Trends and socioeconomic, demographic, and environmental factors associated with antimicrobial resistance: a longitudinal analysis in 39 hospitals in Chile 2008-2017.

Background: Antimicrobial resistance (AMR) is among the most critical global health threats of the 21st century. AMR is primarily driven by the use and misuse of antibiotics but can be affected by socioeconomic and environmental factors. Reliable and comparable estimates of AMR over time are essential to making public health decisions, defining research priorities, and evaluating interventions.

Novel Megaplasmid Driving NDM-1-Mediated Carbapenem Resistance in ST1588 in South America.

Carbapenem-resistant Enterobacterales (CRE) is a critical public health problem in South America, where the prevalence of NDM metallo-betalactamases has increased substantially in recent years. In this study, we used whole genome sequencing to characterize a multidrug-resistant (MDR) (UCO-361 strain) clinical isolate from a teaching hospital in Chile. Using long-read (Nanopore) and short-read (Illumina) sequence data, we identified a novel un-typeable megaplasmid (314,976 kb, pNDM-1_UCO-361) carrying the carbapenem resistance gene within a Tn transposon.

Use of collagen and negative pressure wound therapy on a diabetic foot ulcer: a case study.

This case study describes the combined use of a wound contact layer dressing containing collagen with negative pressure wound therapy (NPWT) on a diabetic foot ulcer (DFU). The patient was treated at a university hospital in Santiago, Chile. A wound size reduction of 58% was observed within the first 10 weeks of treatment, and the wound went on to heal fully over the next 14 weeks.

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: The following case study describes the use of a collagen layer in combination with negative pressure wound therapy in a diabetic foot ulcer, treated in a hospital in Chile. The wound reduced 58% in size in the first 10 weeks of treatment, reaching complete healing in the following 14 weeks. The treatment carried out avoided amputation of the foot of the patient who, at 64 years of age, maintained his independence and quality of life.

Draft genome sequence of a multidrug-resistant KPC-2 and SRT-2 co-producing Serratia marcescens strain isolated from a hospitalised patient in Chile.

Objectives: Serratia marcescens is a neglected opportunistic pathogen of public-health concern, especially due to its antimicrobial resistance features. Here we report the draft genome sequence of the first KPC-2 and SRT-2 co-producing S. marcescens strain (UCO-366) recovered from a catheter tip culture of a hospitalised patient in Santiago, Chile, in 2014.

[Critical review of a suboptimal antibiotic, frequently overused and inappropriately dosed: Vancomycin].

Background: Vancomycin, standard parenteral therapy for Gram positive cocci resistant to traditional beta-lactam antibiotics (Staphylococcus aureus and coagulase negative staphylococci [CNS]) and Enterococcus spp, frequent agents of nosocomial infections, is extensively used empirically in that setting. However, its pharmacological weakness, narrow therapeutic margin and poorly predictable pharmacokinetics, make it a suboptimal drug according to contemporary criteria. Vancomycin is over utilized due to both, overestimation of bacterial infections and, in genuine cases, overestimation of the etiological role of these resistant cocci, either nosocomially or community acquired.

Introduction of NDM-1 and OXA-370 from Brazil into Chile in strains of Klebsiella pneumoniae isolated from a single patient.

Carbapenemase-producing Enterobacteriaceae have rapidly disseminated worldwide and can colonize patients in healthcare centers. As in Chile the first isolations of NDM-1 and OXA-370 carbapenemases were related with a patient arriving from Brazil, the genetic relatedness of Klebsiella pneumoniae strains producers of these enzymes and isolated in both countries was assessed. PFGE analyses revealed that the isolates were clonally related, illustrating how travel contributes to the spread of multidrug-resistant microorganisms.

Antimicrobial properties of a novel copper-based composite coating with potential for use in healthcare facilities.

Background: Healthcare-associated infections (HAIs) have a major impact on public health worldwide. Particularly, hospital surfaces contaminated with bacterial pathogens are often the origin of both sporadic cases and outbreaks of HAIs. It has been demonstrated that copper surfaces reduce the microbial burden of high touch surfaces in the hospital environment.

[Incidence of multi-resistant bacteria in Intensive Care Units of Chilean hospitals].

Introduction: Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals.

Aim: To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile.

Methods: Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested.

[Brucellosis in Chile: Description of a series of 13 cases].

Introduction: Brucellosis is a zoonosis caused by Brucella spp. It may be acquired by consuming unpasteurized dairy products. Brucellosis has a low incidence in Chile, thus, we have a scarce data.

[Antiseptics and disinfectants: aiming at rational use. Recommendations of the Advisory Committee on Healthcare Associated Infections. Sociedad Chilena de Infectología].

Proper use of antiseptics and disinfectants, is an essential tool to prevent the spread of infectious agents and to control of healthcare-associated infections (HAI). Given the increasing importance of environmental aspects, as well as several advances and updates in the field of its proper use at local and intemational level, the SOCHINF HAI Advisory Committee considers that it is necessary to develop a guide for the rational use of antiseptics and disinfectants, which it will provide consistent scientific basis with that purpose.

[Grupo Colaborativo de Resistencia Bacteriana, Chile: recommendations 2014 towards the control of bacteria resistance].

Five issues were reviewed in depth at the 2014 annual meeting of Colaborative Group Against Bacterial Resistance and the antecedents and conclusions are detailed in this document. I.- News in CLSI 2014: the difficulties and implications on its implementation at the local level were reviewed and recommendations were set.

A first insight on the population structure of Mycobacterium tuberculosis complex as studied by spoligotyping and MIRU-VNTRs in Santiago, Chile.

Tuberculosis (TB) remains a significant public health problem worldwide, but the ecology of the prevalent mycobacterial strains, and their transmission, can vary depending on country and region. Chile is a country with low incidence of TB, that has a geographically isolated location in relation to the rest of South American countries due to the Andes Mountains, but recent migration from neighboring countries has changed this situation. We aimed to assess the genotypic diversity of Mycobacterium tuberculosis complex (MTBC) strains in Santiago, Chile, and compare with reports from other Latin-American countries.

[Physician's adherence to medical indications for invasive procedures in the critical care unit of a university hospital].

Introduction: Physicians' adherence to pre-established criteria for the indication and/or maintenance of invasive devices is a weak point in infection control programs. Fulfillment of the recommendations for preventing infections associated with invasive devices is essential to reduce their risk.

Objective: To assess the adherence of physicians to the standardized criteria for indication of central venous catheter (CVC) and permanent urinary catheter (PUC) and to the application of supervision guidelines.

[Presence of Bejing genotype among Mycobacterium tuberculosis strains in two centres of the Region Metropolitana of Chile].

Background: Genotyping of Mycobacterium tuberculosis complex (cMtb) allows us to know geographically predominant lineages. Some lineages spread more rapidly and are associated with multidrug resistance, particularly Beijing, which has been reported in Latin America (Peru). There is little information about this topic in Chile and there are no reports of the presence of the Beijing genotype.

[First isolation of KPC in Chile: from Italy to a public hospital in Santiago].

Carbapenem resistance in Enterobacteriaceae is an emerging problem worldwide. Among the mechanisms involved are the production of ESBLs or AmpC associated with porins loss or the presence of carbapenemases. Among these, the KPC betalactamase has become especially relevant given its rapid spread.

[Serotypes and antimicrobial susceptibility of Streptococcus agalactiae].

Background: Streptococcus agalactiae or group B streptococcus, GBS, is the leading cause of neonatal and maternal infections and an opportunistic pathogen in adults with underlying disease. In the last decade, a dramatic increase in the resistance of this microorganism to erythromycin and clindamycin has been observed.

Aim: To determine the serotype distribution and antimicrobial susceptibility of isolates of S.