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Cercenado E, Ramos B, Pérez-Abeledo M, Sempere J, Yuste J, Sanz JC. Invasive disease caused simultaneously by two different serotypes of Streptococcus pneumoniae: a microbiological appreciation. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04787-x. [PMID: 38416289 DOI: 10.1007/s10096-024-04787-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
We report a clinical case of a child with an invasive pneumococcal disease caused by two different pneumococcal serotypes that belonged to different sequence types. She was a 15-month-old girl with pneumonia and pleural effusion in which S. pneumoniae colonies with different morphologies grew, one from the blood culture (characteristic greyish appearance) and the other from the pleural fluid (mucoid appearance). The isolate from blood was serotype 22 F (ST698/CC698/GPSC61), while the isolate from the pleural fluid was serotype 3 (ST180/CC180/GPSC12). The patient fully recovered after treatment with intravenous ampicillin followed by oral amoxicillin.
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Affiliation(s)
- Emilia Cercenado
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, 28029, Spain
| | - Belén Ramos
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, Madrid, 28055, Spain
| | - Marta Pérez-Abeledo
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, Madrid, 28055, Spain
| | - Julio Sempere
- CIBER of Respiratory Diseases (CIBERES), Madrid, 28029, Spain
- Spanish Pneumococcal Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Yuste
- CIBER of Respiratory Diseases (CIBERES), Madrid, 28029, Spain
- Spanish Pneumococcal Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Sanz
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, Madrid, 28055, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain.
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2
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Gavilán AM, Perán-Ramos P, Sanz JC, García-Comas L, Pérez-Abeledo M, Castellanos AM, Berciano JM, López-Perea N, Masa-Calles J, Echevarría JE, Fernández-García A. Investigating Local Patterns of Mumps Virus Circulation, Using a Combination of Molecular Tools. Viruses 2023; 15:2420. [PMID: 38140661 PMCID: PMC10747990 DOI: 10.3390/v15122420] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Mumps is a vaccine-preventable disease caused by the mumps virus (MuV). However, MuV has re-emerged in many countries with high vaccine coverage. The World Health Organization (WHO) recommends molecular surveillance based on sequencing of the small hydrophobic (SH) gene. Additionally, the combined use of SH and non-coding regions (NCR) has been described in different studies, proving to be a useful complement marker to discriminate general patterns of circulation at national and international levels. The aim of this work is to test local-level usefulness of the combination of SH and MF-NCR sequencing in tracing hidden transmission clusters and chains during the last epidemic wave (2015-2020) in Spain. A database with 903 cases from the Autonomous Community of Madrid was generated by the integration of microbiological and epidemiological data. Of these, 453 representative cases were genotyped. Eight different SH variants and thirty-four SH haplotypes were detected. Local MuV circulation showed the same temporal pattern previously described at a national level. Only two of the thirteen previously identified outbreaks were caused by more than one variant/haplotype. Geographical representation of SH variants allowed the identification of several previously undetected clusters, which were analysed phylogenetically by the combination of SH and MF-NCR, in a total of 90 cases. MF-NCR was not able to improve the discrimination of geographical clusters based on SH sequencing, showing limited resolution for outbreak investigations.
