[Microbiological air quality in a Community Family Health Center of Talcahuano, Biobío Region, Chile]. / Calidad microbiológica del aire en un Centro Comunitario de Salud Familiar de Talcahuano, Región del Biobío, Chile.

BACKGROUND: Indoor air quality in health centers is essential to protect the health of people. In Chile, the Community Family Health Centers (CECOSF) are places with large attendance of people, favoring the dissemination of microorganisms, and there are no reports of the microbial air loading these health centers. AIM: To evaluate the microbiological indoor air quality in CECOSF-Centinela in Talcahuano, Biobío Region. METHODS: Air samples were taken in 6 rooms of the CECOSF, every 15 days between July 2018 and June 2019, with the MAS-100 NT equipment using trypticase and Sabouraud agars. Different morphotypes of bacteria and fungi were identified by PCR. RESULTS: The bacterial and fungal counts varied between 9.1 × 101 - 2.4 × 103 cfu/m3 and 10 - 1.5 × 102 cfu/m3, respectively. The air in the waiting room presented the highest counts, both for bacteria and fungi (P < 0.05). Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter were identified, highlighting the species Staphylococcus aureus and Pseudomonas oryzihabitans, the latter described as a nosocomial pathogen. Among the fungi, Aspergillus, Meyerozyma and Rhodotorula were identified. CONCLUSION: The indoor air of the CECOSF-Centinela presents microorganisms of importance in human health. Therefore, it is necessary to formulate more regular monitoring programs for the control of air quality inside these health centers.

Calidad microbiológica del aire en un Centro Comunitario de Salud Familiar de Talcahuano, Región del Biobío, Chile / Microbiological air quality in a Community Family Health Center of Talcahuano, Biobío Region, Chile

INTRODUCCIÓN: La calidad del aire en centros de salud es fundamental para resguardar la salud de las personas. En Chile, los Centros Comunitarios de Salud Familiar (CECOSF) son lugares de gran concurrencia de personas, favoreciendo la diseminación de microorganismos. OBJETIVO: Evaluar la calidad microbiológica del aire al interior del CECOSF-Centinela en Talcahuano, Región del Biobío. METODOLOGÍA: Se tomó muestras de aire en seis salas del CECOSF, quincenalmente, entre julio de 2018 y junio de 2019, con el equipo MAS-100 NT, empleando agar tripticasa y agar Sabouraud. Diferentes morfotipos de bacterias y hongos fueron identificados mediante RPC. RESULTADOS: Los recuentos de bacterias y hongos variaron entre 9,1 × 101 - 2,4 × 103 ufc/m3 y 10 - 1,5 × 102 ufc/m3, respectivamente. El aire de la sala de espera presentó los recuentos más altos, tanto para bacterias como hongos (P < 0,05). Se identificó Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter, destacando las especies Staphylococcus aureus y Pseudomonas oryzihabitans, microrganismo este último, descrito actualmente como patógeno nosocomial. Entre los hongos se identificó Aspergillus, Meyerozyma y Rhodotorula. CONCLUSIÓN: Las muestras de aire del CECOSF-Centinela presentan microrganismos de importancia en salud humana. De ahí la necesidad de formular programas de monitoreo más regulares para controlar la calidad del aire al interior de estos establecimientos.

BACKGROUND: Indoor air quality in health centers is essential to protect the health of people. In Chile, the Community Family Health Centers (CECOSF) are places with large attendance of people, favoring the dissemination of microorganisms, and there are no reports of the microbial air loading these health centers. AIM: To evaluate the microbiological indoor air quality in CECOSF-Centinela in Talcahuano, Biobío Region. METHODS: Air samples were taken in 6 rooms of the CECOSF, every 15 days between July 2018 and June 2019, with the MAS-100 NT equipment using trypticase and Sabouraud agars. Different morphotypes of bacteria and fungi were identified by PCR. Results: The bacterial and fungal counts varied between 9.1 × 101 - 2.4 × 103 cfu/m3 and 10 - 1.5 × 102 cfu/m3, respectively. The air in the waiting room presented the highest counts, both for bacteria and fungi (P < 0.05). Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter were identified, highlighting the species Staphylococcus aureus and Pseudomonas oryzihabitans, the latter described as a nosocomial pathogen. Among the fungi, Aspergillus, Meyerozyma and Rhodotorula were identified. CONCLUSION: The indoor air of the CECOSF-Centinela presents microorganisms of importance in human health. Therefore, it is necessary to formulate more regular monitoring programs for the control of air quality inside these health centers.

