Maestría en Laboratorio Clínico
Permanent URI for this collectionhttp://repositorio.uta.edu.ec/handle/123456789/35482
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Item Diseño de implementación de un laboratorio de biología molecular en el Hospital Provincial General Docente Ambato(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2023-04-04) Nieto Condo, Valeria Lilibeth; Inca Torres, Alberto RenatoMolecular biology has improved the diagnosis and treatment of diseases at the genetic level, and the PCR technique is essential in the clinical laboratory. The implementation of a molecular biology laboratory in a hospital can be of great importance, and facilities, equipment, and personnel must be considered. In Ecuador, the General Teaching Hospital of Ambato needs a molecular diagnosis area to improve the quality of medical care and diagnostic support. The implementation of molecular biology laboratories in hospitals in Latin America has been a growing trend in the last decade, with successful examples in Argentina, Colombia, Mexico, Paraguay, Peru, and Brazil. These laboratories have been fundamental for the diagnosis of genetic and infectious diseases, allowing early detection and more precise treatment. The COVID-19 pandemic has highlighted the importance of laboratory diagnosis, and efforts have been made to standardize diagnostic procedures. The study was conducted at the General Teaching Provincial Hospital of Ambato in Ecuador, using an observational and descriptive research model with a qualitative approach. The study population included medical personnel, clinical laboratory technologists, and nurses working directly at the hospital. The sample size was 66 individuals. Data collection for the project involved a literature review and a survey to determine the need and feasibility of implementing a molecular biology laboratory in the hospital. The survey was conducted with 66 healthcare professionals and analyzed using statistical tools. There is a need and feasibility to implement a molecular biology laboratory in the General Teaching Hospital of Ambato in Ecuador, with the aim of improving the quality of medical care and diagnostic support.Item Aplicación de fotometría reflectante y microscopia digital en el diagnóstico de infecciones de vías urinarias(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-12) Cajas Vilema Lcdo. MG, Jorge Patricio; Monge Moreno MG.BQF., Adriana MonserrathAntimicrobial resistance is a growing global problem, which also affects the common etiological agents of urinary tract infections (UTIs) and may involve increased mortality without proper treatment. There are different resistances at the outpatient versus nosocomial level that must be taken into account, any use of anti-biotics causes selective pressure on the microbiome by eliminating susceptible bacteria and increases the risk of infections by resistant bacteria. Therefore, a study was carried out at the Calderón General Hospital in the city of Quito, where 684 urine samples from outpatient, emergency and internal medicine patients were analyzed, in which Urine Culture was requested to correlate the parameters of EMO with Urine Culture. The EMO was performed in the Laura XL team, the chemical analysis, and digital microscopy, the chemical in an automated way in the Laura XL team, where the parameters of leukocytes and nitrites were taken into account for the microscopic analysis the values of leukocytes and bacteria were collected. For the urine culture we isolated the colonies, made a quantitative count and identified the most common uropathogens in patients, making a presumptive recognition. In the samples analyzed, it was found that 63% of requests for urine culture correspond to women, and it was shown that the diagnosis of UTI occurs more frequently in adult women as geriatrics. Of the samples analyzed, the positive urine cultures were 29%, in which the most frequent bacterium was E. coli.Item Evaluación del aseguramiento de la calidad de los resultados, como parte de la gestión técnica de los laboratorios clínicos privados del cantón Ambato(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio Clínico, 2022-11-01) Intriago León, Shirley Carolina; Galárraga Pérez, Edison Arturo Dr. Mg.Private clinical laboratories in Ambato canton fulfill important phases regarding the analysis of samples, both in the area of Clinical Chemistry, Hematology, Parasitology, Uroanalysis, among others, this process covers, the time when the doctor requests the order, in the so-called pre-analytical stage, followed by the classic pre-analytical and postanalytical stages, because the laboratory is involved in 70% of the clinical diagnosis is essential for patient safety, this is achieved through the control and assurance of these phases. Nowadays, analytical quality assurance is an essential part of the administration of private clinical laboratories, the objective of which is to evaluate in a transparent and documented manner the validity of the procedures used in these laboratories, and thus generate reliable results. Nowadays there is a great interest in the determination of quality assurance systems in private clinical laboratories, since the credibility and confidence of the results depends on the identification of such sources of variability, the documentation that demonstrates it and the control. The ISO 17025 standard, published in