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Biomedical subjects

A Andreu

Publications and source records attributed to A Andreu.

At least 19 recordsLinked to original sources

Sexually transmitted Chlamydia trachomatis, Neisseria gonorrhoeae, and HIV-1 infections in two at-risk populations in Barcelona: female street prostitutes and STI clinic attendees.

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and HIV-1 infections in female street prostitutes and STI clinic attendees in Barcelona. DESIGN: This was a prospective study carried out in two four-month periods over two years. Urine specimens were tested for CT and NG using a PCR pooling algorithm. Among street prostitutes HIV-1 testing in urine was also carried out. RESULTS: The prevalences of CT, NG, and HIV-1 in female street prostitutes (n=301) were 4.7%, 3.7%, and 1.0%, respectively. Women from Eastern Europe had the highest prevalence of CT (p=0.01). Prevalences of CT, NG, and HIV-1 among all clinic attendees (n=536) were 4.3%, 4.5%, and 4.4%, respectively. Prevalence of HIV-1 infection among homosexual men was higher compared with heterosexual men and women (p<0.001). CONCLUSIONS: Overall CT prevalence is currently lower than in other European countries, although it could increase as a result of immigration. Rates of HIV-1 and of NG are higher among homosexual than among heterosexual men.

Ambulatory Care Facilities↗

Relationship between Escherichia coli strains causing urinary tract infection in women and the dominant faecal flora of the same hosts.

To clarify whether prevalence or special pathogenicity is more important in determining urinary tract infection (UTI) causation, we compared the biotype, phylogenetic group, and virulence genes of Escherichia coli urine strains from 11 women with acute lower UTI with those of the host's dominant intestinal E. coli strain(s). Twenty-one unique E. coli clones were identified. For three women, the single faecal clone identified was also the host's urine clone, whereas for eight women faecal samples yielded 1 or 2 distinct non-urine clones (total, n = 10), either with (n = 3) or without (n = 5) the concurrent urine clone. The eight urine clones from the latter eight women exhibited significantly greater inferred virulence, according to virulence gene content and phylogenetic background, than did the hosts' 10 corresponding 'faecal only' clones. In contrast, the three urine clones that were detected as the host's sole faecal clone exhibited significantly lower inferred virulence than the other eight urine clones, and were statistically indistinguishable from the 10 'faecal only' clones. In conclusion, special pathogenicity is an important determinant of UTI pathogenesis in women, although prevalence may occasionally allow less virulent strains to cause UTI.

Adult↗

Pathogenicity island markers in commensal and uropathogenic Escherichia coli isolates.

Uropathogenic isolates of Escherichia coli (UPEC) contain blocks of DNA, termed pathogenicity islands (PAIs), that contribute to their virulence. Two multiplex PCR assays were developed to detect eight PAI markers among 50 commensal E. coli and 100 UPEC isolates. In total, 40% of commensal isolates and 93% of UPEC carried PAIs. Despite this difference, the distribution of various PAIs showed the same pattern in both groups, with the most prevalent being PAI IV(536) (38% commensal vs. 89% UPEC), followed by PAI I(CFT073) (26% vs. 73%), PAI II(CFT073) (14% vs. 46%), PAI II(J96) (8% vs. 34%), PAI I(536) (8% vs. 33%) and PAI II(536) (4% vs. 20%). PAI III(536) was detected only in UPEC (2%), while PAI I(J96) was not detected in any isolate. Although the mean number of PAIs per isolate was higher among UPEC (2.97) than in commensal (0.98) isolates, there were no statistical differences among group B2 E. coli from the two origins; however, commensal isolates from groups D and B1 appeared to be less virulent than pathogenic isolates. Regardless of their phylogenetic group, nearly all the commensal and UPEC isolates with the same number of PAIs had the same PAI combinations. Although group B2 E. coli are uncommon among commensal intestinal flora, they are highly virulent when present, suggesting that the intestinal flora may act as a reservoir for bacteria that can cause urinary tract infection.

Escherichia coli↗

Multicenter study of the mechanisms of resistance and clonal relationships of Streptococcus agalactiae isolates resistant to macrolides, lincosamides, and ketolides in Spain.

