Incidence and outcomes of fever of unknown origin after kidney transplant in the modern era.

BACKGROUND: While presumably less common with modern molecular diagnostic and imaging techniques, fever of unknown origin (FUO) remains a challenge in kidney transplant recipients (KTRs). Additionally, the impact of FUO on patient and graft survival is poorly described. METHODS: A cohort of adult KTRs between January 1, 1995 and December 31, 2018 was followed at the University of Wisconsin Hospital. Patients transplanted from January 1, 1995 to December 31, 2005 were included in the "early era"; patients transplanted from January 1, 2006 to December 31, 2018 were included in the "modern era". The primary objective was to describe the epidemiology and etiology of FUO diagnoses over time. Secondary outcomes included rejection, graft and patient survival. RESULTS: There were 5590 kidney transplants at our center during the study window. FUO was identified in 323 patients with an overall incidence rate of .8/100 person-years. Considering only the first 3 years after transplant, the incidence of FUO was significantly lower in the modern era than in the early era, with an Incidence Rate Ratio (IRR) per 100 person-years of .48; 95% CI: .35-.63; p < .001. A total of 102 (31.9%) of 323 patients had an etiology determined within 90 days after FUO diagnosis: 100 were infectious, and two were malignancies. In the modern era, FUO remained significantly associated with rejection (HR = 44.1; 95% CI: 16.6-102; p < .001) but not graft failure (HR = 1.21; 95% CI: .68-2.18; p = .52) total graft loss (HR = 1.17; 95% CI: .85-1.62; p = .34), or death (HR = 1.17; 95% CI: .79-1.76; p = .43. CONCLUSIONS: FUO is less common in KTRs during the modern era. Our study suggests infection remains the most common etiology. FUO remains associated with significant increases in risk of rejection, warranting further inquiry into the management of immunosuppressive medications in SOT recipients in the setting of FUO.

Radiographic and CT features of metallosis in a lame dog after total hip replacement: the cloud sign.

A 2-year-old female American Akita was referred for CT of the pelvis and hindlimbs due to a left hindlimb lameness after a left total hip replacement. Referral radiographs and CT images demonstrated amorphous soft-tissue and mineral opacities surrounding the proximal femur and the prosthetic stem, consistent with the "cloud sign" reported as a characteristic of metallosis in humans. Dorsomedial displacement of the prosthetic head, multiple foci of geographic osteolysis alongside the "cloud sign", presumed pseudotumor lesions, and medial iliac lymphadenopathy were also identified with CT. Metallosis was confirmed based on ultrasound-guided cytology, revision surgery, and histopathology.

[Asociación de exposición a humo de camiones en adolescentes con asma de un centro de referencia del noreste de México].

Objective: To compare whether adolescents who are exposed to truck smoke have a higher prevalence of asthma symptomatology versus those who are not exposed. Methods: A cross-sectional, descriptive, and comparative study. Adolescents aged 13 and 14 years were included and completed a self-report questionnaire. Subjects were selected following the same methodology as in ISAAC phase III. They underwent an epidemiological survey for the presence of symptoms. Ex- posure to truck smoke was defined as passing trucks most of the day as perceived by the patient. The distribution was assessed with the Kolmogorov-Smirnov test. Comparisons with Chi-square or Student's t-test, as appropriate. A value of p³0.05 was considered statistically significant. Results: A total of 492 patients were included. The demographic variables can be seen in Table 1. When performing the association between the groups of ad- olescents with asthma exposed to truck smoke, a significant difference was found in the prevalence of respiratory symptomatology and asthma (26.0% vs 9.6%, p=0.000) (Table 1). Conclusions: Adolescent patients with asthma who are exposed to truck smoke demonstrated a significant difference in the presence of respiratory symptom- atology and asthma compared to patients without exposure.

