Maestría en Laboratorio Clínico Mención Microbiología Clínica

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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 Krupskaya
Urinary 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.
Moraxella catarrhalis en infecciones respiratorias altas en niños de 4 a 10 años atendidos en el hospital básico moderno – Riobamba.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Ulloa Sánchez, Ruth Elizabeth Licenciada; González Romero PhD.Licenciada, Ana Carolina
Moraxella catarrhalis, es una bacteria frecuentemente asociada con infecciones respiratorias menores en niños, siendo una causa principal de otitis media, sinusitis y neumonía. es considerada un comensal y patógeno, se encuentra principalmente en vías del sistema respiratorio superior del ser humano. La relevancia de M. catarrhalis ha aumentado significativamente, como agente de infecciones respiratorias y otitis media en niños sanos. Aunque las bacteriemias por este microorganismo son raras (0,57 casos por cada 100.000 infantes), es crucial considerar a M. catarrhalis en niños pequeños con sepsis que presenten sintomatología de vías aéreas superiores. El objetivo de esta investigación es determinar la prevalencia de M. catarrhalis en infecciones respiratorias altas en niños de 4 a 10 años atendidos en el Hospital Básico Moderno de Riobamba. Se realizó un estudio con enfoque cuantitativo, utilizando un diseño observacional, de corte transversal con análisis estadístico. La muestra incluyó 99 niños con infección respiratoria alta del Hospital Básico Moderno. Las muestras de exudados faríngeos, nasales y óticos se procesaron utilizando la técnica de cultivo en placa en agar sangre de cordero al 5%, para su identificación se realizó prueba de gram, catalasa, oxidasa y DNasa y se confirmó las muestras positivas mediante el sistema MicroScan para una identificación precisa. Las secreciones faríngeas fueron el tipo de muestra más frecuente recolectada en los niños, representando el 85% del total. De estas muestras, 17 resultaron positivas para M. catarrhalis, con la mayoría de los casos en niños de 4 a 7 años. La correlación punto-biserial reveló que la asistencia a la guardería, el uso previo de antibióticos y una tabla de alimentación incompleta están significativamente asociados con los casos positivos de M. catarrhalis. La prueba de nitrocefin mostró la presencia de betalactamasas en 9 de las 17 muestras. Se concluyó que M. catarrhalis productora de betalactamasas es prevalente en infecciones respiratorias altas en niños. Por ende, se ha establecido un protocolo de manejo de muestras respiratorias, lo que facilita una mejor identificación y tratamiento de esta bacteria.
Coincidencias en la detección de toxoplasma gondii entre el método inmunocromatográfico y el método elisa en mujeres embarazadas atendidas en el hospital general Alfredo Noboa Montenegro.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Guzmán Arellano, Maryori Tatiana Licenciada; Ana Gabriela. Bioquímica Farmacéutica Magister, Pacha Jara
Toxoplasma gondii is an obligate intracellular parasite that represents a challenge for public health due to its ability to infect humans and animals, without necessarily showing clinical manifestations. It is considered a Group 2 risk agent, that is, moderate individual risk and low community risk. However, it has a great impact on populations with compromised immune systems because it has the ability to damage the central nervous system. Pregnant women are among the vulnerable groups, as they can have significant complications, such as neurological, visual, and auditory disorders, and even the death of the newborn. This work focused on analyzing the coincidences in the detection of Toxoplasma gondii between the immunochromatographic method and ELISA in pregnant patients treated at the Alfredo Noboa Montenegro General Hospital. The study was carried out using a non experimental cross-sectional and correlational design, with a quantitative approach. The results indicated that the sample presented a balanced distribution in terms of age, with a predominant concentration of low results in the ELISA IgG and IgM tests, and a moderate dispersion around the mean value. The IgG immunochromatography test showed a clear and adequate interpretation, while the IgM revealed a low prevalence of positive results, suggesting the need for further evaluation for indeterminate cases. Although the IgM immunochromatography test presents higher sensitivity, the IgM ELISA presented a greater consistency in the reporting of results. The statistical analysis did not show significant differences between the Immunochromatography and ELISA tests, suggesting a similar capacity to detect positive and negative cases. In conclusion, the results obtained from the comparison between the Immunochromatography and ELISA tests for the detection of Toxoplasma gondii suggest that both methodologies present a similar capacity to identify positive and negative cases in the analyzed sample
Estrategias terapéuticas de aceites esenciales microencapsulados en escherichia coli atcc 25922, pseudomonas aeruginosa atcc 10145, staphylococcus aureus atcc 25923 y candida albicans atcc 10231.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Núñez Hernández, Erika Tatiana Licenciada; Proaño Pérez, María Elizabeth PhD. Licenciada
