Molecular Prevalence and Subtypes Distribution of Blastocystis spp. in Humans of Latin America: A Systematic Review.

Blastocystis spp. are among the few enteric parasites with a prevalence that can reach up to approximately 80% in communities of developing countries. This systematic review updates and summarizes available literature on the molecular prevalence and subtype distribution of Blastocystis spp. in Latin American people. This work follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The literature revised covers from 1 January 2015 to 6 October 2023 in seven different scientific databases, and the material was selected through inclusion and exclusion criteria. According to data found in the 36 selected articles, the prevalence of Blastocystis spp. in Latin America ranged between 5.8% (Bolivian rural communities) and 94.0% (Colombian general public). Generally, genomic DNA was extracted from approximately 200 mg fecal sediments using commercial kits, such as the QIAamp Stool Mini Kit (QIAGEN, Hilden, Germany) or the Norgen Stool DNA Isolation Kit (Norgen Biotek Corporation, Thorold, ON, Canada). Subtype-specific primers (such as the couple of primers BhRDr-RD5) developed from unique sequences of the SSU rRNA gene were applied to Blastocystis subtyping. Ten specific subtypes (STs) were found as well as various mixed infections, and the most circulating Blastocystis STs were in the order ST3, ST1, ST2, and ST4. The most recent data about Blastocystis spp. molecular epidemiology and the STs in communities of Latin America are limited to studies from specific countries. Novel scientific data from the other countries are required to obtain a complete picture and truly understand the distribution and prevalence of Blastocystis spp. and the STs.

Antimicrobial resistance trends in methicillin-resistant and methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidis isolates obtained from patients admitted to intensive care units. 2010-2015 / Tendencias de resistencia antimicrobiana en Staphylococcus aureus y Staphylococcus epidermidis resistentes y susceptibles a meticilina aislados, obtenidos en unidades de cuidados intensivos, 2010-2015

Absctract Introduction: The emergence and spread of antimicrobial-resistant strains in hospitals, mainly in intensive care units (ICU), has become a serious public health problem. Objective: To analyze the temporal trends of bacterial resistance phenotypes of methicillin-resistant and methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidis isolates obtained from ICU patients of a tertiary hospital in Cartagena, Colombia, between 2010 and 2015. Methods: A cross-sectional study was carried out between January 2010 and December 2015. Methicillin-resistant and Methicillin-susceptible S. aureus and S. epidermidis isolates (MRSA, MSSA, MRSE and MSSE) were used. Culture medium microdilution technique was used to detect minimal inhibitory concentration (MIC). Results: 313 Staphylococcus spp. isolates were identified, and most of them were methicillin-resistant (63.6%). Methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) strains represented 13.7% and 27.8%, respectively, of the total sample. The highest antibiotic resistance values in MRSA and MRSE isolates were observed for the following antibiotics: erythromycin (57.6% and 81.2%, respectively), clindamycin (54.6% and 71.0%), ciprofloxacin (48.4% and 36.4%) and trimethoprim-sulfametoxazole (36.4% and 51.4%). Conclusions: The results reported here suggest the need to rethink the control strategies designed to minimize antibiotic resistance in the hospital in which the study was conducted.

Resumen Introducción. La aparición y la diseminación de cepas resistentes en hospitales, principalmente en unidades de cuidado intensivo (UCI), se han convertido en un serio problema de salud pública. Objetivo. Analizar la tendencia de los fenotipos de resistencia de Staphylococcus aureus y Staphylococcus epidermidis resistentes y susceptibles a meticilina aislados en pacientes atendidos en UCI de un hospital de alta complejidad de Cartagena, Colombia, del 2010 al 2015. Materiales y métodos. Estudio analítico transversal realizado entre enero de 2010 y diciembre de 2015. Se utilizaron aislamientos de S. aureus y S. epidermidis meticilino-susceptibles y meticilino-resistentes (SARM, SASR, SERM y SESM). La técnica de susceptibilidad empleada fue el método microdilución en caldo para la detección de la concentración mínima inhibitoria. Resultados. Se identificaron 313 aislamientos de Staphylococcus spp., la mayoría resistentes a meticilina (63.6%). Las cepas SARM y SERM correspondieron al 13.7% y al 27.8% del total de aislamientos, respectivamente. Los mayores porcentajes de resistencia en SARM y SERM correspondieron a eritromicina (57.6% y 81.2%, respectivamente), clindamicina (54.6% y 71.0%), ciprofloxacina (48.4% y 36.4%) y trimetoprima-sulfametoxazol (36.4% y 51.4%). Conclusión. Los resultados encontrados sugieren el replanteamiento de las estrategias de control de la resistencia antimicrobiana en el hospital objeto de estudio.

