Analysis for Candida albicans in samples of intravenous lipids administered to premature infants with the goal of optimizing the use of the 1.2 µm filter / Determinación de Candida albicans en muestras de lípidos intravenosos administrados en prematuros para optimizar el uso correcto del filtro de 1.2 µm

Introduction: parenteral nutrition is a mixture of macro and micronutrients necessary for the premature infant who cannot be fed enterally. The binary mixture contains carbohydrates, amino acids and micronutrients in one bag and intravenous lipids in another. The latter are more susceptible to microbial contamination, especially by Candida albicans. For this reason, many professional associations typically recommend the use of a single filter in line “Y”; however, this has not yet become standard hospital practice. Aim: to determine the presence of Candida albicans in devices that contain intravenous lipids used in neonates and relate it to the correct use of the 1.2 µm filter. Method: three groups of samples consisting of the remains of a lipid solution (ML) administered to the premature patient for 24 h seeded on Sabouraud agar organized as follows: (ML1), lipid solution obtained directly from the ethinyl vinyl acetate bag were evaluated. (ML2): filtered lipid solution with a 1.2 µm device connected directly to the catheter. (ML3): solution of lipids intentionally contaminated with Candida and subsequently filtered. Results: Candida albicans was not detected in any of the filtered simples (ML2 and ML3) and also not detected in any of the unfiltered simples (ML1). Conclusions: there was no presence of Candida albicans in the lipid solutions used directly with a 1.2 µm filter, however, the use of a single 1.2 µm filter in line “Y” is recommended according to international standards to save the health system. (AU)

Introducción: la nutrición parenteral es una mezcla de macro y micronutrientes necesarios para el prematuro que no puede alimentarse por vía enteral. La mezcla binaria contiene en una bolsa carbohidratos, proteínas y micronutrientes y en otra los lípidos intravenosos, que son más susceptibles de contaminación microbiana especialmente por Candida albicans, por lo que asociaciones profesionales recomiendan el uso en línea “y” de un solo filtro, lo que no es práctica habitual hospitalaria. Objetivo: determinar la presencia de Candida albicans en dispositivos que contienen lípidos intravenosos usados en neonatos y relacionarla con el uso correcto del filtro de 1.2 µm. Método: se evaluaron tres grupos de muestras constituidas por los restos de una solución de lípidos (ML) administrados al paciente prematuro durante 24 h. sembradas en agar Sabouraud organizadas en: (ML1): solución de lípidos obtenida directamente de la bolsa de etinil vinil acetato (EVA). (ML2): solución de lípidos filtrados con dispositivo de 1.2 µm. conectado directamente al catéter (práctica observada). (ML3): solución de lípidos contaminados con Candida que fueron sembrados en agar Sabouraud y posteriormente filtrados. Resultados: el 100 % de las muestras filtradas (ML2) y (ML3) como se esperaba, no presentaron Candida albicans, el 100 % de las muestras(ML1) que no fueron filtradas, tampoco presentaron Candida albicans. Conclusiones: no hubo presencia de Candida albicans en las soluciones lipídicas utilizadas directamente con filtro 1.2 µm, sin embargo, se recomienda el uso de un solo filtro 1.2 µm en línea “Y” según las normas internacionales para el ahorro del Sistema sanitario. (AU)

Analysis for Candida albicans in samples of intravenous lipids administered to premature infants with the goal of optimizing the use of the 1.2 µm filter.

Introduction: Introduction: parenteral nutrition is a mixture of macro and micronutrients necessary for the premature infant who cannot be fed enterally. The binary mixture contains carbohydrates, amino acids and micronutrients in one bag and intravenous lipids in another. The latter are more susceptible to microbial contamination, especially by Candida albicans. For this reason, many professional associations typically recommend the use of a single filter in line "Y"; however, this has not yet become standard hospital practice. Aim: to determine the presence of Candida albicans in devices that contain intravenous lipids used in neonates and relate it to the correct use of the 1.2 µm filter. Method: three groups of samples consisting of the remains of a lipid solution (ML) administered to the premature patient for 24 h seeded on Sabouraud agar organized as follows: (ML1), lipid solution obtained directly from the ethinyl vinyl acetate bag were evaluated. (ML2): filtered lipid solution with a 1.2 µm device connected directly to the catheter. (ML3): solution of lipids intentionally contaminated with Candida and subsequently filtered. Results: Candida albicans was not detected in any of the filtered simples (ML2 and ML3) and also not detected in any of the unfiltered simples (ML1). Conclusions: there was no presence of Candida albicans in the lipid solutions used directly with a 1.2 µm filter, however, the use of a single 1.2 µm filter in line "Y" is recommended according to international standards to save the health system.

