Experience of a novel lung transplant program in Mexico.

Lung transplantation is the gold standard therapy for patients in the end stages of pulmonary disease. However, in numerous countries, candidates for lung transplants often die on the waiting list due to a shortage of donors and limited access to transplant centers. This article delves into the experience of our hospital, Christus Muguerza in Monterrey, Mexico, as the sole active lung transplant program in the country, having conducted 35 transplants from August 2017 to March 2023. We discuss the actual situation of lung transplantation in Mexico and the challenges we have faced over time, such as late patient referrals for evaluation and eventual transplantation. In addition, we outline the challenges we anticipate as more transplant programs emerge in the country.

A multicentric outbreak of Candida auris in Mexico: 2020 to 2023.

BACKGROUND: Candida auris, an emerging multidrug-resistant yeast, has become a global concern due to its association with nosocomial outbreaks and resistance to antifungal medications. The COVID-19 pandemic has exacerbated the situation, with several outbreaks reported worldwide, including in Mexico. We describe the clinical and microbiological characteristics of a multicentric outbreak in private institutions in Mexico. METHODS: A retrospective observational study was conducted across 4 Christus Muguerza Hospital Health Care System facilities in Monterrey, Mexico, where simultaneous outbreaks of C auris occurred. Patients with colonization or infection with C auris between September 2020 and December 2023 were included. RESULTS: Analysis revealed 37 cases, predominantly male (median age, 55.8years). While most cases were initially colonization, a significant proportion progressed to infection (32.4%). Patients with documented infection had longer intensive care unit and hospital stays, often requiring mechanical ventilation. Antifungal treatment varied, with empirical fluconazole being the first drug in most cases, followed by anidulafungin and caspofungin. Resistance to fluconazole was widespread, but susceptibility to other antifungals varied. The overall mortality rates were high (40.5%), with no significant difference in median survival between colonized and infected patients. CONCLUSIONS: We reported a high rate of infection in previously colonized cases associated with longer hospital lenght stay, and a high susceptibility to echinocandins.

Appropriate use of antibiotics: an unmet need.

Increasing bacterial resistance combined with a steady decline in the discovery of new antibiotics has resulted in a global healthcare crisis. Overuse of antibiotics, for example, in the poultry and cattle industry, and misuse and improper prescription of antibiotics are leading causes of multidrug resistance (MDR). The increasing use of antibiotics, particularly in developing countries, is a big concern for antibiotic resistance and can cause other health threats such as increased risk of recurrent infections and increased risk of cardiovascular death with chronic use of macrolides. Carbapenems are the last line of defense in many cases of resistant infection, but trends show that resistance against these agents is also increasing. This narrative review is based on relevant literature according to the experience and expertise of the authors and presents an overview of the current knowledge on antibiotic resistance, the key driving factors, and possible strategies to tackle antibiotic resistance. Collectively, studies show that hospital-wide antibiotic stewardship programs are effective in decreasing the spread of antibacterial resistance. As resistance varies according to local patterns of use, it is essential to observe the epidemiology at both a regional and an institutional level. Furthermore, adaptation of clinical guidelines is necessary, particularly for inpatient care. Future guidelines should include a justification step for continued treatment of antibiotic treatments and criteria for selection of antibiotics at the start of treatment. Nonantibiotic prevention strategies can limit infections and should also be considered in treatment plans. Vaccines against MDR organisms have shown some efficacy in phase II trials in critical care patients. Nonimmunogenic and microbiologic treatment options such as fecal transplants may be particularly important for elderly and immune-compromised patients.

Factores socioeconómicos y culturales de los padres de los niños hospitalizados en el servicio en pediatría, que determina el uso de la medicina tradicional. Hospital Provincial Cotopaxi, Latacunga 1993 / Socioeconomic and cultural factors of the parents of the children hospitalized in the service in pediatría, that determines the use of the traditional medicine. Provincial Hospital Cotopaxi, Latacunga 1993

El Ecuador, por pertenecer al área Andina, se encuentra en proceso de desarrollo, sisendo enminentemente agrícola. La mayor parte de sus productos se cultivan en la costa y valles profundos de la sierra, posee una cultura invalorable en cuanto a su forma de vida y comportamiento, siendo ésta una de las causas principales para que se transmitan creencias y costumbres arraigadas desde la antihuedad como es la práctica de la medicina tradicional. Nosotros como parte integral del equipo de salud del servicio de Pediatría hemos detectado que la población con mayor frecuencia hace uso de la Medicina Tradicional antes de recibir tratamiento Profesional es la de Chimborazo, aspecto que queremos investigar, estudio que servirá de guía para incorporar la Medicina Profesional a la Tradicional y conjuntamente lograr una recuperación precoz del paciente evitando complicaciones futuras que peligren la vida del niño...