{"id":143517,"date":"2013-11-05T15:25:22","date_gmt":"2013-11-05T14:25:22","guid":{"rendered":"http:\/\/www.madrimasd.org\/blogs\/universo\/?p=143517"},"modified":"2013-11-05T15:25:22","modified_gmt":"2013-11-05T14:25:22","slug":"suelos-desastres-naturales-e-infecciones-emergentes-la-zigomicosis","status":"publish","type":"post","link":"https:\/\/www.madrimasd.org\/blogs\/universo\/2013\/11\/05\/143517","title":{"rendered":"Suelos, Desastres Naturales e infecciones emergentes (la Zigomicosis)"},"content":{"rendered":"

El suelo alberga una enorme cantidad de microorganismos, siendo muy pocos de ellos pat\u00f3genos<\/strong> <\/span>que afecten severamente al ser humano, como hemos venido describiendo en post anteriores. Sin embargo,\u00a0la mala gesti\u00f3n del medio ed\u00e1fico se encuentra causando el auge de enfermedades nosocomiales<\/span><\/strong>, como venimos reincidiendo, una y otra vez, en las entregas incluidas en nuestra categor\u00eda los suelos y la salud<\/a>.\u00a0\u00a0 Bajo circunstancias especiales ciertos microrganismos como el moho<\/span> <\/strong>Apophysomyces elegans<\/em><\/strong> puede llegar a causar la muerte<\/strong>. La noticia de hoy nos informa<\/span> de varios fallecimientos ocurridos en EE.UU., tras el paso de un tornado que arrastr\u00f3 suelos y materia org\u00e1nica en descomposici\u00f3n<\/strong>. Tal hecho en s\u00ed no deber\u00eda generar mayores problemas si la poblaci\u00f3n afectada no hubiera padecido<\/strong> <\/span>a su vez, impactos y heridas traum\u00e1ticas<\/strong>, por las que penetr\u00f3 este hongo, dando lugar\u00a0a una r\u00e1pida invasi\u00f3n de los tejidos blandos de las personas afectadas<\/strong><\/span>. Y as\u00ed se produjo la temida zigomicosis<\/strong><\/span>, o fascitis necrosante<\/strong><\/span>, seg\u00fan algunos sitios Web que he inspeccionado (ya sab\u00e9is que no soy experto en la materia, por lo que no puedo precisar m\u00e1s). Si tal infecci\u00f3n es detectada a tiempo, existen remedios para erradicarla con rapidez<\/strong><\/span> mediante terapias antif\u00fangicas. Ahora bien, cuando la respuesta es tard\u00eda, como\u00a0la enfermedad progresa velozmente<\/span><\/strong>, causa morbilidad y mortalidad, al parecer, preferentemente en ciudadanos con alg\u00fan s\u00edntoma de inmunodepresi\u00f3n. \u00a0Y este fue justamente el problema del caso que nos narra la nota de prensa de ScienceDaily<\/strong> <\/span>que reproducimos hoy. Como consecuencia de estos estos desastres naturales, los heridos se multiplican, siendo la intervenci\u00f3n y diagn\u00f3stico m\u00e9dico menos efectivo de lo habitual<\/strong><\/span>.<\/p>\n

\u00a0Seg\u00fan la noticia Apophysomyces elegans<\/em><\/strong> <\/span>resulta ser un hongo com\u00fan que habita en el suelo, madera o agua que generalmente<\/strong> <\/strong>no causa ning\u00fan efecto nocivo en las personas con las que toma contacto. Sin embargo<\/strong><\/span>, una vez que penetra profundamente en el cuerpo a trav\u00e9s de una herida de punci\u00f3n<\/span><\/strong> propiciada por <\/strong>un traumatismo, puede crecer r\u00e1pidamente en ausencia de una inmediata respuesta m\u00e9dica. Cinco de las 13 personas infectadas a trav\u00e9s de lesiones sufridas durante el tornado de Joplin murieron en el plazo de dos semanas<\/strong><\/span>. Actualmente, a este hongo\u00a0comienza a prest\u00e1rsele m\u00e1s atenci\u00f3n debido a su poder necrosante<\/strong> <\/span>cuando infecta tejidos blandos<\/strong> <\/span>despu\u00e9s de un desastre natural<\/strong><\/span>. Un tratamiento temprano puede mejorar los resultados. Sin las m\u00faltiples y profundas heridas causadas la por este devastador tornado entre los ciudadanos afectados, las infecciones deber\u00edan haber sido\u00a0muy raras<\/strong><\/span>. No obstante (\u2026.)<\/p>\n

