Sepsis et choc septique en réanimation à Brazzaville (Congo) / Sepsis and septic shock in polyvalent intensive care at Brazzaville (Congo)

Objectifs. Décrire les aspects cliniques, bactériologiques et évolutifs du sepsis et du choc septique dans le service de réanimation polyvalente du CHUB. Patients et méthodes. Il s'agit d'une étude transversale, monocentrique et descriptive, durant 12 mois, incluant les patients âgés d'au moins 18 ans admis en réanimation polyvalente pour un sepsis ou choc septique. Les variables épidémiologiques, cliniques, bactériologiques et évolutives ont été analysées avec Excel 2019. Résultats. 56 patients ont été retenus (20,7%). Leur âge moyen était de 43,1 ± 17,9 ans (extrêmes de 18 et 84 ans), avec 66,1% des hommes. Le foyer infectieux initial était péritonéal (64,3 %). À l'admission, le nombre médian de défaillances d'organes par patient était de trois (maximum 5). Les défaillances rénale (71,4%), hépatique (69,6%) et hémodynamique (62,5%) étaient les plus représentées. Le taux de réalisation du bilan bactériologique était de 35,7% : hémoculture (10,7%), uroculture (14,3%), porte d'entrée infectieuse (7,1%). La durée d'hospitalisation des patients sortis vivants était de 8,1 ± 6,3 jours (extrêmes de 2 et 31 jours). Le taux de mortalité était de 57,1%. Les décès survenaient au-delà de 24 h d'hospitalisation (75%), chez des patients avec comorbidités (65,6%), porte d'entrée péritonéale (59,4%), et défaillances hémodynamique (81,2%) et rénale (75%). Conclusion. Les prévalences du sepsis et du choc septique dans notre série sont superposables à celles de la littérature. Le taux de réalisation des bilans bactériologiques reste faible. La mortalité du sepsis demeure très élevée.

Introduction. No accurate data on sepsis and septic shock in intensive care unit (ICU) in the Republic of Congo are available. The aim of the study was to describe the course of patients with sepsis and/or septic shock in the polyvalent ICU of the University Teaching Hospital of Brazzaville. Patients and methods. This was a cross-sectional, monocentric and descriptive study, lasting 12 months, including patients aged at least 18 years admitted to ICU for sepsis or septic shock. The clinical presentation, the bacteriological findings and the outcome were analyzed with Excel 2019. Results. 56 patients were selected (20.7%). The average age was 43.1 ± 17.9 years (extremes 18 and 84 years), with 66.1% of men. The initial infection was peritoneal (64.3%). At admission, the median number of organ failures per patient was three (maximum 5). Renal (71.4%), hepatic (69.6%) and hemodynamic (62.5%) failures were the most common. Bacteriological assessment rate was 35.7%: blood culture (10.7%), urine culture (14.3%). The duration of hospitalization of alive patients was 8.1 ± 6.3 days (extremes 2 and 31 days). The mortality rate was 57.1%. Deaths occurred beyond 24 hours of hospitalization (75%), in patients with comorbidities (65.6%), peritonitis (59.4%), hemodynamic (81.2%) and renal (75%) failures. Conclusion. The prevalence of sepsis and septic shock in our study is comparable to other published series. The bacteriological assessments rate is still low. The mortality is very high.

Cultivo primario de Helicobacter pylori a partir de biopsias gástricas obtenidas por endoscopia / Primary culture of Helicobacter pylori from endoscopic gastric biopsies

