Dioctophymosis: situación actual en un área endémica y nuevos desafíos

Desde el año 2005 ininterrumpidamente, el grupo de trabajo realiza tareas en un área de la provincia de Buenos Aires, Barrio “El Molino”, Localidad de Ensenada (34° 49′ 0″ S). La zona, Gran Bañado, corresponde a la selva en galería mas austral del mundo. El hábitat, favorece la presencia y permanencia de parasitosis de ciclo biológico acuático. El trabajo realizado en muestras humanas, ambientales y animales, logró el diagnóstico de situación. Se detectó la circulación de numerosos patógenos, varios zoonóticos. Se analizaron 881 caninos, se diagnosticó dioctophymosis en 35,2%. Se hallaron huevos de Dioctophyme renale en 63,3% de muestras de suelo y fueron negativas 257 muestras de orinas humanas.Facultad de Ciencias VeterinariasInstituto de Investigaciones Bioquímicas de La Plat

Study of infestation of dogs with Echinococcus granulosus in the province of La Rioja, Argentina

Fil: Amaya, Juan C. Programa de Zoonosis, La Rioja; Argentina.Fil: Moreno, Nancy. Departamento de Investigaciones del Instituto Universitario de Ciencias de la Salud, Fundación Barceló; Argentina.Fil: Salmaso, Nancy. Laboratorio Bioquímico de Serología, Hospital Enrique Vera Barros; Argentina.Fil: Bazan, Eduardo. Laboratorio Bioquímico de Serología, Hospital Enrique Vera Barros, La Rioja; Argentina.Fil: Ricoy, Gerardo. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología; Argentina.Fil: Córdoba, Patricia. Dirección de Epidemiología del Ministerio de Salud Pública, La Rioja; Argentina.Fil: Santillán, Graciela I. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología; Argentina.This work was conducted in the province of La Rioja, located in northwestern Argentina. The aim of this study was to estimate the percentage of dog feces showing the presence of antigens of Echinococcus sp. in different regions of the province. A total of 269 samples of dried canine stool were taken, which were analyzed by the copro-ELISA technique. The most affected area was zone IV, which had 30.5% of positive samples. Zone I corresponding to the Capital Department of the province had 12% of positivity. In other areas, the percentages ranged between 11.4% and 14.8%. This is the first study in the province of La Rioja on the existence of this disease in dogs. The lack of control strategies has allowed the spread of echinococcosis

Humoral immune response of pigs infected with Toxocara cati

Fil: Sierra, Maria Florencia. Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Salud Pública; Argentina.Fil: Ricoy, Gerardo. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología. Servicio inmunología parasitaria; Argentina.Fil: Sosa, Sonia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología. Servicio inmunología parasitaria; Argentina.Fil: Colavecchia, Silvia Beatriz. Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Inmunología; Argentina.Fil: Santillan, Graciela. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Parasitología. Servicio inmunología parasitaria; Argentina.Fil: López, Clara Maria. Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Salud Pública; Argentina.Fil: Mundo, Silvia Leonor. Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Inmunología; Argentina.Fil: Sommerfelt, I E. Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Salud Pública; Argentina.Toxocara cati is one of the causative agents of human toxocariasis. Serological methods are used for diagnosis in paratenic hosts like humans but the humoral immune response triggered by this parasite is unknown. We characterized the humoral immune response to T. cati excretory-secretory antigens (TES) in pigs as animal model during the acute and chronic stages of infection. ELISA and Western Blot techniques were used to determine antibody response. Pigs were experimentally inoculated with 100,000 infective Toxocara cati eggs. Blood was collected at 7, 14, 21 and 28 days post-inoculation (d.p.i.) to assess the acute stage of infection and 90, 120 and 180 d. p.i. for chronic stage analysis. ELISA showed values higher than the cut-off of specific IgM and IgG at 7 d. p.i. with significant differences at 0 and 7 d. p.i. for IgM and at 14, 21 and 28 d. p.i. for IgG in the acute stage. Higher and stable levels were detected in the chronic stage. Western Blot showed bands from 102 to 38 kDa detected by specific IgM and IgG. More immunogenic bands were identified by specific IgG. In the chronic stage of infection a band near 31 kDa was the only band detected by IgM until 150 d. p.i. Specific IgG recognized bands between 102 and 31 kDa. This study demonstrates how the humoral immune response evolves in the acute and chronic stages of infection and provides evidence on the role of the pig as a paratenic host of T. cati

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Introduction. This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods. A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results. In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 (p<0.001). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions. Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system

Knowledge, attitudes and perceptions of Latin American healthcare workers relating to antibiotic stewardship and antibiotic use: a cross-sectional multi-country study

Abstract Background The burden of antimicrobial resistance (AMR) in Latin America is high. Little is known about healthcare workers’ (HCWs) knowledge, attitudes, and perceptions of antimicrobial stewardship (AS), AMR, and antibiotic use (AU) in the region. Methods HCWs from 42 hospitals from 5 Latin American countries were invited to take an electronic, voluntary, anonymous survey regarding knowledge, attitudes, and perceptions of AS, AMR, and AU between March–April 2023. Findings Overall, 996 HCWs completed the survey (52% physicians, 32% nurses, 11% pharmacists, 3% microbiologists, and 2% “other”). More than 90% of respondents indicated optimizing AU was a priority at their healthcare facility (HCF), 69% stated the importance of AS was communicated at their HCF, and 23% were unfamiliar with the term “antibiotic stewardship”. Most (> 95%) respondents acknowledged that appropriate AU can reduce AMR; however, few thought AU (< 30%) or AMR (< 50%) were a problem in their HCF. Lack of access to antibiogram and to locally endorsed guidelines was reported by 51% and 34% of HCWs, respectively. Among prescribers, 53% did not consider non-physicians’ opinions to make antibiotic-related decisions, 22% reported not receiving education on how to select antibiotics based on culture results and 60% stated patients and families influence their antibiotic decisions. Conclusions Although HCWs perceived improving AU as a priority, they did not perceive AU or AMR as a problem in their HCF. AS opportunities include improved access to guidelines, access to AMR/AU data, teamwork, and education on AS for HCWs and patients and families