Abstract Few studies have screened fresh orange juice for the presence of foodborne pathogens. This study therefore evaluated the microbiological quality and occurrence of Salmonella, Shigella, Escherichia coli, and diarrheagenic E. coli pathotypes (DEP) in fresh-squeezed orange juice purchased from street vendors in Morelia, Michoacan, Mexico. The general hygienic practices of street vendors were poor. All 100 samples analyzed were positive for aerobic mesophilic bacteria, with concentrations ranging from 2.41 to 6.03 log CFU/mL. A total of 90 (90%), 35 (35%), and 14 (14%) samples were positive for total coliforms, fecal coliforms, and E. coli, respectively, present with concentrations ranging from < 1 to 4.84 log CFU/mL, < 3 to > 1,100 MPN/mL, and < 3 to 210 MPN/mL, respectively. Salmonella was not detected in any of the samples, whereas Shigella sonnei was isolated from one sample. Two samples were positive for DEP; one harbored ETEC strains and the other STEC strains. Our results highlight the elevated risk for consumer health associated with the ingestion of fresh-squeezed orange juice.

Abstract This study evaluated the microbiological quality and prevalence of Escherichia coli and diarrheagenic E. coli pathotypes (DEP) among fresh-squeezed orange juice from street vendors and their hygienic practices. Sixty orange juice stalls in Mexico City were visited, and 60 samples were purchased. Most (65%) of the street vendors had poor hygienic practices. Twelve (20%) prepared orange juice at the time of purchase, while the other stalls sold already-squeezed orange juice. All samples analyzed were positive for aerobic mesophilic bacteria, with limits ranging from 1 to 6.8 log CFU/mL. A total of 35 (58.3%), 27 (45%), and 5 (8.3%) samples were positive for total coliforms, fecal coliforms, and E. coli, respectively, present at concentrations ranging from < 3 to > 1100, < 3 to > 1100, and < 3 to 53 MPN/mL, respectively. Two samples harbored DEP at concentrations of 3.6 and 9.2 MPN/mL. Both samples harbored Shiga toxin-producing E. coli strains, positive for the Shiga toxin 2 (stx2) locus. Our results suggest that consumption of fresh-squeezed street-vended orange juice may pose a health risk for consumers, revealing the necessity to implement adequate hygiene and safety practices to protect the health of consumers.

Resumen La Candidiasis Invasora (CI) y la candidemia, como su manifestación más frecuente, se ha convertido en la principal causa de micosis oportunista a nivel hospitalario. Este manuscrito realizado por miembros de la Asociación Colombiana de Infectología (ACIN), tuvo como objetivo proporcionar un conjunto de recomendaciones para manejo, seguimiento y prevención de la CI/candidemia y de la infección candidiásica de mucosas, en población adulta, pediátrica y neonatal, en un entorno hospitalario, incluyendo las unidades hemato-oncológicas y unidades de cuidado crítico. Todos los datos obtenidos mediante una búsqueda exhaustiva, fueron revisados y analizados de manera amplia por todos los miembros del grupo, y las recomendaciones emitidas se elaboraron luego de la evaluación de la literatura científica disponible, y el consenso de todos los especialistas involucrados, reconociendo el problema de la emergencia de las infecciones por Candida Spp. y brindando una correcta orientación a los profesionales de la salud sobre el manejo de pacientes con enfermedad candidiásica, de una forma racional y práctica, enfatizando en la evaluación del paciente, estrategias de diagnóstico, profilaxis, tratamiento empírico, tratamiento dirigido y terapia preventiva.

Abstract Invasive Candidiasis (IC) and candidemia (as its most frequent manifestation) have become the main cause of opportunistic mycosis at hospital settings. This study, made by members of the Colombian Association of Infectious Diseases (ACIN), was aimed at providing a set of recommendations for the management, follow-up and prevention of IC / candidemia and mucous membrane candida infection in adult, pediatric and neonatal patients in a hospital setting, including the hemato-oncological and critical care units. All the data obtained through an exhaustive search were reviewed and analyzed in a comprehensive manner by all the members of the group, and the recommendations issued are being made after a careful review of the scientific literature available and the consensus of all specialists involved; the emergence of Candida Spp. problem is highlighted and a correct orientation to health professionals regarding the management of patients with candidiasis is provided in a rational and practical way, emphasizing patient evaluation, diagnostic strategies, prophylaxis, empirical treatment, directed treatment and preventative therapy.

Resumen Describir algunos conocimientos, actitudes y prácticas de médicos en 3 ciudades colombianas con respecto a la prescripción de antibióticos. Se realizó una encuesta sobre conocimientos, actitudes y prácticas de la prescripción de antibióticos en médicos asistentes a 3 conferencias científicas de la Asociación Colombiana de Infectología en Febrero de 2008. La encuesta fue anónima e individual. Los resultados se analizaron usando Excel 2007 y STATA 2000. Se realizaron 96 encuestas a 29 médicos generales y 67 médicos especialistas. Entre el 29,2% y el 67,42% tienen conocimientos equivocados respecto a la prescripción de antibióticos. El 97,4% de los médicos encuestados considera que la venta de antibióticos debe realizarse únicamente bajo prescripción médica. La mayoría de los encuestados reconoce limitaciones del intervalo de dosificación y de la seguridad para la prescripción de antibióticos. El 60% se mostró en desacuerdo con la aplicación de guías de otros países en nuestros medio y el 76% de los consideran que los infectólogos aportan al manejo clínico de los pacientes. El 72% de los encuestados reportó tener apoyo de un infectólogo y en su institución existen estrategias de restricción de uso de antibióticos, refieren además utilizar asilamiento de contacto frente a organismos multiresistentes. Las respuestas no son significativamente diferentes de acuerdo a los años de experiencia. Los médicos reportaron en su mayoría prácticas conservadoras y racionales del uso de antibióticos aunque algunas limitaciones en el conocimiento farmacológico de los mismos.

Abstract Describe knowledge, attittudes and, practices about antibiotic use in Colombian physicians from three different cities. We applied a voluntary survey about knowledge, attittudes and practices about antibiotic prescription at three scientific meetings of the Asociacion Colombiana de Infectología, on February 2008. The survey was anonimous and individual. The results were analyzed using Excel 2007 and STATA 2000. We analyzed 96 surveys, 29 from general practitioners and 67 medical specialists. Physicians had wrong knowledge about antibiotic use between 29,2% and 67,42%. Most physicians (97.4%) considered the antibiotics have to be sold only under medical prescription. Many physicians recognized having limited knowledge about antibiotic dosing interval and security. 60% physicians disagreed with the application of guidelines from other countries in our enviroment and 76% physician consider the infectious disease experts contribute to clinical management of patients. Physicians reported having support from an infectious disease expert on 72%, and had strategies to restrict the use of some antibiotics, likecontact isolation when multi-resistant organisms had been suspected. There were not differences between answers according to years of experience. Several physcians reported conservative practices and rational antibiotic use with limited knowledge about antibiotic pharmacokinetics and pharmacodynamics.

Resumen La búsqueda de estrategias para la disminución de la infección de sitio operatorio (ISO) es una prioridad, dado el impacto que ésta tiene en los resultados de la atención de los pacientes. Recientemente ha tomado gran relevancia en la prevención de la ISO, la preparación prequirúrgica de la piel del paciente como uno de los factores clave, en los que se puede intervenir y disminuir el riesgo. En los últimos años han aparecido revisiones exhaustivas dedicadas no solo a la comparación de las soluciones antisépticas, y técnica de aplicación, también acerca de la importancia del baño pre operatorio, uso de cintas y compresas quirúrgicas impregnadas con antisépticos y el recorte de cabello preoperatorio. En esta publicación se describen los hallazgos más importantes relacionados con la preparación antiséptica de la piel del paciente y se propone un protocolo con recomendaciones prácticas para ser implementado en las instituciones del país. Se incluyen recomendaciones basadas en niveles de evidencia sobre el uso de las soluciones antisépticas (yodopovidona, clorhexidina, clorhexidina mas alcohol, entre otras) con énfasis en las ventajas y desventajas de cada una de ellas.

Abstract The search for strategies for reduction of Surgical Site infection (SSI) is a priority, given the impact that infections have on the outcome of the patients. The preoperative patient skin antisepsis, has recently gained greater significance in the prevention of SSI, as one of the critical factors, which can be intervened and can reduce the risk of infection. In recent years, comprehensive investigations have been published not only dedicated to the comparison of antiseptic solutions, application techniques, but also about the importance of preoperative bathing, use of surgical tapes and dressings impregnated with antiseptics, and preoperative shaving. This review outlines the key findings related to the preoperative patient's skin antisepsis and offers a protocol with practical recommendations to be implemented in the institutions of our country. It provides evidence based recommendations about the use of antiseptic solutions (povidone iodine, chlorhexidine, chlorhexidine plus alcohol, etc.) with emphasis on the advantages and disadvantages of each one.

Resumen Como parte de la Guia de atencion integral para la prevencion, deteccion temprana y tratamiento de las complicaciones del embarazo, desarrollada y financiada por el Departamento de Ciencia, Tecnologia e Innovacion, Colciencias, y el Ministerio de Salud y Proteccion Social de Colombia, se seleccionó a la infeccion por Toxoplasma para el desarrollo de recomendaciones para su prevencion, diagnostico y tratamiento. La infeccion por Toxoplasma gondii (T. gondii) durante el embarazo puede resultar en graves complicaciones para el feto y dejar importantes secuelas al recien nacido. Se realizo una guia basada en la mejor evidencia disponible en la literatura cientifica, con especial pertinencia a la informacion colombiana. Un consenso de expertos en parasitologia, ginecologia, neonatologia e infectologia, tanto de adultos como pediatrica, desarrollo las recomendaciones. Se propone que las recomendaciones de esta guia de atencion integral sean utilizadas por los profesionales de salud de los programas de atencion del embarazo del pais con el fin de disminuir la morbilidad y mortalidad atribuible a esta enfermedad. Se formulan recomendaciones especificas para el diagnostico desde el primer trimestre, consejos de prevencion en las mujeres no infectadas, identificacion de la infeccion del feto o del recien nacido y recomendaciones de tratamiento en estos escenarios.

Abstract Toxoplasma infection, an aspect included in the Integral Care Guidelines for prevention, early detection and treatment of complications during pregnancy developed and sponsored by the Department of Science, Technology and Innovation, Colciencias and the Ministry of Health and Social Protection; was selected to develop recommendations that may contribute to its prevention diagnostic and treatment. Guidelines were developed through systematic review of literature, two panels of evaluation, gradation of evidence: SIGN (Scottish Intercollegiate Guidelines Network), discussion panel with users and patients, external evaluation and socioeconomical evaluation of the impact of recommendations. The Toxoplasma gondii infection that occurs during pregnancy may cause serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts in parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. It is suggested that the recommendations included in this guideline be followed by healthcare professionals in pregnancy care programs nationwide, with the purpose of lowering the morbidity and mortality related to this disease. Specific recommendations for diagnosis during the first trimester of the pregnancy, recommendations for prevention in noninfected women, identification of fetal or newborn infection and recommendations for treatment in those given cases are included.

OBJECTIVE: The aim of this study was to describe the most frequently found bacterial microorganisms in bloodstream isolates taken from patients in intensive care units in Colombia and their resistance profiles. METHODS: This was a multicentre descriptive observational study that was carried out between January 2001 and June 2008 with laboratory data from 33 participating hospitals in a surveillance network. RESULTS: The most frequently found microorganisms were coagulase-negative Staphylococci 39.6%, Staphylococcus aureus 12.3%, Klebsiella pneumoniae 8.2%, Escherichia coli 5.7%, Acinetobacter baumannii, 4.0% and Pseudomonas aeruginosa 3.8%. Coagulase-negative Staphylococci registered greater than 70% oxacillin resistance rate. S. aureus presented a change in its multiresistance profile during the years of follow-up. There was a trend towards a lower resistance rate among E. coli and K. pneumoniae isolates during the study period while A. baumannii carbapenem resistance rate exceeded 50%. DISCUSSION: There has been a change in the frequency of species being isolated with a higher frequency of enterobacteriaceae compared to Gram-positive microorganisms, in general with a high resistance rate.

OBJECTIVE: To evaluate risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia emergence, its prognosis, and mortality-determining factors in critically ill patients in Colombia. METHODS: A multicenter, retrospective cohort study conducted in 2005-2008 at 16 public and private reference health care institutions in Bogotá, Colombia, that form part of a national epidemiological surveillance network and a hospital network with 4 469 beds. Methicillin-resistant emergence and mortality were analyzed using descriptive and time-to-event analysis; a multivariate Cox proportional hazard regression model was built to test the association between methicillin resistance and mortality. RESULTS: A total of 372 patients were studied: 186 with MRSA bacteremia, randomly matched with 186 with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. Previous surgery, antibiotic exposure, and hospital-acquired infections were independently associated with methicillin resistance. MRSA caused longer hospital stays among survivors (median 24 versus 18 days, P = 0.014). Mortality predictors were: patient age, creatinine level over 1.21mg/dl at ICU admission, severe sepsis, and inotropic requirement. Appropriate antimicrobial therapy and antimicrobial therapy change were independent protective factors, as was male gender. CONCLUSIONS: Methicillin resistance per se was not a mortality-independent prognostic factor. Previous conditions, such as age, baseline renal impairment, severe sepsis, and inotropy demand explained the observed mortality. Appropriate antimicrobial therapy remained a protective factor. A call to improve infection control measures in Colombia is mandatory.

OBJETIVO: Evaluar los factores de riesgo asociados con la aparición de bacteriemia por Staphylococcus aureus resistente a la meticilina (MRSA), su pronóstico y los factores determinantes de la mortalidad en pacientes gravemente enfermos en Colombia. MÉTODOS: Estudio retrospectivo multicéntrico de cohortes realizado en el período del 2005 al 2008 en 16 instituciones de atención de salud de referencia públicas y privadas de Bogotá, Colombia, que forman parte de una red nacional de vigilancia epidemiológica y de una red hospitalaria de 4 469 camas. Se analizaron la aparición de resistencia a la meticilina y la mortalidad mediante análisis descriptivos y de tiempo transcurrido hasta un suceso; se estableció un modelo multifactorial de regresión de riesgos proporcionales de Cox para evaluar la asociación entre la resistencia a la meticilina y la mortalidad. RESULTADOS: Se estudiaron 372 pacientes: 186 con bacteriemia por MRSA, apareados aleatoriamente con 186 con bacteriemia por Staphylococcus aureus sensible a la meticilina (MSSA). La cirugía previa, el tratamiento con antibióticos y las infecciones intrahospitalarias se asociaron independientemente con la resistencia a la meticilina. El MRSA provocó hospitalizaciones más prolongadas en los sobrevivientes (mediana de 24 frente a 18 días, P = 0,014). Los factores predictivos de mortalidad fueron: la edad del paciente, un nivel de creatinina superior a 1,21 mg/dl al ingresar en la UCI, la septicemia grave y el requerimiento de inotrópicos. El tratamiento antimicrobiano apropiado y el cambio de tratamiento antimicrobiano constituyeron factores protectores independientes, igual que el sexo masculino. CONCLUSIONES: La resistencia a la meticilina per se no fue un factor pronóstico independiente de la mortalidad. Las condiciones previas, como la edad, la insuficiencia renal inicial, la septicemia grave y el requerimiento de inotrópicos explicaron la mortalidad observada. El tratamiento antimicrobiano apropiado seguía siendo un factor protector. Es obligatorio hacer un llamamiento para mejorar las medidas de control de las infecciones en Colombia y en otros contextos similares.

Los manglares son abundantes e importantes ecosistemas marino-costeros en Costa Rica pero están siendo afectados por la actividad humana. Se analizo la estructura y cobertura de ambos manglares presentes en Bahía Culebra (Panamá e Iguanita), Guanacaste, Pacifico norte de Costa Rica. Se utilizo el PCQM para estructura durante la época seca entre diciembre 2007 y marzo 2008. Se utilizaron dos imágenes MASTER CARTA 2005 georreferenciadas para mapeo. El área aproximada de bosque de manglar en Panamá fue de 13.7ha; y de 40.8ha en Iguanita. Panamá contiene 51% de manglar denso en el área de estudio, 35% bosque seco, 2% sin vegetación y 12% de arena o agua. En Iguanita el 84% del área corresponde a manglar denso, 5% manglar de baja densidad y 10% sin cobertura vegetal o era arena o agua. Se hallaron cinco especies de manglar en Panamá (Avicennia germinans, Avicennia bicolor, Conocarpus erectus, Laguncularia racemosa y Rhizophora mangle); y tres en Iguanita (A. germinans, L. racemosa y R. mangle). En general, la presencia de las especies de manglar siguió un patrón similar en ambos manglares. La densidad total fue menor que en manglares cercanos; y Panamá (8.4tallos/0.1ha) mucho menor que Iguanita (67.2tallos/0.1 ha). El Índice de Complejidad (IC) fue mucho mayor en Iguanita (IC= 86.5), con dominancia de R. mangle, que en Panamá (IC= 1.1), con dominancia marcada de A. germinans. Estructuralmente ambos manglares son muy distintos entre sí y parecen encontrarse en contextos hidrodinámicos diferentes.

Mangrove forests are abundant and important coastal marine ecosystems that are being impacted by human activity in Costa Rica. There are two mangrove stands (Panama and Iguanita) in Bahia Culebra, Guanacaste, North Pacific coast of Costa Rica. Their forest structure was determined with the Point-Centered Quarter Method (PCQM) during the dry season (December 2007-March 2008). Eleven transects were established at Panama mangrove, with a total of 52 points and 208 quadrats. Two transects were established at Iguanita with a total of 16 points and 62 quadrats given access difficulty. Mapping of both stands was done with two georeferenced MASTER CARTA 2005 images. Images were digitized to 1:5000 scale using the following categories: mangrove forest, low density mangrove, no mangrove, transition to dry forest, sand and water. In the area studied at Panama was 13.7ha, and 40.8ha for Iguanita. Panama is mostly composed of dense mangrove forest (51% of total study area) and dry forest species (35% of total study area). A small area (2%) had dry soil and scarce mangrove trees and the remaining 12% corresponds to water, sand and other areas without vegetation. At Iguanita, 84% was dense mangrove, 5% scarce mangrove trees and the remaining 10% corresponds to water, sand and other areas without vegetation. Five mangrove species were encountered at Panama (Avicennia germinans, Avicennia bicolor, Conocarpus erectus, Laguncularia racemosa, and Rhizophora mangle), and three at Iguanita (A. germinans, L. racemosa, and R. mangle). Species zonation was similar at both stands; with Rhizophora near water channels and inundated areas, Avicennia frequent in drier areas, and Laguncularia (both stands) and Conocarpus (only Panama) more frequent near fresh water input. Densities at both stands (Iguanita= 67.2 and Panama= 8.4 stems/0.1 ha) were lower than reported for the north Pacific of Costa Rica. Complexity index was higher at Iguanita (CI= 86.5) with R. mangle dominance, than Panama (CI= 1.1) with A. germinans dominance. While both stands are in Bahia Culebra, structurally they are very different and seem to be under two different hydrodynamic contexts. Sea level rise related to global climate change might impact both mangrove stands as they would not be able to migrate further inland (given land elevation at the back of Iguanita, and a paved road at Panama). Given the socio-economic and ecological importance of mangrove habitats, further study and continued conservation efforts of Costa Rican mangroves are needed.

Tyrosine kinase inhibitors have changed the management and outcomes of chronic myeloid leukemia patients. Quantitative polymerase chain reaction is used to monitor molecular responses to tyrosine kinase inhibitors. Molecular monitoring represents the most sensitive tool to judge chronic myeloid leukemia disease course and allows early detection of relapse. Evidence of achieving molecular response is important for several reasons: 1. early molecular response is associated with major molecular response rates at 18-24 months; 2. patients achieving major molecular response are less likely to lose their complete cytogenetic response; 3. a durable, stable major molecular response is associated with increased progression-free survival. However, standardization of molecular techniques is still challenging.

Pseudomonas aeruginosa is an important and frightening microorganism for patients suffering from cancer. Multiresistant P. aeruginosa (MRPA) may appear as a consequence of exposure to multiple antibiotics or from a breakdown in infection control practices. This article reports an MRPA outbreak in a cancer treatment centre and the consequent case control study. Mechanical ventilation was identified as being the main risk factor for developing MRPA colonisation or infection; molecular analysis confirmed the outbreak. A multifaceted strategy was adopted, involving reinforcing hand-washing practices, contact isolation, antibiotic restriction and suction devices for mechanically-ventilated patients. MRPA was controlled and the outbreak ended. Such strategy may be effective in controlling MRPS in low-resource environments amongst high risk cancer patients.

Objective Determining the prevalence of methicillin-resistant Staphylococcus aureus (CA-MRSA) and susceptibility to erythromycin and clindamycin (resistance profile suggestive of being CA-MRSA) in community isolates from de GREBO's database from 2001-2005. Materials and Methods GREBO's database has been complied since 2001, using more than 22 hospitals in Bogota. S. aureus resistance profiles were determined from community isolates. Whonet 5.3 software and CLSI breakpoints (2003) were used. Results 2 308 S. aureus community isolates were identified. 618 (26,8 %) were methicillin-resistant Staphylococcus aureus (MRSA). 74 (3,2 %) MRSA exhibited susceptibility to all other antibiotics (erythromycin, clindamycin), suggesting that S. aureus belonged to CA-MRSA. Conclusions CA-MRSA might have emerged in Bogotá thereby having a profound implication for public health due to possible dissemination in the community and because antibiotic protocols for emergency settings should be changed. The results of our study suggested that CA-MRSA could be more common in Bogotá than currently expected.

Objetivo Determinar la prevalencia de Staphylococcus aureus resistente a meticilina y sensible a eritromicina y clindamicina (perfil de resistencia sugestivo de ser adquirido en la comunidad) (SARM-AC), de aislamientos ambulatorios de la base de datos de Grebo durante el periodo 2001-2005. Materiales y Métodos La base de datos del grupo Grebo se integró desde 2001 con más de 22 hospitales participantes en Bogotá. A partir de esta base de datos y con la ayuda del programa Whonet 5.3, se determinaron los perfiles de resistencia de los aislamientos ambulatorios de S.aureus. Se tomaron los puntos de corte establecidos por la CLSI (2003). Resultados Se identificaron 2 308 aislamientos de S. aureus provenientes de aislamientos ambulatorios, de los cuales 618 (26,8 %) eran Staphylococcus aureus meticilino resistente (SARM). Setenta y cuatro (3,2 %) de éstos, presentaban sensibilidad a todos los otros antibióticos (eritromicina, clindamicina), sugestivos de corresponder al fenotipo SARM-AC. Conclusiones La presencia en Bogotá de aislamiento de S. aureus sugestivos de tener el perfil de SARM -AC, implica un gran problema de salud pública debido a su posibilidad de diseminación en la comunidad y cambios en el empleo de antibióticos en los servicios de urgencias. Los datos de nuestro estudio sugieren que los aislamientos de SARM-AC en nuestro medio, pueden ser más comúnes de lo que pensamos.

Objetivo Determinar la prevalencia de Staphylococcus aureus resistente a meticilina y sensible a eritromicina y clindamicina (perfil de resistencia sugestivo de ser adquirido en la comunidad) (SARM-AC), de aislamientos ambulatorios de la base de datos de Grebo durante el periodo 2001-2005. Materiales y Métodos La base de datos del grupo Grebo se integró desde 2001 con más de 22 hospitales participantes en Bogotá. A partir de esta base de datos y con la ayuda del programa Whonet 5.3, se determinaron los perfiles de resistencia de los aislamientos ambulatorios de S.aureus. Se tomaron los puntos de corte establecidos por la CLSI (2003). Resultados Se identificaron 2 308 aislamientos de S. aureus provenientes de aislamientos ambulatorios, de los cuales 618 (26,8 %) eran Staphylococcus aureus meticilino resistente (SARM). Setenta y cuatro (3,2 %) de éstos, presentaban sensibilidad a todos los otros antibióticos (eritromicina, clindamicina), sugestivos de corresponder al fenotipo SARM-AC. Conclusiones La presencia en Bogotá de aislamiento de S. aureus sugestivos de tener el perfil de SARM -AC, implica un gran problema de salud pública debido a su posibilidad de diseminación en la comunidad y cambios en el empleo de antibióticos en los servicios de urgencias. Los datos de nuestro estudio sugieren que los aislamientos de SARM-AC en nuestro medio, pueden ser más comúnes de lo que pensamos.

Objective Determining the prevalence of methicillin-resistant Staphylococcus aureus (CA-MRSA) and susceptibility to erythromycin and clindamycin (resistance profile suggestive of being CA-MRSA) in community isolates from de GREBO's database from 2001-2005. Materials and Methods GREBO's database has been complied since 2001, using more than 22 hospitals in Bogota. S. aureus resistance profiles were determined from community isolates. Whonet 5.3 software and CLSI breakpoints (2003) were used. Results 2 308 S. aureus community isolates were identified. 618 (26,8 %) were methicillin-resistant Staphylococcus aureus (MRSA). 74 (3,2 %) MRSA exhibited susceptibility to all other antibiotics (erythromycin, clindamycin), suggesting that S. aureus belonged to CA-MRSA. Conclusions CA-MRSA might have emerged in Bogotá thereby having a profound implication for public health due to possible dissemination in the community and because antibiotic protocols for emergency settings should be changed. The results of our study suggested that CA-MRSA could be more common in Bogotá than currently expected.

El pasto marino de Perezoso en el Parque Nacional Cahuita, costa Caribe de Costa Rica, se está monitoreando con el protocolo de CARICOMP. La productividad (2.7±1.15 g/m²/d, n=74) resultó intermedia, comparada con otros sitios del Caribe. La biomasa total resultó de intermedia a alta (750-1 500 g/m²) en la mayoría de los sitios CARICOMP (Colombia, Cuba, Mexico, Puerto Rico y Venezuela) incluyendo Costa Rica (822.8±391.84 g/m², n=32). Las tasas de recambio son altas (5.5±1.36%, n=74) comparadas con lo que se encontró en marzo y agosto en otros sitios. La densidad promedio es de 725 plántulas/m², en la región Caribe, mientras que en Costa Rica resultó mayor (1 184±335.5 plántulas/m²). El largo y ancho de hoja promedio en toda la región es de 14.4 cm y 10.6 mm, respectivamente, similar a lo que se encontró en este estudio, pero el índice de área foliar promedio es de 3.4 m²m-2, mayor a lo que se encontró en Costa Rica (0.92 m²m-2). En Cahuita la productividad del pasto es significativamente menor comparado con los seis años previos, y la biomasa disminuyó en el tiempo. La productividad y biomasa de los pastos se está viendo afectada por las temperaturas máximas que aumentaron casi 10 °C de 1999 a 2005, y muestran una alta correlación negativa. La tasa de recambio y la temperatura no mostraron correlación. La actividad por botes, nadadores y la alta carga de nutrientes proveniente de la contaminación local por aguas negras, la deforestación y las actividades agrícolas en tierras costeras y rivereñas son fuentes potenciales de impacto en los pastos marinos de Cahuita.

Seagrass monitoring at Perezoso, Cahuita, Costa Rica (CARICOMP site). The seagrass of Perezoso (Cahuita National Park, Caribbean coast of Costa Rica) was monitored using the CARICOMP protocol. Productivity (2.7±1.15 g/m²/d; n=74) was intermediate, compared to other Caribbean sites. Total biomass was intermediate to high (750-1500 g/m²) at most CARICOMP sites (Colombia, Cuba, Mexico, Puerto Rico and Venezuela) including Costa Rica (822.8±391.84 g/m²; n=32). Turnover rates were high (5.5±1.36 %; n=74) compared to what was found in March and August at other sites. Shoot densities average 725 shoots/m², in the Caribbean region, while in Costa Rica the value was higher (1184±335.5 shoots/m²). Average leaf length and width in the entire region were 14.4 cm and 10.6 mm, respectively, similar to what we found, but leaf area index average 3.4 m²m-2, higher than what was found in Costa Rica (0.92 m²m-2). At Cahuita, seagrass productivity was significantly lower in March 2005 compared with the previous six years, and biomass has decreased with time. Seagrass productivity and biomass are being affected by the maximum temperatures, which increased by almost 10 °C from 1999 to 2005, and show a high negative correlation. Turnover rate and temperature were not correlated. Recreational boating, swimming and nutrient loading from deforested lands in the coast, the upstream rivers and local pollution are potential sources of impact to the seagrass beds at Cahuita. Rev. Biol. Trop. 55 (1): 55-66. Epub 2007 March. 31.

Objetivos Determinar la resistencia antimicrobiana entre los aislamientos bacterianos identificados en pacientes hospitalizados en Unidades de Cuidado Intensivo. Métodos Se recolectó la información de los aislamientos de microbiología provenientes de las Unidades de Cuidado Intensivo (UCI) de 14 instituciones de tercer nivel, pertenecientes al Grupo para el Control de la Resistencia Bacteriana de Bogotá (GREBO), entre los ańos 2001 y 2003. Se obtuvieron 27301 aislamientos y su perfil de susceptibilidad fue analizado por el programa Whonet 5.3. Resultados Los microorganismos aislados con mayor frecuencia fueron Staphylococcus aureus, Escherichia coli, Staphylococci coagulasa negativo (SCN), Pseudomonas aeruginosa y Klebsiella pneumoniae. Las tasas de resistencia de S. aureus y de SCN a oxacilina del 2001 al 2003 oscilaron entre 61 y 63 % y entre 78 y 83 %, respectivamente. La resistencia a cefalosporinas de tercera generación en E. coli fue cercana a 10 % y a ciprofloxacina fue superior a 20 %. La resistencia a cefalosporinas de tercera generación de K. pneumoniae fue superior a 30 % durante el 2001. La resistencia de P. aeruginosa a varios grupos de antibióticos superó 30 % y la frecuencia de cepas multirresistentes osciló entre 16 y 24 %. Conclusión Las tasas de resistencia encontradas son superiores a las mostradas por estudios de vigilancia en E.E.U.U., Europa y otras ciudades de América Latina.

Objectives Determining the frequency of antimicrobial resistance amongst bacterial isolates obtained from patients in Intensive Care Units (ICU). Methods Study data relating to 2001 to 2003 regarding microbiological isolates was obtained from a laboratory network for the ICUs of 14 third-level hospitals in Bogotá belonging to the Bogotá Bacterial Resistance Control Group (BBRCG). 27,301 isolates were obtained and their susceptibility profiles were analysed using WHONET 5.3. Results Staphylococcus aureus, Escherichia coli, coagulase negative Staphylococci (CNS), Pseudomonas aeruginosa y Klebsiella pneumoniae were the most commonly found microorganisms. Oxacillin-resistance rate ranged from 61% at 63 % during 2001 to 2003 amongst S. aureus isolates and 78 % to 83 % amongst coagulase negative Staphylococci (CNS). E. coli resistance to third generation cephalosporines was found to be about 10 % and over 20 % to ciprofloxacin. K. pneumoniae isolates’ resistance to third-generation cephalosporines was found to be more than 30 % in 2001. P. aeruginosa resistance to all but a few antibiotics was found to be over 30 % and multirresistance frequency was found to be 16 % to 24 %. Conclusion The antimicrobial resistance rates found in the ICU of hospitals in Bogotá were higher than those reported in surveillance studies in the USA, Europe or other Latin-American cities.