Heat resistance of Listeria monocytogenes in sterile distilled water in the presence of nanoemulsion of D-limonene

Nanoemulsions of oil essentials prevent microbial growth and even improving antimicrobial effect than when applied directly. Currently, there are no many studies where nanoemulsified essential oils have been combined with other factors of stress for the microorganism. This study demonstrates an interesting combined effect when applied heat and D-limonene nanoemulsion greatly reducing the value D significantly. These results could be of interest in the food industry to decrease thermal treatments and avoid the deterioration of the food due to the heat.This research was made possible by financial support from the Ministry of science and innovation and FEDER through the AGL - 2010-19775 and AGL2013-48993-C2-1-R projects

Efecto combinado de nisina y D‐limoneno sobre Listeria monocytogenes aplicados mediante nanoemulsiones

La nisina y el D‐limoneno son compuestos naturales con carácter antimicrobiano. Durante la última década, algunas investigaciones han llegado a la conclusión de que el empleo combinado de algunos aceites esenciales con la nisina podría presentar cierto efecto sinérgico. Entre los principales inconvenientes del empleo de estos compuestos en la industria alimentaria destacan su baja estabilidad debido a su naturaleza oxidativa, su pronunciado carácter aromático y a su carácter hidrofóbico. El objetivo de este estudio fue evaluar el posible efecto sinérgico de nisina y Dlimoneno en Listeria monocytogenes, al aplicarlos mediante una nanoemulsión. Los resultados evidenciaron un notable efecto sinérgico al emplearse de manera combinada la nisina con el D‐limoneno, siendo este efecto más evidente al aplicarlos en forma de nanoemulsión que por medio de la adición directa de los mismos. Los datos mostraron una disminución de los recuentos en 2 unidades logarítmicas cuando se aplicaron la nisina y el D‐limoneno de manera directa, y de 4 unidades logarítmicas en el caso de aplicarlos en forma de nanoemulsión. Estos datos ponen de manifiesto que el empleo de aceites esenciales en forma de nanoemulsión podría tener numerosas aplicaciones en la industria alimentaria solventando los problemas anteriormente mencionados.Esta investigación ha sido posible gracias a la financiación por parte del Ministerio de Ciencia e Innovación y fondos FEDER a través de los proyectos AGL‐ 2010‐19775 y AGL2010‐22206‐ C02‐02

Risk factors associated with inappropriate empirical antimicrobial treatment in bloodstream infections. A cohort study

Introduction: Bloodstream infections (BSI) are a major cause of mortality all over the world. Inappropriate empirical antimicrobial treatment (i-EAT) impact on mortality has been largely reported. However, information on related factors for the election of i-EAT in the treatment of BSI in adults is lacking. The aim of the study was the identification of risk-factors associated with the use of i-EAT in BSI.Methods: A retrospective, observational cohort study, from a prospective database was conducted in a 400-bed acute-care teaching hospital including all BSI episodes in adult patients between January and December 2018. The main outcome variable was EAT appropriation. Multivariate analysis using logistic regression was performed.Results: 599 BSI episodes were included, 146 (24%) received i-EAT. Male gender, nosocomial and healthcare-associated acquisition of infection, a high Charlson Comorbidity Index (CCI) score and the isolation of multidrug resistant (MDR) microorganisms were more frequent in the i-EAT group. Adequation to local guidelines’ recommendations on EAT resulted in 91% of appropriate empirical antimicrobial treatment (a-EAT). Patients receiving i-EAT presented higher mortality rates at day 14 and 30 when compared to patients with a-EAT (14% vs. 6%, p = 0.002 and 22% vs. 9%, p < 0.001 respectively). In the multivariate analysis, a CCI score ≥3 (OR 1.90 (95% CI 1.16–3.12) p = 0.01) and the isolation of a multidrug resistant (MDR) microorganism (OR 3.79 (95% CI 2.28–6.30), p < 0.001) were found as independent risk factors for i-EAT. In contrast, female gender (OR 0.59 (95% CI 0.35–0.98), p = 0.04), a correct identification of clinical syndrome prior to antibiotics administration (OR 0.26 (95% CI 0.16–0.44), p < 0.001) and adherence to local guidelines (OR 0.22 (95% CI 0.13–0.38), p < 0.001) were identified as protective factors against i-EAT.Conclusion: One quarter of BSI episodes received i-EAT. Some of the i-EAT related factors were unmodifiable (male gender, CCI score ≥3 and isolation of a MDR microorganism) but others (incorrect identification of clinical syndrome before starting EAT or the use of local guidelines for EAT) could be addressed to optimize the use of antimicrobials

