Clavispora lusitaniae: From a saprophytic yeast to an emergent pathogen.

Clavispora lusitaniae has been isolated from different substrates, such as soil, water, fruit, vegetables, plants, and the gastrointestinal tract of animals and humans. However, its importance lies in being isolated from in invasive infections, particularly in pediatric patients with hematologic malignancies. It is an emerging nosocomial pathogen commonly associated with fatal prognosis in immunocompromised hosts. C. lusitaniae has attracted attention in the last decade because of resistance to amphotericin B, 5- flucytosine, and fluconazole. The adaptations of this yeast to the human host may contribute to its pathogenicity. Further study will be needed to understand C. lusitaniae's ability as a potential pathogen. This mini-review highlights the importance of the growing number of invasive disease cases caused by this yeast.

Encapsulation of Citrus sinensis essential oil and R-limonene in lipid nanocarriers: A potential strategy for the treatment of leishmaniasis.

Leishmaniases, a group of neglected tropical diseases caused by an intracellular parasite of the genus Leishmania, have significant impacts on global health. Current treatment options are limited due to drug resistance, toxicity, and high cost. This study aimed to develop nanostructured lipid carriers (NLCs) for delivering Citrus sinensis essential oil (CSEO) and its main constituent, R-limonene, against leishmaniasis. The influence of surface-modified NLCs using chitosan was also examined. The NLCs were prepared using a warm microemulsion method, and surface modification with chitosan was achieved through electrostatic interaction. These nanocarriers were characterized by differential scanning calorimetry (DSC), X-ray diffraction (XRD), transmission electron microscopy, and dynamic light scattering (DLS). In vitro cytotoxicity was assessed in L929 and RAW 264.7 cells, and leishmanicidal activity was evaluated against promastigote and amastigote forms. The NLCs were spherical, with particle sizes ranging from 97.9 nm to 111.3 nm. Chitosan-coated NLCs had a positive surface charge, with zeta potential values ranging from 45.8 mV to 59.0 mV. Exposure of L929 cells to NLCs resulted in over 70 % cell viability. Conversely, surface modification significantly reduced the viability of promastigotes (93 %) compared to free compounds. Moreover, chitosan-coated NLCs presented a better IC50 against the amastigote forms than uncoated NLCs. Taken together, these findings demonstrate the feasibility of using NLCs to overcome the limitations of current leishmaniasis treatments, warranting further research.

Fibrilación auricular de novo en síndrome coronario agudo / Atrial fibrillation de novo in acute coronary syndrome

Resumen Una de las complicaciones durante un evento de síndrome coronario agudo es la presencia de arritmias. Dentro de ellas, las de tipo supraventricular, en especial fibrilación auricular, acarrea un mal pronóstico tanto a corto como a largo plazo y es la causa de situaciones como evento vascular cerebral, arritmias ventriculares y aumento de la mortalidad. Dicha arritmia tiende a aparecer en cierto grupo de población con particulares factores de riesgo durante el evento índice en aproximadamente 10% de los casos. Un tratamiento apropiado en el momento de su aparición, gracias al uso de fármacos que modulan la frecuencia cardiaca, el ritmo y el manejo anticoagulante en los grupos más vulnerables conllevará un desenlace menos sombrío para estos pacientes.

Abstract One of the complications during an acute coronary syndrome event is the presence of arrhythmias. Among them, those of the supraventricular type, especially atrial fibrillation, carry a poor prognosis both in the short and long term, being the cause of situations such as cerebrovascular event, ventricular arrhythmias, and increased mortality. The arrhythmia tends to appear in a certain population group with particular risk factors during the index event in approximately 10% of cases. Appropriate treatment at the time of its onset, thanks to the use of drugs that modulate heart rate, rhythm, and anticoagulant management in the most vulnerable groups, will lead to a less bleak outcome for these patients.

Determination of gas flux and animal performance test duration of growing cattle in confined conditions.

