Recent Submissions

  • South American Validation of a Survey to Assess Eco-Anxiety in Adults (ECO-ANS-LATAM)

    Mejia, Christian R.; Alvarez-Risco, Aldo; Vizcardo, David A.; Sedano-Ochoa, Luzmila; Medina Rivera, Maria Fe; Shimabukuro Jaramillo, Claudia; Cedillo-Balcázar, Jamil; Mamani-Benito, Oscar; Carranza Esteban, Renzo Felipe; Armada, Jose; Ubillus, Milward; Del-Aguila-Arcentales, Shyla; Davies, Neal M.; Yáñez, Jaime A. (MDPI, 2024-04-01)
    Background: climate change is a reality, and more and more people are becoming aware of this global problem, which has generated anxiety in some populations. To validate a short survey to assess eco-anxiety in adults in South America. Methods: It is an instrumental study, and the validation was based on a previous survey, which had six questions and was generated by 217 respondents in the USA in 2021. These questions were subjected to a validation process with expert judgment, pilot and application, and then statistics were obtained. It was validated with 1907 people in six countries in South America, where the mean, standard deviation, skewness and kurtosis were adequate. Results: The initial confirmatory factorial model obtained unsatisfactory goodness-of-fit indices, so the indices were modified through a re-specification, where two items were eliminated, after which adequate values were obtained (χ2 = 22.34, df = 2, p = 0.00; RMR = 0.020; GFI = 0.990; CFI = 0.990; TLI = 0.990; and RMSEA = 0.070). Finally, the overall Cronbach’s α was calculated to be 0.88 (95% CI = 0.86–0.89). Conclusions: The test was validated in a large South American population and found that only four questions can efficiently measure anxiety about the effects of climate change. The instrument can be used with other tests to screen different age groups, ethnicities and realities.
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  • New Psychometric Evidence of the Grief Impairment Scale (GIS) in People Who Have Experienced the Death of a Loved One From a Network Psychometric Approach in Two Latin American Countries

    Caycho-Rodríguez, Tomás; Travezaño-Cabrera, Aaron; Ventura-León, José; Vilca, Lindsey W.; Baños-Chaparro, Jonatan; Yupanqui-Lorenzo, Daniel E.; Valencia, Pablo D.; Torales, Julio; Carbajal-León, Carlos; Lobos-Rivera, Marlon Elías; Reyes-Bossio, Mario; Barrios, Iván; Jaimes-Alvarez, Freddy; Lee, Sherman A. (SAGE Publications, 2024-05-31)
    This study aimed to evaluate the psychometric properties of the Grief Impairment Scale (GIS) using a network psychometric model. A total of 1048 individuals from Peru and El Salvador participated. A network psychometric model was used to determine internal structure, reliability, and cross-country invariance. The results indicate that the GIS items were grouped into a single network structure through Exploratory Graph Analysis. Reliability was estimated by structural consistency, and it was found that when replicating the network structure within an empirical dimension, a single network structure was consistently obtained, and all items remained stable. Furthermore, the network structure was invariant, thus functioning similarly across the different country groups. In conclusion, the GIS presented solid psychometric evidence of validity based on its internal structure, reliability, and cross-country invariance. Therefore, the GIS is a psychometrically sound measure of functional impairment symptoms due to grief for Peruvian and Salvadoran individuals.
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  • Programmatic implementation of depression screening and remote mental health support sessions for persons recently diagnosed with TB in Lima, Peru during the COVID-19 pandemic

    Contreras, Carmen; Cruz, Janeth Santa; Galea, Jerome T.; Chu, Alexander L.; Puma, Daniela; Ramos, Lourdes; Tovar, Marco; Peinado, Jesús; Lecca, Leonid; Keshavjee, Salmaan; Yuen, Courtney M.; Raviola, Giuseppe (Cambridge University Press (CUP), 2024-04-04)
    Background: Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote lowintensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. Methods: We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9 ≥ 5). Participants with PHQ-9, 5–14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6 months after intervention completion. Wethen compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9 ≥ 15 were referred to higherlevel care. Findings: We found that 62 (45.9%) of the 135 participants had PHQ-9 ≥ 5 at baseline. Then, 54 individuals with PHQ-9, 5–9 received PFA, of which 44 (81.5%) were reevaluated. We observed significant reductions in median PHQ-9 scores from 6 to 2 (r = 0.98; p < 0.001). Four participants with PHQ-9, 10–14 received PM+ but were unable to be reevaluated. Four participants with PHQ-9 ≥ 15 were referred to higher-level care. Conclusions: Depressive symptoms were common among persons recently diagnosed with TB. We observed improvements in depressive symptoms 6 months later for most participants who received remote sessions of PFA.
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  • Financial inclusion and the informal sector

