Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Hospitalized Patients in Peru.

There is a knowledge gap in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) causing bloodstream infections (BSIs) in Peru. Through a surveillance study in 13 hospitals of 10 Peruvian regions (2017-2019), we assessed the proportion of MRSA among S. aureus BSIs as well as the molecular typing of the isolates. A total of 166 S. aureus isolates were collected, and 36.1% of them were MRSA. Of note, MRSA isolates with phenotypic and genetic characteristics of the hospital-associated Chilean-Cordobes clone (multidrug-resistant SCCmec I, non-Panton-Valentine leukocidin [PVL] producers) were most commonly found (70%), five isolates with genetic characteristics of community-associated MRSA (CA-MRSA)-SCCmec IV, PVL-producer-(8.3%) were seen in three separate regions. These results demonstrate that hospital-associated MRSA is the most frequent MRSA found in patients with BSIs in Peru. They also show the emergence of S. aureus with genetic characteristics of CA-MRSA. Further studies are needed to evaluate the extension of CA-MRSA dissemination in Peru.

Fiebre de origen desconocido y eosinofilia a propósito de un caso de fasciolasis humana / Fever of unknown origin and eosinophilia with regard to a case of human fasciolasis

Se revisa la definición y principales causas de fiebre de origen desconocido (FOD) así como de la eosinofilia: primero en foma individual y luego ambas coexisten. Seguidamente se presenta el caso clínico de una mujer de 64 años procedente del caserío de Villachaqui, Salpo, Otusco. La Libertad, quien presento fiebre de más de dos meses de evolución, dolor en hipocondrio derecho, cosinofilia severa, leucocitos, fosfatasa alcalina elevada, proteínas séricas elevadas a predominio de las globulinas, ecografías y TAC con imágenes anormales en el hígado y derrame pleural derecho, en quien, finalmente, se le encontró huevos de fasciola hepatica en heces. Recibió triclabendazol remitiendo sus molestias. Se discuten estos hallazgos y se concluyó que: 1) en pacientes con fiebre de origen oscuro y eosinofilia debe considerarse la posibilidad de fasciolasis hepática en nuestro medio, 2) es necesario contar con métodos diagnósticos serológicos ya que la investigación de huevos en heces es un procedimiento muy poco sensible en la primera fase da la infestación. 3) se debe adiestrar a los médicos en la lectura de imágenes que sugieran fasciolasis hepática. 4) se debe iniciar una investigación epidemiológica en el distrito de Sapo, Otusco, con el fin de determinar el grado de infestación de su población. 5) se debe iniciar una campaña desincentivando el consumo de berros, de aguas de estanques y acequias sin hervir y de emolientes.

The is cheeked the definition and main fever causes of the fever of unknown origin (FOD) as son as of the eosinofilia, first individual and the both coexist. Then it is presennted the clinic case of a 64 years old woman. from the hamlet or Villachaqui, Salpo, Otusco, La Libertad, who showed fever of more than two months of evolution, pain in the right hypocondrio, severe cosinophilia, leucocotosis, high alkaline phosphata, high serum protein with predominance of the globulins , ecography and CAT with abnormal images in the liver and r right pleural effusion, in which finally, were found eggs o Hepatic fasciola in faeces. She received triclabendazole disminishing her sympotoms. The discoveries are discussed and it is concluded that in: 1) in patients with fever of unknown origin, considerer the possibility of hepatic fasciolasis in our enviroment. 2) it is necessary to count with serum methods diagnostic, because the research of eggs in faeces in very little sensible process in the first phase of the in infestation. 3) Doctors should he train in the reading of images that suggest hepatic fasciolasis. 4) An epidemiolagist research should be started in the district of Salpo, Otusco, with the objective to determining the degree of infestation of its population. 5) It should be started a campaing to lose interest to the consumption, of watercress, pont water and irrigation ditch withoud boil and emollients.