共查询到20条相似文献,搜索用时 15 毫秒
1.
David Pérez-Boto José Antonio López-PortolésCristina Simón María Aurora Echeita 《Enfermedades infecciosas y microbiología clínica》2014
Introduction
Outbreaks of campylobacteriosis are infrequent and usually involve a low number of patients, although it is estimated that many more remain undiagnosed. The most successful techniques for outbreak investigation in Campylobacter spp. (PFGE, MLST) have the drawback of being laborious and not available in many laboratories.Methods
During the year 2008, 352 isolates of C. jejuni and C. coli from 16 hospitals were received in our laboratory. All strains were genotyped by RFLP-PCR-flaA (flaA type) and phenotyped with their resistotype. It was established that the strains of the same species from the same hospital, isolated over a period of up to 11 days, with MIC values of ± 1 dilution with the same flaA type could belong to an outbreak. Strains that met these criteria would be later subtyped by KpnI-PFGE and MLST.Results
A total of 23 out of 352 isolates, distributed in 10 groups, met the criteria for being associated with putative undiagnosed outbreaks. The similarity of the PFGE-profiles in 8 groups was greater than 95% among the isolates from each group. In 7 of the groups, the sequence types (MLST) were coincident.Conclusions
The use of 2 easy markers (resistotype and RFLP-PCR-flaA) may detect isolates probably belonging to an undiagnosed outbreak of campylobacteriosis. Accurate diagnosis requires other molecular markers and epidemiological data of each isolate. The study suggests that, as in other countries, the number of outbreaks of campylobacteriosis in Spain is probably underestimated. 相似文献2.
3.
Luis Navarro-i-Martinez Alexandre J. da Silva José Llovo Taboada Carmen del Águila Norman J. Pieniazek Fernando J. Bornay-Llinares 《Enfermedades infecciosas y microbiología clínica》2013
Molecular PCR based diagnostic techniques have enabled us to distinguish between the different, morphologically identical, Cryptosporidium species that can infect humans. Of the 23 recognized species in the genus, at least 9 are able to infect humans. As the intensity of the clinical manifestations, pathogenicity, excretion of oocysts, and incidence, are different between this species, molecular studies are crucial for a better understanding of the epidemiology of human cryptosporidiosis. 相似文献
4.
Ainhoa Gutiérrez Isabel Viciana Francisca Rius Alfonso Pinedo 《Enfermedades infecciosas y microbiología clínica》2012
Background
Variations of C gene give rise to precore and basal core mutations, which influence HBeAg expression The antiviral treatment failure is due to the presence of variations in the gene P, which cause mutations in the viral polymerase.Methods
We performed genotyping of HBV P gene by sequencing, and gene C in patients with chronic hepatitis B over a period of five years.Results
A total of 75 % of the patients had some mutation in precore or in basal core promoter regions, and 37 % demonstrated resistance mutations to antiviral treatment. The most frequent genotypes were A and D.Conclusions
The presence of mutations in core/precore regions in patients with chronic hepatitis has led to tighter control of these patients. Detecting for resistance should be done as quickly as possible before there is an increase in viral load. 相似文献5.
Joaquín Bermejo Mariano Gianello María L. Pascale Noemí Borda Julieta Freije Rodolfo Notario 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
To evaluate the clinical significance of the isolation of Staphylococcus aureus in urine samples.Methods
A retrospective study was performed on adult patients identified from a microbiology database in a 200-bed general hospital between the years 2000 and 2009. The demographic data, comorbidities, and risk factors, were reviewed, particularly those associated with the concomitant isolation of S. aureus in blood cultures.Results
The frequency of S. aureus found in urine samples was 0.63%. A total of 43 patients (mean age 68.7 years [SD ± 16], and 58.1% males) were identified in the database. A Charlson comorbidity index > 3 was observed in 20.9%. Concurrent bacteremia was seen in 48.8%. Two groups of patients were distinguished: with concomitant bacteremia (n = 21) or without (n = 22). Intervention in the urinary tract significantly predicted (P = .00004) bacteriuria without bacteremia (81.8%), compared to bacteremia cases (19%). The attributable mortality was 47.6% in patients with bacteremia compared to non-bacteremia (no deaths), even though the appropriate antibiotic treatment was more frequent among patients with bacteremia (92% and 60%, respectively).Conclusion
The presence of S. aureus in urine was accompanied by bacteremia in half of the cases, but in patients without previous urinary tract intervention such a possibility increased to 81%. Concomitant bacteremia predicts a worse prognosis even with appropriate treatment. 相似文献6.
