Abscesos hepaticos en tiempos de pandemia (covid19) / Hepatic abscesses in time of pandemic (COVID 19)

Introducción. Los abscesos hepáticos son infecciones focales supurativas. La Klebsiella pneumoniae es el agente etiológico más frecuente. Afecta principalmente a hombres de edad media, diabéticos, con afecciones hepáticas o en contexto de inmunodepresión. Se clasifican en abscesos colangíticos, pioflebíticos, hematógenos, por continuidad, traumáticos y criptogénicos, según mecanismo de producción. Se manifiestan con dolor abdominal en hipocondrio derecho, sd. febril y sd. colestásico en presencia de obstrucción de vía biliar. La ecografía, TAC y la Resonancia magnética de abdomen son los métodos de elección para determinar topografía y morfología de las colecciones. El tratamiento consiste en el drenaje oportuno de la colección por vía percutánea o quirúrgica, asociado al tratamiento antibiótico. Objetivos: 1. Análisis epidemiológico de abscesos hepáticos durante la Pandemia por Covid 19 en una Institución privada de Tucumán. 2. Estudiar la fisiopatología y agentes patógenos responsables de los mismos. 3. Comparar estadísticas con era similar no Covid 19. Material y métodos. Estudio descriptivo retrospectivo. Se incluyeron seis pacientes con diagnóstico de Absceso Hepático, cinco de ellos del período de la era Covid 19 y uno de la era no Covid 19. Las variables analizadas fueron: cantidad de pacientes ingresados al Servicio, pacientes con absceso hepático, sexo, edad, comorbilidades, métodos de diagnóstico imagenológico utilizados, localización anatómica del absceso, número de lesiones, microbiología de la muestra quirúrgica y en sangre, tratamiento implementado, días desde el diagnóstico hasta la resolución, STROC y recidiva. Resultados: En el análisis epidemiológico se evidenció un notable descenso de la actividad quirúrgica en el periodo del 2020, respecto al mismo período del año previo, a predominio del mes de abril con un porcentaje de descenso del 52%, coincidiendo este período con el inicio de la cuarentena en la provincia. En nuestra serie resultaron todos masculinos, hipertensos y 3 de ellos diabéticos. Todos estudiados por ecografía y 3 complementaron con TAC con contraste EV. Fueron tratados en un promedio de 48hs desde el diagnóstico. Cultivos positivos, Klebsiella Pn (3), St aureus (1), E. Coli (1), Bacilo gram ­ (1). Hemocultivos: 3 negativos, 2 positivos para Klebsiella Pn y 1 para St. Aureus. 3 pacientes fueron sometidos a drenaje percutáneo, 2 a laparoscópico y uno convencional. Se registraron 2 STROC IIIA y 1 IIIB. Un paciente obitó, el resto recibió alta sanatorial. Se registraron 2 recidivas. Conclusiones: Nuestros pacientes, en su totalidad masculinos y diabéticos, desarrollaron abscesos hepáticos piógenos; el agente patógeno más frecuente fue la Klebsiella Pneumoniae. Los abscesos criptogénicos fueron los más prevalentes. En las recidivas documentadas, se determinó misma ubicación topográfica y agente etiológico del primer episodio, lo que nos lleva a preguntarnos sobre la eficacia del tratamiento implementado en cada caso.

