The intestinal microbiota is currently known as a "metabolic organ" that significantly influences the health of the host from the first years of life, being a crucial factor for optimal development of immunity and regulation of different physiological processes such as digestion, absorption, metabolism and synthesis of nutrients. This work aims to show the relationship between epigenetics, the exposome and the development of the intestinal microbiota in the newborn according to the route of birth. A documentary review of the literature of the last 5 years was carried out and it was found that the majority of non-communicable diseases are due to epigenetic modifications that can occur in the prenatal stages, together with environmental factors that also contribute to these epigenetic changes, term known as an exposome. In this sense, the greatest exposure of microorganisms for the development of intestinal colonization is at the time of birth, being Bifidobacterium one of the most important genera that contribute to immune function, found to a lesser extent in newborns born by abdominal route (cesarean section ), this type has been associated with dysbiosis of the intestinal microbiota, generating consequences in the development of diseases such as obesity, diabetes, asthma, food allergy and autism spectrum disorder. Allowing to conclude that both epigenetics and the exposome and the intestinal microbiota are simultaneously related from the early stages of life and can be the cause of various non-communicable diseases.
Acinetobacter baumannii is an opportunistic pathogen that seriously affects sick patients, causing Health Care Associated Infections (HCAI) such as pneumonia associated with mechanical ventilation, urinary tract infections and bacteremia, in recent years this bacterium has become a health problem worldwide, its isolation from infections present in hospitalized patients has been increasing, and it also has various mechanisms of resistance to antibiotics. The present documentary research aims to describe the mechanisms of pathogenicity and resistance to antibiotics used by Acinetobacter baumannii as a causal agent of HCAI. To carry out this work, a literature search was carried out in databases such as: Scielo, PubMed, NCBI, and Elsevier. The pathogenicity mechanisms that allow it to colonize and develop infections in hospitalized patients are: porins, biofilms, pili, lipopolysaccharides, phospholipases, outer membrane vesicles and the production of siderophores. It has enzymatic resistance mechanisms such as beta-lactamases and non-enzymatic mechanisms such as porin modification, efflux pumps, and modifications in DNA gyrase. There are extrinsic factors that favor the development of HCAI, such as the immunological and health condition of the patient, as well as the association with medical equipment. Studies carried out between the years 2005 to 2018 reveal that A. baumannii is one of the main causative agents of pneumonia associated with mechanical ventilation in patients admitted to the Intensive care unit.
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