Data from three experiments was analyzed to determine the number of visits and days to assess gas flux (CH4, CO2, and O2), dry matter intake (DMI), and average daily gain (ADG) from growing animals under confined conditions. In experiment 1, 213 animals (461 ±â€…91 kg initial body weight [BW]) were fed a backgrounding diet and evaluated for 60 d. In experiment 2, 169 steers (488 ±â€…37 kg initial BW) were fed a finishing diet and assessed for 70 d. In experiment 3, 64 steers (514 ±â€…42 kg initial BW) were fed a finishing diet and evaluated for 80 d. In each experiment, animals were placed in one pen with one Greenfeed and five SmartFeeds to collect gas flux and feed intake simultaneously. Gas flux was analyzed using data from 161 animals from the three experiments with 100 visits for 2 or more min or 3 or more min. Also, metabolic heat production (MHP) was estimated using the individual gas flux. Daily DMI was calculated as the daily feed intake corrected by the dry matter concentration. ADG was computed as the slope of the regression of the shrunk BW (96% BW) throughout each of the experimental periods. The mean gas flux and MHP were estimated for increasing or decreasing 5-visit intervals starting with the first or the last 5 visits and increasing or decreasing until the full 100-visit dataset was utilized, respectively. Intervals of DMI were estimated for increasing or decreasing 5-d intervals starting with the first or the last 5 d and increasing or decreasing until the end of the experimental period, respectively. Intervals of ADG were estimated for increasing or decreasing measurement period intervals until the end of the experimental period, respectively. Pearson and Spearman correlations were computed between the maximum visits or days and each shortened visit or day interval. The minimum number of visits and days was determined when correlations with the total visits were greater than 0.95. The results indicated that the minimum number of visits needed to quantify CO2, O2, and MHP accurately was 40, while CH4 was 60. A visitation length of 2 min or more or 3 min or more did not modify the gas flux determination. Thus, based on the average daily visitation in these experiments, gas flux data could be collected for 25 d. Additionally, the required days to determine DMI was 30, while ADG could not be assessed in a shorter than 60-d period.

Mother's smoking habits affects IL10 methylation but not asthma in Ecuadorian children.

There is no evidence evaluating the IL10 epigenetic upregulation among mestizo children in a high-altitude Andean city in Latin America. OBJECTIVE: To identify polymorphisms and methylation profiles in the IL10 gene associated with asthma in children aged 5 to 11. METHODS: A case-control study was conducted with asthmatic and non-asthmatic children aged 5 to 11 years in Cuenca-Ecuador. Data on allergic diseases and risk factors were collected through a questionnaire for parents. Atopy was measured by skin prick test (SPT) to relevant aeroallergens. Three IL10 single nucleotide polymorphisms were evaluated in all participants, and methylation analysis was performed in 54 participants. Association between risk factors, allergic diseases and genetic factors were estimated using multivariate logistic regression. RESULTS: The results of polymorphisms showed no differences between cases and controls when comparing the SNPs rs3024495, rs3024496, rs1800896 allelic and genotypic frequencies. In the methylation analysis, no differences in the IL10 methylation profile were found between cases and controls; however, the multivariate analysis showed an association between the mother's smoking habits and the IL10 methylation profile. CONCLUSION: Smoking habit could be essential as an environmental exposure factor in regulating gene expression in children with asthma.

Priapismo y leucemia mieloide crónica en adolescente. Debut poco frecuente. Reporte de caso / Priapism and chronic myeloid leukemia in an adolescent. Rare debut presentation. A case report

El priapismo es una erección dolorosa y persistente acompañada o no de estímulo sexual. Una causa poco frecuente de esta anormalidad es la leucemia mieloide crónica. Se han reportado pocos casos de priapismo como manifestación inicial de una leucemia de este tipo en pacientes adolescentes. A continuación, se informa el caso de un paciente de 16 años de edad que presentó priapismo como manifestación inicial de una leucemia mieloide crónica. Durante su evolución, no se realizó aspiración de los cuerpos cavernosos. Se inició tratamiento hematológico específico y, ante la persistencia del priapismo, fue necesario realizar un shunt de cuerpos cavernosos en dos ocasiones, tratamiento a pesar del cual existen altas probabilidades de secuelas.

Priapism is a painful and persistent erection, with or without sexual stimulation. A rare cause of such abnormality is chronic myeloid leukemia. Few cases of priapism as an initial manifestation of this type of leukemia have been reported in adolescent patients. Here we describe the case of a 16-year-old patient who presented with priapism as the initial manifestation of chronic myeloid leukemia. No cavernosal aspiration was performed. A specific hematological treatment was started and, given the persistence of priapism, the patient required 2 corpora cavernosa shunt procedures; despite this treatment, there is a high probability of sequelae.