Contribución de las políticas públicas a la realización efectiva de los derechos de la mujer

En el presente estudio se parte de que la protección efectiva e integral de los derechos de las mujeres constituye una de las tareas inacabadas de mayor alcance en las sociedades contemporáneas. En él se analizan las políticas públicas que desde un enfoque de la igualdad y no discriminación tienen influencia en las esferas pública y privada; tratándose todo ello conforme a los postulados de la Ley Orgánica española 3/2007, de 22 de marzo, para la igualdad efectiva de mujeres y hombres. Por último, se aportan veintiséis recomendaciones y propuestas para hacer que los derechos de las mujeres sean tomados en serioIn this study the premise is the effective and comprehensive protection of women's rights as one of the most important pending duties of modern society. Public policies are analysed from the perspective of equality and non‐discrimination in public and private fields, all of which are considered in accordance with the Fundamental Act 3/2007 of 22nd March, for the effective equality between women and men. Lastly, twenty‐six recommendations are proposed in order that women's rights may be taken seriously

Contribución de las políticas públicas a la realización efectiva de los derechos de la mujer

En el presente estudio se parte de que la protección efectiva e integral de los derechos de las mujeres constituye una de las tareas inacabadas de mayor alcance en las sociedades contemporáneas. En él se analizan las políticas públicas que desde un enfoque de la igualdad y no discriminación tienen influencia en las esferas pública y privada; tratándose todo ello conforme a los postulados de la Ley Orgánica española 3/2007, de 22 de marzo, para la igualdad efectiva de mujeres y hombres. Por último, se aportan veintiséis recomendaciones y propuestas para hacer que los derechos de las mujeres sean tomados en serioIn this study the premise is the effective and comprehensive protection of women's rights as one of the most important pending duties of modern society. Public policies are analysed from the perspective of equality and non‐discrimination in public and private fields, all of which are considered in accordance with the Fundamental Act 3/2007 of 22nd March, for the effective equality between women and men. Lastly, twenty‐six recommendations are proposed in order that women's rights may be taken seriously

Do specific antimicrobial stewardship interventions have an impact on carbapenem resistance in Gram-negative bacilli? A multicentre quasi-experimental ecological study: time-trend analysis and characterization of carbapenemases

CarbaPIRASOA team.[Background] Carbapenem-resistant Gram-negative bacilli (CR-GNB) are among the most threatening microorganisms worldwide and carbapenem use facilitates their spread. Antimicrobial stewardship programmes (ASPs) can help to optimize the use of antibiotics. This study evaluates the impact of a multifaceted educational ASP on carbapenem use and on the epidemiology of CR-GNB.[Methods] We conducted a quasi-experimental, time-series study in seven hospitals, from January 2014 to September 2018. The key intervention was composed of educational interviews promoting the appropriate use of carbapenems. The primary endpoints were carbapenem consumption and incidence density (ID) of CR-GNB. All non-duplicated CR-GNB clinical isolates were tested using phenotypic assays and PCR for the presence of carbapenemases. Joinpoint regression and interrupted time-series analyses were used to determine trends.[Results] A decrease in carbapenem consumption throughout the study period [average quarterly percentage change (AQPC) −1.5%, P < 0.001] and a −8.170 (−16.064 to −0.277) level change following the intervention were observed. The ID of CR-Acinetobacter baumannii decreased (AQPC −3.5%, P = 0.02) and the overall ID of CR-GNB remained stable (AQPC −0.4%, P = 0.52). CR-GNB, CR-Pseudomonas aeruginosa and CR-A. baumannii IDs per hospital correlated with the local consumption of carbapenems. The most prevalent carbapenem resistance mechanisms were OXA-23 for CR-A. baumannii (76.1%), OXA-48 for CR-Klebsiella pneumoniae (66%) and no carbapenemases for CR-P. aeruginosa (91.7%). The epidemiology of carbapenemases was heterogeneous throughout the study, especially for carbapenemase-producing Enterobacteriaceae.[Conclusions] In conclusion, a multifaceted, educational interview-based ASP targeting carbapenem prescribing reduced carbapenem use and the ID of CR-A. baumannii.This work was funded by the Spanish Infectious Diseases and Clinical Microbiology Society (SEIMC).Peer reviewe

