Maestría en Laboratorio Clínico

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Aplicación de fotometría reflectante y microscopia digital en el diagnóstico de infecciones de vías urinarias
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-12) Cajas Vilema Lcdo. MG, Jorge Patricio; Monge Moreno MG.BQF., Adriana Monserrath
Antimicrobial resistance is a growing global problem, which also affects the common etiological agents of urinary tract infections (UTIs) and may involve increased mortality without proper treatment. There are different resistances at the outpatient versus nosocomial level that must be taken into account, any use of anti-biotics causes selective pressure on the microbiome by eliminating susceptible bacteria and increases the risk of infections by resistant bacteria. Therefore, a study was carried out at the Calderón General Hospital in the city of Quito, where 684 urine samples from outpatient, emergency and internal medicine patients were analyzed, in which Urine Culture was requested to correlate the parameters of EMO with Urine Culture. The EMO was performed in the Laura XL team, the chemical analysis, and digital microscopy, the chemical in an automated way in the Laura XL team, where the parameters of leukocytes and nitrites were taken into account for the microscopic analysis the values of leukocytes and bacteria were collected. For the urine culture we isolated the colonies, made a quantitative count and identified the most common uropathogens in patients, making a presumptive recognition. In the samples analyzed, it was found that 63% of requests for urine culture correspond to women, and it was shown that the diagnosis of UTI occurs more frequently in adult women as geriatrics. Of the samples analyzed, the positive urine cultures were 29%, in which the most frequent bacterium was E. coli.
Caracterización de la resistencia a Linezolid y Vancomicina mediada por plásmidos en Enterococcus faecalis y Enterococcus faecium
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrados, 2022-09-01) Jaramillo Ruales, Evelyn Katherine Bq. Cl.; Calero Cáceres, William Ricardo PhD.
Enterococcus sp. is an opportunistic pathogen in patients with immunosuppression, causing diseases such as endocarditis, urinary tract infections or surgical wounds. The World Health Organization (WHO) has categorized vancomycin-resistant E. faecium as High priority (Priority 2). Vancomycin resistance is associated with the acquisition of genes such as vanA, vanB and vanC. Therefore, the therapeutic option is linezolid, however Enterococcus resistant to linezolid due to the acquisition of genes such as optrA, cfr and poxtA has already been reported. Objective: The aim of this study is to describe resistance to linezolid and vancomycin due to the acquisition of plasmids in E. faecalis and E. faecium isolated at INSPI-Quito, during 2017-2020. Methodology: The population of E. faecium and E. faecalis resistant to vancomycin and linezolid was analyzed in order to characterize the strains phenotypically and genotypically; in addition, correlate epidemiological data, georeference and create dendrograms. Results: 203 isolates were analyzed, mostly identified in the provinces of the Sierra part of Ecuador; 134 E. faecium resistant to vancomycin were identified, due to the presence of the vanA gene (44%) and the vanB gene (22%); 41 strains resistant to lineozlid are described, mostly E. faecalis, due to the presence of the optrA gene (88%); cfr and poxtA genes are not identified. Conclusions: Resistance to vancomycin is described in E. faecium and a high percentage of resistance to linezolid in E. faecalis, mostly due to the presence of plasmid genes, in addition, E. faecalis produces lower levels of antibiotic resistance than E. faecium.
Caracterización de los perfiles de resistencia antimicrobiana
(Universdidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2022-06-01) Moreno Avilés, Mónica Susana; Monge Moreno Dra. Mgs, . Adriana Monserrath
Introduction The World Health Organization (WHO) in 2011 declared antimicrobial resistance a public health problem and announced a global strategy against antimicrobial resistance. Objective To characterize the antimicrobial resistance profiles in the Riobamba General Hospital in 2020. Methodology The present project used a quantitative, retrospective study of analysis of information from the Vitek equipment database of bacterial cultures and susceptibility tests of the year 2020, it is quasi-experimental and of intervention since the WHONET software was used for the elaboration of the antimicrobial susceptibility primer. Results The microorganisms frequently isolated in 2020 were Escherichia coli and Klebsiella pneumoniae, S. aureus and epidermidis. Urine and stool samples were the most prevalent, in addition, Klebsiella pneumoniae and Staphylococcus aureus were evidenced in pharyngeal secretion samples. The presence of carbapenem resistance was revealed in K. pneumoniae; and the prevalence of BLEE in Escherichia coli and Klebsiella. Conclusions: By characterizing the antimicrobial resistance profiles at the Riobamba General Hospital, the Institution's annual antimicrobial susceptibility primer was designed.
