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Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(1, cont.): 1-6, jan-jun. 2021.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1222347


A raiva é uma antropozoonose viral que se desenvolve de forma progressiva e aguda podendo apresentar até 100% de letalidade. O seu agente etiológico é o vírus rábico do gênero Lyssavirus pertencente à família Rhabdoviridae. O presente trabalho teve como objetivo divulgar informações acerca da ocorrência da raiva em humanos em virtude da sua expressiva importância para saúde pública e analisar a percepção da população sobre a raiva humana, de forma a obter dados relacionados a conhecimentos básicos sobre a doença. Para isso, foi criada uma página informativa denominada "@contraraiva_" na rede social Instagram para a realização de postagens interativas sobre o tema abordado, e uso de um questionário criado a partir da plataforma Google Forms em diferentes mídias sociais para a obtenção e coleta de dados. Foram obtidas 1.075 respostas, provenientes de diferentes localidades. O questionário alcançou todas as regiões brasileiras, todos 26 estados e o Distrito Federal. As informações publicadas pela página criada ajudaram a sanar dúvidas relacionadas aos principais aspectos da doença. Os dados obtidos a partir do questionário contribuem para o planejamento de ações voltadas para a educação em saúde de forma mais estratégica, visando contribuir para os pontos em que a população tem menos conhecimentos.

Rabies is a viral anthropozoonosis that is developed in a progressive and acute way and can present up to 100% lethality. Its etiologic agent is the rabies virus of the Lyssavirus gene belonging to the Rhabdoviridae family. This study aimed at disseminating information about the occurrence of rabies in humans due to its expressive importance for public health, and at analyzing the population perception on human rabies in order to obtain data related to basic knowledge about the disease. For that purpose, an information page called "@ contraraiva _" was created on the social network Instagram for providing interactive posts on the topic, and a questionnaire was created from the Google Forms platform on different social media to obtain and collect data. A total of 1,075 responses were obtained from different locations. The questionnaire included all Brazilian regions, all 26 states and the Federal District. The information published on the created page helped to clarify doubts related to the main aspects of the disease. The data obtained from the questionnaire contribute towards the planning of actions aimed at health education in a more strategic way, aiming at contributing to the points where the population is less knowledgeable.

La rabia es una antropozoonosis viral que se desarrolla de forma progresiva y aguda y puede presentar hasta un 100% de letalidad. Su agente etiológico es el virus de la rabia del género Lyssavirus perteneciente a la familia Rhabdoviridae. Este estudio tuvo como objetivo difundir informaciones sobre la ocurrencia de la rabia en humanos en virtud de su importancia expresiva para la salud pública, y analizar la percepción de la población sobre la rabia humana, con el fin de obtener datos relacionados a los conocimientos básicos sobre la enfermedad. Para ello, se creó una página de información denominada "@ contraraiva _" en la red social Instagram para realizar publicaciones interactivas sobre el tema abordado, y utilizar un cuestionario creado a partir de la plataforma Google Forms en diferentes redes sociales para la obtención y recolección de datos. Se obtuvieron 1.075 respuestas de diferentes lugares. El cuestionario llegó a todas las regiones brasileñas, a los 26 estados y al Distrito Federal. Las informaciones publicadas en el sitio web creado, ayudaron a sanar dudas relacionadas a los principales aspectos de la enfermedad. Los datos obtenidos del cuestionario contribuyen a la planificación de acciones orientadas a la educación para la salud de forma más estratégica, con el objetivo de contribuir a los puntos donde la población tiene menos conocimientos.

Medicina (B Aires) ; 81(2): 257-268, 2021.
Artículo en Español | MEDLINE | ID: mdl-33906145


Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diagnosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.

Complicaciones Parasitarias del Embarazo , Toxoplasma , Toxoplasmosis Congénita , Toxoplasmosis , Niño , Consenso , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Anamnesis , Embarazo , Toxoplasmosis Congénita/diagnóstico , Toxoplasmosis Congénita/tratamiento farmacológico , Toxoplasmosis Congénita/prevención & control
Mar Drugs ; 19(5)2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33922065


Schistosomiasis is a parasitic disease that affects more than 250 million people. The treatment is limited to praziquantel and the control of the intermediate host with the highly toxic molluscicidal niclosamide. Marine algae are a poorly explored and promising alternative that can provide lead compounds, and the use of multivariate analysis could contribute to quicker discovery. As part of our search for new natural compounds with which to control schistosomiasis, we screened 45 crude extracts obtained from 37 Brazilian seaweed species for their molluscicidal activity against Biomphalaria glabrata embryos and schistosomicidal activities against Schistosoma mansoni. Two sets of extracts were taxonomically grouped for metabolomic analysis. The extracts were analyzed by GC-MS, and the data were subjected to Pattern Hunter and Pearson correlation tests. Overall, 22 species (60%) showed activity in at least one of the two models. Multivariate analysis pointed towards 3 hits against B. glabrata veliger embryos in the Laurencia/Laurenciella set, 5 hits against B. glabrata blastula embryos, and 31 against S. mansoni in the Ochrophyta set. Preliminary annotations suggested some compounds such as triquinane alcohols, prenylated guaianes, dichotomanes, and xenianes. Despite the putative identification, this work presents potential candidates and can guide future isolation and identification.

PLoS Negl Trop Dis ; 15(3): e0009130, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33661891


BACKGROUND: Rabies is a viral zoonosis that imposes a substantial disease and economic burden in many developing countries. Dogs are the primary source of rabies transmission; eliminating dog rabies reduces the risk of exposure in humans significantly. Through mass annual dog rabies vaccination campaigns, the national program of rabies control in Mexico progressively reduced rabies cases in dogs and humans since 1990. In 2019, the World Health Organization validated Mexico for eliminating rabies as a public health problem. Using a governmental perspective, we retrospectively assessed the economic costs, effectiveness, and cost-effectiveness of the national program of rabies control in Mexico, 1990-2015. METHODOLOGY: Combining various data sources, including administrative records, national statistics, and scientific literature, we retrospectively compared the current scenario of annual dog vaccination campaigns and post-exposure prophylaxis (PEP) with a counterfactual scenario without an annual dog vaccination campaign but including PEP. The counterfactual scenario was estimated using a mathematical model of dog rabies transmission (RabiesEcon). We performed a thorough sensitivity analysis of the main results. PRINCIPAL FINDINGS: Results suggest that in 1990 through 2015, the national dog rabies vaccination program in Mexico prevented about 13,000 human rabies deaths, at an incremental cost (MXN 2015) of $4,700 million (USD 300 million). We estimated an average cost of $360,000 (USD 23,000) per human rabies death averted, $6,500 (USD 410) per additional year-of-life, and $3,000 (USD 190) per dog rabies death averted. Results were robust to several counterfactual scenarios, including high and low rabies transmission scenarios and various assumptions about potential costs without mass dog rabies vaccination campaigns. CONCLUSIONS: Annual dog rabies vaccination campaigns have eliminated the transmission of dog-to-dog rabies and dog-mediated human rabies deaths in Mexico. According to World Health Organization standards, our results show that the national program of rabies control in Mexico has been highly cost-effective.

Int J Infect Dis ; 105: 261-266, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33592342


BACKGROUND: Evidence suggests that biological mechanisms involved in helminth infections and vitamin deficiencies increase susceptibility to other infections. The aim of this study was to investigate the associations of helminth co-infection and select micronutrient deficiencies with leprosy using a case-control design. METHODS: From 2016 to 2018, individuals aged ≥3 years were recruited at clinics in and around Governador Valadares, Minas Gerais, Brazil in three groups: cases of leprosy, household contacts and community-matched (non-contact) controls. Helminths were diagnosed through stool Kato Katz examination and serum reactivity to anti-soluble adult worm antigen preparation IgG4. Serum ferritin, 25-OH vitamin D and retinol concentrations were measured. Multi-variate logistic regression was conducted to identify associations with active leprosy. RESULTS: Seventy-nine cases of leprosy, 96 household contacts and 81 non-contact controls were recruited; 48.1% of participants were male with a median age of 40 years. Helminths were found in 7.1% of participants on Kato Katz test, all but one of which were Schistosoma mansoni, and 32.3% of participants were positive for S. mansoni serology. On multi-variate analysis, cases were more likely to be infected with helminths (diagnosed by stool) than household contacts [adjusted odds ratio (aOR) 8.69, 95% confidence interval (CI) 1.50-50.51]. Vitamin D deficiency was common, and was more likely in cases compared with non-contact controls (aOR 4.66, 95% CI 1.42,-15.33). Iron deficiency was not associated with leprosy, and vitamin A deficiency was not detected. CONCLUSION: These associations suggest that the immune consequences of schistosomiasis and vitamin D deficiency may increase the risk of active leprosy. Comorbid conditions of poverty deserve further study as addressing co-infections and nutritional deficiencies could be incorporated into programmes to improve leprosy control.

