Emergence and clonal expansión of Klebsiella pneumoniae ST307, simultaneously producing KPC-3 and NDM-1

Abstract MDR Klebsiella pneumoniae ST307 is a high-risk clone, whose genetic features contribute to its adaptation to hospital environments and the human host. This study describesthe emergence and clonal dissemination of K. pneumoniae ST307, recovered during November2018 to February 2019 in a hospital in Buenos Aires city, which concurrently harbored KPC-3and NDM-1. These isolates were resistant to all -lactams and to the ceftazidime/avibactamcombination. Molecular studies showed that blaKPC-3was located in Tn4401a platform, whileblaNDM-1was surrounded upstream by ISKpn14 followed by a partial sequence of ISAba125 anddownstream by bleMBL-trpF, located in a 145.5 kb conjugative plasmid belonging to the Inc A/Cgroup. The dissemination of K. pneumoniae ST307 isolates co-producing KPC-3 and NDM-1 couldlead to a worrisome scenario due to the remarkable features of this clone and its resistanceprofile.

Resumen Klebsiella pneumoniae ST307 es un clon de alto riesgo, cuyas características genéticas contribuyen a su adaptación al entorno hospitalario y al huésped humano. Este estudio describe la emergencia y diseminación clonal de aislamientos de K. pneumoniae ST307 productores de KPC-3 y NDM-1, recuperados en un hospital de Buenos Aires. Estos aislamientos fueron resistentes a todos los p-lactámicos y a la combinación ceftacidima/avibactam. Los estudios moleculares evidenciaron que el contexto genético de blaKPC-3 se correspondió con el Tn4401a, mientras que blaNDM-1 estuvo flanqueado corriente arriba por ISKpn14 y una secuencia parcial de ISAba125 y corriente abajo por bleMBL - trpF, localizado a su vez en un plásmido conjugativo de 145.5 kb perteneciente al grupo Inc A/C. La emergencia de aislamientos de K. pneumoniae ST307 coproductores de KPC-3 y NDM-1 pone de manifiesto una situación altamente preocupante debido a las características de este clon y a su perfil de multirresistencia.

Anatomical Variations Of Inca Bone In Adult Human Egyptian Skulls

Background: The Inca bone is integral part of the occipital bone of the skull in its interparietal region andappears during radiological examination of the skull.Aim of the work: This study aimed to estimate the incidence rates and variations of interparietal (Inca) andpreinterparietal bones in adult human Egyptian skulls .Materials and methods: In the present study 60 dry human Egyptian skulls (37 males and 23 females) wereexamined to determine the incidence rates of Inca and preinterparietal bones with detailed measurements forInca bone in mm using electronic digital caliber.Results: The incidence rates of Inca and preinterparietal bones were higher in male skulls than female skulls andthe interparietal or Inca bone was observed in only 4 skulls ( 6.66% ) while the preinterparietal bone wasobserved only in 2 skulls ( 3.33 %) .Conclusion: The presence of the Inca and preinterparietal bones was rare in the human Egyptian skulls andtheir incidence rates were higher in male skulls .

Bioética y justicia ambiental en la salud de los pobladores andinos de Perú / Bioethics and environmental justice in the health of the Andean residents of Peru / Bioética e justiça ambiental na saúde dos habitantes andinos do Peru

Resumen Este artículo intenta plasmar el panorama bioético-ambiental de la salud del poblador que habita en la sierra peruana, remarcando la inequidad en el acceso a los servicios de salud que existe en esta región y reflexionando sobre las posibles causas contextuales, históricas y actuales que han originado diferencias entre el poblador andino del incanato y el poblador andino actual, el cambio de cosmovisón sobre el ambiente y los recursos, el deterioro del enfoque de justicia, solidaridad, bienestar y respeto hacia el ser humano y la naturaleza. Además, se describe la salud desde el escenario histórico de esta región, donde la salud pública tiene y tendrá como desafío la aplicación de programas que respondan a las necesidades específicas de esta población, con un enfoque dirigido hacia lo ambiental.

Abstract This article attempts to capture the bioethical-environmental panorama of the health in the residents who live on the Peruvian highlands, highlighting the inequity in access to health services that exist in this region and reflecting on the possible historical and current contextual causes that have originated differences between Inca-Andean settler and modern-Andean settler. The change in the view of the world about the environment and natural resources, the decline of justice approach, loss of solidarity, welfare, and respect to human being and nature. Besides, we describe health from a historical scenario of this region, where Public health has and will have as a challenge the application of programs that respond to the specific needs of this population, with a focus on the environment.

