Analysis of the urine microbiological results and its impact on the protocol of the prophylaxis of the urology department in our area

Objetivos: Analizar cuáles son los microorganismos más frecuentemente aislados en los urinocultivos realizados en nuestro centro hospitalario. Estudiar el antibiograma de dichos gérmenes para definir cuál es la mejor profilaxis preoperatoria en la cirugía urológica en nuestro medio. Material y métodos: Se realizó un análisis retrospectivo de todos los urinocultivos de pacientes adultos recogidos en el Servicio de Microbiología de nuestro hospital durante el año 2015. La identificación y estudio de sensibilidad de los microorganismos aislados se realizó mediante el sistema automático Vitek 2 (BioMèrieux), seleccionando los antibióticos en función del microorganismo aislado. Se estudió el antibiograma comparándolo con las sugerencias recogidas en la última actualización de las Guías Europeas de Urología sobre infecciones urológicas, que recomiendan ampliamente el empleo de fluorquinolonas, cotrimoxazol, aminopenicilinas/betalactamasas y cefalosporinas en la cirugía limpia-contaminada, la más frecuente en nuestra actividad quirúrgica. Resultados: Se estudió un total de 11.987 muestras de orina, de las cuales 3.457 (28%) fueron positivas en la detección de microorganismos. Los más frecuentes aislados fueron Escherichia coli (46%%), Klebsiella pneumoniae (14%) y Enterococcus faecalis (11%). En el análisis de los antibiogramas se detectaron resistencias superiores al 30% en E.coli frente a los antibióticos recomendados en las Guías de referencia. De igual forma, E. faecalis, otro de los uropatógenos más frecuentes es intrínsecamente resistente a cefalosporinas. Conclusión: El empleo de guías clínicas con grados de recomendación es de vital importancia en la patología infecciosa urológica, debiéndose adecuar al entorno microbiológico de cada área. En nuestro caso, inferimos que tanto el empleo de amoxicilina-clavulánico como fosfomicina se perfilan como la mejor opción para la profilaxis preoperatoria en pacientes de bajo riesgo así, como para el manejo empírico en casos de infección urinaria.Object: To analyze which are the more often microorganism isolated in the urine cultures in our hospital. To study the antibiogram to define which is the best preoperative prophylaxis in our urological surgeries. Material and methods: We retrospective reviewed consecutive urine culture samples assembled in adult patients in the Service of Microbiology in our hospital during 2015. The identification and study of sensibility of the isolated microorganisms was realized by means of the automatic system Vitek 2 (BioMèrieux), selecting the antibiotics according to the isolated microorganism. The antibiogram was studied comparing the suggestions gathered in the last update of the European Guides of Urología in urological infections, that recommend employment extensively: fluoroquinolones, cotrimoxazole, aminopenicillins / beta-lactamases and cephalosporins in the clean-contaminated, most frequent surgery in our daily surgical practice. Results: In total 11.987 urine samples were evaluated, 3.457 (28%) were positive. The most frequent micro-organisms isolated were Escherichia coli (46%), Klebsiella pneumoniae (14%) and Enterococcus faecalis (11%). In the antibiogram analysis resistances was detected up to 30% in E. coli, opposite to the antibiotics recommendations in the Guides of reference. Even, E. faecalis, another of the most frequent uropathogens is intrinsically resistant to cefalosporins. Conclusions: The use of clinical guides with grade of recommendation it is of vital importance in the urological infection pathology, and they should be adapted to the microbiological environment of each area. In our case, we infer that the use of Amoxicillin-clavulanic and Fosfomycin are outlined like the best option for preoperative prophylaxis in low risk patients and for empirical handling in cases of urine infection

CdEr2Se4: A new erbium spin ice system in a spinel structure

Here we present a detailed study of the spinel CdEr2Se4 and show it to be a new instance of spin ice, the first one in an erbium material and the first one in a spinel. Definitive experimental evidence comes from the temperature dependence of the magnetic entropy, which shows an excellent agreement with the predicted behavior for a spin ice state. Crystal field calculations demonstrate that the change in the local environment from that of the titanates completely alters the rare-earth anisotropy giving rise, in the case of Er3+, to the required Ising anisotropy, when Er2Ti2O7 behaves as an XY antiferromagnet. This finding opens up the possibility of new exotic ground states within the CdR2Se4 and CdR2Se4 families. © 2010 The American Physical Society

CdEr2Se4: A New Erbium Spin Ice System in a Spinel Structure

we present a detailed study of the spinel CdEr2Se4 and show it to be a new instance of spin ice, the first one in an erbium material and the first one in a spinel. Definitive experimental evidence comes from the temperature dependence of the magnetic entropy, which shows an excellent agreement with the predicted behavior for a spin ice state. Crystal field calculations demonstrate that the change in the local environment from that of the titanates completely alters the rare-earth anisotropy giving rise, in the case of Er3+, to the required Ising anisotropy, when Er2Ti2O7 behaves as an XY antiferromagnet. This finding opens up the possibility of new exotic ground states within the CdR2Se4 and CdR2Se4 families

Operations of and Future Plans for the Pierre Auger Observatory

Technical reports on operations and features of the Pierre Auger Observatory, including ongoing and planned enhancements and the status of the future northern hemisphere portion of the Observatory. Contributions to the 31st International Cosmic Ray Conference, Lodz, Poland, July 2009.Comment: Contributions to the 31st ICRC, Lodz, Poland, July 200

Measurement of the Depth of Maximum of Extensive Air Showers above 10^18 eV

We describe the measurement of the depth of maximum, Xmax, of the longitudinal development of air showers induced by cosmic rays. Almost four thousand events above 10^18 eV observed by the fluorescence detector of the Pierre Auger Observatory in coincidence with at least one surface detector station are selected for the analysis. The average shower maximum was found to evolve with energy at a rate of (106 +35/-21) g/cm^2/decade below 10^(18.24 +/- 0.05) eV and (24 +/- 3) g/cm^2/decade above this energy. The measured shower-to-shower fluctuations decrease from about 55 to 26 g/cm^2. The interpretation of these results in terms of the cosmic ray mass composition is briefly discussed.Comment: Accepted for publication by PR

Atmospheric effects on extensive air showers observed with the Surface Detector of the Pierre Auger Observatory

Atmospheric parameters, such as pressure (P), temperature (T) and density, affect the development of extensive air showers initiated by energetic cosmic rays. We have studied the impact of atmospheric variations on extensive air showers by means of the surface detector of the Pierre Auger Observatory. The rate of events shows a ~10% seasonal modulation and ~2% diurnal one. We find that the observed behaviour is explained by a model including the effects associated with the variations of pressure and density. The former affects the longitudinal development of air showers while the latter influences the Moliere radius and hence the lateral distribution of the shower particles. The model is validated with full simulations of extensive air showers using atmospheric profiles measured at the site of the Pierre Auger Observatory.Comment: 24 pages, 9 figures, accepted for publication in Astroparticle Physic