    Rojas Cama, Freddy; Emara, Noha; Trabelsi, Mohamed (RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS, 2024-06-01)
    This paper explores the relationship between the informal sector and financial inclusion for a sample of 186 countries across the period 2004–2018 by using various methods of estimations—ordinary least squares, instrumental variables, fixed effects, and general method of moments. The results show financial inclusion significantly reduces the size of the shadow economy throughout indicators of access and usage of financial services. The results are also robust when controlling by income level, these results strongly support the use of financial inclusion as an effective vehicle to lessen informality. Our policy recommendations are directed towards improving financial infrastructure and fostering inclusive financial environments to effectively decrease informality. Adopting dynamic, long-term strategies to sustain financial inclusiveness is key to achieving lasting reductions in the informal sector.
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  • The Transformative Role of Technology in Medical Education

    Quispe, Justiniano Felix Palomino; Choque-Flores, Leopoldo; León, Alisson Lizbeth Castro; Carbajal, Luis Villar Requis; Ferrer-Peñaranda, Lucio Arnulfo; Llaja, Lindomira Castro; García-Huamantumba, Elvira; Dávila-Morán, Roberto Carlos; Dávila, Leonardo Velarde (Editorial Salud, Ciencia y Tecnologia, 2024-01-01)
    Introduction: medical education has undergone a remarkable transformation driven by technological advances in recent decades. The progressive integration of digital tools and innovative technologies has significantly enriched access to educational resources and improved clinical practice. Objective: this analysis aims to evaluate the impact of various emerging technologies in medical education and their influence on clinical practice, highlighting improvements in skills and diagnostic accuracy, as well as the personalization of learning. Methods: a comprehensive analysis of pilot studies and systematic reviews was conducted that evaluated the impact of various technologies on medical education. Data collected from leading institutions were examined and statistical techniques were used to evaluate the effectiveness of these technological interventions. Results: pilot studies demonstrated significant improvements in surgical skills and diagnostic accuracy of medical students who benefited from virtual reality and clinical simulators. The application of artificial intelligence and machine learning has also improved the interpretation of medical data and early diagnosis of diseases. Conclusions: the continued integration of emerging technologies into medical education shows promising potential to personalize learning and improve patient care. However, challenges such as data security and appropriate training must be addressed to ensure successful implementation and lasting impact on clinical practice and medical education.
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  • Application of mobile reality in the training of health sciences students

    García-Huamantumba, Elvira; García-Huamantumba, Camilo Fermín; Dávila, Leonardo Velarde; García, Jhonny Henry Piñán; Guardia, Pedro Getulio Villavicencio; Del Carmen Pastrana Díaz, Nérida; Reyes, Guadalupe Ramírez; Pino, Gelacio Pozo; Zevallos, David Julio Martel; Quiñones, Lida Days Beraun (Editorial Salud, Ciencia y Tecnologia, 2024-01-01)
    Introduction: education in the 21st century has undergone a profound transformation thanks to technological advances. In this context, augmented reality (AR) has emerged as an innovative pedagogical tool that promises to revolutionize the way students acquire knowledge and skills. Objective: establish the impact of augmented reality on the learning of health sciences students at a private university in Lima. Methods: it is a quantitative, descriptive, non-experimental, cross-sectional study, whose sample was 74 health sciences students from a private university in Lima. The survey technique was used and the instrument was the questionnaire. Results: the use of AR was located at an intermediate level with 43,24 % (32), in learning, a medium level was recorded in 40,54 % (30) of the participants; The same trend occurred in the dimensions of both variables. Conclusions: it was determined that AR has a significant impact on the learning process of health sciences students at a private university in Lima, demonstrated through the Chi-square analysis, p-value = 0,023 < 0,05.
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  • Thriving in a World of Giants: Craft Breweries’ Workings in a Major Tourism Destination