Caracterización Microbiológica y diseño de un plan de mejoramiento, saneamiento e higiene del agua de consumo de la parroquia San Bartolomé de Pinllo
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Proaño Santamaría, Jorge Luis Lcdo.; Inca Torres, Alberto Renato Bqf. Ph.D,
The presence of both traditional and emerging contaminants is one of the greatest concerns regarding the quality of water for human consumption. It is in this sense that different protocols have been developed for quality control in the aquatic environment, but a growing concern in this field is the relatively small concentrations and the fact that they cannot be eliminated by conventional water/wastewater treatment processes. Therefore, it poses new challenges in terms of the appropriate selection of technologies from a technical, economic and environmental point of view. In general, the literature discusses the removal of contaminants at significant concentrations (such as those found in wastewater), while few studies consider their low concentrations to occur in untreated water. This study presents an analysis of water for human consumption in the parish of San Bartolomé de Pinllo, where we have evaluated 22 water samples to determine the microbiological profile. The results of this research have been compared to samples from the same neuralgic points in the chain. of distribution at two time points, in November 2021 and March 2022. In this sense, once the 22 samples have been analyzed, the presence of total or fecal coliforms has not been evidenced at the two time points in which the samples for analysis were taken. The study is completed with a discussion on the implementation of environmental assessment instruments (life cycle assessment, carbon, water footprint, other types of assessments) that can be used to select advanced and sustainable drinking water treatment processes capable of remove emerging contaminants. This document critically reviews the main research topics related to the main microbiological contaminants and the importance of managing and implementing adequate methods to control the quality of water for human consumption.
Co-infecciones bacterianas asociadas a la virulencia por SARS- CoV- 2. Parroquia Misahuallí, Cantón Tena, Provincia de Napo. Ecuador. 2021
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrado, 2022-09-01) Llangarí Cujilema, Jorge Luis, Lcdo.; Velásquez de Preciado, Glenda Coromoto, PhD.
Co-infection by pathogens, especially bacteria, is an important risk factor that generates adverse results in COVID-19, becoming an important cause of morbidity and mortality. The following were established as specific objectives: to distribute the population according to age groups and gender, to characterize the social determinants of health in the selected population, to diagnose the SARS-CoV-2 virus by RT-PCR using nasopharyngeal swabs, to isolate the bacteria present in the sputum samples and pharyngeal exudates, as well as to evaluate the susceptibility to microbial agents, to finally measure the impact of intervention actions. It was an investigation with a quantitative, intervention, descriptive, non-experimental, field, documentary, cross- sectional approach. The age group mostly interviewed corresponded to those over 60 years of age. The male gender predominated (67.92 %). The subjects are settled in the rural area (84.90%). They belong to the Kichwa ethnic group (69.0%). The level of education corresponded to complete secondary (39.62%) and the population has informal employment (60.37%). 53 people tested positive for the RT-PCR technique for the SARS-CoV-2 virus. The microorganisms isolated in the most prevalent sputum and pharyngeal exudate samples were Gram negative: (Klebsiella pneumoniae; 47.16%); Gram positive: (Staphylococcus aureus; 7.56%). A high rate of resistance to the beta-lactam family was found. During the intervention there was a change of attitude specifically, on the use of personal protective equipment to reduce cases of SARS-CoV-2 in the area.
Control microbiológico en la empresa de productos lácteos SOPRAB alimentos KAZU del cantón Ambato en la provincia de Tungurahua
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrado, 2022-09-01) Tobar Martínez, Grimanesa Thalía; Tinajero Vasconez, María Fernanda Bqf. Mg.
