Recommendations for SARS-CoV- 2/ COVID-19 testing: a scoping review of current guidance

Background Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV- 2/COVID-19. Methods We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool. Results We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were ‘Editorial independence’ (Median=4%) and ‘Applicability’ (Median=6%). Only six documents obtained at least 50% score for the ‘Rigour of development’ domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov- 2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens. Conclusion This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.Instituto de Salud Carlos III 2017/CD17/00219European Social Fund 2014-2020, 'Investing in your future'Spanish Governmen

Free PCR virus detection via few-layer bismuthene and tetrahedral DNA nanostructured assemblies

In this work we describe a highly sensitive method based on a biocatalyzed electrochemiluminescence approach. The system combines, for the first time, the use of few-layer bismuthene (FLB) as a platform for the oriented immobilization of tetrahedral DNA nanostructures (TDNs) specifically designed and synthetized to detect a specific SARS-CoV-2 gene sequence. In one of its vertices, these TDNs contain a DNA capture probe of the open reading frame 1 ab (ORF1ab) of the virus, available for the biorecognition of the target DNA/RNA. At the other three vertices, there are thiol groups that enable the stable anchoring/binding to the FLB surface. This novel geometry/approach enables not only the binding of the TDNs to surfaces, but also the orientation of the capture probe in a direction normal to the bismuthine surface so that it is readily accessible for binding/recognition of the specific SARS-CoV-2 sequence. The analytical signal is based on the anodic electrochemiluminescence (ECL) intensity of luminol which, in turn, arises as a result of the reaction with H2O2, generated by the enzymatic reaction of glucose oxidation, catalyzed by the biocatalytic label avidin-glucose oxidase conjugate (Av-GOx), which acts as co-reactant in the electrochemiluminescent reaction. The method exhibits a limit of detection (LOD) of 4.31 aM and a wide linear range from 14.4 aM to 1.00 μM, and its applicability was confirmed by detecting SARS-CoV-2 in nasopharyngeal samples from COVID-19 patients without the need of any amplification processPID2020-116728RB-I00, PID2020-116661RB-I00, PID2020-119352RB-I00, PDC2021-120782-C2, PID2022-138908NB-C31, CTQ2015-71955-REDT, S2018/NMT-434

Impacto de los movimientos migratorios en la resistencia bacteriana a los antibióticos

Background: Spain is among the main receptor countries for immigration; but there are few studies available which target antibiotic-resistance in immigrants. Our objective was to review the current knowledge on the impact of antibiotic resistance in immigrants compared with the prevalence in the autochthonous population. Methods: A comprehensive bibliographical search was performed to detect published works in the 1998-2013 period. Common keywords were: resistance; immigrant, and Spain; particular keywords were: Mycobacterium tuberculosis, Neisseria gonorrhoeae, or Enterobacteriaceae and travellers in each topic. Results: Global percentage of resistant M. tuberculosis strains was 2.5-4 times more frequent in immigrant population than native population. The proportion of MDR strains was also higher in adult and infant immigrant populations (2,5% and 4,5% respectively) than in native population (0,1%-0% respectively). Known cases of gonorrhoea among immigrant population represented 28%, proceeding from geographical areas with high resistance to macrolide (30%) and cephalosporins (20%). This data revels the possibility of dissemination of untreatable N. gonorrhoeae strains. The detection of multidrug-resistant Enterobacteriaceae in Spaniard travellers visiting countries with high rates of antibiotic resistance was increased from 7.9% to 17.9% (even 37.4% in native travellers from India). Conclusion: The different rates of antibiotic resistance between native and immigrant populations in the studied models in this review, revealed as the migration can affect to emergence and re-emergence of infection diseases, but also the potential spreading of untreatable microorganisms.Fundamentos: España es uno de los principales aceptores mundiales de inmigrantes. Sin embargo existen escasos trabajos sobre la caracterización de bacterias resistentes en la población inmigrante en España. El objetivo es conocer el impacto de la inmigración en la prevalencia de la resistencia antibiótica en España. Métodos: Se realizó una revisión bibliográfica artículos originales publicados entre 1998-2013 realizando la búsqueda con las palabras clave resistencia, inmigrante y España más Mycobacterium tuberculosis, Neisseria gonorrhoeae o Enterobacteriaceae y diarrea del viajero para cada uno de los sub-apartados. Resultados: El porcentaje global de cepas de M. tuberculosis resistentes fue 2,5-4 veces más frecuente en la población inmigrante que en la población nativa. La proporción de cepas multiresistentes fue también mayor en población inmigrante adulta (2,5%) e infantil (4,5%) respecto a población autóctona (0,1-0%) respectivamente. El 28% de casos de gonococia en España se detectaron en inmigrantes procedentes de áreas con altos niveles de resistencia a macrólidos (30%) y cefalosporinas (20%) suponiendo un peligro de diseminación de cepas de N. gonorrhoeae de difícil tratamiento. La detección de enterobacterias multiresistentes en individuos españoles antes y después de realizar viajes a países con alta resistencia se elevó desde 7,9% a 17,9% (a 37,4% en personas procedentes de India). Conclusiones: Las diferentes tasas de resistencia entre población autóctona y población inmigrante en los modelos estudiados en esta revisión revelan que los flujos migratorios no solo afectan a la emergencia o re-emergencia de enfermedades infecciosas sino también a la elección de tratamiento efectivo

