Pyogenic liver abscess caused by an atypical hypervirulent Klebsiella pneumoniae K1-ST23 in Mexico.

Hypervirulent K. pneumoniae infection has been raising worldwide and is one of the major causes of community-acquired pyogenic liver abscess. We described a case report of pyogenic liver abscess caused by an atypical hypervirulent (non-hypermucoviscous) K. pneumoniae K1 ST23 in a diabetic Asian patient who resided in Mexico. The susceptibility to antimicrobials, pathogenicity, molecular and genomic analysis were determined. A man from Guangdong (China) with a recent diagnosis of diabetes mellitus was admitted to the hospital, and he denied traveling in the last 3 months. A computed tomography revealed a right lobe liver abscess. On the third day after admission a Klebsiella pneumoniae isolate (14652) was obtained. The isolate corresponded to a susceptible K. pneumoniae with capsular type K1 and ST23 (CG23) and exhibited a non-hypermucoviscous phenotype. The isolate 14652 was genetically related to the globally distributed lineage ST23-KL1. This study describes the first case in Mexico of K. pneumoniae capsular type K1 and ST23 with an atypical hypervirulent phenotype.

[Nosocomial pneumonia in patients with haematological malignancies]. / Neumonía nosocomial (NN) en pacientes con neoplasias hematológicas (NH).

INTRODUCTION: Nosocomial pneumonia (NP) in patients with hematological malignancies (HM) has an attributable mortality over 90%. There are few studies that report the incidence of nosocomial infections in patients with HM. OBJECTIVE: To describe the epidemiology and clinical course of NP in a cohort of patients with hematologic malignancies. MATERIAL AND METHODS: Single-center study of patients with leukemia, lymphoma or multiple myeloma diagnosed with NP, hospitalized between January 2011 and December 2012. RESULTS: One-hundred and five NP were recorded: 51 leukemias (48%) and 45 lymphomas (43%); 50 (48%) were in relapse or progression. Median days for NP development were 13 days (IQ 6-20). Sixty percent of the patients had severe neutropenia. The most frequent symptom was fever 73 (70%). CT scan showed infiltrates in 100% of cases; 45 (43%) with findings suggestive of invasive fungal infection. Seven (7%) had confirmed invasive fungal infection, possible 9 (9%) and 45 (43%) probable. There were 99 cultures taken, 30 blood cultures (67% were positive) and 31 sputum (71% positive). Sixty percent of Gramnegative bacteria were multi-drug resistant and 50% of the Grampositive, E. coli, 19 (30%) was the most frequent isolated, Aspergillus spp. was the third, but the one with the highest associated mortality. Attributable mortality for pneumonia was 50% and 73% in patients that required mechanical ventilation (p = 0.001). CONCLUSIONS: We observed a high mortality rate in patients with HM and NP. Standardized diagnostic routes are needed for patients with HM with suspicion of pneumonia. Novel diagnostic techniques to enhance Aspergillus and respiratory viruses diagnosis should be introduced in this setting.

El bosque tropical seco en riesgo: Conflictos entre uso agropecuario, desarrollo turístico y provisión de servicios ecosistémicos en la Costa de Jalisco, México / The dry tropical forest at risk: Conflicts between agricultural and cattle use, turism development, and provision of ecosystemic services in the Coast of Jalisco, Mexico / O bosque tropical seco em risco: Conflitos entre uso agropecuario, desenvolvimento turístico e provisão de serviços ecossistêmicos na Costa de Jalisco, México

El bosque tropical seco (BTS) es un ambiente de alto valor ecológico y en la región del Pacífico mexicano cubre extensas áreas. La Reserva de la Biosfera Chamela-Cuixmala, Jalisco, México, protege poco más de 13000ha de este ecosistema. No hay comunidades humanas dentro de la reserva, pero en su zona aledaña la mayor parte de las tierras pertenecen a campesinos ejidatarios, y en la región colindante con el mar existen hoteles, casas de playa y otras facilidades turísticas. Con el fin de estudiar las relaciones entre la sociedad y el BTS, el presente trabajo analiza 1) aspectos de la historia ambiental de la región, 2) las visiones de los campesinos sobre el uso y transformación de este ecosistema, y 3) las unidades turísticas y la provisión de servicios ecosistémicos. Históricamente la región se pobló lentamente y los bosques se han visto como ambientes difíciles para el trabajo productivo. El reparto agrario y las políticas públicas han sido los principales motores de la transformación de los bosques. A pesar de ello aun existe una cobertura forestal de 50-80% en las tierras campesinas. El desarrollo turístico ha sido lento a pesar del alto potencial que se le ha dado desde hace décadas. La zona se encuentra en riesgo debido a proyectos turísticos de gran envergadura que pueden ocasionar graves deterioros de los ecosistemas y de sus capacidades de proveer servicios.

The tropical dry forest (TDF) constitutes an environment of a high ecological value and covers extensive areas in the Mexican Pacific. The Biosphere Reserve of Chamela-Cuixmala, in Jalisco, México, protects over 13000ha of this ecosystem. There are no human communities within the Reserve, but in its neighboring area most of the land belongs to farmers (ejidatarios), while in the coastal zone there are hotels, beach houses and other touristic facilities. In order to study the relations between society and the TDF, this work analyzes 1) aspects of the environmental history of the region, 2) the visions of farmers about the use and transformation of this ecosystem, and 3) the touristic units and the provision of ecosystemic services. Historically, the region was slowly populated and forests have been seen as difficult environments for productive labor. The agrarian reform land distribution and public policies have been the main drivers of forest transformation. Despite of this, there is still a 50-80% forest cover in farmers land. The touristic development has been slow in view of the high potential it has had for decades. The zone is currently at risk due to large touristic projects that can produce severe deterioration of the ecosystems and their service-providing capacities.

O bosque tropical seco (BTS) é um ambiente de alto valor ecológico e na região do Pacifico mexicano cobre extensas áreas. A Reserva da Biosfera Chamela-Cuixmala, Jalisco, México, protege pouco mais de 13000 ha deste ecossistema. Não há comunidades humanas dentro da reserva, mas na sua zona aledanha a maior parte das terras pertencem a camponeses ejidatarios, e na região colindante com o mar existem hoteis, casas de praia e oturas facilidades turísticas. Com o fim de estudar as relações entre a sociedade e o BTS, o presente trabalho analisa 1) aspectos da historia ambiental da região, 2) as visões dos camponeses sobre o uso e transformação deste ecossistema, e 3) as unidades turísticas e a provisão de serviços ecossisêmicos. Históricamente a região se povuou lentamente e os bosques tem sido vistos como ambientes difíceis para o trabalho produtivo. A repartição agrária e as políticas públicas tem sido os principais motores da transformação dos bosques. A pesar disto ainda existe uma cobertura florestal de 50-80% nas terras camponesas. O desenvolvimento turístico tem sido lento a pesar do alto potencial que se lhe tem dado desde faz décadas. A zona se encontra em risco devido a projetos turísticos de grande envergadura que podem ocasionar graves deterioros dos ecossistemas e de suas capacidades de prover serviços.