Search

Abstract Introduction Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022. Methods Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the bla KPC, bla NDM, bla OXA-48, bla VIM and bla IMP genes. In addition, A. baumannii isolates were screened for the bla OXA-23, bla OXA-58 and bla OXA-24/40 genes. Results Carbapenemase production was observed in 96.84% of the isolates. The bla KPC, bla NDM and bla OXA-48 genes were detected in Enterobacterales, with bla KPC being predominant. The bla VIM gene was detected in P. aeruginosa, and bla OXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases. Conclusion The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring bla KPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.

Introduction: Carbapenemase-producing Enterobacteriaceae (CPE) are of global concern due to the growing number of patients who acquire them and their association with high mortality rates. Although there are some reports of endemicity in developing countries, little is known about this microorganism, and Ecuador is not an exception. Subsequently, our objective was to clinically and molecularly characterize carbapenemase producing-Enterobacteriaceae in intensive care units (ICUs) in Guayaquil, Ecuador. Methods: To determine CPE colonization, we obtained perineal and inguinal swabs from patients admitted to seven intensive-care adult units in Guayaquil-Ecuador between February and April 2016. The Centers for Disease Control and Prevention (CDC) laboratory protocol and chromogenic agar were used to process the cultures. Polymerase chain reaction was used to confirm carbapenemase production. Genotypic analysis was performed by Multilocus Sequence Typing (MLST) and pulsed-field electrophoresis (PFEG). Demographic and clinical data were obtained from the electronic charts and patient’s relatives. Results: Six hundred seventy-seven patients were included in the study, of whom 255 were colonized/infected by CPE. The CPE prevalence was 37.67%. Previous use of antimicrobials, use of invasive procedures and being burned at admission were associated with CPE. The most frequent infection was found after a surgical procedure. Klebsiella pneumoniae (n = 249) was the predominant microorganism harbouring blaKPC, followed by Enterobactercloacae (n = 8), Klebsiella aerogenes (n = 4), Escherichia coli (n = 4) and Klebsiella oxytoca (n = 1). NDM was present in Proteus mirabilis. The strains were distributed in 19 sequence types (ST), and 10 were not reported previously in Ecuador. ST 258 was the sequence type isolated most frequently. Conclusion: This study shows a high prevalence of CPE in ICUs, particularly K. pneumoniae blaKPC ST 258. The identification of KPC alleles may help to understand the routes of dissemination and control spread within ICUs in Guayaquil, Ecuador. Keywords: Carbapenemase, Intensive care units, Prevalence

Informado por la teoría del goce femenino que elaboran Freud, Lacan y Cixous, este trabajo explora la serie fotográfica "Sueños" que Grete Stern publica en Buenos Aires en Idilio (1948-51). En una revista destinada a un público femenino de clase media y baja, la serie fotográfica de esta diseñadora gráfica y fotógrafa alemana que llega a Buenos Aires en 1935 ilustra la sección "El psicoanálisis te ayudará", una sección que publica los sueños que las lectoras mandan para que Richard Rest (seudónimo de Gino Germani y Enrique Butelman) los interprete. Es precisamente siguiendo el recorrido de los sueños representados por Stern que se observa una solidaridad indiscutible entre la emergencia de la mujer como subjetividad y el comienzo del psicoanálisis en la cultura porteña.Informed by the theory of jouissance that Freud, Lacan and Cixous elaborate, this paper explores the photographic series entitled "Dreams" that Grete Stern publishes in Buenos Aires in Idilio (1948-51). In a magazine aimed for a feminine audience of middle and low class, the series of this German graphic designer and photographer who arrives in Buenos Aires in 1935, illustrates the section called "Psychoanalysis will help you." The section publishes the dreams that readers submit to the magazine so that Richard Rest (nickname for Gino Germani and Enrique Butelman) would give his interpretation. Its is precisely following the path of the dreams as represented by Grete Stern that one can observe a solidarity between women's agency and the beginning of psychoanalytic practice in the culture of Buenos Aires.

Abstract Background Emerging zoonotic diseases arise from cross-species transmission events between wild or domesticated animals and humans, with bats being one of the major reservoirs of zoonotic viruses. Viral metagenomics has led to the discovery of many viruses, but efforts have mainly been focused on some areas of the world and on certain viral families. Methods We set out to describe full-length genomes of new picorna-like viruses by collecting feces from hundreds of bats captured in different regions of Spain. Viral sequences were obtained by high-throughput Illumina sequencing and analyzed phylogenetically to classify them in the context of known viruses. Linear discriminant analysis (LDA) was performed to infer likely hosts based on genome composition. Results We found five complete or nearly complete genomes belonging to the family Picornaviridae, including a new species of the subfamily Ensavirinae. LDA suggested that these were true vertebrate viruses, rather than viruses from the bat diet. Some of these viruses were related to picornaviruses previously found in other bat species from distant geographical regions. We also found a calhevirus genome that most likely belongs to a proposed new family within the order Picornavirales, and for which genome composition analysis suggested a plant host. Conclusions Our findings describe new picorna-like viral species and variants circulating in the Iberian Peninsula, illustrate the wide geographical distribution and interspecies transmissibility of picornaviruses, and suggest new hosts for calheviruses.