Plant-Based Fermented Beverages: Nutritional Composition, Sensory Properties, and Health Benefits.

Plant-based beverages have gained consumers' attention for being the main substitutes for dairy milk, especially for people with lactose intolerance, milk allergies, and a prevalence of hypercholesterolemia. Moreover, there is a growing demand for a more sustainable diet and plant-based lifestyle due to concerns related to animal wellbeing, environmental impacts linked to dairy production, and the rising cost of animal-derived foods. However, there are some factors that restrict plant-based beverage consumption, including their nutritional quality and poor sensory profile. In this context, fermentation processes can contribute to the improvement of their sensory properties, nutritional composition, and functional/bioactive profile. In particular, the fermentation process can enhance flavor compounds (e.g., acetoin and acetic acid) while decreasing off-flavor components (e.g., hexanal and hexanol) in the substrate. Furthermore, it enhances the digestibility and bioavailability of nutrients, leading to increased levels of vitamins (e.g., ascorbic acid and B complex), amino acids (e.g., methionine and tryptophan), and proteins, while simultaneously decreasing the presence of anti-nutritional factors (e.g., phytic acid and saponins). In contrast, plant-based fermented beverages have been demonstrated to possess diverse bioactive compounds (e.g., polyphenols and peptides) with different biological properties (e.g., antioxidant, anti-inflammatory, and antihypertensive). Therefore, this article provides an overview of plant-based fermented beverages including their production, technological aspects, and health benefits.

Long-term antigen-specific immune response by an oncolytic adenovirus encoding SP-SA-E7-4-1BBL in HPV-16 cancer model.

BACKGROUND: To describe an oncolytic adenovirus (OAd) encoding SP-SA-E7-4-1BBL that is capable of inducing tumor regression in therapeutic assays. Herein, we tested whether the antitumor effect is given by the induction of a tumor-specific immune response, as well as the minimum dose needed to elicit antitumor protection and monitor the OAd biodistribution over time. METHODS AND RESULTS: C57BL/6 mice (n = 5) per group were immunized twice with OAds encoding SP-SA-E7-4-1BBL, SA-E7-4-1BBL, or SP-SA-4-1BBL and challenged with TC-1 cancer cells. The DNA construct SP-SA-E7-4-1BBL was employed as a control via biolistic or PBS injection. Groups without tumor development at 47 days were rechallenged with TC-1 cells, and follow-up lasted until day 90. The minimum dose of OAd to induce the antitumor effect was established by immunization using serial dilution doses. The cytometry bead assay and the ELISpot assay were used to evaluate cytokine release in response to ex vivo antigenic stimulation. The distribution profile of the OAd vaccine was evaluated in the different organs by histological, immunohistochemical and qPCR analyses. The OAd SP-SA-E7-4-1BBL-immunized mice did not develop tumors even in a rechallenge. A protective antitumor effect was observed from a dose that is one hundredth of most reports of adenoviral vaccines. Immunization with OAd increases Interferon-gamma-producing cells in response to antigen stimulation. OAd was detected in tumors over time, with significant morphological changes, contrary to nontumor tissues. CONCLUSIONS: The OAd SP-SA-E7-4-1BBL vaccine confers a prophylactic, safe, long-lasting, and antigen-dependent antitumor effect mediated by a Th1 antitumor immune response.

Hamamelis virginiana L. extract presents antimicrobial and antibiofilm effects, absence of cytotoxicity, anti-inflammatory action, and potential to fight infections through the nitric oxide production by macrophages.

The potential of H. virginiana L. was evaluated against Candida spp. (C. albicans, C. dubliniensis, C. glabrata, C. guilliermondii, C. krusei, and C. tropicalis) and bacteria (Acinetobacter baumannii, Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus mutans). Effect on murine macrophages (RAW 264.7) was also evaluated with respect to cytotoxicity and production of cytokines (IL-1ß and TNF-α) and nitric oxide (NO). The most effective concentrations of the extract were determined by microdilution broth. These concentrations were analyzed on biofilms, after 5 min or 24 h exposure. Cytotoxicity was performed by MTT assay and quantification of cytokines and NO by ELISA and Griess reagent, respectively. The extract acted against the planktonic forms and provided significant reductions of all the microbial biofilms; besides, showed no cytotoxic effect, except at 100 mg/mL, after 24 h exposure. There was cytokine production; however, a modulatory effect was observed in groups exposed to lipopolysaccharide (LPS) from E. coli. NO production was similar or higher than the control group. Thus, H. virginiana L. extract showed antimicrobial and antibiofilm effects; absence of cytotoxicity for RAW 264.7; anti-inflammatory action; and potential to fight infections through the NO production.

