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Garcia-Corredor D, Alvarado M, Pulido-Medellín M, Muñoz M, Cruz-Saavedra L, Hernández C, Giraldo JC, Vásquez-Arteaga LR, Morillo Coronado AC, Ramírez JD. Molecular characterization of Fasciola hepatica in endemic regions of Colombia. Front Vet Sci 2023; 10:1171147. [PMID: 37360412 PMCID: PMC10288157 DOI: 10.3389/fvets.2023.1171147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Fasciola hepatica is a zoonotic trematode that affects a wide range of hosts, including cattle, sheep, and goats. The economic impact of the parasite on the cattle industry is significant, with high losses reported worldwide. While its impact on human health was previously underestimated, recent years have seen a rise in fascioliasis cases, leading to increased interest among researchers globally. To characterize the genetic diversity and intraspecific variation of this parasite in South America, specifically in Colombia, we collected 105 adult parasites from cattle bile ducts in seven Colombian departments (Antioquia, Boyacá, Santander, Cauca, Cundinamarca, Nariño, Norte de Santander, and Santander) to assess the parasite's phenotypic analyses, genetic diversity, and population structure. A computer image analysis system (CIAS) was applied based on standardized morphological measurements. Liver-fluke size was studied by principal component analysis (PCA). DNA sequences were obtained for nuclear markers such as the 28S, β-tubulin 3, ITS1, ITS2, and the mitochondrial marker Cytochrome Oxidase I (COI). Multiple statistical tests were performed, and the parasite's population structure was analyzed. Maximum Likelihood (ML) phylogenetic reconstructions were carried out using the sequences obtained herein and sequences available in GenBank. Morphological results revealed that all the obtained individuals matched F. hepatica's morphology. There was no evidence of high genetic diversity, and the absence of genetic structure at the country-level was notable, possibly caused by a demographic expansion of this trematode in Colombia or the low resolution of the molecular markers employed. Future studies are still needed to unveil the genetic population structure of F. hepatica across the country.
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Affiliation(s)
- Diego Garcia-Corredor
- Grupo de Investigación en Medicina Veterinaria y Zootecnia (GIDIMEVETZ), Facultad de Ciencias Agropecuarias, Universidad Pedagógica y Tecnológica de Colombia (UPTC), Tunja, Colombia
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Mateo Alvarado
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Martín Pulido-Medellín
- Grupo de Investigación en Medicina Veterinaria y Zootecnia (GIDIMEVETZ), Facultad de Ciencias Agropecuarias, Universidad Pedagógica y Tecnológica de Colombia (UPTC), Tunja, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia
| | - Julio Cesar Giraldo
- Grupo de Investigación en Parasitología y Microbiología Tropical, Programa de Biología, Universidad INCCA de Colombia, Bogotá, Colombia
- Facultad de Medicina y Ciencias de la Salud, Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Luis R. Vásquez-Arteaga
- Centro de Estudios en Microbiología y Parasitología, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Ana Cruz Morillo Coronado
- Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias Agropecuarias, Tunja, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Higuera A, Villamizar X, Herrera G, Giraldo JC, Vasquez-A LR, Urbano P, Villalobos O, Tovar C, Ramírez JD. Molecular detection and genotyping of intestinal protozoa from different biogeographical regions of Colombia. PeerJ 2020; 8:e8554. [PMID: 32195042 PMCID: PMC7067185 DOI: 10.7717/peerj.8554] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background Intestinal parasitic protozoa represent a serious problem of public health particularly in developing countries. Protozoa such as Blastocystis, Giardia intestinalis, Entamoeba histolytica and Cryptosporidium spp. are associated with diarrheal symptoms. In Colombia, there is little region-specific data on the frequency and circulating genotypes/species of these microorganisms. Therefore, the main objective of our study was to employ molecular detection and genotyping of G. intestinalis and Blastocystis, Cryptosporidium and Entamoeba spp. in samples from different biogeographical regions of Colombia. Methods We collected 649 human fecal samples from five biogeographical regions of Colombia: the Amazon, Andean, Caribbean, Orinoco and Pacific regions. Blastocystis, G. intestinalis, Cryptosporidium spp. and Entamoeba complex were detected by microscopy and conventional PCR. Molecular genotyping was conducted to identify Blastocystis subtypes (STs) (18s), G. intestinalis assemblages (triose phosphate isomerase and glutamate dehydrogenase) and Cryptosporidium species (18s). Genetic diversity indices were determined using dnasp.5. Results We detected G. intestinalis in 45.4% (n = 280) of samples, Blastocystis in 54.5% (n = 336) of samples, Cryptosporidium spp. in 7.3% (n = 45) of samples, Entamoeba dispar in 1.5% (n = 9) of samples, and Entamoeba moshkovskii in 0.32% (n = 2) of samples. Blastocystis STs 1–4, 8 and 9 and G. intestinalis assemblages AII, BIII, BIV, D and G were identified. The following Cryptosporidium species were identified: C. hominis, C. parvum, C. bovis, C. andersoni, C. muris, C. ubiquitum and C. felis. The Caribbean region had the highest frequency for each of the microorganisms evaluated (91.9% for G. duodenalis, 97.3% for Blastocystis, 10.8% for Cryptosporidium spp., 13.5% for E. dispar and 2.7% for E. moshkovskii). The Orinoco region had a high frequency of Blastocystis (97.2%) and the Andean region had a high frequency of G. intestinalis (69.4%). High and active transmission was apparent in several regions of the country, implying that mechanisms for prevention and control of intestinal parasitosis in different parts of the country must be improved.
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Affiliation(s)
- Adriana Higuera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Ximena Villamizar
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | | | - Luis Reinel Vasquez-A
- Centro de Estudios en Microbiología y Parasitología (CEMPA), Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayan, Colombia
| | - Plutarco Urbano
- Grupo de Investigaciones Biológicas de la Orinoquia, Unitrópico, Yopal, Colombia
| | - Oswaldo Villalobos
- Hospital Local Santa María de Mompox, Programas Especiales (Lepra y TB), Mompox, Bolivar, Colombia
| | - Catalina Tovar
- Grupo de Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Monteria, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
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Villamizar X, Higuera A, Herrera G, Vasquez-A LR, Buitron L, Muñoz LM, Gonzalez-C FE, Lopez MC, Giraldo JC, Ramírez JD. Molecular and descriptive epidemiology of intestinal protozoan parasites of children and their pets in Cauca, Colombia: a cross-sectional study. BMC Infect Dis 2019; 19:190. [PMID: 30808303 PMCID: PMC6390308 DOI: 10.1186/s12879-019-3810-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/12/2019] [Indexed: 01/18/2023] Open
Abstract
Background Parasitic infections, particularly those caused by protozoa, represent a considerable public health problem in developing countries. Blastocystis, Giardia duodenalis, Cryptosporidium spp. and the Entamoeba complex (Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii) are the most common etiological causes of intestinal parasitic infections. Methods We carried out a descriptive cross-sectional study in school-age children attending a daycare institution in commune eight of Popayán, Cauca (Southwest Colombia). A total of 266 fecal samples were collected (258 from children and eight from pets). Blastocystis, G. duodenalis, Cryptosporidium spp. and the Entamoeba complex were identified by microscopy, quantitative real-time PCR (qPCR) and conventional PCR. The concordance of qPCR and microscopy was assessed using the Kappa index. Molecular characterization was conducted to identify Blastocystis subtypes (18S), G. duodenalis assemblages (tpi and gdh) and Cryptosporidium species/subtypes (18S and GP60). Potential associations between intestinal parasitism and sociodemographic factors were examined using bivariate analyses. Results A total of 258 fecal samples from children were analyzed by microscopy and 255 samples were analyzed by qPCR. The prevalence of Blastocystis was between 25.19% (microscopy) and 39.22% (qPCR), that of G. duodenalis was between 8.14% (microscopy) and 10.59% (qPCR), that of Cryptosporidium spp. was estimated at 9.8% (qPCR), and that of the Entamoeba complex was between 0.39% (conventional PCR) and 0.78% (microscopy). The concordance between microscopy and qPCR was very low. Blastocystis ST1 (alleles 4, 8, and 80), ST2 (alleles 11, 12, and 15), ST3 (alleles 31, 34, 36, 38,57, and 151), and ST4 (alleles 42 and 91), G. duodenalis assemblages AII, BIII, BIV and D, C. parvum subtype IIa and C. hominis subtype IbA9G3R2 were identified. The only identified member of the Entamoeba complex corresponded to E. histolytica. No statistically significant association was identified between parasitic infection and any sociodemographic variable. Conclusion This study revealed the usefulness of molecular methods to depict the transmission dynamics of parasitic protozoa in southwest Colombia. The presence of some of these protozoa in domestic animals may be involved in their transmission.
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Affiliation(s)
- Ximena Villamizar
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Adriana Higuera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Luis Reinel Vasquez-A
- Centro de estudios en Microbiología y Parasitología (CEMPA), Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Lorena Buitron
- Centro de estudios en Microbiología y Parasitología (CEMPA), Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Lina Maria Muñoz
- Centro de estudios en Microbiología y Parasitología (CEMPA), Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Fabiola E Gonzalez-C
- Centro de estudios en Microbiología y Parasitología (CEMPA), Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Myriam Consuelo Lopez
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia.
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Ramírez JD, Flórez C, Olivera M, Bernal MC, Giraldo JC. Blastocystis subtyping and its association with intestinal parasites in children from different geographical regions of Colombia. PLoS One 2017; 12:e0172586. [PMID: 28222192 PMCID: PMC5319748 DOI: 10.1371/journal.pone.0172586] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 02/07/2017] [Indexed: 11/18/2022] Open
Abstract
Blastocystis is a common enteric protist colonizing probably more than 1 billion people with a large variety of non-human hosts. Remarkable genetic diversity has been observed, leading to the subdivision of the genus into multiple subtypes (ST), some of which are exclusively found in non-human hosts. The aim of this study was to determine the distribution of Blastocystis STs/18S alleles in symptomatic (abdominal pain, anal pruritus, diarrhea, headache, nauseas and/or vomit) and asymptomatic children from nine geographical regions of Colombia. A total of 2026 fecal samples were collected as part of a national survey to estimate the frequency of intestinal parasites in children. A set of 256 samples that were Blastocystis positive was finally selected. The samples were submitted to DNA extraction, Real Time PCR and sequencing using Blastocystis-specific primers targeting the small subunit rRNA gene for ST identification. DNA of Ascaris lumbricoides (16.4%), Trichuris trichiura (8.2%), hookworms (Necator americanus/Ancylostoma duodenale) (7.3%), Giardia duodenalis (23.1%), Entamoeba complex (82%), Entamoeba coli (55%), Hymenolepis nana (0.8%), Endolimax nana (33.2%) and Neobalantidium coli (2.7%) was detected in the Blastocystis-positive samples. We detected ST1 (21.4%), ST2 (19.5%), ST3 (55.5%), ST4 (0.8%), ST6 (2%) and ST7 (0.8%); alleles 1, 2, 4, 81, 82 and 83 for ST1; alleles 9, 11, 12, 15, 67, 71 and 73 for ST2; alleles 34, 36, 38, 45, 49, 55, 134 and 128 for ST3; allele 42 for ST4; allele 122 for ST6, and allele 142 for ST7. Further studies implementing high-resolution molecular markers are necessary to understand the dynamics of Blastocystis transmission and the role of this Stramenopila in health and disease.
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MESH Headings
- Adolescent
- Alleles
- Asymptomatic Diseases
- Blastocystis/classification
- Blastocystis/genetics
- Blastocystis Infections/epidemiology
- Blastocystis Infections/parasitology
- Child
- Child, Preschool
- Coinfection
- Colombia/epidemiology
- DNA Barcoding, Taxonomic
- DNA, Protozoan/analysis
- DNA, Protozoan/isolation & purification
- DNA, Ribosomal/analysis
- DNA, Ribosomal/isolation & purification
- Feces/parasitology
- Female
- Genetic Variation
- Geography, Medical
- Health Surveys
- Humans
- Intestinal Diseases, Parasitic/parasitology
- Male
- RNA, Protozoan/genetics
- RNA, Ribosomal, 18S/genetics
- Real-Time Polymerase Chain Reaction
- Ribotyping
- Species Specificity
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Affiliation(s)
- Juan David Ramírez
- Grupo de Investigaciones Microbiológicas – UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá – Colombia
- * E-mail:
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá – Colombia
| | - Mario Olivera
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá – Colombia
| | - María Consuelo Bernal
- Programa profesional de Biología, Grupo de Investigación en Parasitología y Microbiología tropical – GIPAMT, Universidad Incca de Colombia, Bogotá – Colombia
| | - Julio Cesar Giraldo
- Programa profesional de Biología, Grupo de Investigación en Parasitología y Microbiología tropical – GIPAMT, Universidad Incca de Colombia, Bogotá – Colombia
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Ramírez JD, Sánchez A, Hernández C, Flórez C, Bernal MC, Giraldo JC, Reyes P, López MC, García L, Cooper PJ, Vicuña Y, Mongi F, Casero RD. Geographic distribution of human Blastocystis subtypes in South America. Infect Genet Evol 2016; 41:32-35. [PMID: 27034056 DOI: 10.1016/j.meegid.2016.03.017] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 11/25/2022]
Abstract
Blastocystis is a cosmopolitan enteric protist colonizing probably more than 1 billion people. This protozoan exhibits genetic diversity and is subdivided into subtypes (STs). The aim of this study was to determine the distribution of Blastocystis STs in symptomatic and asymptomatic human samples from different countries of South America. A total of 346 fecal samples were genotyped by SSU rDNA showing ST1 (28.3%), ST2 (22.2%), ST3 (36.7%), ST4 (2%), ST5 (2.3%), ST6 (2%), ST7 (2.3%), ST8 (0.6%), ST12 (0.9%) and a novel ST (2.7%). These findings update the epidemiology of Blastocystis in South America and expand our knowledge of the phylogeographic differences exhibited by this stramenopile.
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Affiliation(s)
- Juan David Ramírez
- Grupo de Investigaciones Microbiológicas, UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia.
| | - Angie Sánchez
- Grupo de Investigaciones Microbiológicas, UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Grupo de Investigaciones Microbiológicas, UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - María Consuelo Bernal
- Programa Profesional de Biología, Grupo de Investigación en Parasitología y Microbiología Tropical, GIPAMT, Universidad Incca de Colombia, Bogotá, Colombia
| | - Julio Cesar Giraldo
- Programa Profesional de Biología, Grupo de Investigación en Parasitología y Microbiología Tropical, GIPAMT, Universidad Incca de Colombia, Bogotá, Colombia
| | - Patricia Reyes
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Myriam Consuelo López
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Lineth García
- Instituto de Investigaciones Biomédicas, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Philip J Cooper
- Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador; Facultad de Ciencias Médicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Yosselin Vicuña
- Laboratorio de Investigaciones FEPIS, Quininde, Esmeraldas Province, Ecuador
| | - Florencia Mongi
- Departamento de Parasitología del Hospital Nacional de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Rodolfo D Casero
- Departamento de Parasitología del Hospital Nacional de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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González AC, Giraldo JC. Prevalencia de Parásitos Intestinales Zoonóticos En Caninos (Canis Lupus Familiaris) del área urbana del municipio de Coyaima (Tolima). ACTA ACUST UNITED AC 2015. [DOI: 10.18359/rmed.1743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
<p class="Cuerpodeltexto20">Introducción: Las enfermedades parasitarias son un problema de salud pública al ser causadas por agentes patógenos que afectan animales domésticos, los que a su vez pueden infectar humanos, principalmente en países ubicados en áreas tropicales.</p><p class="Cuerpodeltexto20">Objetivo: Identificar parásitos intestinales que afectan a caninos domiciliados de la zona urbana del municipio de Coyaima, y determinar la prevalencia y las variables asociadas al parasitismo en el área de estudio.</p><p class="Cuerpodeltexto20">Materiales y Métodos: Se realizó un estudio descriptivo de corte transversal de febrero del 2011 a marzo del 2012, recolectando muestras de 175 caninos domiciliados de la zona urbana del municipio de Coyaima, las cuales se procesaron mediante la técnica de concentración formol - éter para la identificación de estadios de huevos de helmintos y quistes de protozoarios. Los datos fueron tabulados y analizados con el programa estadístico SPSS<sup>v20</sup>.</p><p class="Cuerpodeltexto20">Resultados: La prevalencia hallada para el parasitismo intestinal canino de la zona urbana del municipio de Coyaima fue del 53,1%, siendo estos resultados concordantes con los reportados por otros autores en estudios similares, realizados en países latinoamericanos.</p><p class="Cuerpodeltexto20">Conclusiones: La población canina de la zona urbana del municipio de Coyaima presenta afección por parásitos gastrointestinales, siendo entidades prevalentes Uncinarias, 20,6%, Toxocara canis 8,6%, Stongyloides spp., 2,9%, Entamoeba spp., 21,1%, Blastocystis spp., 18,3% y Giardia spp., 16%, entre las cuales se destacan, agentes etiológicos de relevancia por su carácter zoonótico, como los causantes de la toxocariosis, la migración larvaria cutánea y la giardiasis, entre otras. Se recomienda implementar campañas de educación en la población en general y ejecutar acciones de prevención por parte de estamentos responsables de la salud animal.</p>
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Montes FR, Sanchez SI, Giraldo JC, Rincón JD, Rincón IE, Vanegas MV, Charris H. The lack of benefit of tracheal extubation in the operating room after coronary artery bypass surgery. Anesth Analg 2000; 91:776-80. [PMID: 11004025 DOI: 10.1097/00000539-200010000-00003] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although early tracheal extubation in cardiac anesthesia is safe and cost beneficial, questions still remain regarding how early after cardiac surgery patients should be tracheally extubated (TE). Our objective was to determine the effects on resource use if patients scheduled for coronary artery bypass grafting have TE in the operating room (OR). We studied 100 consecutive patients undergoing elective coronary artery bypass grafting, requiring extracorporeal circulation, and those eligible for a fast-track pathway. At the end of the procedure, the patients were evaluated for TE in the OR if they were hemodynamically stable, were without significant bleeding, and fulfilled clinical and blood gas analysis variables. Patients who did not meet the requirements had TE in the intensive care unit (ICU). Fifty patients had TE in the OR and 50 patients in the ICU. Time in the OR after skin closure, ICU length of stay, and postoperative length of stay were similar between the groups. Four patients (8%) in the OR group were tracheally reintubated secondary to respiratory depression (P = 0.11). Three patients (6%) in the OR group had postoperative myocardial infarction, and one postoperative myocardial infarction (2%) occurred in the ICU group (P = 0.61). All four patients recovered satisfactorily. The incidences of other complications were similar between groups.
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Affiliation(s)
- F R Montes
- Department of Anesthesia, Fundación Cardio Infantil-Instituto de Cardiologia, Santafé de Bogotá, Colombia, South America.
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