Pericardiectomía parcial y drenaje pericárdico mínimamente invasivo en cirugía infantil / Partial pericardiectomy and minimally invasive pericardial drainage in pediatric surgery

Introducción. Una de las patologías más frecuentes del pericardio es la pericarditis, que puede presentarse como pericarditis aguda, subaguda o crónica, derrame pericárdico, taponamiento cardíaco o pericarditis constrictiva. Sin embargo, es una condición infrecuente en la población pediátrica. Métodos. Presentamos una serie de casos de pacientes con pericarditis que fueron llevados a pericardiotomía, drenaje pericárdico y pericardiectomía parcial anterior, entre julio de 2014 y junio de 2023. Se recolectaron las variables demográficas y clínicas, se evaluaron los aislamientos microbiológicos y el manejo recibido. Resultados. Un total de 12 pacientes fueron llevados a manejo quirúrgico mínimamente invasivo; de estos, 58 % pertenecían a comunidades indígenas y residían en zonas rurales. La mitad tenían neumonía asociada. En la mayoría de los casos no se obtuvo aislamiento microbiológico. Conclusión. La necesidad de manejo quirúrgico está determinada por la repercusión en las variables hemodinámicas relacionadas con el derrame y el compromiso pericárdico. La pericardiectomía parcial por toracoscopia es una alternativa en estos casos.

Introduction. One of the most common pathologies of the pericardium is pericarditis, which can present as acute, subacute or chronic pericarditis, pericardial effusion, cardiac tamponade or constrictive pericarditis. However, it is a rare condition in the pediatric population. Methods. A series of cases of patients with pericarditis who were taken to pericardiotomy, pericardial drainage and anterior partial pericardiectomy, between July 2014 and June 2023 is presented. Demographic and clinical variables were collected, microbiological isolates and the management received were evaluated. Results. A total of 12 patients underwent minimally invasive surgical management; of these, 58% belonged to indigenous communities and lived in rural areas. Half had associated pneumonia. In most cases, no microbiological isolation was obtained. Conclusion. The need for surgical management is determined by the impact on the hemodynamic variables related to the effusion and pericardial compromise. Partial pericardiectomy by thoracoscopy is an alternative in these cases.

Mucormicosis: un dulce enemigo, serie de casos / Mucormycosis: A sweet enemy, case series

La mucormicosis es una infección fúngica poco frecuente causada por hongos del orden Mucorales, la cual se presenta en individuos inmunocomprometidos o con pérdida de la integridad de la barrera de piel o mucosas. Se reportan cuatro casos de mucormicosis rinocerebral atendidos en un hospital de tercer nivel de Cali (Colombia) durante un periodo de tres años. Los cuatro pacientes presentaron diferentes cuadros clínicos y tiempos de evolución. Todos tenían diagnóstico de diabetes mellitus de tipo 2, de novo o previo, con una hemoglobina glucosilada de ingreso mayor del 10 % y en todos se descartaron otras enfermedades que explicaran su compromiso inmunitario. La mucormicosis se diagnosticó por la visualización directa de hifas hialinas sincitiales (coenocytic) en las biopsias tomadas. El pilar del tratamiento fue la anfotericina B liposómica junto con el desbridamiento quirúrgico. Dos pacientes presentaron coinfección bacteriana. De los cuatro, uno firmó su egreso voluntario sin completar el tratamiento y otro falleció. Los dos pacientes restantes han asistido a los controles y han mostrado una adecuada evolución.

Mucormycosis is a rare fungal infection caused by fungi of the Mucorales order that occurs in immunocompromised individuals or with loss of skin or mucosa barrier integrity. This report presents four cases of rhinocerebral mucormycosis attended at a third-level hospital in Cali (Colombia) during a period of three years. All patients had different case histories and times of evolution. All four had a previous or de novo diagnosis of type 2 diabetes mellitus, with glycated hemoglobin higher than 10% on admission. We ruled out other possible pathologies that could explain their immunocompromised condition. Mucormycosis diagnosis was made with direct visualization of hyaline coenocytic hyphae on biopsies. The basis of treatment was liposomal amphotericin B and surgical debridement. Two patients presented bacterial coinfection. One asked for voluntary discharge without having completed the treatment, and another one died. The remaining two have attended controls and had an adequate evolution.

Un padre olvidado de la Microbiología: Louis Joblot / A forgotten father of Microbiology

El microscopista francés Louis Joblot (1645-1723), contemporáneo de Antoine van Leeuwenhoek y Robert Hooke, puede ser considerado uno de los padres de la protistología/microbiología. Su obra titulada "Descripciones y usos de varios microscopios nuevos" de 1718 contiene varias extraordinarias imágenes de protozoos en movimiento y en división binaria. Lamentablemente, algunas imágenes de dicha obra contenían figuras fantásticas, por lo que su legado fue rápidamente obscurecido. Sus experimentos sobre el fenómeno de generación espontánea marcaron un hito en el desarrollo de este debate y se adelantaron en casi siglo y medio a los experimentos de Louis Pasteur.

The French microscopist Louis Joblot (1645-1723), a contemporary of Antoine van Leeuwenhoek and Robert Hooke, he can be considered one of the fathers of protistology/microbiology. His work entitled "Descriptions and uses of various new microscopes" of 1718 contains several extraordinary images of protozoa in motion and in binary division. Unfortunately, some images of this work contained fantastic figures, so his legacy was quickly obscured. His experiments on the phenomenon of spontaneous generation marked a milestone in the development of this debate and anticipated Louis Pasteur's experiments by almost a century and a half.

