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Investigación

Special Pathogens

Líneas de investigación

Content with Investigacion Virus del papiloma humano .

A) Effect of vaccination on the prevalence and distribution of Human Papillomavirus (HPV) genotypes. HPV vaccination was introduced in Spain in 2007-2008 for the prevention of cervical cancer and other cancers associated with these viral infections. The use of HPV vaccination is expected to lead to a decrease in vaccine genotypes in the population. However, it may also lead to an increase in other non-vaccine genotypes, similar to the change in vaccine serotypes observed in pneumococcal infections. This requires continuous surveillance of genotype frequency and data to monitor the efficacy of the HPV vaccination program.

B) Study of the distribution and dynamics of HPV infections in risk groups. There are some particularly vulnerable groups, some of them difficult to access (sex workers, transgender groups, etc.), in which HPV infections deserve special attention. The prevalence of HPV infection is especially high in people living with HIV and/or among men who have sex with men. Knowledge of the distribution and dynamics of infections is especially interesting in these groups, as they may help to improve current algorithms for the prevention of anogenital cancer.

C) Study of infection by HPV genotypes and their relationship with progression to neoplastic processes. The oncogenic capacity of some HPV genotypes and their involvement in the production of anogenital cancer is well known. In addition, there are other oncological processes, such as non-melanoma skin cancer, in which HPV could be implicated. Thus, members of the gamma-24 HPV species have recently been associated with skin cancer. It is to be hoped that the appearance of new genotypes and the performance of more extensive studies may lead to the identification of new associations between HPV and neoplastic processes.

D) Study of co-infections by different HPV genotypes. The presence of co-infections of different HPV genotypes is a very frequent finding, both in skin samples and in different mucous membranes. The great genetic diversity of HPV limits the ability of classical molecular methods to perform a comprehensive detection and study of the genotypes present. However, the use of massive sequencing makes it possible to eliminate some of these biases and to obtain more detailed information on the existing HPV populations, as well as to analyze interactions between the different genotypes.

E) Description of new HPV genotypes/variants. Currently at the International HPV Reference Center (Karolinska Institute, Sweden) more than 220 HPV genotypes are described, distributed in 5 different genera. However, improved molecular detection techniques, as well as the use of massive sequencing, are allowing this number to increase rapidly. The study of new genotypes and variants is essential for the validation and quality control of available diagnostic methods. Similarly, their characterization and the study of possible associations of HPV with pathologies other than those already known is a field of great interest for research.

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9: Harvala H, Broberg E, Benschop K, Berginc N, Ladhani S, Susi P, Christiansen C, McKenna J, Allen D, Makiello P, McAllister G, Ca

9: Harvala H, Broberg E, Benschop K, Berginc N, Ladhani S, Susi P, Christiansen C, McKenna J, Allen D, Makiello P, McAllister G, Carmen M, Zakikhany K, Dyrdak R, Nielsen X, Madsen T, Paul J, Moore C, von Eije K, Piralla A, Carlier M, Vanoverschelde L, Poelman R, Anton A, López-Labrador FX, Pellegrinelli L, Keeren K, Maier M, Cassidy H, Derdas S, Savolainen-Kopra C, Diedrich S, Nordbø S, Buesa J, Bailly JL, Baldanti F, MacAdam A, Mirand A, Dudman S, Schuffenecker I, Kadambari S, Neyts J, Griffiths MJ, Richter J, Margaretto C, Govind S, Morley U, Adams O, Krokstad S, Dean J, Pons-Salort M, Prochazka B, Cabrerizo M, Majumdar M, Nebbia G, Wiewel M, Cottrell S, Coyle P, Martin J, Moore C, Midgley S, Horby P, Wolthers K, Simmonds P, Niesters H, Fischer TK. Recommendations for enterovirus diagnostics and characterisation within and beyond Europe. J Clin Virol. 2018 Apr; 101:11-17. doi: 10.1016/j.jcv.2018.01.008. Epub 2018 Feb 6. PMID: 29414181.

Inhibition of LpxC Increases Antibiotic Susceptibility in Acinetobacter baumannii

Inhibition of LpxC Increases Antibiotic Susceptibility in Acinetobacter baumannii. García-Quintanilla M, Caro-Vega JM, Pulido MR, Moreno-Martínez P, Pachón J, McConnell MJ. Antimicrob Agents Chemother. 2016 Jul 22;60(8):5076-9. doi: 10.1128/AAC.00407-16.

PUBMED

New Panfungal Real-Time PCR Assay for Diagnosis of Invasive Fungal Infections.

