Contamination by Antibiotic-Resistant Bacteria on Cell Phones of Vendors in a Peruvian Market.

Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby-Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones.

Dengue and COVID-19, overlapping epidemics? An analysis from Colombia.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout Latin America, a region swept by multiple previous and ongoing epidemics. There are significant concerns that the arrival of COVID-19 is currently overlapping with other viruses, particularly dengue, in various endo-epidemic regions across South America. In this report, we analyzed trends for both viral infections in Colombia during the first 20 epidemiological weeks (EWs) of 2020. From 1st January to 16th May 2020 (EWs, 1-20), a total of 52 679 cases of dengue and 14 943 cases of COVID-19 have been confirmed in Colombia. As both conditions may potentially lead to fatal outcomes, especially in patients with chronic co-morbidities, overlapping infections, and co-occurrence may increase the number of patients requiring intensive care and mechanical ventilation. In regions, such as Valle del Cauca, intensified preparation for such scenarios should be pondered, and further studies should be performed to address this critical issue in a timely matter.

Survival and adequate preoperative staging in patients undergoing gastric cancer surgery at a Peruvian Police Hospital.

INTRODUCTION: Gastric cancer is the fifth most common malignant neoplasm and the third leading cause of cancer-related death worldwide. In Peru, its incidence is 15.8 per 100,000 population, and it is associated with high mortality rates, especially in areas with low socioeconomic status. The aim of this study was to compare preoperative, postoperative, and anatomopathological staging results and their relation to disease recurrence and survival. METHODS: We conducted a retrospective cohort study of patients undergoing surgery for gastric cancer with a definitive postoperative anatomopathological diagnosis from 2005 to 2014 at the Hospital Nacional Luis N. Sáenz. Statistical analyses included descriptive and correlation statistics using the κ index, determination of associations between preoperative and postoperative staging and surgical reintervention and recurrence using the χ2  test, as well as Kaplan Meier survival analysis. RESULTS: There was little correlation between preoperative staging and final anatomopathological diagnosis, while there was a good correlation with postoperative staging. A significant association was found between preoperative staging and cancer recurrence. In the survival analysis, survival was lower among patients with underestimated staging. CONCLUSIONS: The survival of patients with gastric cancer can be affected by an overestimation of preoperative staging, therefore improvements in preoperative staging could lengthen the survival of patients undergoing gastric cancer surgery.

Viral Replication and Antibody Kinetics in the Recognition of Asymptomatic COVID-19 Patients.

Following the discovery of COVID-19 disease caused by the SARS-CoV-2 coronavirus, different studies have been carried out to recognize the stages of the disease and the methods of achieving correct diagnosis. Investigations of cases and their contacts have revealed different degrees in the symptomatology of the disease, with asymptomatic patients gaining relevance because of the controversy regarding their role in the spread of the disease. Recognition and assessment of asymptomatic patients is essential to carry out containment actions such as public health measures for affected patients and contacts. In this review, we assess the diagnostic aspects of asymptomatic patients according to the available evidence of people with COVID-19.

Disseminated Cutaneous Leishmaniasis in a Pediatric Patient from Peru.

INTRODUCTION: Leishmaniasis is a disease predominantly prevalent in the tropics, considered as one of the primary neglected diseases, preferably affects individuals of low socioeconomic status. Although this condition is well described in children, disseminated cutaneous leishmaniasis is a rare form of increasing importance and multiple cases observed in the adult population; however, still little described in children. CASE: We present the case of a 12-year-old male, who has multiple ulcerative and nodular lesions distributed throughout the body, of ∼1 year of evolution that did not respond to antimicrobial treatment. After the diagnostic process, positive serological tests were found for leishmaniasis, with improvement in the picture after the use of sodium stibogluconate. DISCUSSION: Disseminated cutaneous leishmaniasis is a clinical form that is described with increasing frequency and should be recognized and treated appropriately, mainly in the pediatric population, avoiding complications and sequelae.

Steven-Jonhson Syndrome in a Patient With Dengue Infection in Peru: A Case Report.

Stevens-Johnson syndrome is an infrequent condition affecting the skin and mucous membranes, it involves cutaneous detachment with high mortality without adequate treatment. We present the case of a 40-year-old male with a history of epilepsy treated with valproic acid and lamotrigine, previously diagnosed with dengue. Evaluation showed erythematous blisters on skin and mucosa with bleeding and desquamation, covering 10% of the body surface. The patient progressed favorably with the medical care received. Stevens-Johnson syndrome should be studied in association with arboviral diseases.

Compliance with Antibiotic Prophylaxis in Obstetric and Gynecological Surgeries in Two Peruvian Hospitals.

