Características del almacenamiento de antibióticos en una población suburbana de México

Objetivo: Determinar las características de almacenamiento de los antibióticos de las familias en una población suburbana en México. Metodología: El enfoque del estudio es cuantitativo, observacional, de corte transversal y alcance descriptivo. La unidad de estudio fueron las familias que vivían en el área de estudio de una zona suburbana en México. Resultados: Se encuestaron un total de 235 familias, dentro de las cuales existen diversos grupos etarios, de los cuales predominaron las edades de entre 36 a 64 años en 153 familias. Se obtuvo que más del 70 % presentaban enfermedades y, respecto a la posibilidad de que tuviesen almacenados medicamentos antibióticos caducados o próximos a caducar, el 68.1 % mencionó que no era probable. Conclusiones: El importante número de población adulta, la amplia presencia de comorbilidades y diversos factores sociodemográficos impactan en las prácticas y actitudes en relación con las formas en que las familias obtienen, usan, almacenan y desechan los medicamentos dentro de sus hogares. Esta investigación busca contribuir a la concientización y creación de diversos programas para la adopción de medidas de seguridad para el almacenamiento de medicamentos dentro del hogar, así como servir de guía en la identificación de procedimientos óptimos, eficientes y eficaces para tratar este fenómeno.

Objetivo: Determinar as características do armazenamento de antibióticos das famílias em uma população suburbana no México. Metodologia: A abordagem do estudo é quantitativa, observacional, transversal e de escopo descritivo. A unidade de estudo foram as famílias que viviam na área de estudo de uma zona suburbana no México. Resultados: Foram pesquisadas 235 famílias, de diversas faixas etárias, das quais predominaram as idades de 36 a 64 anos em 153 famílias. Verificou-se que mais de 70% apresentavam enfermidades, e com relação à possibilidade de terem medicamentos antibióticos vencidos ou prestes a vencer armazenados, 68,1 % mencionaram que não era provável. Conclusões: O significativo número de população adulta, a ampla presença de comorbidades e vários fatores sociodemográficos impactam nas práticas e atitudes relativas às formas como as famílias obtêm, usam, armazenam e descartam medicamentos em suas residências. Esta pesquisa busca contribuir para a conscientização e a criação de vários programas para a adoção de medidas de segurança para o armazenamento de medicamentos em casa, bem como servir de guia na identificação de procedimentos ideais, eficientes e eficazes para lidar com esse fenômeno.

Objective: To determine the antibiotic storage characteristics of families in a suburban population in Mexico. Methodology: The study approach is quantitative, observational, cross-sectional and descriptive in scope. The unit of study was families living in the area under study in a suburban zone of Mexico. Results: A total of 235 families were surveyed, within which there are different age groups, with 153 families predominantly aged between 36 and 64 years old. It was obtained that more than 70 % presented illnesses and, regarding the possibility that they had stored expired or soon to expire antibiotic drugs, 68.1 % mentioned that it was not likely. Conclusions: The significant number of adult population, the wide presence of comorbidities and various sociodemographic factors impact practices and attitudes regarding the ways in which families obtain, use, store and dispose of medications within their homes. This research seeks to contribute to the awareness and creation of various programs for the adoption of safety measures for the storage of medicines within the home, as well as to serve as a guide in the identification of optimal, efficient and effective procedures to deal with this phenomenon.

Antimicrobial sensitivity pattern of bacterial pathogens for uncomplicated urinary tract infection in female patients at a tertiary level hospital

Background: Urinary tract infections (UTIs) remain the common infections in outpatients as well as hospitalized patients. Antimicrobials are frequently used drugs for the treatment of UTIs. Periodic evaluation of antimicrobial activity of different antimicrobial agents is essential as the pattern of antimicrobial sensitivity may vary over period. The aim of this study was to identify the antimicrobial sensitivity pattern of the isolated uropathogens in female patients in urinary tract infection at a tertiary care hospital in Bangladesh. Methods: This observational cross-sectional type of study was conducted in the department of pharmacology and therapeutics in collaboration with department of microbiology SBMC, outpatient department of medicine, and gynaecology and obstetrics, SBMCH, Barishal, from January 2017 to December 2017. Results: In this study, age of the subjects ranging from 18 to 65 years, majority subjects (57.0%) belonged to age group of 31-44 years. The mean age was found 44.5±9.1 years. Out of 200 cases, 83% cases hailing from rural area and 17% from urban site. In this study microbial culture result of uncomplicated UTI revealed that 103 (51.5%) of urine samples had significant bacteriuria. E. coli was found to be the most prevalent 47 (45.6%), followed by Klebsiella pneumoniae 18 (17.4%), Proteus spp. 11 (10.6%) and Enterobacter spp. 9 (8.7%). Conclusions: The pattern of resistance to commonly used antimicrobials for treating UTI alerts us against indiscriminate usage of antimicrobials.

Absceso epidural intracraneal asociado a sinusitis con respuesta al tratamiento médico / Intracranial epidural abscess associated to sinusitis with positive response to medical treatment

Resumen Los abscesos epidurales son infecciones intracra neales de baja frecuencia. Pueden ocurrir derivados de procedimientos neuroquirúrgicos, o infecciones de cabeza y cuello. El tratamiento exitoso generalmente requiere la combinación de un procedimiento de drenaje y antibioticoterapia. Se presenta el caso de un paciente joven, con un absceso epidural intracraneal y meningitis, secundario a sinusitis que recibió solo tratamiento con corticoides y antibioticoterapia con buena evolución.

