The 24th Congress of the Spanish Society for Microbiology (L'Hospitalet de Llobregat, Barcelona, 10-13 July 2013)

The 24th Congress of the Spanish Society for Microbiology (SEM) took place on 10-13 July, 2013 at the Bellvitge Campus of the University of Barcelona (UB), in L'Hospitalet de Llobregat, Barcelona [http://congresosem2013.semicro-biologia.org](Fig. 1). This meeting brought together 618 microbiologists from several prestigious universities and research centers throughou Spain, as well as experts from 24 countries including the United States, the United Kingdom, Germany, Australia, Canada, France, Italy, Belgium, Mexico, Austria, Chile, China, Denmark, Slovenia, the Netherlands, Peru, Sweden, Scotland, Turkey, Uruguay, and Venezuela

A mechanism of carbapenem resistance due to a new insertion element (ISPa133) in Pseudomonas aeruginosa

This study explored the evolutionary mechanism by which the clinical isolate PA110514 yields the imipenemresistantderivative PA116136. Both isolates were examined by PFGE and SDS-PAGE, which led to the identification of a new insertion sequence, ISPa133. This element was shown to have distinct chromosomal locations in each of the original isolatesthat appeared to explain the differences in imipenem susceptibilty. In strain PA110514, ISPa133 is located 56 nucleotides upstream of the translational start codon, which has no effect on expression of the porin OprD. However, in strain PA116136 ISPa133 it is located in front of nucleotide 696 and, by interrupting the coding region, causes a loss of OprD expression, thus conferring imipenem resistance. In vitro experiments mimicking the natural conditions of selective pressure yielded imipenem- resistant strains in which ISPa133 similarly interrupted oprD. Amechanism is proposed whereby ISPa133 acts as a mobile switch, with its position in oprD depending on the degree of selective pressure exerted by imipenem. [Int Microbiol 2011; 14(1):51-58

Diabetic foot infection in Spain

Introduction: The associated complications of diabetes mellitus significantly impair the quality of life of affected patients. The disease leads to a wide variety of complications; among them foot ulcers are common being the most frequent cause of hospitaliza- tion of diabetic patients. Moreover, foot ulcers predict disability, morbidity, and mortality in diabetic patients in addition to incurring considerable healthcare costs. We investigate the bacteria involved in diabetic foot ulcers infection and record the evolution and epi- demiological data of a group of patients. Materials and methods: The study population consisted of prospectively enrolled diabetic patients who attended two hospitals in Barcelona: one specializing in foot care (Hospital Podologic of the University of Barcelona) and the other a tertiary referral hospital (Hospital de Sant Pau). A comparison of microbiological results and their dependence on the sampling method (swab or punch) was done. Results: Diabetic Foot Syndrome was more prevalent in males than in females and more prevalent in patients with type 2 than type 1 diabetes. It becomes apparent that individuals living alone (singles, widowers and widows, etc.) tend to request medical assi- stance later or perhaps they take less attention to their feet, thus percentage of singles increased with the severity. Relatives and nur- sing care seem to play a relevant role in the evolution and prognosis of diabetic foot ulcers. Conclusion: Relatives and nursing care seem to play a crucial role in the evolution and prognosis of diabetic foot ulcers. Pseudomonas and Staphylococcus were the most frequent bacteria infecting ulcers. The use of ciprofloxacin should be discouraged since resistance accounted up to a 40%

Metodología para el análisis de accesibilidad a los recursos sanitarios : el caso de Catalunya

En la planificación de servicios públicos, como los servicios sanitarios, resulta útil poder disponer de técnicas objetivas para el análisis y la cuantificación de su adecuación a la distribución de la población en el territorio. Con este objetivo, y con la colaboración entre el Departamento de Salud de la Generalitat de Cataluña, y el Departamento de Geografía y el Centro de Investigación Ecológica y Aplicaciones Forestales (CREAF) de la UAB, se llevó a cabo, entre los años 2007 y 2008, un estudio de la accesibilidad a los centros sanitarios públicos de Cataluña, mediante la utilización de herramientas de cálculo de rutas óptimas, integradas en un SIG. Los resultados ponen de manifiesto el interesante potencial de la metodología utilizada en la planificación territorial de los servicios sanitarios y los principales puntos a mejorar en términos de accesibilidad de la población a los recursos sanitarios.In the planning of public services such as health services, it is useful to have techniques for objective analysis and quantification of its suitability to the population distribution in the territory. With this purpose, and the collaboration between the Department of Health of the Generalitat of Catalonia, and the Department of Geography and the Center for Ecological Research and Forestry Applications (CREAF) at UAB, a study of accessibility to public health centers of Catalonia, through the use of tools for optimal routing, integrated into a GIS, was carried out during the years 2007 and 2008. The results show the interesting potential of the methodology used in the planning of health services and key points to improve in terms of accessibility of people to health resources

An overview of antimicrobial peptides and the latest advances in their development

INTRODUCTION: The recent dramatic increase in the incidence of antimicrobial resistance has been recognized by organizations such as the United Nations and World Health Organization as well as the governments of the USA and several European countries. A relatively new weapon in the fight against severe infections caused by multi-drug resistant bacteria is antimicrobial peptides (AMPs). These include colistin, currently regarded as the last line of antimicrobial therapy against multi-drug resistant microorganisms. Areas covered: Here, the authors provide an overview of the current research on AMPs. The focus is AMPs currently being developed for the treatment of recalcitrant bacterial infections, the synergies of AMPs and antibiotics, and the activity of AMPs against biofilm. This review also includes a brief introduction into the use of AMPs in infections caused by Mycobacterium, fungi, and parasites. Expert opinion: In research into new antimicrobials, AMPs are gaining increasing attention. While many are natural and are produced by a wide variety of organisms, others are being newly designed and chemically synthesized in the laboratory to achieve novel antimicrobial agents. The same strategy to fight infections in nature is thus being effectively exploited to safeguard human and animal health

Efficacy of combinations of colistin with other antimicrobials involves membrane fluidity and efflux machinery

Objective: Despite its use was abandoned several decades ago, the polycationic peptide colistin has become the last hope to treat severe infections caused by multidrug-resistant Gram-negative bacteria. Thus, the development of colistin resistance may seriously compromise the efficacy of treatment. Moreover, colistin has high toxicity being dose dependent. A potentially effective strategy to avoid resistance may be to combine colistin with other antimicrobials. This may help in the rescue of old antimicrobials and in reducing toxic undesired effects. Methods: Antimicrobial susceptibility determination, efflux machinery function measurements in different conditions and measurement of inhibition of the extrusion by colistin were performed. Moreover, modifications of anisotropy of the membranes by using fluorescent dyes was accomplished. Results: Sub-inhibitory concentrations of colistin have a synergistic effect with several antimicrobials that act intracellularly (targeting protein synthesis and DNA replication). This effect was demonstrated through the uptake increases of acridine orange. in Pseudomonas aeruginosa, Escherichia coli and Acinetobacter baumanii but also in an intrinsically colistin-resistant species as Serratia marcescens. Measurements of the anisotropy of bacterial membranes, as a measure of membrane fluidity, showed significant changes indicative of colistin activity. Conclusion: The alterations in the cellular efflux machinery that resulted in higher intracellular concentrations of acridine orange, and likely of other antimicrobials combined with data of membrane fluidity and measured synergism in vitro allow us to envisage the use of these combinations to fight infections caused by multidrug-resistant bact

A descriptive analysis of urinary ESBL-Producing-Escherichia coli in Cerdanya Hospital

Urinary tract infections caused by extended-spectrum β-lactamase Escherichia coli (ESBLEC) are increasing worldwide and are a current concern because treatment options are often limited. This study investigated antimicrobial susceptibility, antimicrobial resistance genes (ARGs), and the biological diversity of urinary ESBL-EC isolates at Cerdanya Hospital, a European cross-border hospital that combines French and Spanish healthcare models. Bacterial identification and susceptibility were determined using the Microscan WalkAway® system and ESBL production was examined by the double-disk synergy method. Isolates were sequenced using the Ion S5¿ next-generation sequencing system, with the whole-genome sequences then assembled using SPADEs software and analyzed using PubMLST, ResFinder, FimTyper, PlasmidFinder, and VirulenceFinder. A phylogenetic analysis was performed by constructing an assembly-based core-SNV alignment, followed by a phylogenetic tree constructed using Parsnp from the Harvest suite. All isolates studied were multidrug-resistant and could be classified into 19 different sequence types characterized by a high genetic diversity. The most prevalent ESBL-enzymes were CTX-M-14 and CTX-M-15. High-risk international clones (ST131, ST10, and ST405) were also identified. The results demonstrated the absence of a single predominant clone of ESBL-MDR-EC at Cerdanya Hospital

Projecte Portfoli a les practiques de Microbiologia.

Projecte: 2018PID-UB/B09Projecte d’utilització de la eina portfoli en les practiques de laboratori de microbiologia a odontologia. Actuacions d'avaluacio gamificades

Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: implementation and results

Background: Venous catheterization for diagnostic and therapeutic purposes is part of routine hospital practice, as approximately 70% of hospitalized patients have a peripheral venous catheter (PVC). This practice, however, can lead to both local complications, (e.g., chemical, mechanical and infectious phlebitis) and systemic complications (e.g., PVC-related bloodstream infections [PVC-BSIs]). Surveillance data and activities are central to preventing nosocomial infections, phlebitis and improving patient care and safety. The aim of this study was to evaluate the impact of a care bundle on reducing PVC-BSI rates and phlebitis at a secondary care hospital in Mallorca, Spain. Methods: Three-phase intervention study targeting hospitalized patients with a PVC. The VINCat criteria were used to define PVC-BSIs and calculate incidence. In phase I (August-December 2015), we retrospectively analyzed baseline PVC-BSI rates at our hospital. In phase II (2016-2017), we conducted safety rounds and developed a care bundle with the goal of reducing PVC-BSI rates. In phase III (2018), we expanded the PVC-BSI bundle to prevent phlebitis and analyzed its impact. Results: The incidence of PVC-BSIs decreased from 0.48 episodes per 1000 patient-days in 2015 to 0.17 episodes per 1000 patient-days in 2018. The 2017 safety rounds also detected a reduction in phlebitis (from 4.6% of 2.6%). Overall, 680 healthcare professionals were trained in catheter care and five safety rounds were conducted to assess bedside care. Conclusion: Implementation of a care bundle significantly reduced PVC-BSI rates and phlebitis at our hospital. Continuous surveillance programs are needed to adapt measures to improve patient care and guarantee safety