Vancomycin susceptibility determination through various antimicrobial susceptibility tests in Methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from a tertiary care hospital in Medellín.

ABSTRACT: Vancomycin has been the most effective antibiotic against infections caused by methicillin resistant Staphylococcus aureus (MRSA). To date there are no reports of Intermediate Vancomycin-Intermediate Staphylococcus aureus (VISA) or Vancomycin-Resistant Staphylococcus aureus (VRSA) in Colombia; however there is a high prevalence of MRSA and increased vancomycin use, which are contributing factors to their emergence. Additionally, routine methods used for detection of these strains such as automated and disc diffusion have limitations. OBJECTIVE To evaluate vancomycin susceptibility in a collection of MRSA strains isolated from patients between 2008-2010 in a University hospital of Medellin. MATERIALS AND METHODS 150 MRSA isolates were selected. The vancomycin minimum inhibitory concentration (MIC) was performed by Vitek-2 and Etest. Additionally, vancomycin screen agar plates were employed. RESULTS All of the isolates tested were susceptible to vancomycin, however, differences between the evaluated methods were observed: the 59.3% of the isolates (n = 89) showed an MIC ≤ 1 µg/mL by Etest, whereas by Vitek2, only the 22% (n = 33) of the isolates had this value. CONCLUSIONS We found a significant number of isolates with an MIC ≤ 1 µg/mL, which have been associated with increased risk of treatment failure. These results show the relevance of permanent surveillance of antibiotic resistance, to achieve the establishment of appropriate control strategies. comycin has been the most effective antibiotic against infections caused by methicillin resistant Staphylococcus aureus (MRSA). To date there are no reports of Intermediate Vancomycin-Intermediate Staphylococcus aureus (VISA) or Vancomycin-Resistant Staphylococcus aureus (VRSA) in Colombia; however there is a high prevalence of MRSA and increased vancomycin use, which are contributing factors to their emergence. Additionally, routine methods used for detection of these strains such as automated and disc diffusion have limitations. Key words: Antimicrobial Susceptibility Testing. Methicillin-resistant Staphylococcus aureus (MRSA). Resistance. Vancomycin.RESUMEN: La vancomicina ha sido el antibiótico más eficaz contra las infecciones causadas por Staphylococcus aureus resistente a la meticilina (SARM). En Colombia, hasta la fecha, no se han reportado aislamientos con sensibilidad intermedia o resistentes a vancomicina, no obstante se presenta una prevalencia alta de SAMR y un alto consumo de vancomicina, condiciones que favorecerían su aparición. Adicionalmente, los métodos automatizados y de difusión en disco, empleados de rutina para la detección de estas cepas presentan limitaciones. OBJETIVO Determinar la susceptibilidad a vancomicina en una colección de aislamientos de SARM obtenidos de pacientes durante los años 2008-2010 en un hospital universitario de la ciudad de Medellín. MATERIALES Y MÉTODOS Se seleccionaron 150 aislamientos de SARM en los cuales la susceptibilidad a vancomicina se determinó empleando agar de tamización BHI-vancomicina y la concentración Inhibitoria mínima (CIM) se determinó por Vitek-2 y Etest. RESULTADOS La totalidad de los aislamientos evaluados fueron sensibles a vancomicina. Se observaron diferencias entre los métodos evaluados, 59,3% de los aislamientos (n=89), presentaron una CIM ≤ 1 µg/mL, por Etest, mientras que por Vitek2 solo el 22% (n=33) presentaron este valor. CONCLUSIÓN Se determinó un numero importante de aislamientos con una CIM ≤ 1 µg/mL, las cuales se han asociado con mayor riesgo de falla terapéutica. Estos resultados evidencian la importancia de establecer una vigilancia constante de la resistencia a antibióticos, para lograr el establecimiento de estrategias adecuadas de control. Palabras clave: Pruebas de susceptibilidad antimicrobiana. Staphylococcus aureus meticilino resistente (SARM). Resistencia. Vancomicina

Fenoles totales y actividad antioxidante en hojas de dos especies colombianas del género Meriania (melastomataceae)

Se estudiaron las hojas de las especies Merianiaspeciosa y Meriania nobilis, obteniendoextractos de diferente polaridad, a los que seles realizaron diversas pruebas cualitativas. Sedeterminó el contenido de fenoles totales y seevaluó la actividad captadora de radicales conDPPH (FRS50: capacidad captadora de radicalesque reduce en un 50% al radical DPPH)en microplacas de 96 pozos. Este estudiodeterminó que las dos especies presentan unabuena actividad antioxidante. Los extractosque mayor actividad antioxidante mostraronfueron: butanol con FRS50 de 7,6 ± 0,8 y 23,4± 2,4; acuoso con FRS50 de 28,5 ± 2,9 y 63,0± 2,6 y hexano 2 con FRS50 de 17,0 ± 2,6 y18,2 ± 2,5 mg/L, para las especies M. speciosay M. nobilis respectivamente. Los extractosque presentaron un alto contenido de fenolestotales fueron: metanol 2 con valor de 0,47 ±0,06 y 0,40 ± 0,03 mg equivalentes de ácidogálico (EAG)/g extracto seco (ES) y el extractoacuoso: 0,16 ± 0,06 y 0,12 ± 0,03 mg EAG/gES para las especies M. speciosa y M. nobilisrespectivamente. El extracto butanólico de laespecie M. speciosa mostró la mayor actividadantioxidante con un FRS50 de 7,6 mg/L ± 0,8,este valor es comparable con el valor halladopara la quercetina FRS50: 4,2 mg/L ± 0,4, loque indica que este extracto es promisorioen el contenido de metabolitos secundariosque exhiben actividad antioxidante y parala fabricación de productos agroquímicos,cosméticos y farmacéuticos

Reserva cognitiva e rendimento cognitivo em adultos maiores saudáveis com história de prática musical reglada

Objective: cognitive reserve (CR) is defined as the brain’s ability to tolerate and support neuropathologies before reaching the threshold that gives rise to clinical manifestations. Due to the increase in life expectancy, this concept arises with the purpose of identifying factors that maintain the functionality and independence of the elderly, thus favoring the quality of life in this population group. The objective of this study was to analyze the relationship between the time of exposure to directed musical practice and the cognitive performance of healthy older adults. Methodology: Observational, descriptive study including 11 healthy, older adults with a history of guided musical practice. The Cognitive Reserve questionnaire was applied and neurocognitive performance was evaluated using the K-BIT intellectual capacity test and the NEURONORMA COLOMBIA battery. Results: in people with musical training, cognitive reserve was associated to better performance in tasks of denomination, visuospatial and verbal working memory, focused and alternating attention, phonological verbal fluency and semantic performance. On the other hand, the time of exposure to directed musical practice was associated to better performance in semantic language and favored working memory and in the long term. Conclusions: time of exposure to directed musical practice, age, and educational level favor cognitive reserve in the linguistic and mnemonic domains.Objetivo: la reserva cognitiva (RC) se define como la capacidad cerebral de tolerar y soportar las neuropatologías antes de alcanzar el umbral que da inicio a las manifestaciones clínicas. Debido al aumento de la esperanza de vida, este concepto surge con el propósito de identificar factores que mantengan la funcionalidad e independencia de los adultos mayores, favoreciendo así la calidad de vida en este grupo poblacional. El objetivo de este estudio fue analizar la relación entre el tiempo de exposición a práctica musical dirigida y el rendimiento cognitivo de adultos mayores sanos. Metodología: estudio observacional descriptivo de 11 adultos mayores sanos con historia de práctica musical dirigida. Se aplicó el cuestionario de Reserva Cognitiva, y se evaluó el rendimiento neurocognitivo con el test de capacidad intelectual K-BIT y la batería NEURONORMA COLOMBIA. Resultados: en personas con entrenamiento musical, la reserva cognitiva está relacionada con mejor desempeño en tareas de denominación, memoria de trabajo visoespacial y verbal, atención focalizada y alternante, fluidez verbal fonológica y rendimiento semántico. Por otra parte, el tiempo de exposición a práctica musical dirigida se asoció a mejor desempeño en lenguaje semántico y favorece la memoria de trabajo y a largo plazo. Conclusiones: el tiempo de exposición a la práctica musical dirigida, la edad y el nivel educativo, favorecen la reserva cognitiva en los dominios lingüísticos y mnémicos.Objetivo: a reserva cognitiva (RC) se define como a capacidade cerebral de tolerar e suportar as neuropatologias antes de alcançar o umbral que dá início às manifestações clínicas. Devido ao aumento da esperança de vida, este conceito surge com o propósito de identificar fatores que mantenham a funcionalidade e independência dos adultos maiores, favorecendo assim a qualidade de vida neste grupo populacional. O objetivo deste estudo foi analisar a relação entre o tempo de exposição a prática musical dirigida e o rendimento cognitivo de adultos maiores saudáveis. Metodologia: estudo observacional descritivo de 11 adultos maiores saudáveis com história de prática musical dirigida. Se aplicou o questionário de Reserva Cognitiva, e se avaliou o rendimento neurocognitivo com o teste de capacidade intelectual K-BIT e a bateria NEURONORMA COLÔMBIA. Resultados: em pessoas com treinamento musical, a reserva cognitiva está relacionada com melhor desempenho em tarefas de denominação, memória de trabalho visoespacial e verbal, atenção focalizada e alternante, fluidez verbal fonológica e rendimento semântico. Por outra parte, o tempo de exposição a prática musical dirigida se associou a melhor desempenho em linguagem semântico e favorece a memória de trabalho e a longo prazo. Conclusões: o tempo de exposição à prática musical dirigida, a idade e o nível educativo, favorecem a reserva cognitiva nos domínios linguísticos e mnêmicos

