Abstract Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In Part I, recommendations on the use of a computerized microbiological data management system in clinical practice, data and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In Part II, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Resumen La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en el cual el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

Abstract Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In the first part, recommendations on the use of a computerized microbiological data management system in clinical practice, data, and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In the second part, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Resumen La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en los cuales el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso, hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, así como y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

ABSTRACT The research evaluated the isolation, identification, and prospection of species-specific beneficial bacteria in fish farming of ornamental fish Betta splendens. For this, the microbiological material was obtained from the intestinal tract of healthy specimens, with bacterial growth in selective culture medium Man Rogosa Sharped (MRS). Sixteen strains were isolated based on the response of in vitro tests of catalase, Gram, nilin blue, hemolytic activity and antibiogram to pathogens Aeromonas hydrophila, Pseudomonas aeroginosa, Enterococcus durans and Escherichia coli. Of the isolated strains C1BS and C5BS, they showed the best responses, which were later identified by the Maldi-TOF method as Lactobacillus plantarum and Enterococcus faecium. Due to the performance of lactic acid strains in in vitro tests and the bibliographic record of their performance as probiotics, the species have great potential for species-specific use in the ornamental production of Betta splendens. isolation identification speciesspecific specific splendens this specimens MRS. MRS . (MRS) catalase Gram blue hydrophila aeroginosa coli CBS C BS C5BS responses MaldiTOF Maldi TOF faecium probiotics (MRS

RESUMO A pesquisa avaliou o isolamento, a identificação e a prospecção de bactérias benéficas espécie-específico na piscicultura do peixe ornamental Betta splendens. Para isso, o material microbiológico foi obtido do trato intestinal de espécimes sadios, com crescimento bacteriano em meio de cultura seletivo Man Rogosa Sharped (MRS). Dezesseis cepas foram isoladas com base na resposta dos testes in vitro de catalase, Gram, azul de anilina, atividade hemolítica e antibiograma aos patógenos Aeromonas hydrophila, Pseudomonas aeroginosa, Enterococcus durans e Escherichia coli. Das cepas isoladas, C1BS e C5BS foram as que apresentaram melhores respostas, as quais posteriormente foram identificadas, pelo método Maldi-TOF, como Lactobacillus plantarum e Enterococcus faecium. Devido ao registro bibliográfico e ao desempenho das cepas ácido lácticas nos testes in vitro, essas apresentam um grande potencial para uso probiótico espécie-específico na produção ornamental de Betta splendens. isolamento espécieespecífico espécie específico splendens isso sadios MRS. MRS . (MRS) catalase Gram anilina hydrophila aeroginosa coli CBS C BS respostas identificadas MaldiTOF, MaldiTOF Maldi TOF, TOF Maldi-TOF faecium (MRS

Aim To investigate the bacteriological profile of oral and maxillofacial infections and the pattern of sensitivity to a specific group of antibiotics in a reference emergency hospital in Brazil. Methods This is a prospective cohort institutional study that studied patients affected by oral and/or maxillofacial infections in a Brazilian emergency hospital, over a 12-month period, of different etiologies, through data collection, culture and antibiogram tests, and monitoring of the process of resolution of the infectious condition. The variables were analyzed using the chi-square and Mann-Whitney tests, using a significance level of 5%. Results The sample consisted of 61 patients, 62.3% male. The mean age of participants was 34.3 years. Odontogenic infection was the most frequent etiology and the submandibular space was the most affected. The bacterial species Streptococcus viridans was isolated in 21.6% of cases. Levofloxacin, vancomycin and penicillin were the antibiotics with the highest frequency of bacterial sensitivity, while clindamycin and erythromycin showed the highest percentages of resistance. Conclusions The results suggest that, among the most used antibiotics for the treatment of these infections, penicillin remains an excellent option of choice for empirical therapy. Brazil andor or 12month month 12 period etiologies collection tests condition chisquare chi square MannWhitney Mann Whitney 5 5% 6 623 62 3 62.3 male 343 34 34. years 216 21 21.6 cases Levofloxacin resistance therapy 1 62. 2 21.

