Complexity of Genomic Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Isolates in Colombia Urges the Reinforcement of Whole Genome Sequencing-Based Surveillance Programs.

BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging public health problem. This study explores the specifics of CRKP epidemiology in Colombia based on whole genome sequencing (WGS) of the National Reference Laboratory at Instituto Nacional de Salud (INS)'s 2013-2017 sample collection. METHODS: A total of 425 CRKP isolates from 21 departments were analyzed by HiSeq-X10®Illumina high-throughput sequencing. Bioinformatic analysis was performed, primarily using the pipelines developed collaboratively by the National Institute for Health Research Global Health Research Unit (GHRU) on Genomic Surveillance of Antimicrobial Resistance (AMR), and AGROSAVIA. RESULTS: Of the 425 CRKP isolates, 91.5% were carbapenemase-producing strains. The data support a recent expansion and the endemicity of CRKP in Colombia with the circulation of 7 high-risk clones, the most frequent being CG258 (48.39% of isolates). We identified genes encoding carbapenemases blaKPC-3, blaKPC-2, blaNDM-1, blaNDM-9, blaVIM-2, blaVIM-4, and blaVIM-24, and various mobile genetic elements (MGE). The virulence of CRKP isolates was low, but colibactin (clb3) was present in 25.2% of isolates, and a hypervirulent CRKP clone (CG380) was reported for the first time in Colombia. ST258, ST512, and ST4851 were characterized by low levels of diversity in the core genome (ANI > 99.9%). CONCLUSIONS: The study outlines complex CRKP epidemiology in Colombia. CG258 expanded clonally and carries specific carbapenemases in specific MGEs, while the other high-risk clones (CG147, CG307, and CG152) present a more diverse complement of carbapenemases. The specifics of the Colombian situation stress the importance of WGS-based surveillance to monitor evolutionary trends of sequence types (STs), MGE, and resistance and virulence genes.

Relationship between vitamin intake and total antioxidant capacity in elderly adults / Relación entre ingesta de vitaminas y capacidad atnioxidante total en adultos mayores / Relação entre a ingestão de vitaminas e a capacidade antioxidante total em idosos

Abstract The consumption of foods high in natural antioxidants, like fruits and vegetables, is associated with a lower risk of oxidative stress-related diseases. The aim of this study was to establish the relationship between the plasma antioxidant capacity in adults over fifty and their intake of vitamin A, C, and E. We evaluated 118 24-hour recalls of intake of foods. The intake of vitamin A, C, and E was quantified using food composition tables. We quantified plasma phenols using the Folin-Ciocalteu method. The antioxidant capacity was determined using the Trolox Equivalent Antioxidant Capacity (TEAC) and Oxygen Radical Absorption Capacity (ORAC) methods. Correlation analyses were performed between the studied variables and a positive correlation was found in most cases. However, none of the correlations was statistically significant. In all cases p-value was >0.05. The quantification of nutrient intake is not an adequate predictor of plasma antioxidant capacity in individuals over fifty.

Resumen El consumo de alimentos ricos en antioxidantes naturales, como frutas y vegetales, está asociado con un menor riesgo de enfermedades relacionadas con el estrés oxidativo. El objetivo de este trabajo fue establecer la relación entre capacidad antioxidante del plasma en adultos mayores de cincuenta años y su consumo de vitamina A, C y E. Se evaluaron 118 recordatorios de ingesta de alimentos de 24 horas. La ingesta de vitamina A, C y E fue cuantificada usando tablas de composición de alimentos. Se cuantificaron los fenoles en plasma usando el método Folin-Ciocalteu, y la capacidad antioxidante se determinó con base en los métodos de Capacidad Antioxidante Equivalente a Trolox (TEAC) y de Capacidad de Absorción de Radicales de Oxígeno (ORAC). Se realizaron análisis de correlación entre las variables estudiadas y se encontró una correlación positiva en la mayoría de los casos. Sin embargo, ninguna de las correlaciones resultó estadísticamente significativa. En todos los casos, p > 0.05. La cuantificación de ingesta de nutrientes no es un predictor adecuado de la capacidad antioxidante del plasma en adultos mayores de 50 años.

Resumo O consumo de alimentos ricos em antioxidantes naturais, como frutas e vegetáis, é associado a um baixo risco de doenças relacionadas ao estresse oxidativo. O objetivo do trabalho foi determinar a relação entre a capacidade antioxidante plasmática em adultos acima de cinquenta anos e sua ingestão de vitamina A, C e E. Foram avaliados 118 lembretes de consumo de alimentos de 24 horas. A ingestão de vitamina A, C e E foi quantificada usando tabelas de composição de alimentos. Foram quantificados fenóis plasmáticos usando método Folin-Ciocalteu baseado na base de dados de um estúdio prévio e obtivemos a capacidade antioxidante utilizando os métodos de Capacidade Antioxidante Equivalente de Trolox (TEAC) e Capacidade de Absorção de Radical Oxigênio (ORAC). Análises de correlação foram realizadas para cada variável estudada e uma correlação positiva foi obtida na maioria dos casos. Entretanto, nenhuma das relações mostrou resultados estatisticamente significativos. Em todos os casos, o valor dep > 0,05. A quantificação da ingestão de nutrientes não é um preditor adequado da capacidade antioxidante plasmática em indivíduos acima de cinquenta anos.