Influence of surgical instrument identifiers on microbial contamination of scalpel handles after cleaning and sterilization / Influencia de los identificadores de instrumental quirúrgicos en la contaminación microbiana de mangos para cuchillas de bisturí después de la limpieza y esterilización / Influência dos identificadores de instrumental cirúrgico na contaminação microbiana de cabos para lâminas de bisturi após limpeza e esterilização

Objective: To evaluate the influence of different instrument identifiers on the microbial growth of critical devices after cleaning and steriliza-tion steps. Method: Fifteen No. 3 scalpel handles were used as test specimens, divided into 3 groups (n=5), with each group consisting of an instrument without an identifier and four other instruments with the following identifiers: laser engraving, silicone ring, vinyl identifier with permanent adhesive and personalized adhesive label. After being submerged in the surgical aspirate, the instruments were processed in accordance with the good practice requirements of Resolution No. 15/2012 from the National Health Surveillance Agency (Anvisa). Microbial growth was evaluated at different times qual-itatively, by the presence or absence of growth, and quantitatively for positive cases, by counting viable colony-forming units (log CFU/scalpel handle). Results: At some point, there was microbial growth on the instruments regardless of the type of identifier. However, there was no continuous and pro-gressive contamination after repeating the cleaning and sterilization steps. Conclusion: The type of dental instrument identifier does not interfere with microbial growth as long as cleaning and sterilization standards are respected. (AU)

Objetivo: Evaluar la influencia de los diferentes identificadores de instrumental en el crecimiento microbiano de dispositivos críticos después de las etapas de limpieza y esterilización. Método: Se utilizaron 15 mangos #3 para cuchillas de bisturí como cuerpo de prueba, divididos en 3 grupos (n=5), cada grupo compuesto por un instrumental sin identificador y otros cuatro instrumentales con los siguientes identificadores: grabado a láser, ani-llo de silicona, identificador vinílico con adhesivo permanente y etiqueta adhesiva personalizada. Después de ser sumergidos en el aspirado quirúrgico, los instrumentales fueron procesados de acuerdo con los requisitos de buenas prácticas de la Resolución nº 15/2012 de la Agencia Nacional de Vigilancia Sanitaria (Anvisa). El crecimiento microbiano se evaluó en diferentes momentos de forma cualitativa, por la presencia o ausencia de crecimiento, y de forma cuantitativa para los casos positivos, mediante el recuento de unidades formadoras de colonias viables (log UFC/mango de bisturí). Resultados: En algún momento, hubo crecimiento microbiano en los instrumentales independientemente del tipo de identificador. Sin embargo, no hubo contaminación con-tinua y progresiva después de la repetición de las etapas de limpieza y esterilización. Conclusión: El tipo de identificador de instrumental odontológico no interfiere en el crecimiento microbiano siempre que se respeten las normas de limpieza y esterilización. (AU)

Objetivo: Avaliar a influência dos diferentes identificadores de instrumental no crescimento microbiano de dispositivos críticos após etapas de limpeza e esterilização. Método: Foram utilizados 15 cabos no 3 para lâminas de bisturi como corpo de prova, divididos em 3 grupos (n=5), sendo cada grupo composto de um instrumental sem identificador e outros quatro instrumentais com os seguintes identificadores: gravação a laser, anel de silicone, identificador vinílico com adesivo permanente e etiqueta adesiva personalizada. Após serem submersos no aspirado cirúrgico, os instrumentais foram processados de acordo com os requisitos de boas práticas da Resolução n. 15/2012 da Agência Nacional de Vigilância Sanitária (Anvisa). O crescimento microbiano foi avaliado em diferentes momentos de forma qualitativa, pela presença ou ausência de crescimento, e de forma quantitativa para os casos positivos, por meio de contagem de unidades formadoras de colônia viáveis (log UFC/cabo de bisturi). Resultados: Em algum momento, houve cres-cimento microbiano nos instrumentais independentemente do tipo de identificador. No entanto, não houve contaminação contínua e progressiva após repetição das etapas de limpeza e esterilização. Conclusão: O tipo de identificador de instrumental odontológico não interfere no crescimento micro-biano desde que sejam respeitadas as normas de limpeza e esterilização. (AU)

Micro duelo: adaptação do jogo Yu-Gi-Oh para o ensino da Microbiologia / Micro duel: adaptation of the game Yu-Gi-Oh for teaching Microbiology / Micro duelo: adaptación del juego Yu-Gi-Oh para la enseñanza de Microbiología

Objetivo: Relatar a experiência de professores tutores e professores da Educação Básica, participantes do curso EAD Ensino de Ciências para a Promoção de Saúde na Escola Básica, na construção de um material didático-pedagógico para ser utilizado em sala de aula. Método: Para diversificar a rotina de aulas no ensino de Ciências e Biologia, direcionadas para alunos do ensino médio, os professores da Educação Básica que trabalharam os conteúdos do módulo de Saúde e Educação, desenvolveram um jogo de cartas que aborda a microbiologia, inspirado em Yu-Gi-Oh, uma série animada de mangá (histórias japonesas em quadrinhos), onde os jogadores usam cartas para duelar, em uma batalha simulada. Resultados: O material didático descreve os principais conceitos utilizados nojogo (duelo, pontos de vida, tipos de cartas etc.), as fases do duelo e os passos para iniciar o jogo. As cartas foram adaptadas para os assuntos abordados na microbiologia e continham nome do agente, tipo, descrição, atributo em cores, nível de ação em estrelas, número da carta e os pontos de ataque e de defesa. Conclusão: Espera-se estimular a interação e o aprendizado dos estudantes, através da aquisição de habilidades indispensáveis ao desenvolvimento intelectual e facilitação dos conceitos relacionados à microbiologia.

