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Article ; Online: Profile and complexity of travel medicine consultations in Chile

Thomas Weitzel

BMJ Open, Vol 10, Iss

unicentric cross-sectional study

2020 Volume 9

Abstract: Objective To analyse the spectrum, vaccination needs and pretravel advice complexity of travellers presenting at a travel medicine clinic in Santiago, Chile.Design Cross-sectional study.Setting Pretravel consultations in a private healthcare centre in ... ...

Abstract	Objective To analyse the spectrum, vaccination needs and pretravel advice complexity of travellers presenting at a travel medicine clinic in Santiago, Chile.Design Cross-sectional study.Setting Pretravel consultations in a private healthcare centre in Chile, an ‘emerging market’ country in South America.Participants Travellers (n=1341) seeking pretravel advice at the Travel Medicine Program of Clínica Alemana, Santiago, from April 2016 to March 2018.Primary and secondary outcome measures Demographical and travel characteristics, indications for travel vaccines and malaria prophylaxis, and complexity of travel consultations.Results Of 1341 travellers, 51% were female; the median age was 33 years. Most frequent travel reasons were tourism (67%) and business (20%). Median travel duration and time to departure were 21 days and 28 days, respectively. Most destinations were located in America (41%), followed by Asia (36%) and Africa (26%); 96% visited less developed countries, mostly in tropical regions, with risk of arboviral infections (94%) and malaria (69%). The indicated vaccine indications comprised hepatitis A (84%), yellow fever (58%), typhoid fever (51%), rabies (29%), polio (8%), Japanese encephalitis (6%) and meningococcal meningitis (5%). More than 60% of consultations were classified as complex.Conclusion The studied population mostly visited less developed tropical regions, resulting in a high requirement of yellow fever and other travel-related vaccinations. Most consultations were complex and required a comprehensive knowledge and training in travel medicine.
Keywords	Medicine ; R
Subject code	380 ; 910
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Campylobacter spp. Prevalence in Santiago, Chile

Lorena Porte / Caricia Pérez / Mario Barbé / Carmen Varela / Valeska Vollrath / Paulette Legarraga / Thomas Weitzel

Pathogens, Vol 12, Iss 504, p

A Study Based on Molecular Detection in Clinical Stool Samples from 2014 to 2019

2023 Volume 504

Abstract: Campylobacter spp. is an emerging cause of infectious diarrhea worldwide. In South American countries such as Chile, its prevalence is underestimated due to inadequate detection methods. Gastrointestinal multiplex PCR panels (GMP) permit rapid and ... ...

Abstract	Campylobacter spp. is an emerging cause of infectious diarrhea worldwide. In South American countries such as Chile, its prevalence is underestimated due to inadequate detection methods. Gastrointestinal multiplex PCR panels (GMP) permit rapid and sensitive detection of bacterial pathogens and provide important epidemiological information. This study aimed to analyze Campylobacter epidemiology using the results of molecular methods and to compare molecular detection results to those of culture methods. We performed a retrospective, descriptive analysis of Campylobacter spp. detected in clinical stool samples between 2014–2019 by GMP and culture. Within 16,582 specimens examined by GMP, Campylobacter was the most prevalent enteropathogenic bacteria (8.5%), followed by Salmonella spp. (3.9%), Shigella spp./enteroinvasive Escherichia coli (EIEC) (1.9%), and Yersinia enterocolitica (0.8%). The highest Campylobacter prevalence occurred in 2014/2015. Campylobacteriosis affected more males (57.2%) and adults from 19–65 years (47.9%) and showed a bimodal seasonality with summer and winter peaks. In 11,251 routine stool cultures, Campylobacter spp. was detected in 4.6%, mostly C. jejuni (89.6%). Among 4533 samples tested by GMP and culture in parallel, GMP showed a superior sensitivity (99.1% versus 50%, respectively). The study suggests that Campylobacter spp. is the most frequent bacterial enteropathogen in Chile.
Keywords	campylobacteriosis ; epidemiology ; gastrointestinal multiplex panel ; PCR ; diagnosis ; South America ; Medicine ; R
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Rickettsial infections

Jeanne Salje / Thomas Weitzel / Paul N Newton / George M Varghese / Nicholas Day

PLoS Neglected Tropical Diseases, Vol 15, Iss 5, p e

A blind spot in our view of neglected tropical diseases.