4. Valero C, de la Cruz-Villar L, Zaragoza O, Buitrago MJ. New Panfungal Real-Time PCR Assay for Diagnosis of Invasive Fungal Infections. J Clin Microbiol. 2016 Dec;54(12):2910-2918. doi: 10.1128/JCM.01580-16. Epub 2016 Sep 14. PMID: 27629898.

DOI

A Multiplex Real-Time PCR Assay for Identification of Pneumocystis jirovecii, Histoplasma capsulatum, and Cryptococcus neoformans/Cryptococcus gattii in Samples from AIDS Patients with Opportunistic Pneumonia

6. Gago S, Esteban C, Valero C, Zaragoza O, Puig de la Bellacasa J, Buitrago MJ. A multiplex real-time PCR assay for identification of Pneumocystis jirovecii, Histoplasma capsulatum, and Cryptococcus neoformans/Cryptococcus gattii in samples from AIDS patients with opportunistic pneumonia. J Clin Microbiol. 2014 Apr;52(4):1168-76. doi: 10.1128/JCM.02895-13. Epub 2014 Jan 29. PMID: 24478409.

PUBMED DOI

Analysis of strain relatedness using High Resolution Melting in a case of recurrent candiduria

7. Gago S, Lorenzo B, Gomez-Lopez A, Cuesta I, Cuenca-Estrella M, Buitrago MJ. Analysis of strain relatedness using high resolution melting in a case of recurrent candiduria. BMC Microbiol. 2013 Jan 23;13:13. doi: 10.1186/1471-2180-13-13. PMID: 23343107.

PUBMED DOI

High-Resolution Melting Analysis for Identification of the Cryptococcus neoformans-Cryptococcus gattii Complex

8. Gago S, Zaragoza Ó, Cuesta I, Rodríguez-Tudela JL, Cuenca-Estrella M, Buitrago MJ. High-resolution melting analysis for identification of the Cryptococcus neoformans-Cryptococcus gattii complex. J Clin Microbiol. 2011 Oct;49(10):3663-6. doi: 10.1128/JCM.01091-11. Epub 2011 Aug 10. PMID: 21832024.

PUBMED DOI

Performance of Panfungal- and Specific-PCR-Based Procedures for Etiological Diagnosis of Invasive Fungal Diseases on Tissue Biopsy Specimens with Proven Infection: a 7-Year Retrospective Analysis from a Reference Laboratory

9. Buitrago MJ, Bernal-Martinez L, Castelli MV, Rodriguez-Tudela JL, Cuenca-Estrella M Performance of panfungal--and specific-PCR-based procedures for etiological diagnosis of invasive fungal diseases on tissue biopsy specimens with proven infection: a 7-year retrospective analysis from a reference laboratory. J Clin Microbiol. 2014 May;52(5):1737-40. doi: 10.1128/JCM.00328-14. Epub 2014 Feb 26.PMID: 24574295.

PUBMED DOI

Epidemiología actual y diagnóstico de laboratorio de las micosis endémicas en España

11. Buitrago MJ, Cuenca-Estrella M. [Current epidemiology and laboratory diagnosis of endemic mycoses in Spain]. Enferm Infecc Microbiol Clin. 2012 Aug;30(7):407-13. doi: 10.1016/j.eimc.2011.09.014. Epub 2011 Nov 29. PMID: 22130575 Review. Spanish.

PUBMED DOI

A matrix-assisted laser desorption/ionization time of flight mass spectrometry reference database for the identification of Histoplasma capsulatum

12. Buitrago MJ, Bernal-Martínez L, Castelli MV, Rodríguez-Tudela JL, Cuenca-Estrella M. Histoplasmosis and paracoccidioidomycosis in a non-endemic area: a review of cases and diagnosis. J Travel Med. 2011 Jan-Feb;18(1):26-33. doi: 10.1111/j.1708-8305.2010.00477.x. Epub 2010 Nov 28. PMID: 21199139.

PUBMED DOI

Copy Number Variation of Mitochondrial DNA Genes in Pneumocystis jirovecii According to the Fungal Load in BAL Specimens

13. Valero C, Buitrago MJ, Gago S, Quiles-Melero I, García-Rodríguez J. A matrix-assisted laser desorption/ionization time of flight mass spectrometry reference database for the identification of Histoplasma capsulatum. Med Mycol. 2018 Apr 1;56 (3):307-314. doi: 10.1093/mmy/myx047. PMID: 28992262.