\u00a0\"apophysomyces02\"<\/p>\n

Apophysomyces<\/em> Fuente: Mycology On Line<\/a><\/p>\n

<\/p>\n

Sin embargo como veremos abajo, algunos expertos hablan de<\/strong><\/span> Pat\u00f3geno emergente<\/a>. La especie en cuesti\u00f3n pertenece al orden de los Mucorales y m\u00e1s concretamente a los denominados Zygomicetos<\/a>. Muchas especies de Mucorales son saprotr\u00f3ficas, y crecen en<\/strong> sustratos org\u00e1nicos<\/strong> <\/span>(frutas, suelo, esti\u00e9rcol<\/span>,<\/strong> maderas). Algunas especies son par\u00e1sitas o pat\u00f3genas de animales, plantas y hongos. Unas pocas especies causan enfermedades ficomic\u00f3ticas<\/strong> <\/span>humanas y animales, como tambi\u00e9n reacciones al\u00e9rgicas<\/strong><\/span>.<\/p>\n

\u00a0De acuerdo a Torres Narbona y colaboradores<\/a>:<\/p>\n

\u00a0\u201cLa zigomicosis o mucormicosis es la tercera infecci\u00f3n f\u00fangica invasora tras la candidiasis y la aspergilosis<\/em><\/strong>. Tradicionalmente se ha considerado una enfermedad de adquisici\u00f3n comunitaria, pero se est\u00e1 convirtiendo en una infecci\u00f3n de frecuente adquisici\u00f3n nosocomial<\/strong>. En los \u00faltimos a\u00f1os, numerosos estudios en instituciones aisladas apuntan a un aumento del n\u00famero de casos de zigomicosis invasora a ra\u00edz de las nuevas terapias antif\u00fangicas e nmunosupresoras, y<\/strong> al aumento de la poblaci\u00f3n inmunodeprimida<\/strong>. Por otro lado, el diagn\u00f3stico de la zigomicosis muchas veces es complicado, sobre todo en las formas pulmonares y diseminadas. Uno de los principales problemas que presenta el aislamiento de zigomicetos de muestras cl\u00ednicas en el laboratorio de microbiolog\u00eda es que con frecuencia los resultados tienen una dif\u00edcil interpretaci\u00f3n. Adem\u00e1s, el aumento del n\u00famero de micosis invasoras por hongos resistentes a los antif\u00fangicos ha llevado al desarrollo de nuevas mol\u00e9culas con actividad <\/strong>antif\u00fangica y diferentes perfiles de actividad frente a los zigomicetos<\/em>\u201d.<\/p>\n

\u00a0Os dejamos ya pues con la nota de prensa ofrecida por Siciencedaily, as\u00ed como algunos comentarios extra\u00eddos de Wikipedia.<\/p>\n

\u00a0Flesh Eating Fungus Responsible for Five Deaths in Wake of Massive Tornado<\/strong><\/a><\/strong><\/h3>\n

\u00a0<\/strong>Dec. 14, 2012<\/em><\/strong> \u2014 A fast growing, flesh-eating fungus killed 5 people following a massive tornado<\/strong> that devastated Joplin, Mo., according to two new studies based on genomic sequencing by the Translational Genomics Research Institute (TGen) and the U.S. Centers for Disease Control and Prevention (CDC).<\/p>\n

\u00a0Health officials should be aware of infections caused by the fungus Apophysomyces<\/em>, according to the studies, which tracked 13 people infected by the pathogen during the Class EF-5 tornado — the most powerful category<\/strong> — whose 200-plus mph winds plowed through Joplin on May 22, 2011, initially killing 160 and injuring more than 1,000.<\/p>\n