Bull Entomol Res ; 111(3): 379-384, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33541447


The olive fruit fly, Bactrocera oleae, the most serious pest of olives, requires the endosymbiotic bacteria Candidatus Erwinia dacicola in order to complete its development in unripe green olives. Hence a better understanding of the symbiosis of Ca. E. dacicola and its insect host may lead to new strategies for reduction of B. oleae and thus minimize its economic impact on olive production. Studies of this symbiosis are hampered as the bacterium cannot be grown in vitro and the established B. oleae laboratory populations, raised on artificial diets, are devoid of this bacterium. Here, we sought to develop a method to transfer the bacteria from wild samples to laboratory populations. We tested several strategies. Cohabitation of flies from the field with the laboratory line did not result in a stable transfer of bacteria. We provided the bacteria directly to the egg and also in the food of the larvae but neither approach was successful. However, a robust method for transfer of Ca. E. dacicola from wild larvae or adults to uninfected flies by transplantation to females was established. Single female lines were set up and the bacteria were successfully transmitted for at least three generations. These results open up the possibilities to study the interaction between the symbiont and the host under controlled conditions, in view of both understanding the molecular underpinnings of an exciting, unique in nature symbiotic relationship, as well as developing novel, innovative control approaches.

Erwinia/crecimiento & desarrollo , Tephritidae/microbiología , Animales , Productos Agrícolas , Control de Insectos , Laboratorios , Olea , Control de Plagas , Simbiosis
Sci Total Environ ; 770: 145225, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-33513511


AIM: COVID-19 pandemic has posed an unprecedented pressure on health systems and economies worldwide. Delivery services have grown as an alternative source of revenue for many people. Consumers generally perceive that delivery services are safer than going into a restaurant, because they reduce exposure to other people and their risk of SARS-CoV-2 contagion. There are no studies analyzing viral load or the burden of COID-19 within this population. This study aims to describe the presence of SARS-CoV-2 among food delivery riders in the city of Quito, Ecuador. STUDY DESIGN: From July and August 2020, bike and motorbike riders self-employed in two of the main online delivery services in Quito, Ecuador, were invited for RT-PCR testing for SARS-CoV-2 detection during the compulsory lockdown due to the COVID-19 pandemic. The Center for Disease Control (CDC) 2019-Novel Coronavirus (2019-nCoV) RT-qPCR Diagnostic Panel was used to identify the presence of SARS-CoV-2 in nasopharyngeal swabs. All samples were processed in the BSL2 certified molecular biology laboratory at Universidad de Las Americas. RESULTS: A total of 22 out of 145 delivery workers (15.2%) tested positive for SARS-CoV-2. The majority of workers were men (n = 138), the average age of male workers was 32 years-old (±7.3) and 38 years-old (± 10.6) for females. The presence of mild symptoms was reported in only 9 subjects (6%). The calculated viral load was higher among males with 1.31E+08 copies/mL vs 2.30E+06 in females, although this difference was not statistically significant (p value: 0.68, [CI: -53 to -79]). CONCLUSIONS: The self-employed food delivery riders have a high incidence rate of SARS-CoV-2 infection in relation to the national average. It is important to point out that this is the first study of its kind in Latin-American and probably one of the very few in the world. The results emphasize the need for policy makers to look at the pandemic from as many population's sub-groups as possible. Delivery riders are a highly moving population that offer their services to a wide range of clients, including vulnerable populations such as the elderly or those less likely to leave their house for basic needs stoking.

Adulto , Anciano , Control de Enfermedades Transmisibles , Ecuador/epidemiología , Femenino , Humanos , Masculino , Pandemias , Prevalencia
Marine Drugs, v. 19, n. 5, 234, abr. 2021
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IBPROD, Sec. Est. Saúde SP | ID: bud-3693


Schistosomiasis is a parasitic disease that affects more than 250 million people. The treatment is limited to praziquantel and the control of the intermediate host with the highly toxic molluscicidal niclosamide. Marine algae are a poorly explored and promising alternative that can provide lead compounds, and the use of multivariate analysis could contribute to quicker discovery. As part of our search for new natural compounds with which to control schistosomiasis, we screened 45 crude extracts obtained from 37 Brazilian seaweed species for their molluscicidal activity against Biomphalaria glabrata embryos and schistosomicidal activities against Schistosoma mansoni. Two sets of extracts were taxonomically grouped for metabolomic analysis. The extracts were analyzed by GC–MS, and the data were subjected to Pattern Hunter and Pearson correlation tests. Overall, 22 species (60%) showed activity in at least one of the two models. Multivariate analysis pointed towards 3 hits against B. glabrata veliger embryos in the Laurencia/Laurenciella set, 5 hits against B. glabrata blastula embryos, and 31 against S. mansoni in the Ochrophyta set. Preliminary annotations suggested some compounds such as triquinane alcohols, prenylated guaianes, dichotomanes, and xenianes. Despite the putative identification, this work presents potential candidates and can guide future isolation and identification