Macrolide, lincosamide, and ketolide mechanisms of resistance and clonal relationships were characterized in a collection of 79 resistant group B streptococcus isolates obtained from neonates or pregnant women. The erm(B), erm(TR), and mef(A) genes were present in 62%, 30.4%, and 3.8% of the isolates, respectively. There was considerable clonal diversity among them.

Anti-Bacterial Agents↗

[Thoracic actinomycosis: an old disorder with new clinical manifestations].

Three cases of thoracic actinomycosis are described, two associated to bronchial obstruction (foreign body and bronchogenic carcinoma) and one in a patient with empyema. The clinical and radiological manifestations and diagnostic criteria are reviewed and all published cases in the Spanish literature are thoroughly analyzed.

Actinomycosis↗

[Evolution of perinatal Escherichia coli disease in the era of group B Streptococcus prophylaxis].

BACKGROUND: The aim of this study was to characterize perinatal Escherichia coli disease, and to analyze its possible correlation with the employment of prophylaxis for group B streptococcal (GBS)disease. PATIENTS AND METHOD: Between 1994 and 2000, 24 neonates born in our hospital were diagnosed of early-onset E. coli disease: 12 born to mothers who received prenatal care in our center and 12 born to mothers who were referred from other hospitals shortly before labor. Three further neonates born in other centers were also referred with the same diagnosis. RESULTS: The annual rate did not change significantly (RR:1.065; confidence interval [CI] 95% -0.873-1.301; p = 0.533):from 0.6 per 1,000 live births in 1994 to 1.7 per 1,000 in 1997 and 0.5 in 2000. Among mothers, 92% presented obstetric risk factors including 68% with prematurity (mean 32.9 gestation weeks, median 32), 64% with prolonged rupture of membranes (mean 184 hours,median 44), and 56% with intrapartum fever. Twelve percent of mothers received intrapartum ampicillin as prophylaxis against GBS and 80% received antibiotics: prophylaxis for rupture of membranes in 6 cases, treatment of urinary tract infection in 6 cases and treatment of probable chorioamnionitis in 8 cases. Ampicillin-resistant E. coli was isolated in 81% of neonates. No significant correlation was found between ampicillin resistance and prematurity(p = 0.57), rupture of membranes (p = 0.63), intrapartum fever(p = 0.24) or death (p = 0.53). CONCLUSIONS: Our results suggest that perinatal E. coli disease is not related with the employment of prophylaxis against GBS disease. Instead, it seems to be related with prematurity, prolonged gestation in premature rupture of membranes and exposure to antibiotics.

Bacteremia↗

[Role of Lactobacillus as protector against vaginal candidiasis].

BACKGROUND: To evaluate the possible protector role of Lactobacillus against vaginal candidiasis. PATIENTS AND METHOD: In vitro studies performed to assess the capacity of 15 Lactobacillus strains to block the adhesion of two Candida albicans and one C. glabrata strain to vaginal epithelial cells and to inhibit the growth of these yeasts. Moreover, the presence of Lactobacillus was analyzed in 115 vaginal exudates from women with vaginal candidiasis. RESULTS: Only 8 of the 15 lactobacilli studied significantly blocked the adhesion of C. albicans Y18 to vaginal cells. Lactobacilli from group III showed the greatest blocking capacity (62.9%), followed by group II (50.6%) and group I (26.1%). In solid assays, none of the 15 Lactobacillus strains studied was able to inhibit growth of the 3 yeasts. However, in liquid assays some lactobacilli evidenced a certain degree of inhibitory power against C. albicans Y17 (35.7%, 41.7% and 38.1% of light transmittance for Lactobacillus groups I, II and III, respectively). Lactobacillus was detected in 89.6% of women with vaginal candidiasis (by microscopy in 87.8% and by culture in 72.2%). CONCLUSIONS: These results lead us to suggest that probably Lactobacillus provides protection against vaginal candidiasis.

Adult↗

Assessment of the capacity of Lactobacillus to inhibit the growth of uropathogens and block their adhesion to vaginal epithelial cells.