Priapism and chronic myeloid leukemia in an adolescent. Rare debut presentation. A case report. / Priapismo y leucemia mieloide crónica en adolescente. Debut poco frecuente. Reporte de caso.

Priapism is a painful and persistent erection, with or without sexual stimulation. A rare cause of such abnormality is chronic myeloid leukemia. Few cases of priapism as an initial manifestation of this type of leukemia have been reported in adolescent patients. Here we describe the case of a 16-year-old patient who presented with priapism as the initial manifestation of chronic myeloid leukemia. No cavernosal aspiration was performed. A specific hematological treatment was started and, given the persistence of priapism, the patient required 2 corpora cavernosa shunt procedures; despite this treatment, there is a high probability of sequelae.

El priapismo es una erección dolorosa y persistente acompañada o no de estímulo sexual. Una causa poco frecuente de esta anormalidad es la leucemia mieloide crónica. Se han reportado pocos casos de priapismo como manifestación inicial de una leucemia de este tipo en pacientes adolescentes. A continuación, se informa el caso de un paciente de 16 años de edad que presentó priapismo como manifestación inicial de una leucemia mieloide crónica. Durante su evolución, no se realizó aspiración de los cuerpos cavernosos. Se inició tratamiento hematológico específico y, ante la persistencia del priapismo, fue necesario realizar un shunt de cuerpos cavernosos en dos ocasiones, tratamiento a pesar del cual existen altas probabilidades de secuelas.

Dactylopius opuntiae [Cockerell] Could Be a Source of Antioxidants for the Preservation of Beef Patties.

Dactylopius opuntiae is an insect pest that contains at least carminic acid, which has antioxidant properties. Since there is a relationship between the antioxidant ability and preservative action of compounds applied to meat products, the purpose of this study was to evaluate the antioxidant activity and usefulness of a D. opuntiae extract for beef patty preservation. The insects were bred and processed to obtain a liquid extract. For the extract, its carminic acid content, antioxidant activity against two free radicals, and actions on food quality parameters were determined. The D. opuntiae dry powder contained 2.91% w/w carminic acid, while the liquid extract exhibited an IC50 value of 3437.8 ± 67.8 and 19633.0 ± 674.5 µg/mL against the DPPH and ABTS radicals. Nevertheless, these antioxidant actions were lower than those found in a D. coccus extract. The D. opuntiae extract improved in a short time the redness and yellowness, eliminated the unfavorable effect of their vehicle on the MetMb level, and greatly reduced the TBARS formation. For the first time, an extract of D. opuntiae was applied to beef patties, and its beneficial antioxidant action on meat acceptance parameters was confirmed, which has potential commercial applications.

Hyperprolactinemia modifies extracellular matrix components associated with collagen fibrillogenesis in harderian glands of non- and pregnant female mice.

The harderian gland (HG) is a gland located at the base of the nictating membrane and fills the inferomedial aspect of the orbit in rodents. It is under the influence of the hypothalamic-pituitary-gonadal axis and, because of its hormone receptors, it is a target tissue for prolactin (PRL) and sex steroid hormones (estrogen and progesterone). In humans and murine, the anterior surface of the eyes is protected by a tear film synthesized by glands associated with the eye. In order to understand the endocrine changes caused by hyperprolactinemia in the glands responsible for the formation of the tear film, we used an animal model with metoclopramide-induced hyperprolactinemia (HPRL). Given the evidences that HPRL can lead to a process of cell death and tissue fibrosis, the protein expression of small leucine-rich proteoglycans (SLRPs) was analyzed through immunohistochemistry in the HG of the non- and the pregnant female mice with hyperprolactinemia. The SRLPs are related to collagen fibrillogenesis and they participate in pro-apoptotic signals. Our data revealed that high prolactin levels and changes in steroid hormones (estrogen and progesterone) can lead to an alteration in the amount of collagen, and in the structure of type I and III collagen fibers through changes in the amounts of lumican and decorin, which are responsible for collagen fibrillogenesis. This fact can lead to the impaired functioning of the HG by excessive apoptosis in the HG of the non- and the pregnant female mice with HPRL and especially in the HG of pregnancy-associated hyperprolactinemia.