Según la Organización Mundial de la Salud (OMS), a partir del 2018 existió el incremento de infecciones resistentes a los antibióticos en un 82 %(1). Esto se asocia al consumo excesivo de antimicrobianos, principal responsable de la existencia de cepas resistentes y multirresistente(2). Por esta razón se proponen estrategias terapéuticas utilizando aceites esenciales microencapsulados (AEM). Evaluar el efecto antimicrobiano de los AEM de Anethum graveolens (eneldo), Rosmarinus officinalis(romero), Mentha spicata (menta), Ocimum basilicum (albahaca) y Cymbopogon citratus (hierba luisa) en Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 10145, Staphylococcus aureus ATCC 25923 y Candida albicans ATCC 10231. La microencapsulación de los aceites esenciales (AE) se realizó con la técnica de secado por pulverización de partículas utilizando el equipo Mini Spray Dryer Büchi B-290, se empleó polímeros encapsulantes en una relación 80:20 (%v/v). En la evaluación de propiedades antimicrobianas de los AEM se trabajó con el método Kirby-Baüer modificado. Además, se determinaron la concentración mínima inhibitoria (CIM) y la concentración mínima bactericida (CBM) de los AEM por la técnica de viabilidad con resazurina al 0.1%. En el proceso de la microencapsulación de los AE, se demostró su eficacia en los intervalos de longitud de onda de 1604 a 1112 cm-1 obtenidos del infrarrojo ATR-FTIR, Nicolet IR100. En cuanto al efecto antimicrobiano producido por los AEM se obtuvo que Escherichia coli ATCC 25922 fue inhibida con el AEM de Ocimum basilicum, generando halos de inhibición de 17.5 mm, una (CIM) de 0.0075g y una (CBM) de 0.03 g. Por otra parte, en Staphylococcus aureus ATCC 25923 los AEM de Rosmarinus officinalis y Cymbopogon citratus presentaron halos de inhibición de 14 mm, 16 mm, una CIM de 0.0075g y una CBM de 0.03g respectivamente. Con respecto a Pseudomonas aeruginosa ATCC 27853 se observó inhibición con el AEM Cymbopogon citratus produciendo halos de inhibición 19 mm, una CMI de 0.015g y la CMB de 0.03g. En el análisis de Candida albicans ATCC 10231 se obtuvo efecto antifúngico con todos los AEM. Los AEM de Anethum graveolens, Rosmarinus officinalis, Mentha spicata, Ocimum basilicum y Cymbopogon citratus en microorganismos ATCC presentaron actividad antimicrobiana.
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 Paul
This 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.
Resistencia antimicrobiana en enterobacterias productora de β-lactamasas de espectro extendido blee aislada de aguas residuales.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Malán Tacuamán, Gabriela Estefanía Licenciada; Vilcacundo Córdova, Mario Fernando Licenciado Máster
La resistencia antimicrobiana causada por enterobacterias productoras de β-lactamasas de espectro extendido (BLEE) en aguas residuales representa un problema crítico de salud pública a nivel mundial. La presencia de antibióticos y microorganismos patógenos en aguas residuales no tratadas, especialmente aquellas provenientes de entornos clínicos, crea condiciones ideales para el desarrollo y diseminación de cepas bacterianas resistentes, lo que amplifica el riesgo de propagación de infecciones resistentes a múltiples fármacos. En este contexto, se realizó un estudio cuasi experimental, transversal y descriptivo, cuyo objetivo fue analizar la resistencia antimicrobiana en enterobacterias productoras de BLEE aisladas de aguas residuales recolectadas de un laboratorio clínico de alta complejidad. Para ello, se recolectaron 16 muestras de aguas residuales, las cuales fueron procesadas siguiendo los lineamientos establecidos en la Norma NTE INEN 2169:2013. La identificación microbiológica de las enterobacterias productoras de BLEE se llevó a cabo utilizando el medio de cultivo diferencial CHROMagar BLEE, y los patrones de resistencia a los antimicrobianos se evaluaron mediante el uso de la placa Sensititre para bacterias Gram negativas. De las muestras analizadas, el 37.6% (n=6) resultaron positivas para enterobacterias productoras de BLEE, siendo Escherichia coli la especie más frecuentemente aislada, con un 57.1% de los casos (n=4), seguida por Pseudomonas sp, Klebsiella sp y Enterobacter sp. Se observó una alta resistencia a las cefalosporinas de tercera generación y a los monobactámicos, lo que evidencia la capacidad de estas bacterias para evadir tratamientos antimicrobianos comunes. Los resultados de este estudio indican que las aguas residuales provenientes de laboratorios clínicos contienen una cantidad significativa de enterobacterias productoras de BLEE con resistencia multimicrobiana, lo que constituye un riesgo latente para la salud pública. En respuesta a esta problemática, es imperativo desarrollar e implementar un manual de procedimientos para el adecuado manejo y tratamiento de las aguas residuales en estos entornos, con el fin de evitar la propagación de microorganismos resistentes y proteger tanto la salud pública como el medio ambiente, reduciendo así la diseminación de patógenos multirresistentes en la comunidad.
