11 research outputs found
Evolution and Application of Inteins in Candida species: a Review
Inteins are invasive intervening sequences that perform an autocatalytic splicing from their host proteins. Among eukaryotes, these elements are present in many fungal species, including those considered opportunistic or primary pathogens, such as Candida spp. Here we reviewed and updated the list of Candida species containing inteins in the genes VMA, THRRS and GLT1 and pointed out the importance of these elements as molecular markers for molecular epidemiological researches and species-specific diagnosis, since the presence, as well as the size of these inteins, is polymorphic among the different species. Although absent in Candida albicans, these elements are present in different sizes, in some environmental Candida spp. and also in most of the non-albicans Candida spp. considered emergent opportunistic pathogens. Besides, the possible role of these inteins in yeast physiology was also discussed in the light of the recent findings on the importance of these elements as post-translational modulators of gene expression, reinforcing their relevance as alternative therapeutic targets for the treatment of non-albicans Candida infections, because, once the splicing of an intein is inhibited, its host protein, which is usually a housekeeping protein, becomes nonfunctional
Loop-mediated Isothermal Amplification and nested PCR of the Internal Transcribed Spacer (ITS) for Histoplasma capsulatum detection.
BackgroundHistoplasmosis is a neglected disease that affects mainly immunocompromised patients, presenting a progressive dissemination pattern and a high mortality rate, mainly due to delayed diagnosis, caused by slow fungal growth in culture. Therefore, a fast, suitable and cost-effective assay is required for the diagnosis of histoplasmosis in resource-limited laboratories. This study aimed to develop and evaluate two new molecular approaches for a more cost-effective diagnosis of histoplasmosis.MethodologySeeking a fast, suitable, sensitive, specific and low-cost molecular detection technique, we developed a new Loop-mediated Isothermal Amplification (LAMP) assay and nested PCR, both targeting the Internal Transcribed Spacer (ITS) multicopy region of Histoplasma capsulatum. The sensitivity was evaluated using 26 bone marrow and 1 whole blood specimens from patients suspected to have histoplasmosis and 5 whole blood samples from healthy subjects. All specimens were evaluated in culture, as a reference standard test, and Hcp100 nPCR, as a molecular reference test. A heparin-containing whole blood sample from a heathy subject was spiked with H. capsulatum cells and directly assayed with no previous DNA extraction.ResultsBoth assays were able to detect down to 1 fg/ÎŒL of H. capsulatum DNA, and ITS LAMP results could also be revealed to the naked-eye by adding SYBR green to the reaction tube. In addition, both assays were able to detect all clades of Histoplasma capsulatum cryptic species complex. No cross-reaction with other fungal pathogens was presented. In comparison with Hcp100 nPCR, both assays reached 83% sensitivity and 92% specificity. Furthermore, ITS LAMP assay showed no need for DNA extraction, since it could be directly applied to crude whole blood specimens, with a limit of detection of 10 yeasts/ÎŒL.ConclusionITS LAMP and nPCR assays have the potential to be used in conjunction with culture for early diagnosis of progressive disseminated histoplasmosis, allowing earlier, appropriate treatment of the patient. The possibility of applying ITS LAMP, as a direct assay, with no DNA extraction and purification steps, makes it suitable for resource-limited laboratories. However, more studies are necessary to validate ITS LAMP and nPCR as direct assay in other types of clinical specimens
Cryptococcus neoformans Prp8 Intein: An In Vivo Target-Based Drug Screening System in Saccharomyces cerevisiae to Identify Protein Splicing Inhibitors and Explore Its Dynamics
Inteins are genetic mobile elements that are inserted within protein-coding genes, which are usually housekeeping genes. They are transcribed and translated along with the host gene, then catalyze their own splicing out of the host protein, which assumes its functional conformation thereafter. As Prp8 inteins are found in several important fungal pathogens and are absent in mammals, they are considered potential therapeutic targets since inhibiting their splicing would selectively block the maturation of fungal proteins. We developed a target-based drug screening system to evaluate the splicing of Prp8 intein from the yeast pathogen Cryptococcus neoformans (CnePrp8i) using Saccharomyces cerevisiae Ura3 as a non-native host protein. In our heterologous system, intein splicing preserved the full functionality of Ura3. To validate the system for drug screening, we examined cisplatin, which has been described as an intein splicing inhibitor. By using our system, new potential protein splicing inhibitors may be identified and used, in the future, as a new class of drugs for mycosis treatment. Our system also greatly facilitates the visualization of CnePrp8i splicing dynamics in vivo