Resistencia antimicrobiana en staphylococcus aureus y staphylococcus epidermidis: tendencia temporal (2010-2016) y fenotipos de multirresistencia, Cartagena (Colombia) / Antimicrobial resistance in staphylococcus aureus and staphylococcus epidermidis: temporal tendencies (2010-2016) and multi-drug resistance phenotypes, Cartagena (Colombia)

RESUMEN Introducción: Las especies de Staphylococcus spp. son patógenos oportunistas que causan enfermedades como osteomielitis y bacteriemias. Estas bacterias pueden adquirir resistencia a antibióticos, lo que hace que se conviertan en un problema de salud pública debido a la restricción de opciones terapéuticas. Objetivo: Evaluar la tendencia de los perfiles de resistencia antimicrobiana de S. aureus y S. epidermidis aislados en un hospital de Cartagena entre 2010 y 2016. Materiales y métodos: Estudio de corte transversal. El método de microdilución en caldo fue usado para la determinación de la concentración mínima inhibitoria de 12 agentes antimicrobianos. Se estudió el comportamiento de la resistencia antimicrobiana de acuerdo a la especie Staphylococcus, el sitio de infección y el período de tiempo. Resultados: Se aislaron 1218 cocos grampositivos, de los cuales 42,7 % fueron S. aureus y 18,9 % S. epidermidis. El 47,5 % de S. aureus fueron resistentes a meticilina y se encontraron principalmente en secreciones (43,3 %); mientras que el 68,7 % de S. epidermidis fueron meticilino resistentes y aislados principalmente en sangre (76,9 %). Conclusión: Se identificaron aislamientos clínicos de S. aureus y S. epidermidis con perfil de multirresistencia. Se observo un comportamiento constante en sus perfiles de resistencia durante el período de estudio, excepto en los dos últimos años en los que se identificó una reducción significativa de la meticilino resistencia en S. epidermidis.

ABSTRACT Introduction: Staphylococcus spp. are opportunistic pathogens that cause diseases like osteomyelitis and bacteremia. These bacteria can acquire resistance to antibiotics being a public health problem due to the restriction of therapeutic options. Objective: To evaluate the tendency of antimicrobial resistance profiles of Staphylococcus aureus and Staphylococcus epidermidis isolated in a hospital in CartagenaColombia between 2010 and 2016. Materials and methods: Cross-sectional study. The broth microdilution method was used to determine the minimum inhibitory concentration of 12 antimicrobial agents. The behavior of antimicrobial resistance was studied according to the Staphylococcus species, the site of infection and the time period. Results: A total of 1218 Gram-positive cocci were isolated of which 42.7% were S. aureus, and 18.9% belonged to S. epidermidis. Of the isolates of S. aureus, 47.5% were resistant to methicillin and were found mainly in secretions (43.3%). In the case of S. epidermidis, 68.7% were resistant to methicillin and were found mainly in the blood (76.9%). Conclusion: Clinical isolates of S. aureus and S. epidermidis with a multi-resistance profile was identified. A constant behavior in their resistance profiles was detected during the study period except in the last two years in which a significant reduction of methicillin resistance in S. epidermidis was recognized.

Análisis filogenético de secuencias suramericanas del gen ns1 del serotipo dengue-2, relacionadas con sangrado clínico severo / Phylogenetic analysis of South American sequences of the nonstructural protein-1 (ns1) of dengue serotype 2 associated with severe clinical bleeding