Susceptibilidad antimicrobiana en bacterias patógenas aisladas en el área de microbiología del laboratorio clínico de la clínica Ibarra
(2024-09-01) Jaramillo Castro, Jaquelin Liseth Bioquímica Clínica; Jaramillo Ruales, Evelyn Katherine Magister. Bioquímica Clínica
Pathogenic bacteria that exhibit Antimicrobial Resistance (AMR) have become an increasingly significant public health issue. In recognition of this global threat, the World Health Assembly adopted the AMR Action Plan, aimed at implementing strategies, surveillance tools, and networks of specialized laboratories to help reduce its spread. Based on this problem, the present investigation was proposed as an objective to determine the to determine the antimicrobial susceptibility of pathogenic bacteria isolated in the microbiology department of the Clinical Laboratory at Clínica Ibarra during the period 2023-2024. For this purpose, a non-study experimental, cross sectional, descriptive, and observational study with a quantitative approach was conducted. Different pathogenic bacteria isolated and their susceptibility profiles were identified from all the samples received. Among the main results obtained a total of 265 positive microbiological samples were identified (215 urine, 49 secretions, 1 blood culture). Three main pathogenic agents were isolated, with the following frequencies: 66.8% Escherichia coli, 6.8% Proteus mirabilis, and 5.3% Enterococcus faecalis. Regarding susceptibility, the antibiotics with the highest sensitivity for Gram-negative bacteria were Amikacin, Ceftazidime, and Ceftriaxone, while for Gram-positive bacteria, they were Linezolid, Ciprofloxacin, and Vancomycin. Based on the data entered the Whonet system, a susceptibility chart was developed, which includes two areas of relevance in the institution: Outpatient Care and Emergency. Therefore, it is concluded that: Pathogenic agents were identified, with three being Gram-negative and two Gram-positive. Additionally, the primary causative agent of urinary tract infections (UTIs) was Escherichia coli, which was found to be sensitive to Fosfomycin. A susceptibility chart was also developed and presented for use in Clínica Ibarra.
Fase analítica en el diagnóstico de infecciones del tracto urinario en el laboratorio de microbiología del hospital general IESS Ibarra
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Andrade Cadena, Cesar David Licenciado; Jaramillo Ruales, Evelyn Katherine Bioquímica Clínica Magister.
Las infecciones del tracto urinario son consideradas a nivel mundial como la tercera causa más común de infecciones después del tracto respiratorio, por lo cual es de suma importancia utilizar las herramientas diagnosticas como el Elemental y microscópico de orina (EMO) y el urocultivo debiendo existir correlación entre ellos y así obtener un diagnóstico acertado y oportuno para una terapia antimicrobiana apropiada, optimizando tiempo y recurso humano en el laboratorio y hospital. Evaluar el cumplimiento de la fase analítica en el diagnóstico de Infecciones del Tracto Urinario en el Laboratorio de microbiología del Hospital general IESS Ibarra. Se realizó un estudio del tipo transversal, descriptivo, observacional y prospectivo con un enfoque mixto, aplicando una lista de chequeo para valorar el cumplimiento de la fase analítica. El proceso y posterior análisis del examen químico en el equipo (Urit-1600) y examen microscópico equipo (Urit-1280), para el procesamiento del urocultivo, se realizó la siembra mediante asa calibrada de 0.00, la identificación y prueba de sensibilidad en el equipo PHOENIX M50. Se analizaron un total de 204 muestras de orina, de las cuales se analizó la lista de chequeo de los procedimientos internos establecidos en la institución tanto del EMO y urocultivo del análisis de cada muestra, obteniendo como resultado que no existe relación estadísticamente significativa entre las variables medidas y el resultado de urocultivo, con respecto al aislamiento de patógenos que se encontraron en el estudio y fueron identificados se obtuvo en gran porcentaje Escherichia coli como el primer germen causante de ITU con un 57%, mientras que en segundo lugar