Dairy products are an essential component of the daily diet and the economy, but they can become potentially dangerous products if they are not processed and distributed properly, so it is important to introduce a system that ensures safety throughout the food chain. The main objective of this project was to carry out a microbiological control in the milk pasteurization line in the dairy products company SOPRAB Alimentos Kazu in the Ambato canton in the province of Tungurahua. Using the Petrifilm plate count technique for the identification of Mesophilic Aerobes, total coliforms, molds and yeasts, samples were taken at five different points in the pasteurization line, obtaining the highest count of indicator microorganisms at point one corresponding to the raw material; at subsequent points, the counts decreased until <=1 cfu/mL was obtained in the final product. The results indicate that in the first two points sampled, 100 % of the samples had a high count for both aerobic Mesophiles (average count of 4971868.2 cfu/ml) and total coliforms (average count of 49428. 46 cfu/ml), but as the pasteurization process began, the counts for the indicator microorganisms decreased, obtaining an average count for Mesophilic aerobes of 306 cfu/ml while for total coliforms, molds and yeasts the count was 0 cfu/mL. These data obtained were within the values recommended in the Ecuadorian Technical Standard NTE INEN 9:2012, showing total conformity in the microbiological quality of pasteurized milk.
Diseño de implementación de un laboratorio de biología molecular en el Hospital Provincial General Docente Ambato
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2023-04-04) Nieto Condo, Valeria Lilibeth; Inca Torres, Alberto Renato
Molecular biology has improved the diagnosis and treatment of diseases at the genetic level, and the PCR technique is essential in the clinical laboratory. The implementation of a molecular biology laboratory in a hospital can be of great importance, and facilities, equipment, and personnel must be considered. In Ecuador, the General Teaching Hospital of Ambato needs a molecular diagnosis area to improve the quality of medical care and diagnostic support. The implementation of molecular biology laboratories in hospitals in Latin America has been a growing trend in the last decade, with successful examples in Argentina, Colombia, Mexico, Paraguay, Peru, and Brazil. These laboratories have been fundamental for the diagnosis of genetic and infectious diseases, allowing early detection and more precise treatment. The COVID-19 pandemic has highlighted the importance of laboratory diagnosis, and efforts have been made to standardize diagnostic procedures. The study was conducted at the General Teaching Provincial Hospital of Ambato in Ecuador, using an observational and descriptive research model with a qualitative approach. The study population included medical personnel, clinical laboratory technologists, and nurses working directly at the hospital. The sample size was 66 individuals. Data collection for the project involved a literature review and a survey to determine the need and feasibility of implementing a molecular biology laboratory in the hospital. The survey was conducted with 66 healthcare professionals and analyzed using statistical tools. There is a need and feasibility to implement a molecular biology laboratory in the General Teaching Hospital of Ambato in Ecuador, with the aim of improving the quality of medical care and diagnostic support.
Diseño de la implementación del área de micología humana en el hospital general docente Ambato
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Fonseca Zuñiga, Jackeline Elizabeth; Ramos Ramírez, Martha Cecilia Bq.F. Mg.
The main objective of this research was to design a functional area of human mycology in the Ambato General Teaching Hospital, whose methodology corresponded to a mix (cualitativecuantitative) and transactional study; for data collection, a survey was designed and applied to 101 professionals who work in the hospital, which was previously validated by ten (10) experts; and from its application, the perspective of the respondents regarding the project was determined, as well as the demand for the planned analysis. Obtaining as a result that there is indeed a need to carry out mycological analyzes since there are no mycology laboratories in the area and the approximate demand was recorded in more than 300 analyzes per month and the approval of the project was also validated by more than 90% of the staff professional who works in the institution, who mostly corresponded to workers who have between 11 to 15 years of service, work mainly in outpatient clinics and are medical specialists of the HGDA. For the development of the proposal, the area for the operation of the laboratory was determined and it was categorized as a LAC-2, together the equipment, reagents and materials that must be acquired for the proper functioning of the laboratory and its reference costs were established obtaining a total of 89,746.06 dollars for the project, which includes technical and human resources, thus completing the pertinent technical, administrative, operational and financial proposal to be presented to the institution's authorities
Diseño de un programa para el control de infecciones bacterianas en hogares de acogida.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrados, 2022-09-01) López Acuña, Mario Daniel Lic.; Ortiz Jiménez, José Marcelo Mgs.
Older adults are a vulnerable population group that due to their physiological and bodily alterations typical of aging, the long periods of hospitalization to which they are subjected, the use of inadequate antibiotic treatments and the existing comorbidities, make them predisposed to suffer infectious diseases that lead to severe clinical pictures, sepsis and in many cases death (Esme et al., 2019). Therein lies the importance of knowing how infectious diseases affect this population group, and the risk of contagion that residents of foster homes possess. Objective To design a program for the control of bacterial infections in elderly residents of foster homes Methodology. The type of study was descriptive, cross-sectional with a mixed approach, the risk of infection of the subjects under study was determined, the microbiological analysis of urine, stool and sputum samples of the elderly was performed by urine culture, stool culture and sputum culture, to determine whether they presented bacterial development; In addition, the antibiogram test was performed to check if the isolated microorganisms presented resistance phenotypes. A survey was made to the personnel working in this institution to be aware of their knowledge about the care of the residents, and a program was developed for the control of bacterial infections in the Instituto Estupiñán foster home. Results. Of the 45 urines analyzed, 66.7% (30) showed no bacterial growth and 33.3% (15) showed bacterial growth. Among the group of microorganisms that grew, 15.5% were Escherichia coli, 4.4% Citrobacter freundii, 2.2% Pseudomonas aeruginosa and 2.2% Edwarsiella tarda. Among the group of Escherichia coli isolated, 9.0% presented the BLEE (extended spectrum beta-lactamase) resistance phenotype. The study of the 45 sputum samples established that 49.0% showed no bacterial growth, 28.9% developed normal flora, 8.9% showed coagulase-negative staphylococcus, 4.4% Escherichia coli, 2.2% Citrobacter freundii, 2.2% Klebsiella oxytoca and 4.4% Klebsiella pneumoniae BLEE (extended spectrum beta-lactamases). The 45 stool samples studied showed the development of normal intestinal flora. Based on the "Scale for measuring the risk of infection associated with adult care", 48.9% of the elderly in this study were at medium risk of suffering a bacterial disease, 35.6% at high risk and 15.6% at low risk. Conclusions. The xiv microbiological study of urine, sputum and stool samples of the residents of the Instituto Estupiñán foster home by means of culture and antibiogram, proved the presence of bacteria causing infections; and antibiotic resistance phenotypes. It was evidenced that, due to intrinsic factors, these individuals have a medium risk level of acquiring a bacterial infection. On the other hand, the knowledge of the personnel in charge of the care of older adults was assessed, and based on the information obtained, an infection control program for nursing homes was developed.
Diseño para la implementación del área del laboratorio de microbiología del Hospital Básico Machachi, Cantón Mejía
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Conterón Tene, Elizabeth; Guangasig Toapanta, Víctor Hernán Bq. F. Mg.
Introduction: Currently some infections must be diagnosed clinically and in the same way they must be treated in a timely manner, if there is no prior isolation of the causative microorganism or determination of susceptibility to antibiotics, effective treatment is difficult, being essential the design of a microbiology Laboratory. Objective: The purpose of this research is to design the space for the assembly of the Microbiology Laboratory, under locative, administrative and financial parameters and thus propose the implementation of the microbiology area in the Machachi Basic Hospital clinical laboratory. Methodology: descriptive type, since it shows the reality of the current situation of the Machachi Basic Hospital at the time of conducting the study; it is a non-experimental investigation of transectional cut; applying a survey to patients diagnosed with infectious pathologies who come to the hospital applying a "focus group" to the medical personnel of the Hospital, in general terms, all the doctors of the hospital indicated that microbiology exams are of great importance and a lot of diagnostic help for the proper management and timely treatment of patients who come to the Machachi Basic Hospital. Results: it was evidenced that the patients express the need to include the microbiology area. Specifically, 98.2% of the sample indicates the need for a microbiology laboratory, and it is opportune to speed up the process for the design and implementation of the laboratory, and in this way guarantee the adequate diagnosis of the different infectious diseases that threaten the population in order to ensure timely and effective treatment. Additionally, 96.4% stopped performing exams due to lack of budget. 96.4% of patients surveyed consider that timely treatment will be given if the Microbiology laboratory is increased. Conclusions: Based on these antecedents, the adequate space is established within the laboratory, for the implementation of the microbiology area, the area arranged in the hospital consists of 16.22 m2, it has the facilities for the operation of the laboratory and the proposal for the design and implementation of the microbiology area adjusted to the characteristics of this hospital, and complying with all relevant regulations and requirements, with the ultimate goal of being evaluated by the competent authorities and considering including this area within those that offers this institution.
