Determinar la Resistencia Antimicrobiana de las Enterobacterias y el uso de antibióticos en pacientes de UCI de la Clínica D.A.M.E. 2014

Se determinó que la resistencia antimicrobiana de las enterobacterias (productoras de betalactamasas de espectro extendido) en pacientes de UCI de la clínica DAME ubicada en la ciudad de Quito, provincia de Pichincha. Se analizaron 279 muestras biológicas de pacientes de la UCI, donde se aislaron e identificaron los microorganismos causantes, utilizando el sistema Microgen, donde se comprobó la susceptibilidad antibiótica mediante discos de papel impregnados de antibiótico, determinando la sensibilidad por el diámetro del halo cuya lectura viene estandarizada. Se determinó que los principales microorganismos causantes de infecciones nosocomiales en los pacientes de la UCI del centro médico, son las enterobacterias Escherichia coli en un 47.4%, la Klebsiella pneumoniae en un 29.5%, Proteus mirabilis en un 7.7 %, Staphylococcus aureus en un 6.4 %, Enterococcus 6.4% y Pseudomona aeruginosa 2.6%. El 57% de cepas de enterobacterias son multirresistentes, de las cuales la Klebsiella pneumoniae presenta un 74% de multirresistencia, Escherichia coli un 54%, Pseudomona aeruginosa un 50 % y en Proteus mirabilis un 16%. Los antibióticos a los que mayor resistencia presentaron las enterobacterias estudiadas son las cefalosporinas de tercera y cuarta generación y sulfatrimetoprim; la amikacina es el antibiótico frente a la que hay un 89% de sensibilidad. La Multirresistencia está relacionada con el tipo de microorganismo, tipo de antibiótico y el uso de antibioticoterapia previa. Se concluye que la resistencia antimicrobiana de las enterobacterias es un problema significativo, debido principalmente al uso inapropiado de antibióticos que favorece el desarrollo de los diferentes mecanismos de resistencia. Se recomienda realizar cultivo y antibiograma a todos los pacientes con cuadros infecciosos, antes de iniciar con terapia antibiótica.It was determined the antimicrobian resistance in enterobacteria ( productors of beta lactamases of spread spectrum) in patients of UCI (intensive Care Unit) of the DAME clinic (acute diagnostic and specialist) located in Quito city, Pichincha province. Were analyzed 279 biological samples of the UCI patients, were the originator m icroorganisms were identified and isolated, using the Microgen system, were the antibiotic susceptibility was proved through paper discs impregnated of antibiotic, determining the sensibility by the halo diameter whose reading comes standardized . It was de termined that the main microorganisms caused of nosocomial infections in the patients of UCI of medical care center, are the enterobacterias E. coli in 47.4% Klebsiella pneumoniae in 29.5%, Proteus mirabilis in 7.7 %, Staphylococcus aureus in 6.4%, Enteroc occus 6.4 % and Pseudomona aeruginosa 2.6% . The 57% of enterobacterias strains are multiresistant, of which the Klebsiella pneumoniae present 74% of multiresistant, E. coli 54%, Pseudomona aeruginosa 50% and Proteus mirabilis 16%. The antibiotics to the great resistance present the enterobacterias studied are the cephalosporins of third and fourth generation and sulfatrimtroprim; the amikacynis the antibiotic whose has 89% of sensibility. The multiresistance is related with th e type of microorganism, type of antibiotic and the use of previous antibiotic therapy. It was conclude that the antimicrobian resistance of the enterobacterias is a meaningful problem, due to mainly the inappropriate use of antibiotic that promotes develo ping of the different resistance mechanisms. It is recommended to realize culture and antibiogram to all the patients with infections processes, before to start with antibiotic therapy

Peridomestic natural breeding sites of Nyssomyia whitmani (Antunes and Coutinho) in an endemic area of tegumentary leishmaniasis in northeastern Argentina

