Data gaps and opportunities for comparative and conservation biology.

Biodiversity loss is a major challenge. Over the past century, the average rate of vertebrate extinction has been about 100-fold higher than the estimated background rate and population declines continue to increase globally. Birth and death rates determine the pace of population increase or decline, thus driving the expansion or extinction of a species. Design of species conservation policies hence depends on demographic data (e.g., for extinction risk assessments or estimation of harvesting quotas). However, an overview of the accessible data, even for better known taxa, is lacking. Here, we present the Demographic Species Knowledge Index, which classifies the available information for 32,144 (97%) of extant described mammals, birds, reptiles, and amphibians. We show that only 1.3% of the tetrapod species have comprehensive information on birth and death rates. We found no demographic measures, not even crude ones such as maximum life span or typical litter/clutch size, for 65% of threatened tetrapods. More field studies are needed; however, some progress can be made by digitalizing existing knowledge, by imputing data from related species with similar life histories, and by using information from captive populations. We show that data from zoos and aquariums in the Species360 network can significantly improve knowledge for an almost eightfold gain. Assessing the landscape of limited demographic knowledge is essential to prioritize ways to fill data gaps. Such information is urgently needed to implement management strategies to conserve at-risk taxa and to discover new unifying concepts and evolutionary relationships across thousands of tetrapod species.

Transmission of malaria from donors to solid organ transplant recipients: A case report and literature review.

Malaria is a febrile and potentially fatal infection. It is typically transmitted to humans through the bite of Anopheles mosquitoes and less frequently can be contracted through blood transfusions, sharing contaminated needles and syringes, mother-to-child transmission, or after solid organ transplantation. Posttransplant malaria has rarely been reported in the literature, even in endemic areas. We report the cases of three solid organ recipients in which Plasmodium vivax infection was documented during postsurgical evaluation 30 days after transplant surgery. The diagnosis of donor-derived malaria was confirmed in all patients by demonstrating Plasmodium in a peripheral blood smear and by polymerase chain reaction (PCR). All recipients had symptoms. The liver transplant recipient had myalgia, arthralgia, and thrombocytopenia; the kidney transplant recipient developed acute renal failure; and the heart transplant recipient had fever, cephalalgia, and tonic-clonic seizures. Pre-transplant screening of donors and recipients from endemic regions may not be sufficient to safely rule out persistent malaria. In Colombia, according to legislation, no mandatory testing is required for the diagnosis of malaria in organ donors in nonendemic areas. Therefore, donor screening by questionnaire is the only tool for preventing transplant-borne malaria. The migratory trend from Venezuela to Colombia has increased the number of imported cases of malaria, and the infection may be present in endemic and nonendemic regions. Although donor evaluation is not standardized in current guidelines, we suggest that donors be tested for malaria with a peripheral blood smear, detection of specific IgG antibodies against Plasmodium, and techniques such as PCR, if possible.

Mates Matter: Gametophyte Kinship Recognition and Inbreeding in the Giant Kelp, Macrocystis pyrifera (Laminariales, Phaeophyceae).

Inbreeding, the mating between genetically related individuals, often results in reduced survival and fecundity of offspring, relative to outcrossing. Yet, high inbreeding rates are commonly observed in seaweeds, suggesting compensatory reproductive traits may affect the costs and benefits of the mating system. We experimentally manipulated inbreeding levels in controlled crossing experiments, using gametophytes from 19 populations of Macrocystis pyrifera along its Eastern Pacific coastal distribution (EPC). The objective was to investigate the effects of male-female kinship on female fecundity and fertility, to estimate inbreeding depression in the F1 progeny, and to assess the variability of these effects among different regions and habitats of the EPC. Results revealed that the presence and kinship of males had a significant effect on fecundity and fertility of female gametophytes. Females left alone or in the presence of sibling males express the highest gametophyte size, number, and size of oogonia, suggesting they were able to sense the presence and the identity of their mates before gamete contact. The opposite trend was observed for the production of embryos per female gametes, indicating higher costs of selfing and parthenogenesis than outcrossing on fertility. However, the increased fecundity compensated for the reduced fertility, leading to a stable overall reproductive output. Inbreeding also affected morphological traits of juvenile sporophytes, but not their heatwave tolerance. The male-female kinship effect was stronger in high-latitude populations, suggesting that females from low-latitude marginal populations might have evolved to mate with any male gamete to guarantee reproductive success.

Presence of two mitochondrial genomes in the mytilid Perumytilus purpuratus: Phylogenetic evidence for doubly uniparental inheritance.

