DNA Damage Response After Treatment of Cycling and Quiescent Cord Blood Hematopoietic Stem Cells With Distinct Genotoxic Noxae.

Hematopoietic stem cells (HSC) from cord blood can be applied as an alternative to bone marrow in transplantation to treat hematological diseases. Umbilical cord blood (UCB) consists of cycling and non-cycling CD34+/CD45low cells needed for long-term and short-term engraftment. After sorting and subsequent in vitro culture, quiescent HSCs enter the cell cycle. This enables the analysis of HSCs in 2 different cell cycle stages and the comparison of their responses to different genotoxic noxae. To analyze different mechanisms of DNA damage induction in cells, 2 different genotoxins were compared: etoposide, a topoisomerase II inhibitor that targets mitosis in the S/G2-phase of the cell cycle and the alkylating nitrosamine N-Nitroso-N-methylurea (MNU), which leads to the formation of methyl DNA adducts resulting in DNA double breaks during DNA replication and persistent mutations. Cycling cells recovered after treatment even with higher concentrations of etoposide (1.5µM/ 5µM/10µM), while sorted cells treated with MNU (0.1mM/0.3mM/0.5mM/1mM/3Mm/ 5mM) recovered after treatment with the lower MNU concentrations whereas high MNU concentrations resulted in apoptosis activation. Quiescent cells were not affected by etoposide treatment showing no damage upon entry into the cell cycle. Treatment with MNU, similarly to the cycling cells, resulted in a dose-dependent cell death. In conclusion, we found that depending on the genotoxic trigger and the cycling status, CD34+cells have distinct responses to DNA damage. Cycling cells employ both DDR and apoptosis mechanisms to prevent damage accumulation. Quiescent cells predominantly undergo apoptosis upon damage, but their cell cycle status protects them from certain genotoxic insults.

Species diversity and spatial distribution of mosquitoes (Diptera: Culicidae) from La Isla Amazon Park, Napo Province, Ecuador / Diversidad de especies y distribución espacial de mosquitos (Diptera: Culicidae) del Parque Amazónico La Isla, provincia de Napo, Ecuador

Abstract Introduction: Vector-borne diseases are prevalent in the Amazon and Coastal regions of Ecuador. However, there is a scarcity of mosquito ecology studies in these areas. The most recent list of species reported for the country comprises 8 tribes, 22 genera, and 200 species. Objectives: To document the Culicidae species found in La Isla Amazon Park, Napo, Ecuador, including those with epidemiological significance; and to analyze their composition, abundance, and diversity, focusing on larval habitats during the dry and rainy periods. Methods: We evaluated different larval habitats, considering collection duration as the primary criterion. We used CDC and Shannon traps to collect adult mosquitoes during both rainy and dry periods. To assess sampling effort, we used accumulation curves and non-parametric estimators of species richness, while we employed Hill numbers to determine diversity. Additionally, we used the Berger-Parker and Pielou indices to evaluate species dominance and evenness. We conducted cluster analysis and ANOSIM tests to assess the similarity between habitats and the differences in taxonomic composition between periods. Results: We collected a total of 802 individuals from 15 species and 4 taxonomic units, 5 genera, and 4 tribes. Notably, this may be the first records of Wyeomyia felicia Dyar & Núñez Tovar and Culex derivator Dyar & Knab from Ecuador. Additionally, the presence of Culex dunni Dyar and Psorophora ferox von Humboldt (both recognized as vectors) was correlated with increased rainfall. Conclusions: The abundance of mosquitoes, including potential vector species, increased during the rainy season, indicating a higher risk of pathogen transmission. However, the relationship between rainfall amount and diversity patterns is not well-defined.

Resumen Introducción: Las enfermedades vectoriales son prevalentes en las regiones amazónica y costera de Ecuador. Sin embargo, hay una escasez de estudios de ecología de mosquitos en estas áreas. En el país se ha reportado 8 tribus, 22 géneros y 200 especies. Objetivos: Documentar las especies de Culicidae encontradas en el Parque Amazónico La Isla, Napo, Ecuador, incluyendo aquellas con importancia epidemiológica; y analizar su composición, abundancia y diversidad, enfocándose en los hábitats de las larvas durante los períodos seco y lluvioso. Métodos: Evaluamos diferentes hábitats larvarios, con la duración de la recolecta como criterio. Las trampas CDC y Shannon recolectaron mosquitos adultos durante los períodos seco y lluvioso. Evaluamos la riqueza de especies con curvas de acumulación y estimadores no paramétricos, mientras que determinamos la diversidad con los números de Hill. Además, utilizamos los índices de Berger-Parker y Pielou para evaluar la dominancia y la uniformidad de las especies. Realizamos análisis de conglomerados y la prueba ANOSIM para evaluar la similitud entre hábitats y estaciones, así como las diferencias en la composición taxonómica, respectivamente. Resultados: Recolectamos un total de 802 individuos de 15 especies y 4 unidades taxonómicas, 5 géneros y 4 tribus. Este podría ser el primer registro de Wyeomyia felicia Dyar & Núñez Tovar y Culex derivator Dyar & Knab en Ecuador. Además, la presencia de Culex dunni Dyar y Psorophora ferox von Humboldt (ambos potenciales vectores) se correlacionó con el aumento de las precipitaciones. Conclusiones: El aumento de la abundancia de mosquitos durante el periodo lluvioso indica un mayor riesgo de transmisión de patógenos. Sin embargo, la relación entre la cantidad de precipitaciones y los patrones de diversidad no está bien definida.

Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Objetivo: Avaliar o valor preditivo da colonização prévia por Acinetobacter baumannii (CRAB) e Pseudomonas aeruginosa (CRPA) resistente a carbapenêmicos estabelecida em culturas de vigilância para infecção subsequente por esses patógenos em pacientes internados em UTI. Métodos: Foi realizado um estudo de coorte com pacientes internados na unidade de terapia intensiva por pelo menos 48 h. Foram medidos os valores preditivos negativos e positivos, sensibilidade e especificidade das culturas de vigilância em CRAB e CRPA. Resultados: Foram incluídos 693 pacientes infectados. Pacientes previamente colonizados por CRAB e CRPA tiveram maior probabilidade de serem infectados por esses patógenos: OR ajustado: 10,34 (6,58 - 16,45; p < 0,001) e 2,30 (3,88 - 10,26; p < 0,001), respectivamente. Encontramos altos valores preditivos negativos de culturas de vigilância para CRAB (87,18%) e CRPA (88,30%) e alta especificidade 91,96% e 90,13%, respectivamente. Conclusões: Pacientes não colonizados por CRAB e CRPA mostraram-se menos propensos à infecção por esses patógenos. Esses achados podem contribuir para a escolha da terapia antimicrobiana empírica e desencorajar a prescrição de antibióticos contra esses patógenos em pacientes sem colonização prévia.

Objective: To assess the predictive value of prior carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) colonization established in surveillance cultures for subsequent infection by these pathogens in ICU patients. Methods: A cohort study was performed with patients admitted to the intensive care unit for at least 48 h. Negative and positive predictive values, sensitivity, and specificity of surveillance cultures in CRAB and CRPA were measured. Results: 693 infected patients were included. Patients previously colonized by CRAB and CRPA were more likely to be infected by these pathogens: adjusted OR: 10.34 (6.58 - 16.45; p < 0.001) and 2.30 (3.88 - 10.26; p < 0.001), respectively. We found high negative predictive values of surveillance cultures for CRAB (87.18%) and CRPA (88.30%) and high specificity 91.96% and 90.13%, respectively. Conclusions: Patients not colonized by CRAB and CRPA were less prone to infection by these pathogens. These findings may contribute to the choice of empirical antimicrobial therapy and discourage the prescription of antibiotics against these pathogens in patients without previous colonization.

Atividade in vitro de extratos e frações de Copernicia prunifera (Arecaceae) contra bactérias de importância clínica em saúde pública / In vitro activity of extracts and fractions of Copernicia prunifera (Arecaceae) against bacteria of clinical importance in public health / Actividad in vitro de extractos y fracciones de Copernicia prunifera (Arecaceae) frente a bacterias de importancia clínica en salud pública

Introdução: O aumento contínuo da resistência bacteriana aos antibióticos convencionais é um problema de importância global. Encontrar produtos como alternativas terapêuticas naturais é essencial. As plantas medicinais possuem uma composição química muito rica, que podem ser estruturalmente otimizadas e processadas em novos antimicrobianos. Objetivo: Avaliar o potencial antibacteriano frente a microrganismos humanos potencialmente patogênicos do extrato etanólico e frações de Copernicia prunifera. Metodologia: A triagem fitoquímica de plantas foi realizada usando métodos de precipitação e coloração e a atividade antibacteriana utilizando o método de difusão em disco e microdiluição em caldo contra cepas padronizadas de Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa e Staphylococcus aureus. Resultados: A triagem fitoquímica revela a presença de taninos, flavonoides, esteroides, triterpernóides, saponinas e alcaloides. Os extratos etanólico e frações da casca do caule e folhas tiveram atividade inibitória contra S. aureus e K. pneumonie com zona de inibição que variou de 7,0±1,73 a 9,33±0,58 mm pelo método de difusão em disco. Pelo método de microdiluição em caldo os extratos foram satisfatórios somente contra K. pneumoniae (CIM = 125 a 1000 µg/mL) S. aureus, P. aeruginosa e E. coli se mostraram resistentes aos testes (CIM > 1000 µg/mL). Conclusão: Esses resultados fornecem uma base para futuras investigações em modelos in vivo, para que os compostos de C. prunifera possam ser aplicados no desenvolvimento de novos agentes antimicrobianos contra K. pneumoniae.

Introduction: The continuous increase in bacterial resistance to conventional antibiotics is a problem of global importance. Finding products as natural therapeutic alternatives is essential. Medicinal plants have a very rich chemical composition, which can be structurally optimized and processed into novel antimicrobials. Objective: To evaluate the antibacterial potential against potentially pathogenic human microorganisms of the ethanolic extract and fractions of Copernicia prunifera. Methodology: Phytochemical screening of plants was performed using precipitation and staining methods and antibacterial activity using the disk diffusion and broth microdilution method against standardized strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Results: Phytochemical screening reveals the presence of tannins, flavonoids, steroids, triterpernoids, saponins and alkaloids. The ethanolic extracts and fractions of stem bark and leaves had inhibitory activity against S. aureus and K. pneumonie with zone of inhibition ranging from 7.0±1.73 to 9.33±0.58 mm by disc diffusion method. By broth microdilution method the extracts were satisfactory only against K. pneumoniae (MIC = 125 to 1000 µg/mL) S. aureus, P. aeruginosa and E. coli were resistant to the tests (MIC > 1000 µg/mL). Conclusion: These results provide a basis for further investigation in in vivo models, so that compounds from C. prunifera can be applied in the development of new antimicrobial agents against K. pneumoniae.

Introducción: El continuo aumento de la resistencia bacteriana a los antibióticos convencionales es un problema de importancia mundial. Es esencial encontrar productos como alternativas terapéuticas naturales. Las plantas medicinales tienen una composición química muy rica, que puede optimizarse estructuralmente y transformarse en nuevos antimicrobianos. Objetivo: Evaluar el potencial antibacteriano frente a microorganismos humanos potencialmente patógenos del extracto etanólico y fracciones de Copernicia prunifera. Metodología: Se realizó el cribado fitoquímico de las plantas mediante los métodos de precipitación y tinción y la actividad antibacteriana mediante el método de difusión en disco y microdilución en caldo frente a cepas estandarizadas de Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa y Staphylococcus aureus. Resultados: El cribado fitoquímico revela la presencia de taninos, flavonoides, esteroides, triterpernoides, saponinas y alcaloides. Los extractos etanólicos y las fracciones de la corteza del tallo y las hojas presentaron actividad inhibitoria contra S. aureus y K. pneumonie con una zona de inhibición que osciló entre 7,0±1,73 y 9,33±0,58 mm por el método de difusión en disco. Por el método de microdilución en caldo, los extractos sólo fueron satisfactorios frente a K. pneumoniae (CMI = 125 a 1000 µg/mL). S. aureus, P. aeruginosa y E. coli fueron resistentes a las pruebas (CMI > 1000 µg/mL). Conclusiones: Estos resultados proporcionan una base para futuras investigaciones en modelos in vivo, de modo que los compuestos de C. prunifera puedan aplicarse en el desarrollo de nuevos agentes antimicrobianos contra K. pneumoniae.