2021 Volume 0009353

Abstract: Rickettsial diseases are a group of vector-borne bacterial infections that cause acute febrile illness with potentially severe or fatal complications. These vector-borne diseases are prevalent in tropical and subtropical regions worldwide and ... ...

Abstract	Rickettsial diseases are a group of vector-borne bacterial infections that cause acute febrile illness with potentially severe or fatal complications. These vector-borne diseases are prevalent in tropical and subtropical regions worldwide and disproportionately affect poorer communities but are scientifically underrecognized. Despite this, they are not included in the World Health Organization's list of neglected tropical diseases nor were they mentioned in Peter Hotez's recent reflections on "What constitutes a neglected tropical disease?" in PLOS Neglected Tropical Diseases [1]. Here we present the case that rickettsial infections, as an overlooked cause of morbidity, mortality, and economic losses in marginalized populations, should be recognized as neglected tropical diseases. We describe how this oversight is the result of a number of factors and how it negatively impacts patient outcomes. We then propose measures to address the neglect of rickettsial infections in both scientific research and public health interventions.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Development of a New Genus-Specific Quantitative Real-Time PCR Assay for the Diagnosis of Scrub Typhus in South America

Ju Jiang / Constanza Martínez-Valdebenito / Thomas Weitzel / Christina M. Farris / Gerardo Acosta-Jamett / Katia Abarca / Allen L. Richards

Frontiers in Medicine, Vol

2022 Volume 9

Abstract: Scrub typhus is a potentially severe rickettsiosis, caused by Orientia tsutsugamushi in the Asia-Pacific region. Recently, however, two distinct pathogens, “Candidatus Orientia chuto” and “Candidatus Orientia chiloensis”, have been discovered in the ... ...

Abstract	Scrub typhus is a potentially severe rickettsiosis, caused by Orientia tsutsugamushi in the Asia-Pacific region. Recently, however, two distinct pathogens, “Candidatus Orientia chuto” and “Candidatus Orientia chiloensis”, have been discovered in the Middle East and South America, respectively. Since the novel pathogens differ significantly from O. tsutsugamushi, many established diagnostic methods are unreliable. This work describes the development and validation of a new quantitative real-time PCR (qPCR) assay (Orien16S) for the detection of all known Orientia species. Based on a 94 bp sequence of the 16S rRNA gene (rrs), Orien16S recognized DNA samples from O. tsutsugamushi (n = 41), Ca. O. chiloensis (n = 5), and Ca. O. chuto (n = 1), but was negative for DNA preparations from closely related rickettsiae and other members of the order Rickettsiales (n = 22) as well as unrelated bacterial species (n = 11). After its implementation in Chile, the assay was verified, correctly identifying all tested eschar and buffy coat samples (n = 28) of clinical suspected cases. Furthermore, Orien16S detected Orientia DNA in trombiculid mites collected in endemic regions in southern Chile. The presented novel qPCR assay provides a useful tool for detecting Orientia and diagnosing scrub typhus from all geographical regions.
Keywords	scrub typhus ; Orientia ; Candidatus Orientia chiloensis ; molecular diagnostic techniques ; quantitative real-time PCR (qPCR) ; Orien16S ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recomendaciones para viajeros chilenos a la Copa Mundial de la FIFA 2014 en Brasil

Cecilia Perret / Thomas Weitzel

Revista Chilena de Infectología, Vol 31, Iss 2, Pp 207-

2014 Volume 208

Abstract: Este artículo proporciona una serie de precauciones a observar y vacunas recomendadas para viajeros chilenos que asistirán a la Copa Mundial de Fútbol 2014 en Brasil. Su propósito es ayudar a los médicos a preparar a los visitantes a este masivo evento y ...