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Affiliation(s)
- Ana M. Gavilán
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Paula Perán-Ramos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Juan Carlos Sanz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Luis García-Comas
- Servicio de Epidemiología, Consejería de Sanidad de la Comunidad de Madrid, 28009 Madrid, Spain;
| | - Marta Pérez-Abeledo
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Ana M. Castellanos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - José M. Berciano
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Noemí López-Perea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPAZ, 28049 Madrid, Spain
| | - Josefa Masa-Calles
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Juan E. Echevarría
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Aurora Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
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Pérez-Abeledo M, Barrioluengo V, Maeso E, Sanz JC. Performance of 2 automated real time PCR methods for the detection of Bordetella pertussis and Bordetella parapertussis. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:640-641. [PMID: 37573243 DOI: 10.1016/j.eimce.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/14/2023] [Indexed: 08/14/2023]
Affiliation(s)
- Marta Pérez-Abeledo
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública de la Comunidad de Madrid, Madrid, Spain
| | | | | | - Juan Carlos Sanz
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública de la Comunidad de Madrid, Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Pérez-Abeledo M, Zaragoza G, Ramos B, Sanz JC. High frequency of Streptococcus pneumoniae serotype 3 in negative pleural fluid cultures from paediatric samples obtained in the Madrid region from 2018 to 2022, detected by direct identification using PCR-reverse-hybridization strip-based assay. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:447-448. [PMID: 37169650 DOI: 10.1016/j.eimce.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/19/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Marta Pérez-Abeledo
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública de la Comunidad de Madrid, Spain
| | - Gloria Zaragoza
- Servicio de Microbiología y Parasitología del Hospital Universitario de Getafe, Spain
| | - Belén Ramos
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública de la Comunidad de Madrid, Spain
| | - Juan Carlos Sanz
- Unidad de Microbiología Clínica, Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública de la Comunidad de Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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de Miguel S, Pérez-Abeledo M, Ramos B, García L, Arce A, Martínez-Arce R, Yuste J, Sanz JC. Distribution of Multidrug-Resistant Invasive Serotypes of Streptococcus pneumoniae during the Period 2007-2021 in Madrid, Spain. Antibiotics (Basel) 2023; 12:antibiotics12020342. [PMID: 36830253 PMCID: PMC9951976 DOI: 10.3390/antibiotics12020342] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
After the systematic use of conjugate vaccines, the invasive pneumococcal disease (IPD) was included into the Madrid Notifiable Diseases Surveillance System through an Epidemiological Surveillance Network. Furthermore, Streptococcus pneumoniae was included in the Spanish Plan of Antibiotic Resistance. The aim of this study was to analyse the multidrug-resistant (MDR) phenotype distribution among invasive strains of Streptococcus pneumoniae isolated during 2007-2021 from usually sterile clinical samples in Madrid, Spain. A total number of 7133 invasive pneumococcal isolates were studied during the period from February 2007 to December 2021. Serotyping was characterised using the Pneumotest-Latex and by the Quellung reaction. Antibiotic susceptibility testing to penicillin (PEN), erythromycin (ERY), and levofloxacin (LVX) was performed using the E-test according to the EUCAST guidelines and breakpoints. Combination of non-susceptibility to PEN at standard dosing regimen (PNSSDR), resistance to ERY (ERYR) and to LVX (LVXR) was considered to be multidrug-resistant at standard dosing regimen of penicillin (MRPSDR), whereas the combination of resistance to PEN (PENR), ERYR, and LVXR was considered multidrug-resistant (MDR). The number of MDRPSDR and or MDR strains in the entire population (n = 7133) during the complete period (2007-2021) were 51 (0.7%) and 6 (0.1%), respectively. All MDRPSDR and/or MDR strains belonged to nine serotypes: 19A (n = 13), 15A (n = 12), 9V (n = 12), 14 (n = 7), 24F (n = 3), 15F (n = 1), 19F (n = 1), 6B (n = 1) and 6C (n = 1). Only two serotypes (9V and 19A) were found among MDR strains, and most of them (5/6) belonged to serotype 9V. Only 12.4% of the strains typified as serotype 9V were MDRPSDR and only 5.2% as MDR. The levels of pneumococcal MDRPSDR and/or MDR in this study were low and all six MDR strains were isolated between 2014 and 2018. These results reinforce the importance of monitoring the evolution of non-susceptible serotypes including those with MDR in the coming years, especially after the introduction of new conjugate vaccines of a broader spectrum.