This study presents evidence, using sequences of ribosomal 16S and COI mtDNA, for the presence of two mitochondrial genomes in Perumytilus purpuratus. This may be considered evidence of doubly uniparental mtDNA inheritance. The presence of the two types of mitochondrial genomes differentiates females from males. The F genome was found in the somatic and gonadal tissues of females and in the somatic tissues of males; the M genome was found in the gonads and mantle of males only. For the mitochondrial 16S region, ten haplotypes were found for the F genome (nucleotide diversity 0.004), and 7 haplotypes for the M genome (nucleotide diversity 0.001), with a distance Dxy of 0.125 and divergence Kxy of 60.33%. For the COI gene 17 haplotypes were found for the F genome (nucleotide diversity 0.009), and 10 haplotypes for the M genome (nucleotide diversity 0.010), with a genetic distance Dxy of 0.184 and divergence Kxy of 99.97%. Our results report the presence of two well-differentiated, sex-specific types of mitochondrial genome (one present in the male gonad, the other in the female gonad), implying the presence of DUI in P. purpuratus. These results indicate that care must be taken in phylogenetic comparisons using mtDNA sequences of P. purpuratus without considering the sex of the individuals.

Predictors of mortality in hospitalised patients with COVID-19: a 1-year case-control study.

BACKGROUND: A paucity of predictive models assessing risk factors for COVID-19 mortality that extend beyond age and gender in Latino population is evident in the current academic literature. OBJECTIVES: To determine the associated factors with mortality, in addition to age and sex during the first year of the pandemic. DESIGN: A case-control study with retrospective revision of clinical and paraclinical variables by systematic revision of clinical records was conducted. Multiple imputations by chained equation were implemented to account for missing variables. Classification and regression trees (CART) were estimated to evaluate the interaction of associated factors on admission and their role in predicting mortality during hospitalisation. No intervention was performed. SETTING: High-complexity centre above 2640 m above sea level (masl) in Colombia. PARTICIPANTS: A population sample of 564 patients admitted to the hospital with confirmed COVID-19 by PCR. Deceased patients (n=282) and a control group (n=282), matched by age, sex and month of admission, were included. MAIN OUTCOME MEASURE: Mortality during hospitalisation. MAIN RESULTS: After the imputation of datasets, CART analysis estimated 11 clinical profiles based on respiratory distress, haemoglobin, lactate dehydrogenase, partial pressure of oxygen to inspired partial pressure of oxygen ratio, chronic kidney disease, ferritin, creatinine and leucocytes on admission. The accuracy model for prediction was 80.4% (95% CI 71.8% to 87.3%), with an area under the curve of 78.8% (95% CI 69.63% to 87.93%). CONCLUSIONS: This study discloses new interactions between clinical and paraclinical features beyond age and sex influencing mortality in COVID-19 patients. Furthermore, the predictive model could offer new clues for the personalised management of this condition in clinical settings.

Pharmacy-based immunization: a systematic review.

Background: The coronavirus disease 2019 pandemic has prompted the exploration of new response strategies for such health contingencies in the near future. Over the last 15 years, several pharmacy-based immunization (PBI) strategies have emerged seeking to exploit the potential of pharmacies as immunization, medication sale, and rapid test centers. However, the participation of pharmacies during the last pandemic was very uneven from one country to another, suggesting a lack of consensus on the definition of their roles and gaps between the literature and practice. Purpose: This study aimed to consolidate the current state of the literature on PBI, document its progress over time, and identify the gaps not yet addressed. Moreover, this study seeks to (i) provide new researchers with an overview of the studies on PBI and (ii) to inform both public health and private organization managers on the range of possible immunization models and strategies. Methodology: A systematic review of scientific qualitative and quantitative studies on the most important scientific databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-analyzes guidelines were followed. Finally, this study discusses the trends, challenges, and limitations on the existing literature on PBI. Findings: Must studies concluded that PBI is a beneficial strategy for the population, particularly in terms of accessibility and territorial equity. However, the effectiveness of PBI is affected by the economic, political, and/or social context of the region. The collaboration between the public (government and health departments) and private (various pharmacy chains) sectors contributes to PBI's success. Originality: Unlike previous literature reviews on PBI that compiled qualitative and statistical studies, this study reviewed studies proposing mathematical optimization methods to approach PBI.

Metabolic fingerprinting of systemic sclerosis: a systematic review.