ABSTRACT. The study was carried out in the region of Placas, Pará. Objective: identify the main causing agents of mastitis, as well as evaluating the resistance profile of the isolated agents against antimicrobials. Methods: Ten properties were evaluated, where 161 animals were submitted to the California Mastitis Test (CMT) for the diagnosis of subclinical mastitis, and milk samples were collected from positive animals and led for culture and antibiogram. Results: In total, 31.06% of the animals were positive for CMT. The main agents identified were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae and Streptococcus bovis. The antibiogram indicated resistance to Penicillin, Ceftazidime and Cephalothin. Conclusion: The properties surveyed showed a high rate of subclinical mastitis, regarding antimicrobial resistance, in general, all agents showed high resistance. ABSTRACT Placas Pará Objective mastitis antimicrobials Methods evaluated 16 CMT (CMT Results total 3106 31 06 31.06 aureus epidermidis bovis Penicillin Cephalothin Conclusion general 1 310 3 0 31.0 31.

Resumo A presença de bactérias patogênicas em alimentos é considerada a principal causa de doenças transmitidas por alimentos e deterioração da qualidade dos alimentos em todo o mundo. O presente estudo teve como objetivo determinar a eficácia de cinco óleos essenciais (OEs) contra patógenos de origem alimentar multirresistentes. No presente estudo, bactérias Gram-negativas (Escherichia, Enterobacter, Citrobacter, Proteus, Pseudomonas e Klebsiella) e as bactérias Gram-positivas Staphylococcus foram isoladas do leite cru e caracterizadas bioquimicamente. O efeito antibacteriano de diferentes antibióticos e OEs (tomilho, orégano, capim-limão, hortelã e alecrim) foi determinado usando o método padrão de difusão em disco. O estudo do antibiograma revelou que as bactérias Gram-negativas eram altamente resistentes à penicilina, enquanto o Staphylococcus era resistente à estreptomicina, amoxicilina e lincomicina. Foi observada resistência moderada à doxiciclina, amicacina, enrofloxacina, canamicina e cefixima. Os isolados foram encontrados menos resistentes à gentamicina, cloranfenicol e ciprofloxacina. Os OEs mostraram uma ampla gama de atividade antimicrobiana contra todas as bactérias, exceto P. aeruginosa. Destes, o tomilho foi mais eficaz contra a maioria das cepas bacterianas multirresistentes e formou a maior zona de inibição (26 mm) contra Escherichia seguido de óleo de orégano (18 mm) contra Staphylococcus (p<0,05). Klebsiella spp e Citrobacter spp apresentaram resistência ao óleo de menta e capim-limão, respectivamente. Os OEs como capim-limão, hortelã e alecrim foram menos ativos contra todas as bactérias. Os resultados do estudo recente sugerem o uso de OEs como agentes antibacterianos naturais para conservação de alimentos.

Abstract The presence of pathogenic bacteria in food is considered as a primary cause of food-borne illness and food quality deterioration worldwide. The present study aimed to determine the effectiveness of five essential oils (EOs) against multidrug-resistant foodborne pathogens. In the current study Gram-negative bacteria (Escherichia, Enterobacter, Citrobacter, Proteus, Pseudomonas, and Klebsiella) and the Gram-positive bacteria Staphylococcus were isolated from raw milk and biochemically characterized. The anti-bacterial effect of different antibiotics and EOs (thyme, oregano, lemongrass, mint, and rosemary) was determined using the standard disc diffusion method. The antibiogram study revealed that Gram-negative bacteria were highly resistant to penicillin while Staphylococcus was resistant to streptomycin, amoxicillin, and lincomycin. Moderate resistance was observed to doxycycline, amikacin, enrofloxacin, kanamycin and cefixime. Isolates were found less resistant to gentamycin, chloramphenicol, and ciprofloxacin. EOs showed a broad range of antimicrobial activity against all bacteria except P. aeruginosa. Of these, thyme was more effective against most of the multi-drug resistant bacterial strains and formed the largest zone of inhibition (26 mm) against Escherichia followed by oregano oil (18 mm) against Staphylococcus (p<0.05). Klebsiella spp and Citrobacter spp showed resistance to mint and lemongrass oil respectively. The EOs such as lemongrass, mint and rosemary were less active against all the bacteria. The findings of the recent study suggest the use of EOs as natural antibacterial agents for food preservation.

