Caracterización cualitativa del marketing digital en las micro y pequeñas empresas del sector textil del Valle de Aburrá

Los hallazgos que se presentan en este texto han sido alcanzados en el marco de una investigación cualitativa -- Los datos obtenidos en el transcurso del trabajo de campo se construyeron con testimonios de actores a través de un conjunto de entrevistas en profundidad en tres microempresas y tres empresas pequeñas del sector textil del Valle de Aburrá (Colombia), en las cuales se les preguntó por el uso del mercadeo digital y las cuatro variables que se escogieron para este estudio: presencia en la web, mercadeo de buscadores, publicidad en internet y mercadeo móvil -- En este documento se ofrecen claras imágenes del uso del mercadeo digital en las empresas estudiadas y las prácticas comunes que se encontraron en ella

Brotes de histoplasmosis registrados en el área andina colombiana

A review of 12 histoplasmosis outbreaks that occurred in the Colombian Andean region, are presented. According to their location, 3 were detected in each of the following states: Tolima, Caldas and Antioquia and 1 each in Cundinamarca, Boyacá and Risaralda. In 9 of the outbreaks it was possible to trace the following activities which led to the infection: visits to bat-inhabited caves, removing debris incide a hollowed tree, demolition of an old house, use of contaminated lime for fertilization, handling chickenmanure fettilised soil and the severe pruning of coffee trees. Histoplasma capsulatum var. capsulatum was isolated from environmental samples in 5 of the 8 outbreaks where it was feasible to obtain material for culture and animal inoculation. It was found that 332 persons had been in contact with the various infectious sources, including the 11 index cases (2 outbreaks had the same index case). All of them were studied by means of immunological tests designed to detect antibodies; based on the findings of reactive tests, al1 the index cases and 140 (42%) of those exposed had antibodies indicative of infection by the fungus. The above cases reveal the importance of histoplasmosis in immunocompetent individuals who, for occupational or recreational reasons, are exposed to infectious aerosols generated when disturbing the natural habitat of H. capsulatum var. capsulatum

Identification of Candida species colonizing the lower respiratory tract in patients with respiratory symptoms

ABSTRACT: Colonization of the lower respiratory tract by Candida spp., is considered a prerequisite for the development of Candida infection in patients with risk factors. OBJECTIVE To determine the different Candida species colonizing the lower respiratory tract in patients with respiratory symptoms by bronchoalveolar lavages (BAL) assessment. MATERIALS AND METHODS We conducted a descriptive study, which analyzed 61 BAL samples from patients with respiratory symptoms. BAL samples were cultured on selective media including CHROMagar Candida™, tobacco agar and hypertonic Sabouraud agar; and identification was also performed by sugar assimilation method API 20C AUX®. Additionally, we determined the minimal inhibitory concentration (MIC) for fluconazole and voriconazole. RESULTS In 61 patients studied, we observed that 26 (42.6%) of them were colonized according to the following distribution: C. albicans (36.1%.), C. tropicalis (8.2%), C. krusei (3.3%), C. glabrata (3.3%), C. dubliniensis (4.9%), C. lusitaniae (1.6%) and other Candida species (6.6%). In addition, we found that some patients were colonized by more than one Candida species. Candida krusei and C. glabrata showed a diminished susceptibility or resistance to azoles, whereas C. albicans was 100% sensitive to these antifungals. CONCLUSIONS These results indicate that the frequency of the Candida spp., isolates in BAL from patients with respiratory symptoms is higher than that reported in other studies.RESUMEN: La sobrecolonización del tracto respiratorio inferior por levaduras del género Candida se considera una condición necesaria para el desarrollo de la infección candidiásica en pacientes con factores de riesgo. OBJETIVO Determinar las diferentes especies de Candida que colonizan el tracto respiratorio inferior en pacientes sintomáticos respiratorios, mediante el estudio del lavado broncoalveolar. MATERIALES Y MÉTODOS Se realizó un estudio descriptivo, en el que se analizaron 61 muestras de lavados broncoalveolares (LBA) provenientes de pacientes sintomáticos respiratorios. Las muestras se cultivaron en medios selectivos que inclueyron el CHROMagar Candida™, agar tabaco y agar Sabouraud hipertónico; y se realizó identificación por medio de la técnica de asimilación de azúcares API 20C AUX®. Adicionalmente, se determinó la concentración inhibitoria mínima (CIM) para el fluconazol y voriconazol. voriconazol. RESULTADOS En 61 pacientes estudiados se observó que 26 de ellos (42.6%) estaban colonizados por una o mas especies de Candida de acuerdo con la siguiente distribución: C. albicans (36.1%.), C. tropicalis (8.2%), C. krusei (3.3%), C. glabrata (3.3%), C. dubliniensis (4.9%), C. lusitaniae (1.6%) y otras especies de Candida (6.6%). Adicionalmente, se anotó que algunos de los pacientes estaban colonizados por más de una especie de Candida. C. krusei y C. glabrata presentaron sensibilidad disminuida o resistencia a los azoles, mientras que C. albicans fue 100% sensible a estos antifúngicos. CONCLUSIÓN Los resultados indican que la frecuencia de aislamientos de Candida spp., a partir de lavado broncoalveolar es mayor a lo reportado en otros estudios

