RESUMEN
Adherence to preventive measures is influenced by people's knowledge, attitudes and practices towards a disease; therefore, assessing knowledge of COVID-19 is critical in the overall effort to contain the outbreak. This cross-sectional study was conducted among undergraduates (n = 3621) of different programs and different levels of education associated with universities in north-central Ecuador. The form consisted of 32 questions covering demographics, symptoms, detection, treatment, transmission, prevention and knowledge of the virus. The rate of correct answers was 75.5% (21.1 ± 5 out of 28), with differences observed regarding program of study, educational level and location of institution (α = 0.05), although effect size analyses showed that these differences could not be considered large. Multiple linear regression analyses showed that lower scores were associated with initial stages of education, careers related to social sciences and location of institution. Participants possessed sufficient knowledge about detection, transmission and prevention, although they overestimated fatality rate and were less confident about the characteristics of the virus and the effectiveness of traditional medicine. Consequently, future educational programs must place emphasis on addressing deficient knowledge. Certainly, improving COVID-19 literacy will promote the appropriate application of protective measures aimed at preventing the virus' spread.
Asunto(s)
COVID-19 , Estudios Transversales , Ecuador/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , SARS-CoV-2 , Estudiantes , Encuestas y CuestionariosRESUMEN
Urban river pollution by multidrug-resistant (MDR) bacteria constitutes an important public health concern. Epidemiologically important strains of MDR Escherichia coli transmissible at the human-animal-environment interfaces are especially worrying. Quantifying and characterizing MDR E. coli at a molecular level is thus imperative for understanding its epidemiology in natural environments and its role in the spread of resistance in precise geographical areas. Cefotaxime-resistant E. coli was characterized along the watercourse of the major urban river in Quito. Our results showed high quantities of cefotaxime-resistant E. coli (2.7 × 103-5.4 × 105 CFU/100 mL). The antimicrobial resistance index (ARI) revealed the exposure of the river to antibiotic contamination, and the multiple antibiotic resistance index indicated a high risk of contamination. The blaCTX-M-15 gene was the most prevalent in our samples. Isolates also had class 1 integrons carrying aminoglycoside-modifying enzymes and folate pathway inhibitors. The isolates belonged to phylogroups A, B1 and D. Clonal complex 10 was found to be the most prevalent (ST10, ST44 and ST 167), followed by ST162, ST394 and ST46. Our study provides a warning about the high potential of the major urban river in Quito for spreading the epidemiologically important MDR E. coli.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Escherichia coli , Ríos/microbiología , Animales , Antibacterianos , Ecuador , Monitoreo del Ambiente , Infecciones por Escherichia coli , Humanos , Pruebas de Sensibilidad Microbiana , Microbiología del AguaRESUMEN
OBJECTIVES: The purpose of this study was to describe the clonal relationships and phylogroups of extended-spectrum ß-lactamase-producing Escherichia coli (ESBL-Ec) isolated from patients with bacteraemia in three hospitals in Quito, Ecuador. METHODS: Between June 2013 and September 2014, a total of 4354 blood cultures were performed in three hospitals located in different areas of Quito. A BACTECTM system was used for blood culture, and the VITEK®2 system was used for species identification and in vitro antimicrobial susceptibility testing. The ESBL genotype, presence of the blaCTX-M, blaTEM and blaSHV genes, and the phylogenetic group of E. coli isolates was determined by PCR. Clonal groups were established by multilocus sequence typing (MLST). RESULTS: Of 929 blood cultures positive for Gram-negative bacilli, 181 (19.5%) were positive for E. coli, representing the most frequent bacteraemia isolates in each hospital. Of the 181 E. coli isolates, 57 (31.5%) were ESBL-Ec. The main sources of ESBL-Ec bacteraemia were urinary tract infection (40; 70.2%), biliary tract infection (10; 17.5%) and other infections (7; 12.3%). The majority of ESBL-Ec isolates (39; 68.4%) from the three hospitals belonged to the virulent phylogenetic group B2, of which 36/39 (92.3%) were ST131 and 33/36 (91.7%) carried the blaCTX-M-15 gene. CONCLUSION: These results provide knowledge of the phylogenetic relationships of E. coli from bacteraemia in Ecuadorian patients. ST131 has emerged in ESBL-Ec, representing an important public-health problem because this multiresistant clone is considered to be a vehicle for the propagation of antimicrobial resistance genes and is a highly virulent, well-adapted human pathogen.