con 12% se encuentran las muestras con poli microbiota que se les interpreta como contaminación de la muestra de orina, mientras que en cuarto y quinto lugar encontramos a bacterias de suma importancia hospitalaria como lo son: Klebsiella pneumoniae y Enterobacter cloacae obteniendo un porcentaje de 7%, y no menos importantes otros patógenos Enterobacteriales con un 17%. Para la correlación del EMO y el urocultivo se realizó una prueba de correlación Pearson demostrando que las bacterias poseen una fuerte relación con el urocultivo, mientras que para la prueba de Regresión logística binomial se obtuvo un valor de 86.3% de acierto en predicción de resultados negativos y resultados positivos frente al urocultivo, a diferencia de una correlación moderada entre piocitos y urocultivo, el valor predictivo fue de 77.5% siendo buen predictor de resultados negativos pero menos preciso con los resultados positivos de urocultivo, tomando en cuenta que la predicción de los xi piocitos mejoraría asociándose conjuntamente con bacterias. En tanto que para las células escamosas se obtuvo una correlación nula frente al urocultivo demostrando la existencia de contaminación en la toma de muestra. Con estos resultados se podrá considerar criterios de exclusión para la siembra del urocultivo sugiriendo modificar e implementar los procedimientos internos de urocultivos. La evaluación de la fase analítica determino que no existe relación de las variables que no cumplieron con el procedimiento de análisis del EMO y del urocultivo, mostrando que no influyen en el resultado final del examen tanto de EMO y urocultivo. Se identificaron diferentes agentes patógenos, siendo el más prevalente E. coli, Se determino la correlación entre el EMO y el urocultivo demostrando que la bacteriuria y la piuria en el EMO ayuda al pronóstico del crecimiento bacteriano en el urocultivo, se presentó la modificación al procedimiento de urocultivos y el procedimiento de recepción y rechazo de muestras.
Método automatizado y manual en la detección de escherichia coli productora de betalactamasas de espectro extendido en infección del tracto urinario, en una población de 18 a 35 años de edad.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Lascano Ortiz, Yadira Michelle Licenciada; Moina Veloz, Álvaro PaulMédico Especialista.
Urinary Tract Infections (UTIs) are defined as the presence of microorganisms (typically bacteria) in the urinary tract, with or without symptoms. The most common pathogen causing UTIs is Escherichia coli (E. coli), responsible for 75 to 80% of cases. Extended-Spectrum Beta-Lactamases (ESBLs) are plasmid-mediated enzymes frequently produced by E. coli and Klebsiella pneumoniae, which confer resistance to beta-lactam antibiotics, with the exception of cephamycins and carbapenems, as well as other commonly used antibiotics such as aminoglycosides, tetracyclines, trimethoprim/sulfamethoxazole, and quinolones. To compare the automated method and the manual method for detecting ESBL-producing Escherichia coli in urinary tract infections in a population aged 18 to 35 years. Methodology: This was a cross sectional, descriptive, observational study with a qualitative-quantitative approach. Data collection took place in Ambato city, La Merced parish, at the "Divino Niño" clinical laboratory. Urine samples were collected from patients aged 18 to 35 years who presented with UTIs caused by E. coli. ESBL production was determined using the disk diffusion method (manual method) and the Vitek 2 Compact automated system (automated method). Results: Out of 182 samples analyzed, 31 strains suspected of being ESBL-producing E. coli were identified and confirmed by both the manual and automated methods. The manual method confirmed 28 ESBL-positive E. coli strains, while the automated method reported 30 ESBL-positive strains. Both methods were valid and complementary, significantly contributing to clinical management and control of ESBL-producing E. coli infections in the studied population. The choice between methods may depend on resource availability and diagnostic urgency, as both methods offer complementary benefits for clinical management.
