Actualizaciones en Sida e Infectología
type: channel
description: ASEI es una revista científica de Fundación Huésped y la SADI que publica artículos sobre infectología, con foco en sida.
publisher: Fundación Huesped - Sociedad Argentina de Infectología
language: en
publication name: Actualizaciones en Sida e Infectología
issn: 2718-7845
items: Inter-society document updating on dengue vaccination in Argentina
items: HIV-TB co-infection in Argentina: an unresolved public health issue
items: Antiretroviral treatment: what is coming
items: Beyond cardiopulmonary syndrome: Hantavirus-associated parainfectious encephalitis
items: Update on hepatitis A vaccination in Argentina
items: Antibiotic therapy adequacy to PROA flowchart in community-acquired pneumonia in moderate care patients
items: Pneumococcal vaccination: an ongoing challenge
items: Lepromatous leprosy regarding a case diagnosed in Tierra del Fuego
items: Detection of viral agents in cerebrospinal fluid in pediatrics: 7 years of experience
items: Tuberculosis preventive treatment in people living with HIV in Argentina
items: Bacillary angiomatosis and Kaposi's sarcoma in skin lesion of HIV positive patient
items: Bronchial mucormycosis, an unusual finding on bronchoscopy
items: Chromoblastomycosis: a combination therapy approach
items: Artificial intelligence in infectious diseases
items: Phagotherapy: an emerging alternative in the antibiotic multiresistance era
items: Analysis on the effects of the SARS-CoV-2 Pandemic in relation to voluntary HIV testing at a Public Hospital in Buenos Aires City
items: Carbapenem-resistant Enterobacterales: Epidemiological study of isolates in a public hospital in Santa Fe
items: Syphilis, HIV and hepatitis B in the Mother-Child binomial
items: Educational intervention to improve ceftriaxone prescription in an emergency department
items: ATV/r+RAL (DT) after failure with NNRTI
items: Vaccines save lives
items: Viruses that kill bacteria: “Back to the Future”, 100 years later
items: Guía para la implementación de un programa de optimización de antibióticos
items: Documento sobre el uso de vacunas para la prevención del dengue
items: Severe thrombocytopenia associated with monkeypox infection
items: Abdominal aortic aneurysm infected by Yersinia enterocolitica
items: Pneumonia in the critically ill patient: rapid syndromic diagnosis by multiplex PCR in a General Hospital for Acute Care
items: Phenotypic and genotypic characterization of double carbapenemase producing Enterobacterales in a University Hospital
items: Late diagnosis of HIV-infection: differences between natives and international migrants. Observational study in a hospital of Ciudad Autónoma de Buenos Aires
items: Implementation of a program to face antimicrobial resistance on a low resources hospital

Inter-society document updating on dengue vaccination in Argentina
type: item
description: Dengue fever has become a serious public health problem in Argentina, with a progressive geographic expansion and a sustained increase in the number of cases. During the 2023-2024 season, more than 580,000 cases and 419 deaths were recorded, underscoring the urgent need to implement preventive strategies that complement vector control. Vaccination with TAK-003 represents a fundamental advance in dengue prevention in Argentina within the framework of a comprehensive disease control strategy.
subject: Supplement
  topic: section
subject: dengue
  topic: keywords
subject: vaccine
  topic: keywords
subject: TAK-300
  topic: keywords
creator: Bertachini Bertachini
creator: Pablo Bonvehí
creator: Florencia Cahn
creator: María Marta Contrini
creator: Silvia González Ayala
creator: Susana Lloveras
creator: Alfonso Rodríguez Morales
creator: Hebe Vázquez
rights: Copyright (c) 2025 Octavia Bertachini, Pablo Bonvehí, Florencia Cahn, María Marta Contrini, Silvia González Ayala, Susana Lloveras, Alfonso Rodríguez Morales, Hebe Vázquez https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-16
publication date: 2025-12-16
doi: 10.52226/qswpfr05

HIV-TB co-infection in Argentina: an unresolved public health issue
type: item
description: Tuberculosis (TB) and HIV co-infection represents one of the most complex challenges for public health in Latin America and the Caribbean, and Argentina is no exception. In a regional context where both epidemics have shown sustained growth since 2015, the interaction between TB and HIV continues to have a disproportionate impact, particularly on the most vulnerable populations.
subject: Editorial
  topic: section
subject: tuberculosis
  topic: keywords
subject: public health
  topic: keywords
creator: Omar Sued
creator: Pedro Avedillo
rights: Copyright (c) 2025 Omar Sued, Pablo Avedillo https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/1xrd7040

Antiretroviral treatment: what is coming
type: item
description: Most people living with HIV who can access and take oral anti-retroviral therapy (ART) can enjoy a normal life expectancy. However, stigma (daily reminder of status and fear of disclosure), forgetting and the inconvenience of daily pills remain barriers to successful ART for some people (1). There is significant interest in longer-acting treatment modalities and the first ever complete long-acting (2-monthly) intramuscular injectable regimen for people who are virally suppressed was licensed for use in 2021. It consists of a novel integrase strand transfer inhibitor (INSTI) called cabotegravir, and rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). People who take it prefer it to daily oral therapy with high rates of treatment satisfaction and the discontinuation rates are low. The efficacy has been shown to be similar to that of daily oral ART in both clinical trials and clinical practice. However, the genetic barrier to resistance is lower and when virological failure occurs, single or dual class resistance is very common (2). Providing 2-monthly injections is labour-intensive for clinicians and uptake has not been as high as expected, mainly because it is not presented as an option universally. Data of off-license use in people who are not-virally suppressed are limited.
subject: Editorial
  topic: section
subject: HIV
  topic: keywords
subject: treatment
  topic: keywords
creator: Chloe Orkin
rights: Copyright (c) 2025 Chloe Orkin https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/vr0x0w90

Beyond cardiopulmonary syndrome: Hantavirus-associated parainfectious encephalitis
type: item
description: Hantavirus is a viral zoonosis transmitted primarily by rodents and classically associated with cardiopulmonary syndrome. Parainfectious neurological manifestations are rare and poorly documented in the literature. We present the case of a previously healthy 34-year-old man who developed hantavirus-associated parainfectious encephalitis as a complication of hantavirus infection. With intensive support, hemodialysis, and plasmapheresis, the patient achieved a favorable outcome. This case represents an important epidemiological and clinical contribution, highlighting the need to consider neurological manifestations in patients with hantavirus infection.
subject: Case Report
  topic: section
subject: Hantavirus, Encephalitis, Zoonoses, Plasmapheresis
  topic: keywords
creator: María Alejandrina Guerrera
creator: Micaela Nomdedeu
creator: María José Teruggi
creator: Juan Ignacio Irigoitia
creator: Anabella Erviti
creator: Guillermo Bertoni
creator: Alién Fernández
creator: Nadia Baldoni
creator: Florencia Otermin
creator: Juan Manuel Poggio
rights: Copyright (c) 2025 Maria Alejandrina Guerrera, Micaela Nomdedeu, María José Teruggi, Juan Ignacio Irigoitia, Anabella Erviti, Guillermo Bertoni, Ailén Fernández, Nadia Baldoni, Florencia Otermin, Juan Manuel Poggio https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/6zkxp194

Update on hepatitis A vaccination in Argentina
type: item
description: This issue of ASEI presents an update on the topic prepared by the Vaccine Commission of the Argentine Society of Infectious Diseases (SADI). This update constitutes a fundamental tool for guiding clinical and public health decisions. The document reviews current indications, vaccination schedules, outbreak control strategies, and specificities in immunocompromised hosts. The Editorial Committee of the ASEI Journal encourages all healthcare teams to read, apply, and disseminate this document. Prevention, ultimately, remains the most effective tool for preserving the health of the population.
subject: Supplement
  topic: section
subject: Hepatitis A
  topic: keywords
creator: Alejandra Gaiano
creator: Andrea Mónaco
creator: Ana De Prada
creator: Mariana Golikow
creator: Ana Ceballos
creator: Gisela Calderón Arévalo
creator: Gabriela Quintana
creator: Silvia González Ayala
rights: Copyright (c) 2025 Alejandra Gaiano, Andrea Mónaco, Martina De Prada, Mariana Golikow, Ana Ceballos, Gisela Calderón Arévalo, Gabriela Quintana , Silvia González Ayala https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/rkkqcr50

Antibiotic therapy adequacy to PROA flowchart in community-acquired pneumonia in moderate care patients
type: item
description: Introduction: Antimicrobial Stewardship Programs (ASP) use evidence-based flowcharts to standardize infection management. Their implementation is rarely evaluated, limiting the validation of their impact. Objective: To evaluate the adequacy of antibiotic treatment according to the ASP flowchart in patients with community-acquired pneumonia (CAP) hospitalized in a moderate care unit at a tertiary care center. Methods: Observational, retrospective study (April-December 2024) was conducted on 50 immunocompetent patients ≥18 years of age with CAP hospitalized in a moderate care unit. Six adequacy indicators were analyzed (empirical selection, dosage, time to first dose < 4 hours, therapeutic adjustment, sequential therapy, and treatment duration), classified as optimal (>90%), intermediate (60-90%), or low (<60%). Results were expressed using descriptive statistics. Results: The mean age was 74.8 years, and 56% were male. Adequacy was low for four indicators: empirical selection (48%), therapeutic adjustment (23%), sequential therapy (55%), and treatment duration (16%). The time to first dose < 4 hours was appropriate at an intermediate level (66%). Correct dosage (96%) was the only indicator that reached an optimal level. Discussion: There are critical gaps in the antibiotic treatment adequacy in NAC associated with low adequacy of empirical antibiotic treatment and adjustment, delay and underuse of sequential therapy, and excessively prolonged treatments. Immediate interventions from the ASP Team are needed, focusing on training in empirical selection and therapeutic adjustment, mandatory reassessment protocols to counteract therapeutic inertia, support systems for sequential therapy and duration, and prospective audits with real-time feedback.
subject: Original article
  topic: section
subject: Antimicrobial Stewardship
  topic: keywords
subject: Community Acquired Pneumonia
  topic: keywords
subject: Inpatients
  topic: keywords
subject: Guideline Adherence
  topic: keywords
creator: Joaquín Ferreira Bacciarini
creator: Angélica Benavente
creator: Mariela Seguezza
creator: Francisco Rodríguez De León
creator: Paulina Brasó
rights: Copyright (c) 2025 Joaquín Ferreira Bacciarini, Angélica Benavente, Mariela Seguezza, Francisco Rodríguez De León, Paulina Brasó https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/ncm3dt52

Pneumococcal vaccination: an ongoing challenge
type: item
description: Pneumonia and invasive pneumococcal disease are associated with high morbidity and mortality, underscoring the importance of vaccination as a preventive strategy. In Argentina, since 2017, a sequential vaccination schedule with the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been recommended for adults aged 65 years and older, as well as for younger adults with comorbidities. The introduction of the 20-valent pneumococcal conjugate vaccine (PCV20) to replace the sequential scheme, has not only the purpose to simplify vaccination schedules but also improve adherence. The aim of this study was to describe the pneumococcal vaccination status among hospitalized adults in a Hospital in Buenos Aires, Argentina. An observational, descriptive, cross-sectional study was conducted among individuals aged 18 years and older with an indication for vaccination between November 2024 and February 2025. Patients were classified into three groups: complete vaccination (VC), incomplete vaccination (VI), and unvaccinated (NV). A total of 137 patients were analyzed; 56.9% were male, and the mean age was 74.3 years. Of them, 88.3% were older than 65 years; among younger patients, the predominant comorbidities were diabetes, smoking, HIV, and cancer. Overall, 46 patients (33.5%) had complete vaccination, 14 (10.2%) had an incomplete schedule, and 77 (56.2%) had not received any dose. None had received PCV20, as it was not available at our center during the study period. Our findings suggest that pneumococcal vaccination coverage remains suboptimal. It is essential to obtain data from local healthcare centers to develop targeted strategies to improve it.
subject: Brief communication
  topic: section
subject: Streptococcus pneumoniae
  topic: keywords
subject: vaccination
  topic: keywords
subject: adherence
  topic: keywords
creator: Marianela Paula López
creator: Paula Castro
creator: María Vanesa Durán
rights: Copyright (c) 2025 Marianela Paula López, Paula Castro, María Vanesa Durán https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/vekgxv39

Lepromatous leprosy regarding a case diagnosed in Tierra del Fuego
type: item
description: Leprosy is a chronic, endemic and ubiquitous infectious disease. In 2000, the World Health Organization declared the elimination of leprosy as a global public health problem. Although the prevalence has decreased drastically since the introduction of multidrug therapy, there are still a considerable number of cases appearing in central African countries, India, China and Brazil (1, 2, 3). In Argentina, there are 400 cases per year under treatment, and a geographic focus on provinces in the northeast, northwest and center of the country, which concentrate approximately 70% of the cases (4, 5). The importance of reporting this case in Tierra del Fuego is due to the fact that it is not an endemic area of leprosy and since it is not a public health problem, it is difficult to diagnose because physicians do not suspect it as a possible differential diagnosis within dermatoses (1).
subject: Case Report
  topic: section
subject: Leprosy, bacilloscopy multibacillary, Tierra del Fuego.
  topic: keywords
creator: Carla Cabrera
creator: Mariela Toledo
creator: Pablo Berenstein
creator: Juan Manuel Márquez
rights: Copyright (c) 2025 Carla Cabrera, Mariela Toledo, Pablo Berenstein, Juan Manuel Márquez https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/qp7z9d16

Detection of viral agents in cerebrospinal fluid in pediatrics: 7 years of experience
type: item
description: The diagnosis of viral meningoencephalitis and encephalitis is a frequent challenge in pediatrics and the establishment of viral etiology by polymerase chain reaction (PCR) is important because it allows guiding treatment and avoiding the unnecessary use of antibiotics. We designed a retrospective study with the aim of describing the frequency of distribution of viral agents detected in cerebrospinal fluid (CSF) of children with suspected meningoencephalitis/viral encephalitis, assessing the percentage of HSV1-2 detection in second lumbar puncture when the first result was negative and correlating with the cytophysicochemical study. CSF samples collected in the period April 2017 to February 2024 from 590 hospitalized patients were analyzed with mutiplex PCR Meningitis/Encephalitis Panel (FilmArray, Biofire Diagnostics) and commercial techniques for HSV1-2. At least one viral agent was detected in 17% of the samples, with the highest frequency of Enterovirus: 10.8%, Human Herpes-6: 3.9% and HSV1: 1.9%. Patients with detectable PCR presented meningoencephalitis: 53% and encephalitis 19%. In 22% of cases they were associated with other pathologies. All second samples (40/590) tested for HSV1-2 were negative. Cytophysicochemical tests showed no differences between cases of herpetic and non-herpetic encephalitis.
subject: Original article
  topic: section
subject: Viral meningoencephalitis, Herpetic encephalitis, Cerebrospinal fluid, Herpes simplex virus, Viral diagnosis.
  topic: keywords
creator: Maria Juliana Palau
creator: Natalia Treviño
creator: Maria Paula Eguiguren
creator: Lucía Zaccarello
creator: Sebastián Oderiz
creator: Cecilia Vescina
rights: Copyright (c) 2025 Maria Juliana Palau, Natalia Treviño, Maria Paula Eguiguren, Lucía Zaccarello, Sebastián Oderiz, Cecilia Vescina https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/2xan1a92

Tuberculosis preventive treatment in people living with HIV in Argentina
type: item
description: Tuberculosis (TB) remains a major threat to people living with HIV (PLHIV) in Argentina. Despite robust scientific evidence supporting the implementation of TB preventive therapy (TPT) in this group, its adoption in clinical practice within the country remains limited. This article discusses the need to detect and treat TB infection in PLHIV in Argentina and proposes an operational strategy for the implementation of TPT in this population. It concludes that establishing a comprehensive system for screening, treatment, and information recording in PLHIV is essential.
subject: Revision
  topic: section
subject: tuberculosis
  topic: keywords
subject: preventive treatment
  topic: keywords
subject: HIV
  topic: keywords
subject: Argentina
  topic: keywords
creator: Fernando Biasutti
rights: Copyright (c) 2025 Fernando Biasutti https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/n4pn6078

Bacillary angiomatosis and Kaposi's sarcoma in skin lesion of HIV positive patient
type: item
description: Bacillary angiomatosis (BA) is a rare infectious disease, caused by bacteria of the genus Bartonella spp, transmitted by vectors such as fleas, lice and mosquitoes. It causes different clinical syndromes in humans. In patients with human immunodeficiency virus (HIV) infection with an LT CD4 + <100 cell/μL count, it is associated with the development of angiomatous lesions with neovascularization involving the skin and, with less frequency, mucous membranes, liver, spleen and bones. Kaposi's sarcoma (KS) is a neoplasm characterized by multifocal vascular hyperplasia of endothelial origin related to human herpes virus 8. It can also compromiso the skin, mucous membranes and viscera, with the epidemic variant being a marker disease of advanced HIV infection. The main clinical differential diagnosis for KS skin and mucosal lesions is the BA. Herein we present a patient with HIV/AIDS disease that developed BA and KS concomitantly in the same skin lesion.
subject: Case Report
  topic: section
subject: Bacillary angiomatosis, Kaposi’s sarcoma, HIV, AIDS
  topic: keywords
creator: Graciana Lucía Cárdenas
creator: Natalia Soledad Vittar
creator: Javier José Ricart
creator: Laura Gabriela Moreno Macías
creator: Jorge Velázquez
creator: Esteban Maronna
creator: Marcelo Corti
rights: Copyright (c) 2023 Graciana Lucía Cárdenas, Natalia Soledad Vittar, Javier José Ricart, Laura Gabriela Moreno Macías, Jorge Velázquez , Esteban Maronna, Marcelo Corti
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.179

Bronchial mucormycosis, an unusual finding on bronchoscopy
type: item
description: Mucormycosis is an infection caused by opportunistic fungi belonging to the order Mucorales. Since the SARS CoV 2 pandemic, warnings have been issued about the increase in the presentation of this infection. The presentation of tracheobronchial mucormycosis represents 37% of pulmonary involvement. We present the clinical case of a diabetic patient with severe pneumonia due to SARS VOC 2, with unfavorable evolution, who was taken to bronchoscopy and found whitish pseudomembranes obstructing the lumen of the left main bronchus, confirming histopathologically the presence of mucormycosis. A report of the present case is made to recognize the appearance of fungal infections in patients with poorly controlled diabetes and SARS COV 2 infection, who have a torpid evolution. The presence of white pseudomembranes should be an alarm sign to have this type of infections within the diagnostic possibilities.
subject: Case Report
  topic: section
subject: Diabetes mellitus
  topic: keywords
subject: mucormycosis
  topic: keywords
subject: SARS CoV 2
  topic: keywords
creator: Natalia Fernanda Calderón Lopez
creator: Diego Armando Oquendo Gahona
creator: Giovani Lastra González
creator: Jose Jovany Puentes
rights: Copyright (c) 2023 Natalia Fernanda Calderón Lopez, Diego Armando Oquendo Gahona, Giovani Lastra González, Jose Jovany Puentes
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.176

Chromoblastomycosis: a combination therapy approach
type: item
description: Chromoblastomycosis is a chronic and subcutaneous mycosis caused by various dematiaceous fungi, In Latin America, the most frequently found species are Fonsecaea pedrosoi and Cladophialophora carrionii. Treatment is a challenge because of the lack of response and recurrence in in some cases, especially in patients with extensive and chronic lesions. We report an individual with relapse of chromoblastomycosis (by Fonsecaea pedrosoi) in the right lower limb, who had undergone incomplete treatment with terbinafine and itraconazole. The patient responded favorably to retreatment with itraconazole and terbinafine combined with partial surgical resection of the lesion and skin grafting at the surgical site.
subject: Case Report
  topic: section
subject: chromoblastomycosis, terbinafine, itraconazole. tropical wart syndrome
  topic: keywords
creator: Viviana Leiro
creator: Patricia Fernández Pardal
creator: Mauro Coringrato
creator: Ornela Piñeiro
creator: Esteban Maronna
creator: Gabriela Santiso
rights: Copyright (c) 2023 Viviana Leiro, Patricia Fernández Pardal, Mauro Coringrato, Ornela Piñeiro, Esteban Maronna, Gabriela Santiso
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.164

Artificial intelligence in infectious diseases
type: item
description: We are in the midst of a true technological revolution in healthcare. Processes based upon artificial intelligence and machine learning are progressively touching all disciplinary areas, and its implementation in the field of infectious diseases is astonishing, accelerated by the COVID-19 pandemic. Today we have tools that can not only assist or carry on decision-making processes based upon guidelines or algorithms, but also modify its performance from the previously completed tasks. From optimization of the identification of resistant pathogens, selection of candidates for participating in clinical trials, the search of new antimicrobial therapeutic agents, the development of new vaccines, the prediction of future epidemics and pandemics, the clinical follow up of patients suffering infectious diseases up to the resource allocation in the management of an outbreak, are all current activities that can apply artificial intelligence in order to improve their final outcomes. This development has an exponential possibility of application, and is undoubtedly one of the main determinants that will shape medical activity in the future. Notwithstanding the maturation of this technology that is required for its definitive insertion in day-to-day healthcare activities, should be accompanied by definition of reference parameters, validation systems and regulatory guidelines that do not exist yet or are still in its initial stages.
subject: Revision
  topic: section
subject: artificial intelligence
  topic: keywords
subject: infectious diseases
  topic: keywords
subject: machine learning
  topic: keywords
subject: validation
  topic: keywords
subject: regulatory system
  topic: keywords
creator: Waldo Belloso
creator: Fernando Pasterán
creator: Valeria Burgos
creator: Sofía Díaz
creator: Vitas Ciabis
creator: Marcelo Risk
rights: Copyright (c) 2023 Waldo Belloso, Fernando Pasterán, Valeria Burgos, Sofía Díaz, Vitas Ciabis, Marcelo Risk
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.209

Phagotherapy: an emerging alternative in the antibiotic multiresistance era
type: item
description: The rising antimicrobial resistance associated with the crisis in new antibiotics production and the human and economic consequences of this phenomenon constitute a complex scenario that requires the urgent development of alternative antimicrobial strategies. Bacteriophages are viruses that infect and lyse bacteria. They have been known for over a century but in the last two decades, phage administration has gained popularity worldwide. There is an extensive body of preclinical and clinical evidence that positions phage therapy as one of the main tools for the treatment of difficult-to-treat infections. Although this is conceptually promising, its implementation is limited by the paucity of clinical data on safety and efficacy, obtained according to current scientific standards. This review describes the most relevant data on phage biology, pharmacokinetic and pharmacodynamic aspects known to date, regulatory issues, and the most relevant clinical results.
subject: Revision
  topic: section
subject: fagotherapy bacteriophage, phage, difficult-to-treat infections, antimicrobial resistance.
  topic: keywords
creator: Leda Guzzi
rights: Copyright (c) 2023 Leda Guzzi
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.123

Analysis on the effects of the SARS-CoV-2 Pandemic in relation to voluntary HIV testing at a Public Hospital in Buenos Aires City
type: item
description: The emergence of SARS-COV-2 at the end of 2019 caused difficulties for the public health system to achieve the goals set by the WHO (World’s Health Organization) focused on the eradication of HIV, mainly in developing countries. With the purpose of evaluating the impact in our field, a public hospital in Ciudad Autónoma de Buenos Aires provided the information about the volunteers tested in the time span of January 2017 up until June 2022 according to the records from the main laboratory. The number of tests conducted during the pre-pandemic were double in comparison of the ones made during the pandemic. There were significant statistical differences in the average of monthly tests conducted, with a reduction of up to 60%. Even in the course of 2022, they stayed below the numbers before 2019. Regarding the prevalence of reactive serologies, they were similar to the ones from 2019 (2.4%). Considering the lack of verified diagnosis of HIV implies the progression to AIDS, vulnerability to opportunistic infections, exposure of other people to the infection, risk of life and perpetuation of the virus in the population, it is necessary to actively retake the fight against HIV.
subject: Brief communication
  topic: section
subject: COVID-19 and HIV. Serological testing. HIV prevalence.
  topic: keywords
creator: María Teresa Gabriela Rocculi
rights: Copyright (c) 2023 María Teresa Gabriela Rocculi
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.158

