Antibiotic resistance in 3113 blood isolates of Staphylococcus aureus in 40 Spanish hospitals participating in the European Antimicrobial Resistance Surveillance System (2000-2002)

OBJECTIVES: Since 1998 the European Commission has funded EARSS. We present the antibiotic susceptibility results of invasive Staphylococcus aureus obtained in Spain (2000-2002). MATERIAL AND METHODS: Forty hospitals participated in this study, covering nearly 30% of the Spanish population. All blood isolates of S. aureus were included. Laboratories used their usual methods to perform microbiological studies. Annual external quality controls were carried out. A questionnaire with hospital, patient and specimen data was completed for each isolate. Results were included in a database and analysed with WHONET 5 software. RESULTS: Invasive S. aureus was isolated in 3113 patients. Resistance was 24.5% to oxacillin, 25.4% to ciprofloxacin, 25.2% to erythromycin and 12.1% to gentamicin. Gentamicin resistance decreased from 16.6% (2000) to 9.7% (2002). Multiresistance was observed in 68.1% of oxacillin-resistant isolates. More prevalent multiresistance profiles consisted of oxacillin-ciprofloxacin-erythromycin-gentamicin (7.4%) and oxacillin-ciprofloxacin-erythromycin (7.1%). Oxacillin resistance was significantly higher in nosocomial isolates than in those implicated in community-onset infections (26.7% versus 14.2%), in isolates from adults than in those from children (27.3% versus 4.7%), in hospitals with >500 beds than in those with <500 beds (31.1% versus 18.3%) and in isolates from Intensive Care Units than in those from other departments (39.3% versus 24%). Decreased susceptibility to vancomycin was not detected. CONCLUSIONS: In Spain, S. aureus blood isolates present a high prevalence of resistance to oxacillin, ciprofloxacin and erythromycin, as well as a high prevalence of multiresistance. Oxacillin resistance remains stable but varies in relation to hospital size, patient age, hospital department and place of infection acquisition.     

Chloroquine-resistant malaria in travelers returning from haiti after 2010 earthquake

We investigated chloroquine sensitivity to Plasmodium falciparum in travelers returning to France and Canada from Haiti during a 23-year period. Two of 19 isolates obtained after the 2010 earthquake showed mixed pfcrt 76K+T genotype and high 50% inhibitory concentration. Physicians treating malaria acquired in Haiti should be aware of possible chloroquine resistance.     

All India Ophthalmological Society (AIOS) Task Force guidelines to prevent intraocular infections and cluster outbreaks after cataract surgery

Infectious endophthalmitis is a serious and vision-threatening complication of commonly performed intraocular surgeries such as cataract surgery. The occurrence of endophthalmitis can result in severe damage to the uveal and other ocular tissues even among patients undergoing an uncomplicated surgical procedure. If the infections result from common factors such as surgical supplies, operative or operation theater-related risks, there can be a cluster outbreak of toxic anterior segment syndrome (TASS) or infectious endophthalmitis, leading to several patients having an undesirable outcome. Since prevention of intraocular infections is of paramount importance to ophthalmic surgeons, the All India Ophthalmological Society (AIOS) has taken the lead in the formation of a National Task Force to help ophthalmic surgeons apply certain universal precautions in their clinical practice. The Task Force has prepared a handy checklist and evidence-based guidelines to minimize the risk of infectious endophthalmitis following cataract surgery.     

Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship

Background  

Electronic evaluation portfolios may play a role in learning and evaluation in clinical settings and may complement other traditional evaluation methods (bedside evaluations, written exams and tutor-led evaluations).