Infección VIH/Sida y otras infecciones de transmisión sexual en la población inmigrante en España: revisión bibliográfica

Background: Migration flows have the ability to disperse infectious agents and alter local epidemiologies. The aim of the study is to describe the socio-epidemiological, clinical and microbiology / molecular epidemiology of HIV / AIDS infection in the immigrant population. Methods: Review of the literature following the methodology Scoping review. A literature search in Medline and MEDES, original items made in Spain, published between 1998-2012, with people from Latin America, sub-Saharan Africa, North Africa, Asia and / or Eastern Europe was conducted. Results: 41 articles were selected. The most studied population was from Latin America (48.8%). Higher HIV prevalence than in native was observed in men who have sex with men from Latin America (18.1%), transvestite and transsexual sex workers from Latin America (23.3%), pregnant women (0.9%) and men and women from sub-Saharan Africa (9.1% and 7.5%). Risk behaviors were different depending on the country of origin and sex. The diagnostic delay of HIV infections reached 43%, with higher prevalence in immigrants from sub-Saharan Africa, which showed delayed diagnosis in 41% and resistance to anti-retroviral treatment in 13%. Immigrant women had more losses to follow up, worse immunological response to antiretroviral treatment and shorter time treatment failure. Conclusion: Higher prevalence of HIV is presented by subjects from sub-Saharan Africa, men who have sex with men and transgender and transvestite sex workers from Latin America. Also pregnant women. Delayed diagnosis and resistance to treatment are more common in individuals from sub-Saharan Africa. Immigrant women presented poorer response to antiretroviral treatment.Fundamentos: Los flujos migratorios tienen la capacidad de dispersar agentes infecciosos y alterar las epidemiologías locales. El objetivo del estudio es describir las características socio-epidemiológicas, clínicas y de microbiología/epidemiología molecular de la infección VIH/Sida en la población inmigrada. Métodos: Revisión de la literatura científica mediante la metodología de Scoping Review. Se realizó una búsqueda bibliográfica en las bases de datos Medline y MEDES. Se seleccionaron artículos originales realizados en España y publicados entre 1998-2012, en los que participara población procedente de América Latina, África subsahariana, Norte de África, Asia y Europa del Este. Resultados: Se seleccionaron 41 artículos. La población más estudiada fue la de América Latina (48,8%). Se observaron prevalencias mayores de VIH que en autóctonos en los hombres que tienen sexo con hombres de América Latina (18,1%), travestis y transexuales trabajadores del sexo de América Latina (23,3%), mujeres gestantes (0,9%) y hombres y mujeres de África Subsahariana (9,1% y 7,5%). Las conductas de riesgo fueron diferentes en función del país de origen y del sexo. El retraso diagnóstico llegó al 43% de las infecciones VIH, hallándose mayor prevalencia en inmigrantes de África subsahariana, que mostraron retraso diagnóstico en el 41% y resistencias al tratamiento anti-retroviral en el 13%. Las mujeres inmigrantes presentaron más pérdidas de seguimiento, peor respuesta inmunológica al TARV y menor tiempo de fracaso terapéutico. Conclusiones: La mayor prevalencia de VIH la presentan los sujetos procedentes de África subsahariana y los hombres que tienen sexo con hombres y travestis y transexuales trabajadores del sexo de América Latina. También las mujeres gestantes. El retraso diagnóstico y las resistencias al tratamiento son más frecuentes en sujetos de África Subsahariana. Las mujeres inmigrantes respondieron peor al tratamiento antiretroviral