Objective: Report the experience of tutors and Basic Education teachers, participants in the EAD course Teaching Science for Health Promotion in Basic Schools, in the construction of didactic-pedagogical material to be used in the classroom. Method: To diversify the routine of teaching Science and Biology classes, aimed at high school students, the Basic Education teachers who worked on the contents of the Health and Education module, developed a card game that addresses microbiology, inspired by Yu-Gi-Oh, an animated manga series (Japanese comic books), where players use cards to duel in a simulated battle. Results: The teaching material describes the main concepts used in the game (duel, life points, types of cards, etc.), the phases of the duel and the steps to start the game. The cards were adapted to the subjects covered in microbiology and contained the agent's name, type, description, attribute in colors, action level in stars, card number and attack and defense points. Conclusion: It is expected to stimulate student interaction and learning, through the acquisition of skills essential for intellectual development and facilitation of concepts related to microbiology.

Objetivo: Reportar la experiencia de tutores y docentes de Educación Básica, participantes del curso EADEnseñanza de Ciencias para la Promoción de la Salud en Escuelas Básicas, en la construcción de material didáctico-pedagógico para ser utilizado en aula. Método: Para diversificar la rutina de enseñanza de las clases de Ciencias y Biología, dirigidas a estudiantes de secundaria, los docentes de Educación Básica que trabajaron los contenidos Salud y Educación desarrollaron un juego de cartas que aborda la microbiología, inspirado en Yu-Gi-Oh, una serie animada de manga (cómics japoneses), donde los jugadores usan cartas para batirse en duelo en una batalla simulada. Resultados: El material didáctico describe los principales conceptos utilizados en el juego (duelo, puntos de vida, tipos de cartas, etc.), las fases del duelo y los pasos para iniciar el juego. Las tarjetas estaban adaptadas a los temas tratados en microbiología y contenían el nombre del agente, tipo, descripción, atributo en colores, nivel de acción en estrellas, número de tarjeta y puntos de ataque y defensa. Conclusión: Se espera estimular la interacción y el aprendizaje de los estudiantes, a través de la adquisición de habilidades esenciales para el desarrollo intelectual y la facilitación de conceptos relacionados con la microbiología.

El papel del laboratorio de microbiología en la práctica clínica / The role of the microbiology laboratory in clinical practice

Los seres humanos albergamos en el cuerpo a cientos de miles de microbios (bacterias, virus, hongos, archaea). Con la mayoría convivimos armónicamente, y obtenemos beneficios mutuos. Ellos participan activamente en nuestros procesos metabólicos e inmunológicos, y nosotros les damos vivienda y nutrientes [1]. Si el equilibrio se altera, como ocurre cuando el sistema inmune se suprime, algunos de estos microorganismos aprovechan la oportunidad y desencadenan infección [2], siendo este el origen de la mayoría de las infecciones, pero no el único, pues los ambientes externos al cuerpo humano también están poblados de microbios, y si bien pocos se consideran patógenos, al entrar en contacto con ellos adquirimos infecciones que llamamos exógenas. De acuerdo con la Organización Mundial de la Salud (OMS), las enfermedades transmisibles están entre las 10 principales causas de muerte en el mundo, y excluyendo la infección por SARS-CoV-2 (COVID-19) en 2021, las infecciones respiratorias agudas fueron la cuarta causa más frecuente de defunción a nivel mundial [3]. El laboratorio de microbiología clínica tiene un papel crucial en el proceso diagnóstico, terapéutico y preventivo de las enfermedades infecciosas causadas por bacterias, hongos, virus y parásitos, pues determinar el agente causal de manera eficaz permite tomar acciones oportunas para definir el manejo individual de las personas infectadas y cortar la cadena de transmisión cuando se requiera [2]

Los inicios de la fagoterapia en Chile: los doctores Mercedes Perez Matus y Hugo Vaccaro Kosovich / The beginnings of phage therapy in Chile: the doctors Mercedes Perez Matus and Hugo Vaccaro Kosovich

Mercedes Pérez Matus y Hugo Vaccaro Kosovich fueron destacados médicos y microbiólogos de la cátedra ordinaria de Bacteriología de la Facultad de Medicina de la Universidad de Chile. En 1931, ambos médicos fueron contratados por la Facultad de Medicina para reorganizar la convulsionada Cátedra de Bacteriología luego de la crisis política de 1931. En el mismo período el destacado investigador del instituto Pasteur Eugéne Wollman vino a Chile a dirigir el Instituto Sanitas (1929-1931), incorporando en nuestro país el conocimiento sobre los bacteriófagos y las técnicas para su aislamiento. La prolongada labor docente y de investigación de Vaccaro y Pérez se extendió por casi 40 años (1931-1970). Publicaron numerosos artículos científicos, siendo uno de sus temas preferidos, en los primeros años, el estudio de los bacteriófagos que aprendieron junto a Wollman. En la década de los 40, bajo el liderazgo de los Dres. Vaccaro y Pérez, se inició la fagoterapia en Chile.

