DSpace Repository :: Browsing by Author "Dabanch, Jeannette"

Browsing by Author "Dabanch, Jeannette"

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Bacteriemia por Vibrio cholerae no-O1/no-O139 que porta una región homóloga a la isla de patogenicidad VpaI-7
(2019) Olivares, Felipe; Domínguez, Ignacio; Dabanch, Jeannette; Porte, Lorena; Ulloa, María; Osorio, Gonzalo
Presentamos un caso de bacteriemia por Vibrio cholerae no-O1/ no-O139 en una mujer de 81 años con un cuadro de dolor abdominal, fiebre, vómitos, diarrea, coluria e ictericia, mientras visitaba una zona rural sin acceso a agua potable. La identificación se realizó por la técnica de espectrometría de masa MALDI-TOF, confirmándose una cepa no toxigénica no-O1/no-139. La caracterización molecular del aislado demostró la ausencia del gen de la toxina del cólera (CTX), y pilus TCP; sin embargo, presentó cinco de los seis genes de virulencia presentes en la isla de patogenicidad homóloga denominada VPaI-7 del V. parahaemolyticus (vcs N2+, vcs C2+, vcs V2+,toxR-, vspD+, T vopF+). Además, el aislado presentó los genes de virulencia hylA y rtxA. Este es el primer caso reportado en Chile de una cepa clínica de V. cholerae no-O1, no-O139 aislada de hemocultivos portador de un segmento homólogo de la isla de patogenicidad denominada VPaI-7 de V. parahaemolyticus, el cual codifica para un sistema de secreción tipo III (TTSS), que probablemente contribuye a su virulencia. We report a case of V. cholerae non-O1 / non-O139 bacteremia in an 81-year-old woman with abdominal pain, fever, vomiting, liquid stools, choluria and jaundice, while visiting a rural area without access to potable water. The identification was made by the MALDI-TOF mass spectrometry technique and subsequently the non-toxigenic non-O1 / non-139 strain was confirmed in the national reference laboratory. The molecular characterization demonstrated the absence of the cholera toxin gene (CTX), and the TCP pilus, however, presented 5 of 6 virulence genes present in an island of homologous pathogenicity named VPaI-7 of V. parahaemolyticus (vcs N2 +, vcs C2 +, vcs V2 +, toxR-, vspD +, T vopF +) and in addition it was positive for hylAy rtxA virulence genes recognized outside the island. This is the first case reported in Chile of a clinical strain of V. cholerae non-O1, non-O139 isolated from blood culture that carries in its genome a homologous segment of the pathogenicity island named VPaI-7 of V. parahaemolyticus, which codifies for a type III secretion system (TTSS) that probably contributes to his virulence.
Brotes de salmonelosis y el tamaño y rol del Estado en Chile
(Sociedad Chilena de Infectología, 2012) Fica, Alberto; Acosta-Jamett, Gerardo; Dabanch, Jeannette; Perret, Cecilia; Torres, Marisa; Lopez, Javier; Jofre, Leonor; Weitzel, Thomas; Comité de Infecciones Emergentes de la Sociedad Chilena de Infectología
During year 2011 two outbreaks of Salmonella infection captured media attention in the Metropolitan Area (MA) in Chile: one of typhoid fever associated to Salmonella serotype Typhi, and the other, of gastroenteritis related to Salmonella serotype Enteritidis, both with decreasing or stable rates in the previous years. The aim of this work is to analyze probable causes of their reemergence. Methods: Several government websites were searched looking for epidemiological data. Results: Typhoid fever rates have declined to current values of 1 case per 100.000 habitants, a decreased associated to improvements in the human development index. The typhoid outbreak was associated to a predominant clone within the MA. The only risk factor identified was consumption of raw vegetables acquired in open fairs, but without identifying a common source. Despite improvements in disease notification and molecular epidemiology capabilities, this outbreak is coincidental with a reduced number of food inspection visits in the MA, probably explained by the limited personnel available for this task. In the case of Salmonella Enteritidis, rates have increased twice since 1998 (5.3 to 10.7 per 100.000 habitants) with an important increase in the number of outbreaks linked to this agent (7 to 31 annual outbreaks) since year 2005. Persistence of this problem is probably associated to the low surveillance of poultry farms made by the Chilean state, to the absence of a cold chain during collection, distribution and selling of eggs, and to the lack of an educational program directed to the population. The recent regulation that bans home-made mayonnaise in restaurant or fast food stores is an important advance that requires further evaluation. Conclusions: The persistence and reemergence of different kind of Salmonellosis in Chile suggests chronic problems on the size and role of the Chilean state regarding food safety.