Objetivo: Comparar si los adolescentes que están expuestos a humo de camiones tienen mayor prevalencia de sintomatología de asma contra quienes no están expuestos. Métodos: Estudio transversal, descriptivo y comparativo. Se incluyeron adolescentes de 13 y 14 años de edad quienes completaron un cuestionario autoinfor- mado. Los sujetos se seleccionaron siguiendo la misma metodología que en la fase III de ISAAC. Se les realizó una encuesta epidemiológica para la presencia de síntomas. Exposición al humo de camiones se definió como el paso de camiones la mayoría del día a percepción del paciente. La distribución fue evaluada con la prueba de Kolmogórov-Smirnov. Comparaciones con prueba de Chi-cuadrada o T de Student, según corresponda. Un valor de p £ 0.05 fue considerado estadísticamente significativo. Resultados: Se incluyeron un total de 492 pacientes. Las variables demográficas se pueden observar en la Tabla 1. Al realizar la asociación entre los grupos de adolescentes con asma que se encuentran expuestos a humo de camiones se encontró una diferencia significativa en la prevalencia de sintomatología respira- toria y asma (26.0% vs 9.6%, p = 0.000). Conclusiones: Los pacientes adolescentes con asma que se encuentran expuestos al humo de camiones demostraron tener diferencia significativa en la presencia de sintomatología respiratoria y asma en comparación con los pacientes sin exposición.

Molecular Surveillance of Canine Degenerative Myelopathy in Breeding Kennels from Romania.

Canine degenerative myelopathy (CDM) is a spontaneous neurodegenerative disease. Genetically, CDM is an autosomal recessive disease with incomplete penetrance, most commonly caused by a genetic mutation in exon 2 of gene SOD1 (c.118G > A). This study aimed to determine the mutant allele frequency associated with CDM in various dog breeds from Romania. Dogs (n = 230) from 26 breeds were included in the study. Genotyping using the PCR-RFLP technique was performed on DNA extracted from oral swabs. The results revealed that 204 dogs were homozygous for the wild-type allele (G/G), 16 were heterozygous (A/G), and 10 were homozygous for the mutant allele (A/A). The mutant allele was identified in Wire Fox Terrier, Romanian Mioritic Shepherd, German Shepherd, Rottweiler, Belgian Shepherd, and Czechoslovakian Wolfdog breeds. The mutant allele frequency (A) within the tested population was 0.0783. The results for Belgian Shepherd, German Shepherd, and Romanian Mioritic Shepherd were in Hardy-Weinberg equilibrium, but a departure was observed for Rottweiler. The current study included a first screening of the Romanian Bucovina Shepherd, Romanian Mioritic Shepherd, and Caucasian Shepherd breeds. Genetic testing for the mutation associated with CDM is important in order to avoid the risk of the emergence of dogs homozygous for the SOD1:c118G > A allele.

Reorganization of thalamocortical connections in congenitally blind humans.

Cross-modal plasticity in blind individuals has been reported over the past decades showing that nonvisual information is carried and processed by "visual" brain structures. However, despite multiple efforts, the structural underpinnings of cross-modal plasticity in congenitally blind individuals remain unclear. We mapped thalamocortical connectivity and assessed the integrity of white matter of 10 congenitally blind individuals and 10 sighted controls. We hypothesized an aberrant thalamocortical pattern of connectivity taking place in the absence of visual stimuli from birth as a potential mechanism of cross-modal plasticity. In addition to the impaired microstructure of visual white matter bundles, we observed structural connectivity changes between the thalamus and occipital and temporal cortices. Specifically, the thalamic territory dedicated to connections with the occipital cortex was smaller and displayed weaker connectivity in congenitally blind individuals, whereas those connecting with the temporal cortex showed greater volume and increased connectivity. The abnormal pattern of thalamocortical connectivity included the lateral and medial geniculate nuclei and the pulvinar nucleus. For the first time in humans, a remapping of structural thalamocortical connections involving both unimodal and multimodal thalamic nuclei has been demonstrated, shedding light on the possible mechanisms of cross-modal plasticity in humans. The present findings may help understand the functional adaptations commonly observed in congenitally blind individuals.

Emphysematous Pyelonephritis Complicated With Hyperglycemic Hyperosmolar State and Sepsis: A Case Report and Literature Review.

Emphysematous pyelonephritis (EPN) is an acute life-threatening necrotizing infection of the renal parenchyma and perirenal tissues. There are multiple treatment strategies for EPN depending on the initial classification; over the last three decades, the treatment approach has favored kidney sparing strategies and the use of nephrectomy only as salvage therapy. We report a case involving a patient with unilateral emphysematous pyelonephritis complicated with hyperglycemic hyperosmolar state (HHS), sepsis, and multiple risk factors associated with poor prognosis who was successfully treated with conservative management sparing nephrectomy. This case report aims to create awareness among clinicians that even in the presence of multiple risk factors for poor prognosis, conservative management should be considered before nephrectomy.

A Rare Case of Empagliflozin-Induced Euglycemic Diabetic Ketoacidosis Obscured by Alkalosis.

Empagliflozin-induced euglycemic diabetic ketoacidosis is a life-threatening metabolic complication of diabetes mellitus characterized by metabolic acidosis, ketonemia, and relatively normal serum glucose levels. We present a rare case of empagliflozin-induced diabetic ketoacidosis obscured by alkalosis. This case report aims to create awareness among clinicians about this entity and consider this diagnosis in their differential, especially in patients taking sodium-glucose co-transporter (SGLT-2) inhibitors who present to the hospital with unspecific symptoms that may not suggest DKA.

Immune response in COVID-19: what is next?

The coronavirus disease 2019 (COVID-19) has been a global pandemic for more than 2 years and it still impacts our daily lifestyle and quality in unprecedented ways. A better understanding of immunity and its regulation in response to SARS-CoV-2 infection is urgently needed. Based on the current literature, we review here the various virus mutations and the evolving disease manifestations along with the alterations of immune responses with specific focuses on the innate immune response, neutrophil extracellular traps, humoral immunity, and cellular immunity. Different types of vaccines were compared and analyzed based on their unique properties to elicit specific immunity. Various therapeutic strategies such as antibody, anti-viral medications and inflammation control were discussed. We predict that with the available and continuously emerging new technologies, more powerful vaccines and administration schedules, more effective medications and better public health measures, the COVID-19 pandemic will be under control in the near future.

Regeneration in starved planarians depends on TRiC/CCT subunits modulating the unfolded protein response.

Planarians are able to stand long periods of starvation by maintaining adult stem cell pools and regenerative capacity. The molecular pathways that are needed for the maintenance of regeneration during starvation are not known. Here, we show that down-regulation of chaperonin TRiC/CCT subunits abrogates the regeneration capacity of planarians during starvation, but TRiC/CCT subunits are dispensable for regeneration in fed planarians. Under starvation, they are required to maintain mitotic fidelity and for blastema formation. We show that TRiC subunits modulate the unfolded protein response (UPR) and are required to maintain ATP levels in starved planarians. Regenerative defects in starved CCT-depleted planarians can be rescued by either chemical induction of mild endoplasmic reticulum stress, which leads to induction of the UPR, or by the supplementation of fatty acids. Together, these results indicate that CCT-dependent UPR induction promotes regeneration of planarians under food restriction.

Tnfaip2/exoc3-driven lipid metabolism is essential for stem cell differentiation and organ homeostasis.