[Carbapenemases produced by Carbapenem-resistant Pseudomonas aeruginosa isolated from hospitals in Chile]. / Carbapenemasas en aislamientos de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en hospitales de Chile.

BACKGROUND: Carbapenem resistance mediated by carbapenemases in Pseudomonas aeruginosa is an important mechanism; however, loss of porin OprD remains as the most frequent. AIM: To determine the proportion of P. aeruginosa isolates, resistant to imipenem and/or meropenem, producing carbapenemases, the type of enzyme produced and the genetic relationship between the isolates. METHODS: One hundred and thirteen resistant to at least one carbapenem isolates, obtained in 12 hospitals and 9 cities in Chile were studied. Additionally, susceptibility to ceftazidime, amikacin, gentamicin, piperacillin/tazobactam, ciprofloxacin and colistin was determined. Carba NP was performed and in the positive isolates carbapenemase genes were detected by PCR. The isolates were typified by restriction with SpeI and PFGE. RESULTS: Not all isolates produce carbapenemases, and only in 61/113 of them (54%) the blaKPC (32) or blaVIM (29) was amplified. In none of the isolates was found the coharboring of both genes. The pulsotypes indicated no clonal dissemination of the isolates, evidencing an important genetic diversity. CONCLUSIONS: P. aeruginosa isolates producing carbapenemases, obtained in Chilean hospitals carry blaKPC and blaVIM genes and, mostly, are polyclonal. These results emphasize the importance of carrying out epidemiological studies with a greater number of isolates to allow a better understanding of the epidemiology of carbapenemase-producing P. aeruginosa in Chile.

Carbapenemasas en aislamientos de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en hospitales de Chile

Resumen Introducción: La resistencia a carbapenémicos mediada por carbapenemasas en Pseudomonas aeruginosa es un mecanismo importante; sin embargo, la pérdida de la porina OprD continúa siendo el mecanismo más frecuente. Objetivo: Determinar la proporción de aislados de P. aeruginosa, resistentes a imipenem y/o meropenem, productores de carbapenemasas, el tipo de enzima producida y la relación genética entre los aislados. Material y Métodos: Se incluyó 113 aislados resistentes al menos a un carbapenémico, provenientes de 12 hospitales de 9 ciudades de Chile. Adicionalmente se determinó la susceptibilidad a ceftazidima, amikacina, gentamicina, piperacilina/tazobactam, ciprofloxacina y colistina. Se realizó Carba NP y en los aislados positivos (n: 61) se detectó genes de carbapenemasas por RPC. Los aislados fueron tipificados por restricción con SpeI y PFGE. Resultados: No todos los aislados presentan carbapenemasas, y sólo en 61/113 de ellos (54%) se amplificó blaKPC (32) o blaVIM (29). En ninguno de los aislados se encontró co-portación de ambos genes. Los pulsotipos indican que no hay diseminación clonal de los aislados, evidenciando una importante diversidad genética. Conclusiones: Los aislados de P. aeruginosa productores de carbapenemasas, obtenidos en hospitales de Chile, portan genes blaKPC y blaVIM y, en su mayoría, son policlonales. Estos resultados ponen énfasis en la importancia de realizar estudios epidemiológicos con mayor número de aislados que permitan conocer mejor la epidemiología de P. aeruginosa productoras de carbapenemasas en Chile.

