Castilla J.,Institute Salud Publica Of Navarra |
Castilla J.,CIBER ISCIII |
Martinez-Baz I.,Institute Salud Publica Of Navarra |
Martinez-Baz I.,CIBER ISCIII |
And 18 more authors.
Preventive Medicine | Year: 2013
Objective: To evaluate trends in seasonal influenza vaccination coverage in primary healthcare workers (PHCWs) in Spain between 2008 and 2011. Methods: We made an anonymous web survey of PHCWs in 2012. Information on attitudes towards and knowledge of influenza vaccine, and immunization in previous seasons was collected. Self-reported vaccination coverage and factors related to vaccination continuity were analysed. Results: Of 5433 workers contacted, 2625 (48.3%) responded to the survey: 47.0% were general practitioners, 10.3% paediatricians and 42.7% nurses. Their reported vaccination rates from seasons 2008-2009 to 2011-2012 decreased over time: 58.4%, 57.4%, 53.2% and 49.3% (linear trend, p. <. 0.001). Among workers vaccinated in any previous season, 70.2% were vaccinated again in 2011-2012, compared with 5.2% among those not previously vaccinated (p. <. 0.001). Continuity of vaccination increased with age and with the worker or cohabitant having a major chronic condition. Vaccination was higher in workers who recognized vaccination as effective and those worried about being infected or infecting patients. Conclusion: Influenza vaccination coverage in PHCWs has declined, especially after the pandemic. Intensive interventions are needed to change this trend. Knowledge of vaccination should be reinforced by stressing the effectiveness of the vaccine and the risks of influenza for workers and patients. © 2013 Elsevier Inc.
A single-day point-prevalence study of faecal carriers in long-term care hospitals in Madrid (Spain) depicts a complex clonal and polyclonal dissemination of carbapenemase-producing Enterobacteriaceae
PubMed | Hospital Virgen Of La Poveda, Area de Epidemiologia, Hospital Universitario Ramon jal And Instituto Ramon jal Of Investigacion Sanitaria Irycis, Hospital Of Guadarrama and Hospital Of La Fuenfria
Type: Journal Article | Journal: The Journal of antimicrobial chemotherapy | Year: 2016
The objective of this study was to describe the prevalence and microbiological characteristics of carbapenemase-producing Enterobacteriaceae (CPE) colonizing patients in long-term care hospitals (LTCHs) in Madrid, Spain.Three LTCHs were included in a single-day point-prevalence survey (September 2013). Rectal swabs, collected from all hospitalized patients (137 in LTCH-A, 121 in LTCH-B and 83 in LTCH-C), were plated onto chromogenic media. Population structure (PFGE and MLST), genes encoding carbapenemases and ESBLs and plasmids carrying carbapenemase genes were characterized.The prevalence of CPE carriers was 4.1% (14/341) [2.9% (4/137), LTCH-A; 4.1% (5/121), LTCH-B; and 6.0% (5/83), LTCH-C]. OXA-48 was the most prevalent carbapenemase (nine Klebsiella pneumoniae, two Escherichia coli, one Enterobacter cloacae and one Citrobacter braakii) followed by VIM-1 (one K. pneumoniae and one Raoultella ornithinolytica). One patient (LTCH-C) was co-colonized with OXA-48-producing K. pneumoniae and E. coli. K. pneumoniae and E. coli isolates also coproduced CTX-M-15 (n = 11) or CTX-M-9 (n = 1) enzymes. K. pneumoniae clustered into six PFGE types corresponding to ST11 (n = 1), ST15 (n = 6), ST307 (n = 1) and ST405 (n = 2). E. coli from LTCH-A and LTCH-C exhibited two different PFGE types associated with ST68. OXA-48 and VIM-1 enzymes were found in different clones in LTCH-A and LTCH-C. However, OXA-48 was the only carbapenemase detected in LTCH-B, mainly associated with K. pneumoniae ST15. KPC, IMP and NDM enzymes were not detected. blaOXA-48 was located on an 60 kb plasmid with a pOXA-48a-IncL/M backbone.We describe the first point-prevalence study of CPE faecal carriers in LTCHs in Spain. OXA-48, the most prevalent carbapenemase, showed a complex dissemination pattern with clonal and polyclonal bacterial populations.