    Carrillo, Brendali; Barbieri, Carla (SAGE Publications Ltd, 2024-01-01)
    Major tourism destinations depending on iconic resources to draw tourists are seeking to diversify their offerings. Building upon neolocalism, craft-beverage tourism has emerged as a diversification strategy. Such a strategy requires establishing a vibrant craft-beer industry that, according to the resource partitioning theory (RPT) requires applying four mechanisms (location, anti-mass production sentiment, customization, and conspicuous status). Since it is unknown how the RPT unfolds in tourism destinations, we interviewed 21 producers in Cusco (Peru), a major destination with an emerging craft-brewery industry, to identify the strategies they are utilizing to position their products when juxtaposed with tourism and neolocalism. We identified 17 actions that local craft-brewers apply and a strong tourism-neolocalism intersection, which altogether enriches the RPT. Findings suggest that craft-brewers build upon local places and culture to differentiate from, rather than fight against, their competitors. Findings can also guide agencies seeking to diversify the tourism offerings through craft-beverage tourism.
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  • Profitability enhancement by digital transformation and canvas digital model on strategic processes in post-Covid-19 in logistics SMEs

    Rojas-García, José Antonio; Elias-Giordano, Cynthia; Quiroz-Flores, Juan Carlos; Nallusamy, S. (Elsevier Ltd, 2024-01-01)
    The main objective of every Small and Medium Enterprise is to develop the ability to generate profits permanently over time; However, the Covid-19 pandemic significantly affected the global economy, generating an average reduction of 27% in global production and consumption, as well as a reduction in the use of labor, either due to reduced wages or reduction in working hours, which has had an impact on the increase in poverty. It is in this context that SMEs, with the aim of continuing to operate, implemented a strategy to reinvent themselves, which has been based on the greater use of the Internet and digital platforms with the aim of energizing their market or changing their line of business., will thus develop activities in other areas or new services that did not exist before the moment of this reinvention. In this context, electronic commerce increased in a first stage, promoting the need to develop the so-called ‘last mile’ processes, which is provided most of the time by light logistics companies; However, the lack of agile and rapid implementation methodologies that facilitate the identification and selection of digital technologies appropriate to the processes of SMEs has caused the growth rate of e-commerce sales to decrease, which affects consumption and poverty reduction. Therefore, the objectives of this research are to provide a methodology that allows improving the strategic planning of the organization, adapting the strategy to changes in the environment in an agile and rapid manner, and identifying the resources and actions required that contribute to increasing the productivity through the Digital Canvas Model and Digital Transformation in logistics SMEs in the short term.
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  • The rebranding of the Lima Cathedral Museum

    Rodríguez-Calmet, María Fernanda; Gallardo-Echenique, Eliana (Associacao Iberica de Sistemas e Tecnologias de Informacao, 2024-01-01)
    In recent years, the Cathedral Museum of Lima has implemented brand rebranding as a new communication strategy. The aim of this study is to analyze how the rebranding of the Lima Cathedral Museum contributes to the formation of brand bonds. This study is situated in an interpretative paradigm. Fifteen semi-structured interviews were conducted with university students in the last cycles of the Hotel and Tourism career. Acceptance and positive attitude towards rebranding is evidenced, promoting, among them, their experience. It is concluded that the rebranding of the museum contributes to the formation of brand bonds. It is essential to continue promoting the tourist attraction so that they feel part of the Catholic community and, in turn, Peruvian and foreign visitors feel identified with Peruvian culture through this museum.
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  • The use of Instagram for building Babysec’s digital communication and corporate reputation

    Lopez-Villacrez, Alexandra; Vargas-Sardon, Jorge Lucas; Chávez-Chuquimango, María (Associacao Iberica de Sistemas e Tecnologias de Informacao, 2024-01-01)
    The growth of social networks and their influence have taken an important role in the purchase decision process of users. Therefore, it is relevant to understand and know what corporate communication strategies can generate in the digital reputation of the brand. For that reason, this study aims to analyze the perceptions of user mothers of the Babysec brand on the management of digital corporate communication through Instagram communities to generate corporate reputation. Its approach is qualitative, it is positioned in the interpretive paradigm and case design. Interviews were applied to six young mother’s consumers of the brand. From this, experiences were shared about the construction of a community on Instagram, immediate responses and attention by the brand, concern for accessible prices and products for different types of users, among others.
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  • Inclusion in advertising to connect with the consumer

    La-Jara, Nicole; Gallardo-Echenique, Eliana (Associacao Iberica de Sistemas e Tecnologias de Informacao, 2024-01-01)
    Today’s consumers are more aware of what is happening in their social environment. Therefore, brands are adapting to these new consumer needs that lead to the romanticization of advertising strategies. The objective of this study is to identify the emotions felt by mothers in the inclusive discourse of Milo’s “Together in this back to school” campaign for the generation of awareness and loyalty. Its paradigm and design is phenomenological. The sampling was by snowball. Semi-structured interviews were conducted with twenty women mothers between the ages of 23 and 40. As a result, the use of inclusive discourse in advertising produced positive emotions such as “tenderness” and “emotion”. As a conclusion, if a brand works with social values and uses an inclusive discourse, it can achieve greater consumer acceptance and a change in their behavior towards the brand.
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  • Predicting Smartphone Addiction in Teenagers: An Integrative Model Incorporating Machine Learning and Big Five Personality Traits