Adsorption and Photodegradation of Lanasol Yellow 4G in Aqueous Solution by Natural Zeolite Treated by CO2-Laser Radiation.

Natural zeolite is a widely used material with excellent environmental cleaning performance, especially in water and wastewater treatment. Natural zeolite (Zini) calcined by CO2-laser radiation (ZL) was tested as a catalyst for the photodegradation and the adsorption of industrial azo dye Lanasol Yellow 4G (LY4G) in water. Morphology, chemical structure, and surface composition of Zini and ZL were analyzed by XRD, SEM, EDS, and XPS. UV/Visible spectrophotometry was used to evaluate the photocatalytic activity of Zini and ZL. The photocatalytic activity of the studied zeolites was associated with the presence of Fe oxides in their composition. Laser-treated natural zeolite showed higher efficiency as a photocatalyst compared to untreated natural zeolite.

Evaluación de cultivares de arroz (Oryza sativa L.) de Vietnam, para su introducción en Cuba

Con el objetivo de evaluar la diversidad fenotípica de ocho cultivares de arroz (Oryza sativa L.) procedentes de Vietnam, para su introducción en los programas de mejora y en la producción en Cuba, apoyados en caracteres morfoagronómicos y técnicas de análisis multivariado, fue desarrollado este trabajo en la Unidad Científico Tecnológica de Base "Los Palacios", perteneciente al Instituto Nacional de Ciencias Agrícolas de Cuba. Los cultivares vietnamitas se sembraron en campo junto a los comerciales INCA LP-5 e INCA LP-7, para ser caracterizados agronómicamente con la utilización de 29 descriptores cualitativos y 22 cuantitativos. Los resultados mostraron que 16 caracteres cualitativos resultaron homogéneos para los ocho cultivares procedentes de Vietnam y los dos cultivares comerciales cubanos, la asociación entre varios caracteres cuantitativos reafirma la influencia que ejercen algunos componentes sobre el rendimiento, los que son considerados como marcadores para la selección, tres cultivares de procedencia vietnamita (GL301, LCG3-4 y DS1) no pueden ser utilizados en la producción arrocera en Cuba, por su susceptibilidad a Tagosodes. Todos los cultivares mostraron resistencia a Rhizoctonia solani y Sarocladium oryzae y dos (GL 301 y LTH 31) fueron susceptibles a Pyricularia grisea. Los cultivares OM6976, OM5451 y OM8087 alcanzaron valores altos de rendimiento, por lo que pudieran ser utilizados, como progenitores en los programas de mejora, así como cultivares comerciales.

With the objective of evaluating the phenotypic diversity of eight rice cultivars (Oryza sativa L.) from Vietnam, for their introduction in breeding programs and production in Cuba, supported by morphoagronomic characters and multivariate analysis techniques, this work was developed in Scientific and Technological Base Unit belonging to the National Agricultural Sciences Institute of Cuba. The Vietnamese cultivars were planted in the field together with the commercial cultivars INCA LP-5 and INCA LP-7, to be characterized agronomically with the use of 29 qualitative and 22 quantitative descriptors. The results showed that 16 qualitative characters were homogeneous for the eight cultivars from Vietnam and the two Cuban commercial cultivars, the association between various quantitative characters reaffirms the influence exerted by some components on yield, which are considered as markers for selection. Three cultivars of Vietnamese origin (GL301, LCG3-4 and DS1) cannot be used in Cuban rice production, due to their susceptibility to Tagosodes. All cultivars showed resistance to Rhizoctonia solani and Sarocladium oryzae and two (GL 301 and LTH 31) were susceptible to Pyricularia grisea. The OM6976, OM5451 and OM8087 cultivars reached high yield values, so they could be used as parents in breeding programs, as well as commercial cultivars.