Mercedes Perez Matus and Hugo Vaccaro Kosovich were distinguished doctors and microbiologists from the ordinary chair of Bacteriology at the Faculty of Medicine of the University of Chile. In 1931, both doctors were hired by the F aculty of Medicine to reorganize the convulsed Chair of Bacteriology after the political crisis of 1931. In the same period, the prominent Pasteur Institute researcher Eugene Wollman came to Chile to direct the Sanitas Institute (1929-1931), incorporating in our country the knowledge about bacteriophages and the techniques for their isolation. The long teaching and research work of Vaccaro and Pérez spanned almost 40 years (1931-1970). They published numerous scientific articles, being one of their favorite topics, in the early years, the study of bacteriophages that they learned together with Wollman. In the 1940s, under the leadership of Drs. Vaccaro and Pérez, phage therapy began in Chile.

Mikros, aplicación androide para Microbiología y Parasitología en la Universidad de Ciencias Médicas de Camagüey / Mikros, an Android Application for the Microbiology and Parasitology Subject in the University of Medical Sciences of Camagüey

Introducción: El aprendizaje móvil (m-learning) es la inclusión de dispositivos móviles en las actividades de aprendizaje. En la enseñanza de Microbiología y Parasitología médica estos ofrecen un alto poder de ilustración y contribuyen al aprendizaje de la asignatura de los estudiantes de la carrera de medicina; además, sirven de apoyo a otros perfiles como Tecnología de la Salud. Objetivo: Exponer la actualización del curso de Microbiología y Parasitología en la Universidad de Ciencias Médicas de Camagüey mediante una aplicación androide. Métodos: Se realizó una aplicación optimizada para androide 4.4 o superior con el lenguaje de programación Java. Esta investigación se desarrolló en la Universidad de Ciencias Médicas Carlos J. Finlay y se aplicó a estudiantes de la carrera de medicina en los cursos 2018-2019 y 2019-2020. El universo del estudio fueron 1446 estudiantes de los cursos de 2016-2020. Se realizó una encuesta validada por expertos a una muestra probabilística de 88 estudiantes de la Universidad de Ciencias Médicas de Camagüey, en el período comprendido entre noviembre y diciembre de 2020. Se calculó el coeficiente concordancia general W de Kendall en cuanto a las respuestas a las preguntas. Resultados: Mikros fue una herramienta de apoyo a la docencia, fruto de un proyecto de colaboración entre el Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas y la Facultad de Ingeniería Informática de la Universidad Ignacio Agramonte, de Camagüey, que permitió introducir al profesor en una modalidad de enseñanza muy a tono con estos tiempos. Conclusiones: La aplicación Mikros incluyó conceptos básicos y un alto nivel de actualización. También contribuyó a elevar el índice académico y a una mayor satisfacción del alumno en el aprendizaje, y resultó una herramienta de consulta práctica para estudiantes de años posteriores de la carrera en rotación por el área clínica y útil para el aprendizaje a distancia en tiempos de COVID-19(AU)

Introduction: Mobile learning (m-learning) consists in the inclusion of mobile devices into learning activities. In the teaching of medical parasitology and microbiology, such devices offer a high power of illustration and contribute to medical students' learning of the subject; in addition, they serve as support to other profiles such as health technology. Objective: To present the update, by means of an android application, of the Microbiology and Parasitology course at the University of Medical Sciences of Camagüey. Methods: An optimized application for android 4.4 or higher was created with the Java programming language. This research was carried out at Carlos J. Finlay University of Medical Sciences and applied to medical students in the 2018-2019 and 2019-2020 academic years. The study universe was made up of 1446 students from the academic years from 2016 to 2020. A survey validated by experts was carried out, in the period between November and December 2020, with a probabilistic sample of 88 students from the University of Medical Sciences of Camagüey. Kendall's coefficient of general concordance (W) was calculated for the answers to the questions. Results: Mikros was a teaching support tool, the result of a collaborative project between the Center of Immunology and Biological Products at the University of Medical Sciences and the School of Computer Engineering at Ignacio Agramonte University, in Camagüey, which allowed to present the professor in a teaching modality much in tune with the current times. Conclusions: The Mikros application included basic concepts and a high update level. It also contributed to raising the student's academic index and satisfaction with learning. It turned out to be a practical consultation tool for students of higher academic years of the major who are rotating through the clinical area, as well as a useful tool for distance learning in COVID-19 times(AU)

Does ascitic fluid filtration improve the microbiological diagnosis of spontaneous bacterial peritonitis? An experimental laboratory study / A filtração do líquido ascítico melhora o diagnóstico microbiológico da peritonite bacteriana espontânea? Um estudo experimental laboratorial

Background: Spontaneous Bacterial Peritonitis (SBP) is a serious and frequent complication among cirrhotic patients with ascites and can be diagnosed by cytological analysis of the ascitic fluid. The microbiological culture of ascitic fluid, however, is positive in less than 40% of SBP cases, which often results in inappropriate antimicrobial therapy. Empirical therapy may be suboptimal, increasing patient's risk of aggravation, or overestimated, unnecessarily boosting bacterial resistance. Objective: This experimental laboratory study aimed to standardize and verify the technical feasibility of ascitic fluid vacuum filtration, as a way to optimize the etiological diagnosis of SBP, compared to the automated method. Method: The method evaluated and standardized in this study was ascitic fluid vacuum filtration. Its principle is the concentration of bacteria on a filter membrane. Results: This study included 36 cirrhotic patients treated at a public university hospital between 11.13.2017 and 06.30.2019. Among them, 47.2% (17/36) presented cytology test results compatible with SBP. For these patients, culture sensitivity using the automated method was 35.3% (6/17), against 11.8% (2/17) with the vacuum filtration method. Conclusion: In conclusion, vacuum filtration does not improve the microbiological diagnosis of SBP in this population compared to the automated method (AU)