The scarce information about breeding sites of phlebotomines limits our understanding of the epidemiology of tegumentary leishmaniasis. Identifying the breeding sites and seasons of immature stages of these vectors is essential to propose prevention and control strategies different from those targeting the adult stage. Here we identified the rural breeding environments of immature stages of Ny. whitmani, vector species of Leishmania braziliensis in the north of Misiones province, Argentina; then we determined and compared the environmental and structural characteristics of those sites. We also identified the season of greatest emergence and its relationship with adult abundance. During a first collection period, between 28 and 48 emergence traps were set continuously for 16 months in six environments of the farm peridomicile and domicile: below house, chicken shed, experimental chicken shed, forest edge, pigsty and under fruit tree. Traps were checked and rotated every 40 nights. A total of 146 newly emerged individuals were collected (93.8% of them were Ny. whitmani), totaling an effort of 23,040 emergence trap-nights. The most productive environments were chicken shed and below house, and the greatest emergence was recorded in spring and summer. During a second collection period, emergence traps and light traps for adult cap-ture were placed in the chicken shed and below house environments of eight farms. Emergence traps were active continuously during spring, summer, and early autumn. Environmental and structural characteristics of each environment were recorded. A total of 84 newly emerged phlebotomines (92.9% Ny. whitmani; 72,144 emergence trap-nights) and 13,993 adult phlebotomines (147 light trap-nights) were recorded in the chicken shed and below house environments. A positive correlation was also observed between trap success of newly emerged phlebotomines and of adults after 120 days. A high spatial variability was observed in the emergence of Ny. whitmani, with the number of newly emerged individuals being highest in soils of chicken sheds with the highest number of chickens and closest to forest edge. Moreover, below house was found to be as important as chicken sheds as breeding sites of Ny. whitmani. Management of the number of chickens in sheds, soil mois-ture and pH, and the decision of where to localize the chicken sheds in relation to the houses and the forest edge, might contribute to reduce the risk of human vector exposure and transmission of Leishmania.Fil: Manteca Acosta, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; ArgentinaFil: Cavia, Regino. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Utgés, María Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; ArgentinaFil: Salomón, Oscar Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Medicina Tropical; ArgentinaFil: Santini, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; Argentin

Abundance of Lutzomyia longipalpis and Nyssomyia whitmani, the Leishmania spp. vectors in northeastern of Argentina: Are spatial and temporal changing patterns consistence?

Lutzomyia longipalpis and Nyssomyia whitmani were incriminated as vectors of Leishmania sp. Spatial heterogeneity together with seasonal changes in abundance constitute important elements for the understanding of the dynamics of vector populations, and there are fundamental for the development of adequate prevention and control strategies. The aim of this work was to compare the spatial and seasonal abundance of Lu. longipalpis and Ny. whitmani at a city spatial scale between two periods separated by three years. To study the spatial distribution, we compared the abundance distribution of these species at two warm times, 2011 with 2014. Respect to inter-annual seasonal abundance changes, we compared the four seasons of the year between two periods (2011–2012 vs 2014–2016). The spatial distribution for both species were found to be distributed mainly in the same areas of the city in both periods. We change for: Respect to the seasonal pattern of abundance, we observed that seasonal patterns showed changes between periods. Our study defines the ‘where’ and ‘when’ implement the actions to mitigate leishmaniasis cases.Fil: Santini, Maria Soledad. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán". Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cavia, Regino. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; ArgentinaFil: Quintana, María Gabriela. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Manteca Acosta, Mariana. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Centro Nacional de Diagnóstico e Investigaciones Endemo-epidémicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salomón, Oscar Daniel. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Peridomestic natural breeding sites of Nyssomyia whitmani (Antunes and Coutinho) in an endemic area of tegumentary leishmaniasis in northeastern Argentina

