Characterizing carbapenemase-producing Escherichia coli isolates from Spain: high genetic heterogeneity and wide geographical spread

IntroductionCarbapenemase-Producing Escherichia coli (CP-Eco) isolates, though less prevalent than other CP-Enterobacterales, have the capacity to rapidly disseminate antibiotic resistance genes (ARGs) and cause serious difficult-to-treat infections. The aim of this study is phenotypically and genotypically characterizing CP-Eco isolates collected from Spain to better understand their resistance mechanisms and population structure.MethodsNinety representative isolates received from 2015 to 2020 from 25 provinces and 59 hospitals Spanish hospitals were included. Antibiotic susceptibility was determined according to EUCAST guidelines and whole-genome sequencing was performed. Antibiotic resistance and virulence-associated genes, phylogeny and population structure, and carbapenemase genes-carrying plasmids were analyzed.Results and discussionThe 90 CP-Eco isolates were highly polyclonal, where the most prevalent was ST131, detected in 14 (15.6%) of the isolates. The carbapenemase genes detected were blaOXA-48 (45.6%), blaVIM-1 (23.3%), blaNDM-1 (7.8%), blaKPC-3 (6.7%), and blaNDM-5 (6.7%). Forty (44.4%) were resistant to 6 or more antibiotic groups and the most active antibiotics were colistin (98.9%), plazomicin (92.2%) and cefiderocol (92.2%). Four of the seven cefiderocol-resistant isolates belonged to ST167 and six harbored blaNDM. Five of the plazomicin-resistant isolates harbored rmt. IncL plasmids were the most frequent (45.7%) and eight of these harbored blaVIM-1. blaOXA-48 was found in IncF plasmids in eight isolates. Metallo-β-lactamases were more frequent in isolates with resistance to six or more antibiotic groups, with their genes often present on the same plasmid/integron. ST131 isolates were associated with sat and pap virulence genes. This study highlights the genetic versatility of CP-Eco and its potential to disseminate ARGs and cause community and nosocomial infections

Gestión del conocimiento: perspectiva multidisciplinaria. Volumen 11

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 11, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro cuenta con el apoyo de los grupos de investigación: Universidad Sur del Lago “Jesús María Semprúm” (UNESUR), Zulia – Venezuela; Universidad Politécnica Territorial de Falcón Alonso Gamero (UPTAG), Falcón – Venezuela; Universidad Politécnica Territorial de Mérida Kleber Ramírez (UPTM), Mérida – Venezuela; Universidad Guanajuato (UG) - Campus Celaya - Salvatierra - Cuerpo Académico de Biodesarrollo y Bioeconomía en las Organizaciones y Políticas Públicas (C.A.B.B.O.P.P), Guanajuato – México; Centro de Altos Estudios de Venezuela (CEALEVE), Zulia – Venezuela, Centro Integral de Formación Educativa Especializada del Sur (CIFE - SUR) - Zulia - Venezuela, Centro de Investigaciones Internacionales SAS (CIN), Antioquia - Colombia.y diferentes grupos de investigación del ámbito nacional e internacional que hoy se unen para estrechar vínculos investigativos, para que sus aportes científicos formen parte de los libros que se publiquen en formatos digital e impreso

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Patrón oro y estabilidad cambiaria en México, 1905-1910

In 1905, the Mexican government realized the change of the monetary bimetallic system to the pattern change gold. This reform had as purpose to provide of stability to the type of change and the external accounts of the nation. With it seeks to obtain the stability of the public finances and to support an increasing flow of foreign investment to the Mexican economy. This presentation seeks to study the impact of the above mentioned reform from its accomplishment up to the beginning of the Mexican revolution and to investigate if the objective of the reform were fulfilled in the short term. Prominent figures of the politics and the contemporary business to the facts gave its positions on this matter of interest for the Mexican society. This one is one of the aspects that the work tried as a thread that allows to clarify the impact of the reform in the different economic activities.En 1905, el gobierno mexicano realizó el cambio del sistema monetario bimetálico al patrón cambio oro. Esta reforma tenía como propósito proporcionar estabilidad al tipo de cambio y a las cuentas externas de la nación, con el fin de dar estabilidad a las finanzas públicas y atraer inversión extranjera a la economía mexicana. Este artículo busca estudiar el impacto de la reforma en la economía desde su realización hasta el principio de la revolución mexicana, así como investigar si el objetivo de la reforma se consiguió a corto plazo. Las figuras prominentes de la política y los negocios, contemporáneos a los hechos, dieron sus posiciones respecto a esta materia de interés para la sociedad mexicana. Este es uno de los aspectos que el trabajo aborda para comprender el impacto de la reforma en las diversas actividades económicas

