24 results on '"Ochoa, Theresa J."'
Search Results
2. Knowledge, attitudes and practices of parents towards antibiotic use in rural communities in Peru: a cross-sectional multicentre study
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Paredes, Jose Luis, Navarro, Rafaella, Watanabe, Takashi, Morán, Flavia, Balmaceda, Maria Pia, Reateguí, Andrea, Elias, Raul, Bardellini, Miguel, and Ochoa, Theresa J.
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- 2022
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3. Acute Gastroenteritis Morbidity and Mortality Trends Following Universal Rotavirus Vaccination in Children in Peru: Ecological Database Study with Time-Trend Analysis
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Juliao, Patricia, Guzman-Holst, Adriana, Gupta, Vinay, Velez, Claudia, Petrozzi, Veronica, and Ochoa, Theresa J.
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- 2021
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4. Epidemiologic, clinical and bacteriologic characteristics of pneumococcal meningitis in pediatric patients from Lima, Peru
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Davalos, Long, Terrazas, Yessica, Quintana, Ana, Egoavil, Martha, Sedano, Katherine, Castillo, María E., Reyes, Isabel, Chaparro, Eduardo, Silva, Wilda, Campos, Francisco, Saenz, Andrés, Hernandez, Roger, del Águila, Olguita, Guillén Pinto, Daniel, and Ochoa, Theresa J.
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Male ,streptococcus pneumoniae ,perú ,lcsh:R5-920 ,Meningitis, Pneumococcal ,lcsh:R ,Infant ,lcsh:Medicine ,meningitis neumocócica ,Pneumococcal Vaccines ,Streptococcus pneumoniae ,Meningitis, pneumococcal ,Peru ,Infant mortality ,Child, Preschool ,Humans ,Female ,Prospective Studies ,Meningitis neumocócica ,Perú ,Mortalidad infantil ,Serotyping ,mortalidad infantil ,Child ,lcsh:Medicine (General) - Abstract
Objectives. To describe the clinical characteristics, lethality, antibiotic susceptibility, and serotype distribution of pneumococcal meningitis in pediatric patients in Lima, Peru. Materials and Methods. A case series of pneumococcal meningitis in children less than 16 years of age from two prospective, multicenter, passive surveillance studies of invasive pneumococcal diseases held in Lima-Peru from 2006 to 2008 and 2009 to 2011. Results. We report 44 pneumococcal meningitis episodes; 68.2% of them were in children less than 2 years old. The overall case fatality rate was 32.6%; 92.9% of fatal cases were in children less than 2 years of age (p0.05). Malnutrition was associated with fatal cases (p0.05). 64.3% of fatal cases died within the first two days. 41.9% of pneumococcal isolates were resistant to penicillin, 23.3% were intermediate resistant to ceftriaxone (none were highly resistant) and 9.3% were resistant to chloramphenicol. The most common serotypes were 6B, 14, 19F and 23F, which accounted for 68.3% of all strains; 84.1% of strains were PCV13 serotypes. Conclusions. Pneumococcal meningitis continues to be a lethal disease, especially in children less than 2 years of age. Since almost two third of lethal cases lead to death within the first 48 hours, prompt diagnosis and management is critical, as well as assurance of immunization with pneumococcal vaccine. Objetivos. Describir las características clínicas, letalidad, susceptibilidad antibiótica y distribución de serotipos de meningitis neumocócica en pacientes pediátricos de Lima, Perú. Materiales y Métodos. Serie de casos de meningitis neumocócica en niños menores de 16 años. Los datos fueron obtenidos de dos estudios multicéntricos prospectivos, de vigilancia pasiva de enfermedad neumocócica invasiva realizados en Lima-Perú desde los años 2006 al 2008, y del 2009 al 2011. Resultados. Reportamos 44 episodios de meningitis neumocócica; 68,2% fueron en niños menores de 2 años. La tasa de letalidad fue 32,6; y 92,9% de los casos letales ocurrieron en niños menores de dos años (p0,05). La desnutrición estuvo asociada a los casos letales (p0,05). El 64,3% de los casos fatales murieron dentro de los 2 primeros días. El 41,9% de los cultivos con neumococo fueron resistentes a la penicilina, 23,3% mostró resistencia intermedia a ceftriaxona (ninguno mostró resistencia completa) y 9,3% mostró resistencia a cloranfenicol. Los serotipos más frecuentes fueron 6B, 14, 19F y 23F, los cuales constituyeron el 68,3% de todas las cepas; 84,1% de las cepas encontradas están incluidas en los serotipos de la vacuna 13 valente. Conclusiones. La meningitis neumocócica continúa siendo una enfermedad letal, especialmente en niños menores de 2 años. Dado que aproximadamente dos tercios de los casos letales fallecen en las primeras 48 h, es crítico un diagnóstico y tratamiento oportuno, así como asegurar el cumplimiento de la inmunización con la vacuna neumocócica.