Monitoring the Establishment of VOC Gamma in Minas Gerais, Brazil: A Retrospective Epidemiological and Genomic Surveillance Study
Since its first identification in Brazil, the variant of concern (VOC) Gamma has been associated with increased infection and transmission rates, hospitalizations, and deaths. Minas Gerais (MG), the second-largest populated Brazilian state with more than 20 million inhabitants, observed a peak of cases and deaths in March–April 2021. We conducted a surveillance study in 1240 COVID-19-positive samples from 305 municipalities distributed across MG’s 28 Regional Health Units (RHU) between 1 March to 27 April 2021. The most common variant was the VOC Gamma (71.2%), followed by the variant of interest (VOI) zeta (12.4%) and VOC alpha (9.6%). Although the predominance of Gamma was found in most of the RHUs, clusters of Zeta and Alpha variants were observed. One Alpha-clustered RHU has a history of high human mobility from countries with Alpha predominance. Other less frequent lineages, such as P.4, P.5, and P.7, were also identified. With our genomic characterization approach, we estimated the introduction of Gamma on 7 January 2021, at RHU Belo Horizonte. Differences in mortality between the Zeta, Gamma and Alpha variants were not observed. We reinforce the importance of vaccination programs to prevent severe cases and deaths during transmission peaks
Field and classroom initiatives for portable sequence-based monitoring of dengue virus in Brazil
This work was supported by Decit, SCTIE, Brazilian
Ministry of Health, Conselho Nacional de Desenvolvimento CientĂfico - CNPq (440685/
2016-8, 440856/2016-7 and 421598/2018-2), Coordenação de Aperfeiçoamento de Pessoal de NĂvel Superior - CAPES - (88887.130716/2016-00), European Unionâs Horizon
2020 Research and Innovation Programme under ZIKAlliance Grant Agreement
(734548), STARBIOS (709517), Fundação de Amparo à Pesquisa do Estado do Rio de
Janeiro â FAPERJ (E-26/2002.930/2016), International Development Research Centre
(IDRC) Canada (108411-001), European Unionâs Horizon 2020 under grant agreements
ZIKACTION (734857) and ZIKAPLAN (734548).Fundação Ezequiel Dias. LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Minas Gerais. Belo Horizonte, MG, Brazil / Latin American Genomic Surveillance Arboviral Network.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil / Latin American Genomic Surveillance Arboviral Network.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil Latin American Genomic Surveillance Arboviral Network.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto LeĂŽnidas e Maria Deane. LaboratĂłrio de Ecologia de Doenças TransmissĂveis na AmazĂŽnia. Manaus, AM, Brazil.Secretaria de SaĂșde do Estado de Mato Grosso do Sul. LaboratĂłrio Central de SaĂșde PĂșblica. Campo Grande, MS, Brazil.Fundação Ezequiel Dias. LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Minas Gerais. Belo Horizonte, MG, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Dr. Giovanni Cysneiros. GoiĂąnia, GO, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Professor Gonçalo Moniz. Salvador, BA, Brazil.Secretaria de SaĂșde do Estado da Bahia. Salvador, BA, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Dr. Milton Bezerra Sobral. Recife, PE, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Mato Grosso. CuiabĂĄ, MT, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Distrito Federal. BrasĂlia, DF, Brazil.Fundação Ezequiel Dias. LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Minas Gerais. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Coordenação Geral dos LaboratĂłrios de SaĂșde PĂșblica. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Coordenação Geral dos LaboratĂłrios de SaĂșde PĂșblica. BrasĂlia, DF, Brazil.Organização Pan-Americana da SaĂșde / Organização Mundial da SaĂșde. BrasĂlia, DF, Brazil.Organização Pan-Americana da SaĂșde / Organização Mundial da SaĂșde. BrasĂlia, DF, Brazil.Organização Pan-Americana da SaĂșde / Organização Mundial da SaĂșde. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde Coordenação Geral das Arboviroses. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde Coordenação Geral das Arboviroses. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde Coordenação Geral das Arboviroses. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde Coordenação Geral das Arboviroses. BrasĂlia, DF, Brazil.Fundação Hemocentro de RibeirĂŁo Preto. RibeirĂŁo Preto, SP, Brazil.Gorgas Memorial Institute for Health Studies. Panama, Panama.Universidade Federal da Bahia. VitĂłria da Conquista, BA, Brazil.Laboratorio Central de Salud PĂșblica. AsunciĂłn, Paraguay.Fundação Oswaldo Cruz. Bio-Manguinhos. Rio de Janeiro, RJ, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Coordenação Geral dos LaboratĂłrios de SaĂșde PĂșblica. BrasĂlia, DF, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, BrazilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, BrazilMinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Mato Grosso do Sul. Campo Grande, MS, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Mato Grosso do Sul. Campo Grande, MS, Brazil.Instituto de Investigaciones en Ciencias de la Salud. San Lorenzo, Paraguay.Secretaria de Estado de SaĂșde de Mato Grosso do Sul. Campo Grande, MS, Brazil.Fundação Oswaldo Cruz. Campo Grande, MS, Brazil.Fundação Hemocentro de RibeirĂŁo Preto. RibeirĂŁo Preto, SP, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Dr. Giovanni Cysneiros. GoiĂąnia, GO, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Dr. Giovanni Cysneiros. GoiĂąnia, GO, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Professor Gonçalo Moniz. Salvador, BA, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Dr. Milton Bezerra Sobral. Recife, PE, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Distrito Federal. BrasĂlia, DF, Brazil.Secretaria de SaĂșde de Feira de Santana. Feira de Santana, Ba, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Secretaria de SaĂșde do Estado de Minas Gerais. Belo Horizonte, MG, Brazil.Hospital das Forças Armadas. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. BrasĂlia, DF, Brazil.Universidade Nova de Lisboa. Instituto de Higiene e Medicina Tropical. Lisboa, Portugal.University of Sydney. School of Life and Environmental Sciences and School of Medical Sciences. Marie Bashir Institute for Infectious Diseases and Biosecurity. Sydney, NSW, Australia.University of KwaZulu-Natal. College of Health Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform. Durban, South Africa.University of Oxford. Peter Medawar Building. Department of Zoology. Oxford, UK.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Universidade Estadual de Feira de Santana. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil.Universidade de BrasĂlia. BrasĂlia, DF, Brazil.Universidade Salvador. Salvador, BA, Brazil.Fundação Ezequiel Dias. Belo Horizonte, MG, Brazil.Fundação Ezequiel Dias. Belo Horizonte, MG, Brazil.Fundação Ezequiel Dias. Belo Horizonte, MG, Brazil.Fundação Ezequiel Dias. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de FlavivĂrus. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. LaboratĂłrio de Hantaviroses e Rickettsioses. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto LeĂŽnidas e Maria Deane. LaboratĂłrio de Ecologia de Doenças TransmissĂveis na AmazĂŽnia. Manaus, AM, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Medicina VeterinĂĄria. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Medicina VeterinĂĄria. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado do ParanĂĄ. Curitiba, PR, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado de RondĂŽnia. Porto Velho, RO, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado do Amazonas. Manaus, AM, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado do Rio Grande do Norte. Natal, RN, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica do Estado de Mato Grosso. CuiabĂĄ, MT, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Professor Gonçalo Moniz. Salvador, BA, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Professor Gonçalo Moniz. Salvador, BA, Brazil.LaboratĂłrio Central de SaĂșde PĂșblica Noel Nutels. Rio de Janeiro, RJ, Brazil.Instituto Adolfo Lutz. SĂŁo Paulo, SP, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Universidade de SĂŁo Paulo. Instituto de Medicina Tropical. SĂŁo Paulo, SP, Brazil.Universidade de SĂŁo Paulo. Instituto de Medicina Tropical. SĂŁo Paulo, SP, Brazil.Universidade de SĂŁo Paulo. Instituto de Medicina Tropical. SĂŁo Paulo, SP, Brazil.University of Oxford. Peter Medawar Building. Department of Zoology. Oxford, UK.Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui. Pergamino, Argentina.Gorgas Memorial Institute for Health Studies. Panama, Panama.Gorgas Memorial Institute for Health Studies. Panama, Panama.Gorgas Memorial Institute for Health Studies. Panama, Panama.Instituto de Salud PĂșblica de Chile. Santiago, Chile.Instituto de DiagnĂłstico y Referencia EpidemiolĂłgicos Dr. Manuel MartĂnez BĂĄez. Ciudad de MĂ©xico, MĂ©xico.Instituto Nacional de Enfermedades Infecciosas Dr Carlos G MalbrĂĄn. Buenos Aires, Argentina.Ministerio de Salud PĂșblica de Uruguay. Montevideo, Uruguay.Instituto Costarricense de InvestigaciĂłn y Enseñanza em NutriciĂłn y Salud. Tres RĂos, Costa Rica.Instituto Nacional de Investigacion en Salud Publica Dr Leopoldo Izquieta PĂ©rez. Guayaquil, Ecuador.Instituto Nacional de Investigacion en Salud Publica Dr Leopoldo Izquieta PĂ©rez. Guayaquil, Ecuador.Universidade Federal de Pernambuco. Recife, PE, Brazil.Secretaria de SaĂșde do Estado de Minas Gerais. Belo Horizonte. MG, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. BrasĂlia, DF, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. BrasĂlia, DF, Brazil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Universidade Federal de Ouro Preto. Ouro Preto, MG, Brazil.Universidade Federal de Ouro Preto. Ouro Preto, MG, Brazil.Universidade Federal de Ouro Preto. Ouro Preto, MG, Brazil.Universidade Federal de Ouro Preto. Ouro Preto, MG, Brazil.Fundação Hemocentro de RibeirĂŁo Preto. RibeirĂŁo Preto, SP, Brazil.Secretaria de SaĂșde de Feira de Santana. Feira de Santana, BA, Brazil.Universidade Federal de Minas Gerais. Instituto de CiĂȘncias BiolĂłgicas. Belo Horizonte, MG, Brazil.Brazil experienced a large dengue virus (DENV) epidemic in 2019, highlighting a continuous struggle with effective control and public health preparedness. Using Oxford Nanopore sequencing, we led field and classroom initiatives for the monitoring of DENV in Brazil, generating 227 novel genome sequences of DENV1-2 from 85 municipalities (2015â2019). This equated to an over 50% increase in the number of DENV genomes from Brazil available in public databases. Using both phylogenetic and epidemiological models we retrospectively reconstructed the recent transmission history of DENV1-2. Phylogenetic analysis revealed complex patterns of transmission, with both lineage co-circulation and replacement. We identified two lineages within the DENV2 BR-4 clade, for which we estimated the effective reproduction number and pattern of seasonality. Overall, the surveillance outputs and training initiative described here serve as a proof-of-concept for the utility of real-time portable sequencing for research and local capacity building in the genomic surveillance of emerging viruses
Recommended from our members
7th Drug hypersensitivity meeting: part two
Table of contents Poster walk 11: miscellaneous drug hypersensitivity 2 (P92âP94, P96âP101) P92 16 years of experience with proton pump inhibitors (PPIs) Javier Dionicio Elera, Cosmin Boteanu, Maria Aranzazu Jimenez Blanco, Rosario Gonzalez-Mendiola, Irene Carrasco GarcĂa, Antonio Alvarez, Jose Julio Laguna Martinez P93 Allergy evaluation of quinolone induced adverse reactions Jaume MartĂ Garrido, Carla TorĂĄn Barona, Carolina Perales Chorda, RamĂłn LĂłpez Salgueiro, Miguel DĂaz Palacios, Dolores HernĂĄndez FernĂĄndez De Rojas P94 Bupropion-induced acute urticaria and angioedema, a case report Emre Ali Acar, Ayse Aktas, Aylin TĂŒrel Ermertcan, Peyker Temiz P96 Delayed type hypersensitivity and study of cross-reactivity between proton-pump inhibitors Chien-Yio Lin, Chung-Yee Rosaline Hui, Ya-Ching Chang, Chih-Hsun Yang, Wen-Hung Chung P97 Diagnostic work-up in suspected hypersensitivity to proton-pump inhibitors: looking at cross-reactivity FabrĂcia Carolino, Diana Silva, Eunice Dias De Castro, Josefina R. Cernadas P98 Management of infusion-related hypersensitivity reactions to enzyme replacement therapy for lysosomal diseases Luis Felipe Ensina, Carolina Aranda, Ines Camelo Nunes, Alex Lacerda, Ana Maria Martins, Ekaterini Goudouris, Marcia Ribeiro, JosĂ© Francisco Da Silva Franco, Leandra Queiroz, Dirceu SolĂ© P99 Management of insulin allergy with continuous subcutaneous insulin infusion Ceyda Tunakan Dalgiç, AytĂŒl Zerrin Sin, Fatma DĂŒsĂŒnĂŒr GĂŒnsen, Gökten Bulut, Fatma ĂmĂŒr Ardeniz, Okan GĂŒlbahar, Emine Nihal Mete Gökmen, Ali Kokuludag P100 Off-label use of icatibant for management of serious angioedema associated with angiotensin inhibitors Ana M. Montoro De Francisco, TalĂa MÂȘ De Vicente JimĂ©nez, Adriana M. Mendoza Parra, Angella M. Burgos Pimentel, Amelia GarcĂa Luque P101 Thiocolchicoside anaphylaxis: an unusual suspect? Luis Amaral, Fabricia Carolino, Leonor Carneiro LeĂŁo, Eunice Castro, Josefina Cernadas Poster walk 12: betalactam hypersensitivity (P102âP111) P102 A curious delayed reading: a case report of a ÎČ-lactam allergy in a child Nicole Pinto, Joana Belo, JoĂŁo Marques, Pedro Carreiro-Martins, Paula Leiria-Pinto P103 Betalactam-induced hypersensitivity: a 10-yearsâ experience Amel Chaabane, Haifa Ben Romdhane, Nadia Ben Fredj, Zohra Chadly, Naceur A. Boughattas, Karim Aouam P104 Cefazolin hypersensitivity: towards optimized diagnosis Astrid P. Uyttebroek, Chris H. Bridts, Antonino Romano, Didier G. Ebo, Vito Sabato P105 Clavulanic acid allergy: two cases report Anabela Lopes, Joana Cosme, Rita Aguiar, Tatiana Lourenço, Maria-JoĂŁo Paes, AmĂ©lia SpĂnola-Santos, Manuel Pereira-Barbosa P106 Diagnosis of betalactam allergy in an allergy department CĂntia Rito Cruz, Rute Pereira Dos Reis, Elza Tomaz, Ana Paula Pires, Filipe InĂĄcio P107 Diagnostic work-up of 410 patients with suspicion of betalactam antibiotic hypersensitivity Filipe Benito-Garcia, InĂȘs Mota, Magna Correia, Ăngela Gaspar, Marta Chambel, Susana Piedade, MĂĄrio Morais-Almeida P108 Immediate selective hypersensitivity reactions to clavulanic acid Alla Nakonechna, Yurij Antipkin, Tetiana Umanets, Fernando Pineda, Francisca Arribas, Volodymyr Lapshyn P109 Prevalence and incidence of penicillin hypersensitivity reactions in Colombia Pablo AndrĂ©s Miranda, Bautista De La Cruz Hoyos P110 Selective sensitization to amoxicilin and clavulanic acid Jose Julio Laguna Martinez, Aranzazu Jimenez Blanco, Javier Dionicio Elera, Cosmin Boteanu, Rosario Gonzalez-Mendiola, Marta Del Pozo P111 Infliximab-specific T cells are detectable also in treated patients who have not developed anti-drug antibodies Alessandra Vultaggio, Francesca Nencini, Sara Pratesi, Andrea Matucci, Enrico Maggi Poster walk 13: biologicals, local anesthetics, others (P112âP118) P112 A case report of allergic immediate systemic reaction to adalimumab and certolizumab Ceyda Tunakan Dalgiç, Fatma DĂŒsĂŒnĂŒr GĂŒnsen, Gökten Bulut, Fatma ĂmĂŒr Ardeniz, Okan GĂŒlbahar, Emine Nihal Mete Gökmen, AytĂŒl Zerrin Sin, Ali Kokuludag P113 Allergy to local anesthetics: negative predictive value of skin tests Ivana Cegec, Danica Juricic Nahal, Viktorija Erdeljic Turk, Matea Radacic Aumiler, Ksenija Makar Ausperger, Iva Kraljickovic, Iveta Simic P114 Cutaneous adverse reactions of molecular targeted agents: a retrospective analysis in 150 patients in our department Yukie Yamaguchi, Tomoya Watanabe, Megumi Satoh, Tomohiko Tanegashima, Kayoko Oda, Hidefumi Wada, Michiko Aihara P115 Generalized paralysis induced by local lidocaine injection Jaechun Jason Lee, Jay Chol Choi, Hwa Young Lee P116 Hypersensitivity to local anaesthetics: a 10 year review Rosa-Anita Rodrigues Fernandes, EmĂlia Faria, Joana Pita, Nuno Sousa, Carmelita Ribeiro, Isabel Carrapatoso, Ana Todo Bom P117 Local anaesthetics: a rare culprit in hypersensitivity reactions Ana Rodolfo, Eunice Dias-Castro, Josefina Cernadas P118 StevensâJohnson syndrome in clinical practice: a variant of clinical course Marina Voronova Poster walk 14: RCM (P119âP128) P119 13 cases of severe anaphylactic reactions due to radiocontrast media Jaume MartĂ Garrido, Ramon Lopez Salgueiro, Diana Kury Valle, VerĂłnica Pacheco Coronel, Carolina Perales ChordĂĄ, Dolores Hernandez Fernandez De Rojas P120 Anaphylactic shock after administration of iodinated contrast medium during cardiac catheterization Roselle Catherine Yu Madamba, Marta Ferrer, Maria Jose Goikoetxea, Carmen DâAmelio, Amalia Bernad, Olga Vega, Gabriel Gastaminza P121 Anaphylactic shock and cardiac arrest induced by gadolinium-based contrast agents Beatriz Pola BibiĂĄn, Marina Lluncor Salazar, Gemma VilĂ Nadal, Ana MarĂa Fiandor Roman, Javier Dominguez Ortega, Miguel Gonzalez Muñoz, Santiago Quirce Gancedo, Maria Rosario Cabañas Moreno P122 Anaphylaxis to gadobenate and cross-reactivity to other gadolinium-based contrast agents in two patients Kathrin Scherer Hofmeier P123 Anaphylaxis to glatiramer acetate in a patient with multiple sclerosis FabrĂcia Carolino, Vladyslava Barzylovych, Josefina R. Cernadas P124 Delayed hypersensitivity reaction to radiocontrast media FabrĂcia Carolino, Diana Silva, Leonor LeĂŁo, Josefina R. Cernadas P125 Drug reaction with eosinophilia and systemic symptoms induced by iodixanol Gemma VilĂ -Nadal, Beatriz Pola, Marina Lluncor, Ana Fiandor, Teresa BellĂłn, Javier DomĂnguez, Santiago Quirce P126 Electronic consultation support system for radiocontrast media hypersensitivity changes clinicianâs behavior Min-Suk Yang, Sun-Sin Kim, Sae-Hoon Kim, Hye-Ryun Kang, Heung-Woo Park, Sang-Heon Cho, Kyung-Up Min, Yoon-Seok Chang P127 Hypersensitivity reactions to iodinated contrast media: skin testing and follow-up Danica Juricic Nahal, Ivana Cegec, Viktorija Erdeljic Turk, Iva Kraljickovic, Matea Radacic Aumiler, Ksenija Makar Ausperger, Iveta Simic P128 Would iodine allergy exist? ClĂ©mence Delahaye, Jenny Flabbee, Julie Waton, Olivia Bauvin, Annick Barbaud Poster walk 15: MPE/type 4 (P129âP137) P129 Delayed hypersensitivity cutaneous reactions: a case/control study from a tunisian database Karim Aouam, Najah Ben Fadhel, Zohra Chadly, Nadia Ben Fredj, Naceur A. Boughattas, Amel Chaabane P130 Delayed hypersensitivity reactions to cephalosporins: a review of seven cases Joana Cosme, Anabela Lopes, AmĂ©lia SpĂnola-Santos, Manuel Pereira-Barbosa P131 Diclofenac induced allergic contact dermatitis: case series of four patients Sandra Jerkovic Gulin, Anca Chiriac P132 Late-onset maculopapular rash to irbesartan BĂĄrbara Kong Cardoso, Elza Tomaz, Regina Viseu, Filipe InĂĄcio P133 