INTRODUCTION: Surgical site infections (SSI) can be as high in gynecology and obstetrics surgeries compared to other areas. Antimicrobial prophylaxis is an effective tool in the prevention of SSIs; however, it is often not adequately administered, so this study aimed to understand the compliance and factors associated with the use of the clinical practice guidelines for antibiotic prophylaxis in gynecological surgeries in two hospitals in the city of Huanuco, Peru. METHODS: An analytical cross-sectional study of all gynecologic surgeries performed during 2019 was performed. Compliance was determined based on the antibiotic chosen, dose, administration time, redosing, and prophylaxis duration. Age, hospital of origin, presence of comorbidities, surgery performed, as well as its duration, types of surgery, and anesthesia were considered as related factors. RESULTS: We collected 529 medical records of patients undergoing gynecological surgery with a median age of 33 years. The prophylactic antibiotic was correctly indicated in 55.5% of cases, and the dose was correct in 31.2%. Total compliance with the five variables evaluated was only 3.9%. Cefazolin was the most commonly used antibiotic. CONCLUSION: Low compliance with the institutional clinical practice guidelines for antibiotic prophylaxis was identified, showing that antimicrobial prophylaxis in the hospitals studied was inadequate.

Antibiotic prophylaxis compliance differences in surgery and gynecology/obstetrics services in Huánuco, Peru.

Introduction: Surgical site infections (SSIs) can increase mortality and morbidity in patients after surgery. Antibiotic prophylaxis is an effective measure to prevent SSIs, but inappropriate prescription is frequent. The objective of the study was to determine compliance with the clinical practice guideline for antibiotic prophylaxis in the general surgery and gynecology and obstetrics wards in the city of Huánuco, Peru. Methods: An analytical cross-sectional study was carried out on all surgical interventions in the general surgery and gynecology and obstetrics services during the year 2019. Compliance was determined based on the chosen antibiotic, dose, time of administration, and duration of prophylaxis. Related factors considered were age, presence of co-morbidities, surgery performed, duration of surgery, types of procedure, anesthesia, as well as years as a surgeon and anesthesiologist. Results: A total of 557 medical records of patients with a median age of 33 years undergoing surgery were collected,. Antibiotic prophylaxis was correctly followed in all aspects in 14.6% of cases in the general surgery service and only in 5.6% of cases in the gynecology and obstetrics service. The correct duration of prophylaxis was 11.6% and 19.7% in general surgery and gynecology and obstetrics, respectively. Conclusion: Low compliance with institutional clinical practice guidelines for antibiotic prophylaxis was identified in both services. However, surgical interventions in the general surgery service presented better compliance with antibiotic prophylaxis compared to gynecology and obstetrics procedures.

A systematic review and meta-analysis of bovine brucellosis seroprevalence in Latin America and the Caribbean.

Introduction: Bovine brucellosis is a significant public health problem in countries with economic and zoonotic implications. Although relevant, there are no previous systematic reviews about bovine brucellosis in Latin America. Methods: We performed a systematic literature review in five data-bases to assess the seroprevalence of Brucella in cattle. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95% confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported. Results: The literature search yielded 3,403 articles, of which 65 studies were fully valid for analysis. The pooled seroprevalence for Brucella in bovine (n â€‹= â€‹46,883,177) was 4.0% (95%CI: 3.0%-5.0%; p â€‹< â€‹0.001), and Venezuela was the country with the highest prevalence (16.0%). By regions, the highest seroprevalence is in Central America and the Caribbean islands (8.0%,95%CI: 3.0%-15.0%; p â€‹< â€‹0.001, I2 â€‹= â€‹99.85). Conclusions: Some countries reported still relevant seroprevalences of bovine brucellosis, especially at the Central America and Caribbean islands. Multiple factors may influence the survival and spread of pathogens in the environment; farms located in regions bordering forest areas, in areas of difficult access to the veterinary service; extensive beef herds raised at pastures with different age and productive groups inter-mingled, and minimal concerns regarding hygiene practices and disease prevention measures. Bovine brucellosis has not been eliminated and needs to be considered with new tools for prevention and control, especially being a zoonosis.

A Comprehensive Review on Monkeypox Viral Disease with Potential Diagnostics and Therapeutic Options.

The purpose of this review is to give an up-to-date, thorough, and timely overview of monkeypox (Mpox), a severe infectious viral disease. Furthermore, this review provides an up-to-date treatment option for Mpox. The monkeypox virus (MPXV) has remained the most virulent poxvirus for humans since the elimination of smallpox approximately 41 years ago, with distribution mainly in central and west Africa. Mpox in humans is a zoonotically transferred disease that results in symptoms like those of smallpox. It had spread throughout west and central Africa when it was first diagnosed in the Republic of Congo in 1970. Mpox has become a major threat to global health security, necessitating a quick response by virologists, veterinarians, public health professionals, doctors, and researchers to create high-efficiency diagnostic tests, vaccinations, antivirals, and other infection control techniques. The emergence of epidemics outside of Africa emphasizes the disease's global significance. A better understanding of Mpox's dynamic epidemiology may be attained by increased surveillance and identification of cases.

An Updated Review on Monkeypox Viral Disease: Emphasis on Genomic Diversity.