Abstract Epidural abscesses are rare intracranial infections. They can occur from neurosurgical procedures, or head and neck infections. Successful treatment usually re quires a combination of drainage procedure and anti biotic therapy. We present the case of a young patient with an in tracranial epidural abscess and meningitis secondary to sinusitis who received only corticosteroids and antibiotic therapy, with good evolution.

Expert perspectives on the clinical use of high-dose amoxicillin with clavulanic acid in pediatric practice in Indian settings

Background: This study was conducted to gather expert opinion regarding the clinical use of a high dose of amoxicillin 600 mg + clavulanic acid 42.9 mg in pediatric practice in Indian settings.Methods: This cross-sectional study comprised 19 questions and gathered perspectives from pediatricians across India regarding the prescription practices of amoxicillin (600 mg) and clavulanic acid (42.9 mg) for various bacterial infections in pediatric patients. Data were analyzed using descriptive statistics.Results: Majority (85.65%) of clinicians opined that the high dose of amoxicillin (600 mg) and clavulanic acid (42.9 mg) was very effective in treating bacterial infections in pediatric patients. About 54% of the respondents reported prescribing 600 mg amoxicillin + 42.9 mg clavulanic acid as the high dose for pediatric patients, while 41% of them prescribed 400 mg amoxicillin + 57 mg clavulanic acid as the high dose for pediatric patients. According to 51% of clinicians, the benefits of prescribing the higher-strength formulation of amoxicillin (600 mg) + clavulanic acid (42.9 mg) compared to the standard-strength formulation of amoxicillin (500 mg) + clavulanic acid (125 mg) include increased effectiveness against resistant bacteria, reduced risk of adverse effects, and reduced frequency of dosing.Conclusions: This study highlighted the clinicians' preference for the high dose of amoxicillin (600 mg) and clavulanic acid (42.9 mg) as an effective treatment for bacterial infections in pediatric patients. The respondents preferred the high dose over other doses of amoxicillin and clavulanic acid due to the lower percentage of adverse effects.

Caracterização dos pacientes internados por infecção odontogênica em unidade hospitalar / Characterization of patients hospitalized for odontogenic infection in a hospital unit / Caracterización de pacientes hospitalizados por infección odontogénica en una unidad hospitalaria

Introdução: As infecções orais e maxilofaciais de origem odontogênica representam uma área relevante do conhecimento médico, pois podem evoluir para quadros de alta morbidade e mortalidade. Objetivo: Avaliar o perfil dos pacientes atendidos com diagnostico de infecção de origem odontogênica em um hospital público de Mato Groso do Sul. Métodos: Trata-se de um estudo retrospectiva do tipo observacional e transversal que consistiu na análise de 68 prontuários de pacientes com diagnostico de infecção odontogênica, no período de março de 2019 a fevereiro de 2022. Resultados e Conclusão: Os resultados apontam para uma incidência de infecção odontogênica em 39,70% para a população jovem entre 16 a 28 anos, com sintomas como edema em 82,35% dos casos, seguidos de trismo 51,47% e disfagia 17,64%, uma média de internação de 6,1 dias e necessidade de traqueostomia em 10,29% dos casos. Deste modo, o cirurgião dentista em frente a processos agudos de infecção odontogênica exerce a função primordial do reconhecimento dos sintomas e intervenção precoce evitando seu agravamento... (AU)

Introduction: Oral and maxillofacial infections of odontogenic origin represent a relevant area of medical knowledge, as they can evolve into cases of high morbidity and mortality. Objective: To evaluate the profile of patients treated with a diagnosis of infection of odontogenic origin in a public hospital in Mato Groso do Sul. Methods: This is a retrospective observational and cross-sectional study that consisted of analyzing 68 medical records of patients diagnosed with odontogenic infection, from March 2019 to February 2022. Results and Conclusion: The results point to an incidence of odontogenic infection in 39.70% for the young population between 16 and 28 years old, with symptoms such as edema in 82.35% of cases, followed by trismus 51.47% and dysphagia 17.64%, an average hospital stay of 6 ,1 days and need for tracheostomy in 10.29% of cases. In this way, the dental surgeon, faced with acute pro[1]cesses of odontogenic infection, plays the primary role of recognizing the symptoms and early intervention, preventing their aggravation... (AU)

Introducción: Las infecciones orales y maxilofaciales de origen odontogénico representan un área relevante del conocimiento médico, ya que pueden evolucionar hacia casos de alta morbilidad y mortalidad. Objetivo: Evaluar el perfil de los pacientes atendidos con diagnóstico de infección de origen odontogénico en un hospital público de Mato Groso do Sul. Métodos: Se trata de un estudio observacional retrospectivo y transversal que consistió en analizar 68 historias clínicas de pacientes con diagnóstico de infección odontogénica, desde marzo de 2019 hasta febrero de 2022. Resultados y Conclusión: Los resultados apuntan a una incidencia de infección odontogénica del 39,70%. para la población joven entre 16 y 28 años, con síntomas como edema en el 82,35% de los casos, seguido de trismo 51,47% y disfagia 17,64%, estancia hospitalaria promedio de 6,1 días y necesidad de traqueotomía en el 10,29% de los casos . De esta forma, el cirujano dentista, ante procesos agudos de infección odontogénica, realiza la función primordial de reconocer los síntomas e intervenir precozmente, evitando su agravamiento... (AU)

Diagnostic accuracy of pocket-size lung ultrasound for etiological definition of pneumonia and surveillance of complications in children hospitalized: a prospective diagnostic cohort study