    Osorio, Jacobo; Figueroa, Marko; Wong, Lenis (Science Publications, 2024-01-01)
    Smartphone addiction has emerged as a growing concern in society, particularly among teenagers, due to its potential negative impact on physical, emotional social well-being. The excessive use of smartphones has consistently shown associations with negative outcomes, highlighting a strong dependence on these devices, which often leads to detrimental effects on mental health, including heightened levels of anxiety, distress, stress depression. This psychological burden can further result in the neglect of daily activities as individuals become increasingly engrossed in seeking pleasure through their smartphones. The aim of this study is to develop a predictive model utilizing machine learning techniques to identify smartphone addiction based on the "Big Five Personality Traits (BFPT)". The model was developed by following five out of the six phases of the "Cross Industry Standard Process for Data Mining (CRISP-DM)" methodology, namely "business understanding," "data understanding," "data preparation," "modeling," and "evaluation." To construct the database, data was collected from a school using the Big Five Inventory (BFI) and the Smartphone Addiction Scale (SAS) questionnaires. Subsequently, four algorithms (DT, RF, XGB LG) were employed the correlation between the personality traits and addiction was examined. The analysis revealed a relationship between the traits of neuroticism and conscientiousness with smartphone addiction. The results demonstrated that the RF algorithm achieved an accuracy of 89.7%, a precision of 87.3% the highest AUC value on the ROC curve. These findings highlight the effectiveness of the proposed model in accurately predicting smartphone addiction among adolescents.
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  • CollabVR: VR Testing for Increasing Social Interaction between College Students

    Johnson, Diego; Mamani, Brayan; Salas, Cesar (Multidisciplinary Digital Publishing Institute (MDPI), 2024-02-01)
    The impact of the COVID-19 pandemic on education has accelerated the shift in learning paradigms toward synchronous and asynchronous online approaches, significantly reducing students’ social interactions. This study introduces CollabVR, as a social virtual reality (SVR) platform designed to improve social interaction among remote university students through extracurricular activities (ECAs). Leveraging technologies such as Unity3D for the development of the SVR environment, Photon Unity Networking for real-time participant connection, Oculus Quest 2 for immersive virtual reality experience, and AWS for efficient and scalable system performance, it aims to mitigate this social interaction deficit. The platform was tested using the sociability scale of Kreijns et al., comparing it with traditional online platforms. Results from a focus group in Lima, Peru, with students participating in online ECAs, demonstrated that CollabVR significantly improved participants perceived social interaction, with a mean of 4.65 ± 0.49 compared to traditional platforms with a mean of 2.35 ± 0.75, fostering a sense of community and improving communication. The study highlights the potential of CollabVR as a powerful tool to overcome socialization challenges in virtual learning environments, suggesting a more immersive and engaging approach to distance education.
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  • Framework for Enhancing Customer Service Advisor Training through Gamification

    Sierra, Christian Peña; Cutipa, Enrique Agreda; Wong, Lenis (Institute of Electrical and Electronics Engineers Inc, 2024-01-01)
    In the Peruvian financial sector, deficiencies persist in customer service training due to inadequate comprehension of work motivation and the absence of suitable incentives, reflective of concerns regarding skill shortages and operational inconsistencies among employees. This study proposes a gamification framework tailored to enhance the training of Customer Service advisors within financial entities, addressing the gap in specific training models for this crucial sector. Through analysis, design, and validation stages, the research scrutinizes existing methodologies and implements the framework within a financial Contact Center, yielding impressive results. Notably, a remarkable 85% reduction in training time (from 60 to 8.80 minutes) while maintaining consistent evaluation scores with a 1% increase, alongside a noteworthy 13% decrease in average evaluation duration, underscores the framework's efficacy. These findings emphasize its potential for continual enhancement in training practices, promoting heightened productivity, knowledge retention, and motivation among Customer Service advisors within the financial landscape.
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  • Framework for the Adaptive Learning of Higher Education Students in Virtual Classes in Peru Using CRISP-DM and Machine Learning