Contexto: A Peritonite Bacteriana Espontânea (PBE) é uma complicação grave e frequente entre pacientes cirróticos com ascite, diagnosticada por meio da análise citológica do líquido ascítico. A cultura microbiológica do líquido ascítico, por sua vez, é positiva em menos de 40% dos casos de PBE, o que resulta frequentemente na instituição de terapia antimicrobiana inapropriada. A terapia empírica pode ser subótima, aumentando o risco de agravamento do paciente, ou superestimada, impulsionando desnecessariamente a resistência bacteriana. Objetivo: Estudo experimental laboratorial, propôs padronizar e verificar a viabilidade técnica da filtração a vácuo do líquido ascítico, como forma de otimizar o diagnóstico etiológico na PBE, comparativamente ao sistema automatizado de culturas de sangue. Método: O método avaliado e padronizado neste estudo foi a da filtragem a vácuo do líquido ascítico. Esse tem como princípio a concentração da bactéria em uma membrana filtrante. Resultados: Nesse estudo, foram incluídos 36 pacientes cirróticos atendidos em um hospital público universitário, entre 13.11.2017 e 30.06.2019. Entre eles, 47,2% (17/36) apresentaram citologia compatível com PBE. Nesses, a sensibilidade da cultura pelo método semi-automatizado foi de 35,3% (6/17) e da cultura pelo método da filtragem a vácuo foi de 11,8% (2/17). Conclusão: Em conclusão, a filtragem a vácuo não melhora o diagnóstico microbiológico da PBE em relação ao método automatizado (AU)

Semina morbi o semillas de enfermedad / Semina morbi or seeds of disease

Resumen Ya en la antigüedad existía la idea de que pequeñísimos animales o insectos podían causar enfermedades al ser ingeridos o respirados. En forma paralela, varios filósofos desarrollaron el concepto de semillas para explicar la composición del mundo. Ambos conceptos fueron amalgamados en la genial idea de semillas de enfermedad que fue difundida en el célebre poema del filósofo epicúreo Lucrecio denominado "De rerum natura" o "Sobre la naturaleza de las cosas". La idea fue refinada en el Renacimiento por el destacado médico renacentista Gerónimo Fracastorius con sus famosas semina morbi (semillas de enfermedad) que explicaban el contagio. La teoría germinal de los microbios del s. XIX no hizo más que adjudicarle a esta idea ya milenaria un substrato material.

Abstract Already in ancient times there was the idea that tiny animals or insects could cause diseases when ingested or breathed. In parallel, several philosophers developed the concept of seeds to explain the composition of the world. Both concepts were amalgamated in the brilliant idea of seeds of disease that was spread in the famous poem "De rerum natura" by the Epicurean philosopher Lucretius. The idea was refined in the Renaissance by the prominent physician Girolamo Fracastorius with his famous semina morbi (seeds of disease) that explained contagion. The germinal theory of microbes of the s. XIX did nothing more than assign to this already millenary idea a material substratum.

Identificación directa de microorganismos a partir de hemocultivos positivos utilizando espectrometría de masas (MALDI-TOF MS) / Direct identification of microorganisms in positive blood culture bottles by mass spectrometry (MALDI-TOF MS)

Resumen La espectrometría de masas (MALDI-TOF MS) permite la identificación de microorganismos directamente de las colonias en pocos minutos. En este estudio se ha desarrollado y evaluado un protocolo reducido para identificar microorganismos directamente de las botellas de hemocultivos positivos en 30 minutos con una alta sensibilidad y especificidad, utilizando MALDITOF. Un total de 2535 hemocultivos positivos fueron estudiados por el método directo de MALDI-TOF MS, a partir de una alícuota de sangre de las botellas y el método de colonia, utilizando los cultivos desarrollados en medios sólidos. Del total de hemocultivos positivos incluidos en este estudio, 2381 (93,9%) fueron monomicrobianos y 146 (5,8%) polimicrobianos. Mil trescientos treinta (55,9%) de los aislamientos correspondieron a cocos gram positivos, 922 (38,7%) a bacilos gram negativos, 60 (2,5%) a anaerobios, 36 (1,5%) a bacilos gram positivos y 13 a levaduras. La concordancia global entre ambos métodos fue del 81,7% a nivel de especie (90,0% para bacilos gram negativos, 76,7% para cocos gram positivos y 33,3% para bacilos gram positivos). Se identificó al menos un germen en el 88% de las botellas positivas con desarrollo polimicrobiano. Los resultados del presente estudio demostraron que el protocolo basado en MALDI-TOF MS permite la identificación microbiana directamente de hemocultivos positivos en un tiempo corto, con una alta precisión, con excepción de los bacilos gram positivos.

Abstract Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) enables the identification of microorganisms directly from colonies within minutes. In this study this technology was adapted and tested for use with blood culture bottles, thus allowing identification in 30 minutes once the blood culture is detected as positive by the automate. A total of 2535 blood culture bottles reported as positive were tested by MALDI-TOF MS directly from positive blood culture bottles and colonies. A total of 2381 (93.9%) and 146 (5.8%) of the positive blood cultures were monomicrobial and polymicrobial, respectively. And 1330 (55.9%), 922 (38.7%), 60 (2.5%), 36 (1.5%) and 13 of the isolates were gram-positive cocci (GPC), gram-negative bacilli (GNB), anaerobic bacteria, gram-positive bacilli (GPB) and yeast respectively. Concordance between both methods was 81.7% (76.7% of GPC, 90% of GNB, 74.2% of anaerobic bacteria and 33.3% of GPB) in monomicrobial cultures. Eighty eight per cent of the polymicrobial cultures were identified correctly in at least one of the two bacteria. The results of the present study show that this fast, MALDI-TOF MS based method allows microbial identification directly from positive blood culture in a short time, with a high accuracy, with the exception of gram-positive bacilli.