PUBMED DOI

Copy Number Variation of Mitochondrial DNA Genes in Pneumocystis jirovecii According to the Fungal Load in BAL Specimens

14. Valero C, Buitrago MJ, Gits-Muselli M, Benazra M, Sturny-Leclère A, Hamane S, Guigue N, Bretagne S, Alanio A. Copy Number Variation of Mitochondrial DNA Genes in Pneumocystis jirovecii According to the Fungal Load in BAL Specimens. Front Microbiol. 2016 Sep 12;7:1413. doi: 10.3389/fmicb.2016.01413. eCollection 2016. PMID: 27672381.

PUBMED DOI

Identification of Off-Patent Compounds That Present Antifungal Activity Against the Emerging Fungal Pathogen Candida auris

2: de Oliveira HC, Monteiro MC, Rossi SA, Pemán J, Ruiz-Gaitán A, Mendes- Giannini MJS, Mellado E, Zaragoza O. Identification of Off-Patent Compounds That Present Antifungal Activity Against the Emerging Fungal Pathogen Candida auris. Front Cell Infect Microbiol. 2019 Apr 2;9:83. PMCID: PMC6454888.

PUBMED DOI

Cryptococcus neoformans can form titan-like cells in vitro in response to multiple signals

Trevijano-Contador N, de Oliveira HC, García-Rodas R, Rossi SA, Llorente I, Zaballos Á, Janbon G, Ariño J, Zaragoza Ó. Cryptococcus neoformans can form titan-like cells in vitro in response to multiple signals. PLoS Pathog. 2018 May 18;14(5):e1007007. PMCID: PMC6454888.

PUBMED DOI

Cell Wall Changes in Amphotericin B-Resistant Strains from Candida tropicalis and Relationship with the Immune Responses Elicited by the Host

5: Mesa-Arango AC, Rueda C, Román E, Quintin J, Terrón MC, Luque D, Netea MG, Pla J, Zaragoza O. Cell Wall Changes in Amphotericin B-Resistant Strains from Candida tropicalis and Relationship with the Immune Responses Elicited by the Host. Antimicrob Agents Chemother. 2016 Mar 25;60(4):2326-35. PMCID: PMC4808153.

PUBMED DOI

The production of reactive oxygen species is a universal action mechanism of Amphotericin B against pathogenic yeasts and contributes to the fungicidal effect of this drug

8: Mesa-Arango AC, Trevijano-Contador N, Román E, Sánchez-Fresneda R, Casas C, Herrero E, Argüelles JC, Pla J, Cuenca-Estrella M, Zaragoza O. The production of reactive oxygen species is a universal action mechanism of Amphotericin B against pathogenic yeasts and contributes to the fungicidal effect of this drug. Antimicrob Agents Chemother. 2014 Nov;58(11):6627-38. PMCID: PMC4249417.

PUBMED DOI

Capsule Growth in Cryptococcus neoformans Is Coordinated with Cell Cycle Progression

9: García-Rodas R, Cordero RJ, Trevijano-Contador N, Janbon G, Moyrand F, Casadevall A, Zaragoza O. Capsule growth in Cryptococcus neoformans is coordinated with cell cycle progression. mBio. 2014 Jun 17;5(3):e00945-14. PMCID: PMC4056547.

PUBMED DOI

The interaction between Candida krusei and murine macrophages results in multiple outcomes, including intracellular survival and escape from killing

12: García-Rodas R, González-Camacho F, Rodríguez-Tudela JL, Cuenca-Estrella M, Zaragoza O. The interaction between Candida krusei and murine macrophages results in multiple outcomes, including intracellular survival and escape from killing. Infect Immun. 2011 Jun;79(6):2136-44. PMCID: PMC3125833.

PUBMED DOI

Fungal Cell Gigantism during Mammalian Infection

13: Zaragoza O, García-Rodas R, Nosanchuk JD, Cuenca-Estrella M, Rodríguez- Tudela JL, Casadevall A. Fungal cell gigantism during mammalian infection. PLoS Pathog. 2010 Jun 17;6(6):e1000945. PMCID: PMC2887474.

PUBMED DOI

Human IgM Inhibits the Formation of Titan-Like Cells in Cryptococcus neoformans

14: Trevijano-Contador N, Pianalto KM, Nichols CB, Zaragoza O, Alspaugh JA, Pirofski LA. Human IgM Inhibits the Formation of Titan-Like Cells in Cryptococcus neoformans. Infect Immun. 2020 Mar 23;88(4):e00046-20. PMCID: PMC7093138.