Elaboración de la cartilla epidemiológica aplicado en las diferentes áreas hospitalarias del Hospital General Docente Ambato Distrito de Salud
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10-01) Pérez Zapata, Ángela Yolanda; Mario F. MSc .Lcdo., Vilcacundo Córdova
The prevalence of multiresistant bacteria is a serious public health problem. According to the WHO, this problem is considered one of the ten most relevant today in the health area. The elaboration of instruments that help to identify which are the most prevalent multi-resistant microorganisms in a locality helps greatly to develop public health policies and control strategies for both microorganisms and the sale and distribution of antibiotics. The present work was developed within the Hospital General Docente Ambato Distrito de Salud 18D0, where a survey was carried out on a sample of the personnel that works in said health house on knowledge of the management of multiresistant bacteria and on their knowledge of concepts associated with this problematic. An epidemiological survey of the samples analyzed in the microbiology laboratory of the institution was also developed to obtain information on the most prevalent microorganisms in the most frequent analytes in the laboratory. Finally, from the data extracted from the microbiology laboratory, and epidemiological chart was prepared with the most prevalent microorganisms in the analytes. From these analyzes, it was possible to determine a wide prevalence of E. coli, Klebsiella pneumoniae, and Proteus within the main samples analyzed within the microbiology laboratory. Once these relevant microorganisms were identified, it was also possible to observe a broad resistance of E. coli to a wide panel of antibiotics. This suggests that there is a wide distribution of genes that confer resistance to antibiotics within our population. Therefore, the elaboration of instruments such as the epidemiological primer is of great importance to generate public health policies for adequate control of this problem.
Elaboración y Ejecución del manual para la toma de Cultivo de tejido de úlceras de pie diabético en el servicio de Cirugía Vascular del Hospital General Latacunga
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Herrera Durán, Magaly Johana Lcda.; Brito Zambrano, Johana Susana Med. Esp.
Introduction Infections are one of the usual complications of diabetic foot, a risk factor for amputation and the most frequent cause of extended stay of these patients, the diagnosis is very important as well as the identification of the microorganism and the patient's clinic (Segovia -Coronel et al., 2017). The importance of implementing the manual for taking diabetic foot ulcer tissue crop samples helped to improve order in practical activities and standardize the documentation associated with all processes, in addition to reducing errors that could confuse an eventual medical diagnosis. Objective. To implement a manual for taking tissue crop samples from ulcers in patients diagnosed with diabetic foot in the Vascular Surgery Service of the Latacunga General Hospital. Methodology This study is a non-experimental, cross-sectional, observational design, due to the fact that data will be collected in a certain time without intervening in the environment where the collection and processing of crop samples of swabs/ulcer tissue in patients will be carried out. Diagnosis of diabetic foot of the Angiology service of the General Hospital of Latacunga. The results obtained an increase of 31.11% in successfully processed samples thanks to the application of the manual, reaching 88.89% of adequate samples for the proper microbiological study (40 samples), thereby improving clinical diagnosis and contributing to correct antibiotic treatment. Conclusion The constant training of all the health personnel involved in the process of taking samples of diabetic foot ulcer tissue crop samples, is of great importance, in addition to the sequential updating of the elaborated manual.
Evaluación del aseguramiento de la calidad de los resultados, como parte de la gestión técnica de los laboratorios clínicos privados del cantón Ambato
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio Clínico, 2022-11-01) Intriago León, Shirley Carolina; Galárraga Pérez, Edison Arturo Dr. Mg.
Private clinical laboratories in Ambato canton fulfill important phases regarding the analysis of samples, both in the area of Clinical Chemistry, Hematology, Parasitology, Uroanalysis, among others, this process covers, the time when the doctor requests the order, in the so-called pre-analytical stage, followed by the classic pre-analytical and postanalytical stages, because the laboratory is involved in 70% of the clinical diagnosis is essential for patient safety, this is achieved through the control and assurance of these phases. Nowadays, analytical quality assurance is an essential part of the administration of private clinical laboratories, the objective of which is to evaluate in a transparent and documented manner the validity of the procedures used in these laboratories, and thus generate reliable results. Nowadays there is a great interest in the determination of quality assurance systems in private clinical laboratories, since the credibility and confidence of the results depends on the identification of such sources of variability, the documentation that demonstrates it and the control. The ISO 17025 standard, published in December 1999, establishes the technical and administrative requirements that a testing laboratory must follow in order to issue a reliable result. The clinical laboratory evolves as it adapts to scientific, technological and management changes, mediated by advances in medicine, new methods and analytical tests, as well as the growing demand and expectation of patients for higher quality services and products; in any perspective, the task before the new challenges to improve quality will depend on the performance of each of the quality management systems, ensuring the possible success for xiv the patient's health and prioritizing the optimal use of available resources to obtain a reliable result.
