Contribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions

BACKGROUND: To assess the performance of Candida albicans germ tube antibody (CAGTA), (1 → 3)-ß-D-glucan (BDG), mannan antigen (mannan-Ag), anti-mannan antibodies (mannan-Ab), and Candida DNA for diagnosing invasive candidiasis (IC) in ICU patients with severe abdominal conditions (SAC). METHODS: A prospective study of 233 non-neutropenic patients with SAC on ICU admission and expected stay ≥ 7 days. CAGTA (cutoff positivity ≥ 1/160), BDG (≥80, 100 and 200 pg/mL), mannan-Ag (≥60 pg/mL), mannan-Ab (≥10 UA/mL) were measured twice a week, and Candida DNA only in patients treated with systemic antifungals. IC diagnosis required positivities of two biomarkers in a single sample or positivities of any biomarker in two consecutive samples. Patients were classified as neither colonized nor infected (n = 48), Candida spp. colonization (n = 154) (low-grade, n = 130; high-grade, n = 24), and IC (n = 31) (intra-abdominal candidiasis, n = 20; candidemia, n = 11). RESULTS: The combination of CAGTA and BDG positivities in a single sample or at least one of the two biomarkers positive in two consecutive samples showed 90.3 % (95 % CI 74.2–98.0) sensitivity, 42.1 % (95 % CI 35.2–98.8) specificity, and 96.6 % (95 % CI 90.5–98.8) negative predictive value. BDG positivities in two consecutive samples had 76.7 % (95 % CI 57.7–90.1) sensitivity and 57.2 % (95 % CI 49.9–64.3) specificity. Mannan-Ag, mannan-Ab, and Candida DNA individually or combined showed a low discriminating capacity. CONCLUSIONS: Positive Candida albicans germ tube antibody and (1 → 3)-ß-D-glucan in a single blood sample or (1 → 3)-ß-D-glucan positivity in two consecutive blood samples allowed discriminating invasive candidiasis from Candida spp. colonization in critically ill patients with severe abdominal conditions. These findings may be helpful to tailor empirical antifungal therapy in this patient population

SARS-CoV-2 seroprevalence on the north coast of Peru: A cross-sectional study after the first wave

Peru had the second-highest number of COVID-19 cases in Latin America. After the first wave, Peru registered more than 900,000 cases of COVID-19 and more than 36,000 confirmed deaths from the disease. Tumbes, a border area with poor sanitation and not enough water, had the fifth highest death rate. The cross-sectional analytic study aimed: a) to assess seroprevalence of COVID-19 after the first wave; b) to assess sociodemographic determinants and symptoms associated with a positive COVID-19 antibody lateral flow test

Death in the sun: the bioarchaeology of an early post-medieval hospital in Gibraltar

In 2014, during construction work at the ex-Civil Hospital in Gibraltar, excavations led by the Gibraltar Museum revealed a major, previously unknown burial ground containing more than 200 skeletons. We present the historical, archaeological and radiometric dating evidence from the site alongside the results of initial osteological analyses. The data indicate that the burials pertain to an earlier 16th-century Spanish hospice, and therefore stand to offer new insights into the functioning of this early modern hospital and the health and movements of people at a time of incipient globalization

A Model to Define an eHealth Technological Ecosystem for Caregivers

The ageing of world population has a direct impact on the health and care systems, as it means an increase in the number of people needing care which leads to higher care costs and the need for more resources. In this context, informal caregivers play an important role as they enable dependent persons to stay at home and thus reduce care costs. However, long-term continuous care provision has also an impact in the physical and mental health of the caregivers. Moreover, geographical barriers make it difficult for caregivers to accessing psychoeducation as a way to alleviate their problems. To support caregivers in their needs and provide specialized training, technology plays a fundamental role. The present work provides the theoretical basis for the development of a technological ecosystem focused on learning and knowledge management processes to develop and enhance the caregiving competences of formal and informal caregivers, both at home and in care environments. In particular, a platform-specific model to support the definition of the ecosystem based on Open Source software components is presented, along with a Business Model Canvas to define the business structure as part of the human elements of the technological ecosystem