Protocolo clínico de atendimento de pneumonia adquirida na comunidade para Pronto-Socorro Infantil do Hospital do Servidor Público Municipal de São Paulo / Clinical protocol for community-acquired pneumonia care for the Children's Emergency Room of the Hospital do Servidor Público Municipal de São Paulo

A pneumonia adquirida na comunidade (PAC) é a infecção aguda do parênquima pulmonar que ocorre no meio comunitário. A PAC representa a maior causa de morbidade e mortalidade em todo o mundo em crianças abaixo de cinco anos. Nesta faixa etária, a etiologia viral é a mais comum; porém, dentre as causas bacterianas, o Streptoccocus pneumoniae é o mais prevalente. As manifestações clínicas variam de acordo com o patógeno, hospedeiro e da gravidade da doença, sendo geralmente descrita com tosse, febre e desconforto respiratório. A PAC complicada é a pneumonia que, apesar do uso de antibióticos, evolui com complicações locais ou sistêmicas. Nos pacientes hospitalizados, as hemoculturas devem ser consideradas para auxiliar no diagnóstico etiológico e planejamento terapêutico. O tratamento inicial deve ser iniciado empiricamente com antibióticos. Caso haja necessidade de hospitalização, hemoculturas devem ser consideradas para auxiliar na propedêutica. Após implementação das vacinas pneumocócicas, principalmente após introdução da vacina pneumocócica 13 valente (PCV 13), houve redução significativa dos casos de pneumonia bacteriana e também da necessidade hospitalização. Diante de tal realidade, a elaboração do trabalho possui como objetivo a melhora dos procedimentos e a padronização dos atendimentos da população pediátrica com um quadro clínico sugestivo pneumonia adquirida na comunidade, que procura o serviço de Pronto Atendimento Infantil do Hospital do Servidor Público Municipal de São Paulo (HSPM), ao construir um protocolo clínico de atendimento específico para a doença. O presente trabalho objetiva elaborar um protocolo clínico de atendimento de pneumonia adquirida na comunidade no Hospital do Servidor Público Municipal de São Paulo, contribuindo na assistência médica dos pacientes pediátricos. Apesar do grande avanço com a introdução das vacinas pneumocócicas, a PAC ainda representa uma importante causa de mortalidade na população infantil, sendo fundamental a elaboração de protocolos clínicos para abordar corretamente os pacientes que recorrem a um Pronto Socorro Infantil. Protocolos clínicos são diretrizes fundamentadas nas melhores práticas para a abordagem e tratamento de determinadas doenças, baseadas em evidência científica. O presente trabalho objetiva a melhora dos procedimentos e a uniformização dos atendimentos da população pediátrica com pneumonia, que procura o serviço de Pronto Atendimento Infantil do Hospital do Servidor Público Municipal de São Paulo (HSPM), com a construção de um protocolo clínico de atendimento específico para a doença, a partir da revisão de literatura atualizada, cujo período de vigência seguirá os progressos científicos sobre o tema. Palavras-chave: Pneumonia Adquirida da Comunidade. Protocolos clínicos. Pediatria. Serviços Médicos de Emergência. Vacinas Pneumocócicas

Biofilme na indústria de alimentos: micro-organismos envolvidos e métodos de controle / Biofilm in the food industry: micro-organisms involved and control methods

Os biofilmes podem acarretar vários problemas em diversas áreas, principalmente na indústria alimentícia, já que sua colonização nas superfícies como aço inoxidável, polietileno, polipropileno, podem contaminar produtos, causando sua deterioração, além de possibilitar diversas doenças transmitidas por alimentos. A formação de biofilme pode ocorrer em diferentes tipos de superfícies e pode envolver diversos micro-organismos. Práticas adequadas de higienização na indústria de alimentos são fundamentais para manter medidas seguras de preservação da qualidade dos alimentos. Portanto, o presente estudo objetiva realizar levantamento bibliográfico para explanar a formação e caracterização de biofilmes, ressaltando sua importância na indústria de alimentos e os métodos de prevenção de biofilmes disponíveis. Pode-se observar a necessidade de novas tecnologias no controle e erradicação de Biofilmes.

Biofilms can cause several problems in different areas, especially in food, as their colonization on surfaces in industries such as stainless steel, polyethylene, polypropylene, can contaminate products, causing their deterioration, in addition to making various food-borne diseases possible. Biofilm formation can occur on different types of surfaces and can involve different microorganisms. Adequate hygiene practices in the food industry are essential to maintain safe measures to preserve food quality. Therefore, the present study aims to carry out a bibliographical survey to explain the formation and characterization of biofilms, highlighting the importance in the food industry and the available biofilm prevention methods. The need for new technologies in the control and eradication of Biofilms can be observed.

Genes involucrados con resistencia antimicrobiana en hospitales del Ecuador / Genes involved with antimicrobial resistance in Ecuadorian hospitals