    Bautista, Maryori; Alfaro, Sebastian; Wong, Lenis (Science Publications, 2024-01-01)
    During the COVID-19 pandemic, virtual education played a significant role around the world. In post-pandemic Peru, higher education institutions did not entirely dismiss the online education modality. However, this virtual education system maintains a traditional teaching-learning model, where all students receive the same content material and are expected to learn in the same way; as a result, it has not been effective in meeting the individual needs of students, causing poor performance in many cases. For this reason, a framework is proposed for the adaptive learning of higher education students in virtual classes using the Cross-Industry Standard Process for Data Mining (CRISP-DM) and Machine Learning (ML) methodology in order to recommend individualized learning materials. This framework is made up of four stages: (i) Analysis of student aspects, (ii) Analysis of Learning Methodology (LM), (iii) ML development and (iv) Integration of LM and ML models. (i) evaluates the student-related factors to be considered in adapting their learning content material. (ii) Evaluate which LM is more effective in a virtual environment. In (iii), Four ML algorithms based on the CRISP-DM methodology are implemented. In (iv), The best ML model is integrated with the LM in a virtual class. Two experiments were carried out to compare the traditional teaching methodology (experiment I) and the proposed framework (experiment 2) with a sample of 68 students. The results showed that the framework was more effective in promoting progress and academic performance, obtaining an Improvement Percentage (IP) of 39.72%. This percentage was calculated by subtracting the grade average of the tests taken at the beginning and end of each experiment.
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  • AyudaMujer: A Mobile Application for the Treatment of Violence Against Women in Peru

    Mauricio, David; Zeña, Alejandro; Avila, Umer; Castañeda, Pedro; García, Lupe; Maculan, Nelson (Routledge, 2024-01-01)
    Violence against women in Peru is a problem that has a high incidence and is increasing, despite the policies undertaken by past governments and the creation of the Ministry of Women and Vulnerable Populations in 1996, causing that one in two women have been abused at some point in their lives. However, the treatment of abused women is still insufficient even though there are more Women’s Emergency Centers (WEC) each year, where victims can ask for professional support and treatment quickly and effectively. The chatbot provides an alternative to eliminate the distance between the abused woman and the WEC; therefore, a mobile application called AyudaMujer is proposed that includes a chatbot, news, a map of nearby WECs, and the connection with specialists for the treatment of violence against women. The chatbot identifies, automatically and through a natural dialogue, the type of violence and its level of risk. Additionally, it assigns a specialist to provide personalized professional treatment. The testing of AyudaMujer with 20 abused women from Lima, Peru, shows that the risk of violence is reduced by an average of 19.43% after three weeks of use. The results show that this tool can contribute to the treatment of abused women.
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  • Empathic Attitude of Dental Students from a Peruvian Public University Associated with Reading Habit: a Regression Analysis

    Garcia-Rupaya, Carmen R.; Chacon G., Doris M.; Caballero Garcia, Carmen S. (Universidad de Costa Rica, 2024-01-01)
    The present study aims to identify the empathic attitude of dental students from a Peruvian public university, about their reading habits, as well as the level of studies and other sociodemographic variables. 226 first-, fourth-, and sixth-year students registered in the academic year 2022 were enrolled in the study. The Jefferson Empathy scale, which included 20 items, was used with a Likert scale ranging from 1 to 7, i.e., from totally disagree to totally agree. A file containing questions about the sociodemographic data registry was prepared together with the Jefferson Empathy questionnaire. It was found that the profile of the students was mainly feminine, and the average age was 22 years; they came from Lima. They had the habit of reading and a little more than half of the group did not participate in sports activities. The "adequate" level of empathy was the highest (51.77%). By dichotomizing the response variable, it was found that adequate empathy was related to the habit of reading, especially reading dental books. Dental students from this public university mostly have an adequate level of empathy; it is independent of the sociodemographic variables but is related to reading habits.
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  • Basic psychological needs and GRIT in Peruvian university students

