Molecular epidemiology and drug resistance of Mycobacterium tuberculosis in a tertiary care hospital in northeastern Mexico.

INTRODUCTION: Tuberculosis (TB) is a re-emerging disease considered a public health concern. In the present study, we analyzed the epidemiology and drug resistance of Mycobacterium tuberculosis strains isolated from patients with pulmonary TB. METHODOLOGY: Mycobacterium tuberculosis isolates (n = 190) were obtained from patients with pulmonary TB admitted to Dr. José Eleuterio González University Hospital (UH). Each M. tuberculosis isolate was analyzed by spoligotyping (spacer oligonucleotide typing) and MIRU-VNTR (Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeat). Drug resistance was evaluated using the Anyplex™ II MTB/MDR/XDR assay. RESULTS: The predominant spoligotypes observed were X1 (SIT 119, n = 46), T1 (SIT 53, n = 40), H3 (SIT 50, n = 13), Beijing (SIT 1, n = 11), and EAI2-Manila (SIT 19, n = 8). MIRU-VNTR analysis showed that the locus QUB-26 had the highest allelic variability. The observed drug resistance included monoresistance to rifampicin (2.6%; n = 5), isoniazid (3.2%; n = 6), and fluoroquinolones (1.6%; n = 3) as well as multidrug resistance (5.3%; n = 10). All of the Beijing strains were susceptible. Regarding comorbidities, 13.7% (26/190) of the patients were co-infected with TB and HIV (TB+HIV+), and 31.6% (55/190) had TB along with diabetes (TB + diabetes). CONCLUSIONS: The most prevalent lineages were X1 (SIT 119; 24.3%) and T1 (SIT 53; 21%). An alarming proportion (12.6%) of M. tuberculosis isolates presented drug resistance. To effectively manage TB, continuous surveillance of regional strain dissemination, drug resistance profiles, and TB-associated comorbidities is crucial.

Seroprevalence of Anti-SARS-CoV-2 Antibodies in Blood Donors from Nuevo Leon State, Mexico, during 2020: A Retrospective Cross-Sectional Evaluation.

The progression and distribution of the SARS-CoV-2 pandemic are continuously changing over time and can be traced by blood donors' serological survey. Here, we investigated the seroprevalence of anti-SARS-CoV-2 antibodies in blood donors in Nuevo Leon, Mexico during 2020 as a strategy for the rapid evaluation of the spread of SARS-CoV-2 and asymptomatic case detection. We collected residual plasma samples from blood donors who attended two regional donation centers from January to December of 2020 to identify changes in anti-SARS-CoV-2 IgG prevalence. Plasma samples were analyzed on the Abbott Architect instrument using the commercial Abbott SARS-CoV-2 IgG chemiluminescent assay. We found a total of 99 reactive samples from 2068 analyzed plasma samples, resulting in a raw prevalence of 4.87%. Donors aged 18-49 years were more likely to be seropositive compared to those aged >50 years (p < 0.001). Weekly seroprevalence increased from 1.8% during the early pandemic stage to 27.59% by the end of the year. Prevalence was 1.46-fold higher in females compared to males. Case geographical mapping showed that Monterrey city recorded the majority of SARS-CoV-2 cases. These results show that there is a growing trend of seroprevalence over time associated with asymptomatic infection that is unnoticed under the current epidemiological surveillance protocols.

Norovirus Is the Most Frequent Cause of Diarrhea in Hospitalized Patients in Monterrey, Mexico.

Little information is available regarding the pathogens that cause diarrhea in hospitalized patients who also have various clinical problems. The purpose of this study was to determine the presence of pathogens in fecal samples of hospitalized patients all suffering diarrhea in addition to other problems in Mexico. Diarrheic stools from 240 patients were obtained in a third-level hospital in Monterrey, Mexico. PCR was used for the detection of Salmonella spp., Shigella spp., Campylobacter spp., Yersinia spp., Aeromonas spp., Clostridioides difficile, and norovirus GI and GII. The presence of trophozoites, cysts of protozoa, eggs, and/or helminth larvae was determined by microscopic observation. Of the 240 patients analyzed, 40.4% presented at least one of the pathogens analyzed. Norovirus was the pathogen most frequently found (28.6%), followed by bacteria (11.7%), and parasites (8.3%). The majority of co-infections were parasites + norovirus, and bacteria + norovirus. Norovirus was detected mainly in children aged 0 to 10 years (9/15, 60%). Patients aged 0-20 years did not present co-infections. Entamoeba coli and Entamoeba histolytica were the most common parasites, (8/240), and Salmonella was the most prevalent bacteria (10/240). This information can help design specific strategies useful for hospitalized people with a compromised status.