The common fungus — which lives in soil, wood or water — usually has no effect on people. But<\/strong> once it is introduced deep into the body through a blunt trauma puncture wound, it can grow quickly if the proper medical response is not immediate<\/strong>, the studies said. Five of the 13 people infected through injuries suffered during the Joplin tornado died within two weeks.<\/p>\n

\u00abIncreased awareness of fungi as a cause of necrotizing soft-tissue infections after a natural disaster is warranted<\/strong> \u2026 since early treatment may improve outcomes,\u00bb concluded one study published Dec. 6 in The New England Journal of Medicine<\/em>.<\/p>\n

Using whole genome sequencing<\/strong>, which decoded the billions of chemical letters in the fungus’ DNA, TGen scientists concluded that the Joplin infections represented the largest documented cluster of Apophysomyces<\/em> infections<\/strong>, according to a study published Nov. 27 in the journal PLOS One<\/em>.<\/p>\n

\u00abThis is one of the most severe fungal infections that anyone’s ever seen<\/strong>,\u00bb said David Engelthaler, Director of Programs and Operations for TGen’s Pathogen Genomics Division. Engelthaler was the senior author of the PLOS One<\/em> study, and a contributing author of the NEJM<\/em> study.<\/p>\n

\u00abWe’re able to apply the latest in science and technology to explore these strange and dangerous pathogens<\/strong>, like we’ve never been able to before,\u00bb said Engelthaler, adding that this is the latest in a series of collaborations between CDC and TGen. \u00abThis is the first peek into the genome of this dangerous fungus.\u00bb<\/p>\n

Dr. Benjamin Park, chief of the Epidemiology Team at the CDC’s Mycotic Diseases<\/strong> Branch, said the victims were infected when their injuries from the tornado were contaminated with debris from the storm, including gravel, wood and soil, as well as the aerosolized fungus<\/strong>.<\/p>\n

Without the multiple and deep wounds caused the by the storm, cases involving fungal infection are rare<\/strong>, said Dr. Park, the senior author of the NEJM<\/em> study and a contributing author of the PLOS One<\/em> study. \u00abA typical hospital might normally see one case in a year<\/strong>.\u00bb<\/p>\n

Engelthaler said Apophysomyces<\/em> infections rapidly ravage the body, quickly sealing off capillaries, shutting off the blood supply and leaving tissue to rot. Physicians try to get ahead of the infection by surgically removing sections of dead, damaged or infected tissue, a process called debridement.<\/p>\n

For example, Engelthaler said, one victim who suffered a deep wound to the upper right chest required a new titanium rib cage after the fungus rapidly destroyed skin and bones.<\/p>\n

\u00abIt’s unlike anything you’ve ever seen before,\u00bb said Engelthaler, a former State of Arizona Epidemiologist and former Arizona Biodefense Coordinator. \u00abIt’s unreal. It looks like there is no way this person can be alive.\u00bb<\/p>\n

The studies show the need for rapid and accurate identification of the exact mold causing an infection, since only two FDA-approved drugs — amphotericin B and posaconazole — are commonly used against mucormycetes, the group of molds that includes Apophysomyces<\/em> and causes mucormycosis.<\/p>\n

\u00abIt is not known whether the outcomes for these case patients would have been different if mucormycete-active agents had been used initially,\u00bb said the NEJM study. \u00abThe timely diagnosis of mucormycosis is essential for guiding therapy, because the early initiation of appropriate anti-fungal medication and aggressive surgical debridement are associated with improved outcomes.\u00bb<\/p>\n

Both the NEJM<\/em> and PLOS One<\/em> studies said whole genome sequencing could lead to better diagnosis and a better understanding of this pathogen.<\/p>\n

TGen’s DNA sequencing identified Apophysomyces<\/em> in all 13 of the Joplin cases. The DNA analysis also established that several strains of Apophysomyces<\/em> were involved in the outbreak, giving scientists further clues that this fungus was well established in the area, and probably had been so for a long time.<\/p>\n

