Publications by authors named "Marylin Hidalgo"

42 Publications

Experimental infection and vector competence of Amblyomma patinoi, a member of the Amblyomma cajennense species complex, for the human pathogen Rickettsia rickettsii.

Ticks Tick Borne Dis 2021 May 29;12(5):101751. Epub 2021 May 29.

Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo-USP, Av. Prof. Orlando Marques de Paiva, 87, São Paulo, SP 05508-270, Brazil. Electronic address:

Amblyomma patinoi ticks infected with Rickettsia rickettsii are present in Colombia, but its vector competence is unknown. Hence, we evaluated the vector competence of A. patinoi with R. rickettsii under laboratory conditions. Experimental guinea pigs and rabbits (males and females) were separated in the infected group (IG) and the control group (CG). In the IG, the filial 1 (F1) larvae (R. rickettsii-free) from Colombian A. patinoi engorged female specimens were exposed to R. rickettsii (ITU strain) by feeding on infected guinea pigs. Next, F1 nymphs and adults, and F2 larvae were allowed to feed on uninfected guinea pigs or rabbits and tested by qPCR targeting the gltA rickettsial gene. All animals used to feed the IG F1 ticks became febrile and had R. rickettsii infection (89% fatality rate) detected through serological or molecular techniques. After the F1 larvae ticks became R. rickettsii infected, subsequent IG tick stages were able to maintain the rickettsial infection by transstadial maintenance to all infested animals, indicating A. patinoi vector competence. Subsequently, almost 31% of the F1 female egg masses and only 42% of their F2 larvae were infected. Less than 50% of the infected females transmitted R. rickettsii transovarially, and only a part of the offspring were infected. This study demonstrated that A. patinoi might not be able to sustain R. rickettsii infection by transovarial transmission for successive tick generations without horizontal transmission via rickettsemic hosts. This condition might result in low R. rickettsii-infection rates of A. patinoi under natural conditions.
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http://dx.doi.org/10.1016/j.ttbdis.2021.101751DOI Listing
May 2021

Clinical, epidemiological, and laboratory features of Rickettsia parkeri rickettsiosis: A systematic review.

Ticks Tick Borne Dis 2021 07 1;12(4):101734. Epub 2021 May 1.

Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA; Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología, Bogotá, Colombia. Electronic address:

Rickettsia parkeri rickettsiosis is recognized as the second most prevalent tick-borne disease caused by spotted fever group rickettsiae in the Americas, where two pathogenic strains (R. parkeri sensu stricto and R. parkeri strain Atlantic rainforest) have been related to human infections and transmitted by Amblyomma spp. ticks. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of R. parkeri rickettsiosis, including confirmed and probable cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. We excluded papers that contained missing information of some variables and publications in which it was not possible to separate data for confirmed and probable cases. A total of 77 clinical cases (32 confirmed cases and 45 probable cases) were considered for this review. Overall, our results show that R. parkeri rickettsiosis is more frequent in males in the age group of 18-64 years and that a history of tick exposure was frequent (>90%). Cases were described in the United States, Argentina, Brazil, Uruguay and Colombia. Clinically, more than 60% of the cases had fever (mean of 93%), eschar (mean of 87%), and rash (mean of 68%). Headache and myalgia were predominant nonspecific symptoms (mean of 67% and 61%, respectively). Our results show that at least 60% of R. parkeri cases had altered laboratory parameters, most often showing an increase in transaminases and leukopenia. Tetracyclines-class antibiotics were used in most (>85%) of the patients. Overall, only 9% of cases required hospitalization and there was a 100% rate of clinical recovery in all of cases.
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http://dx.doi.org/10.1016/j.ttbdis.2021.101734DOI Listing
July 2021

Seroprevalence and Genotypic Analysis of Ehrlichia canis Infection in Dogs and Humans in Cauca, Colombia.

Am J Trop Med Hyg 2021 Mar 22. Epub 2021 Mar 22.

2Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, Texas.

Ehrlichia canis infections have been reported in humans in Venezuela and Costa Rica. In this study, 506 healthy residents and 114 dogs from four municipalities (Cauca, Colombia) were surveyed and blood samples collected. Antibodies to E. canis in human and canine sera were evaluated using the Tandem repeat protein 19 (TRP19) peptide ELISA and indirect immunofluorescence assay (IFA). Ehrlichia canis TRP19 antibodies were detected in only 1/506 human sera, but the single positive sample was negative by IFA. The majority (75/114; 66%) of dogs surveyed had antibodies to the E. canis TRP19 peptide by ELISA, and eight randomly selected sera were further confirmed by E. canis IFA. Genomic DNA samples obtained from 73 E. canis TRP19 ELISA-positive dog blood samples were examined by PCR targeting the 16S rRNA gene. Ehrlichia canis 16S rRNA was amplified in 30 (41%) of the dogs, and 16 amplicons were selected for DNA sequencing, which confirmed that all were E. canis. A second PCR was performed on the 16 confirmed E. canis 16S rRNA PCR-positive samples to determine the TRP36 genotype by amplifying the trp36 gene. TRP36 PCR amplicon sequencing identified nine dogs infected with the U.S. E. canis TRP36 genotype (56%), one dog with the Brazilian genotype (6%), and six dogs with the Costa Rican genotype (38%). Moreover, these molecular genotype signatures were consistent with serologic analysis using TRP36 genotype-specific peptides. Notably, there was no serologic evidence of E. canis infection in humans, suggesting that E. canis infection in dogs in Cauca is not associated with zoonotic human infection.
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http://dx.doi.org/10.4269/ajtmh.20-0965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103471PMC
March 2021

Bolivian hemorrhagic fever: A narrative review.

