Arturo Plascencia-Hernández

Cockroaches serve as mechanical vectors for medically important pathogens, and their presence in hospitals is a common occurrence. This review summarizes the pathogens carried by cockroaches collected in hospitals around the world during the period 2000–2024 and focuses on their antibiotic resistance mechanisms and potential impact on the public health system. The conventional techniques are most used to identify microorganisms and determine antibiotic resistance, but there are few studies that use molecular techniques for bacterial identification and resistance mechanism detection. The species that appear most frequently in the selected articles were Escherichia coli (22 articles) and Pseudomonas aeruginosa (11 articles). Regarding antibiotic resistance, this review describes 79.0% (34/43) of the studies analyzed. E. coli and P. aeruginosa bacteria were found to be resistant to antibiotics in 51.2% and 25.6% of articles, respectively. The identification of pathogens carried by cockroaches collected in hospitals suggests a potential risk of these insects in the transmission of healthcare-associated infections, mainly in developing countries, where this issue is most alarming. The collected data suggest that integrated approaches to cockroach control and infestation management should be put in place based on scientific evidence.

Cockroaches serve as mechanical vectors for medically important pathogens, and their presence in hospitals is a common occurrence. Describe the pathogens and their resistance mechanisms carried by cockroaches collected in hospitals in different parts of the world during the period 2000-2023. This will be achieved through a systematic review of the indexed literature. The studies were identified through a search of the Google Scholar search engine and in electronic databases related to health: LILACS, Scielo Regional, and PubMed. The search strategy was conducted in accordance with the principles for systematic reviews and meta-analysis (PRISMA). The review encompassed 22 studies conducted during the specified period. Blattella germanica and Periplaneta americana are referenced in 15 and 13 of the analyzed studies, respectively. A variety of pathogens, including bacteria, fungi, protozoa, helminths, and rotavirus, were isolated and identified from the external and internal body parts of cockroaches. Bacteria represent the most frequently identified group. The species that appear most frequently in the selected articles are Escherichia coli (11 articles), Staphylococcus aureus (9 articles), Klebsiella pneumoniae (7 articles), and Pseudomonas aeruginosa (6 articles). E. coli and S. aureus bacteria were found to be resistant to antibiotics in 19% and 12% of articles, respectively. Conventional techniques, including seeding in culture media, Gram staining (GS), conventional biochemical tests (CBT), direct parasitological methods, and disc diffusion, have historically been the primary methods for identifying microorganisms and determining antibiotic susceptibility profiles in bacteria. However, there is a paucity of studies that use molecular tech-niques for bacterial identification and resistance mechanism detection. The identification of pathogens carried by cockroaches collected in hospitals suggests a potential risk of these insects in the transmission of healthcare-associated infections.

Spirometra (Cestoda: Diphyllobothriidea) affects humans and some species of domestic and wild animals which eventually interact with humans. In this article, we report three new cases of Spirometra decipiens (Diesing, 1850) infection observed in two intermediate hosts and one definitive host, in Cuba. Genetic and morphological identification of S. decipiens in two snakes and a domestic dog were carried out by molecular means and routine histological study using hematoxylin–eosin staining, respectively. Taken together, the anatomical location, the host species infected with the specimens and their morphological and genetic features, all the samples were identified as S. decipiens. In each of the three cases, PCR assays using specific primers amplified bands that corresponded to S. decipiens species. To our knowledge, this paper is the first report of S. decipiens in species of Cuban endemic fauna and in the Caribbean islands. These species constitute a real or potential risk of transmission of Spirometra to humans in Cuba.

The results of the genotypic characterization of Pneumocystis jirovecii are described in lung tissue samples from 41 Cubans who died of AIDS with pneumocystosis between 1995 and 2008. Histological sections of the lung preserved as formalin-fixed and paraffin-embedded tissue were examined. PCR amplification and nucleotide sequencing of the two mitochondrial genes (large and small) of the pathogen allowed verification of a predominance of genotype 3 (85T/248C) of the large mitochondrial gene and genotype 3 (160A/196T) of the small mitochondrial gene over a period of 14 years (1995–2008). These results suggest that the 85T/248C//160A/196T genotype circulates with the highest frequency (81.3%) among AIDS patients in Cuba. Multilocus analysis indicates a limited circulation of pathogen genotypes on the island with the existence of a clonal genotype with an epidemic structure. Furthermore, it appears that circulating strains of P. jirovecii have not developed mutations related to sulfonamide resistance. Taken together, the data in this study revealed important elements about pneumocystosis in Cuban patients dying of AIDS and the usefulness of formalin-fixed and paraffin-embedded samples to carry out molecular epidemiology studies of P. jirovecii.

Key words: endocarditis; caspofungin; Candida albicans; liposomal amphotericin B

An adequate immune and antioxidant response is a key to the resolution of sepsis. Heme oxygenase-1 (HMOX1) is a stress protein with a polymorphic (GT)n repeat in its gene promoter that regulates its expression in response to oxidative injury, such as that present in sepsis. HMOX1 is the rate-limiting enzyme of heme degradation, and the heme breakdown products, CO, Fe, and bilirubin, are considered to be biologically active metabolites with direct or indirect antioxidant and anti-inflammatory properties. In this study, we investigated the inflammatory and antioxidant response and the relationship with the HMOX1 levels and HMOX1 polymorphism in Mexican septic pediatric patients. In a case-control pilot study, we enrolled 64 septic patients and 72 hospitalized control patients without a diagnosis of sepsis. DNA extracted from buffy coat was genotyped for HMOX1 (GT)n polymorphism by PCR and markers of antioxidant and inflammatory status were quantified in plasma by analysis of the oxygen radical absorbance capacity (ORAC), protein carbonyl (PC), interleukin (IL) 6, IL10, and HMOX1 levels. In septic children, oxidative and inflammatory markers were elevated, and HMOX1 levels were positively correlated with IL10 levels. Genotypic and allelic distribution of HMOX1 polymorphism showed no difference between groups. HMOX1 short-allele septic carriers (< 25 GT repeats) presented favorable ORAC, PC and IL10 levels. This study confirms that an active response against pediatric sepsis involves the expression of HMOX1 and IL10, suggesting that the high antioxidant status associated with HMOX1 short-allele septic carriers might provide a beneficial environment for sepsis resolution.

Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil.

Local sequelae of group A beta-hemolytic streptococci (GABHS) are common and can vary from otitis media, sinusitis, cervical adenitis associated with generalized adenopathy, peritonsillitis and persisting symptoms in spite of therapy, GABHS is one of the pathogens isolated in acute or chronic otitis media and in acute maxillary sinusitis. In cervical adenitis associated with generalized adenopathy GABHS is, along with S. aureus, the most commonly recovered bacteria. In peritonsillitis, GABHS can be recovered alone or in combination with anaerobes in 50% of the cases. These sequelae are usually associated with a slow clinical response to therapy and a high percentage of relapses, reinfections, and chronic infections in the presence of a penicillin-sensitive GABHS. One of the possible causes of these so-called failures is the interference that beta-lactamase producing bacteria can have on the activity of penicillin and similar compounds. When to select a beta-lactamase-resistant antibiotic for the treatment of an apparent penicillin-sensitive infection remains an important area for further research.