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Aims We described the presence of Helicobacter pylori (HP) and estimated the prevalence of primary and secondary resistance using molecular detection in gastric biopsies of Ecuadorian patients. Methods and Results 66.7% (238/357) of the patients demonstrated the presence of HP using CerTest qPCR. Of these, 69.79% (104/149) were without previous HP eradication treatment and 64.42% (134/208) with prior HP eradication treatment. The mutation-associated resistance rate for clarithromycin was 33.64% (primary resistance) and 32.82% (secondary resistance), whereas that in levofloxacin the primary and secondary resistance was 37.38% and 42%, respectively. For tetracycline and rifabutin, primary and secondary resistance was 0%. Primary and secondary resistance for metronidazole and amoxicillin could not be evaluated by genotypic methods (PCR and sequencing). Conclusions The analysis of mutations in gyrA, 23S rRNA and 16S rRNA is useful to detect bacterial resistance as a guide for eradication therapy following failure of the first-line regimen. Significance and Impact of the Study This study carried out in an Ecuadorian population indicates that the resistance of HP to first-line antibiotics is high, which may contribute to the high rates of treatment failure, and other treatment alternatives should be considered.

Las infecciones del tracto urinario (ITU) se encuentran entre las enfermedades infecciosas más frecuentes que afectan a los seres humanos y representan un importante problema de salud pública con una carga de morbilidad y de altos costos sanitarios especialmente cuando se complican. Los objetivos de este estudio son actualizar los patrones de resistencia a los antibióticos utilizados para las ITU causadas por E. coli comunitaria, comparar la resistencia antimicrobiana con otros datos publicados en Ecuador y sugerir varias estrategias para superar los desafíos que se presentan en el trabajo diario del laboratorio y la práctica clínica asociados con este importante problema. Resultados: Se aislaron 3341 Escherichia coli (79,38%), 299 Klebsiella pneumoniae (7,1%), 192 Enterococcus faecalis (4,56%), y otros microorganismos en el resto de muestras. Las alternativas de tratamiento empírico para E. coli son: nitrofurantoina, fosfomicina, amoxicilina/clavulanato, cefuroxima, ampicilina/sulbactam. E. coli productora de BLEE se encontró en 612 muestras (18,4%). Conclusión: es fundamental vigilar la resistencia bacteriana a nivel de comunidad, los datos obtenidos de la vigilancia hospitalaria no deben ser extrapolados a la comunidad.

Escherichia coli es el patógeno más común causante de infecciones de vías urinarias (IVU) no complicadas. [1] El tratamiento empírico cuando la resistencia es menor al 20% es trimetoprima-sulfametaxole seguido de ciprofloxacino, también se recomienda fosfomicina y nitrofurantoína, obteniéndose los mismos resultados con un número reducido de efectos adversos.

La secuencia tipo Escherichia coli 131 (E. coli-ST131) se identificó por primera vez entre los aislados productores de β-lactamasas de espectro extendido (BLEE) en Asia, Europa y Norteamérica en el 2008. [1] Este clon ha emergido rápidamente a nivel mundial hasta llegar a ser un importante patógeno extra-intestinal, siendo el más predominante gracias a su capacidad de adaptación. [2]

There is a dearth of data from Ecuador on the burden of life-threatening fungal disease entities; therefore, we estimated the burden of serious fungal infections in Ecuador based on the populations at risk and available epidemiological databases and publications. A full literature search was done to identify all epidemiology papers reporting fungal infection rates. WHO, ONU-AIDS, Index Mundi, Global Asthma Report, Globocan, and national data [Instituto Nacional de Estadística y Censos (INEC), Ministerio de Salud Pública (MSP), Sociedad de Lucha Contra el Cáncer (SOLCA), Instituto Nacional de Donación y Trasplante de Órganos, Tejidos y Células (INDOT)] were reviewed. When no data existed, risk populations were used to estimate frequencies of fungal infections, using previously described methodology by LIFE. Ecuador has a variety of climates from the cold of the Andes through temperate to humid hot weather at the coast and in the Amazon basin. Ecuador has a population of 15,223,680 people and an average life expectancy of 76 years. The median estimate of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) population at risk for fungal disease (

Objectives The purpose of this study was to describe the clonal relationships and phylogroups of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-Ec) isolated from patients with bacteraemia in three hospitals in Quito, Ecuador. Methods Between June 2013 and September 2014, a total of 4354 blood cultures were performed in three hospitals located in different areas of Quito. A BACTECTM system was used for blood culture, and the VITEK®2 system was used for species identification and in vitro antimicrobial susceptibility testing. The ESBL genotype, presence of the blaCTX-M, blaTEM and blaSHV genes, and the phylogenetic group of E. coli isolates was determined by PCR. Clonal groups were established by multilocus sequence typing (MLST). Results Of 929 blood cultures positive for Gram-negative bacilli, 181 (19.5%) were positive for E. coli, representing the most frequent bacteraemia isolates in each hospital. Of the 181 E. coli isolates, 57 (31.5%) were ESBL-Ec. The main sources of ESBL-Ec bacteraemia were urinary tract infection (40; 70.2%), biliary tract infection (10; 17.5%) and other infections (7; 12.3%). The majority of ESBL-Ec isolates (39; 68.4%) from the three hospitals belonged to the virulent phylogenetic group B2, of which 36/39 (92.3%) were ST131 and 33/36 (91.7%) carried the blaCTX-M-15 gene. Conclusion These results provide knowledge of the phylogenetic relationships of E. coli from bacteraemia in Ecuadorian patients. ST131 has emerged in ESBL-Ec, representing an important public-health problem because this multiresistant clone is considered to be a vehicle for the propagation of antimicrobial resistance genes and is a highly virulent, well-adapted human pathogen.

Introduction: Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled. Methodology: Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA. Results: Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room. Conclusion: Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.

© The Author(s)., [Background]: Ring chromosome 15 has been associated in previous studies with different clinical characteristic such as cardiac problems, digit and musculoskeletal abnormalities, and mental and motor problems among others. Only 97 clinical cases of ring chromosome 15 syndrome have been reported since 1966 and a common phenotype for these patients has not been established., [Case presentation]: The present case report describes a 15-month-old girl from the Amazon region of Ecuador, of Mestizo ancestry, who after cytogenetic tests showed a 46,XX,r(15) karyotype in more than 70% of metaphases observed. Her parents were healthy and non-related. The pregnancy was complicated and was positive for intrauterine growth retardation. Her birth weight was 1950 g, her length was 43.5 cm, and she had a head circumference of 29.3. In addition to postnatal growth delay, she had scant frontal hair, small eyes, hypertelorism, low-set of ears, flattened nasal bridge, anteverted nostrils, down-turned mouth, three café au lait spots, and delayed dentition., [Conclusions]: Despite the frequency of some phenotypes expressed in the different clinical cases reviewed and the present case, a common phenotype for patients with ring 15 could not be determined and it is restricted to the region of the chromosome lost during the ring formation., Funding for this research was completely managed by the institutions affiliated. Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador. Facultad de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador. Unidad de Investigación en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador. Servicio de Hematología, Hospital Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain. Molecular Medicine Unit, Department of Medicine, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain. Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-SACYL-CSIC, Salamanca, Spain.