Serological screening in donors in Mexico: advances and technology / Tamizaje serológico en donadores de México: avances y tecnología

The residual risk of transfusion-related infections has decreased dramatically in countries that have routinely implemented serological screening. Most of the donation in Mexico is from replacement practice, a risk factor for positive serology. In Mexico, the altruistic donation is only 2.7%. The heterogeneity of technical factors, regional factors and internal policies of each center influences the variability of data on the prevalence of positive screening, as well as the prevalence of confirmed cases. The main advantage of nucleic acid technology is the detection of donors in the period of serological window or occult infections, being occult hepatitis reports in Mexican donors from 1 to 3.4%. The limitation of available technology, the scope of the clinic and perspectives, invites us to improve technology and health policies in the interest of transfusion safety.

El riesgo residual de las infecciones relacionadas a la transfusión ha disminuido drásticamente en los países que han implementado rutinariamente el tamizaje serológico. La mayor parte de la donación en México es de reposición, factor de riesgo para serología positiva, y en donde la donación altruista es de apenas 2.7%. La heterogeneidad de factores técnicos, regionales y políticas internas de cada centro influyen en la variabilidad de datos en prevalencia del tamizaje positivo, así como en la prevalencia de casos confirmados. La principal ventaja de la tecnología de ácidos nucleicos es la detección de donadores en periodo de ventana serológico o de infecciones ocultas, con reportes de hepatitis ocultas en donadores de 1-3.4% en México. Las limitantes de la tecnología disponible, el alcance de la clínica y de las perspectivas, nos invita a la mejora tecnológica y de las políticas sanitarias en aras de la seguridad transfusional.

Microbiology of genus Raoultella, clinical features and difficulties in its diagnosis / Microbiología del género Raoultella, características clínicas y dificultades para su diagnóstico

The genus Raoultella, which belongs to the Enterobacteriaceae family, encompasses gramnegative, oxidase-negative, aerobic, encapsulated and motionless bacilli. Currently, four species of this genus have been described: Raoultella terrigena (R. terrigena), Raoultella planticola (R. planticola), Raoultella ornithinolytica (R. ornithinolytica) and Raoultella electrica (R. electrica), out of which R. planticola and R. ornithinolytica are the most important because of their probable association as pathogenic agents. The incidence of this genus has been underestimated, given that detecting it is really difficult, since it is misidentified as Klebsiella spp. by using manual and automated conventional phenotypic methods. The rapid and correct detection has been increasing since the advent of mass spectrometers (MALDI-TOF MS), which have been used for the differentiation of Klebsiella spp. and Raoultella spp. Currently 80 cases of bacteremia secondary to Raoultella spp. have been identified with different sites of primary infection, which is why it is important to emphasize proper detection in hospitals and healthcare facilities.

El género Raoultella, perteneciente a la familia Enterobacteriaceae, engloba bacilos gram negativos, oxidasa negativos, aeróbicos, encapsulados e inmóviles. Actualmente se han descrito cuatro especies de este género: Raoultella terrigena (R. terrigena), Raoultella planticola (R. planticola), Raoultella ornithinolytica (R. ornithinolytica) y Raoultella electrica (R. electrica), entre las que la R. planticola y la R. ornithinolytica son las más importantes por su probable asociación como agentes patógenos. Se ha subestimado la incidencia del género por la dificultad que presenta su caracterización al ser mal identificado como Klebsiella spp., al usar métodos fenotípicos manuales y automatizados convencionales. La rápida y correcta detección de Raoultella spp. ha ido aumentando desde la llegada de espectrómetros de masas (MALDI-TOF MS), útiles en la diferenciación entre Klebsiella spp. y Raoultella spp. Se han identificado 80 casos de bacteremia por Raoultella spp., con infección primaria en diversos sitios, por lo que es importante hacer énfasis en su correcta detección en los hospitales y centros de atención médica.

[Comparative study of a rapid testing with real time RT-PCR for diagnosis of influenza AH1N1 2009]. / Estudio comparativo entre una prueba rápida y RT-PCR tiempo real en el diagnóstico de influenza AH1N1 2009.

