Papers by Amparo Fernandez
Forensic Science International, 2003
The interpretation of the level of strontium (Sr) in blood has been demonstrated to be useful in ... more The interpretation of the level of strontium (Sr) in blood has been demonstrated to be useful in the diagnosis of death by drowning occurred in sea water, but its use in fresh water drownings is not so evident because of the low Sr concentration present in most of fresh water media. In this paper, we show a survey of the results obtained in the casework analysis of Sr in ventricular blood used in the diagnosis of drowning in 144 bodies found immersed in fresh water over a period of 10 years. Thirty-two percent of the immersion cases examined could be diagnosed as drownings with a reasonable degree of confidence. It is thought that this percentage of positive diagnoses could be largely improved in the case of blood samples taken a few hours after death.
Croatian medical journal, 2001
To evaluate the performance of three multiplex short tandem repeat (STR) systems (AmpflSTR Profil... more To evaluate the performance of three multiplex short tandem repeat (STR) systems (AmpflSTR Profiler, AmpflSTR Profiler Plus, and AmpflSTR COfiler), and a megaplex STR system (PowerPlex 16) on DNA extracted from the skeletal remains. By performing a microbial DNA challenge study, we also evaluated the influence of microbial DNA on human DNA typing. A subset of 86 DNA extracts isolated from 8-50 years old bone and teeth samples, corresponding to 20 identification cases from mass graves in Croatia and Bosnia and Herzegovina, and to 4 paternity cases involving deceased parents in Spain, were analyzed by the above systems. Bone samples with no detectable human DNA (tested with Quantiblot), as well as teeth samples with detectable human DNA, were successfully amplified. Surprisingly, even in highly degraded samples, PowerPlex 16 offered very robust amplification for the both Penta E and Penta D markers. We observed a few non-specific extra peaks of 202 and 308 base pairs, which appeared t...
Diagnostic Microbiology and Infectious Disease, 2008
Accurate identification of meningococcal sudden deaths is needed to avoid underestimation of the ... more Accurate identification of meningococcal sudden deaths is needed to avoid underestimation of the true incidence of the disease. This study analyzed the usefulness of a real-time polymerase chain reaction (PCR) protocol using MGB (3′-minor groove binder) probes to detect Neisseria meningitidis in formalin-fixed paraffin-embedded tissues from sudden deaths where a meningococcal fulminating infection was suspected. The protocol included detection of
Enfermedades Infecciosas y Microbiología Clínica, 2014
Croatian medical journal, 2005
In cases of mass disaster, there is often a need for managing, analyzing, and comparing large num... more In cases of mass disaster, there is often a need for managing, analyzing, and comparing large numbers of biological samples and DNA profiles. This requires the use of laboratory information management systems for large-scale sample logging and tracking, coupled with bioinformatic tools for DNA database searching according to different matching algorithms, and for the evaluation of the significance of each match by likelihood ratio calculations. There are many different interrelated factors and circumstances involved in each specific mass disaster scenario that may challenge the final DNA identification goal, such as: the number of victims, the mechanisms of body destruction, the extent of body fragmentation, the rate of DNA degradation, the body accessibility for sample collection, or the type of DNA reference samples availability. In this paper, we examine the different steps of the DNA identification analysis (DNA sampling, DNA analysis and technology, DNA database searching, and ...
Revista Española de Salud Pública, 2008
Las infecciones por estreptococo betahemolítico grupo A (EGA) sólo excepcionalmente son agresivas... more Las infecciones por estreptococo betahemolítico grupo A (EGA) sólo excepcionalmente son agresivas y con letalidad alta. Más infrecuente aún es la ocurrencia de un brote. El objetivo de este estudio es la descrpción de un brote epidémico por estreptococo beta-hemolítico grupo A en una guardería de Cantabria. Métodos: Estudio descriptivo de un brote de síndrome de shock tóxico estreptocócico (3 casos, uno letal) en una guardería, que motivó una intervención de salud pública con quimioprofilaxis, cierre de la guardería y estudio de los contactos. Se analizan los determinantes de la infección en los casos invasivos y no invasivos, y los resultados de los cultivos faríngeos de los contactos. Resultados: Se identificaron 3 casos invasivos y 14 no invasivos entre los 40 niños de la guardería (tasa de ataque 42,5%). Se estudiaron 19 posibles determinantes de la infección, asociándose sólo la edad mayor de 24 meses y la asistencia al aula de fichas (la de los niños más mayores). No se asoció a la varicela. Se investigaron microbiológicamente todos los niños de la guardería y su personal (4 cuidadoras) y 258 personas de contacto. En 12 de los niños se aisló el estreptococo emm 4, incluyendo 2 de los 3 casos con enfermedad invasiva. En 13 de los 258 contactos se aislaron otras cepas de estreptococo, pero en ninguno la causante del brote. Se hizo quimioprofilaxis con azitromicina a todos los niños y contactos, y a los positivos se les repitió el tratamiento hasta su negativización. Conclusiones: La cepa invasiva circuló sólo en la guardería. La quimioprofilaxis erradicó efectivamente la infección.
