Analysis of the Antimicrobial Resistance Profile of Microorganisms Closely Related to Healthcare-Associated Infections: Catalonia, 2016-2019

Resistència als antimicrobians; Infeccions; Assistència sanitàriaResistencia a los antimicrobianos; Infecciones; Asistencia sanitariaResistance to antimicrobials; Infections; Health careL’objectiu d’aquest Informe és l’anàlisi de la sensibilitat antimicrobiana dels microorganismes estretament associats a les IRA. També s’analitzen els seus mecanismes de resistència i la presència de soques multiresistents, extremadament resistents i panresistents en els anys 2016 - 2019. Els microorganismes objecte d’estudi són cocs grampositius: Enterococcus faecalis, Enterococcus faecium, Streptococcus agalactiae, Streptococcus pyogenes i Staphylococus aureus (MSSA i MRSA); els enterobacteris: Escherichia coli i Klebsiella pneumoniae, i els bacils gramnegatius no fermentadors: Acinetobacter baumannii i Pseudomonas aeruginosa

The role of cats in the eco-epidemiology of spotted fever group diseases

Mediterranean Spotted Fever (MSF), whose etiological agent is R. conorii, is one of the oldest described vector-borne infectious diseases. Although it is endemic in the Mediterranean area, clinical cases have also been reported in other regions. R. massiliae- Bar29 is related to MSF cases. This strain is distributed worldwide. R. conorii and R. massiliae- Bar29 are transmitted by ticks. Dogs are considered the sentinel of R. conorii infection. Cats could also be involved in their transmission. Rickettsia felis, etiological agent of Flea-borne spotted fever, is mainly transmitted by the cat flea, Ctenocephalides felis. Up to now, the role of cats in its transmission is not entirely elucidated. The aim of the study is to analyze the infection in cats by these microorganisms. The study was undertaken in Northeastern Spain. Twenty municipalities of seven regions participated in the study. 212 cats (pets and stray cats) were analyzed. Variables surveyed were: date of collection, age, sex, municipality, source, living place, outdoor activities, health status, type of disease, contact with other animals, and ectoparasite infestation. Sera were evaluated by indirect immunofluorescence antibody assay (IFA). Molecular detection (real-time PCR and sequencing) and cultures were performed on blood samples. There were 59 (27.8%) cats seroreactive to one or more microorganisms. Considering cross-reactions, the seroprevalences were 15.6%-19.5% (R. massiliae -Bar29), 1.9%-6.2% (R. conorii), and 5.2%-7.5% (R. felis). A weak association was observed between SFG seropositivity and tick infestation. Ticks found on seropositive cats were Rhipicephalus pusillus, R. sanguineus and R. turanicus. DNA of Rickettsia was detected in 23 cats. 21 of them could be sequenced. Sequences obtained were identical to those sequences of SFG rickettsiae similar to R. conorii and R. massiliae. No amplification of R. felis was obtained. Cats can be infected by SFG rickettsiae and produce antibodies against them. Cats may play a role in the transmission cycle of R. conorii and R. massiliae -Bar29, although the role in the R. felis cycle needs further analysis

Anàlisi de la sensibilitat als antimicrobians d’Acinetobacter baumannii i Pseudomonas aeruginosa: Catalunya, 2020-2022

Resistència als antimicrobians; Ainetobacter baumannii; Pseudomonas aeruginosaResistencia a los antimicrobianos; Ainetobacter baumannii; Pseudomonas aeruginosaResistance to antimicrobials; Ainetobacter baumannii; Pseudomonas aeruginosaL’objectiu d’aquest informe és analitzar la sensibilitat als antimicrobians i els mecanismes de resistència d’Acinetobacter baumannii i Pseudomonas aeruginosa invasius aïllats a Catalunya durant els anys 2020-2022 i analitzar les tendències de les resistències en el període 2016-2022

Anàlisi de la sensibilitat als antimicrobians d’Enterococcus faecalis i Enterococcus faecium: Catalunya, 2016-2022

Resistència als antimicrobians; Infeccions; EnterococcusResistencia a los antimicrobianos; Infecciones; EnterococcusResistance to antimicrobials; Infections; EnterococcusL’objectiu d’aquest Informe és l’anàlisi de la sensibilitat als antibiòtics i dels mecanismes de resistència d’E. faecalis i E. faecium invasius aïllats a Catalunya en el període 2016-2022