THE IGNORED PANDEMIC OF PUBLIC HEALTH CORRUPTION: A CALL FOR ACTION AMID AND BEYOND SARS-COV-2/COVID-19

Corruption in healthcare is on the rise. When corruption infiltrates global health, causes embezzlement of public health funds, malfunctioning medical equipment, fraudulent or ineffective health services such as expired medicines and fake vaccines that could have life-or-death consequences. A corrupt healthcare system, amid global health crises like the COVID-19 pandemic, when resources are in constraint and trust is in high demand, can lead to devastating, though avoidable, health and economic consequences. It is imperative for policymakers, health experts, patients, caregivers, and global health funders to promptly acknowledge and address corruption in healthcare. The current pandemic generates an emergency and disorder state on health care systems across the globe, especially in low- and middle-income countries, where a weakening of control measures is evident, creating the perfect storm for corruption. This paper builds on existing research to examine processes that support essential stakeholder engagement in anti-corruption efforts. In this context, an extensive review of literature has been conducted by using various databases such as PubMed, Science direct, SCOPUS, Research Gate, and Google Scholar and a total of 45 articles and documents on corruption and COVID-19 were screened and selected by authors independently. To fill the knowledge gaps about the need for actions to be taken during a pandemic like COVID-19, we propose an anti-corruption grassroots movement that focuses on changing the social norms surrounding corruption in healthcare. By pushing forward a practice that normalizes conversations about corruption in everyday health practices and involving more stakeholders in the protection of public health resources, we argue that not only local health systems can become more resilient and resistant to corruption, but also global health initiatives can become more effective and efficient to improve individual and global health

Viruses Previously Identified in Brazil as Belonging to HIV-1 CRF72_BF1 Represent Two Closely Related Circulating Recombinant Forms, One of Which, Designated CRF122_BF1, Is Also Circulating in Spain