Análisis de concordancia de diferentes metodologías para la identificación de aislamientos orales de especies de candida

Background: The yeasts species determination is fundamental not only for an accurate diagnosis but also for establishing a suitable patient treatment. We performed a concordance study of five methodologies for the species identification of oral isolates of Candida in Colombia. Methods: Sixty-seven Candida isolates were tested by; API® 20C-AUX, Vitek®2 Compact, Vitek®MS, Microflex® and a molecular test (panfungal PCR and sequencing). The commercial cost and processing time of the samples was done by graphical analysis. Results: Panfungal PCR differentiated 12 species of Candida, Vitek®MS and Microflex® methods identified 9 species, and API® 20C-AUX and Vitek®2 Compact methods identified 8 species each. Weighted Kappa (wK) showed a high agreement between Panfungal PCR, Vitek®MS, Microflex® and API® 20C-AUX (wK 0.62-0.93). The wK that involved the Vitek®2 Compact method presented moderate or good concordances compared with the other methods (wK 0.56-0.73). Methodologies based on MALDI TOF MS required 4 minutes to generate results and the Microflex® method had the lowest selling price. Conclusion: The methods evaluated showed high concordance in their results, being higher for the molecular methods and the methodologies based on MALDI TOF. The latter are faster and cheaper, presenting as promising alternatives for the routine identification of yeast species of the genus Candida. © 2018. Universidad del Valle

Concordance analysis between different methodologies used for identification of oral isolates of Candida species

Introducción: La clasificación a nivel de especies de las levaduras del género Candida de origen clínico es fundamental para el diagnóstico y la instauración de un adecuado tratamiento para el paciente. Se realizó un estudio de concordancia de cinco metodologías usadas para la identificación de aislamientos orales de Candida spp en Colombia. Métodos: Sesenta y siete aislamientos de Candida spp fueron identificados a nivel de especie utilizando; API® 20 C AUX‚ Vitek® 2 Compact, MALDI TOF (Vitek® MS y Microflex®) y una prueba molecular, PCR Panfungal y secuenciación. Un análisis del costo comercial y tiempo de procesamiento de las muestras por cada método fue realizado mediante el análisis gráfico de ambas variables. Resultados: La PCR Panfungal y secuenciación diferenció 12 especies de Candida ‚ los métodos Vitek® MS y Microflex® identificaron 9 especies y los métodos API® 20 C AUX y Vitek® 2 Compact identificaron 8 especies. El análisis de Kappa ponderado (wK) demostró una concordancia alta entre los métodos PCR Panfungal y secuenciación‚ Vitek® MS‚ Microflex® y API® 20 C AUX‚ concordancias agrupadas en las categorías buena y muy buena (wK 0.62-0.93); los Kp que involucraron el método Vitek® 2 Compact presentaron concordancias moderadas o buenas frente a los otros métodos (wK 0.56-0.73). Las metodologías basadas en MALDI TOF MS requirieron 4 minutos para generar un resultado y el método Microflex® fue el método que en nuestro medio presentó el menor precio de venta del servicio. Conclusión: Los métodos evaluados presentaron una alta concordancia en sus resultados‚ siendo más alta para los métodos moleculares y las metodologías basadas en MALDI TOF MS; estas últimas son metodologías más rápidas, económicas y precisas, las cuales se presentan como alternativas prometedoras para la identificación rutinaria de especies de levaduras del género Candida.Q3Q3Artículo original160-167Background: The yeasts species determination is fundamental not only for an accurate diagnosis but also for establishing a suitable patient treatment. We performed a concordance study of five methodologies for the species identification of oral isolates of Candida in Colombia. Methods: Sixty-seven Candida isolates were tested by; API® 20C-AUX, Vitek®2 Compact, Vitek®MS, Microflex® and a molecular test (panfungal PCR and sequencing). The commercial cost and processing time of the samples was done by graphical analysis. Results: Panfungal PCR differentiated 12 species of Candida, Vitek®MS and Microflex® methods identified 9 species, and API® 20C-AUX and Vitek®2 Compact methods identified 8 species each. Weighted Kappa (wK) showed a high agreement between Panfungal PCR, Vitek®MS, Microflex® and API® 20C-AUX (wK 0.62-0.93). The wK that involved the Vitek®2 Compact method presented moderate or good concordances compared with the other methods (wK 0.56-0.73). Methodologies based on MALDI TOF MS required 4 minutes to generate results and the Microflex® method had the lowest selling price. Conclusion: The methods evaluated showed high concordance in their results, being higher for the molecular methods and the methodologies based on MALDI TOF. The latter are faster and cheaper, presenting as promising alternatives for the routine identification of yeast species of the genus Candida