Introduction: liver abscess is a common infection. Klebsiella pneumoniae was de most frecuently etiologic agent. The patients were middle-aged men with diabetes, another liver afection or immunodepression context. According to the production mechanism, they are classified in colangitics, pyophlebics, haematogenes, by continuity, traumatic and cryptogrnics. Patients usually present with right upper quadrant, fever, colestasic síndrome when bile-way obstruction exist. Imaging techniques such as ultrasonography, computed tomography scanning and magnetic resonance are useful tools to demostrtate a space occupying lesión and morfology of liver abscess. Treatment consist in timely drainage by percutaneous or surgical route, plus antibiotic treatment. Objetives: 1. Epidemiological análisis of liver abscesses during the pandemic Covid 19 in a private center in Tucumán. 2. Study physiology and pathogenic agents. 3. Campare statistics whit previusly period. Materials and methods: retrospective descriptive study. Six live abscess diagnosis patient were included, five of them included in stage Covid 19 and only one belong stage no Covid 19. Variables analysed: number of patients belong to the Service, number of patients whit liver abscess diagnosis, sex, age, comorbilities, imaging methods, location and number of abscess, microbiology of surgical sample and blood, treatment, days from diagnosis to resolution, STROC and recidivation. Results: epidemiological análisis showed a decrease in surgeries in the period 2020, compared to the same period of the previous year, a predominance in April with a percentage decrease of 52%, coinciding with the start of quarantine in the province. All patients were male, hypertensive and 3 of them with diabetes. Al lof them studied by ultrasound and tomography with contrast. They were treated at 48hours of diagnosis. Microbiology of surgical sample positive: Klebsiella Pn (3), St aureus (1), E. Coli (1), Bacillos gram ­ (1). Microbiology of blood: 3 negative, 2 positive to Klebsiella Pn and 1 to St. Aureus. 3 patients were drainage by percutaneous , 2 by laparoscopic and 1 by surgical conventional. They registered 2 STROC IIIA y 1 IIIB. 1 patiente dead, the rest were external from hospital. Conclusions: our patients developed liver abscess, they were male, diabetics and the most frecuently agent was the Klebsiella pneumoniae. Criptogenics abscess were the most prevalent. The same topographic location in the liver and the etiologic agent was determined in recurrence. That´s why we wonder about the effectiveness of the treatment implemented.

Identificação da população fúngica em amostras de ar coletadas em clínica de ensino de Odontopediatria / Identification of the fungal population in air samples collected at Pediatric Dentistry teaching clinic

Agentes infecciosos podem ser transmitidos via partículas microscópicas suspensas no ar e secreções presentes em superfícies contaminadas de instrumentos e equipamentos. Entre os contaminantes veiculados pelo ar em ambiente interno estão os fungos, bactérias e vírus, que são provenientes do ar externo, do sistema de climatização, da construção, mobiliário, carpete e de seus ocupantes. A maioria dos procedimentos realizados na clínica odontológica libera grande quantidade de aerossóis, partículas diminutas que ficam durante várias horas no ar e podem conter diversos micro-organismos, dentre eles, os fungos. Em clínicas de ensino, esta contaminação é maior devido ao alto número de ocupantes e de procedimentos realizados ao mesmo tempo. Ao conhecer os gêneros fúngicos aos quais seus pacientes estão expostos, o profissional pode minimizar os riscos de infecção, adotando práticas de higienização do ambiente e do ar que possam auxiliar na prevenção de doenças. A verificação de fungos foi realizada pelo método de sedimentação em placa, que se mostra útil para a análise da quantidade e da qualidade de fungos presentes em ambientes internos e externos. Foram identificadas espécies pertencentes aos gêneros Aspergillus, Fusarium, Cladosporium, Nigrospora e Penicillium, encontrados com maior frequência os gêneros Penicillium e Aspergillus provenientes de ambiente externo e interno (AU).

Infectious agents can be transmitted via microscopic particles suspended in the air and secretions present on contaminated surfaces of instruments and equipment. Indoor airborne contaminants include fungi, bacteria and viruses, which come from outside air, the air conditioning system, the building, furniture, carpet and their occupants. Most procedures performed at the dental clinic release large amounts of aerosols, minute particles that remain for several hours in the air and may contain several microorganisms, among them fungi. In teaching clinics, this contamination is greater due to the high number of occupants and procedures performed at the same time. By knowing the fungal genera to which their patients are exposed, the professional can minimize the risks of infection, adopting practices of hygiene of the environment and air that can aid in the prevention of diseases. The fungi check was performed by the plate sedimentation method, which is useful for the analysis of the quantity and quality of fungi present in internal and external environments. Species belonging to the genus Aspergillus, Fusarium, Cladosporium, Nigrospora and Penicillium were identified, most frequently found Penicillium and Aspergillus genera from external and internal environment (AU).

Under the superficial dichotomy pathogen and allergen are two manifestations of same immune activation and pathogenesis mechanisms

Pathogens and allergens are deemed as two contrasting facets of host immune status, deficiency and exuberant. In silico domain analysis of a diverse panel of pathogen and allergen proteins has revealed the shortcoming of this notion. Both the pathogen and allergen proteins elicit immune activation, with the outcome of immune agitation depending on the pathogen strain, allergen exposure duration, and host factors. Pathogens can replicate within the host and constantly irritate the immune system, leading to blood coagulation, respiratory collapse and death. Allergens, being non-viable, can only provoke the immune system transiently; however, depending on the allergen dose and extent exposed to, inflammation and fatality can occur. In silico analysis of pathogen and allergen proteins showed the conserved domains to be AAA, WR1, VKc, Kelch, Hr1, HAMP, HELICc, Dak2, CHAD, CHASE2, Galanin, PKS_TE, Robl_LC7, Excalibur, DISIN, etc. This exciting discovery can have far-reaching effects in drug target identification approaches (AU)

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The oxidative stress response of the opportunistic fungal pathogen Candida glabrata / Respuesta al estrés oxidante en el hongo patógeno oportunista Candida glabrata

Organisms have evolved different strategies to respond to oxidative stress generated as a by-product of aerobic respiration and thus maintain the redox homeostasis within the cell. In particular, fungal pathogens are exposed to reactive oxygen species (ROS) when they interact with the phagocytic cells of the host which are the first line of defense against fungal infections. These pathogens have co-opted the enzymatic (catalases, superoxide dismutases (SODs), and peroxidases) and non-enzymatic (glutathione) mechanisms used to maintain the redox homeostasis within the cell, to resist oxidative stress and ensure survival within the host. Several virulence factors have been related to the response to oxidative stress in pathogenic fungi. The opportunistic fungal pathogen Candida glabrata (C. glabrata) is the second most common cause of candidiasis after Candida albicans (C. albicans). C. glabrata has a well defined oxidative stress response (OSR), which include both enzymatic and non-enzymatic mechanisms. C. glabrata OSR is controlled by the well-conserved transcription factors Yap1, Skn7, Msn2 and Msn4. In this review, we describe the OSR of C. glabrata, what is known about its core elements, its regulation and how C. glabrata interacts with the host. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012) (AU)

Los microorganismos han establecido diferentes estrategias para controlar el estrés oxidante generado durante la respiración aeróbica y, por consiguiente, mantener la homeostasia redox en la célula. En particular, los hongos patógenos se exponen a especies reactivas del oxígeno cuando interactúan con las células fagocíticas del huésped que son la primera línea de defensa contra estos agentes infecciosos. Estos patógenos han reclutado sistemas enzimáticos (catalasas, superóxido dismutasas y peroxidasas) y no enzimáticos (glutatión) que normalmente utilizan para mantener la homeostasis redox en la célula, para resistir frente al estrés oxidante y garantizar la supervivencia dentro del huésped. Varios factores de virulencia se han relacionado con la respuesta al estrés oxidante de los hongos patógenos. El hongo patógeno oportunista Candida glabrata (C. glabrata) es la segunda causa más frecuente de candidiasis después de Candida albicans (C. albicans). C. glabrata tiene una respuesta bien definida al estrés oxidante, que incluye sistemas enzimáticos y no enzimáticos y está regulada por los factores de transcripción Yap1, Skn7, Msn2 y Msn4. En esta revisión, describimos los elementos de la respuesta de C. glabrata a dicho estrés, cómo se regula y cómo C. glabrata interacciona con el huésped.Este artículo forma parte de una serie de estudios presentados en el «V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi» (Oaxaca, México, 2012) (AU)

Epidemiología molecular de pseudomonas aeruginosa resistente a ß-lactámicos de amplio espectro en el Hospital San Jerónimo De Montería / Molecular epidemiolgy of broad-spectrum ß-lactams resistant Pseudomonasaeruginosa in Hospital San Jerónimo, Montería

Pseudomonas aeruginosa ha emergido como uno de los principales patógenos hospitalarios causantes de infecciones graves y productores de β -lactamasas de espectro extendido (BLEE) inusuales, como PER- 1, OXA y carbapenemasas. Objetivo. Caracterizar los aislamientos de P. aeruginosa resistentes a -β -lactámicos de amplio espectro por investigación de los genotipos por rep- PCR y su diseminación en este hospital. Métodos. Se obtuvieron 26 aislamientos clínicos de P. aeruginosaresistentes a β -lact´micos de amplio espectro del Hospital San Jerónimo de enero a agosto del 2002. La resistencia a los β -lact´micos de amplio espectro se estableció con el sistema MicroScan® ESBL plusTM. Se utilizó la técnica de rep- PCR para la tipificación molecular de los microorganismos. Resultados. Los aislamientos mostraron resistencia a la fluoroquinolona ciprofloxacina (15/26, 57,6%) y aminoglucósidos, como gentamicina (14/ 26, 53,8%) y amikacina (9/26, 34,6%). También se observó resistencia a meropenem e imipenem (3/ 26, 11,5%). La tipificación molecular por rep-PCR mostró dos clones A y B de 15 y 3 aislamientos, respectivamente y 8 aislamientos no relacionados. El clon A con 15 aislamientos incluía dos subclones idénticos de 8 y 2 aislamientos, y 5 aislamientos estrechamente relacionadas. El clon B incluyó 3 aislamientos estrechamente relacionados con similaridad mayor del 90% Conclusiones. La relación de los fenotipos de resistencia expresados por estos aislamientos, posiblemente, indique la existencia de plásmidos de resistencia causantes de la infección hospitalaria en este hospital y responsables de codificar la resistencia a β-lact´micos de amplio espectro. Asimismo, el análisis molecular por rep-PCR mostró la diseminación de dos clones de P. aeruginosa en el hospital, de los cuales el clon A presentó aislamientos idénticos diseminados en diferentes servicios de la institución, lo que sugiere una transmisión horizontal.

Pseudomonas aeruginosa has emergence as nosocomial pathogen mean causing several illness and producer of extended-spectrum β-lactamases (ESBL) unusual as PER-1, OXA and carbapenemases. Objetives Characterized isolates of broadspectrum β -lactams resistant P. aeruginosa by research of genotype rep-PCR and spread in this hospital. Methods: 26 clinical isolates of broadspectrum β-lactams resistant P. aeruginosa were obtained from Hospital San Jeronimo (HSJ), between January and August 2002. Broadspectrum β-lactams resistant was established with system MicroScan® ESBL plusTM (Dade Inc). Assays by rep-PCR were utilized for molecular typing of microorganisms. Results: Those isolates showed resistance to fluoroquinolone as ciprofloxacin (15/26, 57.6%) and aminoglicosides as gentamicin (14/26, 53.8%) and amikacin (9/26, 34.6%). Also showed resistance to meropenem and imipenem (3/26, 11.5%). Molecular typing by rep-PCR showed 2 clusters of 15 and 3 strains, and 8 strains unrelationed. Cluster of 15 strains included two clons of 8 and 2 strains, and 5 strains relationed. Cluster of 3 strains showed isolates relationed. Conclusions: Relation of resistance phenotypic expressed for this isolates indicating possibly the existance resistence plasmids causing of nosocomial infections in this hospital and responsible encoding broad-spectrum β-lactams resistant, moreover molecular assays by rep-PCR showed spread of 14 cluster of P. aeruginosa in HSJ, the clusters 1, 3 y 6 showed the biggest number of isolates, the remained clusters corresponded to single isolates that suggest an horizontal transmission.

Methyl bromide fumigant lethal to Bacillus anthracis spores.

Methyl bromide (MB), an agricultural fumigant used in the United States, is capable of reducing or eliminating Bacillis anthracis spores. In the event of a bioterrorist attack, MB might serve as an excellent decontaminating agent because it leaves no residue and does not damage furnishings and commodities.