Travel Med Infect Dis 2021 Mar-Apr;40:102001. Epub 2021 Feb 25.

Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.

Bolivian hemorrhagic fever (BHF) is a sporadic high-mortality febrile illness. Two etiological agents are currently recognized: Machupo virus and Chapare virus. Infection in humans occurs by exposure to excreta and secretions of wild native rodents in Bolivia. BHF is considered a severe disease that has three clinical phases: prodromal, hemorrhagic, and convalescent. Unspecific symptoms occur during the first phase, severe hemorrhagic manifestations occur during the second phase, and finally patients who survive experience a slow convalescent phase. The incubation period is variable and depends on host factors, viral pathogenicity, and severity of the disease. The diagnosis is primarily clinical and epidemiological, and though diagnosis should be confirmed by laboratory tests, viral agents of BHF are considered very pathogenic and need to be handled in reference laboratories that are not available in endemic areas. The most recent outbreak was in 2019, in which health-care professionals were infected and is recognized as the first outbreak in La Paz department, Bolivia, a place where no prior cases had been reported. In addition, as tourism and travelling increase in Bolivia, along with ecological practices that could represent a risk for acquiring BHF, travelers could be infected, develop the disease, and be a diagnostic challenge in non endemic countries. No vaccines or antiviral therapies are available and approved for human use. Control measures are focused on peridomicile rodent population eradication which demonstrated efficacy in reducing cases during the first outbreaks.
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http://dx.doi.org/10.1016/j.tmaid.2021.102001DOI Listing
February 2021

Flea-borne Rickettsia species in fleas, Caldas department, Colombia.

J Infect Dev Ctries 2020 10 31;14(10):1155-1163. Epub 2020 Oct 31.

Grupo de Enfermedades Infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.

Introduction: Rickettsioses are zoonotic diseases caused by pathogenic bacteria of the genus Rickettsia and transmitted to man by means of arthropod vectors such as ticks, fleas, mites and lice. Historically, Caldas Department has reported a significant number of cases of murine typhus to the Colombian national health surveillance system, and consequent studies of flea-borne rickettsiosis identified the circulation of Rickettsia typhi and Rickettsia felis in multiple municipalities. Our aim was to genotype species of Rickettsia detected in fleas collected from domestic and wild mammals in Caldas.

Methodology: Flea samples were taken by convenience sampling from dogs, cats and wild mammals (rodents and marsupials) in 26 municipalities. Specimens were classified by current taxonomic keys and pooled for DNA extraction and molecular screening for Rickettsia spp. by PCR amplification of gltA, htrA and sca5 genes. Positive samples were genotyped by enzyme digestion (htrA) and sequencing.

Results: A total of 1388 flea samples were collected. Rickettsia DNA was amplified in 818 (gltA), 883 (htrA) and 424 (sca5) flea pools. Alignment analysis with available Rickettsia DNA sequences showed greater similarity with R. asembonensis (gltA) and with R. felis (sca5 and htrA). Restriction pattern was compatible with R. felis. R. typhi was not identified.

Conclusion: The present study confirms the presence and high prevalence of R. asembonensis and R. felis in fleas from domestic and wild animals in different municipalities from Caldas Department.
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http://dx.doi.org/10.3855/jidc.12524DOI Listing
October 2020

Methicillin-resistant Staphylococcus aureus nasal colonization in cardiovascular surgery patients at a university hospital in Bogotá, Colombia

Biomedica 2020 05 1;40(Supl. 1):37-44. Epub 2020 May 1.

Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a microorganism that colonizes nostrils and different parts of the body, which is considered a risk factor to acquire invasive infections, especially in cardiovascular surgery patients. Objective: To determine the frequency of nasal colonization by MRSA and to establish the clinical characteristics in patients scheduled for cardiovascular surgery. Materials and methods: This was a descriptive study conducted between February and December, 2015. We included adult patients scheduled for cardiovascular surgery at the Hospital Universitario San Ignacio in Bogotá, Colombia. Colonization was identified by real-time PCR from nasal swabs. Colonized patients were treated with mupirocin 2.0% intranasally twice a day and bathed with chlorhexidine 4% from the neck downwards for five days. At the end of this treatment, PCR control was carried out. Results: We included 141 patients with a percentage of nasal colonization of 13.4% (19/141). There were 52 hospitalized patients and 89 outpatients with a percentage of nasal colonization of 17.3% (9/52), and 11.2% (10/89), respectively. All colonized patients who received treatment had a negative PCR at the end of the regime and none of the participating patients had a surgical site infection by S. aureus at the end of the study. Conclusions: Nasal colonization was observed both in hospitalized patients and outpatients. Decolonization treatment with mupirocin was effective to eradicate the carrier state in the short term, which could impact the rates of surgical wound infection associated with cardiovascular surgery.
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http://dx.doi.org/10.7705/biomedica.4791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449105PMC
May 2020

Bats are a potential reservoir of pathogenic Leptospira species in Colombia.