Introduction: Systemic sclerosis (SSc) is a chronic autoimmune disease, marked by an unpredictable course, high morbidity, and increased mortality risk that occurs especially in the diffuse and rapidly progressive forms of the disease, characterized by fibrosis of the skin and internal organs and endothelial dysfunction. Recent studies suggest that the identification of altered metabolic pathways may play a key role in understanding the pathophysiology of the disease. Therefore, metabolomics might be pivotal in a better understanding of these pathogenic mechanisms. Methods: Through a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA), searches were done in the PubMed, EMBASE, Web of Science, and Scopus databases from 2000 to September 2022. Three researchers independently reviewed the literature and extracted the data based on predefined inclusion and exclusion criteria. Results: Of the screened studies, 26 fulfilled the inclusion criteria. A total of 151 metabolites were differentially distributed between SSc patients and healthy controls (HC). The main deregulated metabolites were those derived from amino acids, specifically homocysteine (Hcy), proline, alpha-N-phenylacetyl-L-glutamine, glutamine, asymmetric dimethylarginine (ADMA), citrulline and ornithine, kynurenine (Kyn), and tryptophan (Trp), as well as acylcarnitines associated with long-chain fatty acids and tricarboxylic acids such as citrate and succinate. Additionally, differences in metabolic profiling between SSc subtypes were identified. The diffuse cutaneous systemic sclerosis (dcSSc) subtype showed upregulated amino acid-related pathways involved in fibrosis, endothelial dysfunction, and gut dysbiosis. Lastly, potential biomarkers were evaluated for the diagnosis of SSc, the identification of the dcSSc subtype, pulmonary arterial hypertension, and interstitial lung disease. These potential biomarkers are within amino acids, nucleotides, carboxylic acids, and carbohydrate metabolism. Discussion: The altered metabolite mechanisms identified in this study mostly point to perturbations in amino acid-related pathways, fatty acid beta-oxidation, and in the tricarboxylic acid cycle, possibly associated with inflammation, vascular damage, fibrosis, and gut dysbiosis. Further studies in targeted metabolomics are required to evaluate potential biomarkers for diagnosis, prognosis, and treatment response.

Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual's functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.

Inotropic support in cardiogenic shock: who leads the battle, milrinone or dobutamine?

Cardiovascular diseases remain the leading cause of death globally, with acute myocardial infarction being one of the most frequent. One of the complications that can occur after a myocardial infarction is cardiogenic shock. At present, the evidence on the use of inotropic agents for the management of this complication is scarce, and only a few trials have evaluated the efficacy-adverse effects relationship of some agents. Milrinone and Dobutamine are some of the most frequently mentioned drugs that have been studied recently. However, there are still no data that affirm with certainty the supremacy of one over the other. The aim of this review is to synthesize evidence on basic and practical aspects of these agents, allowing us to conclude which might be more useful in current clinical practice, based on the emerging literature.

Explorando un sistema de control de la consanguinidad vía toros de inseminación en sistemas de producción cerrados carentes de registros genealógicos / Exploring an inbreeding control system using insemination bulls in closed production systems without pedigrees / Explorando um sistema de controle da consanguinidade via touros de inseminação em sistemas de produção cerrados carentes de registros genealógicos

Resumen Si en un sistema de producción animal se sobrepasa un umbral de consanguinidad (F) promedio (en torno al 6,25%), pueden comenzar a surgir una serie de anomalías como la aparición de enfermedades autosómicas recesivas, disminución en la capacidad de respuesta inmune y en los promedios productivos y reproductivos de los rebaños, fenómeno conocido como depresión endogámica. Este problema puede verse magnificado en sistemas de producción en los que la mejora genética se realiza a través de inseminación artificial (IA) pues, en varios países, se ha informado de elevados grados de parentesco familiar entre toros de inseminación pertenecientes a una misma raza. En el presente estudio se exponen los resultados de la simulación de una estrategia para el control de la consanguinidad en rebaños productivos de la raza Aberdeen angus, basada en la gestión de registros genealógicos de toros de inseminación. Los resultados del presente estudio indican que, en teoría, es posible implementar programas de control de la consanguinidad en planteles productivos de bovinos de carne sometidos a IA, a través de una estrategia que no dependa de la existencia de registros genealógicos prediales, sino que de los registros de los toros de inseminación. Dicha estrategia dependería únicamente de la información proporcionada a los productores por parte de las empresas proveedoras de semen. Sin embargo, el método propuesto no es aplicable a criaderos de reproductores, los cuales no pueden prescindir de registros genealógicos y de un control de la consanguinidad que considere apareamientos de mínimo parentesco.