Circulating recombinant forms (CRFs) are important components of the HIV-1 pandemic. Those derived from recombination between subtype B and subsubtype F1, with 18 reported, most of them of South American origin, are among the most diverse. In this study, we identified a HIV-1 BF1 recombinant cluster that is expanding in Spain, transmitted mainly via heterosexual contact, which, analyzed in near full-length genomes in four viruses, exhibited a coincident BF1 mosaic structure, with 12 breakpoints, that fully coincided with that of two viruses (10BR_MG003 and 10BR_MG005) from Brazil, previously classified as CRF72_BF1. The three remaining Brazilian viruses (10BR_MG002, 10BR_MG004, and 10BR_MG008) previously identified as CRF72_BF1 exhibited mosaic structures highly similar, but not identical, to that of the Spanish viruses and to 10BR_MG003 and 10BR_MG005, with discrepant subtypes in two short genome segments, located in pol and gp120env. Based on these results, we propose that the five viruses from Brazil previously identified as CRF72_BF1 actually belong to two closely related CRFs, one comprising 10BR_MG002, 10BR_MG004, and 10BR_MG008, which keep their CRF72_BF1 designation, and the other, designated CRF122_BF1, comprising 10BR_MG003, 10BR_MG005, and the viruses of the identified Spanish cluster. Three other BF1 recombinant genomes, two from Brazil and one from Italy, previously identified as unique recombinant forms, were classified as CRF72_BF1. CRF122_BF1, but not CRF72_BF1, was associated with protease L89M substitution, which was reported to contribute to antiretroviral drug resistance. Phylodynamic analyses estimate the emergence of CRF122_BF1 in Brazil around 1987. Given their close phylogenetic relationship and similar structures, the grouping of CRF72_BF1 and CRF122_BF1 in a CRF family is proposed.This work was funded through Acción Estratégica en Salud Intramural (AESI), Instituto de Salud Carlos III, projects “Estudios Sobre Vigilancia Epidemiológica Molecular del VIH-1 en España”, PI16CIII/00033, and “Epidemiología Molecular del VIH-1 en España y su Utilidad Para Investigaciones Biológicas y en Vacunas“, PI19CIII/00042, and through scientific agreement with Consellería de Sanidade, Government of Galicia (MVI 1004/16).S

Antibacterial and cytotoxic bioactivity of marine Actinobacteria from Loreto Bay National Park, Mexico

Production of bioactive compounds is intimately linked to the ecology of the producing organisms. Taking this into account, the objective of this study was to evaluate the bioactive properties of isolated Actinobacteria from sea sediments of a high biodiversity zone; under the hypothesis that the ecological characteristics of this site stimulate the presence of unique and bioactive strains that can be screened for new compounds with antibiotic and anticancer properties. The elected zone was the Loreto Bay National Park in the Gulf of California Mexico, a protected natural area, with high diversity of flora and fauna. The bioactive properties of strains from this area were different to that reported elsewhere. The cytotoxic activity tested by in vitro assays was present in 40% of the tested strains and antibacterial activity in 71% of all evaluated strains. This percentage of active strains resulted unusually high when it was compared to similar studies from other regions of the world. This supports the hypothesis of the influence of ecological characteristics of the area of study on the presence of unique and bioactive Actinobacteria. Thereby, the Actinobacteria community found in Loreto Bay, in the Gulf of California, which presented unusual bioactive properties, represents a potential source for obtaining novel compounds with antibacterial and anticancer activity

Cold ischemia >4 hours increases heart transplantation mortality. An analysis of the Spanish heart transplantation registry

[Abstract] Background. Cold ischemia time (CIT) has been associated to heart transplantation (HT) prognosis. However, there is still uncertainty regarding the CIT cutoff value that might have relevant clinical implications. Methods. We analyzed all adults that received a first HT during the period 2008–2018. CIT was defined as the time between the cross-clamp of the donor aorta and the reperfusion of the heart. Primary outcome was 1-month mortality. Results. We included 2629 patients, mean age was 53.3 ± 12.1 years and 655 (24.9%) were female. Mean CIT was 202 ± 67 min (minimum 20 min, maximum 600 min). One-month mortality per CIT quartile was 9, 12, 13, and 19%. One-year mortality per CIT quartile was 16, 19, 21, and 28%. CIT was an independent predictor of 1-month mortality, but only in the last quartile of CIT >246 min (odds ratio 2.1, 95% confidence interval 1.49–3.08, p < .001). We found no relevant differences in CIT during the study period. However, the impact of CIT in 1-month and 1-year mortality decreased with time (p value for the distribution of ischemic time by year 0.01), particularly during the last 5 years. Conclusions. Although the impact of CIT in HT prognosis seems to be decreasing in the last years, CIT in the last quartile (>246 min) is associated with 1-month and 1-year mortality. Our findings suggest the need to limit HT with CIT > 246 min or to use different myocardial preservation systems if the expected CIT is >4 h

Phylogeny and phylogeography of a recent HIV-1 subtype F outbreak among men who have sex with men in Spain deriving from a cluster with a wide geographic circulation in Western Europe

