Introducción. El municipio de Ovejas en Los Montes de María es un foco urbano autóctono de leishmaniasis y registra casos esporádicos de la enfermedad de Chagas. Aunque Didelphis marsupialis (zarigüeya) es reconocido como huésped, hospedador u hospedero, rural de tripanosomatídeos en Colombia, se desconoce su papel en esta zona del país. Objetivo. Evaluar la frecuencia de infección natural por Leishmania spp. y Trypanosoma cruzi en D. marsupialis de ambientes peridomiciliarios del municipio de Ovejas. Materiales y métodos. Entre agosto y octubre del 2015 se capturaron zarigüeyas en las áreas urbanas con trampas de vida Tomahawk. Tras evaluación morfométrica, identificación del sexo y conteo de piezas dentales, se obtuvieron muestras sanguíneas por punción cardiaca, usadas para detectar anticuerpos IgG contra Leishmania spp. y T. cruzi, amplificar blancos genéticos específicos de estos parásitos y para aislamiento in vitro. Los parásitos se tipificaron mediante análisis filogenético de los genes citocromo b y hsp70. Resultados. Se capturaron 26 individuos (12 machos y 14 hembras; 16 adultos, 7 subadultos y 3 juveniles). Se obtuvo una prevalencia de anticuerpos del 23,08 y 53,85 %, contra Leishmania spp. y T. cruzi, respectivamente, con 11,54 % de coinfección. La frecuencia de infección molecular por T. cruzi fue del 61,54 y 23,08 % para Leishmania spp. Se logró aislar y genotipificar una cepa de T. cruzi. Conclusión. Las altas frecuencias de infección simple y coinfección indican que D. marsupialis podría actuar como huésped sinantrópico de Leishmania spp. y T. cruzi en Ovejas, sugiriendo su participación en el mantenimiento de los ciclos domésticos de transmisión urbana.
ABSTRACT Background Kidney transplant recipients in endemic areas are at risk of Trypanosoma cruzi reactivation or donor‐derived infection. Methods We performed a retrospective study of all kidney transplants conducted between January 2018 and October 2023. Patients at risk for Chagas disease were defined as those with a seropositive donor and seronegative recipient (D+/R−), a seronegative donor and seropositive recipient (D−/R+), or a seropositive donor and a seropositive recipient (D+/R+). Screening was based on serology. Posttransplant monitoring included parasitemia detection using direct microscopy (Strout method) and quantitative polymerase chain reaction (qPCR). Outcomes included Chagas reactivation or primary infection, parasitemia dynamics, and clinical outcomes. Data on immunosuppression, rejection treatment, and graft and patient survival were also collected. Results Among 954 kidney transplant recipients, 48 (5%) were identified as being at risk. Two patients were excluded (follow‐up at another center, n = 1; immediate graft loss due to hyperacute rejection, n = 1). qPCR detected parasitemia in 3/17 (18%) seropositive recipients and 2/28 (7%) recipients of organs from seropositive donors. (One of these two patients was non‐adherent to monitoring, and developed parasitemia detectable by the Strout method and clinical disease). Antitrypanosomal therapy was initiated in five patients (benznidazole, n = 4; nifurtimox, n = 1), including three R+ and two D+/R− cases, all achieving molecular clearance. During follow‐up (median: 29.77 months (range: 8.49–80.7), no patient developed further clinical manifestations after treatment. Conclusions Molecular monitoring allows early detection of Chagas reactivation or transmission after kidney transplantation. Preemptive treatment triggered by parasitemia appears effective in preventing progression to clinical disease, with favorable long‐term outcomes.
Abstract Background The Global Action in Healthcare Network-Antimicrobial Resistance Module (GAIHN-AR), led by the U.S. CDC, enhances prevention, detection and response in low-resource hospital settings (LRS) against emerging antimicrobial resistance (AR) threats, with an initial focus on carbapenemase-producing organisms. GAIHN-AR includes a lab. component for improving early AR detection, an infection prevention and control program, and a communication platform for rapid response coordination. We describe the implementation verification/validation of new AR diagnostic methods and their integration into clinical workflow Table Methods Prior to GAIHN-AR initiation in two hospitals in Argentina in January 2023, validation of CPO diagnostic techniques was conducted. For this, reference strains characterized by WGS from the CDC & FDA AR-Bank and Argentina-NRL repository were used. Evaluation followed manufacturer specifications, with GeneXpert also tested with alternative Dacron swabs. Pure colonies were used for validation of all methods, except for GENEXPERT®Carba-R where contrived fecal sample were also used. Methodologies were acceptable with sensitivity, specificity, and precision values ≥ 95%.The following methodologies were verified for carbapenemase detection in Enterobacterales, P. aeruginosa, and Acinetobacter spp. (ACI): (i) GENEXPERT®Carba-R; (ii) NG-Test®CARBA-5 lateral flow (ACI excluded); (iii) CHROMagar mSuperCARBA® chromogenic medium for carbapenem resistance detection; (iv) RAPIDEC® CARBA-NP. Additionally, the GENEXPERT®Carba-R was validated for: i) KPC variants with ceftazidime/avibactam resistance, ii) local circulation metallo-β-lactamase IMP variants Results The methodologies under evaluation achieved performance between 95-100%, except for the IMP variants with GenXpert Carba-R where sensitivity was reduced to 44% (Table). Conclusion Verification/validation process demonstrated that most methods had acceptable performance, allowing integration into lab workflows to facilitate prompt diagnosis and rapid communication with IPC teams. Results benefited not only GAIHN-AR hospitals but also other LRS facilities with whom they were shared through the NRL, offering valuable lessons for similar settings Disclosures All Authors: No reported disclosures
Studies show the link between hantavirus infection in rodents and human infection risk. Understanding factors contributing to rodent hantavirus transmission is crucial for assessing and predicting human hantavirus pulmonary syndrome risk. Infection dynamics are often studied using seroprevalence time series from serological tests, but this method only provides an average consequence over time, offering limited insight into timing or mechanisms. To overcome this, we developed a strategy which combines capture-mark-recapture data and longitudinal serological data in order to determine the likely time window for infection and correlate it with individual features (sex and age) and the weather conditions to which each individual rodent was subject throughout its lifetime. We applied our seroconversion model to field data from two sigmodontine species, Akodon azarae and Oligoryzomys flavescens, collected in agroecosystems in the Buenos Aires province of Argentina, from May 2014 to January 2016, with a trapping effort of 19,800 trap-nights. By using daily time series, we found different weather conditions related to high seroconversion rates for each species, hardly identifiable in seroprevalence data. Higher infection rates in males and the fact that strongest effects on seroconversion converge at the time of the year that corresponds to the reproductive period indicate that transmission may be connected to matting behavior. In addition, by comparing weather conditions that relate to seroconversion with those which favor virus persistence in the environment, we argue that nesting habits could also play a role in hantavirus transmission.
In this study, we describe two closely related cases of multifocal MSSA infections within the same household. The dissemination of infection was severe in both cases, but none of the patients presented endocarditis. All isolates shared resistance to erythromycin and clindamycin (inducible macrolide resistance phenotype, iMLSb). The genomic analysis of one of the isolates indicated that it belongs to the human-associated CC398-MSSA clonal complex, an emerging lineage in our region. Whole genome sequencing enabled the characterization and differentiation of this clone from the livestock-associated CC398-MSSA lineage.