Asunto(s)
Bacteriemia/epidemiología , Farmacorresistencia Bacteriana Múltiple , Infecciones por Escherichia coli/epidemiología , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Filogenia , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/microbiología , Técnicas de Tipificación Bacteriana , Ecuador/epidemiología , Escherichia coli/enzimología , Femenino , Genotipo , Hospitales/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Tipificación de Secuencias Multilocus , Prevalencia , beta-Lactamasas/genéticaRESUMEN
OBJECTIVES: This study focused on estimating the prevalence of extended-spectrum ß-lactamases (ESBLs), plasmid-mediated AmpC ß-lactamases, carbapenemases and MCR-1-producing Escherichia coli in canine faeces from a public park in Quito, Ecuador. METHODS: Phenotypic and genotypic characterisation of E. coli isolated from 50 canine faecal samples recovered from a city park in Quito was performed. In addition, a multiple choice survey was conducted among 50 dog owners. RESULTS: Of the 50 faecal samples, 20 (40.0%) presented E. coli resistant to ceftriaxone. Moreover, 23 E. coli isolates were recovered for further analysis. All of the isolates showed as multidrug-resistant (MDR) phenotype (resistant to three or more antibiotic families). Resistance to carbapenems, tigecycline and amikacin was not observed. No major clonal relatedness was observed among the resistant isolates. The ESBL genes blaCTX-M-15, blaCTX-M-55 and blaCTX-M-65 were the most common. Two isolates harboured the blaCMY-2 gene and one isolate harboured both mcr-1 and blaCTX-M-65. Statistical analysis showed that older people were more conscious of collecting and disposing of dog faeces than subjects aged <35 years (P < 0.05). CONCLUSION: The finding of MDR E. coli in dog faeces in a city park in Ecuador illustrates the importance of analysing canine faeces in public settings (e.g. parks, playgrounds) as part of surveillance programmes for MDR E. coli. In addition, this research might be a sentinel sampling method to gain a better understanding of community sources of antibiotic-resistant Enterobacteriaceae at human-animal-environment interfaces.
Asunto(s)
Antibacterianos/farmacología , Perros/microbiología , Farmacorresistencia Bacteriana Múltiple , Infecciones por Escherichia coli/veterinaria , Escherichia coli/efectos de los fármacos , Heces/microbiología , Animales , Ecuador , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/microbiología , Proteínas de Escherichia coli/genética , Genotipo , Pruebas de Sensibilidad Microbiana , Parques Recreativos , Prevalencia , beta-Lactamasas/genéticaRESUMEN
Dissemination of Extended spectrum ß-lactamases (ESBL) Enterobacteriaceae is a major medical threat. Vegetables and fruits, which are usually consumed raw, are a very suitable pathway for the spread of these bacteria from farm-to-fork. However, limited information exists regarding resistant bacteria and epidemic clones that are disseminated in vegetables and tap water in South America. We processed a total of 90 samples in triplicate of nine typically consumed raw vegetables from a central municipal market, and tap water samples were processed from twenty-one locations in Quito, Ecuador. The samples were analyzed for total coliforms and ESBL Enterobacteriaceae contamination using the dilution filtration method. ESBL Escherichia coli isolates were phenotypically and genotypically characterized. The water was free of Enterobacteriaceae, but all the vegetables and fruits (except for blackberries) presented total coliform counts. Watercress had the highest load of total coliforms (3.3â¯×â¯10E4). ESBL E. coli was detected in alfalfa, leaf lettuce and parsley/cilantro samples. Alfalfa had the highest load of ESBL E. coli/total coliforms (1/3.3â¯×â¯10E2). We identified E. coli ST44-A and ST410-A harboring blaCTX-M-15 downstream of ISEcp1. Alfalfa and parsley/cilantro were contaminated with hyperepidemic E. coli ST410-A, which was resistant to quinolones and harbored blaCTX-M-15. For the first time, we report ESBL E. coli ST410-A from vegetables and express an alert regarding the health risk this could represent.
Asunto(s)
Agua Potable/microbiología , Escherichia coli , Frutas/microbiología , Verduras/microbiología , Resistencia betalactámica/genética , beta-Lactamasas/genética , Antibacterianos/farmacología , Ecuador , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/microbiología , Microbiología de Alimentos , Genotipo , Humanos , Quinolonas/farmacología , América del Sur , beta-Lactamas/farmacologíaRESUMEN
