P575Merging technologies to provide Mexico an innovative nationwide AMI management network

Background

“Cόdigo Infarto”, the vast patient-centric, app-based, educational crusade of the Mexican Society of Interventional Cardiology (SOCIME) has been combined with the Latin America Telemedicine Infarct Network (LATIN) to create a comprehensive, national AMI program for Mexico.

Purpose

To demonstrate the benefits of amalgamating educational initiatives of national cardiology societies with a global telemedicine program for improving AMI management.

Methods

“Cόdigo Infarto” App connects patients to a network of several hundred cardiologists and 250 Primary PCI-capable labs. LATIN provides the partnership with its robust telemedicine platform, a hub-spoke strategy that supports patient's access to appropriate medical management. Remotely located experts, in Colombia, provide urgent EKG diagnosis via tele-consultation to the entire LATIN Mexico network. They activate ambulance dispatch and implement guideline-based protocols.

Results

Numerous “Cόdigo Infarto” sites have incorporated LATIN to provide a simple and accelerated management of AMI patients. Currently, the partnership (7 hubs, 78 spokes) has screened 19,886 patients. A total of 359 STEMI cases (1.8%) have been diagnosed; 118 patients (33%) were urgently reperfused, Primary PCI was performed in 74% of the latter cases. D2B time was 41 min. Reasons for the lack of treatment include delayed presentation, lack of ICU beds and insurance denials. Currently, these constraints are being methodically probed. Updated results will be available at time of presentation.

Conclusions

The synergy of the AMI initiative for Mexico provides a template for similar initiatives in developing countries.

[Antimicrobial resistance of different Acinetobacter baumannii biotypes isolated in the northern region of Chile]

BACKGROUND

Acinetobacter baumannii nosocomial outbreaks are common and the microorganism is frequently resistant to multiple antimicrobials. There is little information about Acinetobacter baumannii antimicrobial susceptibility in the northern region of Chile.

AIM

To identify different Acinetobacter baumannii biotypes isolated from clinical samples and to determine their antimicrobial susceptibility.

MATERIAL AND METHODS

One hundred twenty three Acinetobacter baumannii isolates were studied. The identification and typing of Acinetobacter baumannii was based on phenotypic characteristics. Antimicrobial susceptibility was investigated using agar dilution techniques.

RESULTS

Most Acinetobacter baumannii strains were isolated from wounds, urinary and respiratory infections. Seven biotypes were isolated, being biotype 9 the most frequent. Imipenem was the antimicrobial with the higher activity against the microorganism. Amikacin, cefoperazonesulbactam, ampicillinsulbactam and ceftazidime had a moderate activity. There were high resistance levels to ampicillin and older cephalosporins.

CONCLUSIONS

Acinetobacter baumannii is emerging as a significant nosocomial pathogen in Chile and shows high resistance rates to multiple antibiotics.

Differential mechanisms of multidrug resistance are expressed during stepwise selection of KB-3-1 cells with adriamycin

A major limitation of cancer chemotherapy is development of resistance. In this study, we analyzed KB-3-1 cells and adriamycin-selected multidrug resistant sublines KB-A1 and KB-A10 cells for mechanisms of resistance. KB-A10 cells are 10-fold more resistant than KB-A1 cells but have lower P-glycoprotein. Of the known mechanisms of multidrug resistance, topoisomerase II and lung-resistance-related protein were altered between the resistant cell lines. Glutathione-S-transferase activity and multidrug-resistance-related protein levels were higher in the resistant cell lines compared to the sensitive cells but were similar in KB-A1 and KB-A10 cells. Results indicate differential regulation of mechanisms of resistance with stepwise selection.