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- 2016
5. Prevalence of purchase of antibiotics without prescription and antibiotic recommendation practices for children under five years of age in private pharmacies in peri-urban areas of Lima, Peru
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Valle Mendoza, Luis Javier del, Ecker, Lucie, Vargas, Martha, Ochoa, Theresa J., Universitat Politècnica de Catalunya. Departament d'Enginyeria Química, Universitat Politècnica de Catalunya. PSEP - Polimers Sintètics: Estructura i Propietats. Polimers Biodegradables., and Universitat Politècnica de Catalunya. PSEP - Polimers Sintètics: Estructura i Propietats. Polimers Biodegradables
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Farmàcies ,Perú ,Enginyeria química [Àrees temàtiques de la UPC] ,Antibiotics ,Venta de antibióticos ,Peru ,prescripción de antibióticos ,Antibiòtics ,Drugstores ,resistencia antibiótica ,niños ,farmacias - Abstract
Objetivos. Determinar la prevalencia de compra sin receta médica y recomendación de antibióticos para su uso en niños menores de 5 años en farmacias privadas de zonas peri-urbanas de Lima. Materiales y métodos. Se aplicó una encuesta anónima poblacional en adultos que compraron un antibiótico para un niño menor de cinco años en una farmacia privada. En un subgrupo de farmacias se aplicaron casos ficticios para evaluar prácticas de recomendación de antibióticos. Resultados. La prevalencia de compra sin receta fue de 13%; 1,7% por automedicación y 11,3% por indicación del farmacéutico. El 66,7% de los medicamentos para tratar resfrío fueron antibióticos de los cuales 56,9% tenían receta. El 64,4% de los medicamentos comprados para tratar broncoespasmo fueron antibióticos; el 96,4% de los medicamentos para tratar diarreas acuosas y el 90,9% de los medicamentos para tratar faringitis. Amoxicilina (51,5%) y trimetoprim-sulfametoxazol (20,6%) fueron los más comprados. En el 60% de los casos ficticios de resfrío común, en el 76% de los de broncoespasmo, en el 44% de los de diarrea acuosa y en el 76% de los casos de disentería, el farmacéutico indicó un antibiótico. Conclusiones. La compra de antibióticos para niños menores de cinco años en farmacias privadas es principalmente con receta médica. La recomendación de antibióticos por parte de la farmacia es alta cuando no hay receta médica. Urgen medidas para disminuir el uso inadecuado de antibióticos tanto a nivel médico como en las farmacias
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- 2016
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6. [Prevalence of purchase of antibiotics without prescription and antibiotic recommendation practices for children under five years of age in private pharmacies in peri-urban areas of Lima, Peru]
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Ecker, Lucie, Joaquim Ruiz, Vargas, Martha, Del Valle, Luis J., and Ochoa, Theresa J.
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Male ,Pharmacies ,lcsh:R5-920 ,lcsh:R ,Infant, Newborn ,venta de antibióticos, resistencia antibiótica, niños, prescripción de antibióticos, farmacias ,lcsh:Medicine ,Infant ,Pharmacists ,Anti-Bacterial Agents ,Prescriptions ,Child, Preschool ,Peru ,Prevalence ,Prescription drug misuse, Drug resistance, microbial ,child ,Drug prescription ,Humans ,Female ,lcsh:Medicine (General) - Abstract
Objetivos. Determinar la prevalencia de compra sin receta médica y recomendación de antibióticos para su uso en niños menores de 5 años en farmacias privadas de zonas peri-urbanas de Lima. Materiales y métodos. Se aplicó una encuesta anónima poblacional en adultos que compraron un antibiótico para un niño menor de cinco años en una farmacia privada. En un subgrupo de farmacias se aplicaron casos ficticios para evaluar prácticas de recomendación de antibióticos. Resultados. La prevalencia de compra sin receta fue de 13%; 1,7% por automedicación y 11,3% por indicación del farmacéutico. El 66,7% de los medicamentos para tratar resfrío fueron antibióticos de los cuales 56,9% tenían receta. El 64,4% de los medicamentos comprados para tratar broncoespasmo fueron antibióticos; el 96,4% de los medicamentos para tratar diarreas acuosas y el 90,9% de los medicamentos para tratar faringitis. Amoxicilina (51,5%) y trimetoprim-sulfametoxazol (20,6%) fueron los más comprados. En el 60% de los casos ficticios de resfrío común, en el 76% de los de broncoespasmo, en el 44% de los de diarrea acuosa y en el 76% de los casos de disentería, el farmacéutico indicó un antibiótico. Conclusiones. La compra de antibióticos para niños menores de cinco años en farmacias privadas es principalmente con receta médica. La recomendación de antibióticos por parte de la farmacia es alta cuando no hay receta médica. Urgen medidas para disminuir el uso inadecuado de antibióticos tanto a nivel médico como en las farmacias.
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- 2015
7. Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Peru
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Ochoa, Theresa J., Ecker, Lucie, Barletta, Francesca, Mispireta, Mónica L., Gil, Ana I., Contreras, Carmen, Molina, Margarita, Amemiya, Isabel, Verastegui, Hector, Hall, Eric R., Cleary, Thomas G., and Lanata, Claudio F.
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Diarrhea ,Diarrheagenic E. coli ,Peru ,Age-related susceptibility ,Infants - Abstract
Theresa.J.Ochoa@uth.tmc.edu Article BACKGROUND: Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants. METHODS: We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction. RESULTS: The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants aged >or=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P or=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged
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- 2015
8. [Pneumococcal serotypes in carrier children prior to the introduction of anti-pneumococcal vaccines in Peru]
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Mercado, Erik H., Egoavil, Martha, Horna, Sara G., Torres, Nancy, Velásquez, Ricardo, Castillo, María E., Chaparro, Eduardo, Hernández, Roger, Silva, Wilda, Campos, Francisco E., Sáenz, Andrés, Hidalgo, Félix, Letona, Carolina, Valencia, Ángel G., Cerpa, Rosario, López-de-Romaña, Bernardo, Pando, Jackeline, Torres, Berenice, Castillo, Fiorella, Calle, Andrea, Rabanal, Synthia, and Ochoa, Theresa J.
