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Brotes de salmonelosis y el tamaño y rol del Estado en Chile
(2012)
Alberto Fica
;
Gerardo Acosta
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Jeannette Dabanch
;
Cecilia Perret
;
Marisa Torres
Scopus© Citations 12 1
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<i>Notes from the Field:</i> Scrub Typhus Outbreak — Los Lagos Region, Chile, January–February 2023
(2023)
WEITZEL, THOMAS
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Constanza Martínez-Valdebenito
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Gerardo Acosta-Jamett
;
Katia Abarca
6Scopus© Citations 4
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A multispecies outbreak of carbapenem-resistant bacteria harboring the blaKPC gene in a non-classical transposon element
(2021)
Aniela Wozniak
;
Cristian Figueroa
;
Francisco Moya-Flores
;
Piero Guggiana
;
Claudia Castillo
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p><jats:italic>Klebsiella pneumoniae</jats:italic> is the most frequent KPC-producing bacteria. The <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene is frequently embedded in Tn4401 transposon, and less frequently in non-Tn4401 elements (NTE<jats:sub>KPC</jats:sub>) variants I-III. The first case of KPC in the UC-CHRISTUS Clinical Hospital was detected in <jats:italic>Pseudomonas aeruginosa</jats:italic>. Soon after this event, KPC was detected in 2 additional <jats:italic>Pseudomonas aeruginosa</jats:italic>, 3 <jats:italic>Escherichia coli</jats:italic>, 3 <jats:italic>Enterobacter cloacae</jats:italic>, 3 <jats:italic>Klebsiella pneumoniae,</jats:italic> and 1 <jats:italic>Citrobacter freundii</jats:italic>, isolated from 6 different patients. We aimed to elucidate the possible mechanisms of genetic transfer and dissemination of the <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene among isolates of this multispecies outbreak. A molecular epidemiology analysis of the above mentioned clinical isolates (<jats:italic>n</jats:italic> = 13) through Multi-Locus Sequence Typing, plasmid analysis, Pulsed-Field Gel-Electrophoresis, and Whole-genome sequencing (WGS) was performed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>High-risk sequence types were found: <jats:italic>K. pneumoniae</jats:italic> ST11, <jats:italic>P. aeruginosa</jats:italic> ST654, and <jats:italic>E. cloacae</jats:italic> ST114. All enterobacterial isolates were not clonal except for 3 <jats:italic>E. coli</jats:italic> isolated from the same patient. WGS analysis in 6 enterobacterial isolates showed that 4 of them had <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> embedded in a novel variant of NTE<jats:sub>KPC</jats:sub> designated NTE<jats:sub>KPC</jats:sub>-IIe. Upstream of <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene there was a 570 pb truncated <jats:italic>bla</jats:italic><jats:sub>TEM-1</jats:sub> gene followed by an insertion sequence that was 84% similar to ISEc63, a 4473 bp element of the Tn3 family. Downstream the <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene there was a truncated ISKpn6 gene, and the inverted repeat right sequence of Tn4401. The ISec63-like element together with the <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene plus Tn4401 remnants were inserted in the Tra operon involved in conjugative transfer of the plasmid. This NTE was carried in a broad host-range IncN plasmid. <jats:italic>P. aeruginosa</jats:italic> isolates carried <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> gene embedded in a typical Tn4401b transposon in a different plasmid, suggesting that there was no plasmid transfer between <jats:italic>Enterobacteriaceae</jats:italic> and <jats:italic>P. aeruginosa</jats:italic> as initially hypothesized.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Most enterobacterial isolates had <jats:italic>bla</jats:italic><jats:sub>KPC</jats:sub> embedded in the same NTE<jats:sub>KPC</jats:sub>-IIe element, suggesting that this multispecies KPC outbreak was due to horizontal gene transfer rather than clonal spread. This poses a greater challenge to infection control measures often directed against containment of clonal spread.</jats:p> </jats:sec>
Scopus© Citations 21 3
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Implementation of physiotherapy telerehabilitation before and post Covid-19 outbreak: A comparative narrative between South American countries and Australia
(2022)
Antonio Michell
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BESOMI MOLINA, MANUELA
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Pamela Seron
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Matías Voigt
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Rodrigo Cubillos
<jats:p>The continuous development in telecommunication technologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These technological advances, along with the demographic and social characteristics of each country, have made the implementation of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Oceania and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.</jats:p>
Scopus© Citations 13 2
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Genomic Epidemiology of Vancomycin-Resistant Enterococcus faecium (VREfm) in Latin America: Revisiting The Global VRE Population Structure
(2020)
Rafael Rios
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Jinnethe Reyes
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Lina P. Carvajal
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Sandra Rincon
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Diana Panesso
<jats:title>Abstract</jats:title><jats:p>Little is known about the population structure of vancomycin-resistant <jats:italic>Enterococcus faecium</jats:italic> (VR<jats:italic>Efm</jats:italic>) in Latin America (LATAM). Here, we provide a complete genomic characterization of 55 representative Latin American VR<jats:italic>Efm</jats:italic> recovered from 1998–2015 in 5 countries. The LATAM VR<jats:italic>Efm</jats:italic> population is structured into two main clinical clades without geographical clustering. Using the LATAM genomes, we reconstructed the global population of VR<jats:italic>Efm</jats:italic> by including 285 genomes from 36 countries spanning from 1946 to 2017. In contrast to previous studies, our results show an early branching of animal related isolates and a further split of clinical isolates into two sub-clades within clade A. The overall phylogenomic structure of clade A was highly dependent on recombination (54% of the genome) and the split between clades A and B was estimated to have occurred more than 2,765 years ago. Furthermore, our molecular clock calculations suggest the branching of animal isolates and clinical clades occurred ~502 years ago whereas the split within the clinical clade occurred ~302 years ago (previous studies showed a more recent split between clinical an animal branches around ~74 years ago). By including isolates from Latin America, we present novel insights into the population structure of VR<jats:italic>Efm</jats:italic> and revisit the evolution of these pathogens.</jats:p>
1Scopus© Citations 47 1
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Trust predicts COVID-19 prescribed and discretionary behavioral intentions in 23 countries
(2021)
Stefano Pagliaro
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Simona Sacchi
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Maria Giuseppina Pacilli
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Marco Brambilla
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Francesca Lionetti
<jats:p>The worldwide spread of a new coronavirus (SARS-CoV-2) since December 2019 has posed a severe threat to individuals’ well-being. While the world at large is waiting that the released vaccines immunize most citizens, public health experts suggest that, in the meantime, it is only through behavior change that the spread of COVID-19 can be controlled. Importantly, the required behaviors are aimed not only at safeguarding one’s own health. Instead, individuals are asked to adapt their behaviors to protect the community at large. This raises the question of which social concerns and moral principles make people willing to do so. We considered in 23 countries (<jats:italic>N</jats:italic> = 6948) individuals’ willingness to engage in prescribed and discretionary behaviors, as well as country-level and individual-level factors that might drive such behavioral intentions. Results from multilevel multiple regressions, with country as the nesting variable, showed that publicized number of infections were not significantly related to individual intentions to comply with the prescribed measures and intentions to engage in discretionary prosocial behaviors. Instead, psychological differences in terms of trust in government, citizens, and in particular toward science predicted individuals’ behavioral intentions across countries. The more people endorsed moral principles of fairness and care (vs. loyalty and authority), the more they were inclined to report trust in science, which, in turn, statistically predicted prescribed and discretionary behavioral intentions. Results have implications for the type of intervention and public communication strategies that should be most effective to induce the behavioral changes that are needed to control the COVID-19 outbreak.</jats:p>
Scopus© Citations 143 1
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Effectiveness of CoronaVac in children 3–5 years of age during the SARS-CoV-2 Omicron outbreak in Chile
(2022)
Alejandro Jara
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Eduardo A. Undurraga
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José R. Zubizarreta
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Cecilia González
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Acevedo, Johanna
<jats:title>Abstract</jats:title><jats:p>The outbreak of the B.1.1.529 lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Omicron) has caused an unprecedented number of Coronavirus Disease 2019 (COVID-19) cases, including pediatric hospital admissions. Policymakers urgently need evidence of vaccine effectiveness in children to balance the costs and benefits of vaccination campaigns, but, to date, the evidence is sparse. Leveraging a population-based cohort in Chile of 490,694 children aged 3–5 years, we estimated the effectiveness of administering a two-dose schedule, 28 days apart, of Sinovac’s inactivated SARS-CoV-2 vaccine (CoronaVac). We used inverse probability-weighted survival regression models to estimate hazard ratios of symptomatic COVID-19, hospitalization and admission to an intensive care unit (ICU) for children with complete immunization over non-vaccination, accounting for time-varying vaccination exposure and relevant confounders. The study was conducted between 6 December 2021 and 26 February 2022, during the Omicron outbreak in Chile. The estimated vaccine effectiveness was 38.2% (95% confidence interval (CI), 36.5–39.9) against symptomatic COVID-19, 64.6% (95% CI, 49.6–75.2) against hospitalization and 69.0% (95% CI, 18.6–88.2) against ICU admission. The effectiveness against symptomatic COVID-19 was modest; however, protection against severe disease was high. These results support vaccination of children aged 3–5 years to prevent severe illness and associated complications and highlight the importance of maintaining layered protections against SARS-CoV-2 infection.</jats:p>
Scopus© Citations 82 8
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Epidemic preparedness in urban settings: new challenges and opportunities
(2020)
Vernon J Lee
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Marc Ho
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Chen Wen Kai
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AGUILERA SANHUEZA, XIMENA PAZ
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David Heymann
17Scopus© Citations 93
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Prevención de una epidemia de sarampión en la Casa Nacional del Niño. Publicado en Revista Chilena de Pediatría el año 1933.
(2019)
LUISA SCHONHAUT BERMAN
;
Guillermo Repetto D.
6
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Sarampión: antecedentes históricos y situación actual
(2019)
Ricardo Fadic R.
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Guillermo Repetto D.
4Scopus© Citations 7

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