Objetivo Comparar secuencias de nucleótidos y de aminoácidos de la proteína no estructural 1-NS1 de cepas DENV-2, aisladas de pacientes febriles de diferentes países suramericanos, que cursaron cuadros clínicos con severidad o sin ella. Materiales y Métodos El análisis filogenético fue realizado a partir de 28 secuencias moleculares completas (1 056 pb) del gen NS1 del serotipo DENV-2. Se realizó un análisis filogenético bayesiano utilizando el software MrBayes v.3.2.0, con el modelo SYM+G y un análisis filogenético con el método Neighbor-Joining con el modelo Jukes-Cantor. Además, las secuencias de aminoácidos fueron alineadas y comparadas entre sí, mediante el programa Clustal W incluido en el software MEGA v. 5.2. Resultados En las secuencias de aminoácidos asociadas a sangrado, la sustitución más frecuente fue isoleucina→ treonina, en la posición 93. Estas secuencias presentaron un mayor porcentaje (94,6 %) de homología de aminoácidos de la proteína NS1 en comparación con el porcentaje de homología (74 %) de los aislamientos DENV-2 no asociados a sangrado. Se identificaron cinco clados que agrupan la mayoría de las secuencias analizadas (19/24; 79,2 %) con valores de probabilidad posterior mayores o iguales al 58 %. Siete (87,5 %) secuencias asociadas a sangrado se relacionan filogenéticamente dentro de los clados 4 y 5, con valores de probabilidad posterior del 58 % y 97 %, respectivamente. Conclusión No se encontraron características filogenéticas ni tampoco diferencias entre las secuencias de aminoácidos de la proteína NS1-DENV-2 estudiadas, que pudieran ser relacionadas, de manera directa, con la severidad de la enfermedad.(AU)

Objective The objective of this in silico study was to compare nucleotide and amino acids DENV-2-NS1 sequences isolated from febrile patients, with and without disease severity, from different South American countries. Matherials and Methods A bayesian MCMC phylogenetic analysis was carried out using 28 complete sequences of the gene NS1 of the DENV-2 serotype (1 056 bp), using MrBayes v.3.2.0 software, with the model SYM+G (2.5 million generations). We also carried out a phylogenetic analysis with Neighbor-Joining method (Jukes-Cantor model). In addition, the amino acids sequences were aligned and compared with each other, using Clustal W included in MEGA v.5.2 software. Results In the amino acids sequences associated with bleeding, the most frequent substitution was isoleucine → threonine at posicion 93. These sequences showed a high percentage (94.6 %) of amino acid homology in comparison with the percentage of amino acids homology (74 %) of DENV-2 isolates not associated with bleeding. Five clades were identified that group the vast majority of the DENV-2-NS1 sequences analyzed (19/24; 79.2 %) with posterior probability values greater than or equal to 58 %. Seven sequences (87.5 %) associated with bleeding were phylogenetically related within clades 4 and 5, the posterior probability values were 58 % and 97 %, respectively. Conclusion Neither phylogenetic characteristics nor differences between amino acids of the DENV-2-NS1 sequences studied were found that could be associated directly with severity of the disease.(AU)

[Phylogenetic analysis of South American sequences of the nonstructural protein-1 (ns1) of dengue serotype 2 associated with severe clinical bleeding]. / Análisis filogenético de secuencias suramericanas del gen ns1 del serotipo dengue-2, relacionadas con sangrado clínico severo.

Objective The objective of this in silico study was to compare nucleotide and amino acids DENV-2-NS1 sequences isolated from febrile patients, with and without disease severity, from different South American countries. Matherials and Methods A bayesian MCMC phylogenetic analysis was carried out using 28 complete sequences of the gene NS1 of the DENV-2 serotype (1 056 bp), using MrBayes v.3.2.0 software, with the model SYM+G (2.5 million generations). We also carried out a phylogenetic analysis with Neighbor-Joining method (Jukes-Cantor model). In addition, the amino acids sequences were aligned and compared with each other, using Clustal W included in MEGA v.5.2 software. Results In the amino acids sequences associated with bleeding, the most frequent substitution was isoleucine → threonine at posicion 93. These sequences showed a high percentage (94.6 %) of amino acid homology in comparison with the percentage of amino acids homology (74 %) of DENV-2 isolates not associated with bleeding. Five clades were identified that group the vast majority of the DENV-2-NS1 sequences analyzed (19/24; 79.2 %) with posterior probability values greater than or equal to 58 %. Seven sequences (87.5 %) associated with bleeding were phylogenetically related within clades 4 and 5, the posterior probability values were 58 % and 97 %, respectively. Conclusion Neither phylogenetic characteristics nor differences between amino acids of the DENV-2-NS1 sequences studied were found that could be associated directly with severity of the disease.

