Tanise V. Dalmolin1,2, Daiana de Lima-Morales1, Afonso L. Barth1,2*

1LABRESIS – Laboratório de Pesquisa em Resistência Bacteriana, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

2Programa De Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

Polymyxins (polymyxin E/colistin and polymyxin B) are considered the last-resort therapy against carbapenem-resistant Enterobacterales; however, the resistance of Enterobacterales to polymyxins is increasing worldwide. Until 2015, this resistance was related to chromosomal mutations, but in November 2015, it was described in China the transferable colistin resistance in animals and humans isolates of E. coli and K. pneumoniae, mediated by the mcr-1 gene (mobile colistin resistance), located in a plasmid. Following the first description of the mcr-1 gene, it has been reported in several regions of the world, in different bacterial species, from different sources and others mcr variants have been described. Moreover, the co-occurence of the mcr gene and other antimicrobial resistance genes was reported. This discovery changed the scenario of resistance to polymyxins, as this gene could be promptly disseminated among Gram negative bacilli becoming a major concern for public health. This review summarizes recent data about the plasmid-borne mcr colistin resistance gene.

DOI: 10.29245/2689-9981/2018/2.1109 View / Download Pdf

Erik De Clercq*

Rega Institute for Medical Research, KU Leuven, Herestraat 49, B-3000 Leuven, Belgium

DOI: 10.29245/2689-9981/2018/2.1114 View / Download Pdf

Harish C Gugnani*

Retd. Professor & Head, Division of Medical Mycology, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India

DOI: 10.29245/2689-9981/2018/2.1112 View / Download Pdf

Ashok Kuwal1*, Naveen Dutt2, Nishant Chauhan2

1Department of Respiratory Medicine, Pacific Institute of Medical Sciences, India

2Department of Pulmonary Medicine, AIIMS Jodhpur, India

Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality among patients undergoing hematopoietic stem cell transplant (HSCT). The majority of cases are detected during the period of neutropenia (following conditioning regimen) or immunosuppression (treatment of graft versus host disease). Development of IPA after one-year post- HSCT is extremely rare. Here, we report a case of a 43-year-old male who developed IPA two years after an allogenic stem cell transplant and 406 days after stopping the immunosuppressive medication.

DOI: 10.29245/2689-9981/2018/2.1111 View / Download Pdf

Jorge L Zirulnik*, Maria Sol Retamar, Hector M Perez

HIV/Infectious Diseases Division, JA Fernandez Hospital, Buenos Aires, Argentina

DOI: 10.29245/2689-9981/2018/1.1110 View / Download Pdf

Aurora Brønstad*

Department of Clinical medicine, University of Bergen, Bergen, Norway

DOI: 10.29245/2689-9981/2018/1.1107 View / Download Pdf

Eun-Jung Kim*

Department of Nursing, Pyeongtaek University, Gyung-gi, Korea

Background: This study will analyze the existing studies and provide the basis for immunity and immune duration that can be obtained by prophylactic chemotherapy.

Methods: Based on the data of the patients who take preventive chemotherapy (taking group) and those who do not (non-taking group), cost benefit analysis is conducted considering the direct and indirect benefits obtained by taking malaria treatment.

Results: The results of economic evaluation of preventive use of malaria chemoprophylaxis that higher malaria incidence rates of non-taking groups showed a (+) positive value for the NPV, a CBR of greater than 1 (1.34), so economically viable vaccine with a high benefit per cost.

Conclusion: Chemoprophylaxis could be cost-effective if the incidence of non-taking group in the risk area is maintained above 50%. Therefore, it will be possible to block the incidence of malaria in the future through analysis of the trend of incidence of malaria, and to inform the effect of the chemoprophylaxis method through educational and public relations activities.

DOI: 10.29245/2689-9981/2018/1.1102 View / Download Pdf

Licia Torres1#, Vinicius Dantas Martins2#, Ana Maria Caetano Faria2, Tatiani Uceli Maioli1,2*

1Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Universidade Federal de Minas Gerais, Brazil

2Programa de Pós-Graduação em Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Brazil

#Both authors contributed equally

The number of overweight people worldwide is steadily growing. Obesity has become a serious health problem even in developing countries where infectious diseases are still highly prevalent. However, the interactions between these two conditions are still unclear. It is known that, during obesity, lipid deposits induce metabolic alterations associated with increased pro-inflammatory status, which disrupts the body hemostasis and could impair the immune responses against microorganisms. Moreover, studies in humans and animal models with infectious diseases have demonstrated that obesity usually correlates with increased susceptibility to bacterial, viral and protozoa parasite infections. In this mini-review, we will discuss some few studies that characterized the interactions between obesity and infections to clarify why obesity-associated inflammation results in impaired protective immunity.

DOI: 10.29245/2689-9981/2018/1.1104 View / Download Pdf

Guillermo Enrique Ramos*

Department of Intensive Care Medicine, Argerich Hospital, Buenos Aires City, Argentina

As nosocomial infections in burn patients are prevalent and dangerous, systemic antibiotic prophylaxis has been considered, beside other interventions. However, this kind of therapy has been questioned due to controversy related to its effectiveness and complications, such as drug toxicity and development of multidrug-resistance. This review includes evidence reported during the period 1966-2016. The quality of evidence and strength of recommendation of these guidelines are based on the GRADE system. Early post-burn prophylaxis showed no effectiveness for toxic shock syndrome or burn wound infection prevention (Grade 1C) in non-severe burn patients but it could be useful for those who had severe burns and require mechanical ventilation (Grade 2B). Perioperative prophylaxis would neither have indications for wound cleaning nor for devitalized tissue debridement of most burn patients (Grade 2B), but there is not enough evidence to make a strong recommendation to those who have extensive burns. Finally, prophylaxis could be used to prevent skin graft infections in selected procedures (Grade 2B).

DOI: 10.29245/2689-9981/2018/1.1105 View / Download Pdf