Association between migration and physical activity among medical students from a university located in Lima, Peru.

OBJECTIVE: To evaluate the association between migration and physical activity among medical students from a university located in Lima, Peru. METHODS: A cross-sectional study was conducted among second-year medical students from a Peruvian university. Data on moderate- to vigorous-intensity physical activity (MVPA) and migration features were obtained through a self-report questionnaire. To assess the associations of interest, prevalence ratios (PR) along with their 95% confidence intervals (95% CI) were calculated using Poisson regression with robust variances. RESULTS: We analyzed data from 312 students (54.5% were women, mean age: 19.0 years, standard deviation: 1.4 years), 90 (28.9%) students performed MVPA for ≥150 minutes/week, 118 (37.8%) performed MVPA for ≤30 minutes/week, and 114 (36.7%) were migrants. Being a migrant was not associated with performing MVPA for ≤30 nor ≥150 minutes/week. However, adjusted analysis showed that the frequency of performing MVPA for ≤30 minutes/week was greater among those who migrated less than five years ago (PR: 1.43; 95% CI: 1.05-1.93) and among those who migrated to continue their studies (PR: 1.44; 95% CI: 1.06-1.94), compared to non-migrants. CONCLUSION: In our population, being a migrant was not associated with physical activity. However, low physical activity was more prevalent among recent migrants and among those who had migrated to study, compared to non-migrants.

Diseminación clonal de KPC-2 en Klebsiella pneumoniae resistente a carbapenémicos / Clonal dissemination of KPC-2 in carbapenem resistant Klebsiella pneumoniae

Objetivo: Determinar los mecanismos de resistencia antibiótica y la epidemiología molecular de aislados clínicos de Klebsiella pneumoniae resistentes a carbapenémicos. Materiales y métodos: 30 aislados multirresistentes de K. pneumoniae fueron obtenidos a partir de: urocultivo, aspirado traqueal, secreción de herida, sonda vesical, hemocultivo, líquido peritoneal, punta de catéter, colección abdominal y secreción bronquial. Los aislados fueron colectados de noviembre de 2012 a abril de 2013. La identificación y susceptibilidad antibiótica fue determinada por el sistema automatizado VITEK 2. Para la amplificación de genes de resistencia se empleó PCR, la determinación de las Secuencias Tipo (ST) fue obtenida por tipificación multilocus de secuencias (MLST) y la relación clonal fue establecida por electroforesis en gel de campo pulsado (PFGE). Resultados: Todos los aislados mostraron fenotipos multirresistentes, excepto a colistina y tigeciclina. El 100% de los aislados fue productor de la carbapenemasa KPC-2. La determinación de la presencia de genes codificantes de β-lactamasas de Espectro Extendido mostró que el 67% de los aislados fue positivo para el gen blaCTX-M, el 100% fue positivo para el gen blaSHV y 93% fue positivo para el gen blaTEM. El análisis de la relación clonal de los 30 aislados agrupó a 20 en un mismo pulso tipo. El análisis por MLST demostró que la ST predominante fue ST258 presente en el 60% de la población, seguida de ST1199 presente en el 20% de la población analizada. Conclusiones: Los resultados obtenidos demuestran la importancia de implementar y combinar estudios epidemiológicos, clínicos y moleculares para comprender la distribución de la resistencia entre bacterias de interés clínico.

Objective: To determine the mechanism of antibiotic resistance and molecular epidemiology of carbapenem resistant isolates of Klebsiella pneumoniae. Materials and Methods: 30 multidrug resistant isolates of K. pneumoniae were obtained from urine culture, tracheal aspirate, wound secretion, bladder catheter, blood culture, peritoneal fluid, catheter tip, abdominal collection, and bronchial secretion. K. pneumoniae isolates were collected between November 2012 and April 2013. Identification and susceptibility were determined by the VITEK 2 system. Resistance genes were identified by PCR, sequence type (ST) was established by multilocus sequence typing (MLST), and clonal relationship was defined by pulsed field gel electrophoresis (PFGE). Results: All isolates were multidrug resistant and susceptible to colistin and tigecycline. 100% of isolates produced KPC-2 carbapenemase. This study detected Extended Spectrum β-Lactamases enconding genes. 67% of isolates were positive for blaCTX-M, 100% were positive for blaSHV, and 93% of isolates were positive for blaTEM. Analysis of the clonal relationship clustered 20 isolates in the same clonal complex. Multilocus sequence typing showed the predominant sequence type ST 258 in 60% of population. ST 1199 were present in 20% of bacterial population. Conclusion: Molecular epidemiology, clinical research and molecular biology studies improve understanding of mechanisms of resistance distribution among bacteria of clinical interest.