Introduction: Persistent high-risk human papillomavirus (HPV) infections are strongly associated with cervical cancer, the leading cause of cancer-related deaths among women aged 30-59 years in Colombia. This study presents the screening results and distribution of high-risk HPV genotypes in women enrolled in the Por Ti Mujer programme in Cali, Colombia. Materials and Methods: A cross-sectional descriptive observational study was conducted using medical records of adult women screened using conventional cytology, high-risk HPV DNA testing, and visual inspection with acetic acid and lugol's iodine. Data were collected between January and June 2023 using the Por Ti Mujer program. Results: A total of 15,130 records were analyzed. Overall positivity, regardless of screening method, was 10.2%; positivity for HPV DNA was 15.2%, and positivity for cytology was 5.4%. Women aged 30-65 years and those in the contributory health insurance scheme group had higher rates of abnormal results. The most frequent high-risk HPV genotypes were 56-59-66 (21.2%), 33-39-68 (17.0%), 16 (13.8%), 33-58 (12.1%), and 52 (11.1%). Discussion: The HPV DNA positivity rate in the Por Ti Mujer program (15.2%) was higher than the global average (10.4%), but lower than the regional Latin American estimate (16.1%). The most prevalent genotypes were 56-59-66 and 33-39-68.
Introducción la lepra es una enfermedad infecciosa de baja contagiosidad causada por 2 especies de micobacterias. Los pacientes suelen presentar emociones negativas y experiencias de estigma social asociado a ella. En Colombia, esta infección sigue representando un problema de salud pública. Objetivo analizar las representaciones sociales de médicos en diferentes servicios de urgencias de Cali, Colombia. Material y métodos se realizó una investigación cualitativa con enfoque de representaciones sociales en 25 médicos de urgencias. Se aplicó la técnica de listado libre de palabras y comparación pareada. Se realizó análisis prototípico para conocer el núcleo central y periférico de la representación, análisis procesual para conocer el contenido, e índice de distancia para conocer la organización de la representación. Resultados el término lepra se asocia al estigma y aislamiento social con orígenes religiosos e históricos, así como a creencias falsas como que es propia de la pobreza, el hacinamiento y las zonas selváticas. Se encontró desconocimiento generalizado tanto de la enfermedad como del tratamiento, principalmente por falta de experiencia, así como al temor por el contagio. Conclusiones los médicos de urgencias tienen percepciones estigmatizantes derivadas del desconocimiento sobre la enfermedad. La representación del concepto estudiado incluye elementos de construcción social, propios de enfermedad, creencias falsas y elementos emocionales.
Introducción. El manejo adecuado de la tuberculosis multirresistente es una estrategia priorizada para el control de la tuberculosis en el mundo. Objetivo. Evaluar las diferencias entre las características demográficas y clínicas, y los indicadores programáticos de los pacientes con diagnóstico confirmado de tuberculosis pulmonar resistente a rifampicina o multirresistente en Buenaventura, frente a la cohorte de los demás municipios del Valle del Cauca entre 2013 y 2016. Materiales y métodos. Se desarrolló un estudio analítico de cohortes para comparar los registros de pacientes mayores de 15 años con tuberculosis multirresistente, del Programa de Tuberculosis de Buenaventura (con ácido paraaminosalicílico), frente a los demás municipios del Valle del Cauca (sin ácido paraaminosalicílico). Resultados. Se registraron 99 casos con una mediana de edad de 40 años (RIC = 26- 53); en Buenaventura, el 56 % eran mujeres; en los demás municipios, predominaron los hombres (67 %); el 95 % de los evaluados tenía aseguramiento en salud. La comorbilidad más frecuente fue diabetes (14 %). Las reacciones adversas a medicamentos antituberculosos en Buenaventura fueron 1,3 veces más frecuentes que en los demás municipios (OR = 2,3; IC95 %: 0,993 - 5,568; p = 0,04). En Buenaventura falleció el 5 % de los casos frente al 15 % reportado en los demás municipios. No hubo fracasos con el tratamiento en Buenaventura, pero se reportó un 35 % de pérdida del seguimiento. El éxito del tratamiento fue mayor en Buenaventura en el 56 %. Conclusión. El programa fortalecido de Buenaventura presentó mejores resultados programáticos que los demás municipios del Valle del Cauca. El acceso a pruebas moleculares, la disponibilidad de tratamientos acortados y el seguimiento continuo para identificar reacciones adversas a medicamentos antituberculosos son un derrotero para todos los programas de control.
OBJECTIVE:To investigate the prevalence of non-communicable diseases among household contacts of people with tuberculosis. METHODS:We conducted a systematic review and individual participant data meta-analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non-communicable disease among household contacts of people with clinical tuberculosis. We estimated the non-communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta-analyses. Furthermore, we compared age and sex-standardised non-communicable disease prevalence with national-level estimates standardised for age and sex. RESULTS:We identified 39 eligible studies, of which 14 provided individual participant data (29,194 contacts). Of the remaining 25 studies, 18 studies reported aggregated data suitable for aggregated data meta-analysis. In individual participant data analysis, the pooled prevalence of diabetes in studies that undertook biochemical testing was 8.8% (95% confidence interval [CI], 5.1%-14.9%, four studies). Age-and sex-standardised prevalence was higher in two studies (10.4% vs. 6.9% and 11.5% vs. 8.4%) than the corresponding national estimates and similar in two studies. Prevalence of diabetes mellitus based on self-report or medical records was 3.4% (95% CI 2.6%-4.6%, 14 studies). Prevalence did not significantly differ compared to estimates from aggregated data meta-analysis. There were limited data for other non-communicable diseases. CONCLUSION:The prevalence of diabetes mellitus among household contacts was high while that of known diabetes was substantially lower, suggesting the underdiagnosis. tuberculosis household contact investigation offers opportunities to deliver multifaceted interventions to identify tuberculosis infection and disease, screen for non-communicable diseases and address shared risk factors.
El presente trabajo analiza cómo el discurso médico, conformado por los conocimientos y creencias sobre la lepra, de un grupo de profesionales de la salud internos puede influir en la relación médico-paciente. Este estudio, de carácter exploratorio y descriptivo mixto, encuentra que el estigma de la lepra se sigue reproduciendo debido a la invisibilidad de la enfermedad en la formación médica y a la carga simbólica (histórica y social) persistente. Sin embargo, un mayor conocimiento biomédico y experiencial sobre la lepra, junto con la comprensión de su dimensión sociocultural en los escenarios de formación médica, puede servir para visibilizar esta enfermedad a los ojos clínicos y atenuar las disposiciones negativas de los futuros médicos y médicas al momento de interactuar con una persona enferma.
IntroductionContact investigation is a proven intervention for tuberculosis (TB) case finding and prevention. Although widely endorsed by national public health authorities and the World Health Organization, many countries struggle to implement it effectively. The objective of the study is to describe and characterize the barriers and facilitators of TB contact investigation in Cali, Colombia from the perspective and experience of the key stakeholders involved. MethodsWe collected data from group discussions during two workshop sessions with clinic and public health staff involved in TB contact investigation (June 2019 and March 2020 respectively) and semi-structured interviews with TB cases and their household contacts (July 2019 to April 2020). We undertook an inductive thematic analysis with the RADaR technique to characterize the barriers and facilitators of the TB contact investigation process. ResultsThe two workshops included 21 clinics and 12 public health staff. We also conducted 26 semi-structured interviews with TB cases and their household contacts. Using thematic analysis, we identified four common themes: Healthcare Operations, Essential Knowledge, Time Limitations and Competing Responsibilities, and Interpersonal Interactions. The main barriers to conducting household visits were low data quality, stigma and mistrust, safety concerns for health workers, and limited resources. The main barriers to TB uptake by contacts were competing responsibilities, low TB risk perceptions among contacts, and difficulty accessing diagnostic tests for contacts. In contrast, good communication and social skills among health workers and accurate TB knowledge facilitated successful household visits and TB test uptake, according to key stakeholders. ConclusionThis study provides a deeper understanding of TB contact investigation barriers and facilitators in a high-prevalence urban setting in a middle-income country from the perspective and experience of key stakeholders. The study shed light on the barriers that hinder household contacts engagement and TB test uptake such as issues of systemic capacity and TB knowledge. Also, highlighted facilitators such as the importance of interpersonal communication skills among health workers in the public and private sector. The insights from this study can serve as a valuable resource for public health organizations seeking to enhance their contact investigation efforts and improve TB control in similar settings.