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Male ,Pneumococcal Vaccines ,Cross-Sectional Studies ,Streptococcus pneumoniae ,Portador ,Serotipificación ,Niño ,Perú ,Carrier State ,Peru ,Humans ,Infant ,Female ,Serotyping ,Carriage ,Child - Abstract
Objectives. To determine the carriage rate and serotype distribution of Streptococcus pneumoniae in the nasopharynx of healthy children younger than 2 years prior to the universal use of the pneumococcal conjugate vaccines in Peru. Materials and methods. Between 2007 and 2009 we collected nasopharyngeal swab samples from 2,123 healthy children aged 2 to 24 months in the vaccination and healthy children consultation offices of pediatric hospitals and health centers in 7 cities in Peru: on the coast (Lima, Piura), highlands (Cusco, Abancay, Arequipa and Huancayo) and amazon basin (Iquitos). The pneumococcal strains were isolated and identified at the central laboratory of the project in Lima, and serotyped by Quellung reaction in the pneumococcal reference laboratory at the Center for Diseases Control and Prevention (CDC). Results. We found 27% (573/2123) of pneumococcal nasopharyngeal healthy carrier children. Among the 526 analyzed strains, we found 42 serotypes; the most common were: 19f (18.1%), 6B (14.3%); 23f (8.9%) and 14 (6.5%). Conclusions. The distribution of vaccine serotypes in the analyzed strains was of 50% for the serotypes present in the seven-valent vaccine, 50.2% for the serotypes present in the ten-valent vaccine and 57.2% for those present in the thirteen-valent vaccine. Objetivos. Determinar la frecuencia y distribución de serotipos de S. pneumoniae en portadores nasofaríngeos sanos menores de dos años previa al uso universal de la vacuna conjugada antineumocócica en el Perú. Materiales y métodos. Entre los años 2007 y 2009 se tomaron muestras de hisopado nasofaríngeo a 2123 niños sanos entre 2 y 24 meses de edad en los consultorios de crecimiento y desarrollo o vacunación de hospitales y centros de salud de siete ciudades del Perú: costa (Lima, Piura); sierra (Cusco, Abancay, Arequipa y Huancayo) y selva (Iquitos). Las cepas de neumococo fueron aisladas e identificadas en el laboratorio central del proyecto en Lima y serotipificadas por reacción de Quellung en el Laboratorio de Referencia de Neumococo del Centro de Control y Prevención de Enfermedades. Resultados. Se encontró 27,0% (573/2123) de portadores nasofaríngeos sanos de neumococo. En las 526 cepas analizadas se encontraron 42 serotipos; los más frecuentes fueron: 19f (18,1%), 6B (14,3%); 23f (8,9%) y 14 (6,5%). Conclusiones. La distribución de serotipos vacunales en las cepas analizadas fue de 50,0% para los serotipos presentes en la vacuna conjugada heptavalente; 50,2% para los serotipos presentes en la vacuna decavalente y 57,2% para la vacuna 13-valente.
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- 2012
9. Age-related susceptibility to infection with diarrheagenic E. coli in infants from peri-urban areas of Lima, Peru
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Ochoa, Theresa J., Ecker, Lucie, Barletta, Francesca, Mispireta, Mónica L., Gil, Ana I., Contreras, Carmen, Molina, Margarita, Amemiya, Isabel, Verastegui, Hector, Hall, Eric R., Cleary, Thomas G., and Lanata, Claudio F.
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Male ,Population Surveillance ,Diarrhea, Infantile ,Peru ,Age Factors ,Escherichia coli ,Prevalence ,Humans ,Infant ,Female ,Article ,Escherichia coli Infections - Abstract
Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants.We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction.The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants agedor=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P.05). Children agedor=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged6 months (13.5% vs 3.6%; P.001). Among children with diarrheagenic E. coli-positive samples, coinfections with other pathogens were more common in children with diarrhea than in control children (40.1% vs 15.6%; P.001).Diarrheagenic E. coli strains were more frequently isolated in samples from older infants. In this setting with high frequency of pathogen exposure and high frequency of breastfeeding, we hypothesize that the major age-related differences result from decreased exposure to milk-related protective factors and from increased exposure to contaminated food and water.
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- 2009
10. Pathogenicity Island O-122 in enteropathogenic Escherichia coli strains is associated with diarrhea severity in children from Lima Peru.
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Mercado, Erik H., Piscoche, Cristian, Contreras, Carmen, Durand, David, Riveros, Maribel, Ruiz, Joaquim, and Ochoa, Theresa J.
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MICROBIAL virulence ,DIARRHEA ,DIARRHEA in children ,ENTEROCYTES ,CONTROL groups - Abstract
EPEC is an attaching and effacing diarrheal pathogen that carries a large pathogenicity island, locus for enterocyte effacement (LEE). Recently, the pathogenicity island PAI O-122 was described among non-LEE effectors and found to be associated with diarrhea among atypical EPEC strains. It is unknown if incomplete PAI O-122 could be associated with diarrhea duration and severity. To identify these virulence determinants we analyzed 379 EPEC strains isolated from Peruvian children. EPEC was diagnosed by PCR(eae+, stx-) and classified as typical(t-EPEC) or atypical(a-EPEC). To characterize PAI O-122 we amplified three modules by PCR: Module 1( pagC ), Module 2( senA , nleB and nleE ) and Module 3( lifA/efa-1 ). To characterize the large ORF lifA/efa-1 we amplified the regions known as efa-N, efa-M and efa-C. Clinical information was obtained from the cohort study. A total of 379 EPEC strains were able to analyze PAI O-122 genes, 128 (10.4%) EPEC strains were isolated from 1235 diarrhea episodes and 251(9.2%) from 2734 healthy controls. t-EPEC strains were isolated from 14.8% (19/128) of children with diarrhea and 25/251(10.0%) from healthy controls. The most frequent PAI O-122 genes were nleE (37.7%), senA (34.6%) and nleB (37.5%), with similar prevalence among diarrhea and control samples. However, lifA/efa-1 was more common among diarrhea cases than healthy control cases (30.5% vs. 21.1%, p < 0.05). The presence of complete PAI O-122 was associated with diarrhea episodes of higher severity among single pathogen infection (33.3% vs. 1.8%, p < 0.05) mainly due to the presence of a complete lifA/efa- 1 gene. In summary, the gene lifA/efa-1 is significantly associated with diarrheal episodes of higher severity, suggesting to be an important virulent factor. [ABSTRACT FROM AUTHOR]
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- 2016
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11. Comparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Peru.