Diferencias y similitudes entre las estrategias de gestión integrada para la prevención y control del dengue en Colombia y Perú / Differences and similarities in approach of integrated strategy for dengue prevention and control between Colombia and Peru

Se analizaron y compararon aspectos esenciales de las Estrategias de Gestión Integrada (EGI) Nacional Colombia y Nacional Perú, mediante una revisión narrativa de las fuentes disponibles, con la finalidad de identificar semejanzas y diferencias en dos países andinos en el contexto del dengue. Se identificaron diferencias relacionadas con la valoración del problema, la conformación de grupos de participantes y la información cuantitativa aportada por los indicadores de cumplimiento. Las debilidades identificadas en la EGI-Dengue Nacional Colombia 2006-2010 son consideradas en una nueva versión de la estrategia (2012-2021). Se documentó el impacto epidemiológico de la implementación de la EGI Nacional Colombia 2006-2010. Adicionalmente, se observó un incremento gradual en la tasa de incidencia reportada que pudiera estar relacionado con el fortalecimiento del sistema de vigilancia integral de la EGI Nacional Perú...

We analyzed and compared two Integrated Management Strategies for Dengue Prevention and Control (IMS-dengue Colombia and IMS-dengue Peru), through a narrative review of available literature, in order to identify common and dissimilar patterns in two Andean countries with epidemiological differences in the context of dengue disease. We were able to identify differences related to: formal assessment of problem, formation of groups of actors, and quantitative information provided by performance indicators. These limitations identified in IMS-dengue Colombia 2006-2010 were overcome in a new version of the strategy (IMS-dengue Colombia 2012-2021). We were able to document an epidemiological impact of implementation of IMS-dengue Colombia 2006-2010. Additionally, a gradual increase was observed in incidence rates of dengue cases that could be related to the strengthening of surveillance system of IMS-dengue Peru...

Estrés oxidative-nitrosativo y dengue: revisión sistemática de estudios in vivo e in vitro / Oxidative-nitrosative stress and dengue disease: a systematic review of in vivo/in vitro studies

Objective: In this systematic review the aim was to summarise the in vivo/in vitro evidence on the role of oxidative-nitrosative stress in pathogenesis of dengue. Methods: We searched electronic databases (PubMed, EMBASE, The COCHRANE library, ScienceDirect, Scopus, SciELO, LILACS via Virtual Health Library, Google Scholar) using the term: dengue, dengue virus, severe dengue, oxidative stress, nitrosative stress, antioxidants, oxidants, free radicals, oxidized lipid products, lipid peroxides, nitric oxide, and nitric oxide synthase. Articles were selected for review by title and abstract excluding letter, review, epidemiological studies, and duplicates studies. Selected articles were reviewed for used animal model or cell cultures, original purposes, strain of virus or type of antibody, main outcomes, methods, and oxidative-nitrosative stress markers values. Results: In total, 4330 non-duplicates articles were identified from computerized searches of reference databases, of which 32 were eligible for full text searching. The results of in vivo studies were obtained from monkey and knockout and/or wild-type mice. Human peripheral blood mononuclear cells were cell cultures most commonly used in identified in vitro studies, following by human endothelial cells cultures. DENV-2 strains were most used. Conclusions: In conclusion, a large body of in vivo and in vitro evidences showed that oxidative/nitrosative stress can be related to production of pathogenesis-related protein, increased susceptibility of mice to DENV infection, hemorrhage development in mice, proinflammatory cytokines and transcriptional factor expression, and DENV replication in various cell cultures(AU)

Objetivo: sistematizar las evidencias in vivo/in vitro de la participación del estrés oxidativo-nitrosativo en el curso de la infección por virus del dengue. Métodos: revisión sistemática de estudios observacionales en las bases de datos (PubMed, EMBASE, The COCHRANE library, ScienceDirect, Scopus, SciELO, LILACS via Virtual Health Library, Google Scholar) utilizando las siguientes palabras clave: dengue, dengue virus, severe dengue, oxidative stress, nitrosative stress, antioxidants, oxidants, free radicals, oxidized lipid products, lipid peroxides, nitric oxide y nitric oxide synthase. La selección inicial fue realizada a partir del título y resumen excluyéndose: cartas para editor, revisiones, estudios con diseños epidemiológicos y estudios duplicados. A cada artículo seleccionado, se le revisó el objetivo o propósito, cultivos celulares o modelos animales utilizados, cepas víricas o tipo de anticuerpos utilizados, métodos y valores de los marcadores de estrés oxidativo-nitrosativo. Resultados: de 4330 publicaciones encontradas, 32 estudios cumplieron con los criterios de inclusión. Se utilizaron primates no humanos y ratones knockout o tipo salvaje para la obtención de las evidencias in vivo. Los cultivos celulares más utilizados fueron de células mononucleares de sangre periférica y de células endoteliales humanas. Las cepas más utilizadas en los ensayos correspondieron al serotipo 2 del virus dengue. Conclusiones: existen evidencias in vivo/in vitro que muestran la posible asociación entre el estrés oxidativo-nitrosativo con: producción de proteínas relacionadas con la patogénesis del dengue, incremento en la susceptibilidad de ratones por la infección por dengue, desarrollo de hemorragias en modelo de ratón, expresión de citoquinas proinflamatorias y replicación viral en varios cultivos de células tanto humanas como de origen animal(AU)

[Differences and similarities in approach of integrated strategy for dengue prevention and control between Colombia and Peru]. / Diferencias y similitudes entre las estrategias de gestión integrada para la prevención y control del dengue en Colombia y Perú.

