There is little information about the amount of recent tuberculosis transmission in low-income settings. Genetic clustering can help identify ongoing transmission events. A retrospective observational study was performed on Mycobacterium tuberculosis isolates from persons living with HIV (PLHIV) and HIV-seronegative participants who submitted samples to a referral tuberculosis laboratory in Guatemala City, Guatemala from 2010 to 2014. Genotyping results were classified according to the international spoligotyping database, SITVIT2. Spoligotype patterns were categorized as clustered or nonclustered depending on their genotype. The proportion of clustering and the index of recent transmission index (RTIn-1) were estimated. In the RTIn-1 method, clustered cases represent recent transmission, whereas nonclustered cases represent reactivation of older tuberculosis infections. As a secondary aim, the potential risk factors associated with clustering in isolates from the subset of participants living with HIV were explored. From 2010 to 2014, a total of 479 study participants were confirmed as culture-positive tuberculosis cases. Among the 400 available isolates, 71 spoligotype patterns were identified. Overall, the most frequent spoligotyping families were Latin American-Mediterranean (LAM) (39%), followed by T (22%) and Haarlem (14%). Out of the 400 isolates, 365 were grouped in 36 clusters (range of cluster size: 2-92). Thus, the proportion of clustering was 91% and the RTIn-1 was 82%. Among PLHIV, pulmonary tuberculosis was associated with clustering (OR = 4.3, 95% CI 1.0-17.7). Our findings suggest high levels of ongoing transmission of M. tuberculosis in Guatemala as revealed by the high proportion of isolates falling into genomic clusters.
Limited data are available regarding the molecular epidemiology of Mycobacterium tuberculosis (Mtb) strains circulating in Guatemala. Beijing-lineage Mtb strains have gained prevalence worldwide and are associated with increased virulence and drug resistance, but there have been only a few cases reported in Central America. Here we report the first whole genome sequencing of Central American Beijing-lineage strains of Mtb. We find that multiple Beijing-lineage strains, derived from independent founding events, are currently circulating in Guatemala, but overall still represent a relatively small proportion of disease burden. Finally, we identify a specific Beijing-lineage outbreak centered on a poor neighborhood in Guatemala City.
La resistencia a la terapia antirretroviral (TARV) es un factor determinante para el fallo virológico en pacientes con VIH. El objetivo de este estudio fue identificar los patrones genotípicos de resistencia en pacientes con fallo virológico. Fueron incluidos pacientes de las diferentes unidades de atención integral de VIH en Guatemala, de quienes se sospechaba resistencia y que necesitaban cambios en la TARV por fallo virológico, se requirió haber evaluado la adherencia y una carga viral ≥1,000 copias/ml. La información clínica y demográfica fue recolectada a través de la forma de solicitud. El análisis de resistencia se realizó a través de la metodología TRUGENE® HIV-1. La muestra se restringió a 25 pacientes por motivos de accesibilidad. El 68% de las muestras analizadas presentaron resistencia; por familia de ARV la resistencia fue de 88.2% para ITINN, 70.5% para ITIAN y 17.6% para IP. Se identificaron 79 mutaciones entre el grupo de estudio, el 46.8% de fueron asociadas a ITINN, 76.6% a ITIAN y 26.6% a IP. Para ITIAN las mutaciones más frecuentes fueron la M184V 43%, M184I 14% y K219E 10%; el 23.8% fueron mutaciones TAMs. Para ITINN fueron la V179D 16%, K103N 14%, G190A 14% y Y181C 14%. Para los IP la mutación más frecuente fue la M36I con 29%. La resistencia identificada en este grupo, fue menor a lo reportado en otros países latinoamericanos; sin embargo es similar a lo reportado por OMS en países con bajo o medio ingreso económico.
What Do Linguists Deal About? - „Ausbruch" der Orthographie aus der Sprachwissenschaft? — Zum Verhältnis von Sprachwissenschaft und Orthographie im 19. Jahrhundert was published in Volume 3 on page 2604.