GENEXPERT, BACILOSCOPÍA Y CULTIVOS EN EL DIAGNÓSTICO DE TUBERCULOSIS PULMONAR EN PACIENTES QUE ACUDEN AL HOSPITAL JOSÉ MARÍA VELASCO IBARRA DE TENA
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Coba Cueva, Rosa Guadalupe; Vilcacundo Córdova, Mario Fernando
The World Health Organization recommends the use of rapid molecular kind tests such as Gene Xpert MTB RIF/ULTRA for the diagnosis of Pulmonary Tuberculosis, the same ones that have a high precision, in addition you can perform bacilloscopies and culture of Mycobacterium tuberculosis that also contribute to the determination of this pathology. In this study, Pulmonary Tuberculosis was identified using Gene Xpert with a quantitative approach, with a descriptive kind of cross-sectional and nonexperimental design employing a non-experimental, cross-sectional, descriptive design. The bacteria were also detected through Ziehl-Neelsen staining, and records of culture results for the pathogen under study were reviewed, subsequently the analysis was carried out, the description of variables and their interrelation. A total of 33 sputum samples were evaluated, 67% of positive samples were determined according to Gene Xpert, and 33% of negative samples, of which resistance to rifampicin was detected in only 0.33%, which suggests a low probability of finding this type of condition in this population. Furthermore, comparing the other microbiological diagnostic techniques against the use of Molecular Biology, a sensitivity of 100% was obtained concerning Baciloscopy and concerning culture 75%, with a specificity of 84.6% for smear microscopy and 80% for culture. A rapid diagnostic algorithm for pulmonary tuberculosis was also designed. One of the main conclusions of this work is that Pulmonary Tuberculosis was identified in a shorter time, approximately 2 hours, through the use of Gene Xpert MTB RIF/ULTRA, resistance to rifampicin was also detected with this test, concerning culture, although it is true that it constitutes the gold standard, it has the limitation of time since several weeks passed from receipt of the sample to the issuance of results. An algorithm was also designed for the rapid diagnosis of pulmonary tuberculosis using this rapid automated test, which indicates this test as the beginning of the evaluation of this type of patient.
CARACTERIZACIÓN MICROBIOLÓGICA DE PLASMODIUM SPP. Y DISEÑO DE UNA ESTRATEGIA DE INTERVENCIÓN COMUNITARIA
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Napa Altamirano, Yomara Cristina; Salazar Garcés, Dolores Krupskaya
Malaria is a disease caused by protozoan parasites of the genus Plasmodium that are transmitted through the bite of a female mosquito of the genus Anopheles. Within this genus we find four species of great health interest, which are P. vivax, P. ovale, P. malariae and P. falciparum; The latter is the one that generates the most complications in humans. The primary objective is to microbiologically characterize Plasmodium spp. For the determination of malaria in peripheral smear samples from the residents of the Domingo Playa community in the province of Orellana, the methodology used in this study is a descriptive and observational cross-sectional type with a nonexperimental quantitative approach because no modifications were made. the variables under study by the researcher the results obtained from the 60 participants of the sampling corresponding to 100%, 48% belong to the male population and 52% to the female sex, for the analysis the positive cases are taken as reference, with sex predominating male with 57%, while 43% are female, of which 100% are indigenous, 73.3% of patients who came to undergo the study in the Domingo Playa community tested positive through thick smear analysis and 26.7% reflected negative results, 9.1% of them presented Plasmodium falciparum, while the parasite that predominated was Plasmodium vivax in 90.9% of the total of 44 patients positive for malaria and aged between 20-24 years, in conclusion the risk factors were determined, which found that 25% of the patients do not present any type of risk, 43.3% of the participants live near the river, while 16.7% lack an awning 10% do not have coverage and 5% maintain constant trips, so they are autochthonous cases, all of the above are risk factors for malaria contagion. In a globalized world, diseases have no borders, so the fight against malaria must be done jointly to allow for strategies to eradicate malaria
ESTUDIO DE LA ACTIVIDAD ENZIMÁTICA DE HEMOLISINA Y FOSFOLIPASAS DE CANDIDA SPP, EN AISLADOS CLÍNICOS DE PACIENTES QUE ACUDEN AL LABORATORIO COCAMED
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Preciado Marcillo, Evelyn Cristina; Echeverria Valencia, Gabriela Fernanda
Microorganisms belonging to the Candida genus have evolved and over time have developed mechanisms of entry, persistence and pathogenicity to remain in the host, invade it and cause infection. There are several factors that favor pathogenicity by directly contributing to virulence, such as hemolysin and phospholipase activities. This work focused on determining the hemolysin and phospholipase activity of Candida spp, in clinical isolates from patients who come to the Cocamed clinical laboratory. The study is cross-sectional and descriptive, in which Candidas were identified by manual methods using chromogenic agar and automated methods such as Vitek, the hemolysin and phospholipase activity of Candidas was studied through specific plate media based on egg yolk and the other with lamb blood. In the results obtained from the Candida spp isolates, Candida albicans and non-albicans Candida were identified. Regarding phospholipase activity, C. albicans cultures had high and very high activity, and the remaining low/null activity, while non-albicans cultures had high and very high activity, and the remaining low/null activity. In Hemolysin, C. albicans cultures showed very high, high, low and very low/null activity. Non-albicans cultures, in terms of their different species, had variability in their activity. In conclusion, the identification of C. albicans and non-albicans was successfully carried out using the CHROMagar and Vitek 2 methods, with consistent results and no significant differences between both methods. The activity of phospholipases and hemolysin varied between the identified species, being mostly high or very high in C. albicans cultures, while in non-albicans this activity showed greater variability.
