RESPIRATORY CRYPTOSPORIDIOSIS IN HIV-SERONEGATIVE

CHILDREN IN UGANDA: POTENTIAL FOR RESPIRATORY

TRANSMISSION

Natalia Salazar VMedicine – Semester III

UPB

Respiratory Cryptosporidiosis in HIV-Seronegative

Children in Uganda: Potential for RespiratoryTransmission

Jeffrey K. Griffiths

INTRODUCTION

Cryptosporidiosis is a parasitic disease that cause diarrheal

illness.

Its Caused by Cryptosporidium

It is a protozoan pathogen enteric parasite.

It is spread through the fecal-oral route, through contaminated water.

The transmission occurs after ingestion of oocysts

INTRODUCTION

INTRODUCTION

Human immunodeficiency virus (HIV) is a retrovirus

The HIV that causes a condition in humans in which the immune system begins to fail

OBJECTIVE

To confirm or refute the hypothesis that respiratory cryptosporidiosis is common among both HIV-seropositive and HIV-seronegative hosts.

MATERIALES Y METODOS

Pacientes

Niños 9 -36 meses

Diarrea persistente (>= 3 deposiciones al dia).

* Presencia de Cryptosporidium en el esputo.

Lugar: Hospital Mulago de KampalaNoviembre 2007 –Enero 2009

Niños con preexistencias medicas

Moribundos.

Seleccion Inicial Rechazados

Conteo de linfocitos CD4

Muestra de saliva

Muestra fecal con hisopo.

Analisis de tincion Para Cryptosporidium

Muestra de sangre.

Procedimientos clinicos - Muestras

Examen fisico detallado

1 Niño por cada 4 niños positivos

Tarjetas FTA

Muestra de esputo

Incluyo conteo de celulas sanguineas

Tecnica PCR anidadoTarjetas FTA

Tecnica PCR anidado

(+) (-)

RESULTADOS

Resultados

(-) CryptosporidiumMuestra saliva

1 No se le hizo prueba de esputo

2 (+) CryptosporidiumMuestra saliva

103 Muestras

PARA SALIVA

1Tos sin vomito Cryptosporidium en

PCR anidado

Resultados

810 (-) CryptosporidiumMuestra fecal

53 Niños sometidos aprueba de esputo

116 (+) CryptosporidiumMuestra fecal

13 Niños sometidos aprueba de esputo

0 (+)

926 Niños

5 (+) CryptosporidiumEn PCR primera muestra

PARA ESPUTO

17 (+) Cryptosporidium En PCR anidado

Hallazgos:

En 13 muestras de esputo: Cryptosporidium hominis En 4 muestras esputos: Cryptosporidium parvum

En las 2 salivas Cryptosporidium hominis

C. hominis C. parvum C. meleagridis

Saliva

Patron Genotipico

DISCUSSION

“This study has several limitations. Stool specimens were screened for Cryptosporidium using modified acid-fast stain stain rather than more-sensitive but laborious methods, such as PCR, to allow a rapid diagnosis.It is therefore likely that some children with stool samples that had negative microscopy findings in fact had the parasite. In our experience, and in several published studies”

Morgan UM, Pallant L, Dwyer BW, Forbes DA, Rich G, Thompson

Stroup SE, Roy S, McHele J, et al.

“Respiratory cryptosporidiosis is believed to occur rarely, if at all, in immunologically healthy humans. Only 2 case reports have documented respiratory infection in immunocompetent persons.”

Harari MD, West B, Dwyer BCampayo Ibanez A, Lacruz

Rodrigo J, Valls Ferrer JM, Bonora Tamarit

“However, coinfection with organisms such as cytomegalovirus and Pneumocystis jiroveci can obscure the specific contribution of cryptosporidiosis to respiratory disease in persons with AIDS”

Ma P, Villanueva TG, Kaufman D, Gillooley JF.

“Historically, studies have relied on staining methods to identify parasites in respiratory tissues and secretions.

The low sensitivity of these methods may partly account for the limited number of reports in healthy persons. PCR detection of Cryptosporidium is diagnostically superior for detecting parasites in stool samples”

Balatbat AB, Jordan GW, Tang YJ, Silva J, Jr.

NOYESTextAuthor

CONCLUSIONS

With this investigation we may conclude that the Cryptosporidiosis is not only for HIV-seronegative people, because in this study there are seventeen persons infected with the parasite and they are not inmunodeficient.

We may see the importance of the PCR, because it allowed to determinate the specificity of the microorganism, identifying it’s different strains.

The specific identification with PCR is very important for the future treatments to different diseases, because it be able attack the specific organism who is making injuries inside the people without collateral damages.

We can not be quiet with some enteric diseases or enteric parasites because we can see how they easily move from the gastric area to the lungs, and it could endanger the life.

MAPA CONCEPTUALRespiratory Cryptosporidiosis in

HIV-SeronegativeChildren in Uganda: Potential for Respiratory

Transmission

Muestra la disminucion de linfocitos CD4 del paciente.

Procedimientos clinicos - Conteo

En SIDA: Conteo CD4, menor a 200 celulas /mlt sangre

Virus transforma material genetico y lo usa para replicarse asi mismo.

Linfocitos CD4: Coordinan la respuesta ante antigenos.

x

Tarjetas FTAMétodo seguro y confiale para la recogida, transporte, y almacenamiento

seguro de ADN.

Las células se lisan y los ácidos nucleicos son inmovilizados.

El ADN genómico almacenadas en tarjetas FTA a temperatura ambiente durante más de 11 años y no presenta ninguna pérdida en la eficiencia de la PCR.

Pruebas de Laboratorio

x

PCRPCR

Tecnica de amplificacion directa de un gen o fragmento de DNA.

PCR anidadaPCR anidada

Aumenta la especificidad al hacer una segunda PCR a partir del producto de la primera PCR que es usado como molde.

Da productos mas cortos, pero mas especificos.

UsoUso Deteccion de M.O infecciosos Clonacion Analisis de huellas geneticas en muestras forenses. Otros

Pruebas de Laboratorio

x