Background: Pneumonia, the leading infectious cause of death in children worldwide, often requires a chest radiograph (CXR) for diagnosis, involving radiation exposure. Point-of-Care Ultrasound (POCUS) offers a radiation-free alternative and, specifically the pocket-size variant, enhances convenience at the patient's bedside. While evidence supports ultrasound's accuracy in detecting community-acquired pneumonia (CAP) in children comparable to CXR, few studies have explored its ability to distinguish pneumonia etiology, especially utilizing pocket-size POCUS devices. Methods: In this prospective diagnostic cohort study conducted over a year in a tertiary pediatric referral center, we aim to assess the diagnostic accuracy of a pocket-size POCUS device compared to CXR for determining the etiology of CAP in pediatric patients (aged >6 months and <18 years). At least 76 participants diagnosed with CAP will undergo independent POCUS examinations at various intervals, complemented by CXRs when necessary, independently classified by a third investigator. The General Electrics Vscan AirTM®, featuring Bluetooth connectivity to smartphone/tablet, will be employed for POCUS. Data collection will include systematized POCUS and CXR descriptions, alongside sociodemographic, clinical, and therapeutic variables. Statistical analysis using SPSS® version 28 will evaluate the diagnostic accuracy of the POCUS device. Conclusions: This trial's outcomes hold significant promise in unveiling unknown data about the diagnostic accuracy of pocket-size POCUS for pediatric CAP etiological diagnosis. Utilizing a device meeting technical recommendations, featuring a dual-headed probe and Bluetooth connectivity, this study has the potential to bring innovation to clinical practice, improving patient care and creating scientific value. Trial Registration Number: NCT06296693.

Bacterial profiling, sensitivity and resistance pattern of neonatal sepsis in neonatal intensive care unit of tertiary care hospital

Background: This study aimed to identify the distribution of pathogens and their antimicrobial resistance patterns in the neonates admitted to the NICU of a tertiary care hospital in northern India.Methods: After obtaining written informed consent, neonates with confirmed or suspected cases of neonatal sepsis (n=167) aged 0-28 days were included. As soon as the baby arrived, all the clothes were removed and kept in a pre-heated warmer. Before administering I/V antibiotics, all the routine and culture samples were taken. The clinical data were collected and analysed using SPSS.Results: Most of the neonates were from lower middle class, out-born, LSCS, early preterm, and low birth weight (LBW). 167 neonates had culture-confirmed infections [blood culture positive (13.8%) and sepsis screen positive (86.2%)]. Gastric aspirate cytology was positive in 61.7% of patients. Maximum cytology-positive cases were seen in neonates with EOS. The most common risk factors were birth asphyxia. 142 individuals were discharged, with 72.5% diagnosed with EOS and 89% with LOS. There was a significant difference in gastric aspirate cytology when associated with expiry and discharge. Out of 167 neonates, 13.77% were culture-positive for neonatal sepsis. Out of 23 organisms, 82.6% were resistant, while, 17.4% were not. Staph aureus was the major causative organisms. Among the Gram Positive and Negative bacteria, the highest sensitivity was observed for imipenum. All gram-positive bacteria were resistant to cotrimazole, tobramycin, and erythromycin.Conclusions: Implementation of effective preventive strategies to combat the emergence of antibiotic resistance is urgently needed.

Obtención de celulasas bacterianas usando residuos orgánicos generados en plazas de mercado / Bacterial cellulases obtention from organic wastes generated in marketplaces

RESUMEN Los residuos agrícolas son una fuente de celulosa que puede ser aprovechada para producir enzimas hidrolíticas, como las celulasas, mediante acción microbiana. Estas celulasas son utilizadas en procesos extractivos de biomoléculas, en la producción de biogás, en la industria textil, detergente, alimentaria y del papel. El propósito del estudio es la obtención de celulasas bacterianas utilizando residuos orgánicos, generados en plazas de mercado. Se realizaron dos medios de cultivo (A1 y A2), a partir de ameros de mazorca y cáscaras de leguminosas, ajustando el pH del medio A1 a 7,0 y el de A2 a 5,0. Los medios fueron fermentados por 75 horas, mediante la cepa bacteriana C6M2, aislada de residuos de plazas de mercado, monitoreando la actividad enzimática, la concentración de azúcares reductores y la celulosa residual. La máxima actividad celulolítica se logró a las 56 horas de fermentación en A1 y a las 32 horas, en A2. El extracto enzimático se precipitó, dializó y ultrafiltró, obteniendo una actividad final de 9,07 ± 0,48 U/mL. Los ameros y las cáscaras de leguminosa se pueden aprovechar como sustratos en la producción de celulasas, con posibles aplicaciones en procesos donde requieran bajos grados de pureza.

ABSTRACT Agricultural wastes are a source of cellulose that could be used to produce hydrolytic enzymes such as cellulases by microbial action. Cellulases are used in the extractive process of biomolecules, in biogas production, textile, detergent, food, and paper industry. The study purpose is the obtention of bacterial cellulases using organic wastes generated in marketplaces. Two culture media were done (A1 and A2) with corn cob leaves and legume seed pods adjusting the A1 medium pH at 7.0 and the A2 pH at 5.0. The media were fermented for 75 hours by the bacterial strain C6M2, isolated from marketplace wastes, and the enzyme activity, reducing sugar concentration, and residual cellulose were monitored. The maximum cellulolytic activity was obtained at 56 hours of fermentation in A1 and in A2 it was at 32 hours. The enzyme extract was precipitated, dialyzed and ultra-filtrated obtaining a final activity of 9.07 ± 0.48 U/mL. The corn cob leaves and legume seed pods can be used as substrates in the production of cellulases which might be applied in processes with low requirements of enzyme purity.