We analyzed and compared two Integrated Management Strategies for Dengue Prevention and Control (IMS-dengue Colombia and IMS-dengue Peru), through a narrative review of available literature, in order to identify common and dissimilar patterns in two Andean countries with epidemiological differences in the context of dengue disease. We were able to identify differences related to: formal assessment of problem, formation of groups of actors, and quantitative information provided by performance indicators. These limitations identified in IMS-dengue Colombia 2006-2010 were overcome in a new version of the strategy (IMS-dengue Colombia 2012-2021). We were able to document an epidemiological impact of implementation of IMS-dengue Colombia 2006-2010. Additionally, a gradual increase was observed in incidence rates of dengue cases that could be related to the strengthening of surveillance system of IMS- dengue Peru.

Amigos imaginaroos: ¿recurso válido en la redacción de textos científicos en español? / Imaginary riendss: a valid resource for the writing of scientific texts in spanish?

Este artículo discute el uso de palabras no aceptadas oficialmente por la Real Academia Española incluidas en artículos publicados, y pretende abrir un espacio para la discusión de criterios académicos que validen o censuren el uso de esos términos. En consecuencia, se propone una categoría denominada amigos imaginarios, para hacer referencia a palabras adaptadas o incorrectamente utilizadas, las cuales, sin tener una denotación aceptada, terminan ocupando el sitio de palabras validadas por la Real Academia Española.

This article discusses the use of words, included in articles published, which are not formally accepted by the Spanish Royal Academy. In this way, the paper aims to open a space for discussion of academic criteria to validate or to censor the use of those terms. Accordingly, we propose a category called imaginary friends to refer to adapted or incorrectly used words, that without having any accepted denotation, end up occupying the site of accepted words by the Spanish Royal Academy.

[Cardiovascular risk factors among 7-and 14-year old schoolchildren in Cartagena, Colombia, 2009]. / Factores de riesgo cardiovascular en escolares entre 7 y 14 años en Cartagena, Colombia, 2009.

OBJECTIVE: Identifying family history, dyslipidaemia, hyperglycaemia, low physical activity and being overweight or suffering from obesity as cardiovascular risk factors in children aged 7 to 14 years in Cartagena, 2009. MATERIALS AND METHODS: A descriptive study of 173 children from Cartagena, Colombia, was designed. Biochemical serum parameters were determined by spectrophotometric methods. Habits were investigated through interviews and altered body weight was established using the body mass index (BMI). RESULTS: The sample consisted of 87 girls and 86 boys, and mean age was 9.9 years (9.6-10.3, 95 % CI). 75.1% (68.7-81.5, 95 % CI) had a family history of being overweight; 2.3 % (0.1-4.5, 95 % CI) were overweight and 1.7 % (0.0-3.6 95 %CI) were obese. More than half of the children had hightotal cholesterol levels (53.2 %; 45.8-60.695 %CI) and LDL (57.2 %; 49.8-64.6 95 % CI). Non-HDL cholesterol was found to be increased by 46.8 % (39.4-54.2 95 % CI). There was a significant difference between genders for triglyceridemia (females: 94.1 mg/dL; 87.0-101.2 mg/dL 95 % CI; males: 81.7 mg/dL; 75.0-88.5 mg/dL 95 % CI; p=0.005) and low physical activity (females: 83.8 %; 73.5-94.5 % 95 % CI; males: 44.2 %; 45.4-66.6 % 95 % CI; p=0,0001). CONCLUSIONS: Cardiovascular risk factors in these schoolchildren, even in those who were not obese, justify the need for the early detection of these factors as well as their strict controlto reduce their impact on people's future quality of life.