El mercurio y la producción minera en la Nueva España, 1810-1821

En el presente artículo se exponen los avances de investigación sobre el financiamiento, transporte y asignación del azogue a la minería novohispana durante este periodo. El trabajo subraya el hecho de que la guerra fue la  causa principal de la crisis minera. En este sentido busca  precisar el efecto del  conflicto bélico sobre la forma de  organización de la producción de la industria platera colonial y sus formas de  distribución. El estu­dio sostiene que el retiro del crédito, por parte  del gobierno español, fue uno de los golpes más severos que sufrió la acti­vidad minera durante el conflicto bélico. Además, aporta datos sobre la cantidad de mercurio disponible para la minería, los costos de su transporte, su asignación y distribución a los rea­les mineros

Las raíces de la ortodoxia en México

This work is part of a broader research that aims to explore and describe some of the events that allowed the development of economic orthodoxy in Mexico and Mexican liberalism that shaped the twentieth century. It supports the hypothesis that the formation of this current was a conscious act of a sector of the Mexican economic elite, to create an alternative to what has been called the current Mexican economic nationalism which came along with the Mexican Revolution of 1910 and consolidated with the social and economic reforms promoted by President Lázaro Cárdenas (1934-1940). This opposition used the works of two important liberals from the era as an inspiration: Ludwig von Mises and Friedrich von Hayek. In this work we will take a look at their visits to Mexico and their reunions with several bussiness man.Este trabajo es parte de una investigación más amplia que aspira explorar y relatar algunos de los acontecimientos que permitieron o abrieron paso al desarrollo de la ortodoxia económica en México y que formó el liberalismo mexicano del siglo XX. Se sostiene la hipótesis que la formación de esta corriente fue un acto consciente de un sector de la élite económica mexicana con el fin de crear un proyecto alternativo a lo que se ha sido denominado como la corriente del nacionalismo económico mexicano que surgió con la Revolución Mexicana de 1910 y se consolidó con las reformas económicas y sociales impulsadas por el presidente Lázaro Cárdenas (1934-1940). Esta oposición se apoyó en el trabajo de dos intelectuales liberales de la época: Ludwig von Mises y Friedrich von Hayek. En este artículo comentamos sus visitas a México y reuniones con los empresarios

El debate sobre la reforma monetaria de 1905 en México

El presente artículo tiene como propósito indagar el debate sobre el ingreso de México al patrón oro realizado al interior de la Comisión Monetaria nombrada por el presidente Porfirio Díaz, a través de su ministro de finanzas, José Yves Limantour. La pertinencia del estudio radica en que muestra los distintos intereses económicos que se encontraban establecidos en el mercado mexicano y que se confrontaron y negociaron el cambio del sistema monetario.AbstractThe purpose of this essay is to inquire about the way in which the internal debate regarding Mexico’s entrance into the Gold Standard was carried out during the Porfirian period. The debate occurred inside a Monetary Commission appointed by José Yves Limantour who, at the time, was Secretary of the Treasury. This discussion took place within a frame of struggle between domestic and international economic interests

El mercurio y la producción minera en la Nueva España (1810-1821)

En el presente artículo se exponen los avances de investigación sobre el financiamiento, transporte y asignación del azogue a la minería novohispana durante este periodo. El trabajo subraya el hecho que la guerra fue la causa principal de la crisis minera. En este sentido busca precisar el efecto del conflicto bélico sobre la forma de organización de la producción de la industria platera colonial y sus formas de distribución. El estudio sostiene que el retiro del crédito, por parte del gobierno español, fue uno de los golpes más severos que sufrió la actividad minera durante el conflicto bélico. Además, aporta datos sobre la cantidad de mercurio disponible para la minería, sobre los costos de su transporte, su asignación y distribución a los reales mineros