Nonimmediate hypersensitivity reactions to betalactams: a retrospective analysis Ana Moreira, Susana Cadinha, Ana Castro Neves, Patricia Barreira, Daniela Malheiro, J. P. Moreira Da Silva P134 Occupational airborne contact dermatitis to omeprazole RuĆŸica Jurakic-Toncic, Suzana Ljubojevic, Petra Turcic P135 Ornidazole-induced fixed drug eruption confirmed by positive patch test on a residual pigmented lesion Liesbeth Gilissen, Sara Huygens, An Goossens P136 Repeated delayed reaction induced by amoxicillin and amoxicillin clavulanate Inmaculada Andreu, Ramon Lopez-Salgueiro, Alicia Martinez Romero, Pau Gomez Cabezas P137 Systemic photosensitivity from fenofibrate in a patient photo-sensitized to ketoprofen Liesbeth Gilissen, An Goossens Poster walk 16: HLA genetics (P138âP146) P138 A copy number variation in ALOX5 and PTGER1 is associated with nonsteroidal anti-inflammatory drugs induced urticaria and/or angioedema Pedro Ayuso Parejo, Maria Del Carmen Plaza-SerĂłn, Inmaculada Doña, Natalia Blanca LĂłpez, Carlos Flores, Luisa Galindo, Ana Molina, James Richard Perkins, Jose Antonio Cornejo-GarcĂa, JosĂ© Augusto GarcĂa-AgĂșndez, Elena GarcĂa-MartĂn, Paloma Campo, MarĂa Gabriela Canto, Miguel Blanca P139 Association of galectin-3 (LGALS3) single nucleotide polymorphisms with non-steroidal anti-inflammatory drugs-induced urticaria/angioedema JosĂ© Antonio Cornejo-Garcia, Inmaculada Doña, Rosa MarĂa GuĂ©ant-RodrĂguez, Natalia Blanca-LĂłpez, MarĂa Carmen Plaza-SerĂłn, Raquel Jurado-Escobar, Esther Barrionuevo, MarĂa Salas, MarĂa Luisa Galindo, Gabriela Canto, Miguel Blanca, Jean-Louis GuĂ©ant P140 Detection of T cell responses to ticlopidine using peripheral blood mononuclear cells from HLA-A*33:03+ healthy donors Toru Usui, Arun Tailor, Lee Faulkner, John Farrell, Ana Alfirevic, B. Kevin Park, Dean J. Naisbitt P141 Epistasis approaches to identify novel genes potentially involved in NSAIDs hypersensitivity James Richard Perkins, Jose Antonio Cornejo GarcĂa, Oswaldo Trelles, Inmaculada Doña, Esther Barrionuevo, MarĂa Salas, MarĂa Auxiliadora Guerrero, Miguel Blanca, Alex Upton P142 Genetic predisposition of cold medicine related SJS/TEN with severe ocular complications Mayumi Ueta, Hiromi Sawai, Chie Sotozono, Katushi Tokunaga, Shigeru Kinoshita P143 HLA-B*13:01 and dapsone induced hypersensitivity in Thai population Chonlaphat Chonlaphat Sukasem, Patompong Satapornpong, Therdpong Tempark, Pawinee Rerknimitr, Kulprapat Pairayayutakul, Jettanong Klaewsongkram P144 HLA-B*15:02 alleles and lamotrigine-induced cutaneous adverse drug reactions in Thai Chonlaphat Sukasem, N. Koomdee, T. Jantararoungtong, S. Santon, A. Puangpetch, U. Intusoma, W. Tassaneeyakul, V. Theeramoke P145 HLA-B*38:01 and HLA-A*24:02 allele frequencies in Spanish patients with lamotrigine-induced SCARs Teresa BellĂłn, Elena Ramirez, Alberto Manuel Borobia, Hoi Tong, Jose Luis Castañer, Francisco JosĂ© De Abajo P146 Overrepresentation of a class II HLA haplotype in severe hypersensitivity type I reactions to carboplatin Violeta RĂ©gnier Galvao, Rebecca Pavlos, Elizabeth Mckinnon, Kristina Williams, Alicia Beeghly-Fadiel, Alec Redwood, Elizabeth Phillips, Mariana Castells Poster walk 17: in vivo diagnosis + sIgE (P147âP154) P147 Absence of specific Ig-e against beta-lactams 9 months after an allergic reaction to amoxicillin-clavulanic acid Elisa Boni, Marina Russello, Marina Mauro P148 Drug provocation tests in suspected opioid allergy Kok Loong Ue, Krzysztof Rutkowski P149 Improvement to the specific IgE cut-off in the assess of ÎČ-lactamic allergy Victor Soriano Gomis, Jorge Frances Ferre, Angel Esteban Rodriguez, Vicente CantĂł Reig, Javier Fernandez Sanchez P150 Initial false negative specific IgE to gelatin in a patient with gelatin-induced anaphylaxis Christine Breynaert, Erna Van Hoeyveld, Rik Schrijvers P151 Inmediate reactions to beta-lactam antibiotics: pattern of skin test response over the time Jose Julio Laguna Martinez, Rosario Gonzalez Mendiola, Javier Dionicio Elera, Cosmin Boteanu, Aranzazu Jimenez Blanco, Marta Del Pozo, Raquel Fuentes Irigoyen P152 New fluorescent dendrimeric antigens for the evaluation of dendritic cell maturation as a test to detect allergy reactions to amoxicillin Daniel Collado, Yolanda Vida, Francisco Najera, Ezequiel Perez-Inestrosa, Pablo Mesa-Antunez, Cristobalina Mayorga, MarĂa JosĂ© Torres, Miguel Blanca P153 Positive skin test or positive specific IgE to penicillin does not predict penicillin allergy Line K. Tannert, Charlotte G. Mortz, Per Stahl Skov, Carsten Bindslev-Jensen P154 Significance of skin testing and in vitro-analysis of neuromuscular blocking agents in diagnosis of perioperative drug hypersensitivity: evaluation of a negative control population Wolfgang PfĂŒtzner, Hannah Dörnbach, Johanna Visse, Michele Rauber, Christian Möbs Poster walk 18: in