Resumo Este estudo teve como objetivo investigar a diversidade genética de Hepatozoon spp. em roedores de Valdivia, Chile. Um total de 74 roedores (sinantrópicos n=38; selvagens n=36) foram capturados. PCR convencional foi realizada para organismos Apicomplexa, visando dois fragmentos sobrepostos do gene 18S rDNA (600 bp e 900 bp), seguida pelo sequenciamento de amplicons selecionados. A ocorrência de Hepatozoon spp. foi de 82,43% (61/74). Doze sequências obtidas dos fragmentos de 18S rDNA de 600 pb e dez dos fragmentos de 18S rDNA de 900 pb foram identificadas como Hepatozoon sp. Seis sequências obtidas, a partir de protocolos de PCR sobrepostos, foram usadas para análises filogenéticas (1.400 bp), de haplótipos e de distância. Sequências concatenadas 18S rDNA do presente estudo foram detectadas em Oligoryzomys longicaudatus, Rattus norvegicus, Mus musculus e Abrothrix longipilis e agrupadas com Hepatozoon descrito em roedores e répteis do Chile e do Brasil. A análise de polimorfismos das seis sequências deste estudo, junto com outras sequências chilenas de roedores e carrapatos de roedores, mostrou alta diversidade com um total de nove haplótipos no Chile. Três haplótipos detectados em Valdivia foram identificados pela primeira vez neste estudo, sugerindo que novos haplótipos circulam em roedores do sul do Chile.

Abstract This study aimed to investigate the genetic diversity of Hepatozoon spp. in rodents from Valdivia, Chile. A total of 74 rodents (synanthropic n=38; wild n=36) were trapped in Valdivia. We performed conventional PCR assays for Apicomplexa organisms targeting two overlapping 18S rDNA gene fragments (600 bp and 900 bp) followed by sequencing of selected amplicons. Hepatozoon spp. occurrence was 82.43% (61/74). Twelve sequences obtained from the 600 bp and ten from the 900 bp 18S rDNA fragments were identified as Hepatozoon sp. Six sequences obtained from 18S rDNA-based overlapping PCR protocols were used for concatenated (1,400 bp) phylogenetic, haplotype and distance analyses. Hepatozoon spp. 18S rDNA concatenated sequences from the present study were detected in Oligoryzomys longicaudatus, Rattus norvegicus, Mus musculus, and Abrothrix longipilis grouped with Hepatozoon species earlier described in rodents and reptiles from Chile and Brazil. Nucleotide polymorphism of the six 18S rDNA sequences (1,400 bp) from this study, and other Chilean sequences from rodents and rodent’s ticks, showed high diversity with a total of nine Chilean haplotypes. Three haplotypes from Valdivia were identified for the first time in this study, suggesting the circulation of novel haplotypes in rodents from southern Chile.

Background: Currently in Chile, due to the frequent clinical suspicion of Hantavirus disease and the high public health impact that this causes, it is necessary to strengthen the criteria for clinical and epidemiological suspicion in the health team. Objective: To analyze the information contained in the reports of suspected Hantavirus infection versus the confirmatory diagnosis with the reference technique, IgM capture ELISA anti-hantavirus. Material andMethods: Correlation between the information provided in notifications versus the result of confirmation was analyzed by calculating diagnostic accuracy. Results: 3.4% of 1,566 patients studied (53 cases) was confirmed as SCPH. 58.6% of the analyzed notifications was incomplete. The percentage of positivity of the reference technique associated with fever, myalgia and headache was 80-85%. The presence of immunoblasts (> 10%) showed 25% sensitivity, 98% specificity, 37% PPV, 97% NPV. Thrombocytopenia exhibited 98% sensitivity, 74% specificity, 16% PPV, 100% NPV. Conclusion: It is necessary to reinforce the importance of comprehensive data reporting at the health system level. The presence of thrombocytopenia and immunoblasts (> 10%) is highly sensitive and specific, respectively, for detecting patients with SCPH. There is a need to develop training programs in order to optimize the suspicion of Hantavirus infection and appropriate use of health resources.