Endocarditis por Haemophilus aphrophilus

La endocarditis infecciosa (EI) es una enfermedad causada por microorganismos que se asientan principalmente en las válvulas cardiacas. Frecuentemente ocurren por laceraciones orales, gastrointestinales y urogenitales, además de procedimientos médicos que pueden causar bacteriemia la cual conlleva a adherencia bacteriana e inflamación local y éstas a destrucción valvular(1,2). Las bacterias grampositivas son mayoritariamente asociadas a EI, y en menor proporción, las del grupo HACEK, saprofitos de la orofaringe, que son responsables de menos del 5% de casos(2-4). Se presenta el caso de un varón de 23 años con cuadro de 1 mes de evolución de sensación febril, sudoración y astenia; al que posteriormente se agrega tos productiva. Se plantea foco probable cardiológico por antecedentes y hallazgos físicos, retornando aislamiento del germen Haemophilus aphrophilus, microorganismo poco habitual.

Infective endocarditis (IE) is a disease caused by microorganisms that settle mainly in the heart valves. They frequently occur due to oral, gastrointestinal and urogenital lacerations, in addition to medical procedures that can cause bacteremia which leads to bacterial adhesion and local inflammation and these to valve destruction(1,2).. Gram-positive bacteria are mostly associated with IE, and to a lesser extent, those of the HACEK group, saprophytes of the oropharynx, which are responsible for less than 5% of cases(2-4). We present the case of a 23-year-old man with a 1-month history of fever, sweating, and asthenia; to which a productive cough is later added. A probable cardiological focus is proposed due to history and physical findings, returning isolation of the Haemophilus aphrophilus germ, an unusual microorganism.

Determinantes sociales de la salud y prevención de infecciones de transmisión sexual en estudiantes de una institución educativa del Perú / Social determinantsof health and prevention of sexually transmitted infections in students of an educational institution in Perú

Objetivo: Establecer la relación entre los determinantes sociales de la salud y prevención de infecciones de transmisión sexual en estudiantes de una Institución Educativa del Perú. Material y métodos: Estudio descriptivo, con enfoque cuantitativo, nivel correlacional y diseño no experimental, donde se contó con una muestra de 144 estudiantes, evaluados mediante un instrumento como el cuestionario estructurado, validado y con un nivel alto de confiabilidad. Resultados: Evidenciaron que la prevención de ITS mostró una relación significativa con las dimensiones biológico, estilo de vida y el sistema sanitario, donde el p valor alcanzado fue de 0,000, así como una correlación positiva media, donde los coeficientes obtenidos fueron 0,500, 0.485 y 0,434 respectivamente. Conclusiones: Predominó una relación significativa, así como una correlación positiva considerable entre las variables evaluadas, por lo mismo que se contó con un p valor de 0.000 y un coeficiente de 0,642 correspondientemente

Objective: To establish the relationship between the social determinants of health and the prevention of sexually transmitted infections in students of an educational institution in Peru. Material and method:descriptive study, with a quantitative approach, correlational level and non-experimental design, where there was a sample of 144 students, evaluated using an instrument such as the structured questionnaire, validated and with a high level of reliability. Results:Showed that STI prevention showed a significant relationship with the biological, lifestyle and health system dimensions, where the p value achieved was 0.000, as well as a mean positive correlation, where the coefficients obtained were 0.500, 0.485 and 0.434 respectively. Conclusions: A significant relationship predominated, as well as a considerable positive correlation between the variables evaluated, for the same reason that there was a p value of 0.000 and a coefficient of 0.642 respectively

Adesão aos bundles de prevenção a infecções relacionadas à assistência à saúde / Adherence to bundles for prevention of infections related to health cares / Adhesión a los paquetes para la prevención de infecciones relacionadas com la atención médica

Objetivo: Analisar a adesão aos bundles de prevenção a infecções relacionadas a assistência à saúde. Métodos: Trata-se de um estudo transversal, realizado com dados secundários a partir de registros em fichas de notificação e investigação, além de prontuários de pacientes. Foram analisados Bundles de prevenção para Pneumonia por Assistência Ventilatória, Cateter Venoso Central, Cateter Vesical de Demora e Higiene de Mãos. Estatísticas descritivas e de tendência central foram aplicadas a todas as variáveis. Resultados: A adesão ao Bundle de Pneumonia por Assistência Ventilatória mostrou índices médios de 56,6%. Em relação ao de Cateter Vesical de Demora sua adesão alcançou 100% na maioria dos meses estudados. Para o Bundle de Cateter Venoso Central houve prevalência de 97,1% de adesão. Já a adesão a higienização das mãos, apontou resultados superiores a 94,2%, chegando a 97,1%. Conclusão: A assistência aos pacientes deve ocorrer de forma sistemática e multidisciplinar pelos profissionais de saúde para que medidas corretas e eficazes sejam adotadas. (AU)

Objective: To analyze adherence to healthcare-related infection prevention bundles. Methods: This is a cross-sectional study, performed with secondary data from records in notification and investigation forms, in addition to patient records. Bundles for prevention of Pneumonia by Ventilatory Assistance, Central Venous Catheter, Delayed Vesical Catheter and Hand Hygiene were analyzed. Descriptive and central tendency statistics were applied to all variables. Results: Adherence to the Pneumonia Bundle for Ventilatory Assistance showed average rates of 56.64%. In relation to the Demora Vesical Catheter, its adherence reached 100% in most months studied. For the Central Venous Catheter Bundle there was a prevalence of 97.06% adherence. Adherence to hand hygiene showed results above 94.23%, reaching 97.14%. Conclusion: Patient care must occur in a systematic and multidisciplinary way by health professionals so that correct and effective measures are adopted. (AU)

Objetivo: analizar la adherencia a los paquetes de prevención de infecciones relacionadas con la salud. Métodos: Se trata de un estudio transversal, realizado con datos secundarios de registros en formularios de notificación e investigación, además de histórias clínicas. Se analizaron los paquetes para la prevención de la neumonía por asistencia ventilatoria, catéter venoso central, catéter vesical retardado e higiene de manos. A todas las variables se les aplicó estadística descriptiva y de tendencia central. Resultados: La adherencia al paquete de neumonía para asistencia respiratoria mostró tasas promedio de 56,64%. En relación al Catéter Demora Vesical, su adherencia alcanzó el 100% en la mayoría de los meses estudiados. Para el paquete de catéter venoso central hubo una prevalencia de adherencia del 97,06%. La adherencia a la higiene de manos mostró resultados superiores al 94,23%, alcanzando el 97,14%. Conclusión: La atención al paciente debe darse de forma sistemática y multidisciplinar por parte de los profesionales sanitarios para que se adopten las medidas correctas y eficaces. (AU)

Bacterial vaginosis and the role of prebiotics and probiotics: current practices

Bacterial vaginosis (BV) is characterized by overgrowth of opportunistic bacteria and a decrease in the levels of Lactobacilli. BV is commonly encountered by gynaecologists practicing in India. The opinions of 21 gynaecologists across India regarding diagnosis and management of BV were sought via focussed group discussions. In Indian women, BV is more common in the reproductive age group, perimenopausal women, women with polycystic ovarian disease (PCOD), pregnant women, and in teenagers/pubertal age group. BV is often underestimated as it is not diagnosed by family physicians. The panel of experts opined that they preferred to conduct screening for BV in all high-risk pregnant cases, women with bad obstetric history such as premature abortions and women with a history of tuberculosis. One challenge faced by clinicians in the real-world setting is recurrent infections of BV in their patients. For the treatment of BV, antibiotics can be prescribed along with pre-probiotics to avoid dysbiosis and to prevent recurrence of BV. Pre-probiotics should be administered in sufficient amounts for adequate management of BV. More than 80% of Lactobacilli species should be present in an ideal pre-probiotic to ensure adequate production of acid and bacteriocins for the destruction of unhealthy bacteria and prevention of microfilm formation. The results with the pre-probiotics used will depend on the quality of the formulation and the maintenance of the cold chain. Prebiotic -probiotic supplementation may be considered a new adjuvant treatment for BV.

Pregnancy outcome in women with bacterial vaginosis

Background: Bacterial vaginosis is a condition characterized by alteration in the vaginal flora. It is a common occurrence during pregnancy and is one of the established risk factors for preterm delivery, premature rupture of membranes and chorioamnionitis. The objective of the study was to study the prevalence and effects of bacterial vaginosis during pregnancy.Methods: : The study was a hospital based prospective study conducted in the department of obstetrics and gynaecology, RIMS, Imphal from January to December, 2021. 250 women between 20-28 weeks of gestation underwent examination and testing for bacterial vaginosis and were followed up till delivery. Pregnancy outcomes like pre-term labour, premature rupture of membrane; fetal outcomes like birth-weight, APGAR score, NICU admission, or any other complications were noted.Results: Out of the 250 singleton pregnancies, 48 women (19.2%) were found to have bacterial vaginosis. Pregnancies associated with bacterial vaginosis had more chances of premature rupture of membranes, low birth weight babies. But, there was no significant association of the same to preterm labor and to the rate of NICU admission of the newborns.Conclusions: Vaginal infection during pregnancy should also be entertained seriously and treated well since bacterial vaginosis may directly or indirectly be related to preterm delivery and low birth weight babies.

Resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario en pacientes ambulatorios / Antimicrobial resistance of Enterobacteriaceae causing urinary tract infection in ambulatory patients / Resistência antimicrobiana de Enterobacteriaceae causadora de infecção do trato urinário em pacientes ambulatoriais

Las infecciones del tracto urinario son consideradas un problema de salud a nivel hospitalario y comunitario por el aumento de bacterias resistentes a los antibióticos. Objetivo: Analizar el patrón de susceptibilidad y resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario. Métodos: Se aplicó una investigación descriptiva de diseño documental. La población fue de 672 registros de urocultivos positivos, recopilados de la base de datos del Laboratorio San Pablo en el periodo 2021-2022. Para su tabulación y análisis los datos obtenidos fueron procesados en el Software SPSS versión 25.0. Resultados: Las ITU se presentan con mayor frecuencia en el género femenino 86,5%. El grupo etario con más afección es la edad adulta 50,4%. El agente etiológico con mayor incidencia fue Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. La producción de BLEE como mecanismo de resistencia predominaron en las cepas de E.coli y Klebsiella spp. Se encontró un mayor porcentaje de resistencia para Ampicilina y SXT. Los antibióticos con mejor sensibilidad destacaron nitrofurantoína, fosfomicina. Conclusión: La especie con mayor aislamiento, implicada en la etiología de infecciones urinarias sigue siendo E.coli con una sensibilidad alta para nitrofurantoína y fosfomicina.

Urinary tract infections are considered a health problem at hospital and community level due to the increase of antibiotic resistant bacteria. Objective: To analyze the pattern of susceptibility and antimicrobial resistance of Enterobacteriaceae causing urinary tract infection. Methods: A descriptive research of documentary design was applied. The population was 672 records of positive urine cultures, collected from the San Pablo Laboratory database in the period 2021-2022. For tabulation and analysis, the data obtained were processed in SPSS software version 25.0. Results: UTIs occur more frequently in females 86.5%. The age group with the highest incidence was adulthood 50.4%. The etiological agent with the highest incidence was Escherichia coli 75.74%, Citrobacter Freundii 8.93%, Klebsiella spp 6.10%. The production of BLEE as a mechanism of resistance predominated in the strains of E.coli and Klebsiella spp. A higher percentage of resistance was found for Ampicillin and SXT. The antibiotics with the best sensitivity were nitrofurantoin and fosfomycin. Conclusion: The species with the highest isolation, implicated in the etiology of urinary tract infections, continues to be E.coli with a high sensitivity to nitrofurantoin and fosfomycin.

As infecções do trato urinário são consideradas um problema de saúde a nível hospitalar e comunitário devido ao aumento de bactérias resistentes aos antibióticos. Objetivo: Analisar o padrão de suscetibilidade e resistência antimicrobiana das Enterobacteriaceae causadoras de infecções do trato urinário. Métodos: Foi aplicada uma metodologia de investigação documental descritiva. A população foi de 672 registros de culturas de urina positivas, coletados do banco de dados do Laboratório San Pablo no período de 2021-2022. Para tabulação e análise, os dados obtidos foram processados no software SPSS versão 25.0 Resultados: As ITUs ocorreram com maior frequência no sexo feminino 86,5%. A faixa etária com maior incidência foi a adulta 50,4%. O agente etiológico com maior incidência foi a Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. A produção de BLEE como mecanismo de resistência predominou em E. coli e Klebsiella spp. Foi encontrada uma maior percentagem de resistência para a ampicilina e o SXT. Os antibióticos com melhor sensibilidade foram a nitrofurantoína e a fosfomicina. Conclusão: A espécie com maior isolamento, implicada na etiologia das infecções do trato urinário, continua a ser a E. coli com uma elevada sensibilidade à nitrofurantoína e à fosfomicina.

Síndrome de piel escaldada asociado a estafilococcemia en un neonato: reporte de un caso / Scalded skin syndrome associated with staphylococcemia in a neonate: a case report

RESUMEN El síndrome de piel escaldada estafilocócica es una patología poco frecuente que principalmente afecta a población pediátrica. Si bien en la mayoría de los casos tiene un desenlace favorable, un buen diagnóstico diferencial y manejo antibiótico oportuno son cruciales para un buen pronóstico. Objetivo: Describir un caso de síndrome de piel escaldada con aislamiento en hemocultivos de S. Aureus meticilino resistente en un neonato. Caso clínico: Femenina de 25 días de vida, nacida a término y sin antecedentes perinatales relevantes que cursa con fiebre, dermatosis eritemato-descamativa generalizada, edema palpebral y de miembros inferiores. Se hospitalizó con diagnóstico de sepsis neonatal tardía y sindrome de piel escaldada. Reporte de hemocultivos con crecimiento de S. Aureus meticilino resistente, manejada con vancomicina durante 14 días. Control de hemocultivos negativos, evolución satisfactoria y de alta hospitalaria sin complicaciones. Conclusiones: A pesar de la baja incidencia del síndrome de piel escaldada, es importante incluir dentro del diagnóstico diferencial de la fiebre y las dermatosis tardías del neonato la infecciones por toxinas del S. Aureus, ya que su identificación y tratamiento oportuno son de gran importancia en el pronóstico del menor.

ABSTRACT Staphylococcal scalded skin syndrome is a rare pathology, which mainly affects pediatric population. Although in most cases it has a favorable outcome, making a good differential diagnosis and early antibiotic management are crucial for a good prognosis. Objective: To describe a case of scalded skin syndrome with methicillin-resistant S. aureus bloodstream infection in a newborn. Clinical case: A 25-day-old female, born at term and with no relevant perinatal history, presented with fever, generalized scaly erythematous dermatosis, eyelid and lower limb edema. She is hospitalized with a diagnosis of late neonatal sepsis and scalded skin syndrome. Report of blood cultures with growth of methicillin-resistant S. Aureus, managed with vancomycin for 14 days. Control cultures were negative, satisfactory evolution and hospital discharge without complications. Conclusions: Despite the low incidence of scalded skin syndrome, it is important to include S. aureus toxin infections in the differential diagnosis of fever and late-onset dermatoses in the newborn. The identification and early treatment are of great importance in the prognosis of the child.

Vacinas passado e futuro ­ Reflexões para discussão / The past and future of vaccines ­ Reflections for discussion

Neste artigo de opinião, apresento uma breve história do desenvolvimento de vacinas, comentando sobre as formas clássicas de produção de vacinas utilizando o próprio agente infeccioso. Em seguida, abordo as vacinas virais, discutindo seus benefícios e dificuldades e a questão dos sorotipos virais, bem como as vacinas bacterianas e seu relativo sucesso. Apresento nossos estudos sobre doença cardíaca reumática e o desenvolvimento de uma vacina contra infecções estreptocócicas. Também discuto plataformas vacinais, especialmente os sucessos alcançados com vacinas de vetores virais não replicantes e, acima de tudo, o grande êxito das vacinas de RNA mensageiro (mRNA). As vacinas de mRNA tornaram-se possíveis somente após os avanços obtidos com a substituição de nucleotídeos que reduziam a ação da imunidade inata. Serão todas as vacinas desenvolvidas a partir de mRNA no futuro? Em seguida, abordo a questão das vias de administração de vacinas, seja por via subcutânea, intradérmica, intramuscular ou nasal. Exponho dados do meu laboratório sobre o desenvolvimento de uma vacina de instilação nasal que induziu uma resposta de proteção da mucosa, prevenindo a infecção e, consequentemente, a transmissão do SARS-CoV-2. Posteriormente, discuto quais vacinas futuras poderiam ser desenvolvidas para além das doenças infecciosas agudas. Por fim, discuto as vantagens do desenvolvimento de vacinas seguras, eficazes e de uso múltiplo, bem como a forma de torná-las acessíveis à população mundial, promovendo a equidade em saúde.