Abstract If an average consanguinity (F), threshold is exceeded (about 6.25%) in an animal production system, a series of anomalies may begin to appear, such as the appearance of autosomal recessive diseases, a decrease in the immune response capacity and in the productive and reproductive averages of the herds, a phenomenon known as inbreeding depression. This problem can be magnified in production systems in which genetic improvement is carried out through artificial insemination (IA by its acronym in Spanish), since, in several countries, high degrees of family kinship between inseminations bulls belonging to the same breed have been reported. In the present study are presented the results of the simulation of a strategy for the control of inbreeding in productive herds of the Aberdeen angus breed, based on the management of genealogical records of insemination bulls. The results of this study indicate that, in theory, it is possible to implement consanguinity control programs in productive farms of beef cattle subjected to IA, through a strategy that does not depend on the existence of farm genealogical records, but on records of insemination bulls. Said strategy would depend solely on the information provided to the producers by the semen supplying companies. However, the proposed method is not applicable to breeding farms, which cannot do without genealogical records and consanguinity control that considers pairings of minimal kinship.

Resumo Se um limiar médio de consanguinidade (F) for ultrapassado em um sistema de produção animal (em torno de 6,25%), uma série de anomalias pode começar a aparecer, como o emergência de doenças autossômicas recessivas, diminuição da capacidade de resposta imune e das médias populacionais para variáveis ​​de interesse produtivo, fenômeno conhecido como depressão endogâmica. Esse problema pode ser ampliado em sistemas de produção em que o melhoramento genético é realizado por meio de inseminação artificial (IA), pois, em vários países, tem sido relatado alto grau de parentesco familiar entre touros inseminados de uma mesma raça. No presente estudo, são apresentados os resultados da simulação de uma estratégia para o controle da endogamia em rebanhos produtivos da raça Aberdeen angus, com base no manejo de registros genealógicos de touros inseminados. Os resultados deste estudo indicam que, em teoria, é possível implementar programas de controle de consanguinidade em fazendas produtivas de bovinos de corte submetidos à IA, por meio de uma estratégia que não depende da existência de registros genealógicos da fazenda, mas de registros de touros inseminados. Essa estratégia dependeria exclusivamente das informações fornecidas aos produtores pelas empresas fornecedoras de sêmen. No entanto, o método proposto não é aplicável a fazendas de criação, que não podem prescindir de registros genealógicos intra-fazenda e controle de consanguinidade que considera pares de parentesco mínimo.

Remarkable Diagnostic Magnetic Resonance Imaging Findings in Sellar Xanthogranuloma: Report of Three First Cases in Latin America.

The sellar xanthogranuloma is a rare lesion of the sellar-parasellar region difficult to differentiate from other tumors such as craniopharyngiomas or Rathke's cleft cyst in the preoperative evaluation. As they are recently recognized as a separate entity and the few number of reports in the literature, its etiology is unknown and its impact remains uncertain. This article will describe the first three cases reported in Latin America, identified in one of them an imaging feature that may be helpful to elucidate an imaging growth pattern. Current evidence will be described regarding to the clinicopathological features, imaging diagnosis, and etiology origin theories.

Relación genética entre toros de inseminación comercializados en Chile por distintas empresas proveedoras de semen: un estudio de caso en las razas Holstein y Angus / Genetic relationship between insemination bulls marketed in Chile by two semen suppliers: a case study in Holstein and Angus breeds / Relação genética entre touros de inseminação comercializados no Chile por diferentes empresas fornecedoras de sêmen: um estudo de caso nas raças Holstein e Angus

Resumen La inseminación artificial (IA) es actualmente el manejo reproductivo preferido para la mayoría de los ganaderos que trabajan con razas deganado internacionales como Holstein Friesian y Aberdeen Angus. En relación con esto, varios autores han descrito que a lo largo de los años ha habido una alteración en parámetros de productivos, lo que se asociaría significativamente con un aumento en el grado de endogamia en los animales. Esta situación tendría su origen a nivel de los núcleos genéticos, en los que se llevan a cabo programas de mejora, debido al pequeño número de líneas familiares a las que pertenecen los animales seleccionados como reproductores. Este estudio evaluó el grado de parentesco entre toros de inseminación Holstein Friesian y Aberdeen Angus comercializados en Chile por dos empresas de distribución de semen. Se estudiaron un total de 86 toros disponibles en catálogos hasta el año 2017. La información genealógica de cada toro se remonta hasta trastatarabuelo y luego se construyó un registro genealógico consolidado para cada raza. Este análisis consideró la estimación del porcentaje de endogamia (F) de cada toro y la construcción de una matriz de parentesco aditivo (A) entre los animales. Los resultados indicaron que el 99% de los toros Holstein y el 79% de los toros Angus están emparentados. Como resultado de lo anterior, se concluye que es esencial que en Chile se inicie un programa de gestión de información genealógica para controlar adecuadamente los niveles de endogamia y poder mitigar los problemas que puedan surgir a causa de este fenómeno.

