1
|
de Melo SA, Pinto SD, Ferreira EDS, Brotas R, Marinho EPM, da Silva VA, Monte RL, Feitoza PVS, Reis MF, Almeida TVR, Ferreira LCDL, Bastos MDS. Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas. Front Med (Lausanne) 2024; 10:1298435. [PMID: 38264048 PMCID: PMC10803427 DOI: 10.3389/fmed.2023.1298435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024] Open
Abstract
Background Opportunistic infections in the central nervous system (CNS) of people with HIV/AIDS (PLWHA) remain significant contributors to morbidity and mortality, especially in resource-limited scenarios. Diagnosing these infections can be challenging, as brain imaging is non-specific and expensive. Therefore, molecular analysis of cerebrospinal fluid (CSF) may offer a more accurate and affordable method for diagnosing pathogens. Methods We conducted extensive real-time PCR testing (qPCR) on CSF to evaluate etiological agents in PLWHA with neurological manifestations. Primers targeting DNA from specific pathogens, including cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), John Cunningham virus (JCV), Toxoplasma gondii, and human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2), were used. Results Cerebrospinal fluid samples revealed 90 pathogens (36.7%). Toxoplasma gondii was the most frequently detected pathogen, found in 22 samples (30.5%). Other pathogens included Cryptococcus sp. (7.7%), EBV (5.3%), CMV, VZV, and JCV (4.0% each). Conclusion Despite antiretroviral therapy and medical follow-up, opportunistic central nervous system infections remain frequent in PLWHA. Herpesviruses are commonly detected, but T. gondii is the most prevalent opportunistic pathogen in our study population. Therefore, molecular diagnosis is a crucial tool for identifying opportunistic infections, even in patients undergoing treatment.
Collapse
Affiliation(s)
| | | | | | - Reinan Brotas
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | | | - Rossiclea Lins Monte
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | | | | | - Taynná V. Rocha Almeida
- Departamento de Formação em Emergências em Saúde Pública, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | | |
Collapse
|
2
|
Marinho EPM, Ferreira EDS, Barrionuevo CCLB, Melo SA, Cordeiro JSM, Pinto SD, Monte RL, da Silva VA, Martins YF, Reis MF, Tufic-Garutti SDS, Sampaio VDS, de Castro DB, Feitoza PVS, da Rocha LA, de Lima Ferreira LC, Bastos MDS. Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles. Front Public Health 2023; 11:1329091. [PMID: 38186717 PMCID: PMC10768178 DOI: 10.3389/fpubh.2023.1329091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
Background Central nervous system (CNS) infections are important causes of mortality and morbidity in children, and they are related to severe problems such as hearing loss, neurological sequelae, and death. The objective was to describe clinical and laboratory exam profiles of children who were diagnosed with CNS infections. Methods We conducted a cross-sectional study based on medical records, which included pediatric patients aged from 3 months to 15 years, with a clinical suspicion of CNS infection between January 2014 to December 2019. The pathogens were confirmed in cerebrospinal fluid (CSF) samples using Gram staining, cell culture, molecular diagnostics (PCR and qPCR), and serology. Results Out of the 689 enrolled patients, 108 (15.6%) had laboratory-confirmed infections in CSF. The most common bacterial pathogens isolated from the culture were Neisseria meningitidis serogroup C in 19, Streptococcus pneumoniae in 11, and Haemophilus influenzae in seven samples. The viruses identified were Enterovirus, Cytomegalovirus, Varicella-zoster virus, Epstein-Barr virus, and arbovirus. No patient was found to be positive for Herpes simplex virus 1 and 2. Patients with viral infections showed altered levels of consciousness (p = 0.001) when compared to bacterial infections. Conclusion This study shows the presence of important vaccine-preventable pathogens, and different families of viruses causing CNS infections in the pediatric patients of Manaus.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Monique Freire Reis
- Departamento de Patologia e Medicina Legal, Universidade Federal do Amazonas, Manaus, Brazil
- Departamento de Ensino e Pesquisa, Fundação Centro de Controle de Oncologia do Amazonas, Manaus, Brazil
| | | | | | - Daniel Barros de Castro
- Universidade Federal do Amazonas, Manaus, Brazil
- Fundação de Vigilância em Saúde Dra. Rosemary Casta Pinto, Manaus, Brazil
| | | | - Lucia Alves da Rocha
- Universidade Federal do Amazonas, Manaus, Brazil
- Hospital e Pronto Socorro da Criança Zona Oeste, Manaus, Brazil
| | | | - Michele de Souza Bastos
- Universidade Federal do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| |
Collapse
|
3
|
Ferreira EDS, Gómez ASP, Almeida TVR, Frank CHM, de Melo SA, Marinho EPM, Pinto SD, Feitoza PVS, Monte RL, Bastos MDS. Microbiological profile of bloodstream infections and antimicrobial resistance patterns at a tertiary referral hospital in Amazon, Brazil. Rev Soc Bras Med Trop 2023; 56:e03822023. [PMID: 37792844 PMCID: PMC10550097 DOI: 10.1590/0037-8682-0382-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients. METHODS A retrospective, observational and descriptive study was conducted by reviewing blood culture records collected from patients with suspected BSI, between January 2017 and December 2019. RESULTS The most frequent antimicrobial resistant (AMR) pathogens were methicillin-resistantStaphylococcus aureus(MRSA) (40%), methicillin-resistantS. epidermidis (MRSE) (9.5%), and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (35.3%). CONCLUSIONS Our findings underscore the importance of continued vigilance and advocate for the rational use of antimicrobial agents.
