6 research outputs found

    CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

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    ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

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    Incluye los folletos en distintos idiomas elaborados por el centro para informar a los padres sobre la educación en la Comunidad de MadridParte de la necesidad de desarrollar un plan de acogida al alumnado inmigrante para que se adapte desde un primer momento al centro, la clase, los compañeros y el entorno. La finalidad inicial es crear una actitud crítica que lleve al alumnado a sensibilizarse ante situaciones de injusticia, respeto intelectual y étnico y erradicar actitudes de discriminación dentro de un contexto de desigualdad y respeto a la diferencia individual. Los objetivos son fomentar la integración, fortalecer la seguridad, la confianza, autonomía, la participación y la aceptación a la diversidad; cultivar actitudes interculturales positivas, potenciando la convivencia y cooperación entre alumnos de culturas diferenciadas; mejorar el autoconcepto personal, cultural y académico de los alumnos; desarrollar la expresión, la creatividad, el razonamiento, la comunicación y la iniciativa; aumentar las relaciones con la familia y, mantener con los tutores una adecuada coordinación en el proceso de enseñanza-aprendizaje de los alumnos. Las actividades organizativas y de centro son la creación de datos informativos en diferentes idiomas sobre la educación en la Comunidad de Madrid; la incorporación de las solicitudes de matriculación en distintos idiomas; y la creación de un equipo de acogida del alumnado extranjero. Las actividades con el alumnado son la creación de carteles de las distintas dependencias del colegio y un libro viajero intercultural, jornadas de juegos populares, celebración del día intercultural y de Madrid. Se evalúa la organización del proyecto.Madrid (Comunidad Autonóma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

    Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain

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    New insights into the genetic etiology of Alzheimer’s disease and related dementias

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    Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele
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