Suberosis is a type of hypersensitivity pneumonitis caused by exposure to cork proteins and molds such as Aspergillus fumigatus and Penicillium frequentans. We present the case of a man with suberosis caused by Mucor species, a mold that has been rarely reported to cause hypersensitivity pneumonitis. Furthermore, the patient had symptoms and lung function tests indicating bronchial obstruction—an atypical presentation of hypersensitivity pneumonitis. No imaging abnormalities were observed. A diagnosis was made on the basis of bronchoalveolar lavage and transbronchial biopsy findings. Mucor species was identified as the causative agent using a specific bronchial challenge test. 相似文献
7.
Carmen Lozano Carmen Aspiroz Elena Gómez-Sanz Gabriel Tirado Blanca Fortuño Myriam Zarazaga Carmen Torres 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
Linezolid resistance is mainly due to mutations in the 23S rRNA target. The aim of this study was to characterize linezolid and methicillin resistant Staphylococcus epidermidis (SE-LMR) and S. haemolyticus (SH-LMR) strains detected in a Spanish hospital.Methods
SE-LMR and SH-LMR strains obtained in the period June 2009-August 2011 in a second level hospital were recorded along with the epidemiological characteristics of the patients. These strains were typed, and their resistance, phenotype, genotype and the factors determining their virulence were analysed.Results
Linezolid resistance was explained by the presence of G2603T mutation (23S rRNA) and aminoacid changes in L3 and L4 ribosomal proteins. The 25 SE-LMR strains belonged to sequence type ST2, presented SCCmec type III, and two different PFGE patterns. The two SH-LMR strains showed non-typeable SCCmec. SE-LMR strains harboured the resistance genes aac(6’)-aph(2”), and dfrS1. SH-LMR strains contained these genes and the gene erm(C). No lincomycin resistance mechanism was identified in SE-LMR strains regardless of showing lincomycin resistance and diminished susceptibility to clindamycin.Conclusions
Linezolid resistance is of concern in hospitals, and requires continued vigilance. Several linezolid resistance mechanisms (mutation in 23S RNAr and amino acid changes in L3 and L4) were identified in this study. 相似文献8.
Introduction
Triple therapy, which remains the standard treatment for Helicobacter pylori infection, should be discouraged when its efficacy is lower than 80% or when clarithromycin resistance rates are above 15-20%.Aim
To update the available evidence on the effectiveness of triple therapy and clarithromycin resistance rates in adults in Spain over the last 6 years.Methods
A literature search (2007-2012) was conducted in Medline and the abstracts books of the annual meetings of several Spanish gastroenterological and microbiological congresses. The search terms were «Helicobacter pylori», «Spain» and «clarithromycin». Studies were selected if they included triple therapy consisting of a proton pump inhibitor with clarithromycin and amoxicillin or if they analyzed H. pylori clarithromycin susceptibility in treatment-naïve patients.Results
There were five articles and nine abstracts (3147 patients) on triple therapy, which showed a mean cure rate of 70.8% (95% CI = 66-76%). When stratified by the duration of therapy, the mean cure rates were 68.8% (60-76%) for 7-day regimens and 71.76% (68-78%) for 10-day regimens. For clarithromycin resistance rates, four articles and five abstracts (1709 patients) revealed a mean resistance rate of 18.3% (13-22%).Conclusions
The efficacy of triple therapy seems to be unacceptable in recent studies conducted in Spain, possibly associated with clarithromcyin resistance rates higher than previously reported. 相似文献9.