Abstract	Este artículo proporciona una serie de precauciones a observar y vacunas recomendadas para viajeros chilenos que asistirán a la Copa Mundial de Fútbol 2014 en Brasil. Su propósito es ayudar a los médicos a preparar a los visitantes a este masivo evento y resume las recomendaciones útiles para evitar enfermedades infecciosas, teniendo en consideración las circunstancias y disponibilidad en Chile.
Keywords	Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Spanish
Publishing date	2014-04-01T00:00:00Z
Publisher	Sociedad Chilena de Infectología
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Gastos hospitalarios en pacientes con fascioliasis en fase aguda, hidatidosis de tratamiento quirúrgico y neurocisticercosis en un hospital general en Chile

Alberto Fica / Thomas Weitzel

Revista Chilena de Infectología, Vol 31, Iss 4, Pp 406-

2014 Volume 410

Abstract: Antecedentes: La fascioliasis aguda (FA), la equinococosis o hidatidosis (H) y la neurocisticercosis (NCC) son tres enfermedades parasitarias endémicas en Chile de las cuales hay escasa información sobre el impacto económico que ellas generan por ... ...

Abstract	Antecedentes: La fascioliasis aguda (FA), la equinococosis o hidatidosis (H) y la neurocisticercosis (NCC) son tres enfermedades parasitarias endémicas en Chile de las cuales hay escasa información sobre el impacto económico que ellas generan por atención hospitalaria. Objetivos: Cuantificar y comparar los gastos hospitalarios causados por estas tres infecciones por helmintos en un hospital en Chile. Materiales y Métodos: Análisis retrospectivo de gastos hospitalarios en un hospital de referencia en Santiago entre los años 2006 y 2010. Se incluyeron aquellos casos identificados en las bases de datos de hospital y que contaran con datos económicos suficientes. Resultados: Un total de 16 pacientes con 21 ingresos fue identificado y analizado: 4 con FA, 11 con H y 6 con NCC. La mediana de gastos hospitalarios para los ingresos por FA fue de US$ 1.799, originados fundamentalmente por el costo del día cama. La mediana de los gastos en ingresos por H fue de US$ 4.707 y los componentes más importantes en el gasto fueron los medicamentos, estadía hospitalaria e insumos. Los pacientes con NCC tuvieron una mediana de gastos de US$ 1.293 explicado principalmente por la estadía hospitalaria. Los pacientes con formas no parenquimatosas o mixtas tuvieron una tendencia a presentar gastos más altos que aquellos con formas parenquimatosas de NCC. Conclusiones: Aunque las infecciones por helmintos están en declinación en Chile, un país de ingresos medios, y son consideradas raras en la práctica clínica, los gastos hospitalarios generados por la atención de pacientes con FA, H y NCC, son elevados y aún representan una importante carga económica para el sistema de salud chileno.
Keywords	Fascioliasis ; neurocisticercosis ; equinococosis ; hidatidosis ; gastos de hospitalización ; gastos en salud ; Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Spanish
Publishing date	2014-08-01T00:00:00Z
Publisher	Sociedad Chilena de Infectología
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diphyllobothrium latum

Reinaldo Rosas / Thomas Weitzel

Revista Chilena de Infectología, Vol 31, Iss 2, Pp 211-

2014 Volume 212

Keywords	Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Spanish
Publishing date	2014-04-01T00:00:00Z
Publisher	Sociedad Chilena de Infectología
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Eco-epidemiology of rodent-associated trombiculid mites and infection with Orientia spp. in Southern Chile.

María Carolina Silva de la Fuente / Caricia Pérez / Constanza Martínez-Valdebenito / Ruth Pérez / Cecilia Vial / Alexandr Stekolnikov / Katia Abarca / Thomas Weitzel / Gerardo Acosta-Jamett

PLoS Neglected Tropical Diseases, Vol 17, Iss 1, p e

2023 Volume 0011051

Abstract: Background Scrub typhus is a potentially severe infection caused by bacteria of the genus Orientia, endemic in Asia-Pacific and recently discovered in southern Chile. The presented study aimed to determine the prevalence and species richness of rodent- ... ...