Pediatric Infectious Disease Journal, 2008
ABSTRACT Most cases of invasive group A streptococcal (GAS) disease arise sporadically in the com... more ABSTRACT Most cases of invasive group A streptococcal (GAS) disease arise sporadically in the community, but outbreaks of severe invasive GAS infections have been reported in closed environments, such as military populations, family communities and hospitals. An outbreak of invasive GAS disease involving 3 cases of streptococcal toxic shock syndrome (TSS), one with a fatal course, occurred among children attending a day-care center located in Cantabria, Northern Spain. To determine the characteristics of GAS isolates obtained from the outbreak environment. GAS isolates obtained from children attending the same day-care facility, staff members, and family contacts were assayed for emm typing, pulse-field gel electrophoresis (PFGE), and toxin-gene content. One isolate obtained from the fatal case was also characterized by multilocus sequence typing. Antimicrobial susceptibility testing was done. Strains from patients unrelated to the outbreak were included for comparison. All GAS isolates from children attending the day-care center, including those from streptococcal TSS cases, shared the same emm type 4, genomic pattern by PFGE (A) and toxin-gene profile. Neither the emm type nor the PFGE pattern or toxin gene profile of the outbreak-associated strains were encountered among GAS isolated from household or staff contacts. A clone of GAS belonging to emm type 4 and characterized by a specific PFGE pattern and toxin-gene profile was responsible for a community outbreak of streptococcal TSS disease in a child day-care center in Spain. This is the first day-care outbreak reported in our country.
International Journal of Antimicrobial Agents, 2007
Forensic Science International, 2012
Forensic Science International, 2006
Infections are considered to be an important cause of unexpected death in children. It has also b... more Infections are considered to be an important cause of unexpected death in children. It has also been assumed that respiratory viruses are involved in the genesis of sudden infant death syndrome (SIDS). The Spanish National Institute of Toxicology and Forensic Sciences act as the forensic reference centre for Spain. We analyse the experience of this centre in the virological study of 64 cases of sudden children death where viral serology, virological cultures, herpesviruses polymerase chain reaction (PCR) and electron microscopy were performed. According to pathological findings, death could only be attributed to an adenovirus infection in one amygdalitis with upper airways stenosis and asphyxia. Human herpes virus 6 (HHV-6) was detected by PCR in one case with pathological findings characteristic of SIDS. Recent infection by respiratory syncytial virus (RSV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were also detected. Meanwhile, 85.9% of the cases yielded negative viral results. Twenty-eight infants were finally categorised as SIDS. Pathological findings of infection were detected in 12 patients despite the negativity of viral analyses. Although viral infection is an uncommon cause of sudden children death, a complete microbiological investigation will help to solve the puzzle of SIDS. Definitive guidelines for microbiological analyses need to be updated whilst new pathogens are discovered or new techniques are implemented in order to clarify unsolved cases.
Forensic Science International, 2008
The role of viruses in the context of sudden infant death in early childhood is still unclear, al... more The role of viruses in the context of sudden infant death in early childhood is still unclear, although there are many findings pointing to a viral infection possibly leading to death. To analyse the prevalence and viral loads of human herpesvirus-6 (HHV-6), Epstein-Barr virus (EBV), and cytomegalovirus (CMV), three viruses that have been previously detected in some cases of sudden death in infants, in tissues from sudden infant death syndrome (SIDS) patients and controls. Thirty-nine formalin-fixed paraffin-embedded tissue sections of eleven consecutive cases of SIDS, and thirty-nine formalin-fixed paraffin-embedded tissue sections of nine control cases were analysed by a specific quantitative real-time PCR for the detection of HHV-6, EBV, and CMV. The comparison of the whole viral DNA prevalence in cases and tissue sections between SIDS and controls showed a statistical significance (72.7% vs. 22.2%, p=0.025; 41.1% vs. 10.3%, p=0.001, respectively); in particular, we found a statistical significant difference for the EBV DNA prevalence among cases (p=0.042) and tissues (p=0.048), and a statistical significant difference for the HHV-6 DNA prevalence among cases (p=0.017). This is one of the first studies using quantitative real-time PCR for virus detection in cases of SIDS, and the results suggest that some herpesvirus infections, and particularly those caused by EBV and HHV-6 could be related with some cases of SIDS. Further studies will be necessary to understand the real significance of these findings in the context of SIDS.
Enfermedades Infecciosas y Microbiología Clínica, 2013
Post-mortem microbiology is useful in both clinical and forensic autopsies, and allows a suspecte... more Post-mortem microbiology is useful in both clinical and forensic autopsies, and allows a suspected infection to be confirmed. Indeed, it is routinely applied to donor studies in the clinical setting, as well as in sudden and unexpected death in the forensic field. Implementation of specific sampling techniques in autopsy can minimize the possibility of contamination, making interpretation of the results easier. Specific interpretation criteria for post-mortem cultures, the use of molecular diagnosis, and its fusion with molecular biology and histopathology have led to post-mortem microbiology playing a major role in autopsy. Multidisciplinary work involving microbiologists, pathologists, and forensic physicians will help to improve the achievements of post-mortem microbiology, prevent infectious diseases, and contribute to a healthier population.
BJU International, 2009
We report a TaqMan® real-time polymerase chain reaction (PCR) protocol for diagnosing cryptococco... more We report a TaqMan® real-time polymerase chain reaction (PCR) protocol for diagnosing cryptococcosis. Specificity was tested with 33 fungal strains. The 7 clinical samples found positive by culture also tested positive by real-time PCR. No false negatives were found among the 94 clinical samples that were negative by culture for Cryptococcus spp. The sensitivity threshold was about 10 plasmid copies per assay. Crown
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Papers by Amparo Fernandez