Toxoplasma gondii in small neotropical wild felids

Na ultima década, pesquisas em animais silvestres no mundo todo, tem demonstrado aspectos importantes na epidemiologia do ciclo silvestre de Toxoplasma gondii. No entanto, apesar do papel conhecido dos felinos silvestres como hospedeiros definitivos na transmissão e manutenção desse parasita, há poucos estudos sobre o envolvimento desses animais. O Brasil possui a maior quantidade de espécies de felinos silvestres do continente americano, todas em estado crítico de conservação. Porém, a detecção sorológica, pesquisas epidemiológicas e algumas caracterizações moleculares do T. gondii nestas espécies, utilizaram principalmente populações de felinos neotropicais mantidos em cativeiro, o que não reflete o comportamento da doença em condições de vida livre.Uma revisão sistemática da literatura cientifica mundial foi realizada focando a toxoplasmose em pequenos felinos neotropicais, abrangendo aspectos como o estado da pesquisa cientifica, transmissão do parasita na vida silvestre, características genéticas dos isolados e sua relação com a patogenicidade, além dos fatores de risco ligados aos conflitos com o homem. Esta revisão mostra a importância do estudo dessas populações de felinos, em função das frequentes interações com o homem em áreas peri-urbanas e a necessidade de estudos mais  abrangentes, que estabeleçam a real importância do T. gondii no tangente á saúde pública e saúde animal nas regiões tropicais e temperadas.In the last decade, studies on wildlife worldwide have discovered key epidemiological aspects of the sylvatic cycle of Toxoplasma gondii. However, despite the known role of wild felines as definitive hosts in the transmission and maintenance of this parasite, few studies have focused on the involvement of these animals. Brazil exhibits the largest number of wild felid species in the Americas, all of which have a critical conservation status. However, serological detections, epidemiological studies and some molecular characterizations of T. gondii have primarily used Neotropical felid populations that are maintained in captivity, which does not reflect the disease behavior in free-living conditions. A systematic review of the worldwide scientific literature was conducted focusing on toxoplasmosis in small Neotropical felids. This review covered a number of aspects, including the state of scientific research, parasite transmission in the wild, the genetic characteristics of isolates, the relationship between these genetic characteristics and the pathogenicity of the parasite, and the risk factors linked to conflicts with humans. The present review shows the relevance of studying these felid populations based on their frequent interactions with humans in peri-urban areas and the need for further comprehensive studies to establish the real significance of T. gondii in public and animal health in tropical and temperate regions

Clinical characterization of neonatal and pediatric enteroviral infections: an Italian single center study

Enteroviruses (EVs) are an important cause of illness, especially in neonates and young infants. Clinical and laboratory findings at different ages, brain imaging, and outcomes have been inadequately investigated.Background Enteroviruses (EVs) are an important cause of illness, especially in neonates and young infants. Clinical and laboratory findings at different ages, brain imaging, and outcomes have been inadequately investigated. Methods We retrospectively investigated EV infections occurring at an Italian tertiary care center during 2006-2017. Cases were confirmed with a positive polymerase chain reaction on blood or cerebrospinal fluid. Clinical and laboratory findings according to age at presentation were analyzed. Results Among 61 cases of EV infection, 56 had meningitis, 4 had encephalitis, and 1 had unspecific febrile illness. Forty-seven cases (77.0%) presented at less than 1 year of age, and most were less than 90 days of age (n = 44). Presentation with fever (p < 0.01), higher median temperature (p < 0.01), and irritability (p < 0.01) were significantly more common among infants aged less than 90 days, who also had significantly higher peak temperatures during the course of the disease (p < 0.01). In contrast, gastrointestinal symptoms were more common in infants and children aged over 90 days (p = 0.02). Only 4 of 61 infections (6.5%) were severe and all affected younger infants (p < 0.01). Conclusions We detail epidemiological, clinical, and laboratory findings in a cohort of 61 children. Infants aged less than 90 days have more severe disease; they are more likely to present with fever, higher median temperature, and irritability and less likely to develop gastrointestinal symptoms