Artículo en Inglés | PAHO-IRIS | ID: phr-53141


[Extract]. Antimicrobial resistance (AMR) is one of the greatest global threats to human health. It is estimated that by 2050, AMR will lead to approximately 10 million annual deaths worldwide. Considering the impact of AMR on reproductive capacity and food production, in addition to its direct effect on infected people, the world's population could drop by between 11 and 444 million inhabitants by 2050 if AMR control is not achieved. As migrations and shared economies lead to the transmission of resistant bacteria across borders, the impacts of AMR become regionally significant. In the United States, methicillin-resistant Staphylococcus aureus caused 10 600 deaths in 2017. In Latin American and Caribbean countries, information is available from studies conducted in hospitals and other health facilities on the prevalence of antimicrobial-resistant pathogens. In many hospitals in Mexico, Peru, and Colombia, for example, resistance to third-generation cephalosporins and fluoroquinolones in Escherichia coli isolates is reaching almost 60%. Moreover, the dynamics of colonization and infection of multidrug-resistant organisms (such as carbapenemaseproducing Klebsiella pneumoniae) are unique in endemic areas of Latin America, favoring spread and dissemination. [...]

Farmacorresistencia Microbiana , Resistencia a Medicamentos , Medicina Basada en la Evidencia , Política Informada por la Evidencia , Escherichia coli , Klebsiella pneumoniae
Vet Parasitol ; 287: 109258, 2020 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-33075729


Cystic echinococcosis (CE) is a parasitic zoonosis, caused by the larval stage of Echinococcus granulosus. This disease has a worldwide distribution and is considered an important zoonosis in Chile, especially in regions where raising livestock dominates. We aimed to describe the spatial distribution and risk factors for CE in cattle and sheep slaughtered in the Aysén Region, Chile between 2015 and 2016, to inform disease control in this hyper-endemic region. Clustering and hotspot analyses of CE at the farm-level were performed (Moran's global index, local indicator of spatial autocorrelation (LISA), and the scan statistic Poisson model), and we used spatial interpolation to display areas with a higher risk of CE. Mixed effects logistic regression models were fit to assess the association between municipality of origin and age of animals and CE detected at slaughter, with the farm of origin included as a random effect. Overall, data from 1532 cattle farms (1078 geocoded) and 30,805 cattle were analyzed, with a 64 % and 39 % CE prevalence at the farm and animal-level, respectively. For sheep farms, data from 381 (296 geocoded) farms and 58,223 sheep were analyzed, with a 71 % and 18 % CE prevalence at the farm and animal-level, respectively. Globally, the CE prevalence in both cattle and sheep farms was not clustered. However, we found 14 cattle and 23 sheep farms with high prevalence that were locally clustered. We also detected 6 and 11 clusters in cattle and sheep farms, respectively. Risk of reported CE varied according to municipalities of origin, and the age of animals. This study confirms that the Aysén region is a hyper-endemic region for CE. It demonstrates the usefulness of the traceability of animals slaughtered for understanding the epidemiology of CE. The results suggest that in this hyper-endemic region in which there are limited financial resources available, that intervention activities - at the beginning of a control program - should be focused on farms with high prevalence and identified disease clusters.

BMC Infect Dis ; 20(1): 778, 2020 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-33081712


BACKGROUND: International organizations advocate for the elimination of dog-mediated rabies, but there is only limited guidance on interpreting surveillance data for managing elimination programmes. With the regional programme in Latin America approaching elimination of dog-mediated rabies, we aimed to develop a tool to evaluate the programme's performance and generate locally-tailored rabies control programme management guidance to overcome remaining obstacles. METHODS: We developed and validated a robust algorithm to classify progress towards rabies elimination within sub-national administrative units, which we applied to surveillance data from Brazil and Mexico. The method combines criteria that are easy to understand, including logistic regression analysis of case detection time series, assessment of rabies virus variants, and of incursion risk. Subjecting the algorithm to robustness testing, we further employed simulated data sub-sampled at differing levels of case detection to assess the algorithm's performance and sensitivity to surveillance quality. RESULTS: Our tool demonstrated clear epidemiological transitions in Mexico and Brazil: most states progressed rapidly towards elimination, but a few regressed due to incursions and control lapses. In 2015, dog-mediated rabies continued to circulate in the poorest states, with foci remaining in only 1 of 32 states in Mexico, and 2 of 27 in Brazil, posing incursion risks to the wider region. The classification tool was robust in determining epidemiological status irrespective of most levels of surveillance quality. In endemic settings, surveillance would need to detect less than 2.5% of all circulating cases to result in misclassification, whereas in settings where incursions become the main source of cases the threshold detection level for correct classification should not be less than 5%. CONCLUSION: Our tool provides guidance on how to progress effectively towards elimination targets and tailor strategies to local epidemiological situations, while revealing insights into rabies dynamics. Post-campaign assessments of dog vaccination coverage in endemic states, and enhanced surveillance to verify and maintain freedom in states threatened by incursions were identified as priorities to catalyze progress towards elimination. Our finding suggests genomic surveillance should become increasingly valuable during the endgame for discriminating circulating variants and pinpointing sources of incursions.