This work received support from the Dirección General de Farmacia, Ministerio de Sanidad, Servicios Sociales e Igualdad, Government of Spain, grant EC11-272; European Network of Excellence EUROPRISE (Rational Design of HIV Vaccines and Microbicides), grant LSHP-CT-2006-037611; European Research Infrastructures for Poverty Related Diseases (EURIPRED). Seventh Framework Programme: FP7-Capacities-infrastructures-2012-1, grant agreement 312661; Instituto de Salud Carlos III, Subdirección General de Evaluación, and Fondo Europeo de Desarrollo Regional (FEDER), Plan Nacional I + D + I, through project RD12/0017/0026; Consellería de Sanidade, Government of Galicia, Spain (MVI 1291/08); and the Osakidetza-Servicio Vasco de Salud, Basque Country, Spain (MVI-1255-08). Marcos Pérez-Losada was supported by a DC D-CFAR Research Award from the District of Columbia Developmental Center for AIDS Research (P30AI087714) and by an University Facilitating Fund award from George Washington University. Aurora Fernández-García is supported by CIBER in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain.We recently reported the rapid expansion of an HIV-1 subtype F cluster among men who have sex with men (MSM) in the region of Galicia, Northwest Spain. Here we update this outbreak, analyze near full-length genomes, determine phylogenetic relationships, and estimate its origin. For this study, we used sequences of HIV-1 protease-reverse transcriptase and env V3 region, and for 17 samples, near full-length genome sequences were obtained. Phylogenetic analyses were performed via maximum likelihood. Locations and times of most recent common ancestors were estimated using Bayesian inference. Among samples analyzed by us, 100 HIV-1 F1 subsubtype infections of monophyletic origin were diagnosed in Spain, including 88 in Galicia and 12 in four other regions. Most viruses (n = 90) grouped in a subcluster (Galician subcluster), while 7 from Valladolid (Central Spain) grouped in another subcluster. At least 94 individuals were sexually-infected males and at least 71 were MSM. Seventeen near full-length genomes were uniformly of F1 subsubtype. Through similarity searches and phylogenetic analyses, we identified 18 viruses from four other Western European countries [Switzerland (n = 8), Belgium (n = 5), France (n = 3), and United Kingdom (n = 2)] and one from Brazil, from samples collected in 2005?2011, which branched within the subtype F cluster, outside of both Spanish subclusters, most of them corresponding to recently infected individuals. The most probable geographic origin and age of the Galician subcluster was Ferrol, Northwest Galicia, around 2007, while the Western European cluster probably emerged in Switzerland around 2002. In conclusion, a recently expanded HIV-1 subtype F cluster, the largest non-subtype B cluster reported in Western Europe, continues to spread among MSM in Spain; this cluster is part of a larger cluster with a wide geographic circulation in diverse Western European countries.Publisher PDFPeer reviewe

A Single Argonaute Gene Participates in Exogenous and Endogenous RNAi and Controls Cellular Functions in the Basal Fungus Mucor circinelloides

The mechanism of RNAi is well described in metazoans where it plays a role in diverse cellular functions. However, although different classes of endogenous small RNAs (esRNAs) have been identified in fungi, their biological roles are poorly described due, in part, to the lack of phenotype of mutants affected in the biogenesis of these esRNAs. Argonaute proteins are one of the key components of the RNAi pathways, in which different members of this protein family participate in the biogenesis of a wide repertoire of esRNAs molecules. Here we identified three argonaute genes of the fungus Mucor circinelloides and investigated their participation in exogenous and endogenous RNAi. We found that only one of the ago genes, ago-1, is involved in RNAi during vegetative growth and is required for both transgene-induced RNA silencing and the accumulation of distinct classes of esRNAs derived from exons (ex-siRNAs). Classes I and II ex-siRNAs bind to Ago-1 to control mRNA accumulation of the target protein coding genes. Class III ex-siRNAs do not specifically bind to Ago-1, but requires this protein for their production, revealing the complexity of the biogenesis pathways of ex-siRNAs. We also show that ago-1 is involved in the response to environmental signals, since vegetative development and autolysis induced by nutritional stress are affected in ago-1(-) M. circinelloides mutants. Our results demonstrate that a single Ago protein participates in the production of different classes of esRNAs that are generated through different pathways. They also highlight the role of ex-siRNAs in the regulation of endogenous genes in fungi and expand the range of biological functions modulated by RNAi