Different nematodes affect canines, however Acanthocheilonema reconditum was considered mostly a non-pathogenic parasite. Climate change, animal migration, and other factors transformed the dynamics of vector-borne diseases, including filariasis. Since 2016, a sudden increase in the number of dogs with microfilaremia was reported by different veterinary centers in Cali, southwest Colombia. The objective of this study was to molecularly identify the etiologic agent of this filariasis outbreak detected in this city, using PCR–RFLP and evaluating dogs’ clinical signs. From 2018–2019, canine filariasis cases were prospectively evaluated after a microscopic test, recruiting 82 cases and 43 healthy controls from 2971 samples. Acanthocheilonema reconditum (Nematoda, Onchocercidae) was identified in 61.3% of the cases (49/82) by PCR–RFLP. Sanger sequencing of the 5.8S ribosomal RNA gene and internal transcribed spacer-2 fragment was additionally performed on seven cases, confirming A. reconditum in all of them. The filariasis cases are statistically associated with male dogs who have clinical signs of anemia, low levels of hemoglobin and hematocrit (p < 0.0001), and high levels of plasma proteins (p < 0.001). This emerging canine disease constitutes an important public health concern among veterinarians and active surveillance is advised to explore its zoonotic potential.
Los datos disponibles de farmacovigilancia de las vacunas contra la COVID-19 en Latinoamérica son limitados. El objetivo de este estudio fue determinar la frecuencia de los eventos adversos posteriores a la vacunación (EAPV) con la primera y la segunda dosis contra la COVID-19 en estudiantes de medicina de Cali (Colombia), en el 2021. Se realizó un estudio observacional descriptivo de corte transversal en adultos voluntarios que habían recibido al menos una dosis de la vacuna BNT162b2 de Pfizer-BioNTech, y que respondieron una encuesta electrónica. De los invitados, 292 adultos con una mediana de edad de 21 años (RIC: 20-22) aceptaron participar. El 95% de ellos recibió dos dosis y el 5% una dosis, el 64,4% eran mujeres y el 76,37% reportó al menos un EAPV, todos de severidad leve. El dolor en el sitio de inyección, con un 73,6%, fue el evento más reportado. Lo siguieron EAPV sistémicos como fatiga, sueño y cefalea, con el 56,8%, 46,9% y 38,6%, respectivamente, los cuales se presentaron en mayor proporción después de la segunda dosis. Con significancia estadística, las mujeres presentaron una odds ratio de exposición mayor para dolor en el sitio de inyección y escalofríos con (OR = 1,89; IC 95%: 1,07-3,33; p = 0,01) y (OR = 3,03; IC 95%: 1,63-5,88; p = 0,0002), respectivamente, en comparación con los hombres. Otras condiciones clínicas y demográficas evaluadas no tuvieron asociación significativa con el desarrollo de eventos. Por lo tanto, en esta población, al menos un EAPV se presentó en tres de cada cuatro vacunados con BNT162b2; el dolor en el sitio de inyección, la fatiga, el sueño y el dolor de cabeza, fueron los más frecuentes. Las mujeres presentaron EAPV con más frecuencia y los EAPV sistémicos se presentaron en mayor proporción para ambos sexos tras la segunda dosis. No obstante, todos los EAPV reportados fueron leves y de corta duración.