Objetivo: Determinar la viabilidad del cultivo de la bacteria Helicobacter pylori en Costa Rica por medio de la documentación de toma de muestras, la comparación del diagnóstico histopatológico y la descripción de los diagnósticos asociados a los aislamientos obtenidos con los resultados de la ureasa rápida. Métodos: Investigación descriptiva que involucró a pacientes de entre los 35 y 70 años, de ambos sexos, que asistieron al Servicio de Endoscopia Digestiva del Hospital Clínica Bíblica entre febrero y junio del 2019 para estudio gastroscópico. Se obtuvieron biopsias gástricas para diagnóstico histopatológico, prueba de ureasa rápida y cultivo de Helicobacter pylori. Para este último, se transportaron las biopsias en un medio de transporte semisólido, se maceró el tejido y se cultivó enagar Skirrow y agar selectivo para Helicobacter; una placa de cada medio se incubó a 37 °C en microaerofilia entre 48 horas y 10 días. La positividad del cultivo se realizó por observación de la morfología colonial y la bacteria se identificó por análisis microscópico al fresco, tinción de Gram y pruebas bioquímicas (catalasa, ureasa y oxidasa). Resultados: Se incluyó a 44 pacientes (edad: 50.6 ± 10.0, 54.5% masculinos). Se recuperó Helicobacter pylori en biopsias de 27 pacientes (61.4% de éxito). La recuperación de la bacteria fue similar en el medio Skirrow y en el selectivo para Helicobacter. El porcentaje de éxito de recuperación semanal aumentó durante el estudio hasta alcanzar un éxito del 100% en la semana 11. Se comparó el cultivo con la ureasa rápida en 27 pacientes y la concordancia entre ambos métodos fue de un coeficiente kappa de Cohen de 0.48. El cultivo detectó la bacteria en un 56% de los pacientes, la ureasa rápida en un 37% y la combinación de ambas técnicas permitió la detección en un 60%. El diagnóstico endoscópico más frecuente en los pacientes con cultivo positivo fue la gastritis eritematosa y gastritis crónica superficial y el diagnóstico histopatológico predominante fue gastritis crónica con atrofia gástrica. El diagnóstico por cultivo coincidió con la detección por azul de toluidina en un 80.4% de los casos. Conclusiones: Se puede implementar el cultivo de Helicobacter pylori en Costa Rica. Este estudio tuvo un porcentaje de recuperación de la bacteria de 61.4%. La combinación del método de cultivo con la prueba de ureasa rápida y la detección histológica contribuye a un diagnóstico certero y oportuno. Recomendamos que, con base en protocolos descritos en esta investigación, cada laboratorio estandarice las condiciones que le permitan un buen porcentaje de recuperación y una implementación adaptada a sus actividades de rutina.

Aim: To document the recent experiences on the implementation of sampling and culturing Helicobacter pylori in Costa Rica, to compare it with other diagnostic methods: rapid urease test and histopathology and to describe the diagnoses associated with the obtained isolates. Methods: Descriptive research involving patients who visited the digestive endoscopy department of the Clínica Bíblica hospital in San José, Costa Rica between February and July of 2019 for gastroscopy. Gastric biopsies were obtained and histopathological analysis, rapid urease test, and bacteriological culture for Helicobacter pylori were performed. For culture techniques, the sample was transported in an in-house semi-solid medium. Biopsy fragments were macerated and plated on Skirrow agar and Helicobacterselective in-house agar, and incubated in microaerophilic atmosphere for 48 hours to 10 days. Culture positivity was determined by observation of the colonial morphology and microscopic observation; Gram staining and biochemical tests (urease, catalase, and oxidase) were used for bacterial identification. Results: 44 patients (mean aged 50.6 ± 10.0 years old, 54.5% male) were included in the study. Helicobacter pylori was recovered in biopsies from 27 patients (61.4% success rate). Bacterial growth was similar regardless the culture medium, but the physiological state of the bacteria was better in the Helicobacter-selective agar than in Skirrow. The weekly recovery rate increased to reach a 100% recovery plateau on week 11. Culture was compared with the rapid urease test in 27 patients, and the concordance between both methods using Cohen's kappa coefficient was 0.48. Whilst the culture detected Helicobacter pylori in 56% of the patients, and the rapid urease test in 37%, the combination of both allowed a 60% rate. The most frequent endoscopic diagnosis in patients with positive cultures were erythematous gastritis and chronic superficial gastritis, and the predominant histopathological diagnosis was chronic atrophic gastritis. Culture-based diagnosis was consistent with the histopathology detection of Helicobacter pylori in 80.4% of the cases. Conclusions: The implementation of H. pylori culture in Costa Rica is possible. This study had a 61.4% recovery rate. The combination of culture with rapid urease test and histopathology increases the probability of an accurate and timely diagnosis. We recommend that, based on previously described protocols such as ours, each laboratory adjusts the conditions to allow a good recovery rate and implement H. pylori diagnostic methods most suitable to their routine activities.

