Human Metapneumovirus (hMPV) is a negative single-stranded RNA virus. Infection by hMPV mainly affects the pediatric population and can cause upper or lower respiratory tract pathologies which can develop life threating complications. This study was carried out between 2009 and 2010 in a high complexity national hospital in Lima, Peru. The time frame corresponds to the pandemic of influenza A H1N1.A prospective study was performed between September 2009 and September 2010. Patients with a clinical diagnosis suggestive of an acute respiratory infection were included. RT-PCR was utilized to attain the amplification and identification of the hMPV.A total of 539 samples were analyzed from patients with a clinical context suggestive of an acute respiratory tract infection. Of these samples 73, (13.54%) were positive for hMPV. Out of the positive cases, 63% were under one year old, and increased to nearly 80% when considering children younger than two years old. Cough was the most frequent symptom presented by our population with a number of 62 cases (84.93%). Viral seasonality was also established, noting its predominance during the months of summer in the southern hemisphere. The infection by hMPV has an important prevalence in Peru. It mainly affects children under one year old and should be considered an important differential diagnosis in a patient with an acute respiratory infection.
Background: Oropouche virus (OROV) is an underreported and emerging infectious disease. Its incidence is underestimated mainly due to clinical similarities with other diseases that are also caused by arboviruses present in endemic areas. We report the first outbreak of OROV in the western region of the Peruvian Amazon in the department of Huanuco, Peru. Methods & Materials: Transversal studie about a outbreak occurred in the region of Huanuco, Peru during July of 2016. Blood samples were taken from 268 patients who presented acute febrile syndrome to be later analyzed for Oropouche Virus via Polymerase Chain Reaction. Results: Of all 268 patients, 46 (17%) cases tested were positive for OROV. the most common symptom reported was headaches with a frequency of 87% (n = 40) followed by myalgias with 76% (n = 35), arthralgias with 65.2% (n = 30), retro-ocular pain 60.8% (n = 28) and hyporexia with 50% (n = 23). Concerning signs and symptoms that may suggest severe OROV infection, 4.3% (n = 2) had low platelet count, 8.6% (n = 4) had intense abdominal pain, and only 2.1% (n = 1) had a presentation with thoracic pain. Conclusion: The disease caused by the OROV is an emerging, underdiagnosed infection that requires ongoing research to determine its virulence, pathogenesis, host range and vectors involved in the urban and sylvatic cycles as well as identifying new genotypes to implement diagnostic tools with appropriate sensitivity, that can be applied to endemic regions. This study reports an outbreak of OROV in a region where it was not previously identified. Even though there have not been any mortalities reported since the initial identification of OROV, recent outbreaks demonstrate a pattern that highlights the emerging potential of the virus and shows the need to prioritize local epidemiological surveillance and the implementation of new public health policies to decrease the health implications that future outbreaks may cause in the population.
Chronic musculoskeletal (MSK) symptoms such as arthralgia and arthritis develop in up to half of patients after acute chikungunya virus (CHIKV) infection. While MSK complaints are common during the acute infection, chronic post-CHIKV rheumatism represents a more severe outcome and is usually assessed by joint counts, laboratory markers and patient-reported outcomes (PROs). Ultrasound (US) may be a practical tool for predicting and confirming the development of chronic CHIKV.
Objectives
To evaluate the clinical relevance of MSKUS findings in post-chikungunya rheumatism.
Methods
80 patients with acute CHIKV infection were enrolled in a prospective cohort study in Jaén, Peru. Clinical exam, US scans using grey-scale and power Doppler (PDUS), and serum inflammatory markers were performed at inclusion and at 3-month follow-up. Patients completed the RAPID3 outcome assessment and a MSK stiffness questionnaire. Joint counts and PDUS scans included 20 pairs of joints. Global synovitis and tenosynovitis scores were calculated following the EULAR-OMERACT recommendations for rheumatoid arthritis (GLOESS).
Results
59 patients (mean age 35 years, 68% female) were assessed both in the acute infection stage and at 3-month follow-up. 21 patients (35%) met strict criteria for defining chronic CHIKV rheumatism with a mean 4.4 (±2.2) tender joints and RAPID3 scores >6. In the acute infection phase, global PDUS synovitis and tenosynovitis scores correlated moderately with tender joint count and with pain severity, joint stiffness and RAPID3 scores, but were not strongly predictive of patients who went on to develop chronic arthralgia. After 3 months, global PDUS synovitis scores correlated more strongly with tender joint count (r=0.53, p<0.0001), pain severity (r=0.60, p<0.0001), joint stiffness (r=0.53, p<0.0001) and RAPID3 scores (r=0.60, p<0.0001) (Table 1).