Novel Therapy for Acquired Tracheomalacia with a Tissue-Engineered Extraluminal Tracheal Splint and Autologous Mesenchymal-Derived Chondrocytes

Abstract Introduction Acquired tracheomalacia (ATM) is characterized by a loss of structural strength of the tracheal framework, resulting in airway collapse during breathing. Near half of the patients undergoing prolonged invasive mechanical ventilation will suffer tracheal lesions. Treatment for ATM includes external splinting with rib grafts, prosthetic materials, and tracheal resection. Failure in the use of prosthetic materials has made reconsidering natural origin scaffolds and tissue engineering as a suitable alternative. Objective To restore adequate airway patency in an ovine model with surgicallyinduced ATM employing a tissue-engineered extraluminal tracheal splint (TE-ETS). Methods In the present prospective pilot study, tracheal rings were partially resected to induce airway collapse in 16 Suffolk sheep (Ovis aries). The TE-ETS was developed with autologous mesenchymal-derived chondrocytes and allogenic decellularized tracheal segments and was implanted above debilitated tracheal rings. The animals were followed-up at 8, 12, and 16 weeks and at 1-year postinsertion. Flexible tracheoscopies were performed at each stage. After sacrifice, a histopathological study of the trachea and the splint were performed. Results The TE-ETS prevented airway collapse for 16 weeks and up to 1-year postinsertion. Tracheoscopies revealed a noncollapsing airway during inspiration. Histopathological analyses showed the organization of mesenchymal-derived chondrocytes in lacunae, the proliferation of blood vessels, and recovery of epithelial tissue subjacent to the splint. Splints without autologous cells did not prevent airway collapse. Conclusion It is possible to treat acquired tracheomalacia with TE-ETS without further surgical removal since it undergoes physiological degradation. The present study supports the development of tissue-engineered tracheal substitutes for airway disease.

Essential oil Ageratum conyzoides chemotypes and anti-tick activities.

Rhipicephalus (Boophilus) microplus represents a significant obstacle to animal productivity in tropical and subtropical areas, leading to considerable economic losses for the dairy and meat production industries. Essential oils (EO) extracted from Ageratum conyzoides are known to cause death and induce morphogenetic abnormalities in several insect species. This plant, however, presents morphological flower variations, which range from white to purple, associated to different chemotypes. In this context, this study aimed to conduct a novel assessment on the effects of EO extracted from two A. conyzoides chemotypes in the control of the bovine tick R. microplus. The primary constituents of the oil obtained from white flower samples (WFs) were precocene I (80.4 %) and (E)-caryophyllene (14.8 %), while purple flower oil samples (PFs) contained predominantly ß-acoradiene (12.9 %), γ-amorphene (12.3 %), α-pinene (9.9 %), bicyclogermacrene (8.9 %), α-santalene (8.7 %), and andro encecalinol (5.6 %). Interestingly, only the EO chemotype from A. conyzoides PFs displayed acaricidal activity towards R. microplus larvae, with an LC50 of 1.49 mg/mL.

[Application and research progress of autologous soft tissue substitute materials in gingival augmentation of natural teeth].

Subepithelial connective tissue or free gingival grafts are often used in traditional mucogingival surgery to treat gingival recession and keratinized gingival insufficiency. However, due to the disadvantages of autologous soft tissue grafts, such as the preparation of the second surgical site, the limited amount of tissue in the donor site, and postoperative discomfort for patients, the research on autologous soft tissue substitute materials has attracted extensive attention. A variety of donor-substitute materials from different sources are currently used in membranous gingival surgeries, including platelet-rich fibrin, acellular dermal matrix, xenogeneic collagen matrix, etc. This paper reviews the research progress and application of several different types of substitute materials in soft tissue augmentation for natural teeth, providing a reference for the application of autologous soft tissue substitutes in clinical gingival augmentation surgery.

Microorganisms isolated in patients with post-cardiac surgery mediastinitis at a cardiology hospital of Mexico City.

INTRODUCTION: Mediastinitis after cardiovascular surgery gives rise to prolonged hospital stay and increased medical care costs, and is associated with high in-hospital mortality. OBJECTIVE: To describe the clinical characteristics of patients with post-surgical mediastinitis, including the isolated microorganisms, resistance profile, and in-hospital survival. METHODS: Cross-sectional study of patients with bacteriologically-confirmed post-surgical mediastinitis cared for at a cardiology hospital in Mexico City between January 2017 and March 2019. RESULTS: Fifty-eight cases of mediastinitis were included. Median age was 67 years. Most subjects were males who underwent myocardial revascularization. During in-hospital follow-up, all-cause and mediastinitis-related mortality were 27.6% and 20.7%, respectively. Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli were the most commonly isolated microorganisms. High resistance to methicillin was found in coagulase-negative staphylococci, as well as high expression of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae strains. CONCLUSIONS: High mortality and significant antimicrobial resistance were found in patients with post-cardiac surgery mediastinitis.