Monkeypox virus has remained the most virulent poxvirus since the elimination of smallpox approximately 41 years ago, with distribution mostly in Central and West Africa. Monkeypox (Mpox) in humans is a zoonotically transferred disease that results in a smallpox-like disease. It was first diagnosed in 1970 in the Democratic Republic of the Congo (DRC), and the disease has spread over West and Central Africa. The purpose of this review was to give an up-to-date, thorough, and timely overview on the genomic diversity and evolution of a re-emerging infectious disease. The genetic profile of Mpox may also be helpful in targeting new therapeutic options based on genes, mutations, and phylogeny. Mpox has become a major threat to global health security, necessitating a quick response by virologists, veterinarians, public health professionals, doctors, and researchers to create high-efficiency diagnostic tests, vaccinations, antivirals, and other infection control techniques. The emergence of epidemics outside of Africa emphasizes the disease's global significance. Increased monitoring and identification of Mpox cases are critical tools for obtaining a better knowledge of the ever-changing epidemiology of this disease.

Application of CRISPR-Cas System to Mitigate Superbug Infections.

Multidrug resistance in bacterial strains known as superbugs is estimated to cause fatal infections worldwide. Migration and urbanization have resulted in overcrowding and inadequate sanitation, contributing to a high risk of superbug infections within and between different communities. The CRISPR-Cas system, mainly type II, has been projected as a robust tool to precisely edit drug-resistant bacterial genomes to combat antibiotic-resistant bacterial strains effectively. To entirely opt for its potential, advanced development in the CRISPR-Cas system is needed to reduce toxicity and promote efficacy in gene-editing applications. This might involve base-editing techniques used to produce point mutations. These methods employ designed Cas9 variations, such as the adenine base editor (ABE) and the cytidine base editor (CBE), to directly edit single base pairs without causing DSBs. The CBE and ABE could change a target base pair into a different one (for example, G-C to A-T or C-G to A-T). In this review, we addressed the limitations of the CRISPR/Cas system and explored strategies for circumventing these limitations by applying diverse base-editing techniques. Furthermore, we also discussed recent research showcasing the ability of base editors to eliminate drug-resistant microbes.

Blastocystis species and Gastrointestinal Symptoms in Peruvian Adults Attended in a Public Hospital.

The objective of this study was to evaluate the role of Blastocystis sp. in gastrointestinal symptoms reported by adult patients in a Peruvian hospital. A case-control 3:1 study was performed at the outpatient clinic. Direct stool examinations were done. One hundred sixty patients were included, 40 cases and 120 controls. Positivity to Blastocystis sp. was associated with dyspepsia (P <0.001), bloating (P <0.001) and abdominal pain (P = 0.03) in patients attending our hospital outpatient clinic.

Pulmonary Ultrasound in the Diagnosis and Monitoring of Coronavirus Disease (COVID-19): A Systematic Review.

The goal of this review was to systematize the evidence on pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with coronavirus disease 2019 (COVID-19). Evidence on the use of PU for diagnosis and monitorization of or as hospital discharge criteria for COVID-19 patients confirmed to have COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) between December 1, 2019 and July 5, 2020 was compared with evidence obtained with thoracic radiography (TR), chest computed tomography (CT) and RT-PCR. The type of study, motives for use of PU, population, type of transducer and protocol, results of PU and quantitative or qualitative correlation with TR and/or chest CT and/or RT-PCR were evaluated. A total of 28 articles comprising 418 patients were involved. The average age was 50 y (standard deviation: 25.1 y), and there were 395 adults and 23 children. One hundred forty-three were women, 13 of whom were pregnant. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted or thickened. The presence of subpleural consolidation was noduliform, lobar or multilobar. There was good qualitative correlation between TR and chest CT and a quantitative correlation with chest CT of r = 0.65 (p < 0.001). Forty-four patients were evaluated only with PU. PU is a useful tool for diagnosis and monitorization and as criteria for hospital discharge for patients with COVID-19.

Human visceral leishmaniasis prevalence by different diagnostic methods in Latin America: a systematic review and meta-analysis.

Visceral leishmaniasis is a neglected zoonotic disease that affects animals and humans in different tropical and subtropical regions and even beyond, with variable prevalence among infected hosts. To date, there have been no systematic reviews on human visceral leishmaniasis prevalence in Latin America. We therefore performed a systematic literature review with meta-analysis, using six databases to assess prevalence of visceral leishmaniasis in human patients in Latin American countries. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). In all, 10,435 articles were retrieved for the time frame (1950-2019). After initial screening, 120 articles were selected for full-text assessment, 97 being finally included for qualitative and quantitative analyses. Overall, VL pooled prevalence was estimated at 38.8% (95% CI 33.8-43.8%), derived from 97 studies, including 44,986 individuals. Many aspects of the transmission dynamics of Leishmania and the exact burden of this parasitosis on public health remain largely unknown. Although the elimination of zoonotic VL in the Americas appears an unrealistic goal, additional efforts need to be put in place to achieve better diagnosis, treatment, and prevention of VL.