Revisiting the epidemiology of bloodstream infections and healthcare-associated episodes: results from a multicentre prospective cohort in Spain (PRO-BAC Study)

PROBAC REIPI/GEIH-SEIMC/SAEI Group.The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed. Bivariate analyses stratified by type of acquisition were performed. Multivariate analyses were performed by logistic regression. Overall, 6345 BSI episodes were included; 2510 (39.8%) were community-acquired (CA), 1661 (26.3%) were healthcare-associated (HCA) and 2056 (32.6%) hospital-acquired (HA). The 30-day mortality rates were 11.6%, 19.5% and 22.0%, respectively. The median age of patients was 71 years (interquartile range 60–81 years) and 3656 (58.3%; 95% confidence interval 57.1–59.6%) occurred in males. The proportions according to patient sex varied according to age strata. Escherichia coli (43.8%), Klebsiella spp. (8.9%), Staphylococcus aureus (8.9%) and coagulase-negative staphylococci (7.4%) were the most frequent pathogens. Multivariate analyses confirmed important differences between CA and HCA episodes, but also between HCA and HA episodes, in demographics, underlying conditions and aetiology. In conclusion, we have updated the epidemiological information regarding patients’ profiles, underlying conditions, frequency of acquisition types and aetiological agents of BSI in Spain. HCA is confirmed as a distinct type of acquisition.This work was financed by grants from Plan Nacional de I+D+i 2013–2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades [PI16/01432] and the Spanish Network for Research in Infectious Diseases (REIPI) [RD16/0016/0001; RD16/0016/0008], co‐financed by the European Development Regional Fund ‘A way to achieve Europe’, Operative program Intelligent Growth 2014–2020

Generación coordinada e integración en la docencia de objetos y recursos virtuales de aprendizaje en las asignaturas de Didáctica de la Matemática del Grado en Educación Primaria

Tras la experiencia adquirida en el curso pasado en el uso de herramientas y recursos para la docencia online provocada por la suspensión de la actividad presencial debido a la pandemia, arrancamos este PID que buscaba el diseño, generación e integración en la docencia de objetos y recursos virtuales de aprendizaje, que fuesen útiles en cualquier modalidad de docencia (presencial, semipresencial u online) y con el objetivo de maximizar las oportunidades de aprendizaje de los estudiantes en dos asignaturas del grado en Educación Primaria. Por ello, mediante el presente PID se han desarrollado varios objetos de aprendizaje, a saber: cuestionarios de Moodle para la autoevaluación de los alumnos, que han sido muy bien aceptados y utilizados por los estudiantes, guiones de prácticas basados en materiales y recursos online, y varias píldoras en el formato “Saber, extender” que servirán tanto de material para varias asignaturas del área como de medio de difusión de conocimiento para la comunidad educativa. Aunque el objetivo inicial, además de desarrollar estos materiales, también incluía su implementación en el curso actual, solo se han podido implementar los cuestionarios de Moodle, pues los diferentes compromisos de los integrantes del equipo de trabajo han ralentizado el trabajo de diseño y generación. No obstante, gracias a la coordinación que se ha promovido entre el profesorado participante, creemos que este proyecto, inicialmente ambicioso, solo es el comienzo de futuras colaboraciones para el desarrollo de otros materiales y su implementación en los próximos cursos.Didáctica de las Ciencias Experimentales, Sociales y de la Matemátic

