Rito Zerpa

Campylobacter antimicrobial resistance in Peru: a ten-year observational study

BackgroundCampylobacter jejuni and Campylobacter coli are food-borne pathogens of great importance and feature prominently in the etiology of developing world enteritis and travellers’ diarrhoea. Increasing antimicrobial resistant Campylobacter prevalence has been described globally, yet data from Peru is limited. Our objective was to describe the prevalence trends of fluoroquinolone and macrolide-resistant C. jejuni and C. coli stool isolates from three regions in Peru over a ten-year period.MethodsSurveillance for enteric pathogens was conducted in Lima, Iquitos and Cusco between 2001 and 2010. Campylobacter stool isolates were tested for susceptibilities to ciprofloxacin, azithromycin and erythromycin. Susceptibilities were reviewed for 4652 isolates from Lima ( n = 3419), Iquitos ( n = 625) and Cusco ( n = 608).ResultsComparing the study periods of 2001-2005 and 2006-2010, prevalence of ciprofloxacin-resistant C. jejuni isolates rose in the study areas of Lima (73.1% to 89.8%, p < 0.001) and Iquitos (24.1% to 48.9%, p < 0.001). Ciprofloxacin-resistant C. coli rates also increased in Lima (48.1% to 87.4%, p < 0.001) and Cusco (10.0% to 65.9%, p = 0.005). Small but significant increases in azithromycin-resistant and erythromycin-resistant C. jejuni prevalence were noted in Iquitos (2.2% to 14.9%, p < 0.001; 3.2% to 14.9%, p = 0.002), and erythromycin-resistant C. coli rates increased in Lima (0.0% to 5.3%, p = 0.038). The prevalence of C. jejuni isolates resistant to both ciprofloxacin and azithromycin increased in Iquitos (0.3% to 14.9%, p < 0.001) and Lima (0.3% to 1.6%, p = 0.011), and prevalence of C. jejuni isolates resistant to both ciprofloxacin and erythromycin rose in Iquitos (0.0% to 14.9%, p < 0.001). Ciprofloxacin and erythromycin resistant C. coli prevalence increased in Lima (0.0% to 5.3%, p = 0.034).ConclusionsThese results have implications for the empirical management of enterocolitis in Peru. Ongoing surveillance is essential to guide appropriate antimicrobial use in this setting. Local epidemiological studies to explore the relationship between increasing antimicrobial resistance and agricultural or human antibiotic use may be valuable.

Hallazgo de Lophomonas sp. en secreciones del tracto respiratorio de niños hospitalizados con enfermedad pulmonar grave

Lophomonas sp. is a habitual parasite of the intestinal tract of the cockroaches and that is not recognized as pathogenic human being. Nevertheless, in the world literature are few reports of Lophomonas sp. in respiratory tract secretions in patients with severe pulmonary disease, mostly in adults. We present evidences of Lophomonas sp. in the respiratory low tract of children attended in the national reference center of paediatric diseases of Lima, Peru, in the period 2009- 2010. We found six cases, 4/23 from broncoalveolar lavage and 2/794 from tracheal aspirate samples of children. Five of them had pneumonia and one atelectasis, four were hospitalized in the intensive care unit. Increase knowledge about the presence of this organism in respiratory infections is needed, as its real pathogenic role.

Infección del tracto respiratorio humano por Lophomonas spp.

Citar como: Zerpa R, Ore E. Infección del tracto respiratorio humano por Lophomonas spp. Rev Peru Med Exp Salud Publica. 2016;33(4):827-8.doi: 10.17843/ rpmesp.2016.334.2572 Lophomonas sp., es un protozoario multiflagelado anaerobio, con dos especies reconocidas: Lophomonas blattarum y Lophomonas striata. Se ha descrito como comensales en el tracto digestivo de cucarachas: Periplaneta americana, Blatta orientales y Blatta germanica; también en termitas y ciertas aves como las avutardas. En la literatura mundial todavía hay escasos reportes de este protozoario zoonótico emergente en infecciones en humanos; descrito afectando principalmente al tracto respiratorio inferior en pacientes con enfermedad pulmonar grave en niños y adultos y, recientemente, en adultos con asma bronquial; en nuestro medio Lophomonas sp. se ha reportado en el tracto respiratorio de niños con neumonía, principalmente de unidad de cuidados intensivos (UCI) (1); niños con cuadros coqueluchoides y coinfección con Bordetella pertussis, así como en pacientes adultas con asma bronquial (2).

Agentes de infecciones por hongos dimorficos y Cryptococcus neoformans

, agente etiologico de la criptococosis, infeccion subaguda o cronica, principalmente del sistema nervioso central, que ingresa al organismo via inhalatoria y rara vez por via subcutanea, puede atacar el aparato respiratorio, ademas del sistema nervioso, piel, mucosa, ganglios linfaticos, huesos, etc. El

Imágenes de parásitos causantes de fasciolosis, cisticercosis, hidatidosis y toxocarosis

Las zoonosis son enfermedades infecciosas transmisi-bles en condiciones naturales entre los animales y el hombre, que son importantes no solo para la salud hu-mana y animal, sino tambien por sus repercusiones eco-nomicas en la actividad ganadera.Los paises subdesarrollados son afectados frecuente-mente por las zoonosis parasitarias y el Peru en par-ticular es uno de los paises endemicos con mayores tasas de estas enfermedades. En este numero de la Revista se presentan cuatro de las principales zoono-sis que afectan a nuestra poblacion: fasciolosis, hidati-dosis, cisticercosis y toxocariosis