RESUMEN
BACKGROUND: Knowledge of nasal carriage is important in predicting staphylococcal infection, and no information exists regarding the endemicity of Staphylococcus aureus in Haiti. METHODS: We performed a cross-sectional analysis of S. aureus nasal screening in an acute care, a subacute rehabilitation, and a community setting, with a brief medical and epidemiological history. PCR-positive S. aureus screening nasal cultures underwent molecular analysis for spa type, SCCmec type, and virulence genes (Panton-Valentine leukocidin (PVL), toxic shock syndrome toxin (TSST), and arginine catabolic mobile element (ACME)), and were evaluated for antibiotic susceptibility using commercial tests. RESULTS: Overall carriage rates of 8.4% methicillin-susceptible S. aureus (MSSA) and 2.8% methicillin-resistant S. aureus (MRSA) were identified, with a high rate of tetracycline resistance. TSST and PVL genes were identified in MSSA. MRSA isolates contained no virulence markers. Unique MSSA phenotypes (i.e., linezolid-resistant, vancomycin-sensitive/daptomycin non-susceptible) were identified, as were two PVL-positive ST152 MSSA colonization isolates, previously geographically limited to Africa. CONCLUSIONS: We found a low S. aureus carriage rate with complete vancomycin susceptibility and high tetracycline resistance, which has important public health implications with regard to treatment. Additionally, the finding of PVL-positive MSSA isolates, including the expansion of a previously described limited 'divergent' clone, ST152, warrants further evaluation.
Asunto(s)
Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Toxinas Bacterianas/genética , Estudios Transversales , Terremotos , Enterotoxinas/genética , Exotoxinas/genética , Femenino , Haití/epidemiología , Humanos , Leucocidinas/genética , Masculino , Resistencia a la Meticilina , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Persona de Mediana Edad , Infecciones Estafilocócicas/virología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Superantígenos/genética , Factores de Virulencia/genética , Adulto JovenRESUMEN
OBJECTIVE: Hypertension is an important risk factor for cardiovascular disease throughout the world. Little is known about the prevalence of hypertension in rural Haiti. Our study aims to estimate prevalence and knowledge of hypertension in Northern Haiti. DESIGN: Cross-sectional. SETTING: Four rural communities surrounding Milot, Haiti. PARTICIPANTS: Participants (69 males, 106 females, 175 total) were eligible to take part if they were aged > 18 years and not pregnant. Enrollment was voluntary. METHODS: Two initial blood pressure measurements were taken for each participant. Participants who had an average systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg were instructed to return in 1 week for two additional confirmatory measurements. Based on these measures, participants were classified as either hypertensive or not. All participants were surveyed to assess their knowledge of hypertension. RESULTS: The prevalence of hypertension among the study sample was 36.6%. Overall, 47% of women and 21% of men were hypertensive. Approximately 30% of women of reproductive age (18-39 years) were hypertensive. Participants showed little knowledge of the asymptomatic nature of hypertension and the need for lifelong treatment. CONCLUSIONS: Hypertension is prevalent in Haiti. The high prevalence of hypertension among women of reproductive age is a concern since it is a risk factor for cardiovascular disease. Lack of knowledge surrounding hypertension indicates low awareness of the condition and is a possible target for future educational interventions.