Prevalence and characteristics of methicillin-resistant staphylococci in goats on the island of Tenerife, Spain

The aim of this study was to determine the prevalence of methicillin-resistant Staphylococcus (MRS) in healthy goats on the Island of Tenerife, Spain, as well as to identify the phenotypic and genotypic characteristics of the strains found. A cross-sectional prevalence study was conducted. A total of 158 goats from 15 different farms were sampled between September 2017 and January 2018. The percentage of positive samples of methicillin-resistant Staphylococcus aureus (MRSA) was 15.8% (25/158) and that of methicillin-resistant coagulase-negative staphylococci (MRCoNS) was 6.9% (11/158). All MRSA isolates from goats belonged to one clonal group showing Multi-Locus Sequence type 398. All strains studied (n = 36) were resistant to non-carbapenem beta-lactam antibiotics and susceptible to teicoplanin, linezolid, vancomycin, rifampicin, quinupristin-dalfospristin and mupirocine. In MRSA isolates, the highest percentage of resistance obtained, besides beta-lactam non-carbapenem antibiotics, was to trimethoprim-sulphamethoxazole and, in the case of MRCoNS isolates, to phosphomycin and erythromycin. A total of 12 resistance patterns were obtained, presenting differences between patterns obtained for MRSA and MRCoNS, with 7 different patterns for MRSA and 5 for MRCoNS. We therefore consider it essential to expand the epidemiological study of these strains of animal origin, as well as to increase surveillance and control measures at all stages of the food chain

Estudio microbiológico de las comidas servidas en comedores escolares de la isla de Tenerife

Fundamento:Valorar la calidad higiénico-sanitaria de las comidas servidas en comedores escolares con la finalidad de conocer si es adecuada o por el contrario su ingesta puede representar un grave problema de salud para este colectivo de alto riesgo. Métodos: Estudio epidemiológico descriptivo transversal. Se analizan 898 muestras de alimentos recogidos en comedores de 101 colegios de Tenerife, seleccionados por un muestreo probabilístico aleatorio estratificado, 58 con elaboración propia de los alimentos (gestión directa) y 43 con comidas servidas por un catering (elaboración contratada). Resultados:En ninguna de las muestras analizadas se aislaron los patógenos Salmonellaspp. y Listeria monocytogenes. El 79% de los alimentos estudiados presentó recuentos para este parámetro, (91%) de ensaladas y (85%) de segundos platos. Para Enterobacteriaceaetotales, el 15% de las muestras analizadas fueron positivas. Escherichia coli se aisló en el 24% de las ensaladas, el 4% de los complementos y el 1% de los segundos platos y Staphylococcus aureus se aisló en tres alimentos. Los recuentos más elevados se obtuvieron para los microorganismos aerobios mesófilos totales. Del total de muestras analizadas un 8,24% de las mismas superaron uno o más de los límites establecidos para los parámetros estudiados. Conclusiones: La calidad microbiológica de las comidas servidas en los comedores escolares es aceptable, si bien al existir un porcentaje de alimentos que superan los límites establecidos en microorganismos indicadores y testigos de falta de higiene y al ser los escolares un colectivo de alto riesgo, será necesaria la revisión de la vigilancia en los puntos de control crítico

