Bacterial incidence and drug resistance from pathogens recovered from blood, cerebrospinal and pleural fluids in 2019-2020. Results of the Invifar network.

Background: Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure. Methods: We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For Streptococcus pneumoniae, a comparative analysis was performed with data from the broth microdilution method. Results: Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF, Staphylococcus epidermidis was the most frequent. For blood, among gram negatives, the most frequent was Escherichia coli. Among Enterobacterales, 9.8% of K. pneumoniae were carbapenem-resistant. For S. pneumoniae, similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was E. coli. In Acinetobacter baumannii, carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was E. coli; in A. baumannii, carbapenem resistance was 96.3%. Conclusion: Gram-negative bacteria, with E. coli most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In S. pneumoniae, the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.

Diagnóstico de lumbalgia en estudiantes universitarios del área de salud en Tepic, Nayarit / Diagnosis of low back pain in university students in health department in Tepic, Nayarit

Resumen La lumbalgia es una sensación de dolor y malestar por debajo de la zona lumbar, ocasionando una discapacidad parcial o total. El objetivo de este estudio fue determinar la prevalencia de lumbalgia en estudiantes universitarios de Tepic Nayarit México. Se eligieron estudiantes de la Licenciatura en Nutrición y Fisioterapia, participando 90 los cuales 45 de cada profesión, quienes llenaron un cuestionario Nórdico de Kuorinka sobre padecimiento de lumbalgia relacionados con el tiempo que se encontraban en la escuela y sus actividades fuera de ella. El dolor de espalda prevaleció en los estudiantes de Nutrición (77.77%). La mala postura se adopta comúnmente en las clases. El 31.11% de los estudiantes de nutrición usan el respaldo de la butaca de manera ocasional y el 44.22% los de Fisioterapia lo utilizan de manera constante y ocasional. El 42.22% de los estudiantes tienen una posición normal al momento de escribir y el 33.33% en apoyo. Las posturas fueron un factor determinante para padecer el dolor lumbar en los estudiantes de ambas licenciaturas. La percepción dolorosa en la zona lumbar se debió por la malas medidas ergonomícas del mobiliario y las butacas no se contaban adaptadas a la complexión de la mayoría de los estudiantes.

Abstract Low back pain is a sensation of pain and discomfort below the lumbar area. This pain is caused by various factors causing a partial or total disability. The aim of the study is to determine the prevalence of low back pain in university students of Tepic Nayarit Mexico. It presents a study of prevalence of low back pain in students of the Nutrition physiotherapy. 90 students participated, 45 of each profession, who, after obtaining their informed consent, completed a questionnaire on the condition of low back pain related to the time found in the school and its activities outside it, based on the Kuorinka Nordic Questionnaire. Back pain prevailed in nutrition degree students (77.77%). Bad posture is commonly adopted in classes. The 31.11% of the nutrition degree students use the seat back occasionally, while the 44.22% of physiotherapy degree use it in a constant and occasional way. The 42.22% of students have a normal position at the time of writing and 33.33% in support. The postures were a determining factor for suffering lumbar pain. The students of the Nutrition degree and the Physiotherapy degree were prone to suffer it and most of them had a painful perception in the lumbar area, by the bad measures ergonomics of the furniture in the university and because they were not. They had seats adapted to the complexion, stature and manner of writing of most students.

[Resistance to non-beta-lactam antibiotics in the clinical isolates of Streptococcus pneumoniae of children in Latin America. SIREVA II, 2000-2005]. / Resistencia a antibióticos no betalactámicos de aislamientos invasores de Streptococcus pneumoniae en niños latinoamericanos. SIREVA II, 2000-2005.

