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Cona E, Pidal P, Martínez MC, Airola C, Torrejón C, Chacón E, Santos Y, Smoilis S, Araya I, Araya P. Enterobacterales productores de carbapenemasas en sifones de lavamanos de una Unidad de Paciente Crítico. Rev Chilena Infectol 2022. [DOI: 10.4067/s0716-10182022000400495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Olmos C, Campaña G, Monreal V, Pidal P, Sanchez N, Airola C, Sanhueza D, Tapia P, Muñoz AM, Corvalan F, Hurtado S, Meneses C, Orellana A, Montecino M, Arriagada G, Bustos FJ. SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile. PLoS One 2021; 16:e0245913. [PMID: 33507981 PMCID: PMC7842995 DOI: 10.1371/journal.pone.0245913] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/09/2021] [Indexed: 12/20/2022] Open
Abstract
Asymptomatic SARS-CoV-2 infection of healthcare workers (HCWs) has been reported as a key player in the nosocomial spreading of COVID-19. Early detection of infected HCWs can prevent spreading of the virus in hospitals among HCWs and patients. We conducted a cross-sectional study to determine the asymptomatic infection of HCWs in a private clinic in the city of Santiago, Chile. Our study was conducted during a period of 5 weeks at the peak of transmission of SARS-CoV-2 in Chile. Nasopharyngeal samples were obtained from 413 HCWs and tested for the presence of SARS-CoV-2 using RT-qPCR. We found that a 3.14% of HCWs were positive for the presence of SARS-CoV-2 (14/413). Out of these, 7/14 were completely asymptomatic and did not develop symptoms within 3 weeks of testing. Sequencing of viral genomes showed the predominance of the GR clade; however, sequence comparison demonstrated numerous genetic differences among them suggesting community infection as the main focus of transmission among HCWs. Our study demonstrates that the protocols applied to protect HCWs and patients have been effective as no infection clusters due to asymptomatic carriers were found in the clinic. Together, these data suggest that infection with SARS-CoV-2 among HCWs of this health center is not nosocomial.
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Affiliation(s)
- Claudio Olmos
- Clinica INDISA, Santiago, Chile
- Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | - Gonzalo Campaña
- Clinica INDISA, Santiago, Chile
- Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | - Victor Monreal
- Clinica INDISA, Santiago, Chile
- Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | | | | | - Dayan Sanhueza
- Facultad de Ciencias de la Vida, Centro de Biotecnología Vegetal, Universidad Andres Bello, Santiago, Chile
| | - Patricio Tapia
- Facultad de Ciencias de la Vida, Centro de Biotecnología Vegetal, Universidad Andres Bello, Santiago, Chile
- FONDAP Center for Genome Regulation, Santiago, Chile
| | | | | | | | - Claudio Meneses
- Facultad de Ciencias de la Vida, Centro de Biotecnología Vegetal, Universidad Andres Bello, Santiago, Chile
- FONDAP Center for Genome Regulation, Santiago, Chile
| | - Ariel Orellana
- Facultad de Ciencias de la Vida, Centro de Biotecnología Vegetal, Universidad Andres Bello, Santiago, Chile
- FONDAP Center for Genome Regulation, Santiago, Chile
| | - Martin Montecino
- FONDAP Center for Genome Regulation, Santiago, Chile
- Instituto de Ciencias Biomedicas, Facultad de Medicina y Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Gloria Arriagada
- Instituto de Ciencias Biomedicas, Facultad de Medicina y Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Fernando Jose Bustos
- Instituto de Ciencias Biomedicas, Facultad de Medicina y Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
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Orsini M, Otaíza F, Vega P, Hederra LM, Pidal P, Salas V, Coria P, Urízar C, Sepúlveda D, Palma M, Fernández J, Martínez MC, Hormazábal JC. [Outbreak of fungemias by Sarocladium kiliense in eight public hospitals per intrinsic contamination of ondansetron intravenous]. Rev Chilena Infectol 2019; 35:363-370. [PMID: 30534922 DOI: 10.4067/s0716-10182018000400363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/14/2018] [Indexed: 11/17/2022] Open
Abstract
Sarocladium kiliense is a saprophyte fungus that can cause opportunistic infections associated to invasive procedures. We report a multi-hospital nosocomial outbreak of fungemias due to this agent. Patients with positive blood culture to this agent were studied after six bloodstream infections identified in three Chilean hospitals in July 2013 were reported to Ministry of Health National Infection and Prevention Control Program. In general, there were mild clinical manifestations, without deaths attributable to the infection. Epidemiological and micro-biological study identified 65 cases in 8 hospitals, mostly pediatric patients in chemotherapy. Initial studies of 94 different drugs and medical devices had negative results, until a second analysis of specific blisters and their pharmaceutical matrix selected by epidemiological criteria identified an intrinsic contamination of ondansetron blisters from a specific producer used in all the patients. A recall of contaminated ondansetron blisters was performed in all the country, after which the outbreak was contained. Surveillance and response of local and national infection prevention and control programs and laboratory support were key to control of a national multi-hospital common source outbreak due to contamination of a drug by an unusual fungus.