PUBMED DOI

The lymphocyte scavenger receptor CD5 plays a nonredundant role in fungal infection

15: Velasco-de-Andrés M, Català C, Casadó-Llombart S, Simões I, Zaragoza O, Carreras E, Lozano F. The lymphocyte scavenger receptor CD5 plays a nonredundant role in fungal infection. Cell Mol Immunol. 2020 Apr 24.

PUBMED DOI

List of staff

Información adicional

1.- The study of non-gastrointestinal zoonoses, some of them transmitted by vectors and/or emerging, aims to: 

  • The development and validation of new diagnostic and genotyping techniques represent important scientific-technical support to the National Health System, acting as a reference laboratory. 
  • Research on the Molecular Epidemiology of Coxiella burnetii studies the circulating genotypes and their association with the different clinical presentations of Q fever. 
  • Discovery of new pathogens: especially relevant in the case of Francisella with the description of F. hispaniensis, as well as taxonomically unknown variants of Bartonella, Borrelia and Rickettsia, found in reservoirs, vectors and clinical samples. 
  • Surveillance in nature analyzes kinetics, transmission cycles and reservoirs. 

• Genotyping techniques allow traceability studies to be carried out in the case of natural outbreaks or intentional release. • Method accreditation: ISO15189 standard (clinical samples), ISO17025 (environmental). 

2.- The study of bacteria with potential use in bioterrorism through participation in European projects (Joint Actions: QUANDHIP, EMERGE, SHARP) allows us to respond appropriately to possible health alert situations. An important methodological development has been carried out for the detection of these agents and a Rapid Response System has been implemented.

The current director of CNM is Dr. José Miguel Rubio Muñoz.

Dr. José Miguel Rubio has a degree in Biological Sciences from the Universidad Autónoma de Madrid (1986) and a PhD in Biological Sciences from the same university (1992). He carried out his doctoral thesis at the Department of Genetics of the Universidad Autónoma de Madrid, as Associate Professor (1988-1989), and at the School of Biology of the University of East Anglia in Norwich, UK, as Senior Research Assistant (1989-1992).

During his postdoctoral period he obtained a grant from the European Commission within the Human Capital and Mobility Program to be carried out at the University of “La Sapienza” in Rome, Italy and the Institute of Molecular Biology and Biotechnology in Crete, Greece (1993-1994). Subsequently, he made a further stay funded by the WHO and the university itself at the Department of Entomology, Wageningen University, The Netherlands (1994-1996).

Since 1997 he has been a member of the Instituto de Salud Carlos III (ISCIII), where he joined the Department of Parasitology of the National Center of Microbiology, as an EU-INCO postdoctoral fellow and later with a grant from the Autonomous Community of Madrid (CAM). She was part of the founding group of the National Center for Tropical Medicine (2003-2006) and of the 24/7 Alerts and Emergencies Unit (2006-2018) and is currently Head of the Malaria and Emerging Parasitosis Unit of the National Microbiology Center and is part, as research staff, of the Center for Biomedical Research Network on Infectious Diseases (CIBERINFEC/ISCIII).

During his scientific career he has been Visiting Scientist at the Leonidas e Marie Dean Center (FIOCRUZ-AMAZONAS, Manaus, Brazil) and is an External Consultant of the Parasitology Departments of Cairo University (Egypt) and the Medical Research Center (MRC) of Kuala Lumpur (Malaysia).  He also belongs or has belonged to different national and international committees:  Member of the expert group for malaria control of the European Centre for Disease Control (ECDC) since 2011; Expert-Evaluator for health programs of the European Commission since 2004; Spanish Representative (commissioned by ISCIII and MSC) in the Technical Scientific Committee of the TDR (WHO) 2007-2008; Spanish Deputy Focal Point for microbiology at the European Centre for Disease Control (ECDC) from 2012 to 2020; and, member of the Research Ethics Committee of ISCIII until 2019.

In this period he has published more than 100 articles in international indexed journals, 10 book chapters and has been co-editor of two books in the area of malaria, tropical medicine and neglected diseases. He has participated in 58 competitively funded research projects, 20 of them international, having been the principal investigator in 8 national and 11 international projects as PI of the project or WP leader. In addition, he has led five agreements with companies. Currently he has been awarded four sexenios of research, being presented this year 2025 to the fifth. In the teaching field, he participates in different postgraduate programs in the areas of microbiology and parasitology, having directed seven doctoral theses and more than 20 Master's or Degree final projects, both nationally and internationally. ​​​​​

El laboratorio de Referencia e Investigación en Resistencia a Antibióticos ofrece una amplia cartera de servicios al Sistema Nacional de Salud, las cuales pueden solicitarse en cnm-laboratorios.isciii.es. Jefe del Laboratorio: Jesús Oteo Iglesias (Punto focal Nacional de Resistencia antibiótica).

Dispone de dos programas de Vigilancia oficiales y gratuitos que engloban los ensayos ofertados ya sea como aislamientos individuales o mediante estudio de brotes. El Laboratorio utiliza asimismo técnicas de PCR en tiempo real para la detección de genes de resistencia, estas técnicas se han adaptado a un formato multiplex que permite detectar varios genes en la misma reacción. En los últimos años se han incluido metodologías basadas en la secuenciación de genomas completos para el análisis de bacterias multiresistentes (WGS).

Programa de vigilancia de Haemophilus influenzae. Responsables: María Pérez Vázquez (Punto focal Nacional de Haemophilus influenzae) y Belén Aracil. Laboratorio encargado de la identificación, estudio de sensibilidad y análisis genotípico de aislados de Haemophilus influenzae, centrándose esencialmente en la patología invasiva debida este patógeno. 

Programa de vigilancia de Resistencia a Antibióticos. Responsables: María Pérez Vázquez  y Belén Aracil (Punto focal Nacional de Resistencia antibiótica). Laboratorio encargado de la identificación, el estudio de sensibilidad antibiótica, y el diagnóstico fenotípico y genotípico de los diferentes mecanismos de resistencia a antibióticos fundamentalmente en enterobacterias y gram-negativos no fermentadores y Enterococcus spp.

Estudio de brotes. Responsables: Belén Aracil y María Pérez Vázquez. El programa incluye la caracterización de brotes nosocomiales y clones emergentes de alto riesgo mediante diferentes técnicas moleculares (tabla resumen). Éstas, nos permiten realizar estudios filogenéticos con el fin de obtener una información detallada acerca la relación entre los diferentes aislados y su trazabilidad. El objetivo final es generar datos que se transfieren a los hospitales como ayuda para la prevención o control de la propagación del brote.

Acreditación y Calidad. Responsable: Belén Aracil. El laboratorio Referencia e Investigación en Resistencia a Antibióticos ha sido de los primeros en el ISCIII en la utilización de técnicas acreditadas por la Entidad Nacional de Acreditaciones (ENAC). Este laboratorio consiguió la primera acreditación homologada de técnicas diagnósticas en 2012, programa que ha sido ampliado, de manera que en la actualidad más de la mitad de las técnicas ofrecidas al Sistema Nacional de Salud están debidamente acreditadas por ENAC.

Técnicos responsables de las técnicas realizadas en el Laboratorio: Noelia Lara Fuella y Verónica Bautista Sánchez.

En la siguiente imagen se resumen las técnicas ofrecidas al Sistema Nacional de Salud.

PROGRAMAS NOMBRE CARTERA SERVICIO PATÓGENO DETERMINACIÓN, DETECCIÓN, ANÁLISIS MÉTODOS

Programa de vigilancia de Haemophilus

Programa de vigilancia de resistencia a antibióticos.

 Identificación bacteriana

Haemophilus sp.

Enterobacterias, gram-negativos no fermentadores, Enterococcus spp

 Identificación bacteriana

Bioquímicos

MALDI TOF

Secuenciación de RNAr
​ Identificación capsular

Haemophilus influenzae

 

 Identificación capsular fenotípica y genotípica

Aglutinación serológica en latex

PCR ind/multiplex
​ Determinación de Sensibilidad

Haemophilus sp.

Enterobacterias, gram-negativos no fermentadores, Enterococcus

 

 Determinación de Sensibilidad

Microdilución                

Tiras epsilon               

Kirby Bauer
​ Métodos fenotípicos de detección de mecanismos de resistencia

Enterobacterias, gram-negativos no fermentadores,

 

 Métodos fenotípicos de detección de mecanismos de resistencia

Discos y tabletas combinados con inhibidores                

Tiras combinadas     

Test de Hodge modificado

CabaNP                               

Inmunocromatografía CBP
​ Métodos genotípicos de detección de mecanismos de resistencia

Haemophilus sp.

Enterobacterias, gram-negativos no fermentadores, Enterococcus

 

 ADN, PCR y secuenciación

PCR ind/multiplex

Análisis comparativo de las secuencias
​ Tipificación molecular/análisis filogenéticos

Haemophilus sp.

Enterobacterias, gram-negativos no fermentadores, Enterococcus

 

Corte enzimas de restricción, electroforesis

ADN, PCR y secuenciación

Preparación de librerías y secuenciación y análisis de genomas completos

 

PFGE

 

MLST

 

WGS