Conclusion
Global PDUS synovitis and tenosynovitis scores may be an objective measure of disease severity in patients developing chronic CHIKV rheumatism. Further validation with longer-term follow-up is needed.
REFERENCES:
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Acknowledgements:
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Disclosure of Interests
Hugh Watson Shareholder of: Sanofi, Employee of: Sanofi, Evotec, Juana del Valle Mendoza Grant/research support from: Sanofi, Evotec, Wilmer Silva Caso Grant/research support from: Sanofi, Evotec, Miguel Aguilar Luis Grant/research support from: Sanofi, Evotec, Andrea NIzzardo Employee of: Evotec, Giulia Calusi Employee of: Evotec, Marie Mandron Employee of: Sanofi, Evotec, Maria-Antonietta D'Agostino Consultant of: Evotec.
Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion's disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers), and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion's disease.
Comparison of cytokines levels among COVID-19 patients living at sea level and high altitudeABSTRACTObjective: The objective of this study was to compare the levels of pro-inflammatory cytokines (IL-6, IL-2, IL-10, INF-α and IFN-γ) in COVID-19 patients and healthy subjects, residing in two cities of Peru at different altitudes. Results: A total of 35 COVID-19 patients and 10 healthy subjects were recruited from each study site. The mean levels of IL-6 (p<0.03) and TNF-α (p<0.01) were significantly different among the study groups. In the case of IL-6, patients from Lima had a mean level of 16.2 pg/ml (healthy) and 48.3 pg/ml (COVID-19), meanwhile, patients from Huaraz had levels of 67.3 pg/ml (healthy) and 97.9 pg/ml (COVID-19). Regarding TNF-α, patients from Lima had a mean level of 25.9 pg/ml (healthy) and 61.6 pg/ml (COVID-19), meanwhile, patients from Huaraz had levels of 89.0 pg/ml (healthy) and 120.6 pg/ml (COVID-19). The levels of IL-2, IL-10 and IFN-γ) were not significantly different in the study groups.
Gut microbiota in hospitalized children under 5 years with acute infective gastroenteritis caused by virus or bacteria in a regional Peruvian hospital ABSTRACTObjective: The main objective of this study was to describe the prevalence of 13 representative bacteria from the gut microbiota (GM) in stools samples from children under 5 years of age with acute infective gastroenteritis (AIG) as well as to describe clinical and demographic features from our study population.Results: The most commonly isolated bacteria from the GM were Firmicutes (63.2%) Bacteriodetes (62.4%), Lactobacillus (59.8%), Prevotella (57.3%), Proteobacterium (53.8%), regardless of the etiological agent responsible for the AIG. Interestingly, despite the high prevalence of Firmicutes, Bacteroidetes, Lactobacillus, and Prevotella across all samples, a visible reduction of these agents was observed especially among patients with a single bacterial infection or even bacteria – bacteria coinfections when compared to viral etiologies. Patients with exclusive or mixed breastfeeding registered the highest amount of gut microbiota bacteria, in contrast to infants who received formula or were not breastfed. Keywords: Intestinal microbiota, acute enteritis, child, bacterial infection, viral infection, gastrointestinal infection
Gut microbiota in hospitalized children under 5 years with acute infective gastroenteritis caused by virus or bacteria in a regional Peruvian hospital ABSTRACTObjective: The main objective of this study was to describe the prevalence of 13 representative bacteria from the gut microbiota (GM) in stools samples from children under 5 years of age with acute infective gastroenteritis (AIG) as well as to describe clinical and demographic features from our study population.Results: The most commonly isolated bacteria from the GM were Firmicutes (63.2%) Bacteriodetes (62.4%), Lactobacillus (59.8%), Prevotella (57.3%), Proteobacterium (53.8%), regardless of the etiological agent responsible for the AIG. Interestingly, despite the high prevalence of Firmicutes, Bacteroidetes, Lactobacillus, and Prevotella across all samples, a visible reduction of these agents was observed especially among patients with a single bacterial infection or even bacteria – bacteria coinfections when compared to viral etiologies. Patients with exclusive or mixed breastfeeding registered the highest amount of gut microbiota bacteria, in contrast to infants who received formula or were not breastfed.
Background The Chikungunya virus (CHIKV) is an emerging arthropod-borne virus (arbovirus) that causes undifferentiated acute febrile illness. Cases of CHIKV may be under-reported in Peru, given the various difficulties in diagnosing it, such as lack of diagnostic tests in remote areas, the passive nature of epidemiological surveillance, and co-circulation of other arthropod-borne pathogens. Therefore, a study was conducted in the high jungle of northern Peru to determine the prevalence of CHIKV among febrile patients and describe their clinical characteristics. Methods A cross-sectional study was conducted in the province of Jaen, Cajamarca, located in the high jungle of northern Peru. Patients attending primary healthcare centers within Cajamarca’s Regional Health Directorate were enrolled. The study took place from June 2020 through June 2021. Patients were eligible if they sought outpatient healthcare for a clinical diagnosis of acute febrile illness (AFI). Serum samples were collected from all patients, and the diagnosis of CHIKV was determined using real-time RT-PCR, as well as the detection of IgM antibodies by ELISA. A logistic regression model was employed to identify the risk factors for CHIKV, and the odds ratios (ORs) were calculated, along with their corresponding 95% confidence intervals (95% CI). Results A total of 1 047 patients with AFI were included during the study period. CHIKV was identified in 130 patients of 1 047 (12.4%). Among the CHIKV positive cases, 84 of 130 (64.6%) were diagnosed by RT-PCR, 42 of 130 (32.3%) by IgM ELISA detection, and 4 of 130 (3.1%) by both assays. The majority of patients with CHIKV infection fell within the 18–39 years age group (50.0%), followed by the 40–59 years age group (23.9%) and those with 60 years or older (10.8%). The most common clinical symptoms observed in patients with CHIKV infection were headache (85.4%), myalgias (72.3%), and arthralgias (64.6%). The highest number of positive CHIKV cases occurred in May (23.1%), followed by March (20.0%) and February (13.8%) of 2021. Conclusion The study reports a considerable frequency of CHIKV infections among patients with AFI from the high jungle of northern Peru. These findings highlight the importance of recognizing CHIKV as an ongoing pathogen with continuous transmission in various areas of Peru. It is crucial to enhance epidemiological surveillance by implementing reliable diagnostic techniques, as the clinical symptoms of CHIKV infection can be nonspecific.
Background and Objectives: Pertussis is an infectious disease caused by the Gram-negative bacterium Bordetella pertussis. In Peru, actual public health programs indicate that vaccination against B. pertussis must be mandatory and generalized, besides all detected cases must be reported. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age with a presumptive diagnosis of whopping cough in Cajamarca, a region located in northern Peru. Materials and Methods: The population of this cross-sectional study were children under 5 years old hospitalized as presumptive cases of pertussis during December 2017 to December 2018. The nasopharyngeal samples were analyzed by real-time PCR for the detection of B. pertussis.
Objective . To evaluate the in vitro adherence and viability of 3 bacterial species Streptococcus mutans (ATCC 25175), Streptococcus sanguinis (ATCC 10556), and Porphyromonas gingivalis (ATCC 33277) on the surfaces of dental implants of titanium, zirconium, and their respective fixing screws. Methods . Two analysis groups were formed: group 1 with 3 titanium pillars and group 2 with 3 zirconium pillars, each with their respective fixing screws. Each of these groups was included in tubes with bacterial cultures of Streptococcus mutans (ATCC 25175), Streptococcus sanguinis (ATCC 10556), and Porphyromonas gingivalis (ATCC 33277). These samples were incubated at 37°C under anaerobic conditions. Bacterial adherence was assessed by measurement of the change in colony-forming units (CFU), and bacterial viability was evaluated with the colorimetric test of 3-(4,5-dimethylthiazol-2)-2,5 diphenyl tetrazolium bromide (MTT). Results . The bacterial adhesion in the titanium abutments was higher for Streptococcus mutans (190.90 CFU/mL), and the viability was greater in Porphyromonas gingivalis (73.22%). The zirconium abutment group showed the highest adherence with Streptococcus mutans (331.82 CFU/mL) and the highest bacterial viability with the S. sanguinis strain (38.42%). The titanium fixation screws showed the highest adhesion with S. sanguinis (132.5 CFU/mL) compared to the zirconium fixation screws where S. mutans had the highest adhesion (145.5 CFU/mL). The bacterial viability of S. mutans was greater both in the titanium fixation screws and in the zirconium fixation screws 78.04% and 57.38%, respectively. Conclusions . Our results indicate that there is in vitro bacterial adherence and viability in both titanium abutments and zirconium abutments and fixation screws for both. Streptococcus mutans is the microorganism that shows the greatest adherence to the surfaces of both titanium and zirconium and the fixing screws of the latter. On the contrary, bacterial viability is greater on the titanium abutments with P. gingivalis than on the zirconium abutments with S. sanguinis . With respect to the fixation screws, in both cases, the viability of S. mutans was greater with respect to the other bacteria. In general, the titanium abutments showed less adherence but greater bacterial viability.