Antibiotic resistance and associated resistance determinants in different Salmonella enterica serovars isolated from pigs in Argentina

Background and Aim: Salmonellosis is one of the most common foodborne diseases in the world, and the increasing antibiotic resistance in Salmonella enterica subsp. enterica recovered from food animals constitutes an important risk from a One Health approach. This study aimed to characterize antibiotic resistance and some of its associated resistance determinants in different S. enterica serovars isolated from pigs in Argentina. Materials and Methods: A retrospective study was conducted on Salmonella strains isolated between 2011 and 2015 from pigs in the Pampean region of Argentina. The antimicrobial susceptibility patterns to 21 antimicrobials and some antibiotic resistance determinants were characterized in 55 Salmonella isolates, representing 58 farms. Results: We identified 56% (n=30) of the strains as multidrug-resistant, where resistance to tetracycline (62%, n=34), ampicillin (53%, n=29), nalidixic acid (53%, n=29), chloramphenicol (33%, n=18), and trimethoprim-sulfamethoxazole (31%, n=17) was most common. The wide range of resistance to ampicillin correlates with the presence of TEM type β-lactamases in the strains. However, high susceptibility was found in the new generation of β-lactams. Fluoroquinolone resistance is a major concern. Most strains with decreased susceptibility to ciprofloxacin showed gyrA mutations and plasmid-mediated quinolone resistance gene qnrB. Conclusion: Here, we identified broad resistance to some antibiotics frequently used in human therapeutics and several easily transferable resistance mechanisms that could endanger public health.Fil: Parada, Julian. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Río Cuarto. Facultad de Agronomía y Veterinaria; ArgentinaFil: Galas, Marcelo Fabián. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Área de Antimicrobianos; Argentina. Pan American Health Organization. Communicable Diseases and Environmental Determinants of Health. Antimicrobial Resistance Special Program; Estados UnidosFil: Faccone, Diego Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Área de Antimicrobianos; ArgentinaFil: Tamiozzo, Pablo Jesus. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Río Cuarto. Facultad de Agronomía y Veterinaria; ArgentinaFil: Carranza, Alicia. Universidad Nacional de Río Cuarto. Facultad de Agronomía y Veterinaria; Argentin

Clinical recommendations for postoperative care after heart transplantation in children: 21 years of a single-center experience

Heart transplantation is an option for children with complex congenital heart disease and cardiomyopathies. A patient's quality of life and long-term survival depend on successful management of the surgical complications and adverse side effects of immunosuppression. The purpose of this review was to summarize the practical management of postoperative care in this patient population and to make recommendations for the future

Differential distribution of plasmid-mediated quinolone resistance genes in clinical enterobacteria with unusual phenotypes of quinolone susceptibility from Argentina

