Detection of Viral and Bacterial Respiratory Pathogens Identified by Molecular Methods in COVID-19 Hospitalized Patients and Its Impact on Mortality and Unfavorable Outcomes.

PURPOSE: The purpose of this study is to evaluate the frequency of viral and bacterial respiratory pathogens detected by molecular methods in sputum samples of patients hospitalized for COVID-19 and to evaluate its impact on mortality and unfavorable outcomes (in-hospital death or mechanical ventilation). PATIENTS AND METHODS: The prospective cohort included patients with diagnosis of COVID-19 hospitalized at Hospital Nacional Hipólito Unanue. Sociodemographic and clinical data were collected from clinical records. Sputum samples were analyzed with the Biofire Filmarray Pneumonia plus® respiratory panel. Crude and adjusted associations with unfavorable outcomes were evaluated using logistic regression models. RESULTS: Ninety-three patients who were able to collect sputum samples were recruited between September 8 and December 28, 2020. The median age was 61.7 years (IQR 52.3-69-8) and 66 (71%) were male. The most frequent symptoms were dyspnea, cough, fever, and general malaise found in 80 (86%), 76 (82%), 45 (48%), and 34 (37%) patients, respectively. Fifty-three percent of patients had comorbidities. Seventy-six (82%) patients received antibiotics prior to admission and 29 (31%) developed unfavorable outcome. Coinfection was evidenced in 38 (40.86%) cases. The most frequently found bacteria were Staphylococcus aureus, Streptococcus agalactiae, Haemophilus influenzae and Klebsiella pneumoniae in 11 (11.83%), 10 (10.75%), 10 (10.75%), and 8 (8.6%) cases, respectively. Streptococcus pneumoniae was found in one case (1.08%). We neither identify atypical bacteria nor influenza virus. No association was found between the presence of viral or bacterial microorganisms and development of unfavorable outcomes (OR 1.63; 95% CI 0.45-5.82). CONCLUSION: A high frequency of respiratory pathogens was detected by molecular methods in patients with COVID-19 pneumonia but were not associated with unfavorable outcomes. No atypical agents or influenza virus were found. The high use antibiotics before admission is a concern. Our data suggest that the use of drug therapy against atypical bacteria and viruses would not be justified in patients hospitalized for COVID-19.

Factores determinantes de la cesárea en los hospitales de Tumbes (2011)

El aumento de la tasa de cesárea en los hospitales de Tumbes es motivo de preocupación. En el hospital de apoyo I-2 Jose Alfredo Mendoza Olavarría, la tasa de cesárea varió entre el 35% y 49% durante los años 2003-2005, mientras que el hospital I EsSalud registró una tasa del 45% en el año 2006. Frente a esta realidad, se planteó el problema de investigación para determinar cuáles fueron los factores determinantes de la cesárea en los hospitales del departamento de Tumbes durante el año 2011. Con el objetivo de conocer los factores maternos y fetales asociados a la cesárea y la frecuencia de la operación, se realizó el estudio en las cesareadas de los hospitales del Ministerio de Salud y EsSalud de Tumbes durante seis meses. Las técnicas e instrumentos de recolección de datos fueron observacionales, utilizandose una ficha de recolección de datos que contenía los antecedentes personales y ginecoobstétricos de la gestante, así como datos fundamentales de recién nacido. Se realizaron entrevistas a las pacientes cesareadas, utilizando un cuestionario con preguntas estructuradas y no estructuradas, para reseñar los datos relacionados con la indicación de la cesárea. Se encontraron que en el Hospital del Ministerio de Salud, La edad promedio fue de 26,4 años, mientras que en el de EsSalud fue de 29,4. En cuanto al control prenatal, fueron gestantes controladas con más de 6 controles prenatales y con embarazos previos a quienes se les explicó el motivo pero no las probables complicaciones de la cesárea. Los recién nacidos en el hospital del Ministerio de Salud tuvieron en promedio un peso de 3194 g y un apgar de 9,1, mientras que en la seguridad social el peso fue de 3200 g y un apgar promedio de 9,2. La frecuencia de cesárea en el hospital de EsSalud fue de 58,76% y de 49,52% en el MINSA.