Effectiveness of population-based interventions on the prevention of overweight in children and adolescents [Efectividad de las intervenciones de base poblacional dirigidas a la prevención del sobrepeso en la población infantil y adolescente]
Lopez L.,Area de Epidemiologia |
Audisio Y.,National University of Cordoba |
Berra S.,Agncia dAvaluacio de Tecnologia i Recerca Mdiques AATRM |
Berra S.,CIBER ISCIII
Medicina Clinica | Year: 2010
This study aimed to assess the available scientific evidence on the effectiveness or cost-effectiveness of interventions to prevent obesity, carried out in child and adolescent population. We conducted a systematic review, searching 10 databases and other resource directories for the period January 1998-July 2008. We assessed study quality and extracted and summarized information that met the established criteria. Results included 40 studies that evaluated interventions showing mostly components of physical activity, nutrition and education. We found no evaluations of cost-effectiveness. Thirteen studies resulted in a significant reduction in favor of intervention in some of the anthropometric measurements. In conclusion, some interventions showed an impact in preventing weight gain. However, it is weak, since most studies have not had the expected result, were heterogeneous and of short duration. © 2009 Elsevier España, S.L. All rights reserved.
PubMed | Servicio Andaluz de Salud, CIBER ISCIII, Servicio de Vigilancia de Andalucia, Agencia de Salud Publica de Catalonia and 3 more.
Type: | Journal: BMC family practice | Year: 2015
To assess the contribution of physician-related factors, especially their influenza vaccine status, in the vaccination coverage of their patients.A study of vaccination coverage was carried out in Spain in 2011-12. The dependent variable (vaccination coverage in patients aged 65 years) was obtained from regional records. Information was gathered on the vaccination of physicians through an anonymous web survey. We compared the vaccination coverage of patients with the vaccination of their physicians using the Student t test. Associations were determined using a multilevel regression model.The coverage in patients aged 65 years was 56.3% and was higher (57.3%) in patients whose physician had been vaccinated than in those whose physician had not (55.2%) (p = 0.008). In the multilevel regression model, vaccination of the physician was associated (p = 0.049) with vaccination of their patients after controlling for the effects of age (p = 0.046), region (p = 0.089), and opinions on the effectiveness of the vaccine (p = 0.013).Vaccination of physicians together with their opinions on the effectiveness of the vaccine may be a predictor of vaccination coverage in their patients. Further studies are required to confirm this.
Moreno M.L.,Centro Regional Of Investigaciones Cientificas Y Transferencia Tecnologica Crilar |
Moretti E.,Coordinacion Nacional de Control de Vectores |
Basso B.,Coordinacion Nacional de Control de Vectores |
Cespedes M.F.,Area de Epidemiologia |
And 2 more authors.
Acta Tropica | Year: 2010
We compared age-related seroprevalence of Trypanosoma cruzi infection with history of vector control interventions and social and ecological changes in three historically endemic departments of Cordoba province, Argentina, covering an area of 42,600km2 of the Gran Chaco region. Using a cross sectional design, blood samples of 5240 people between 6 months and 40 years of age, living in 192 rural communities were analyzed to detect T. cruzi infection using ELISA tests, and confirmed with indirect immunofluorescent antibody test and indirect haemoagglutination. Overall seroprevalence was 5.4%, 7.9% and 7.5% in the north, northwest and west studied areas (average for all areas 6.95%). Seroprevalence for T cruzi increased with population age, especially in age classes older than 15 years of age. Communities of the north and west areas showed 0.59% seroprevalence for T. cruzi in children below 15 years of age, whereas children of the same age in the northwest region showed a seroprevalence of 3.08%. Comparative analyses indicate that vector control activities and land use changes during the last decades are the most likely causes of the overall reduction of T. cruzi prevalence. Results suggest that the vectorial transmission of T. cruzi has been strongly reduced and probably interrupted in the north and west areas, but it is still active in the northwestern rural settlements of Córdoba province. © 2009 Elsevier B.V.