RESISTENCIA ANTIMICROBIANA DE ENTEROCOCCUS SPP. Y SU RELACIÓN CON INFECCIONES ENDO-PERIODONTICAS EN CENTROS ODONTOLÓGICOS
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Pulamarin Logacho, Daniela Azucena; Valenzuela Sánchez, Gabriela Paola
Antimicrobial resistance is a public health problem worldwide, the incidence of infections by gram-positive microorganisms is high, both in the hospital environment and in the community, the isolation of Enterococcus spp. in the microbiology laboratory allows the detection of their antimicrobial resistance in endo-periodontic infections, both at phenotypic and genotypic level, which has great clinical and epidemiological significance. To determine the antimicrobial resistance of Enterococcus spp. strains and their relationship with endo-periodontic infections in dental centers. A descriptive, cross-sectional study was carried out with a quantitative, qualitative, and descriptive approach because the problem was thoroughly detailed in order to identify the strains of Enterococcus spp. causing oral infections and their resistance to antibiotics, of the 150 samples processed, 30 Enterococcus feacalis were isolated with resistance to gentamycin and ampicillin, additional research was done in scientific databases that acquired resistance genes, efflux pump mechanisms, alterations in therapeutic targets, In addition, informative brochures were prepared for patients attending dental centers to improve education and awareness of the importance of oral hygiene, the rational use of antibiotics, as well as endo-periodontal, the strains of Enterococcus spp. present in endo-periodontic infections were identified by manual methods. strains present in endo-periodontic infections were identified by manual methods, then differential biochemical tests were performed between species where Enterococcus feacalis prevails, the susceptibility profile was analyzed where resistance to the antibiotics gentamycin and ampicillin, was observed, scientific databases such as PubMed, Scopus, Web of Science with relevant scientific articles were used to investigate the factors of antimicrobial resistance strains and the antimicrobial resistance of Enterococcus spp. were analyzed.
CARACTERIZACIÓN FENOTÍPICAS DE BETALACTAMASAS DE TIPO AMPC EN ESCHERICHIA COLI AISLADAS EN INFECCIONES DEL TRACTO URINARIO EN PACIENTES DEL LABORATORIO CLÍNICO BACTERIOLÓGICO MEDIN–LAB
(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-09-03) Analuisa Tubon, Alonso Vladimir; Valenzuela Sánchez, Gabriela Paola
AmpC-type beta-lactamases, enzymes that confer resistance to a variety of β-lactam antibiotics, have shown an increase in prevalence, particularly in pathogens responsible for urinary tract infections (UTIs), such as Escherichia coli. Antimicrobial resistance poses a significant threat to global public health, as it complicates the treatment of common infections and increases the risk of disease spread. The rising resistance of bacteria to antibiotic treatments is associated not only with clinical challenges but also with considerable social and economic consequences. Limiting the spread of resistant microorganisms and reducing associated morbidity is crucial to preserving the effectiveness of antibiotics and preventing public health crises. Research has primarily focused on extended-spectrum beta-lactamases, complicating the establishment of routine reporting protocols in clinical laboratories, making it essential to consider the clinical and epidemiological significance of AmpC betalactamases. The methodology included the identification of Escherichia coli in patients with UTIs and the detection of AmpC beta-lactamases using the disk approximation method. Escherichia coli was the most frequently identified microorganism in UTIs, accounting for 47.61% of the infections in the study. Most patients were female (97.5%), and the most affected age group was 18 to 35 years (36.25%). Thirteen strains were identified as AmpC-positive (16.25%), with most affected being adult women. The positive strains showed resistance to cefoxitin (16.25%), cefotaxime (16.25%), and amoxicillin/clavulanic acid (16.25%). Additionally, the protocol developed for the phenotypic identification of AmpC betalactamases was outlined in a flowchart for laboratory application, enabling control of resistance mechanisms through phenotypic identification methods. These findings underscore the importance of considering bacterial resistance when prescribing antibiotics, especially in cases of UTIs, and highlight the need for prudent antibiotic use to combat emerging resistance.