J Infect Dev Ctries 2019 04 30;13(4):278-283. Epub 2019 Apr 30.

Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.

Introduction: Bats have become an epidemiologically significant source of pathogenic microorganisms, such as leptospires, the causative agents of leptospirosis. However, little information exists about bats and their potential role as a reservoir of pathogenic Leptospira spp. in Colombia. The aim of this study was to evaluate the presence of pathogenic Leptospira spp. in the kidneys of bats from the Caribbean region of Colombia deposited in the collection of mammals of the Museo Javeriano de Historia Natural (MPUJ-MAMM).

Methodology: DNA was extracted from twenty-six kidney samples from a total of 13 species of bats captured in Colombia. First, 16S ribosomal RNA conventional PCR was performed to detect the presence of Leptospira spp. Then, in samples that tested positive, LipL32 PCR was performed to detect pathogenic Leptospira spp. by sequencing and phylogenetic analysis.

Results: The presence of Leptospira spp. was observed in 7/26 (26.9%) bats from the following 6 species: Carollia perspicillata, Glossophaga soricina, Dermanura phaeotis, Uroderma bilobatum, Desmodus rotundus, and Lophostoma silvicolum, and pathogenic Leptospira spp. were detected in 4/26 samples (15.4%).

Conclusions: This study suggests that bats present in the Caribbean region of Colombia could be potential reservoirs of pathogenic Leptospira spp.
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http://dx.doi.org/10.3855/jidc.10642DOI Listing
April 2019

Candidatus Rickettsia senegalensis in Cat Fleas (Siphonaptera: Pulicidae) Collected from Dogs and Cats in Cauca, Colombia.

J Med Entomol 2020 02;57(2):382-387

Grupo de enfermedades infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.

Rickettsia typhi and Rickettsia felis (Rickettsiales: Rickettsiaceae) are flea-transmitted pathogens. They are important causes of acute febrile illness throughout the world. We, therefore, sought to identify the rickettsial species present in the fleas of dogs and cats in the department of Cauca, Colombia. In this study, we collected 1,242 fleas from 132 dogs and 43 fleas from 11 cats. All fleas were morphologically identified as Ctenocephalides felis (Bouché) adults and organized in pools for DNA extraction (234 pools from dogs and 11 from cats). The gltA gene from rickettsiae was targeted for screening amplification using conventional PCR. In total, 144 of the 245 pools (58.7%) were positive. The positive samples were then processed for the amplification of the 17kDa antigen gene (144/144; 100% positive) and sca5 gene (140/144; 97.2% positive). In addition, restriction enzyme length polymorphism analysis using NlaIV on the amplified product of the sca5 gene demonstrated several organisms: 21/140 (15%) were R. felis, 118/140 (84.3%) were Rickettsia asemboensis, and 1/140 (0.7%) were Candidatus Rickettsia senegalensis. Subsequent sequencing confirmed Candidatus Rickettsia senegalensis in C. felis collected from dogs the first reported from Colombia.
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http://dx.doi.org/10.1093/jme/tjz177DOI Listing
February 2020

Bartonella quintana and Typhus Group Rickettsiae Exposure among Homeless Persons, Bogotá, Colombia.

Emerg Infect Dis 2017 11;23(11):1876-1879

In 2015, we investigated Bartonella quintana and typhus group rickettsiae in body lice from homeless persons in Bogotá, Colombia. We found B. quintana-infected body lice and seroprevalence of this microorganism in 19% of homeless persons and typhus group rickettsiae in 56%. Public health professionals should start preemptive measures and active vector control.
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http://dx.doi.org/10.3201/eid2311.170341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652414PMC
November 2017

Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach.

PLoS Negl Trop Dis 2017 Sep 18;11(9):e0005892. Epub 2017 Sep 18.

Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.

