a need to develop strategies to minimize microbial translocation in the future. Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.


Pinazo M.-J.,University of Barcelona | Guerrero L.,University of Barcelona | Posada E.,University of Barcelona | Rodriguez E.,Center for International Health Research | And 2 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2013

For treating Chagas disease (CD), a current worldwide health problem, only benznidazole and nifurtimox have been approved to be used. In both cases, unwanted drug-related adverse events (ADRs) are frequent when these drugs are used in adults in the chronic stage. The main objective of this study was to establish benznidazole ADRs and their relationship to serum concentrations in patients with chronic Trypanosoma cruzi infection in order to perform more accurate dosages to minimize ADRs. A total of 54 patients were recruited over 12 months. Of these 54 patients, 53 (98%) experienced at least one ADR during follow-up, and the overall average ADR incidence was 2.4 episodes/patient/month. Benznidazole treatment was discontinued in 11 patients, 7 among them due to severe adverse effects. The mean duration of treatment before withdrawal was 11 days. Benznidazole serum concentrations were recorded on days 15, 30, 45, and 60 of follow-up and evaluated according to clinical and epidemiological variables and ADR severity. No relationship was found between the benznidazole serum concentration and the ADRs. The mean (standard deviation) trough serum benznidazole concentrations (all below 20 mcg/ml) on days 15, 30, 45, and 60 were 6.4 (1.9), 6.1 (1.8), 6.2 (2.2), and 5.7 (1.7) μg/ml, respectively. Benznidazole serum concentrations do not appear to be related to the appearance of serious ADRs. Further, well-controlled studies are necessary to establish the optimal regimen for benznidazole in adults with chronic CD. Copyright © 2013, American Society for Microbiology. All Rights Reserved.


PubMed | University of Barcelona, Hospital Universitario Ramon jal And Instituto Ramon jal Of Investigacion Sanitaria Irycis, Ferrer Laboratories and Center for International Health Research
Type: Comparative Study | Journal: The Journal of antimicrobial chemotherapy | Year: 2014

To determine the frequency of selecting mutants resistant to ozenoxacin, a des-fluoro-(6)-quinolone active against pathogens involved in skin and skin structure infections, compared with levofloxacin and ciprofloxacin in quinolone-susceptible and -resistant Gram-positive cocci.Forty-nine quinolone-susceptible and -resistant Gram-positive cocci strains with different profiles of mutations in the quinolone resistance-determining region (QRDR) were examined to determine the frequency of selecting mutants resistant to ozenoxacin compared with levofloxacin and ciprofloxacin. MICs and mutations in the QRDR were determined by standard broth microdilution and PCR amplification and sequencing, respectively.The mean resistance rates were 3.8 10(-9) (range <9 10(-11)-1 10(-8)) for ozenoxacin, 9.7 10(-9) (range <1.1 10(-11)-4.2 10(-8)) for levofloxacin and 1.2 10(-8) (range <1.6 10(-10)-2.6 10(-7)) for ciprofloxacin. Spontaneous mutants resistant to ozenoxacin showed lower MICs ( 16 mg/L) than mutants resistant to levofloxacin and ciprofloxacin ( 512 mg/L). Additional mutations were observed only in ParC at Ser-80 in Staphylococcus spp., Ser-79 in Streptococcus agalactiae and Asp-83 and Ser-89 in Streptococcus pyogenes.The probability of ozenoxacin selecting spontaneous resistant mutants in quinolone-susceptible and -resistant strains with pre-existing mutations in the QRDR is low, supporting the potential utility of ozenoxacin as a therapeutic alternative in the treatment of skin infections caused by strains highly resistant to quinolones.


PubMed | Center for International Health Research
Type: Journal Article | Journal: The Journal of infectious diseases | Year: 2014

Schistosomiasis affects approximately 40 million women of reproductive age and has been linked to elevated levels of circulating endotoxin in nonpregnant individuals. We have evaluated endotoxin levels in maternal, placental, and newborn blood collected from women residing in Leyte, Philippines. Endotoxin levels in both maternal and placental compartments in pregnant women with schistosomiasis were 1.3- and 2.4-fold higher, respectively, than in uninfected women. In addition, higher concentrations of endotoxin in placental blood were associated with premature birth, acute chorioamnionitis, and elevated proinflammatory cytokines. By promoting endotoxemia, schistosomiasis may exert additional, maladaptive influences on pregnancy outcomes.

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