Susceptibilidad antimicrobiana de bacterias aisladas en sepsis del acceso vascular. Instituto de Nefrología, 2019 / Antimicrobial susceptibility of bacteria isolated from vascular access sepsis. Institute of Nephrology, 2019

Introducción: El acceso vascular en hemodiálisis es esencial para el enfermo renal por su repercusión en la calidad de vida. La fístula arteriovenosa, los catéteres para hemodiálisis o las prótesis vasculares, aunque han evolucionado gradualmente hacia el perfeccionamiento, son proclives a las infecciones debidas fundamentalmente a bacterias de la microbiota de la piel y mucosas. Objetivo: Caracterizar la susceptibilidad antimicrobiana de las bacterias aisladas de pacientes con sepsis del acceso vascular en el servicio de hemodiálisis del Instituto de Nefrología. Material y Métodos: Estudio de corte transversal, en el período comprendido entre enero a diciembre de 2019. El universo estuvo constituido por 112 aislamientos obtenidos a partir de muestras de hemocultivos, secreciones y puntas de catéter de los pacientes con bacteriemias, sepsis o secreción en el sitio de inserción del catéter o acceso vascular. Resultados: El 72,3 por ciento de las muestras estudiadas fueron hemocultivos. Se obtuvo 38,3 % de aislamientos de Staphylococcus aureus, sensibles en su totalidad a la vancomicina. El 68,1 % de las cepas de Escherichia coli fueron productoras de betalactamasas de espectro extendido (BLEE) con sensibilidad superior a 60 % a aminoglucósidos y carbapenémicos; similar patrón de sensibilidad mostraron las cepas de Pseudomonas, no obstante, el 100% fue resistente a las cefalosporinas. Conclusiones: No se reportó resistencia a la vancomicina en el estudio. Los aislamientos de los gérmenes gramnegativos mostraron elevada resistencia a las cefalosporinas y una buena sensibilidad a aminoglucósidos y carbapenémicos(AU)

Introduction: The vascular access in hemodialysis is essential for the renal patient both for its associated morbidity and mortality as well as for its impact on quality of life. Although arteriovenous fistula, hemodialysis catheters or vascular prostheses have gradually evolved toward improvement, they are prone to infections primarily due to bacteria on the skin and mucosal microbiota. Objective: To characterize the antimicrobial susceptibility of bacteria isolated from patients with vascular access sepsis in the hemodialysis service of the Institute of Nephrology. Material and Methods: A cross-sectional study was conducted in the period January-December 2019. The universe consisted of all 112 isolates obtained from blood culture samples, secretions and catheter tips from patients with bacteremia, sepsis or discharge at the site of catheter insertion or vascular access. Results: The results show that 72.3% of the samples studied were blood cultures. Also, 38.3 percent of Staphylococcus aureus isolates, which were totally sensitive to vancomycin, were obtained. On the other hand, 68.1% of Escherichia coli strains were extended spectrum beta-lactamases (ESBL) producers with sensitivity to aminoglycosides and carbapenems greater than 60%. Pseudomonas strains exhibited a similar pattern of sensitivity, however, 100% were resistant to cephalosporins. Conclusions: No resistance to vancomycin was reported in this study. Gram-negative isolates showed high resistance to cephalosporins and good sensitivity to aminoglycosides and carbapenems(AU)

Asociación del grupo sanguíneo ABO con susceptibilidad a COVID-19 / Association of ABO blood group with COVID-19 susceptibility

La pandemia de COVID-19, causada por el virus SARS-CoV-2, ha infectado ya a más de 25 millones de personas, ocasionando más de 850,000 muertos y causando serios problemas en hospitales y sistemas de salud en todo el mundo. Una de las mayores dificultades que presenta la infección por SARS-CoV-2 es su gran variación en presentación clínica, que puede ir desde casos asintomáticos hasta síndromes de distrés respiratorio agudo, fallo múltiple de órganos y muerte. De aquí la importancia del estudio de factores demográficos, clínicos y genéticos que permitan la identificación de personas con mayor riesgo de adquirir la infección y sufrir manifestaciones graves de la enfermedad. Un número creciente de reportes en la literatura han sugerido que el grupo sanguíneo ABO está relacionado con el riesgo a COVID-19, coincidiendo en que personas con sangre del grupo A muestran el mayor riesgo, mientras que personas con sangre del grupo O el menor. Los objetivos de esta revisión son presentar un resumen de la evidencia existente en la literatura científica reciente y discutir estas observaciones en el contexto del conocimiento sobre la asociación de los grupos sanguíneos a varias infecciones y otras enfermedades, así como de los mecanismos potenciales involucrados. Finalmente, las implicaciones de la relación entre el grupo sanguíneo y susceptibilidad a COVID-19 son también discutidas con relación a la población guatemalteca.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has already infected more than 25 million people, resulting in more than 850,000 deaths and causing serious problems in hospitals and health systems worldwide. One of the biggest problems posed by the SARS-CoV-2 infection is its great variation in clinical presentation, which can range from asymptomatic cases to syndromes of acute respiratory distress, multiple organ failure, and death. Hence the importance of studying demographic, clinical and genetic factors that allow the identification of people at increased risk of suffering serious manifestations. A growing number of reports in the literature have suggested that the ABO blood group is related to the risk of COVID-19, demonstrating that people with type A blood have the highest risk, while people with type O blood the lowest. The objective of this review is to present a summary of the existing evidence in the recent scientific literature and to discuss these observations in the context of the knowledge of the association of blood groups to various infections and other diseases, as well as the potential mechanisms involved. Finally, the implications of the relationship between the blood groups and COVID-19 susceptibility are also discussed in relationship to the Guatemalan population.

Influência do tratamento com benzonidazol na resposta imunológica de camundongos infectados com cepas do trypanosoma cruzi de diferentes biodemas / Influence of treatment with benznidazole in the immune response of mice infected with Trypanosoma cruzi strains of different biodemes

A infecção pelo Trypanosoma cruzi determina uma resposta imunológica inata do hospedeiro vertebrado, decorrente da multiplicação parasitaria em macrófagos e a produção de Interferon gama (IFNy) pelas células T ativadas, além de estimulação policlonal de células do baço, com imunossupressão. Por outro lado tem sido demonstrado que o tratamento com quimioterápico Benzonidazol em camundongos infectados, além de determinar uma destruição dos parasitos, tem também uma ação sobre o sistema imunológico em camundongos infectados com cepas do T. cruzi com diferentes graus de suscetibilidade ao Benzonidazol, como a cepa Y (suscetível ao quimioterápico) e a cepa Colombiana (resistente). No presente estudo procura-se investigar a influência do tratamento com o Benzonidazol sobre a resposta imunológica em camundongos infectados com cepa suscetível (Cepa Y) ou resistente (Colombiana). Foram utilizados 320 camundongos, subdivididos em grupos experimentais: Infectados tratados cepa Y (YT) e não tratados (Y-NT); Colombiana tratados (COL-T) e não tratados (COL-NT), Tratados não infectados (TNI) e Controles sem tratamento (CI). O inóculo foi de 1,0 x 104 por via intraperitoneal. O tratamento foi iniciado no pico parasitêmico de cada cepa, sendo no 7º dia após a infecção nos animais infectados pela cepa Y e, nos tratados e não infectados, no 18º dia de infecção na cepa Colombiana. A quimioterapia foi realizada em 60 doses (100mg/kg/dia de Benzonidazol-Benz). Os camundongos sacrificados na fase aguda e na fase crônica em todos os grupos tiveram as secções de coração e músculo esquelético coletadas, fixadas e processadas para o estudo histopatológico em secções coradas pela Hematoxilina & Eosina e Picro-Sirius. Investigou-se a resposta humoral pela sorologia (Imunofluorescência indireta) e pela reação de Elisa. A resposta celular pela proliferação celular do baço, e pela avaliação quantitativa das subpopulações celulares no baço de CD4+, CD8+...

Infection with T. cruzi determines an immunological response in the vertebrate host, wit h parasites multiplication in macrophages, with production of TNFα by these cells an IFNγ, by stimulated T. cells: a polyclonal multiplication of spleen cells is present, with immunossuppression. Treatment of infected mice with BENZ showed that this chemotherapy determines parasitic destruction and also stimulates the immunological system in mice infected either with the Y or the Colombian strain which differs in the susceptibility to chemotherapy with BENZ. In the present study we intend to investigate the influence of treatment with BENZ on the immunological response in mice infected either with the Y strain (susceptible) or the Colombian strain (resistant). This study was performed by comparing the results obtained with the groups of mice not infected and treated, and infected controls, not treated. Material and methods : Number of animals: 320, sub-divided in the experimental groups:Ystrain infected and treated with BENZ(YT) or not-treated (YNT); Colombian treated (COL-T) and not-treated (COL-NT); treated not infected (TNI); Control not treated (COL-NT). Inoculum : 1x104 trypomastigotes, (blood forms) injected intraperitoneally. Treatment was initiated in the peak of parasitemia for each strain:7th day for the Y strain and in the 18th day in the infection with the Colombian strain. Chemotherapy was performed in 60 doses (100mg x kg x day) of BENZ. Mice were killed in the acute and chronic phases post infection; sections of the heart and skeletal muscles were collected, fixed and processed for histopathology, in sections stained with Hematoxylin and Eosin, and with Picro-Sirius staining, for collagen. The humoral response was evaluated by serological reactium of indirect immununofluorescence and ELISA reaction. Celular responses were evaluated by celular proliferation in the spleen of CD4+, CD8+...

Melioidosis: an under-diagnosed entity in western coastal India: a clinico-microbiological analysis.

Clinico-microbiological analysis of a series of 25 patients with culture proven melioidosis was done. All patients came from the coastal regions of Kerala and Karnataka and presented between June 2005 to July 2006. They were analysed with respect to clinical presentation, occupation, epidemiology and microbiological features. No single presenting clinical feature was found to be typical of melioidosis. The disease was found to mimic a variety of conditions, including tuberculosis and malignancy. Burkholderia pseudomallei was isolated from blood, sputum, pus, urine, synovial, peritoneal and pericardial fluids. Diabetes mellitus was the most common predisposing factor and 80% of the cases presented during the Southwest monsoon (June to September). It is probable that melioidosis is highly prevalent in western coastal India and yet, greatly underestimated. Better awareness, both among clinicians and microbiologists, coupled with improved diagnostic methods to allow early diagnosis and hence early treatment, will significantly reduce the morbidity and mortality associated with this disease.