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Medina, Anicia M., Rivera, Fulton P., Pons, Maria J., Riveros, Maribel, Gomes, Cláudia, Bernal, María, Meza, Rina, Maves, Ryan C., Huicho, Luis, Chea-Woo, Elsa, Lanata, Claudio F., Gil, Ana I., Ochoa, Theresa J., and Ruiz, Joaquim
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COMPARATIVE studies ,ESCHERICHIA coli ,ESCHERICHIA ,COLIFORMS - Abstract
Background: Antibiotic resistance is increasing worldwide, being of special concern in low- and middle-income countries. The aim of this study was to determine the antimicrobial susceptibility and mechanisms of resistance in 205 enterotoxigenic Escherichia coli (ETEC) isolates from two cohort studies in children,24 months in Lima, Peru. Methods: ETEC were identified by an in-house multiplex real-time PCR. Susceptibility to 13 antimicrobial agents was tested by disk diffusion; mechanisms of resistance were evaluated by PCR. Results: ETEC isolates were resistant to ampicillin (64%), cotrimoxazole (52%), tetracycline (37%); 39% of the isolates were multidrug-resistant. Heat-stable toxin producing (ETEC-st) (48%) and heat-labile toxin producing ETEC (ETEC-lt) (40%) had higher rates of multidrug resistance than isolates producing both toxins (ETEC-lt-st) (21%), p,0.05. Only 10% of isolates were resistant to nalidixic acid and none to ciprofloxacin or cefotaxime. Ampicillin and sulfamethoxazole resistance were most often associated with bla
TEM (69%) and sul2 genes (68%), respectively. Tetracycline resistance was associated with tet(A) (49%) and tet(B) (39%) genes. Azithromycin inhibitory diameters were ≤15 mm in 36% of isolates, with 5% of those presenting the mph(A) gene. Conclusions: ETEC from Peruvian children are often resistant to older, inexpensive antibiotics, while remaining susceptible to ciprofloxacin, cephalosporins and furazolidone. Fluoroquinolones and azithromycin remain the drugs of choice for ETEC infections in Peru. However, further development of resistance should be closely monitored. [ABSTRACT FROM AUTHOR]- Published
- 2015
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12. Pneumocystis primary infection in non-immunosuppressed infants in Lima, Peru.
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Ochoa, Theresa J., Bustamante, Beatriz, Garcia, Coralith, Neyra, Edgar, Mendoza, Karina, Calderón, Enrique J., Le Gal, Solene, Miller, Robert F., Ponce, Carolina A., Nevez, Gilles, and Vargas, Sergio L.
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To provide original data on Pneumocystis primary infection in non-immunosuppressed infants from Peru. A cross sectional study was performed. Infants less than seven months old, without any underlying medical conditions attending the "well baby" outpatient clinic at one hospital in Lima, Peru were prospectively enrolled during a 15-month period from November 2016 to February 2018. All had a nasopharyngeal aspirate (NPA) for detection of P. jirovecii DNA using a PCR assay, regardless of respiratory symptoms. P. jirovecii DNA detection was considered to represent pulmonary colonization contemporaneous with Pneumocystis primary infection. Associations between infants' clinical and demographic characteristics and results of P. jirovecii DNA detection were analyzed. P. jirovecii DNA was detected in 45 of 146 infants (30.8%) and detection was not associated with concurrent respiratory symptoms in 40 of 45 infants. Infants with P. jirovecii had a lower mean age when compared to infants not colonized (p <0.05). The highest frequency of P. jirovecii was observed in 2–3-month-old infants (p < 0.01) and in the cooler winter and spring seasons (p <0.01). Multivariable analysis showed that infants living in a home with ≤ 1 bedroom were more likely to be colonized; Odds Ratio =3.03 (95%CI 1.31–7.00; p = 0.01). Pneumocystis primary infection in this single site in Lima, Peru, was most frequently observed in 2–3-month-old infants, in winter and spring seasons, and with higher detection rates being associated with household conditions favoring close inter-individual contacts and potential transmission of P. jirovecii. [ABSTRACT FROM AUTHOR]
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- 2022
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13. FRECUENCIA Y PATOTIPOS DE Escherichia coli DIARROGÉNICA EN NIÑOS PERUANOS CON Y SIN DIARREA.
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Ochoa, Theresa J., Mercado, Erik H., Durand, David, Rivera, Fulton P., Mosquito, Susan, Contreras, Carmen, Riveros, Maribel, Lluque, Angela, Barletta, Francesca, Prada, Ana, and Ruiz, Joaquim
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ESCHERICHIA coli , *MICROBIAL virulence , *DIARRHEA in children , *POLYMERASE chain reaction , *BACTERIAL genes - Abstract
Introduction. Diarrheagenic E. coli (DEC) are a major cause of diarrhea in children in developing countries. However, they are not part of routine diagnosis in clinical laboratories. Objectives. To determine the DEC prevalence in Peruvian children and to describe the genetic variability of these strains. Materials and methods. A total of 8 003 E. coli strains previously isolated from eight different studies of diarrhea in children, mainly from peri-urban areas of Lima, were analyzed. Diagnosis of DEC was done with Multiplex real-time PCR using genes for each of the 6 DEC groups. Conventional PCR was performed for the detection of additional virulence genes. Results. Globally, the mean prevalence in diarrhea samples (n=4,243) was: enteroaggregative E. coli (EAEC) 9.9%, enteropathogenic E. coli (EPEC) 8.5%, enterotoxigenic E. coli (ETEC) 6.9%, diffusely adherent E. coli (DAEC) 4.8%, Shiga toxin-producing E. coli (STEC) 0.8% and enteroinvasive E. coli (EIEC) 0.6%. The relative frequency of each pathogen varies according to the age and the type of study. The main pathotypes in control samples (n=3,760) were EPEC (10.9%) and EAEC (10.4%). An important variability in the virulence genes frequency and molecular resistance mechanisms for each pathotype was found, without differences between diarrhea and control groups. Conclusions. DEC are a major cause of diarrhea in Peruvian children. These pathogens are highly heterogeneous. Additional studies are required to determine the prevalence in rural areas of Peru and in severe diarrhea cases. [ABSTRACT FROM AUTHOR]
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- 2011
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14. Invasive pneumococcal diseases among hospitalized children in Lima, Peru.
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Ochoa, Theresa J., Egoavil, Martha, Castillo, María E., Reyes, Isabel, Chaparro, Eduardo, Silva, Wilda, Campos, Francisco, and Sáenz, Andrés
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STREPTOCOCCUS pneumoniae , *JUVENILE diseases , *HOSPITAL care , *CHILD care , *PNEUMOCOCCAL vaccines - Abstract
Objective. To determine the epidemiology of invasive pneumococcal disease (IPD) and the antibiotic susceptibility and serotype distribution of S. pneumoniae in pediatric patients in Lima, Peru. Methods. A 2-year, multicenter, passive surveillance study conducted from May 2006-April 2008 in 11 public hospitals and five private laboratories in Lima, Peru, in patients less than 16 years of age with sterile site cultures yielding S. pneumoniae. Antibiotic susceptibility was performed by Etest (AB Biodisk, Solna, Switzerland). Strains were serotyped by the Quellung reaction. Results. In all, 101 IPD episodes were studied, 68.3% of which were among children less than 24 months of age. Diagnoses were: pneumonia (47.5%), meningitis (38.6%), and sepsis (7.9%). The overall case fatality rate was 22.0%; case fatality rate in meningitis was 32.4%. While 80.0% of fatal cases were in those less than 24 months of age, only 50.7% of non-fatal cases (P < 0.05) were in this age group. Resistance rates were high for trimethoprim/sulfamethoxazole (76.2%), erythromycin (24.8%), and penicillin (22.8%). The most common serotypes were 14, 6B, 19F, 23F, and 5, which accounted for 69.7% of all strains and 87.0% of penicillin non-susceptible strains. Conclusion. IPD in hospitalized children in Lima is associated with high antimicrobial resistance levels and elevated case fatality rate, especially in young children. This baseline data will be useful for evaluating the effects of vaccine introduction. [ABSTRACT FROM AUTHOR]
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- 2010
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15. Penicillin resistance and serotypes/serogroups of Streptococcus pneumoniae in nasopharyngeal carrier children younger than 2 years in Lima, Peru
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Ochoa, Theresa J., Rupa, Rocio, Guerra, Humberto, Hernandez, Herminio, Chaparro, Eduardo, Tamariz, Jesus, Wanger, Audrey, and Mason, Edward O.
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PENICILLIN , *BETA lactam antibiotics , *PNEUMOCOCCAL vaccines , *STREPTOCOCCUS pneumoniae - Abstract
Abstract: The purpose of this study was to determine the carriage rate, susceptibility pattern, and serotype distribution of Streptococcus pneumoniae in the nasopharynx of children younger than 2 years old in Lima, Peru. A total of 666 children were evaluated during 3 periods, 1997, 2001, and 2003. The overall pneumococcal carrier rate was 41%. Reduced susceptibility to penicillin was found in 5% (4/75) of isolates in 1997, 20% (15/75) in 2001, and 37% (40/109) in 2003. Reduced susceptibility to ceftriaxone was found in 12% of isolates in 2003. Serogroups 6, 19, 23, 15, and 14 accounted for 68% of all the isolates and for 81% of the penicillin-nonsusceptible strains. Only 65% of the isolated strains had serogroups found in the 7-valent conjugate pneumococcal vaccine. This highlights the importance of regional surveillance studies for effective vaccine strategies and treatment protocols. [Copyright &y& Elsevier]
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- 2005
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16. Norovirus prevalence in ‘pathogen negative’ gastroenteritis in children from periurban areas in Lima, Peru
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Rivera, Fulton P., Ochoa, Theresa J., Ruiz, Joaquim, Medina, Anicia M., Ecker, Lucie, Mercado, Erik, Gil, Ana I., Huicho, Luis, and Lanata, Claudio F.
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NOROVIRUSES ,PATHOGENIC microorganisms ,GASTROENTERITIS in children ,DIARRHEA in children ,EPIDEMIOLOGY - Abstract
Summary: Norovirus was detected in 17.4% of 224 diarrhoeal samples from children younger than 24 months of age in Lima, in whom all common pathogens had been excluded (pathogen negative). Norovirus was identified more frequently in children older than 12 months of age than in younger children (34% vs 8%, P <0.001). Among norovirus-positive samples, genogroup II was the predominant group (92%). Compared with rotavirus, norovirus episodes tended to be of shorter duration and less severe. The role of norovirus as a cause of diarrhoea and the ascertainment of its severity in developing countries needs further confirmation by future epidemiological studies. [ABSTRACT FROM AUTHOR]
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- 2011
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17. Parental Antibiotic Use in Urban and Peri-Urban Health Care Centers in Lima: A Cross-Sectional Study of Knowledge, Attitudes, and Practices.
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Paredes, Jose L, Navarro, Rafaella, Riveros, Maribel, Picon, Veronica, Conde, Francisco, Suito-Ferrand, Mario, and Ochoa, Theresa J
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In pediatric patients, the antibiotic use is affected by parental beliefs and practices; especially in countries where it is possible to acquire them without prescription. This study aims to describe the knowledge, attitudes, and practices on antibiotic use among parents of children from urban and peri-urban health care centers in Lima. A cross-sectional study was performed at 1 urban and 2 peri-urban health care centers selected in Lima, Perú. Parents of children below the age of 3 years answered a knowledge-attitudes-practices-validated questionnaire about antibiotic use and were categorized as high, moderate, and low knowledge regarding antibiotics. We analyzed potential determinants for low knowledge and having medicated their children with unprescribed antibiotics using bivariate and multivariate analyses. A total of 224 parents were enrolled, and 8% were categorized as low knowledge. Half of the parents could not recognize that antibiotics cannot cure viral infections, 59.4% disagreed with "antibiotics speed up recovery from a cold," and 53.2% stored antibiotics at home. Remarkably 23.5% of parents reported having medicated their children with antibiotics without prescription, which was associated with belonging to the peri-urban health care center, use of antibiotics by their children in the last 12 months, and having purchased antibiotics without physicians' prescription. An alarming overuse of antibiotics without prescription was described among children below the age of 3 years. Educational interventions, addressing parental attitudes and practices, and health policies should be developed to limit inappropriate antibiotic use especially in peri-urban communities. [ABSTRACT FROM AUTHOR]
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- 2019
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18. Frequency and pathotypes of diarrheagenic Escherichia coli in Peruvian children with and without diarrhea
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Ochoa, Theresa J., Mercado, Erik H., Durand, David, Rivera, Fulton P., Mosquito, Susan, Contreras, Carmen, Riveros, Maribel, Lluque, Angela, Barletta, Francesca, Prada, Ana, and Joaquim Ruiz
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Diarrhea ,Perú ,Virulencia ,Virulence ,Niño ,parasitic diseases ,Peru ,Escherichia coli ,Diarrea ,Child - Abstract
Introducción. Las E. coli diarrogénicas (DEC) son una de las principales causas de diarrea en niños en países en vías de desarrollo. Sin embargo, no son rutinariamente diagnosticadas en los laboratorios clínicos. Objetivos. Determinar la prevalencia de las DEC en niños peruanos y describir la variabilidad genética de estas cepas. Materiales y métodos. Se utilizaron 8 003 cepas de E. coli previamente aisladas de ocho estudios previos de diarrea en niños, mayormente en zonas periurbanas de Lima. El diagnóstico de las DEC fue a través de un PCR múltiple a tiempo real para los seis grupos de DEC. Se empleó PCR para la determinación de genes adicionales de virulencia. Resultados. La prevalencia promedio global en muestras de diarrea (n=4 243) fue: E. coli enteroagregativa (EAEC) 9,9%, enteropatogénica (EPEC) 8,5%, enterotoxigénica (ETEC) 6,9%, difusamente adherente (DAEC) 4,8%, productora de toxina shiga (STEC) 0,8% y enteroinvasiva (EIEC) 0,6%. La frecuencia relativa de cada patógeno varía según la edad y tipo de estudio. Los principales patotipos en muestras control (n=3 760) fueron EPEC (10,9%) y EAEC (10,4%). Se encontró una gran variabilidad en la frecuencia de genes de virulencia para cada patotipo, así como en los mecanismos moleculares de resistencia, sin diferencias significativas entre muestras de diarrea y control. Conclusiones. Las DEC son causa importante de diarrea en niños peruanos. Estos patógenos son altamente heterogéneos. Se requieren estudios adicionales para determinar la prevalencia en zonas rurales del Perú, así como en casos graves de diarrea. Introduction. Diarrheagenic E. coli (DEC) are a major cause of diarrhea in children in developing countries. However, they are not part of routine diagnosis in clinical laboratories. Objectives. To determine the DEC prevalence in Peruvian children and to describe the genetic variability of these strains. Materials and methods. A total of 8 003 E. coli strains previously isolated from eight different studies of diarrhea in children, mainly from peri-urban areas of Lima, were analyzed. Diagnosis of DEC was done with Multiplex real-time PCR using genes for each of the 6 DEC groups. Conventional PCR was performed for the detection of additional virulence genes. Results. Globally, the mean prevalence in diarrhea samples (n=4,243) was: enteroaggregative E. coli (EAEC) 9.9%, enteropathogenic E. coli (EPEC) 8.5%, enterotoxigenic E. coli (ETEC) 6.9%, diffusely adherent E. coli (DAEC) 4.8%, Shiga toxin-producing E. coli (STEC) 0.8% and enteroinvasive E. coli (EIEC) 0.6%. The relative frequency of each pathogen varies according to the age and the type of study. The main pathotypes in control samples (n=3,760) were EPEC (10.9%) and EAEC (10.4%). An important variability in the virulence genes frequency and molecular resistance mechanisms for each pathotype was found, without differences between diarrhea and control groups. Conclusions. DEC are a major cause of diarrhea in Peruvian children. These pathogens are highly heterogeneous. Additional studies are required to determine the prevalence in rural areas of Peru and in severe diarrhea cases.
19. RESISTENCIA ANTIMICROBIANA DE CEPAS COMENSALES DE Escherichia coli EN NIÑOS DE DOS COMUNIDADES RURALES PERUANAS.
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Alzamora, Maria C., Echevarría, Andrea C., Ferraro, Valeria M., Riveros, Maribel D., Zambruni, Mara, and Ochoa, Theresa J.
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Antibiotic resistance is a major global problem. The objective of this study was to determine antibiotic resistance in commensal strains isolated from healthy children from rural communities of Moyobamba and Urubamba in Peru. This cohort study identified 179 commensal E. coli strains from 93 children, followed for six months. Thirteen antibiotics were analyzed by diffusion disk. The highest rates of resistance were for cotrimoxazole (49.1%), ampicillin (48.0%), and nalidixic acid (31.8%). An 11.6% increase in resistance was found for nalidixic acid and 6.4% for cotrimoxazole in this period; while 34.0% of the isolates were multidrug-resistant. This study supports previous findings of multidrug resistance in commensal strains in rural communities and highlights the increased rates of resistance over time. We recommend studies in larger populations with a longer follow-up. [ABSTRACT FROM AUTHOR]
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- 2019
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20. PRESENCIA DE Enterobacteriaceae y Escherichia coli MULTIRRESISTENTE A ANTIMICROBIANOS EN CARNE ADQUIRIDA EN MERCADOS TRADICIONALES EN LIMA.
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Ruiz-Roldán, Lidia, Martínez-Puchol, Sandra, Gomes, Cláudia, Palma, Noemí, Riveros, Maribel, Ocampo, Karen, Durand, David, Ochoa, Theresa J., Ruiz, Joaquim, and Pons, Maria J.
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Objective. The objective of this study was to describe the presence of Enterobacteriaceae in meat samples collected in traditional markets of Lima and to establish the levels of antimicrobial resistance and the presence of extended spectrum beta-lactamases (BLEE) and AmpC in Escherichia coli. Materials and Methods. A total of 138 meat samples, 64 (46.4%) chicken, 44 (31.9%) beef and 30 (21.7%) pork were collected. The isolated bacteria belonged to 17 different genera and, specifically, 14 were classified as Enterobacteriaceae. Sensitivity to ten antimicrobial agents was analyzed using the Kirby-Bauer disc diffusion method, BLEE and AmpC were determined by double disc and imipenem-ceftazidime induction tests, respectively. Results. Antimicrobial resistance levels were high against trimethoprim-sulfamethoxazole, ampicillin, tetracycline, nalidixic acid, ciprofloxacin and chloramphenicol. There are significant differences in antibiotic resistance levels depending on the type of meat (chicken, beef and pork) (p <0.05). Multiple drug resistance (MDR) levels were particularly high in chicken and pork (98.2% and 86.4%, respectively). In addition, the presence of BLEE in Escherichia coli isolated from chicken meat was 59.4%. Conclusions. Multiple drug resistance levels were high compared to antibiotics frequently used in humans; chicken and beef are highlighted as potential reservoirs of BLEE and pAmpC-producing Escherichia coli, respectively. [ABSTRACT FROM AUTHOR]
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- 2018
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21. RESISTENCIA ANTIBIÓTICA Y DISTRIBUCIÓN DE SEROTIPOS EN CEPAS NEUMOCÓCICAS INVASIVAS EN ADULTOS HOSPITALIZADOS EN LIMA, PERÚ.
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Castro, Juan D., Siccha, Sofía M., Egoavil, Martha, Chaparro, Eduardo, Hernandez, Roger, Silva, Wilda, Del Águila, Olguita, Saenz, Andrés, Campos, Francisco, Reyes, Isabel, Castillo, María E., and Ochoa, Theresa J.
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Objectives. Describe the clinical features, antibiotic resistance and serotype strains' distribution that cause invasive pneumococcal disease (IPD) in adults. Materials and methods. Case series. Pneumococcal strains from hospitalized adults were collected in 5 hospitals and 2 laboratories in Lima during the years 2009-2011. Results. Data from 43 patients with IPD were studied, 58,2% were older than 60 years. The diagnoses were pneumonia 39,5%, meningitis (MEC) 30,2%, bacteremia 13,9%, peritonitis 11,6% and septic arthritis 4,8%. 28,9% of the patients dead, of which 72,7% were older than 60 years. The antibiotic resistance of pneumococcal strains was as following: penicillin 0% in non-MEC strains and 30,8% in MEC strains; Ceftriaxone 4,5% in non-MEC strains and 16,7% intermediate resistance in MEC strains; trimethoprim/sulfamethoxazole 69% and 35,7% was resistant to erythromycin. The most common serotypes were 19F, 23F, 6B, 14 and 6C. The percentage of vaccine strains for the seven-valent conjugate vaccine (PCV7) and PCV10 were 44,2%, 51,2% for PCV13 and 60,4% for the 23-valent polysaccharide vaccine (PPV23). Conclusions. Streptococcus pneumoniae is a relevant pathogen in adults, especially in the elderly, due to its high mortality. [ABSTRACT FROM AUTHOR]
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- 2017
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22. Oxacillin disk diffusion testing for the prediction of penicillin resistance in Streptococcus pneumoniae.
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Horna, Gertrudis, Molero, María L., Benites, Liliana, Roman, Sigri, Carbajal, Luz, Mercado, Erik, Castillo, María E., Zerpa, Rito, Chaparro, Eduardo, Hernandez, Roger, Silva, Wilda, Campos, Francisco, Saenz, Andy, Reyes, Isabel, Villalobos, Alex, and Ochoa, Theresa J.
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OXACILLIN , *DISC diffusion tests (Microbiology) , *PENICILLIN , *DRUG resistance in bacteria , *STREPTOCOCCUS pneumoniae , *CEFTRIAXONE , *COMMUNITY-acquired pneumonia , *OTITIS media treatment - Abstract
Objective. To 1) describe the correlation between the zones of inhibition in 1-µg oxacillin disk diffusion (ODD) tests and penicillin and ceftriaxone minimum inhibitory concentrations (MICs) of meningeal and non-meningeal strains of Streptococcus pneumoniae and 2) evaluate the usefulness of the ODD test as a predictor of susceptibility to penicillin in S. pneumoniae and as a quick and cost-effective method easily implemented in a routine clinical laboratory setting. Methods. S. pneumoniae isolates from healthy nasopharyngeal carriers less than 2 years old, obtained in a multicentric cross-sectional study conducted in various Peruvian hospitals and health centers from 2007 to 2009, were analyzed. Using Clinical and Laboratory Standards Institute (CLSI) breakpoints, the correlation between the zones of inhibition of the ODD test and the MICs of penicillin and ceftriaxone was determined. Results. Of the 571 S. pneumoniae isolates, 314 (55%) showed resistance to penicillin (MIC ≥ 0.12 µg/mL) and 124 (21.7%) showed resistance to ceftriaxone (MIC ≥ 1 µg/mL). Comparison of the ODD test zones of inhibition and the penicillin MICs, using the CLSI meningeal breakpoints, showed good correlation (Cohen's kappa coefficient = 0.8239). Conclusions. There was good correlation between ODD zones of inhibition and penicillin meningeal breakpoints but weak correlation between the ODD results and non-meningeal breakpoints for both penicillin and ceftriaxone. Therefore, the ODD test appears to be a useful tool for predicting penicillin resistance in cases of meningeal strains of S. pneumoniae, particularly in low- and middle-income countries, where MIC determination is not routinely available. [ABSTRACT FROM AUTHOR]
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- 2016
23. CARACTERÍSTICAS EPIDEMIOLÓGICAS, CLÍNICAS Y BACTERIOLÓGICAS DE MENINGITIS NEUMOCÓCICA EN PACIENTES PEDIÁTRICOS DE LIMA, PERÚ.
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Davalos, Long, Terrazas, Yessica, Quintana, Ana, Egoavil, Martha, Sedano, Katherine, Castillo, María E., Reyes, Isabel, Chaparro, Eduardo, Silva, Wilda, Campos, Francisco, Saenz, Andrés, Hernandez, Roger, del Águila, Olguita, Pinto, Daniel Guillén, and Ochoa, Theresa J.
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Objectives. To describe the clinical characteristics, lethality, antibiotic susceptibility, and serotype distribution of pneumococcal meningitis in pediatric patients in Lima, Peru. Materials and Methods. A case series of pneumococcal meningitis in children less than 16 years of age from two prospective, multicenter, passive surveillance studies of invasive pneumococcal diseases held in Lima-Peru from 2006 to 2008 and 2009 to 2011. Results. We report 44 pneumococcal meningitis episodes; 68,2% of them were in children less than 2 years old. The overall case fatality rate was 32.6%; 92.9% of fatal cases were in children less than 2 years of age (p<0.05). Malnutrition was associated with fatal cases (p<0.05). 64,3% of fatal cases died within the first two days. 41,9% of pneumococcal isolates were resistant to penicillin, 23,3% were intermediate resistant to ceftriaxone (none were highly resistant) and 9,3% were resistant to chloramphenicol. The most common serotypes were 6B, 14, 19F and 23F, which accounted for 68,3% of all strains; 84,1% of strains were PCV13 serotypes. Conclusions. Pneumococcal meningitis continues to be a lethal disease, especially in children less than 2 years of age. Since almost two third of lethal cases lead to death within the first 48 hours, prompt diagnosis and management is critical, as well as assurance of immunization with pneumococcal vaccine. [ABSTRACT FROM AUTHOR]
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- 2016
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24. Physicians' responsibility for antibiotic use in infants from periurban Lima, Peru.
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Ecker, Lucie, Olarte, Liset, Vilchez, Gustavo, Ochoa, Theresa J., Amemiya, Isabel, Gil, Ana I., and Lanata, Claudio F.
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ANTIBIOTICS , *MEDICAL prescriptions , *COMMON cold , *SKIN inflammation - Abstract
Objective. To describe the use of antibiotics in Peruvian children under 1 year in a setting where they are available without a prescription. Methods. Data were analyzed from a cohort study between September 2006 and December 2007 of 1 023 children < 2 months old in periurban Lima, Peru, followed until they were 1 year old. Results. Seven hundred seventy of 1 023 (75.3%) children took 2 085 courses of antibiotics. There were two courses per child per year (range 0-12). Higher rates of antibiotic use were found in children 3-6 months old (37.2%). Antibiotics were given to children for 8.2% of common colds, 58.6% of all pharyngitis, 66.0% of bronchitis, 40.7% of diarrheas, 22.8% of dermatitis, and 12.0% of bronchial obstructions. A physician's prescription was the most common reason for antibiotic use (90.8%). Medication use without a prescription was found in 6.9% of children, and in 63.9% of them it was preceded by a physician's prescription. Conclusions. Infants are often exposed to antibiotics in this setting. Overuse of antibiotics is common for diagnoses such as pharyngitis, bronchitis, bronchial obstruction, and diarrhea but is typically inappropriate (83.1% of courses) based on the most common etiologies for this age group. Interventions to improve the use of antibiotics should focus on physicians, since a physician's prescription was the most common reason for antibiotic use. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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