Zurriaga O.,Area de Epidemiologia |
Zurriaga O.,Centro Superior Of Investigacion En Salud Publica |
Quiles Izquierdo J.,Area de Epidemiologia |
Gil Costa M.,Area de Epidemiologia |
And 6 more authors.
Public Health Nutrition | Year: 2011
Objective To estimate the association strength of dietary behaviour and sedentary habits in relation to childhood obesity in Spain.Design A matched case-control study was carried out using data collected by sentinel network paediatricians in general practices.Setting Five Spanish autonomous communities.Subjects Cases were 437 children (2-14 years old) with BMI >95th percentile according to Spanish reference tables. Controls were 751 children (2-14 years old; two paired per case) with BMI <84th percentile. Data were collected in two phases: individual (questionnaires filled in by sentinel paediatricians) and family (self-administered questionnaires filled in a family environment). Crude OR and adjusted OR (ORc and adj OR) for the given variables were calculated using a simple and multiple conditional logistic regression analysis.Results The factors with the greatest effect on obesity were family history of obesity: both parents (adj OR = 112), mother but not father (adj OR = 91), father but not mother (adj OR = 61), siblings (adj OR = 27); and eating between meals (adj OR = 25) and consumption of sweets and soft drinks >2 times/week (adj OR = 20). The highest protection effect was found for five meals per day (adj OR = 05), the regular consumption of breakfast (adj OR = 05) and for eating fruit for dessert (adj OR = 06). Factors related to sedentary habits did not appear as noteworthy.Conclusions We have determined the association between certain dietary behaviour and family history with childhood obesity in several Spanish regions. © 2011 The Authors.
Seara N.,Hospital Universitario La Paz |
Oteo J.,Institute Salud Carlos III |
Carrillo R.,Hospital Universitario La Paz |
Perez-Blanco V.,Hospital Universitario La Paz |
And 10 more authors.
International Journal of Antimicrobial Agents | Year: 2015
Abstract This study describes an interhospital spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) producing NDM-7 carbapenemase that started in December 2013 in Madrid, Spain. NDM-7-producing CRKP were isolated from urine, rectal swabs or blood samples from seven patients admitted to three different hospitals (Hospital Universitario La Paz, Hospital de Cantoblanco and Hospital Central de la Cruz Roja). The isolates were resistant to all antimicrobials tested except colistin and fosfomycin. One blood isolate was susceptible to minocycline and tigecycline but was resistant to fosfomycin. All isolates were closely related by pulsed-field gel electrophoresis (PFGE) and DiversiLab® analysis and belonged to multilocus sequence typing (MLST) sequence type 437. In addition, blaNDM-7, blaTEM-1, blaCTX-M-15 and aac(3)-IIa were identified. Family contacts of the index case were negative for NDM-producing bacteria. The outbreak occurred in two separate waves and the cases associated with Hospital de Cantoblanco had been admitted to the same room. Environmental samples from the trap of a sink and a shower in this room were positive for NDM-7-producing CRKP. To our knowledge, this is the first reported worldwide outbreak of NDM-7-producing CRKP. No relationship with the Indian continent, the Balkans or the Middle East could be established. Frequent transfer of aged or chronically ill patients between the facilities involved may have favoured the spread of NDM-7-producing CRKP. The spread of the second wave in Hospital de Cantoblanco probably occurred as a result of transmission from an environmental reservoir. © 2015 Elsevier B.V. and the International Society of Chemotherapy.