ABSTRACT The spread of pandemic Staphylococcus aureus clones, mainly methicillin-resistant S. aureus (MRSA), must be kept under surveillance to assemble an accurate, local epidemiological analysis. In Ecuador, the prevalence of the USA300 Latin American variant clone (USA300-LV) is well known; however, there is little information about other circulating clones. The aim of this work was to identify the sequence types (ST) using a Multiple-Locus Variable number tandem repeat Analysis 14-locus genotyping approach. We analyzed 132 S. aureus strains that were recovered from 2005 to 2013 and isolated in several clinical settings in Quito, Ecuador. MRSA isolates composed 46.97% (62/132) of the study population. Within MRSA, 37 isolates were related to the USA300-LV clone (ST8-MRSA-IV, Panton-Valentine Leukocidin [PVL] +) and 10 were related to the Brazilian clone (ST239-MRSA-III, PVL−). Additionally, two isolates (ST5-MRSA-II, PVL−) were related to the New York/Japan clone. One isolate was related to the Pediatric clone (ST5-MRSA-IV, PVL−), one isolate (ST45-MRSA-II, PVL−) was related to the USA600 clone, and one (ST22-MRSA-IV, PVL−) was related to the epidemic UK-EMRSA-15 clone. Moreover, the most prevalent MSSA sequence types were ST8 (11 isolates), ST45 (8 isolates), ST30 (8 isolates), ST5 (7 isolates) and ST22 (6 isolates). Additionally, we found one isolate that was related to the livestock associated S. aureus clone ST398. We conclude that in addition to the high prevalence of clone LV-ST8-MRSA-IV, other epidemic clones are circulating in Quito, such as the Brazilian, Pediatric and New York/Japan clones. The USA600 and UK-EMRSA-15 clones, which were not previously described in Ecuador, were also found. Moreover, we found evidence of the presence of the livestock associated clone ST398 in a hospital environment.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/genética , Toxinas Bacterianas/genética , Exotoxinas/genética , Leucocidinas/genética , Antibacterianos/farmacología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/clasificación , ADN Bacteriano , Pruebas de Sensibilidad Microbiana , Prevalencia , Factores de Virulencia/genética , Ecuador , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/genética , Tipificación de Secuencias Multilocus , GenotipoRESUMEN
The spread of pandemic Staphylococcus aureus clones, mainly methicillin-resistant S. aureus (MRSA), must be kept under surveillance to assemble an accurate, local epidemiological analysis. In Ecuador, the prevalence of the USA300 Latin American variant clone (USA300-LV) is well known; however, there is little information about other circulating clones. The aim of this work was to identify the sequence types (ST) using a Multiple-Locus Variable number tandem repeat Analysis 14-locus genotyping approach. We analyzed 132 S. aureus strains that were recovered from 2005 to 2013 and isolated in several clinical settings in Quito, Ecuador. MRSA isolates composed 46.97% (62/132) of the study population. Within MRSA, 37 isolates were related to the USA300-LV clone (ST8-MRSA-IV, Panton-Valentine Leukocidin [PVL] +) and 10 were related to the Brazilian clone (ST239-MRSA-III, PVL-). Additionally, two isolates (ST5-MRSA-II, PVL-) were related to the New York/Japan clone. One isolate was related to the Pediatric clone (ST5-MRSA-IV, PVL-), one isolate (ST45-MRSA-II, PVL-) was related to the USA600 clone, and one (ST22-MRSA-IV, PVL-) was related to the epidemic UK-EMRSA-15 clone. Moreover, the most prevalent MSSA sequence types were ST8 (11 isolates), ST45 (8 isolates), ST30 (8 isolates), ST5 (7 isolates) and ST22 (6 isolates). Additionally, we found one isolate that was related to the livestock associated S. aureus clone ST398. We conclude that in addition to the high prevalence of clone LV-ST8-MRSA-IV, other epidemic clones are circulating in Quito, such as the Brazilian, Pediatric and New York/Japan clones. The USA600 and UK-EMRSA-15 clones, which were not previously described in Ecuador, were also found. Moreover, we found evidence of the presence of the livestock associated clone ST398 in a hospital environment.
Asunto(s)
Antibacterianos/farmacología , Toxinas Bacterianas/genética , Exotoxinas/genética , Leucocidinas/genética , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , ADN Bacteriano , Ecuador , Femenino , Genotipo , Humanos , Lactante , Recién Nacido , Masculino , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Tipificación de Secuencias Multilocus , Prevalencia , Staphylococcus aureus/clasificación , Staphylococcus aureus/aislamiento & purificación , Factores de Virulencia/genética , Adulto JovenRESUMEN
Shigella sonnei harboring blaCTX-M-55 was isolated outside of Asia for the first time. The blaCTX-M-55 gene was found to be downstream of ISEcp-1 and located in a ~130 kb conjugative plasmid belonging to the I1 incompatibility group. The strain was recovered from a 7-year-old Ecuadorian girl with watery diarrhea who had not travelled abroad. Recent local data describe the emergence of blaCTX-M-55 and other variants typically found in Asia in the Andean Region, suggesting that increased travel of humans and trade relationships with Asian countries are influencing the current Ecuadorian bacterial resistance situation.
Asunto(s)
Disentería Bacilar/microbiología , Shigella sonnei/aislamiento & purificación , Antibacterianos/administración & dosificación , Toxinas Bacterianas/genética , Niño , Disentería Bacilar/tratamiento farmacológico , Ecuador , Femenino , Humanos , Shigella sonnei/clasificación , Shigella sonnei/efectos de los fármacos , Shigella sonnei/genéticaRESUMEN
Histoplasmosis is a zoonotic systemic mycosis caused by Histoplasma capsulatum. We report a case of a female canine, 4 years old, presenting multifocal lymphadenitis and skin and gingival lesions, in Ecuador. Based on cytological, histopathological, histochemical analyses, fungal culture and DNA sequencing of the ITS region of the fungus, the diagnosis confirmed the presence of H. capsulatum as the agent of infection. The treatment plan included ketoconazole with a satisfactory outcome.