Luque Chipana, Nestor Alejandro

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Luque Chipana, Nestor Alejandro
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Luque Chipana, Nestor Alejandro
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Luque, Nestor Alejandro
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Universidad Peruana Unión
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  • Publicacion
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    blaOXA−51-Negative Acinetobacter calcoaceticus–baumannii Complex as a Cause of Human Infection in Peru
    (John Wiley and Sons Ltd, 2025-01-01)
    Oporto-Llerena, Rosario
    ;
    Huerto-Huanuco, Rosario
    ;
    Quispe-Hualpa, Yaneth
    ;
    Palomino-Kobayashi, Luciano A.
    ;
    Soza, Gabriela
    Background Common identification techniques do not differentiate among members of the Acinetobacter calcoaceticus–baumannii (ACB) complex, and the presence of non‐ baumannii Acinetobacter is often misinterpreted. The <jats:italic/jats:italic> l a OXA−51 gene is located within the chromosome of Acinetobacter baumannii . Despite its plasmid dissemination to other members of the genus, it may be considered in initial species screening. Thus, this study aimed to determine the presence of <jats:italic/jats:italic> l a OXA−51 ‐negative Acinetobacter spp. as a cause of infection in Peru. Methods Two hundred ninety‐eight ACB complex isolates from different regions of Peru were isolated between January 2018 and March 2024. Of these, 272 and 25 were confirmed as hospital‐acquired and community infections, respectively. The presence of <jats:italic/jats:italic> l a OXA−51 was determined by polymerase chain reaction, and the susceptibility levels to 12 antimicrobial agents were determined. Results The results showed that 38 (12.7%) isolates were <jats:italic/jats:italic> l a OXA−51 ‐negative. These isolates were frequent among community infections (13/25, p < 0.0001), often causing urine infections. They showed significantly lower levels of resistance to almost all antimicrobial agents tested, and most of them were recovered from regions outside metropolitan Lima. Conclusion A relevant number of infections by non‐ baumannii Acinetobacter species in Peru is suggested, highlighting the need for systematic identification of these species in the country.
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    Detection of SARS-CoV-2 variants in hospital wastewater in Peru, 2022
    (2024-06-21)
    Marcos Carbajal, Pool  
    ;
    Yareta Yareta, José Luis  
    ;
    Otiniano Trujillo, Miguel Angel  
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    Galarza- Pérez, Marco
    ;
    Espinoza-Culupu, Abraham
    OBJECTIVE.: To identify the presence of the SARS-CoV-2 virus in wastewater from hospitals in Peru. MATERIALS AND METHODS.: Water samples were collected from the effluents of nine hospitals in Peru during March and September 2022. SARS-CoV-2 was identified by using Illumina sequencing. Variant, lineage and clade assignments were carried out using the Illumina and Nextclado tools. We verified whether the SARS-CoV-2 variants obtained from wastewater were similar to those reported by the National Institute of Health of Peru from patients during the same period and region. RESULTS.: Eighteen of the 20 hospital wastewater samples (90%) provided sequences of sufficient quality to be classified as the Omicron variant according to the WHO classification. Among them, six (30%) were assigned by Nextclade to clades 21K lineage BA.1.1 (n=1), 21L lineage BA.2 (n=2), and 22B lineages BA.5.1 (n=2) and BA .5.5 (n=1). CONCLUSIONS.: SARS-CoV-2 variants were found in hospital wastewater samples and were similar to those reported by the surveillance system in patients during the same weeks and geographic areas. Wastewater monitoring could provide information on the environmental and temporal variation of viruses such as SARS-CoV-2. Motivation for the study. To contribute to the surveillance of environmental samples from hospital effluents in order to achieve early warning of possible infectious disease outbreaks. Main findings. The Omicron variant of the COVID-19 virus was detected in wastewater from hospitals in Puno, Cuzco and Cajamarca; these results are similar to the reports by the Peruvian National Institute of Health based on nasopharyngeal swab samples. Implications. The presence of the Omicron variant in hospital wastewater during the third wave of the pandemic should raise awareness of the treatment system before wastewater is discharged into the public sewer system.
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    Tolerance to disinfectants (chlorhexidine and isopropanol) and its association with antibiotic resistance in clinically-related Klebsiella pneumoniae isolates
    (Taylor and Francis Ltd., 2021-01-02)
    Morante, Jasmine
    ;
    Quispe, Antonio M.
