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1. Increased frequency of HLA-DR3 and complotype SCO1 in Mexican mestizo children with amoebic abscess of the liver

Author

Arellano, J., Martha Perez-Rodriguez, López-Osuna, M., Velázquez, J. R., Granados, J., Justiniani, N., Santos, J. I., Madrazo, A., Muñoz, L., and Kretschmer, R.

Subjects
Adult, Male, Linkage disequilibrium, Adolescent, Immunology, Population, HLA-DR3, HLA-DR6 Antigen, Disease, Human leukocyte antigen, HLA-DR5 Antigen, Linkage Disequilibrium, White People, Cohort Studies, HLA-DR3 Antigen, Gene Frequency, Risk Factors, medicine, Ethnicity, Humans, Abscess, education, Child, Mexico, education.field_of_study, Amoebic liver abscess, business.industry, Infant, medicine.disease, Parasitic disease, Case-Control Studies, Child, Preschool, Dysentery, Amebic, Indians, North American, Liver Abscess, Amebic, Parasitology, Female, business
Abstract

The increase of HLA-DR3 and complotype SCO1 previously found in Mexican mestizo adults with E. histolytica amoebic abscess of the liver, was also found in Mexican mestizo children of either sex with the same disease, when compared to the healthy control population (adults and/or children) of the same ethnic and socioeconomic background. This HLA and complotype pattern was not found in Mexican Mestizo patients with amoebic rectocolitis. No linkage disequilibrium was found between these and the other MHC determinants tested in this survey. Thus, HLA-DR3 and SCO1 may constitute primary, independent risk factors, not for any kind of amoebic tissue invasion (i.e. amoebic rectocolitis), but specifically for amoebic liver abscess, irrespective of age or sex. The possibility of linkage disequilibrium with other factors (i.e. the TNF family) within or close to the MHC that were not tested in this study, is discussed. Children with amoebic liver abscess revealed a significant increase in HLA-DR5, and the absence of HLA-DR6 when compared to adults with amoebic liver abscess, suggesting that at least in this ethnic group these class II HLA traits may contribute to some of the peculiarities of pediatric amoebic liver abscess as opposed to the adult version of this disease. HLA-DR3, SCO1, but also HLA-DR5 and HLA-DR6 have all been associated with certain forms of immune-dysfunction, and may thus contribute to some of the clinical and immunological features of this parasitic disease.

Published
1996

3. Prevalencia de infecciones nosocomiales en niños: encuesta de 21 hospitales en México

Author

Avila-Figueroa Carlos, Cashat-Cruz Miguel, Aranda-Patrón Eduardo, León Angel R., Justiniani Nancy, Pérez-Ricárdez Lucía, Avila-Cortés Francisco, Castelán Manuel, Becerril Roberto, and Luz Herrera Enedina

Subjects
infección hospitalaria, hospitales pediátricos, México, Public aspects of medicine, RA1-1270
Abstract

OBJETIVO. Determinar la prevalencia de infecciones nosocomiales, los factores de riesgo, su microbiología, la prevalencia de uso de antibióticos y la mortalidad asociada en niños hospitalizados. MATERIAL Y MÉTODOS. Se realizó un estudio transversal en 21 hospitales públicos que atienden a niños. Se incluyeron pacientes desde recién nacidos hasta de 17 años de edad. Los riesgos ajustados se estimaron mediante regresión logística múltiple. RESULTADOS. En 1 183 niños estudiados se identificaron 116 pacientes con infección nosocomial, con una prevalencia de 9.8% (IC95% 8.1-11.6). Los sitios de infección más frecuentes fueron: neumonía (25%), sepsis/bacteriemia (19%) e infección del tracto urinario (5%). El principal microrganismo identificado en hemocultivo fue Klebsiella pneumoniae (31%). La prevalencia de uso de antibióticos fue de 49% con una variación de entre 3 y 83%. Mediante regresión logística múltiple se encontraron cuatro factores independientemente asociados con el desarrollo de infección nosocomial: exposición a catéteres intravenosos (RM 3.3, IC95% 1.9-5.9), alimentación parenteral (RM 2.1, IC95% 1.0-4.5), ventilación mecánica (RM 2.3, IC95% 1.2-4.1) y ser recién nacido de bajo peso (RM 2.6, IC95% 1.0-6.8). La mortalidad general fue de 4.8%; sin embargo, el riesgo de morir en pacientes con infección nosocomial fue del doble comparado con los no infectados (RM 2.6, IC95% 1.3-5.1). CONCLUSIONES. Esta evaluación rápida, usando una metodología estándar, ha permitido caracterizar la epidemiología de las infecciones nosocomiales en niños. Los resultados dieron lugar a programas preventivos dirigidos específicamente al cuidado de catéteres intravasculares y al uso de ventilación asistida, a fin de reducir la ocurrencia de sepsis/bacteriemia y neumonías, infecciones nosocomiales de alta prevalencia y mortalidad.