Rickettsiosis is a re-emergent infectious disease without epidemiological surveillance in Colombia. This disease is generally undiagnosed and several deadly outbreaks have been reported in the country in the last decade. The aim of this study is to analyze the eco-epidemiological aspects of rickettsial seropositivity in rural areas of Colombia where outbreaks of the disease were previously reported. A cross-sectional study, which included 597 people living in 246 households from nine hamlets in two municipalities of Colombia, was conducted from November 2015 to January 2016. The survey was conducted to collect sociodemographic and household characteristics (exposure) data. Blood samples were collected to determine the rickettsial seropositivity in humans, horses and dogs (IFA, cut-off = 1/128). In addition, infections by rickettsiae were detected in ticks from humans and animals by real-time PCR targeting gltA and ompA genes. Data was analyzed by weighted multilevel clog-log regression model using three levels (person, household and hamlets) and rickettsial seropositivity in humans was the main outcome. Overall prevalence of rickettsial seropositivity in humans was 25.62% (95%CI 22.11-29.12). Age in years (PR = 1.01 95%CI 1.01-1.02) and male sex (PR = 1.65 95%CI 1.43-1.90) were risk markers for rickettsial seropositivity. Working outdoors (PR = 1.20 95%CI 1.02-1.41), deforestation and forest fragmentation for agriculture use (PR = 1.75 95%CI 1.51-2.02), opossum in peridomiciliary area (PR = 1.56 95%CI 1.37-1.79) and a high proportion of seropositive domestic animals in the home (PR20-40% vs <20% = 2.28 95%CI 1.59-3.23 and PR>40% vs <20% = 3.14 95%CI 2.43-4.04) were associated with rickettsial seropositivity in humans. This study showed the presence of Rickettsia antibodies in human populations and domestic animals. In addition, different species of rickettsiae were detected in ticks collected from humans and animals. Our results highlighted the role of domestic animals as sentinels of rickettsial infection to identify areas at risk of transmission, and the importance of preventive measures aimed at curtailing deforestation and the fragmentation of forests as a way of reducing the risk of transmission of emergent and re-emergent pathogens.
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http://dx.doi.org/10.1371/journal.pntd.0005892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5619838PMC
September 2017

Wild and domestic animals likely involved in rickettsial endemic zones of Northwestern Colombia.

Ticks Tick Borne Dis 2017 10 21;8(6):887-894. Epub 2017 Jul 21.

Grupo de Investigación en Ciencias Veterinarias, Centauro, Universidad de Antioquia U de A; Calle 70 No. 52-21, Medellín, Colombia. Electronic address:

Between 2006 and 2008, three outbreaks of human rickettsiosis occurred in Northwestern Colombia (municipalities of Necoclí, Los Córdobas and Turbo), with case fatality rates between 27% and 54%. The aim of this study was to determine previous exposure of wild and domestic animals to spotted fever group (SFG) rickettsiae through serological tests, to detect rickettsial evidence in their ectoparasites, and to analyze their possible role in the epidemiology of rickettsial diseases in this zone of the country. A cross-sectional association study was performed from 2010 to 2011. Blood and ectoparasite samples were collected from domestic animals and small mammals. A statistically significant association (p<0.05) between seropositive animals and the study zones was observed. A total of 2937 ticks, 672 fleas and 74 lice were collected and tested in pools by PCR. The minimum infection rate (MIR) of the positive pools was 5% in ticks, 4% in fleas, and 0% in lice. Phylogenetic analyses showed circulation of three 4.Rickettsia species: R. felis in fleas, and R. bellii and Rickettsia sp. strain Atlantic rainforest, both in Amblyomma ovale ticks. In conclusion, this study demonstrated the occurrence of SFG rickettsiae in domestic, synanthropic and wild animals, and suggests the use of equines and canines as good sentinels of infection, in the study zone. We speculate that a transmission cycle exist involving rodents in the areas where these outbreaks have occurred. Tomes' spiny rats (Proechimys semispinosus) and common opossums (Didelphis marsupialis) could be good candidates as amplifier hosts for SFG rickettsiae in enzootic/endemic zones.
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http://dx.doi.org/10.1016/j.ttbdis.2017.07.007DOI Listing
October 2017

Epidemiology of Spotted Fever Group Rickettsioses and Acute Undifferentiated Febrile Illness in Villeta, Colombia.

Am J Trop Med Hyg 2017 Sep 19;97(3):782-788. Epub 2017 Jul 19.

Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia.

Etiology of acute undifferentiated febrile syndrome (AUFS) is often unknown, leading to inaccurate diagnosis and treatment. Villeta town has been identified as an endemic area for spotted fever group (SFG) rickettsioses but little is known about possible amplifier hosts and other species different from . Besides, few studies have approached other AUFS etiologies in the region. We investigated the role of dengue, leptospirosis, rickettsioses, human anaplasmosis, and Q fever as possible causes of AUFS in patients from Villeta. Sera specimens and ticks from animals as well as ticks from vegetation were studied for the presence of different spp. Among 104 sera from patients with AUFS, 16.4%, 24.0%, and 2.9% patients seroconverted to dengue, , and SFG , respectively, with a case of probable coinfection or cross-reaction with . None of the samples were reactive for . Sera samples from 74 horses, 118 dogs, and 62 bovines were collected and showed 33.8%, 14.4%, and 50.0% of seroprevalence for SFG , respectively. A total of 1,287 ixodid ticks were collected from animals/vegetation and processed in pools for polymerase chain reaction. Among them, 1.7% was positive for genes, and , , and spp. were found. These results confirm the circulation of dengue, different SFG species and the relevance of other etiologies like leptospirosis and human anaplasmosis. Further studies must identify different epidemiological variables to establish proper surveillance and control programs.
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http://dx.doi.org/10.4269/ajtmh.16-0442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590559PMC
September 2017

Human prevalence of the spotted fever group (SFG) rickettsiae in endemic zones of Northwestern Colombia.

Ticks Tick Borne Dis 2017 06 9;8(4):477-482. Epub 2017 Feb 9.

Grupo de Investigación en Ciencias Veterinarias, Centauro, Universidad de Antioquia U de A, Calle 70 No. 52-21, Medellín, Colombia. Electronic address:

In February 2006, an outbreak of human rickettsiosis occurred in the municipality of Necoclí Colombia, with 35% of lethality. This episode was, followed by two more, one in the municipality of Los Cordobas in 2007 with a 54% of lethality and the other one in the municipality of Turbo in 2008 with 27% of lethality. The aim of this study was to perform serological tests in healthy persons to determine the seroprevalence of antibodies against spotted fever group (SFG) rickettsiae and develop a survey to study some infection risk-related factors. A cross-sectional study was performed in 2011 and 2012. A blood sample and survey of associated factors was performed in healthy persons. A prevalence of 32%-41% was found in healthy people. From the multivariate analysis, we found that people living more than 16 years in these sites had a 79% higher risk of being seropositive and a 46% higher risk when they reported having birds in their houses if the variable of having a horse was included in the model. In conclusion, this study shows endemicity of at least one spotted fever group Rickettsia in the study zone.
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http://dx.doi.org/10.1016/j.ttbdis.2017.02.006DOI Listing
June 2017

Probable case of spotted fever group rickettsial infection in a new suspected endemic area, Colombia.

J Infect Public Health 2017 May - Jun;10(3):353-356. Epub 2016 Sep 7.

Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia.

Spoted fever group (SFG) rickettsioses are actually considered as emerging and re-emerging zoonotic diseases, caused by pathogenic bacteria of the spotted fever group rickettsiae (SFGR). Recently, serologic studies in human and animals conducted in Colombian Orinoquia, showed a high seroprevalence against SFGR. In June 2015, a 50-year-old male was admitted to a hospital in Bogotá, Colombia, with two days of malaise and temperature of 39°C, associated to generalized rash 24h after the onset of fever. He referred a work visit and outdoor activities in rural area of the Department of Meta 15days prior the onset of symptoms. The patient was transferred to the intensive care unit with supplementary oxygen, inotropic support and was assessed by the infectious diseases department, indicating the addition of Doxycycline. After seven days of antibiotic treatment the patient was discharged with no evidence of new symptoms or sequels. Retrospectively, two serum samples collected during the acute and convalescent phase were evaluated; there was four fold rise in titer against SFGR. With the foregoing, associated with the recent serological evidence that suggests the circulation of SFGR species in the Colombian Orinoquia, we consider to recognize this region as a new endemic area for SFG Rickettsioses.
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http://dx.doi.org/10.1016/j.jiph.2016.08.012DOI Listing
December 2017

CONTRIBUTIONS TO RICKETTSIOSES RESEARCH IN COLOMBIA (1917-1943), LUIS B. PATIÑO CAMARGO.

Rev Inst Med Trop Sao Paulo 2016 8;58:33. Epub 2016 Apr 8.

Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.

Colombian physician Luis Benigno Patiño Camargo was one of the pioneers in the study of rickettsioses in South America, demonstrating for the first time in Colombia the presence of Rickettsia rickettsii as the etiological agent of a highly deadly exanthematic febrile syndrome in the 1930s. However, Patiño-Camargo performed other investigations from 1917-1943, which represent the first descriptions and scientific evidence of the presence of R. prowazekii and R. typhi in Colombia. Almost 60 years after the latest research conducted by Dr. Patiño-Camargo, rickettsioses were again a matter of interest and research. In the last decade over 20 research studies have been published, showing new endemic areas for R. rickettsii, as well as the description of new rickettsial species in Colombia.
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http://dx.doi.org/10.1590/S1678-9946201658033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826086PMC
August 2016

Molecular Evidence of Different Rickettsia Species in Villeta, Colombia.

Vector Borne Zoonotic Dis 2016 Feb 20;16(2):85-7. Epub 2016 Jan 20.

1 Microbiology Department, Faculty of Sciences, Pontificia Universidad Javeriana , Bogotá, Colombia .

The aim of this work was to detect and identify Rickettsia species in ticks collected in rural areas of Villeta, Colombia. Tick specimens were collected from domestic animals and walls of houses in five rural villages of Villeta town and from humans in Naranjal village (same town). Moreover, a flea collected from the same area was also processed. DNA was extracted and tested by conventional, semi-nested, and nested PCR reactions targeting rickettsial genes. In the ticks collected from humans from Naranjal village, a nymph of Amblyomma cajennense sensu lato was amplified using primers for ompA and sequenced (100% identity with "Candidatus Rickettsia amblyommii"). Last, three amplicons from the Ctenocephalides felis flea, corresponding to gltA, ompB, and 16S rRNA genes, showed high identity with R. felis (98.5%, 97.3%, and 99.2%, respectively) and "Candidatus Rickettsia asemboensis" (99.7% and 100%, respectively). To our knowledge, these results correspond to the first molecular detection in Colombia of "Candidatus Rickettsia amblyommii" and "Ca. Rickettsia asemboensis" in fleas.
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http://dx.doi.org/10.1089/vbz.2015.1841DOI Listing
February 2016

Endothelial Cell Proteomic Response to Rickettsia conorii Infection Reveals Activation of the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription (STAT)-Inferferon Stimulated Gene (ISG)15 Pathway and Reprogramming Plasma Membrane Integrin/Cadherin Signaling.

Mol Cell Proteomics 2016 Jan 11;15(1):289-304. Epub 2015 Nov 11.

From the Departments of ‡Internal Medicine and §Institute for Translational Sciences, and ¶Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas 77555-1060,

Rickettsia conorii is the etiologic agent of Mediterranean spotted fever, a re-emerging infectious disease with significant mortality. This Gram-negative, obligately intracellular pathogen is transmitted via tick bites, resulting in disseminated vascular endothelial cell infection with vascular leakage. In the infected human, Rickettsia conorii infects endothelial cells, stimulating expression of cytokines and pro-coagulant factors. However, the integrated proteomic response of human endothelial cells to R. conorii infection is not known. In this study, we performed quantitative proteomic profiling of primary human umbilical vein endothelial cells (HUVECs) with established R conorii infection versus those stimulated with endotoxin (LPS) alone. We observed differential expression of 55 proteins in HUVEC whole cell lysates. Of these, we observed induction of signal transducer and activator of transcription (STAT)1, MX dynamin-like GTPase (MX1), and ISG15 ubiquitin-like modifier, indicating activation of the JAK-STAT signaling pathway occurs in R. conorii-infected HUVECs. The down-regulated proteins included those involved in the pyrimidine and arginine biosynthetic pathways. A highly specific biotinylated cross-linking enrichment protocol was performed to identify dysregulation of 11 integral plasma membrane proteins that included up-regulated expression of a sodium/potassium transporter and down-regulation of α-actin 1. Analysis of Golgi and soluble Golgi fractions identified up-regulated proteins involved in platelet-endothelial adhesion, phospholipase activity, and IFN activity. Thirty four rickettsial proteins were identified with high confidence in the Golgi, plasma membrane, or secreted protein fractions. The host proteins associated with rickettsial infections indicate activation of interferon-STAT signaling pathways; the disruption of cellular adhesion and alteration of antigen presentation pathways in response to rickettsial infections are distinct from those produced by nonspecific LPS stimulation. These patterns of differentially expressed proteins suggest mechanisms of pathogenesis as well as methods for diagnosis and monitoring Rickettsia infections.
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http://dx.doi.org/10.1074/mcp.M115.054361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762516PMC
January 2016

Methicillin-Resistant Staphylococcus aureus USA300 Latin American Variant in Patients Undergoing Hemodialysis and HIV Infected in a Hospital in Bogotá, Colombia.

PLoS One 2015 16;10(10):e0140748. Epub 2015 Oct 16.

Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia; Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical School at Houston, Houston, Texas, United States of America.

We aimed to determine the prevalence of MRSA colonization and examine the molecular characteristics of colonizing isolates in patients receiving hemodialysis and HIV-infected in a Colombian hospital. Patients on hemodialysis and HIV-infected were prospectively followed between July 2011 and June 2012 in Bogota, Colombia. Nasal and axillary swabs were obtained and cultured. Colonizing S. aureus isolates were identified by standard and molecular techniques. Molecular typing was performed by using pulse-field gel electrophoresis and evaluating the presence of lukF-PV/lukS-PV by PCR. A total of 29% (n = 82) of HIV-infected and 45.5% (n = 15) of patients on hemodialysis exhibited S. aureus colonization. MSSA/MRSA colonization was observed in 28% and 3.6% of the HIV patients, respectively and in 42.4% and 13.3% of the hemodialysis patients, respectively. Staphylococcal cassette chromosome mec typing showed that four MRSA isolates harbored the type IV cassette, and one type I. In the hemodialysis group, two MRSA isolates were classified as belonging to the USA300-LV genetic lineage. Conversely, in the HIV infected group, no colonizing isolates belonging to the USA300-Latin American Variant (UDA300-LV) lineage were identified. Colonizing isolates recovered from the HIV-infected group belonged to the prevalent hospital-associated clones circulating in Latin America (Chilean [n = 1] and Pediatric [n = 2]). The prevalence of MRSA colonization in the study groups was 3.6% (HIV) and 13.3% (hemodialysis). Surveillance programs should be implemented in this group of patients in order to understand the dynamics of colonization and infection in high-risk patients.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140748PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608721PMC
June 2016

Syndromic classification of rickettsioses: an approach for clinical practice.

Int J Infect Dis 2014 Nov 19;28:126-39. Epub 2014 Sep 19.