December 1999, establishes the technical and administrative requirements that a testing laboratory must follow in order to issue a reliable result. The clinical laboratory evolves as it adapts to scientific, technological and management changes, mediated by advances in medicine, new methods and analytical tests, as well as the growing demand and expectation of patients for higher quality services and products; in any perspective, the task before the new challenges to improve quality will depend on the performance of each of the quality management systems, ensuring the possible success for xiv the patient's health and prioritizing the optimal use of available resources to obtain a reliable result.Item Implementación de un protocolo de diagnóstico epidemiológico para la determinación la incidencia de la infección por Helicobacter pylori en pacientes adultos que se atienden en el centro de salud de Pasa – Tungurahua(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-11) Chagcha Frutos, Alexandra Alice; Urbina Salazar, Anabell del Rocío PhDGastrointestinal diseases being one of the main public health problems in Ecuador, they are transmitted by the fecal-oral route, or by the consumption of contaminated water or food; its prevalence depends on the socioeconomic level of the patients, the pathogens involved are viruses, parasites and bacteria. The study aimed to evaluate the diagnostic methods used in the health center of Pasa to establish Helicobacter pylori infection as well as the phase of eradication of the posttreatment microorganism, to implement an epidemiological diagnostic protocol to determine the prevalence of Helicobacter pylori infection Helicobacter pylori in adult patients treated at the Pasa - Tungurahua health center through the systematic use of the Immunochromatography test of the rapid test of the Antigen in feces with the specificity of 98.4% that allowed confirming the diagnosis and the eradication of Helicobacter pylori infection, analyzing the presence of risk factors in the study population. The methodology used was observational field type, prospective during the period September 2021-March 2022, it was carried out in two phases; the first was the determination of the current conditions of the prevalence and diagnosis of Helicobacter pylori infection and the second the determination of the eradication of the infection with the treatment of the patients who required it in the first phase, the collection of data, surveys were applied that were validated by professionals of the institution according to parameters of reliability, validity and objectivity. The results obtained show the prevalence of 52% of the patients of the studied sample that present concomitant factors for infection, the sample was 50 patients, 92.31% of patients, the pharmacological therapy used served for sensitization and eradication, 7.69% were obtained where apparently the treatment did not have an effect, but not due to the action of the treatment but due to the lack of adherence, a condition that can favor bacterial resistance. UNIVERSIDAD TÉCNICA DE AMBATO CENTRO DE POSGRADOS 17 It is concluded that according to the results the prevalence of Helicobacter pylori infection is significant with 52% in the study population. The epidemiological diagnosis protocol was implemented that will serve as a guide in the care of patients who present symptoms related to Helicobacter pylori infection. The use of rapid tests by detecting fecal antigens for the determination of Helicobacter pylori and the performance of the second tests for the eradication of the infection were made known to the medical and technical personnel in the Health Unit. patients on the prevention of infection, diagnosis and treatment to eradicate the bacteria to avoid complications and support the process of timely and efficient care for patients with this morbidity to avoid relevant mortality.Item Microbiología de las infecciones urinarias en pacientes diabéticos del Hospital Básico de Colta(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Aucancela Mullo, Alex Bladimir; Ortiz Jiménez, José Marcelo Bq.F. Mg.Introduction: Urinary tract infections are common in diabetic patients, with reduced and predictable etiological agents; but with a high rate of antibiotic resistance that makes treatment difficult. Objective: to evaluate the microbiology of urinary tract infections in diabetic patients of the Basic Hospital of Colta, determining demographic, microbiological and laboratory characteristics. Methodology: This is a quasi-experimental study with a quantitative approach, descriptive-observational, prospective cross-sectional type, carried out in the Hospital de Colta with 38 patients. Results: The prevalence of UTI in diabetics was found in those over 50 years of age (71.1%), with primary education (55.5%); of female gender (65.8%) and married (86.8%). The associated risk factors were poorly controlled diabetes (69.4%) and recurrent urinary tract infections (57.9%). Among the microorganisms found were E. coli (42.1%); S. saprophytic (31.6%); S. aureus (13.2%); in addition to k. oxytoca, and E. faecalis (7.9% and 5.3%). In relation to resistance we have: ciprofloxacin (45%) and cephalexin (42%); while sensitivity was for amoxicillin plus clavulanic acid and ampicillin plus IBL (84% and 66%); cefuroxime (74%), gentamicin (71%). Conclusions. The characterization of urinary tract