Implantación electiva de stent recubierto en la coartación y recoartación en el joven y en el adulto
Juan Alcibar Roberto Blanco Luis Fernandez Josune Arriola Koldobika Garcia Natividad Peña Ramón Inguanzo Roberto Voces Enrique Castellanos Pedro M. Montes 《Revista espa?ola de cardiología》2013
Introduction and objectives
Stent implantation is an effective therapy for aortic coarctation and recoarctation. However, in adolescents and adults, aortic wall rupture and dissection can occur, as well as aneurysms during follow-up. In order to reduce these complications, we electively implant covered stents.Methods
Since 2005, we have performed the procedure using femoral access in 17 patients (2 adolescents and 15 adults), 16 electively and 1 as a rescue procedure. We used the Mullins technique in all cases, implanting a NuMED® covered stent.Results
Good stent apposition was achieved in all 17 procedures; 8 patients required a distal flare. Gradient was reduced from 40 (16) mmHg to 2 (2) mmHg (P<.001) and lumen diameter increased from 4 (2) mm to 19 (3) mm (P<.001). Two exceptional cases are discussed: one patient with aortic wall rupture who underwent a rescue procedure using a stent within a covered stent and another patient with total obstruction and intercostal aneurysm in whom the outcome was fatal at 48 h postprocedure (autopsy is shown). Four-year clinical follow-up included Doppler echocardiography; an additional imaging technique was required in 13 patients. All patients recovered well and there were no complications.Conclusions
Covered stents are effective in treating coarctation and recoarctation in adolescents and adults, are the treatment of choice in patients with complex anatomy, and must be available in the operating room as a rescue device when implanting a conventional stent.Full English text available from:www.revespcardiol.org/en 相似文献10.
11.
Sara López-Aguilera María del Mar Goñi-Yeste Laura Barrado M. Carmen González-Rodríguez-Salinas Joaquín R. Otero Fernando Chaves 《Enfermedades infecciosas y microbiología clínica》2013
Background
Staphylococcus aureus is the main pathogen causing nosocomial infections. Health professionals, including medical students, could be a source of transmission. The aims of the study were to determine the rate of nasal carriage of S. aureus susceptible and resistant to methicillin (MRSA) and evaluate the knowledge and adherence that students had about hand hygiene.Methods
The study included medical students attached to the Hospital Universitario 12 de Octubre (Madrid, Spain). We collected samples from both nasal vestibules, and the antimicrobial susceptibility was determined on all isolates. Data collection was performed using a self-administered questionnaire that included risk factors for colonization, hygiene habits and knowledge of hand hygiene protocols.Results
Of the 140 students included, 55 (39.3%) were colonized by S. aureus, and 3 (2,1%) by MRSA. The exposure to antibiotics in the last 3 months was lower in colonized students (12.3% vs. 25.9%, P = .03). Self-assessment showed that 56.4% of students almost never washed their hands before to attending to the first patient, and only 38.6% always washed after examining patients. More than a third (35.7%) ignored the hand hygiene protocol, and 38.6% had not received specific formation.Conclusions
Medical students should be included in hospital infection control programs. Hand hygiene training should be given to students before they begin their practices in the hospital. 相似文献12.
Cuneyt Tayman Ferhat Cekmez Ilker Mustafa Kafa Fuat Emre Canpolat Merih Cetinkaya Alparslan Tonbul Sema Uysal Turan Tunc S. Umit Sarici 《Archivos de bronconeumología》2013
Background
Oxygen-induced lung injury is believed to lead to the development of bronchopulmonary dysplasia in premature infants. We have evaluated the beneficial effects of Nigella sativa oil (NSO) on rats with hyperoxia-induced lung injury.Methods
Thirty newborn Sprague-Dawley rats were randomly divided into 3 groups as hyperoxia (95% O2), hyperoxia + NSO and control (21% O2). Pups in the hyperoxia + NSO group were administered intraperitoneal NSO at a dose of 4 ml/kg daily during the study period. Histopathologic, immunochemical, and biochemical evaluations (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], malonaldehyde [MDA] and myeloperoxidase [MPO]) were performed.Results
In the histopathologic and immunochemical evaluation, severity of lung damage was significantly lower in the hyperoxia + NOS group (P < .05). Tissue GSH-Px and SOD levels were significantly preserved, and MDA, MPO levels were significantly lower in the hyperoxia + NSO group (P < .05).Conclusion
NSO significantly reduced the severity of lung damage due to hyperoxia. 相似文献13.