In this opinion article, I provide a brief history of vaccine development, commenting on the classic ways of producing vaccines using the infectious agent itself. I address viral vaccines, discussing their benefits and challenges and the issue of viral serotypes, as well as bacterial vaccines and their relative success. I present our studies on rheumatic heart disease and the development of a vaccine against streptococcal infection. I also discuss vaccine platforms, highlighting the success achieved with non-replicating viral vector-based vaccines and, especially, with messenger RNA (mRNA) vaccines. mRNA vaccines only became possible after the advances provided by the replacement of nucleotides that reduced the action of the innate immune system. Will all vaccines be made from mRNA in the future? Then, I address the issue of vaccine administration routes, whether subcutaneously, intradermally, intramuscularly, or intranasal. I present data from my laboratory on the development of an intranasal vaccine that induced a protective mucosal response, preventing infection and, consequently, the transmission of SARSCoV- 2. I discuss which future vaccines could be developed beyond acute infectious diseases. Finally, I discuss the advantages of developing safe, effective, multiple-use vaccines and how to make them accessible worldwide by promoting health equity.

A COMPARATIVE STUDY TO EVALUATE EFFICACY AND SAFETY OF TOPICAL CIPROFLOXACIN V/S FORTIFIED GENTAMICIN-CEFTAZIDIME IN BACTERIAL KERATITIS” AT A TERTIARY CARE CENTRE IN TELANGANA

Objective: To compare the efficacy and safety of topical ciprofloxacin v/s fortified gentamicin-ceftazidime in bacterial keratitis.Methods: This was a randomized control trial done on 60 subjects with 30 subjects in each group. The clinical signs and symptoms are recorded in two groups of bacterial keratitis patients at baseline and after 2 w of treatment using ciprofloxacin ophthalmic solution and standard therapy regimen of fortified gentamicin-ceftazidime using scoring of ocular signs and symptoms (1=minimum, not present), (5=maximum, severe) with a study period of 3 moResults: The group administered with fortified ceftazidime+gentamicin demonstrated superior clinical and statistical efficacy compared to ciprofloxacin in treating bacterial keratitis. This regimen led to a substantial alleviation of symptoms and minimized ocular discomfort to a greater extent. Notably, the calculated p-value for the day 14 score, standing at 0.02 (below the 0.05 threshold), underscores the significant superiority of fortified ceftazidime+gentamicin in symptom reduction.Conclusion: We conclude that fortified ceftazidime+gentamicin is better than ciprofloxacin for the treatment of bacterial keratitis.

Uso de antimicrobianos en la unidad de cuidados intensivos de un hospital público de Loreto / Use of antimicrobials in the intensive care unit of a Loreto public hospital

RESUMEN Introducción. El uso inapropiado de antimicrobianos en las unidades de cuidados intensivos (UCI) contribuye a la resistencia bacteriana. Objetivo. El propósito del presente estudio fue medir el uso y tipo de antimicrobianos en los pacientes hospitalizados en la Unidad de Cuidados Intensivos del Hospital Regional de Loreto (HRL). Métodos. Estudio de tipo descriptivo. Revisamos 120 historias clínicas en pacientes de UCI-HRL desde enero a junio 2023. Resultados. La mayoría de los pacientes usaron antimicrobianos (74,2%), indicados por shock séptico (42,7%), de 1 a 3 antimicrobianos (93,2%), con terapia de 1 a 3 días (45%). Del total de antimicrobianos usados, la mayor proporción fueron bactericidas 89 (90,4%), de la familia de cefalosporinas (33,1%) y carbapenémicos (23,5%); los fármacos más empleados fueron ceftriaxona (26,5%) y meropenem (21,1%) por vía intravenosa (90,4%). Conclusión. La mayor proporción de pacientes hospitalizados usan antimicrobianos de la familia de cefalosporinas y carbapenémicos.

ABSTRACT Introduction. Inappropriate use of antimicrobials in the Intensive Care Unit (ICU) contributes to bacterial resistance. Objective. The purpose of the present study was to measure the use and type of antimicrobials in patients hospitalized in the Intensive Care Unit of the Loreto Regional Hospital (HRL). Methods. Descriptive study. We reviewed 120 medical records in ICU-HRL patients from January to June 2023. Results. Most patients used antimicrobials (74.2%), indicated for septic shock (42.7%), 1 to 3 antimicrobials (93.2%), with therapy of 1 to 3 days (45%). Of the total number of antimicrobials used, the greatest proportion were bactericides 89 (90.4%), from the cephalosporin family (33.1%) and carbapenemics (23.5%); the most commonly used drugs were ceftriaxone (26.5%) and meropenem (21.1%) by the intravenous route (90.4%). Conclusion. The highest proportion of hospitalized patients use antimicrobials of the cephalosporin and carbapenemics family.