Abstract Artificial insemination (AI) is currently the preferred reproductive management for most cattle farmers working with international cattle breeds likes Holstein Friesian and Aberdeen Angus. In relation to this, several authors have described that over the years there has been an alteration in the production parameters, which would be significantly associated with an increase in the inbreeding degree of the animals. This fact would have its origin at the genetic nucleus level, in which improvement programs are carried out, due to the small number of family lines which the animals selected as breeding stock belong to. This study evaluated the degree of kinship between Holstein Friesian and Aberdeen Angus insemination bulls marketed in Chile by two semen distribution companies. A total of 86 bulls available in catalogues until 2017 were studied. The genealogical information of each bull was traced back up to great-great-grandfather and then a consolidated genealogical record was built for each breed. This analysis considered the estimation of each bull's inbreeding percentage (F) and the construction of a co-ancestry matrix among animals. Results indicated that 99% of Holstein bulls and 79% of Angus bulls, are related to some extent. As a result of the above, it is concluded that is essential that in Chile a program management of genealogical information be initiated to adequately control inbreeding problems that may arise from the use of related animals.

Resumo A inseminação artificial (IA) atualmente é o manejo reprodutivo preferido da maioria dos criadores de gado que trabalham com raças de gado internacionais, como o Holstein Friesian e o Aberdeen Angus. Nesse âmbito, vários autores assinalam que, ao longo dos anos, tem ocorrido uma alteração dos parâmetros produtivos, que poderia estar associada de forma significativa com um aumento no nível de endogamia nos animais. A origem dessa situação poderia estar nos núcleos genéticos, pois nos programas de melhoria, os animais que são selecionados como reprodutores pertencem a um reduzido número de linhas familiares. Esta pesquisa avalia os graus de parentesco entre touros para inseminação Holstein Friesian e Aberdeen Angus comercializados no Chile por duas empresas de distribuição de sêmen. No total, 86 touros foram analisados, disponíveis em catálogos de até 2017. As informações genealógicas de cada touro remontam aos tetravós. Posteriormente, foi elaborado um registro genealógico consolidado para cada raça. A análise considerou a estimação da porcentagem de endogamia (F) de cada touro e a construção de uma matriz de parentesco aditivo (A) entre os animais. Os resultados indicam que 99% dos touros Holstein e 79% dos touros Angus são aparentados. Como resultado disso, chega-se à conclusão de que é essencial se ter um programa de gestão de informações genealógicas no Chile para controlar adequadamente os níveis de endogamia e assim mitigar os possíveis problemas gerados por esse fenômeno.

[Cytogenetic alterations in field workers routinely exposed to pesticides in Bogota flowers farms]. / Alteraciones citogenéticas en trabajadoras con riesgo ocupacional de exposición a plaguicidas en cultivos de flores en Bogotá.

Frequency of cytogenetic alterations (micronuclei and chromosome aberrations), DNA repair deficiencies and acetylcholinesterase activity was determined for field workers in Bogotá, Colombia. These workers were regularly exposed to organophosphate and carbamate insecticides while employed on farms for flower growing. Interviews were conducted with 31 workers associated with occupational risk of pesticides exposure and 30 without exposure. A standard cytogenetic assay was used to determine chromosome aberrations and micronuclei frequencies. In addition, a challenge assay assessed response to gamma-rays as an indication of DNA repair deficiencies--cells were exposed to gamma-rays in vitro and the frequencies of chromosome aberrations in post-irradiation metaphase cells were quantified. The data were evaluated for percentage of aberrant cells, cells with chromosome aberrations and frequencies of chromatid breaks per 100 metaphase cells in each worker. The exposed group had a significantly higher frequency of cells with chromosome aberrations and micronuclei as compared with the non-exposed group (p = 0.02). However, the challenge assay did not indicate a significant difference (p > 0.1). These findings require confirmation by further analytical studies involving larger sample. Cytogenetic and toxicological studies, in conjunction with thorough clinical examination are recommended.