Erradicación de la Enfermedad/métodos , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/prevención & control , Control de Infecciones/métodos , Virus de la Rabia/genética , Rabia/epidemiología , Rabia/prevención & control , Algoritmos , Animales , Brasil/epidemiología , Perros , Genómica/métodos , Humanos , América Latina/epidemiología , Vacunación Masiva , México/epidemiología , Rabia/transmisión , Rabia/virología , Estudios Retrospectivos , Cobertura de Vacunación
PLoS Negl Trop Dis ; 14(9): e0008625, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32956390


BACKGROUND: Efforts to control soil-transmitted helminth (STH) infections have intensified over the past decade. Field-survey data on STH prevalence, infection intensity and drug efficacy is necessary to guide the implementation of control programs and should be of the best possible quality. METHODOLOGY: During four clinical trials designed to evaluate the efficacy of albendazole against STHs in Brazil, Ethiopia, Lao PDR and Tanzania, quality control (QC) was performed on the duplicate Kato-Katz thick smears and the data entry. We analyzed datasets following QC on both fecal egg counts (FECs) and data entry, and compared the prevalence of any STH infection and moderate-to-heavy intensity (MHI) infections and the drug efficacy against STH infections. RESULTS: Across the four study sites, a total of 450 out of 4,830 (9.3%) Kato-Katz thick smears were re-examined. Discrepancies in FECs varied from ~3% (hookworms) to ~6.5% (Ascaris lumbricoides and Trichuris trichiura). The difference in STH prevalence and prevalence of MHI infections using the datasets with and without QC of the FECs did not exceed 0.3%, except for hookworm infections in Tanzania, where we noted a 2.2 percentage point increase in MHI infections (pre-QC: 1.6% vs. post-QC: 3.8%). There was a 100% agreement in the classification of drug efficacy of albendazole against STH between the two datasets. In total, 201 of the 28,980 (0.65%) data entries that were made to digitize the FECs were different between both data-entry clerks. Nevertheless, the overall prevalence of STH, the prevalence of MHI infections and the classification of drug efficacy remained largely unaffected. CONCLUSION/SIGNIFICANCE: In these trials, where staff was informed that QC would take place, minimal changes in study outcomes were reported following QC on FECs or data entry. Nevertheless, imposing QC did reduce the number of errors. Therefore, application of QC together with proper training of the personnel and the availability of clear standard operating procedures is expected to support higher data quality.

Albendazol/uso terapéutico , Helmintiasis/tratamiento farmacológico , Control de Calidad , Ancylostomatoidea , Animales , Ascaris , Brasil/epidemiología , Ensayos Clínicos como Asunto , Etiopía/epidemiología , Heces/parasitología , Guías como Asunto , Helmintiasis/epidemiología , Helmintiasis/transmisión , Infecciones por Uncinaria/tratamiento farmacológico , Infecciones por Uncinaria/epidemiología , Humanos , Laos/epidemiología , Recuento de Huevos de Parásitos , Prevalencia , Suelo/parasitología , Tanzanía/epidemiología , Trichuris
Rev. ecuat. pediatr ; 21(2): 1-11, 31 de agosto del 2020.
Artículo en Español | LILACS | ID: biblio-1141081


