Maestría en Laboratorio Clínico Mención Microbiología Clínica
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Item Malassezia asociada a la dermatitis seborreica en los vendedores del Centro Comercial la Condamine en la ciudad de Riobamba(2025-04-09) González Polo, Sandra Isabel; González Romero, Ana Carolina; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de PosgradosSeborrheic Dermatitis is a chronic inflammatory skin disease associated with the proliferation of the fungus Malassezia sp. and various environmental and anthropogenic factors. This study aimed to analyze the relationship between the presence of Malassezia sp. and seborrheic dermatitis in vendors at the La Condamine Shopping Center in the city of Riobamba. A descriptive, cross-sectional, and observational study was conducted with a sample of 72 workers from the shopping center. The samples were processed at the GISOCH research laboratory, part of the Faculty of Sciences at the Escuela Superior Politécnica de Chimborazo, using conventional microbiological methods. To identify Malassezia sp. in the participants' scalps, techniques such as fresh preparation with 20% KOH and culture in Sabouraud medium were employed. The results indicated that 8.33% of the participants showed positive growth of Malassezia sp., accompanied by clinical signs of seborrheic dermatitis, such as pruritus, scaling, yellowish crusts, and scalp redness. In contrast, 91.67% showed no clinical or microbiological evidence of infection. The main factors associated with seborrheic dermatitis were prolonged use of hats, high thermal sensation in the work environment, excess scalp oil, and stress, with the latter being a key factor in disease exacerbation. Additionally, a higher prevalence was observed in the 41 to 60-year-old age group. As part of the study, a training session was conducted, and a manual with recommendations for seborrheic dermatitis prevention and scalp care was provided, emphasizing the importance of personal hygiene, stress reduction, and the use of dermatological products. It is suggested that molecular studies be conducted for the specific identification of Malassezia species, a more in-depth analysis of the cutaneous dermobiota, and the implementation of continuous education programs led by the GAD Municipal of Riobamba to strengthen the prevention of skin diseases in workers exposed to predisposing factors.Item STREPTOCOCCUS AGALACTIAE EN SECRECIONES VAGINALES DE MUJERES GESTANTES QUE ACUDEN POR CONTROL AL HOSPITAL BÁSICO DE SANGOLQUÍ(Ciencias de la Salud. Centro de Posgrado, 2024-11-13) Vaca Jerez, Oscar Santiago; Vilcacundo Córdova, Mario FernandoThe present work mentions that the Streptococcus agalactiae is a significant pathogen that can cause serious complications in both newborns and pregnant mothers, with neonatal sepsis being one of the most critical. The incidence of this pathogen is related to various factors such as a history of infections, maternal age, inadequate hygiene of the genital area, multiparity and lack of adequate prenatal checkups. Early and accurate identification of this microorganism is important to prevent serious complications and improve clinical outcomes for both mothers and newborns. The general objective of this study is to identify the presence of Streptococcus agalactiae in vaginal fluids and secretions of pregnant women who come for prenatal care at the Sangolquí Basic Hospital. The specific objectives include determining the frequency of colonization of Streptococcus agalactiae in vaginal secretions, establishing the antibiotic sensitivity profile of this microorganism in pregnant women, and designing a protocol for handling vaginal samples in pregnant patients. The research adopted a qualitativequantitative approach. Vaginal swabs were taken from pregnant women, followed by various microbiological tests: Gram stain, blood agar culture, catalase, coagulase, and CAMP tests. These tests allowed determining the presence of Streptococcus agalactiae and quantifying its prevalence. Of a total of 191 samples analyzed, 5 were positive for Streptococcus agalactiae, representing a prevalence of 2.6%. The low prevalence of Streptococcus agalactiae observed is consistent with rates reported in various populations. However, the identification of any positive case is essential for the implementation of adequate preventive measures. Adoption of an effective clinical protocol can significantly reduce the risk of vertical transmission of the pathogen and severe neonatal infections. It is recommended to strengthen prenatal control programs with the routine inclusion of vaginal exudate cultures for the detection of Streptococcus agalactiae.Item ENTEROBACTERIACEAE PRODUCTORAS DE CARBAPENEMASAS EN PACIENTES HOSPITALIZADOS EN EL HOSPITAL DE ESPECIALIDADES FUERZAS ARMADAS NO.1.(2024-11-08) Morillo Perugachi, Edison Wladimir; Poveda Paredes, Francisco Xavier; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de PosgradosCarbapenemase-producing Enterobacterales represent a global health problem since therapeutic possibilities are almost nil. Carbapenems are the last step in the treatment of bacterial infections, resistance to these has managed to put the scientific communities in check in search of new drugs as well as achieving an effective identification, the spread of this class of bacteria in hospital environments has caused patients to be associated with higher statistics of morbidity, mortality, hospital stay and high economic costs. To identify carbapenemase-producing Enterobacteriaceae in patients hospitalized at the Armed Forces Specialty Hospital No. 1. It is of an observational descriptive type, since it improved the identification by giving an algorithm in the face of the suspicion of enterobacteriaceae with resistance to carbapenems from a result provided by the automated Vitek®2 equipment by micro dilution obtaining data with the minimum inhibitory concentration and phenotypic methods, all of these were correlated with the desire to provide more information on other antimicrobial agents other than beta-lactams with the epidemiological booklet. Fourteen isolates of Enterobacteriaceae strains were described with phenotypic determination of KPC type carbapenemase, following algorithms of automated methods in Vitek®2 and phenotypic methods such as the Inhibition synergy test with disks such as phenyl boronic acid (PBA) for serine betalactamase type Enterobacteriaceae and the ethylenediaminetetraacetic acid (EDTA) disk for metallo beta-lactamase type Enterobacteriaceae, modified carbapenem inactivation method (m CIM) and immunochromatography for the detection of OXA-48, KPC, NDM, IMP VIM carbapenemases. It was possible to identify 14 enterobacteriaceae producing KPC-type carbapenemases following a detection algorithm in which the automated Vitek®2 method was detailed with the respective analysis of the interpretation of the antibiogram with the minimum inhibitory concentrations of the carbapenems as well as the phenotypic methods of the Synergy Inhibition Test with disks, modified method of carbapenem inactivation and immunochromatography.Item CARACTERIZACIÓN DE BACTERIAS PREDOMINANTES CAUSANTES DE SEPSIS EN PACIENTES DE UCI EN EL HOSPITAL GENERAL LATACUNGA(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-28) Vizcaino Borja, Poulette Virginia; González Romero, Ana CarolinaCharacterization of the causative agents of sepsis will provide valuable information on infection rates, epidemiology, and resistance patterns at the local level, which will help improve sepsis management in the hospital and its setting. In order to characterize the bacteria most frequently associated with sepsis in patients hospitalized in the ICU of the Latacunga General Hospital during the period from November 2023 to April 2024, this study used a type of descriptive, correlational observational research with a nonexperimental design and quantitative approach, during the study period in the Intensive Care Unit (ICU) of the Latacunga General Hospital, where the predominant bacteria in cases of sepsis were identified with a significant prevalence of Escherichia coli highlighting the need for specific treatment strategies and targeted preventive measures, in addition, the analysis of antimicrobial susceptibility profiles revealed that a substantial percentage of these bacteria were resistant to several antibiotics such as Broad Spectrum Cephalosporins, Carbapenems, which underscores the urgency of more prudent antimicrobial use policies, in terms of the evaluation of risk factors associated with previous use of antibiotics, sex, age, and specific comorbidities of a patient. A comprehensive approach that considers not only microbiological characteristics but also the clinical history of patients, as a direct consequence of these findings, recommendations have been established for the implementation of antibiotic use protocols, infection prevention strategies and antimicrobial resistance control measures. Concluding with the effective application of these recommendations has the potential to significantly improve clinical management and reduce the incidence of sepsis in this specific hospital environment, where they highlighted that the predominant bacteria in sepsis cases accounted for approximately 60% of the infections identified.Item ANÁLISIS DE LA SUSCEPTIBILIDAD A ANTIFÚNGICOS Y EVALUACIÓN DE FACTORES DE RIESGO ASOCIADOS EN CEPAS DE CANDIDA SPP. AISLADAS DE SECRECIONES VAGINALES EN MUJERES DE 22 A 65 AÑOS(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-14) Alquinga Lovato, Jenny Carolina; Moina Veloz, Álvaro PaúlCandida spp. is a fungus that can be found in the vagina, causing vulvovaginal candidiasis (VC) causing gynecological problems in different ages, including those with diabetes, producing an impact on physical health, and their intimate relationships, commonly used as treatment azoles, the prognosis is good and curative, but if the predisposing factors of mycosis are not corrected a new reinfection occurs. Species identification was performed with CHROMagar candida and Biggy nickerson as control agar, in addition, antifungal susceptibility testing was performed along with a closed-question survey to identify risk factors associated with VC. To analyze antifungal susceptibility and evaluate the associated risk factors in Candida spp.strains isolated from vaginal secretions in women aged 22 to 65 years and to develop an algorithm for the identification and characterization of Candida spp. strains. The methodology has a descriptive, prospective, cross-sectional approach, involves the collection of a vaginal swab sample, the information and data were obtained during the course of the research. The results obtained represent the susceptibility profile circulating in this health center and could be potentially useful for monitoring and guiding treatment. When testing for susceptibility to antifungals C. albicans, C. parapsilosis were sensitive to fluconazole and voriconazole in 100%, C. glabrata was SDD for fluconazole, voriconazole has no cut-off point and C. krusei presented sensitivity to voriconazole, fluconazole shows intrinsic resistance. krusei presented sensitivity to voriconazole, fluconazole shows intrinsic resistance, within the risk factors we have the active sexual life, diabetes, which proposes to implement preventive measures to avoid recurrence of vaginal infections, for this reason it is necessary to expand the research in other populations such as pregnant women, patients with Human Immunodeficiency Virus, and minors.Item MÉTODOS MICROBIOLÓGICOS PARA LA DETECCIÓN DE ENTEROBACTERALES PRODUCTORAS DE BLEE Y CARBAPENEMASAS EN PACIENTES INGRESADOS EN EL HOSPITAL DE TENA(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-10) Chávez Trávez, Erika Carolina; Poveda Paredes, Francisco XavierOver the years bacteria have been evolving and acquiring different qualities and abilities to avoid the action of antibiotics on them, which has become a public health problem involving the general population. This study focused on two types of bacterial resistance which are the extended spectrum beta-lactamases (ESBL) and Carbapenemases that primarily affect hospitalization services. The objective is to correlate phenotypic and automated microbiological diagnostic methods for the detection of ESBL- and Carbapenemase-producing Enterobacteriaceae. Methodology. A prospective, cross-sectional, observational and non-experimental design study was carried out at the General Hospital José María Velasco Ibarra in the hospitalization areas of Internal Medicine and the Intensive Care Unit (ICU), services that are characterized by showing more pathologies related to bacterial infections within the health facility. Results. Of the 107 samples analyzed, there was a presence of Enterobacteriaceae, it was evidenced that 19 samples showed resistance to Betalactams in the automated VITEK 2 compact system, while in the manual phenotypic method, 21 specimens with the same multi-resistance were obtained, after performing the quality controls and comparison with pre-established protocols in addition to the realization of a statistical study of Pearson coefficient, it was demonstrated that the methods have great similarity in their results. Additionally, during this study two samples were collected that presented resistance to Carbapenemics, in this identification the methods that were compared had 100% concordance, which suggests that the technique we choose will help us to recognize Carbapenemase-producing enterobacteria, taking into account that the techniques go hand in hand for the issuance of a result. Once all the transcendence data were recognized, a diagnostic algorithm was designed that can help us for the correct processing of enterobacteria with these types of resistance in the microbiology laboratory, in order to help the doctor in the diagnosis and timely treatment of this type of infections in hospitalized patients. ESBL- and Carbapenemase-producing enterobacteria were identified in the different samples received from the hospitalization areas of Internal Medicine and ICU, and it was determined that the automated method will be the Gold standard for finding bacterial resistances, however the manual method is also highly reliable. Finally, an algorithm was developed to help in the adequate characterization of multidrugresistant organisms.Item COINCIDENCIAS DEL DIAGNÓSTICO DEL GÉNERO STREPTOCOCCUS ENTRE MÉTODO MANUAL Y EL MÉTODO AUTOMATIZADO EN EL LABORATORIO AUTOMATIZADO ZAMORA(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-01) Zamora Sánchez, María Cristina; Guangasig Toapanta, Víctor HernánThe genus Streptococcus sp. They are gram positive cocci; these bacteria grow in chains or pairs which are oxidase and catalase negative. Among the groups that cause disease in humans are the most frequent such as Streptococcus pyogenes (group A) produces tonsillitis and impetigo, Streptococcus pneumoniae is the cause. Of the majority of pneumonias acquired in the community, Streptococcus viridans and its groups are the cause of dental abscesses, within the subgenus is Streptococcus