Escherichia coli resistente a la fosfomicina: un hecho que nos invita a reflexionar sobre la resistencia bacteriana / Escherichia coli resistant to fosfomycin: a fact that invite us to think about antibiotic resistance

La resistencia bacteriana es un problema de salud pública que dificulta cada vez más el tratamiento de los pacientes con infecciones del tracto urinario o de otros sistemas. Si bien los casos de resistencia estaban restringidos al entorno hospitalario, en la actualidad son más comunes las infecciones adquiridas en la comunidad causadas por bacterias ultirresistentes. En este artículo se presenta una reflexión acerca del riesgo que representa la multirresistencia, y el surgimiento de resistencia a las alternativas terapéuticas para el tratamiento exitoso de las infecciones de tracto urinario, así como se reflexiona sobre puntos clave relacionados con el uso adecuado de las pruebas diagnósticas y los antibióticos en este tipo de infecciones.

Antibiotic resistance is a public health problem that makes urinary tract infections and infections in other organs increasingly difficult to treat. Although bacterial resistance was once restricted to hospitals, nowadays community acquired infections caused by multidrug resistant bacteria are be comingincreasingly more common. This review article reflects on the risks associated with antibiotic resistance and the emergence of resistance to alternative antibiotic treatments available for the successful treatment of urinary tract infections; it also considers key points concerning the proper use of diagnostic tests and the antibiotic drugs used to diagnose and treat these infections.

El urocultivo: prueba ineludible para el diagnóstico específico de la infección del tracto urinario y el uso racional de los antibióticos / Urine culture: an unavoidable test for specific diagnosis of urinary tract infection and rational use of antibiotics

Resumen: las infecciones del tracto urinario son la tercera infección más frecuente que se presenta en el ser humano y la segunda razón por la cual se prescriben antibióticos. Los cultivos de las muestras de orina (urocultivos) son el cultivo más solicitado a los laboratorios de microbiología y continúan siendo la prueba de referencia para su diagnóstico. En este artículo de revisión se tratan aspectos como la etiología y la problemática de la resistencia a los principales antibióticos que se emplean de manera empírica para el tratamiento de las infecciones del tracto urinario adquiridas en la comunidad. Además, se analizan las pruebas de laboratorio básicas que apoyan el diagnóstico de esta infección; se detallan los aspectos relacionados con el urocultivo, desde el cuándo está indicado solicitarlo hasta el informe final y la interpretación de los resultados, con el fin de promover un uso racional de los antibióticos.De esta manera, además de contribuir a disminuir el efecto colateral del empleo de antibióticos, se mejora el costo-beneficio del proceso diagnóstico-tratamiento y lo fundamental, se recupera la salud del paciente.

Abstract: Urinary tract infections are the third most common infection among humans and the second cause for antibiotic prescription. Urine cultures are the most commonly requested type of culture to microbiology laboratories and this test remains as the gold standard for diagnosis. This article reviews aspects such as etiology of the infection and issues related with empiric antimicrobial utilization to treat community acquired urinary tract infections. In addition, basic laboratory tests that support the diagnosis of urinary tract infections are reviewed. The article will also describe aspects related to urine culture, from the moment this test is indicated until the final report and interpretation of results are issued by the laboratory, in order to promote rational use of antibiotics. The proposed approach will not only help to reduce collateral effects of antibiotic use, it may also improve the cost-benefit of the diagnosis-treatment process, and the most importantly, it may help in the recovery of the patient’s health.

Streptococcus agalactiae en gestantes: diagnóstico y profilaxis / Streptococcus agalactiae in pregnant women: diagnosis and prophylaxis

Streptococcus agalactiae o Streptococcus del Grupo B es la principal bacteria que causa enfermedadinvasiva temprana en los neonatos. La bacteria es transmitida durante el parto al 10% a 63% de los fetos de madre con colonización recto-vaginal; aproximadamente un 2% de los neonatos que adquieren la bacteria desarrollan una enfermedad invasiva y la mortalidad es de aproximadamente el 2% al 3% en los neonatos a término y hasta del 20% en prematuros. Se ha demostrado que la administraciónde antibióticos a la madre colonizada, al momento del parto, puede prevenir la transmisión de la bacteria y como tal, la enfermedad en el neonato; de hecho, esta práctica ha disminuido la incidencia de la enfermedad invasiva temprana en Estados Unidos de 1,7 casos/1.000 nacidos vivos, a comienzos de los años 1990, a 0,3 casos/1.000 nacidos vivos a partir del año 2003. Por tal razón, se recomienda el tamizaje de las gestantes y el método estándar recomendado para determinar que una embarazada está colonizada es el cultivo de una muestra de recto y vagina entre las semanas 35 y 37 de gestación. En este sentido, los laboratorios clínicos deben estar preparados para ofrecer los estudios relacionados con esta bacteria, mientras que la comunidad médica debe incorporar a la rutina la tamización y la profilaxis universal de las embarazadas colonizadas por Streptococcus agalactiae. En este módulo se describirán los aspectos generales de la colonización materna por Streptococcus agalactiae, las condiciones para su diagnóstico, tratamiento y prevención de la enfermedad invasiva temprana neonatal.