Factores de riesgo cardiovascular en escolares entre 7 y 14 años en Cartagena, Colombia, 2009 / Cardiovascular risk factors among 7-and 14-year old schoolchildren in Cartagena, Colombia, 2009

Objetivo Identificar antecedentes familiares, dislipidemias, hiperglucemia, escasa actividad física y sobrepeso u obesidad como factores de riesgo cardiovascular en niños entre 7 y 14 años de Cartagena, 2009. Materiales y Métodos Se realizó un estudio descriptivo en 173 niños de Cartagena, Colombia. Se determinaron los parámetros bioquímicos en suero mediante técnicas espectrofotométricas. Los hábitos fueron indagados mediante entrevista y las alteraciones de peso fueron establecidas utilizando el índice de masa corporal. Resultados La muestra quedó conformada por 87 niñas y 86 niños con edad promedio de 9,9 años (IC95 por ciento 9,6-10,3). El 75,1 por ciento (IC95 por ciento 68,7-81.5) presentaron antecedentes familiares; 2,3 por ciento (IC95 por ciento 0,1-4,5) tuvieron sobrepeso y 1,7 por ciento (IC95 por ciento 0,0-3,6) obesidad. Más de la mitad de los niños presentaron niveles elevados de colesterol total (53,2 por ciento; IC95 por ciento 45,8-60,6) y LDL (57,2 por ciento; IC95 por ciento 49,8-64,6). El colesterol no HDL se halló incrementado en el 46,8 por ciento (IC95 por ciento 39,4-54,2). Las niñas presentaron mayor concentración de triglicéridos (94,1 mg/dL; IC95 por ciento 93,0-95,2 mg/dL) que los niños (81,7 mg/dL; IC95 por ciento 80,6-82,8 mg/dL) con diferencia significativa (p=0,005) y también presentaron con mayor frecuencia baja actividad física (niñas: 83,8 por ciento; IC95 por ciento 73,5-94,5 por ciento; varones: 44,2 por ciento; IC95 por ciento 45,4-66,6; p=0,0001). Conclusión Los factores de riesgo cardiovascular presentes en esta población, inclusive en ausencia de obesidad, muestran la necesidad de implementar programas que los identifiquen e intervengan de manera oportuna para disminuir su impacto en la calidad de vida futura.

Objective Identifying family history, dyslipidaemia, hyperglycaemia, low physical activity and being overweight or suffering from obesity as cardiovascular risk factors in children aged 7 to 14 years in Cartagena, 2009. Materials and Methods A descriptive study of 173 children from Cartagena, Colombia, was designed. Biochemical serum parameters were determined by spectrophotometric methods. Habits were investigated through interviews and altered body weight was established using the body mass index (BMI). Results The sample consisted of 87 girls and 86 boys, and mean age was 9.9 years (9.6-10.3, 95 percent CI). 75.1 percent (68.7-81.5, 95 percent CI) had a family history of being overweight; 2.3 percent (0.1-4.5, 95 percent CI) were overweight and 1.7 percent (0.0-3.6 95 percentCI) were obese. More than half of the children had hightotal cholesterol levels (53.2 percent; 45.8-60.695 percentCI) and LDL (57.2 percent; 49.8-64.6 95 percent CI). Non-HDL cholesterol was found to be increased by 46.8 percent (39.4-54.2 95 percent CI). There was a significant difference between genders for triglyceridemia (females: 94.1 mg/dL; 87.0-101.2 mg/dL 95 percent CI; males: 81.7 mg/dL; 75.0-88.5 mg/dL 95 percent CI; p=0.005) and low physical activity (females: 83.8 percent; 73.5-94.5 percent 95 percent CI; males: 44.2 percent; 45.4-66.6 percent 95 percent CI; p=0,0001). Conclusions Cardiovascular risk factors in these schoolchildren, even in those who were not obese, justify the need for the early detection of these factors as well as their strict controlto reduce their impact on people's future quality of life.

Patrones de resistencia antimicrobiana en uropatógenos gramnegativos aislados de pacientes ambulatorios y hospitalizados Cartagena, 2005-2008 / Antimicrobial resistance pattern for gram-negative uropathogens isolated from hospitalised patients and outpatients in Cartagena, 2005-2008