The scarce information about breeding sites of phlebotomines limits our understanding of the epidemiology of tegumentary leishmaniasis. Identifying the breeding sites and seasons of immature stages of these vectors is essential to propose prevention and control strategies different from those targeting the adult stage. Here we identified the rural breeding environments of immature stages of Ny. whitmani, vector species of Leishmania braziliensis in the north of Misiones province, Argentina; then we determined and compared the environmental and structural characteristics of those sites. We also identified the season of greatest emergence and its relationship with adult abundance. During a first collection period, between 28 and 48 emergence traps were set continuously for 16 months in six environments of the farm peridomicile and domicile: below house, chicken shed, experimental chicken shed, forest edge, pigsty and under fruit tree. Traps were checked and rotated every 40 nights. A total of 146 newly emerged individuals were collected (93.8% of them were Ny. whitmani), totaling an effort of 23,040 emergence trap-nights. The most productive environments were chicken shed and below house, and the greatest emergence was recorded in spring and summer. During a second collection period, emergence traps and light traps for adult cap-ture were placed in the chicken shed and below house environments of eight farms. Emergence traps were active continuously during spring, summer, and early autumn. Environmental and structural characteristics of each environment were recorded. A total of 84 newly emerged phlebotomines (92.9% Ny. whitmani; 72,144 emergence trap-nights) and 13,993 adult phlebotomines (147 light trap-nights) were recorded in the chicken shed and below house environments. A positive correlation was also observed between trap success of newly emerged phlebotomines and of adults after 120 days. A high spatial variability was observed in the emergence of Ny. whitmani, with the number of newly emerged individuals being highest in soils of chicken sheds with the highest number of chickens and closest to forest edge. Moreover, below house was found to be as important as chicken sheds as breeding sites of Ny. whitmani. Management of the number of chickens in sheds, soil mois-ture and pH, and the decision of where to localize the chicken sheds in relation to the houses and the forest edge, might contribute to reduce the risk of human vector exposure and transmission of Leishmania.Fil: Manteca Acosta, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; ArgentinaFil: Cavia, Regino. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Utgés, María Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; ArgentinaFil: Salomón, Oscar Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Medicina Tropical; ArgentinaFil: Santini, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación.Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"; Argentin

Lutzomyia longipalpis presence and abundance distribution at different microspatial scales in an urban scenario

The principal objective of this study was to assess a modeling approach to Lu. longipalpis distribution in an urban scenario, discriminating micro-scale landscape variables at microhabitat and macrohabitat scales and the presence from the abundance of the vector. For this objective, we studied vectors and domestic reservoirs and evaluated different environmental variables simultaneously, so we constructed a set of 13 models to account for microhabitats, macro-habitats and mixed-habitats. We captured a total of 853 sandflies, of which 98.35% were Lu. longipalpis.We sampled a total of 197 dogs; 177 of which were associated with households where insects were sampled. Positive rK39 dogs represented 16.75% of the total, of which 47% were asymptomatic. Distance to the border of the city and high to medium density vegetation cover ended to be the explanatory variables, all positive, for the presence of sandflies in the city. All variables in the abundance model ended to be explanatory, trees around the trap, distance to the stream and its quadratic, being the last one the only one with negative coefficient indicating that the maximum abundance was associated with medium values of distance to the stream. The spatial distribution of dogs infected with L. infantum showed a heterogeneous pattern throughout the city; however, we could not confirm an association of the distribution with the variables assessed. In relation to Lu. longipalpis distribution, the strategy to discriminate the micro-spatial scales at which the environmental variables were recorded allowed us to associate presence with macrohabitat variables and abundance with microhabitat and macrohabitat variables. Based on the variables associated with Lu. longipalpis, the model will be validated in other cities and environmental surveillance, and control interventions will be proposed and evaluated in the microscale level and integrated with socio-cultural approaches and programmatic and village (mesoscale) strategies.Fil: Santini, Maria Soledad. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Centro Nacional de Diagnóstico e Investigaciones Endemo-epidémicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Red de Investigación de la Leishmaniasis en Argentina; ArgentinaFil: Utgés, María Eugenia. Red de Investigación de la Leishmaniasis en Argentina; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; ArgentinaFil: Berrozpe, Pablo Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Red de Investigación de la Leishmaniasis en Argentina; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; ArgentinaFil: Manteca Acosta, Mariana. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina. Red de Investigación de la Leishmaniasis en Argentina; ArgentinaFil: Casas, Natalia. Red de Investigación de la Leishmaniasis en Argentina; Argentina. Ministerio de Salud. Programa Nacional de Control de Enfermedades Zoonóticas.; ArgentinaFil: Heuer, Paola. Fundación Héctor A. Barceló. Laboratorio de Control de Vectores Entomológicos de Importancia Sanitaria; ArgentinaFil: Salomón, Oscar Daniel. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Red de Investigación de la Leishmaniasis en Argentina; Argentin

Characterization of Suicide in the Department of Sucre: An Analysis of the News Published in El Meridiano de Sucre Newspaper, Colombia