Streptococcus agalactiae, also known as group B Streptococci, is the main cause for early-onset invasive neonatal bacterial disease. Approximately 10% to 63% of fetuses acquire the bacteria during birth if pregnant women have recto-vaginal colonization with group B Streptococci; around 2% of the exposed newborns develop an invasive disease, and the mortality rate is approximately 2% to 3% in term infants, and up to 20% in premature infants. It has been shown that intrapartum antibiotics can prevent the transmission of the bacteria from the mother to the fetus, and consequently it may prevent disease from occurring in the neonate. In fact, such practice has decreased the incidence of early-onset group B streptococcal disease in the United States; its national incidence has declined from an estimated 1.7 cases per 1000 live births in 1990 to 0.3 cases per 1000 live births in 2003. As consequence, screening of pregnant women is recommended; the standard method to identify pregnant women colonized with the bacteria is the recto-vaginal culture for group B Streptococci at 35-37 weeks of gestation. Accordingly, clinical laboratories must be prepared to offer the appropriate diagnostic techniques, and the physicians should incorporate universal screening into their daily routine as well as chemoprophylaxis of pregnant women colonized Streptococcus agalactiae. This review article includes a general overview of colonization by S. agalactiae in pregnant women, the diagnosis of colonization, its treatment, and prevention of early-onset invasive neonatal disease.

Mapping EST-derived SSRs and ESTs involved in resistance to bacterial blight in Manihot esculenta.

Cassava (Manihot esculenta Crantz) is a major root crop widely grown in the tropics. Cassava bacterial blight, caused by Xanthomonas axonopodis pv. manihotis (Xam), is an important disease in Latin America and Africa resulting in significant losses. The preferred control method is the use of resistant genotypes. Mapping expressed sequence tags (ESTs) and determining their co-localization with quantitative trait loci (QTLs) may give additional evidence of the role of the corresponding genes in resistance or defense. Twenty-one EST-derived simple sequence repeats (SSRs) were mapped in 16 linkage groups. ESTs showing similarities with candidate resistance genes or defense genes were also mapped using strategies such as restriction fragment length polymorphisms, cleaved amplified polymorphic sequences, and allele-specific primers. In total, 10 defense-related genes and 2 bacterial artificial chromosomes (BACs) containing resistance gene candidates (RGCs) were mapped in 11 linkage groups. Two new QTLs associated with resistance to Xam strains CIO121 and CIO151 were detected in linkage groups A and U, respectively. The QTL in linkage group U explained 61.6% of the phenotypic variance and was associated with an RGC-containing BAC. No correlation was found between the new EST-derived SSRs or other mapped ESTs and the new or previously reported QTLs.

K. pneumoniae: ¿La nueva "superbacteria"?: Patogenicidad, epidemiología y mecanismos de resistencia / K. pneumoniae: the new "superbacteria"?: Pathogenicity, epidemiology and resistance mechanisms

La resistencia de los microorganismos a los antibióticos es un problema cada vez creciente en salud pública. Entre estos, Klebsiella pneumoniae es un representante importante no sólo por su frecuencia como causa de infecciones asociadas al cuidado de la salud y de la comunidad, sino por los mecanismos patogénicos que posee, como la capacidad de producir cápsula, la presencia de estructuras especializadas que le permiten adherirse a las células del hospedero (pilis), y de sideróforos que le permiten obtener el hierro necesario para su desarrollo. La resistencia de Klebsiella pneumoniae a los antimicrobianos ha evolucionado de acuerdo con la aparición y uso de estas moléculas en el tratamiento de los pacientes, siendo cada vez más amplio el espectro que abarcan, el cual va desde la resistencia a la ampicilina por la producción de la ß lactamasa SHV– 1, hasta la resistencia a los carbapenemos por diversos mecanismos, pasando por la producción de las ß lactamasas de espectro extendido, denominadas así por su capacidad de degradar las cefalosporinas de últimas generaciones y el aztreonam.El laboratorio de microbiología debe seguir las recomendaciones internacionales para detectar y confirmar la presencia de estos mecanismos de resistencia en las cepas cultivadas de las muestras remitidas para su estudio, e igual que el clínico, debe interpretar de manera óptima sus resultados, de tal forma que se pueda elegir y administrar el antibiótico más apropiado para el paciente.