Introducción: La pandemia COVID-19 demanda permanentes adaptaciones en la gestión según la situación epidemiológica. Objetivo: Analizar el comportamiento epidemiológico de COVID-19 en Cali post levantamiento de obligatoriedad de usar mascarillas en ambientes abiertos y cerrados, entre marzo 1 y julio 11/2022. Materiales y métodos: Estudio observacional descriptivo de casos de COVID-19 e incidencia acumulada (IA) para 7 días, con dos hitos temporales: desistimiento del uso mandatorio de mascarillas en ambientes abiertos y cerrados, usando datos publicados por el Instituto Nacional de Salud. Se evaluó la tendencia temporal con la prueba no paramétrica Mann-Kendall. Resultados: Se demostraron diferencias entre el primer y segundo hito: 922 casos en 75 días versus 12.037 en 59 días; Tau -0,22 versus 0,57, S -608 versus 968, Var(S) 47.574,66 versus 233.280,66; pendiente de Sen -0,10 (IC95%: -0,18 y -0,03) versus 7,39 (IC95%: 5,23 y 8,88). Luego del segundo hito, la IA aumentó con tendencia positiva (p=0,006). Conclusiones: El aumento significativo de casos de COVID-19 y de IA coincidió con el levantamiento de la medida de usar mascarillas en espacios cerrados. Por tanto, se apoya el regresar al uso de mascarillas en espacios cerrados, reforzar la gestión infodémica, promover la vacunación y acrecentar la ventilación natural.
Introducción: La pandemia COVID-19 demanda permanentes adaptaciones en la gestión según la situación epidemiológica. Objetivo: Analizar el comportamiento epidemiológico de COVID-19 en Cali (Colombia) post levantamiento de obligatoriedad de usar mascarillas en ambientes abiertos y cerrados, entre marzo 1 y julio 11 de 2022. Materiales y métodos: Estudio observacional descriptivo de casos de COVID-19 e incidencia acumulada (IA) para 7 días, con dos hitos temporales: desistimiento del uso mandatorio de mascarillas en ambientes abiertos y cerrados, usando datos publicados por el Instituto Nacional de Salud. Se evaluó la tendencia temporal con la prueba no paramétrica Mann-Kendall. Resultados: Se demostraron diferencias entre el primer y segundo hito: 922 casos en 75 días versus 12.037 en 59 días; Tau=-0,22 versus 0,57, S=-608 versus 968, Var(S)=47.574,66 versus 233.280,66; pendiente de Sen=-0,10 (IC95%: -0,18 y -0,03) versus 7,39 (IC95%: 5,23 y 8,88). Luego del segundo hito, la IA aumentó con tendencia positiva (S=23, p=0,006). Conclusiones: El aumento significativo de casos de COVID-19 y de IA coincidió con el levantamiento de la medida de usar mascarillas en espacios cerrados. Por tanto, se apoya el regresar al uso de mascarillas en espacios cerrados, reforzar la gestión infodémica, promover la vacunación y acrecentar la ventilación natural.
Objetivo: Describir la frecuencia, las características clínicodemográficas y los factores relacionados con el retraso diagnóstico, con tratamientos incompletos y con el desarrollo de discapacidad entre el ingreso y el egreso de pacientes inscritos en el “Programa de Control de la Enfermedad de Hansen del Valle del Cauca”, de 2010 a 2016. Metodología: Se realizó un estudio observacional descriptivo de una cohorte retrospectiva de pacientes con lepra. Resultados: La incidencia promedio fue de 0,99 casos / 100 000 habitantes. La mediana de edad fue 54 años (rango intercuartílico: 39-65); el 58,82 % fueron hombres, el 49,73 % pertenecía al régimen subsidiado. El 83,68 % fueron casos nuevos, de los cuales, el 76,47 % eran multibacilares (47,9 % con lepra lepromatosa). El 59,54 % manifestó discapacidad y el 10,54 % tuvo leprorreacciones. El 50% presentó retraso diagnóstico, y el 9,09 %, abandonó tratamiento. Se encontró dependencia significativa entre retraso diagnóstico y discapacidad al ingreso (or: 2,09, ic 95 %: 1,28- 3,41, p = 0,003), y entre la no finalización del tratamiento y ser previamente tratado (or: 2,82, ic 95 %: 1,28-6,18, p = 0,009). Conclusión: La lepra continúa siendo frecuente en el Valle del Cauca. El retraso diagnóstico y el ingreso con alguna discapacidad connotan captación tardía de los pacientes y en estadios avanzados. El abandono y la discapacidad al egreso se suman a la complejidad de la situación. Se evidencia la necesidad de fortalecer las intervenciones actuales dirigidas hacia el paciente, sus contactos domiciliarios, el personal de salud y la comunidad en general.
Nontuberculous mycobacteria (NTM) are ubiquitous microorganisms naturally resistant to antibiotics and disinfectants that can colonize drinking water supply systems. Information regarding the spread of NTM in specifically South America and Colombia is limited. We aimed to identify and characterize NTM present in tap water samples from Cali, Colombia. Drinking water samples and faucet biofilm swabs were collected in 18 places, including the city’s three main water treatment plants (WTPs). Filter-trapped material and eluates (0.45 μm) from swab washes were plated in 7H11 agar plates. Suspected colonies were evaluated microscopically, and NTM species were identified based on the rpoB gene. Antibiotic susceptibility testing was also performed. Fifty percent (9/18) of sampling points were positive for NTM (including two WTPs), from which 16 different isolates were identified: Mycobacterium mucogenicum (8/16), M. phocaicum (3/16), M. chelonae (2/16), M. mageritense (2/16), and M. fortuitum (1/16), all rapidly growing mycobacteria. A susceptibility profile was obtained from 68.75% (11/16) of the isolates. M. chelonae was the most resistant species. All NTM isolated are potentially responsible for human diseases; our findings might provide a baseline for exploring NTM transmission dynamics and clinical characterization, as well as potential associations between NTM species found in drinking water and isolates from patients.
Introduction: Pulmonary disease produced by nontuberculous mycobacteria and pulmonary tuberculosis can share clinical signs and symptoms. It is important to discern one from the other in order to provide the proper treatment and programmatic management. Objective: To describe the frequency of nontuberculous mycobacteria isolated from patients registered in the tuberculosis control program in Cali. Methods: We conducted a descriptive study to know what extent of the pulmonary tuberculosis load in Cali-Colombia corresponds to nontuberculous mycobacteria, in a four-year period, 2014-2017. Demographic (sex, age, health insurance), clinical (diagnosis dates, laboratory data, comorbidities) and programmatic data (tuberculosis treatment initiation and duration) was collected for statistical analysis. Results: Of 3,651 patients registered in the local tuberculosis program with an initial diagnosis of pulmonary tuberculosis, 2,904 had sputum culture and among them 1.5% (43/2904) had nontuberculous mycobacteria isolation rather than Mycobacterium tuberculosis. Most of the nontuberculous mycobacteria isolates were not identified at the species level; M. fortuitum and M. abscessus were the most common species identified. 86% of patients initiated unnecessary tuberculosis treatment. Conclusion: Nontuberculous mycobacteria isolation from pulmonary samples could be frequent in patients registered in the tuberculosis program in Cali, Colombia. The lack of clinical suspicion, the limited laboratory infrastructure, and the absence of a reporting system could be contributing factors to underestimate the importance of nontuberculous mycobacteria in this setting. We recommend that nontuberculous mycobacteria identification should be considered for public health intervention.
Bioactive secondary metabolite production from endophytic fungi has gained a recurring research focus in recent decades as these microorganisms represent an unexplored biological niche for their diverse biotechnological potential. Despite this focus, studies involving tropical endophytes remain scarce, particularly those isolated from medicinal plants of these ecosystems. In addition, the state of the art of the pharmaceutical industry has experienced stagnation in the past 30years, which has pushed pathogenic infections to get one step ahead, resulting in the development of resistance to existing treatments. Here, five fungal endophytes were isolated from the medicinal plant Otoba gracilipes (Myristicaceae), which corresponded to the genera Xylaria and Diaporthe, and screened to demonstrate the promissory potential of these microorganisms for producing bioactive secondary metabolites with broad-spectrum antibacterial activities. Thus, the evaluation of crude organic extracts obtained from the mycelia and exhaust medium allowed the elucidation of Xylaria sp. and Diaporthe endophytica potential toward providing crude extracellular extracts with promising bioactivities against reference strains of Escherichia coli (ATCC 25922) and Staphylococcus aureus (ATCC 25923), according to the determined half-maximum inhibitory concentration (IC50) with values down to 3.91 and 10.50mg/ml against each pathogen, respectively. Follow-up studies provided insights into the polarity nature of bioactive compounds in the crude extracts through bioactivity guided fractionation using a polymeric resin absorbent alternative extraction procedure. In addition, evaluation of the co-culturing methods demonstrated how this strategy can enhance endophytes biosynthetic capacity and improve their antibacterial potential with a 10-fold decrease in the IC50 values against both pathogens compared to the obtained values in the preliminary evaluations of Xylaria sp. and D. endophytica crude extracts. These results support the potential of Colombian native biodiversity to provide new approaches concerning the global emergence of antibiotics resistance and future production of undiscovered compounds different from the currently used antibiotics classes and simultaneously call for the value of preserving native habitats due to their promising ecosystemic applications in the biotechnological and pharmaceutical industries.
Este libro está dirigido a la comunidad académica, científica y en general a aquellas personas interesadas en ampliar sus conocimientos sobre la tuberculosis. Iniciamos con una revisión general de la evolución de las metodologías diagnósticas. Posteriormente, destacamos diferentes trabajos de investigación realizados en Cali y el Valle del Cauca en torno a la tuberculosis, resaltando herramientas empleadas para la vigilancia epidemiológica de la enfermedad, así como el estudio de la tuberculosis en población vulnerable (tuberculosis infantil y la incidencia de esta enfermedad en trabajadores de la salud en los últimos años en Cali). Este libro resalta la necesidad de entender el enfoque humano que rodea esta enfermedad, en esa dirección los dos últimos capítulos los enfocamos en las creencias sobre la tuberculosis y la interacción del paciente con las entidades prestadoras de servicios de salud. Esperamos que nuestro libro genere importantes aportes a aquellos que se involucran en el estudio de esta enfermedad que ha acompañado al hombre probablemente desde su presencia en el planeta y sea, además, el insumo de futuros investigadores en las diversas áreas del conocimiento que confluyen en el entendimiento de esta enfermedad infecciosa.
Tuberculosis (TB) contact investigation facilitates earlier TB diagnosis and initiation of preventive therapy, but little data exist about the quality of its implementation. We conducted a retrospective cohort study to evaluate processes of TB contact investigation for index TB patients diagnosed in Cali, Colombia, in 2017, including dropout at each stage and overall yield. We constructed multivariable models to identify predictors of completing 1) the baseline household visit and 2) a follow-up clinic visit for TB evaluation among referred contacts. Sixty-eight percent (759/1,120) of registered TB patients were eligible for contact investigation; 77% (582/759) received a household visit. Odds of completing a household visit were significantly lower among men (adjusted odds ratio [aOR]: 0.6; 95% CI: 0.4-0.9; P = 0.009) and patients living in Cali's western zone (aOR: 0.5; 95% CI: 0.3-0.8; P = 0.008). Among 1880 screened contacts, 31% (n = 582) met the criteria for clinic referral, 47% (n = 271) completed a clinic visit, and 85% (231/271) completed testing. After adjusting for clustering by index patient, odds of completing referral were higher among contacts with cough (aOR: 22; 95% CI: 7.1-66; P < 0.001) and contacts living in the western zone (aOR: 4.1; 95% CI: 1.2-15; P = 0.03). The cumulative probability of a symptomatic contact from an eligible household completing TB evaluation was only 28%. The yield of active TB patients among contacts was only 0.3% (5/1880). Only 16% (17/103) of children aged < 5 years and none of the eight persons living with HIV, reported preventive therapy initiation. Routine monitoring of process indicators may facilitate quality improvement to close gaps in contact tracing and increase yield.
Reports of infection and/or disease caused by non-tuberculous mycobacteria (NTM) are becoming increasingly frequent. This scope review describes the epidemiological and clinical trend of infection/disease caused by NTM in Latin America. OVID MEDLINE, Embase and LILACS databases were explored for relevant articles. After filtering, we included 44 articles, representing an overall population of 2,826 subjects diagnosed with NTM infection and disease; the majority of the publications included subjects from Brazil and Colombia (75%), cross-sectional studies were the most common (36.6%), most subjects were male (61.3%) and the median age of subjects was 40.1 years. Disease by NTM was reported in 37 publications, extrapulmonary presentation was the most frequent (54%), main comorbidities were other pulmonary diseases, HIV, cystic fibrosis, diabetes and malnutrition, as reported in 13 studies; tuberculosis diagnosis previous to NTM disease was reported in 15 articles. Aesthetic procedures were reported in 12 articles while clinical procedures were reported in 3 articles. Several NTM species were reported, being Mycobacterium avium (52%), M. abscessus (34%), M. chelonae (18%), M. fortuitum (16%) and M. kansasii (9.1%) the most frequent. Culture and molecular testing were the main methods for diagnosis and identification. Scientific literature on NTM from Latin American countries is scarce. There is an urgent need to conduct studies on the frequency and clinical impact of NTM infections, in order to accurately identify the current morbidity and mortality associated with NTM in Latin American. It is also important to strengthen the local diagnostic capacity and the existing networks focused on studying NTM.
Beijing strains of Mycobacterium tuberculosis (lineage 2) have been associated with drug-resistance and transmission of tuberculosis worldwide. Most of the Beijing strains identified in the Colombian Pacific coast have exhibited a multidrug resistant (MDR) phenotype. We sought to evaluate the clonality and sublineage of Beijing strains circulating in Southwestern Colombia. Thirty-seven Beijing strains were identified through spoligotyping out of 311 clinical isolates collected in 9 years from 2002-2010. Further analysis by MIRU-VNTR 24 loci was conducted for the Beijing strains. For sublineage classification, deletions of RD105, RD207, and RD131 and point mutations at fbpB, mutT2, and acs were evaluated. Drug-resistance associated mutations to first-and second-line anti-TB drugs were also evaluated. Additionally, two Beijing strains were Illumina-whole genome sequenced (one MDR and one drug-susceptible). Among the 37 Beijing strains characterized, 36 belonged to the SIT190 type from which 28 were MDR, four pre-extensively drug resistant (XDR) TB, and four XDR-TB. The remaining strain was SIT1 and drug susceptible. MIRU-VNTR analysis allowed the identification of three Beijing clusters and two unique strains. Beijing strains were confirmed as "modern" sublineage. The mutations rpoB S531L and katG S315T were the most common among MDR strains. Moreover, the two strains evaluated by whole genome sequencing (WGS) shared most of the genetic features with the sublineage 2.2.1 "modern" Beijing previously characterized from Asian strains. WGS analysis of the MDR strain revealed the presence of eight SNPs previously reported in other MDR "Beijing-like" strains from Colombia. The presence of "modern" Beijing strains in Southwestern Colombia, most of them with MDR phenotype, suggests a different origin of this M. tuberculosis sublineage compared to other Beijing strains found in neighboring South American countries. This work may serve as a genetic baseline to study the evolution and spread of M. tuberculosis Beijing strains in Colombia, which play an important role in the propagation of MDR-TB.
Different nematodes affect canines, however, Dirofilaria immitis is the most prevalent filariae. D. immitis causes heartworm disease that can be fatal for dogs and potentially transmitted to humans. Climate change, animal migration, among other factors have changed the dynamics of vector-borne diseases, including filariasis. In the last four years, a sudden increase of dogs with microfilaremia was reported by different veterinary centers in Cali, the main city of Southwest Colombia. The objective of this study was to molecularly identify the etiologic agent of this filariasis outbreak reported in this area from 2018-2019, using a novel PCR–RFLP method. Those filariasis cases were initially detected by microscopic and serological tests. A total of 82 canine filariasis cases were molecularly analyzed, identifying 55 (67%) of them as Acantacheilonema reconditum. PCR-sequencing was performed in eight cases confirming this finding. The filariasis cases were statistically associated with male dogs who had clinical signs of anemia, with low levels of hemoglobin and hematocrit (p <0.0001), and high levels of plasma proteins (p <0.001). This emerging canine disease constitutes an important public health concern among clinicians and advises active surveillance to explore its zoonotic potential.