Objetivo Determinar el patrón de resistencia antimicrobiana de bacterias patógenas asociadas a infecciones urinarias en pacientes ambulatorios y hospitalizados. Métodos Se realizó un estudio descriptivo entre febrero de 2005 y noviembre de 2008 en el Laboratorio Clínico de la Universidad de San Buenaventura, Cartagena. La susceptibilidad antimicrobiana fue evaluada con el método de difusión en agar empleado la técnica de Kirby Bauer aplicando procedimientos normalizados. Resultados Del total de muestras de orina analizadas (1 384) durante el período de estudio, 32,9 por ciento (455) fueron urocultivos positivos, la mayoría de éstos (81,4 por ciento) provenían de mujeres. Los agentes bacterianos más frecuentes fueron Escherichia. coli (60,1 por ciento), Klebsiella pneumoniae (6,9 por ciento), Pseudomonas aeruginosa (6,6 por ciento), Proteus mirabilis (5,4 por ciento) y Acinetobacter baumannii (1,4 por ciento). Los aislamientos gramnegativos mostraron una alta resistencia a la ampicilina (84,3100 por ciento), amoxacilina/ácido clavulánico (66,5 80,0 por ciento) y ciprofloxacina (40,057,9 por ciento). Conclusión Las bacterias gramnegativas fueron los principales agentes asociados a infecciones urinarias en esta población siendo E. coli el aislamiento más frecuente. La interpretación de los perfiles de susceptibilidad encontrados permite considerar como prudente la administración empírica de cefalosporinas de tercera generación como tratamiento inicial de las infecciones urinarias en esta población.

Objective Determining the microbial aetiology spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infections in hospitalised patients and outpatients. Methods A descriptive study was carried out between February 2005 and November 2008 at the San Buenaventura University's Clinical Laboratory in Cartagena. Antibiotic sensitivity was determined by the Kirby Bauer method. Results Out of the total specimens (1,384) analysed over the four-year study period, 455 of the urine samples (32.9 percent) were culture positive, most (81.4 percent) having come from females. The bacterium isolated most frequently was Escherichia coli (60.1 percent) followed by Klebsiella pneumoniae (6.9 percent), Pseudomonas aeruginosa (6.6 percent), Proteus mirabilis (5.4 percent) and Acinetobacter baumannii (1.4 percent). The Gram-negative isolates displayed a high level of resistance to ampicillin (range 84.3100 percent), amoxicillin/clavulanic acid (range 66.580 percent) and ciprofloxacin (range 4057.9 percent). Conclusion Gram-negative bacteria were responsible for urinary tract infections in the patients involved in this study. The most commonly isolated bacteria were E. coli. Empirical administration of a third-generation cephalosporin for initial treatment of urinary tract infections in this population appears prudent from the perspective of antimicrobial susceptibility.

Staphylococcus aureus meticilino resistente en niños escolares de Cartagena / Methicillin-resistant Staphylococcus aureus in children attending school in Cartagena, Colombia

Objetivo Determinar portadores nasales de Staphylococcus aureus resistente a meticilina (SARM) y factores de riesgo asociados a esta colonización, en una población escolar de Cartagena de Indias. Métodos Se realizó un estudio analítico transversal en 100 niños escolares sanos, para la búsqueda de portadores nasales de cepas SARM y su asociación con factores de riesgo. Para la identificación bacteriana se utilizaron métodos convencionales. A todos los aislamientos se les determinó la sensibilidad a antibióticos por el método de Kirby-Bauer. Resultados De la población escolar, se identificaron 36 cepas de S. aureus; 25 por ciento, oxacilino-resistentes; 66,7 por ciento, oxacilino-sensibles y 8,3 por ciento, con sensibilidad intermedia. El 67 por ciento de cepas SARM aisladas fueron sensibles a todos los antibióticos probados. Una cepa (SARM-Ant4) presentó resistencia a tres antibióticos con mecanismos de acción diferentes. Conclusiones Este es el primer estudio realizado en Cartagena, que determinó las frecuencias de portadores nasales de S. aureus y cepas SARM en una población escolar, registrándose un 33 por ciento y 9 por ciento, respectivamente. Todas las cepas de S. aureus oxacilino-resistente, fueron también cefoxitino-resistente, lo que hace sospechar la presencia del gen mecA. El uso de antibióticos betalactámicos en los últimos tres meses, incrementa aproximadamente cinco veces más el riesgo de ser portador nasal de cepas SARM (aOR=4,72 [IC95 por ciento=0,96-23,98] p<0,05). Los antibiotipos (Ant) encontrados hacen sospechar la presencia de cepas SARM adquiridas en la comunidad (SARM-AC, multisensible) y adquiridas en hospitales (SARM-AH, multirresistente).