Medical versus surgical approach to initial treatment in septic arthritis: A single spanish center’s 8-year experience

Objective The aim of this study was to compare the functional results of 2 different procedure types, medical or surgical used in treating native joint septic arthritis. Methods In this cohort study, we reviewed the clinical registries of patients admitted to a single third-level hospital with the diagnosis of septic arthritis during the period of January 1, 2008, to January 31, 2016. Results A total of 63 cases of septic arthritis were identified in which the initial approach for 49 patients was medical (arthrocentesis), whereas the initial approach for 14 patients was surgical (arthroscopy or arthrotomy). Of the 49 patients who received initial medical treatment (IMT), 15 patients (30%) later required surgical treatment because of poor progress. The median age of the patients was 60 (SD, 18) years. The group who received IMT were older than those who received initial surgical treatment (median, 64 years [interquartile range {IQR}, 54–76 years], vs. 48 years [IQR, 30–60 years]). There was a larger percentage of male patients in the surgical group (78% vs. 42% [p = 0.018]). Thirty percent of the medical group had been receiving corticosteroid treatment (p = 0.018). Results of complete recovery of joint functionality showed no significant differences after 1 year (68% with MT vs. 67% with ST, p = 0.91). Both groups had similar symptom duration until diagnosis, duration of antibiotic therapy (median, 30 days [IQR, 28–49 days], vs. 29.5 days [IQR, 27–49] days), and mortality rate (3 in the medical group). Conclusions The results of the study show that initial surgical treatment in patients with native joint septic arthritis is not superior to IMT. However, half of the patients with shoulder and hip infections treated with IMT eventually required surgical intervention, suggesting that perhaps this should be the preferred initial approach in these cases

Risk Factors and Predictive Score for Bacteremic Biliary Tract Infections Due to Enterococcus faecalis and Enterococcus faecium: a Multicenter Cohort Study from the PROBAC Project

Biliary-tract bloodstream infections (BT-BSI) caused by Enterococcus faecalis and E. faecium are associated with inappropriate empirical treatment and worse outcomes compared to other etiologies. The objective of this study was to investigate the risk factors for enterococcal BT-BSI. Patients with BT-BSI from the PROBAC cohort, including consecutive patients with BSI in 26 Spanish hospitals between October 2016 and March 2017, were selected; episodes caused by E. faecalis or E. faecium and other causes were compared. Independent predictors for enterococci were identified by logistic regression, and a predictive score was developed. Eight hundred fifty episodes of BT-BSI were included; 73 (8.5%) were due to target Enterococcus spp. (48 [66%] were E. faecium and 25 [34%] E. faecalis). By multivariate analysis, the variables independently associated with Enterococcus spp. were (OR; 95% confidence interval): cholangiocarcinoma (4.48;1.32 to 15.25), hospital acquisition (3.58;2.11 to 6.07), use of carbapenems in the previous month (3.35;1.45 to 7.78), biliary prosthesis (2.19;1.24 to 3.90), and moderate or severe chronic kidney disease (1.55;1.07 to 2.26). The AUC of the model was 0.74 [95% CI0.67 to 0.80]. A score was developed, with 7, 6, 5, 4, and 2 points for these variables, respectively, with a negative predictive value of 95% for a score ? 6. A model, including cholangiocarcinoma, biliary prosthesis, hospital acquisition, previous carbapenems, and chronic kidney disease showed moderate prediction ability for enterococcal BT-BSI. Although the score will need to be validated, this information may be useful for deciding empirical therapy in biliary tract infections when bacteremia is suspected. IMPORTANCE Biliary tract infections are frequent, and a significant cause of morbidity and mortality. Bacteremia is common in these infections, particularly in the elderly and patients with cancer. Inappropriate empirical treatment has been associated with increased risk of mortality in bacteremic cholangitis, and the probability of receiving inactive empirical treatment is higher in episodes caused by enterococci. This is because many of the antimicrobial agents recommended in guidelines for biliary tract infections lack activity against these organisms. To the best of our knowledge, this is the first study analyzing the predictive factors for enterococcal BT-BSI and deriving a predictive score