Presença de anticorpos anti-Neospora caninum e Toxoplasma gondii em cães com leishmaniose visceral da região de Araçatuba, São Paulo, Brasil

Dogs that had positive and negative sera to Leishmania chagasi from the region of Araçatuba, São Paulo, Brazil, were evaluated for the presence of anti-Neospora caninum and anti-Toxoplasma gondii antibodies as potential co-infecting agents. Blood samples were collected from 204 dogs and out of them 98 were carriers of leishmaniosis. Sera were tested for the presence of anti-L. chagasi antibodies by ELISA, and anti-T. gondii and anti-N. caninum by an indirect fluorescent antibody test (IFAT). Age, gender, and association between the presences of anti-L. chagasi antibodies and seroprevalence to N. caninum and T. gondii were analyzed by chi-square test. Out of the 204 sera investigated, 36 (17.6%) were positive for N. caninum (IFAT=50) and 75 (36.8%) to T. gondii (IFAT=16) with titers that varied from 50 to 6400 for N. caninum, and from 16 to 16384 for T. gondii. The co-presence of anti-L. chagasi, N. caninum and T. gondii antibodies was observed in 17 (8.3%) dogs. Antibodies to N. caninum were observed in four (3.8%) out of 106 dogs that were negative for L. chagasi, and in 32 (32.6%) out of the 98 dogs that were positive for L. chagasi. Anti-T. gondii antibodies were found in 40 (41.0%) and in 35 (33.0%) of the 98 positive dogs and in 106 negative dogs for L. chagasi, respectively. An association between the presence of antibodies against L. chagasi and a positive response to N. caninum (p;0.05), with the exception of age and presence of anti-L. chagasi antibodies, in which only a slight association was observed (p=0.038). Within this interaction, a higher number of dogs, older than four years, were positive for this agent when compared to other age groups.Cães soropositivos e soronegativos à Leishmania chagasi da região de Araçatuba, São Paulo, Brasil, foram avaliados quanto à presença de possível co-infecção por Neospora caninum e Toxoplasma gondii. Amostras de sangue de 204 cães, sendo 98 portadores de leishmaniose, foram coletadas e os soros testados quanto à presença de anticorpos anti-L. chagasi pelo método de ELISA e anti-T. gondii e N. caninum pela reação de imunofluorescência indireta (RIFI). Idade, sexo e possíveis associações entre a presença de anticorpos anti-L. chagasi e a soroprevalência de N. caninum e T. gondii foram analisados pelo teste do Qui-quadrado. Dos 204 soros examinados, 36 (17,6%) foram positivos para N. caninum (RIFI ³50) e 75 (36,8%) para T. gondii (RIFI ³16) com títulos que variaram de 50 a 6.400 para N. caninum, e de 16 a 16.384 para T. gondii. A co-presença de anticorpos anti-L. chagasi, N. caninum e T. gondii foi observada em 17 (8,3%) cães. Anticorpos anti-N. caninum foram observados em quatro (3,8%) dos 106 cães negativos e em 32 (32,6%) dos 98 cães positivos à L. chagasi. Anticorpos anti-T. gondii foram encontrados em 40 (41%) e em 35 (33%) dos 98 cães positivos e dos 106 cães negativos à L. chagasi, respectivamente. Foi observada associação entre a presença de anticorpos anti-L.chagasi e a presença de anticorpos anti-N. caninum (p;0,05), com exceção da idade e presença de anticorpos anti-L. chagasi , que apresentou uma associação fraca (p=0,038), com maior número de cães com mais de quatro anos de idade positivos a esse agente quando comparado às outras idades

Avaliação da performance do teste de aglutinação modifica (MAT) para a detecção de anticorpos anti-Toxoplasma gondii em cães

