Factors Associated With Drug Consumption Without Scientific Evidence in Patients With Mild COVID-19 in Peru

Soriano-Moreno, David R.; Fernández-Guzman, Daniel; Sangster-Carrasco, Lucero; Quispe-Vicuña, Carlos; Grados-Espinoza, Pamela; Ccami-Bernal, Fabricio; Morocho-Alburqueque, Noelia; Coba-Villan, Naomi; Velasquez-Fernandez, Randy; Nieto-Gutiérrez, Wendy

doi:10.1097/pts.0000000000001053

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…Besides the irrational antibiotic consumption or overuse in LIMCs such as Peru [7], a special mention must be made of the recent global pandemics. Therefore, resistance to macrolides or fluoquinolones found in our study could be due to the irrational use of azithromycin in the first year of the COVID-19 pandemic [30] or other endemic infectious conditions requiring this sort of treatment (e.g., Helicobacter pylori [31], sexually transmitted diseases [32,33]).…”

Section: Discussionmentioning

confidence: 88%

Uncovering the Resistome of a Peruvian City through a Metagenomic Analysis of Sewage Samples

Poterico,

Jaramillo-Valverde,

Pablo-Ramirez

et al. 2023

Environments

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Background: Antibiotic resistance is a major public health concern globally. In this study, we aimed to evaluate the abundance and diversity of antibiotic resistance genes (ARGs) in sewage water samples from two hospitals and an adjacent community or urban setting in Huanuco, a Peruvian city located in the highlands. Methods: We collected samples from the community wastewater system and from sewage pipes from the two hospitals in Huanuco. DNA was extracted from 250 mL of sewage water samples (n = 6) and subjected to microbiome profiling using 16S rRNA short amplicon sequencing and shotgun metagenomics. We analyzed the taxonomic and functional content in all samples, including alpha and beta diversity metrics, and searched for ARGs. Results: Our results showed that samples taken from the community wastewater system were compositionally different and harbored greater bacterial taxonomic and functional diversity compared to samples collected from the hospitals’ wastewater system. We found a high abundance of bacteria associated with resistance to beta-lactams, macrolides, aminoglycosides, fluoroquinolones, and tetracyclines in all samples. However, there were no significant differences in the abundance or composition of ARGs between the community wastewater samples and those taken from the two hospitals. Conclusions: Our findings suggest that metagenomics analyses in wastewater sewage could be a useful tool for monitoring antibiotic resistance in urban settings. These data could be used to develop local public health policies, particularly in cities or countries with limited resources to establish large-scale One Health projects.

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Section: Discussionmentioning

confidence: 88%

Uncovering the Resistome of a Peruvian City through a Metagenomic Analysis of Sewage Samples

Poterico,

Jaramillo-Valverde,

Pablo-Ramirez

et al. 2023

Environments

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“…Antibiotic overuse could be related to the prevalence of infectious diseases, which is common in LMIC (3). Therefore, resistance to macrolides found if our study could be due to the irrational use of azithromycin in the first year of the COVID-19 pandemic (15) or other endemic infectious conditions requiring this sort of treatment (e.g., Helicobacter pylori ( 16)). Moreover, it is not surprising that we found high levels of resistance to rifampin or fluoroquinolones, as Peru is a country with high rates of tuberculosis (TB) treatment resistance (17).…”

Section: Discussionmentioning

confidence: 93%

Antibiotic resistance genes in sewages from hospitals and the urban setting in a Peruvian city in the highlands

Poterico¹,

Jaramillo‐Valverde

Pablo-Ramirez

et al. 2022

Preprint

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Background: The establishment of the metagenomics seems a suitable approach to assess the abundance and diversity of antibiotic resistance genes (ARG) Methods: Metagenomics study in a Peruvian city from the highlands, where samples derived from sewage waters from two hospitals and the urban setting. DNA extraction was performed in 250 mL and then16S rRNA gene amplification and shotgun sequencing were carried out. The bioinformatic pipeline was performed following recommendations for metagenomics analysis. Alpha diversity was evaluated with the Shannon and Simpsons indices; whereas beta diversity was evaluated through the Bray-Curtis index, and using the principal coordinate analysis (PCoA) to explore and visualize the differences. Results: We found a high abundance of bacteria related to resistance to beta-lactams, macrolides, aminoglycosides, fluoroquinolones and tetracyclines. The urban sample did not differ significantly from the wastewater ARG presence from the hospitals in Huanuco. Conclusion: Metagenomics analysis through sewage strategies seems to help to monitor the AMR to establish local public health policies, especially in cities or countries with limited resources to establish large projects conceiving the One Health approach.

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“…Other aspects that would explain the high proportion of home fatalities were self-medication and insufficient oxygen supply. At first, a significant fraction of the population preferred to self-medicate with hydroxychloroquine, azithromycin, ivermectin, and even chlorine dioxide, instead of going to a hospital, died in their homes due to the rapid evolution of the disease [ 40 , 41 , 42 ]. Later, the supply of oxygen proved to be largely insufficient in public health facilities in the interior of the country as they did not have oxygen plants, which led people to decide to manage their family members at home, acquiring oxygen from private providers combined with the exaggerated increase in the cost of this service, so many families could not afford it.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics of Deaths from COVID-19 in Peru during the Initial Pandemic Response

et al. 2022

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Background and aim: Peru is the country with the highest mortality rate from COVID-19 globally, so the analysis of the characteristics of deaths is of national and international interest. The aim was to determine the epidemiological characteristics of deaths from COVID-19 in Peru from 28 March to 21 May 2020. Methods: Deaths from various sources were investigated, including the COVID-19 Epidemiological Surveillance and the National System of Deaths (SINADEF). In all, 3851 deaths that met the definition of a confirmed case and had a positive result of RT-PCR or rapid test IgM/IgG, were considered for the analysis. We obtained the epidemiological variables and carried out an analysis of time defined as the pre-hospital time from the onset of symptoms to hospitalization, and hospital time from the date of hospitalization to death. Results: Deaths were more frequent in males (72.0%), seniors (68.8%) and residents of the region of Lima (42.7%). In 17.8% of cases, the death occurred out-of-hospital, and 31.4% had some comorbidity. The median of pre-hospital time was 7 days (IQR: 4.0–9.0) and for the hospital time was 5 days (IQR: 3.0–9.0). The multivariable analysis with Poisson regression with robust variance found that the age group, comorbidity diagnosis and the region of origin significantly influenced pre-hospital time; while sex, comorbidity diagnosis, healthcare provider and the region of origin significantly influenced hospital time. Conclusion: Deaths occurred mainly in males, seniors and on the coast, with considerable out-of-hospital deaths. Pre-hospital time was affected by age group, the diagnosis of comorbidities and the region of origin; while, hospital time was influenced by gender, the diagnosis of comorbidities, healthcare provider and the region of origin.

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Factors Associated With Drug Consumption Without Scientific Evidence in Patients With Mild COVID-19 in Peru

Cited by 4 publications

References 30 publications

Uncovering the Resistome of a Peruvian City through a Metagenomic Analysis of Sewage Samples

Uncovering the Resistome of a Peruvian City through a Metagenomic Analysis of Sewage Samples

Antibiotic resistance genes in sewages from hospitals and the urban setting in a Peruvian city in the highlands

Epidemiological Characteristics of Deaths from COVID-19 in Peru during the Initial Pandemic Response

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