Objective Determining nasal carriers of methicillin-resistant Staphylococcus aureus (MRSA) and associated risk factors for nasal colonisation in a school-aged population in the seaside city of Cartagena, Colombia. Methods A cross-sectional, analytical study was carried out on 100 healthy schoolchildren to determine MRSA nasal carriage and its association with risk factors. Bacteria were identified using conventional methods. Antibiotic sensitivity was determined by the Kirby Bauer method. Results A total of 36 isolates of S. aureus were identified in the school children. 25 percent of the strains were oxacillin-resistant, 66.7 percent oxacillin-sensitive and 8.3 percent had intermediate susceptibility. 67 percent of the MRSA strains isolated were sensitive to all antibiotics tested. One strain (MRSA-Ant4) showed resistance to antibiotics having different mechanisms of action. Conclusions This is the first study in Cartagena which determined the frequency of S. aureus and MRSA strains nasal carriers in a school population (33 percent and 9 percent, respectively). All S. aureus oxacillin-resistant strains were cephoxitin-resistant, thereby leading to the presence of the mecA gene being suspected. Having used beta-lactam antibiotics during the last three months increased the likelihood of being an MRSA nasal carrier by around five times (OR=4.72; 0.96-23.98 95 percentCL; p<0.05). The antibiotypes (Ant) found suggested the presence of community-acquired (multisensitive CA-MRSA,) and hospital-acquired-MRSA (multidrug resistant HA-MRSA,).

[Antimicrobial resistance pattern for gram-negative uropathogens isolated from hospitalised patients and outpatients in Cartagena, 2005-2008]. / Patrones de resistencia antimicrobiana en uropatógenos gramnegativos aislados de pacientes ambulatorios y hospitalizados Cartagena, 2005-2008.

OBJECTIVE: Determining the microbial aetiology spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infections in hospitalised patients and outpatients. METHODS: A descriptive study was carried out between February 2005 and November 2008 at the San Buenaventura University's Clinical Laboratory in Cartagena. Antibiotic sensitivity was determined by the Kirby Bauer method. RESULTS: Out of the total specimens (1,384) analysed over the four-year study period, 455 of the urine samples (32.9 %) were culture positive, most (81.4 %) having come from females. The bacterium isolated most frequently was Escherichia coli (60.1 %) followed by Klebsiella pneumoniae (6.9 %), Pseudomonas aeruginosa (6.6 %), Proteus mirabilis (5.4 %) and Acinetobacter baumannii (1.4 %). The Gram-negative isolates displayed a high level of resistance to ampicillin (range 84.3100 %), amoxicillin/clavulanic acid (range 66.580 %) and ciprofloxacin (range 4057.9 %). CONCLUSION: Gram-negative bacteria were responsible for urinary tract infections in the patients involved in this study. The most commonly isolated bacteria were E. coli. Empirical administration of a third-generation cephalosporin for initial treatment of urinary tract infections in this population appears prudent from the perspective of antimicrobial susceptibility.

[Methicillin-resistant Staphylococcus aureus in children attending school in Cartagena, Colombia]. / Staphylococcus aureus meticilino resistente en niños escolares de Cartagena.

OBJECTIVE: Determining nasal carriers of methicillin-resistant Staphylococcus aureus (MRSA) and associated risk factors for nasal colonisation in a school-aged population in the seaside city of Cartagena, Colombia. METHODS: A cross-sectional, analytical study was carried out on 100 healthy schoolchildren to determine MRSA nasal carriage and its association with risk factors. Bacteria were identified using conventional methods. Antibiotic sensitivity was determined by the Kirby Bauer method. RESULTS: A total of 36 isolates of S. aureus were identified in the school children. 25 % of the strains were oxacillin-resistant, 66.7 % oxacillin-sensitive and 8.3 % had intermediate susceptibility. 67 % of the MRSA strains isolated were sensitive to all antibiotics tested. One strain (MRSA-Ant4) showed resistance to antibiotics having different mechanisms of action. CONCLUSIONS: This is the first study in Cartagena which determined the frequency of S. aureus and MRSA strains nasal carriers in a school population (33 % and 9 %, respectively). All S. aureus oxacillin-resistant strains were cephoxitin-resistant, thereby leading to the presence of the mecA gene being suspected. Having used beta-lactam antibiotics during the last three months increased the likelihood of being an MRSA nasal carrier by around five times (OR=4.72; 0.96-23.98 95 %CL; p<0.05). The antibiotypes (Ant) found suggested the presence of community-acquired (multisensitive CA-MRSA,) and hospital-acquired-MRSA (multidrug resistant HA-MRSA,).