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Affiliation(s)
- Sara de Miguel
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
- Department of Preventive Medicine, University Hospital 12 de Octubre, 28041 Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Departamento de Epidemiología y Salud Pública, Epidemiología de las Enfermedades Infecciosas, Universidad de Alcalá, Alcalá de Henares, 28881 Madrid, Spain
| | - Marta Pérez-Abeledo
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Belén Ramos
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Luis García
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
| | - Araceli Arce
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
| | - Rodrigo Martínez-Arce
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Jose Yuste
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Juan Carlos Sanz
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence:
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de Miguel S, Pérez-Abeledo M, Ramos B, García L, Arce A, Martínez-Arce R, Yuste J, Sanz JC. Evolution of Antimicrobial Susceptibility to Penicillin in Invasive Strains of Streptococcus pneumoniae during 2007-2021 in Madrid, Spain. Antibiotics (Basel) 2023; 12:antibiotics12020289. [PMID: 36830208 PMCID: PMC9952450 DOI: 10.3390/antibiotics12020289] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
The use of pneumococcal conjugate vaccines has affected the epidemiology and distribution of Streptococcus pneumoniae serotypes causing Invasive Pneumococcal Disease (IPD). The aim of this study was to analyze the evolution of the phenotypical profiles of antimicrobial susceptibility to penicillin (PEN) in all IPD strains isolated in Madrid, Spain, during 2007-2021. In total, 7133 invasive clinical isolates were characterized between 2007 and 2021. Levels of PENR and PNSSDR were 2.0% and 24.2%, respectively. In addition, 94.4% of all the PENR belonged to four serotypes, including 11A (33.6%), 19A (30.8%), 14 (20.3%) and 9V (9.8%). All the strains of serotype 11A, which is a non-PCV13 serotype, were detected after the year 2011. Serotypes 6C, 15A, 23B, 24F, 35B, 19F, 16F, 6B, 23F, 24B, 24A, 15F and a limited number of strains of serogroups 16 and 24 (non-typed at serotype level) were associated with PNSSDR (p < 0.05). PNSSDR strains of non-PCV13 serotypes 11A, 24F, 23B, 24B, 23A and 16F were more frequent from 2014 to 2021. The changes in S. pneumoniae serotype distribution associated with the use of conjugate vaccines had caused in our region the emergence of non-PCV13 pneumococcal strains with different PENR or PNSSDR patterns. The emergence of serotype 11A resistant to penicillin as the most important non-PCV13 serotype is a worrisome event with marked relevance from the clinical and epidemiological perspective.
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Affiliation(s)
- Sara de Miguel
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
- Department of Preventive Medicine, University Hospital 12 de Octubre, 28041 Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Departamento de Epidemiología y Salud Pública, Epidemiología de las Enfermedades Infecciosas, Universidad de Alcalá, Alcalá de Henares, 28801 Madrid, Spain
| | - Marta Pérez-Abeledo
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Belén Ramos
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Luis García
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
| | - Araceli Arce
- Epidemiology Department, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28002 Madrid, Spain
| | - Rodrigo Martínez-Arce
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
| | - Jose Yuste
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Juan Carlos Sanz
- Clinical Microbiology Unit, Public Health Regional Laboratory of the Community of Madrid, Directorate General of Public Health, Regional Ministry of Health of Madrid, 28055 Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence:
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Sanz JC, Pérez-Abeledo M. Measles in Spain at the elimination phase: The enemy knocking on the door. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:529-531. [PMID: 36464470 DOI: 10.1016/j.eimce.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 06/17/2023]
Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Marta Pérez-Abeledo
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
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San Román J, Candel FJ, del Mar Carretero M, Sanz JC, Pérez-Abeledo M, Barreiro P, Viñuela-Prieto JM, Ramos B, Canora J, Barba R, Zapatero A, Martínez-Peromingo FJ. Cross-Sectional Analysis of Risk Factors for Outbreak of COVID-19 in Nursing Homes for Older Adults in the Community of Madrid. Gerontology 2022; 69:163-171. [PMID: 35654010 PMCID: PMC9393782 DOI: 10.1159/000524553] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/10/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Nursing homes for older adults have been hot spots for SARS-CoV-2 infections and mortality. Factors that facilitate COVID-19 outbreaks in these settings need to be assessed. METHODS A retrospective cross-sectional study of a cohort of residents and workers in nursing homes taking occasion of a point seroprevalence survey was done in the Community of Madrid. Factors related to outbreaks in these facilities were analyzed. RESULTS A total of 369 nursing homes for older adults, making a population of 23,756 residents and 20,795 staff members, were followed from July to December 2020. There were 54.2% SARS-CoV-2 IgG+ results in residents and in 32.2% of workers. Sixty-two nursing homes (16.8%) had an outbreak during the follow-up. Nursing homes with outbreaks had more residents than those without (median number of 81 [IQR, 74] vs. 50 [IQR, 56], p < 0.001). Seropositivity for SARS-CoV-2 was lower in facilities with versus without outbreaks, for residents (42.2% [IQR, 55.7] vs. 58.7% [IQR, 43.4], p = 0.002) and for workers (23.9% [IQR, 26.4] vs. 32.8% [IQR, 26.3], p = 0.01). For both residents and staff, the number of infections in outbreaks was larger in centers with lower, as compared with intermediate or high seroprevalence. The size of the facility did not correlate with the number of cases in the outbreak. Taking the incidence of cases in the community as a time-dependent variable (p = 0.03), a Cox analysis (HR [95% CI], p) showed that intermediate or high seroprevalence among residents in the facility was related to a reduction of 55% (0.45 [0.25-0.80], p = 0.007) and 78% (0.22 [0.10-0.48], p < 0.001) in the risk of outbreaks, respectively, as compared with low sero-prevalence. Also, as compared with smaller, medium (1.91 [1.00-3.65], p = 0.05) or large centers (4.57 [2.38-8.75], p < 0.001) had more respective risk of outbreaks. CONCLUSIONS The size of the facility and the seroprevalence among residents in nursing homes, and the incidence of infections in the community, are associated with the risk of outbreaks of COVID-19. Facilities with greater proportion of seropositives had smaller number of cases. Monitoring of immunity in nursing homes may help detect those at a greater risk of future cases.
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Affiliation(s)
- Jesús San Román
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Francisco J. Candel
- Clinical Microbiology and Infectious Diseases, IdISSC and IML Health Institutes, Hospital Universitario San Carlos, Madrid, Spain
| | | | - Juan Carlos Sanz
- Regional Public Health Laboratory, Community of Madrid, Madrid, Spain
| | | | - Pablo Barreiro
- Infectious Diseases, Internal Medicine, Hospital General Universitario La Paz, Madrid, Spain,*Pablo Barreiro,
| | | | - Belén Ramos
- Regional Public Health Laboratory, Community of Madrid, Madrid, Spain
| | - Jesús Canora
- Assistant to the Vice-counselor of Public Health, Community of Madrid, Madrid, Spain
| | - Raquel Barba
- Service of Internal Medicine, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - Antonio Zapatero
- Vice-counselor of Healthcare and Public Health, Community of Madrid, Madrid, Spain