Whole-genome sequencing to determine origin of multinational outbreak of Sarocladium kiliense bloodstream infections

We used whole-genome sequence typing (WGST) to investigate an outbreak of Sarocladium kiliense bloodstream infections (BSI) associated with receipt of contaminated antinausea medication among oncology patients in Colombia and Chile during 2013-2014. Twenty-five outbreak isolates (18 from patients and 7 from medication vials) and 11 control isolates unrelated to this outbreak were subjected to WGST to elucidate a source of infection. All outbreak isolates were nearly indistinguishable (≤5 single-nucleotide polymorphisms), and >21,000 single-nucleotide polymorphisms were identified from unrelated control isolates, suggesting a point source for this outbreak. S. kiliense has been previously implicated in healthcare-related infections; however, the lack of available typing methods has precluded the ability to substantiate point sources. WGST for outbreak investigation caused by eukaryotic pathogens without reference genomes or existing genotyping methods enables accurate source identification to guide implementation of appropriate control and prevention measures. © 2016, Centers for Disease Control and Prevention (CDC). All rights reserved

In vitro susceptibility testing of Fonsecaea pedrosoi to antifungals

Based on the difficulties experienced in the treatment of chromoblastomycosis, 12 primary human isolates of F. pedrosoi, were tested for their in vitro susceptibility to various antimycotics. We adapted the recommendations of the NCCLS for yeasts and followed the indications for mold testing from other authors in order to determine their MIC’s and the MLC’s. It was found that a significant proportion of the isolates were resistant to 3 of the 4 antimycotics tested, as revealed by high MIC values, as follows: 33% were resistant to amphotericin B (AMB), 58.3% to 5 fluocytosine (5 FC) and 66.7% to fluconazole (FLU). Contrarywise, none of the isolates proved resistant to itraconazole (ITZ). Determination of the MLC’s revealed that a larger proportion of the isolates were not killed by AMB, 5 FC (91.7%), FLU (100%) or even, ITZ (41.7%). These data indicate that it would be desirable to determine the susceptibility of F. pedrosoi before initiating therapy, in order to choose the more effective antifungal and avoid clinical failureTestes de suscetibilidade in vitro de Fonsecaea pedrosoi a antifúngicos Baseados nas dificuldades experimentadas no sucesso do tratamento da cromoblastomicose, 12 isolamentos humanos primários do F. pedrosoi foram examinados para a sua suscetibilidade in vitro aos vários antifúngicos. Nos adaptamos às recomendações da NCCLS feitas para leveduras e, seguimos as indicações para fungos filamentosos testados dadas por outros autores para as determinações dos MIC’s e dos MCLS. Nossos resultados mostraram que uma proporção significativa dos isolados testados foi resistente a três ou quatro dos antifúngicos experimentados, como revelaram os altos valores do MIC; assim, 33% dos isolados foram resistentes à anfotericina-B (AMB) 58,3% à fluorocitosina (5FC) e 66,7% ao fluconazole (FLU); pelo contrário, nenhum dos isolados examinados mostrou-se resistente ao itraconazole (ITZ). As determinações dos MLC revelaram que grande proporção dos isolados não foram mortos nem pela AMB (91,7%) 5FC (91,7%) FLU (100%) ou ainda, pelo ITZ (41,7%). Estes resultados indicam que seria muito desejável determinar a suscetibilidade do F. pedrosoi antes de começar o tratamento, para se poder escolher o antifúngico mais eficaz e evitar falha clínic

Implementation of a training course increased the diagnosis of histoplasmosis in Colombia

Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009-November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program. Copyright © 2015 by The American Society of Tropical Medicine and Hygiene