Toxoplasmosis is a zoonosis that has been the subject of study in Brazil and worldwide. The dogs are sentinels for the infection and can carry Toxoplasma gondii in the environment. Seroepidemiological surveys of these animals are an important tool in the surveillance and control of the disease and inform decision-making in health programs. In this study the performance of the Modified Agglutination Test (MAT) in the serodiagnosis of canine toxoplasmosis is evaluated and compared to the indirect immunofluorescent-antibody test (IFAT). A sample of 157 dog sera from the county of Monte Negro, Rondônia, with 76.40% positive reactions for Toxoplasma gondii (IFAT =16) was analyzed using the MAT (=25), presenting sensitivity of 85.00% (Confidence Interval 95.00%: 79.4 - 90.60%) and specificity of 100.00%.Toxoplasmose é uma zoonose que vem sendo objeto de estudos no Brasil e em todas as partes do mundo. Os cães são considerados sentinelas da infecção, podendo carrear o agente pelo ambiente. Levantamentos soro-epidemiológicos desses animais são importantes ferramentas de vigilância e controle da doença em programas de saúde. Neste estudo a performance do Teste de Aglutinação Modificada (MAT) no sorodiagnóstico da toxoplasmose canina foi avaliado e comparado à reação de imunoflorescência indireta (RIFI). Uma amostra de 157 soros de cães do município de Monte Negro, Rondônia, com 76.40% de animais positivos ao Toxoplasma gondii (RIFI =16) foi analisado utilizando o MAT (=25) e apresentou sensibilidade de 85,00% (Intervalo de Confiança 95,00%: 79,4-90,60%) e especificidade de 100,00%

Pneumocystosis as a Complication of H1N1 Influenza A Infection in an HIV-Positive Patient on Effective cART

H1N1 influenza A virus can affect the immune system, causing lymphopenia. This might be of great concern for HIV individuals undergoing effective antireroviral therapy (cART). We report the first confirmed case of H1N1-induced AIDS and Pneumocystis jiroveci pneumonia in an HIV-positive woman on effective cART since 2006

Pulmonary disease caused by Mycobacterium marseillense, Italy

Mycobacteriummarseillense was recently described as a new species belonging to the Mycobacterium avium complex (MAC).We describe a case of pulmonary disease caused by M. marseillense in an immunocompetent patient. All strains isolated from the patient were preliminarily identified as M. intracellulare; however, a retrospective molecular analysis corrected the identification to M. marseillense

COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis

Introduction. Patients receiving in-center hemodialysis are extremely vulnerable to COVID-19. It is unclear if routine screening of asymptomatic hemodialysis patients is an effective strategy to prevent COVID-19 outbreaks within the dialysis unit. Methods. We conducted a retrospective analysis of in-center hemodialysis patients who underwent bimonthly COVID-19 rapid antigen test screening from February 15(th) to December 26(th), 2021. Nasal rapid antigen testing was performed in all asymptomatic patients. All rapid antigen-positive tests were confirmed by RT-PCR nasopharyngeal swab. Besides universal rapid antigen screening, RT-PCR testing was conducted in all symptomatic patients and contacts of COVID-19 subjects. Results. Overall, 4079 rapid antigen tests were performed in 277 hemodialysis patients on chronic hemodialysis with a mean age of 68.4 +/- 14.6 years. Thirty-eight (0.9%) rapid antigen tests resulted positive. Only five (13.8%) positive-rapid antigen tests were also positive by RT-PCR testing. During the same period, 219 patients regularly screened by rapid antigen tests bimonthly underwent 442 RT-PCR nasopharyngeal swabs for clinical reasons. RT-PCR testing yielded a positive result in 13 (5.9%) patients. The time elapsed between PCR and the negative-rapid antigen test was 7.7 +/- 4.6 days (range 1.8-13.9 days). At the end of the follow-up, 6.4% of the population on in-center hemodialysis contracted COVID-19, and routine rapid antigen tests detected only 5 out of 18 (27.7%) COVID-19 cases. No outbreaks of COVID-19 were identified within the dialysis unit. Conclusion. Bimonthly rapid antigen screening led to the early diagnosis of COVID-19 in less than one-third of cases. The short incubation period of the new SARS-CoV-2 variants makes bimonthly test screening inadequate for an early diagnosis of COVID-19. More frequent tests are probably necessary to improve the utility of COVID-19 nasal rapid antigen test in patients on hemodialysis

Evaluation of HIV-1 integrase variability by combining computational and probabilistic approaches

