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Biomedical subjects

L Aguilar

Publications and source records attributed to L Aguilar.

At least 19 recordsLinked to original sources

Phospholipid membranes form specific nonbilayer molecular arrangements that are antigenic.

Hexagonal phase (H(II))-preferring lipids such as phosphatidate, cardiolipin, and phosphatidylserine form nonbilayer molecular arrangements in lipid bilayers. While their presence in biological membranes has not been established, in vitro studies suggest that alterations in membrane properties modify their function. In this study, antiphospholipid monoclonal antibodies were developed against nonbilayer structures. One of the monoclonal antibodies identifies nonplanar surfaces in liposomes and in membranes of cultured cells. These results are the first evidence that natural membranes maintain a fragile balance between bilayer and nonbilayer lipid arrangements. Therefore, these antibodies can be used to evaluate the role of H(II)-preferring lipids in the modulation of membrane activities. Our studies demonstrated that nonplanar surfaces are highly immunogenic. Although these structures are normally transient, their formation can be stabilized by temperature variations, drugs, antibiotics, apolar peptides, and divalent cations. Our studies demonstrated that abnormal exposure of nonbilayer arrangements may induce autoimmune responses as found in the antiphospholipid syndrome.

Animals

Low prevalence of diphtheria immunity in the Spanish population: results of a cross-sectional study.

A seroepidemiological study was conducted on a representative sample (n = 3944) of the Spanish population to assess the immune status to diphtheria. A total of 1907 men and 2037 women in the 5-59 years age range were stratified by sex and age (5-12, 13-19, 20-29, 30-39, 40-49, 50-59 years). Concentrations of toxin antibodies were measured using a commercial ELISA kit. Samples with titres > or = 0.1 IU/ml were considered to show full protection. Only 26% (95% CI: 25-28%) of the overall population studied was fully protected. The highest number of subjects with uncertain or no protection was found in the 20-39 age group (> 85%). The prevalence of fully protected subjects progressively declined from 51% for the 5-12 year age group, to 14% for the 30-39 year age group, whereas it increased to 20% and 35% for the 40-49 and the 50-59 year age groups, respectively (p < 0.0001). These results stress the need to intensify vaccination programs in adolescents and adults with periodic booster doses of diphtheria toxoid.

Adolescent

Is sexual transmission an important pattern for herpes simplex type 2 virus seroconversion in the Spanish general population?

Herpes simplex type 2 (HSV-2) seroprevalence within a community is determined by sexual and perinatal transmission from mother to baby, the two main sources of virus shedding. A seroepidemiological study of HSV-2 was undertaken on a representative sample (n = 3974) of the Spanish population to assess indirectly the relative relevance of these two transmission routes. The sample comprised 1922 men and 2052 women in the age range 5-59 years, stratified by sex and age (5-12, 13-19, 20-29, 30-39, 40-49, and 50-59 years). Sera were screened for HSV-2 specific Ig G antibodies by an enzyme-linked immunoabsorbent assay based on recombinant glycoprotein G2 (gG2). The overall prevalence of antibodies to HSV-2 was 3.6% (95% CI: 3. 1-4.2%). Prevalence by gender did not differ: males (3.6%; 95% CI: 2. 8-4.6%) and females (3.6%; 95% CI: 2.8-4.5%). There were no significant differences between age groups with respect to seropositivity rates. Detection of HSV-2 antibodies was not associated with increasing age, as is expected for a sexually transmitted disease. The fact that seroprevalence rates among the different age groups did not differ suggests that the virus is not circulating in the general population and may be restricted to risk groups only. Similar positivity rates found in the group of females of childbearing age and in the youngest population indicate that perinatal viral shedding is the main source of HSV-2 seroconversion in the Spanish population.

Adolescent

Prevalence of hepatitis A in an institution for the mentally retarded in an intermediate endemicity area: influence of age length of institutionalization.