Lipid metabolism influences stem cell maintenance and differentiation but genetic factors that control these processes remain to be delineated. Here, we identify Tnfaip2 as an inhibitor of reprogramming of mouse fibroblasts into induced pluripotent stem cells. Tnfaip2 knockout impairs differentiation of embryonic stem cells (ESCs), and knockdown of the planarian para-ortholog, Smed-exoc3, abrogates in vivo tissue homeostasis and regeneration-processes that are driven by somatic stem cells. When stimulated to differentiate, Tnfaip2-deficient ESCs fail to induce synthesis of cellular triacylglycerol (TAG) and lipid droplets (LD) coinciding with reduced expression of vimentin (Vim)-a known inducer of LD formation. Smed-exoc3 depletion also causes a strong reduction of TAGs in planarians. The study shows that Tnfaip2 acts epistatically with and upstream of Vim in impairing cellular reprogramming. Supplementing palmitic acid (PA) and palmitoyl-L-carnitine (the mobilized form of PA) restores the differentiation capacity of Tnfaip2-deficient ESCs and organ maintenance in Smed-exoc3-depleted planarians. Together, these results identify a novel role of Tnfaip2 and exoc3 in controlling lipid metabolism, which is essential for ESC differentiation and planarian organ maintenance.

Quantification of Reducing Sugars Based on the Qualitative Technique of Benedict.

Determination of reducing sugars is carried out routinely in the food industry, in biological research, or pharmaceutical and biomedical quality control to estimate metabolically assimilable sugars. Widespread detection methods are complex, expensive, or highly polluting. Here, we propose the use of spectrophotometric quantification for reducing sugars (Benedictq) based on the qualitative method of Benedict. The protocol was validated, to verify its reproducibility and precision. With the proposed method (Benedictq), the reducing sugar glucose can be determined in a range of 0.167-10 mg mL-1, with an R 2 of 0.997 and accuracy (expressed as % of recovery) greater than 97%. Other reducing sugars, such as maltose, fructose, and lactose, showed similar values. The method robustness was verified for pH values greater than or equal to 4. In the case of protein presence, a correction is proposed in the range of 0-1.67 mg mL-1. Modifications implemented in the protocol reduce cost, working time, and reaction volumes with respect to the original assay without detriments in accuracy and precision. In addition, waste reduction represents an important contribution of the method.

Calidad microbiológica de las aguas termales del balneario "El Tingo". Pichincha. Ecuador / Microbial Quality of the Thermal Waters of the Spa "El Tingo". Pichincha. Ecuador

OBJETIVO: El propósito del trabajo fue determinar la calidad microbiológica del agua termal del Balneario "El Tingo", situado a 2500 msnm, Provincia de Pichincha, Ecuador. Materiales y MÉTODOS: Se realizaron cuatro muestreos en diferentes épocas del año y en dos zonas del Balneario. Se determinaron "in situ" los parámetros fisicoquímicos (conductividad, dureza, oxígeno disuelto, pH y temperatura). La cuantificación de bacterias heterótrofas, coliformes y hongos se hizo en medios de cultivos específicos para cada grupo microbiano. La identificación de las cepas bacterianas aisladas se realizó de acuerdo con lo indicado por MacFaddin (2004). RESULTADOS: Los resultados indican que el agua termal del Tingo se clasifica como de conductividad muy fuerte, mineralización excesiva, aguas muy duras, con muy poco oxígeno disuelto, pH neutro e hipertermales. El contaje promedio de bacterias heterótrofas en el agua contenida en la cisterna del balneario fue de 2,10 X 102 UFC/mL, coliformes totales de 0,30 X 10 UFC/mL y hongos 1,00 X 10 UFC/mL. Para las duchas de agua termal los valores promedios fueron de 2,42 X 102 UFC/mL de bacterias heterótrofas, 0,85 X 10 UFC/mL coliformes totales y 0,68 X 10 UFC/mL de hongos. No se detectó la presencia de Escherichia coli en ninguna de las muestras analizadas. Se identificaron 14 cepas Gram negativas de los géneros Aeromonas, Burkholderia, Citrobacter y Pseudomonas, 5 Gram positivas de los géneros Bacillus y Staphylococcus y 2 cepas fúngicas del género Aspergillus. CONCLUSIONES: Los resultados obtenidos demuestran una población microbiana escasa y poco diversa, lo que implica una buena calidad del agua y de los acuíferos