Resumo A Escherichia coli patogênica aviária (APEC) induz a colibacilose, uma doença aguda e sistêmica, resultando em perdas econômicas substanciais no setor avícola. Este estudo teve como objetivo investigar o padrão de resistência a antibióticos associado à frequente distribuição de genes de virulência em APEC O78:K80 que podem causar alterações patológicas em galinhas. O perfil do antibiograma mostrou alta resistência à eritromicina, cloranfenicol, tetraciclina, ampicilina e cotrimoxazol; resistência intermediária à ciprofloxacina, levofloxacina, enrofloxacina, norfloxacina, nitrofurantoína e cloridrato de doxiciclina; e sensível à amicacina, estreptomicina, gentamicina e colistina . A distribuição de genes de virulência identificou oito genes (irp-2, iutA, ompT, iss, iucD, astA, hlyF e iroN) por meio de uma reação em cadeia da polimerase convencional. A APEC O78:K80 causou concentrações significativamente altas de enzimas hepáticas, níveis séricos de interleucina-6 e fator de necrose tumoral alfa em aves experimentais. Além disso, aves infectadas apresentaram hipoproteinemia, hipoalbuminemia e hiperglobulinemia. O exame de necropsia revelou peri-hepatite e pericardite fibrinosa, pulmões congestos, hemorragias equimóticas do intestino e granulomatose necrosante do baço. O exame histopatológico mostrou degeneração hepatocelular, necrose miocárdica, nefrite intersticial, hemorragias intestinais e linfopenia no baço. Este estudo é a primeira evidência para avaliar o perfil de resistência a antibióticos associado a genes de virulência e potencial clínico-patológico de APEC O78:K80 em galinhas no Paquistão, o que pode ser uma abordagem útil e rápida para prevenir e controlar a doença por meio do desenvolvimento de estratégias de controle.

Abstract Avian pathogenic Escherichia coli (APEC) induces colibacillosis, an acute and systemic disease, resulting in substantial economic losses in the poultry sector. This study aimed to investigate the antibiotic resistance pattern associated with frequent virulence gene distribution in APEC O78:K80 that may cause pathological alterations in chickens. The antibiogram profile showed high resistance to erythromycin, chloramphenicol, tetracycline, ampicillin, and co-trimoxazole, followed by intermediate resistance to ciprofloxacin, levofloxacin, enrofloxacin, norfloxacin, nitrofurantoin, and doxycycline hydrochloride, and sensitive to amikacin, streptomycin, gentamicin, and colistin. Virulence gene distribution identifies eight (irp-2, iutA, ompT, iss, iucD, astA, hlyF, iroN) genes through a conventional polymerase chain reaction. APEC O78:K80 caused significantly high liver enzyme concentrations, serum interleukin-6 and tumor necrosis factor-alpha levels in experimental birds. Also, infected birds have hypoproteinemia, hypoalbuminemia, and hyperglobulinemia. Necropsy examination revealed fibrinous perihepatitis and pericarditis, congested lungs, intestinal ecchymotic hemorrhages and necrotizing granulomatosis of the spleen. Histopathological examination depicted hepatocellular degeneration, myocardial necrosis, interstitial nephritis, intestinal hemorrhages and lymphopenia in the spleen. This study is the first evidence to assess the antibiotic resistance profile linked with virulence genes and clinicopathological potential of APEC O78:K80 in chickens in Pakistan, which could be a useful and rapid approach to prevent and control the disease by developing the control strategies.

Resumo: A ciprofloxacina é um antibiótico extremamente importante para a saúde humana. O aumento da resistência da Escherichia coli à ciprofloxacina é um problema de saúde pública global devido à sua importância no tratamento de infecções complicadas do trato urinário e outras infecções graves; no entanto, sua prescrição é alta no caribe colombiano. O objetivo foi determinar a tendência de resistência da E. coli à ciprofloxacina em um hospital colombiano de alta complexidade. A partir de relatórios de antibiogramas, os isolados foram categorizados de acordo com os critérios do Instituto de Padrões Clínicos e Laboratoriais dos Estados Unidos para cada ano estudado; as proporções foram calculadas e as diferenças de sensibilidade foram exploradas com os testes χ2. O teste de Cochran-Armitage foi usado para avaliar a tendência de resistência. Os valores de p ≤ 0,05 foram considerados significativos. Um total de 6.848 isolados foi testado e foi encontrada uma taxa de resistência de 49,31%. Por origem, a resistência foi mais alta em amostras comunitárias (51,96% - IC95%: 50,51; 53,41) e, por tipo de amostra, em pele e tecidos (61,76% - IC95%: 56,96; 66,35) e urina (48,97% - IC95%: 47,71; 50,23). Foi encontrada uma tendência de aumento na resistência por ano (p < 0,0001), em amostras da comunidade (p = 0,0002) e na urina (p < 0,0001). A resistência à ciprofloxacina é alta e tende a aumentar na comunidade e na urina, excedendo o limite estabelecido para uso ambulatorial, o que é preocupante, dada a alta prescrição de fluoroquinolonas na localidade.

Abstract: Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality.

Resumen: La ciprofloxacina es un antibiótico de importancia crítica para la salud humana. El aumento de la resistencia de Escherichia coli a ciprofloxacina es un problema de salud pública global por su importancia en el tratamiento de infecciones urinarias complicadas y otras infecciones graves; sin embargo, su prescripción es alta en el caribe colombiano. El objetivo fue determinar la tendencia de resistencia de E. coli a ciprofloxacina en un hospital colombiano de alta complejidad. A partir de reportes de antibiogramas, los aislados fueron categorizados según los criterios del Instituto de Normas Clínicas y de Laboratorio de los Estados Unidos para cada año estudiado; se calcularon proporciones y se exploraron diferencias en la sensibilidad con pruebas χ2. Se utilizó la prueba de Cochran-Armitage para evaluar la tendencia de la resistencia. Valores de p ≤ 0,05 se consideraron significativos. Se analizaron 6.848 aislados, encontrándose una resistencia de 49,31%. Según el origen, la resistencia más alta fue en muestras comunitarias (51,96% - IC95%: 50,51; 53,41), y por tipo de muestra, en piel y tejidos (61,76% - IC95%: 56,96; 66,35) y orina (48,97% - IC95%: 47,71; 50,23). Se halló una tendencia al aumento en la resistencia por año (p < 0,0001), en muestras comunitarias (p = 0,0002) y en orina (p < 0,0001). La resistencia a ciprofloxacina es alta y tiende al aumento en comunidad y en orina, superando el límite establecido para su uso a nivel ambulatorio, lo que es preocupante por la alta prescripción de fluoroquinolonas en la localidad.

Abstract The aim of this study was to evaluate the antimicrobial susceptibility profile of Aeromonas sp., and Escherichia coli isolated from samples of yellow hake (Cynoscion acoupa). We analyzed 53 Aeromonas spp. and four E. coli isolates. We observed increased resistance of E. coli to levofloxacin and sulfa-trimethoprim as well as resistance of Aeromonas spp. to ampicillin, amoxicillin-clavulanate, cefuroxime, and cefotaxime. The multiple antimicrobial resistance(MAR) index indicated multidrug resistance in 90.54% (n=48) of Aeromonas spp. isolates and in 50% (n=2) of E. coli isolates. One strain of Aeromonas spp. was resistant to all 11tested antimicrobials (MAR index = 1.00). In vitro,piperacillin + tazobactam was the most effective antimicrobial for E. coli,and cefepime and levofloxacin were the most effective antimicrobials for Aeromonas spp. Therefore, in case of illnesses caused by these microorganisms, these antimicrobials should be used. The multidrug resistance of Aeromonas spp. and E. coli in this study is elevated. This is worrisome considering the increase in bacteria resistant to multiple drugs, reducing the options for successful clinical antimicrobial use. sp sp. Cynoscion acoupa. acoupa . acoupa) 5 spp E sulfatrimethoprim sulfa trimethoprim ampicillin amoxicillinclavulanate, amoxicillinclavulanate amoxicillin clavulanate, clavulanate amoxicillin-clavulanate cefuroxime cefotaxime resistanceMAR MAR resistance(MAR 9054 90 54 90.54 n=48 n48 n 48 (n=48 50 n=2 n2 2 (n=2 tested 1.00. 100 1.00 1 00 1.00) vitropiperacillin vitro piperacillin coliand Therefore microorganisms used elevated drugs use 905 9 90.5 n=4 n4 4 (n=4 n= (n= 10 1.0 0 90. (n 1.

Resumo O trabalho teve como objetivo avaliar o perfil de suscetibilidade a antimicrobianos de bactérias do gênero Aeromonas e Escherichia coli isoladas de amostras de pescada amarela (Cynoscion acoupa). Foram analisados 53 isolados de Aeromonas spp. e quatro isolados de Escherichia coli. Foi verificada maior resistência de E. coli à levofloxacina e sulfa-trimetoprim; assim como houve resistência antimicrobiana dos isolados de Aeromonas spp. à ampicilina, amoxicilina-clavulanato, cefuroxima e cefotaxima. Os valores encontrados para o índice MAR, evidenciam multirresistência em 90,54% (n=48) dos isolados de Aeromonas spp. e em 50% (n=2) dos isolados de E. coli. Uma cepa de Aeromonas spp. apresentou resistência a todos os onze antimicrobianos testados (MAR = 1,00). A pesquisa mostrou que, no tratamento de infecções causadas por E. coli, a piperacilina-tazobactam é a mais eficaz in vitro. Para Aeromonas spp., os antimicrobianos mais eficazes in vitro foram cefepime e levofloxacina. Dessa forma, em caso de enfermidades ocasionadas por esse micro-organismo, seriam esses os antimicrobianos de eleição para o tratamento das infecções. A multirresistência dos isolados de Aeromonas spp. e E. coli foi considerada elevada. Este é um dado importante visto que o aumento do aparecimento de bactérias resistentes a múltiplas drogas é preocupante, diminuindo as opções de uso de antimicrobianos com sucesso clínico. Cynoscion acoupa. acoupa . acoupa) 5 spp E sulfatrimetoprim sulfa trimetoprim sulfa-trimetoprim ampicilina amoxicilinaclavulanato, amoxicilinaclavulanato amoxicilina clavulanato, clavulanato amoxicilina-clavulanato cefotaxima MAR 9054 90 54 90,54 n=48 n48 n 48 (n=48 50 n=2 n2 2 (n=2 1,00. 100 1,00 1 00 1,00) piperacilinatazobactam piperacilina tazobactam forma microorganismo, microorganismo micro organismo, organismo micro-organismo elevada preocupante clínico 905 9 90,5 n=4 n4 4 (n=4 n= (n= 10 1,0 0 90, (n 1,

Abstract: Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality. Abstract however Caribbean E complexity reports studied χ CochranArmitage Cochran Armitage pvalue p value 005 0 05 0.05 total 6848 6 848 6,84 analyzed 4931 49 31 49.31 found origin 51.96% 5196 51 96 (51.96 95%CI 95CI CI 95 50.51 5051 50 53.41, 5341 53.41 , 53 41 53.41) sample 61.76% 6176 61 76 (61.76 56.96 5696 56 66.35 6635 66 35 48.97% 4897 48 97 (48.97 47.71 4771 47 71 50.23. 5023 50.23 . 23 50.23) 0.0001, 00001 0.0001 0001 0.0001) 0.0002 00002 0002 0.0001. level locality 00 0.0 684 84 6,8 493 4 3 49.3 51.96 519 5 9 (51.9 50.5 505 534 53.4 61.76 617 7 (61.7 56.9 569 66.3 663 48.97 489 (48.9 47.7 477 502 50.2 2 0000 0.000 000 0. 68 8 6, 49. 51.9 (51. 50. 53. 61.7 (61. 56. 66. 48.9 (48. 47. 0.00 51. (51 61. (61 48. (48 (5 (6 (4 (

Resumo: A ciprofloxacina é um antibiótico extremamente importante para a saúde humana. O aumento da resistência da Escherichia coli à ciprofloxacina é um problema de saúde pública global devido à sua importância no tratamento de infecções complicadas do trato urinário e outras infecções graves; no entanto, sua prescrição é alta no caribe colombiano. O objetivo foi determinar a tendência de resistência da E. coli à ciprofloxacina em um hospital colombiano de alta complexidade. A partir de relatórios de antibiogramas, os isolados foram categorizados de acordo com os critérios do Instituto de Padrões Clínicos e Laboratoriais dos Estados Unidos para cada ano estudado; as proporções foram calculadas e as diferenças de sensibilidade foram exploradas com os testes χ2. O teste de Cochran-Armitage foi usado para avaliar a tendência de resistência. Os valores de p ≤ 0,05 foram considerados significativos. Um total de 6.848 isolados foi testado e foi encontrada uma taxa de resistência de 49,31%. Por origem, a resistência foi mais alta em amostras comunitárias (51,96% - IC95%: 50,51; 53,41) e, por tipo de amostra, em pele e tecidos (61,76% - IC95%: 56,96; 66,35) e urina (48,97% - IC95%: 47,71; 50,23). Foi encontrada uma tendência de aumento na resistência por ano (p < 0,0001), em amostras da comunidade (p = 0,0002) e na urina (p < 0,0001). A resistência à ciprofloxacina é alta e tende a aumentar na comunidade e na urina, excedendo o limite estabelecido para uso ambulatorial, o que é preocupante, dada a alta prescrição de fluoroquinolonas na localidade. Resumo humana graves entanto E complexidade antibiogramas estudado χ2 χ CochranArmitage Cochran Armitage 005 0 05 0,0 significativos 6848 6 848 6.84 4931 49 31 49,31% origem 51,96% 5196 51 96 (51,96 IC95% IC95 IC 50,51 5051 50 53,41 5341 53 41 amostra 61,76% 6176 61 76 (61,76 56,96 5696 56 66,35 6635 66 35 48,97% 4897 48 97 (48,97 47,71 4771 47 71 50,23. 5023 50,23 . 23 50,23) 0,0001, 00001 0,0001 , 0001 0,0001) 0,0002 00002 0002 0,0001. ambulatorial preocupante localidade 00 0, 684 84 6.8 493 4 3 49,31 51,96 519 5 9 (51,9 IC9 50,5 505 53,4 534 61,76 617 7 (61,7 56,9 569 66,3 663 48,97 489 (48,9 47,7 477 502 50,2 2 0000 0,000 000 68 8 6. 49,3 51,9 (51, 50, 53, 61,7 (61, 56, 66, 48,9 (48, 47, 0,00 49, 51, (51 61, (61 48, (48 (5 (6 (4 (

Resumen: La ciprofloxacina es un antibiótico de importancia crítica para la salud humana. El aumento de la resistencia de Escherichia coli a ciprofloxacina es un problema de salud pública global por su importancia en el tratamiento de infecciones urinarias complicadas y otras infecciones graves; sin embargo, su prescripción es alta en el caribe colombiano. El objetivo fue determinar la tendencia de resistencia de E. coli a ciprofloxacina en un hospital colombiano de alta complejidad. A partir de reportes de antibiogramas, los aislados fueron categorizados según los criterios del Instituto de Normas Clínicas y de Laboratorio de los Estados Unidos para cada año estudiado; se calcularon proporciones y se exploraron diferencias en la sensibilidad con pruebas χ2. Se utilizó la prueba de Cochran-Armitage para evaluar la tendencia de la resistencia. Valores de p ≤ 0,05 se consideraron significativos. Se analizaron 6.848 aislados, encontrándose una resistencia de 49,31%. Según el origen, la resistencia más alta fue en muestras comunitarias (51,96% - IC95%: 50,51; 53,41), y por tipo de muestra, en piel y tejidos (61,76% - IC95%: 56,96; 66,35) y orina (48,97% - IC95%: 47,71; 50,23). Se halló una tendencia al aumento en la resistencia por año (p < 0,0001), en muestras comunitarias (p = 0,0002) y en orina (p < 0,0001). La resistencia a ciprofloxacina es alta y tiende al aumento en comunidad y en orina, superando el límite establecido para su uso a nivel ambulatorio, lo que es preocupante por la alta prescripción de fluoroquinolonas en la localidad. Resumen humana graves embargo E complejidad antibiogramas estudiado χ2 χ CochranArmitage Cochran Armitage 005 0 05 0,0 significativos 6848 6 848 6.84 4931 49 31 49,31% origen 51,96% 5196 51 96 (51,96 IC95% IC95 IC 50,51 5051 50 53,41, 5341 53,41 , 53 41 53,41) muestra 61,76% 6176 61 76 (61,76 56,96 5696 56 66,35 6635 66 35 48,97% 4897 48 97 (48,97 47,71 4771 47 71 50,23. 5023 50,23 . 23 50,23) 0,0001, 00001 0,0001 0001 0,0001) 0,0002 00002 0002 0,0001. ambulatorio localidad 00 0, 684 84 6.8 493 4 3 49,31 51,96 519 5 9 (51,9 IC9 50,5 505 534 53,4 61,76 617 7 (61,7 56,9 569 66,3 663 48,97 489 (48,9 47,7 477 502 50,2 2 0000 0,000 000 68 8 6. 49,3 51,9 (51, 50, 53, 61,7 (61, 56, 66, 48,9 (48, 47, 0,00 49, 51, (51 61, (61 48, (48 (5 (6 (4 (

RESUMEN El objetivo fue conocer la calidad e inocuidad del queso fresco que se expende en un mercado de la Ciudad de Riobamba con la finalidad de establecer si es apto para el consumo humano, el nivel de resistencia bacteriana y las repercusiones en la salud del consumidor, siguiendo procedimientos y normativas nacionales e internacionales. Se analizó la presencia de Staphylococcus aureus, Coliformes totales y Escherichia coli, con recuentos en Placas Petrifilm 3M, el procedimiento se manejó con tres diluciones consecutivas, las mismas que se inocularon, incubaron, cuantificaron, se realizaron las pruebas confirmatorias en Placas Petri y antibiograma utilizando el método Kirby Bawer. Los resultados fueron: 1,3x106 UFC/g de Staphylococcus aureus, 7x105 UFC/g de Escherichia coli y 8,5x105 UFC/g de Coliformes totales; después se comparó estadísticamente mediante el Test T de Student, demostrando que los valores sobrepasan los máximos permitidos para el consumo humano, lo cual indica una cadena agroalimentaria deficiente, en donde existe un gran nivel de contaminación del medio en el cual se procesan, transportan y expenden los quesos frescos, por ende se hace un llamado a las entidades municipales y gubernamentales de salud para que incluyan políticas de control y regulación.

ABSTRACT The objective was to determine the quality and safety of fresh cheese sold in a market in the city of Riobamba in order to establish whether it is suitable for human consumption, the level of bacterial resistance and the repercussions on consumer health, following national and international procedures and regulations. The presence of Staphylococcus aureus, total coliforms and Escherichia coli was analyzed with counts in 3M Petrifilm Plates, The procedure was handled with three consecutive dilutions, which were inoculated, incubated, quantified, and confirmatory tests were performed in Petri Plates and antibiogram using the Kirby Bawer method. The results were: 1.3x106 CFU/g of Staphylococcus aureus, 7x105 CFU/g of Escherichia coli and 8.5x105 CFU/g of total coliforms. Statistical comparisons were then performed using the Student's t-test. It was found that the levels exceed the maximum values allowed for human consumption, which indicates a deficient agri-food chain, where there is a high level of contamination of the environment in which fresh cheeses are processed, transported and sold. In this regard, a call is made to municipal and governmental health entities to include control and regulation policies.

Resumen En México, la resistencia a los antimicrobianos es difícil de abordar debido a la ausencia de un organismo regulador que controle de manera efectiva el uso y la venta de antimicrobianos; y la baja vigilancia de prescripción y automedicación. Este estudio tuvo como objetivo determinar la prevalencia de resistencia a antibióticos en bacterias aisladas de muestras clínicas en el Hospital General de Obregón, Sonora. En este estudio se recolectó información de los cultivos que se realizaron en el área de Microbiología del Laboratorio de Análisis Clínicos y su resistencia a antibióticos, desde diciembre de 2016 hasta enero de 2018, en el Hospital General de Obregón, Sonora. Las infecciones por Escherichia coli, Klebsiella pneumoniae y Staphylococcus aureus fueron las más frecuentes entre los pacientes de todos los servicios de atención. Bacterias, como E. coli y S. aureus mostraron resistencia a los antibióticos hasta en un 90 y 100 %. La bencilpenicilina fue el antibiótico al que se observó alta resistencia en el servicio de cuidados intensivos (100 %). En el presente estudio se encontró una alta resistencia bacteriana a los antibióticos desde diciembre de 2016 hasta enero de 2018 y, en comparación con pocos estudios mexicanos, se ha mantenido sin cambios.

Abstract Antimicrobial resistance in Mexico is difficult to address due to the absence of a regulatory instance that effectively control the use and sale of antimicrobials; and the low surveillance of prescription and self-medication. This study aimed to determine the prevalence of bacterial resistance to antibiotics isolated from clinical samples in the General Hospital of Obregon, Sonora. Information was obtained from the culture logs processed and analyzed at the Microbiology area of the Clinical Laboratory and its resistance to antibiotics, from December 2016 to January 2018. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus infections were the most common among patients from all care services. Bacteria such as S. aureus and E. coli, showed antibiotic resistance of up to 90 and 100 %. A high resistance was observed against benzylpenicillin at the intensive care unit service (100 %). High bacterial resistance to antibiotics was found from December 2016 to January 2018 in the present study, and this apparently remains unchanged in our country which was inferred by data reported by previous few Mexican studies.

RESUMO O presente estudo avaliou o potencial probiótico in vitro de bactérias ácido-láticas (BAL) isoladas de queijo artesanal da Serra Geral (MG), com 14 e 21 dias de maturação, leite cru e pingo, utilizados em sua elaboração, e de bancadas de produção. As bactérias foram submetidas aos testes de antibiograma, à tolerância a ácido gástrico artificial e a sais biliares e ao antagonismo contra micro-organismos indicadores. Levilactobacillus brevis (Q521) e Lactococcus lactis (LLSG) apresentaram os melhores resultados e foram selecionados para a produção de leite fermentado. Apenas LLSG foi capaz de fermentar o leite. O produto apresentou qualidade microbiológica e físico-química adequada, exceto para os teores de proteína, segundo a legislação vigente para leites fermentados, demonstrando potencial tecnológico. A partir dos resultados apresentados, sugere-se que testes in vivo sejam realizados para que LLSG possa vir a ser utilizado como probiótico. ácidoláticas láticas BAL (BAL MG, MG , (MG) 1 2 maturação pingo elaboração antibiograma microorganismos micro organismos indicadores Q521 Q (Q521 (LLSG fermentado físicoquímica físico química adequada proteína fermentados tecnológico apresentados sugerese sugere se (MG Q52 (Q52 Q5 (Q5 (Q

ABSTRACT The objective of this work was to characterize reference bacteria strains, belonging to the genus Bacillus and species of correlated genera, by simplified morphological and biochemical methods. The morphological characterization is based on the aspects of the colonies, as well as cytomorphology of the species, by optical and scanning microscopy. For biochemical characterization, the sensitivity test to antimicrobials by disk-diffusion is performed. Moreover, the strains were characterized by extracting intracellular proteins. Characteristics such as shape, color, and consistency of the colonies, in addition to the type of spore and production of protein crystals were determinants for the morphological characterization of these species. The antibiogram revealed high resistance to β-lactam group antibiotics, in species of Bacillus cereus s.l group. In Bacillus subtilis s.l. group there was high susceptibility to antibiograms, mainly for species of B. subtilis. The protein profile provided specific protein patterns for some species, mainly bands of 130 e 65 kDa for B. thuringiensis, 140 e 130 kDa for Lysinibacillus sphaericus, and 115 kDa for Brevibacillus laterosporus. Our results showed that the morphological and biochemical characterizations, provided a simple identification, with easy interpretation, and low cost. genera methods colonies microscopy diskdiffusion disk diffusion performed Moreover proteins shape color βlactam β lactam antibiotics sl s l antibiograms B 13 6 thuringiensis 14 sphaericus 11 laterosporus characterizations identification interpretation cost 1

ABSTRACT Introduction: The oral cavity hosts a large number of microorganisms, such as Gram negative bacilli, and among them, bacteria of great medical importance due to their capacity to cause serious diseases for humans, especially in immunosuppressed patients. The objective of this work was to determine the presence of Gram Negative Bacilli and their patterns of resistance to antibiotics, in a student population of the city of Asunción, in the years 2019 and 2020. Materials and methods: An observational, descriptive cross-sectional study was carried out, where oral cavity swabs were made from 35 students between 18 and 24 years of age, from a private university in the city of Asunción. Informed consent signed by the participants was required and those who had antibiotic treatments were excluded. The samples were obtained with a cotton swab, later they were placed in a transport medium to later be cultured in MacConkey Agar. The culture was carried out for 48 hours at 37° Celsius, then the bacterial identification was carried out. Finally, the antibiogram was performed. Results: Of the 35 students, a frequency of 48,57% of Gram negative bacilli was found. Klebsiella pneumoniae strains were the most frequent (35.29%). The bacteria were found to be highly resistant to Amoxicillin/Clavulanic Acid. Conclusions: The presence of these types of microorganisms can be dangerous for the general health of people, specifically of patients with some type of immunosuppression, due to the great resistance to antibiotics presented by some strains.

RESUMEN Introducción: La cavidad bucal hospeda una gran cantidad de microorganismos, como los bacilos Gram negativos, y entre ellas, bacterias de gran importancia médica debido a su capacidad de producir enfermedades graves para el ser humano, especialmente en pacientes inmunodeprimidos. El objetivo de este trabajo fue determinar la presencia de Bacilos Gram Negativos y sus patrones de resistencia a antibióticos, en una población estudiantil de la ciudad de Asunción, en los años 2019 y 2020. Materiales y métodos: Se realizó un estudio observacional, descriptivo de corte transversal, donde se realizaron hisopados de la cavidad bucal a 35 alumnos de entre 18 a 24 años, de una universidad privada en la ciudad de Asunción. Se requirió consentimiento informado firmado por los participantes y fueron excluidos quienes tuvieron tratamientos antibióticos. Las muestras fueron obtenidas con un hisopo de algodón, posteriormente se colocaron en un medio de transporte para luego ser cultivadas en Agar MacConkey. El cultivo se realizó por 48 horas a 37° centígrados, luego se procedió a la identificación bacteriana. Por último, se realizó el antibiograma. Resultados: De los 35 alumnos se encontró una frecuencia de 48,57% de bacilos Gram negativos. Cepas de Klebsiella pneumoniae fueron las más frecuentes (35,29%). Se observó que las bacterias eran altamente resistentes a la Amoxicilina/Ácido Clavulánico. Conclusiones: La presencia de estos tipos de microorganismos puede ser peligrosa para la salud general de las personas, específicamente de los pacientes con algún tipo de inmunodepresión, debido a la gran la resistencia a antibióticos presentadas por algunas cepas.