infections in diabetics corresponds to those older than 50 years, with primary education, female gender and married marital status; while their risk factors are poorly controlled diabetes and recurrent infections; among the microorganisms found were E. coli, S. saprophytic, S. aureus, K. oxitoca, and E. faecalis with resistance to ciprofloxacin and cephalexin, with sensitivity to cefuroxime, amoxicillin plus clavulanic acid and gentamicinItem Diseño para la implementación del área del laboratorio de microbiología del Hospital Básico Machachi, Cantón Mejía(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Conterón Tene, Elizabeth; Guangasig Toapanta, Víctor Hernán Bq. F. Mg.Introduction: Currently some infections must be diagnosed clinically and in the same way they must be treated in a timely manner, if there is no prior isolation of the causative microorganism or determination of susceptibility to antibiotics, effective treatment is difficult, being essential the design of a microbiology Laboratory. Objective: The purpose of this research is to design the space for the assembly of the Microbiology Laboratory, under locative, administrative and financial parameters and thus propose the implementation of the microbiology area in the Machachi Basic Hospital clinical laboratory. Methodology: descriptive type, since it shows the reality of the current situation of the Machachi Basic Hospital at the time of conducting the study; it is a non-experimental investigation of transectional cut; applying a survey to patients diagnosed with infectious pathologies who come to the hospital applying a "focus group" to the medical personnel of the Hospital, in general terms, all the doctors of the hospital indicated that microbiology exams are of great importance and a lot of diagnostic help for the proper management and timely treatment of patients who come to the Machachi Basic Hospital. Results: it was evidenced that the patients express the need to include the microbiology area. Specifically, 98.2% of the sample indicates the need for a microbiology laboratory, and it is opportune to speed up the process for the design and implementation of the laboratory, and in this way guarantee the adequate diagnosis of the different infectious diseases that threaten the population in order to ensure timely and effective treatment. Additionally, 96.4% stopped performing exams due to lack of budget. 96.4% of patients surveyed consider that timely treatment will be given if the Microbiology laboratory is increased. Conclusions: Based on these antecedents, the adequate space is established within the laboratory, for the implementation of the microbiology area, the area arranged in the hospital consists of 16.22 m2, it has the facilities for the operation of the laboratory and the proposal for the design and implementation of the microbiology area adjusted to the characteristics of this hospital, and complying with all relevant regulations and requirements, with the ultimate goal of being evaluated by the competent authorities and considering including this area within those that offers this institution.Item Identificación genotípica y análisis de prevalencia de Mycobacterium kansassii en muestras de pacientes con sospecha de tuberculosis pulmonar que asisten al centro de Salud # 1 de la ciudad de Ambato – Tungurahua(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Monge López, Jessica Lizbeth Lcda.; Monge Moreno, Adriana Monserrath Dra. Mg.My present research work was carried out at the Health Center No. 1, in the city of Ambato, Province of Tungurahua, with samples from patients with suspected pulmonary tuberculosis, my study is aimed at investigating the genotypes and prevalence analysis of Mycobacterium kansasii. Taking into account that in recent years, M. kansasii has emerged as one of the main atypical mycobacteria causing disease in man, with its most frequent clinical manifestation being lung disease. Generally, it is sensitive to classic tuberculostatics, and therapeutic failures are usually associated with resistance to rifampicin. Although phenotypically it is a very homogeneous species; there are different studies that describe different biotypes. In addition, in recent years the existence of seven genotypes (I to VII) has been described, of which genotype I is the most prevalent and the main cause of disease in man. For all these reasons, in this work I set out to know the genotypes of M. kansasii circulating in the area of influence of the Health Center No. 1, for which we carried out a genotypic characterization that showed a high homogeneity among our patients, being mostly included in a biotype; the detection of M. kansasii-specific DNA probes that confirmed species identification and reverse hybridization techniques that determined that all our isolates belonged to genotype I.Item Implementación de un protocolo de control de calidad para la esterilización de desechos biocontaminados producidos en el laboratorio de microbiología del Hospital General Ambato(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Ñacato Anchaluisa, Byron Rafael; Guangasig Toapanta, Víctor Hernán Bq.F. Mg.The correct disposal of biocontaminated elements is a responsibility that cannot be taken as a minor problem and even worse considering that the management of these wastes can be done without the respective considerations, the impact that the incorrect