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Introduction. The increase in antimicrobial resistance (AMR) is a major cause of morbidity and mortality in the health care systems worldwide. The excessive use of antibiotics and the lack of knowledge in population contributes with the appearance, persistence and transmission of resistant bacteria. Objective. To analyze the level of knowledge about the use of antibiotics and AMR, and its association with the attitudes and habits of responsible consumption of antibiotics by the adult population of the Veracruz-Boca del Rio metropolitan area. Material and methods. Observational and cross-sectional study, in which 400 surveys were carried out evaluating knowledge about antibiotics and AMR, attitudes, antibiotic consumption, and access to information related to AMR. Results. About 27% had a sufficient level of knowledge about AMR and antibiotic consumption, while 59.8% obtained a regular level and 13.3% an insufficient level. More than 60% consumed antibiotics in the last six months, mainly from the private sector (67.5%). The higher level of knowledge was associated with higher education (p<0.023), older age (p<0.001), occupation (p<0.001), and have received information in the last year (p<0.001). Health personnel were the main source of information (55.5%). Conclusions. Most of the respondents had a regular or sufficient level of knowledge, however, misconceptions and inappropriate attitudes of relevance were identified, so AMR information among young people should be improved, through digital and social media to improve knowledge and antibiotic consumption habits. [ABSTRACT FROM AUTHOR]

Introduction: The growing resistance to antibiotics worldwide represents a global threat to public health. The larval excretions and secretions derived from necrophagous flies from the Calliphoridae family could represent a promising source for counteracting their effects. Objective: To compare the antimicrobial activity of Calliphora vicina and Sarconesiopsis magellanica (Diptera: Calliphoridae) native excretions and secretions and those weighing more than 10 kDa and less. Materials and methods: We used the turbidimetry technique for the bioassay; we determined the minimum inhibitory concentration (MIC) for excretions and secretions weighing less than 10 kDa. Results: Calliphora vicina and S. magellanica native excretions and secretions and those weighing less than 10 kDa exhibited potent antibacterial activity against three Staphylococcus aureus strains and four Gram-negative bacteria; those weighing less than 10 kDa were more effective than the native ones in the two species of flies evaluated here. Furthermore, excretions and secretions weighing less than 10 kDa had the same effectiveness, except in the MIC trials where S. magellanica excretions and secretions weighing less than 10 kDa were more potent against all the bacteria evaluated, except for S. aureus ATCC 25923. Excretions and secretions weighing more than 10 kDa did not inhibit bacterial growth. Conclusions: These results potentially validate these substances as an important source for isolating and characterizing antimicrobial agents. [ABSTRACT FROM AUTHOR]

Nocardia infection is not common in immunocompetent patients, the empirical antimicrobial treatment directed by anatomical regions does not contemplate the particularities of the germ and the microbiological analysis is necessary for the specific treatment. We present the case of a previously healthy patient, immunocompetent and without known risk factors for Nocardia spp infection with evidence of pulmonary parenchymal and skin involvement and subsequent development of multiple brain abscesses. [ABSTRACT FROM AUTHOR]