Introducción: Introducción: la nutrición parenteral es una mezcla de macro y micronutrientes necesarios para el prematuro que no puede alimentarse por vía enteral. La mezcla binaria contiene en una bolsa carbohidratos, proteínas y micronutrientes y en otra los lípidos intravenosos, que son más susceptibles de contaminación microbiana especialmente por Candida albicans, por lo que asociaciones profesionales recomiendan el uso en línea "y" de un solo filtro, lo que no es práctica habitual hospitalaria. Objetivo: determinar la presencia de Candida albicans en dispositivos que contienen lípidos intravenosos usados en neonatos y relacionarla con el uso correcto del filtro de 1.2 µm. Método: se evaluaron tres grupos de muestras constituidas por los restos de una solución de lípidos (ML) administrados al paciente prematuro durante 24 h. sembradas en agar Sabouraud organizadas en: (ML1): solución de lípidos obtenida directamente de la bolsa de etinil vinil acetato (EVA). (ML2): solución de lípidos filtrados con dispositivo de 1.2 µm. conectado directamente al catéter (práctica observada). (ML3): solución de lípidos contaminados con Candida que fueron sembrados en agar Sabouraud y posteriormente filtrados. Resultados: el 100 % de las muestras filtradas (ML2) y (ML3) como se esperaba, no presentaron Candida albicans, el 100 % de las muestras (ML1) que no fueron filtradas, tampoco presentaron Candida albicans. Conclusiones: no hubo presencia de Candida albicans en las soluciones lipídicas utilizadas directamente con filtro 1.2 µm, sin embargo, se recomienda el uso de un solo filtro 1.2 µm en línea "Y" según las normas internacionales para el ahorro del Sistema sanitario.

Biosynthetic Basis for Structural Diversity of Aminophenylpyrrole-Derived Alkaloids.

Bacterial aminophenylpyrrole-derived alkaloids (APPAs) represent high value lead compounds. Pyrrolnitrin, which was developed into globally important fungicides, is the only reported APPA produced by Proteobacteria. Recently, various APPAs showing diverse bioactivities were discovered from Bacteroidetes. Here, a bioinformatics and phylogenetic approach enabled the elucidation of the biosynthesis of the highly diverse APPAs in Cytophagales bacteria and their chemical diversification strategy. The biosynthetic gene clusters were identified in producer strains, and the biosynthesis was experimentally validated by heterologous expression experiments in E. coli. First, one enzyme-dependent biosynthetic step yields the tryptophan-derived precursor 3-(2'-aminophenyl)-pyrrole. Second, a spontaneous Pictet-Spengler-like coupling reaction enables the bacterial producer strains to create a library of tricyclic alkaloids, since several aldehydes can be applied as substrates. The diversity of this natural products class is further enlarged by the catalytic action of a methyltransferase, which adds one or more methyl groups to the aminophenyl intermediate.

Diversity and Antimicrobial Potential of Predatory Bacteria from the Peruvian Coastline.