We studied a collection of 105 clinical enterobacteria with unusual phenotypes of quinolone susceptibility to analyze the occurrence of plasmid-mediated quinolone resistance (PMQR) and oqx genes and their implications for quinolone susceptibility. The oqxA and oqxB genes were found in 31/34 (91%) Klebsiella pneumoniae and 1/3 Klebsiella oxytoca isolates. However, the oqxA- and oqxB-harboring isolates lacking other known quinolone resistance determinants showed wide ranges of susceptibility to nalidixic acid and ciprofloxacin. Sixty of the 105 isolates (57%) harbored at least one PMQR gene [qnrB19, qnrB10, qnrB2, qnrB1, qnrS1, or aac(6′)-Ib-cr)], belong to 8 enterobacterial species, and were disseminated throughout the country, and most of them were categorized as susceptible by the current clinical quinolone susceptibility breakpoints. We developed a disk diffusion-based method to improve the phenotypic detection of aac(6′)-Ib-cr. The most common PMQR genes in our collection [qnrB19, qnrB10, and aac(6′)-Ib-cr] were differentially distributed among enterobacterial species, and two different epidemiological settings were evident. First, the species associated with community-acquired infections (Salmonella spp. and Escherichia coli) mainly harbored qnrB19 (a unique PMQR gene) located in small ColE1-type plasmids that might constitute its natural reservoirs. qnrB19 was not associated with an extended-spectrum β-lactamase phenotype. Second, the species associated with hospital-acquired infections (Enterobacter spp., Klebsiella spp., and Serratia marcescens) mainly harbored qnrB10 in ISCR1-containing class 1 integrons that may also have aac(6′)-Ib-cr as a cassette within the variable region. These two PMQR genes were strongly associated with an extended-spectrum β-lactamase phenotype. Therefore, this differential distribution of PMQR genes is strongly influenced by their linkage or lack of linkage to integrons.Fil: Andrés, Patricia. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Lucero, Celeste. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Soler Bistue, Alfonso Jc. Fundación Instituto Leloir; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Guerriero, Leonor. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Albornoz, Ezequiel Pablo. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Tran, Tung. California State University; Estados UnidosFil: Zorreguieta, Ángeles. Fundación Instituto Leloir; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: PMQR Group. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Galas, Marcelo Fabián. Dirección Nacional de Instituto de Investigación. Adm.nacional de Laboratorio E Instituto de Salud "dr.c.g.malbran". Instituto Nacional de Enfermedades Infecciosas. Departamento de Bacteriologia; ArgentinaFil: Corso, Alejandra. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Tolmasky, Marcelo. California State University; Estados UnidosFil: Petroni, Alejandro. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; Argentin

Peptidome profiling for the immunological stratification in sepsis: a proof of concept study

Sepsis has been called the graveyard of pharmaceutical companies due to the numerous failed clinical trials. The lack of tools to monitor the immunological status in sepsis constrains the development of therapies. Here, we evaluated a test based on whole plasma peptidome acquired by MALDI-TOF-mass spectrometer and machine-learning algorithms to discriminate two lipopolysaccharide-(LPS) induced murine models emulating the pro- and anti-inflammatory/immunosuppression environments that can be found during sepsis. The LPS group was inoculated with a single high dose of LPS and the IS group was subjected to increasing doses of LPS, to induce proinflammatory and anti-inflammatory/immunosuppression profiles respectively. The LPS group showed leukopenia and higher levels of cytokines and tissue damage markers, and the IS group showed neutrophilia, lymphopenia and decreased humoral response. Principal component analysis of the plasma peptidomes formed discrete clusters that mostly coincided with the experimental groups. In addition, machine-learning algorithms discriminated the different experimental groups with a sensitivity of 95.7% and specificity of 90.9%. Data reveal the potential of plasma fingerprints analysis by MALDI-TOF-mass spectrometry as a simple, speedy and readily transferrable method for sepsis patient stratification that would contribute to therapeutic decision-making based on their immunological status.Fil: Ledesma, Martin Manuel. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Todero, Maria Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Maceira, Lautaro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Prieto, Monica. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas; Argentina. Administración Nacional de Laboratorio e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Epidemiologia. Departamento de Investigación; ArgentinaFil: Vay, Carlos. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; ArgentinaFil: Galas, Marcelo Fabián. Organización Panamericana de la Salud; Estados UnidosFil: López, Beatriz. Administración Nacional de Laboratorio e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Epidemiologia. Departamento de Investigación; ArgentinaFil: Yokobori, Noemí. Administración Nacional de Laboratorio e Institutos de Salud "Dr. Carlos G. Malbrán". Instituto Nacional de Epidemiologia. Departamento de Investigación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rearte, María Bárbara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentin

Antimicrobial susceptibility testing in clinically relevant non-fermenting gram-negative bacilli: recommendations from the Antimicrobial Agents Subcommittee of the Sociedad Argentina de Bacteriología, Micología y Parasitología Clínicas, Asociación Argentina de Microbiología

