RESUMO
AIM: Human papillomavirus (HPV) has been reported to be associated with oral and oropharyngeal cancer. However, little information is available about the epidemiology of oral HPV infection in Jamaica. The purpose of the present study was to assess the prevalence of oral HPV strains using the oral rinse method in HIV and non-HIV Jamaican patients, as well as to determine the association of HPV with sexual practices, smoking, and alcohol use. METHODS: A cross-sectional study was conducted on patients attending The University of the West Indies Mona Dental Polyclinic and the Centre for HIV/AIDS Research and Education Services. Salivary samples were tested through molecular analysis for 37 HPV genotypes using the linear array HPV genotyping test. A survey questionnaire was used to obtain demographic details, smoking history, alcohol practice, sexual practice, and history of HPV testing. RESULTS: The HPV prevalence was 8.65% in 18-64 y olds (N = 104), with a slight female predilection (55%). No high-risk HPV types were found. HPV-84 was the most common type in both HIV and non-HIV patients; 66.7% of HPV-positive participants reported that they had six or more lifetime sexual partners. CONCLUSION: The prevalence of oral HPV was similar to that in other countries. No statistically-significant relationship was observed between the prevalence of HPV and either the number of sexual partners, smoking, or alcohol history. A nationwide study on oral HPV detection might be helpful in developing a HPV vaccination policy in Jamaica.
Assuntos
Genótipo , Infecções por HIV/complicações , Epidemiologia Molecular , Antissépticos Bucais , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Adolescente , Adulto , Estudos Transversais , DNA Viral/análise , Feminino , Técnicas de Genotipagem , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças da Boca/epidemiologia , Doenças da Boca/virologia , Neoplasias Orofaríngeas , Prevalência , Fatores de Risco , Comportamento Sexual , Fumar , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: The global dissemination of the New Delhi metallo-beta-lactamase (NDM) gene among certain strains of bacteria has serious implications since the infections caused by such organisms pose a therapeutic challenge. Although the NDM gene has been detected in various parts of the world, this is the first report of its detection in the English-speaking Caribbean. The NDM producing Klebsiella pneumoniae was isolated from an Indian patient who had recently relocated to Jamaica. METHODOLOGY: Identification and susceptibility testing of the K. pneumoniae isolate was performed using the Vitek 2 automated system) in keeping with Clinical and Laboratory Standards Institute (CLSI) standards. It was identified as a metallobetalactamase producer using the Rosco KPC+MBL kit. Genotypic screening for common betalactamase (including carbapenemase) genes, was carried out using two multiplex PCRs: one for SHV-, TEM-, CTX-M-, OXA-1-, and CMY-2-types, and one for VIM-, KPC-, IMP-, OXA-48, GES-, and NDM-types. Strain typing was conducted by pulsed-field gel electrophoresis (PFGE) using XbaI and multi-locus sequencing (MLS). Plasmid isolation and analysis was also performed. RESULTS: K. pneumoniae (N11-02395), not previously associated with the dissemination of the NDM in India, Sweden or the UK, was found to harbor the NDM-1 gene on plasmid pNDM112395. CONCLUSION: The identification of the NDM-1 gene underscores the need for effective surveillance and infection control measures to identify and prevent spread of multidrug resistant Gram negative bacilli. Strict infection control measures implemented for this patient helped to prevent the spread of this organism to other patients.