Resumo A espectrometria de massa (MALDI-TOF MS) permite a identificação de microorganismos diretamente das colônias em minutos. Nesse estudo, foi desenvolvido um protocolo reduzido para identificar microrganismos diretamente das garrafas de hemoculturas positivas em 30 minutos com alta sensibilidade e especificidade, utilizando MALDI-TOF. Um total de 2535 hemoculturas positivas foram relatadas -o método direto de MALDI-TOF MS, a partir de uma alíquota de sangue dos vidros e o método de colônia, a partir das culturas desenvolvidas em meios sólidos. Do total de hemoculturas positivas incluídas neste estudo, 2.381 (93,9%) eram monomicrobianas e 146 (5,8%) eram polimicrobianas. Mil trezentos e trinta (55,9%) dos isolados corresponderam a cocos gram-positivos, 922 (38,7%) bacilos gram-negativos, 60 (2,5%) anaeróbios, 36 (1,5%) bacilos gram-positivos e 13 leveduras. A concordância geral entre os dois métodos foi de 81,7% em nivel de especie (90,0% para bacilos gram-negativos, 76,7% para cocos gram-positivos e 33,3% para bacilos gram-positivos). Pelo menos um germe foi identificado em 88% dos vidros positivos com desenvolvimento polimicrobiano. Os resultados do presente estudo demonstraram que o protocolo baseado em MALDI-TOF MS permite a identificação microbiana diretamente de hemoculturas positivas em um curto espaço de tempo, com alta precisão, com exceção de bacilos gram-positivos.

Estudio de la actividad antimicrobiana de Xenophyllum poposum sobre microorganismos de la cavidad bucal por el método de difusión radial / Study of the antimicrobial activity of Xenophyllum poposum on microorganisms of the oral cavity by the radial diffusion method

Resumen En este estudio se evaluó la actividad antimicrobiana in vitro de extractos de Xenophyllum poposum sobre microorganismos bucales como Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans y Veillonella sp. Se empleó el método de difusión radial en agar y como controles negativo y positivo de inhibición se emplearon etanol y clorhexidina al 0,12% (Plac out NF®) respectivamente. Los extractos con mayor actividad antimicrobiana fueron el etanólico y el clorofórmico. La diferencia entre ambos no fue estadísticamente significativa (p≥0,05). Tampoco se observó diferencia significativa con respecto a la clorhexidina, excepto sobre Veillonella sp., ya que el extracto etanólico presentó halos de inhibición significativamente menores sobre este microorganismo. Esto es importante ya que Veillonella se considera indicador de salud en relación a la caries dental. En base a esto, el extracto etanólico de Xenophyllum poposum podría ser usado como control químico de la biopelícula dental.

Abstract In this study, the in vitro antimicrobial activity of Xenophyllum poposum extracts on oral microorganisms such as Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans, Veillonella sp. was evaluated. The radial diffusion method in agar was used and 0.12% ethanol and chlorhexidine (Plac out NF®) were used as negative and positive inhibition controls, respectively. The extracts with the highest antimicrobial activity were the ethanolic and chloroform extracts. The difference between the two was not statistically significant (p≥0.05). No significant difference was observed with respect to chlorhexidine, except on Veillonella sp., since the ethanolic extract presented significantly lower inhibition halos on this microorganism. This is important as Veillonella is considered an indicator of health in relation to dental caries. Based on this, the ethanolic extract of Xenophyllum poposum could be used as chemical control of dental biofilm.

Resumo Neste estudo, a atividade antimicrobiana de extratos de Xenophyllum poposum sobre microrganismos orais como Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans e Veillonella sp. Foi utilizado o método de difusão radial em ágar e etanol 0,12% e clorexidina (Plac out NF®) como controles de inibição negativa e positiva, respectivamente. Os extratos com maior atividade antimicrobiana foram os extratos etanólico e clorofórmio. A diferença entre os dois não foi estatisticamente significativa (p≥0,05). Não foi observada diferença significativa em relação à clorexidina 0,12%, exceto em Veillonella sp., uma vez que o extrato etanólico apresentou halos de inibição significativamente menores neste microrganismo. Isso é importante, pois a Veillonella é considerada um indicador de saúde em relação à cárie dentária. Com base nisso, o extrato etanólico de Xenophyllum poposum pode ser utilizado como controle químico do biofilme dental.

Effect of handling, time of use and photoactivation on the contamination of dental composite resins

This study evaluated the effect of contamination of composite resins (CRs) handled by undergraduate students during restorative procedures, varying the time (baseline, 30 days and 60 days) and experimental condition (before and after handling, contamination with saliva [positive control] and photoactivation). Eight CR tubes were randomly distributed at the dental clinic and the samples were organized into four groups: CR fragments collected before (GB) and after (GA) the restorative procedure; CR fragments contaminated with saliva (GS) and photoactivated (GP) both collected after the procedure. These 4 groups were evaluated in 3 different times: baseline (after sealing), 30 days and 60 days of use of the CR. Samples that had positive turbidity in Brain HeartInfusion (BHI) broth were sown in BHI and Sabouraud Dextrose (SB) agars for subsequent counting of Colony Forming Units (CFU mL-1). The results showed that the handling was responsible for increasing contamination (p < 0.05) at the baseline (GB [n = 0] and GA [n = 3]), as well as after 30 (GB [n = 1] and GA [n = 6]) and 60 (GB [n = 1] and GA [n = 5]) days of use. Photoactivation was responsible for the reduction for microorganisms in T0 and T60. Additionally, the time use and conservation did not influencethe contamination of CRs. Handling was responsible for the increase of contamination of CR, the photoactivation seems to reduce the number of viable microorganisms and the time of use seems not to potentiate the effect of tube contamination.