En este documento se dan a conocer una serie de recomendaciones para el ensayo, la lectura, la interpretación y el informe de las pruebas de sensibilidad a los antimicrobianos para los bacilos gram negativos no fermentadores (BGNNF) que se aíslan en humanos. Se adoptaron como base las recomendaciones internacionales, las de la Subcomisión de Antimicrobianos de la Sociedad Argentina de Bacteriología, Micología y Parasitología Clínicas y las de un grupo de expertos invitados. Se incluye, además, la nomenclatura actualizada de los BGNNF y la descripción de algunas de sus características individuales, de sus resistencias naturales o habituales a los antimicrobianos de uso clínico y de los mecanismos responsables de tales resistencias. También se indican los agentes antimicrobianos que se deberían ensayar frente a las distintas especies, con la especificación de cuáles deberían ser informados, y su ubicación estratégica en las placas de cultivo para poder detectar los mecanismos de resistencia más frecuentes y relevantes. Por último, se detallan los métodos de detección y de confirmación fenotípica de la presencia de b-lactamasas emergentes en Argentina, como las carbapenemasas clases A y B.This document contains the recommendations for antimicrobial susceptibility testing of the clinically relevant non-fermenting gram-negative bacilli (NFGNB), adopted after conforming those from international committees to the experience of the Antimicrobial Agents Subcommittee members and invited experts. This document includes an update on NFGNB classification and description, as well as some specific descriptions regarding natural or frequent antimicrobial resistance and a brief account of associated resistance mechanisms. These recommendations not only suggest the antimicrobial drugs to be evaluated in each case, but also provide an optimization of the disk diffusion layout and a selection of results to be reported. Finally, this document also includes a summary of the different methodological approaches that may be used for detection and confirmation of emerging b-lactamases, such as class A and B carbapenemases.Fil: Radice, Marcela Alejandra. Asociación Argentina de Microbiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Marin, Marcelo. Asociación Argentina de Microbiología; ArgentinaFil: Giovanakis, Marta. Asociación Argentina de Microbiología; ArgentinaFil: Vay, Carlos.Fil: Almuzara, Marisa.Fil: Limansky, Adriana.Fil: Casellas, José M.. Asociación Argentina de Microbiología; ArgentinaFil: Famiglietti, Angela. Asociación Argentina de Microbiología; ArgentinaFil: Quinteros, Mirta. Asociación Argentina de Microbiología; ArgentinaFil: Bantar, Carlos. Asociación Argentina de Microbiología; ArgentinaFil: Galas, Marcelo.Fil: Kovensky Pupko, Jaime. Asociación Argentina de Microbiología; ArgentinaFil: Nicola, Federico. Asociación Argentina de Microbiología; ArgentinaFil: Pasteran, Fernando. Asociación Argentina de Microbiología; ArgentinaFil: Soloaga, Rolando. Asociación Argentina de Microbiología; ArgentinaFil: Gutkind, Gabriel Osvaldo. Asociación Argentina de Microbiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin

Lactate and base deficit are predictors of mortality in critically ill patients with cancer

Cancer patients frequently require admission to intensive care unit. However, there are a few data regarding predictive factors for mortality in this group of patients. The aim of this study was to evaluate whether arterial lactate or standard base deficit on admission and after 24 hours can predict mortality for patients with cancer.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

ESTRATÉGIAS DE INCORPORAÇÃO E REESTRUTURAÇÕES ORGANIZACIONAIS NO ENSINO SUPERIOR PRIVADO BRASILEIRO: UMA ESCUTA AO TESTEMUNHO DE DOCENTES