Validación del modelo REI para medir la clase social en población adulta

Fundamento: La clase social generalmente se mide de manera categórica y basada en la ocupación laboral, lo cual tiene múltiples limitaciones. El objetivo de este trabajo es elaborar un indicador cuantitativo de clase social, fácilmente estandarizable, validarlo en población adulta y comprobar su aptitud para medir el impacto de la clase social como determinante de salud. Métodos: estudio transversal de 6.729 individuos para medir la clase social con las variables: Renta familiar per cápita, Índice de hacinamiento, Estudios realizados, Ocupación laboral y Situación laboral. Se crearon dos modelos y mediante curvas COR se seleccionó el mejor para validarlo analizando su capacidad de estimar los riesgos relativos de: residir en barrio pobre o rico, mantener un patrón dietético típico de clases sociales pobres y presentar problemas de salud actualmente asociados a la pobreza. Resultados: el modelo sólo incluyó las variables Renta, Estudios e Índice de hacinamiento (REI), produjo un indicador con rango de valores entre 4 y 21 y mostró correlación inversa con la edad (r= -0,28; p<0,001), con el consumo de papas (r= -0,17; p<0,001) y con el consumo de legumbres (r= -0,03; p=0,01), además de correlación directa con el consumo de ensalada (r = 0,10; p<0,001); su sensibilidad para detectar la residencia en barrio pobre alcanzó el 97% para valores menores a 10. REI estimó que las clases sociales pobres presentan riesgos significativos de situación laboral de desempleo (OR=5,4), ocupación laboral de baja cualificación (OR=40,9), habitar en barrios pobres (OR =30,2), bajo consumo de ensaladas (OR = 2,2), gran consumo de papas (OR = 4,5) y alto consumo de legumbres (OR = 1,6). En ambos sexos las clases pobres presentaron mayor riesgo de problemas de salud, con mayor fuerza en las mujeres: sedentarismo (OR = 1,8), obesidad (OR = 4,4), obesidad abdominal (OR = 5,4), síndrome metabólico (OR = 3,4) y diabetes mellitus (OR = 2,0). Conclusiones: REI es un indicador válido, no basado en la ocupación ni en la situación laboral, fácilmente estandarizable, apto para medir cuantitativamente la clase social en estudios que precisen analizar el impacto de la misma como determinante de salud

Prevalence and Characterisation of Multiresistant Bacterial Strains Isolated in Pigs from the Island of Tenerife

Background: Antibiotic-resistant bacteria can circulate among human and animal populations through direct contact with animals, as well as via food and the environment. The purpose of this study was to examine the prevalence and characterisation of multiresistant bacteria in pig samples. Methods: 224 samples of pig livestock were taken at the slaughterhouse on the island of Tenerife. A nasal and a rectal sample were collected from each pig. The presence of methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus coagulase-negative (MRCoNS), vancomycin-resistant Enterococcus (VRE), extended-spectrum ß-lactamase-producing Enterobacteriaceae (BLEE), carbapenemase-producing Enterobacteriaceae (CPE), and colistin-resistant Enterobacteriaceae was investigated. The resistance genes of the isolated bacteria were characterised by specific PCRs depending on the microorganism to be studied, and in vitro antimicrobial resistance was determined using the broth microdilution method (Vitek®2 system bioMérieux®, Nurtingen, Germany). Results: MRSA prevalence was 73.21% (164 isolates). MRCoNS prevalence was 9.8% (22 isolates), S. sciuri being the prevalent species. Six isolates presented a 2.7% prevalence of extended-spectrum ß-lactamase-producing Escherichia coli (BLEE) in the CTX-M-1 group. No vancomycin-resistant Enterococcus (VRE), carbapenemase-producing Enterobacteriaceae (CRE), or colistin-resistant Enterobacteriaceae were isolated. Conclusion: we found a high presence of multiresistant bacteria, suggesting the need for increased control and surveillance of this type of strains in pig livestock and a better understanding of the possible transmission routes of these microorganisms through livestock products

Increased Antimicrobial Resistance of MRSA Strains Isolated from Pigs in Spain between 2009 and 2018