disposal of waste has several consequences, it can affect both the personnel who work in the institution, as well as the other people who come to the HGDA for any other reason, as well as the environmental impact becomes irreversible. There are regulations issued by the Ministry of Health, the same ones that are not carried out due to various factors, or due to ignorance of these regulations, despite the fact that they are documents available to officials and that they should only be compliance compliance, notwithstanding the This work points out the issue of sterilization of biocontaminated waste before its final disposal, with which we will be able to reduce the chances of causing cross-infection, between the waste produced in the microbiology area and the personnel who work in this department. The protocol to be implemented will allow us to carry out an effective, controlled and verified process of sterilization of biocontaminated waste, thanks to the verification and monitoring of physical controls (temperature, time, pressure), chemical (control tape) and biological (thermostatic bacteria). resistant). A critical point that was denoted when conducting a brief survey of the personnel involved, is that many do not know the correct way to eliminate or handle these contaminated elements, which is why this work will allow us to identify the shortcomings to correct them and promote the actions that are done correctlyItem Diseño de la implementación del área de micología humana en el hospital general docente Ambato(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Fonseca Zuñiga, Jackeline Elizabeth; Ramos Ramírez, Martha Cecilia Bq.F. Mg.The main objective of this research was to design a functional area of human mycology in the Ambato General Teaching Hospital, whose methodology corresponded to a mix (cualitativecuantitative) and transactional study; for data collection, a survey was designed and applied to 101 professionals who work in the hospital, which was previously validated by ten (10) experts; and from its application, the perspective of the respondents regarding the project was determined, as well as the demand for the planned analysis. Obtaining as a result that there is indeed a need to carry out mycological analyzes since there are no mycology laboratories in the area and the approximate demand was recorded in more than 300 analyzes per month and the approval of the project was also validated by more than 90% of the staff professional who works in the institution, who mostly corresponded to workers who have between 11 to 15 years of service, work mainly in outpatient clinics and are medical specialists of the HGDA. For the development of the proposal, the area for the operation of the laboratory was determined and it was categorized as a LAC-2, together the equipment, reagents and materials that must be acquired for the proper functioning of the laboratory and its reference costs were established obtaining a total of 89,746.06 dollars for the project, which includes technical and human resources, thus completing the pertinent technical, administrative, operational and financial proposal to be presented to the institution's authoritiesItem Identificación rápida de Staphylococcus Aureus Meticilino Resistente, mediante la Técnica Slidex Mrsa en personal de salud portadores sanos del Hospital Básico Salcedo(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-10) Quispe Gallo, José Luis; Brito Zambrano, Johana Susana Med. Esp.Introduction: Staphylococcus aureus is a Gram positive, nosocomial pathogen. MRSA is associated with resistance to multiple antibiotics, which makes its control and treatment difficult, being located in the nostrils of healthy people, in health personnel for being in direct contact with patients. Objective: The presence of methicillin-resistant Staphylococcus aureus was identified from cultures of nasal samples using the Slidex MRSA Technique from healthy carrier patients. Methodology: The present development project is quasi-experimental and crosssectional, since a study was carried out where the identification of MRSA is sought, using the Slidex mrsa technique. In which the percentage of patients who are healthy carriers of resistant microorganisms will be determined. Results: Of the 36 participants, 35 cultures were obtained with bacterial growth in Blood Agar, which represents 97.2%, of this percentage 97.1% were Gram positive arranged in a Staphtype cluster, while 2.9% were Gram negative. The work was only developed with gram positives which were planted in Mannitol Agar to continue with the study, of the 34 cultures planted 6 were mannitol positive representing 17.6%, of all the mannitol positive microorganisms 100% were coagulase positive and For the identification of Mrsa, the traditional procedure was used: sensitivity to Oxacillin by the disc diffusion method, to which 5 samples presented resistance, which represented 83% of the microorganisms that were coagulase positive. These same microorganisms were processed with the Slidex Mrsa Technique and we observed that 100% presented agglutination, allowing the detection of methicillin resistance. Conclusion: The Slidex MRSA rapid identification technique, when compared with traditional identification methods such as oxacillin resistance, allowed to achieve even better results and faster
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