Characterization of uropathogenic escherichia coli isolated in women aged 18 to 45 years

Introduction: Urinary tract infections (UTIs) are common during the fertile age, especially in pregnant women, with Escherichia coli being the main cause. Bacterial resistance, particularly to first-line antibiotics, poses a challenge in treatment. In Latin America, the lack of updated data on antimicrobial resistance in UTIs is a problem. This study focuses on characterizing Uropathogenic Escherichia coli in women aged 18 to 45 in Babahoyo, Ecuador, in 2020. Objective: To characterize Uropathogenic Escherichia coli isolated from women aged 18 to 45 at the ZHIEL Laboratory in Babahoyo in 2020. Methodology: A quantitative, empirical, and descriptive study was conducted, analyzing 85 urine samples from women aged 18 to 45 obtained at the ZHIEL Laboratory in 2020. Inclusion and exclusion criteria were applied, and variables such as age, residence, and antimicrobial susceptibility testing were used. Results: There was an increase in the identification of Escherichia coli strains in 2021 compared to 2020. Most cases were found in young adults (72.6%). Babahoyo had the highest prevalence of cases (58.9%). Bacterial resistance was generally low, with higher resistance to nitrofurantoin. Conclusion: The study highlights temporal changes in the epidemiology of Escherichia coli in Babahoyo, with a predominance in young adults and low antimicrobial resistance. These findings are relevant for the management of urinary infections and the selection of appropriate treatments. Specific area of study: Microbiology.   

Ana Gabriela Quijano Robys, Vinicio Estuardo Santillán

6-19

Antimicrobial susceptibility profile of enterobacteria causing urinary tract infection in outpatients of the Loja- Ecuador.

Urinary tract infection (UTI) is defined as the growth of microorganisms in sterile urine culture in a patient with compatible clinical symptoms or without symptoms. Being a frequent cause of visits to the doctor; and these are among the most prevalent infections in clinical practice. Objective: To characterize the antimicrobial susceptibility profile of Enterobacteriaceae that cause urinary tract infection in patients who attend the SER laboratory in Loja-Ecuador 2022. Methods: The descriptive, secondary documentary, observational method was used. Records of urine cultures positive for Enterobacteria were collected from patients who attended the SER clinical laboratory in Loja between January - December 2022, and a sample of n= 229 records was obtained. For the statistical analysis, a database was generated in the SPSS program, which was carried out using descriptive statistics and frequency analysis. Results: In the present study of the 229 valid cases under study, 87.8% corresponded to the female sex. Regarding the age group most affected, it was the group corresponding to old age (60 or older) with 44.54%. The bacterial species with the highest incidence was Escherichia coli with 79.04%, Klebsiella pneumoniae with 9.17%, Proteus mirabilis with 4.80%, Proteus vulgaris 2.18%, Citrobcter cloacae with 1 .31%; Edwarsiella spp, Klebsiella aerogenes, Pseu-domona aeruginosa and Salmonella spp with 0.44% each, and Morganella morganii and Serratia Marcescens with 0.87%. ESBL production as a resistance mechanism pre-dominated in E.coli and Klebsiella pneumoniae strains. Conclusion: The main pathogen causing urinary tract infections in patients who attend the SER laboratory in the city of Loja is Escherichia coli, with a higher incidence in females in the old age group (60 or more years).

Diana Carolina Ramón Montaño, Jonnathan Gerardo Ortiz Tejedor

20-37

Antimicrobial susceptibility of bacteria causing urinary infections in women and girls

Introduction. Urinary tract infection is one of the most frequent infections in humans, and is therefore considered a public health problem with high incidence and morbidity rates in the pediatric and adult population in different regions of the world, being the main cause of these infections of bacterial origin, therefore the treatments are based on antibiotic therapy. However, over the years, the failure of empirical treatments due to bacterial resistance has been observed globally, with a higher incidence in underdeveloped countries. Objective.  Characterize the different bacterial agents that cause urinary tract infection in women who come for consultation at the Pablo Jaramillo Crespo Humanitarian Foundation during the year 2022, also identify the most common causal agent and its classification depending on whether or not they present the beta-lactamase enzyme ESBL extended spectrum. Methodology. Descriptive cross-sectional cohort study, secondary documentary study of non-probabilistic sampling by total coverage. Results.  Of 304 positive urine cultures, 62.5% cases of urinary tract infection were identified in adult women and 37.5% in girls, with Escherichia coli as the most common etiologic agent 82.2%, followed by Proteus mirabilis 11.5%, Klebsiella pneumoniae 1.6% and 4.7% of other granmenegative microorganisms. There were 11.5% of positive cases for the presence of ESBL, with Escherichia coli being the etiologic agent with the most positive cases for this mechanism of resistance, with a greater number of cases in the pediatric population (21 cases). Conclusion.  The most common etiological agent causing urinary tract infection in the population of this health center is Escherichia coli, with a higher percentage of cases of extended-spectrum beta-lactamase in children, which demonstrates the importance of performing a urine culture and antibiogram in order to establish a correct treatment plan for patients and thus prevent microorganisms from generating bacterial resistance mechanisms.

Edisson Javier Barbecho Quizhpi, Diego Andrade Campoverde

38-52

Characterization of Carbapenemase-producing Enterobacteriaceae, from clinical isolates from the Homero Castanier Crespo Hospital, Azogues-Ecuador

Introduction. Antibiotic resistance constitutes an increasingly important global problem. The excessive and irrational use of antibiotics triggers the development of resistant strains such as carbapenemase-producing Enterobacteriaceae (CPE), reducing the treatment options available in the clinical field. This emergence of new strains resistant to almost all antimicrobial agents is a result of their inappropriate use, self-medication, and therapeutic non-compliance. In addition to increasing rates of resistance to carbapenems, emergencies with highly resistant microorganisms have been demonstrated during the COVID-19 pandemic, which may be related to increased use of broad-spectrum antibiotics by patients. Objective. Characterize carbapenemase-producing Enterobacteriaceae, based on their frequency in hospital areas and type of sample in patients who were admitted to the Homero Castanier Crespo Hospital (HHCC) in the city of Azogues, Ecuador, period January 2020 to April 2022. Methodology. It is a positivist study with a quantitative, cross-sectional, descriptive, documentary-type approach. Results. 2021 was the year with the highest incidence of CLD 69.6%, the most affected age group was adults (30-59 years) with 54.9% and it occurred most frequently in males 76.5%. The presence of CLD was more common in samples of endotracheal secretion from the intensive care unit area 70.1%, the etiological agent with the highest incidence was Klebsiella pneumoniae 90.19%. All clinical isolates were resistant to beta-lactams, the antibiotics with the best sensitivity 96% were gentamicin and amikacin Conclusion. The results demonstrate an increase in infections by carbapenemase-producing Enterobacteriaceae and Klebsiella pneumoniae was the most prevalent bacterial species. Among these isolates, 100% resistance to beta-lactam antibiotics was determined, including carbapenems that are considered last-line, which highlights the importance of adequate management of antimicrobial resistance.

Tania Elizabeth Tacuri Sumba, Jonnathan Gerardo Ortiz Tejedor

53-68

Characterization of urinary tract infection from positive urine cultures isolated from pregnant women in the city of Machala year 2022

Introduction.  Urinary tract infections (UTI) during pregnancy increase the risk of maternal and neonatal morbidity and mortality. Bacteria, due to their great conditioning capacity, manage to develop several resistance mechanisms to antimicrobials that were previously used to eliminate them; Enterobacteriaceae ESBL being the most prevalent globally. Objective.  To characterize the main enterobacteria causing UTI in pregnant women treated in health centers in the city of Machala. Methodology. This research had a quantitative, descriptive, secondary documentary, cross-sectional approach carried out from the records of positive urine cultures from the microbiology laboratory of the IESS Machala General Hospital and Solidarity Clinical Laboratory. Results. It was shown that 85.5% (83/97) of positive urine cultures causing UTI belong to Enterobacteriaceae; the ESBL producing uropathogenic species with the greatest dominance in this study were E. Coli. and Klebsiella aerogenes (1.2%). Conclusion. E. coli and Klebsiella aerogenes were the ESBL-producing enterobacteria with the greatest resistance to antibiotics such as FEP, CRO and KF (each with 50% resistance), which may be related to the low cost of said medications; therefore, it is important to provide continuous health education and constant reviews about the antimicrobial resistance profile to reduce the repercussions of UTI and bacteria with greater resistance in pregnant women.