Abstract	Background Scrub typhus is a potentially severe infection caused by bacteria of the genus Orientia, endemic in Asia-Pacific and recently discovered in southern Chile. The presented study aimed to determine the prevalence and species richness of rodent-associated trombiculid mites and their infection with Orientia spp. in different areas of two regions in southern Chile. Methodology/principal findings During summer 2020, trombiculid mites were collected from rodents captured in three areas in southern Chile known to be endemic for scrub typhus (Cochamó and Chiloé Island in the Los Lagos Region and Tortel in the Aysén Region). A total of 132 rodents belonging to five species were captured using Sherman-like traps; 89.4% were infested with trombiculids. Mite specimens were morphologically identified and subsequently tested by Orientia-specific qPCR. Six mite species were identified. Among chigger-infested rodents, 33.9% carried Orientia-positive mites; this rate was higher in Tortel (63.8%) than in Cochamó (45.0%) and Chiloé Island (2.0%). The analysis of individual mites (n = 901) revealed that 31.2% of Herpetacarus antarctica samples (n = 202) were positive for Orientia DNA; the prevalence was 7.0% in Paratrombicula neuquenensis (n = 213), 6.9% in Herpetacarus eloisae (n = 144), 3.6% in Argentinacarus expansus (n = 55), and 0% in Paratrombicula goffi (n = 110) and Quadraseta chiloensis (n = 177). The southernmost site (Tortel) showed the highest rates of trombiculid infestation, trombiculid load, and Orientia infection in the captured rodents. Conclusions/significance Our study provides new insights into the trombiculid fauna and prevalence of Orientia in mites collected from wild rodents in southern Chile. Orientia DNA was detected in four of the six mite species. Rates of infestation, mite loads, and Orientia prevalences differed geographically and were highest in the Aysén Region. Our data improve our knowledge on possible vectors of scrub typhus and their distribution in Chile.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	590
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Genomic analysis of the diversity, antimicrobial resistance and virulence potential of clinical Campylobacter jejuni and Campylobacter coli strains from Chile.

Veronica Bravo / Assaf Katz / Lorena Porte / Thomas Weitzel / Carmen Varela / Narjol Gonzalez-Escalona / Carlos J Blondel

PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e

2021 Volume 0009207

Abstract: Campylobacter jejuni and Campylobacter coli are the leading cause of human gastroenteritis in the industrialized world and an emerging threat in developing countries. The incidence of campylobacteriosis in South America is greatly underestimated, mostly ... ...

Abstract	Campylobacter jejuni and Campylobacter coli are the leading cause of human gastroenteritis in the industrialized world and an emerging threat in developing countries. The incidence of campylobacteriosis in South America is greatly underestimated, mostly due to the lack of adequate diagnostic methods. Accordingly, there is limited genomic and epidemiological data from this region. In the present study, we performed a genome-wide analysis of the genetic diversity, virulence, and antimicrobial resistance of the largest collection of clinical C. jejuni and C. coli strains from Chile available to date (n = 81), collected in 2017-2019 in Santiago, Chile. This culture collection accounts for more than one third of the available genome sequences from South American clinical strains. cgMLST analysis identified high genetic diversity as well as 13 novel STs and alleles in both C. jejuni and C. coli. Pangenome and virulome analyses showed a differential distribution of virulence factors, including both plasmid and chromosomally encoded T6SSs and T4SSs. Resistome analysis predicted widespread resistance to fluoroquinolones, but low rates of erythromycin resistance. This study provides valuable genomic and epidemiological data and highlights the need for further genomic epidemiology studies in Chile and other South American countries to better understand molecular epidemiology and antimicrobial resistance of this emerging intestinal pathogen.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Corynebacterium kroppenstedtii

Lorena Porte / Thomas Weitzel

Revista Chilena de Infectología, Vol 29, Iss 6, Pp 655-

2012 Volume 656

Keywords	Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Spanish
Publishing date	2012-12-01T00:00:00Z
Publisher	Sociedad Chilena de Infectología
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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