OBJECTIVE: This study aimed to examine the prevalence of antibodies against hepatitis A (anti-HAV) in a population of institutionalized mentally retarded persons compared with that of institutionalized non-mentally retarded persons in an area with moderate endemicity of HAV infection. METHODS: The study population was a group of mentally retarded persons aged between 10 and 30 years, institutionalized in one residence in Madrid, Spain. A group of non-mentally retarded subjects in the same age range was chosen as controls. Information about demography and duration of institutionalization was obtained by the investigator. Four drops of whole blood were obtained from each person by finger-stick, collected on filter paper, air-dried and stored at +4 degrees C until antibody determination. Eluates were tested by an ELISA method. RESULTS: A total of 314 institutionalized subjects were included: 157 mentally retarded (mean age and mean duration of institutionalization were 24.4+/-3 and 9.7+/-5 years respectively) and 157 non-mentally retarded (mean age and mean duration of institutionalization were 19.2+/-5 and 4.6+/-3 years respectively). The prevalence of anti-HAV antibody was 54% (95% confidence interval (CI) 50-58) in mentally retarded and 22% (95% CI 19-25) in non-mentally retarded [P<0.001; odds ratio (OR): 4.2 (95% CI 2.5-7)]. In both groups, these differences were not statistically significant for anti-HAV antibody prevalence between persons institutionalized for >5 years compared with those institutionalized for < or = 5 years. CONCLUSIONS: There results indicate that in an area of moderate endemicity the institutionalized mentally retarded are at increased risk of having acquired hepatitis A infection compared to the non-mentally retarded. In these institutionalized persons, regardless whether they are mentally retarded or not, prevalence is not influenced by age or length of stay in institutions.

Adolescent

Antimicrobial treatment of an experimental otitis media caused by a beta-lactamase positive isolate of Haemophilus influenzae.

A gerbil model of otitis media induced by a beta-lactamase producing and non-serotypeable isolate of Haemophilus influenzae was used to assess the in-vivo efficacy of co-amoxiclav and cefuroxime at low (5 mg/kg) and high (20 mg/kg) doses. The MIC of the antibiotics tested against the pathogen was 1 mg/L (1/0.5 mg/L for co-amoxiclav). The organism was inoculated (+/-10(6) cfu) by transbullar challenge directly in the middle ear and antibiotic treatment was commenced 2 h post-inoculation and continued at 8 h intervals for three doses. Only high dose co-amoxiclav significantly reduced the number of culture-positive specimens as compared with untreated animals or with other treatment groups (91.7% as compared with 36.7% for high dose cefuroxime). The results obtained in any treatment group were related to middle ear antibiotic level/MIC. Antibiotic concentrations in the middle ear 90 min after administration were about 10% of serum levels at 15 min, probably related to a slight inflammatory response. Only after high dose co-amoxiclav did the concentration in the middle ear exceed the MIC by a factor of four. In otitis media with effusion, if indicated, antibiotics active in vitro should be administered in high doses and, to avoid side effects, probably in short courses.

Amoxicillin-Potassium Clavulanate Combination

Antimicrobial resistance of 914 beta-hemolytic streptococci isolated from pharyngeal swabs in Spain: results of a 1-year (1996-1997) multicenter surveillance study. The Spanish Surveillance Group for Respiratory Pathogens.

A nationwide susceptibility surveillance study of beta-hemolytic streptococcal isolates from pharyngeal swabs obtained in 11 Spanish hospitals between May 1996 and April 1997 against 12 antibiotics was carried out. Of the isolates 86% (786 of 914 isolates) were group A and 8.4% (77 of 914 isolates) were group C. No resistance was found to beta-lactam antibiotics, but significant differences (P < 0.001) with respect to lack of susceptibility to macrolides were found between groups (27% for group A and 12% for group C) and between seasons (13.2% in summer and 31.7% in winter). Most of these isolates displayed the M phenotype (low-level resistance to erythromycin and susceptibility to clindamycin).

Drug Resistance, Microbial

Antimicrobial resistance of 1,113 Streptococcus pneumoniae isolates from patients with respiratory tract infections in Spain: results of a 1-year (1996-1997) multicenter surveillance study. The Spanish Surveillance Group for Respiratory Pathogens.

A nationwide susceptibility surveillance of 1,113 Streptococcus pneumoniae isolates was carried out and found the following percentages of resistance: cefuroxime, 46%; penicillin, 37%; macrolides, 33%; aminopenicillins, 24%; cefotaxime, 13%; and ceftriaxone, 8%. A significant (P < 0.05) seasonality pattern for beta-lactam antibiotics was observed. Resistance to macrolides was higher (P < 0.05) in middle-ear samples. Higher percentages of resistance to cefuroxime and macrolides were observed among penicillin-intermediate and -resistant strains, whereas high frequencies of resistance to aminopenicillins and expanded-spectrum cephalosporins were observed only among penicillin-resistant strains.