OBJECTIVE: Compare QuickVue Influenza A+B test with real-time RT-PCR for the diagnosis of influenza AH1N1 2009. MATERIAL AND METHODS: Retrospective-comparative study of 135 respiratory specimens from individuals with symptoms of influenza processed from May 2009 to October 2010.The above mentioned tests were performed simultaneously. For statistic analysisthe softwareof Confidence IntervalAnalysis 2000 was used. RESULTS: The parameters obtained were: sensitivity 62.96; specificity 94.44; negative predictive value 62.9; positive predictive value 94.44; positive likelihood ratio 11.33; negative likelihood ratio 0.39. Confidence intervals to 95,were calculated to all of the above data. DISCUSSION: The test QuickVue InfluenzaA+B is a rapid,simple test,with lower cost than real-time RT-PCR useful for identifying the type of virus outbreaks of influenza in a given population.It correlates well with more specific test and similar reports.

Estudio comparativo entre una prueba rápida y RT-PCR tiempo real en el diagnóstico de influenza AH1N1 2009 / Comparative study of a rapid testing with real time RT-PCR for diagnosis of influenza AH1N1 2009

OBJETIVO: Comparar la prueba QuickVue Influenza A+B empleando como estándar la RT-PCR tiempo real para influenza AH1N1 2009. MATERIAL Y MÉTODOS: Estudio retrospectivo-comparativo de 135 muestras de vías respiratorias de individuos sintomáticos para influenza procesadas de mayo 2009 a octubre 2010.Las pruebas citadas se realizaron simultáneamente. Se utilizó el software Confidence Interval Analysis 2000. RESULTADOS: Sensibilidad 62.96; especificidad 94.44; valor predictivo negativo 62.9; valor predictivo positivo 94.44; razón de probabilidad positiva 11.33 y razón de probabilidad negativa 0.39. Se calcularon intervalos de confianza a 95. DISCUSIÓN: Los valores obtenidos concuerdan con otros estudios donde la sensibilidad fluctúa de 50 a 70 y especificidad entre 90 y 95 por ciento. La prueba QuickVue Influenza A+B es rápida, simple y de menor costo que el RT-PCR tiempo real, útil para identificar el tipo de virus en brotes de influenza de una población determinada.

OBJECTIVE: Compare QuickVue Influenza A+B test with real-time RT-PCR for the diagnosis of influenza AH1N1 2009. MATERIAL AND METHODS: Retrospective-comparative study of 135 respiratory specimens from individuals with symptoms of influenza processed from May 2009 to October 2010.The above mentioned tests were performed simultaneously. For statistic analysisthe softwareof Confidence IntervalAnalysis 2000 was used. RESULTS: The parameters obtained were: sensitivity 62.96; specificity 94.44; negative predictive value 62.9; positive predictive value 94.44; positive likelihood ratio 11.33; negative likelihood ratio 0.39. Confidence intervals to 95,were calculated to all of the above data. DISCUSSION: The test QuickVue InfluenzaA+B is a rapid,simple test,with lower cost than real-time RT-PCR useful for identifying the type of virus outbreaks of influenza in a given population.It correlates well with more specific test and similar reports.

Experiencias en la Universidad Autónoma de Nuevo León: un programa multidisciplinario de integración docente - asistencial en la atención primaria de la salud / Experiences at the Universidad Automa de Nuevo Leon:a multidisciplinary programof health care and teaching integration in primary health care

Se muestra la organización por niveles de atención, los porcentajes de problemas de salud asignados a los diferentes niveles y el análisis del costo / beneficio de cada uno, metodología de trabajo en un programa docente-asistencial y la asignación de recursos humanos y financieros para una determinada población. Se expone el "Programa de Salud de Guadalupe" implementado en el estado de Nuevo León por la Universidad Autónoma de dicho estado, su organización, recursos humanos y financieros, población a la que se destina el programa, y la evaluación de sus resultados (asistencial-docente-investigación). En las conclusiones se valorizan la importancia de los programas integrados por mejorar el aprendizaje y la calidad y cobertura de la asistencia en salud. Se enfatiza el menor costo anual por estudiante respecto a sistemas tradicionales, así como los costos por consulta y servicio. Se hace referencia a la mejoría en la mayoría de los indicadores de salud gracias al Plan Integrado (mortalidad infantil-natalidad-morbilidad por infecciosas) etc. Se enumeran recomendaciones para la mejor evolución del programa