Does ascitic fluid filtration improve the microbiological diagnosis of spontaneous bacterial peritonitis? An experimental laboratory study / A filtração do líquido ascítico melhora o diagnóstico microbiológico da peritonite bacteriana espontânea? Um estudo experimental laboratoria

ABSTRAC: Background: Spontaneous Bacterial Peritonitis (SBP) is a serious and frequent complication among cirrhotic patients with ascites and can be diagnosed by cytological analysis of the ascitic fluid. The microbiological culture of ascitic fluid, however, is positive in less than 40% of SBP cases, which often results in inappropriate antimicrobial therapy. Empirical therapy may be suboptimal, increasing patient's risk of aggravation, or overestimated, unnecessarily boosting bacterial resistance. Objective: This experimental laboratory study aimed to standardize and verify the technical feasibility of ascitic fluid vacuum filtration, as a way to optimize the etiological diagnosis of SBP, compared to the automated method. Method: The method evaluated and standardized in this study was ascitic fluid vacuum filtration. Its principle is the concentration of bacteria on a filter membrane. Results: This study included 36 cirrhotic patients treated at a public university hospital between 11.13.2017 and 06.30.2019. Among them, 47.2% (17/36) presented cytology test results compatible with SBP. For these patients, culture sensitivity using the automated method was 35.3% (6/17), against 11.8% (2/17) with the vacuum filtration method. Conclusion: In conclusion, vacuum filtration does not improve the microbiological diagnosis of SBP in this population compared to the automated method. (AU)

RESUMO:Contexto: A Peritonite Bacteriana Espontânea (PBE) é uma complicação grave e frequente entre pacientes cirróticos com ascite, diagnosticada por meio da análise citológica do líquido ascítico. A cultura microbiológica do líquido ascítico, por sua vez, é positiva em menos de 40% dos casos de PBE, o que resulta frequentemente na instituição de terapia antimicrobiana inapropriada. A terapia empírica pode ser subótima, aumentando o risco de agravamento do paciente, ou superestimada, impulsionando desnecessariamente a resistência bacteriana. Objetivo: Estudo experimental laboratorial, propôs padronizar e verificar a viabilidade técnica da filtração a vácuo do líquido ascítico, como forma de otimizar o diagnóstico etiológico na PBE, comparativamente ao sistema automatizado de culturas de sangue. Método: O método avaliado e padronizado neste estudo foi a da filtragem a vácuo do líquido ascítico. Esse tem como princípio a concentração da bactéria em uma membrana filtrante. Resultados: Nesse estudo, foram incluídos 36 pacientes cirróticos atendidos em um hospital público universitário, entre 13.11.2017 e 30.06.2019. Entre eles, 47,2% (17/36) apresentaram citologia compatível com PBE. Nesses, a sensibilidade da cultura pelo método semi-automatizado foi de 35,3% (6/17) e da cultura pelo método da filtragem a vácuo foi de 11,8% (2/17). Conclusão: Em conclusão, a filtragem a vácuo não melhora o diagnóstico microbiológico da PBE em relação ao método automatizado. (AU)

La lucha antimicrobiana: Desarrollo de competencias en 6 universidades ecuatorianas / The antimicrobial fight: Development of skills in 6 Ecuadorian universities

Los microorganismos son seres vivos, que han ido adaptándose y evolucionando permitiendo su supervivencia, evadiendo las respuesta innata de los hospedadores e incluso modificando sus estructuras biológicas antes moléculas farmacológicas, que se han, en los últimos años, empleado de manera inadecuadas, bien sea por abuso o por deficiencia en el cumplimiento del esquema del tratamiento, o desaciertos para tratar un germen en específico y, como consecuencia, la actual crisis mundial por la resistencia a los antimicrobianos; considerado un problema de salud pública, requiere de esfuerzos multisectoriales e integrales que aporten soluciones mediatas, a corto y mediano plazo, sostenibles en el tiempo. Para ellos, es clave la formación de los nuevos profesionales, en el área de microbiología, de las diferentes carreras biomédicas. Es por ello, el presente estudio identificó las competencias que deben desarrollar los estudiantes, de seis universidades ecuatorianas. Se aplicaron cuestionarios, inquiriendo la importancia atribuida y el grado de desarrollo percibido de cada competencia mediante escala tipo Likert, además de seis dimensiones distribuidas en 40 indicadores. Se identificó mayor desarrollo de competencias en la identificación del patógeno, diagnóstico y análisis e interpretación de los resultados; además las seis dimensiones educativas fueron clasificadas como relevantes. Sin embargo, los resultados sugieren falencia en el desarrollo de competencias en la temática de resistencia antimicrobiana, por lo que se sugiere la revisión de los contenidos programáticos y aplicar nuevas herramientas pedagógicas que permitan al estudiantado aprender a aprender, aplicando un modelo socio-critico, y como base la investigación y el conocimiento científico actualizado(AU)