To gain insight into the mechanisms by which Lactobacillus blocks the adherence of uropathogens to vaginal epithelial cells and inhibits their growth, 15 Lactobacillus strains and 22 uropathogens were studied. Lactobacilli from hemagglutination group III, identified as Lactobacillus crispatus, showed greater capacity to block uropathogen adherence than those from hemagglutination groups II and I (61.9%, 49.5%, and 52.6% of blockage, respectively). Pseudomonas aeruginosa PA5 and Klebsiella pneumoniae KP7 were the uropathogens most susceptible to blockage, and Staphylococcus aureus SA11 and Proteus mirabilis PM1 were the most resistant. Lactobacillus inhibited uropathogen growth better in liquid assays; the 3 Lactobacillus groups showed similar inhibitory power (72.3%, 71.9%, and 74.2% of light transmittance). P. aeruginosa PA5 was the most inhibited, and Enterococcus species E15 was the least inhibited. There is considerable variation among Lactobacillus strains regarding their adherence to uroepithelium, blockage of uropathogen attachment, and inhibition of uropathogen growth. Although these properties are independent, they may coincide and therefore allow for these strains to balance the vaginal ecosystem and to make them useful as probiotics.

Adolescent↗

[Changes in emergency visits of patients infected by human immunodeficiency virus since the widespread use of protease inhibitors].

OBJECTIVE: To evaluate the changes in the urgent visits made by HIV+ patients after generalisation of the protease inhibitors. PATIENTS AND METHODS: Comparison on the visits made during a period prior to and after use of protease inhibitor. RESULTS: After the generalisation of the protease inhibitors the visits rate decreased, the motives for consulting with the physician and complementary examinations changed, invasive therapeutic procedures, admissions from urgencies and death rates decreased. CONCLUSIONS: The protease inhibitors have changed the urgent visits profile of HIV+ patients.

Acquired Immunodeficiency Syndrome↗

[Microorganisms isolated in cases of pertussis-like syndrome].

OBJECTIVE: To describe the etiologic study of the pertussis-like syndrome, not only as far as Bordetella genus is concerned but also regarding the causative role of other microorganisms for a 11-year period (1988-1998). METHODS: In all specimens from patients suffering from pertussis-like cough the presence of Bordetella spp., other bacteria, viruses, and mycoplasma was investigated. The analysed data included microbiological findings and epidemiologic issues (age, sex, hospital admission area, yearly distribution and seasonal period). RESULTS: A total of 1,063 specimens were investigated, most of them nasopharyngeal aspirates (910), corresponding to 905 patients; a positive culture was obtained form 56.9 of these patients. B. pertussis was isolated from 10.5% of patients. As for other bacteria, Haemophilus influenzae and Streptococcus pneumoniae were also isolated, in 16.9% and 15.8% of occasions, respectively. The respiratory syncitial virus was isolated from 10.7% of patients and other viruses in 9.4%. Among mycoplasma, Ureaplasma urealyticum predominated, with a recovery rate of 2.9%. The male/female ratio was 495/410; the ages of 67.2% of patients ranged from 0 to 6 months; a total of 689 (76.1%) required hospital admission. The recovery of B. pertussis and adenoviruses predominated during spring and summer months. In contrast, H. influenzae, S. pneumoniae and respiratory syncitial virus were recovered more frequently during winter months. CONCLUSIONS: Most patients with pertussis-like syndrome are children aged less than 6 months. The recovery percentages of B. pertussis and respiratory syncitial virus are identical and therefore we think that the investigation of their presence in this syndrome is fully warranted as well as the search for other microorganisms, since clinical symptoms are commonly non-specific among infants.

Age Distribution↗

Prevalence of bacterial vaginosis and correlation of clinical to Gram stain diagnostic criteria in low risk pregnant women.

The present study aimed to evaluate the prevalence of bacterial vaginosis, and the correlation of clinical Amsel criteria with Gram Nugent criteria for the diagnosis of bacterial vaginosis in a low risk population of pregnant women. Pregnant women under 28 weeks of gestation who were followed in the low risk clinics at two centers were evaluated for the presence of bacterial vaginosis using the Amsel clinical criteria, and underwent vaginal samples for Gram staining. Gram smears were examined for the diagnosis of bacterial vaginosis on the basis of Nugent's criteria. A total of 492 women were included in the study. Bacterial vaginosis was diagnosed in 1.6% (8/492) women on the basis of clinical criteria, and in 4.5% (22/492) according to Gram stain. The sensitivity and specificity of Amsel criteria compared with Gram stain were 35% and 99%, respectively. In accordance with other recent reports, the prevalence of bacterial vaginosis appears to be much lower in certain areas than figures previously suggested. In these populations, the correlation of composite clinical criteria defined in groups with high prevalence of bacterial vaginosis appears to be also poor.