Competencias cognitivas sobre profilaxis antibiótica de endocarditis infecciosa en estudiantes de odontología

Introducción: La endocarditis infecciosa es una enfermedad con riesgo de mortalidad que se puede originar por un tratamiento odontológico. Por ello, los cirujanos dentistas deben tener conocimientos básicos sobre la prevención de endocarditis infecciosa. Objetivo: Determinar el nivel de conocimientos sobre la profilaxis antibiótica de endocarditis infecciosa previa a procedimientos odontológicos en estudiantes de pregrado y posgrado de estomatología. Métodos: Se diseñó un estudio descriptivo y transversal cuya muestra estuvo formada por 74 estudiantes de pregrado y 234 de posgrado de la carrera de Estomatología de la Universidad Científica del Sur en el año 2019. Se empleó un cuestionario previo validado en el Perú, conformado por 20 preguntas de opción múltiple y dividido en 4 dimensiones (epidemiología, etiopatogenia, indicación y farmacología de la profilaxis antibiótica de endocarditis infecciosa). Los resultados se categorizaron en nivel de conocimiento bajo, regular y alto. Resultados: El 73,1 % de los estudiantes presentó un nivel de conocimiento global bajo, mientras que el 23,7 % presentó un nivel regular y el 3,2 %; un nivel alto. La calificación promedio fue 8,71 ± 2,78 [IC95 % 8,40 a 9,10]. Los estudiantes de pregrado tuvieron un puntaje de 8,64 ± 2,72 [IC95 % 8,01 a 9,26] y los de posgrado; 8,74 ± 2,80 [IC95 % 8,38 a 9,10]. Conclusión: El nivel de conocimiento sobre profilaxis antibiótica para la prevención de endocarditis infecciosa previa a procedimientos odontológicos es bajo en pregrado y posgrado.

Introduction: Infective endocarditis is a potentially life-threatening disease that can be caused by dental treatment. Therefore, dental surgeons should have basic knowledge about the prevention of infective endocarditis. Objective: To determine the level of knowledge of antibiotic prophylaxis of infective endocarditis prior to dental procedures in undergraduate and postgraduate students of stomatology at the Universidad Cientifica del Sur, Lima - Peru. Method: A descriptive and cross-sectional study was designed with a sample of 74 undergraduate and 234 graduate students of the Universidad Cientifica del Sur Stomatology career in 2019. A questionnaire previously validated in Peru was used, consisting of 20 multiple-choice questions, and divided into 4 dimensions (epidemiology, etiopathogenesis, indication, and pharmacology of antibiotic prophylaxis of infective endocarditis). The results were categorized into low, regular, and high levels of knowledge. Results: 73.1% of the students presented a low level of global knowledge, while 23.7% presented a regular level, and 3.2% a high level. The average score was 8.71 ± 2.78 [95% CI 8.40 to 9.10]. Undergraduate students had a score of 8.64 ± 2.72 [95% CI 8.01 to 9.26] and graduate students; 8.74 ± 2.80 [95% CI 8.38 to 9.10]. Conclusion: The level of knowledge of antibiotic prophylaxis for the prevention of infective endocarditis prior to dental procedures was predominantly low in undergraduate and postgraduate students.

Infecciones cervicovaginales en la prueba de Papanicolaou de pacientes asintomáticas

Introducción: La prueba de Papanicolaou estudia las células exfoliadas de la unión escamo-columnar del cuello uterino para la detección de células anómalas y también es útil para el diagnóstico de infecciones cervicovaginales. Objetivo: Caracterizar a las pacientes con infecciones cervicovaginales asintomáticas, diagnosticadas por prueba de Papanicolaou. Métodos: Se realizó una investigación observacional, descriptiva y transversal, en 656 pacientes con infección cervicovaginal asintomática, diagnosticadas por prueba de Papanicolaou. Se estudiaron: gérmenes, edad, inicio de las relaciones sexuales, número de compañeros sexuales, anomalías de células epiteliales cervicales. La información se obtuvo mediante interrogatorio, examen clínico y prueba de Papanicolaou. Se utilizaron técnicas de estadística descriptiva para el cálculo de las frecuencias absolutas, porcentajes, media y desviación estándar. Resultado: Se halló un predominio de la vaginosis bacteriana (46 %), seguido de la infección por Candida spp (38,2 %). La edad media de las pacientes fue de 36,4 años. Se observó que en 244 mujeres la edad de inicio de las relaciones sexuales fue de 16 - 20 años (37,2 %). Tuvieron un compañero sexual activo 531 casos (80,9 %). El 86 % no presentó lesiones cervicales, pero el 72,7 % de las infecciones por VPH sí tuvieron. Conclusiones: La generalidad de las mujeres tiene vaginosis bacteriana, son adultas, con inicio precoz de las relaciones sexuales y un compañero sexual activo. Gran parte no presentan lesiones cervicales, la mayoría, con infección por VPH, poseen anomalías de las células epiteliales cervicales.

Introduction: The Papanicolaou test studies the exfoliated cells of the squamo-columnar junction of the cervix for the detection of abnormal cells and is also useful for the diagnosis of cervicovaginal infections. Objective: To characterize patients with asymptomatic cervicovaginal infections diagnosed by Papanicolaou test. Methods: An observational, descriptive and cross-sectional investigation was carried out in 656 patients with asymptomatic cervicovaginal infection, diagnosed by Papanicolaou test. The following were studied: germs, age, initiation of sexual relations, number of sexual partners, anomalies of cervical epithelial cells. The information was obtained through interrogation, clinical examination and Papanicolaou test. Descriptive statistical techniques were used to calculate absolute frequencies, percentages, mean and standard deviation. Result: A predominance of bacterial vaginosis was found (46%), followed by Candida spp infection (38.2%). The average age of the patients was 36.4 years. It was observed that in 244 women the age at which sexual relations began was 16 - 20 years (37.2%). 531 cases (80.9%) had an active sexual partner. 86% did not present cervical lesions, but 72.7% of HPV infections did. Conclusions: The majority of women have bacterial vaginosis, they are adults, with early onset of sexual relations and an active sexual partner. Most of them do not have cervical lesions, the majority, with HPV infection, have anomalies of the cervical epithelial cells.