vitro/ex vivo (P155âP158, P160âP164) P155 Diagnostic value of the lymphocyte toxicity assay (LTA) and the in vitro platelet toxicity assay (IPTA) for ÎČ-lactam allergy Abdelbaset A. Elzagallaai, Lindsey Chow, Awatif M. Abuzgaia, Michael J. Rieder P156 Enzyme linked immunospot assay used in the diagnosis of severe cutaneous adverse reactions to antimicrobials Alec Redwood, Jason Trubiano, Rebecca Pavlos, Emily Woolnough, Kaija Stautins, Christina Cheng, Elizabeth Phillips P157 Evaluation of in vitro diagnostic methods for identifying the culprit drugs in drug hypersensitivity Kenichi Kato, Hiroaki Azukizawa, Takaaki Hanafusa, Ichiro Katayama P158 Ex-vivo expanded skin-infiltrating T cells from severe drug eruptions are reactive with causative drugs: a possible novel method for determination of causative drugs Toshiharu Fujiyama, Hideo Hashizume, Takatsune Umayahara, Taisuke Ito, Yoshiki Tokura P160 In vitro release of IL-2, IL-5 and IL-13 in diagnosis of patients with delayed-type nickel hypersensitivity Mira Silar, Mihaela Zidarn, Helena Rupnik, Peter Korosec P161 Single cell analysis of drug responsive T cells; identification of candidate drug reactive T cell receptors in abacavir and carbamazepine hypersensitivity Alec James Redwood, Kaija Strautins, Katie White, Abha Chopra, Katherine Konvinse, Shay Leary, Rebecca Pavlos, Simon Mallal, Elizabeth Phillips P162 Specificity and sensitivity of LTT in DRESS: analysis of agreement with the Spanish pharmacovigilance system probability algorithm Rosario Cabañas, Elena Ramirez, Ana MarĂa Fiandor, Teresa BellĂłn P163 The role of interleukin-22 in ÎČ-lactam hypersensitivity Andrew Sullivan, Paul Whitaker, Daniel Peckham, B. Kevin Park, Dean J. Naisbitt P164 Vancomycin-specific T cell responses and teicoplanin cross-reactivity Wei Yann Haw, Marta E. Polak, Carolann Mcguire, Michael R. Ardern-Jones Poster walk 19: BAT and biomarkers (P165âP173) P165 A combination of early biomarkers useful for the prediction of severe ADRs Yumi Aoyama, Tetsuo Shiohara P166 Basophil activation test in the diagnostic approach of reactions during general anaesthesia Ana Moreira, Susana Cadinha, PatrĂcia Barreira, Ana Castro Neves, Daniela Malheiro, Sara Correia, J. P. Moreira Da Silva P167 IL-10 can be related to successful desensitization Asli Gelincik, Semra Demir, Fatma Sen, Hamza Ugur Bozbey, Muge Olgac, Derya Unal, Raif Coskun, Bahauddin Colakoglu, Suna Buyuozturk, Esin Ăatin-Aktas, Gunnur Deniz P168 Immediate reactions to proton pump inhibitors: value of basophil activation test Maria Salas, Jose Julio Laguna, Esther Barrionuevo, J. Dionicio, Tahia Fernandez, R. Gonzalez-Mendiola, I. Olazabal, Maria Dolores Ruiz, Miguel Blanca, Cristobalina Mayorga, Maria JosĂ© Torres P169 Improvement of the elevated tryptase criterion to discriminate IgE from non-IgE mediated allergic reactions Gabriel Gastaminza, Alberto Lafuente, Carmen DâAmelio, Amalia Bernad, Olga Vega, Roselle Catherine Madamba, M. Jose Goikoetxea, Marta Ferrer, Jorge NĂșñez P170 Low expression of Tim-3 could serve as a biomarker for control and diagnose maculopapular exanthema induced by drugs Tahia Diana FernĂĄndez, Inmaculada Doña, Francisca Palomares, RubĂ©n FernĂĄndez, Maria Salas, Esther Barrionuevo, Maria Isabel Sanchez, Miguel Blanca, Maria JosĂ© Torres, Cristobalina Mayorga P171 Role of basophil activation test using two different activation markers for the diagnosis of allergy to fluoroquinolones Esther Barrionuevo, TahĂa Fernandez, Arturo Ruiz, Adriana Ariza, Maria Salas, Inmaculada Doña, Ana Molina, Miguel Blanca, Maria Jose Torres, Cristobalina Mayorga P172 The importance of basophil activation test in anaphylaxis due to celecoxib Amalia Bernad Alonso, Carmen DâAmelio GarĂłfalo, Olga Vega Matute, Marta Ferrer Puga, MarĂa JosĂ© Goikoetxea Lapresa, Roselle Catherine Yu Madamba, Gabriel Gastaminza Lasarte P173 The role of basophil activation test in the diagnosis of immediate type drug hypersensitivity to betalactam antibiotics Antonia Thinnes, Hans F. Merk, Jens Malte Baron, Martin Leverkus, Galina Balakirski Poster walk 20: TCR recognition, cellular (P174âP183) P174 Characterisation of the effect of co-inhibitory signalling on the activation of drug-derived antigen-specific T-cells Andrew Gibson, Monday Ogese, Lee Faulkner, B. Kevin Park, Dean J. Naisbitt P175 Characterization of drug hapten-specific T cell responses in piperacillin hypersensitive patients Zaid Al-Attar, Fiazia Yaseen, Xiaoli Meng, Rozalind Jenkins, Paul Whitaker, Daniel Peckham, Lee Faulkner, John Farrel, Kevin Park, Dean Naisbitt P176 Characterization of the response of T-cells to telaprevir and its metabolite in normal volunteers Zaid Al-Attar, Khetam Alhilali, Yanni Xue, John Farrell, Lee Faulkner, Kevin Park, Dean Naisbitt P177 Characterization of the T cell receptor signatures of drug-responsive T