RESUMO Variações climáticas tendem a aumentar a ocorrência de condições extremas de seca em ambientes semiáridos e isso pode comprometer o rendimento mesmo de culturas tolerantes como palma forrageira. A irrigação da palma com água salina têm possibilitado bons resultados, e sua combinação com modificações nas densidades de plantio pode refletir em mudanças na resposta produtiva da cultura. Um experimento de campo em dois ciclos de cultivo foi realizado para avaliar as concentrações de nutrientes em palma forrageira ‘Gigante’ (Opuntia ficus-indica Mill) irrigada sob diferentes laminas de água salina e densidades de plantio. O delineamento experimental foi em blocos casualizados em esquema de parcelas subsubdivididas, sendo alocados nas parcelas dois turnos de rega (7 e 14 dias), nas subparcelas quatro densidades de plantio (20.000; 40.000; 60.000 e 80.000 plantas ha-1) e nas subsubparcelas quatro lâminas de irrigação com água salina de condutividade elétrica de 2,91 dS m-1 (0, 11, 22 e 33% da evapotranspiração de referência - ETo). As lâminas de irrigação foram aplicadas somente no período do ano sem chuva. Densidades de plantio intermediárias (43.002 e 54.687 plantas ha-1) promovem menores concentrações de P, Ca e Fe nos tecidos dos cladódios de palma forrageira ‘Gigante’. Irrigação de palma forrageira ‘Gigante’ com água salina até a lâmina 33% da ETo, possibilita aumento das concentrações de N, P, Ca, Mg, B, Cu, Mn e Zn nos tecidos dos cladódios. Lâminas de irrigação entre 16 e 25% da ETo com água salina, promove máximas concentrações de K, S e Na.

ABSTRACT Climate variability tends to increase the occurrence of extreme drought conditions in semi-arid regions, thereby compromising crop yield, including that of drought-tolerant plants such as forage cactus pear. Irrigation of cactus with saline water has enabled good results, and its combination with changes in planting densities may promote changes in the production response of this crop. A field experiment spanning two crop cycles was carried out to evaluate nutrient concentrations in ‘Gigante’ forage cactus pear (Opuntia ficus-indica Mill) under different saline water irrigation depths and planting densities. A randomized block design was used with treatments arranged in split-split plots. Two irrigation intervals (7 and 14 days) were assigned to plots, four planting densities (20,000; 40,000; 60,000 and 80,000 plants ha-1) to subplots, and four irrigation depths of saline water of electrical conductivity 2.91 dS m-1 (0, 11, 22 and 33% of reference evapotranspiration) to sub-subplots. The irrigation depths were applied only in the period of the year without rain. Intermediate planting densities (43,002 and 54,687 plants ha-1) promote lower P, Ca and Fe concentrations in cladode tissues of forage cactus pear. Irrigating ‘Gigante’ cactus forage with saline water up to 33% ETo increases the concentrations of N, P, Ca, Mg, B, Cu, Mn and Zn in cladode tissues. Irrigation levels between 16 and 25% of ETo with saline water resulted in the highest concentrations of K, S and Na.

Abstract: SCS125 is a late-maturing cultivar with a normal plant type, good resistance to lodging, resistance to blast, high yield, grains with long-thin shape, and good sensory and cooking properties either for parboiling or white rice. SCS125 has better yield and milling quality than SCS116 Satoru and SCS122 Miura.

RESUMO A capacidade de adaptação da palma forrageira às condições edafoclimáticas, associada às suas respostas às alterações no sistema de manejo, contribuem para o maior aproveitamento do seu potencial produtivo e uso na agropecuária do semiárido. Objetivou-se neste trabalho avaliar as características estruturais da planta e os rendimentos da palma forrageira (Opuntia ficus-indica Mill) em diferentes agroecossistemas do semiárido baiano. Para isso, foram analisadas as características estruturais das plantas e os atributos dos solos. Considerou-se o conhecimento tradicional no manejo da cultura e suas inter-relações com os níveis de rendimento, de modo a identificar os melhores índices de produtividade frente às peculiaridades de cada agroecossistema. A altura das plantas, a espessura e número de cladódios da palma forrageira ‘Gigante’ foram menos afetados pelos agroecossistemas, em detrimento à maior influência dos sistemas de produção. A largura, comprimento e área dos cladódios foram influenciados, em maior proporção, pelos agroecossistemas. Os rendimentos dos palmais, expressos pelas produtividades anual e de massa verde, correlacionou -se positivamente com as características estruturais da planta, como a sua altura e espessura, largura e comprimento dos cladódios. A produtividade de massa de cladódio por planta e a produtividade de massa verde por área foram os rendimentos mais influenciados pelo sistema de manejo adotado pelos produtores tradicionais.

ABSTRACT The adaptation capacity of forage cactus (Opuntia ficus-indica Mill) plants to edaphoclimatic conditions and plant responses to changes in management systems contribute to increase the use of this species in agriculture and the exploration of its productive potential in semi-arid regions. The objective of this work was to evaluate the structural characteristics and cladode yield of forage cactus plants grown under different agroecosystems in the semi-arid region of Bahia, Brazil. Structural characteristics of plants and soils attributes were analyzed. The traditional information on the crop management and its correlations with cladode yield were used to identify the best yield indexes, considering the peculiarities of each agroecosystem. Plant height, cladode thickness, and number of cladodes of the forage cactus plants evaluated were less affected by the agroecosystem than by the production systems. Cladode width, length, and area were more affected by the agroecosystems. The forage cactus crop yields, expressed by the annual cladode fresh matter yield, were positively correlated with the plant structural characteristics: plant height and thickness, and cladode width and length. The cladode weight per plant and fresh matter yield per area were the yield components most affected by the management system adopted by traditional producers.

Resumo Grande parte dos solos agricultáveis brasileiros apresenta deficiência de P, em função da maior parte deste elemento estar indisponível para a absorção pelas plantas. Neste contexto, a habilidade dos fungos filamentosos em solubilizar o P de várias fontes, sejam estas, insolúveis, orgânicas e/ou inorgânicas, tem sido considerada uma característica de destacada importância. O objetivo do presente estudo foi caracterizar a micobiota produtora de fitase no Bioma Cerrado, bem como, apresentar uma caracterização dos fatores abióticos do presente bioma e as possíveis correlações com a micobiota encontrada. As amostras foram coletadas de oito fragmentos florestais, em duas épocas, duas profundidades do solo (0-5 e 5-10 cm) e na camada de serapilheira para a quantificação da micobiota e avaliação da produção de fitase. As coletas foram realizadas em duas épocas, sendo uma na época chuvosa e outra na época seca. Na coleta da época chuvosa, o número total de fungos produtores de fitase foi menor, mas o número de Aspergillus seção Nigri produtores de fitase foi maior. Na época seca, o número de fungos produtores de fitase pertencentes ao gênero Penicillium foi maior. O fator época do ano alterou qualitativamente e quantitativamente a micobiota produtora de fitase. Concluiu-se que os solos do Bioma Cerrado são potencialmente exploráveis para a obtenção de fungos solubilizadores de P, sendo a época seca do ano a mais propícia para este fim.

Abstract The majority of Brazilian arable soils shows P deficiency, due to the fact that most of this element in the soil is unavailable for the plant absorption, for this and other reasons, the ability of filamentous fungi to solubilize P from various sources, insoluble, organic and inorganic, has been considered a desirable feature for several uses. The aim of this study was to characterize the production of phytase mycobiota in soil located in Cerrado in two seasons, under dry and rainy seasons, and also characterize abiotic factors in this biome in order to verify the existence of correlations between the quantitative and qualitative aspects of their mycobiotas in these conditions. The samples were collected from eight forest fragments twice, two soil depths (0-5 and 5-10 cm) and litter layer to quantify mycobiota and the evaluation of phytase production. In the collection carried out in the rainy season, the total number of phytase producing fungi was lower, but the number of Aspergillus section Nigri producers of phytase was greater. In the dry season the number of phytase producing fungi belonging to the genus Penicillium was higher. The year season´s factor alters quantitatively and qualitatively the phytase producer mycobiota. It was concluded that the soils are potentially exploitable in relation to obtaining phosphorus solubilizing fungi, and the dry season is more propitiate to the achievement of these fungi.

Resumen Introducción. El tratamiento de las infecciones urinarias constituye un reto creciente por el aumento de Escherichia coli proveniente de la comunidad multirresistente a los medicamentos. Objetivo. Caracterizar aislamientos de E. coli multirresistente causantes de infecciones urinarias adquiridas en la comunidad en Cumaná, Venezuela, y detectar los posibles riesgos de infección por aislamientos productores de betalactamasas de espectro extendido (BLEE). Materiales y métodos. Se incluyeron todos los pacientes atendidos en la consulta externa de urología y en urgencias del Hospital de Cumaná entre enero y junio de 2014 y que evidenciaban infecciones urinarias. La detección de los genes blaTEM, blaSHV y blaCTX-M se hizo mediante la reacción en cadena de la polimerasa (PCR). Resultados. Se encontró una alta prevalencia de E. coli multirresistente a los medicamentos (25,2 %), con 20,4 % de aislamientos productores de BLEE y una gran frecuencia de resistencia simultánea a trimetoprim-sulfametoxazol, fluoroquinolonas y aminoglucósidos (66,7 %) comparados con los no productores (2,4 %). En el 65,4 % de los aislamientos resistentes, se encontró el gen blaTEM; en 34,6 %, el blaCTX-M, y en 23,1 %, el blaSHV. Los genes blaCTX-M detectados pertenecían a los grupos CTX-M-1 y CTX-M-2. Se demostró la transferencia in vitro de plásmidos por conjugación en 17 de los 26 aislamientos productores de BLEE. Los tres tipos de genes detectados se transfirieron a los transconjugantes. La edad mayor de 60 años, las infecciones urinarias con complicaciones y el uso previo de catéter, predispusieron a la infección por cepas de E. coli productoras de BLEE. Conclusiones. La gran frecuencia de aislamientos multirresistentes productores de BLEE debería alertar a las autoridades sanitarias para tomar medidas que reduzcan el riesgo de epidemias causadas por este tipo de bacterias en la comunidad.

Abstract Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations. Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates. Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR. Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli. Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community.

Resumo Objetivo Comparar a variação dos resultados dasmedidas radiográficas do ângulo de Böhler, no pré e pós-operatório, em fraturas com dois tipos de desvio: graves e moderadas. Métodos: O ângulo de Böhler foi analisado retrospectivamente em 31 radiografias pré e pós-operatórias de fraturas do calcâneo. Quatro pacientes eram do sexo feminino (6,5%) e 26 do masculino (83,9%), entre 23 e 72 anos, média de 44,5. Resultados As medidas pré e pós-operatória demonstraram que o ângulo de Böhler após a cirurgia foi significativamente maior do que o ângulo de Böhler pré-operatório (p-valor = 0,000). Nas análises intraobservador e global, o ângulo de Böhler pósoperatório foi, em média, 10,6 graus maior do que no pré-operatório. O ângulo pósoperatório foi, em média, 108% maior do que o ângulo pré-operatório. No global, a concordância entre os avaliadores é excelente, tanto em relação ao valor pontual estimado (0,98) quanto em relação ao intervalo de confiança do ICC. Conclusão Na análise global, verificou-se que asmedidas do ângulo de Böhler no pósoperatório são, em média, significativamente maiores do que as do ângulo préoperatório. Quanto mais distante da faixa de normalidade (20 a 40 graus) estiver o ângulo pré-operatório, maior a diferença no ângulo após a cirurgia. Quando o ângulo pré-operatório está na faixa de normalidade, o ângulo pós-operatório será, em média, 1,28 vez o ângulo pré-operatório; se o ângulo de Böhler pré-operatório estiver fora da

Abstract Objective To compare pre- and postoperative variation of radiographicmeasurements of the Böhler angle (BA) in fractures with two types of deviations: severe and moderate. Methods Pre- and postoperative BAs in 31 calcaneal fracture radiographs were retrospectively analyzed. A total of 4 patients were female (6.5%) and 26 were male (83.9%), with age ranging from 23 to 72 years old, and a mean age of 44.5 years old. Results The results show that the postoperative BA was significantly larger than the preoperative BA (p = 0.000). At the intraevaluator and overall assessments, the postoperative BA was, on average, 10.6° higher than the preoperative measure. The postoperative angle was, on average, 108% higher than the preoperative angle. In the global assessment, the agreement between evaluatorswas excellent, bothregarding the estimated point value (0.98) and the intraclass correlation (ICC) confidence interval (CI). Conclusion In the global analysis, the postoperative BAs were, on average, significantly higher than the preoperativemeasurements. The farther from the normal range (20° to 40°) the preoperative angle is, the greater the difference after the surgery. When the preoperative angle was normal, the postoperative angle was, on average, 1.28 times the preoperative measurement. If the preoperative BA was abnormal, the postoperative angle was, on average, 17.3 times the preoperativemeasurement. It was demonstrated that more severe fractures present better anatomic results when compared with moderate fractures. The present study also confirms a good interobserver correlation for the BA.

ABSTRACT. The aim of this study was to obtain information for the genetic improvement of kale through repeatability and phenotypic stabilization studies and to compare methodologies that represent the reliability of the estimated parameters. Thirty-three half-sib progenies were evaluated in a randomized block design with three replicates and six plants per plot. Eight harvests were evaluated in terms of the yield of fresh leaves, number of shoots, number of leaves and average mass of leaves. Then, a phenotypic repeatability and stabilization study was performed, estimating the genetic parameters σ2a, σ²g, σ²e, and the coefficient of environmental variation and repeatability using the frequentist and Bayesian methodologies. To evaluate the reliability of these estimates, intervals were obtained using the frequentist, Bayesian and bootstrap methods. It was verified that the reliable selection of progenies of half-sib of kale can be achieved in four harvests that were realized between 95 and 170 days after planting. It was observed that the frequentist and Bayesian methodologies are better suited to obtain reliable estimates of the genetic parameters evaluated, as the last one provided smaller amplitudes for the obtained intervals. The bootstrap methodologies are not recommended for phenotypic repeatability and stabilization studies in kale.

ABSTRACT Multidrug resistance (MDR), virulence and transferable elements potentiate Pseudomonas aeruginosa's role as an opportunistic pathogen creating a high risk for public health. In this study, we evaluated the possible association of multidrug resistance, virulence factors and integrons with intrahospital P. aeruginosa strains isolated from patients at Cumana hospital, Venezuela. Relevant clinical-epidemiological data were collected to study 176 strains (2009-2016) isolated from different hospital units. Bacterial resistance was classified as susceptible, low-level resistant (LDR), multidrug resistant (MDR) and extensively drug-resistant (XDR). Most strains produced pyoverdine, DNase, gelatinase and hemolysin. Around 73% of the strains showed some type of movement. MDR and XDR strains increased from 2009 (24.2% and 4.8%, respectively) to 2016 (53.1% and 18.8%); while LDR decreased from 64.5% to 6.3%. The exoU and exoS genes were found in a significant number of strains (38.1 and 7.4%, respectively). Class I integrons were detected in 35.8% of the strains and the frequency was associated with resistance (42.9, 22.4, 41.4 and 61.9%, for susceptible, LDR, MDR and XDR, respectively). The MDR/XDR strains were positively associated with hemolysins and exoU, but negatively associated with bacterial twitching. MDR/XDR phenotypes were also associated with the Intensive Care Unit (ICU), septicemia, bronchial infection and diabetic foot ulcers, as well as long hospital stay (≥10 days) and previous antimicrobial treatment. High frequency of MDR/XDR strains and their association with class I integrons and virulence factors can increase the infection potential, as well as morbidity and mortality of patients attending this hospital and could spread infection to the community, creating a health risk for the region.

Background: Enterobacteria resistant to quinolones is increasing worldwide, including Venezuela. The mechanism for this resistance could be due to genes included in the chromosome or in transmissible plasmids. Aim: To evaluate the resistance to quinolones, coded by qnr genes present in enterobacteria species, isolated in the University Hospital of Cumana, Venezuela. Methods: Antimicrobial susceptibility tests to quinolones, beta-lactams and aminoglycosides were carried out to all the isolates. The presence of qnr genes were determined by PCR. The isolates carrying the qnr genes were used for bacterial conjugation tests to determine the presence of transferable plasmids. Antimicrobial susceptibility tests and PCR were carried out in the transconjugants to verify the transfer of the genes. Results: High levels of antimicrobial resistance to quinolones and beta-lactams were found among the isolates. We found that 33.6% of the isolates carry the qnrB gene and 0.9% qnr A gene. Of the 23 transconjugants, 20 showed to have qnrB gene, but none qnrA. Discussion: We concluded that the high frequency of qnr genes found in the enterobacteria isolates and their presence on transferable plasmids, complicate the use of quinolones for the treatment of bacterial infections, thus, a treatment plan should be designed with the rational use and the rotation of different types of antimicrobials, in order to avoid the selection of increasingly resistant strains.

Resumen Introducción: La resistencia de enterobacterias a quinolonas se ha difundido por el mundo, fenómeno presente también en Venezuela. El mecanismo de esta resistencia pudiera estar mediado por genes incluidos en el cromosoma bacteriano o transmitirse en el interior de plásmidos. Objetivo: Evaluar la resistencia a quino-lonas, codificada por genes qnr, presentes en cepas de enterobacterias, aisladas en el Hospital Universitario de Cumaná, Venezuela. Métodos: A las cepas obtenidas se les realizaron pruebas de susceptibilidad antimicrobiana a quinolonas, β-lactámicos y aminoglucósidos. La presencia del gen qnr se determinó por RPC. Las enterobacterias portadoras del gen qnr fueron sometidas al proceso de conjugación bacteriana para comprobar su capacidad de transferencia. A las transconjugantes obtenidas se les realizó pruebas de susceptibilidad antimicrobiana y RPC para comprobar la transferencia de los genes. Resultados: Se encontraron elevados porcentajes de resistencia antimicrobiana a quinolonas y betalactámicos. El 33,6% de las cepas eran portadoras del gen qnrB, y 0,9% del gen qnrA. Se obtuvieron 23 cepas transconjugantes; de éstas, 20 portaban el gen qnrB, no se observó la presencia de qnrA. Discusión: En conclusión, el elevado porcentaje de genes qnr encontrado en las enterobacterias aisladas, y comprobada la presencia de éstos en plásmidos transferibles, complica la aplicación de tratamientos basados en quinolonas y fluoroquinolonas, por lo que es recomendable el uso racional de estos antimicrobianos, y proponer la rotación de la terapia antimicrobiana, a fin de evitar la selección de cepas resistentes.

A pesar de la importancia de las especies del complejo Enterobacter cloacae como patógeno nosocomial, poco se conoce sobre la frecuencia de cada especie/genotipo. Aquí se describe una cepa de E. hormaechei subsp. hormaechei aislada de una secreción bronquial de un paciente internado en la Unidad de Cuidados Intensivos del Hospital General de Cumaná, Venezuela, quien murió producto de complicaciones de su infección. La identificación molecular fue hecha por secuenciación del gen ARNr 16S y porcomparación con las secuencias del GenBank. Esta cepa mostró resistencia a múltiples familias de antibióticos (MDR) y se detectaron los genes blaKPCyblaVIMpor PCR. Este es el primer reporte de E. hormaechei en Venezuela.

Besides the importance of Enterobacter cloacae species complex as a nosocomial pathogen, little is known about the frequency of each species/genotype. Here, we describe a strain of E. hormaechei subsp. hormaechei isolated from a bronchial secretion of a patient, in the Intensive Care Unit at the General Hospital of Cumaná, Venezuela, who died due to complications of his infection. The molecular identification was done by sequencing the 16S rRNA gene and comparing it to sequences from the GenBank. This strain showed resistance to multiple families of antibiotics (MDR), and the genes blaKPC and blaVIM were detected by PCR. This is the first time E. hormaechei has been identified in Venezuela.

Introducción. Escherichia coli es uno de los principales agentes causales del síndrome diarreico agudo. Objetivo. Identificar grupos clonales de E. coli enteropatógena en 485 casos de diarrea aguda en niños entre 0 y 10 años de edad atendidos en centros de salud de los municipios de Arismendi, Benítez y Sucre del estado Sucre, Venezuela, entre marzo y diciembre de 2011. Materiales y métodos. Previo consentimiento informado, se recolectaron muestras fecales y se identificó E. coli mediante coprocultivo estándar y serología con antisueros polivalentes y monovalentes. Se aisló el ADN y se amplificaron los genes eae (intimina) y bfpA (bundlina) mediante dos pruebas de reacción en cadena de la polimerasa (PCR) múltiples. Resultados. En 39,6 % de los coprocultivos se determinó la presencia de infección bacteriana. La prevalencia de E. coli fue de 54,7 %; 82,9 % de estas cepas fue positivo por serología para los serogrupos y el serotipo evaluados, principalmente en niños entre los 0 y los 2 años (37,9 %). El 48,6 % de las cepas de E. coli amplificaron para el gen eae y, de estas, 58,8 % se clasificó como cepas de E. coli enteropatógena típica ( eae + y bfp +). El ECEP II fue el serogrupo más frecuente (38,7 %), con predominio de bacterias E. coli enteropatógenas típicas (60 %). El alelo β de la intimina fue el más identificado (74,5 %) en las cepas positivas para el gen eae . Solo se identificaron cuatro cepas con el serotipo O157:H7 utilizando antisueros, las cuales no amplificaron mediante PCR para los genes eae y bfpA . Conclusiones. Este estudio demostró la importancia de aplicar pruebas moleculares en la identificación de las cepas de E. coli causantes de diarrea de diversa gravedad.

Introduction: Diarrheagenic Escherichia coli is an important causative agent of acute diarrheic syndrome. Objective: To identify clonal groups of enteropathogenic E. coli (EPEC), in 485 children with acute diarrhea aged 0 to 10 years attending health care centers in Arismendi, Benítez and Sucre municipalities, Sucre state, Venezuela, from March to December, 2011. Materials and methods: After obtaining the informed consent, stool samples were collected. Escherichia coli was identified using standard coproculture methods and serology with polyvalent and monovalent antisera. DNA was isolated, and eae (intimin) and bfpA (bundlin) genes were amplified through two multiplex polymerase chain reactions (PCR). Results: The presence of bacterial infection was determined in 39.6% of coprocultures. The prevalence of E. coli was 54.7%; 82.9% of these isolates were positive by serology for the evaluated serogroups and serotypes, which were mostly identified in children between 0 and 2 years (37.9%); 48.6% of E. coli strains amplified the eae gene; of these, 58.8% were classified as typical EPEC ( eae + y bfp +). EPEC II was the most common serogroup (38.7%), with predominance of typical EPEC (60%). In positive strains for eae gene, the β intimin allele was the most frequently identified (74.5%). Only four strains with O157:H7 serotype were identified, which showed no PCR amplification of the eae and bfpA genes. Conclusion: This study showed the importance of molecular tests to identify diarrheagenic E. coli strains causing clinical conditions of varying severity.

In order to study the clonal relationship and blaKPC gene detection in clinical isolates of Klebsiella pneumoniae resistant to carbapenems, we analyzed 22 clinical isolates of K. pneumoniae with resistance to imipenem and/ or meropenem, isolated in the laboratory of bacteriology at the University Hospital "Antonio Patricio de Alcalá" (HUAPA) from the Cumana city, Sucre state, Venezuela, for a period of five consecutive years. Susceptibility to different antimicrobials was determined, and the presence of carbapenemases was detected by modified Hodge method, phenyl boronic acid synergy and combination discs. blaKPC gene detection was conducted by polymerase chain reaction and the clonal relationship was determined by pulsed field electrophoresis. High rates of antimicrobial resistance were found, five strains were negative, at least one phenotypic method, and all carried the blaKPC gene. Clonal spread was observed only in the intensive care unit (ICU), while in other services, polyclonality was found. We concluded that blaKPC gene is present in K. pneumoniae strains resistant to carbapenems isolated in the HUAPA and clonal spread it was only in the ICU.

Con el objetivo de estudiar la relación clonal y detección del gen blaKPC en aislados clínicos de Klebsiella pneumoniae resistentes a carbapenémicos, se analizaron 22 cepas clínicas de K. pneumoniae con resistencia a imipenem y/o meropenem, aisladas en el laboratorio de bacteriología del Hospital Universitario "Antonio patricio de Alcalá" (HUAPA) de la ciudad de cumaná, Estado Sucre, Venezuela, durante un período de cinco años continuos. Se determinó la susceptibilidad a diversos antimicrobianos, y se detectó la presencia de carbapenemasas por los métodos de Hodge modificado, sinergia con ácido fenil borónico y combinación de discos. La detección del gen blaKPC se llevó a cabo mediante la técnica de reacción de polimerasa en cadena y la determinación de la relación clonal se realizó por electroforesis de campo pulsado. Se encontraron elevados porcentajes de resistencia antimicrobiana, cinco cepas resultaron negativas, al menos, a un método fenotípico y todas portaban el gen blaKPC. Se observó diseminación de clones únicamente en la Unidad de cuidados Intensivos (UCI), mientras que, en otros servicios, se halló policlonalidad. Se concluye que el gen blaKPC se encuentra presente en cepas de K. pneumoniae resistentes a carbapenémicos aisladas en el HUAPA y que hubo diseminación clonal sólo en UCI.

Introduction: Red Salud UC is an Academic health network where HIV-infected patients from the public and private health system are followed by a multidisplinary team. Aim: To determine virologic and immunologic response after 144 weeks of starting first antiretroviral therapy in these patients. Methods: A retrospective analysis of adult HIV patients attended between 1992 and 2011 was performed. Demographic and clinical characteristics, antiretroviral therapies data and immunologic and virologic outcomes were collected. CD4 count and HIV viral load changes up to 144 weeks after initiation of antiretroviral therapy were analyzed. Results: 860 patients were included in the analyses. Median age was 42 years, 93% were men. Median CD4+ count at baseline was 202 cells/mm³. The most used ART regimen was zidovudine/lamivudine plus efavirenz. First line anti-retroviral therapy was changed in 42% patients, being the most common cause, drug toxicity. At week 144, median CD4+ lymphocyte cell count was 449 cells/mm³. Ninety percent and 96% had undetectable viral load measured as < 50 copies/mL or < 400 copies/mL respectively. Discussion: First report of a university cohort, with CD4 and viral load follow up for 144 weeks, including Chilean patients from public and private system. After initiation of ART, an excellent immunologic and virologic response was observed in this cohort.

Introducción: La Red de Salud UC es una red académica de atención, donde pacientes portadores del VIH del área pública y privada de salud son atendidos por un equipo profesional multidisciplinario. Objetivo: Determinar las respuestas virológicas e inmunológicas a 144 semanas de iniciada la primera terapia antiretroviral en dichos pacientes. Métodos: Análisis retrospectivo de registros de pacientes adultos portadores de VIH atendidos entre 1992 y 2011. Se recolectaron datos demográficos, clínicos, terapia anti-retroviral, resultados inmunológicos y virológicos. Se analizaron los resultados de linfocitos T CD4+ y carga viral de VIH a las 144 semanas de iniciada la primera terapia anti-retroviral. Resultados: Fueron incluidos en el análisis 860 pacientes. El promedio de edad fue 42 años, 93% hombres. La mediana basal de LT CD4+ fue 202 céls/mm³. La terapia más utilizada fue zidovudina/lamivudina/efavirenz. En 42% de los pacientes se cambió la terapia de primera línea; la causa más común fue toxicidad a los anti-retrovirales. A la semana 144 de iniciada la terapia, la mediana de LT CD4+ fue de 449 céls/mm³. Alcanzaron cargas virales indetectables 90 y 96% con < 50 copias ARN/mL o < 400 copias ARN/mL respectivamente. Discusión: Primer reporte de pacientes tratados en un centro universitario, con seguimiento inmuno-virológico a 144 semanas, que incluye pacientes del área pública y privada de salud chilena. Después del inicio de la terapia, se observó una excelente respuesta inmuno-virológica.

Las infecciones por Klebsiella pneumoniae, constituyen un problema creciente en los centros hospitalarios. El objetivo de la presente investigación fue evaluar la resistencia a los aminoglucósidos, así como la presencia de genes que codifican enzimas modificadoras de aminoglucósidos (EMA) en aislados intrahospitalarios de Klebsiella pneumoniae. Se analizaron 56 cepas provenientes de pacientes con diagnóstico de infección intrahospitalaria del Hospital Universitario “Antonio Patricio de Alcalá”, durante el periodo enero-septiembre de 2008. Se determinó la susceptibilidad antimicrobiana mediante los métodos de difusión y dilución en agar, siguiendo los lineamientos del Instituto de Estándares Clínicos y de Laboratorio. Se empleó la técnica de la reacción en cadena de la polimerasa (PCR) para detectar los genes que codifican EMA. Se encontró resistencia a gentamicina y tobramicina en el 33,9% y 35,7%, respectivamente. Los fenotipos de resistencia a aminoglucósidos más frecuentes fueron I (ANGMKTob) y II (GMKTob). Se identificaron los genes aadA (21,4%), aac(3)-IIa (16,1%), aadB (14,3%), aac (6`)-Ib (3,6%) y aph (3`)-Ia (1,8%). En 10 cepas se observó la presencia de más de un gen y en 13 cepas se correlacionó el fenotipo con los genes encontrados. La resistencia a los aminoglucósidos en los aislados evaluados se debe, principalmente, a enzimas de tipo acetiltransferasas.

Klebsiella pneumoniae infection is a growing problem in hospitals. The objective of this study was to evaluate resistance to aminoglycosides and detection of genes encoding for aminoglycoside modifying enzymes (AME) in hospital isolates of K. pneumoniae. Fifty-six isolates from patients with diagnosis of nosocomial infection at the University Hospital Antonio Patricio de Alcala, during the period January to September 2008 were included for study. Antimicrobial susceptibility was determined by the methods of diffusion and agar dilution, following the Institute for Clinical and Laboratory Standards Guidelines. Genes encoding AME were determined by the polymerase chain reaction procedure. Resistance results for Gentamycin were 33.9% and for Tobramycin 35.7%. Aminoglycoside resistance phenotypes most frequently identified were I (ANGMKTob) and II (GMKTob). The genes involved were aadA (21.4%), aac(3)-IIa (16.1%), aadB (14.3%), aac (6`)-Ib (3.6%) y aph (3`)-Ia (1.8%) For 10 of the isolates studied more than one gene was identified. In 13 isolates the phenotype corresponded to the genes found. Aminoglycoside resistance in the isolates studied is mainly due to the presence of acetyltransferase enzymes.

RESUMO O mapeamento das áreas suscetíveis à inundação constitui uma etapa importante na minimização dos danos gerados por enchentes, sobretudo em áreas urbanas. Este mapeamento é usado no estabelecimento de diretrizes de uso e ocupação do solo e na formulação dos planos de defesa civil. No município de Blumenau e Brusque, mapeamentos das áreas atingidas por inundação foram realizados, a partir de levantamentos efetuados após a ocorrência de enchentes. A partir da topografia representada em modelos digitais de terrenos (MDT) o modelo HAND vinha sendo aplicado preliminarmente para a previsão de áreas potenciais de inundação. Recentemente introduziu-se um novo conceito nas curvas de nível acima da drenagem mais próxima (HAND contours), demonstrando para o rio Itajaí Açú em Blumenau a capacidade especifica deste modelo para utilização em mapeamentos de áreas de risco hidrológico. Este trabalho teve por objetivo avaliar mais amplamente o desempenho do método HAND contour no mapeamento de áreas suscetíveis à inundação, tendo por base os levantamentos topográficos e mapas de inundações disponíveis para os municípios de Blumenau e Brusque. Nesta avaliação, foram usadas as variáveis acerto, omissão e comissão e, os parâmetros F estatístico, acurácia geral, Fit (%), taxa de alarme falso (TAF) e a taxa de tendência (BIAS). Os resultados mostraram que para enchentes de pequena magnitude, o modelo HAND superestima significativamente a área suscetível à inundação. À medida que a cota de inundação aumenta, o desempenho do modelo HAND melhora. Para a maior enchente simulada de Blumenau e de Brusque, a omissão (área faltante) foi de 7,5 e 4,7%, respectivamente. A comissão (área excedente) foi de 35,3 e 42,2%, respectivamente. A comparação com outros estudos mostra que o desempenho do modelo HAND é similar aqueles obtidos por outros autores com modelos hidrodinâmicos, cujo requerimento de dados de entrada é elevado.

ABSTRACT Mapping areas susceptible to flooding is an important step to minimize the damage caused by floods, especially in urban areas. This mapping is used to establish guidelines for use and occupation of the soil and in the formulation of civil defense plans. In the municipalities of Blumenau and Brusque, flood stricken areas were mapped, from surveys carried out after the events. From the topography represented in digital terrain models (DTM), the HAND model had been preliminarily applied to predict potential flood areas. Recently a new concept was introduced in contours above the nearest drainage (HAND contours), demonstrating the specific ability of this method for use in hydrological risk area assessment. This study aimed to evaluate more widely the performance of the HAND contour method in mapping areas susceptible to flooding, based on topographic surveys available for the municipalities of Blumenau and Brusque. The evaluation used the variables accuracy, omission and commission, and the parameters F statistic, overall accuracy, Fit (%), false alarm rate (FAR) and the trend rate (BIAS). The results showed that for floods of small magnitude, the HAND model overestimates the area susceptible to flooding. As the flood level increases, the HAND model performance improves. For the largest simulated flood of Brusque and Blumenau, the omission (missing area) was of 7.5 and 4.7%, respectively. The commission (surplus area) was 35.3 and 42.2%, respectively. Comparison with other studies shows that the performance of the HAND model is similar to those obtained by other authors with hydrodynamic models, which have a high demand for data input.