OBJECTIVE: To examine the development of resistance to erythromycin, chloramphenicol, trimethoprim-sulfamethoxazole (TMP-SMZ), and vancomycin of the invasive isolates of Streptococcus pneumoniae obtained from children in 10 Latin American/Caribbean countries during six years of surveillance. METHODS: Analysis of 8 993 isolates of S. pneumoniae recovered in 2000-2005 from children with invasive infections, who were less than 6 years of age, and from Argentina, Brazil, Chile, Colombia, Cuba, Dominican Republic, Mexico, Paraguay, Uruguay, or Venezuela. Antibiotic susceptibility was determined through the methods established and standardized by the SIREVA project. Multidrug resistance was defined as: resistance to three or more antibiotics of the same class; to the non-beta-lactams analyzed by this study; or, to the beta-lactams evaluated by a previous study, in which 37.8% of these isolates showed decreased susceptibility to penicillin. RESULTS: Some degree of resistance was found to TMP-SMZ and erythromycin (56.4% and 15.4% of the isolates studied, respectively), with 4.6% highly resistant to chloramphenicol. All isolates were susceptible to vancomycin. The highest prevalence of TMP-SMZ resistance was observed in the pneumonia isolates; and that of erythromycin, in cases of sepsis (61.6% and 25.5%, respectively; P < 0.01). The highest prevalence of TMP-SMZ resistance was found in Brazil (71.9%), and that of erythromycin, in Mexico (38.2%) and Venezuela (32.9%). The 14, 6B, 19F, and 23F serotypes were most often associated with resistance to the antibiotics in the study. CONCLUSIONS: High and increasing rates of isolates resistant to TMP-SMZ and erythromycin were observed, as well as a decreasing percentage of isolates resistant to chloramphenicol. These trends highlight differences among the countries studied.

El grado de agregación de Ascaris lumbricoides según grupos de edad, después de una intervención antihelmíntica de masas / The degree of age-aggregation of Ascaris lumbricoides in a community after a mass antihelminthic intervention

Objetivo. Descubrir la heterogeneidad de la reinfección por Ascaris lumbricoides según grupos de edad, en distintos intervalos, después de un primer tratamiento antihelmíntico masivo. Material y métodos. A partir de datos de la prevalencia e intensidad de la infección por A. lumbricoides obtenidos en un estudio epidemiológico de ascariasis, realizado en Coatzacoalcos, Veracruz, México, se deriva el grado de agregación por medio del método de máxima verosimilitud, asumiendo una distribución binomial negativa del parásito en el huésped. Resultados. Se muestra que la distribución del parásito en el huésped es distinta en el ámbito poblacional que en el de grupos de edad, que la recuperación de la infección no es uniforme; y que la dinámica de asociación huésped-parásito exhibe una marcada desestabilización de su equilibrio endémico después de una primera intervención de masas. Conclusiones. Lo anterior sugiere que existe una alta variabilidad en la agregación entre los distintos grupos de edad y, por tanto, la infección y la reinfección son heterogéneas respecto a la edad. Después de la desestabilización del equilibrio endémico, los estados que alcanza el sistema huésped-parásito son transitorios. Dada la heterogeneidad de la infección, los tratamientos selectivos parecen ser la estrategia más adecuada para disminuirla

Objective. The degree of aggregation is determined for the whole population and for different age-specific strata and is used for assessing the reinfection rate after a mass antihelminthic chemotherapeutic intervention. Material and methods. The degree of aggregation of Ascaris lumbricoides is derived from prevalence and intensity of infection data obtained from an epidemiological study of ascariasis carried out in Coatzacoalcos, Veracruz, México by means of maximum likelihood estimation of the negative binomial distribution. Results. The results show that the distribution of the parasite for the whole population differs from the distribution of the parasite within each age-specific stratum; the reinfection rate is not uniform; the dynamics of the hostparasite association exhibits a clear destabilization of its endemic equilibrium after a first round of mass treatment.Conclusions. It is suggested that the aggregation among the different age-groups is highly variable and hence the infection and reinfection rates are heterogeneous with regard to age; these states of the host-parasite system are transient. Given the heterogeneity of the infection, the selective treatment seems to be the most adequate strategy to diminish helminth infection rates.