Introducción: Las infecciones nosocomiales ocasionan un costo para el sistema de salud. En este estudio se reporta los datos observacionales de un brote de Klebsiella Pneumoniae en una Unidad de neonatología, y sus medidas posteriores a la identificación. Métodos: Con un diseño descriptivo observacional, ambispectivo se estudiaron casos de infecciones nosocomiales. Se realizaron medidas de barrera estrictas con listas de chequeo y uso de cámaras de vigilancia en una Unidad de Neonatología. Se reportan las observaciones del estudio. Se utiliza estadística descriptiva. Resultados: 6 casos fueron diagnosticados con Klebsiella Pneumoniae, todos fueron pacientes recién nacidos prematuros, tres de ellos extremos. Cuatro pacientes con sepsis temprana. Las muestras de cultivos fueron 3 Hemocultivos, 2 Urocultivos y 1 cultivo de secreción faríngea. Junto con el cultivo de Klebsiella pneumoniae, se identificaron otros patógenos. La coinfección de Klebsiella con S. aureus fue la que se mantuvo más días en aislamiento, en relación al aislamiento de Klebsiella sola. De todos los cultivos, 2 fueron positivos para Klebsiella pneumoniae productora de BLEE, y cuatro para Klebsiella pneumoniae multisensible. Luego de la intervención no se presentaron nuevo casos con un seguimiento de 12 meses posteriores al brote. Conclusiones: Luego del brote de 6 casos de Klebsiella Pneumoniae en la unidad de Neonatología se establecieron medidas estrictas de bioseguridad, las mismas que fueron cumplidas con el registro en listas de chequeo y monitorizadas por cámaras de seguridad. Se logró la eliminación de infecciones nosocomiales en un período de control posterior a 12 meses luego de la implementación

Introduction: Nosocomial infections cause a cost for the health system. This study reports the observational data of an outbreak of Klebsiella Pneumoniae in a neonatology unit, and its measures after identification. Methods: With a descriptive, observational, ambispective design, nosocomial infections were studied. Strict barrier measures were carried out with checklists and the use of surveillance cameras in a Neonatology Unit. Study observations are reported. Descriptive statistics are used. Results: 6 cases were diagnosed with Klebsiella Pneumoniae, all were premature newborn patients, three of them extreme. Four patients with early sepsis. The culture samples were 3 blood cultures, 2 urine cultures and 1 culture of pharyngeal secretion. Along with the Klebsiella pneumoniae culture, other pathogens were identified. Klebsiella co-infection with S. aureus was the one that remained in isolation for more days, in relation to Klebsiella isolation alone. Of all the cultures, 2 were positive for ESBL-producing Klebsiella pneumoniae, and four for multisensitive Klebsiella pneumoniae. After the intervention, no new cases were presented with a follow-up of 12 months after the outbreak. Conclusions: After the outbreak of 6 cases of Klebsiella Pneumoniae in the Neonatology unit, strict biosafety measures were established, which were complied with with the registration in checklists and monitored by security cameras. Elimination of nosocomial infections was achieved in a control period after 12 months after implementation

Humanos , Infecciones por Klebsiella , Klebsiella pneumoniae , Neonatología , Unidades de Cuidado Intensivo Neonatal , Cuidados Críticos
Sex., salud soc. (Rio J.) ; (35): 58-81, maio-ago. 2020.
Artículo en Español | LILACS | ID: biblio-1139643


Resumen El objetivo de este trabajo es analizar las vinculaciones entre las identidades de género y las lógicas de la organización social del cuidado, relacionadas con los riesgos ambientales-sanitarios a partir de los significados y prácticas relativas a la producción agrícola basada en plaguicidas en la pampa húmeda argentina. Realizamos dos trabajos de campo etnográficos de largo alcance y analizamos, por una parte, el proceso de identificación y denuncia de los riesgos relativos a los plaguicidas por mujeres y su relación con la construcción social de femineidades y con la organización generizada del cuidado. En segundo lugar, indagamos un posible vínculo entre la exposición a los plaguicidas y una estrategia de reafirmación de la virilidad.

Abstract This paper analyzes the connections between gender identities and the logics surrounding the social organization of care related to the environmental and health risks that stem from meanings and practices of pesticide-based agricultural production in the Argentine Pampas. After conducting two long-reach ethnographic field-work, we explore the process of women's identifying and denouncing of pesticides related risks and its relationship both with the social construction of femininities and with the gendered organization of care. Furthermore, we study a possible link between the exposure to pesticides and a strategy of reaffirmation of virility.

Resumo O objetivo deste trabalho é analisar as vinculações entre as identidades de gênero e as lógicas da organização social do cuidado, em relação com os riscos ambientais-sanitáriosa partir dos significados e práticas relativas à produção agrícola baseada em pesticidas nos pampas da Argentina. Realizamos dois trabalhos de campo etnográficos de amplo alcance e analisamos, por um lado, o processo de identificação e denúncia dos riscos relacionados coma construção social de feminilidades e com a organização generificada do cuidado. Por outro lado, indagamos sobre um vínculo possível entre a exposição aos pesticidas e uma estratégia de reafirmação da virilidade.