Antecedentes: Actualmente en Chile, debido a la elevada sospecha clínica de enfermedad por hantavirus y el alto impacto en salud pública que esto provoca, se hace necesario reforzar al equipo de salud, los criterios de sospecha clínica y epidemiológica de hantavirosis. Objetivo: Analizar la información contenida en las notificaciones de sospecha de infección por hantavirus versus la técnica de referencia para el diagnóstico confirmatorio de casos sospechosos, ELISA IgM de captura anti-hantavirus. Material y Método: Mediante cálculo de precisión diagnóstica se analizó la correlación que existe entre la información entregada en las notificaciones versus el resultado de la confirmación mediante la técnica de referencia. Resultados: De 1.566 pacientes estudiados 3,4% (53 casos) fue confirmado para SCPH. De las notificaciones analizadas 58,6% estaban con datos incompletos. Los porcentajes de positividad de la técnica de referencia asociada a fiebre, mialgia y cefalea, fueron de 80-85%. Destaca que la presencia de inmunoblastos (> 10%), presenta: S: 25%, E: 98%, VPP: 37%, VPN: 97%. Paratrombocitopenia se obtuvo: S: 98%, E: 74%, VPP: 16%, VPN: 100%. Conclusión: Se hace necesario reiterar a nivel del sistema sanitario chileno la importancia de contar con datos completos en los formularios de notificación. La presencia de trombocitopenia e inmunoblastos (> 10%) fue altamente sensible y especifica, respectivamente, en la detección de pacientes con SCPH. Con el fin de optimizar la sospecha de infección por hantavirus, según la definición de caso sospechoso, se plantea la necesidad de desarrollar programas de capacitación para la sospecha clínica y lectura de parámetros de laboratorio, tales como presencia de inmunoblastos en el hemograma, así como incluir un algoritmo con el fin de optimizar la sospecha y el uso adecuado de los recursos sanitarios.

Introduction: Propolis is a natural product derived from beekeeping. It has anesthetic, anti-inflammatory, immune-stimulant and antibacterial properties on grampositive and gramnegative bacteria. However, little is known regarding its activity on Helicobacter pylori. This bacteria colonizes about half of the world’s population and is associated with chronic gastritis, peptic ulcer and gastric cancer. Objective: The aim of this study was to evaluate the inhibitory activity of 22 propolis extracts from nine of the 11 beekeeping Chilean regions on 10 strains of H. pylori isolated from gastric mucosa. Methods: The antibacterial activity of the extracts was determined using the well diffusion method and diffusion disks. Results: 100% of the extracts were active on the tested strains, showing inhibition halos equal to or greater than 15 mm by both methods. Conclusions: our results show an effective anti H. pylori activity of propolis. However, additional microbiological studies are needed before a potential clinical utility of these natural products is warranted.

Introducción: El propóleos es un producto natural derivado de la apicultura que tiene propiedades anestésicas, anti-inflamatorias, inmuno-estimulantes y antibacterianas. Ejerce su acción sobre distintas bacterias grampositivas y gramnegativas. Sin embargo, es muy poco lo que se sabe en relación a su actividad sobre H. pylori, bacteria asociada con gastritis crónica, úlcera gastro-duodenal y cáncer gástrico y que coloniza a alrededor de la mitad de la población mundial. Objetivo: Evaluar la actividad inhibitoria de 22 extractos de propóleos de orígenes botánicos diferentes, provenientes de nueve de las once zonas mielíferas de Chile, en la época de otoño, sobre 10 cepas de H. pylori aisladas de mucosa gástrica. Metodología: La actividad antibacteriana de los extractos se determinó a través del método de difusión en pocillos y de difusión en discos. Resultados: 100% de los extractos fueron activos sobre las cepas ensayadas, observándose halos de inhibición iguales o mayores a 15 mm en ambos métodos. Conclusiones: Los datos obtenidos in vitro en el presente estudio muestran una efectiva actividad anti H. pylori de los propóleos chilenos, siendo necesario estudios microbiológicos y farmacológicos adicionales para avanzar en una posible utilidad clínica de estos productos naturales.

The cassette chromosome mec (SCCmec) present in methicillin-resistant Staphylococcus aureus (MRSA) has two essential components, the ccr gene complex and the mec gene complex. Additionally, SCCmec has non-essential components called J regions which are used for MRSA subtyping. This study was performed to determine subtypes MRSA strains carrying SCCmec type I based on polymorphism of regions located downstream of the mecA gene. A total of 98 MRSA strains carrying SCCmec type I isolated from patients hospitalized at the County Hospital of Valdivia (Chile) between May 2007 and May 2008, were analyzed by multiplex PCR designed to amplify the mecA gene and 7 DNA hypervariable regions located around the mecA gene. MRSA strains were classified into seventeen genotypes accordingly to amplification patterns of DNA hypervariable regions. Five genotypes showed amplification patterns previously described. The remaining twelve genotypes showed new amplification patterns. Genotypes 18 and Genotype 19 were the most frequently detected. Regions HVR, Ins117 and pI258 stand out as being present in more than 60% of tested isolates. The acquisition of hypervariable regions by MRSA is a continuous horizontal transfer process through which the SCCmec have been preserved intact, or even may give rise to new types and subtypes of SCCmec. Therefore it is possible to infer that most MRSA strains isolated at the County Hospital of Valdivia (Chile) were originated from two local clones which correspond to Genotype 18 and Genotype 19.