The microbiome of three different sites at the Peruvian Pacific coast was analyzed, revealing a lower bacterial biodiversity at Isla Foca than at Paracas and Manglares, with 89 bacterial genera identified, as compared to 195 and 173 genera, respectively. Only 47 of the bacterial genera identified were common to all three sites. In order to obtain promising strains for the putative production of novel antimicrobials, predatory bacteria were isolated from these sampling sites, using two different bait organisms. Even though the proportion of predatory bacteria was only around 0.5% in the here investigated environmental microbiomes, by this approach in total 138 bacterial strains were isolated as axenic culture. 25% of strains showed antibacterial activity, thereby nine revealed activity against clinically relevant methicillin resistant Staphylococcus aureus (MRSA) and three against enterohemorrhagic Escherichia coli (EHEC) strains. Phylogeny and physiological characteristics of the active strains were investigated. First insights into the chemical basis of the antibacterial activity indicated the biosynthetic production of the known compounds ariakemicin, kocurin, naphthyridinomycin, pumilacidins, resistomycin, and surfactin. However, most compounds remained elusive until now. Hence, the obtained results implicate that the microbiome present at the various habitats at the Peruvian coastline is a promising source for heterotrophic bacterial strains showing high potential for the biotechnological production of antibiotics.

Identification and heterologous expression of the kocurin biosynthetic gene cluster.

The antibiotically bioactive thiopeptide compound kocurin was identified in extracts from a newly isolated Kocuria rosea strain. The axenic strain was retrieved from a soil sample of the intertidal area at the Paracas National Park, Peru. The genetic basis of this promising natural product with activity against methicillin-resistant Staphylococcus aureus (MRSA) strains was revealed by comparative genome analysis of this new isolate and other reported thiopeptide producer strains. The functionality of the predicted gene locus was experimentally proven by heterologous expression in Streptomyces coelicolor M1146. Expression of the gene cluster under the control of a constitutive promoter enabled the transgenic strain to produce kocurin in selected media. The kocurin biosynthetic gene cluster comprises nine open reading frames and spans around 12 kbp of the genome.

Quimioterapia combinada con fluoruracil (F), epidoxorubicina (E) y cisplatino (P), en pacientes con cáncer de pulmón a celulas no pequeñas, estadios clínicos III y IV / Drug therapy combination with fluoruracil, epirubicin and cisplatin in patients with stages III and IV non small oat cell cancer

Veintinueve pacientes en el período enero 1986; diciembre 1988, con carcinoma de pulmón a células no pequeñas, estadió clínico III & IV y con enfermedad mensurable, fueron tratados con F 750 mg/m²/24 horas en infusión contínua EV de 120 hrs.; E 25 mg/m²EV directo de 4-5 y P 100 mg/m²/72 horas. EV directo 1-3 cada 3-4 sem. Tres pacientes no fueron evaluables debido a muerte precoz. Los 26 pacientes evaluables fueron 7 mujeres y 19 hombres, con una edad media de 57 años (37-75). Trece pacientes tuvieron capacidad de acción Zubrod <1. Diecisiete pacientes fueron adenocarcinoma y 9 carcinoma epidermoide. 16 pacientes recibieron más de 3 cursos de tratamiento, 10 de ellos completaron los 6 programados. Las metástasis fueron: óseas 7, cerebro 6, e hígado 2. La distribución TNM fue muy dispersa, las más frecuentes fueron T3 N2 MO: 5 pacientes y T3 N2 M1: 4 pacientes. Respuesta Parcial (RP) fue observada en 9/26 pacientes (34.26 por ciento) con una duración media (DM) de 7,33 meses (3-10) y la sobrevida (SV) fue de 12,33 meses (5-22). En 6/26 pacientes (23,8 por ciento) hubo enfermedad Estable (EE) con una DM, de 4 meses (1-7) y una SV de 7,6 meses (2-16), 11/26 (41,31 por ciento) tuvieron No Respuesta (NR) con SV de 5,9 meses (3-12). La diferencia de SV media entre RP y NR no fue estadísticamente significativa por lo reducido de la muestra. Actualmente sólo hay un sobreviviente con enfermedad activa, 21 pacientes fallecieron y 4 se perdieron de vista. 20 pacientes recibieron radioterapia, 8 al foco primario, 6 al cerebro, y 6 a la columna vertebral. El efecto tóxico más común fue gastrointestinal en 25/26 (96,15 por ciento); alopecia en 23/26 (88.47 por ciento); no se observó nefro, ni cardiotoxicidad en ningún caso. Las dos muertes por paro cardiaco no fueron atribuidas a cardiotoxicidad.