Cefuroxime

Is there an ecological relationship between rates of antibiotic resistance of species of the genus Streptococcus? The Spanish Surveillance Group for Respiratory Pathogens.

The relationship between resistance to antibiotics on the part of Streptococcus pneumoniae and Streptococcus pyogenes was studied by comparing different prevalences of resistance among hospitals obtained from a recent microbiological surveillance of community-acquired respiratory tract infections. A high correlation for erythromycin resistance was found between S. pneumoniae isolates from lower respiratory tract infections and S. pyogenes isolates collected from pharyngeal swabs.

Drug Resistance, Microbial

Influence of comorbidity and severity on the clinical outcome of bacteremic pneumococcal pneumonia treated with beta-lactam monotherapy.

The influence of the severity of pneumonia and comorbidity factors, as predictors of clinical outcome, was assessed in patients with microbiologically documented pneumococcal bacteremic pneumonia treated with penicillin or third generation cephalosporin monotherapy in a 5-year retrospective study. Among 288 patients admitted to three Spanish hospitals with bacteremic pneumococcal pneumonia, 65 (23%) were included. Twenty-four were treated with penicillins and 41 with a third-generation cephalosporin. Twenty-seven patients (42%) had severe pneumonia and 41 (63%) had a comorbidity index >1. Twenty-one patients (32%) were infected with penicillin-resistant strains. Four cases (2 with penicillin-resistant strains; 3 treated with cephalosporins) were clinical failures. Four cases (3 with penicillin-resistant strains; 2 treated with cephalosporins) died, i.e. 6% mortality rate. The only factor that influenced empirical treatment election was HIV-positive condition. Clinical outcome was not influenced by treatment election, penicillin susceptibility of the infecting pneumococci, patient basal conditions or severity of pneumonia, but the latter was associated with mortality and length of hospitalization.

Adolescent

Prevalence and risk of cysticercosis and taeniasis in an urban population of soldiers and their relatives.

To determine markers of Taenia solium transmission and risk factors in an urban community, we studied 1,000 soldiers from a military camp in Mexico City and their relatives. Serum samples were used to detect antigens and antibodies and fecal specimens were examined for Taenia coproantigens and helminth eggs. Prevalences of 12.2% and 5.8% for cysticercosis were found among soldiers and their relatives, respectively. Taeniasis was found in 0.5% and none of the groups, respectively. Relatives of soldiers positive for cysticercosis and taeniasis markers ate more pork from street stores than restaurants or markets compared with relatives of soldiers without these indicators of infection. Also, 12.0% of the relatives of positive soldiers had a history of expelling tapeworm proglottids in the feces in contrast to 3.7% of the family members of the control group. Prevalence values and risk factors in this urban population are similar to those of previous studies performed in rural populations.

Adult

Effect of polymorphonuclear neutrophils on serum bactericidal activity against Streptococcus pneumoniae after amoxicillin administration.

The effect of phagocytic killing on serum bactericidal activity against Streptococcus pneumoniae was investigated 0, 1.5, 8 and 12 h after a single 875 mg oral dose of amoxicillin in healthy adults. Killing curves were determined with polymorphonuclear neutrophils (PMN), serum or PMN plus serum. Global killing (i. e. intracellular and extracellular killing) over 3 h of incubation was expressed as the area under the killing curve (AUKC; log cfu x h/ml). Amoxicillin did not affect the activity of PMN alone. For serum alone, the AUKC of post-administration samples (with supra-inhibitory amoxicillin concentrations) was significantly lower than in baseline samples. For serum plus PMN, significant bactericidal activity of serum was still found in samples after antibiotic concentrations had reached sub-inhibitory levels.

Adult

In vivo efficacies of amoxicillin and cefuroxime against penicillin-resistant Streptococcus pneumoniae in a gerbil model of acute otitis media.