From Dresden to the world: images of the German Hygiene Museum's relations with Latin America, 1911-1933 / De Dresden para o mundo: imagens das relações do Museu Alemão de Higiene com a América Latina, 1911-1933

Abstract As of the nineteenth century, the number of world fairs and hygiene exhibitions grew significantly. This phenomenon was linked to the experience of modernity and the emergence of bacteriology, when different cities were sanitized with the aim of combating urban diseases and epidemics. For the purpose of sanitary education and hygiene propaganda, many objects and pictures were displayed in hygiene exhibitions and museums, such as the International Hygiene Exhibition of 1911 and the German Hygiene Museum, both in Dresden. The goal of this article is to analyze a chapter of the international history of health through images that portray the connections between the German Hygiene Museum and Latin American countries between 1911 and 1933.

Resumo A partir do século XIX, o número de exposições universais e de exposições de higiene cresceu significativamente. Esse fenômeno estava ligado à experiência da modernidade e ao surgimento da bacteriologia, quando diferentes cidades foram higienizadas com o objetivo de combater doenças e epidemias urbanas. Visando à educação sanitária e à propaganda da higiene, inúmeros objetos e imagens foram exibidos em exposições e museus de higiene, como na Exposição Internacional de Higiene de 1911 e no Museu Alemão de Higiene, ambos em Dresden. O objetivo deste artigo é analisar um capítulo da história internacional da saúde por meio de imagens que retratam as conexões entre o Museu Alemão de Higiene e os países latino-americanos de 1911 a 1933.

Triunfo de Finlay, una obra para el proceso formativo de profesionales de la salud / Triumph of Finlay, one picture useful for preparation the professionals of the health

Un acontecimiento en la vida del doctor Carlos Juan Finlay Barrés motivó al Maestro Esteban Valderrama Peña a realizar la composición pictórica Triunfo de Finlay. La pintura representa al médico cubano exponiendo ante una comisión médica militar estadounidense, su teoría sobre el modo de contagio de la fiebre amarilla y el ente transmisor, el mosquito Aedes aegypti. Finlay había estudiado durante años la enfermedad sin que las autoridades coloniales reconocieran los resultados de sus investigaciones, a pesar de que la enfermedad causaba estragos en los militares españoles y la población. En 1898 la intervención norteamericana en la guerra de los cubanos contra el colonialismo español, generó la necesidad de sanear la Isla y crear condiciones higiénicas favorables para la estancia de las tropas norteñas. El general y médico Leonard Wood fijó su atención en la teoría de Finlay y solicitó al gobierno de su país especialistas para verificarla. Fue enviada una comisión dirigida por el mayor Walter Reed, cirujano del ejército y catedrático de bacteriología de la Facultad de Medicina Militar en Washington, para confirmarla. En la pintura, el artista representó la reunión de Finlay con la comisión norteña. El presente trabajo destaca la trascendencia de la obra, su valor estético y la integración del arte, la historia, la medicina y la ciencia. Se propone incluir su estudio como parte del trabajo educativo dirigido a fomentar la cultura general en la formación de los profesionales de la salud(AU)

One event for Doctor Carlos J. Finlay Barrés was the motive for the oil painting composition named "Triumph of Finlay" by Master of Art Esteban Valderrama Peña. The picture shows Finlay presenting his theory about the transmission of yellow fever by mosquitoes to the US Army Yellow Fever Commission. He had conceived a new infection way able to explain the propagation of the illness, and added the possibility of their scientific confirmation by experimental method. In 1898 the US army took place in the Cuban`s fighting against the Spanish colonialism. This circumstance beginning the need to improve the sanitary condition in the Island to create favorable hygienic conditions to the stay of the troops. The Military Governor of the Island, general and physician Leonard Wood took Finlay´s theory as center of his attention. He requested the government of his country experts to verify it. One commission heading for Major Walter Reed was sent. Reed was a surgeon of the army and professor of bacteriology in Military Medicine Faculty in Washington. After experimentally investigation, the commission could confirm Finlay´s theory. Valderrama´s picture shows the meeting of Finlay with the experts. This article has like objective to give emphasis about this pictorial by its importance for the Cuba´s medicine and the science history in Cuba. By the esthetic value that contains it must be included in the educational labor towards the preparation the professionals of the health. It is useful for contributing with the general culture integrating art, history, medicine and science(AU)

Bacteriology and antibiotic sensitivity pattern of isolates in patients who underwent Percutaneous Nephrolithotripsy (PCNL) at the Philippine General Hospital: A retrospective cohort study

@#<p style="text-align: justify;"><strong>Background.</strong> Despite being a clean-contaminated procedure, performed only in patients with sterile urine preoperatively, percutaneous nephrolithotripsy (PCNL) is associated with significant infectious perioperative complications. A local antibiogram is of paramount importance in optimizing antibiotic prophylaxis in PCNL because of the substantial variation in bacterial distribution and antibiotic sensitivity worldwide.</p><p style="text-align: justify;"><strong>Objectives.</strong> The incidence of post-PCNL infectious complications, microorganism distribution, and antibiotic sensitivities from patients admitted for PCNL was determined. The risk factors associated with positive cultures and the development of fever and bacteremia were also analyzed.</p><p style="text-align: justify;"><strong>Methods.</strong> A retrospective study of 102 patients who underwent PCNL under a surveillance protocol was done. The susceptibility of isolates from different specimens was evaluated against the most common antibiotics in the hospital. Chi-square and Student's t-test were used to determine differences in the frequencies and means for other risk factors for those who developed fever and urosepsis and those who did not.</p><p style="text-align: justify;"><strong>Results.</strong> The incidence of fever and urosepsis was 25% and 4%, respectively. The most common organism on urine specimens was Escherichia coli which showed high sensitivity to aminoglycosides. The most common isolate on stones was Pseudomonas aeruginosa, which showed higher sensitivities to the fluoroquinolones. The isolates showed nearly consistent resistance to ceftriaxone. No significant association was found between the clinical variables studied and the occurrence of infectious complications.</p><p style="text-align: justify;"><strong>Conclusion.</strong> There are comparable rates of infectious complications to published literature. A change in antibiotic prophylaxis was warranted, given the high resistance to ceftriaxone and the predominance of Pseudomonas aeruginosa on stone isolates. Further surveillance is required to identify significant risk factors for the development of post-PCNL infectious complications.</p>

Pediatría y cultura de viaje: los pensionados españoles y la apropiación del laboratorio en la periferia, 1907-1939 / Pediatrics and travel culture: Spanish travel award-holders and the appropriation of laboratories on the periphery, 1907-1939

Resumen Partiendo de la hipótesis de que el laboratorio jugó un papel importante en la autonomía disciplinar de la pediatría, este artículo estudia la influencia del viaje científico en la apropiación de nuevas metodologías por parte de los pediatras y puericultores españoles del primer tercio del siglo XX. Para ello, se analizan las pensiones concedidas a tal efecto por la Junta para Ampliación de Estudios e Investigaciones Científicas. Se describe la geografía científica creada por el programa y se profundiza en el papel de los mentores - especialmente de Gustavo Pittaluga (1876-1956) - en este proceso. Además de un estudio prosopográfico del grupo, se presentan tres casos que demuestran la importancia del programa en el encuentro de la pediatría con la bacteriología, la anatomía patológica y la bioquímica.

Abstract Starting from the hypothesis that laboratories played an important role in pediatrics becoming an autonomous discipline, this article studies the influence of scientific travel on the appropriation of new methodologies by Spanish pediatricians and child-care experts in the first third of the twentieth century. To do so, it analyzes the travel awards granted by the Junta para Ampliación de Estudios e Investigaciones Científicas. It describes the scientific geography created by the program and takes an in-depth look at the role of mentors - especially Gustavo Pittaluga (1876-1956) - in this process. In addition to a prosopographical study of the group, it presents three cases that demonstrate the importance of the program in bringing pediatrics into contact with bacteriology, pathological anatomy and biochemistry.