Jonathan Macas Vélez, Jonnathan Gerardo Ortiz Tejedor

69-84

Glycogen storage diseases, Type I Glucogenosis

Background: The human body, to obtain energy, breaks down carbohydrates from the diet and converts them into glucose. This process of providing glucose to the body is limited to 2-3 postprandial hours, therefore, a mechanism that guarantees the sustained and sufficient supply of this resource, essential for energy metabolism, is essential. Glycogenosis is a heterogeneous group of hereditary diseases, mostly of autosomal recessive inheritance, which are characterized by a failure in the glycogen metabolic pathway. They are also called “rare” or “orphan” diseases, since few people have them. suffer or have been diagnosed. Objective: synthesize the most current information regarding glycogen diseases type Ia and Ib. Methodology: A narrative bibliographic review was carried out based on a search for scientific articles in the specialized databases SciELO and PubMed. The selection criteria for the construction of the manuscript are: articles in English and/or Spanish that include information regarding the pathophysiology, clinical manifestations, diagnosis and therapeutic approach of glycogenosis type Ia and Ib. Results: An easy-to-read scientific document was constructed that addresses the main topics of glycogenosis Ia and Ib in a way that is accessible to all health levels. Conclusion: Glycogenosis covers a wide range of diseases related to specific enzymatic abnormalities that, depending on the specific type, are more or less complex to diagnose and approach. General area of ​​study: medicine. Specific study area: pediatrics and medical genetics. Type of study: narrative review.

Richard Franklin Avellan Zambrano, Ana María Castro Zambrano, Jesús Gregorio Loor Vera, Dayanara Aracely Lalangui Pinargote, Andrea Isabel Quiroga Sabando

85-98

Effectiveness of Rituximab in patients with lymphoblastic leukemia and its relationship with the number of infections obtained during their first year of treatment

Background: Cancer as a disease that is characterized by the uncontrolled proliferation of cells, thus being able to invade other tissues and multiply autonomously; Thus, for some years now there has been a wide range of alternatives in terms of monoclonal antibodies for the treatment of cancer, including rituximab, which is directed against the CD20 antigen of B lymphocytes, its mechanism of action being the reduction of the B cell, appearing as an option within the treatment in children with severe and resistant autoimmune diseases giving good results. Objective: to determine the effectiveness of Rituximab in patients with lymphoblastic leukemia during their first year of treatment. Methodology: a non-systematic search of original articles, case reports and bibliographic reviews published in SciElo, ScienceDirect, UpToDate was carried out; descriptors: Rituximab; monoclonal antibodies; antineoplastic protocols. Included are jobs with less than 5 years of seniority, English and/or Spanish language. Results: An easy-to-read scientific document was constructed that addresses the main topics for the knowledge of staff at all levels of care. Conclusion: To improve results, vaccines should be administered before therapy with rituximab because it can produce hypogammaglobulinemia, which would represent an increased risk of infections. In cases where there are patients with recurrent infections after therapy with rituximab, antibiotic prophylaxis or even immunoglobulin replacement is suggested. General area of ​​study: medicine. Specific study area: oncology. Type of study: narrative review.

Jhon Loor Izquierdo, Marcela Anthonella Vélez Laaz, Kevin Andrés Loayza Robles, Andrea Isabel Quiroga Sabando, Karol García Palacios

99-111

Relationship between cervical vertebrae position and class II malocclusion. a literature review

In orthodontic clinical practice, careful analysis of craniofacial structures is essential to assess the harmony and anatomical balance in patients. The spinal column plays a crucial role in the anatomy and functionality of the stomatognathic system. Objective: To analyze the information in digital databases to establish the relationship between craniocervical posture and Class II Malocclusion. Materials and Methods: A comprehensive literature review was conducted using databases such as PubMed, SciELO Google Scholar, Taylor & Francis, Redalyc, and Scopus by using keywords obtained from Medical Subject Heading (MeSH) and Health Sciences Descriptors (DeCs). Studies analyzing the relationship between cervical vertebral position, cranial posture, and Class II Malocclusion were considered, and inclusion and exclusion criteria were applied to select the most relevant studies. Justification: Craniocervical evaluation is crucial in orthodontics. This review analyzes its relationship with malocclusion, highlighting its importance for accurate diagnosis and treatment through synthesizing and analyzing existing evidence. Results: Cranio-maxillofacial postural balance occurs when the head is maintained in equilibrium through the atlanto-occipital joint. The cervical spine, maxillae, musculature, hyoid bone, and all related structures maintain a balance of forces.

Yamanua Gabriela León Ochoa, María Isabel Cabrera Padrón, Evelyn Mireya Guiracocha Viñanzaca

112-131