Objectiv. To analyze the news published in the newspaper El Meridiano de Sucre from 2010 to 2016, related to consummated suicide. Method. 1) the search was limited to a specific period of time: 2010 - 2016; 2) the information provided by the newspaper articles was classified taking into account: the date of the event, the place, the age, the sex, the modality and the reason; 3) all information was introduced for analysis into the Statistical Package for Social Science (SPSS v.21). Results. An increase in suicide rate was found between 2015 and 2016. Among the most frequent reasons for committing suicide are: depression, family, health and economic problems. Conclusions. Both in Sincelejo and in rural area, the most frequent type of suicidal act in men and women is hanging, and the most frequent reason: “depression”.Objetivo. Analizar las noticias publicadas sobre suicidio consumado en el Periódico El Meridiano de Sucre del 2010 al 2016. Método. 1) la búsqueda se acotó a un tiempo específico (2010 – 2016); 2) se clasificó la información proporcionada por los artículos de periódico teniendo en cuenta: la fecha del acontecimiento, el lugar, la edad, el sexo, la modalidad y el motivo; 3) se introdujo toda la información al paquete estadístico Statistical Package for Social Science (SPSS v.21) para su análisis. Resultados. Se halló un aumento de las cifras del suicidio en los años 2015 y 2016. Entre los motivos más frecuentes para cometer el acto suicida se encuentran: depresión, problemas familiares, problemas de salud y problemas económicos. Conclusiones. Tanto en Sincelejo como en la zona rural sucreña, la modalidad de acto suicida más frecuente en hombres y mujeres es el ahorcamiento, y el motivo más frecuente: “la depresión”.Objetivo. Analisar as notícias publicadas sobre o suicídio consumado no jornal El Meridiano, de Sucre, de 2010 a 2016. Método. 1) a busca foi limitada a um horário específico (2010 - 2016); 2) as informações fornecidas pelos artigos de jornal foram classificadas levando-se em conta: a data do evento, o local, a idade, o sexo, a modalidade e a razão; 3) todas as informações foram introduzidas no pacote estatístico Statistical Package for Social Science (SPSS v.21) para análise. Resultados. Um aumento nos números de suicídio foi encontrado em 2015 e 2016. Entre os motivos mais frequentes para cometer o ato suicida estão: depressão, problemas familiares, problemas de saúde e problemas econômicos. Conclusões. Tanto em Sincelejo como em Sucreña rural, o tipo mais frequente do ato suicida em homens e mulheres está suspendendo, e a razão mais frequente: “a depressão”

Ideación suicida infanto-juvenil en Sucre: Una comparación entre niños y adolescentes con y sin vivencia de hechos victimizantes en su familia

Objective: 1) To determine the presence of suicidal ideation in children and adolescents in Sincelejo (Sucre, Colombia), considering age and sex and 2) To compare the presence of suicidal ideation in children and adolescents who have experienced a victimizing event with those who have not. Method: Quantitative approach, descriptive-comparative and cross-sectional. 1704 children and adolescents participated in the current study, most of the participants were female (n = 1016 girls; 59.6%). Results: A higher percentage of children and young people presented suicidal ideation between the ages of nine and fifteen, however, the cases decreased from 16 years of age onwards. Compared with children and adolescents who did not experience victimizing events in their family, a higher percentage of children and adolescents who experienced victimizing events in their family showed suicide ideation or planned to commit suicide almost all the time (p = .30). Children and young people with experiences of threat (p = .01), murder of loved ones (p =. 03) and kidnapping in the family (p =. 13) have generally thought or planned to commit suicide in a higher percentage than those without victimizing experiences. Conclusions: The current research contributes to the study of suicidal behaviour in Colombia, its definition and associated risk factors in the child and adolescent population who have lived and who have not experienced victimizing events in the framework of the armed conflict in Colombia.Objetivo: 1) Determinar la presencia de hechos victimizantes y de ideación suicida infanto-juvenil en Sincelejo (Sucre, Colombia), teniendo en cuenta la edad y el sexo y 2) Comparar la presencia de ideación suicida en niños y adolescentes que han vivido algún hecho victimizante con aquellos que no. Método: Enfoque cuantitativo, de tipo descriptivo-comparativo y de corte transversal. Participaron 1704 niños y adolescentes, la mayoría de los participantes fueron de sexo femenino (n= 1016 niñas; 59.6%). Resultados: Entre los nueve y los quince años un mayor porcentaje de niños y jóvenes presentaron ideación suicida, sin embargo, los casos disminuyeron de los 16 años en adelante. En comparación con los niños y adolescentes, que no vivieron hechos victimizantes, aquellos que sí los padecieron, en un más alto porcentaje, pensaron o planearon suicidarse casi todo el tiempo (p= 0.30). Los niños y jóvenes cuyas familias padecieron amenazas (p= 0.01), asesinato de seres queridos (p= 0.03) y secuestro de algún miembro de la familia (p= 0.13), generalmente, han pensado o planeado suicidarse en un mayor porcentaje que aquellos que no vivieron hechos victimizantes. Conclusiones: Esta investigación permite contribuir al estudio de la conducta suicida, su presencia en niños y adolescentes sucreños, y factores de riesgo de la población infantil y adolescente que ha vivido y no ha vivido hechos victimizantes en el marco del conflicto armado en Colombia. Palabras clave: Ideación suicida, niños, adolescentes, conflicto armado, hechos victimizantes

