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Background The first case of SARS-CoV-2 in Mexico was reported in February 2020, since then, high rates of mortality due to COVID-19 have been found. Cytokine storm is linked to the severity and decreasing the survival among infected patients by COVID-19. The serum levels of Interleukin 6 (IL-6) have been correlated to mortality in COVID-19 cases and could be used as indicator of mortality in COVID-19 cases. The aim of this study was to determine levels of IL-6 and assess its usefulness as indicator of mortality among COVID-19 patients from Mexico. Methods A cohort study among 38 adults (28 men, 10 women) was carried out in the Regional High Specialty Hospital of the Yucatan Peninsula in Merida, Yucatan, Mexico. Demographic and clinical biochemistry data were collected. The serum levels of IL-6 were measured in each patient by specific immunoassays. Results High frequency of mortality (36.84%) was found in the sample. The average age of individuals that non-survive was significantly higher (59.71 ± 13.83 years) than the survival group (43.29 ± 11.80 years). Serum levels of IL-6 were significantly higher in patients that did not survive. A correlation between IL-6 levels with lymphocyte count, LDH, CRP and procaciltonin was found. The optimal cutoff value of IL-6 was 30.95 pg/mL with high sensitivity and specificity. Conclusion Our findings demonstrate that level of IL-6 is an indicator of mortality among hospitalized COVID-19 patients in Mexico.

BACKGROUND Point-of-care rapid tests to identify SARS-CoV-2 can be of great help because, in principle, they allow decisions to be made at the site of care for treatment, or for the separation of cohorts avoiding cross-infection, especially in emergency situations. METHODS A cross sectional study in adults requesting care in Emergency Rooms (ER), or the outpatient clinics of referral hospitals for COVID-19, to define the diagnostic characteristics of a rapid antigen test for SARS-CoV-2 (the Abbott PanbioTM) having as a gold standard the RT-PCR for SARS-CoV-2. Health personnel in a routine situation within an active pandemic in several cities of Mexico performed the tests. RESULTS A total of 1,069 participants with a mean age of 47 years (SD 16 years), 47% with a self-reported comorbidity, and an overall prevalence of a positive RT-PCR test of 45%, were recruited from eight hospitals in Mexico. Overall sensitivity of the Panbio test was 54.4% (95%CI 51-57) with a positive likelihood ratio of 35.7, a negative likelihood ratio of 0.46 and a Receiver-Operating Characteristics curve area of 0.77. Positivity for the rapid test depended strongly on an estimate of the viral load (Cycle threshold of RT-PCR, Ct), and the days of symptoms. With a Ct 25, sensitivity of the rapid test was 0.82 (95%CI, 0.76-0.87). For patients during the first week of symptoms sensitivity was 69.6% (95%CI 66-73). On the other hand, specificity of the rapid test was above 97.8% in all groups. CONCLUSIONS The PanbioTM rapid antigen test for SARS-CoV-2 has a good specificity, but due to low and heterogeneous sensitivity in real life, a negative test in a person with suggestive symptoms at a time of community transmission of SARS-CoV-2 requires confirmation with RT-PCR, and after the first week of symptoms, sensitivity decreases considerably.

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BackgroundAntimicrobial stewardship programs (ASPs) promote the responsible use of antimicrobials by limiting inappropriate use. This study evaluates the impact of a prospective ASP implementation on the health-care-associated infections (HCAIs) in a third-level hospital in Yucatán, México, after the establishment of an ASP in October 2017.MethodsThis was a prospective, single-center (Hospital de Alta de Especialidad de la Península de Yucatán -HRAEPY-), pre and post-intervention study, designed to analyze the impact of an ASP on health-care-associated infections rate, during January–October 2017 (pre-ASP) and January–October 2018 (post-ASP) by using comparative descriptive statistic of the monthly and annual rate of health-care-associated infections according to hospital network of epidemiological surveillance (RHOVE) in Mexico.ResultsDuring 2017, RHOVE reported 225 cases of HCAIs equivalent to a rate of 7.46/1,000 days of hospital stay. After ASP in 2018, the RHOVE reported 111 cases of HCAIs, equivalent to a rate of 4.38/1,000 days of hospital stay. This difference represented a reduction of −41.28% of the rate of HCAIs in the HRAEPY (Graphic 1). Antimicrobial susceptibility increased (pre-ASP vs. post-ASP) for 3 Gram-negatives associated with HCAIs at HRAEPY: TMP/SMX for E. coli (49% to 62%), Ciprofloxacino for K. pneumoniae (42% to 51%) and Piperacillin/Tazobactam (62% to 93%); Meropenem (61% to 72%) and Ciprofloxacino (67% to 79%) for P. aeruginosa (Graphic 2).ConclusionASP contributed to reducing the rate of HCAIs in the HRAEPY when it was implemented as an additional measure to the strategies for control of nosocomial infections. Additionally, this ASP caused an increase in the bacterial susceptibility of the most important microorganisms as a cause of infections associated with healthcare in HRAEPY. Disclosures All authors: No reported disclosures.

Background: Hand hygiene (HH) is effective for infection control, but its performance is poor in health-care workers (HCW). Methods: Study to evaluate the WHO technique and adherence to HH in a third-level hospital in Yucatán, Mexico. Data from evaluation certificates and "shadow" studies were analyzed and expressed in tables and graphs. Results: 406 HCW were evaluated for technique and 141 for adherence. Overall Compliance was 89.2% (satisfactory), being lower for cleaning (66%) and inhalation therapy (77%) teams. The lowest indicator was "hygiene time," with 55.4% (precarious). Overall Adherence was 61.4% (minimum), with physicians (12%) and residents and interns (6%) being less adherent than nursing staff (69%). The moments of fewer adherence were "after contact with fluids/secretions" (56.5%) and "after contact with the patient" (47.6%). Conclusions: Low adherence at critical moments during patient-care means that HCW did not extend the protection to themselves. Lack of motivation and professional attitude could be the cause of these results.

A 25-year-old female patient with a recent history of C3-HIV/ AIDS infection (49 cells/mm 3 and 180,000 copies) presented to our Dermatology department with a three-month disease characterized by fever and cervical adenopathy, following ulceration. The presumptive diagnosis was cutaneous tuberculosis (Figure 1). Histopathological analysis showed suppurative granuloma with multiple acid-alcohol-resistant filaments; Nocardia brasiliensis was isolated by culture, and identified by biochemical tests and PCR (16s rRNA), confirming cutaneous nocardiosis. Treatment with amikacin 15 mg/kg/day and trimethoprim/sulfamethoxazole 800 mg/160 mg/12 h was successful with no relapse.

The COVID-19 has affected million people around the world with Mexico being one of the most affected countries. This pandemic has impacted the continuum of care for people living with HIV so it was decided to know the frequency and usefulness of performing rapid HIV tests during COVID-19 pandemic.