Juan Nicolás Dávalos Betancourt y Federico Grande Rossi: dos amigos y una profesión / Juan Nicolás Dávalos Betancourt y Federico Grande Rossi: two friends, one profession

El papel desempeñado por destacados científicos cubanos y matanceros como Juan Nicolás Dávalos Betancourt y Federico Grande Rossi fue fundamental en el desarrollo de la bacteriología en el país. Con este trabajo se pretende acercar a estos dos hombres unidos en la vida como grandes amigos y en la profesión. Juan Nicolás Dávalos Betancourt conocido como "el sabio que soñaba con las bacterias" trasciende su campo de trabajo particular y se proyecta en el desarrollo de nuestra nación. Federico Grande Rossi fue médico bacteriólogo y fecundo escritor (AU).

The role played by eminent Cuban and Matanzasan scientist like Juan Nicolas Davalos Betancourt and Federico Grandi Rossi was essential for the development of the bacteriology in the country. With this work the authors pretend to bring near these two men who were very close in life as friends and colleagues in their profession. Juan Nicolas Davalos Betancourt, known as "the scholar who dreamed with bacteria" went beyond his particular work field and entered the process of development of Cuban nation. Federico Grandi Rossi was a doctor-bacteriologist and a prolific writer (AU).

Primer reporte de escherichia coli productora de toxina shiga no O157 que codifica el gen de la enterohemolisina en carne cruda en colombia / First report of Shiga toxin-producing escherichia coli non-O157 that encodes the enterohemolysin gene in raw beef in colombia

Dentro de los patotipos de Escherichia coli, el grupo STEC puede producir en el ser humano desde diarrea hemorrágica hasta insuficiencia renal aguda e incluso la muerte; el ganado bovino es el principal reservorio de este agente patógeno y por ende la ingestión de alimentos derivados de estos animales de abasto son una fuente muy importante de infección para el hombre. El objetivo principal de este estudio fue determinar la prevalencia de STEC en muestras de carne cruda comercializada en Pamplona-Colombia y en cepas obtenidas a partir de las muestras. Se analizaron cien muestras de carne cruda aplicando la técnica de Reacción en Cadena de la Polimerasa para la detección de los siguientes genes en muestras y en cepas STEC: stx1, stx2, eae y hlyA. Adicionalmente, se estableció el patrón de resistencia-susceptibilidad antibiótica de cepas STEC aisladas empleando métodos regulados. En el 39% de las muestras fue posible detectar el gen stx2; en el 38%, de ellas, se detectaron los genes stx1 y stx2. Además, se aislaron cepas STEC en el 13% de las muestras analizadas, 85% de ellas portaban el gen hlyA. No se detectó la presencia del gen eae o del serogrupo O157. Las cepas aisladas demostraron resistencia frente a algunos antibióticos de primera y segunda generación. En conclusión, se detectó la presencia de genes que codifican factores de virulencia en las muestras de carne analizadas que representan un riesgo potencial para la salud de los consumidores. Este es el primer reporte de STEC no O157 que codifica el gen de la enterohemolisina en alimentos en Colombia(AU)

Within the Escherichia coli patotypes, the STEC group can produce in humans from hemorrhagic diarrhea to acute renal failure and even death; cattle are the main reservoir of this pathogen and therefore the ingestion of food derived from these stock animals are a very important source of infection for man. The main objective of this study was to determine the prevalence of STEC in raw meat samples marketed in Pamplona-Colombia and in strains obtained from those samples. One hundred raw meat samples were analyzed using the Polymerase Chain Reaction technique for the detection of the following genes in samples and in STEC strains: stx1, stx2, eae and hlyA. In addition, STEC strains were isolated in 13% of the analyzed samples, 85% of them carried the hlyA gene. The presence of the eae gene or serogroup O157 was not detected. The isolated strains demonstrated resistance against some first and second generation antibiotics. In conclusion, the presence of genes encoding virulence factors in the meat samples analyzed, that represent a potential health risk factor to consumers, was confirmed. This is the first report of STEC non-O157 that encodes the enterohemolysin gene in foods in Colombia(AU)

