Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae : The Role of Prior Exposure to Fluoroquinolones

Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55-5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10-10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97-16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Educafarma 10.0

Memoria ID-030. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022

Losses produced by soiling in the incoming radiation to photovoltaic modules

The accumulation of dust on the surface of a photovoltaic module decreases the radiation reaching the solar cell and produces losses in the generated power. Dust not only reduces the incoming radiation on the solar cell but also changes the dependence on the angle of incidence of such radiation. This work presents the results of a study carried out at the University of Malaga to quantify radiation losses caused by soiling on the surface of photovoltaic modules. Our results show that the mean of the daily irradiation losses in a year caused by dust deposited on the surface of a photovoltaic module is around 4%. After long periods without rain, daily irradiation losses can be higher than 20%. In addition, the irradiance losses are not constant throughout the day, and they are strongly dependent on the angle of incidence and the ratio between diffuse and direct radiations. The irradiance losses as a function of solar time are symmetric with respect to noon, where they reach the minimum value. We also propose a simple theoretical model that describes the qualitative behaviour of the irradiance losses during the day. This model takes into account the percentage of dirty surface and the diffuse/direct irradiance ratio. Copyright © 2012 John Wiley & Sons, Ltd

Performance of Photovoltaic Modules with Self-Cleaning Coating Surface After Two Years of Outdoor Exposure in South Spain

The deposition of a film with self-cleaning and anti-reflective properties on the surface of the modules reduces the soiling losses and facilitates cleaning when it rains. In this paper we present a comparative study of the performance of photovoltaic modules with and without coating in order to determine the soiling losses as well as the influence of tilt angle on these losses. Two different procedures for quantifying soiling losses have been used: The first one measuring transmittance losses of the module and the second one analyzing the values of the daily performance ratio. Measurements were carried out for two periods: the photovoltaic modules were placed with a south orientation and 21° (first period of measurements) and 40 ° (second period of measurements) tilt angles. The obtained results show that coated modules exhibit lower soiling losses that those without coating and therefore better values of daily yield. Then, soiling losses depend on the module tilt angle and are lower when module inclination is higher

Risk factors for amoxicillin-clavulanate resistance in community-onset urinary tract infections caused by escherichia coli or Klebsiella pneumoniae: the role of prior exposure to fluoroquinolones

Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55-5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10-10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97-16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED