Browsing by Autor "Maydelin Pecchio"

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Mesoamerican Nephropathy in Central Panama
(2022) Karen Courville; Norman Bustamante; Bárbara Hurtado; Maydelin Pecchio; Clarissa Rodríguez; Virginia Núñez-Samudio; Iván Landires
Abstract Background In the last three decades, there has been an increase in the frequency of patients diagnosed with chronic kidney disease of nontraditional causes (CKDnt) in the Mesoamerican region. A region with an increased frequency of patients with chronic kidney disease (CKD) has been identified in central Panama. The present study aims to characterize the clinical presentation of patients with CKDnt in an understudied population of the central region of Panama and compare them with patients with traditional CKD (CKDt). Methods A retrospective descriptive study was conducted in a nephrology reference hospital in the central provinces of Herrera and Los Santos, comparing a group of 15 patients with CKDnt to 91 patients with CKDt. Sociodemographic variables, personal history, laboratory parameters, and of renal ultrasound were compared. Results CKDnt is more common among relatively younger male patients who engage in strenuous work activities at high temperatures. CKDnt is not associated with type 2 diabetes mellitus or chronic hypertension, as it is the case in patients with CKDt. Renal atrophy and hyperuricemia are significant clinical markers of CKDnt. Conclusion To our knowledge, this is the first study in Panama and one of the few in Central America and the world to address the clinical presentation of patients with CKDnt compared to patients with CKDt. Because CKDnt remains asymptomatic for a long time, early detection is important, and efforts should be directed at halting disease progression at an early stage. Current evidence can also inform policies addressing occupational and environmental risk factors associated with CKDnt.
Molecular Epidemiology of Escherichia coli Clinical Isolates from Central Panama
(Multidisciplinary Digital Publishing Institute, 2021) Virginia Núñez-Samudio; Maydelin Pecchio; Gumercindo Pimentel-Peralta; Yohana Quintero; Mellissa Herrera; Iván Landires
Escherichia coli represents one of the most common causes of community-onset and nosocomial infections. Strains carrying extended spectrum β-lactamases (ESBL) are a serious public health problem. In Central America we have not found studies reporting the molecular epidemiology of E. coli strains implicated in local infections, so we conducted this study to fill that gap. Materials and Methods: We report on an epidemiological study in two reference hospitals from central Panama, identifying the susceptibility profile, associated risk factors, and molecular typing of E. coli strains isolated between November 2018 and November 2019 using Pasteur's Multilocus Sequence Typing (MLST) scheme. Results: A total of 30 E. coli isolates with antimicrobial resistance were analyzed, 70% of which came from inpatients and 30% from outpatients (p < 0.001). Two-thirds of the samples came from urine cultures. Forty-three percent of the strains were ESBL producers and 77% were resistant to ciprofloxacin. We identified 10 different sequence types (STs) with 30% of the ESBL strains identified as ST43, which corresponds to ST131 of the Achtman MLST scheme-the E. coli pandemic clone. Thirty-eight percent of the E. coli strains with the ESBL phenotype carried CTX-M-15. Conclusions: To the best of our knowledge, this is the first report confirming the presence of the pandemic E. coli clone ST43/ST131 harboring CTX-M-15 in Central American inpatients and outpatients. This E. coli strain is an important antimicrobial-resistant organism of public health concern, with potential challenges to treat infections in Panama and, perhaps, the rest of Central America.
Molecular Genetic Epidemiology of an Emerging Antimicrobial-Resistant Klebsiella pneumoniae Clone (ST307) Obtained from Clinical Isolates in Central Panama
(Multidisciplinary Digital Publishing Institute, 2022) Virginia Núñez-Samudio; Gumercindo Pimentel-Peralta; Mellissa Herrera; Maydelin Pecchio; Johana Quintero; Iván Landires
We present the first report on ST307 in three reference hospitals in the central region of Panama, which is a high-risk emerging clone and represents a public health alert for potential difficulties in managing K. pneumoniae infections in Panama, and which may extend to other Central American countries.