Carbapenem-resistant Enterobacterales: Epidemiological study of isolates in a public hospital in Santa Fe
type: item
description: Introduction: The incidence of carbapenem-resistant Enterobacterales (CRE) rose in the last decade, and especially during the COVID-19 pandemic. Objective: To identify the antimicrobial resistance profile, as well as the frequency and type of carbapenems that were present in CRE isolations in a tertiary care hospital. Materials and methods: Epidemiological, observational and retrospective study. It included CRE isolated in clinical samples during 2021 in a tertiary care hospital in Argentina. Incidences (isolations/patients-day), confidence intervals of 95% (CI 95%) and statistical comparisons were made with OpenEpi. Results: 348 CRE were isolated (11.9 isolations/1,000 patients-day, IC95% 10.7-13.2). Incidence correlated to COVID-19 cases (rho=0.874, p<0.001). Most isolations were from the Intensive Care Unit (76.4%) and the from respiratory samples (27.6%, n=96) and blood cultures (24.4%, n=92). The main isolated CRE was Klebsiella pneumoniae (71.4%, n=260), with a general carbapenem resistance of 53.4%. KPC was the main resistance mechanism (61.2%). Two double carbapenemase-producing Enterobacterales were isolated. Klebsiella pneumoniae presented a higher overall resistance rate to non-betalactam antibiotics (60.6% vs 38.5%, p<0.001). Among CRE, a higher colistin resistance rate was found in KPC isolations (44.6% vs 23.9%, p=0.001) and lower resistance to amikacin (23.9% vs 72.6%, p<0.001). Conclusion: The difficulty in the selection of antibiotic regimens for CRE forces the treating physicians to put emphasis on the knowledge of resistance mechanisms to optimize them.
subject: Brief communication
  topic: section
subject: Carbapenem-resistant Enterobacteriaceae
  topic: keywords
subject: Carbapenems
  topic: keywords
subject: Antibiotic resistance
  topic: keywords
creator: Maximiliano Gabriel Castro
creator: Andrea Florencia Gómez Colussi2
creator: Gisela Romina Muñoz Cena2Sección de Microbiología, Hospital Dr. JB Iturraspe (Santa Fe, Argentina)
creator: Lucía Inés Ubriego
creator: Macarena Vicino
creator: Virginia Dotti
creator: María Fernanda Argarañá
rights: Copyright (c) 2023 Maximiliano Gabriel Castro, Andrea Florencia Gómez Colussi2, Gisela Romina Muñoz Cena, Lucía Inés Ubriego, Macarena Vicino, Virginia Dotti, María Fernanda Argarañá
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.151

Syphilis, HIV and hepatitis B in the Mother-Child binomial
type: item
description: INTRODUCTION Perinatal infections can be transmitted to the fetus and newborn. Syphilis, HIV and Hepatitis B must be screened during pregnancy. OBJECTIVE To know incidence, prevalence and management of syphilis, HIV and hepatitis B in the mother/child pairing. Compare results with official statistics. MATERIALS AND METHODS Retrospective, descriptive and analytical study, through review of medical records from the Sanatorio la Cañada and Hospital Pasteur in Villa Maria, Cordoba. Period 12/01/2020 to 03/31/2021. RESULTS 870 pregnancies studied, 5.3% reactive syphilis serology and 1% HIV. Maternal syphilis incidence 52.87 per 1000 pregnancies, percentage of positivity 5.3%. 76.1% under 30 years old. 41% late diagnoses. 37% incomplete treatments. Congenital syphilis incidence 18.3 per 1000 live newborns. Percentage of maternal HIV posivity 0.68%. 66.7% under 30 years old. 100% underwent correct treatment and 77.7% undetectable viral load at delivery. 100% exposed newborns studied, all undetectable viral load at birth. No cases of Hepatitis B. CONCLUSION 6.3% of pregnant women presented at least one reactive serology, prevailing age under 30 years. Percentage of maternal syphilis posivity lower than published by province of Cordoba. Congenital syphilis incidence exceeded the provincial and national (18.3 vs 1.18 vs 1.14). Percentage of maternal HIV posivity exceeded provincial ones. No detected vertical transmission of HIV at birth. Hepatitis B prevalence lower than official data. Pregnant women diagnosed with HIV have more follow-up from the health system than those diagnosed with syphilis.
subject: Original article
  topic: section
subject: Vertical Infection Transmission; HIV, Congenital Syphilis; Hepatitis B
  topic: keywords
creator: Lucia Guadalupe Guzmán
creator: Virginia Tavecchio
creator: Laureano Fraga
creator: María Soledad Frola
creator: Darío Quinodoz
rights: Copyright (c) 2023 Lucia Guadalupe Guzmán, Virginia Tavecchio, Laureano Fraga, María Soledad Frola, Darío Quinodoz
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.156

Educational intervention to improve ceftriaxone prescription in an emergency department
type: item
description: Objective: To evaluate the prevalence and appropriateness of ceftriaxone after an educational intervention in an emergency department. Methods: Quasi-experimental study, which included a consecutive sampling of unscheduled consultations of adult patients, during 2 months pre-intervention and post-intervention. The intervention consisted of training physicians to limit its indication only to specific clinical situations (meningitis, pelvic inflammatory disease, and acute abdomen). Retrospective data were used, with additional manual chart review, to validate appropriateness of antibiotic initiation and drug appropriateness. Descriptive and analytical statistics were used. Results: Among 28570 visits, 512 received ceftriaxone (1.79%; 95%CI 1.64-1.95), and only 60.54% were hospitalized. Regarding the before-after comparison, we observed a reduction in the rate of use (from 3.66% to 0.63%; p<0.001), the appropriateness in starting an antimicrobial was maintained (from 84.52% to 86.21%; p=0.778), and the appropriateness of ceftriaxone increased significantly (from 41.78% to 84.00% respectively; p<0.001). Additionally, hospital length of stay was reduced (median 6 to 5 days; p=0.014), with no difference in in-hospital mortality (19.44% vs 17.24%; p=0.691), nor in 30-day mortality (23.41% vs 18.96%; p=0.464). Conclusions: This intervention was effective. These findings represent a fundamental step in programs to optimize the use of hospital antimicrobials, aimed at reducing their overuse and consequent resistance.
subject: Original article
  topic: section
subject: Emergency Service, Hospital
  topic: keywords
subject: Practice Patterns, Physicians'
  topic: keywords
subject: Ceftriaxone
  topic: keywords
subject: Health Care Costs
  topic: keywords
subject: Drug Resistance, Bacterial
  topic: keywords
creator: Maria Florencia Grande Ratti
creator: Marisa Sanchez
creator: Naldo Genoud
creator: Facundo Arguello
creator: Maria Sol Burokas
creator: María Inés Staneloni
creator: Bernardo Julio Martínez
creator: Corina Nemirovsky
rights: Copyright (c) 2023 Maria Florencia Grande Ratti, Marisa Sanchez, Naldo Genoud, Facundo Arguello, Maria Sol Burokas, María Inés Staneloni, Corina Nemirovsky
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.196

ATV/r+RAL (DT) after failure with NNRTI
type: item
description: Background: Dual therapy has emerged as a novel concept for HIV treatment. Thisstudy was aimed at comparing a nucleoside-sparing dual regimen consisting of ATV/r + RAL (DT) vs standard therapy of ATV/r + TDF/FTC (TT) among individuals failing first NNRTI-containing treatment. Methods: Randomized multicenter open-label pilot study. Primary outcome: proportion of subjects with plasma HIV-1 RNA below the limit of detection (<50 copies/mL) at 48 weeks (W48). Secondary outcomes: proportion of discontinuation due to adverse events (AEs), time until viral suppression, time until loss of virological response, development of integrase resistance mutations, and absolute change in CD4 counts. The primary outcome was analyzed using the FDA snapshot analysis. Results: Out of 57 participants screened, 34 were randomized to receive: DT (n: 18) or TT (n: 16). At W48, virological response was achieved in 67% (n: 12/18) of participants receiving DT and 88% (n: 14/16) receiving TT by FDA snapshot analysis (p = NS) and 73% and 93% by per-protocol analysis (p = NS). CD4 cell count median change from baseline to W48 was +119 and + 52 cell/μL in DT and TT, respectively. Four participants receiving DT and one TT presented virological failure at W48, with low pVL. One participant developed an integrase resistance mutation (155H) and suppressed later on TT. Conclusion: ATV/r+RAL as second-line therapy showed a trend to more frequent virological failure, compared to TT, although the study was unpowered to prove this difference. No major differences were seen in tolerance or toxicity. This study is registered with ClinicalTrials.gov, Number: NCT01829802
subject: Original article
  topic: section
subject: Dual therapy
  topic: keywords
subject: Atazanavir
  topic: keywords
subject: Raltegravir
  topic: keywords
subject: Second-line therapy
  topic: keywords
subject: HIV experienced individuals
  topic: keywords
subject: integrase resistance
  topic: keywords
creator: Maria Ines Figueroa
creator: Omar Sued
creator: Carina Cesar
creator: Patricia Patterson
creator: Cleyton Yamamoto
creator: Valeria Fink
creator: Norma Luna
creator: Antonio Camiro-Zuñiga
creator: Ana Gun
creator: Pedro Cahn
rights: Copyright (c) 2023 María Inés Figueroa , Omar Sued, Carina Cesar, Patricia Patterson, Cleyton Yamamoto , Valeria Fink, Norma Luna, Antonio Camiro-Zúñiga, Ana Gun, Pedro Cahn
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.193

Vaccines save lives
type: item
description: According to the World Health Organization (WHO), vaccines and safe drinking water are the two most important health strategies for disease prevention. Argentina has a national vaccination calendar (NVC) that includes free and compulsory vaccines. It went from being almost exclusively for children to offering vaccines for all stages of life. When we say that the vaccines included in the NVC are free and mandatory, we are referring to a right but also to an obligation, because vaccines not only protect those who receive them but also those around them. Vaccines are solidarity-based. The fact that they are free of charge introduces the concept of equity; anyone who has an indication can receive them. Vaccine-preventable diseases are serious and can lead to severe complications, sequelae and even death. But vaccines are also victims of their own success. Thanks to them, some diseases are controlled and are very infrequent. This leads to a low perception of the risk of disease in the population and in the health team, generating a decrease in vaccination coverage, which could result in the re-emergence of previously-controlled pathologies. It is important to clarify that eliminating a disease is not the same as eradicating it. Eliminating a disease implies that the circulation of the infectious agent that produces it is interrupted. This is achieved if there are good vaccination coverages, i.e. if all the people who should be vaccinated are indeed vaccinated (or at least a large percentage). If vaccination coverage decreases, diseases return. In other words, we must continue vaccinating to sustain the elimination status. In the case of disease eradication, the infectious agent is no longer circulating anywhere on the planet and vaccination is no longer necessary. The classic example of an eradicated disease is human smallpox. Recently, thousands of cases of monkeypox have been reported, produced by a virus of the same family as the one that caused human smallpox, but it…
subject: Editorial
  topic: section
subject: vaccines
  topic: keywords
subject: health strategy
  topic: keywords
subject: national vaccination calendar
  topic: keywords
creator: Florencia Cahn
rights: Copyright (c) 2023 Florencia Cahn
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.214

Viruses that kill bacteria: “Back to the Future”, 100 years later
type: item
description: Nearly a century after the discovery and subsequent development of antimicrobials, the dramatic problem of antimicrobial resistance (AMR) is a challenge that affects and expands across a broad ecosystem (human, animal and environmental health). Considering also that the discovery of new drugs has slowed down in the last 20 years, there is a growing interest in alternative approaches to mitigate the effects of AMR (1-4). Known for more than 100 years, the development of phages has been overshadowed by the use of antibiotics. They are considered the most abundant biological entities on the planet, and are used in the food industry for the elimination of the main enteropathogenic bacteria (2, 4-6). In this issue of ASEI, Dr. Guzzi provides a detailed update (expected and necessary) on the characteristics of phages, in order to think about their role in the current context of AMR in Argentina and the region. Phages have a bactericidal effect, with low influence on the intestinal microbiota, no cross-resistance to antibiotics and no tropism towards mammalian cells. Furthermore, their effects could extend to other microorganisms, such as adenoviruses and Aspergillus spp (6, 7). Its activity on the biofilm allows us to consider its use in infections that are difficult to resolve (cystic fibrosis, urinary tract infections associated with lithiasis or urinary devices, diabetic foot, among others). Oral administration would allow its use for gastrointestinal decolonization of resistant germs or selective decolonization in critically ill patients, and for the treatment of C. difficile infection. Other possible uses are the cleaning of surfaces in the hospital environment and the sanitation of contaminated effluents. Considering the low environmental impact of phages, their use in animal health opens up prospects of interest. In short, their applications could be broad and widespread, appealing to resourcefulness and creativity. However, certain questions still remain. If they …
subject: Editorial
  topic: section
subject: antimicrobials
  topic: keywords
subject: antimicrobial resistance
  topic: keywords
subject: phages
  topic: keywords
creator: Francisco Nacinovich
creator: María Inés Stanleoni
rights: Copyright (c) 2023 Francisco Nacinovich, María Inés Stanleoni
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.215