INTRODUCCIÓN. La resistencia a los antimicrobianos es un problema de salud pública actual asociado con alta mortalidad, hospitalización prolongada, alternativas terapéuticas reducidas, mayores costos económicos y la posibilidad de brotes hospitalarios. OBJETIVO. Describir los principales genes involucrados con resistencia antimicrobiana en hospitales del Ecuador. MATERIALES Y MÉTODOS. Se realizó una descripción retrospectiva no experimental, de artículos indexados relacionados con resistencia antimicrobiana en hospitales del Ecuador, con evidencia desde el año 2009 al 2022. La revisión de bibliografías se llevó a cabo en bases de datos como Pubmed, Science Direct y Google Scholar. RESULTADOS. De un grupo original de 77 artículos, se seleccionaron 33 documentos. En Ecuador, varios estudios han descrito los mecanismos moleculares involucrados en la resistencia bacteriana. Sin embargo, en bacterias menos comunes, falta investigación sobre los genes asociados. CONCLUSIONES. Las principales bacterias multirresistentes descritas en Ecuador son Klebsiella pneumoniae, Escherichia coli y Acinetobacter baumanni, las cuales presentan genes involucrados en la producción de carbapenemasas (blaKPC, blaNDM, blaOXA-48). Estas bacterias presentan altos niveles de resistencia a los antibióticos y son objeto de vigilancia epidemiológica por parte del sistema nacional de salud. A nivel local, otras bacterias presentan mecanismos de resistencia a los carbapenémicos (Pseudomonas aeruginosa, Enterobacter sp., Serratia marcescens, Citrobacter sp.), pero no existen descripciones detalladas del genotipo, sus características microbiológicas o la clínica del paciente. El conocimiento de las tasas de resistencia a los antimicrobianos en los diferentes hospitales, la implementación de un plan de administración de antibióticos, el uso correcto de los equipos de protección personal, el aislamiento de las personas con infecciones multirresistentes, así como el trabajo colaborativo entre las diferentes áreas del hospital, son esenciales para reducir la propagación de estos patógenos.

INTRODUCTION. Antimicrobial resistance is a current public health problem associated with high mortality, prolonged hospitalization, reduced therapeutic alternatives, increased economic costs, and the potential for hospital outbreaks. OBJECTIVE. To describe the main genes involved with antimicrobial resistance in hospitals in Ecuador. MATERIALS AND METHODS. A retrospective non-experimental description of indexed articles related to antimicrobial resistance in hospitals in Ecuador was carried out, with evidence from 2009 to 2022. The review of bibliographies was carried out in databases such as Pubmed, Science Direct and Google Scholar. RESULTS. From an original group of 77 articles, 33 papers were selected. In Ecuador, several studies have described the molecular mechanisms involved in bacterial resistance. However, in less common bacteria, research on the associated genes is lacking. CONCLUSIONS. The main multidrug-resistant bacteria described in Ecuador are Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumanni, which present genes involved in the production of carbapenemases (blaKPC, blaNDM, blaOXA-48). These bacteria present high levels of antibiotic resistance and are subject to epidemiological surveillance by the national health system. Locally, other bacteria present mechanisms of resistance to carbapenemics (Pseudomonas aeruginosa, Enterobacter sp., Serratia marcescens, Citrobacter sp.), but there are no detailed descriptions of the genotype, their microbiological characteristics or the patient's clinic. Knowledge of antimicrobial resistance rates in different hospitals, the implementation of an antibiotic stewardship plan, the correct use of personal protective equipment, the isolation of individuals with multidrug-resistant infections, as well as collaborative work between different areas of the hospital, are essential to reduce the spread of these pathogens.

Percepción social sobre roedores urbanos y riesgo sanitario en barrios del Gran La Plata, Provincia de Buenos Aires, Argentina / Social perception on urban rodents and sanitary risk in neighborhoods from Gran La Plata, Province of Buenos Aires, Argentina

NTRODUCCIÓN: Los roedores sinantrópicos, representados por el ratón doméstico (Mus musculus), la rata parda (Rattus norvegicus) y la rata negra (Rattus rattus), representan un riesgo importante para la salud. En Sudamérica, la fragmentación socioeconómica se refleja en marcadas diferencias entre centros urbanos y áreas periféricas, y se asocia a un registro heterogéneo. El objetivo fue relevar datos por encuestas a los habitantes de dos barrios del Gran La Plata con características contrastantes para explorar, describir y evaluar la percepción en relación con la presencia de roedores en domicilio, peridomicilio y barrio como vehículos de transmisión de enfermedades. MÉTODOS: A partir de un diseño descriptivo exploratorio, se confeccionaron y realizaron encuestas siguiendo la técnica de muestreo estratificado. Se consideraron las variables género y grupo, de tal manera que la muestra tuviese la misma distribución. La información se transfirió a una base de datos y se analizó a través de IBM SPSS Statistics V25. RESULTADOS: Existe una preocupación común respecto al rol de los roedores urbanos como reservorios y fuentes de infección de patologías zoonóticas. En el barrio más vulnerable, la presencia de roedores fue más frecuente que en el centro de la ciudad. DISCUSIÓN: Este estudio provee un abordaje diferente en relación con roedores y patologías asociadas, considerando la percepción social y revelando su importancia para los programas de manejo y control.

The importance of environments and surfaces hygienization in pandemic times (Covid-19): a microbiological analysis in places for physical activity practice

The objective of this study was to analyse microbiological organisms in different locations and regions for physical activity in the city of João Pessoa, Brazil. Samples were collected on various objects used, such as: mattresses, drinking fountains, gloves, cell phones and others. The samples were collected in João Pessoa-PB, following the Standard Operating Procedure-SOP/ Microbiology of a specialized laboratory. The collection took place in the five macro-regions: North, South, East, West and Center. Foreach region samples were collected in one public place (square), a private one (gym) and one school (public or private), totaling fifteen collected sites and 450 samples. The following microorganisms were studied in all analyzed surfaces: Bacillus sp, Escherichia Coli, Klebsiella sppor Enterobacter sppand Coag. Neg. Staphylococcus.All regions had a high contamination level by some microorganism. The highest rates were found in the western, central and northern regions -96, 94 and 93% respectively. The Coag. Neg.Staphylococcus presented the highest and lowest incidence rates in the South and East regions, with 43.33 and 6.67%, respectively, as well as Klebsiella sppor Enterobacter spp, which presented high levels. It is concluded that there is a microorganisms' contamination in the most varied places and regions where physical activity practices are developed, with a predominance of Coag. Neg.Staphylococcusand Klebsiella sppor Enterobacter spp. These results lead to a warning about the hygiene importance in places for physical activity practice, especially in pandemic times (COVID-19), since almost all the evaluated surfaces were contaminated.

