Julio César Medina, et al.: Immunologic Response of CMV in Transplantation 103 Immunologic Response and Pathogenic Mechanisms of Cytomegalovirus Infection in Transplant Recipients Correspondence to

Abstract Immunity mechanisms of cytomegalovirus infection control have been studied recently and have contributed to the better understanding of the pathogenesis of this disease in patients with a solid organ transplant. These studies suggest that a relationship exists between cytomegalovirus and the development of acute rejection. This relationship is more evident if the patient develops cytomegalovirus disease and if the donor is cytomegalovirus-positive and the recipient is cytomegalovirusnegative. There is also evidence that the association is probable if there is coinfection with cytomegalovirus and other herpesviruses (human herpesvirus 7). Over the past 30 years, many attempts have been made to design vaccines able to prevent cytomegalovirus infection and disease; however, few vaccines progressed to clinical studies and none have been licensed yet. The purpose of this review is to provide a critical analysis of the most recent evidences from the medical literature with respect to the pathogenesis of cytomegalovirus infection and its association with acute and chronic rejection, as well as the possible implications that the development of future vaccines could have in the prevention of cytomegalovirus disease and acute or chronic rejection

Online continuing interprofessional education on hospital-acquired infections for Latin America

Introduction: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Methods: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. Results: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a “New Challenges” course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions. Keywords: Internet, Continuing education, Interprofessional education, MOOC, Hospital-acquired infections, Latin Americ