STAPHYLOCOCCUS AUREUS METICILINO RESISTENTE EN HISOPADO NASAL DEL PERSONAL DE SALUD DEL HOSPITAL BÁSICO MODERNO – RIOBAMBA
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Inca Martínez, Silvia Marcela; Moreno Avilés, Mónica Susana
Staphylococcus aureus is one of the main human pathogens causing health careassociated infections, with high mortality, due to its virulence factors and antibiotic multidrug resistance. Health personnel at the Hospital Basico Moderno-Riobamba (HBMR) who are nasal carriers of methicillin-resistant S. aureus (MRSA) can become a direct source of transmission to patients and cause serious infections that are difficult to treat, increasing the length and cost of hospital stays. The identification of this microorganism will allow the implementation of control measures. To identify methicillin-resistant Staphylococcus aureus in nasal swabs from health personnel of the Hospital Basico Moderno-Riobamba. The research was based on a mixed approach, using a cross-sectional and descriptive observational design. For statistical analysis, Kolmogorov-Smirnov normality test and chi-square were used. After signing the informed consent, nasal swab samples were cultured in salted mannitol agar and phenotypic tests were applied to identify S. aureus. MRSA determination was performed by disk diffusion using 30 µg cefoxitin. The MLSb phenotype was identified by applying Test D. For quality control, strain ATTC 25923 was used. In the study of 79 nasal swab samples, S. aureus was detected in 19 samples (24.1%). Of these, 4 samples (5.1%) showed methicillin resistance, and 8 samples (10.1%) presented the iMLSb phenotype (inducible resistance to macrolides, lincosamides and streptogramins B). To identify methicillin resistance in S. aureus, a standardized operating procedure (SOP) was implemented and was shown to be effective and reliable. 24.05% of HBMR healthcare personnel were found to carry S. aureus, of these, a significant presence of MRSA of 21.052% in nasal swab was established. The iMLSb phenotype was determined in 42.1%. A SOP for MRSA detection in nasal swab samples was developed and will be implemented in the HBMR Clinical Laboratory.
COINFECCIÓN DE HELICOBACTER PYLORI Y ENTEROPARÁSITOS EN TAXISTAS DE LA CIUDAD DE AMBATO, FACTORES DE RIESGO ASOCIADOS
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Cajo Andrango, Andrés Isaac; Vilcacundo Córdova, Mario Fernando
Coinfection involves two or more microorganisms colonizing the same host; When the Helicobacter pylori bacteria and enteroparasites share the same host, they cause a negative impact on health. These two microorganisms are among the main infectious agents that cause intestinal problems throughout the world. They justify part of the consultations for chronic abdominal pain. They are generally associated with risk factors such as: hygiene habits, age, geographical area, living conditions. Vehicle drivers are subject to the risks of driving itself and also to various problems that arise and alter their health system; gastrointestinal disorders are among one of the main conditions. The objective was to analyze cases of coinfection between Helicobacter pylori and enteroparasites in taxi drivers in the city of Ambato with their associated risk factors. The research had a mixed approach of correlational, transversal and prospective nature. When analyzing the results of the total sample, there was a high frequency of people infected by any of these microorganisms. Of these cases that presented infection, a high percentage had coinfection with both infectious agents; When performing the Chi Square correlation statistical analysis, a statistically significant value was obtained that indicates that there is a correlation between these two microorganisms; Regarding the associated risk factors, lack of knowledge and poor hygiene practices were the main factors that could be evidenced in this study. At the end of this investigation, it was clarified that there is a significant correlation of coinfections caused by Helicobacter pylori and enteroparasites in taxi drivers in the City of Ambato. In addition, a workshop was held with the participants as a preventive contribution, which is why it is of great importance to carry out workshops as strategies to improve health status.
PERFIL DE RESISTENCIA ANTIMICROBIANA EN MUJERES EMBARAZADAS CON INFECCIÓN URINARIA QUE ACUDAN AL HOSPITAL BÁSICO SAN MARCOS
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Coello Barahona, Glenda Patricia; Chicaiza Tayupanta, Jesús
The proliferation of pathogenic microorganisms in the urinary tract is a distinctive feature of urinary tract infection in pregnant women. Physiological changes linked to pregnancy increase the likelihood of complications that can have a significant impact on both the mother and the fetus. The present research aimed to characterize the antimicrobial resistance profile in pregnant women with urinary tract infection who attend the San Marcos Basic Hospital. The study had a mixed approach, observational and descriptive, integrating qualitative elements accompanied by a bibliographic review of digital repositories, books, scientific articles, journals, websites, among others; and quantitative that allowed the recording of the results of the urine cultures of the 100 pregnant women who attended the San Marcos Basic Hospital during the period August 2023 - January 2024. Regarding the results, the following findings were reported: the main causal agent of urinary tract infections was the Escherichia coli bacteria. (65%), followed by Escherichia coli ESBL productive strain (9%), Klebsiella aerogenes (7%), Proteus Mirabilis (7%), and Enterobacter cloacae (3%). The antimicrobial resistance patterns for E. coli were Ampicillin and Sulfamethoxazole/trimethoprim (70%), Escherichia coli. ESBL, with resistance to Ampicillin, Cefuroxime, Sulfamethoxazole/trimethoprim, Ampicillin/sulbactam, Ceftazidime, and Amoxicillin/clavulanic acid (80%); for Klebsiella Pneumoniae it presented resistance to Ampicillin (84%) and Gentamicin (67%); Proteus Mirabilis had resistance to Amikacin and Cefuroxime (50%), and resistance to Ampicillin and Sulfamethoxazole/trimethoprim with 90%. Finally, resistance to Enterobacter Cloacae was Ampicillin and Norfoflaxin Ceftazidime (100%) and Cefuroxime and Clarithromycin (50%). The study concludes that, in the San Marcos Basic Hospital, an adequate use of antibiotics should be carried out, in addition to evaluating the use of antibiotics in pregnant patients who present a urinary tract infection; and how the medical staff requires information related to sensitivity and resistance, so that this can be permanently socialized.