Infecção primária da corrente sanguínea associada ao cateter venoso central em neonatos / Infección primaria del torrente sanguíneo asociada al catéter venoso central en neonatos resumen / Central venous catheter-associated primary bloodstream infection in neonates

RESUMO Objetivo: analisar a infecção primária da corrente sanguínea associada ao cateter venoso central em neonatos internados em unidades de terapia intensiva. Método: tratou-se de um estudo ecológico realizado em 2017 a partir de notificações de infecção primária da corrente sanguínea associada ao cateter venoso central ocorridas na capital de um estado da região Centro-Oeste do Brasil. Os dados foram coletados por meio de um formulário a partir de dois bancos de dados, municipal (2012 a 2016) e nacional (2014 a 2016). Resultados: a tendência temporal da densidade de incidência de infecção foi decrescente (p=0,019), com taxa de utilização de cateter venoso central de 45%. Os patógenos mais frequentes foram Klebsiella pneumoniae, Staphylococcus coagulase negativo e Enterobacter spp. Aumento de resistência às cefalosporinas e à oxacilina ocorreu para bactérias Gram-negativo e Gram-positivo, respectivamente. Conclusão: Conclui-se que houve uma redução na taxa de IPCS associada ao cateter em neonatos no período avaliado e os episódios infecciosos foram predominantemente causados por bactérias Gram-negativo, incluindo isolados multirresistentes aos antimicrobianos. Esses achados apontam para a importância e necessidade de estratégias educacionais para a equipe multiprofissional sobre vigilância de infecção, medidas preventivas e uso racional de antimicrobianos.

Resumen: Objetivo: analizar la infección primaria del torrente sanguíneo asociada al catéter venoso central en neonatos ingresados en unidades de cuidados intensivos. Método: se trató de un estudio ecológico, realizado en 2017, a partir de notificaciones de infección primaria del torrente sanguíneo asociada al catéter venoso central, ocurridas en la capital de un estado de la región Centro-Oeste de Brasil. Los datos fueron recogidos por medio de un formulario de dos bases de datos, municipal (2012 a 2016) y nacional (2014 a 2016). Resultados: la tendencia temporal de la densidad de incidencia de infección fue decreciente (p=0,019), con tasa de utilización de catéter venoso central del 45%. Los patógenos más frecuentes fueron Klebsiella pneumoniae, Staphylococcus coagulase negativa y Enterobacter spp. Aumento de resistencia a las cefalosporinas y a la oxacilina ocurrió para bacterias Gramnegativas y Grampositivas, respectivamente. Conclusión: hubo una reducción en la tasa de infección primaria del torrente sanguíneo asociada al catéter en neonatos en el período evaluado, y los episodios infecciosos fueron predominantemente causados por bacterias gramnegativas, incluyendo aislados multirresistentes a los antimicrobianos. Estos hallazgos señalan la importancia y necesidad de estrategias educativas para el equipo multiprofesional sobre vigilancia de infecciones, medidas preventivas y uso racional de antimicrobianos.

ABSTRACT Objective: to analyze primary bloodstream infections associated with central venous catheter in neonates admitted to intensive care units. Method: ecological study, conducted in 2017, from reports of primary bloodstream infections associated with central venous catheter, which occurred in the capital of a state in the Midwest region of Brazil. Data were collected using a form from two databases, municipal (2012 to 2016) and national (2014 to 2016). Results: the temporal trend of the infection incidence density was decreasing (p=0.019), with a central venous catheter use rate of 45%. The most frequent pathogens were Klebsiella pneumoniae, Coagulase-negative staphylococci, and Enterobacter spp. Increased resistance to cephalosporins and oxacillin occurred for Gram-negative and Gram-positive bacteria, respectively. Conclusion: There was a reduction in the rate of catheter-associated primary bloodstream infection in neonates in the period evaluated, and the infectious episodes were predominantly caused by Gram-negative bacteria, including antimicrobial multi-resistant isolates. These findings point to the importance and need for educational strategies for the multiprofessional team on infection surveillance, preventive measures, and rational use of antimicrobials.

Evaluación microbiológica del caudal de impulsión y extracción mecánica en habitaciones hospitalarias de aislados infecciosos e inmunodeprimidos / Microbiological evaluation of the discharge flow and mechanical extraction in hospital rooms of infectious and immunosuppressed isolates

Por las particularidades de los hospitales, su entorno contiene un gran número de microorganismos proporcionando condiciones muy favorables para la reproducción y la propagación de microorganismos patógenos. Por otro lado, como un sitio importante del uso de antibióticos, las infecciones asociadas a hospitales y la resistencia a los antimicrobianos promueven mutuamente la formación de un círculo vicioso. Existen fuertes evidencias de que la transmisión por aire y aerosoles de los microorganismos patógenos están muy extendidos en los entornos hospitalarios. En ese sentido, las partículas transportadas por el aire se caracterizan por su baja densidad, invisibilidad y susceptibilidad a la turbulencia. El asentamiento de partículas infecciosas en el aire sobre la herida de un paciente puede causar infecciones en cirugía o en caso más graves, infectar a pacientes con sistemas inmunológicos comprometidos, o puede conducir, si las condiciones de ventilación no son apropiadas, a la diseminación de bacterias y hongos (bioaerosoles) desde pacientes infecciosos a toda la comunidad hospitalaria. Para mejorar el estado de estas infecciones asociadas a los hospitales, los sistemas tradicionales se han centrado en estrategias para eliminar patógenos presentes en pacientes, superficies clínicas y trabajadores de la salud, que ha impulsado la implementación de varios protocolos de control y desinfección de infecciones que también han tenido éxito en la reducción de la incidencia de este tipo de infecciones hospitalarias. Dentro de estos procedimientos, está el uso de sistema de ventilación con presión de aire positiva o negativa El objetivo de este trabajo es determinar la capacidad de control microbiano de los sistemas de ventilación en dos centros de asistencia médica del Perú en habitaciones con pacientes inmunosuprimidos (VIH/Sida) aislados o en habitaciones de pacientes infecciosos(AU)