Assuntos
Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/enzimologia , Klebsiella pneumoniae/isolamento & purificação , beta-Lactamases/análise , beta-Lactamases/genética , Eletroforese em Gel de Campo Pulsado , Humanos , Lactente , Jamaica , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/genética , Masculino , Testes de Sensibilidade Microbiana , Tipagem Molecular , Plasmídeos/análiseRESUMO
BACKGROUND: The accurate identification of a pathogen beyond the species level is critical in epidemiological studies and investigations of nosocomial outbreaks of infection. The clonal relatedness of 66 multidrug resistant (MDR) strains of extended spectrum beta-lactamase (ESBL) producing K. pneumoniae isolated from clinical specimens from hospitalized patients at a Jamaican hospital during a 5 year period were determined by pulsed field gel electrophoresis (PFGE). RESULTS: A total 10 different ESBL producing K. pneumoniae genotypes designated Clones I-X were found. The most frequently occurring strains belonged to Clones I (21/66, 32%), II (15/66, 26%), III (13/66, 20%) and IV (8/66, 12%) which accounted for 86% (57/66) of ESBL producing K. pneumoniae strains over the 5 year period. The remaining 9 (14%) cases of ESBL producing K. pneumoniae were due to strains of Clones V-X. The 4 predominant clones persisted for several years in the hospital. CONCLUSIONS: The clonal and temporal distribution of the MDR ESBL producing K. pneumoniae strains among clinical service areas did not suggest outbreaks of the organism during the period of study. Instead the molecular epidemiology of ESBL producing K. pneumoniae at this hospital was more representative of an endemic persistence of clones of the organism with limited dissemination from patient to patient. Further studies to investigate the factors which determine the emergence and persistence of MDR ESBL producing K. pneumoniae in Jamaican hospitals and their impact on clinical and economic outcomes at such institutions would be useful.
Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/genética , Técnicas de Tipagem Bacteriana , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Humanos , Jamaica/epidemiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , beta-Lactamases/genéticaRESUMO
BACKGROUND: The human leukocyte antigens (HLA) are associated with susceptibility to systemic lupus erythematosus (SLE) and manifestations of SLE in different ethnic groups. METHODS: A DNA-based HLA-typing method was used to determine alleles of HLA-DRB1, DRB3, DRB4 and DRB5 in Jamaican patients. A total of 70 patients and 100 control subjects were studied. RESULTS: HLA-DRB3*01/03 was significantly associated with susceptibility to SLE, while DRB1*15/16 was associated with the presence of oral ulcers in patients with SLE. The haplotype DRB1*13/14.DRB3*01/03 was also more frequent in SLE patients. No other significant associations were found. CONCLUSION: The SLE HLA associations in Jamaicans differ from those in other black populations.
Assuntos
Antígenos HLA-DR/análise , Lúpus Eritematoso Sistêmico/imunologia , Adolescente , Adulto , Idoso , Suscetibilidade a Doenças , Feminino , Cadeias HLA-DRB1 , Cadeias HLA-DRB3 , Cadeias HLA-DRB4 , Cadeias HLA-DRB5 , Humanos , Jamaica , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/etnologia , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The accurate identification of a pathogen beyond the species level is critical in epidemiological studies and investigations of nosocomial outbreaks of infection. The clonal relatedness of 66 multidrug resistant (MDR) strains of extended spectrum beta-lactamase (ESBL) producing K. pneumoniae isolated from clinical specimens from hospitalized patients at a Jamaican hospital during a 5 year period were determined by pulsed field gel electrophoresis (PFGE). RESULTS: A total 10 different ESBL producing K. pneumoniae genotypes designated Clones I-X were found. The most frequently occurring strains belonged to Clones I (21/66, 32%), II (15/66, 26%), III (13/66, 20%) and IV (8/66, 12%) which accounted for 86% (57/66) of ESBL producing K. pneumoniae strains over the 5 year period. The remaining 9 (14%) cases of ESBL producing K. pneumoniae were due to strains of Clones V-X. The 4 predominant clones persisted for several years in the hospital. CONCLUSIONS: The clonal and temporal distribution of the MDR ESBL producing K. pneumoniae strains among clinical service areas did not suggest outbreaks of the organism during the period of study. Instead the molecular epidemiology of ESBL producing K. pneumoniae at this hospital was more representative of an endemic persistence of clones of the organism with limited dissemination from patient to patient. Further studies to investigate the factors which determine the emergence and persistence of MDR ESBL producing K. pneumoniae in Jamaican hospitals and their impact on clinical and economic outcomes at such institutions would be useful.