mutas the main agent that causes dental cavities and without forgetting that it causes endocarditis is a common pathogen that causes severe and potentially complicated infections with the possibility of generating serious sequelae, hence the importance of rapid, accurate and timely identification. In this context, it is essential to evaluate the available diagnostic methodologies to determine their relative effectiveness. In particular, the performance of the manual method should be compared with the Vitek 2 Compact automated system, in order to evaluate the concordance between both approaches in the identification of Streptococcus sp. The objective of this study is To evaluate the agreement of the diagnosis of Streptococcus sp. between the manual method and the automated method in the Zamora Automated Clinical Laboratory in the period July and May 2023-2024. The methodology used for this study was Quantitative, non-experimental, observational, descriptive study with verification of coincidences in diagnostic tests for the identification of 100 culture samples with growth for Streptococcus sp. in two laboratories, verification of coincidences in diagnostic tests for identification in 100 culture samples with growth for Streptococcus sp. in two laboratories, using conventional and automated methods (Vitek 2 Compact). To obtain results, tests were carried out to Differentiation tests were performed, obtaining 100% negative catalase, 100% alpha hemolysis, 100% resistant bacitracin, 94% resistant optochin. The identification of pathogens of the genus Streptococcus sp. was carried out using two different methods: one manual and the other automated. The manual method, revealed the following proportions: 94% corresponded to Streptococcus of the viridans group, 6% to S. pneumoniae, and 0% to S. pyogenes. On the other hand, the automated method provide results with 89% of S. viridans, 6% of S. pneumoniae and 0% of S. pyogenes. These findings show a slight discrepancy in the proportion of S. viridans identified by both methods, while the identities of S. pneumoniae and S. pyogenes remained constant between the two analytical approaches. The kappa index determined a concordance of 1 (almost perfect) according to the table between both methods for the identification of S. pneumoniae and 0.635 (considerable for identifying S. viridans. Based on these findings, a proposal was designed for the improvement of diagnostic skills according to the results obtained, the identification of the Streptococcus sp. by the manual method compared to the automated methodology (Vitek 2 Compact), presents high concordance, especially with S. pneumoniae. Strategies must be reviewed and implemented to improve the identification of this pathogen in laboratories how is the implementation of the automated equipment since it has a better identification in the subgenera of the viridans group which are of clinical interest in the dental areaItem EVALUACIÓN DE LA CONFIABILIDAD DE LA METODOLOGÍA MANUAL FRENTE A LA METODOLOGÍA AUTOMATIZADA EN LA IDENTIFICACIÓN DE CÁNDIDA ALBICANS(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-01) Torres Valdez, Lissette Estefanía; Guangasig Toapanta, Víctor HernánCandida albicans is the main species related to most superficial and deep infections caused by yeasts, therefore it is necessary to have tests that are fast and accurate for timely microbiological identification through the reliability of both manual methodologies and automated methodologies such as the VITEK system and thus establish which is the best option to use in the laboratory, THE objective was to evaluate the reliability of manual methodology versus automated methodology in the identification of Candida albicans. The methodology used was a cross-sectional observational analytical study, with a quantitative approach since data collection was used based on numerical measurement and statistical analysis, it is non-experimental, according to the chronology the research is prospective, the inclusion and exclusion criteria were analyzed. The results were as follows: from 100 microbiological samples of fungi where 82% (n=82) corresponds to isolates of the albicans species, 18% corresponds to other species, which are: tropicalis (n=10), glabrata (n=5) and parapsilosis (n=3), was isolated in 82 samples of the microorganism to be identified of which it is observed that 73. 