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    Ymaña, Barbara
    ;
    Moya, Jeel Junior
    ;
    Luque Chipana, Nestor Alejandro  
    Disinfectants play an essential role in controlling the dissemination of bacteria in health care settings, but it may also contribute to the selection of antibiotic resistance bacteria. This study looked at Klebsiella pneumoniae isolates collected from three hospitals in Lima, Peru, in order to evaluate: their susceptibility to chlorhexidine [CHG] and isopropanol [ISP]), and their association with antimicrobial susceptibility. We analyzed 59 K. pneumoniae isolates and assessed their CHG and ISP susceptibility by minimum inhibitory concentrations (MICs). Additionally, we performed a regression analysis to assess the association between disinfectant tolerance and antibiotic resistance (measured by the disc diffusion method), colistin resistance (by microdilution), carbapenemases presence (by polymerase chain reaction [PCR]), and clonal relationships (by pulsed-field gel electrophoresis [PFGE]). Eleven K. pneumoniae strains were isolated from fomites, and 48 strains from clinical samples. The MIC range of these isolates was 8-128 µg/ml for CHG and 16-256 mg/ml for ISP. We found that resistance to trimethoprim/sulfamethoxazole (TMP/SMX) was the main factor associated with CHG log2 MIC (ß = 0.65; 95%CI: 0.03, 1.27; R2 = 0.07). In the case of ISP, the log2(MIC) was associated with the institution of origin, showing lower ISP log2(MIC) in fomites compared to clinical samples(ß = -0.77; 95%CI: -1.54, -0.01; R2 = 0.08). Resistance to CHG and ISP among K. pneumoniae isolates found in Peruvian hospitals seems to be elevated and highly variable. Further studies are needed to confirm our results and implement actionable interventions if necessary.
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    Retrospective analysis of the emergence of antibiotic-resistant Salmonella enterica infections in a level IV hospital from Lima, Peru
    (2021-12-17)
    Ruiz, Joaquim
    ;
    Flores-Paredes, Wilfredo
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    Luque Chipana, Nestor Alejandro  
    ;
    Albornoz Toyohama, Roger Hiroshi  
    ;
    Rojas, Nayade
    This study retrospectively analysed the emergence of multidrug-resistant Salmonella enterica in a level IV hospital in Lima, Peru. A total of 64 S. enterica from January 2009 to June 2010 (Period 1, 24 isolates) and January 2012 to December 2014 (Period 2, 40 isolates) were included. Some 25 were from non-hospitalized and 39 from hospitalized patients. Antimicrobial susceptibility to 15 antimicrobial agents was established by automated methods. Most of the isolates were from blood (46.9%), urine (21.9%) and faeces (14.1%). There was a reduction in blood isolates in Period 2, while all the faecal isolates were from this period. In Period 1, only 3/24 (12.5%) isolates showed antibiotic resistance, whereas 25/39 isolates (64.1%) from Period 2 were antibiotic-resistant, with multidrug-resistant and extensively drug-resistant rates of 17.9% and 20.5%, respectively. Multidrug-resistant/extensively drug-resistant Salmonella isolates were introduced in the hospital in 2013, with Salmonella recovered from faeces from non-hospitalized patients suggested an increase in community-acquired multidrug-resistant/extensively drug-resistant Salmonella infections.
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    KPC-2-NDM-1-producing Serratia marcescens: first description in Peru
    (Elsevier Ltd, 2022-11-01)
    Ymaña, Barbara
    ;
    Luque Chipana, Nestor Alejandro  
    ;
    Pons, María Jesus
    ;
    Ruiz, Joaquim
    Two clonal extensively-resistant S. marcescens were isolated in Peru. The presence and transferability of extended-spectrum β-lactamases and IMP, KPC, NDM, OXA-48 and VIM were determined. The concomitant presence of KPC-2 and NDM-1 was confirmed in both isolates, with KPC-2 being able to be transferred.
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    Evolution of Antimicrobial Resistance Levels of ESKAPE Microorganisms in a Peruvian IV-Level Hospital
    (2021-01-01)
    Flores-Paredes, Wilfredo
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    Luque Chipana, Nestor Alejandro  
    ;
    Albornoz Toyohama, Roger Hiroshi  
    ;
    Rojas, Nayade
    ;
    Espinoza, Manuel
    BACKGOUND: spp.) are a frequent cause of severe infection, ranking among the most relevant causes of hospital infections. In Peru, few studies, often focused in a single ESKAPE microorganism, have been performed, but none providing an overall and comprehensive long-time analysis of the antibiotic resistance of ESKAPE microorganisms. In the present study, the evolution of antimicrobial resistance levels of ESKAPE microorganisms isolated during 2009 - 2010 (Period 1) and 2012 - 2014 (Period 2) in a IV-level hospital in Lima was analyzed. MATERIALS AND METHODS: ) were determined using automatic methods. RESULTS: showed significantly increased resistance to different cephalosporins, carbapenems and amoxicillin plus sulbactam. CONCLUSION: clone in the ICU is suspected. The isolation of ESKAPE and levels of antibiotic resistance levels have reduced over time.
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    Características clínicas y epidemiológicas de las muertes por dengue durante un brote en el norte del Perú
    (Instituto Nacional de Salud, 2023-03-31)
    Luque Chipana, Nestor Alejandro  
    ;
    Cilloniz, Catia
    ;
    Pons, María Jesus
    ;
    Donaires-Toscano, Fernando
    ;
    Albornoz Toyohama, Roger Hiroshi  
    Con el objetivo de describir las características clínicas y epidemiológicas de los pacientes fallecidos por dengue durante el 2017 en Piura, se realizó un estudio retrospectivo de revisión de 24 historias clínicas. El 67% de los casos fueron mujeres y tres (12,5%) estaban embarazadas. La diabetes (12,5%) y la hipertensión (16,7%) fueron las comorbilidades más frecuentes. Sólo en el 12,5% se reportó dengue previo.El tiempo transcurrido desde asistencia sanitaria hasta la muerte fue de 4,10 (DE: 5,34) días. Se hicieron transfusiones de glóbulos rojos en el 45,8% de los casos, plasma en el 25%, plaquetas en el 16,8% ycrioprecipitado en el 16,8%. También fueron frecuentes la terapia con ristaloides (91,7%) y el tratamiento con fármacos vasoactivos (70,8%). En conclusión, la mortalidad del dengue grave fue mayoritaria en las mujeres adultas y el tiempo de atención desde el primer establecimiento de salud hasta una unidad especializada fue prolongada.
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    EVOLUTION OF THE PREVALENCE AND ANTIMICROBIAL RESISTANCE AMONG Escherichia coli ISOLATED AS A CAUSE OF INFECTION IN PATIENTS ADMITTED TO A IV-LEVEL HOSPITAL IN LIMA, PERU
    (Brazilian Society of Parasitology, 2022-10-19)
    Flores-Paredes, Wilfredo
    ;
    Luque Chipana, Nestor Alejandro  
    ;
    Albornoz Toyohama, Roger Hiroshi  
    ;
    Rojas, Nayade
    ;
    Espinoza, Manuel
    The levels and evolution of antimicrobial resistance of Escherichia coli during 01/2009-06/2010 (Period 1), 01/2012-06-2013 (Period 2) and 07/2013-12/2014 (Period 3) were analyzed. Identification, susceptibility levels to 13 antibiotics and the presence of extendedspectrum β-lactamases (ESBLs) were determined. Overall, 9,918 microorganisms were isolated as a cause of infection. Of these 3,016 (30.4%) were E. coli, with 1,770 (59%), 992 (33%) and 254 (8%), from the Medicine and the Surgery Departments and the Intensive Care Unit (ICU), respectively. There was a significant increase (p=0.0002) of E. coli throughout considered periods. The isolates presented high levels of resistance (>60%) to cephalosporins, ciprofloxacin and cotrimoxazole, being only susceptible to imipenem (0.3% of resistance) and tigecycline. Overall the analysis of evolution of antimicrobial resistance showed that resistance to cephalosporins and amikacin significantly increased, while, the ones of piperacillintazobactam, cotrimoxazole and gentamicin had significantly decreased. Nevertheless, the ICU isolates showed an inverse scenario for cephalosporins. These findings agree with an increase of ESBLs on the Medicine (56% to 66%; p<0.0001) and on the Surgery (54% to 62%; p=0.0197) departments, with a parallel decrease in the ICU (76% to 68%). In summary, high levels of antimicrobial resistance have been reported among E. coli, with worrisome levels of ESBL. A continuous surveillance of antimicrobial resistance levels in the area is needed. KEY WORDS: Escherichia coli; antimicrobial resistance; cephalosporins
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    Worrying levels of antimicrobial resistance in Gram-negative bacteria isolated from cell phones and uniforms of Peruvian intensive care unit workers
    (2021-12-20)
    Ymaña, Barbara
    ;
    Luque Chipana, Nestor Alejandro  
    ;
    Ruiz, Joaquim
    ;
    Pons, Maria J
    BACKGROUND: Healthcare worker (HCW) uniforms and cell phones are involved in pathogen transmission. This study aimed to characterize pathogenic microorganism isolates from HCW uniforms and cell phones. METHODS: Gram-negative microorganisms were recovered from HCW uniforms and cell phones. Antimicrobial susceptibility and the presence of extended-spectrum β-lactamases (ESBL) and carbapenemases were determined. RESULTS: Escherichia coli was the most prevalent microorganism. Overall, high levels of resistance to cephalosporins, quinolones, co-trimoxazole and colistin were found. ESBL were mainly related to blaCTX-M-15 and blaSHV- genes. Carbapenem-resistant isolates presented as blaKPC or blaNDM. CONCLUSIONS: High levels of antimicrobial resistance, including colistin, were detected. Therefore, strategies are urgently needed to prevent bacterial dissemination.
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