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Affiliation(s)
- Mauro Orsini
- Programa de Control de Infecciones Asociadas a la Atención de Salud, Departamento de Calidad y Seguridad de la Atención, Ministerio de Salud de Chile, Chile
| | - Fernando Otaíza
- Programa de Control de Infecciones Asociadas a la Atención de Salud, Departamento de Calidad y Seguridad de la Atención, Ministerio de Salud de Chile, Chile
| | - Pablo Vega
- Redes Asistenciales, Ministerio de Salud Chile, Chile
| | - Luz María Hederra
- Agencia Nacional de Medicamentos, Instituto de Salud Pública de Chile, Chile
| | | | - Valentina Salas
- Laboratorio de Micología, Instituto de Salud Pública de Chile, Chile
| | - Paulina Coria
- Programa de Control de Infecciones Asociadas a la Atención de Salud, Hospital Dr. Luis Calvo Mackenna, Chile
| | - Claudia Urízar
- Programa de Control de Infecciones Asociadas a la Atención de Salud, Hospital Dr. Luis Calvo Mackenna, Chile
| | | | | | - Jorge Fernández
- Sub Departamento de Genética Molecular, Instituto de Salud Pública de Chile, Chile
| | - M Cristina Martínez
- Microbiología de Alimentos y Agua, Instituto de Salud Pública de Chile, Chile
| | - J Carlos Hormazábal
- Subdepartamento de Enfermedades Infecciosas, Instituto de Salud Pública de Chile, Chile
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Etienne KA, Roe CC, Smith RM, Vallabhaneni S, Duarte C, Escadon P, Castaneda E, Gomez BL, de Bedout C, López LF, Salas V, Hederra LM, Fernandez J, Pidal P, Hormazabel JC, Otaiza F, Vannberg FO, Gillece J, Lemmer D, Driebe EM, Englethaler DM, Litvintseva AP. Whole-Genome Sequencing to Determine Origin of Multinational Outbreak of Sarocladium kiliense Bloodstream Infections. Emerg Infect Dis 2016; 22:476-81. [PMID: 26891230 PMCID: PMC4766898 DOI: 10.3201/eid2203.151193] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Next-generation technologies and bioinformatics enabled source attribution and implementation of effective control strategies. We used whole-genome sequence typing (WGST) to investigate an outbreak of Sarocladium kiliense bloodstream infections (BSI) associated with receipt of contaminated antinausea medication among oncology patients in Colombia and Chile during 2013–2014. Twenty-five outbreak isolates (18 from patients and 7 from medication vials) and 11 control isolates unrelated to this outbreak were subjected to WGST to elucidate a source of infection. All outbreak isolates were nearly indistinguishable (<5 single-nucleotide polymorphisms), and >21,000 single-nucleotide polymorphisms were identified from unrelated control isolates, suggesting a point source for this outbreak. S. kiliense has been previously implicated in healthcare-related infections; however, the lack of available typing methods has precluded the ability to substantiate point sources. WGST for outbreak investigation caused by eukaryotic pathogens without reference genomes or existing genotyping methods enables accurate source identification to guide implementation of appropriate control and prevention measures.
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Hernández-Rocha C, Pidal P, Ajenjo MC, Quera R, Quintanilla M, Lubascher J, Jemenao MI, Ibáñez P, Álvarez-Lobos M, Diomedi A, Marcotti A, Acuña M, Arab JP, Riquelme A, Candía R, Carvajal S. [Chilean consensus of prevention, diagnosis and treatment of Clostridium difficile-associated diarrhea]. Rev Chilena Infectol 2016; 33:98-118. [PMID: 26965890 DOI: 10.4067/s0716-10182016000100020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Clostridium dijfficile-associated diarrhea (CDAD) has become very important due to the increase in its incidence, severity, recurrence and the associated economic burden. Having a national consensus guideline is essential to improve its management. OBJECTIVE To build a multidisciplinary and evidence-based consensus in prevention, diagnosis and treatment of CDAD. METHODS We convened a panel of experts in the field of infectious diseases, gastroenterology, evidence-based medicine and consensus methodology. The panel conducted a structured review of published literature in CDAD evaluating evidence levels and recommendation degree according to the methodology proposed by the GRADE working-group. A modified three-round Delphi technique was used to reach a consensus among the experts. RESULTS A group of 16 experts was established, 12 of them answered 18 clinically relevant questions. The levels of agreement achieved by the panel of 16 experts were 79% in the first round and 100% in the second and third round. The main consensus recommendations in prevention are: restricting the use of proton-pump inhibitors, primary prophylaxis with probiotics in antibiotics users, education of health personnel, isolation for patients hospitalized with CDAD, and cleaning the rooms exposed to C. difficile with products based in chlorine or hydrogen peroxide. In the diagnosis: use of biology molecular-based techniques is preferred and if not available, glutamate dehydrogenase-based algorithms may be recommended. With regard to treatment: the use of oral metronidazole in mild-moderate CDAD and oral vancomycin in severe CDAD are recommended. Treat the first recurrence with the same antibiotics according to severity. In the case of second and subsequent recurrences consider prolonged therapy with vancomycin, rifaximin or fecal microbiota transplant. CONCLUSION The first Chilean consensus on prevention, diagnosis and treatment of CDAD is presented, which is a major step in improving national standards in the management of this disease.
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Diaz J, Terrazas S, Bierrenbach AL, Toscano CM, Alencar GP, Alvarez A, Valenzuela MT, Andrus J, del Aguila R, Hormazábal JC, Araya P, Pidal P, Matus CR, de Oliveira LH. Effectiveness of the 10-Valent Pneumococcal Conjugate Vaccine (PCV-10) in Children in Chile: A Nested Case-Control Study Using Nationwide Pneumonia Morbidity and Mortality Surveillance Data. PLoS One 2016; 11:e0153141. [PMID: 27058873 PMCID: PMC4825990 DOI: 10.1371/journal.pone.0153141] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/24/2016] [Indexed: 11/19/2022] Open
Abstract
Background The ten-valent pneumococcal conjugate vaccine (PCV10) was introduced into the Chilean National Immunization Program (NIP) in January 2011 with a 3+1 schedule (2, 4, 6 and 12 months) without catch-up vaccination. We evaluated the effectiveness of PCV10 on pneumonia morbidity and mortality among infants during the first two years after vaccine introduction. Methods This is a population-based nested case-control study using four merged nationwide case-based electronic health data registries: live birth, vaccination, hospitalization and mortality. Children born in 2010 and 2011 were followed from two moths of age for a period of two years. Using four different case definitions of pneumonia hospitalization and/or mortality (all-cause and pneumonia related deaths), all cases and four randomly selected matched controls per case were selected. Controls were matched to cases on analysis time. Vaccination status was then assessed. Vaccine effectiveness (VE) was estimated using conditional logistic regression. Results There were a total of 497,996 children in the 2010 and 2011 Chilean live-birth cohorts. PCV10 VE was 11.2% (95%CI 8.5–13.6) when all pneumonia hospitalizations and deaths were used to define cases. VE increased to 20.7 (95%CI 17.3–23.8) when ICD10 codes used to denote viral pneumonia were excluded from the case definition. VE estimates on pneumonia deaths and all-cause deaths were 71.5 (95%CI 9.0–91.8) and 34.8 (95% CI 23.7–44.4), respectively. Conclusion PCV10 vaccination substantially reduced the number of hospitalizations due to pneumonia and deaths due to pneumonia and to all-causes over this study period. Our findings also reinforce the importance of having quality health information systems for measuring VE.
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Affiliation(s)
| | | | | | - Cristiana M. Toscano
- Department of Community Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | | | - Andrés Alvarez
- Department of Statistics and Health Information, Ministry of Health, Santiago, Chile
| | | | - Jon Andrus
- Sabin Vaccine Institute, Washington, DC, United States of America
| | | | | | | | - Paola Pidal
- National Institute of Health, Santiago, Chile
| | - Cuauhtemoc R. Matus
- Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, United States of America
| | - Lucia H. de Oliveira
- Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, United States of America
- * E-mail:
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Díaz J, Cárcamo M, Seoane M, Pidal P, Cavada G, Puentes R, Terrazas S, Araya P, Ibarz-Pavon AB, Manríquez M, Hormazábal JC, Ayala S, Valenzuela MT. Prevalence of meningococcal carriage in children and adolescents aged 10-19 years in Chile in 2013. J Infect Public Health 2016; 9:506-15. [PMID: 26819097 DOI: 10.1016/j.jiph.2015.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/19/2015] [Accepted: 12/11/2015] [Indexed: 12/16/2022] Open
Abstract
In 2011, Chile experienced an increase in the number of cases of IMD caused by Neisseria meningitidis group W. This epidemiological scenario prompted authorities to implement prevention strategies. As part of these strategies, the Institute of Public Heath of Chile conducted a cross-sectional study to determine the prevalence of pharyngeal carriage of N. meningitidis in a representative sample of healthy children and adolescents aged 10-19 years. The identification of presumptive N. meningitidis strains was performed by testing carbohydrate utilization in the National Reference Laboratory at the ISP. Association of meningococcal carriage with risk factors was analyzed by calculating the Odds Ratio. Selected variables were included in a logistic model for risk analyses. The prevalence of carriage of N. meningitidis was 6.5% (CI: 5.7-7.3%). Older age (carriers: 14.2±0.29 vs. non-carriers: 13.8±0.08 years old; p=0.009), cohabitation with children (carriers: 0.9±0.13 vs. non-carriers: 0.7±0.03; p=0.028), number of smoking cohabitants (carriers: 0.55±0.13 vs. non-carriers: 0.44±0.03) and frequent attendance to crowded social venues (carriers: 49% vs. non-carriers: 37%; p=0.008) were determined to favor carriage. Statistical modeling showed that meningococcal carriage was associated with older age (OR: 1.077, p-value: 0.002) and cohabitation with children (OR: 1.182, p-value: 0.02).
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Affiliation(s)
- Janepsy Díaz
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile.
| | - Marcela Cárcamo
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Mabel Seoane
- Departamento de Laboratorio Biomédico Nacional de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Paola Pidal
- Departamento de Laboratorio Biomédico Nacional de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Gabriel Cavada
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Rodrigo Puentes
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Solana Terrazas
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Pamela Araya
- Departamento de Laboratorio Biomédico Nacional de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Ana B Ibarz-Pavon
- Pan-American Health Organization/World Health Organization, Washington, DC, USA
| | - Macarena Manríquez
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Juan C Hormazábal
- Departamento de Laboratorio Biomédico Nacional de Referencia, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Salvador Ayala
- Departamento de Asuntos Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
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Araya P, Fernández J, Del Canto F, Seoane M, Ibarz-Pavón AB, Barra G, Pidal P, Díaz J, Hormazábal JC, Valenzuela MT. Neisseria meningitidis ST-11 clonal complex, Chile 2012. Emerg Infect Dis 2015; 21:339-41. [PMID: 25625322 PMCID: PMC4313638 DOI: 10.3201/eid2102.140746] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Serogroup W Neisseria meningitidis was the main cause of invasive meningococcal disease in Chile during 2012. The case-fatality rate for this disease was higher than in previous years. Genotyping of meningococci isolated from case-patients identified the hypervirulent lineage W:P1.5,2:ST-11, which contained allele 22 of the fHbp gene.
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Araya P, Díaz J, Seoane M, Fernández J, Terrazas S, Canals A, Vaquero A, Barra G, Hormazábal JC, Pidal P, Valenzuela MT. [Laboratory surveillance for invasive meningococcal disease in Chile, 2006-2012]. Rev Chilena Infectol 2015; 31:377-84. [PMID: 25327189 DOI: 10.4067/s0716-10182014000400001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 04/07/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Laboratory surveillance of Invasive Meningococcal Disease (IMD) is performed by the Institute of Public Health of Chile. It confirms identification, classifies in serogroups and analyzes the genetic profiles of Neisseria meningitidis isolates from laboratories throughout the country. AIM To show the results of this surveillance from 2006 to 2012. METHODS A descriptive data analysis of the confirmed cases of IMD and serological characterization, susceptibility and genetic profiles of the isolates. The analysis was disaggregated by serogroup, age and region. RESULTS From 2006 to 2012, 486 isolates of N. meningitidis were confirmed. In 2011 a rise in IMD rates was observed due to an increase in W serogroup cases, mainly affecting children aged 5 years or less. Serogroup W became the most prevalent during 2012 (58.3%), replacing the historically prevalent serogroup B. Predominating strains belonged to ST-32 complex/ET-5 complex (40, 4% of strains) and ST-41/44 complex/ Lineage 3 (45, 9% of strains). CONCLUSIONS Laboratory surveillance has allowed the early detection of increasing IMD caused by serogroup W, which is emergent in Chile. This information has reinforced the daily monitoring of new cases, in collaboration with all the clinical laboratories of the country.
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Valenzuela MT, Seoane M, Canals A, Pidal P, Hormazábal JC, Araya P, Terrazas S, Díaz J. [Laboratory surveillance of Streptococcus pneumoniae from invasive disease, Chile 2007-2012]. Rev Chilena Infectol 2015; 31:651-8. [PMID: 25679919 DOI: 10.4067/s0716-10182014000600002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 10/26/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND 10-valent pneumococcal vaccine (PCV-10) was introduced in 2011 to the National Immunization Program in Chile. It was administered in 4 doses, but in 2012 it was modified to a 3 dose program. This article shows the results of the Laboratory Surveillance System for Streptococcus pneumoniae isolated of invasive disease from 2007 to 2012 and compares the incidence of invasive pneumococcal disease (IPD) by age groups in the prevaccinal (2007-2010) and postvaccinal period (2012). METHODS Descriptive study of S. pneumoniae surveillance in invasive diseases cases confirmed at the National Reference Laboratory of the Institute of Public Health of Chile from 2007 to 2012. RESULTS Global incidence of laboratory confirmed IPD cases decreased 27.8% from 2007 to 2012 and showed a lower risk for IPD in 2012 compared with 2007. Incidence in children aged 1 year or less decreased from 56.1 to 16.3 per 100,000 and from 42.0 to 19.9 per 100,000 in children aged 12 to 23 months in the same period. Highest decreases were observed in IPD cases caused by serotypes 4 (100%), 19F (93.3%), 23F (90.9%), 14 (81.1%), 6B (70%), 18C (58.3%) and 1(81.8%) in children aged 2 years or less. CONCLUSION Surveillance System detects S.pneumoniae isolated from invasive diseases, contributing with information about laboratory confirmed IPD trends, prevalent serotypes and replacement effects. These results can be used as evidence in healthcare decision making for pneumococcal vaccines.
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Prado V, Pidal P, Arellano C, Lagos R, San Martin O, Levine MM. [Antimicrobial multiresistance of Shigella sp strains in a semi rural community of northern Santiago]. Rev Med Chil 1998; 126:1464-71. [PMID: 10349160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
UNLABELLED Appropriate antimicrobial therapy shortens the duration of Shigellosis and significantly reduces the risk of transmission. Shigella strains resistant to common antimicrobials have increased during the past years, determining the need for a periodic surveillance, to guide effective therapy. AIM To report the results of a surveillance program in a rural community near Santiago (Colina), for Shigella infections. MATERIAL AND METHODS Between 1995 and 1997, stool samples from 3,534 episodes of diarrhoea, that occurred in Colina, were obtained. Two hundred twenty six Shigella strains were isolated and studied for susceptibility to ampicilin (AM), amoxicillin/clavulanic acid (AMC), cotrimoxazole (STX), chloramphenicol (CAF), tetracycline (TET), furazolidine (FU), ciprofloxacine (CIPR), nalidixic acid (AC NAL), gentamycin (GENT) and cefotaxime (CFTX). RESULTS Shigella flexnerii represented 134 of 226 Shigella strains isolated. All strains were susceptible to CIPR, AC NAL, GENT and CFTX. Yearly variation of resistance patterns to other antimicrobials were observed for these strains. Resistance to AM varied from 56 to 76%, to AMC from 25 to 56%, to STX from 21 to 47%, to CAF from 36 to 69%, to TET from 44 to 78% and to FU from 9 to 18%. Overall resistance was higher during 1997. All 85 strains of S sonnei were susceptible to CIPR, AC NAL and CFTX. Resistance throughout the years varied from 56 to 88% for AM, from 0 to 28% for AMC, from 44 to 53% for STX, from 11 to 40% for CAF, from 11 to 42% for TET and from 5 to 11% for FU. Overall resistance was also higher during 1997, except for AM and STX. Seven S hoydii strains were isolated, only during 1995. All seven were resistant to AM and TET and none were resistant to FU, CIPR, AC NAL and CFTX. Two strain was resistant to AMC, STX and CAF. CONCLUSIONS Antimicrobial resistance patterns of Shigella sp isolated in Colina have increased from 1995 to 1997, specially for commonly used antimicrobials. Resistance remains low for furazolidine and all strains remain susceptible to quinolones.
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Affiliation(s)
- V Prado
- Unidad de Microbiología, Facultad de Medicina, Universidad de Chile.
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