Evaluación e implementación de métodos de diagnósticos para vaginosis bacteriana en las pacientes del Laboratorio de Especialidades Médicas Ochoa en base a criterios de Amsel y Nugent
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Yuquilema Poma, María Elena Lcda.; Vaca Altamirano, Gabriela Liseth Bqf. Ph.d.
Las infecciones del sistema reproductivo femenino, como la vaginitis y la vaginosis bacteriana, son comunes en mujeres de todas las edades, pero los cambios frecuentes asociados con la biología vaginal son menos conocidos. Esto afecta la calidad de vida de la mujer y provoca frustrantes dolencias como irritación de la vulva, ansiedad, disfunción sexual y molestias vaginales. Inclusive aquejando los costos médicos directos e indirectos relacionados con problemas de salud reproductiva (infertilidad), aborto espontáneo e histerectomía. Por otro lado, no siempre presentan signos o síntomas, pueden ser asintomáticos. Los microorganismos causantes de esta patología en un 40% – 50% son: Cocobacilos Gram Negativos, Bacilos Gram variables curvos y los Bacilos Gram positivos (lactobacilos). El diagnóstico se puede realizar mediante criterios clínicos, evaluando el morfotipo bacteriano con la tinción de Gram realizada en las secreciones vaginales o mediante métodos microbiológicos desarrollados como alternativa al diagnóstico. Este proyecto de desarrollo tiene como objetivo estandarizar los criterios diagnósticos de vaginosis bacteriana en mujeres con enfermedades vaginales mediante la aplicación de los criterios de Nugent (estándar de oro) en los estudios citobacteriológicos realizados en los Laboratorios de Especialidades Médicas Ochoa. Se realiza mediante la observación macroscópica y microscópica de flujo vaginal para analizar y describir la muestra en base a criterios de inclusión y exclusión de la población seleccionada para el muestreo. Se espera que proporcione una visión general de bases fundamentales para el desarrollo, revisión y actualización de métodos de laboratorio existente efectivo para el diagnóstico de la Vaginosis Bacteriana, base elemental para el desarrollo de medidas preparatorias preventivas, que puedan mejorar el nivel de salud y la calidad de vida de la población.
Identificación de agentes patógenos causantes de infecciones en vías urinarias en mujeres embarazadas con patrones de resistencia antimicrobiana.
(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrado, 2022-09-01) Espinoza Vargas, Yadira Lizbeth; Paredes Páliz, Karina Inés, Lcda. PhD.
Urinary tract infection is usually caused by bacteria that can damage the urethra and bladder, or spread to the ureters and kidneys. The anatomical and functional changes that occur during pregnancy increase the predisposition to urinary tract infections. Bacteria, due to their tremendous capacity to adapt, can develop mechanisms of resistance to antibiotics that were initially vulnerable, this can cause an increase in complications in pregnancy that significantly affects the mother and the fetus. The present research work with the theme "Identification of pathogenic agents that cause urinary tract infections in pregnant women with antimicrobial resistance patterns"; whose main objective is to evaluate antimicrobial resistance in urine cultures of pregnant women who attend the clinical laboratory of the Sangolquí Basic Hospital, during the period October 2020 to February 2021. It is a retrospective quasi-experimental study of 60 pregnant women with positive urine cultures, where the causative agent was identified as Escherichia coli bacteria (72%) followed by 11 Staphylococcus auerus (8%) and Klebsiella aerogenes (5%). Regarding the antimicrobial resistance profiles expressed in percentage of resistance for E.coli, they were Amoxicillin/clavulanic acid, Ampicillin, Ampicillin/Sulbactan present 100% resistance; together with Proteus vulgaris and Proteus mirabilis represented by 50%. Regarding the sensitivity profiles of E. coli, it is Cefazolin (89.7%), Nitrofurantoin (67.5%), Cephalexin (63.2%) and finally Fosfomycin (42.1%), with antimicrobial sensitivity belonging to the group of Enterobacteriaceae. Among the Grand positives, Staphylococcus aureus was isolated, where Penicillin, Oxacillin and Erythromycin represent 100% antimicrobial resistance. The recommended treatment for first-line empirical treatment is Cefazolin, Nitrofurantoin, Cephalexin and Cefuroxime as second-line applied to pregnant women. With this information, it is proposed to make a microbiological chart for the treatment of urinary tract infection in the study area. The results support the importance of local monitoring of the microorganisms involved in urinary tract infections, being essential for the success of the treatment to select properly antibiotic therapy according to antimicrobial sensitivity profiles, which can vary regionally, even between different hospital services, allowing to guide actions in health and epidemiological surveillance.