Carmen Aspiroz Carmen Lozano Yolanda Gilaberte Myriam Zarazaga M. José Aldea Carmen Torres 《Enfermedades infecciosas y microbiología clínica》2012
Introduction
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) of sequence type ST398 is a genetic lineage also described in human infections.Methods
Cutaneous infections related with MRSA ST398 are described in 3 patients, two of them pig farmers. The MRSA nasal carriage by patients and their relatives was also studied. MRSA ST398 strains were typed (SCCmec, spa, agr and MLST) and the antimicrobial resistance pattern and virulence genes were determined.Results
Twenty MRSA ST398 isolates were recovered in lesions of three patients, and in nasal samples of two patients and five relatives. Isolates were typed: spa-type t011 or t108; agr-type I and SCCmec IVa or V. MRSA strains were tetracycline-resistant and 15 of them showed a phenotype and genotype of multi-resistance, but they were free of tested virulence genes.Conclusions
LA-MRSA ST398 is an emergent problem in our country, mainly associated with skin and soft tissue infections in people with professional relationships with pig farms. Tetracycline resistance is an important marker for MRSA ST398 detection. 相似文献14.
José M. Rodríguez-Martínez M. Carmen Conejo Paula Díaz de Alba Lorena López-Cerero Pedro Fernandez-Echauri Álvaro Pascual 《Enfermedades infecciosas y microbiología clínica》2012
Background
Combined resistance to quinolones and β-lactams is common in Enterobacteriaceae. The appearance in enterobacteria coding for metallo-β-lactamases and determinants of plasmid-mediated quinolone resistance are an emerging problem in our country.Methods
The susceptibility was determined by E-test. The resistance genes were detected by PCR and the corresponding plasmids were characterised.Results
This study describes 2 strains (1 Klebsiella oxytoca, 1 Klebsiella pneumoniae) carrying the genes qnrS2 and blaVIM-1 in a transferable plasmid of 70-Kb isolated in surveillance cultures at the University Hospital Virgen Macarena in Seville.Conclusion
This is the first combination of qnrS2 and blaVIM-1 on the same non-typeable plasmid isolated in our centre. 相似文献15.
María López Míriam J. Álvarez-Martínez Francesc Marco Carmen Torres 《Enfermedades infecciosas y microbiología clínica》2013
Objective
The objective of this study was to analyse the genotypic characteristics of all Enterococcus isolates with acquired vancomycin resistance (VRE) recovered in the Hospital Clinic (Barcelona, Spain) in a period of three years and two months.Methods
All VRE isolated in the referred Hospital in the period January 2004-March 2007 were included in the study. The vancomycin resistance mechanism was investigated, as well as other antibiotic resistance mechanisms. Isolates were also typed by pulsed-field-gel-electrophoresis (PFGE) and multi-locus-sequence-typing (MLST).Results
Thirty-nine VRE were recovered, all being identified as E. faecium, representing 2% of total enterococci obtained in that period. Thirty-eight of them carried the vanA gene, and one isolate the vanB2 gene. The 39 VRE were classified into 13 different pulsotypes (A-M), with one main pulsotype, A, which included 13 isolates. The sequence type was identified by MLST in 24 VRE (with unrelated or closely-related PFGE patterns), and they were ascribed to the clonal complex CC17, but two classified as CC9. All VRE showed a multiresistance phenotype, including, in most cases ampicillin, ciprofloxacin, erythromycin, streptomycin, gentamicin, kanamycin and chloramphenicol, harbouring multiple antibiotic resistance genes. The presence of esp and/or hyl genes was identified in 37 VRE.Conclusion
All VRE, but one, showed the vanA genotype and they were mostly ascribed to the high-risk clonal complex CC17. 相似文献16.
