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This review provides a comprehensive summary of evidence to explore the role and value of differential diagnosis in the management of Acute Respiratory Infections (ARIs) through point-of-care (POC) rapid testing in a post-pandemic scenario, paying particular attention to coronavirus disease 2019 (COVID-19), influenza, and respiratory syncytial virus (RSV). The document builds on a review of literature and policies and a process of validation and feedback by a group of seven experts from Latin America (LATAM). Evidence was collected to understand scientific and policy perspectives on the differential diagnosis of ARIs and POC rapid testing, with a focus on seven countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru. The evidence indicates that POC rapid testing can serve to improve ARI case management, epidemiological surveillance, research and innovation, and evidence-based decision-making. With multiple types of rapid tests available for POC, decisions regarding which tests to use require the consideration of the testing purpose, available resources, and test characteristics regarding accuracy, accessibility, affordability, and results turnaround time. Based on the understanding of the current situation, this document provides a set of recommendations for the implementation of POC rapid testing in LATAM, supporting decision-making and guiding efforts by a broad range of stakeholders. [ABSTRACT FROM AUTHOR]

Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by exchange of resistance genes between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. Here we characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human faecal and environmental samples from two low-income Latin American communities. We found that resistomes across habitats are generally structured by bacterial phylogeny along ecological gradients, but identified key resistance genes that cross habitat boundaries and determined their association with mobile genetic elements. We also assessed the effectiveness of widely used excreta management strategies in reducing faecal bacteria and resistance genes in these settings representative of low- and middle-income countries. Our results lay the foundation for quantitative risk assessment and surveillance of resistance gene dissemination across interconnected habitats in settings representing over two-thirds of the worlds population., Author(s): Erica C. Pehrsson [1]; Pablo Tsukayama [1]; Sanket Patel [1, 2]; Melissa Meja-Bautista [1, 3]; Giordano Sosa-Soto [1, 3]; Karla M. Navarrete [3]; Maritza Calderon [4]; Lilia Cabrera [5]; [...]

Bacterial pathogens are frequently distinguished by the presence of acquired genes associated with iron acquisition. The presence of specific siderophore receptor genes, however, does not reliably predict activity of the complex protein assemblies involved in synthesis and transport of these secondary metabolites. Here, we have developed a novel quantitative metabolomic approach based on stable isotope dilution to compare the complement of siderophores produced by Escherichia coli strains associated with intestinal colonization or urinary tract disease. Because uropathogenic E. coli are believed to reside in the gut microbiome prior to infection, we compared siderophore production between urinary and rectal isolates within individual patients with recurrent UTI. While all strains produced enterobactin, strong preferential expression of the siderophores yersiniabactin and salmochelin was observed among urinary strains. Conventional PCR genotyping of siderophore receptors was often insensitive to these differences. A linearized enterobactin siderophore was also identified as a product of strains with an active salmochelin gene cluster. These findings argue that qualitative and quantitative epi-genetic optimization occurs in the E. coli secondary metabolome among human uropathogens. Because the virulence-associated biosynthetic pathways are distinct from those associated with rectal colonization, these results suggest strategies for virulence-targeted therapies. [ABSTRACT FROM AUTHOR]

The understanding of COVID-19, caused by the SARS-CoV-2, is essential to improve evidence-based public health policies. The effective reproductive number (Rt) in Peru was estimated using information from 113 complete genomes sequenced by the Instituto Nacional de Salud del Perú (INS), available in the GISAID public database. The Rt trend during March and April of 2020 was found to be similar to results from other epidemiological reports. The Rt decreased during the first two weeks of March. Its lowest value was reported during the week after the quarantine began. The Rt increased moderately after the second week of April. The implication of early decisions taken to mitigate the transmission are discussed. Genomic surveillance will be necessary to understand the transmission and evolution of SARS-CoV-2 in Peru, and will complement the epidemiological information. [ABSTRACT FROM AUTHOR]

Bartonella schoenbuchensis causes bacteremia in ruminants and is transmitted by deer keds. Here, we report the complete genome sequences of three B. schoenbuchensis strains (L2, L19, and L24) recently isolated from deer keds ( Lipoptena fortisetosa ) in Czechia., Competing Interests: The authors declare no conflict of interest.

Competing Interests: JGAR has received support from the US CDC. CZ has received support from the US CDC and Pfizer as an international expert for an expert’s symposia. FK has received support from the US CDC, grants or contracts from the Belgian Directorate of Development Cooperation, the Fogarty International Center of the US NIH, Pfizer as an international expert for an expert’s symposia, Abbott as a key opinion leader advisory board member, and Peruvian Multisectoral Committee to combat antimicrobial resistance as an unpaid member. VGSRC has received support from the US CDC. EGL has received support from the US CDC, the Fogarty International Center of the US NIH, the University of Alabama at Birmingham for the Gorgas Advanced Course, Pfizer as an international expert to support an expert's symposia, the Peruvian Ministry of Health as an unpaid expert, and CFAR at the University of Washington Seattle as an unpaid member. All other authors declare no competing interests. This study was supported by the US Centers for Disease Control and Prevention cooperative agreement award GH00266. CZ and EG had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. FK, JGAR, CZ, VGSRC, FM, PT, EGL, and EG conceived and designed the study. EM coordinated laboratory analysis. PT performed genomic sequencing. PA, FG, SA, CM, VN, MG, and RC coordinated data collection and management. CSNV, DB, and VGSRC performed the statistical analysis. All authors wrote and approved the final manuscript. NK, FK, and EGL drafted, edited, and reviewed the manuscript. LC, AF, and EAB interpreted the findings and edited the manuscript. Data will be shared by the corresponding author upon reasonable request for research purposes. We recognise the contributions from several individuals and institutions to this project, including those from Dr Jorge Ponce, Dr Irma Hidalgo, and Mg Luz Nateros (Diris Lima Centro); Dr Roger Hernández and Dr Ana Quintana (Hospital Cayetano Heredia); Dr César Munayco (CDC Peru); Dr Anna Chard and Dr Sofía Arriola (CDC); and Dr Steev Loyola (Universidad Peruana Cayetano Heredia). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.

Importance: Previous studies have suggested that oral lactoferrin enhances diversity in the gut microbiota in infants while inhibiting the growth of opportunistic pathogens. However, the effect of lactoferrin on infant gut microbiota over time has yet to be thoroughly studied. Our study suggests that lactoferrin oral treatment in infants aged 12-18 months does not affect gut microbiome diversity and composition over time. To our knowledge, this is the first study to report the effect of lactoferrin on infant gut microbiome composition over time and helps elucidate its impact on infant health and its therapeutic potential., Competing Interests: The authors declare no conflict of interest.

We characterized the antimicrobial resistance of 70 Escherichia coli isolates obtained from patients with a urinary tract infection (UTI) from 8 public hospitals in Peru. Resistance profiles were identified using the automated MicroScan® system. A standard polymerase chain reaction was used for the detection of the bla TEM, bla CTX-M, bla SHV and bla PER genes. The 65.7% (46/70) of the isolates presented a multidrug-resistant phenotype and 55.7% (39/70) were extended-spectrum beta-lactamases producers. High levels of resistance were detected for ampicillin (77,1%), ciprofloxacin (74,3%), trimethoprim/sulfamethoxazole (62,9%), cefepime (57,1%), and cefuroxime (57,1%). The bla TEM gene was the most frequent (31,4%), followed by bla CTX-M (18,6%) and bla SHV (2,9%) genes. These results show high resistance levels to antimicrobials of clinical use in E. coli isolates from hospital UTI patients in Peru.