Collapse
Affiliation(s)
- Ewerton da Silva Ferreira
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
- Universidade Federal do Amazonas, Programa de Pós-graduação em Biotecnologia, Manaus, AM, Brasil
| | - Aline Stephanie Pérez Gómez
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
| | - Taynná Vernalha Rocha Almeida
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
- Universidade Federal do Amazonas, Programa de Pós-graduação em Ciências da Saúde, Manaus, AM, Brasil
| | | | - Sabrina Araújo de Melo
- Universidade Federal do Amazonas, Programa de Pós-graduação em Ciências da Saúde, Manaus, AM, Brasil
| | | | - Sergio Damasceno Pinto
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
- Universidade Federal do Amazonas, Programa de Pós-graduação em Ciências da Saúde, Manaus, AM, Brasil
| | | | - Rossicleia Lins Monte
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
| | - Michele de Souza Bastos
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Laboratório de Bacteriologia, Manaus, AM, Brasil
- Universidade Federal do Amazonas, Programa de Pós-graduação em Ciências da Saúde, Manaus, AM, Brasil
| |
Collapse
|
4
|
Coutinho-da-Silva MS, Sucupira PHF, Bicalho KA, Campi-Azevedo AC, Brito-de-Sousa JP, Peruhype-Magalhães V, Rios M, Teixeira-Carvalho A, Coelho-dos-Reis JGA, Antonelli LRDV, de Rezende VB, de Melo FLR, Garcia CC, Silva-Andrade JC, da Costa-Rocha IA, Bastos MDS, da Rocha LA, Silva VA, Ferreira EDS, Marinho EPM, Costa AG, Gomes MDS, Amaral LR, Furtado ECDS, da Silva EVP, Ramos BA, dos Santos ÉB, Freitas MNO, Vasconcelos PFDC, Martins-Filho OA, Araújo MSS, Ferreira MS, Martins LC. Serum Soluble Mediator Profiles and Networks During Acute Infection With Distinct DENV Serotypes. Front Immunol 2022; 13:892990. [PMID: 35711447 PMCID: PMC9193801 DOI: 10.3389/fimmu.2022.892990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
A panoramic analysis of chemokines, pro-inflammatory/regulatory cytokines, and growth factors was performed in serum samples from patients with acute DENV infection (n=317) by a high-throughput microbeads array. Most soluble mediators analyzed were increased in DENV patients regardless of the DENV serotype. The substantial increase (≥10-fold) of CXCL10, IL-6, and IFN-γ, and decreased levels of PDGF (<0.4-fold) was universally identified in all DENV serotypes. Of note, increased levels of CXCL8, CCL4, and IL-12 (≥3-9-fold) were selectively observed in DENV2 as compared to DENV1 and DENV4. Heatmap and biomarker signatures further illustrated the massive release of soluble mediators observed in DENV patients, confirming the marked increase of several soluble mediators in DENV2. Integrative correlation matrices and networks showed that DENV infection exhibited higher connectivity among soluble mediators. Of note, DENV2 displayed a more complex network, with higher connectivity involving a higher number of soluble mediators. The timeline kinetics (Day 0-1, D2, D3, D4-6) analysis additionally demonstrated differences among DENV serotypes. While DENV1 triggers a progressive increase of soluble mediators towards D3 and with a decline at D4-6, DENV2 and DENV4 develop with a progressive increase towards D4-6 with an early plateau observed in DENV4. Overall, our results provided a comprehensive overview of the immune response elicited by DENV infection, revealing that infection with distinct DENV serotypes causes distinct profiles, rhythms, and dynamic network connectivity of soluble mediators. Altogether, these findings may provide novel insights to understand the pathogenesis of acute infection with distinct DENV serotypes.
