5 research outputs found
Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Anti-tuberculosis Drug Resistance from Venezuela
BACKGROUND: Molecular typing of Mycobacterium tuberculosis strains has become a valuable tool in the epidemiology of tuberculosis (TB) by allowing detection of outbreaks, tracking of epidemics, identification of genotypes and transmission events among patients who would have remained undetected by conventional contact investigation. This is the first genetic biodiversity study of M. tuberculosis in Venezuela. Thus, we investigated the genetic patterns of strains isolated in the first survey of anti-tuberculosis drug-resistance realised as part of the Global Project of Anti-tuberculosis Drug Resistance Surveillance (WHO/IUATLD). RESULTS: Clinical isolates (670/873) were genotyped by spoligotyping. The results were compared with the international spoligotyping database (SpolDB4). Multidrug resistant (MDR) strains (14/18) were also analysed by IS6110-RFLP assays, and resistance to isoniazid and rifampicin was characterised. Spoligotyping grouped 82% (548/670) of the strains into 59 clusters. Twenty new spoligotypes (SITs) specific to Venezuela were identified. Eight new inter-regional clusters were created. The Beijing genotype was not found. The genetic network shows that the Latin American and Mediterranean family constitutes the backbone of the genetic TB population-structure in Venezuela, responsible of >60% of total TB cases studied. MDR was 0.5% in never treated patients and 13.5% in previously treated patients. Mutations in rpoB gene and katG genes were detected in 64% and 43% of the MDR strains, respectively. Two clusters were found to be identical by the four different analysis methods, presumably representing cases of recent transmission of MDR tuberculosis. CONCLUSION: This study gives a first overview of the M. tuberculosis strains circulating in Venezuela during the first survey of anti-tuberculosis drug-resistance. It may aid in the creation of a national database that will be a valuable support for further studies
Validation and Search of the Ideal Cut-Off of the Sysmex UF-1000i® Flow Cytometer for the Diagnosis of Urinary Tract Infection in a Tertiary Hospital in Spain
Urinary tract infections (UTI) are one of the most prevalent infections. A rapid and reliable screening method is useful to screen out negative samples. The objective of this study was to validate the Sysmex flow cytometer UF-1000i by evaluating its accuracy, linearity and carry-over; and define an optimal cut-off value to be used in routine practice in our hospital. For the validation of the UF-1000i cytometer, precision, linearity and carry-over were studied in samples with different counts of bacteria, leukocytes and erythrocytes. Between March and June 2016, urine samples were tested in the Clinical Microbiology Laboratory at University Miguel Servet Hospital, in Spain. Samples were analyzed with the Sysmex UF-1000i cytometer, and cultured. Growth of ≥105 CFUs/mL was considered positive. The validation study reveals that the precision in all the variables is acceptable; that there is a good linearity in the dilutions performed, obtaining values almost identical to those theoretically expected; and for the carry-over has practically null values. A total of 1,220 urine specimens were included, of which 213 (17.4%) were culture positive. The optimal cut-off point of the bacteria–leukocyte combination was 138.8 bacteria or 119.8 leukocytes with an S and E of 95.3 and 70.4%, respectively. The UF-1000i cytometer is a valuable method to screen urine samples to effectively rule out UTI and, may contribute to the reduction of unnecessary urine cultures
Guía Clínica Española del Acceso Vascular para Hemodiálisis
El acceso vascular para hemodiálisis es esencial para el enfermo renal tanto por su
morbimortalidad asociada como por su repercusión en la calidad de vida. El proceso que
va desde la creación y mantenimiento del acceso vascular hasta el tratamiento de sus
complicaciones constituye un reto para la toma de decisiones debido a la complejidad de la
patología existente y a la diversidad de especialidades involucradas. Con el fin de conseguir
un abordaje consensuado, el Grupo Español Multidisciplinar del Acceso Vascular (GEMAV),
que incluye expertos de las cinco sociedades científicas implicadas (nefrología [S.E.N.], cirugía
vascular [SEACV], radiología vascular e intervencionista [SERAM-SERVEI], enfermedades
infecciosas [SEIMC] y enfermería nefrológica [SEDEN]), con el soporte metodológico del Centro
Cochrane Iberoamericano, ha realizado una actualización de la Guía del Acceso Vascular
para Hemodiálisis publicada en 2005. Esta guía mantiene una estructura similar, revisando
la evidencia sin renunciar a la vertiente docente, pero se aportan como novedades, por un
lado, la metodología en su elaboración, siguiendo las directrices del sistema GRADE con
el objetivo de traducir esta revisión sistemática de la evidencia en recomendaciones que
faciliten la toma de decisiones en la práctica clínica habitual y, por otro, el establecimiento
de indicadores de calidad que permitan monitorizar la calidad asistencial.Vascular access for haemodialysis is key in renal patients both due to its associated morbidity
and mortality and due to its impact on quality of life. The process, from the creation and
maintenance of vascular access to the treatment of its complications, represents a challenge
when it comes to decision-making, due to the complexity of the existing disease and the
diversity of the specialities involved. With a view to finding a common approach, the Spanish
Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five
scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and
interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing
[SEDEN]), along with the methodological support of the Cochrane Center, has updated the
Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain
a similar structure, in that they review the evidence without compromising the educational
aspects. However, on one hand, they provide an update to methodology development following
the guidelines of the GRADE system in order to translate this systematic review of evidence
into recommendations that facilitate decision-making in routine clinical practice, and, on
the other hand, the guidelines establish quality indicators which make it possible to monitor
the quality of healthcare
Guía Clínica Española del Acceso Vascular para Hemodiálisis
El acceso vascular para hemodiálisis es esencial para el enfermo renal tanto por su
morbimortalidad asociada como por su repercusión en la calidad de vida. El proceso que
va desde la creación y mantenimiento del acceso vascular hasta el tratamiento de sus
complicaciones constituye un reto para la toma de decisiones debido a la complejidad de la
patología existente y a la diversidad de especialidades involucradas. Con el fin de conseguir
un abordaje consensuado, el Grupo Español Multidisciplinar del Acceso Vascular (GEMAV),
que incluye expertos de las cinco sociedades científicas implicadas (nefrología [S.E.N.], cirugía
vascular [SEACV], radiología vascular e intervencionista [SERAM-SERVEI], enfermedades
infecciosas [SEIMC] y enfermería nefrológica [SEDEN]), con el soporte metodológico del Centro
Cochrane Iberoamericano, ha realizado una actualización de la Guía del Acceso Vascular
para Hemodiálisis publicada en 2005. Esta guía mantiene una estructura similar, revisando
la evidencia sin renunciar a la vertiente docente, pero se aportan como novedades, por un
lado, la metodología en su elaboración, siguiendo las directrices del sistema GRADE con
el objetivo de traducir esta revisión sistemática de la evidencia en recomendaciones que
faciliten la toma de decisiones en la práctica clínica habitual y, por otro, el establecimiento
de indicadores de calidad que permitan monitorizar la calidad asistencial.Vascular access for haemodialysis is key in renal patients both due to its associated morbidity
and mortality and due to its impact on quality of life. The process, from the creation and
maintenance of vascular access to the treatment of its complications, represents a challenge
when it comes to decision-making, due to the complexity of the existing disease and the
diversity of the specialities involved. With a view to finding a common approach, the Spanish
Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five
scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and
interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing
[SEDEN]), along with the methodological support of the Cochrane Center, has updated the
Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain
a similar structure, in that they review the evidence without compromising the educational
aspects. However, on one hand, they provide an update to methodology development following
the guidelines of the GRADE system in order to translate this systematic review of evidence
into recommendations that facilitate decision-making in routine clinical practice, and, on
the other hand, the guidelines establish quality indicators which make it possible to monitor
the quality of healthcare