Humanos , Masculino , Femenino , Plaguicidas , Envenenamiento/prevención & control , Riesgos Laborales , Enfermedades de los Trabajadores Agrícolas/prevención & control , Agricultura , Identidad de Género , Argentina , Mujeres Trabajadoras , Factores de Riesgo , Agroquímicos , Impactos en la Salud , Factores Culturales , Hombres , Antropología Cultural
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1353-1362, July-Aug. 2020. tab, graf
Artículo en Portugués | LILACS, VETINDEX | ID: biblio-1131515


Objetivou-se avaliar características de virulência, perfil de resistência antimicrobiana e padrão de similaridade genética de 71 cepas de Salmonella Minnesota isoladas na cadeia produtiva de frangos de corte, entre 2009 e 2010, em duas unidades de uma empresa (A e B). Os isolados foram sorotipificados e submetidos ao teste de susceptibilidade antimicrobiana pelo teste de difusão em disco. Utilizando-se PCR, foi avaliada a presença dos genes invA, lpfA, agfA e sefA e os genes de resistência aos betalactâmicos (bla TEM , bla SHV e bla CTX-M ). A relação filogenética foi determinada por RAPD-PCR. Os maiores percentuais de resistência foram para tetraciclina e sulfonamida. Foram reconhecidos oito perfis de resistência aos antimicrobianos entre as cepas isoladas na indústria A, e 11 perfis de resistência na indústria B. Do total de cepas, 100% foram positivas para o gene invA, 98,6% para o gene agfA, 49,3% para o gene lpfA e nenhuma para o gene sefA. Três cepas foram positivas para o gene bla TEM (4,2%) e 11 (15,5%) para o gene bla CTX-M . A avaliação filogenética demonstrou a presença de sete clusters com similaridade superior a 80% e três perfis distintos. Com base no dendrograma, observou-se a disseminação de um mesmo perfil em ambas as empresas.(AU)

The aim of this study was to evaluate virulence characteristics, antimicrobial resistance profile and the pattern of genetic similarity of 71 strains of Salmonella Minnesota isolated in the production chain of broilers between 2009 and 2010, into two units of a company (A and B). Isolates were serotyped and submitted to antimicrobial susceptibility by disk diffusion test. Using PCR, the presence of genes invA, lpfA, agfA and sefA and the genes conferring resistance to beta-lactam (blaTEM, blaSHV and blaCTX-M) were evaluated. The phylogenetic relationship was determined by the RAPD-PCR method. The highest percentages of resistance were to tetracycline and sulfonamide. Eight antimicrobial resistance profiles were recognized among strains isolated in industry A, and 11 resistance profiles in industry B. Of all strains of both industries, 100% were positive for the invA gene, 98.6% to agfA gene, 49.3% for lpfA gene, and no strain showed the sefA gene. Three strains were positive for the gene blaTEM (4.2%), 11 (15.5%) for the blaCTX-M gene. Phylogenetic evaluation showed the presence of seven clusters with similarity greater than 80% and three distinct profiles. Based on the dendrogram we observed the spread with similar profiles in both companies.(AU)

Humanos , Animales , Aves de Corral , Salmonella , Salmonelosis Animal/epidemiología , Pollos , Factores de Virulencia , Virulencia , Zoonosis/prevención & control , Reacción en Cadena de la Polimerasa , Susceptibilidad a Enfermedades
PLoS Negl Trop Dis ; 14(6): e0008375, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32603324


BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.

Gastroenteritis/epidemiología , Gastroenteritis/etiología , Gastroenteritis/microbiología , Gastroenteritis/virología , Adenoviridae , Infecciones por Adenoviridae/complicaciones , Infecciones por Adenoviridae/epidemiología , Infecciones por Astroviridae/complicaciones , Infecciones por Astroviridae/epidemiología , Infecciones por Caliciviridae/complicaciones , Infecciones por Caliciviridae/epidemiología , Campylobacter , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/epidemiología , Estudios de Casos y Controles , Preescolar , Coinfección/microbiología , Coinfección/virología , Colombia/epidemiología , Criptosporidiosis/complicaciones , Criptosporidiosis/epidemiología , Cryptosporidium , Diarrea/epidemiología , Diarrea/etiología , Diarrea/microbiología , Diarrea/virología , Escherichia coli Enterotoxigénica , Infecciones por Escherichia coli/complicaciones , Infecciones por Escherichia coli/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Norovirus , Reacción en Cadena de la Polimerasa , Rotavirus , Infecciones por Rotavirus/complicaciones , Infecciones por Rotavirus/epidemiología , Salmonella , Infecciones por Salmonella/complicaciones , Infecciones por Salmonella/epidemiología
PLoS Negl Trop Dis ; 14(7): e0008478, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32692739


A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting.