Anàlisi de la sensibilitat als antimicrobians d’Streptococcus pyogenes i Streptococcus agalactiae causants de malaltia invasiva: Catalunya, 2016-2021

Resistència als antimicrobians; Infeccions; StreptococcusResistencia a los antimicrobianos; Infecciones; StreptococcusResistance to antimicrobials; Infections; StreptococcusL’objectiu d’aquest Informe és l’anàlisi de la sensibilitat als antibiòtics i dels mecanismes de resistència d’S. agalactiae i d’S. pyogenes invasius aïllats a Catalunya en el període 2016-2021

Malaltia invasiva per Listeria monocytogenes a Catalunya, 2015 – 2021

Listeria monocytogenes; Malaltia bacteriana; AlimentsListería monocytogenes; Enfermedad bacteriana; AlimentosListeria monocytogenes; Bacterial disease; FoodL’objectiu d’aquest informe és descriure l’epidemiologia dels casos confirmats de listeriosi invasiva declarats en el sistema de notificació microbiològica de Catalunya (SNMC) de la Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública (SGVRESP) en el període 2015 – 2021

Informe sobre els microorganismes causants de malalties infeccioses declarats durant l’any 2021: sistema de notificació microbiològica de Catalunya (SNMC)

Declaracions microbiològiques; Notificació; Indicadors de salutMicrobiological statement; Notification; Health status indicatorsDeclaraciones microbiológicas; Notificación; Indicadores de saludEl sistema de notificació microbiològica de Catalunya (SNMC) pertany a la xarxa de vigilància epidemiològica i recull informació dels microorganismes causants de malalties infeccioses que són objecte de declaració i que es detecten als laboratoris que hi participen. En aquests documents es presenten les declaracions microbiològiques anuals dels laboratoris que han participat en el sistema de notificació microbiològica de Catalunya (SNMC).Microbiological Notification System of Catalonia (SNMC) belongs to the epidemiological surveillance network and collects information of microorganisms that cause infectious diseases which are notified when detected in the involved laboratories. These documents present the annual statements of microbiological laboratories that participated in the Microbiological Notification System of Catalonia (SNMC).El sistema de notificación microbiológica de Cataluña (SNMC) pertenece a la red de vigilancia epidemiológica y recoge información de los microorganismos causantes de enfermedades infecciosas que son objeto de declaración y que se detectan en los laboratorios que participan. En estos documentos se presentan las declaraciones microbiológicas anuales de los laboratorios que han participado en el sistema de notificación microbiológica de Cataluña (SNMC)

Anàlisi de la sensibilitat als antimicrobians de Staphylococcus aureus: Catalunya 2016-2022

Resistència als antimicrobians; Infeccions; Staphylococcus aureusResistencia a los antimicrobianos; Infecciones; Staphylococcus aureusResistance to antimicrobials; Infections; Staphylococcus aureusL’objectiu d’aquest Informe és l’anàlisi de la sensibilitat als antibiòtics de S. aureus SASM i de S. aureus SARM invasius, aïllats a Catalunya en el període 2016–2022

Evaluating Person-Centred Integrated Care to People with Complex Chronic Conditions: Early Implementation Results of the ProPCC Programme

Introduction: The evaluation of integrated care programmes for high-need high-cost older people is a challenge. We aim to share the early implementation results of the ProPCC programme in the North-Barcelona metropolitan area, in Catalonia, Spain. Methods: We analysed the intervention with retrospective data from May 2018 to December 2021 by describing the cohort complexity and by showing its 6-months pre-post impact on time spent at home and resources used: primary care visits, emergency department visits, hospital admissions and hospital stay. Findings: 264 cases were included (91% at home; 9% in nursing homes). 6-month pre vs. 6-months post results were (mean, p-value): primary care visits 8.2 vs. 11.5 (p < 0.05); emergency department visits 1.4 vs. 0.9 (p < 0.05); hospital admissions 0.7 vs. 0.5 (p < 0.05); hospital stay 12.8 vs. 7.9 days (p < 0.05). Time spent at home was 169.2 vs.174.2 days (p < 0.05). Conclusion: Early implementation of the ProPCC programme results in an increase in time spent at home (up to 3%) and significant reductions in emergency department attendance (–37.2%) and hospital stays (–38.3%). The increased use of primary care resources is compensated by the hospital resources savings, with a result in the average total cost of –46.3%

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation