RESUMEN
Laelia is an endemic genus of the neotropical region, with the greatest richness occurring in Mexico. A recent phylogenetic study transferred some Mexican laelias to the genus Schomburgkia, which has generated debate. The aim of the present study was to analyze the patterns of species richness and endemism and the current and potential geographic distributions of the taxa of Laelia s.l., as well as the putative Laelia s.s., distributed in Mexico as part of an exploratory evaluation of the generic limits to sheds light on the taxonomic debate and generate baselines to guide conservation efforts. A database was generated with information from herbarium specimens and publications. The species richness was estimated by political division, biomes, and elevation. The endemism was analyzed by political division and using the weighted and corrected weighted endemism indices. Geographic data, climatic, and topographic variables were used to predict the distributions with the maximum entropy algorithm. The results supported the proposal to transfer some species to the genus Schomburgkia. Some areas of the Sierra Madre del Sur and Oriental should be included as priority areas in the conservation strategies of Laelia. This study highlights the importance of the taxonomy, distribution, and hotspots in diversity conservation.
RESUMEN
Identifying areas of endemism has represented a great challenge, from the search for their definition, the design of methodologies, and the management of essential information to identify areas where the distributions of at least two taxa overlap. Endemicity Analysis is a widely used method that offers good results; however, an evaluation of the results is necessary. We evaluated the previous establishment of the minimum endemicity index of the species as a criterion to identify areas of endemism, applicated to a set of taxa with endemic and preferential distribution to the Sierra Madre Oriental. The taxa included in our analyses were 178 species of plants, vertebrates, and invertebrates. First, we varied the parameter set minimum score species in the software and the size of the cell. Next, we established criteria to evaluate the results obtained: areas supported by unique sets of species, good fit to the area, and sympatric distribution of taxa (extensive or homopatrid). After choosing the minimum ei with the best performance, we modified the study method for the endemicity analysis (Endemicity Analysis with Progressive Species Elimination). Our results indicate that the variation of the ei influenced the number of areas obtained by the program, decreasing considerably after evaluating the first criterion. The best fit to the cells occurred when we set 0.8 as the minimum ei in both cell sizes. The visually-preview of the sympatrid relationships allowed to recognize areas that do not present congruent distributions, although they meet the two previous criteria evaluated. The areas of endemism identified at different scales and those identified with the implementation of our modification were complementary.
Asunto(s)
Vertebrados , Animales , Tamaño de la CélulaRESUMEN
OBJECTIVES.: To identify the main viral etiological agents in patients with severe acute respiratory infection (SARI) hospitalized in a Pediatric Intensive Care Unit (PICU) and to analyze their clinical characteristics. MATERIALS AND METHODS.: Prospective longitudinal study in children under five years of age hospitalized due to SARI at the PICU of t Instituto Nacional de Salud del Niño (National Children´s Hospital) in Lima, Peru. Real-time direct immunofluorescence and RT-PCR tests were performed for the diagnosis of respiratory viruses on tracheal aspirate or nasopharyngeal swab samples. RESULTS.: We included 117 patients. Median age was four months, 66% had comorbidity and 91% required mechanical ventilation. Respiratory virus monoinfection was identified in 47% and viral co-infection in 2.6%, with the respiratory syncytial virus subtype A (RSV-A) being the most frequent. The median length of hospitalization was 21 days and 20 (17%) patients died. An association was found between a history of chronic lung disease and RSV-A infection (p=0.045), and between Down syndrome and influenza A virus infection (p=0.01). After controlling for potential confounders, congenital heart disease (RR 3.1; 95% CI: 1.3-5.8, p=0.002) and nosocomial infection (RR 2.6; 95% CI: 1.0-5.3, p=0.01) were found to increase the risk of death in patients with SARI. CONCLUSIONS.: RSV-A was the most common viral etiology in children under five hospitalized by SARI at the PICU. No association was found between viral infection and patient survival.
OBJETIVOS.: Identificar los principales agentes etiológicos virales en pacientes con infección respiratoria aguda grave (IRAG) hospitalizados en una Unidad de Cuidados Intensivos Pediátricos (UCIP) y analizar sus características clínicas. MATERIALES Y MÉTODOS.: Estudio longitudinal prospectivo en menores de cinco años hospitalizados por IRAG en la UCIP del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizaron pruebas de inmunofluorescencia directa y RT-PCR en tiempo real para el diagnóstico de virus respiratorios en muestras de aspirado traqueal o hisopado nasofaríngeo. RESULTADOS.: Se incluyeron 117 pacientes. La mediana de edad fue cuatro meses, el 66% presentaron comorbilidad y el 91% requirieron ventilación mecánica. Se identificó monoinfección por virus respiratorios en el 47% y coinfección viral en el 2,6%, siendo el virus sincicial respiratorio subtipo A (VSR-A) el más frecuente. La mediana del tiempo de hospitalización fue de 21 días y 20 (17%) pacientes fallecieron. Se encontró asociación entre el antecedente de enfermedad pulmonar crónica y la infección por el VSR-A (p=0,045) y entre el síndrome de Down y la infección por virus influenza A (p=0,01). Después de controlar por potenciales factores de confusión, se halló que la cardiopatía congénita (RR: 3,1; IC 95%: 1,3-5,8; p=0,002) y la infección nosocomial (RR: 2,6; IC 95%: 1,0-5,3; p=0,01) incrementaron el riesgo de muerte en pacientes con IRAG. CONCLUSIONES.: El VSR-A fue la etiología viral más frecuente en menores de cinco años hospitalizados por IRAG en la UCIP. No se encontró asociación entre la infección viral y la sobrevida del paciente.
Asunto(s)
Gripe Humana/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Virosis/epidemiología , Enfermedad Aguda , Femenino , Hospitalización , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico , Tiempo de Internación , Estudios Longitudinales , Masculino , Perú , Estudios Prospectivos , Respiración Artificial/estadística & datos numéricos , Infecciones del Sistema Respiratorio/virología , Índice de Severidad de la Enfermedad , Virosis/virologíaRESUMEN
RESUMEN Objetivos. Identificar los principales agentes etiológicos virales en pacientes con infección respiratoria aguda grave (IRAG) hospitalizados en una Unidad de Cuidados Intensivos Pediátricos (UCIP) y analizar sus características clínicas. Materiales y métodos. Estudio longitudinal prospectivo en menores de cinco años hospitalizados por IRAG en la UCIP del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizaron pruebas de inmunofluorescencia directa y RT-PCR en tiempo real para el diagnóstico de virus respiratorios en muestras de aspirado traqueal o hisopado nasofaríngeo. Resultados. Se incluyeron 117 pacientes. La mediana de edad fue cuatro meses, el 66% presentaron comorbilidad y el 91% requirieron ventilación mecánica. Se identificó monoinfección por virus respiratorios en el 47% y coinfección viral en el 2,6%, siendo el virus sincicial respiratorio subtipo A (VSR-A) el más frecuente. La mediana del tiempo de hospitalización fue de 21 días y 20 (17%) pacientes fallecieron. Se encontró asociación entre el antecedente de enfermedad pulmonar crónica y la infección por el VSR-A (p=0,045) y entre el síndrome de Down y la infección por virus influenza A (p=0,01). Después de controlar por potenciales factores de confusión, se halló que la cardiopatía congénita (RR: 3,1; IC 95%: 1,3-5,8; p=0,002) y la infección nosocomial (RR: 2,6; IC 95%: 1,0-5,3; p=0,01) incrementaron el riesgo de muerte en pacientes con IRAG. Conclusiones. El VSR-A fue la etiología viral más frecuente en menores de cinco años hospitalizados por IRAG en la UCIP. No se encontró asociación entre la infección viral y la sobrevida del paciente.
ABSTRACT Objectives. To identify the main viral etiological agents in patients with severe acute respiratory infection (SARI) hospitalized in a Pediatric Intensive Care Unit (PICU) and to analyze their clinical characteristics. Materials and Methods. Prospective longitudinal study in children under five years of age hospitalized due to SARI at the PICU of t Instituto Nacional de Salud del Niño (National Children´s Hospital) in Lima, Peru. Real-time direct immunofluorescence and RT-PCR tests were performed for the diagnosis of respiratory viruses on tracheal aspirate or nasopharyngeal swab samples. Results. We included 117 patients. Median age was four months, 66% had comorbidity and 91% required mechanical ventilation. Respiratory virus monoinfection was identified in 47% and viral co-infection in 2.6%, with the respiratory syncytial virus subtype A (RSV-A) being the most frequent. The median length of hospitalization was 21 days and 20 (17%) patients died. An association was found between a history of chronic lung disease and RSV-A infection (p=0.045), and between Down syndrome and influenza A virus infection (p=0.01). After controlling for potential confounders, congenital heart disease (RR 3.1; 95% CI: 1.3-5.8, p=0.002) and nosocomial infection (RR 2.6; 95% CI: 1.0-5.3, p=0.01) were found to increase the risk of death in patients with SARI. Conclusions. RSV-A was the most common viral etiology in children under five hospitalized by SARI at the PICU. No association was found between viral infection and patient survival.
Asunto(s)
Femenino , Humanos , Lactante , Masculino , Infecciones del Sistema Respiratorio/epidemiología , Virosis/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Gripe Humana/epidemiología , Perú , Respiración Artificial/estadística & datos numéricos , Infecciones del Sistema Respiratorio/virología , Índice de Severidad de la Enfermedad , Virosis/virología , Unidades de Cuidado Intensivo Pediátrico , Enfermedad Aguda , Estudios Prospectivos , Estudios Longitudinales , Hospitalización , Tiempo de InternaciónRESUMEN
BACKGROUND: Nosocomial Infections (NI) are a frequent and relevant problem. The purpose of this study was to determine the epidemiology of the three most common NI in a Pediatric Intensive Care Unit from a developing country. METHODS: We performed a prospective study in a single Pediatric Intensive Care Unit during 12 months. Children were assessed for 3 NI: bloodstream infections (BSI), ventilator-associated pneumonia (VAP) and urinary tract infections (UTI), according to Center for Disease Control criteria. Use of devices (endotracheal tube [ETT], central venous catheter [CVC] and urinary catheter [UC]) was recorded. RESULTS: Four hundred fourteen patients were admitted; 81 patients (19.5%) developed 85 NIs. Density of incidence of BSI, VAP and UTI was 18.1, 7.9 and 5.1/1000 days of use of CVC, ETT and UC respectively. BSI was more common in children with CVCs than in those without CVCs (20% vs. 4.7%, p < 0.05). Candida spp. was the commonest microorganism in BSI (41%), followed by Coagulase-negative Staphylococcus (17%). Pseudomonas (52%) was the most common germ for VAP and Candida (71%) for UTI. The presence of NI was associated with increased mortality (38.2% vs. 20.4% in children without NI; p < 0.001) and the median length of ICU stay (23 vs. 6 days in children without NI; p < 0.001). Children with NI had longer average hospital stay previous to diagnosis of this condition (12.3 vs. 6 days; p < 0.001). CONCLUSIONS: One of every 5 children acquires an NI in the PICU. Its presence was associated with increased mortality and length of stay. At the same time a longer stay was associated with an increased risk of developing NI.