Resumo Este artigo tenta capturar o panorama bioético-ambiental da saúde dos habitantes que vivem nas ser as peruanas, destacando a desigualdade no acesso aos serviços de saúde que existe nesta região e refletindo sobre as possíveis causas contextuais, históricas e atuais que têm originado diferenças entre o habitante andino do Incanato e a atual população andina, a mudança de cosmovisão sobre o meio ambiente e os recursos, a deterioração da abordagem de justiça, solidariedade, bem-estar e respeito pelos seres humanos e a natureza. Além disso, a saúde é descrita a partir do cenário histórico desta região, onde a saúde pública tem e terá como desafio a aplicação de programas que respondam às necessidades específicas dessa população, com uma abordagem dirigida para o meio ambiente.

Detection of blaNDM-1 in Stenotrophomonas maltophilia isolated from Brazilian soil

This study reports the presence of the blaNDM-1 gene in an isolate of Stenotrophomonas maltophilia obtained from a Brazilian soil, inside an IncA/C plasmid with ~ 45 Kb. To the best of our knowledge, this is the second report in the world and the first in Brazil of NDM-producing bacterium isolated from soil.

Inca bone in human skulls of the west anatolian population / Hueso interparietal en cráneos humanos de la población de anatolia occidental

The Inca bones are rarely seen among other inter sutural bones and are accepted as variants of the normal. The incidence of the Inca bones has been researched in different populations. The aim of this study was to investigate the rate and types of the Inca bones in West Anatolian population. One hundred fifty-one skulls of West Anatolian subjects of unknown ages and sex were examined. None of the specimens showed signs of prior cranial surgery, bony malformation or trauma. The skulls were classified as adults with teeth eruption. The Inca bones were macroscopically determined and analysed. The samples were photoghraphed with Canon 400B (55 mm objective). We follow previous criteria and nomenclatures of the Inca bones. The incidence of Inca bones of examined skulls was 1.98% (3/151). We observed 1 incomplete lateral asymmetric, 1 complete undivided and 1 complete asymmetric bipartita Inca bones. Inca ossicles are accessory bones found in human skulls due to ossification failure. Inca bones can be used in personal identification by comparing the ante- and post-mortem radiographs. There are some regional variations in frequencies within each restricted geographical area. In the present study, the incidence of the Inca bones is 1.98% in West Anatolian population. The frequency of the Inca bones in the skulls belonging to Hellenistic Roman periods of Cyprus and Constantinople in Natural History Museum of Turkey was 1.59%. The variation in Anatolia's population at different times and regions, because of the migrations, may cause the differences between frequencies in these studies. Evaluation of the presence of the Inca bones may be usefull in identification in forensic medicine and paleodermographical studies.

Los huesos interparietales no son frecuentes entre otros huesos suturales interrelacionados y se reconocen como variantes de la normalidad. La incidencia de los huesos interparietales ha sido investigada en diferentes poblaciones. El objetivo de este estudio fue investigar el índice y tipo de hueso interparietal en la población de Anatolia Occidental. Fueron examinados 151 cráneos de individuos de Anatolia Occidental de edades y sexo desconocido. En las muestras no se observaron signos de cirugía craneal previa, malformación ósea o trauma. Los cráneos fueron clasificados como adultos con erupción dental. Los huesos interparietales fueron clasificados y analizados macroscópicamente y se realizaron fotografías de las muestras con equipo Canon 400B (objetivo de 55 mm). Se utilizó la norma para los criterios y nomenclatura de los huesos interparietales. La incidencia de los huesos interparietales en los cráneos examinados fue de 1,98% (3/151). Se registró una asimetría incompleta lateral, una sin división y una asimétrica bipartita total en los huesos examinados. Los huesos interparietales se utilizan en la identificación de individuos mediante la comparación de radiografías ante-mortem y post-mortem. Existen algunas variaciones de región en las frecuencias dentro de cada área de posición limitada. En el presente estudio la incidencia de los huesos interparietales es de 1,98% en la población de Anatolia Occidental. En el Museo de Historia Natural de Turquía, el índicede huesos interparietales en cráneos pertenecientes a los períodos romano helenístico de Chipre y Constantinopla fue de 1,59%. La variación en la población de Anatolia en diferentes épocas y regiones debido a las migraciones, puede ser el motivo de las diferencias en las investigaciones. La evaluación de la presencia de huesos interparietales puede ser útil para la identificación en la medicina forense y estudios paleodemográficos.

A Study of Interparietal Bone in 105 Human Skulls of Gujarat Population.

Introduction : The squamous portion of the occipital bone consists of two different parts: the upper interparietal and the lower supraoccipital. The interparietal part may remain separated from the supraoccipital by a suture; it is then called the interparietal or Inca bone. Aim : In this study, incidence of interparietal bone has been estimated and compared with the other observations. Methodology : Total 105 cadaveric dry human skulls were examined to determine incidence of interparietal bone. Observations : The skulls which were observed, displayed many variations in the occipital region. In 7 cases, single or multiple separated bones were observed. In 4 cases (3.81%), the lower edge of these additional bones was situated above the external occipital protuberance and such bones could be classified as interparietal bones. In 3 cases (2.86%), the lower edge of these additional bones was much higher (between the lambda region and the highest nuchal line). The later can be classified as preinterparietal. Importance : Knowledge of interparietal bone is important for the radiologists, neurosurgeons, anthropologists, orthopedics and forensic experts to avoid misdiagnosis.

COMPOSICIÓN DE ÁCIDOS GRASOS DE SACHA INCHI (Plukenetia volúbilis Linneo) Y SU RELACIÓN CON LA BIOACTIVIDAD DEL VEGETAL / FATTY ACID COMPOSITION OF INCA PEANUT (Plukenetia volúbilis Linneo) AND ITS RELATIONSHIP WITH VEGETAL BIOACTIVITY

Omega and unusual fatty acids were evaluated from ethanol extracts of roots and leaves ofPlukenetia volúbilis L. were evaluated. Seed oil was obtained by soxhlet and bioreactor; the fatty acids were determined and characterized by gas chromatography coupled to mass spectrometry (GLC-MS). Also, antioxidant activity was evaluated using ABTS/HRP enzymatic. Fatty acid in seed oil was beyond 80%. Meanwhile, the main unusually fatty acids in leaves and roots are ciclopropenic acids. The phytocompounds, omega and functional fatty acids could be responsible for the lipophilic antioxidant activity in leaves.

A partir de extractos etanólicos de hojas y raíces de Plukenetia volúbilis L, se evaluó la presencia de ácidos grasos omega (FAc) y funcionales. El aceite de las semillas de la planta, extraído por Soxhlet y a través de un biorreactor, fue caracterizado físicamente, se le determinó el perfil lipídico mediante cromatografía de gases acoplada a espectrometría de masas (CG-EM) y, se evaluó el potencial antioxidante (ABTS-HRP). El análisis dejó ver que el aceite del vegetal contiene ácidos grasos poliinsaturados en una proporción mayor al 80%. Los extractos de hojas y raíces mostraron principalmente ácidos de tipo ciclo-propénico. Tanto los fitocompuestos como los ácidos grasos omega y funcionales parecen estar asociados con la actividad antioxidante de las hojas.

Caracterização de beta-lactamases de espectro ampliado (ESBLs), genes de resistência aos antimicrobianos e conteúdo plasmidial em cepas de Escherichia coli e Salmonella spp. não tifóides isoladas do ambiente hospitalar e da comunidade / Characterization of extended spectrum Beta-lactamase (ESBLs), antimicrobial resistance genes, and plasmid content in Escherichia coli and Salmonella spp. isolates recovered from hospital and community

