RESUMO
INTRODUCTION: Bats have become an epidemiologically significant source of pathogenic microorganisms, such as leptospires, the causative agents of leptospirosis. However, little information exists about bats and their potential role as a reservoir of pathogenic Leptospira spp. in Colombia. The aim of this study was to evaluate the presence of pathogenic Leptospira spp. in the kidneys of bats from the Caribbean region of Colombia deposited in the collection of mammals of the Museo Javeriano de Historia Natural (MPUJ-MAMM). METHODOLOGY: DNA was extracted from twenty-six kidney samples from a total of 13 species of bats captured in Colombia. First, 16S ribosomal RNA conventional PCR was performed to detect the presence of Leptospira spp. Then, in samples that tested positive, LipL32 PCR was performed to detect pathogenic Leptospira spp. by sequencing and phylogenetic analysis. RESULTS: The presence of Leptospira spp. was observed in 7/26 (26.9%) bats from the following 6 species: Carollia perspicillata, Glossophaga soricina, Dermanura phaeotis, Uroderma bilobatum, Desmodus rotundus, and Lophostoma silvicolum, and pathogenic Leptospira spp. were detected in 4/26 samples (15.4%). CONCLUSIONS: This study suggests that bats present in the Caribbean region of Colombia could be potential reservoirs of pathogenic Leptospira spp.
Assuntos
Quirópteros/microbiologia , Reservatórios de Doenças , Rim/microbiologia , Leptospira/isolamento & purificação , Leptospirose/veterinária , Animais , Região do Caribe , Análise por Conglomerados , Colômbia , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Leptospira/classificação , Leptospira/genética , Leptospirose/microbiologia , Filogenia , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
Introducción: La hipotermia terapéutica (HT) es el estándar de cuidado para la encefalopatía hipóxico-isquémica (EHI). El servicio de neonatología implemento el programa de HT en el marco de la red perinatal de la Ciudad de Buenos Aires (RPCABA). Objetivos: Describir la implementación del programa de hipotermia en RPCABA. Reportar la mortalidad, complicaciones y efectos adversos asociados al tratamiento. Métodos: La implementación del programa se realizó en etapas: 1) 2009- 2010 Capacitación y entrenamiento en el uso del equipamiento. 2) 2010 hasta la actualidad: Tratamiento y seguimiento para los pacientes con EHI moderada o grave. Resultados: Hasta Marzo de 2017, 65 neonatos recibieron HT (7 con hipotermia corporal total y los 58 restantes hipotermia activa selectiva), 49 paciente fueron clasificados según la Escala Sarnat & Sarnat como EHI moderada y 16 como EHI grave. Conclusiones: Fue factible implementar el programa en nuestra unidad, auditarlo para mejorarlo y sostenerlo en el tiempo. El sistema de traslado pudo responder ante la activación del "código de hipotermia", cumpliendo tiempos, sosteniendo el tratamiento y el monitoreo adecuado. Creemos necesario mejorar la identificación de neonatos con diagnóstico de EHI en RPCABA. Se necesita nueva capacitación para evitar el subdiagnóstico de esta patología en los centros de nivel 2
Therapeutic hypothermia (TH) is nowadays the gold standard of care for the treatment of hypoxic- ischemic encephalopathy (HIE) in developed countries. The term encephalopathy refers to a diffuse disturbance of brain function, resulting in behavioral changes, altered consciousness or seizures. The brain is particularly vulnerable to even brief interruptions of blood flow or oxygen supply. If the brain´s oxygen supply is insufficient, consciousness is lost rapidly. If oxygenation is restored immediately, consciousness returns without sequelae. However, if oxygen deprivation lasts longer than 1 or 2 minutes, signs of an encephalopathy may persists for hours or permanently. Total ischemic anoxia lasting longer than about 4 minutes usually results in severe irreversible brain damage. The aim of the present report was to describe the implementation of the hypothermia program in a model for the perinatal system at the City of Buenos Aires, with the equipment Cool Cap® for selective hypothermia, and the equipment CFM Olympic 6000® and CFM OMB from Medix® by Natus®, these two to monitoreate the cerebral function. The results obtained are referred, with special consideration to mortality, complications and adverse effects associated with the treatment.