Due to the particularities of hospitals, their environment contains a large number of microorganisms, providing very favorable conditions for the reproduction and spread of pathogenic microorganisms. On the other hand, as an important site of antibiotic use, hospital-associated infections and antimicrobial resistance mutually promote the formation of a vicious circle. There is strong evidence that airborne and aerosol transmission of pathogenic microorganisms is widespread in hospital settings. In that sense, airborne particles are characterized by their low density, invisibility, and susceptibility to turbulence. The settling of airborne infectious particles on a patient's wound can cause infections in surgery or, in more serious cases, infect patients with compromised immune systems, or can lead, if ventilation conditions are not appropriate, to the spread of pathogens. bacteria and fungi (bioaerosols) from infectious patients to the entire hospital community. To improve the status of these hospital-associated infections, traditional systems have focused on strategies to eliminate pathogens present in patients, clinical surfaces, and healthcare workers, which has prompted the implementation of various infection control and disinfection protocols that they have also been successful in reducing the incidence of this type of hospital infection. Within these procedures, there is the use of a ventilation system with positive or negative air pressure. The objective of this work is to determine the microbial control capacity of the ventilation systems in two medical care centers in Peru in rooms with immunosuppressed patients (HIV/AIDS) isolated or in infectious patient rooms(AU)

La lucha antimicrobiana: Desarrollo de competencias en 6 universidades ecuatorianas / The antimicrobial fight: Development of skills in 6 Ecuadorian universities

Los microorganismos son seres vivos, que han ido adaptándose y evolucionando permitiendo su supervivencia, evadiendo las respuesta innata de los hospedadores e incluso modificando sus estructuras biológicas antes moléculas farmacológicas, que se han, en los últimos años, empleado de manera inadecuadas, bien sea por abuso o por deficiencia en el cumplimiento del esquema del tratamiento, o desaciertos para tratar un germen en específico y, como consecuencia, la actual crisis mundial por la resistencia a los antimicrobianos; considerado un problema de salud pública, requiere de esfuerzos multisectoriales e integrales que aporten soluciones mediatas, a corto y mediano plazo, sostenibles en el tiempo. Para ellos, es clave la formación de los nuevos profesionales, en el área de microbiología, de las diferentes carreras biomédicas. Es por ello, el presente estudio identificó las competencias que deben desarrollar los estudiantes, de seis universidades ecuatorianas. Se aplicaron cuestionarios, inquiriendo la importancia atribuida y el grado de desarrollo percibido de cada competencia mediante escala tipo Likert, además de seis dimensiones distribuidas en 40 indicadores. Se identificó mayor desarrollo de competencias en la identificación del patógeno, diagnóstico y análisis e interpretación de los resultados; además las seis dimensiones educativas fueron clasificadas como relevantes. Sin embargo, los resultados sugieren falencia en el desarrollo de competencias en la temática de resistencia antimicrobiana, por lo que se sugiere la revisión de los contenidos programáticos y aplicar nuevas herramientas pedagógicas que permitan al estudiantado aprender a aprender, aplicando un modelo socio-critico, y como base la investigación y el conocimiento científico actualizado(AU)

Microorganisms are living beings, which have been adapting and evolving allowing their survival, evading the innate response of the hosts and even modifying their biological structures before pharmacological molecules, which have, in recent years, been used inappropriately, either by abuse or deficiency in compliance with the treatment scheme, or failure to treat a specific germ and, as a consequence, the current global crisis due to antimicrobial resistance; considered a public health problem, it requires multisectoral and comprehensive efforts that provide immediate, short- and medium-term solutions that are sustainable over time. For them, the training of new professionals in the area of microbiology, of the different biomedical careers, is key. For this reason, this study identified the skills that students from six Ecuadorian universities should develop. Questionnaires were applied, inquiring about the importance attributed and the perceived degree of development of each competency using a Likert-type scale, in addition to six dimensions distributed in 40 indicators. Greater development of skills in the identification of the pathogen, diagnosis and analysis and interpretation of the results was identified; In addition, the six educational dimensions were classified as relevant. However, the results suggest a lack in the development of skills in the subject of antimicrobial resistance, so it is suggested to review the program contents and apply new pedagogical tools that allow students to learn to learn, applying a socio-critical model, and as a basis research and updated scientific knowledge(AU)

Saneamiento industrial: Biodisponibilidad de patógenos en superficies / Industrial sanitation: Bioavailability of pathogens on surfaces

En condiciones adecuadas como humedad, alcalinidad, o temperatura, determinados patógenos logran adherirse a las superficies y sobrevivir ciertos períodos fuera de un anfitrión, persistiendo en algunos casos a procesos deficientes de limpieza y desinfección, configurándose como un posible foco de transmisión. Por ello, el correcto saneamiento cumple un propósito vital en la protección de los trabajadores de la industria y otros sectores frente al riesgo de contaminación por contacto directo con las superficies contaminadas. La literatura científica muestra amplia evidencia de la supervivencia de patógenos sobre superficies que son habituales dentro de instalaciones industriales, como acero, aluminio, madera, plástico y vidrio. La supervivencia de microorganismos en las superficies puede configurarse como candidato a marcador de biodisponibilidad, que puede ser usado en la industria para establecer y auditar los planes de higienización y saneamiento industrial, permitiendo estudiar la eficacia de los compuestos usados en la desinfección, y variables como su concentración, temperatura, e intervalos de aplicación y remoción(AU)

Under suitable conditions such as humidity, alkalinity, or temperature, certain pathogens manage to adhere to surfaces and survive certain periods outside of a host, persisting in some cases to poor cleaning and disinfection processes, becoming a possible source of transmission. Therefore, proper sanitation serves a vital purpose in protecting workers in industry and other sectors from the risk of contamination by direct contact with contaminated surfaces. The scientific literature shows ample evidence of the survival of pathogens on surfaces that are common within industrial facilities, such as steel, aluminum, wood, plastic and glass. The survival of microorganisms on surfaces can be configured as a candidate for bioavailability marker, which can be used in the industry to establish and audit industrial sanitation and sanitation plans, allowing to study the efficacy of the compounds used in disinfection, and variables such as its concentration, temperature, and application and removal intervals(AU(