This study aimed at updating previous data on HIV-1 integrase variability, by using effective bioinformatics methods combining different statistical instruments from simple entropy and mutation rate to more specific approaches such as Hellinger distance. A total of 2133 HIV-1 integrase sequences were analyzed in: i) 1460 samples from drug-naive [DN] individuals; ii) 386 samples from drug-experienced but INI-naive [IN] individuals; iii) 287 samples from INI-experienced [IE] individuals. Within the three groups, 76 amino acid positions were highly conserved (<= 0.2% variation, Hellinger distance: <0.25%), with 35 fully invariant positions; while, 80 positions were conserved (>0.2% to <1% variation, Hellinger distance: <1%). The H12-H16-C40-C43 and D64D116-E152 motifs were all well conserved. Some residues were affected by dramatic changes in their mutation distributions, especially between DN and IE samples (Hellinger distance >= 1%). In particular, 15 positions (D6, S24, V31, S39, L74, A91, S119, T122, T124, T125, V126, K160, N222, S230, C280) showed a significant decrease of mutation rate in IN and/or IE samples compared to DN samples. Conversely, 8 positions showed significantly higher mutation rate in samples from treated individuals (IN and/or IE) compared to DN. Some of these positions, such as E92, T97, G140, Y143, Q148 and N155, were already known to be associated with resistance to integrase inhibitors; other positions including S24, M154, V165 and D270 are not yet documented to be associated with resistance. Our study confirms the high conservation of HIV-1 integrase and identified highly invariant positions using robust and innovative methods. The role of novel mutations located in the critical region of HIV-1 integrase deserves further investigation

Weekly Rapid Antigen Test Screening for COVID-19 in Patients on Hemodialysis

COVID-19 is a concerning issue among in-center hemodialysis (HD) patients. To prevent COVID-19 diffusion in our HD facility, weekly rapid nasal antigen test screening was performed for all asymptomatic patients on chronic HD. This study aimed to assess the performance of weekly rapid antigen test in detecting SARS-CoV-2 infection among asymptomatic patients receiving HD

Long-term data on the efficacy and tolerability of lamivudine plus dolutegravir as a switch strategy in a multi-centre cohort of HIV-1-infected, virologically suppressed patients

BACKGROUND: Results from clinical trials and observational studies suggest that lamivudine plus dolutegravir (3TC+DTG) could be an effective and tolerated option for simplification in human immunodeficiency virus (HIV)-1-positive patients. MATERIALS AND METHODS: This observational study enrolled HIV-1-infected, virologically suppressed patients switching to 3TC+DTG. Kaplan-Meyer survival analysis was performed to evaluate time to virological failure (VF; defined by a single HIV-RNA determination ≥1000 copies/mL or by two consecutive HIV-RNA determinations ≥50 copies/mL) and time to treatment discontinuation (TD; defined as interruption of either 3TC or DTG), Cox regression was performed to assess predictors, and linear mixed model was performed for repeated measures to measure changes in immunological and metabolic parameters. RESULTS: Five hundred and fifty-six patients were eligible for analysis. Their median CD4+ count at baseline was 668 cells/mm3 and median time of virological suppression was 88 months. Estimated probabilities of maintaining virological suppression at 96 and 144 weeks of follow-up were 97.5% [standard deviation (SD) 0.8] and 96.5% (SD 1.0), respectively. Years since HIV diagnosis was the only predictor of VF. In patients with time of virological suppression <88 months, the rate of VF was higher in the presence of the M184V mutation. Estimated probabilities of remaining on 3TC+DTG at 96 and 144 weeks of follow-up were 79.2% (SD 1.9) and 75.2% (SD 2.2), respectively. A significant increase in CD4 cell count (+44 cells/mm3, P=0.015), CD4/CD8 ratio (+0.10, P=0.002) and high-density lipoprotein cholesterol (+5.4 mg/dL, P=0.036) was found at 144 weeks of follow-up; meanwhile, total cholesterol (-9.1 mg/dL, P=0.007) and triglycerides (-2.7, P=0.009) decreased significantly. CONCLUSIONS: These findings confirm the efficacy and tolerability of 3TC+DTG in virologically suppressed patients. Copyright © 2019 Elsevier Ltd. All rights reserved