Fusarium, a member of the Ascomycota fungi, encompasses several pathogenic species significant to plants and animals. Some phytopathogenic species have received special attention due to their ...negative economic impact on the agricultural industry around the world. Traditionally, identification and taxonomic analysis of Fusarium have relied on morphological and phenotypic features, including the fungal host, leading to taxonomic conflicts that have been solved using molecular systematic technologies. In this work, we applied a phylogenomic approach that allowed us to resolve the evolutionary history of the species complexes of the genus and present evidence that supports the F. ventricosum species complex as the most basal lineage of the genus. Additionally, we present evidence that proposes modifications to the previous hypothesis of the evolutionary history of the F. staphyleae, F. newnesense, F. nisikadoi, F. oxysporum, and F. fujikuroi species complexes. Evolutionary analysis showed that the genome GC content tends to be lower in more modern lineages, in both, the whole-genome and core-genome coding DNA sequences. In contrast, genome size gain and losses are present during the evolution of the genus. Interestingly, core genome duplication events positively correlate with genome size. Evolutionary and genome conservation analysis supports the F3 hypothesis of Fusarium as a more compact and conserved group in terms of genome conservation. By contrast, outside of the F3 hypothesis, the most basal clades only share 8.8% of its genomic sequences with the F3 clade.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
While countries are facing different stages in their COVID-19 infection rates, worldwide there are millions of students affected by universities’ facilities closures due to the pandemic. Some ...institutions have enforced strategies to transfer some courses to a virtual modality, but many Dental Schools have been challenged to deal with a situation which requires emergency measures to continue the academic course in the middle of lock-downs and social distancing measures. Despite the fact that the number of online academic programs available, especially graduate programs, has increased in diverse modalities, this pandemic forced e-learning processes to develop abruptly. The likelihood of using e-learning strategies in dentistry was substantiated in the scientific literature and an overview of these opportunities is presented. Additionally, the experience of the University of Costa Rica Faculty of Dentistry is presented, as it was evident that some of the key elements in a e-learning environment needed a quick enhancement and initiation of some processes was required. First, it was necessary to categorize the academic courses depending on their virtualization's possibility (curricula analysis and classification), to better understand the extent of the impact and the work needed to contain, as far as the possibilities allowed, negative consequences on students learning process. Second, teachers needed further training in the application of virtual strategies which they hadn’t used before. do Third, an evaluation of the students’ conditions and needs was conducted in a form of a survey. Finally, teachers and students activated the available virtual platforms. For many Dental Schools, this virtualization process is an ongoing progress although it was abruptly imposed, but this moment indeed represents an enormous opportunity to move forward and get immerse in the virtualization environment as a teaching/learning experience.
Purpose
Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries.
Methods
From 01/01/2014 to 02/10/2022, we conducted a ...prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: gender, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, UC-type, hospitalizationtype, ICU type, facility ownership, and time period.
Results
31,631 patients, hospitalized for 214,669 patient-days, acquired 305 CAUTIs. The pooled CAUTI rate per 1000 UC-days was 2.58, for those using suprapubic catheters, it was 2.99, and for those with indwelling catheters, it was 2.21. The following variables were independently associated with CAUTI: age, rising risk 1% yearly (aOR = 1.01; 95% CI 1.01–1.02;
p
< 0.0001 female gender (aOR = 1.28; 95% CI 1.01–1.61;
p
= 0.04), LOS before CAUTI acquisition, rising risk 7% daily (aOR = 1.07; 95% CI 1.06–1.08;
p
< 0.0001, UC/DU ratio (aOR = 1.14; 95% CI 1.08–1.21;
p
< 0.0001, public facilities (aOR = 2.89; 95% CI 1.75–4.49;
p
< 0.0001. The periods 2014–2016 and 2017–2019 had significantly higher risks than the period 2020–2022. Suprapubic catheters showed similar risks as indwelling catheters.
Conclusion
The following CAUTI RFs are unlikely to change: age, gender, hospitalization type, and facility ownership. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations.
•CLABSI and VAP are independent risk factors for ICU mortality.•Female gender is an independent risk factors for ICU mortality.•Age increase risk of ICU mortality 1% per year of age.•TLength of stay ...increases the risk of ICU mortality by 1% per day of stay.•Central lines increase the risk of ICU mortality by 2% per day.
The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients.
Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries.
Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P<.0001); ventilator-associated pneumonia (aOR:1.48; P<.0001); catheter-associated urinary tract infection (aOR:1.18;P<.0001); medical hospitalization (aOR:1.81; P<.0001); length of stay (LOS), risk rises 1% per day (aOR:1.01; P<.0001); female gender (aOR:1.09; P<.0001); age (aOR:1.012; P<.0001); central line-days, risk rises 2% per day (aOR:1.02; P<.0001); and mechanical ventilator (MV)-utilization ratio (aOR:10.46; P<.0001). Coronary ICU showed the lowest risk for mortality (aOR: 0.34;P<.0001).
Some identified risk factors are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; Central line-associated bloodstream infection, ventilator-associated pneumonia, catheter-associated urinary tract infection, LOS, and MV-utilization. So, to lower the risk of death in ICUs, we recommend focusing on strategies to shorten the LOS, reduce MV-utilization, and use evidence-based recommendations to prevent HAIs.
To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors.
A prospective cohort study.
The study was conducted across 623 ICUs of 224 hospitals in 114 ...cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
The study included 169,036 patients, hospitalized for 1,166,593 patient days.
Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression.
Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89).The following variables were independently associated with CAUTI: Age (adjusted odds ratio aOR, 1.01;
< .0001), female sex (aOR, 1.39;
< .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05;
< .0001), UC DU ratio (aOR, 1.09;
< .0001), public facilities (aOR, 2.24;
< .0001), and neurologic ICUs (aOR, 11.49;
< .0001).
CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
•Latin American central line-associated bloodstream infections (CLABSI) rates are higher than those of high income countries.•Our objective is to identify CLABSI rates and risk factors in Latin ...American intensive care units (ICUs).•Length of stay, duration of central line, femoral, arterial and jugular increase CLABSI risk.•Public hospital, and Medical-surgical ICU increase CLABSI risk.•PICC was not associated with risk for CLABSI.
Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America.
From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR).
About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI:
LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk.
Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.
This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic ...in Mexico.
We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic).
In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (
≤ 0.01) was detected for
, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (
≤ 0.01), for
. In all specimens, increased ampicillin and tetracycline resistance was detected for
(
≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (
≤ 0.01), resistance was detected for
; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (
≤ 0.01), resistance was detected for
.
Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for
and carbapenem resistance for
recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in
was detected, which may be associated with high azithromycin use. In general, for
and
, increasing resistance rates were detected.
Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal.
We implemented a multidimensional approach and an 8-component bundle in ...374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods.
174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58-0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46-0.52; P < 0.001); 14.44 at the 4-15 month (RR = 0.51; 95% CI = 0.48-0.53; P < 0.001); 11.40 at the 16-27 month (RR = 0.41; 95% CI = 0.38-0.42; P < 0.001), and to 9.68 at the 28-39 month (RR = 0.34; 95% CI = 0.32-0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention.
This intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.
•Rates of VAP in Latin America are several times above those of high income countries.•The objective of this study is to identify risk factors for VAP in ICUs of Latin America.•Male gender, age, ...length of stay, and device utilization ratio increase the risk of VAP.•Public hospital, and surgical hospitalization increase the risk of VAP.•Adult-oncology, medical-surgical, and surgical ICUs showed the highest risk of VAP.
Omicron is the most mutated SARS-CoV-2 variant-a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of ...inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy.
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