Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Biodiversidad para el desarrollo. El manejo sostenible de ecosistemas como aporte al bienestar humano

El Instituto Humboldt, en su plan estratégico 2005 -2010 «Biodiversidad para el desarrollo: el manejo sostenible de ecosistemas como aporte al bienestar humano», le apuesta al manejo sostenible de ecosistemas desde una visión integral de los mismos, donde se busca el balance entre conservación, uso sostenible y distribución justa y equitativa de los beneficios derivados de los recursos de la biodiversidad. Este enfoque reconoce a los seres humanos como parte integral de los ecosistemas y por tanto, tiene en cuenta las relaciones y vínculos entre el bienestar humano y su potencial para contribuir a la disminución de la pobreza.BOGOTA D.C

Memoria del proyecto: e-MATE

Memoria ID-059. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2010-2011.El proyecto e-MATE (Enseñanza de las Matemática en red) se ha llevado a cabo como un proyecto global del Departamento de Matemática Aplicada con el objetivo fundamental de dar respuesta a los retos que la enseñanza de las Matemáticas tiene en nuestra Universidad, dado el gran número y variedad de titulaciones en las que el profesorado de nuestro Departamento ejerce su labor docente

Promoción turística sostenible de la reserva de la biosfera Tajo-Tejo Internacional

Convocatoria proyectos de innovación de Extremadura 2020/2021Se describe un proyecto llevado acabo por varios centros educativos ubicados en la zona de la Reserva de la Biosfera Tajo-Tejo Internacional (RBTTI) que pretendía contribuir a la transformación sostenible del entorno mediante su conocimiento y promoción, implementando las competencias digital, social y ciudadana y la cultura emprendedora mediante metodologías activas como el aprendizaje servicio. Entre los objetivos principales del proyecto destacan: dar a conocer las implicaciones de la RBTTI; diseñar una campaña de promoción de la RBTTI mediante trípticos y vídeos promocionales; conocer la Reserva a través de las principales vías pecuarias y caminos que comunican los pueblos; descubrir los principales elementos socioculturales, históricos y tradicionales de la Reserva; valorar la importancia del territorio para conservar la biodiversidad: paisajes, ecosistemas, fauna y flora representativa; relacionar la trashumancia y las vías pecuarias como rasgos identificativos de la Reserva, vinculándolo con la historia y rasgos culturales de los pueblos y valorar el emprendimiento y la iniciativa personal, el asosiacionismo y creación de redes de cooperación en y entre pueblos como motor de desarrolloExtremaduraES

Quorum sensing network in clinical strains of A. baumannii : AidA is a new quorum quenching enzyme

Acinetobacter baumannii is an important pathogen that causes nosocomial infections generally associated with high mortality and morbidity in Intensive Care Units (ICUs). Currently, little is known about the Quorum Sensing (QS)/Quorum Quenching (QQ) systems of this pathogen. We analyzed these mechanisms in seven clinical isolates of A. baumannii. Microarray analysis of one of these clinical isolates, Ab1 (A. baumannii ST-2-clon-2010), previously cultured in the presence of 3-oxo-C12-HSL (a QS signalling molecule) revealed a putative QQ enzyme (α/β hydrolase gene, AidA). This QQ enzyme was present in all nonmotile clinical isolates (67% of which were isolated from the respiratory tract) cultured in nutrient depleted LB medium. Interestingly, this gene was not located in the genome of the only motile clinical strain growing in this medium (A. baumannii strain Ab421-GEIH-2010 [Ab7], isolated from a blood sample). The AidA protein expressed in E. coli showed QQ activity. Finally, we observed downregulation of the AidA protein (QQ system attenuation) in the presence of HO (ROS stress). In conclusion, most of the A. baumannii clinical strains were not surface motile (84%) and were of respiratory origin (67%). Only the pilT gene was involved in surface motility and related to the QS system. Finally, a new QQ enzyme (α/β hydrolase gene, AidA protein) was detected in these strains

Anales de Edafología y Agrobiología Tomo 41 Número 7-8

Suelos. Empleo de mpleo del coeficiente de correlacion para la seleccion de caracteristicas en taxonomia numerica de suelos, por F. Monturiol Rodríguez y. L. Alcala Del Olmo B.-- Modelos dinamicos en el estudio de la genesis del suelo p o r J. E. Garcia Hernandez.-- A computer-based soil evaluation system for assessing soil productivity p o r D. de la Rosa.-- Relaciones fisico-quimicas y espectrales del suelo p o r Jose L. Labrandero.-- procesos de alteracion; genesis y estabilidad mineral de suelos volcanicos (volcan de piedrabuena, ciudad real) II. caracteres fisicos y fisico-quimicos p o r Martín De Vidales, J. L., Sanz, J., Casas, J., Rodríguez Sanchidrian, J. Y, Guerra Delgado, A.-- Significado de la presencia de horizontes bt en suelos de las facies de madrid. aproximacion para explicar el contenido de arcilla en este tipo de horizontes p o r Jimenez Ballesta, R. Martin De Vidales. J. L. y Garcia Gimenez, R.-- Actividad enzima tica y microbiana en diversos andosoles de tenerife p o r J. M. Lozano, P. T. C. Carvalho Y F. Velasco.-- Estudio de la variabilidad de poblaciones de nema todos fitoparasitos de limonero. l. tylenchulus semipenetrans Cobb por Ortuño Martinez, A.Hernansaez Rabay, A., Gomez Gomez, J. y Abrisqueta Garcia, J. M.-- Estudio climatico de la hoja topografica 1:50.000 905 de linares (Jaen) p o r G. Delgado y J. Aguilar.-- Estudio del sistema SI(oh)4-AI+ -Mg2+ -Na+ -h20 a temperatura y presion ordinarias. l. precipit acion de silicio, aluminio y magnesio por Reyes, M., Huertas, F., Linares, J. y Reyes, E. -- Estudio del sistema SI(oh)4-AI+ -Mg2+ -Na+ -h20 a temperatura y presion ordinarias. II. Composicion quimica y mineralogica de los precipitados, por Reyes, M., Huertas, F., Linares, J. y Reyes, E.-- Fertilidad. estudio comparativo sobre nitrificaciones en un suelo de regadio frente a uno de secano por F. Gallardo-Lara. A. Molina-Diaz Y E. Esteban-Velasco.-- Consideraciones sobre la utilizacion de la tecnica extractiv a de burriel y hernando para la evaluacion del p asimilable en suelos por J. A. Díez.—Nutrición y Fisiología Vegetal. Balance nutriente evolutivo: aplicaciones por O. Carpena Artes y R. O. Carpena Ruiz.-- Estudio de algunos aspectos ecofisiologicos en el analisis de la produccion de grano en los cultivos de cebada (gen. Hordeum l) II. Efecto del nitrogeno y del azufre por via foliar por L. F. Garcia Del Moral, J. M. Ramos y L. Recalde-Manrique y L. Recalde Martinez.- Evolucion de la fraccion organica y mineral de un pastizal de la marisma del guadalquivir. ii. fraccion organica de la vegetación por Hernandez, J. M., Barroso, M., Chaves, M. y Murillo, J. M.-- Evolucion de la fraccion organica y mineral de una pradera halofita de la marisma del guadalquivir. III. relaciones fisiológicas Por Barroso, M., Hernandez, J. M., Murillo, J. M. Y Chaves, M.-- Ordenacion automatica de comunidades de pastizal. un ejemplo de su validez con la eliminacion de las especies menos abundantes por A. Puerto Martin, M. Rico Rodriguez, B. Redondo Prieto y J. M. Gomez Gutierrez.-- Produccion y extraccion de bioelementos en pastizales naturales y especies pratenses cultivadas por B. García Criado. A. Garcia Ciudad, M. I. Montalvo Hernandez y L. Garcia Criado.-- Precocidad en tomate para consumo en fresco por J. Cuartero Y F. Nuez.-- Estudio de la nutricion del cultivo del haba (Vicia faba L.) por Eduardo Esteban Velasco. Francisco Gallardo-Lara y Josefa Robles Fernandez.-- Relaciones proteinas y lipidos con niveles de bioelementos edaficos en semillas de leguminosas por Ortuño Martinez, A. Hernansaez Rabay, A. Y Abrisqueta Garcia. J. M.-- Influencia del pretratamiento de semillas de girasol con boro sobre la germinacion y primeras fases de desarrollo de la planta por Jimenez. F. y Aguilar, A.-- Determinacion de la variedad de patata (solanum tuberosum l.) por analisis electroforetico de las proteinas del tuberculo. por J. Lopez-Gorgé, A. Chueca y M. Vilchez.-- Cambios metabolicos durante el proceso de maduracion de la uva (vitis vinifera, l. var. palomino) en la zona del marco de jerez de la frontera (cadiz) por L. Catalina, C. Mazuelos, R. Romero Y R. Sarmiento.-- Datos nomenclaturales y ecologicos sobre taxones españoles del genero satureja (labiatae) por Salvador Rivas-Martinez.—Trabajos recapitulativos.-- La Rizosfera: Interacciones Microbio-Planta por J. M. Barea y C. Azcon-Aguilar.-- MÉtodos de a tomizacion electrotermica en espectrofotometria de absorcion atomica revisión por M. D. Mingorance y M. Lachica.—Notas.Peer reviewe

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)