Infectious Diseases Department, Center of Rickettsioses and Vector-borne Diseases, Hospital San Pedro-CIBIR, Logroño, Spain. Electronic address:

Rickettsioses share common clinical manifestations, such as fever, malaise, exanthema, the presence or absence of an inoculation eschar, and lymphadenopathy. Some of these manifestations can be suggestive of certain species of Rickettsia infection. Nevertheless none of these manifestations are pathognomonic, and direct diagnostic methods to confirm the involved species are always required. A syndrome is a set of signs and symptoms that characterizes a disease with many etiologies or causes. This situation is applicable to rickettsioses, where different species can cause similar clinical presentations. We propose a syndromic classification for these diseases: exanthematic rickettsiosis syndrome with a low probability of inoculation eschar and rickettsiosis syndrome with a probability of inoculation eschar and their variants. In doing so, we take into account the clinical manifestations, the geographic origin, and the possible vector involved, in order to provide a guide for physicians of the most probable etiological agent.
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http://dx.doi.org/10.1016/j.ijid.2014.05.025DOI Listing
November 2014

Infection of Amblyomma ovale by Rickettsia sp. strain Atlantic rainforest, Colombia.

Ticks Tick Borne Dis 2014 Oct 15;5(6):672-5. Epub 2014 Jul 15.

Grupo de Investigación en Ciencias Veterinarias, Centauro, Universidad de Antioquia U de A, Calle 70 No. 52-21, Medellín, Colombia. Electronic address:

Our goal was to understand rickettsial spotted fevers' circulation in areas of previous outbreaks reported from 2006 to 2008 in Colombia. We herein present molecular identification and isolation of Rickettsia sp. Atlantic rainforest strain from Amblyomma ovale ticks, a strain shown to be pathogenic to humans. Infected ticks were found on dogs and a rodent in Antioquia and Córdoba Provinces. This is the first report of this rickettsia outside Brazil, which expands its known range considerably.
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http://dx.doi.org/10.1016/j.ttbdis.2014.04.018DOI Listing
October 2014

[Tick-borne rickettsioses in the Americas: clinical and epidemiological advances, and diagnostic challenges].

Biomedica 2013 Sep;33 Suppl 1:161-78

Pathology Department, University of Texas Medical Branch, Pontificia Universidad Javeriana.

Rickettsioses are a group of zoonotic diseases caused by strict intracellular bacteria of the genus Rickettsia and Orientia which belong to the Rickettsiaceae family. Their ecology is influenced by environmental factors and the presence of specific vectors that determine the establishment and epidemiology in different world regions. In America, during the 20 th century, only three of these diseases were recognized: Rocky Mountain spotted fever, epidemic typhus and endemic typhus. However, since 2000, more than 10 different species that had previously been unknown in this continent have been described, both in arthropods and in clinical cases, fact that classifies them as emerging and re-emerging diseases. Given the clinical manifestations of the diseases caused by rickettsias, being the majority unspecific and, therefore, shared with other infectious diseases, especially viral and bacterial, they have been framed within the differential diagnoses of acute febrile syndrome in urban and tropical areas. Nowadays, there are direct and indirect diagnostic methods, which are useful in the definition of the infectious agent, in this case, the cause of rickettsioses.
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September 2013

[Probable case of flea-borne spotted fever (Rickettsia felis)].

Biomedica 2013 Sep;33 Suppl 1:9-13

Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.

Rickettsia felis is the etiologic agent of flea-borne spotted fever, with Ctenocephalides felis as its main vector and reservoir. Typically, the disease presents as acute fever associated with headache, asthenia, generalized maculo-papular rash, and in some cases, an inoculation eschar. In recent years, R. felis has acquired an important role in the etiology of the acute febrile syndrome; it is indeed an emerging infectious disease, albeit underdiagnosed. Indirect immunofluorescence assay (IFA) is currently the reference diagnostic method. However, this technique has limitations related to the cross reactivity among different species of rickettsiae. Herein, we describe a case of a 16 year-old patient with an acute febrile syndrome secondary to probable infection with R. felis.
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September 2013

Discovery of a protective Rickettsia prowazekii antigen recognized by CD8+ T cells, RP884, using an in vivo screening platform.

PLoS One 2013 16;8(10):e76253. Epub 2013 Oct 16.

Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.

Rickettsia prowazekii has been tested for biological warfare due to the high mortality that it produces after aerosol transmission of very low numbers of rickettsiae. Epidemic typhus, the infection caused by these obligately intracellular bacteria, continues to be a threat because it is difficult to diagnose due to initial non-specific symptoms and the lack of commercial diagnostic tests that are sensitive and specific during the initial clinical presentation. A vaccine to prevent epidemic typhus would constitute an effective deterrent to the weaponization of R. prowazekii; however, an effective and safe vaccine is not currently available. Due to the cytoplasmic niche of Rickettsia, CD8(+) T-cells are critical effectors of immunity; however, the identification of antigens recognized by these cells has not been systematically addressed. To help close this gap, we designed an antigen discovery strategy that uses cell-based vaccination with antigen presenting cells expressing microbe's proteins targeted to the MHC class I presentation pathway. We report the use of this method to discover a protective T-cell rickettsial antigen, RP884, among a test subset of rickettsial proteins.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0076253PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797808PMC
August 2014

Molecular detection of Rickettsia felis in different flea species from Caldas, Colombia.

Am J Trop Med Hyg 2013 Sep 22;89(3):453-9. Epub 2013 Jul 22.