\u00abThese disasters put us at risk for exposure to organisms that are around us, but don’t normally cause disease,\u00bb Engelthaler said. \u00abThere’s clearly an entire world out there that we’re not seeing on a regular basis. It takes a severe event like this tornado for us to come face-to-face with some of the more dangerous pathogens out there.\u00bb<\/p>\n

\u00a0Story Source: <\/strong>The above story is reprinted from materials<\/a> provided by The Translational Genomics Research Institute<\/strong><\/a>. Note: Materials may be edited for content and length. For further information, please contact the source cited above.<\/em><\/p>\n

\u00a0<\/strong>Journal Reference<\/strong>: Marion A. Kainer, David R. Reagan, Duc B. Nguyen, Andrew D. Wiese, Matthew E. Wise, Jennifer Ward, Benjamin J. Park, Meredith L. Kanago, Jane Baumblatt, Melissa K. Schaefer, Brynn E. Berger, Ellyn P. Marder, Jea-Young Min, John R. Dunn, Rachel M. Smith, John Dreyzehner, Timothy F. Jones. Fungal Infections Associated with Contaminated Methylprednisolone in Tennessee<\/strong>. New England Journal of Medicine<\/em>, 2012; 367 (23): 2194 DOI: 10.1056\/NEJMoa1212972<\/a><\/p>\n

\u00a0Wikipedia: Apophysomyces<\/em><\/a><\/strong><\/strong><\/p>\n

Apophysomyces<\/em><\/strong> is a filamentous fungus that is commonly found in soil and decaying vegetation<\/strong>. It normally grows in tropical to subtropical regions.[1]<\/p>\n

\u00a0The genus Apophysomyces<\/em> historically was monospecific, with the only species Apophysomyces elegans<\/em>. However, recently were described three new species; Apophysomyces variabilis, Apophysomyces trapeziformis, <\/em>and Apophysomyces ossiformis<\/em><\/p>\n

Normally, no special precautions are needed with regard to this fungus. However, Apophysomyces elegans<\/em> is the cause of the rare infection, known as zygomycosis<\/a>, in humans, which is often fatal.[5][6]<\/p>\n

\u00a0Infection is usually acquired via traumatic implantations associated with soil or decaying vegetable matter (such as from accidental injuries or insect bites).<\/strong> Invasive soft tissue infections can develop on burns or wounds which are contaminated by soil. Unlike other zygomycosis, the affected host is usually otherwise immunocompetent. Apophysomyces elegans<\/em> infections present most commonly as necrotizing fasciitis, osteomyelitis, and angioinvasion.[6][7][8] Systemic[9] and secondary renal and bladder infections[10] have also been (….)<\/p>\n","protected":false},"excerpt":{"rendered":"

El suelo alberga una enorme cantidad de microorganismos, siendo muy pocos de ellos pat\u00f3genos que afecten severamente al ser humano, como hemos venido describiendo en post anteriores. Sin embargo,\u00a0la mala gesti\u00f3n del medio ed\u00e1fico se encuentra causando el auge de enfermedades nosocomiales, como venimos reincidiendo, una y otra vez, en las entregas incluidas en nuestra categor\u00eda los suelos y la salud.\u00a0\u00a0 Bajo circunstancias especiales ciertos microrganismos como el moho Apophysomyces elegans puede llegar a causar la muerte. La noticia de hoy nos informa de varios fallecimientos ocurridos en EE.UU., tras el paso de un tornado que arrastr\u00f3 suelos y materia\u2026<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[596,592],"tags":[47407,46704,47408,20068,20067],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":4}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/posts\/143517"}],"collection":[{"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/users\/26"}],"replies":[{"embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/comments?post=143517"}],"version-history":[{"count":8,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/posts\/143517\/revisions"}],"predecessor-version":[{"id":144713,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/posts\/143517\/revisions\/144713"}],"wp:attachment":[{"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/media?parent=143517"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/categories?post=143517"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/universo\/wp-json\/wp\/v2\/tags?post=143517"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}