Guía para la implementación de un programa de optimización de antibióticos
type: item
description: Desarrollada por la Comisión de Uso Adecuado de Recursos de la Sociedad Argentina de Infectología
subject: Supplement
  topic: section
subject: PROA
  topic: keywords
creator: Corina Nemirovsky
creator: Eugenia Di Líbero
creator: Marta Torres
creator: Martín Hojman
creator: Pedro Pessacq
creator: Claudia Rodriguez
creator: Marcelo Gañete
creator: Vanesa Kaneshiro
creator: Fernando Mozún Tamborenea
creator: Liliana Clara
creator: Javier Farina
creator: Alicia Puscama
creator: Sandra Aronson
creator: Cecilia Ezcurra
creator: Lautaro De Vedia
creator: Com. de Uso Adecuado de Recursos de SADI
rights: Copyright (c) 2023 Corina Nemirovsky, Eugenia Di Líbero, Marta Torres, Martín Hojman, Pedro Pessacq, Claudia Rodríguez, Marcelo Gañete, Vanesa Kaneshiro, Fernando Mozún Tamborenea, Liliana Clara, Javier Farina, Alicia Puscama, Sandra Aronson, Cecilia Ezcurra, Lautaro De Vedia, Com. de Uso Adecuado de Recursos de SADI
date: 2024-01-29
publication date: 2024-01-29
doi: 10.52226/revista.v31i113.296

Documento sobre el uso de vacunas para la prevención del dengue
type: item
description: Desarrollado en conjunto por SADI y SLAMVI
subject: Supplement
  topic: section
subject: vaccines
  topic: keywords
subject: prevention
  topic: keywords
subject: dengue
  topic: keywords
creator: Gabriela Vidal
creator: Alicia Puscama
creator: Silvina Ivalo
creator: Alejandra Macchi
creator: Silvia González Ayala
creator: Fernanda Ferrer
creator: María Laura Yantorno
creator: Esteban Couto
creator: Sofía Echazarreta
creator: Virginia Angeletti
creator: Susana Lloveras
creator: Cristián Biscayart
rights: Copyright (c) 2023 Gabriela Vidal, Alicia Puscama, Silvina Ivalo, Alejandra Macchi, Silvia González Ayala, Fernanda Ferrer, María Laura Yantorno, Esteban Couto, Sofía Echazarreta, Virginia Angeletti, Susana Lloveras, Cristián Biscayart
date: 2024-01-11
publication date: 2024-01-11
doi: 10.52226/revista.v31i113.294

Severe thrombocytopenia associated with monkeypox infection
type: item
description: Introduction: Secondary immune thrombocytopenia has been described in relation to autoimmune mechanisms during infection by different viruses. Clinical Case: A 58-year-old male patient, diagnosed with HIV infection since 2012, under antiretroviral treatment with virological suppression consults the emergency service of a private clinic in the City of Buenos Aires due to painful cervical and axillary lymphadenopathies. Severe thrombocytopenia was confirmed by laboratory at admission, so hospitalization was decided. Perioral ulcerated maculopapular lesions are founded at examination. Monkeypox infection was confirmed by PCR in such lesions. Treatment with steroids was started, interpreting the condition as thrombocytopenia of autoimmune origin, with good clinical evolution.
subject: Case Report
  topic: section
subject: Autoimmune thrombocytopenia – Monkeypox – Emerging Infectious diseases
  topic: keywords
creator: Yamila Martin
creator: Ariel Braverman
creator: Pablo Lapadula
creator: Daniel Pryluka
rights: Copyright (c) 2023 Yamila Martin, Ariel Braverman, Pablo Lapadula, Daniel Pryluka
date: 2023-11-21
publication date: 2023-11-21
doi: 10.52226/revista.v31i113.185

Abdominal aortic aneurysm infected by Yersinia enterocolitica
type: item
description: Main clinical manifestations of Yersinia enterocolitica infections are acute gastroenteritis and pseudoappendicitis. Although extra intestinal complications have been documented, vascular infections are very rare. We report a case of Yersinia enterocolitica infection of an aortoabdominal aneurysm in a 78-year-old male patient with previous history of aneurysm. The patient was admitted to the Emergency Department with a condition of acute abdomen; after performing an angiotomography, he underwent aortic vascular replacement with homograft because of suspicion of rupture. He evolved with shock, multiple organ system failure and died shortly after surgery. Y. enterocolitica was recovered from cultures of aorta and thrombus. Pathogenesis of this infection may be related to release of septic emboli arising from endocarditis or bacteremia, or by contiguous foci of infection. Suspected diagnosis was infection of the aortic aneurysm by an adjacent intestinal infection though no previous symptoms, such as diarrhea, were documented. Cardiac echodoppler showed no evidence of bacterial endocarditis.
subject: Case Report
  topic: section
subject: Mycotic aneurysm, Yersinia enterocolitica infection, aortic aneurysm
  topic: keywords
creator: Analía Fernández
creator: Patricia Andres
creator: Sergio Andino Di Masi
creator: Bárbara Aristimuño
creator: Carla Medina Villafuerte
creator: Elizabeth Madsen
rights: Copyright (c) 2023 Analía Fernández, Patricia Andres, Sergio Andino Di Masi , Bárbara Aristimuño, Carla Medina Villafuerte, Elizabeth Madsen
date: 2023-11-21
publication date: 2023-11-21
doi: 10.52226/revista.v31i113.184

Pneumonia in the critically ill patient: rapid syndromic diagnosis by multiplex PCR in a General Hospital for Acute Care
type: item
description: It has been shown in various studies that advances in microbiological diagnosis reduce the delivery time of results and have an evident clinical impact. Today, techniques based on nucleic acid amplification allow us to diagnose directly from the sample and add the possibility of detecting more than one agent. This impacts both the control of MMR and the initiation of appropriate therapy. The implementation of a rapid multiplex PCR system for pneumonia can be useful in critical areas where acute respiratory infections (ARI) are frequent and time is a determining factor for therapeutic success. The objective of our project was to evaluate the implementation of rapid syndromic diagnosis by multiple PCR for pneumonia in the management of ARI treatment in an Intensive Care Unit. The therapeutic behavior was the relevant variable. This new diagnosis provided us with an agile tool, with a response time of 3 to 4 hours. The absence or presence of resistance genes and the identified microorganism was what led to the correct therapeutic approach in 75% of the cases. It constituted an important tool for the control of bacterial multiresistance and increased the opportunity for therapeutic success.
subject: Brief communication
  topic: section
subject: rapid diagnosis, pneumonia, pcr, therapeutic behavior
  topic: keywords
creator: Laura Scorzato
creator: Néstor Pinca
creator: Mariana Montoto
creator: Paola Madonni
creator: Rosa Grignet
rights: Copyright (c) 2023 Laura Scorzato, Néstor Pinca, Mariana Montoto, Paola Madonni, Rosa Grignet
date: 2023-11-21
publication date: 2023-11-21
doi: 10.52226/revista.v31i113.204

