The rates of DAI in the Colombian ICUs were lower than those published in some reports from other Latin American countries and were higher than those reported in US ICUs by the NNIS. These data show the need for more-effective infection control interventions in Colombia.

Bacteria that produce the broad-spectrum Carbapenem antibiotic New Delhi Metallo-β-lactamase (NDM) place a burden on health care systems worldwide, due to the limited treatment options for infections caused by them and the rapid global spread of this antibiotic resistance mechanism. Although it is believed that the associated resistance gene blaNDM-1 originated in Acinetobacter spp., the role of Enterobacteriaceae in its dissemination remains unclear. In this study, we used whole genome sequencing to investigate the dissemination dynamics of blaNDM-1-positive plasmids in a set of 21 clinical NDM-1-positive isolates from Colombia and Mexico (Providencia rettgeri, Klebsiella pneumoniae, and Acinetobacter baumannii) as well as six representative NDM-1-positive Escherichia coli transconjugants. Additionally, the plasmids from three representative P. rettgeri isolates were sequenced by PacBio sequencing and finished. Our results demonstrate the presence of previously reported plasmids from K. pneumoniae and A. baumannii in different genetic backgrounds and geographically distant locations in Colombia. Three new previously unclassified plasmids were also identified in P. rettgeri from Colombia and Mexico, plus an interesting genetic link between NDM-1-positive P. rettgeri from distant geographic locations (Canada, Mexico, Colombia, and Israel) without any reported epidemiological links was discovered. Finally, we detected a relationship between plasmids present in P. rettgeri and plasmids from A. baumannii and K. pneumoniae. Overall, our findings suggest a Russian doll model for the dissemination of blaNDM-1 in Latin America, with P. rettgeri playing a central role in this process, and reveal new insights into the evolution and dissemination of plasmids carrying such antibiotic resistance genes.

A statistical evaluation of the population dynamics of R. neivai is based on six cohorts experiments conducted under controlled laboratory conditions. Two blood sources were offered to animals: rabbit and hen. Egg hatching, nymphal development time and mortality, adult longevity and age-specific mortality, female age-specific fecundity and fertility were determined. In addition, some population parameters were evaluated, such as: life expectancy, intrinsic rate of natural increase, net reproduction rate, finite rate of increase, reproductive value and stable age distribution. Life cycle was longer in the animals fed on rabbit, nymphal survival was slightly higher in the individuals fed on hen. Age of first reproduction was lower in the insects fed on hen, but reproductive output and total number of reproductive weeks were greater in the cohorts fed on rabbit. Intrinsic and finite rate of increase were greater in the animals fed on hen. Generation time was slightly greater in the cohorts fed on rabbit. Net reproduction rate was similar on both blood sources, although it was slightly bigger in the individuals fed on rabbit. Reproductive value in the insects fed on rabbit was twice as much as the registered in the animals fed on hen.

Adherence to HH was increased by 55% with the INICC approach. Programs targeted at improving HH in variables found to be predictors of poor compliance should be implemented.

After changing feeding frequency to a weekly and biweekly basis, a statistical evaluation of the variation of some population and reproductive parameters was conducted. It was based on four cohorts experiments of Rhodnius neivai fed on hen or rabbit. We found a direct relationship between blood feeding frequency and the parameters adult average longevity, maximum longevity and life expectancy in the animals fed on hen. On the other hand, in the insect fed biweekly on rabbit, these three values were higher than the registered in the cohorts fed weekly. Reproductive output got bigger and age-specific fertility showed a small decrease when feeding frequency was weekly. Every population parameter, except generation time, was greater in the individuals fed weekly.