Identificación de enfermedades micóticas superficiales y estrategia de prevención en pacientes geriátricos.
(Universdidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2022-06-01) Moya Espín, Santiago Gustavo; Urbina Salazar BqF. Ph.D, Anabell del Rocío
Identificación genotípica y análisis de prevalencia de Mycobacterium kansassii en muestras de pacientes con sospecha de tuberculosis pulmonar que asisten al centro de Salud # 1 de la ciudad de Ambato – Tungurahua
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Monge López, Jessica Lizbeth Lcda.; Monge Moreno, Adriana Monserrath Dra. Mg.
My present research work was carried out at the Health Center No. 1, in the city of Ambato, Province of Tungurahua, with samples from patients with suspected pulmonary tuberculosis, my study is aimed at investigating the genotypes and prevalence analysis of Mycobacterium kansasii. Taking into account that in recent years, M. kansasii has emerged as one of the main atypical mycobacteria causing disease in man, with its most frequent clinical manifestation being lung disease. Generally, it is sensitive to classic tuberculostatics, and therapeutic failures are usually associated with resistance to rifampicin. Although phenotypically it is a very homogeneous species; there are different studies that describe different biotypes. In addition, in recent years the existence of seven genotypes (I to VII) has been described, of which genotype I is the most prevalent and the main cause of disease in man. For all these reasons, in this work I set out to know the genotypes of M. kansasii circulating in the area of influence of the Health Center No. 1, for which we carried out a genotypic characterization that showed a high homogeneity among our patients, being mostly included in a biotype; the detection of M. kansasii-specific DNA probes that confirmed species identification and reverse hybridization techniques that determined that all our isolates belonged to genotype I.
Identificación rápida de Staphylococcus Aureus Meticilino Resistente, mediante la Técnica Slidex Mrsa en personal de salud portadores sanos del Hospital Básico Salcedo
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Quispe Gallo, José Luis; Brito Zambrano, Johana Susana Med. Esp.
Introduction: Staphylococcus aureus is a Gram positive, nosocomial pathogen. MRSA is associated with resistance to multiple antibiotics, which makes its control and treatment difficult, being located in the nostrils of healthy people, in health personnel for being in direct contact with patients. Objective: The presence of methicillin-resistant Staphylococcus aureus was identified from cultures of nasal samples using the Slidex MRSA Technique from healthy carrier patients. Methodology: The present development project is quasi-experimental and crosssectional, since a study was carried out where the identification of MRSA is sought, using the Slidex mrsa technique. In which the percentage of patients who are healthy carriers of resistant microorganisms will be determined. Results: Of the 36 participants, 35 cultures were obtained with bacterial growth in Blood Agar, which represents 97.2%, of this percentage 97.1% were Gram positive arranged in a Staphtype cluster, while 2.9% were Gram negative. The work was only developed with gram positives which were planted in Mannitol Agar to continue with the study, of the 34 cultures planted 6 were mannitol positive representing 17.6%, of all the mannitol positive microorganisms 100% were coagulase positive and For the identification of Mrsa, the traditional procedure was used: sensitivity to Oxacillin by the disc diffusion method, to which 5 samples presented resistance, which represented 83% of the microorganisms that were coagulase positive. These same microorganisms were processed with the Slidex Mrsa Technique and we observed that 100% presented agglutination, allowing the detection of methicillin resistance. Conclusion: The Slidex MRSA rapid identification technique, when compared with traditional identification methods such as oxacillin resistance, allowed to achieve even better results and faster
Implementación de un protocolo de control de calidad para la esterilización de desechos biocontaminados producidos en el laboratorio de microbiología del Hospital General Ambato
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Ñacato Anchaluisa, Byron Rafael; Guangasig Toapanta, Víctor Hernán Bq.F. Mg.