Efecto de la infección por Clostridium difficile sobre la estancia hospitalaria. Estudio de cohortes
Diana Monge Isabel Millán Alba González-Escalada Ángel Asensio 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
Clostridium difficile is responsible for a spectrum of diseases known as “Clostridium difficile infection” (CDI). It is currently the leading cause of nosocomial diarrhea in developed countries. This infection has been associated with both increased hospital stay and mortality, and to a greater likelihood of readmission. In our country these undesirable effects have not yet been characterized. Our objective was to quantify the increase in hospital stay attributable to infection by C. difficile.Methods
A retrospective cohort study matched by age, sex and admission date, was conducted in a tertiary care university hospital during an outbreak of nosocomial transmission of CDI.Results
The cohort study included 38 infected, and 76 non-infected patients. Patients who developed CDI showed a higher proportion of malnutrition at admission (OR = 10.3; 3.6 to 29.6), were exposed to a wider range of antibiotics (mean difference = 1.5; 0.7-2.2), had a higher mortality (31.6% vs. 6.6% of controls, P < .001), and a longer hospital stay (median 31.5 days versus 5.5 days for controls, P < .001). After adjustment, infection by C. difficile was associated with an increase in hospital stay of 4 days (P < .001).Conclusions
C. difficile infection has important consequences on the length of hospital stay, and therefore on health costs. 相似文献17.
Carmen Rodríguez-Avial Andrea Álvarez-Novoa Azucena Losa Juan J. Picazo 《Enfermedades infecciosas y microbiología clínica》2013
Introduction
Staphylococcus aureus is a pathogen of major concern. The emergence of methicillin-resistant S. aureus (MRSA) has increasingly complicated the therapeutic approach of hospital-acquired infections. Surveillance of MRSA and control measures must be implemented in different healthcare settings, including screening programs for carriers. Our first aim was to determine the prevalence of methicillin-susceptible S. aureus (MSSA) and MRSA nasal carriage in medical students from the Clínico San Carlos Hospital (Madrid). As the MRSA carrier rate in healthcare workers is higher than in the general population, we hypothesised that carrier rate could be increased during their clinical practice in their last three years.Methods
We performed an epidemiologic al study of the prevalence of S. aureus colonisation among a group of medical students, who were sampled in 2008 in their third-year, and in 2012 when this class was in its sixth year.Results
We have found a significant increase in MSSA carriage, from 27% to 46%. There were no MRSA colonisations in the third-year, but one was found in the sixth-year group. The large majority of strains (89%) of strains were resistant to penicillin, and 27% to erythromycin and clindamycin. As 19 coagulase-negative Staphylococcus MR were also identified, a horizontal transfer of genes, such as mecA gene to S. aureus, could have occurred.Conclusions
Medical students are both, at risk for acquiring, and a potential source of nosocomial pathogens, mainly MSSA. Therefore, they should take special care for hygienic precautions, such as frequent and proper hand washing, while working in the hospital. 相似文献18.
19.
Alejandra Yunuen Cervantes-Landín Ignacio Martínez-Martínez Pedro A. Reyes Muslim Shabib Bertha Espinoza-Gutiérrez 《Enfermedades infecciosas y microbiología clínica》2014
Introduction
Chagas disease is considered endemic of Latin America. Because of migration of people from this region to non-endemic areas, such as the United States, Canada and Europe, it has become a major health problem. There are parasitology and serology tests for its diagnosis, but only the latter are useful during the chronic phase. Most of these tests require expensive equipment, which make them also inaccessible for laboratories in endemic areas. In the present work we standardize Dot-ELISA as a diagnostic test for Trypanosoma cruzi infection, since it is an easy, inexpensive and an accessible test.Methods
A total of 360 samples were tested: 96 sera from Chagas patients and 153 from healthy people; 40 blood samples spots collected and eluted from filter paper were also tested, as well as 71 serum samples of patients with non-related infections. Sensitivity, specificity and kappa index of Dot-ELISA test were calculated, in order to determine a correlation value of this technique compared to ELISA and Western blot that are already being used for diagnosis.Results
Dot-ELISA obtained 97% sensitivity and 89% specificity, since it showed cross-reaction mainly with Leishmania spp., and a kappa index of 0,79.Conclusions
Dot-ELISA results correlate well with other tests that are already being used for diagnosis of Chagas disease. As it is easy and inexpensive, it may be useful as an additional diagnostic test or for field studies. 相似文献20.
Magdalena Gómez-Mateos Adela Valero-López Teresa de la Rubia-Nieto María del Carmen Romero-López Victoriano Díaz-Sáez 《Enfermedades infecciosas y microbiología clínica》2014