Essential Basic Bacteriology in Managing Musculoarticuloskeletal Infection: Bacterial Anatomy, Their Behavior, Host Phagocytic Activity, Immune System, Nutrition, And Antibiotics

Surgery-related infections have not been irradicated until now. To solve this problem, it is important to know the relationship between bacterial anatomy and bacterial behavior in the tug-of-war between host and pathogen. In this article, bacterial anatomy and functional behavior, host phagocytic activity, immune system, nutrition and antibiotics are reviewed to win the war against the tiny invaders and leave the host unharmed. My suggestion is that scientists should direct their studies not only to developing potent new antibiotics that will never give rise to drug-resistant mutants, but also to developing a very competitive immune system that can suppress or control infection without the aid of antibiotics.

Prevalence state of canine brucellosis in South Korea during 2015 and 2016 / 대한수의학회지

We investigated the prevalence of canine brucellosis in companion and stray dogs between March 2015 and December 2016 and determined the disease characteristics based on the geographic distribution, sex and age of the dogs in South Korea. We conducted a large-scale survey using serological and bacteriological tests. Samples were collected from 2,394 dogs (1,825 companions and 569 strays). Thirty (1.3%) samples were positive for Brucella canis antibodies including 16 (0.9%) from companion dogs and 14 (2.5%) from stray dogs. Two (1.0%) of the 196 samples cultured from the stray dogs were positive. When compared with male dogs, the female companion and stray dogs had a significantly higher prevalence of brucellosis. Moreover, the prevalence of canine brucellosis was significantly higher in stray dogs older than 6 years and the prevalence of the disease in companion dogs was highest in Incheon (2.1%) and Jeolla (2.1%) provinces. Stray dogs from the Daejeon metropolitan area had the highest prevalence of brucellosis (7.9%). National control measures for canine brucellosis have not previously been implemented. Our findings suggest that appropriate screening tests and control measures are necessary to improve the health of dogs and to protect public health in Korea, particularly with the rapid growth of the companion animal industry.

Tendances de la tuberculose pulmonaire bactériologiquement confirmée et issues thérapeutiques en République Démocratique du Congo : 2007-2017

Contexte et objectifs. La République Démocratique du Congo compte parmi les pays à lourd fardeau pour la tuberculose (TB), l'incidence réelle de la maladie n'est pas formellement connue. La présente étude vise à décrire les tendances de l'incidence notifiée des patients atteints de tuberculose pulmonaire bactériologiquement confirmée (TP+) et leurs issues thérapeutiques. Méthodes. Cette étude documentaire, analyse les données des patients diagnostiqués et traités pour tuberculose de 2007 à 2017 en RDC. L'incidence notifiée des patients TP+, le taux d'accroissement annuel, les issues thérapeutiques ont été recherchés. Les variations du nombre de patients sont exprimées par les proportions. Les tendances sont présentées à travers les courbes de régression linéaire. Les issues thérapeutiques sont comparées à l'aide du z-score avec un seuil significatif de p˂ 0,05. Résultats. Au total 884 458 patients TP+ ont été rapportés, dont 820 858 nouveaux patients (NP TP+) et 63 600 déjà traités. Le taux d'accroissement au cours de cette décade était de 28,95%, soit de 66099 en 2007 à 93767 en 2017 pour les NP TP+. L'augmentation annuelle moyenne était de 2,41% +/- 3,28 pour les NP TP+ et de 5,7% +/- 0,26 par an pour les rechutes. La notification des échecs de traitement initial et repris après abandon de traitement ont une tendance à la baisse. L'évaluation thérapeutique de tous les cas cumulés a concerné 848 163 patients dont 789 716 NP TP+ et 58447 en retraitement. Le succès thérapeutique était de 88,0 % pour les NP TP+ et 70,0 % pour les rechutes, de 64,3 % pour les échecs et de 67,8% pour les repris en traitement après abandon. En somme 70 515 (8,3%) patients ont gardé des expectorations positives. Conclusion. Cette étude montre une tendance à la hausse de notification des cas incidents dont l'issue de traitement répond aux standards de l'OMS. En outre, un nombre des personnes demeurent porteurs de germes persistants précurseurs d'une TB pharmacorésistante acquise

Gerencia de diagnóstico y vigilancia epidemiológica del Instituto Nacional de Higiene "Rafael Rangel": Una década de avances y logros / Diagnostic and epidemiological surveillance management The National Institute of Hygiene "Rafael Rangel": A decade of advances and achievements

Buscando en los registros de las principales actividades de la Gerencia de Diagnóstico y Vigilancia Epidemiológica ha sido difícil elegir entre tantas vivencias, aquellos elementos que marcaron pauta durante la década 2008 ­ 2018. No obstante, es de resaltar que los desafíos afrontados ante la aparición de brotes, epidemias y la primera pandemia del siglo XXI, trajeron consigo un cúmulo de experiencias que se presentan en este artículo. Como centro nacional de referencia en las áreas de Bacteriología, Micología y Virología, continuamos aportando soluciones a la salud pública nacional mediante la actualización profesional de nuestro personal y la formación de la generación de relevo, en la que participan profesionales de excelencia, altamente especializados y sensibilizados con la problemática y los requerimientos de nuestra población. Asimismo, a través de la coordinación, supervisión y evaluación de la Red de laboratorios de salud pública, se contribuye con el fortalecimiento del diagnóstico de enfermedades transmisibles y vigilancia epidemiológica en el país. El trabajo realizado en estos diez años ha sido excelente, crucial y prioritario para enfrentar las emergencias. Debemos seguir trabajando en dos aspectos claves: 1. Mayor integración del laboratorio con el componente epidemiológico y clínico del país para ser más útiles al sistema de salud, y 2. Consolidar la creación del edificio sede del Centro de Diagnóstico de Enfermedades Transmisibles del Instituto Nacional de Higiene "Rafael Rangel" (INHRR), proyecto en el que estamos trabajando con la asesoría de la OPS/OMS.

Looking at the records of the main activities of the Diagnostic and Epidemiological Surveillance Management, it has been difficult to choose between many experiences, those elements that set the standard during the 2008 ­ 2018 decade. However, it is noteworthy that the challenges faced with the emergence of outbreaks, epidemics and the first pandemic of the 21st century, brought with it a wealth of experiences that are presented in this article. As a national reference center in Bacteriology, Mycology and Virology areas, we continue to provide solutions to public health through the professional updating of our staff and formation of the relief generation, in which participate professionals of excellence, highly specialized and sensitized with the problems and requirements of our population. Likewise, through the coordination, supervision and evaluation of the public health laboratories network, it contributes to the strengthening of the communicable diseases diagnosis and epidemiological surveillance in the country. The work done in these ten years has been excellent, crucial and priority to face emergencies. We must continue working on two key aspects: 1. Greater laboratory integration with the epidemiological and clinical component of the country to be more useful to the health system, and 2. Consolidate headquarters building creation of the National Institute of Hygiene "Rafael Rangel" (INHRR) Diagnostic Center for Communicable Diseases, project in which we are working with the PAHO / WHO advice.

Aerobic bacteria in oral cavity of Lancehead snakes (Bothrops atrox) with stomatitis / Bactérias aeróbicas da cavidade oral de jararaca-do-norte (Bothrops atrox) com estomatite

Stomatitis is a common disease found on snake farms, and Gram-negative bacilli are the main etiological agents that play an important role as secondary sources of viral or parasitic infections. The purpose of this work was to identify the aerobic bacteria in the oral cavity of Bothrops atrox with stomatitis. Samples for microbiological examination were collected from 12 snakes bred on a commercial snake farm for venom extraction. Samples of the secretion in the oral cavity of each serpent presenting stomatitis were collected from fang sheath, using a cotton swab with sterile alginate. The samples were incubated and cultured on Petri dishes containing blood agar and XLD agar using the agar depletion technique. Bacterial growth occurred in all analyzed samples collected from the oral cavity of Bothrops atrox with stomatitis, and some of the samples contained more than one microorganism. The following Gram-negative bacteria were isolated: Escherichia coli (26.31%), Citrobacter spp. (21.05%), Proteus spp. (15.78%) and Salmonella spp. (10.52%). The only Gram-positive bacterium that was isolated was Staphylococcus spp., which was present in 26.31% of the analyzed samples.