Introduction. Clostridium difficile is considered as one of the principal pathogens to cause nosocomial infections increasing morbidity and mortality. The strain NAP1/027 of Clostridium difficile has been associated with an increased toxin production as well as a severe outcome in disease burden. Objective. Describe the epidemiology of infections associated with Clostridium difficile and the characteristics related with the NAP1/027 strain. Materials and methods. Observational study based on the review of medical chart of patients with positive stool specimens for Clostridium difficile between 2012 and 2015 by the Xpert test. The severity of the disease was assessed with ATLAS score. Results. 42 cases of Clostridium difficile infections were included and 9 of them were positive for the NAP1/027 strain. The use of antibiotics prior to infection for more than 7 days was more frequent among cases who tested negative for NAP1/027. The duration of diarrhea lasted more than 5 days in half of the patients and there was no differences in the strain found (p>0.05). Cases which tested positive for strain NAP1/027 were characterized for manifesting foul and bloody stools. There were no significant differences in severity of infection between positive and negative cases of NAP1/027 strain. Conclusion. Clostridium difficile is the main causative agent of antibiotic associated diarrhea. In Colombia there is transmission of NAP1/027 strain without significant clinical differences which could be due to a limited number of patients. However, the incidence of NAP1/027 strain must raise an alert on medical staff and healthcare institutions due to its high severity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: The Colombian national pharmaceutical policy establishes as a strategy the generation of greater pharmaco-epidemiological research at the national level, especially in the case of antibiotic drugs. Objective: To provide local pharmaco-epidemiological evidence regarding the effectiveness, conditions of use and safety of generic meropenem and cefepime in a tertiary hospital in Bogotá. Materials and methods: We conducted a descriptive, longitudinal and retrospective drug utilization study. The data were collected from the medical histories of all the patients who had cefepime or meropenem prescribed. Results: We included 82 patients treated with cefepime and 91 treated with meropenem in the study. Most of the patients were in services different from the intensive care unit (taking cefepime: 59.8%, and meropenem: 52.7%). Only 21.9% of the patients treated with cefepime and 49% of those treated with meropenem were seen by an infectious disease specialist. The antibiogram was performed for 47% and 60% of the patients treated with cefepime and meropenem, respectively. The most frequent indication for cefepime were respiratory infections and for meropenem, genitourinary ones. Therapeutic success rates were 61.7% for cefepime and 63.0% for meropenem.Conclusions: This study contributes evidence regarding the therapeutic performance of two generic antibiotics used in tertiary hospitals. There were no reports of therapeutic failure during the study period. In the cases of non-response, pharmacokinetic alterations, unfavorable clinical conditions, and inappropriate choice of antimicrobial treatment were identified as frequent factors. [ABSTRACT FROM AUTHOR]

Introduction: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. Objective: To determine the clinical characteristics of hospitalized patients with C. difficile infection. Materials and methods: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C. difficile had been requested from February, 2010, to February, 2012. We defined case as a patient with diarrhea and a positive assay for the toxin, and control as those patients with a negative assay for the toxin. We collected data on demographic and clinical characteristics, risk factors, hospital length of stay, treatment, and complications. Results: We collected data from 123 patients during the follow-up period, 30 of whom were positive for the toxin. Mean age in the study population was 49 years and 60% were men. The main symptoms were abdominal pain (35%) and fever (34%). The principal complications were electrolytic alteration and severe sepsis with secondary acute kidney injury. Mortality was 13% and independent factors associated to the appearance of the infection were the use of proton pump inhibitors and previous gastrointestinal tract surgery. Conclusions: The use of proton pump inhibitors and previous gastrointestinal tract surgery were factors associated to C. difficile infection. [ABSTRACT FROM AUTHOR]

Introduction: One of the strategies for the rational use of antibiotics is the use of the score for community-acquired pneumonia (CAP Score). This instrument clinically evaluates patients with community-acquired pneumonia, thereby facilitating decision making regarding the early and safe withdrawal of antibiotics. Objective: To generate a translation and cross-cultural adaptation of the Community-Acquired Pneumonia (CAP) Score questionnaire in Spanish. Materials and methods: Authorization for cross-cultural adaptation of the Community-Acquired Pneumonia (CAP) Score questionnaire was obtained; the recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the European Organisation for Research and Treatment of Cancer (EORTC) were carried out through the following stages: forward translation, reconciliation, backward translation, harmonization, obtaining a provisional questionnaire, and applying the questionnaire in a pilot test. The pilot test was conducted at a second-level public hospital in Bogotá after the study was approved by the ethics and research institutional boards. Results: The changes suggested by the forward translators were applied. There were no discrepancies between the backward and forward translations, consequently, no revisions were necessary. Five items had modifications based on suggestions made by eleven patients hospitalized with a diagnosis of community-acquired pneumonia during the pilot test. Conclusions: A Spanish version of the Community-Acquired Pneumonia (CAP) Score was crossculturally adapted and is now available. [ABSTRACT FROM AUTHOR]