Diseño: Estudio tipo observacional, descriptivo, transversal y prospectivo. Objetivos: Describir las características clínicas y microbiológicas de las infecciones nosocomiales por Klebsiella pneumoniae resistente a los carbapenémicos. Material y métodos: Revisión de historias clínicas y data proveniente del servicio de Microbiología Clínica de población mayor de 18 años que presenten infección nosocomial causada por Klebsiella pneumoniae resistente a los carbapenémicos admitidos en los diferentes servicios de hospitalización del Hospital Nacional Guillermo Almenara Irigoyen durante el período 2019 – 2020. En el análisis estadístico se realizará usando el software STATA v12.0, se obtendrá descripción de parámetros de tendencia central (media, mediana y moda) y respectivas medidas de dispersión (desviación estándar o rango intercuartílico) para las variables cua...

La criptococosis cutánea no es una entidad habitual en pacientes receptores de trasplante de órganos sólidos (TOS). La forma cutánea localizada es descrita en pacientes inmunocomprometidos y probablemente sea secundaria a una reactivación de un estado latente en ganglios linfáticos o pulmón, además requiere exclusión de compromiso sistémico. Se presenta el caso de una mujer de 40 años receptora de trasplante renal hace 1 año, en inmunosupresión con tacrolimus y prednisona, que desarrolló en 1 semana lesión en cara interna de muslo izquierdo sugestiva de celulitis bacteriana. Se inició tratamiento antibiótico de amplio espectro, pero la lesión progresó a una úlcera necrótica con necesidad de limpieza quirúrgica. La biopsia cutánea evidenció dermatitis nodular crónica granulomatosa no caseificante con múltiples levaduras de criptococo. Se aisló Cryptococcus neofo...

La criptococosis cutánea es una entidad infrecuente en pacientes receptores de trasplante de órganos sólidos (TOS). La forma cutánea localizada es descrita en pacientes inmunocomprometidos y probablemente sea secundaria a una reactivación de un estado latente en ganglios linfáticos o pulmón, además requiere exclusión de compromiso sistémico. Presentamos el caso de una mujer de 40 años receptora de trasplante renal hace 1 año, en inmunosupresión con tacrolimus y prednisona, que desarrolló en 1 semana lesión en cara interna de muslo izquierdo sugestiva de celulitis bacteriana. Se inició tratamiento antibiótico de amplio espectro, pero la lesión progresó a una úlcera necrótica con necesidad de limpieza quirúrgica. La biopsia cutánea evidenció dermatitis nodular crónica granulomatosa no caseificante con múltiples levaduras de criptococo. Se aisló Cryptococ...

La criptococosis cutánea es una entidad infrecuente en pacientes receptores de trasplante de órganos sólidos (TOS). La forma cutánea localizada es descrita en pacientes inmunocomprometidos y probablemente sea secundaria a una reactivación de un estado latente en ganglios linfáticos o pulmón, además requiere exclusión de compromiso sistémico. Presentamos el caso de una mujer de 40 años receptora de trasplante renal hace 1 año, en inmunosupresión con tacrolimus y prednisona, que desarrolló en 1 semana lesión en cara interna de muslo izquierdo sugestiva de celulitis bacteriana. Se inició tratamiento antibiótico de amplio espectro, pero la lesión progresó a una úlcera necrótica con necesidad de limpieza quirúrgica. La biopsia cutánea evidenció dermatitis nodular crónica granulomatosa no caseificante con múltiples levaduras de criptococo. Se aisló Cryptococ...

Objetive: this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. Results: Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia ...

Acinetobacter baumannii has been described as a cause of serious community-acquired infections in tropical countries. Currently, its implications when simultaneously identified with other pathogens are not yet adequately understood. A descriptive study was conducted on hospitalized patients with a diagnosis of moderate/severe SARS-CoV-2-induced pneumonia confirmed via real-time RT-PCR. Patients aged > 18 years who were admitted to a specialized COVID-19 treatment center in Peru were selected for enrollment. A. baumannii was detected via the PCR amplification of the blaOXA-51 gene obtained from nasopharyngeal swabs within 48 h of hospitalization. A total of 295 patients with COVID-19 who met the study inclusion criteria were enrolled. A. baumannii was simultaneously identified in 40/295 (13.5%) of COVID-19-hospitalized patients. Demographic data and comorbidities were comparable in both A...

The impact of respiratory coinfections in COVID-19 is still not well understood despite the growing evidence that consider coinfections greater than expected. A total of 295 patients older than 18 years of age, hospitalized with a confirmed diagnosis of moderate/severe pneumonia due to SARSCoV-2 infection (according to definitions established by the Ministry of Health of Peru) were enrolled during the study period. A coinfection with one or more respiratory pathogens was detected in 154 (52.2%) patients at hospital admission. The most common coinfections were Mycoplasma pneumoniae (28.1%), Chlamydia pneumoniae (8.8%) and with both bacteria (11.5%); followed by Adenovirus (1.7%), Mycoplasma pneumoniae/Adenovirus (0.7%), Chlamydia pneumoniae/Adenovirus (0.7%), RSVB/Chlamydia pneumoniae (0.3%) and Mycoplasma pneumoniae/Chlamydia pneumoniae/Adenovirus (0.3%). Expectoration was less frequent ...

The impact of respiratory coinfections in COVID-19 is still not well understood despite the growing evidence that consider coinfections greater than expected. A total of 295 patients older than 18 years of age, hospitalized with a confirmed diagnosis of moderate/severe pneumonia due to SARS-CoV-2 infection (according to definitions established by the Ministry of Health of Peru) were enrolled during the study period. A coinfection with one or more respiratory pathogens was detected in 154 (52.2%) patients at hospital admission. The most common coinfections were Mycoplasma pneumoniae (28.1%), Chlamydia pneumoniae (8.8%) and with both bacteria (11.5%); followed by Adenovirus (1.7%), Mycoplasma pneumoniae/Adenovirus (0.7%), Chlamydia pneumoniae/Adenovirus (0.7%), RSV-B/Chlamydia pneumoniae (0.3%) and Mycoplasma pneumoniae/Chlamydia pneumoniae/Adenovirus (0.3%). Expectoration was less frequen...

The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (32 control, 30 group 1, 31 group 2). The median time to effective therapy was significantly shorter in group 2 compared to group 1 and control group, respectively (3.75 vs. 10 h, p = 0.004; 3.75 vs. 19 h, p < 0.001). No significant differences in terms of relapse of bacteremia, in-hospital mortalit...