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[PMID]: 26802885
[Au] Autor:Reto Valiente L; Pichilingue Reto C; Pichilingue Prieto O; Dolores Cerna K
[Ad] Address:Hospital Hipólito Unanue. Lima, Perú....
[Ti] Title:Tuberculosis abdominal en niños y adolescentes. Un desafío diagnóstico. [Abdominal Tuberculosis in children and adolescents. A diagnostic challenge].
[So] Source:Rev Gastroenterol Peru;35(4):318-22, 2015 Oct-Dec.
[Is] ISSN:1609-722X
[Cp] Country of publication:Peru
[La] Language:spa
[Ab] Abstract:OBJECTIVE: To present our experience with abdominal tuberculosis in children and adolescents treated in our hospital from 2003 - 2014. MATERIAL AND METHODS: It is a retrospective study. We have collected clinical records of inpatients <20 years old who were admitted at Hipolito Unanue Hospital from January 2003 to July 2014, with diagnosis of abdominal tuberculosis. RESULTS: Among the overall 30 patients, 16 (53.33%) were female and 14 (46.67%) were male. The mean age of all patients was 16.5 years. The most common clinical features were abdominal pain in 29 (96.67%), fever in 26 (86.67%), ascites in 23 (76.67%) and loss of weight in 21 (70%). 63.33% of the patients were eutrophics, 13.34% were overweight or obese and only 23.33% suffered of malnutrition. TB contact was present in 10 (33.33%). Positive tuberculin skin tests were seen in 10%. Extra-abdominal tuberculosis was found in 22 patients (63.32%). 12 cases had coexisting pulmonary tuberculosis and 4 cases had pleural effusion. 12 patients (40%) had tuberculous peritonitis; 12 patients (40%) had intestinal tuberculosis and peritoneal tuberculosis and 4 patients (13.33%) had intestinal tuberculosis. Bacteriological confirmation of tuberculosis was achieved in 10 cases (33.33%). Antituberculous therapy for 6 months was effective in 29 cases. One patient died who multifocal tuberculosis with HIV had associated. CONCLUSIONS: Abdominal tuberculosis is seen in 4.37% of children affected with tuberculosis, of which over 63% will have extra abdominal manifestations. Abdominal tuberculosis should be considered in patients with abdominal pain, fever, weight loss and abnormal chest radiography. Imaging can be useful for early diagnosis of abdominal tuberculosis.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 253060 MEDLINE  
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[PMID]: 26327511
[Au] Autor:Larsen JN; Broge L; Jacobi H
[Ad] Address:ALK A/S, Bøge Allé 1, DK-2970 Hørsholm, Denmark. Electronic address: jnldk@alk.net.
[Ti] Title:Allergy immunotherapy: the future of allergy treatment.
[So] Source:Drug Discov Today;21(1):26-37, 2016 Jan.
[Is] ISSN:1878-5832
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Allergic respiratory disease represents a significant and expanding health problem worldwide. Allergic symptoms, such as asthma and hay fever, cause sleep impairment and reduce school and work performance. The cost to society is substantial. Allergen avoidance and pharmacotherapy cannot control the disease. Only allergy immunotherapy has disease-modifying potential and should be included in optimal treatment strategies. Allergy immunotherapy was first administered as subcutaneous injections and has been practiced for the past 100 years or so. Recently, tablet-based sublingual allergy immunotherapy (SLIT) was introduced with comprehensive clinical documentation. SLIT tablets represent a more patient-friendly concept because they can be used for self-treatment at home.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 253060 MEDLINE  
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[PMID]: 26711718
[Au] Autor:Westover JB; Sefing EJ; Bailey KW; Van Wettere AJ; Jung KH; Dagley A; Wandersee L; Downs B; Smee DF; Furuta Y; Bray M; Gowen BB
[Ad] Address:Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA....
[Ti] Title:Low-dose ribavirin potentiates the antiviral activity of favipiravir against hemorrhagic fever viruses.
[So] Source:Antiviral Res;126:62-8, 2016 Feb.
[Is] ISSN:1872-9096
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Favipiravir is approved in Japan to treat novel or re-emerging influenza viruses, and is active against a broad spectrum of RNA viruses, including Ebola. Ribavirin is the only other licensed drug with activity against multiple RNA viruses. Recent studies show that ribavirin and favipiravir act synergistically to inhibit bunyavirus infections in cultured cells and laboratory mice, likely due to their different mechanisms of action. Convalescent immune globulin is the only approved treatment for Argentine hemorrhagic fever caused by the rodent-borne Junin arenavirus. We previously reported that favipiravir is highly effective in a number of small animal models of Argentine hemorrhagic fever. We now report that addition of low dose of ribavirin synergistically potentiates the activity of favipiravir against Junin virus infection of guinea pigs and another arenavirus, Pichinde virus infection of hamsters. This suggests that the efficacy of favipiravir against hemorrhagic fever viruses can be further enhanced through the addition of low-dose ribavirin.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Cu] Class update date: 160123
[Lr] Last revision date:160123
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 253060 MEDLINE  
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[PMID]: 25597923
[Au] Autor:Nikolaeva D; Draper SJ; Biswas S
[Ad] Address:The Jenner Institute, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Headington, Oxford OX3 7DQ, UK.
[Ti] Title:Toward the development of effective transmission-blocking vaccines for malaria.
[So] Source:Expert Rev Vaccines;14(5):653-80, 2015 May.
[Is] ISSN:1744-8395
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The continued global burden of malaria can in part be attributed to a complex lifecycle, with both human hosts and mosquito vectors serving as transmission reservoirs. In preclinical models of vaccine-induced immunity, antibodies to parasite sexual-stage antigens, ingested in the mosquito blood meal, can inhibit parasite survival in the insect midgut as judged by ex vivo functional studies such as the membrane feeding assay. In an era of renewed political momentum for malaria elimination and eradication campaigns, such observations have fueled support for the development and implementation of so-called transmission-blocking vaccines. While leading candidates are being evaluated using a variety of promising vaccine platforms, the field is also beginning to capitalize on global '-omics' data for the rational genome-based selection and unbiased characterization of parasite and mosquito proteins to expand the candidate list. This review covers the progress and prospects of these recent developments.
[Mh] MeSH terms primary: Antibodies, Protozoan/immunology
Culicidae/parasitology
Disease Transmission, Infectious/prevention & control
Malaria/prevention & control
Plasmodium/immunology
Vaccines/immunology
Vaccines/isolation & purification
[Mh] MeSH terms secundary: Animals
Antibodies, Protozoan/blood
Drug Discovery/trends
Humans
Malaria/epidemiology
Plasmodium/growth & development
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., INTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Name of substance:0 (Antibodies, Protozoan); 0 (Vaccines)
[Em] Entry month:1512
[Cu] Class update date: 160123
[Lr] Last revision date:160123
[Js] Journal subset:IM
[Da] Date of entry for processing:150413
[St] Status:MEDLINE
[do] DOI:10.1586/14760584.2015.993383

  5 / 253060 MEDLINE  
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[PMID]: 25719558
[Au] Autor:El-Ekiaby M; Vargas M; Sayed M; Gorgy G; Goubran H; Radosevic M; Burnouf T
[Ad] Address:Shabrawishi Blood Bank, Shabrawishi Hospital, Cairo, Egypt....
[Ti] Title:Minipool caprylic acid fractionation of plasma using disposable equipment: a practical method to enhance immunoglobulin supply in developing countries.
[So] Source:PLoS Negl Trop Dis;9(2):e0003501, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Immunoglobulin G (IgG) is an essential plasma-derived medicine that is lacking in developing countries. IgG shortages leave immunodeficient patients without treatment, exposing them to devastating recurrent infections from local pathogens. A simple and practical method for producing IgG from normal or convalescent plasma collected in developing countries is needed to provide better, faster access to IgG for patients in need. METHODOLOGY/PRINCIPAL FINDINGS: IgG was purified from 10 consecutive minipools of 20 plasma donations collected in Egypt using single-use equipment. Plasma donations in their collection bags were subjected to 5%-pH5.5 caprylic acid treatment for 90 min at 31°C, and centrifuged to remove the precipitate. Supernatants were pooled, then dialyzed and concentrated using a commercial disposable hemodialyzer. The final preparation was filtered online by gravity, aseptically dispensed into storage transfusion bags, and frozen at <-20°C. The resulting preparation had a mean protein content of 60.5 g/L, 90.2% immunoglobulins, including 83.2% IgG, 12.4% IgA, and 4.4% IgM, and residual albumin. There was fourfold to sixfold enrichment of anti-hepatitis B and anti-rubella antibodies. Analyses of aggregates (<3%), prekallicrein (5-7 IU/mL), plasmin (26.3 mU/mL), thrombin (2.5 mU/mL), thrombin-like activity (0.011 U/g), thrombin generation capacity (< 223 nM), and Factor XI (<0.01 U/mL) activity, Factor XI/XIa antigen (2.4 ng/g) endotoxin (<0.5 EU/mL), and general safety test in rats showed the in vitro safety profile. Viral validation revealed >5 logs reduction of HIV, BVDV, and PRV infectivity in less than 15 min of caprylic acid treatment. CONCLUSIONS/SIGNIFICANCE: 90% pure, virally-inactivated immunoglobulins can be prepared from plasma minipools using simple disposable equipment and bag systems. This easy-to-implement process could be used to produce immunoglobulins from local plasma in developing countries to treat immunodeficient patients. It is also relevant for preparing hyperimmune IgG from convalescent plasma during infectious outbreaks such as the current Ebola virus episode.
[Mh] MeSH terms primary: Caprylates/chemistry
Chemical Fractionation/instrumentation
Immunoglobulin G/isolation & purification
[Mh] MeSH terms secundary: Animals
Blood Banks
Blood Donors
Developing Countries
Disposable Equipment
Egypt
Female
Hemorrhagic Fever, Ebola/therapy
Humans
Immunoglobulin G/blood
Plasma
Rats
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Caprylates); 0 (Immunoglobulin G); 124-07-2 (octanoic acid)
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150227
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003501

  6 / 253060 MEDLINE  
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[PMID]: 25719489
[Au] Autor:Duval D; Galinier R; Mouahid G; Toulza E; Allienne JF; Portela J; Calvayrac C; Rognon A; Arancibia N; Mitta G; Théron A; Gourbal B
[Ad] Address:CNRS, UMR 5244, Ecologie et Evolution des Interactions (2EI), Perpignan, France; Université de Perpignan Via Domitia, Perpignan, France....
[Ti] Title:A novel bacterial pathogen of Biomphalaria glabrata: a potential weapon for schistosomiasis control?
[So] Source:PLoS Negl Trop Dis;9(2):e0003489, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Schistosomiasis is the second-most widespread tropical parasitic disease after malaria. Various research strategies and treatment programs for achieving the objective of eradicating schistosomiasis within a decade have been recommended and supported by the World Health Organization. One of these approaches is based on the control of snail vectors in endemic areas. Previous field studies have shown that competitor or predator introduction can reduce snail numbers, but no systematic investigation has ever been conducted to identify snail microbial pathogens and evaluate their molluscicidal effects. METHODOLOGY/PRINCIPAL FINDINGS: In populations of Biomphalaria glabrata snails experiencing high mortalities, white nodules were visible on snail bodies. Infectious agents were isolated from such nodules. Only one type of bacteria, identified as a new species of Paenibacillus named Candidatus Paenibacillus glabratella, was found, and was shown to be closely related to P. alvei through 16S and Rpob DNA analysis. Histopathological examination showed extensive bacterial infiltration leading to overall tissue disorganization. Exposure of healthy snails to Paenibacillus-infected snails caused massive mortality. Moreover, eggs laid by infected snails were also infected, decreasing hatching but without apparent effects on spawning. Embryonic lethality was correlated with the presence of pathogenic bacteria in eggs. CONCLUSIONS/SIGNIFICANCE: This is the first account of a novel Paenibacillus strain, Ca. Paenibacillus glabratella, as a snail microbial pathogen. Since this strain affects both adult and embryonic stages and causes significant mortality, it may hold promise as a biocontrol agent to limit schistosomiasis transmission in the field.
[Mh] MeSH terms primary: Biological Control Agents
Biomphalaria/microbiology
Disease Eradication/methods
Paenibacillus/pathogenicity
Schistosoma
Schistosomiasis/prevention & control
[Mh] MeSH terms secundary: Animals
Disease Vectors
Molecular Sequence Data
Ovum/microbiology
Paenibacillus/classification
Paenibacillus/isolation & purification
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Biological Control Agents)
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150227
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003489

  7 / 253060 MEDLINE  
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[PMID]: 25710789
[Au] Autor:Andreani G; Ouellet M; Menasria R; Gomez AM; Barat C; Tremblay MJ
[Ad] Address:Axe des Maladies Infectieuses et Immunitaires, Centre de recherche du Centre Hospitalier Universitaire (CHU) de Québec-pavillon CHUL, Québec, Canada....
[Ti] Title:Leishmania infantum amastigotes trigger a subpopulation of human B cells with an immunoregulatory phenotype.
[So] Source:PLoS Negl Trop Dis;9(2):e0003543, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Visceral leishmaniasis is caused by the protozoan parasites Leishmania infantum and Leishmania donovani. This infection is characterized by an uncontrolled parasitization of internal organs which, when left untreated, leads to death. Disease progression is linked with the type of immune response generated and a strong correlation was found between disease progression and serum levels of the immunosuppressive cytokine IL-10. Other studies have suggested a role for B cells in the pathology of this parasitic infection and the recent identification of a B-cell population in humans with regulatory functions, which secretes large amounts of IL-10 following activation, have sparked our interest in the context of visceral leishmaniasis. We report here that incubation of human B cells with Leishmania infantum amastigotes resulted in upregulation of multiple cell surface activation markers and a dose-dependent secretion of IL-10. Conditioned media from B cells incubated with Leishmania infantum amastigotes were shown to strongly inhibit CD4(+) T-cell activation, proliferation and function (i.e. as monitored by TNF and IFNγ secretion). Blockade of IL-10 activity using a soluble IL-10 receptor restored only partially TNF and IFNγ production to control levels. The parasite-mediated IL-10 secretion was shown to rely on the activity of Syk, phosphatidylinositol-3 kinase and p38, as well as to require intracellular calcium mobilization. Cell sorting experiments allowed us to identify the IL-10-secreting B-cell subset (i.e. CD19(+)CD24(+)CD27(-)). In summary, exposure of human B cells to Leishmania infantum amastigotes triggers B cells with regulatory activities mediated in part by IL-10, which could favor parasite dissemination in the organism.
[Mh] MeSH terms primary: B-Lymphocyte Subsets/immunology
Interleukin-10/immunology
Leishmania donovani/immunology
Leishmania infantum/immunology
Leishmaniasis, Visceral/immunology
[Mh] MeSH terms secundary: B-Lymphocyte Subsets/parasitology
Calcium/metabolism
Culture Media, Conditioned/chemistry
Disease Progression
Humans
Interleukin-10/blood
Intracellular Signaling Peptides and Proteins/metabolism
Leishmaniasis, Visceral/parasitology
Lymphocyte Activation/immunology
Phenotype
Phosphatidylinositol 3-Kinase/metabolism
Protein-Tyrosine Kinases/metabolism
p38 Mitogen-Activated Protein Kinases/metabolism
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Culture Media, Conditioned); 0 (IL10 protein, human); 0 (Intracellular Signaling Peptides and Proteins); 130068-27-8 (Interleukin-10); EC 2.7.1.137 (Phosphatidylinositol 3-Kinase); EC 2.7.10.1 (Protein-Tyrosine Kinases); EC 2.7.10.1 (Syk kinase); EC 2.7.11.24 (p38 Mitogen-Activated Protein Kinases); SY7Q814VUP (Calcium)
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150225
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003543

  8 / 253060 MEDLINE  
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[PMID]: 25710684
[Au] Autor:Carter MJ; Emary KR; Moore CE; Parry CM; Sona S; Putchhat H; Reaksmey S; Chanpheaktra N; Stoesser N; Dobson AD; Day NP; Kumar V; Blacksell SD
[Ad] Address:Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Institute of Child Health, University College London, London, Uni...
[Ti] Title:Rapid diagnostic tests for dengue virus infection in febrile Cambodian children: diagnostic accuracy and incorporation into diagnostic algorithms.
[So] Source:PLoS Negl Trop Dis;9(2):e0003424, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Dengue virus (DENV) infection is prevalent across tropical regions and may cause severe disease. Early diagnosis may improve supportive care. We prospectively assessed the Standard Diagnostics (Korea) BIOLINE Dengue Duo DENV rapid diagnostic test (RDT) to NS1 antigen and anti-DENV IgM (NS1 and IgM) in children in Cambodia, with the aim of improving the diagnosis of DENV infection. METHODOLOGY AND PRINCIPAL FINDINGS: We enrolled children admitted to hospital with non-localised febrile illnesses during the 5-month DENV transmission season. Clinical and laboratory variables, and DENV RDT results were recorded at admission. Children had blood culture and serological and molecular tests for common local pathogens, including reference laboratory DENV NS1 antigen and IgM assays. 337 children were admitted with non-localised febrile illness over 5 months. 71 (21%) had DENV infection (reference assay positive). Sensitivity was 58%, and specificity 85% for RDT NS1 and IgM combined. Conditional inference framework analysis showed the additional value of platelet and white cell counts for diagnosis of DENV infection. Variables associated with diagnosis of DENV infection were not associated with critical care admission (70 children, 21%) or mortality (19 children, 6%). Known causes of mortality were melioidosis (4), other sepsis (5), and malignancy (1). 22 (27%) children with a positive DENV RDT had a treatable other infection. CONCLUSIONS: The DENV RDT had low sensitivity for the diagnosis of DENV infection. The high co-prevalence of infections in our cohort indicates the need for a broad microbiological assessment of non-localised febrile illness in these children.
[Mh] MeSH terms primary: Dengue Virus/immunology
Dengue/diagnosis
Diagnostic Tests, Routine/methods
Immunoglobulin M/immunology
Viral Nonstructural Proteins/immunology
[Mh] MeSH terms secundary: Algorithms
Cambodia
Child
Child, Preschool
Dengue/mortality
Dengue/virology
Female
Fever/diagnosis
Fever/virology
Humans
Immunoglobulin M/blood
Infant
Male
Prevalence
Prospective Studies
Reagent Kits, Diagnostic
Republic of Korea
Sensitivity and Specificity
[Pt] Publication type:EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Immunoglobulin M); 0 (Reagent Kits, Diagnostic); 0 (Viral Nonstructural Proteins)
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150225
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003424

  9 / 253060 MEDLINE  
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[PMID]: 25706653
[Au] Autor:Brook CE; Bai Y; Dobson AP; Osikowicz LM; Ranaivoson HC; Zhu Q; Kosoy MY; Dittmar K
[Ad] Address:Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America....
[Ti] Title:Bartonella spp. in fruit bats and blood-feeding Ectoparasites in Madagascar.
[So] Source:PLoS Negl Trop Dis;9(2):e0003532, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We captured, ectoparasite-combed, and blood-sampled cave-roosting Madagascan fruit bats (Eidolon dupreanum) and tree-roosting Madagascan flying foxes (Pteropus rufus) in four single-species roosts within a sympatric geographic foraging range for these species in central Madagascar. We describe infection with novel Bartonella spp. in sampled Eidolon dupreanum and associated bat flies (Cyclopodia dubia), which nest close to or within major known Bartonella lineages; simultaneously, we report the absence of Bartonella spp. in Thaumapsylla sp. fleas collected from these same bats. This represents the first documented finding of Bartonella infection in these species of bat and bat fly, as well as a new geographic record for Thaumapsylla sp. We further relate the absence of both Bartonella spp. and ectoparasites in sympatrically sampled Pteropus rufus, thus suggestive of a potential role for bat flies in Bartonella spp. transmission. These findings shed light on transmission ecology of bat-borne Bartonella spp., recently demonstrated as a potentially zoonotic pathogen.
[Mh] MeSH terms primary: Bartonella Infections/transmission
Bartonella/pathogenicity
Chiroptera/microbiology
Disease Reservoirs/microbiology
Siphonaptera/microbiology
[Mh] MeSH terms secundary: Animals
Bartonella/genetics
Bartonella Infections/microbiology
Female
Madagascar
Molecular Sequence Data
Phylogeny
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150224
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003532

  10 / 253060 MEDLINE  
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[PMID]: 25706392
[Au] Autor:Znazen A; Sellami H; Elleuch E; Hattab Z; Ben Sassi L; Khrouf F; Dammak H; Letaief A; Ben Jemaa M; Hammami A
[Ad] Address:Laboratory of Microbiology, Research Laboratory "MPH", Habib Bourguiba University Hospital of Sfax, Sfax University, Sfax, Tunisia....
[Ti] Title:Comparison of two quantitative real time PCR assays for Rickettsia detection in patients from Tunisia.
[So] Source:PLoS Negl Trop Dis;9(2):e0003487, 2015 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND OBJECTIVES: Quantitative real time PCR (qPCR) offers rapid diagnosis of rickettsial infections. Thus, successful treatment could be initiated to avoid unfavorable outcome. Our aim was to compare two qPCR assays for Rickettsia detection and to evaluate their contribution in early diagnosis of rickettsial infection in Tunisian patients. PATIENTS AND METHODS: Included patients were hospitalized in different hospitals in Tunisia from 2007 to 2012. Serology was performed by microimmunofluorescence assay using R. conorii and R. typhi antigens. Two duplex qPCRs, previously reported, were performed on collected skin biopsies and whole blood samples. The first duplex amplified all Rickettsia species (PanRick) and Rickettsia typhi DNA (Rtt). The second duplex detected spotted fever group Rickettsiae (RC00338) and typhus group Rickettsiae DNA (Rp278). RESULTS: Diagnosis of rickettsiosis was confirmed in 82 cases (57.7%). Among 44 skin biopsies obtained from patients with confirmed diagnosis, the first duplex was positive in 24 samples (54.5%), with three patients positive by Rtt qPCR. Using the second duplex, positivity was noted in 21 samples (47.7%), with two patients positive by Rp278 qPCR. Among79 whole blood samples obtained from patients with confirmed diagnosis, panRick qPCR was positive in 5 cases (6.3%) among which two were positive by Rtt qPCR. Using the second set of qPCRs, positivity was noted in four cases (5%) with one sample positive by Rp278 qPCR. Positivity rates of the two duplex qPCRs were significantly higher among patients presenting with negative first serum than those with already detectable antibodies. CONCLUSIONS: Using qPCR offers a rapid diagnosis. The PanRick qPCR showed a higher sensitivity. Our study showed that this qPCR could offer a prompt diagnosis at the early stage of the disease. However, its implementation in routine needs cost/effectiveness evaluation.
[Mh] MeSH terms primary: Antigens, Bacterial/immunology
DNA, Bacterial/genetics
Fluorescent Antibody Technique/methods
Rickettsia typhi/isolation & purification
Typhus, Endemic Flea-Borne/diagnosis
[Mh] MeSH terms secundary: Adult
DNA, Bacterial/analysis
Early Diagnosis
Female
Humans
Male
Middle Aged
Real-Time Polymerase Chain Reaction/methods
Rickettsia typhi/genetics
Tunisia
Typhus, Endemic Flea-Borne/microbiology
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Name of substance:0 (Antigens, Bacterial); 0 (DNA, Bacterial)
[Em] Entry month:1601
[Cu] Class update date: 150305
[Lr] Last revision date:150305
[Js] Journal subset:IM
[Da] Date of entry for processing:150224
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0003487


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