Herpes simplex virus type 1 (HSV-1) is ubiquitous, neurotropic, and the most common pathogenic cause of sporadic acute encephalitis in humans. Herpes simplex encephalitis is associated with a high mortality rate and significant neu-rological, neuropsychological, and neurobehavioral sequels. HSV-1 infects limbic system structures in the central nervous system (CNS), and has been suggested as an environmental risk factor for Alzheimer’s disease. The possibility that HSV-1 reactivates in CNS neurons causing chronic progressive damage at cellular level and altering the neuronal functionality has not been thoroughly investigated. Currently it is ignored if recurrent reactivation of HSV-1 in asymptomatic patients involves some risk of progressive deterioration of the CNS functions caused, in example, by a neuroinflammatory response against the virus or by direct toxicity of the pathogen on neurons. Therefore, studies regarding the routes of dissemination of HSV-1 from the peripheral ganglions to the CNS, as well as the possible cellular and molecular mechanisms implied in generating neuronal damage during latent and productive infection, are of much relevance.

Helicobacter pylori colonizes more than 50% of the world population thus, it is considered an important cause of gastric cancer. The aim of this study was to determine the isolation frequency of H. pylori in Southern Chile from patients with symptomatology compatible with gastritis or gastric ulcer and to correlate these findings with demographic parameters of infected patients and the susceptibility profiles of the isolated strains to the antimicrobial drugs used in the eradication treatments. A total of 240 patients were enrolled in the study. Each gastric biopsy was homogenized and seeded onto blood agar plates containing a selective antibiotics mixture (DENT supplement). Plates were incubated at 37° C in a microaerophilic environment for five days. The susceptibility profiles to amoxicillin, ciprofloxacin, clarithromycin, tetracycline and metronidazole were determined using the E-test method. H. pylori was isolated from 99 patients (41.3%) with slightly higher frequency in female (42% positive cultures) than male (40.2% positive cultures). With regard to age and educational level, the highest isolation frequencies were obtained in patients between 21-30 (55%) and 41-50 (52.6%) years old, and patients with secondary (43.9%) and university (46.2%) educational levels. Nineteen (21.6%) strains showed resistance to at least one antimicrobial drug. Tetracycline was the most active antimicrobial in vitro, whereas metronidazole was the less active. One strain (5.3%) showed resistance to amoxicillin, clarithomycin and metronidazole, simultaneously.

In vitro susceptibility of nosocomial and community acquired strains of Staphylococcus aureus must be periodically evaluated because of its continuous evolution. Aim: To know the antimicrobial susceptibility of S. aureus isolated in Valdivia, to determine the prevalence of methicillin resistance and global patterns of resistance and to compare the evolution of the susceptibility along the years. Material and Methods: A total of 278 S. aureus strains were evaluated: 136 obtained from hospitalized patients, 50 belonged to outpatients and 92 to healthy carriers. Antimicrobial agents tested were: penicillin, oxacillin, vancomycin, gentamycin, ciprofloxacin, lincomycin and erythromycin. Results: Thirty three, 28 and 1.1% of strains isolated from hospitalized, outpatients and carriers, respectively, were methicillin-resistant. Six resistance patterns were found. No vancomycin resistant strain was isolated. Comment: It is worrisome that 2% of S. aureus strains obtained from hospitalized patients showed intermediate resistance to vancomycin

La susceptibilidad in vitro de Staphylococcus aureus adquirido, tanto en el ambiente hospitalario como en la comunidad, debe ser monitorizada periódicamente por su continua evolución. Objetivos: Conocer la susceptibilidad antimicrobiana de cepas de S. aureus aisladas en Valdivia, determinar la prevalencia de cepas resistentes a meticilina y sus respectivos patrones de resistencia, analizar la evolución de esta susceptibilidad a través de los años. Material y Métodos: Se evaluaron 278 cepas de S. aureus: 136 obtenidas de pacientes hospitalizados, 50 de pacientes ambulatorios y 92 de portadores. Los antimicrobianos ensayados fueron: penicilina, oxacilina, vancomicina, gentamicina, ciprofloxacina, lincomicina y eritromicina

Background: Methicillin resistant strains of Staphylococcus aureus (MRSA) are an important cause of nosocomial infections. Aim: To determine the genotypes of MRSA strains. Material and methods: Fifty five strains of MRSA, isolated from patients hospitalized in Hospital Base Valdivia, were studied. The phenotype was determined through MicroScan® in all strains and by minimum inhibitory concentration (MIC) in 41. The genotype of the strains was analyzed by a duplex polymerase chain reaction (PCR) of the mecA gene, amplifying eight hypervariable DNA regions associated to such gene. Results: According to MIC, 88% of strains had a pattern of resistance against multiple antimicrobial (penicillin, ampicillin, cephradine, gentamycin, ciprofloxacin, ¡incomycin and erythromycin). Vancomicin resistan strains were not detected. Only 53 strains (96%) had at least one of the eight hypervariable regions and were classified as MRSA. Genotypic patterns types 15 were the most commonly detected in 38% and 34% of strains, respectively. MicroScan® erroneously classified five strains in an incorrect phenotype, according to results obtained with duplex PCR. MIC results did not differ from those of duplex PCR. Conclusions: Duplex- PCR is a useful tool to detect hyper variable regions associated to mecA gene