The text socializes results of a qualitative research on organizational restructuring processes caused by incorporation in Brazilian higher education. Some assumptions of structural contingency theory that consider the relationship between organizational and contingencies characteristics affect the organization. The research aims to comprehend the organizational restructuring process of two private colleges before the incorporation of a large educational group in expansionary stage in Brazil, from the testimony of two professors who experienced this process. Methodologically, it is utilized semi-structured interview to collect the data, which started from a guide designed with the intention of evoking testimonial narratives. The results show that the incorporation process implied in great challenges, mainly related to changes in the curricula, the imposition of new teaching practices, the intensification of work, structural changes, and management changes.El texto socializa resultados de una investigación cualitativa sobre los procesos de reestructuración de organización provocados por la incorporación en la educación superior brasileña. Algunos supuestos de la teoría de la contingencia estructural que tengan en cuenta la relación entre las características de organización y contingencias afectan a la organización. La investigación tiene como objetivo comprender el proceso de reestructuración de la organización de dos colegios privados antes de la incorporación de un grupo educativo grande en la etapa expansiva en Brasil, por el testimonio de dos profesores que experimentaron este proceso. Metodológicamente, se utilizó la entrevista semiestructurada para recoger los datos, que se iniciaron a partir de una guía diseñada con la intención de evocar narrativas testimoniales. Los resultados muestran que el proceso de incorporación implícita en grandes retos, principalmente relacionada con los cambios en los planes de estudio, la imposición de nuevas prácticas de enseñanza, la intensificación del trabajo, los cambios estructurales y cambios de gestión.O texto socializa resultados de uma pesquisa qualitativa sobre processos de reestruturação organizacional decorrentes de incorporações no ensino superior brasileiro. Parte de pressupostos da teoria da contingência estrutural que considera a relação entre características organizacionais e contingências que afetam a organização. O objetivo da pesquisa foi compreender o processo de reestruturação organizacional de duas faculdades privadas ante a incorporação de um grande grupo educacional em fase expansionista no Brasil, desde o testemunho de duas docentes que vivenciaram o processo. Utilizou-se a entrevista semiestruturada para coleta de dados, a qual partia de um roteiro concebido com a intenção de evocar narrativas testemunhais. Os resultados mostram que o processo de incorporação implicou em grandes desafios, ligados principalmente às mudanças nas grades curriculares, à imposição de novas práticas de ensino, à intensificação do trabalho, às mudanças estruturais e às alterações na forma de gestão.DOI: 10.21714/2178-8030gep.v18.355

Klebsiella pneumoniae Carbapenemase–2, Buenos Aires, Argentina

Fil: Pasteran, Fernando. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Otaegui, Luis. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Guerriero, Leonor. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Radice, Gabriel. Sanatorio Trinidad Mitre; Argentina.Fil: Maggiora, Ricardo. Sanatorio Trinidad Mitre; Argentina.Fil: Rapoport, Melina. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Faccone, Diego. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: di Martino, Ana. Sanatorio Trinidad Mitre; Argentina.Fil: Galas, Marcelo F. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina

Laboratory-Based Prospective Surveillance for Community Outbreaks of Shigella spp. in Argentina

Background: To implement effective control measures, timely outbreak detection is essential. Shigella is the most common cause of bacterial diarrhea in Argentina. Highly resistant clones of Shigella have emerged, and outbreaks have been recognized in closed settings and in whole communities. We hereby report our experience with an evolving, integrated, laboratory-based, near real-time surveillance system operating in six contiguous provinces of Argentina during April 2009 to March 2012. Methodology To detect localized shigellosis outbreaks timely, we used the prospective space-time permutation scan statistic algorithm of SaTScan, embedded in WHONET software. Twenty three laboratories sent updated Shigella data on a weekly basis to the National Reference Laboratory. Cluster detection analysis was performed at several taxonomic levels: for all Shigella spp., for serotypes within species and for antimicrobial resistance phenotypes within species. Shigella isolates associated with statistically significant signals (clusters in time/space with recurrence interval ≥365 days) were subtyped by pulsed field gel electrophoresis (PFGE) using PulseNet protocols. Principal Findings In three years of active surveillance, our system detected 32 statistically significant events, 26 of them identified before hospital staff was aware of any unexpected increase in the number of Shigella isolates. Twenty-six signals were investigated by PFGE, which confirmed a close relationship among the isolates for 22 events (84.6%). Seven events were investigated epidemiologically, which revealed links among the patients. Seventeen events were found at the resistance profile level. The system detected events of public health importance: infrequent resistance profiles, long-lasting and/or re-emergent clusters and events important for their duration or size, which were reported to local public health authorities. Conclusions/Significance: The WHONET-SaTScan system may serve as a model for surveillance and can be applied to other pathogens, implemented by other networks, and scaled up to national and international levels for early detection and control of outbreaks