Enterobactérias produtoras de ESBLs são descritas tanto no ambiente hospitalar quanto na comunidade em todo o mundo. No Brasil, esses microrganismos também têm emergido como uma causa importante de infecções, sendo as enzimas CTX-M as prevalentes. O objetivo deste estudo foi analisar diferentes aspectos genotípicos relacionados à expressão da resistência aos antimicrobianos em cepas Escherichia coli e de Salmonella spp, tais como: a diversidade de ESBLs, os genes de resistência aos antimicrobianos e o conteúdo plasmidial. Os aspectos epidemiológicos das cepas produtoras de ESBLs também foram investigados. Foram estudadas 88 cepas de enterobactérias, sendo 43 E. coli e 45 cepas de Salmonella spp., de origem hospitalar e da comunidade (principalmente alimentos), isoladas na cidade do Rio de Janeiro. A expressão de ESBL foi observada em sete cepas de E. coli (7/43, 16,3%) e em uma cepa de Salmonella Typhimurium (1/45, 2,3%) e as enzimas foram identificadas como variantes de CTX-M e SHV-5, respectivamente. Entre as cepas de E. coli, a enzima CTX-M-2 foi a mais frequente (n = 4), sendo detectada em cepas isoladas de swab retal de pacientes hospitalizados, enquanto as enzimas CTX-M-59 (uma variante de CTX-M) (n = 1) e CTX-M-9 (n = 2) foram identificadas em cepas isoladas a partir de espécimes clínicos. Salmonella Typhimurium produtora de SHV-5 foi isolada do ambiente hospitalar (fórmula infantil). As cepas de E. coli produtoras das enzimas CTX-M pertenceram a grupos filogenéticos (A, B1, D) e STs (ST34, ST69, ST101) diferentes, sendo os genes blaCTX-M identificados em plasmídeos com tipo de replicon IncA/C de cerca de 150 kb (blaCTX-M-2, blaCTX-M-9, blaCTX-M-59) ou 80 kb (blaCTX-M-2)...

ESBL-producing Enterobacteriaceae have been described in hospitals and in the community worldwide. In Brazil, ESBL-producing Enterobacteriaceae have also emerged as an important cause of infections, being CTX-M enzymes the most prevalent ESBLs. The objective of this study was to analyze different genotypic aspects related to expression of antimicrobial resistance in isolates of Escherichia coli and Salmonella spp., such as: diversity of ESBLs, antibiotic resistance genes and plasmid content. Epidemiological features of ESBL-producing isolates were also investigated. We studied 88 isolates of enterobacteria, 43 E. coli and 45 Salmonella serotypes of hospital and community (mainly food) origin, isolated in the city of Rio de Janeiro. ESBL expression was observed in seven E. coli isolates (7/43; 16,3%) and in one Salmonella Typhimurium (1/45; 2,3%) and the enzymes identified as CTX-M variants and SHV-5, respectively. Among the E. coli isolates, CTX-M-2 was the most frequent (n=4), being detected in isolates recovered from rectal swabs of hospitalized patients, whereas CTX-M-59 (a CTX-M-2-variant) (n=1) and CTX-M-9 (n=2) were identified in E. coli isolated from clinical specimens. SHV-5-producing S. Typhimurium was isolated from the hospital environment (infant formula). CTX-M-producing E. coli belonged to different phylogenetic groups (A, B1, D) and STs (ST34, ST69, ST101), being blaCTX-M genes were identified in IncA/C plasmids of approximately 150 kb (blaCTX-M-2, blaCTX-M-9, blaCTX-M-59) or 80 kb (blaCTX-M-2)...

Medicolegal importance of inca bone in forensic.

Skull is usually available human bone for establishing personal identity. Presence of Inca bone in human skull is one such feature that may be identified on radiological examination and if earlier recorded help in establishing the identity of deceased. Complete division of membranous and cartilaginous part of occipital bone by a transverse suture extending between the two lambdoid sutures at the level of highest nuchal line above the external occipital protuberance, results in rare cranial variation presenting as Inca bone.During medicolegal examination of one male skull at Madhya Pradesh Medicolegal Institute Bhopal, presence of Inca bone was found. The interparietal bone is formed by a part of the squamous occipital bone bounded by two lambdoid sutures on two sides and additional longitudinal suture on both sides between lambdoid suture and external occipital protuberance forming diamond shaped Os Incae Centrale that can also be considered as intra-occipital bone. Such rare findings have significant anthropological and embryological basis. Specific anatomical feature if earlier documented in the clinico-radio-pathological reports of the deceased provides opportunity for establishing the identity.

Interpretación fitosociológica de la vegetación de las lomas del desierto peruano