The correct disposal of biocontaminated elements is a responsibility that cannot be taken as a minor problem and even worse considering that the management of these wastes can be done without the respective considerations, the impact that the incorrect disposal of waste has several consequences, it can affect both the personnel who work in the institution, as well as the other people who come to the HGDA for any other reason, as well as the environmental impact becomes irreversible. There are regulations issued by the Ministry of Health, the same ones that are not carried out due to various factors, or due to ignorance of these regulations, despite the fact that they are documents available to officials and that they should only be compliance compliance, notwithstanding the This work points out the issue of sterilization of biocontaminated waste before its final disposal, with which we will be able to reduce the chances of causing cross-infection, between the waste produced in the microbiology area and the personnel who work in this department. The protocol to be implemented will allow us to carry out an effective, controlled and verified process of sterilization of biocontaminated waste, thanks to the verification and monitoring of physical controls (temperature, time, pressure), chemical (control tape) and biological (thermostatic bacteria). resistant). A critical point that was denoted when conducting a brief survey of the personnel involved, is that many do not know the correct way to eliminate or handle these contaminated elements, which is why this work will allow us to identify the shortcomings to correct them and promote the actions that are done correctly
Implementación de un protocolo de diagnóstico epidemiológico para la determinación la incidencia de la infección por Helicobacter pylori en pacientes adultos que se atienden en el centro de salud de Pasa – Tungurahua
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-11) Chagcha Frutos, Alexandra Alice; Urbina Salazar, Anabell del Rocío PhD
Gastrointestinal diseases being one of the main public health problems in Ecuador, they are transmitted by the fecal-oral route, or by the consumption of contaminated water or food; its prevalence depends on the socioeconomic level of the patients, the pathogens involved are viruses, parasites and bacteria. The study aimed to evaluate the diagnostic methods used in the health center of Pasa to establish Helicobacter pylori infection as well as the phase of eradication of the posttreatment microorganism, to implement an epidemiological diagnostic protocol to determine the prevalence of Helicobacter pylori infection Helicobacter pylori in adult patients treated at the Pasa - Tungurahua health center through the systematic use of the Immunochromatography test of the rapid test of the Antigen in feces with the specificity of 98.4% that allowed confirming the diagnosis and the eradication of Helicobacter pylori infection, analyzing the presence of risk factors in the study population. The methodology used was observational field type, prospective during the period September 2021-March 2022, it was carried out in two phases; the first was the determination of the current conditions of the prevalence and diagnosis of Helicobacter pylori infection and the second the determination of the eradication of the infection with the treatment of the patients who required it in the first phase, the collection of data, surveys were applied that were validated by professionals of the institution according to parameters of reliability, validity and objectivity. The results obtained show the prevalence of 52% of the patients of the studied sample that present concomitant factors for infection, the sample was 50 patients, 92.31% of patients, the pharmacological therapy used served for sensitization and eradication, 7.69% were obtained where apparently the treatment did not have an effect, but not due to the action of the treatment but due to the lack of adherence, a condition that can favor bacterial resistance. UNIVERSIDAD TÉCNICA DE AMBATO CENTRO DE POSGRADOS 17 It is concluded that according to the results the prevalence of Helicobacter pylori infection is significant with 52% in the study population. The epidemiological diagnosis protocol was implemented that will serve as a guide in the care of patients who present symptoms related to Helicobacter pylori infection. The use of rapid tests by detecting fecal antigens for the determination of Helicobacter pylori and the performance of the second tests for the eradication of the infection were made known to the medical and technical personnel in the Health Unit. patients on the prevention of infection, diagnosis and treatment to eradicate the bacteria to avoid complications and support the process of timely and efficient care for patients with this morbidity to avoid relevant mortality.