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San Román J, Candel FJ, Sanz JC, López P, Menéndez-Colino R, Barreiro P, Carretero MDM, Pérez-Abeledo M, Viñuela-Prieto JM, Ramos B, Canora J, Barba R, Zapatero-Gaviria A, Martínez-Peromingo FJ. Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19. Vaccines (Basel) 2022; 10:vaccines10030383. [PMID: 35335015 PMCID: PMC8948814 DOI: 10.3390/vaccines10030383] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Most residents and staff in nursing homes have received full vaccination. Factors related to the immune response to vaccination might be related to the risk of future severe COVID-19 and may guide the need for vaccine boosters. Design: Nursing homes that were tested in a point survey in July-October 2020 were again analyzed after a vaccination campaign in June-July 2021. Immune responses according to IgG against nucleocapsid and spike antigens, and CD4 and CD8 interferon-gamma release assay against spike antigens, were evaluated. Results: A total of 1973 subjects were tested (61.7% residents, 48.3% staff), with a mean (SD) follow-up of 46.4 (3.6) weeks between assessments. More than half of residents and more than a third of staff had evidence of COVID-19 before vaccination; 26.9% and 22.7% had seroreversion of IgG-N, and 8.9% and 4.6% had IgG-N seroconversion at second assessment, respectively. Up to 96.8% of residents and 98.1% of workers had positive IgG-S after a mean of 19.9 (2.1) weeks after vaccination. In residents with vs without a history of COVID-19, IgG-S titers were 4.11 (0.54) vs. 2.73 (0.74) logAU/mL (p < 0.001); in workers these titers were 3.89 (0.61) vs. 3.15 (0.64) logAU/mL (p < 0.001). Linear regression analysis showed that younger age (OR: −0.03 per 10 years-older [95% CI, −0.04 to −0.02], p < 0.001) and evidence of COVID-19 (OR: 1.14 [95% CI, 1.08 to 1.20], p < 0.001) are associated with greater IgG-S titers after vaccination. A direct association was found between IgG-S titers and the intensity of IFN-gamma response against spike antigens. Conclusions: Waning of humoral response and reinfection seems to be more frequent in older as compared to younger adults, although cellular responses shortly after vaccination are comparable between these groups. Younger age and prior COVID-19 are related to greater humoral response after vaccination against SARS-CoV-2.
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Affiliation(s)
- Jesús San Román
- Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
| | - Francisco Javier Candel
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
- Clinical Microbiology and Infectious Diseases, IdISSC and IML Health Institutes, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Juan Carlos Sanz
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
| | - Paloma López
- Nursing Homes and Long-Term Care Facilities Support Unit, Dirección Asistencial Norte, Gerencia Asistencial Atención Primaria, 28035 Madrid, Spain;
| | | | - Pablo Barreiro
- Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
- Correspondence:
| | - María del Mar Carretero
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
| | - Marta Pérez-Abeledo
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
| | - José Manuel Viñuela-Prieto
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
- Department of Neurosurgery, Hospital General Universitario La Paz, 28046 Madrid, Spain
| | - Belén Ramos
- Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (M.d.M.C.); (M.P.-A.); (J.M.V.-P.); (B.R.)
| | - Jesús Canora
- Service of Internal Medicine, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Raquel Barba
- Service of Internal Medicine, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Antonio Zapatero-Gaviria
- Vicecounselor of Healthcare and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
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10
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Pérez-Abeledo M, Ramos B, Candel FJ, Sanz JC. Performance of the Procleix SARS-CoV-2 transcriptase-mediated amplification (TMA) assay for the diagnosis of COVID-19 in nasopharyngeal sample pools. Small pilot study. Rev Esp Quimioter 2022; 35:103-104. [PMID: 34953472 PMCID: PMC8790640 DOI: 10.37201/req/101.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - J C Sanz
- Juan Carlos Sanz Moreno, Unidad de Microbiología Clínica. Laboratorio Regional de Salud Pública de la Comunidad de Madrid. Dirección General de Salud Pública de la Comunidad de Madrid. Edificio Usos Múltiples Hospital Enfermera Isabel Zendal, Planta 1ª. Avenida de Manuel Fraga Iribarne 2, Madrid 28055. Spain.