Phenotypic and genotypic characterization of double carbapenemase producing Enterobacterales in a University Hospital
type: item
description: The emergence of double-carbapenemase (KPC and NDM) producing Klebsiella pneumoniae isolates is one of the consequences derived from the SARS CoV-2 pandemic, which has caused significant impact on the antimicrobial resistance rates in hospital acquired infections. These isolates represent a real challenge for Health Services due to their difficult detection and characterization and subsequent treatment. In the present work we describe the double carbapenemase producing isolates recovered during the year 2022 from clinical samples belonging to hospitalized patients at a University Hospital in Buenos Aires city, we report their phenotypic and genotypic characterization and the excellent activity of the ceftazidime-avibactam-aztreonam combination in the treatment of infections in which the therapeutical options are restricted to non β- lactamic antimicrobials which hold resistance rates higher than 70%.
subject: Brief communication
  topic: section
subject: Klebsiella pneumoniae, double carbapenemase, KPC, NDM
  topic: keywords
creator: Marcela Nastro
creator: Carla Álvarez
creator: Nicolás Potente
creator: Iván Cervino
creator: Carlos Vay
creator: Ángela Famiglietti
creator: Carlos H. Rodríguez
rights: Copyright (c) 2023 Marcela Nastro, Carla Álvarez, Nicolás Potente, Iván Cervino, Carlos Vay, Ángela Famiglietti, Carlos H. Rodríguez
date: 2023-11-20
publication date: 2023-11-20
doi: 10.52226/revista.v31i113.166

Late diagnosis of HIV-infection: differences between natives and international migrants. Observational study in a hospital of Ciudad Autónoma de Buenos Aires
type: item
description: Introducción: El diagnóstico tardío de la infección por VIH y el acceso de los pacientes al sistema de salud con enfermedad avanzada afectan negativamente los beneficios individuales y colectivos del tratamiento antirretroviral. A nivel mundial existe una alta prevalencia de diagnóstico tardío especialmente en poblaciones vulnerables como los migrantes. Objetivos: medir la prevalencia de diagnóstico tardío de infección por VIH entre migrantes internacionales y compararla con la de los argentinos. Material y métodos: estudio retrospectivo, observacional, de personas mayores de 16 años, asistidas en el hospital General de Agudos Donación Francisco Santojanni, que hubieran recibido diagnóstico de infección por VIH entre 01-01-2018 y 31-12-2021. Se determinó la mediana de recuento de CD4 basal y la prevalencia de diagnóstico tardío. Aplicamos la prueba de la suma de rangos de Wilcoxon para la variable contínua y la prueba de Fisher para comparar proporciones. Resultados: Incluimos 180 personas (50 migrantes, 130 argentinos). Los migrantes presentaron un nivel basal de linfocitos CD4 significativamente menor [Mediana (RIC 25-75) 225 (76-394) vs 318 (139-520); p=0,046], mayor tasa de presentación tardía [72% vs 55,4%; RR 1,3 (IC95 1,03-1,64); p=0,04] y con criterios de sida [46% vs 33,1%; RR 1,39 (IC95 0,94-2,05); p=0,12] y una menor proporción de diagnósticos en etapa temprana [12% vs 27,7%; RR 0,43 (IC95 0,19-0,96); p=0,03]. Conclusiones: los migrantes internacionales accedieron al diagnóstico en peor estado clínico que los argentinos. Conocer este dato es imprescindible para elaborar políticas tendientes a mejorar el acceso al diagnóstico de esta población vulnerable.
subject: Brief communication
  topic: section
subject: HIV, late diagnosis, migrants, vulnerable population
  topic: keywords
creator: Edgardo Gabriel Bottaro
creator: Pablo Gustavo Scapellato
creator: Monica Lovera
creator: Valeria Barrera
rights: Copyright (c) 2023 Edgardo Gabriel Bottaro, Pablo Gustavo Scapellato, Monica Lovera, Valeria Barrera
date: 2023-11-20
publication date: 2023-11-20
doi: 10.52226/revista.v31i113.192

Implementation of a program to face antimicrobial resistance on a low resources hospital
type: item
description: This quasi-experimental study was developed in a public hospital with the goal of reducing the impact of antimicrobial resistance through an infection prevention and antimicrobial stewardship program. The following measures were implemented: surveillance of colonization and infection by carbapenemase-producing Enterobacteriaceae (CPE); surveillance and preventive measures for urinary catheter-associated infections (UTIs); surveillance and interventions for hand hygiene; local guidelines for treatment of infectious diseases with compliance and antibiotic (ATB) consumption metrics. Results: comparing the pre-intervention and post-intervention period, CPE rate in clinical samples 1.1 to 0/patient days, incidence rate ratio (IRR): 0.00, p: 0.033 and colonization of 3.3 to 0.61/days patient, IRR: 0.18, p-value: 0.5. UTI rate 8.9 to 7.2/1000 days urinary catheter IRR: 0.81, p 0.5. Hand Hygiene compliance: 77.5% to 70.38%, p 0.0067. ATB consumption: 376.24 to 176.82 DDD, 53% decrease. Compliance to guidelines in ATB selection: 57.1% to 95.4% p 0.00031, duration of ATB from 92.8% to 98.4% p 0.16, and adequacy to microbiological rescue of 57.1% at 100%, p <0.01. Conclusion: it is possible to reduce CPE infections, the consumption of antimicrobials and optimize their use in a public hospital in a country with medium/low resources through a program with basic and tailored measures.
subject: Original article
  topic: section
subject: antimicrobial resistance, Carbapenem Resistant Enterobacteriaceae, multidrug resistant microorganisms, infection control, antimicrobial stewardship
  topic: keywords
creator: Maria Florencia Prieto
creator: María Ofelia Moulins
creator: Griselda Joannas
creator: Estefanía Ghiglione
creator: Raquel Rodriguez
creator: Fabiana Ojeda
creator: Juan Manuel Pérez
creator: Agustina Malvicini
creator: Francisco Nacinovich
creator: María Inés Staneloni
rights: Copyright (c) 2023 Maria Florencia Prieto, María Ofelia Moulins, Griselda Joannas, Estefanía Ghiglione, Raquel Rodriguez, Fabiana Ojeda, Juan Manuel Pérez, Agustina Malvicini, Francisco Nacinovich, María Inés Staneloni
date: 2023-11-20
publication date: 2023-11-20
doi: 10.52226/revista.v31i113.210