Perfil de sensibilidade a antibióticos de um isolado de Providencia rettgeri proveniente de equino / Antibiotic sensitivity profile in isolate of Providencia rettgeri from a horse

Introdução: a meningite bacteriana em equinos é uma enfermidade frequente em animais jovens. Streptococcus spp., Staphylococcus aureus e Escherichia coli são as bactérias mais comumente isoladas nesses casos. Apesar da bactéria Providencia rettgeri já ter sido isolada em casos de meningite humana e de crocodilo, não há relatos de seu isolamento em equinos. Objetivo: relatar o isolamento e a identificação da bactéria P. rettgeri de um potro com sintomas neurológicos e avaliar o perfil de sensibilidade a antibióticos deste isolado. Metodologia: o isolamento foi realizado a partir do líquido cefalorraquidiano do potro, por meio de cultivo em meio ágar chocolate. Após isolamento, as colônias formadas foram identificadas por equipamento Biotyper, baseado em espectrometria de massa. O perfil de sensibilidade foi definido por teste de difusão em discos, seguindo metodologia relatada pelo CLSI M2-A8 em 2003, sendo a bactéria classificada como resistente, padrão indeterminado ou sensível aos antibióticos, de acordo com o descrito pelo EUCAST em 2021. Resultados: este é o primeiro relato do isolamento de P. rettgeri como agente etiológico de meningite em potro. Dos 15 antibióticos testados, a bactéria foi resistente a 9, sensível a 5 e com padrão indeterminado a 1 antibiótico. Conclusão: nossos resultados indicam que P. rettgeri deve ser considerada entre possíveis agentes etiológicos de quadros neurológicos em equinos e que testes de sensibilidade a antibiótico são fundamentais, uma vez que essa bactéria já apresenta resistência a diversos antibióticos disponíveis comercialmente.

Introduction: Bacterial meningitis in horses is a frequent disease in young animals. Streptococcus spp., Staphylococcus aureus and Escherichia coli are the most commonly isolated bacteria in these cases. Although Providencia rettgeri bacterium has already been isolated in cases of human and crocodile meningitis, there are no reports of its isolation in cases of meningitis in horses. Objective: to report isolation and identification of the P. rettgeri bacteria from a foal with neurological symptoms and to assess antibiotic sensitivity profile in isolate of it. Methods: isolation was performed from the foal's cerebrospinal fluid, through cultivation in chocolate agar medium. After isolation, formed colonies were identified by Biotyper equipment, based on mass spectrometry. Sensitivity profile was verified by disk diffusion test, according to methodology that was reported by CLSI M2-A8 in 2003, which classified bacteria as resistant, indeterminate pattern or sensitive to antibiotics, as described by EUCAST in 2021. Results: this is the first report on isolation of P. rettgeri as an etiologic agent of meningitis in foals. Among 15 antibiotics that were tested, results showed bacteria resistence to 9 antibiotics, bacteria sensitivity to 5, but undetermined pattern to 1 antibiotic. Conclusion: results indicate that P. rettgeri shall be considered among potential etiologic agents of neurological conditions in horses and that antibiotic sensitivity tests are essential, since this type of bacterium is already resistant to several commercially available antibiotics.

A Human 3D Cardiomyocyte Risk Model to Study the Cardiotoxic Influence of X-rays and Other Noxae in Adults.

The heart tissue is a potential target of various noxae contributing to the onset of cardiovascular diseases. However, underlying pathophysiological mechanisms are largely unknown. Human stem cell-derived models are promising, but a major concern is cell immaturity when estimating risks for adults. In this study, 3D aggregates of human embryonic stem cell-derived cardiomyocytes were cultivated for 300 days and characterized regarding degree of maturity, structure, and cell composition. Furthermore, effects of ionizing radiation (X-rays, 0.1-2 Gy) on matured aggregates were investigated, representing one of the noxae that are challenging to assess. Video-based functional analyses were correlated to changes in the proteome after irradiation. Cardiomyocytes reached maximum maturity after 100 days in cultivation, judged by α-actinin lengths, and displayed typical multinucleation and branching. At this time, aggregates contained all major cardiac cell types, proven by the patch-clamp technique. Matured and X-ray-irradiated aggregates revealed a subtle increase in beat rates and a more arrhythmic sequence of cellular depolarisation and repolarisation compared to non-irradiated sham controls. The proteome analysis provides first insights into signaling mechanisms contributing to cardiotoxicity. Here, we propose an in vitro model suitable to screen various noxae to target adult cardiotoxicity by preserving all the benefits of a 3D tissue culture.

Nucleic acid-based biosensors: analytical devices for prevention, diagnosis and treatment of diseases / Biosensores basados en ácidos nucleicos: dispositivos analíticos para la prevención, el diagnóstico y tratamiento de enfermedades

BACKGROUND: Biosensing techniques have been the subject of exponentially increasing interest due to their performance advantages such as high selectivity and sensitivity, easy operation, low cost, short analysis time, simple sample preparation, and real-time detection. Biosensors have been developed by integrating the unique specificity of biological reactions and the high sensitivity of physical sensors. Therefore, there has been a broad scope of applications for biosensing techniques, and nowadays, they are ubiquitous in different areas of environmental, healthcare, and food safety. Biosensors have been used for environmental studies, detecting and quantifying pollutants in water, air, and soil. Biosensors also showed great potential for developing analytical tools with countless applications in diagnosing, preventing, and treating diseases, mainly by detecting biomarkers. Biosensors as a medical device can identify nucleic acids, proteins, peptides, metabolites, etc.; these analytes may be biomarkers associated with the disease status. Bacterial food contamination is considered a worldwide public health issue; biosensor-based analytical techniques can identify the presence or absence of pathogenic agents in food. OBJECTIVES: The present review aims to establish state-of-the-art, comprising the recent advances in the use of nucleic acid-based biosensors and their novel application for the detection of nucleic acids. Emphasis will be given to the performance characteristics, advantages, and challenges. Additionally, food safety applications of nucleic acid-based biosensors will be discussed. METHODS: Recent research articles related to nucleic acid-based biosensors, biosensors for detecting nucleic acids, biosensors and food safety, and biosensors in environmental monitoring were reviewed. Also, biosensing platforms associated with the clinical diagnosis and food industry were included. RESULTS: It is possible to appreciate that multiple applications of nucleic acid-based biosensors have been reported in the diagnosis, prevention, and treatment of diseases, as well as to identify foodborne pathogenic bacteria. The use of PNA and aptamers opens the possibility of developing new biometric tools with better analytical properties. CONCLUSIONS: Biosensors could be considered the most important tool for preventing, treating, and monitoring diseases that significantly impact human health. The aptamers have advantages as biorecognition elements due to the structural conformation, hybridization capacity, robustness, stability, and lower costs. It is necessary to implement biosensors in situ to identify analytes with high selectivity and lower detection limits

ANTECEDENTES: Las técnicas de biodetección han sido objeto de un interés cada vez mayor debido a ventajas, tales como alta selectividad y sensibilidad, facilidad de manejo, bajo costo, tiempo de análisis corto, preparación sencilla de muestras y detección en tiempo real. Los biosensores se han desarrollado integrando la especificidad única de las reacciones biológicas y la alta sensibilidad de los sensores físicos. Por lo tanto, las técnicas de biodetección han tenido un amplio campo de aplicación y hoy en día son omnipresentes en diferentes áreas del medio ambiente, la salud y la seguridad alimentaria. Se han utilizado biosensores para estudios ambientales, detectando y cuantificando contaminantes en el agua, el aire y el suelo. Los biosensores también mostraron un gran potencial para desarrollar herramientas analíticas con innumerables aplicaciones en el diagnóstico, prevención y tratamiento de enfermedades, principalmente mediante la detección de biomarcadores. Los biosensores como dispositivo médico pueden utilizarse para identificar ácidos nucleicos, proteínas, péptidos, metabolitos, etc. Estos analitos pueden ser biomarcadores asociados al estado de la enfermedad. La contaminación bacteriana de los alimentos se considera un problema de salud pública mundial; se pueden utilizar técnicas analíticas basadas en biosensores para determinar la presencia o ausencia de agentes patógenos en los alimentos. OBJETIVOS: La presente revisión tiene por objeto establecer los últimos adelantos en la utilización de biosensores basados en ácidos nucleicos y su novedosa aplicación para la detección de ácidos nucleicos. Se hará hincapié en las características del desempeño, las ventajas y los desafíos. Además, se examinarán las aplicaciones de los biosensores basados en ácidos nucleicos para la inocuidad de los alimentos. MÉTODOS: Se examinaron artículos de investigación recientes relacionados con los biosensores a base de ácidos nucleicos, los biosensores para la detección de ácidos nucleicos, los biosensores y la inocuidad de los alimentos, y los biosensores para la vigilancia del medio ambiente. También se incluyeron plataformas de biosensores asociadas al diagnóstico clínico y a la industria alimentaria. RESULTADOS: Es posible apreciar que se han reportado múltiples aplicaciones de biosensores basados en ácido nucleico para el diagnóstico, prevención y tratamiento de enfermedades, así como para identificar bacterias patógenas transmitidas por los alimentos. El uso de PNA y aptámeros abre la posibilidad de desarrollar nuevas herramientas biométricas con mejores propiedades analíticas. CONCLUSIONES: Los biosensores pueden ser considerados como los instrumentos más importantes para la prevención, el tratamiento y la vigilancia de las enfermedades que tienen un impacto significativo en la salud humana. Los aptámeros tienen ventajas como elemento de biorreconocimiento debido a la conformación estructural, capacidad de hibridación, robustez, estabilidad y menores costos. Es necesario implementar biosensores in situ para identificar analitos con alta selectividad y menores límites de detección

Influence of Sliding Time Window Size Selection Based on Heart Rate Variability Signal Analysis on Intelligent Monitoring of Noxious Stimulation under Anesthesia.

In recent decades, little progress of objective evaluation of pain and noxious stimulation has been achieved under anesthesia. Some researches based on medical signals have failed to provide a general understanding of this problem. This paper presents a feature extraction method for heart rate variability signals, aiming at further improving the evaluation of noxious stimulation. In the process of data processing, the empirical mode decomposition is used to decompose and recombine heart rate variability signals, and the sliding time window approach is used to extract the signal features of noxious stimulation, respectively. The influence of window size on feature extraction is studied by changing the window size. By comparing the results, the feature extraction in the process of data processing is valuable, and the selection of window size has a significant impact. With the increase of selected window sizes, we can get better detection results. But for the best choice of window size, to ensure the accuracy of the results and to make it easy to use, then, we need to get just a suitable window size.

Human Milk Concentrations of Minerals, Essential and Toxic Trace Elements and Association with Selective Medical, Social, Demographic and Environmental Factors.

This study aims to quantify concentrations of minerals and trace elements in human milk (HM) and infant formula (IF) and evaluate associations with medical, social, environmental, and demographic variables. A prospective, case series study of 170 nursing mothers was made. HM samples were obtained from full-term (colostrum, intermediate and mature HM) and preterm (mature HM) mothers. Variables of interest were assessed by a questionnaire. For comparison, IF samples (n = 30) were analyzed in a cross-sectional study. Concentrations of 35 minerals, essential and toxic trace elements were quantified, 5 for the first time: thallium in HM and IF; strontium in preterm HM; and gallium, lithium and uranium in IF. In preterm and full-term HM, levels of selenium (p < 0.001) were significantly lower than recommended and were associated with low birth weight (p < 0.002). Cesium and strontium concentrations were significantly higher than recommended (p < 0.001). Associations were observed between arsenic and residence in an urban area (p = 0.013), and between lead and smoking (p = 0.024) and well-water consumption (p = 0.046). In IF, aluminum, vanadium, and uranium levels were higher than in HM (p < 0.001); uranium, quantified for the first time, was 100 times higher in all types of IF than in HM. Our results indicate that concentrations of most trace elements were within internationally accepted ranges for HM and IF. However, preterm infants are at increased risk of nutritional deficiencies and toxicity. IF manufacturers should reduce the content of toxic trace elements.