SARS-CoV-2 seroprevalence on the north coast of Peru: A cross-sectional study after the first wave

During the first wave, COVID-19 had devastating effects on developing countries like Peru, which reported more than 900,000 cases of the disease and more than 36,000 confirmed deaths from it. The informal settlements are counted in COVID-19 regional statistics, but they are very different from the rest of the region in terms of sanitation, access to water and sewage, housing conditions, and others. To make good decisions about public health, it is important to understand how the disease is spread in informal settlements. We did an observational, cross-sectional study in Puerto Pizarro, a remote port village in Tumbes, from November 11, 2020, to November 30, 2020, to assess the seroprevalence of COVID-19 after the first wave, as well as the sociodemographic factors and symptoms linked to a positive COVID-19 antibody lateral flow test. 1391 people older than 2 years old were given census and symptom questionnaires. They were also tested for the presence of anti-SARS-CoV-2 antibodies (IgG and IgM) in their blood. This study shows an adjusted seroprevalence of 24.82 percent (95% CI 22.49–27.25) posterior to the first wave of COVID-19 in Tumbes. Women had higher adjusted seroprevalence (28.03% vs. 21.11% [95% CI 24.83–31.41], p = 0.002). Extrapolating our adjusted prevalence of 24.82 per 100 persons to Tumbes (N = 251,541), 62,432 people were infected during the first wave, which is too high for adequate primary care in health institutions. Puerto Pizarro’s causespecific mortality rate was 198.49 per 100,000 inhabitants (deaths documented between May and December 2020), which was higher than Tumbes’ up to December 2020 (137.6 per 100,000 inhabitants). The presence of mostly symptomatic patients at health care facilities, the limited use of social networks, the scarce availability of eHealth technologies in government institutions, unused emergency telephone numbers, and the fear of dying if referred to the hospital may have led to underreporting cases. Participation of the community in epidemiological surveillance strategies is critical to assisting the Ministry of Health in the future success of the establishment of an eHealth surveillance monitoring program

Genomic and proteomic analyses of Mycobacterium bovis BCG Mexico 1931 reveal a diverse immunogenic repertoire against tuberculosis infection

<p>Abstract</p> <p>Background</p> <p>Studies of <it>Mycobacterium bovis </it>BCG strains used in different countries and vaccination programs show clear variations in the genomes and immune protective properties of BCG strains. The aim of this study was to characterise the genomic and immune proteomic profile of the BCG 1931 strain used in Mexico.</p> <p>Results</p> <p>BCG Mexico 1931 has a circular chromosome of 4,350,386 bp with a G+C content and numbers of genes and pseudogenes similar to those of BCG Tokyo and BCG Pasteur. BCG Mexico 1931 lacks Region of Difference 1 (RD1), RD2 and N-RD18 and one copy of IS6110, indicating that BCG Mexico 1931 belongs to DU2 group IV within the BCG vaccine genealogy. In addition, this strain contains three new RDs, which are 53 (RDMex01), 655 (RDMex02) and 2,847 bp (REDMex03) long, and 55 single-nucleotide polymorphisms representing non-synonymous mutations compared to BCG Pasteur and BCG Tokyo. In a comparative proteomic analysis, the BCG Mexico 1931, Danish, Phipps and Tokyo strains showed 812, 794, 791 and 701 protein spots, respectively. The same analysis showed that BCG Mexico 1931 shares 62% of its protein spots with the BCG Danish strain, 61% with the BCG Phipps strain and only 48% with the BCG Tokyo strain. Thirty-nine reactive spots were detected in BCG Mexico 1931 using sera from subjects with active tuberculosis infections and positive tuberculin skin tests.</p> <p>Conclusions</p> <p>BCG Mexico 1931 has a smaller genome than the BCG Pasteur and BCG Tokyo strains. Two specific deletions in BCG Mexico 1931 are described (RDMex02 and RDMex03). The loss of RDMex02 (<it>fadD23</it>) is associated with enhanced macrophage binding and RDMex03 contains genes that may be involved in regulatory pathways. We also describe new antigenic proteins for the first time.</p