Ritos funerarios y experiencias de duelo en el pasado y durante la pandemia por COVID-19

Debido a las normas de bioseguridad, la pandemia del COVID-19 ha cambiado la manera en que los familiares y amigos asumen el duelo por la muerte de un ser querido, independientemente de la causa de la muerte. El objetivo del estudio fue describir la manifestación de ritos funerarios y experiencias de duelo en el pasado y durante la pandemia por COVID-19 en Sincelejo (Sucre, Colombia). La investigación es de enfoque cualitativo, de alcance descriptivo; se toma la teoría fundamentada como método cualitativo de análisis de datos, con la intención de interpretar los significados desde la realidad social de los individuos. El análisis de los datos se realizó con el programa ATLAS.Ti. Se concluye que los ritos funerarios han cambiado a lo largo del tiempo en el municipio de Sincelejo; sin embargo, debido a la pandemia, estos cambios se han acelerado aún más y han provocado nuevas formas de asumir el duelo: el duelo se vive sin el cuerpo y sin la mirada de los otros

A canine leishmaniasis pilot survey in an emerging focus of visceral leishmaniasis: Posadas (Misiones, Argentina)

<p>Abstract</p> <p>Background</p> <p>An increasing number of reports are calling our attention to the worldwide spread of leishmaniasis. The urbanization of zoonotic visceral leishmaniasis (VL) has been observed in different South American countries, due to changes in demographic and ecological factors. In May 2006, VL was detected for the first time in the city of Posadas (Misiones, Argentina). This event encouraged us to conduct a clinical and parasitological pilot survey on domestic dogs from Posadas to identify their potential role as reservoirs for the disease.</p> <p>Methods</p> <p>One hundred and ten dogs from the city of Posadas were included in the study. They were selected based on convenience and availability. All dogs underwent clinical examination. Symptomatology related to canine leishmaniasis was recorded, and peripheral blood and lymph node aspirates were collected. Anti-<it>Leishmania </it>antibodies were detected using rK39-immunocromatographic tests and IFAT. Parasite detection was based on peripheral blood and lymph node aspirate PCR targeting the <it>SSUrRNA </it>gene. Molecular typing was addressed by DNA sequence analysis of the PCR products obtained by <it>SSUrRNA </it>and ITS-1 PCR.</p> <p>Results</p> <p>According to clinical examination, 69.1% (76/110) of the dogs presented symptoms compatible with canine leishmaniasis. Serological analyses were positive for 43.6% (48/110) of the dogs and parasite DNA was detected in 47.3% (52/110). A total of 63 dogs (57.3%) were positive by serology and/or PCR. Molecular typing identified <it>Leishmania infantum </it>(syn. <it>Leishmania chagasi</it>) as the causative agent.</p> <p>Conclusions</p> <p>This work confirms recent findings which revealed the presence of <it>Lutzomyia longipalpis</it>, the vector of <it>L. infantum </it>in this area of South America. This new VL focus could be well established, and further work is needed to ascertain its magnitude and to prevent further human VL cases.</p