Collapse
Affiliation(s)
| | | | - Kelly Alves Bicalho
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
| | | | | | | | - Maria Rios
- Office of Blood Research and Review (OBRR), Center for Biologics Evaluation and Research (CBER), U.S. Food and Drug Administration (FDA), Silver Spring, MD, United States
| | | | | | | | | | - Fernanda Ludolf Ribeiro de Melo
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cristiana Couto Garcia
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
- Laboratório de Vírus Respiratórios e Sarampo, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | | | | | - Michele de Souza Bastos
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Escola de Enfermagem de Manaus, Universidade Federal do Amazonas (UFAM), Manaus, Brazil
| | - Lucia Alves da Rocha
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Escola de Enfermagem de Manaus, Universidade Federal do Amazonas (UFAM), Manaus, Brazil
| | - Valderjane Aprigio Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Ewerton da Silva Ferreira
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | - Allyson Guimarães Costa
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Escola de Enfermagem de Manaus, Universidade Federal do Amazonas (UFAM), Manaus, Brazil
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil
| | - Matheus de Souza Gomes
- Laboratório de Bioinformática e Análises Moleculares, Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Universidade Federal de Uberlândia (UFU), Patos de Minas, Brazil
| | - Laurence Rodrigues Amaral
- Laboratório de Bioinformática e Análises Moleculares, Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Universidade Federal de Uberlândia (UFU), Patos de Minas, Brazil
| | | | | | - Bruna Alves Ramos
- Departamento de Arboviroses e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Brazil
| | - Éder Barros dos Santos
- Departamento de Arboviroses e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Brazil
| | | | | | - Olindo Assis Martins-Filho
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
- *Correspondence: Olindo Assis Martins-Filho, ; Márcio Sobreira Silva Araújo,
| | - Márcio Sobreira Silva Araújo
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
- *Correspondence: Olindo Assis Martins-Filho, ; Márcio Sobreira Silva Araújo,
| | | | - Livia Carício Martins
- Departamento de Arboviroses e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Brazil
| |
Collapse
|
5
|
Monteiro VS, Baía-da-Silva DC, Silva VA, Pivoto João GA, Marinho EPM, Cubas-Vega NC, Val FFA, Perez-Gomez AS, Monte RL, Mota A, Lacerda MVG, Souza Bastos M. Neurological Manifestations Associated with Parvovirus B19 Infection in Immunocompetent Children: Case Series and Systematic Review. J Trop Pediatr 2021; 67:fmab078. [PMID: 34545404 DOI: 10.1093/tropej/fmab078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
An increasing number of reports have described human parvovirus B19 infection in association with a variety of neurological manifestations, especially in children. This study assessed the clinical and laboratory outcomes found in a case series of immunocompetent children who tested positive for parvovirus B19 by qualitative polymerase chain reaction assays of cerebrospinal fluid, in a tertiary referral center in the western Brazilian Amazon. We screened 178 children with clinically diagnosed central nervous system infections (meningoencephalitis). Of these, five (2.8%) were positive for parvovirus B19. A literature review also presented herein identified a further 50 cases of parvovirus B19 with neurological manifestations. Thus, even if the classic signs of parvovirus B19 infection are absent, such as the well-known rash, children with signs of neurological infection should also be evaluated for parvovirus B19 infection.
Collapse
Affiliation(s)
- Vinícius Silva Monteiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Djane Clarys Baía-da-Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
- Instituto Leônidas and Maria Deane, Fiocruz, Manaus 69.057-070, Brazil
| | - Valderjane Aprigio Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Guilherme Augusto Pivoto João
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Eveny Perlize Melo Marinho
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
| | - Nadia Carolina Cubas-Vega
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Fernando Fonseca Almeida Val
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Aline Stephanie Perez-Gomez
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Rossiclea Lins Monte
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Adolfo Mota
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Michele Souza Bastos
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
| |
Collapse
|