Grupo Parasitología Veterinaria, Universidad Nacional de Colombia, Bogotá, Colombia.

Rickettsioses caused by Rickettsia felis are an emergent global threat. Historically, the northern region of the province of Caldas in Colombia has reported murine typhus cases, and recently, serological studies confirmed high seroprevalence for both R. felis and R. typhi. In the present study, fleas from seven municipalities were collected from dogs, cats, and mice. DNA was extracted and amplified by polymerase chain reaction (PCR) to identify gltA, ompB, and 17kD genes. Positive samples were sequenced to identify the species of Rickettsia. Of 1,341 fleas, Ctenocephalides felis was the most prevalent (76.7%). Positive PCR results in the three genes were evidenced in C. felis (minimum infection rates; 5.3%), C. canis (9.2%), and Pulex irritans (10.0%). Basic Local Alignment Search Tool (BLAST) analyses of sequences showed high identity values (> 98%) with R. felis, and all were highly related by phylogenetic analyses. This work shows the first detection of R. felis in fleas collected from animals in Colombia.
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http://dx.doi.org/10.4269/ajtmh.12-0698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771280PMC
September 2013

Flea-borne rickettsioses in the north of Caldas province, Colombia.

Vector Borne Zoonotic Dis 2013 May 8;13(5):289-94. Epub 2013 Mar 8.

Infectious Diseases Group, Department of Microbiology, Pontificia Universidad Javeriana, Bogotá, Colombia.

Rickettsia typhi and R. felis are the etiological agents of murine typhus and flea-borne spotted fever, respectively. Both are emerging acute febrile zoonotic diseases for which fleas are vectors; they also have similar clinical characteristics and global distribution. In 2005, we identified the circulation of murine typhus in 6 towns within the mountainous coffee-growing area north of Caldas, Colombia. We now report the specific seroprevalence against R. typhi and R. felis, and associated risk factors in 7 towns of this province. The combined seroprevalence against the 2 flea-borne rickettsioses is the highest yet reported in the literature: 71.7% (17.8% for R. felis, 25.2% for R. typhi, and 28.7% for both). We also report a prospective analysis of 26 patients with a febrile illness compatible with rickettsioses, including murine typhus; 9 of these patients had a rickettsiosis. This supports our sero-epidemiological results and highlights the diagnostic complexity of febrile syndromes in this region.
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http://dx.doi.org/10.1089/vbz.2012.1173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636579PMC
May 2013

[Increase in erythromycin-resistant Streptococcus pneumoniae in Colombia, 1994-2008].

Biomedica 2011 Mar;31(1):124-31

Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, D.C, Colombia.

Introduction: Streptococcus pneumoniae is a commonly implicated agent in invasive disease. For infections of S. pneumoniae resistant to b-lactam, macrolides are an alternative treatment. However, resistance to macrolides has increased worldwide as well.

Objective: The frequency of resistance to erythromycin was determined for S. pneumoniae over a 15-year surveillance period, and the resistant isolates were characterized phenotypically and genotypically.

Materials And Methods: Demographic data of the patients, antimicrobial susceptibility and serotypes were analyzed for 3,241 S. pneumoniae isolates recovered between 1994 and 2008. The phenotypes were determined by the double-disc technique and genotypes by PCR (polymerase chain reaction) and PFGE (pulsed field gel electrophoresis). Isolates were recovered from invasive diseases and were provided by national public health laboratories.

Results: Of the 3,241 isolates, 136 were resistant to erythromycin. In the 12-year period between 1994-1996 and 2006-2008, resistance in each 2-year sampling had increased from 2.4% to 6.9% in children under 6 years and from 3.3% to 5.7% in adults. The most common serotypes were 6B (36.8%), 14 (16.9%) and 6A (17.6%). Constitutive phenotype cMLSB was determined in 87 isolates; 82 of these expressed the ermB gene. Phenotype M was determined in 46 isolates; 45 had the mefA gene. An additional three isolates expressed the inducible phenotype (iMLSB), and one expressed the ermB gene. By PFGE, 50 of the isolates were found to be related to international clones--58% were Spain6B-ST90, 26% Spain9V-ST156, 8% Colombia23F-ST338 and 8% Spain23F-ST81.

Conclusion: The increase in erythromycin resistance was primarily related to the mechanism of ribosomal methylation. More than half the cases were congeneric with the clone Spain6B-ST90 that has been circulating in Colombia since 1994.
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http://dx.doi.org/10.1590/S0120-41572011000100015DOI Listing
March 2011

Outbreak of Rocky Mountain spotted fever in Córdoba, Colombia.

Mem Inst Oswaldo Cruz 2011 Feb;106(1):117-8

Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, Colombia.

Rocky Mountain spotted fever (RMSF) is a tick-borne disease caused by the obligate intracellular bacterium Rickettsia rickettsii. Although RMSF was first reported in Colombia in 1937, it remains a neglected disease. Herein, we describe the investigation of a large cluster of cases of spotted fever rickettsiosis in a new area of Colombia.
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http://dx.doi.org/10.1590/s0074-02762011000100019DOI Listing
February 2011