A phytosociological interpretation of vegetation from sandy hills of the Peruvian desert. The vegetation of the sandy hills (“lomas”) constitutes the main originality of the Peruvian and Chilean desert with a high number of endemics that shapes the vicarious associations. in this work, a phytosociological view of sandy environments of the Peruvian coastal desert is presented. According to the Braun-Blanquet method, we have made up 32 phytosociological inventories and added 138 ones from others authors. in each inventory, we have analyzed its floristic composition and ecological parameters, as altitude, soil and geomorphology. All releves were synthesized in a table to deduce the different associations, higher phytosociological units, and the distribution of its flora along the Peruvian coast and the Andean Cordillera. Using the Shannon-Wiener diversity index, the diversity of this flora is discussed making a comparison with historical data about the use of the territory with livestock during pre-inca and inca cultures, and Spanish invasion. As a result, two associations from Southern Peru -Nolanetum scaposo-spathulatae and Palauetum camanensis-weberbaueri-, two alliances -Nolanion humifusae from central Peru, and Nolanion spathulatae from the Southern Peru- and a new order -Tetragonio crystallinae- Plantaginetalia limensis- are described. In Nolanetum scaposo-spathulatae, Dictyophragnus englerianus, Leptoglossis lomana, Nolana scaposa, N. spathulata, Palaua velutina and Tetragonia vestita are the main characteristics, while in Palauetum camanensis-weberbaueri association N. scaposa and P. velutina are replaced by Palaua camanensis and P. weberbaueri. Nolanion humifusae alliance integrates species as Geranium limae, Hymenocallis amancaes, Nolana humifusa, N. latipes, Palaua rhombifolia or Villanova oppositifolia. Likewise, Cistanthe weberbaueri, Cryptantha parviflora, Hoffmannseggia miranda, Lupinus mollendoensis, Nolana confinis, N. pallidula, N. scaposa, N. spathulata, Palaua camanensis, P. velutina, P. weberbaueri, Tetragonia vestita and Weberbauerella brongniartioides are the characteristic species of Nolanion spathulatae alliance. The Tetragonio crystallinae-Plantaginetalia limensis order presents characteristic plants don´t linked with eutrophic soils, as Calandrinia alba, Cryptantha limensis, Dyschoriste repens, Monnina macrostachya, Oxalis lomana, Palaua malvifolia, Pectocarya lateriflora, Plantago limensis or Tetragonia crystallina, with a distribution that claps the geographical area of the new alliances. On the other hand, the vegetation of the desert ravines is discussed in the context of the coastal river plant communities and its disturbance by the dunes. After the application of the Shannon-Wiener diversity index on the synthetic table columns, we can deduce that an increase in Andean and European ruderal species is linked to an intensive livestock activity. The transhumance between the Andes and the coast from pre-inca times until now, produces the plant dispersion of high Andean plants toward the coast; the Spanish colonization was the origin of the presence of European plants in the “lomas” vegetation of Peru. Rev. Biol. Trop. 59 (2): 809-828. Epub 2011 June 01.

La vegetación de las lomas, causada sobre todo por las precipitaciones debidas a la influencia de la corriente fría de Humboldt, constituye la mayor originalidad del desierto peruano y chileno, con un alto número de endemismos que forman asociaciones geovicarias. En este trabajo, presentamos un estudio fitosociológico sobre la vegetación de los medios arenosos de las lomas del desierto costero peruano. De acuerdo con el método de Braun-Blanquet, hemos levantado 32 inventarios fitosociológicos a los que hemos añadido 138 procedentes de la bibliografía. En cada inventario, hemos analizado la composición florística y distintos parámetros ecológicos, como la altitud, el suelo y la geomorfología. Todos los inventarios fueron sintetizados en una tabla para deducir las asociaciones, las unidades fitosociológicas superiores y el origen de su flora. Como resultado, describimos dos nuevas asociaciones del sur del Perú -Nolanetum scaposo-spathulatae y Palauetum camanensis- weberbaueri, dos alianzas -Nolanion humifusae, del centro del Perú, y Nolanion spathulatae del sur del Perú-, y un nuevo orden -Tetragonio crystallinae-Plantaginetalia limensis-. También se presenta la vegetación de las quebradas en el contexto de las comunidades de riberas de la costa y su alteración por las dunas. Después de la aplicación del índice de Shannon-Wiener sobre las columnas de la tabla sintética, podemos deducir que el aumento de especies ruderales andinas y europeas en la costa central del Perú se ha visto favorecido por una actividad ganadera intensiva. La trashumancia entre los Andes y la costa, desde tiempos preincaicos hasta la actualidad, ha producido la dispersión zoócora de plantas altoandinas hacia la costa; la presencia de plantas europeas tuvo su origen en la colonización española de la costa del Perú.

Monitoramento das ações de controle dos cânceres do colo do útero e de mama

Neste segundo boletim de 2010, são apresentados os dados parciais para acompanhamento dos indicadores do Pacto pela Saúde (biênio 2010-2011) e o consolidado final do monitoramento dos indicadores do Pacto em 2009