OBJECTIVE: The purpose of research was determining the microbiological quality of the thermal water of the "El Tingo" Spa, located at 2500 mamsl, Pichincha Province, Ecuador. METHODS: Four samplings were carried out at different times of the year and in two areas of the Spa. The physicochemical parameters (conductivity, hardness, dissolved oxygen, pH, dissolved solids and temperature) were determined "in situ". The heterotrophic bacteria, coliforms and molds was determined, as well as the identification of the isolated strains according to the indicated by MacFaddin (2004). RESULTS: The Tingo thermal water is classified as very strong conductivity, excessive mineralization, very hard water, with very little dissolved oxygen, neutral pH and hyperthermal. The average count of heterotrophic bacteria in the water contained in the cistern of the spa were 2.10 X 102 CFU / mL, coliforms 0.30 X 10 CFU / mL and fungi1,00 X 10 CFU / mL. For the thermal water showers, the average values were 2.42 X 102 CFU/ mL of heterotrophic bacteria, 0.85 X 10 CFU / mL coliforms and 0.68 X 10 CFU/ mLfungi. Escherichia coli were not detectedin any of the samples. It was possible to identify 14 Gram negative strains of the genus Aeromonas, Burkholderia, Citrobacter and Pseudomonas, 5 Gram positive of the genera Bacillus and Staphylococcus and 2 fungal strains of the genus Aspergillus

Downregulation of mTOR Signaling Increases Stem Cell Population Telomere Length during Starvation of Immortal Planarians.

Reduction of caloric intake delays and prevents age-associated diseases and extends the life span in many organisms. It may be that these benefits are due to positive effects of caloric restriction on stem cell function. We use the planarian model Schmidtea mediterranea, an immortal animal that adapts to long periods of starvation by shrinking in size, to investigate the effects of starvation on telomere length. We show that the longest telomeres are a general signature of planarian adult stem cells. We also observe that starvation leads to an enrichment of stem cells with the longest telomeres and that this enrichment is dependent on mTOR signaling. We propose that one important effect of starvation for the rejuvenation of the adult stem cell pool is through increasing the median telomere length in somatic stem cells. Such a mechanism has broad implications for how dietary effects on aging are mediated at the whole-organism level.

Safety of Antithymocyte Globulin in Patients Undergoing Liver Transplantation With Livers From Donation After Circulatory Death Donors.

Background: Studies suggest that rabbit-antithymocyte globulin (rATG) decreases biliary complications (BCs) after donation-after-circulatory-death-donor liver transplantation (DCD LTx), but safety data are lacking. Objective: Our aim was to assess the safety of rATG for this indication. The secondary end point was efficacy of rATG for this indication. Methods: Adult recipients of DCD LTx were divided into 2 cohorts: protocolized use of rATG in the modern era (July 1, 2013, to December 31, 2016) and a historical control without rATG (January 1, 2005, to June 30, 2013). Incidence of infection, leukopenia, and thrombocytopenia were compared for the safety assessment, incidence of BCs, ischemic cholangiopathy (IC), and transplant outcomes for the efficacy assessment. Results: A total of 83 patients met inclusion criteria: 42 in the historical cohort and 41 in the modern cohort. The modern cohort had significantly fewer bacterial infections at 3 months (historical 54.8% vs modern 23%; P = 0.004) and 1 year (historical 62.1% vs modern 34.2%, P = 0.004). The modern cohort also had fewer fungal infections at these time points (historical 33.3% and 47.9% vs modern 15% and 15%; P = 0.001). There were no significant differences in platelet or white blood cell reduction between groups. There was a nonsignificant, but numerical, trend toward reduced IC/BC in the modern cohort at 1 year (IC: historical 30.1% vs modern 13.2%, P = 0.08; BC: historical 51% vs modern 37.5%, P = 0.13). There was no difference in graft/patient survival. Conclusion and Relevance: Our data suggest no major safety issues with rATG in DCD LTx. Our study should ease clinical apprehension surrounding rATG use for this indication. Future prospective studies are needed to further evaluate the role of rATG and its impact on efficacy end points.