The increased rate od cesarean section in hospitals in Tumbes is a concern. At the support hospital I-2 Jose Alfreso Mendoza Olavarría, the cesarean rate varied between 35% and 49% during 2003-2005, while the EsSalud hospital showed a rate of 45% in 2006. This is why the following problem arises: What were the determinants of caesarea section and the frequency of cesarean operation, it was performed the study on the cesarean at the Ministry of Health and Tumbes EsSalud hospitals for six months. The techniques and instruments for data collection were observational, using data collection sheet containing personal history, gynecological and obstetric data of pregnant women and newborn birth. Interviews were conducted with cesarean patients, using a structured and no structured questionnaire to collect data related to the indication for caesarean section. And we were found the following results: at the Hospital of the Ministry of Health, the average age was 26.4 years, while at EsSalud was 29.4. In terms of prenatal care, they were pregnant women monitored over six prenatal checks up and with previous pregnancies ones who were explained with the reason but not the likely complications of cesarean. Infants at the Hospital of the Ministry of Health had an average weight of 3194 grams and an apgar score of 9.1 while at the social security the weight was 3200g and apgar averange of 9.2. The frequency of cesarean section at EsSalud hospital was 58.76% and 49.52% at MINSA.

Molecular characterization of Echinococcus granulosus from Peru by sequencing of the mitochondrial cytochrome C oxidase subunit 1 gene.

Echinococcus granulosus, the etiologic agent of cystic echinococcosis (CE) in humans and other animal species, is distributed worldwide. Ten intra-specific variants, or genotypes (G1-G10), have been defined based on genetic diversity. To determine the genotypes present in endemic areas of Peru, samples were collected from cattle (44), sheep (41) and humans (14) from Junín, Puno Huancavelica, Cusco, Arequipa and Ayacucho. DNA was extracted from protoscolex and/or germinal layers derived from 99 E. granulosus isolates and used as templates to amplify the mitochondrial cytochrome C oxidase subunit 1 gene. The resulting polymerase chain reaction products were sequenced and further examined by sequence analysis. All isolates, independent of the host, exhibited the G1 genotype. Phylogenetic analysis showed that three isolates from Ayacucho shared the same cluster with microvariant G1(4). The G1 genotype is considered the most widespread and infectious form of E. granulosus worldwide and our results confirm that the same patterns apply to this country. Therefore, these findings should be taken into consideration in developing prevention strategies and control programs for CE in Peru.

Molecular characterization of Echinococcus granulosusfrom Peru by sequencing of the mitochondrial cytochrome C oxidase subunit 1 gene

Echinococcus granulosus, the etiologic agent of cystic echinococcosis (CE) in humans and other animal species, is distributed worldwide. Ten intra-specific variants, or genotypes (G1-G10), have been defined based on genetic diversity. To determine the genotypes present in endemic areas of Peru, samples were collected from cattle (44), sheep (41) and humans (14) from Junín, Puno Huancavelica, Cusco, Arequipa and Ayacucho. DNA was extracted from protoscolex and/or germinal layers derived from 99 E. granulosus isolates and used as templates to amplify the mitochondrial cytochrome C oxidase subunit 1 gene. The resulting polymerase chain reaction products were sequenced and further examined by sequence analysis. All isolates, independent of the host, exhibited the G1 genotype. Phylogenetic analysis showed that three isolates from Ayacucho shared the same cluster with microvariant G1(4). The G1 genotype is considered the most widespread and infectious form of E. granulosusworldwide and our results confirm that the same patterns apply to this country. Therefore, these findings should be taken into consideration in developing prevention strategies and control programs for CE in Peru.