Phenotypic and Genetic Characterization of Antimicrobial Profiles of Helicobacter pylori Strains in Cuba

The study evaluated the antibiotic resistance patterns of Helicobacter pylori strains against metronidazole and clarithromycin in a hospital in Havana, Cuba. Eighty-five percent, 22.5%, and 10% of 40 H. pylori strains investigated were resistant to metronidazole, ciprofloxacin, and clarithromycin respectively but all were susceptible to amoxicillin and tetracycline. RdxA truncation was found only in metronidazole-resistant strains. In such strains, reported are eight and two novel mutations in the rdxA and frxA genes respectively. Two-point mutations in the 23S rRNA genes of clarithromycin-resistant strains were detected. A high prevalence of metronidazole resistance was found in Cuban H. pylori strains. Mutations in the rdxA gene may contribute more significantly than frxA gene to the high level of resistance to metronidazole. This study supports the need to continue monitoring the antibiotic susceptibility in H. pylori in Cuba to guide the treatment of such infection

Hernia hiatal y su relación con la ingestión de fibra dietética

Se estudiaron 226 pacientes con diagnóstico de hernia hiatal por radiología, endoscopia y manometría esofágica y 200 controles normales para determinar la cantidad de fibra dietética ingerida y su relación con la hernia hiatal. Se encontró que los pacientes que presentaron hernia hiatal consumían menos cantidad de fibra dietética que los controles, lo cual fue demostrado estadísticamente

Prevalence of Helicobacter pylori vacA, cagA, and iceA Genotypes in Cuban Patients with Upper Gastrointestinal Diseases

Virulence factors of Helicobacter pylori can predict the development of different gastroduodenal diseases. There are scarce reports in Cuba about H. pylori isolates genotyping. The aim of the present investigation was to identify allelic variation of the virulence genes vacA, cagA, and iceA in sixty-eight patients diagnosed as H. pylori positive by culture. In seven out of 68 patients, strains from both gastric regions were obtained and considered independent. DNA was extracted from all the H. pylori strains and evaluated by PCR-genotyping. The vacA s1 allele, cagA gene, and iceA2 allele were the most prevalent (72.0%, 56.0%, and 57.3%, respectively). Alleles from m-region showed a similar frequency as s1a and s1b subtypes. The presence of multiple H. pylori genotypes in a single biopsy and two gastric region specimens were found. Significant statistical association was observed between iceA2 allele and patients with non-peptic ulcer dyspepsia (NUD) (P=0.037) as well as virulence genotypes (s1, s1m2) and patients over 40 years old (P<0.05). In conclusion, the results demonstrated a high prevalence of H. pylori virulent genotypes in Cuban patients over 40 years old while iceA2 alleles demonstrated a good specificity in patients with NUD

Meningitis y diseminación tuberculosa en paciente con el síndrome de inumodeficiencia adquirida (sida)

Las meningoencefalitis por g&eacute;rmenes oportunistas ocupan un lugar importante dentro de la patolog&iacute;a neurol&oacute;gica del paciente sida, Treponema pallidum y Mycobacterium tuberculosis dentro de las bacterias, Cryptococcus neoformans dentro de los hongos, Toxoplasma gondii dentro de los protozoos y el Papovirus JC dentro de los virus, son de los g&eacute;rmenes mas frecuentes dentro de cada grupo. Tambi&eacute;n en los pacientes inmunodeprimidos en general y en particular en el paciente sida, se han encontrado con cierta frecuencia infecciones mixtas, precisamente por el gran deterioro en su barrera inmunol&oacute;gica. La meningitis tuberculosa (MTB) es la forma mas grave en que se manifiesta la tuberculosis extrapulmonar, pues la inespecificidad de sus s&iacute;ntomas, la lentitud en el diagn&oacute;stico etiol&oacute;gico y las severas secuelas neurol&oacute;gicas que puede producir sobre todo en este tipo de paciente, hacen de esta enfermedad un importante problemade salud, tanto en pa&iacute;ses desarrollados como en los que est&aacute;n en v&iacute;as de desarrollo.En este estudio se describe el &uml;primer caso&uml; meningitis e infecci&oacute;n diseminada por Mycobacterium tuberculosis en paciente cubano infectado por el virus de inmunodeficiencia humana.Meningoencephalitis due to opportunistic germs has an important place among the neurological diseases in AIDS patient. Treponema pallidum and Mycobacterium tuberculosis (bacteria), Cryptococcus neoformans (fungi), Toxoplasma gondii (protozoa), and Papovirus JC (virus) are the most frequently germs found in each group. Likewise, in immunodepressed patients in general and in HIV/AIDS patients in particular, mixed infections have been frequently found, basically as a consequence of the patient&rsquo;s deteriorated immunological barrier. Tuberculosis meningitis (TBM) is the most severe form of presentation of the extrapulmonary tuberculosis.Its unspecific symptoms, the delay in the etiological diagnosis, and the severe neurological sequelae that can appear in this specific type of patient make of this disease an important health problem, in both developed and developing countries.This study describes the &ldquo;first case&rdquo; of meningitis and disseminated infection by Mycobacterium tuberculosis in a Cuban patient infected by the human immunodeficiency virus