Vigilance for Salmonella in Feedstuffs Available in Costa Rica: Prevalence, Serotyping and Tetracycline Resistance of Isolates Obtained from 2009 to 2014.

Relevant epidemiological information is provided in this report for Salmonella based on data obtained from a Costa Rican surveillance program for animal feeds. In addition to prevalence, a description in terms of serotypes and tetracycline (TET) resistance of the isolates is included. A total of 1725 feed and feed ingredients samples were analyzed during 2009 and 2014, from which 110 Salmonella strains were recovered (76 from poultry, 23 from meat and bone meal [MBM], 3 from pet foods, and 8 from other feed). Retrieved isolates were serotyped and tested for minimum inhibitory concentration (MIC) against TET. Salmonella strains were found mainly from poultry feed (different growth stages, n = 76/110; 69.1%) and MBM (n = 23/109; 21.1%). The rest of the isolates were recovered from feather meal, pet food, fish meal (n = 3/110; 2.3% each) and swine feed (n = 1/110; 0.9%). From the different serotypes recovered (n = 21), the most common were Salmonella Give (n = 18; 13.8%) and Salmonella Rissen (n = 6; 4.6%) for MBM and Salmonella Havana (n = 14; 10.8%), Salmonella Rissen, Salmonella Soerenga, and Salmonella Schwarzengrund (n = 8; 6.2% each) in poultry feed. Recovered strains were regarded to be sensitive or have an intermediate resistance to TET as evidenced by their MIC50 and MIC90 concentrations of 4 and 8 µg/mL for MBM and poultry feed, respectively. Compound feed and MBM samples exhibited strains characterized by 86.8 and 88.9% of the isolates classified (according to CLSI, 2015 ) as sensitive, 7.7 and 3.7% as intermediate, and 5.5% (with >256 µg/mL as the highest concentration) and 7.4% (with 64 µg/mL as the highest concentration) as resistant to TET, respectively. Salmonella serovars Anatum and Havana exhibited the highest resistance profile >256 and 128 µg/mL, respectively. Hence, MBM and poultry feed seem to be a target of interest if Salmonella incidence is to be controlled. Serotypes recovered have in the past demonstrated pathogenic capability; therefore, hereafter a stricter surveillance program may be in order.

Acute mesenteric arterial thrombosis in severe SARS-Co-2 patient: A case report and literature review.

INTRODUCTION: CoV-2 infection generates a pro-inflammatory state, which conditions the formation of thrombi that can affect any system. Multi-organ dysfunction is a cause of death, mesenteric ischemia in COVID 2019 patients reported is 1.9-4%. DESCRIPTION OF THE CASE: We present the case of a 73-year-old male patient who started with severe SARS-CoV-2 and arterial-type intestinal ischemia, necrosis of 3 m of the small intestine, based on SCARE 2020 guide. DISCUSSION: Complications secondary to thrombosis are as follows; myocardial infarction 1.1%, ischemic cerebral events, 2.5-3.7%, microvascular thrombosis including mesenteric ischemia in less than 1% of cases. In patients with mesenteric ischemia the reported postoperative mortality is 23.8% of patients especially during the first 30 days. CONCLUSION: Intestinal thrombosis in patients with SARS-CoV-2 increases mortality.

Resincronización biatrial en el tratamiento de la fibrilación atrial paroxística. Marcapaso tres y cuatro cámaras / Multisite pacing in atrial fibrillation

La finalidad de la estimulación multisitio es corregir la sincronía eléctrica y mecánica atrial y ventricular que se presenta en pacientes con fibrilación atrial paroxística (FAP) y miocardiopatía dilatada. Reportamos los dos primeros casos, en México, con estimulación biatrial para el tratamiento de la FAP, a uno se le implantó marcapaso tricameral y al otro tetracameral. El primero era un hombre joven al cual se le realizó modificación de la conducción atrioventricular con radiofrecuencia para el control de la frecuencia ventricular durante la fibrilación atrial. El segundo caso era una mujer con transposición corregida de los grandes vasos y fracción de expulsión (FE) del 30 por ciento, el cual presentaba bloqueo atrioventricular completo. El modo de estimulación fue DDD para el primer paciente y DDDR para el segundo, con función nocturna y cambio automático de modo en ambos. Se estimularon ambas aurículas, en la orejuela derecha y la izquierda a través del seno coronario. Los episodios de FAP se presentaron solamente en el primero pero en menor número y duración. La FE y la clase funcional mejoraron en el paciente con sincronización atrial y ventricular. Concluimos que la estimulación biatrial es efectiva en el control de la FAP.