“CLOSTRIDIUM DIFFICILE TOXINA A Y B EN ADULTOS MAYORES Y SU RELACIÓN CON PROBLEMAS GASTROINTESTINALES EN LA CIUDAD DE PUYO
(Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Centro de posgrados, 2024-09-03) Andrade Paredes, Jessica del Pilar; Ramos Ramírez, Martha Cecilia
Clostridium difficile (CD) is a Gram Positive bacteria that can cause serious infections in the intestinal tract. It mainly affects older adults, due to its change in the microbiota as their age increases. Infections can range from mild cases, with symptoms such as diarrhea and abdominal cramps, to severe cases that can cause pseudomembranous colitis, and damage to the colon that can cause death. Transmission of C. difficile occurs primarily through contact with surfaces contaminated with the bacteria's spores. These spores are very resistant and can persist in the environment for a long time. They also produce two types of main toxins, A and B, which are involved in the pathogenesis and severity of the infection. Therefore, the study of this pathogen is essential, mainly in entities that work with this group of people and who, when in contact, could spread. The study was based on a qualitative-quantitative, cross-sectional correlational observational design, in which 68 older adults belonging to the “Golden Years” project of the Provincial Board of Pastaza participated, who underwent CD analysis in stool samples, which which allowed the identification of positive cases for this pathogen, all participants indicated that they had discomfort in the gastrointestinal tract such as: diarrhea, abdominal pain, heartburn, etc. In addition, predisposing factors for contracting the infection were identified such as: age, use of antibiotics, hospitalizations that predispose this is population group to be more prone to infection. This research has allowed a more at detailed view on the relationship of problems of the gastrointestinal system with Clostridium Difficile infection in vulnerable populations such as older adults and emphasizes the importance of the analysis of this microorganism to contribute to the development and prevent the spread of the disease. infection especially in environments where there are gatherings of older adults that they share.
CARACTERIZACIÓN MICROBIOLÓGICA DE AGENTES CAUSANTES DE ONICOMICOSIS EN TRABAJADORES DEL MERCADO MAYORISTA AMBATO
(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-09-04) Villacrés Taco, Lorena Viviana; Salazar Garcés, Dolores Krupskaya
Onychomycosis has become a public health problem in Ecuador, generating a negative and significant impact on people's quality of life. The present study aimed to microbiologically characterize the agents causing onychomycosis in samples of nail lesions of workers at the Ambato Wholesale Market in the period October 2023 - May 2024. In this research, a non-experimental cross-sectional, descriptive and observational study was carried out in which a quantitative and qualitative approach was applied due to the identification of yeast-like mycotic agents and their sensitivity and resistance profile to antifungals in nail lesions of workers. From 212 participants undergoing the research, of which 111 met the requirements and toenail samples were taken, the following results were obtained: a total of 33 positive samples were identified where Candida spp. representing around 69.7%, Trichsoporum rubrum with 12.1%, Epidermophyton floccosum in 9.1% and Aspergillus with 9.1%. It is important to take into account that the Mycosel Agar culture medium was used. In the same way, Candida albicans was identified by culture in CHROMagar in 87%, with Candida parasilopsis 13%. In the samples analyzed, the main agents were Candida species, with a predominance of C. albicans followed by C. parapsilosis and sensitivity to Fluconazole was identified in 90% for C, albicans while in C. parapsilopsis this response was 33.33% and for Itraconazole it was observed that C. parapsiolpsis was sensitive in 100% while for C. albicans the sensitivity was 95%. In response to this, a diagnostic protocol for onychomycosis was developed, with improvement actions in the pre-analytical and analytical phase applicable in the Zamora Ambato Clinical and Bacteriological Laboratory.
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 Hernán
Candida 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..