    Marcelo-Torres, Nohemi; Manyari-Masias, Maria Pia; Calderón-Sánchez, Raymundo; Tutte, Veronica; Brandão, Regina; Caycho-Rodríguez, Tomás; Reyes-Bossio, Mario (Frontiers Media SA, 2024-01-01)
    Introduction: The present quantitative study of predictive design aims to determine the influence of basic psychological needs and some socio-demographic variables on GRIT, in a sample constituted by scholarship students financed by PRONABEC from a private university in Lima. Methods: The GRIT Scale and Basic Psychological Need Satisfaction and Frustration Scale were applied to 865 students, 54.7% were female, the ages fluctuated between 16 and 47 years of age, 74.5% were residents in Lima. Results: The results demonstrated that Basic Psychological Need’s satisfaction has a positive influence on GRIT. On the other hand, there is a negative relationship between the GRIT dimensions (consistency and perseverance) and BPN frustration. In addition, women and first generation students showed higher GRIT levels. Discussion: This research confirms a high degree of influence of the competence needs satisfaction dimension on the GRIT and the influence of sociodemographic variables in achieving objectives.
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  • Dynamics of excretion of Eimeria spp oocysts in alpacas (Vicugna pacos) duringperipartum

    Añamuro, Carlos Enríquez; Watanabe, Raquel Watanabe; Alcántara, Raúl Rosadio (Universidad Nacional Mayor de San Marcos, 2024-01-01)
    Infections of alpacas at very early ages suggest that the dams may act as asymptomatic carriers of some Eimeria species. The aim of this study was to determine the dynamics of Eimeria spp oocyst excretion in alpaca dams during the calving season at the «La Raya» Research and Production Centre, Puno, Peru. Faecal samples were taken from 50 clinically healthy alpacas of the Huacaya breed naturally infected with Eimeria spp in the two weeks prepartum, week of delivery and four weeks postpartum (period December 2018 - March 2019). Dams were categorized into three age groups [A: 3-4 (n=19), B: 5-8 (n=26) and C: 9-12 years (n=5)]. Sample analysis was carried out using Sheather solution flotation and McMaster techniques. The pregnant dams entered the calving season excreting E. punoensis [49/50 (98%)], E. alpacae [43/50 (86%)], E. lamae [5/50 (10%), and E. macusaniensis [3/50 (6%)] but not E. ivitaensis. The percentage of dams shedding oocysts of E. alpacae and E. punoensis increased after the second week postpartum, while it was found a minimal excretion load of E. macusaniensis and E. lamae before and after the calving season. There was a significant difference in opg between A and B, and between the two weeks prepartum and four weeks postpartum, in addition to a very low negative correlation (-0.0538) between the number of opg and age (p=0.0468). Animals infected with E. punoensis presented 6.5 times the prevalence of those parasitized with E. alpacae (p<0.001; 95% CI 2.33-18.13).
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  • Genomic resistant determinants of multidrug-resistant Campylobacter spp. isolates in Peru

    Schiaffino, Francesca; Parker, Craig T.; Paredes Olortegui, Maribel; Pascoe, Ben; Manzanares Villanueva, Katia; Garcia Bardales, Paul F.; Mourkas, Evangelos; Huynh, Steven; Peñataro Yori, Pablo; Romaina Cachique, Lucero; Gray, Hannah K.; Salvatierra, Guillermo; Silva Delgado, Hermann; Sheppard, Samuel K.; Cooper, Kerry K.; Kosek, Margaret N. (Elsevier Ltd, 2024-03-01)
    Objectives: Antimicrobial resistant (AMR) Campylobacter is a global health threat; however, there is limited information on genomic determinants of resistance in low- and middle-income countries. We evaluated genomic determinants of AMR using a collection of whole genome sequenced Campylobacter jejuni and C. coli isolates from Iquitos, Peru. Methods: Campylobacter isolates from two paediatric cohort studies enriched with isolates that demonstrated resistance to ciprofloxacin and azithromycin were sequenced and mined for AMR determinants. Results: The gyrA mutation leading to the Thr86Ile amino acid change was the only gyrA mutation associated with fluoroquinolone resistance identified. The A2075G mutation in 23S rRNA was present, but three other 23S rRNA mutations previously associated with macrolide resistance were not identified. A resistant-enhancing variant of the cmeABC efflux pump genotype (RE-cmeABC) was identified in 36.1% (35/97) of C. jejuni genomes and 17.9% (12/67) of C. coli genomes. Mutations identified in the CmeR-binding site, an inverted repeat sequence in the cmeABC promoter region that increases expression of the operon, were identified in 24/97 C. jejuni and 14/67 C. coli genomes. The presence of these variants, in addition to RE-cmeABC, was noted in 18 of the 24 C. jejuni and 9 of the 14 C. coli genomes. Conclusions: Both RE-cmeABC and mutations in the CmeR-binding site were strongly associated with the MDR phenotype in C. jejuni and C. coli. This is the first report of RE-cmeABC in Peru and suggests it is a major driver of resistance to the principal therapies used to treat human campylobacteriosis in this setting.
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