cells Patricia Illing, Nicole Mifsud, Heidi Fettke, Jeffrey Lai, Rebecca Ho, Patrick Kwan, Anthony Purcell P178 Defining the signals between hepatocytes and immune cells in idiosyncratic drug-induced liver injury (DILI) Monday O. Ogese, Lee Faulkner, B. Kevin Park, Catherine Betts, Dean J. Naisbitt P179 Development of novel chemicals that do not bind to HLA-B*57:01 or activate CD8 + T-cells through modification of the 6-amino cyclopropyl group of abacavir Paul Thomson, John Farrell, Mohammad Alhaidari, Neill Berry, Paul M. OâNeill, B. Kevin Park, Dean J. Naisbitt P180 Generation and characterization of dapsone- and nitroso-dapsone-specific T-cell clones using lymphocytes from healthy volunteers Abdulaziz Alzahrani, Monday O. Ogese, John Farrell, Lee Faulkner, Andrew Gibson, Arun Tailor, B. Kevin Park, Dean J. Naisbitt P181 Identification of benzylpenicillin-hapten peptides responsible for naĂŻve T-cell activation and immunization of allergic patients to penicillin Marie Eliane Azoury, Lucia Fili, Rami Bechara, NoĂ©mie Scornet, Cathy Nhim, Richard Weaver, Nancy Claude, Delphine Joseph, Bernard Maillere, Paola Parronchi, Marc Pallardy P182 Massive expansion of clonotypic and polycytotoxic CD8+ T cells in toxic epidermal necrolysis Axel Patrice Villani, Aurore RoziĂšres, BenoĂźt BensaĂŻd, Mathilde Tardieu, Floriane Albert, Virginie Mutez, Tugba Baysal, Marc Pallardy, Janet Maryanski, Jean-François Nicolas, Osami Kanagawa, Marc Vocanson P183 Pharmaco-immunological synapse of HLA-drug-TCR in SCAR Shuen-Iu Hung Poster walk 21: new in vitro methods, haptens, etc. (P184âP194) P184 Amoxicillin-clavulanate forms distinct multiple haptenic structures on human serum albumin in patients Xiaoli Meng, Arun Tailor, Caroline J. Harrison, Rosalind E. Jenkins, Paul Whitaker, Neil S. French, Dean J. Naisbitt, B. Kevin Park P185 Dendrimeric antigens for studying the influence of penicillin determinants orientation on IgE recognition Maria Isabel Montañez, Cristobalina Mayorga, Francisco Najera, Adriana Ariza, Tahia D. Fernandez, Maria Salas, Angela Martin-Serrano, Miguel Blanca, Ezequiel Perez-Inestrosa, Maria Jose Torres P186 Dendrimeric antigens on solid supports: designed materials for IgE quantification Yolanda Vida, Maria Isabel Montañez, Noemi Molina, Daniel Collado, Francisco Najera, Adriana Ariza, Maria Jose Torres, Cristobalina Mayorga, Ezequiel Perez-Inestrosa P187 Development of a screening assay for drug hypersensitivity using naĂŻve T cells from donors with seven different HLA class I risk alleles Lee Faulkner, Sally Wood, Ana Alfirevic, Munir Pirmohamed, Dean J. Naisbitt, B. Kevin Park P188 Different patterns of recognition of structures derived from amoxicillin by IgE antibodies from patients with immediate hypersensitivity reactions to betalactams Adriana Ariza, Cristobalina Mayorga, MarĂa Isabel Montañez, MarĂa Salas, Inmaculada Doña, Ăngela MartĂn-Serrano, Ezequiel PĂ©rez-Inestrosa, Dolores PĂ©rez-Sala, Miguel Blanca, Antonio E. GuzmĂĄn, MarĂa JosĂ© Torres P189 High-resolution typing of HLA polymorphism and T-cell receptor repertoire for severe adverse drug reactions based on the cost-effective next-generation sequencing approaches Tai-Ming Ko, Yuan-Tsong Chen, Jer-Yuarn Wu P190 Identification and fate of intracellular proteins haptenated by amoxicillin Francisco J. SĂĄnchez-GĂłmez, Juan M. GonzĂĄlez-Morena, Yolanda Vida, Ezequiel PĂ©rez-Inestrosa, Miguel Blanca, MarĂa J. Torres, Dolores PĂ©rez-Sala P191 In vitro detection of terbinafine protein adducts Arun Tailor, Toru Usui, Yanni Xue, Xiaoli Meng, Dean J. Naisbitt, B. Kevin Park P192 MicroRNAs dysregulation in PBMCs from drug hypersensitivity patients during drug challenge in vitro Alejandra Monroy Arreola, Jesus Agustin Badillo Corona, Silvia Mendez Flores, Judith Dominguez Cherit, Dean J. Naisbitt, Noe Valentin Duran Figueroa, Jose Luis Castrejon Flores P193 NSAIDs-exacerbated cutaneous disease: high throughput gene expression profiling JosĂ© Antonio Cornejo-GarcĂa, James Perkins, Natalia Blanca-LĂłpez, Diana PĂ©rez-Alzate, Raquel Jurado-Escobar, Inmaculada Doña, Gador Bogas, MarĂa J. Torres, Gabriela Canto, Miguel Blanca P194 Utility of skin tests in non-immediate reactions to amoxicillin Luis Mario Tubella Marti, Fernando Pineda De La Losa, Francisca Arribas Poves, Jaime Tubella Lopez, Teodora Lopez Santiag
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 studyâa multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58â5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23â0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70â8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39â8·80) and upper-middle-income countries (2·06, 1·11â3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26â11·59) and upper-middle-income countries (3·89, 2·08â7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit