Abstract
Fusarium species represent an opportunistic fungal pathogen. The data in Mexico about Fusarium infections in humans are scarce. Here, we present a retrospective series of patients with a ...confirmed diagnosis of fusariosis in eight different hospitals in Mexico from January 2010 to December 2019. The diagnosis of proven fusariosis was made according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORT/MSG) criteria. A total of 49 cases were identified in our series. Most patients had burn injuries (49%), and 37% had hematological malignancies. Most patients had fire injuries (40%), followed by electric injuries (8%), febrile neutropenia (10%), and pancytopenia (6%). Patients had skin and soft tissue involvement in 49%, followed by blood culture isolation and biopsies from different sites of the body (lung, sinuses, bone tissue, and eyes). Febrile neutropenia (10%) and fungemia (8%) were the most common clinical syndromes in immunosuppressed patients. Most patients received monotherapy (67%), where voriconazole was used in 30% of the cases, followed by conventional amphotericin B (16%), and lipidic formulations of amphotericin B in 10% (either liposomal amphotericin B or amphotericin B lipid complex). Combination therapy was used in 20% of the cases, and the most common combination therapy was triazole plus any lipidic formulation of amphotericin B (10%). Mortality related to Fusarium infection occurred in 22% of patients. Fusariosis is a serious threat. Burn injuries and hematologic malignancies represent the most common causes of infection in this small series from Mexico.
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.
Today bacterial resistance is a global problem, it is estimated that in 2050 it could reach 10 million deaths per year. Bacterial resistance can be caused by different mechanisms, in the case of ...beta-lactams they include the production of flow pumps, the modification or reduction of porin production, alteration of penicillin-binding proteins and production of an enzyme capable of inactivating the antibiotic.
To describe the main bacterial agents reported in the Hospital para el Niño de Toluca and their sensitivity pattern.
This is an observational, descriptive, retrospective cohort study, evaluated from January 1, 2018 to December 31, 2020, in hospitalized patients under 18 years of age, with confirmed infections from blood culture specimens, urine culture, fluid cerebrospinal and secretions.
599 patients with positive cultures were reported. The five most frequently isolated agents were Staphylococci aureus, Escherichia coli, Klebsiella sp, Candida sp and Enterococci sp, Pseudomonas third in frequency in 2019 and fifth in 2020. The main isolated gram positive coconut was S. epidermidis with 52.3% in 2020 , while the BGN report an increase in positive ESBL organisms by 21.5% for 2020.
S aureus, E coli, Klebsiella, Candida, and pseudomonas remain the main causative agents of infection. The GNBs showed an increase in frequency up to 21.5%, showing high resistance in fourth grade cephalosporins, gentamicin, ciprofloxacin and meropenem.