The antimicrobial resistance is an increasing problem of public health. Klebsiella pneumoniae has become one of the most important pathogens because it is a frequent cause of nosocomial and community acquired infections and it has pathogenicity mechanisms like capsules, adhesive properties mediated by specialized estructures (pillis) and siderophores that are capable of taking up iron, an essential factor in bacterial growth. The increase in bacterial resistance to antibiotics has evolved with the use of these in patients treatments, being increasingly wide the spectrum that they include, happening from the resistance to ampicillin by the production of betalactamase SHV– 1 to carbapenems resistance by diverse mechanisms, from the production of extendedspectrum betalactamases (ESBL) that are associated with hydrolysis of extended– spectrum cephalosporins and aztreonam. Microbiology laboratory should follow international recommendations to detect and confirm the presence of this resistance mechanism in bacteria and the clinicians should make a suitable interpretation of the results to make the better choice of the antibiotic therapy.

Actividad in vitro de la tigeciclina en cepas bacterianas cultivadas en muestras clínicas de pacientes atendidos en un hospital universitario / In vitro activity of tigecycline in bacterial strains isolated in clinical specimens from patients seen at a university hospital

Introducción: el constante incremento de la resistencia bacteriana a los antibióticos, hace necesario disponer de herramientas terapéuticas. La tigeciclina es un nuevo antibiótico, derivado de la minociclina, y ha demostrado excelente actividad in vitro en contra de un amplio espectro de microorganismos. Objetivo: describir la sensibilidad de las bacterias aerobias grampositivas y gramnegativas a la tigeciclina, aisladas de muestras clínicas, en un hospital de cuarto nivel de atención. Metodología: se realizó la identificación por medios convencionales y el estudio de sensibilidad a la tigeciclina por el método de difusión con disco, a bacterias cultivadas de muestras (con excepción de orina) provenientes de pacientes atendidos en el servicio de Urgencias y ambulatorios. Resultados: en total se estudiaron 2 515 bacterias. El 100% de las cepas de Staphylococcus aureus (651), Staphylococcus coagulasa negativa (382) y Enterococcus spp. (276) es sensible a la tigeciclina. Del mayor número de enterobacterias analizadas, Escherichia coli (511) presentó una sensibilidad del 99.8%, Klebsiella pneumoniae (332) un 93.1% y Enterobacter cloacae (129) del 96.9%. Las cepas que presentaron mecanismos de resistencia como Staphylococcus spp. oxacilino resistentes y enterobacterias productores de betalactamasas de espectro extendido presentaron altos porcentajes de sensibilidad a la tigeciclina. Conclusiones: la tigeciclina, como en la mayoría de los estudios realizados en otras regiones del mundo, presentó una excelente actividad in vitro en las bacterias cultivadas en las muestras clínicas de este Hospital y, por tanto, podría ser una opción en el tratamiento, tanto empírico como terapéutico, de las infecciones en las que esté indicado su uso.

Introduction: The steady increase in bacterial resistance to antibiotics, will require new therapeutic strategies. Tigecycline is a new antibiotic derived from minocycline, which has demonstrated excellent in vitro activity against a broad spectrum of microorganisms. Objective: To describe the sensitivity of Gram-positive and Gram-negative aerobic bacteria to tigecycline, isolated from clinical samples, in a fourth-level hospital. Methods: The identification was carried out by conventional methodsof identification and the susceptibility study to tigecycline by the disk diffusion method, to isolated bacteria specimens (except urine) from patients treated in the emergency and outpatient department. Results: A total of 2515 bacteria strains were included. 100% of strains of Staphylococcus aureus (651), Staphylococcus coagulase negative (382) and Enterococcus spp. (276), were susceptible to tigecycline. The largest number of Enterobacteriaceae tested, Escherichia coli (511) had a sensitivity of 99.8%, Klebsiella pneumoniae (332) a 93.1% and Enterobacter cloacae (129) of 96.9%. The strains that showed resistance mechanisms such as Staphylococcus spp. oxacillin-resistant or Enterobacteriaceae producing extended spectrum beta lactamases showedhigh rates of susceptibility to tigecycline. Conclusions: Tigecycline, as with most studies conducted in other regions of the world, presented an excellent in vitro activity in bacteria isolated in the clinical samples from this hospital and therefore could be an option in treating both as empirical therapy of infections in which its use is indicated.