Coloring Agents↗

Evaluation of the Granada agar plate for detection of vaginal and rectal group B streptococci in pregnant women.

Granada medium was evaluated for the detection of group B streptococci (GBS) in vaginal and rectal swabs compared with selective Columbia blood agar and selective Lim broth. From May 1996 to March 1998, 702 pregnant women (35 to 37 weeks of gestation) participated in this three-phase study; 103 (14.7%) of these women carried GBS. In the first phase of the experiment (n = 273 women), vaginorectal specimens were collected on the same swab; the sensitivities of Granada tube, selective Columbia blood agar, and Lim broth were 31.4, 94.3, and 74.3%, respectively. In the second and third phases (n = 429 women), vaginal and rectal specimens were collected separately; the sensitivities of Granada plate, selective Columbia blood agar, and Lim broth (subcultured at 4 h on selective Columbia agar in the second phase and at 18 to 24 h in Granada plate in the third phase) were 91.1, 83.9, and 75%, respectively, in the second phase and 88.5, 90.4, and 63.5%, respectively, in the third phase. There were no statistically significant differences in GBS recovery between the Granada agar plate and selective Columbia blood agar, but the Granada plate provided a clear advantage; the characteristic red-orange colonies produced overnight by GBS can be identified by the naked eye and is so specific that further identification is unnecessary. The use of the Granada tube and Lim broth did not result in increased isolation of GBS. In conclusion, the Granada agar plate is highly sensitive for detecting GBS in vaginal and rectal swabs from pregnant women and can provide results in 18 to 24 h.

Agar↗

Use of Granada medium to detect group B streptococcal colonization in pregnant women.

Direct inoculation onto Granada medium (GM) in plates and tubes was compared to inoculation into a selective Todd-Hewitt broth (with 8 microg of gentamicin per ml and 15 microg of nalidixic acid per ml) for detection of group B streptococci (GBS) in pregnant women with 800 vaginal and 450 vaginoanorectal samples. Comparatively, GM was found to be as sensitive as the selective broth for the detection of GBS in vaginal specimens and more sensitive than selective broth for the detection of GBS in vaginoanorectal samples (96 versus 82%). The use of GM improved the time to reporting of a GBS-positive result by at least 24 h and reduced the direct cost of screening. We have also found that the inconvenience of anaerobic incubation of GM plates can be avoided when a cover slide is placed upon the inoculum, because aerobic incubation in GM plates with cover slides causes GBS to develop the same pigmentation that it develops with incubation under anaerobic conditions. These data support the routine use of GM plates or tubes as a more accurate, easier, and cheaper method of identification of GBS-colonized women compared to the enrichment broth technique.

Bacterial Typing Techniques↗

Urovirulence determinants in Escherichia coli strains causing prostatitis.

To define the urovirulence properties of Escherichia coli strains producing prostatitis, E. coli strains isolated from men with acute (7 strains) or chronic (23) prostatitis were compared with E. coli isolates from women with pyelonephritis (30), acute cystitis (60), or complicated urinary tract infection (UTI; 30). Strains from prostatitis patients were significantly more likely to express hemolysin than were strains causing complicated UTI (73% vs. 43%; P = .02) and more often demonstrated hybridization with the cytotoxic necrotizing factor-1 (CNF-1) probe (63%) than did strains from women (44%-48%). P fimbrial expression was highest among pyelonephritis (73%) and prostatitis strains (53%) and lowest among E. coli from women with complicated UTI (23%) and cystitis (30%; P < .05, prostatitis strains vs. either of the latter 2 groups). Results suggest that E. coli strains producing prostatitis generally possess urovirulence profiles similar to those of strains from women with acute uncomplicated pyelonephritis and that hemolysin and CNF-1 are especially prevalent in prostatitis strains.

Acute Disease↗