Enfermedades de los Perros/virología , Profilaxis Posexposición , Vacunas Antirrábicas/inmunología , Rabia/veterinaria , Animales , Mordeduras y Picaduras/complicaciones , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/prevención & control , Perros , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Perú/epidemiología , Rabia/epidemiología , Rabia/prevención & control , Vacunas Antirrábicas/administración & dosificación , Población Urbana , Heridas y Traumatismos/terapia
Rev. cir. (Impr.) ; 72(3): 217-223, jun. 2020. tab
Artículo en Español | LILACS | ID: biblio-1115545


Resumen Introducción: Es importante mantener programas de vigilancia bacteriana para disminuir resistencia y definir esquemas farmacológicos adecuados. Los pacientes con abdomen agudo representan un grupo microbiológico especial. Objetivos: Hacer una revisión de agentes patógenos en pacientes adultos operados en nuestro Servicio de Urgencia por patología abdominal con líquido libre y analizar los resultados obtenidos de cultivos respecto a las cepas y la susceptibilidad a los antibióticos. Materiales y Método: Estudio de cohorte prospectiva con estadística descriptiva. Se incluyen pacientes consecutivos, mayores de 18 años, operados por abdomen agudo que presentan líquido libre intraperitoneal entre noviembre de 2017 y abril de 2018. Se excluyen casos con terapia antimicrobiana, hospitalización y/o cirugía en los 3 meses previos. Se registran los cultivos positivos, cepas aisladas, susceptibilidad antimicrobiana, datos demográficos y evolución clínica. Resultados: De 63 pacientes 55% fueron hombres, edad promedio 52,2 años. Las patologías más frecuentes fueron de origen apendicular (62%) y de causa entérica (30%). En un 44% el cultivo fue positivo y en 36% con más de un germen. Escherichia coli fue el patógeno más frecuente (64,2%) seguidos de Enterococcus faecium y Streptococcus anginosus (7,1%). De los otros patógenos cultivados sólo se observó resistencia múltiple en un caso aislado de Morganella Morganii. Conclusiones: Estos datos constituyen la realidad microbiológica local en abdomen agudo. La Escherichia Coli sigue siendo el germen más frecuente, debe enfrentarse con profilaxis y tratamiento antibiótico adecuado. Es necesario mantener vigilancia microbiología local para un manejo acorde.

Introduction: It is important to maintain bacterial surveillance programs to decrease resistance and define adequate pharmacological schemes. Patients with abdomen represent a special microbiological group. Objetives: Make a review of pathogens in adult patients operated in our Emergency Service for abdominal pathology with free fluid and analyze the results obtained from cultures with respect to the strains and susceptibility to antibiotics. Materials and Method: Prospective cohort study with descriptive statistics. We include consecutive patients, older than 18 years old, operated on by abdomen who present free intraperitoneal fluid between November 2017 and April 2018. Cases with antimicrobial therapy, hospitalization and/or surgery 3 months prior are excluded. Positive cultures, isolated strains, antimicrobial susceptibility, demographic data and clinical evolution are recorded. Results: Of 63 patients, 55% were men and the average age was 52.2 years. The most frequent pathologies were of appendicular origin (62%) and of enteric origin (30%). In 44% the crop was positive and in 36% with more than one germ. Escherichia coli was the most frequent pathogen (64.2%) followed by Enterococcus faecium and Streptococcus anginosus (7.1%). Of the others, cultivated pathogens have only observed multiple resistance in an isolated case of Morganella Morganii. Conclusions: These data include the local microbiological reality in acute abdomen. Escherichia coli is still the most frequent germ that must be faced with the profile and the appropriate treatment. It is necessary to maintain local microbiology surveillance for a proper management.

Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones Bacterianas/tratamiento farmacológico , Abdomen Agudo/cirugía , Abdomen Agudo/complicaciones , Antibacterianos/uso terapéutico , Infecciones Bacterianas/etiología , Infecciones Bacterianas/prevención & control , Líquido Ascítico , Ciprofloxacino/uso terapéutico , Enterococcus faecium/efectos de los fármacos , Streptococcus anginosus , Escherichia coli/efectos de los fármacos , Abdomen Agudo/patología , Metronidazol