The comparative efficacies of amoxicillin and cefuroxime against acute otitis media caused by a penicillin-resistant (MIC, 2 micrograms/ml) Streptococcus pneumoniae strain were assessed in a gerbil model by challenging each ear with 10(7) bacteria through transbullar instillation. Each antibiotic was tested at two doses (5 and 20 mg/kg of body weight) administered at 2, 10, and 18 h postinoculation. Samples were obtained from the middle ear (ME) on days 3 and 7 postinoculation for determination of bacterial counts. Only amoxicillin, at both doses, was able to significantly halt the weight loss in animals, reducing both the number of culture-positive animals and the bacterial concentration in ME samples versus the values for untreated animals. Comparison of the efficacies between the antibiotics, determined by their ability to achieve culture-negative ME specimens, showed that amoxicillin at 5 mg/kg was significantly more active than cefuroxime at the same dose. The use of higher doses of either amoxicillin or cefuroxime did not produce significantly better results than those obtained with the lower dose but caused a greater inflammatory response. The more favorable results obtained with amoxicillin compared with those obtained with cefuroxime could be related to the antimicrobial susceptibility of the pneumococcal strain (MICs and minimum bactericidal concentrations of 1 and 1 microgram/ml and 4 and 4 micrograms/ml for amoxicillin and cefuroxime, respectively) as well as to the better pharmacokinetic parameters obtained with amoxicillin.

Acute Disease

In vitro activities of co-amoxiclav at concentrations achieved in human serum against the resistant subpopulation of heteroresistant Staphylococcus aureus: a controlled study with vancomycin.

The effects of concentrations that simulated those in human serum after a single intravenous dose of amoxicillin (2 g), amoxicillin-clavulanic acid (2,000 and 200 mg, respectively), or vancomycin (500 mg), on the viability and beta-lactamase activity of two isogenic (beta-lactamase and non-beta-lactamase producer) heteroresistant Staphylococcus aureus strains were studied in an in vitro pharmacodynamic model. A reduction of > or = 97% of the initial inoculum was obtained with vancomycin and amoxicillin-clavulanic acid against both strains, with respect to the total bacterial population and the oxacillin-resistant subpopulation. The same pattern was observed with amoxicillin and the beta-lactamase-negative strain. beta-Lactamase activity in the beta-lactamase-positive strain changed over time parallel to viability, decreasing with amoxicillin-clavulanic acid or vancomycin and increasing in the amoxicillin and control groups. Clavulanic acid concentrations achievable in serum that changed over time allowed amoxicillin to act against the beta-lactamase-producing methicillin-resistant S. aureus to a similar extent as vancomycin.

Amoxicillin

Taenia solium: description of the intestinal implantation sites in experimental hamster infections.

Experimental infections in golden hamsters with viable Taenia solium metacestodes were used to study by light and electron microscopy the implantation site of the adult tapeworm in the intestinal wall. Implantation sites from 3-, 4-, 10-, and 40-day infections were located in the upper third of the duodenum, excised and fixed in Zenker's or Karnovsky's solution, embedded in Polybed resin, and sectioned longitudinally to observe the position of the worm on the intestinal wall. The scolex of the tapeworm was situated between host villi, with the rostellum penetrating the intestinal wall and the suckers entrapping adjacent villi. Serial sections through several whole implantation sites revealed that the worm was anchored to the host by all 4 suckers simultaneously, each of which was located at a different level and had entrapped intestinal villi in its cavity. Host tissue within the suckers was damaged, exhibiting various degrees of cell lysis and necrosis of epithelial and submucosal cells. The tegumentary surface and microtriches of the scolex were well preserved, with occasional coalescence of tegumentary microvesicles in 10- and 40-day-old infections; microtriches were in direct contact with the damaged host tissue. This study is the first morphological and ultrastructural description of the attachment of T. solium to the intestinal wall employing an experimental model, the results of which may contribute to a better understanding of the biology of human tapeworm infections.

Animals

Comparative development of Taenia solium in experimental models.

Various mammals were evaluated as experimental models of adult Taenia solium. Suppressed and nonsuppressed hosts were used as experimental models. Infections were performed per os with cysticerci obtained from pigs; immunosuppression was induced with methyl prednisolone acetate at intervals of 10-14 days after infection. Tapeworms developed in hamsters, gerbils, and chinchillas but failed to develop in rabbits, cats, pigs, and rhesus monkeys. In infectable animals, treatment with the steroid facilitated maintenance and development of the parasite, and more tapeworms were obtained. Mature and some pregravid proglottids were recovered from hamsters and gerbils, whereas a gravid T. solium was obtained from a chinchilla at 12 wk postinfection. Eggs recovered from the chinchilla transformed into cysticerci in a pig 12 wk after oral infection. The T. solium-chinchilla experimental system seems to be an alternative definitive host for this parasite and thus the basis for a great diversity of studies.

Animals