It is not all about regeneration: Planarians striking power to stand starvation.

All living forms, prokaryotes as eukaryotes, have some means of adaptation to food scarcity, which extends the survival chances under extreme environmental conditions. Nowadays we know that dietary interventions, including fasting, extends lifespan of many organisms and can also protect against age-related diseases including in humans. Therefore, the capacity of adapting to periods of food scarcity may have evolved billions of years ago not only to allow immediate organismal survival but also to be able to extend organismal lifespan or at least to lead to a healthier remaining lifespan. Planarians have been the center of attention since more than two centuries because of their astonishing power of full body regeneration that relies on a large amount of adult stem cells or neoblasts. However, they also present an often-overlooked characteristic. They are able to stand long time starvation. Planarians have adapted to periods of fasting by shrinking or degrowing. Here we will review the published data about starvation in planarians and conclude with the possibility of starvation being one of the processes that rejuvenate the planarian, thus explaining the historical notion of non-ageing planarians.

Microbiota del agua termal del balneario "Piscinas El Cachaco", Calacalí, Provincia del Pichincha. Ecuador / Microbiota of the thermal water of the spa "Piscinas El Cachaco", Calacalí, Province of Pichincha, Ecuador

Las aguas termales son ecosistemas con microorganismos adaptados a las condiciones de estos ambientes. Se ha postulado que la microbiota de cada balneario es característica. El objetivo del trabajo fue determinar la microbiota del agua del Balneario "Piscinas El Cachaco", Provincia de Pichincha, Ecuador. Se tomaron muestras de agua en tres zonas del balneario por un periodo de dos años, En cada sitio se realizaron pruebas fisicoquímicas utilizando un equipo multiparámetro. La toma y transporte de las muestras para el estudio microbiológico se realizó según la norma ecuatoriana NTE-INEN. Se realizaron los análisis microbiológicos según la metodología AOAC (2000). Para el agua de la naciente del balneario, los valores promedios de bacterias heterótrofas fueron de 8,60 X 10 UFC/mL, bacterias coliformes totales 5,70 X 10 UFC/mL y mohos y levaduras 9,00 UFC/mL. Para el agua del tanque que alimenta la piscina termal los valores promedios fueron para bacterias heterótrofas de 5,20 X 10 UFC/mL, bacterias coliformes totales 3,00 UFC/mL y no se detectaron células de mohos y levaduras En el agua de la Piscina termal, los valores promedios fueron: bacterias heterótrofas 1,60 X 102 UFC/mL, coliformes 5,00 UFC/mL y mohos y levaduras 5,00 UFC/mL. El 50,94 % de las bacterias aisladas fueron Gram negativas, prevaleciendo el género Aeromonas, y un 49,06% fueron Gram positiva, prevaleciendo el género Staphylococcus. Se logro aislar 3 especies de mohos Aspergillus spp. Rhizopus spp y Penicillium spp. Los resultados muestran una microbiota bacteriana escasa y poco diversa en las áreas del Balneario

The thermal waters are ecosystems with microorganisms adapted to these environments. It has been postulated that microbiota of each spa is characteristic. The objective was to determine the microbiota of the water "Piscinas El Cachaco" Spa, Province of Pichincha, Ecuador. Water samples were taken in three areas of the spa for two years. At each site, physicochemical tests were performed using a multiparameter equipment. The taking and transport of the samples for the microbiological study was carried out according Ecuadorian standard NTE-INEN. The microbiological analyzes were carried out by the methodology AOAC (2000). From the source of water, the average values of heterotrophic bacteria were 8,60 X 10 CFU / mL, total coliform 5,70 X 10 CFU / mL and molds and yeasts 9,00 CFU / mL. For the water in the tank, the average values were for heterotrophic bacteria of 5,20 X 10 CFU / mL, total coliform bacteria 3,00 CFU / mL and no molds and yeasts cells were detected. In the thermal pool water, the average values obtained were: heterotrophic bacteria 1,60 X 102 CFU / mL, total coliforms 5,00 CFU / mL and molds and yeasts 5,00 CFU/ mL. 50,94 % of the isolated bacteria were Gram negative, the genus Aeromonas prevailing, while 49,06 % were Gram positive, prevailing the genus Staphylococcus. It was possible to isolate 3 species of mold Aspergillus spp. Rhizopus spp and Penicillium spp. The results show a sparse and little diverse bacterial microbiota in the spa

Nódulos pulmonares contraintuitivos en artritis reumatoide / Counterintuitive Pulmonary Nodules in Rheumatoid Arthritis

No disponible

Resistencia antimicrobiana en cepas de Pseudomonas aeruginosa aisladas de aguas termales de la provincia del Chimborazo, Ecuador / Antimicrobial resistance in strains Pseudomonas aeruginosa isolated from termal waters at Chimborazo, Ecuador

La intervención humana en los manantiales de aguas termales ha traído su contaminación microbiológica y química. El uso indiscriminado de los antimicrobianos, han desembocado en la contaminación de diversos ambientes acuáticos con estas sustancias y con bacterias resistentes a las mismas. En este sentido el objetivo del presente trabajo fue conocer la resistencia antimicrobiana en cepas de Pseudomonas aeruginosa aisladas de aguas termales de la región del Chimborazo, Ecuador. Se analizaron 12 muestras de agua termal procedentes de baños de la Provincia del Chimborazo. Las muestras consistieron de un volumen de 0,5 litro de agua de cada manantial. El aislamiento de Pseudomonas aeruginosa se realizó por la técnica de filtración en membrana, utilizando filtros de acetato de celulosa de 0,45 µm de poro, un volumen de muestra de 100 ml y el agar Cetrimida. Las cepas aisladas se identificaron siguiendo los esquemas de MacFadden (2004) y Barrow y Feltham (1993), complementados con las pruebas bioquímicas de las galerías API (bioMerieux). El perfil de resistencia a los antibióticos se determinó por el método de difusión de Kirby y Bauer (1966) interpretándose según el CLSI (2014). Se identificaron 15 cepas de Pseudomonas aeruginosa. Todas las cepas fueron resistentes a los antibióticos Ampicilina y Ampicilina-Sulbactam, y cinco fueron multiresistentes a seis antibióticos (Ampicilina, Ampicilina-Sulbactam, Amikacina, Ceftazidime, Cefepime y Ciprofloxacina). Los resultados nos señalan la necesidad de realizar estudios del resistoma de los ecosistemas de las aguas termales, para determinar la presencia de genes de resistencias en las bacterias autóctonas

Human intervention in the hot springs has brought its microbiological and chemical contamination. The indiscriminate use of antimicrobials, have resulted in the contamination of various aquatic environments with these substances and bacteria The objectives were meet antimicrobial resistance in Pseudomonas aeruginosa strains isolated from hot springs in the region of Chimborazo, Ecuador. 12 samples of thermal water baths from Chimborazo Province were analyzed. Samples consisted of a volume of 0.5 liters of water. Pseudomonas aeruginosa isolation was performed by the membrane filtration technique using cellulose acetate filter 0.45 um pore, a sample volume of 100 ml and Cetrimide agar. The isolates were identified following schemes MacFadden (2004) and Barrow and Feltham (1993), supplemented with biochemical tests of API (bioMerieux) galleries. The profile of antibiotic resistance was determined by the method of dissemination of Kirby and Bauer (1966) and the results were interpreted according the CLSI (2014). 15 strains of Pseudomonas aeruginosa were identified. All strains were resistant to ampicillin and ampicillin - Sulbactam antibiotics and five were multidrug resistant to six antibiotics (Ampicillin, ampicillin-Sulbactam, amikacin, ceftazidime, cefepime and ciprofloxacin). The results show us the need for studies of resistoma ecosystems hot springs, to determine the presence of resistance genes in indigenous bacteria