Abstract Background: Carbapenem resistance mediated by carbapenemases in Pseudomonas aeruginosa is an important mechanism; however, loss of porin OprD remains as the most frequent. Aim: To determine the proportion of P. aeruginosa isolates, resistant to imipenem and/or meropenem, producing carbapenemases, the type of enzyme produced and the genetic relationship between the isolates. Methods: One hundred and thirteen resistant to at least one carbapenem isolates, obtained in 12 hospitals and 9 cities in Chile were studied. Additionally, susceptibility to ceftazidime, amikacin, gentamicin, piperacillin/tazobactam, ciprofloxacin and colistin was determined. Carba NP was performed and in the positive isolates carbapenemase genes were detected by PCR. The isolates were typified by restriction with SpeI and PFGE. Results: Not all isolates produce carbapenemases, and only in 61/113 of them (54%) the blaKPC (32) or blaVIM (29) was amplified. In none of the isolates was found the coharboring of both genes. The pulsotypes indicated no clonal dissemination of the isolates, evidencing an important genetic diversity. Conclusions: P. aeruginosa isolates producing carbapenemases, obtained in Chilean hospitals carry blaKPC and blaVIM genes and, mostly, are polyclonal. These results emphasize the importance of carrying out epidemiological studies with a greater number of isolates to allow a better understanding of the epidemiology of carbapenemase-producing P. aeruginosa in Chile.

Genetic Features of Antarctic Acinetobacter radioresistens Strain A154 Harboring Multiple Antibiotic-Resistance Genes.

While antibiotic-resistant bacteria have been detected in extreme environments, including Antarctica, to date there are no reports of Acinetobacter species isolated from this region. Here, we characterized by whole-genome sequencing (WGS) the genetic content of a single antibiotic-resistant Acinetobacter spp. isolate (A154) collected in Antarctica. The isolate was recovered in 2013 from soil samples at Fildes Peninsula, Antarctica, and was identified by detection of the intrinsic OXA-23 gene, and confirmed by Tetra Correlation Search (TCS) and WGS. The antibiotic susceptibility profile was determined by disc diffusion, E-test, and broth microdilution methods. From WGS data, the acquired resistome and insertion sequence (IS) content were identified by in silico analyses. Plasmids were studied by the alkaline lysis method followed by pulsed-field gel electrophoresis and conventional PCR. The A154 isolate was identified as A. radioresistens by WGS analysis and displayed >99.9 of similarity by TCS in relation with the databases. Moreover, it was resistant to ampicillin, ceftriaxone, ceftazidime, cefepime, cefotaxime, streptomycin, and kanamycin. Likewise, in addition to the intrinsic blaOXA-23-like gene, A154 harbored the plasmid-encoded antibiotic-resistance genes blaPER-2, tet(B), aph(3')-Vla, strA, and strB, as well as a large diversity of ISs. This is the first report of antibiotic-resistant A. radioresistens in Antarctica. Our findings show the presence of several resistance genes which could be either intrinsic or acquired in the region.

Evolutionary dynamics of carbapenem-resistant Acinetobacter baumannii circulating in Chilean hospitals.

We analyze the evolutionary dynamics of ninety carbapenem-resistant Acinetobacter baumannii (CRAB) isolates collected between 1990 and 2015 in Chile. CRAB were identified at first in an isolate collected in 2005, which harbored the ISAba1-blaOXA-69 arrangement. Later, OXA-58- and OXA-23-producing A. baumannii strains emerged in 2007 and 2009, respectively. This phenomenon was associated with variations in the epidemiology of OXA-type carbapenemases, linked to nosocomial lineages belonging to ST109, ST162, ST15 (CC15) and ST318 (CC15).

Diversity structure of culturable bacteria isolated from the Fildes Peninsula (King George Island, Antarctica): A phylogenetic analysis perspective.

It has been proposed that Antarctic environments select microorganisms with unique biochemical adaptations, based on the tenet 'Everything is everywhere, but, the environment selects' by Baas-Becking. However, this is a hypothesis that has not been extensively evaluated. This study evaluated the fundamental prediction contained in this hypothesis-in the sense that species are structured in the landscape according to their local habitats-, using as study model the phylogenetic diversity of the culturable bacteria of Fildes Peninsula (King George Island, Antarctica). Eighty bacterial strains isolated from 10 different locations in the area, were recovered. Based on phylogenetic analysis of 16S rRNA gene sequences, the isolates were grouped into twenty-six phylotypes distributed in three main clades, of which only six are exclusive to Antarctica. Results showed that phylotypes do not group significantly by habitat type; however, local habitat types had phylogenetic signal, which support the phylogenetic niche conservatism hypothesis and not a selective role of the environment like the Baas-Becking hypothesis suggests. We propose that, more than habitat selection resulting in new local adaptations and diversity, local historical colonization and species sorting (i.e. differences in speciation and extinction rates that arise by interaction of species level traits with the environment) play a fundamental role on the culturable bacterial diversity in Antarctica.

Draft Genome Sequence of a Multidrug-Resistant Acinetobacter baumannii Strain from Chile.

Acinetobacter baumannii strain Ab5 was isolated in the year 2007 in Chile, being one of the first multidrug-resistant (MDR) cases reported in the country. Here, we present the very first draft genome sequence of an MDR Chilean strain, which shows the presence of diverse resistance and acquired virulence genes.

Prevalencia del determinante de resistencia plasmídica a quinolonas aac(6’)-Ib-cren cepas de Escherichia coli y Klebsiella pneumoniae productoras de BLEE aisladas en diez hospitales de Chile / Prevalence of plasmid-mediated quinolone resistance determinant aac(6’)-Ib-cr among ESBL producing enterobacteria isolates from Chile an hospitals

Introducción: En Chile no se conoce la frecuencia del determinante plasmídico de resistencia a quinolonas(DPRQ) aac(6 )-Ib-cr en cepas de Klebsiella pneumoniae y Escherichia coli productoras de BLEE. Metodología: Utilizando PCR, RFLP y secuenciación se detectó aac(6 )-Ib y aac(6 )-Ib-cr en cepas aisladas en 10 hospitales chilenos entre 2008 y 2009.Resultados: Este DPRQ fue detectado ampliamente en K. pneumoniae (54%) y E. coli (74%). La CIM50de CIP fue mayor en cepas con aac(6’)-Ib-cr; 8 veces en K. pneumoniae y 4 en E. coli. En 13 cepas deK. pneumoniae y 3 de E. coli se encontraron ambos genes simultáneamente. Conclusión: Este es el primer informe de aac(6’)-Ib-cr en cepas de K. pneumoniae y E. coli productoras de BLEE aisladas en hospitales chilenos distribuidos en una extensión geográflca superior a 2.800 km (AU)

Introduction: The frequency of aac(6 )-Ib-cr gene in ESBL-producing strains of Klebsiella pneumoniae and Escherichia coli is unknown, in Chile. Methodology: The aac(6 )-Ib and aac(6’)-Ib-cr genes were investigated using polymerase chain reaction(PCR), restriction fragment length polymorphism (RFLP), and sequencing, in strains isolated from 10Chilean hospitals between 2008-2009.Results: The aac(6’)-Ib-cr gene was detected in 54% of K. pneumoniae and 74% of E. coli strains. The CIM50 of CIP was higher among strains harboring aac(6’)-Ib-cr, 8 times higher in K. pneumoniae and 4 times higherin E. coli. Moreover, both aac(6’)-Ib and aac(6’)-Ib-cr were simultaneously found in 13 K. pneumoniae and3 E. coli isolates. Conclusion: This is the first report of aac(6’)-Ib-cr in ESBL-producing strains of K. pneumoniae and E. coliisolated from in-patients in Chilean hospitals located along an area of more than 2,800 Km (AU)

[Prevalence of plasmid-mediated quinolone resistance determinant aac(6')-Ib-cr among ESBL producing enterobacteria isolates from Chilean hospitals]. / Prevalencia del determinante de resistencia plasmídica a quinolonas aac(6')-Ib-cr en cepas de Escherichia coli y Klebsiella pneumoniae productoras de BLEE aisladas en diez hospitales de Chile.

INTRODUCTION: The frequency of aac(6')-Ib-cr gene in ESBL-producing strains of Klebsiella pneumoniae and Escherichia coli is unknown, in Chile. METHODOLOGY: The aac(6')-Ib and aac(6')-Ib-cr genes were investigated using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and sequencing, in strains isolated from 10 Chilean hospitals between 2008-2009. RESULTS: The aac(6')-Ib-cr gene was detected in 54% of K. pneumoniae and 74% of E. coli strains. The CIM(50) of CIP was higher among strains harboring aac(6')-Ib-cr, 8 times higher in K. pneumoniae and 4 times higher in E. coli. Moreover, both aac(6')-Ib and aac(6')-Ib-cr were simultaneously found in 13 K. pneumoniae and 3 E. coli isolates. CONCLUSION: This is the first report of aac(6')-Ib-cr in ESBL-producing strains of K. pneumoniae and E. coli isolated from in-patients in Chilean hospitals located along an area of more than 2,800 Km.