Published
1999

5. [Prevalence of nosocomial infections in children: survey of 21 hospitals in Mexico].

Author

Avila-Figueroa C, Cashat-Cruz M, Aranda-Patrón E, León AR, Justiniani N, Pérez-Ricárdez L, Avila-Cortés F, Castelán M, Becerril R, and Herrera EL

Subjects
Adolescent, Age Factors, Catheterization adverse effects, Child, Child, Preschool, Cross Infection etiology, Cross Infection mortality, Cross-Sectional Studies, Data Collection, Humans, Infant, Infant, Low Birth Weight, Infant, Newborn, Logistic Models, Mexico epidemiology, Parenteral Nutrition, Total adverse effects, Respiration, Artificial adverse effects, Risk Factors, Cross Infection epidemiology
Abstract

Objective: The purpose of this study was to determine the prevalence of nosocomial infections, associated risk factors, microbiology, use of antibiotics, and associated mortality among hospitalized children., Material and Methods: A 1-day prevalence survey was conducted among 1,183 children hospitalized in a nationwide network of 21 public hospitals caring for children. To attain consistency between hospitals, CDC nosocomial infection definitions were used. Adjusted relative odds of bacteremia were estimated using logistic regression analysis., Results: The prevalence of nosocomial acquired infection was 9.8% (CI 95%, 8.1-11.6). The more prevalent infections were pneumonia (25%), sepsis/bacteremia (19%), and urinary tract infection (5%). The main microorganism isolated in blood cultures drown from patients with nosocomial infection was K. pneumoniae (31%). The prevalence of antibiotics use was 49% with substantial variation between hospitals (range 3-83%). Using logistic regression analysis, four factors were independently associated with the risk of nosocomial infection: central venous catheters (OR 3.3; CI 95% 1.0-5.9), total parenteral nutrition (OR 2.1; CI 95% 1.0-4.5) mechanical ventilation (OR 2.3; CI 95% 1.2-4.1), and low birth weight (OR 2.6; CI 95% 1.0-6.8). The overall mortality was 4.8%; however, patients with nosocomial infection had two times greater risk to die as compared to non-infected children (OR 2.6; CI 95% 1.3-5.1)., Conclusions: This rapid assessment survey using a standard methodology allows to document the prevalence of nosocomial infections in children. The results were used to develop targeted programs on central catheters and mechanical ventilation aimed to reduce bacteremia/sepsis and pneumonia, two nosocomial infections characterized by high prevalence and mortality.

Published
1999

6. Increased frequency of HLA-DR3 and complotype SC01 in Mexican Mestizo children with amebic abscess of the liver and summary of our overall HLA-SC01 experience in invasive amebiasis.

Author

Pérez-Rodríguez M, Arellano J, López-Osuna M, Velázquez JR, Granados J, Justiniani N, Santos JI, Madrazo A, Muñoz L, and Kretschmer R

Subjects
Adult, Case-Control Studies, Child, Ethnicity, Humans, Indians, North American genetics, Mexico, White People genetics, Complement C4 genetics, HLA-DR3 Antigen immunology, Haplotypes, Liver Abscess, Amebic immunology, Major Histocompatibility Complex
Published
1997

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