Molecular Epidemiology of Klebsiella pneumoniae Strains Causing Bloodstream Infections in Adults

Molecular epidemiology of Klebsiella pneumoniae bacteremic strains allows for a better understanding of preventive and therapeutic strategies. Clinical and microbiological characteristics of 348 K. pneumoniae bacteremia cases (2007-2009) were retrospectively characterized by multilocus sequence typing and extended-spectrum beta-lactamases (ESBL) production. Overall, 223 (64.08%) cases were nosocomial (NA), 58 (16.67%) healthcare associated, and 67 (19.25%) community acquired. The main infection origins were urinary tract (16.6%, 50.0%, and 43.3%), biliary tract (10.8%, 24.2%, and 31.3%), and catheter-related infection (39.9%, 5.2%, and 0%). The 30-day mortality rate was around 20%. The rates of resistance were around 45% the highest being among NA cases, and ESBL production was detected in 7.2% of cases. A total of 161 different sequence types were grouped into 13 clonal sets by e-burst analysis. No relationship could be established between clonal sets and the origin of infection or the healthcare-related settings. The high genetic variability among the isolates suggests their intrapatient endogenous origin

NWP Activities at AEMET (Spain): 41th EWGLAM & 26th SRNWP Meetings

Póster presentado en: 41th EWGLAM & 26th SRNWP Meetings, celebrado del 30 de septiembre al 3 de octubre de 2019 en Sofia (Bulgaria)

High temperature distributed measurements using multimode gold-coated fiber and BOTDA sensor

RESUMEN: En este trabajo se presenta un sensor distribuido basado en la dispersión estimulada de Brillouin combinado con el empleo de una fibra multimodo con cubierta de oro que permite la realización de medidas distribuidas a alta temperatura. Con este sistema de medida se han realizado medidas de zonas calientes en la fibra hasta alcanzar una temperatura máxima de 600ºC sin que la fibra presente degradación en sus propiedades. La precisión de las medidas está en torno a los 10ºC.ABSTRACT: We present a distributed sensor based on stimulated Brillouin scattering with a gold-coated multimode fiber to carry out high temperature distributed measurements. With this sensor system, it is possible to measure hotspots in the optical fiber up to 600ºC ensuring that the optical fiber does not suffer any detrimental effect on its properties. The achieved accuracy of the measurements is about 10ºC.Este trabajo ha sido cofinanciadopor los proyectos TEC2013-47264-C2-1-R, TEC2016-76021-C2-2-R (AEI/ FEDER, UE), por la beca BES-2014-069736 del gobierno de España y por la beca postdoctoral del Parlamento de Cantabria

Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: Study protocol for the SAFO trial

Introduction Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia. Methods We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (=18 years) with isolation of MSSA from at least one blood culture =72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant). Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ

Diverse Large HIV-1 Non-subtype B Clusters Are Spreading Among Men Who Have Sex With Men in Spain

In Western Europe, the HIV-1 epidemic among men who have sex with men (MSM) is dominated by subtype B. However, recently, other genetic forms have been reported to circulate in this population, as evidenced by their grouping in clusters predominantly comprising European individuals. Here we describe four large HIV-1 non-subtype B clusters spreading among MSM in Spain. Samples were collected in 9 regions. A pol fragment was amplified from plasma RNA or blood-extracted DNA. Phylogenetic analyses were performed via maximum likelihood, including database sequences of the same genetic forms as the identified clusters. Times and locations of the most recent common ancestors (MRCA) of clusters were estimated with a Bayesian method. Five large non-subtype B clusters associated with MSM were identified. The largest one, of F1 subtype, was reported previously. The other four were of CRF02_AG (CRF02_1; n = 115) and subtypes A1 (A1_1; n = 66), F1 (F1_3; n = 36), and C (C_7; n = 17). Most individuals belonging to them had been diagnosed of HIV-1 infection in the last 10 years. Each cluster comprised viruses from 3 to 8 Spanish regions and also comprised or was related to viruses from other countries: CRF02_1 comprised a Japanese subcluster and viruses from 8 other countries from Western Europe, Asia, and South America; A1_1 comprised viruses from Portugal, United Kingom, and United States, and was related to the A1 strain circulating in Greece, Albania and Cyprus; F1_3 was related to viruses from Romania; and C_7 comprised viruses from Portugal and was related to a virus from Mozambique. A subcluster within CRF02_1 was associated with heterosexual transmission. Near full-length genomes of each cluster were of uniform genetic form. Times of MRCAs of CRF02_1, A1_1, F1_3, and C_7 were estimated around 1986, 1989, 2013, and 1983, respectively. MRCA locations for CRF02_1 and A1_1 were uncertain (however initial expansions in Spain in Madrid and Vigo, respectively, were estimated) and were most probable in Bilbao, Spain, for F1_3 and Portugal for C_7. These results show that the HIV-1 epidemic among MSM in Spain is becoming increasingly diverse through the expansion of diverse non-subtype B clusters, comprising or related to viruses circulating in other countries

Prospección, caracterización y conservación de recursos fitogenéticos de espárrago (Asparagus officinalis L.) en el Somontano de Barbastro (póster)

Banco de Germoplasma Hortícola (BGHZ) del CITAPublishe

Vigilancia de la resistencia a antibióticos en enfermedad invasiva por Pseudomonas aeruginosa en Galicia: 2013-2014

Introduction. The aim of this study is to know the antibiotic sensitivity of the Pseudomonas aeruginosa, which produces invasive infections in Galicia in 2013/2014, in the framework of the Surveillance Study of Antimicrobial Resistance. Methods. A total of 357 isolates of P. aeruginosa were analyzed in blood or CSF samples from 9 hospitals in Galicia. The variables were: origin, demographic data, sample type and antibiotic sensitivity. CLSI breakpoints were used. For each antibiotic we analyzed frequencies, cases/100.000 inhabitants, concordance of resistance and differences between hospitals, sex and age. Results. The majority of patients were male gender and the not-sensitives were superior in the 45 to 64 age group with significant differences to ciprofloxacin, imipenem, tobramycin and colistin. The overall not-sensitivity isolates was: piperacillin/tazobactam 18%, ciprofloxacin 28.7%, ceftazidime 17.1%, cefepime 19.7%, imipenem 23.1%, meropenem 22.1%, tobramycin 13.0%, amikacin 7.3% and colistin 4.4%. The cases/100,000 inhabitants were higher in men as age increasing. Without analyzing colistin, the 57.1% of the isolates were sensitives to other antibiotics studied (piperacillin/tazobactam, quinolones, ceftazidime, aminoglycosides, carbapenems), 19.4% were not-susceptible to only one antibiotic, 12. 2% to two, 3.7% to three, 5.1% to four and 2.0% to all antibiotics tested. Conclusions. Of the antibiotics tested, the most susceptible to P. aeruginosa were amikacin and colistin. Our data are consistent with the observed ones nationwide except colistin. Sensitivity patterns of P. aeruginosa should be periodically evaluated in each area and each hospital in order to assess the different therapeutic regimens.Introducción. El objetivo de este estudio es conocer la sensibilidad antibiótica de Pseudomonas aeruginosa productora de enfermedad invasiva en Galicia en 2013/2014, en el marco del Estudio de Vigilancia de las Resistencias Antimicrobianas. Métodos. Se analizaron 357 aislamientos de P. aeruginosa en muestras de sangre o LCR en 9 hospitales de Galicia. Las variables fueron: procedencia, datos demográficos, tipo de muestra y sensibilidad antibiótica. Se usaron puntos de corte de CLSI. Para cada antibiótico se analizaron frecuencias, casos/100.000 habitantes, concordancia de la resistencia y diferencias entre hospitales, sexo y edad. Resultados. El sexo predominante fue el masculino y la no sensibilidad superior en el grupo de 45 a 64 años con diferencias significativas a ciprofloxacino, imipenem, tobramicina y colistina. La no sensibilidad global: piperacilina/tazobactam 18%, ciprofloxacino 28’7%, ceftazidima 17’1%, cefepime 19’7%, imipenem 23’1%, meropenem 22’1%, tobramicina 13’0%; amikacina, 7’3% y colistina 4’4%. Los casos/100.000 habitantes fueron superiores en hombres según aumenta la edad. Sin analizar la colistina, el 57’1% de los aislamientos fueron sensibles a los otros grupos estudiados (piperacilina/tazobactam, quinolonas, ceftazidima, aminoglucósidos, carbapenems), el 19’4% fueron no sensibles a un antibiótico, 12’2% a dos, el 3’7% a tres, el 5’1% a cuatro y el 2’0% a todos los analizados. Conclusiones. De los antibióticos evaluados, los más activos frente a P. aeruginosa fueron amikacina y colistina. Nuestros datos concuerdan con lo observado a nivel nacional, excepto para colistina. Deben evaluarse periódicamente patrones de sensibilidad de P. aeruginosa en cada zona y cada hospital para poder valorar las diferentes pautas terapéuticas

La Mola d'Agres: aportaciones desde una óptica interdisciplinar al estudio de una inhumación individual

Estudio desde una óptica interdisciplinar de una inhumación individual, en fosa, de un adulto joven situada en la estructura constructiva que delimita el poblado de la Mola d'Agres. Del ajuar asociado al enterramiento destaca el puñal de remaches que cabe valorar en relación a la categoría social del individuo inhumado en el contexto del II milenio a.n.e.Amb una òptica interdisciplinar es presenta l'estudi d'una inhumació individual, en fossa, d'una persona adulta jove, localitzada en l'estructura constructiva que delimita el poblat de la Mola d'Agres. De l'aixovar associat a aquest enterrament en destaquem el punyal de reblons que cal valorar en relació amb la categoria social de la persona inhumada dins del panorama funerari del II mil·lenni a.n.e.In this report we present un interdisciplirary study of an individual inhumation. This inhumation, pit grave type, belonged to a young adult. It was located in the structure wich delimitated the site. From the grave goods special importance is griven to the rivet dagger which has to be put in relation with the social status of the individual within the II milenium BC context

Sample pooling for SARS-CoV-2 RT-PCR screening.

To evaluate the efficacy of sample pooling compared to the individual analysis for the diagnosis of coronavirus disease 2019 (COVID-19) by using different commercial platforms for nucleic acid extraction and amplification. A total of 3519 nasopharyngeal samples received at nine Spanish clinical microbiology laboratories were processed individually and in pools (342 pools of ten samples and 11 pools of nine samples) according to the existing methodology in place at each centre. We found that 253 pools (2519 samples) were negative and 99 pools (990 samples) were positive; with 241 positive samples (6.85%), our pooling strategy would have saved 2167 PCR tests. For 29 pools (made out of 290 samples), we found discordant results when compared to their correspondent individual samples, as follows: in 22 of 29 pools (28 samples), minor discordances were found; for seven pools (7 samples), we found major discordances. Sensitivity, specificity and positive and negative predictive values for pooling were 97.10% (95% confidence interval (CI), 94.11-98.82), 100%, 100% and 99.79% (95% CI, 99.56-99.90) respectively; accuracy was 99.80% (95% CI, 99.59-99.92), and the kappa concordant coefficient was 0.984. The dilution of samples in our pooling strategy resulted in a median loss of 2.87 (95% CI, 2.46-3.28) cycle threshold (Ct) for E gene, 3.36 (95% CI, 2.89-3.85) Ct for the RdRP gene and 2.99 (95% CI, 2.56-3.43) Ct for the N gene. We found a high efficiency of pooling strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA testing across different RNA extraction and amplification platforms, with excellent performance in terms of sensitivity, specificity and positive and negative predictive values