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Molecular diagnosis of microbial copathogens with influenza A(H1N1)pdm09 in Oaxaca, Mexico

Authors Ramírez-Palacios LR, Reséndez-Pérez D, Rodríguez-Padilla MC, Saavedra-Alonso S, Real-Najarro O, Fernández-Santos NA, Rodriguez Perez MA

Received 15 June 2017

Accepted for publication 30 January 2018

Published 6 April 2018 Volume 2018:9 Pages 49—62

DOI https://doi.org/10.2147/RRTM.S144075

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Thomas Unnasch


Luis Román Ramírez-Palacios,1 Diana Reséndez-Pérez,2 Maria Cristina Rodríguez-Padilla,2 Santiago Saavedra-Alonso,2 Olga Real-Najarro,3 Nadia A Fernández-Santos,4 Mario A Rodriguez Perez4

1Laboratorio Estatal de Salud Pública de Oaxaca, Oaxaca, 2Departamento de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico; 3Consejería de Educación, Madrid, Spain; 4Instituto Politécnico Nacional (IPN), Centro de Biotecnología Genómica, Reynosa, Mexico

Background: Multiple factors have been associated with the severity of infection by influenza A(H1N1)pdm09. These include H1N1 cases with proven coinfections showing clinical association with bacterial contagions.
Purpose: The objective was to identify H1N1 and copathogens in the Oaxaca (Mexico) population. A cross-sectional survey was conducted from 2009 to 2012. A total of 88 study patients with confirmed H1N1 by quantitative RT-PCR were recruited.
Methods: Total nucleic acid from clinical samples of study patients was analyzed using a TessArray RPM-Flu microarray assay to identify other respiratory pathogens.
Results: High prevalence of copathogens (77.3%; 68 patients harbored one to three pathogens), predominantly from Streptococcus, Haemophilus, Neisseria, and Pseudomonas, were detected. Three patients (3.4%) had four or five respiratory copathogens, whereas others (19.3%) had no copathogens. Copathogenic occurrence with Staphylococcus aureus was 5.7%, Coxsackie virus 2.3%, Moraxella catarrhalis 1.1%, Klebsiella pneumoniae 1.1%, and parainfluenza virus 3 1.1%. The number of patients with copathogens was four times higher to those with H1N1 alone (80.68% and 19.32%, respectively). Four individuals (4.5%; two males, one female, and one infant) who died due to H1N1 were observed to have harbored such copathogens as Streptococcus, Staphylococcus, Haemophilus, and Neisseria.
Conclusion: In summary, copathogens were found in a significant number (>50%) of cases of influenza in Oaxaca. Timely detection of coinfections producing increased acuity or severity of disease and treatment of affected patients is urgently needed.

Keywords: bacteria, copathogens, microarray assay, H1N1

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