The problem of emerging resistant microorganisms such as Methicillin-Resistant Staphylococcus aureus (MRSA) associated to livestock is closely linked to improper use of antimicrobial agents. The aim of this study is to find out the prevalence and characteristics of these strains, as well as their evolution in healthy pigs on the Island of Tenerife, Spain. Between October 2009 and December 2010, 300 pigs from 15 wean-to-finishing farms were screened. Between 1 September 2017 and 31 March 2018, a new sampling was performed collecting 125 nasal swabs from pigs belonging to the same farms and under the same conditions as the previous study. MRSA antibiotic resistant patterns were studied. Results: Prevalence of MRSA isolates was 89.6%. All isolates belonged to Sequence Type 398 (ST398), a livestock related strain. All strains studied were resistant to beta-lactamic non-carbapenemic antibiotics and sensitive to teicoplanin, linezolid, vancomycin, rifampicin, quinupristin-dalfospristin, and mupirocine. Between 2009/2010&#8211;2017/2018 a significant increase in resistance to gentamicin, tobramycin, trimethoprim-sulfomethoxazole, clindamycin, Fosfomycin, and tigecycline antibiotics was observed in isolated MRSA strains compared to the previous period. We consider a major control and surveillance program of antibiotic use in veterinary care is needed in order to reduce the presence of MRSA strains in livestock and control this significant multi-resistance increase

Impact of the Case Management Model through Community Liaison Nurses

The objective of the present study is to assess the model&#8217;s impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002&#8722;2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators&#8217; tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p &lt; 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients&#8217; clinical condition as well as in the quality and efficiency of care

Aplicaciones móviles para mejorar la adherencia a la medicación: revisión y análisis de calidad

Resumen: Objetivo: Revisar las aplicaciones móviles en español para mejorar la adherencia farmacológica y evaluar sus características y calidad con el fin de identificar aplicaciones de alta calidad. Médoto: Se ha hecho una revisión siguiendo un procedimiento por pasos similar a una revisión sistemática de la literatura. La fuente de los datos han sido plataformas de distribución digital de aplicaciones móviles Apple Apps Store y Google Play Store. Se han seleccionado aquellas aplicaciones dirigidas a apoyar la autogestión de los medicamentos, capaces de generar recordatorios, en español, actualizadas en los últimos 2 años y gratuitas. Los análisis de las aplicaciones se han hecho según un conjunto de características consideradas deseables y evaluación de la calidad con la herramienta Mobile App Rating Scale. Resultados: De 708 aplicaciones, se seleccionaron 3. Las aplicaciones Medisafe y Mytherapy presentaron el 89% y el 78% de las características deseables, respectivamente. La aplicación de Sergio Licea presentó el 56%. La mayor puntuación global de calidad la obtuvo MyTherapy (3,79/5; RIQ: 3-4), seguida de Medisafe (3,72/5; RIQ: 3-4) y, por último, Sergio Licea (2,87/5; RIQ: 2-4). La valoración de la calidad es coincidente con la hecha por los usuarios. Hay muchas aplicaciones disponibles, sin embargo, la mayoría no cumplieron los criterios de selección establecidos. Conclusiones: Através de un proceso sistemático por pasos, identificamos la aplicación de mayor calidad en español para que sea probada en un estudio futuro, que proporcionará evidencia sobre el uso de una intervención multicomponente para mejorar la adherencia a la medicación. Abstract: Objective: To review the mobile apps in the Spanish market to improve adherence to medications and evaluate their characteristics and quality to identify high-quality applications. Method: A review was carried out following a stepwise procedure similar to a systematic review of the scientific literature. Apple Apps Store and Google Play Store mobile application digital distribution platforms. Applications aimed at supporting self-management of treatment, which generate reminders, in Spanish, updated in the last 2 years and free. We evaluate the applications according to a set of characteristics considered desirable and the quality with the Mobile App Rating Scale tool. Results: Out of 708 applications, 3 applications were selected. The Medisafe and Mytherapy applications had 89% and 78% of the desirable characteristics, respectively. Sergio Licea's application only had 56%. The highest global quality score was obtained by the MyTherapy application (3.79/5, IQR: 3-4), followed by Medisafe (3.72/5, (IQR: 3-4) and, finally, Sergio Licea (2.87/5, IQR: 2-4). The quality assessment coincides with the user assessment. There are many available applications, however, most did not meet the selection criteria. Conclusions: A systematic stepwise process was able to identify the quality application to be tested in a future study that will provide evidence on the use of a multicomponent intervention to improve medication adherence