A estomatite é uma das doenças mais frequentes em criatórios comerciais de serpentes, sendo os bacilos Gram-negativos os principais agentes etiológicos com importante papel, como fontes secundárias, nas infecções virais ou parasitárias. O objetivo do presente trabalho foi analisar as bactérias aeróbicas presentes na cavidade oral em serpentes da espécie Bothrops atrox. Utilizaram-se 12 amostras colhidas com auxílio de swab estéril na região da bainha da presa, em serpentes que apresentaram estomatite, em um criatório comercial. As amostras foram cultivadas em Ágar-sangue e Ágar XLD. Em todas as amostras analisadas, houve crescimento de, pelo menos, um microrganismo. As bactérias Gram-negativas isoladas foram Escherichia coli (26,31%), Citrobacter spp. (21,05%), Proteus spp. (15,78%) e Salmonella spp. (10,52%). A única bactéria Gram-positiva isolada foi a Staphylococcus spp., presente em 26,31% das amostras analisadas.

Development and trial of vaccines against Brucella

The search for ideal brucellosis vaccines remains active today. Currently, no licensed human or canine anti-brucellosis vaccines are available. In bovines, the most successful vaccine (S19) is only used in calves, as adult vaccination results in orchitis in male, prolonged infection, and possible abortion complications in pregnant female cattle. Another widely deployed vaccine (RB51) has a low protective efficacy. An ideal vaccine should exhibit a safe profile as well as enhance protective efficacy. However, currently available vaccines exhibit one or more major drawbacks. Smooth live attenuated vaccines suffer shortcomings such as residual virulence and serodiagnostic interference. Inactivated vaccines, in general, confer relatively low levels of protection. Recent developments to improve brucellosis vaccines include generation of knockout mutants by targeting genes involved in metabolism, virulence, and the lipopolysaccharide synthesis pathway, as well as generation of DNA vaccines, mucosal vaccines, and live vectored vaccines, have all produced varying degrees of success. Herein, we briefly review the bacteriology, pathogenesis, immunological implications, candidate vaccines, vaccinations, and models related to Brucella.

Performance Evaluation of an Automated Microbiological Stainer, KS-S100

BACKGROUND: There have been few evaluations of the performance of automatic stainers used instead of manual staining in clinical laboratories. We evaluated the performance of an automated stainer, KS-S100 (KS Co. Ltd., Korea), in Gram and acid-fast fluorescence staining of clinical specimens. METHODS: Repeatability was evaluated by comparing the results of Gram stains performed 10 times over 5 days using two standard strains and duplicated acid-fast bacilli (AFB) fluorescence stains using 40 samples. Comparisons to manual staining and to another automatic stainer, AT-2000 (Dagatron, Korea), were performed using 40 remnant respiratory specimens or liquid AFB culture media. The results were interpreted by two experienced technicians, and total test time was measured during the staining of 1, 10, and 20 slides. RESULTS: All 10 pairs of Gram staining results obtained with KS-S100 were identical, and the concordance rate of the duplicate AFB fluorescence stains was 92.5%. Among the results for 20 culture-positive liquid media samples, three AFB fluorescent staining results were not concordant. The weighted kappa values between KS-S100 and manual staining for Gram and AFB fluorescence staining were both 0.94, with concordance within the ±1-grade range. For the staining of a single slide, manual staining was faster. KS-S100 was more efficient than AT-2000 at staining 20 slides. CONCLUSIONS: The automated stainer KS-S100 showed reproducible results comparable to those of manual staining in two major microbiological staining methods, Gram and AFB fluorescence staining, used in clinical applications. Performance evaluations should be conducted before implementation of the automated stainer in microbiological staining.