17% were isolated from vaginal secretion samples, 10.98% from skin secretions, 8.54% from seminal secretions, and 3.66% from oral and intestinal secretions. Of the total of 82 positive samples for Candida albicans, the conventional method (CHROMagar) and the automated method (VITEK) gave 70 correct identifications of the yeast and one incorrect identification of the yeast. On the other hand, CHROMagar identified 3 positive results that VITEK did not and VITEK identified 8 positive results that CHROMagar failed, the Kappa statistic (κ),. κ =0.093 indicates that there is a slight concordance between the CHROMagar and VITEK methods. The results indicate that there is no statistically significant agreement between the CHROMagar and VITEK methods for identifying Candida albicans. The odds ratios suggest some level of association, based on the Kappa statistic, an acceptable to moderate agreement between the two methods is proposed..Item Caracterización de bacterias multidrogoresistentes en infecciones urinarias de mujeres embarazadas(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Sánchez Tite, Viviana Paulina Licenciada.; Salazar Garcés Licenciada. Magister., Dolores KrupskayaUrinary Tract Infection (UTI), is a term used to indicate the growth of pathogenic microorganisms present in the urinary system, capable of producing functional and morphological alterations. Multidrug-resistant bacteria (MDR) are microorganisms that have acquired the ability to resist the action of several antibiotics, complicating their treatment. In pregnant women, urinary tract infections are common due to hormonal changes and the pressure of the uterus on the bladder, which prevents proper urine drainage and greatly facilitates the proliferation of pathogens. By carrying out an exhaustive characterization of the multidrug-resistant bacteria present in urinary infections of pregnant women attending clinical laboratory Tecnoanálisis aims to identify the most frequent microorganisms responsible for this type of infections and different resistances originated in this environment for it, the present study was a non experimental cross-sectional, descriptive and observational study with a quantitative approach, as it identified the different bacteria that cause urinary tract infections in pregnant women. Cultures that had a positive growth and met the characteristics for the study were used where different bacteria were isolated as Escherichia coli presented a higher percentage followed by Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae and Streptococcus agalactiae in the lowest percentage. Concluding that the development of gram-negative bacilli microorganisms predominates, while a minimal percentage corresponded to gram-positive bacteria, the analysis carried out showed that there is a high resistance for more than one antibiotic such as Ampicillin, Trimetropin/sulfamethoxazole, nitrofurantoin, amoxacillin+ clavulanic acid, ampicillin/sulbactam, with respect to multidrug resistance bacteria interpretation protocol, was based on the gestational age and results obtained from the samples processed in this research, taking into account natural and acquired resistance in a schematic form for easy interpretation by the beneficiaries.Item Resistencia antimicrobiana de microrganismos prevalentes en abscesos periodontales en pacientes pediátricos de 6 a 12 años que acuden al consultorio de especialidades odontológicas.(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Velastegui Peñaloza, Teresa Consuelo Licenciada; Moina Veloz Medico Especialista, Álvaro PaulThis research is about antimicrobial resistance of microorganisms prevalent in periodontal abscesses in pediatric patients aged 6 to 12 years who attend the dental Specialties Office. Periodontal abscess is an oral infection caused by bacteria that destroy the connective tissue, encapsulation of the bacterial infection occurs, causing a serious problem. The microorganisms causing periodontal abscess and susceptibility to antibiotics were identified through phenotypic tests, such as selective cultures to isolate microorganisms present in periodontal abscesses, biochemical tests for their identification and antibiogram for the study of susceptibility. The objective is to determine the antimicrobial resistance behavior of microorganisms prevalent in periodontal abscesses. The research is qualitative and quantitative, non-experimental, prospective, non-parametric, the research process goes through the descriptive level because the study was conducted in pediatric children, and in its relationship the research is correlational by establishing a connection between the identification of prevalent microorganisms in periodontal abscesses and antimicrobial resistance patterns and finally it is prospective. From the 110 analyzed samples of periodontal abscesses of pediatric patients, Staphylococcus aureus, Staphylococcus spp, Streptococcus viridans Enterococcus spp were isolated by phenotypic methods. An analysis of the accumulation of susceptibility patterns of prevalent strains was performed. Staphylococcus aureus was identified as the MRSA resistance pattern, Staphylococcus spp and Streptococcus viridans resistant to MLSB and Enterococcus spp resistant to ampicillin identified by the antibiogram and it was determined that there is a high prevalence of periodontal abscesses in pediatric patients aged 6 and 7 years. An antimicrobial susceptibility card was developed for the cumulative analysis of the antimicrobial susceptibility of the bacteria Staphylococcus aureus, Staphylococcus spp, Streptococcus viridans and Enterococcus spp in periodontal abscesses.
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