Revista Peruana de Medicina de Experimental y Salud Publica最新文献

A cross-sectional descriptive and analytical study evaluated years of potential life lost (YPLL) due to drug-susceptible pulmonary tuberculosis in Cali from 2009 to 2020, using death records from the Health Secretariat. Total YPLL and its annual rate were calculated by age at death, and median YPLL values were compared across subgroups. A total of 565 registers of death records were analyzed (71.5% men; median age 56 years, range 38-70), yielding 11,238 YPLL. The highest median YPLL were observed among persons living with HIV, those in socially vulnerable situations, the uninsured or those under subsidized or special coverage, in women, and in those who re-entered after previously discontinuing treatment or experiencing a tuberculosis relapse.

The objective of our study was to determine the resistance to colistin and fosfomycin of extended-spectrum beta-lactamase-producing Escherichia coli (Ec-BLEE). We conducted a cross-sectional descriptive study in which we analyzed 79 isolates of Ec-BLEE obtained from a previous study involving 300 chicken cloacal swab samples. We processed the isolates in the Microbiology and Immunology Laboratory of the Faculty of Medicine of the Universidad de Piura, Lima-Peru. We determined the sensitivity to colistin with the Colistin-AgarSpot detection medium and the sensitivity to fosfomycin by antibiogram according to the CLSI guidelines. We searched for the mcr-1 and fosA3 genes through PCR. We found a resistance to colistin in 17,7% and to fosfomycin in 77% of the samples. We did not detect the mcr-1 gene in the colistin-resistant isolates. The fosA3 gene was present in 100% of the fosfomycin resistant isolates.

Objective.: To determine mortality and associated factors in patients who received an allogeneic hematopoietic stem cell transplant at the Hospital Nacional Edgardo Rebagliati Martins, between January 2017 and December 2022.

Materials and methods.: A retrospective cohort study was conducted on patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) between 2017 and 2022. Death at one hundred days and two years, and its associated factors, were evaluated. Proportional Cox regression models were used.

Results.: 342 post-HSCT patients were included, with a median age of 23 years (interquartile range: 10 to 39), of whom 53.5% were women. The most frequent diagnosis for the transplant was acute lymphoblastic leukemia at 54.1%. Mortality in the first 100 days post-HSCT was 8.2%, and at two years was 30.4%. In the multivariate regression at one hundred days, factors associated with a higher risk of mortality were age over 50 years (HRa: 6.97; 95% CI: 1.18-41.23), being a recipient of a haploidentical transplant (HRa: 3.57; 95% CI: 1.13-11.24), and sepsis as a complication (HRa: 68.78; 95% CI: 19.32-244.84). In the two-year analysis, acute myeloid leukemia (1.72; IC 95%: 1.08-2.74), haploidentical transplant (HRa:1.81; 95%CI: 1.21-2.72), and disease relapse (HRa: 4.17; 95%CI%: 2.75-6.31) were associated with a higher risk of death.

Conclusions.: The mortality found was low and similar to that of countries with higher incomes; however, it is necessary to formulate interventions that reduce the incidence of modifiable factors such as sepsis.

Papiliotrema laurentii (formerly known as Cryptococcus laurentii) is an environmental saprophytic yeast that rarely causes disease in humans, mainly in immunosuppressed patients. We present a case of nosocomial pulmonary mycosis due to Papiliotrema laurentii in a 51-year-old male patient with a COVID-19 infection and a history of untreated type 2 diabetes mellitus. During his hospital stay, he received intravenous fluconazole for two weeks, with a favorable outcome. He was discharged with oral fluconazole for three months and follow-up in an outpatient clinic. One month after hospital discharge, he presented with cardiorespiratory arrest that did not respond to resuscitation maneuvers. The case highlights the importance of considering saprophytic species among the differential diagnoses of opportunistic mycoses.

Objective.: To interpret the social imaginary of family caregivers regarding the daily practices of preventive tuberculosis therapy in children.

Materials and methods.: A qualitative, descriptive-interpretive study, from the perspective of comprehensive and everyday sociology. Fifteen caregivers of children who started preventive tuberculosis therapy in four health facilities in South Lima were interviewed between December 2020 and May 2021. The in-depth interview was used as a technique, and a virtual interview guide as the instrument. The analysis was conducted using the thematic analysis technique.

Results.: Three themes emerged: identifying strengths and limits in coping with tuberculosis; the impact of the social imaginary on sensitive care practices during preventive treatment; and interpreting the social construction of TB and its preventive practices.

Conclusions.: Strengths and limits were evidenced in the daily lives of caregivers while coping with and preventing tuberculosis. Likewise, in their sociability, they provided sensitive care based on their experiences, beliefs, feelings, and social bonds; they showed relative sensitivity and creativity in the face of the imposition of clinical rationalism. Furthermore, it was found that their ordinary knowledge and understanding of the disease were mediated by fears, uncertainties, and beliefs. Finally, their capacity to interpret and give meaning to the lived experience of the other is highlighted.

During the SARS-CoV-2 pandemic, it was suggested that individuals with chronic lung diseases, such as silicosis, could be at increased risk of complications; however, the evidence remains limited. This study describes the prevalence of COVID-19 among 51 miners and former miners with silicosis who were part of an occupational surveillance program. 96% were over 60 years old, 37.2% had moderate or severe silicosis, and 67% had at least one comorbidity. The prevalence of COVID-19 was 15.7%, lower than the general population, with mild cases and no reported deaths. 94.1% had received at least two doses of vaccine; of these, 12.5% were affected by COVID-19, compared to 66.7% of those who were not vaccinated. These findings suggest that vaccination and preventive measures may have contributed to reduce transmission and severity, highlighting the importance of maintaining protection for individuals with chronic respiratory diseases.

Objectives.: To develop and evaluate a loop-mediated isothermal amplification (LAMP) assay for the rapid detection of Campylobacter jejuni in stool samples associated with acute diarrheal disease (ADD) and Guillain-Barré syndrome (GBS) for implementation in regional laboratories and primary health care centers.

Materials and methods.: Four sets of LAMP primers for C. jejuni were designed and initially evaluated with DNA from C. jejuni, Campylobacter coli, Salmonella Infantis, and Escherichia coli extracted using a commercial kit. The best-performing primer set was selected for assay optimization, determination of the limit of detection, and analytical validation with DNA from the aforementioned strains. Subsequently, clinical validation was performed using stool samples from patients with suspected ADD due to C. jejuni, applying the same standardized conditions used for the strain DNA samples. The sensitivity and specificity of the test were determined using real-time PCR (qPCR) as the standard.

Results.: The LAMP assay for the detection of C. jejuni in stool samples using a primer set for the cdtC region showed a sensitivity of 97% (CI: 81.49-99.83%), a specificity of 93% (CI: 75.79-98.80%), a positive predictive value of 94% (CI: 77.78-98.91%), and a negative predictive value of 96% (CI: 79.76-99.81%). Furthermore, a strong agreement was demonstrated between this LAMP assay and qPCR (k=0.9).

Conclusions.: The LAMP assay based on the cdtC gene is a reliable and rapid method, with high sensitivity and specificity comparable to qPCR for the identification of C. jejuni associated with ADD and GBS, especially in low-resource areas, due to its low cost and ease of implementation.