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Jaime Robledo,1– 4 Natalia Maldonado,4,5 Carlos Robledo,1,4 Laura Ceballos Naranjo,2 Valentín Hernández Galeano,2 Juan Jose Pino2 On behalf of Germen Antimicrobial Surveillance network1Laboratorio Médico de Referencia, Medellín, Colombia; 2Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia; 3Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; 4Grupo GERMEN, Medellín, Colombia; 5UGC Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, SpainCorrespondence: Jaime Robledo, Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Carrera 72A No. 78B-141, Medellín, Colombia, Tel +57-4-6051808, Email jrobledo@cib.org.coBackground: Bloodstream infections (BSI) are important causes of morbidity and mortality worldwide. Antimicrobial surveillance is essential for identifying emerging resistance and generating empirical treatment guides, the purpose of this study is to analyze trends in antimicrobial susceptibility of BSI from 2010 to 2019 in healthcare institutions from Medellin and nearby towns in Colombia.Methods: A Whonet database was analyzed from the GERMEN antimicrobial surveillance network; frequency and antibiotic susceptibility trends were calculated on more frequent microorganisms using Mann Kendall and Sen’s Slope Estimator Test.Results: 61,299 isolates were included; the three microorganisms more frequent showed a significant increasing trend through time E. coli (Sen’s Slope estimator = 0.7 p = < 0.01) S. aureus (Sen’s Slope estimator = 0.60 p = < 0.01) and K. pneumonia (Sen’s Slope estimator = 0.30 p = < 0.01). E. coli showed a significant increase trend in cefepime and ceftazidime resistance, while K. pneumoniae showed a significant increase in resistance to cefepime, ciprofloxacin, and gentamicin. P. aeruginosa increases its susceptibility to all analyzed antibiotics and S. aureus to oxacillin. No increasing trend was observed for carbapenem resistance.Conclusion: An upward trends was observed in more frequent microorganisms and resistance to third and fourth-generation cephalosporins for E. coli and K pneumoniae; in contrast, not increasing trends in antibiotic resistance was observed for P. aeruginosa and S. aureus. The essential role of AMR-surveillance programs is to point out and identify these trends, which should improve antibiotic resistance control.Keywords: bacteremia, drug resistance bacterial, antibacterial agents, antimicrobial surveillance

A new or presumably new left bundle branch block along with ischemic symptoms has traditionally been considered an electrocardiographic equivalent of ST-segment elevation myocardial infarction, which should be brought to emergent reperfusion. However, several criteria have been proposed for its definition, but none has reached out an optimal diagnostic yield. Below we detail these criteria, their main problems and the advantages they have shown., (Copyright: © 2019 Permanyer.)

Electrocardiogram is a useful tool for the diagnosis of acute coronary syndrome. In recent years, ST-segment changes in aVR have been shown to provide valuable information about coronary anatomy and early risk stratification of this condition.