ABSTRACT Background There is little information about the proportion of clustering of tuberculosis cases from low-income settings, which can represent ongoing transmission events. We investigated for the first time the proportion of clustered tuberculosis cases based on genotypic matching in Guatemala City, Guatemala between 2010 and 2014 and potential risk factors associated with these clustered cases in HIV-infected subjects. Moreover, the genetic diversity of M. tuberculosis isolates in this country is presented. Design and methods This study was a retrospective observational study conducted on Mycobacterium tuberculosis isolates from HIV-infected and non-HIV infected tuberculosis cases that submitted samples to a referral tuberculosis laboratory in Guatemala City, Guatemala from 2010-2014. Genotyping results were compared with the international spoligotyping database, SITVIT2 and classified accordingly. We generated a spoligoforest using the MERCAT program. We categorized spoligotype patterns as clustered or non-clustered depending of their genotype and estimated the proportion of clustering and the recent transmission index (RTI n-1 ). We analyzed the crude association between demographic, clinical and behavioral variables and clustering in the HIV-population. Results From 2010 to 2014, a total of 479 patients were confirmed as tuberculosis cases by culture at the study site. Spoligotype patterns were available from 391 patients (82%), nine of them with two isolates included in the study. We detected 71 spoligotype patterns and overall, the most frequent spoligotyping families were LAM (39%), followed by T (22%), Haarlem (14%), X (13%), Unknown (6%) and Beijing (3%), representing 97% of the isolates. Out of the 400 isolates, 365 (91%) were grouped in 36 clusters (range: 2-92). The recent transmission index (RTI n-1 ) was 82%. Pulmonary tuberculosis was strongly associated with clustering in the 113 HIV-infected group with available data (OR=4.3, 95% CI 1.0-17.7). Conclusion There might be high levels of ongoing transmission of M. tuberculosis in Guatemala City, Guatemala as indicated by clustering in a convenience sample. Among HIV-infected patients, clustering was more likely in pulmonary disease.
La resistencia a la terapia antirretroviral (TARV) es un factor determinante para el fallo virologico en pacientes con VIH. El objetivo de este estudio fue identificar los patrones genotipicos de resistencia en pacientes con fallo virologico. Fueron incluidos pacientes de las diferentes unidades de atencion integral de VIH en Guatemala, de quienes se sospechaba resistencia y que necesitaban cambios en la TARV por fallo virologico, se requirio haber evaluado la adherencia y una carga viral ≥1,000 copias/ml. La informacion clinica y demografica fue recolectada a traves de la forma de solicitud. El analisis de resistencia se realizo a traves de la metodologia TRUGENE® HIV-1. La muestra se restringio a 25 pacientes por motivos de accesibilidad. El 68% de las muestras analizadas presentaron resistencia; por familia de ARV la resistencia fue de 88.2% para ITINN, 70.5% para ITIAN y 17.6% para IP. Se identificaron 79 mutaciones entre el grupo de estudio, el 46.8% de fueron asociadas a ITINN, 76.6% a ITIAN y 26.6% a IP. Para ITIAN las mutaciones mas frecuentes fueron la M184V 43%, M184I 14% y K219E 10%; el 23.8% fueron mutaciones TAMs. Para ITINN fueron la V179D 16%, K103N 14%, G190A 14% y Y181C 14%. Para los IP la mutacion mas frecuente fue la M36I con 29%. La resistencia identificada en este grupo, fue menor a lo reportado en otros paises latinoamericanos; sin embargo es similar a lo reportado por OMS en paises con bajo o medio ingreso economico.
Aqueous micellar solutions of β-d-octyl glucopyranoside (β-C8G1), β-d-decyl maltopyranoside (β-C10G2), and β-d-dodecyl maltopyranoside (β-C12G2) containing 5 wt % of butanol have been studied by small angle-neutron scattering using contrast matching techniques in order to determine the location of the alcohol molecules in the micelles. At the chosen alcohol content the micelles of all three surfactants take on prolate ellipsoidal shape. Using deuterated butanol in combination with fully protonated surfactants dissolved in an appropriate mixture of H2O/D2O, it was possible to obtain a scattering signal solely due to the alcohol. For all three systems under investigation, it was found that butanol is incorporated into the amphiphile film and is not solubilized into the hydrophobic core of the micelles.
Abstract Various yellow, red, and blue anthraquinone dyes have been synthesized. The structures of the dyes are presented and their properties are discussed with respect to the dichroic ratios, the color gamut, and the obtainable contrast in black colored liquid crystalline dye mixtures. Dichroic ratios of up to N = 10.2 in NP 1132 and ň = 12.3 in RO-TN 404 are calculated. The influence of the positions of the absorption bands on the perceived contrast is studied. It is shown that by shifting the absorption bands of the dyes, the effective dichoric ratio can be increased to N eff = 9.1 in NP 1132 and N eff = 11.4 in RO-TN 404