Microorganisms are living beings, which have been adapting and evolving allowing their survival, evading the innate response of the hosts and even modifying their biological structures before pharmacological molecules, which have, in recent years, been used inappropriately, either by abuse or deficiency in compliance with the treatment scheme, or failure to treat a specific germ and, as a consequence, the current global crisis due to antimicrobial resistance; considered a public health problem, it requires multisectoral and comprehensive efforts that provide immediate, short- and medium-term solutions that are sustainable over time. For them, the training of new professionals in the area of microbiology, of the different biomedical careers, is key. For this reason, this study identified the skills that students from six Ecuadorian universities should develop. Questionnaires were applied, inquiring about the importance attributed and the perceived degree of development of each competency using a Likert-type scale, in addition to six dimensions distributed in 40 indicators. Greater development of skills in the identification of the pathogen, diagnosis and analysis and interpretation of the results was identified; In addition, the six educational dimensions were classified as relevant. However, the results suggest a lack in the development of skills in the subject of antimicrobial resistance, so it is suggested to review the program contents and apply new pedagogical tools that allow students to learn to learn, applying a socio-critical model, and as a basis research and updated scientific knowledge(AU)

Microbiological contamination of improved water sources, Mozambique

Objective To assess if water from improved sources are microbiologically safe in Niassa province, Mozambique, by examining the presence of total coliforms in different types of water sources. Methods We conducted a cross-sectional household survey in two rural districts of Niassa province during the dry season, from 21 August to 4 October 2019. We observed water sources and conducted microbiological water quality tests and structured household interviews. Findings We included 1313 households, of which 812 (61.8%) used water from an improved source. There was no significant difference in presence of total coliforms between water sampled at improved and unimproved water sources, 62.7% (509 samples) and 65.7% (329 samples), respectively (P-value=0.267). Households using improved water sources spent significantly longer time collecting water (59.1 minutes; standard deviation, SD: 55.2) than households using unimproved sources (49.8 minutes; SD: 58.0; P-value <0.001). A smaller proportion of households using improved sources had access to water sources available 24 hours per day than that of households using unimproved sources, 71.7% (582 households) versus 94.2% (472 households; P-value <0.001). Of the 240 households treating water collected from improved sources, 204 (85.4%) had total coliforms in their water, while treated water from 77 of 107 (72.0%) households collecting water from an unimproved source were contaminated. Conclusion Current access to an improved water source does not ensure microbiological safety of water and thereby using access as the proxy indicator for safe drinking and cooking water is questionable. Poor quality of water calls for the need for integration of water quality assessment into regular monitoring programmes.

Resistência bacteriana aos antimicrobianos: uma revisão das principais espécies envolvidas em processos infecciosos / Bacterial resistance to antimicrobials: a review of the main species involved in infectious processes

Os mecanismos de resistência bacteriana podem existir de maneira intrínseca ou adquirida, porém em ambos os casos podem dificultar a terapia antimicrobiana preconizada para tratamento de infecções. Este artigo tem como objetivo apresentar estudos recentes sobre o assunto. Foi realizada uma revisão da literatura sobre resistência bacteriana aos antimi- crobianos, utilizando as bases de dados MEDLINE, LILACS, Scopus e Web of Science. A busca identificou o total de 16 artigos, que foram publicados entre os anos de 2017 a 2021. A maioria dos artigos sobre Gram-negativos tratou do grupo das enterobactérias, assim como os de Gram-positivos tratou dos gêneros Staphylococcus , Enterococcus e Streptococcus. A resistência bacteriana foi encontrada em cefalosporinas, carbapenêmicos, quinolonas, aminoglicosídeos, entre outros. Em relação aos mecanismos de resistência, as ß-Lactamases de espectro estendido (ESBL), enterobactérias resistentes aos carbape- nêmicos (ERC), Staphylococcus aureus resistentes à meticilina (MRSA) e Enterococcus resistentes à vancomicina (VRE) foram relatados e observa-se que a maioria dos trabalhos corrobora que seu rastreamento visa minimizar a transmissão em instituições de saúde.

Bacterial resistance mechanisms can exist intrinsically or acquired, but in both cases they can make the antimicrobial therapy recommended for the treatment of infections difficult. This article aims to present recent studies on the subject. A literature review on bacterial resistance to antimicrobials was carried out using the MEDLINE, LILACS, Scopus and Web of Science databases. The search identified a total of 16 articles, which were published between 2017 and 2021. Most articles on Gram-negatives dealt with the enterobacteria group, as well as Gram-positive articles from the Staphylococcus, Enterococcus and Streptococcus genera. Bacterial resistance was found in cephalosporins, carbapenems, quinolones, aminoglycosides, among others. Regarding resistance mechanisms, Extended Spectrum Beta-Lactamases (ESBL), Carbapenem-Resistant Enterobacteria (ERC), Methicillin- Resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE) have been reported and it is observed that most works corroborate that its tracking aims to minimize transmission in health institutions.

Secretos detectados de la naturaleza por Antoine van Leeuwenhoek / Detected secrets for nature by Antoine van Leeuwenhoek

Resumen Una de las obras, probablemente menos conocidas, de Antoine van Leeuwenhoek (1632-1723) es su Arcana naturae detecta (Secretos detectados de la naturaleza) publicada en su primera edición en 1695. Esta obra es una recopilación de 38 cartas sobre temas científicos y está bellamente ilustrada. Una sección notable de ella es la observación y descripción por primera vez de levaduras de la fermentación y sus experimentos sobre la generación espontánea de microorganismos.

Abstract One of the works, probably less known, of Antoine van Leeuwenhoek (1632-1723) is his Arcana naturae detecta (Detected secrets of nature) published in its first edition in 1695. This work is a compilation of 38 letters on scientific issues and it is beautifully illustrated. A notable section of the work is the observation and description for the first time of fermentation yeasts and his experiments on the spontaneous generation of microorganisms.