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11
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Abstract
Mutations in the SARS-CoV-2 genome can affect the gene encoding the Spike (S) antigen, which interacts with the host cell specific receptor, selecting mutant variants with changes in their infective capacity, pathogenic potential and resistance to neutralizing antibodies. The nomenclature to design the variants uses a colloquial form referred to the country or place of detection, a code from the "Pangolin" database and one from the "Nextstrain" page. New variants that have spread include the British B.1.1.7 (20I/501Y.V1), the South African B.1.351 (20H/501.V2), the Brazilian P.1 (20J/501Y.V3), the Californians B.1.427 B.1.429 (20C/S:452R) and the most recent, the Indian B.1.617 (VUI-21APR-01).The gold standard for the identification of the variants is whole genome sequencing. However, real-time PCR techniques have already been developed for the detection of specific mutations that can facilitate their presumptive identification.The impact of these variants on global vaccination programs has raised concern. It is generally thought that, since the response evoked by the vaccine against the S antigen is directed at the entire protein and the mutations only affect specific regions, the escape effect of the vaccine antibodies will be limited. Among the future strategies proposed for immuno-protection, the increase in the number of doses, the alternation of vaccines and the development of specific vaccines against different variants has been suggested.
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Affiliation(s)
- M Pérez-Abeledo
- Unidad de Microbiología Clínica. Laboratorio Regional de Salud Pública de la Comunidad de Madrid. Dirección General de Salud Pública, Consejería de Sanidad. Comunidad de Madrid, Madrid, España
| | - J C Sanz Moreno
- Unidad de Microbiología Clínica. Laboratorio Regional de Salud Pública de la Comunidad de Madrid. Dirección General de Salud Pública, Consejería de Sanidad. Comunidad de Madrid, Madrid, España
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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12
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Barreiro P, Candel FJ, Sanz JC, San Román J, del Mar Carretero M, Pérez-Abeledo M, Ramos B, Viñuela-Prieto JM, Canora J, Martínez-Peromingo FJ, Zapatero A. Virological Correlates of IgM-IgG Patterns of Response to SARS-CoV-2 Infection According to Targeted Antigens. Viruses 2021; 13:874. [PMID: 34068703 PMCID: PMC8151912 DOI: 10.3390/v13050874] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022] Open
Abstract
The virological meaning of the different patterns of serology in COVID-19 has been little examined in clinical settings. Asymptomatic subjects with IgM-spike (S) and IgG-nucleocapsid (N) determinations by chemiluminescence were studied for SARS-CoV-2 shedding in respiratory secretions by transcription-mediated amplification (TMA). In subjects showing IgM-S positive and IgG-N negative, IgG-S was determined by lateral flow assay. A total of 712 individuals were tested: 30.0% presented IgM-S(+)/IgG-N(-), 25.8% had IgM-S(+)/IgG-N(+) and 44.2% had IgM-S(-)/IgG-N(+); the proportion with TMA(+) were comparable in these three groups: 12.1, 8.7 and 10.5%, respectively. In individuals with IgM-S(+)/IgG-N(-), IgG-S(+) was detected in 66.5%. The frequency of IgM-S(+)/IgG-S(-) in the total population was 10.0%, of whom 24.1% had TMA(+); the chances for TMA(+) in subjects with an IgM-S(+) alone pattern were 2.4%. Targeting of the same SARS-CoV-2 antigen seems to be better for the characterization of IgM/IgG patterns of response. IgM-S(+) alone reactivity is rare, and a small proportion is associated with viral shedding.
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Affiliation(s)
- Pablo Barreiro
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
| | - Francisco Javier Candel
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
| | - Juan Carlos Sanz
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
| | - Jesús San Román
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
| | - María del Mar Carretero
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
| | - Marta Pérez-Abeledo
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
| | - Belén Ramos
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
| | - José Manuel Viñuela-Prieto
- Public Health Regional Laboratory, Hospital Isabel Zendal, Av. Manuel Fraga Iribarne, 2, 28055 Madrid, Spain; (F.J.C.); (J.C.S.); (J.S.R.); (M.d.M.C.); (M.P.-A.); (B.R.); (J.M.V.-P.)
| | - Jesús Canora
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
| | | | - Antonio Zapatero
- Council of Public Health, Community of Madrid, Calle O’Donnell, 50, 28009 Madrid, Spain; (J.C.); (F.J.M.-P.); (A.Z.)
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