INTRODUCCIÓN: La mediastinitis posterior a cirugía cardiovascular deriva en estancia hospitalaria prolongada e incremento de los costos de la atención médica, y se asocia a elevada letalidad hospitalaria. OBJETIVO: Describir las características clínicas de los pacientes con mediastinitis posquirúrgica, incluyendo los microorganismos aislados, perfil de resistencia y supervivencia hospitalaria. MÉTODOS: Estudio transversal de pacientes con mediastinitis posquirúrgica bacteriológicamente confirmada, atendidos en un hospital de cardiología de la Ciudad de México entre enero de 2017 y marzo de 2019. RESULTADOS: Se incluyeron 58 casos de mediastinitis. La mediana de edad fue de 67 años. La mayoría de los sujetos fueron varones sometidos a revascularización miocárdica. Durante el seguimiento hospitalario, la letalidad por todas las causas y la secundaria a la mediastinitis fueron de 27.6 y 20.7 %, respectivamente. Los microorganismos más frecuentemente aislados fueron Staphylococcus aureus, Staphylococcus epidermidis y Escherichia coli. Se encontró alta resistencia a meticilina en los estafilococos coagulasa negativos y alta expresión de betalactamasas de espectro extendido en cepas de Escherichia coli y Klebsiella pneumoniae. CONCLUSIONES: En los pacientes con mediastinitis posquirúrgica analizados se observó alta letalidad e importante resistencia antimicrobiana.

Microorganismos aislados en pacientes con mediastinitis poscirugía cardiaca en un hospital de cardiología de la Ciudad de México / Microorganisms isolated in patients with post-cardiac surgery mediastinitis at a cardiology hospital of Mexico City

Resumen Introducción: La mediastinitis posterior a cirugía cardiovascular deriva en estancia hospitalaria prolongada e incremento de los costos de la atención médica, y se asocia a elevada letalidad hospitalaria. Objetivo: Describir las características clínicas de los pacientes con mediastinitis posquirúrgica, incluyendo los microorganismos aislados, perfil de resistencia y supervivencia hospitalaria. Métodos: Estudio transversal de pacientes con mediastinitis posquirúrgica bacteriológicamente confirmada, atendidos en un hospital de cardiología de la Ciudad de México entre enero de 2017 y marzo de 2019. Resultados: Se incluyeron 58 casos de mediastinitis. La mediana de edad fue de 67 años. La mayoría de los sujetos fueron varones sometidos a revascularización miocárdica. Durante el seguimiento hospitalario, la letalidad por todas las causas y la secundaria a la mediastinitis fueron de 27.6 y 20.7 %, respectivamente. Los microorganismos más frecuentemente aislados fueron Staphylococcus aureus, Staphylococcus epidermidis y Escherichia coli. Se encontró alta resistencia a meticilina en los estafilococos coagulasa negativos y alta expresión de betalactamasas de espectro extendido en cepas de Escherichia coli y Klebsiella pneumoniae. Conclusiones: En los pacientes con mediastinitis posquirúrgica analizados se observó alta letalidad e importante resistencia antimicrobiana.

Abstract Introduction: Mediastinitis after cardiovascular surgery gives rise to prolonged hospital stay and increased medical care costs, and is associated with high in-hospital mortality. Objective: To describe the clinical characteristics of patients with post-surgical mediastinitis, including the isolated microorganisms, resistance profile, and in-hospital survival. Methods: Cross-sectional study of patients with bacteriologically-confirmed post-surgical mediastinitis cared for at a cardiology hospital in Mexico City between January 2017 and March 2019. Results: Fifty-eight cases of mediastinitis were included. Median age was 67 years. Most subjects were males who underwent myocardial revascularization. During in-hospital follow-up, all-cause and mediastinitis-related mortality were 27.6% and 20.7%, respectively. Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli were the most commonly isolated microorganisms. High resistance to methicillin was found in coagulase-negative staphylococci, as well as high expression of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae strains. Conclusions: High mortality and significant antimicrobial resistance were found in patients with post-cardiac surgery mediastinitis.