Características clínicas y factores pronósticos de la enfermedad meningocóccica: un estudio de serie de casos en Chile durante el brote 2012-2013
(Sociedad Chilena de Infectología, 2015) Matute, Isabel; Olea, Andrea; López, Darío; Loayza, Sergio; Nájera, Manuel; González, Claudia; Poffald, Lucy; Hirmas, Macarena; Delgado, Iris; Pedroni, Elena; Alfaro, Tania; Gormaz, Ana María; Sanhueza, Gabriel; Vial, Pablo; Dabanch, Jeannette; Gallegos, Doris; Aguilera, Ximena
Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. Objective: To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Material and Methods: Case series considering149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihoodof dying. Results: 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. Discussion: The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.
Catheter-associated bloodstream infection caused by Leifsonia aquatica in a haemodialysis patient: a case report
(Microbiology Society, 2012) Porte, Lorena; Soto, Andres; Andrighetti, Daniela; Dabanch, Jeannette; Braun, Stephanie; Saldivia, Alejandra; Flores, Juan Carlos; Wozniak, Aniela; Garcia, Patricia; Weitzel, Thomas
Leifsonia aquatica is an aquatic coryneform rod that is capable of forming biofilms in environmental water sources. It has rarely been associated with human infections and its pathogenicity and clinical significance are uncertain. We describe a case of catheter-related bloodstream infection in a haemodialysis patient. The isolate grew on conventional media as a yellow-pigmented colony, but identification required molecular methods. Although the strain displayed reduced sensitivity to vancomycin, the clinical outcome was favourable after catheter removal and intravenous treatment with this antibiotic. Our report gives further evidence of the capability of this aquatic bacterium to cause human infection.
Cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 portan los genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF del sistema de secreción T3SS2 presentes en una isla de patogenicidad
(2019) Ulloa, María Teresa; Sanhueza, Camila; Henríquez, Tania; Aguayo, Benjamín; Hermosilla, Germán; Porte, Lorena; Dabanch, Jeannette; Braun, Stephanie; Fica, Alberto; Briceño, Isabel; Osorio, Carlos
Backgound: The virulence factors of the Vibrio cholerae non-O1, non-O139 strains are not clearly known. The strain of septicemic origin NN1 Vibrio cholerae non-O1, non-O139 was sequenced previously by the Illumina platform. A fragment of the pathogenicity island VPaI-7 of V. parahaemolyticus was detected in its genome. Aim: To detect the virulence genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF in Chilean strains of V. cholerae non-O1, non-O139. Methods: A total of 9 Chilean strains of clinical origin of Vibrio cholerae non-O1, non-O139 isolated between 2006-2012 were analyzed by conventional PCR assays for type III secretion genes encoded on that island: vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF. Additionally, the presence of the virulence genes hylA and rtxA was determined. In addition, REP-PCR and ERIC-PCR assays were performed. Results: most (6/9) Chilean V. cholerae non-O1, non-O139 strains contain the type III secretion genes vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF, encoded in an island of pathogenicity. In addition, all (9/9) the strains contain the virulence genes hylA and rtxA. Conclusion: These results strongly suggest the possibility that those strains possess an important virulence potential in humans.
Chikungunya, enfermedad emergente en América Latina. Descripción de los primeros casos en Chile
(2018) Perret, Cecilia; Vizcaya, Cecilia; Weitzel, Thomas; Rosas, Reinaldo; Dabanch, Jeannette; Martínez, Constanza
Background: Chikungunya (CHIK) was introduced in The Americas in 2013, spreading rapidly. In 2014, the first imported case was diagnosed in Chile. Aim: To identify patients with clinical suspicion of CHIK and describe their clinical and laboratory characteristics. Patients and Methods: Patients with suspected CHIK were enrolled. All were confirmed by PCR, IgM or IgG CHIK. A structured survey was applied, which included demographic questions, travel characteristics, clinical manifestations, and laboratory results. Results: 21 patients were enrolled and CHIK was confirmed in 16, who were further analyzed; 12 were female (75%), average age 39 years (27-52). The Caribbean and South Americawere the most frequent sites of exposure. In 63%, the initial symptom was arthralgia. Most frequent symptoms were myalgias, malaise (both 100%), fever, and polyarthralgia (both 94%). The median duration of arthralgias was 90 days (3-262); in 53% arthralgias lasted ≥ 3 months. Main joints involved were ankles, hands, and wrists; 87% reported invalidating pain. Arthritis lasted longer in men than in women (p < 0.001). 38% of patients presented lymphopenia and one patient mild thrombocytopenia. Two patients required hospitalization, one with severe headaches, the other with acute pyelonephritis. Conclusions: Chikungunya should be suspected in returning travelers presenting with fever and severe polyarthralgia. Travelers to endemic areas should apply prevention measures to avoid mosquito bites.
Hacia una comprensión integral de la relación entre migración internacional y enfermedades infecciosas. De la creencia a la evidencia para la acción sanitaria en Chile
(Colegio Médico de Chile, 2019) Cabieses, Báltica; Libuy, Matías; Dabanch, Jeannette; Cabieses, Báltica; Libuy, Matías; Dabanch, Jeannette
La globalización y los movimientos migratorios de la población conllevan el problema de la transmisión de enfermedades y riesgos en la salud, tanto para los migrantes como para la población residente. En los últimos años el escenario mundial se ha visto desafiado por grandes masas de personas que se han movilizado desde países empobrecidos o en guerra hacia países más ricos, prósperos o con mayor estabilidad política y/o socioeconómica, como medida de supervivencia a las insostenibles condiciones en las que se encontraban en sus países de origen (OIM, 2013). A nivel mundial se ha observado que, en promedio, en la mayoría de los países, la población migrante internacional tiende a ser joven y saludable. Sin embargo, pueden cambiar su comportamiento y adoptar nuevas prácticas similares a la población local (asimilación), así como perder algunas de sus formas de comprender la realidad o sus costumbres y tradiciones (aculturación). Con esto, se pueden asumir nuevos riesgos para su salud mental, salud sexual y reproductiva, volverse más vulnerables al alcoholismo y uso de drogas, sufrir cambios alimentarios o verse obligados a permanecer en espacios sin condiciones adecuadas de saneamiento, agua potable, entre otros. También pueden encontrar el limitado acceso a servicios de salud básicos, agravado por barreras culturales y lingüísticas que aumentan la vulnerabilidad para la población (Cabieses, Pickett, & Tunstall, 2012; United Nations, 2006; Van der Laat, 2017; World Health Organization, 2015). De esta forma, es de preocupación global la protección de migrantes internacionales, sobre todo si experimentan riesgos de vulneración de derechos, de privación o de salud durante la partida, tránsito y llegada.
Is there a risk of filarial infection during long-term missions in Haiti?
(Elsevier, 2016) Weitzel, Thomas; Rosas, Reinaldo; Fica, Alberto; Dabanch, Jeannette; Polanco, Myriam; Egaña, Alicia; Triantafilo, Vjera; Pfarr, Kenneth; Hoerauf, Achim; Reiter-Owona, Ingrid
BACKGROUND: Haiti has the highest prevalence of lymphatic filariasis (Wuchereria bancrofti) in the Western Hemisphere. Still, the risk of filarial infection for long-term visitors such as humanitarian aid workers or military personnel is uncertain. The presented study analyzed the exposure to W. bancrofti in Chilean participants of the UN Stabilization Mission in Haiti (MINUSTAH) in 2011. METHODS: Blood samples collected from 531 participants were screened for antifilarial antibodies by IgG ELISA, and, if positive, analyzed by immunofluorescence assay (IFA), IgG4 ELISA, Real-Time PCR, and circulating filarial antigen (CFA) card test. RESULTS: ELISA screening was positive in 10 cases. Seroconversion occurred in only two cases (0.38%) based on ELISA values determined in samples taken before and after deployment. Positive IgG ELISA values could not be confirmed by IFA and IgG4 ELISA. Real-Time PCR and CFA testing did not reveal the presence of filaria. CONCLUSIONS: Our data indicate that in the examined cohort of MINUSTAH participants in 2011, the risk of filarial exposure or infection was low.
Micobacterias atípicas en cinco pacientes adultos sin evidencias de inmunosupresión. Construyendo una experiencia
(Sociedad Chilena de Infectología, 2015) Fica, Alberto; Soto, Andrés; Dabanch, Jeannette; Porte, Lorena; Thompson, Luis; Balcells, Elvira
We aim to communicate the experience gathered during the management of infections by atypical mycobacteria in immunocompetent patients in a general practice. Between 2008 and 2013, 5 patients with non-tuberculous mycobacterial infections were identified: 2 with cutaneous involvement and 3 with lung infection. None of them had evidence of immunosuppression. A patient with elbow bursitis by M. chelonae presented with a high mononuclear count in fluid analysis with mycobacterial growth at the fifth day of culture. He evolved satisfactorily with clarithromycin. A case with M. fortuitum skin infection had a delayed initial diagnosis with progression to local draining lymph nodes; the culture when requested was positive after 13 days of incubation. Patients with pulmonary infection presented with prolonged cough and sputum and had in common to be postmenopausal women displaying small nodules and bronchiectases at lung images, a classical pattern. Time elapsed between respiratory sampling and a definitive inform ranged from 40 to 89 days. Non-tuberculous mycobacterial infections in non-immunosuppresed patients can generate diagnostic and therapeutic challenges. Delay in identification contributes to this problem.
Recomendación del Comité Asesor de Vacunas y Estrategias de Inmunización (CAVEI) sobre vacunación contra viruela símica en Chile
(2022) Luchsinger, Vivian; Dabanch, Jeannette; King, Alejandra; Wilhelm, Jan; Saldaña, Adiela; Bertoglia, María Paz; García, Christian; Endeiza, María L.; Rodríguez Troncoso, Jaime
La viruela del mono fue declarada emergencia de salud pública de importancia internacional por la Organización Mundial de la Salud el año 2022. En Chile, hasta septiembre se han confirmado sobre 450 enfermos, mayoritariamente hombres jóvenes. Este poxvirus zoonótico se transmite entre humanos por contacto estrecho; la enfermedad es autolimitada y puede ser fatal en inmunocomprometidos. La prevención mediante inmunización es importante. MVA-BN es una de las tres vacunas disponibles, de 3° generación, contiene el virus vaccinia atenuado, no replicante por lo que se puede administrar a pacientes inmunocomprometidos y mujeres embarazadas y está aprobada para viruela símica en personas > 18 años. La información disponible sobre eficacia y efectividad es limitada. El CAVEI recomienda incorporar esta vacuna para interrumpir la cadena de transmisión y reducir el riesgo de enfermedad grave, en dos dosis separadas por 28 días, por vía subcutánea, priorizando el uso post-exposición para contactos estrechos con riesgo de enfermedad grave, idealmente en los primeros 4 días y hasta 14 días post contacto de riesgo y en ausencia de síntomas. Cuando el suministro de vacunas lo permita, se recomienda prevención pre-exposición para personas con alto riesgo ocupacional o por prácticas sexuales. Esta recomendación podría modificarse según la epidemiología, el suministro de vacunas y nueva información científica.

Browsing by Author "Dabanch, Jeannette"

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