Gil-Tomas J.J.,Hospital Universitario Of La Ribera |
Colomina-Rodriguez J.,Hospital Universitario Of La Ribera |
Martinez-Macias O.,Hospital Universitario Of La Ribera |
Borras-Manez M.,Hospital Universitario Of La Ribera |
Guerrero-Espejo A.,Area de Epidemiologia
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2013
Introduction Pertussis is a highly contagious vaccine-preventable disease. An increasing incidence has been reported in several countries around the world in the last few years. The aim of this study is to analyze the situation of pertussis in the Valencian Community (Spain), with the purpose of verifying the increased incidence of the illness. Methods A descriptive analysis of probable and confirmed cases detected during 2011 was conducted. Methods used for Bordetella pertussis detection from clinical samples were: culture isolation, polymerase chain reaction (PCR)-based detection of bacterial DNA, and/or detection of specific IgM antibodies. The disease incidence and other epidemiological variables were estimated. These results were compared to data collected in previous years (2008-2010). The Epidemiological Surveillance Analysis and Microbiological Surveillance Network integrated systems of the regional Department of Health were used as sources of information. Results In 2011, 249 cases of pertussis were detected (incidence rate of 4.89 × 105 inhabitants). This rate is statistically significantly higher than those reported in 2008 (0.73 × 105 inhabitants), 2009 (0.53 × 105 inhabitants), and 2010 (0.53 × 105 inhabitants). The highest incidence rate was observed in cases younger than one year old (252.97 × 105 inhabitants), with marked differences compared to the rest of age groups. More than two-thirds (69%) of reported cases were confirmed by a laboratory test. Detection of specific serum IgM antibodies was positive in 10% of cases, culture isolation was positive in 17%, and PCR-based detection of bacterial DNA in 35% of cases. Conclusions The results of this study show a clear increase of pertussis incidence in the Valencian Community during 2011. © 2013 Elsevier España, S.L.
MacIas O.M.,Hospital Universitario Of La Ribera |
Rodriguez J.C.,Hospital Universitario Of La Ribera |
Marquez M.V.D.,Hospital General Of Castellon |
Espejo A.G.,Hospital Universitario Of La Ribera |
De La Encarnacion Armengol A.,Area de Epidemiologia
Revista Espanola de Salud Publica | Year: 2012
Background: Listeria monocytogenes is an uncommon cause of disease, although in certain age groups (infants, elderly, pregnant women and immunocompromised) may be an important cause of meningoencephalitis, and bacteremia. The aim of this study was to detect the incidence of invasive listeriosis cases found in Valencia during a period of 3 years. Methods: A retrospective study of invasive listeriosis detected in the period 2008-2010 was carried out. The isolation of Listeria from a potentially sterile anatomical location was considered as "case". Data from the Microbiology Surveillance Network of Valencia (RedMIVA) were used as a source of information. Results: 98 cases of invasive listeriosis were detected, of which 58%were men. The largest number of diagnosed cases belonged to the age range 60-80 years (63%). Bacteremic infectious become evident in 57 cases (58%), central nervous system lesions were located in 30 cases (31%) and infectious in sterile liquids occurred in the remaining cases (11%). In 90 strains (92%of cases) could be performed the sensitivity to antibiotics and all were sensitive to ampicillin. Incidence rates were: 0,73 cases/100.000 inhabitans in 2008, 0,70 cases/100.000 inhabitans in 2009 and 0,58 cases/100.000 inhabitans 2010. Conclusions: The average rate of invasive listeriosis in Valencian Community in the period 2008 to 2010 was 0.67 cases per 100,000 inhabitants. Temporal or geographic clusters of cases were not detected.
Appropriateness of antibiotic prescribing in a primary care area: A cross-sectional study [Adecuación de la prescripción de antibióticos en un área de atención primaria: estudio descriptivo transversal]
Fernandez-Urrusuno R.,Servicio de Farmacia |
Flores-Dorado M.,Servicio de Farmacia |
Vilches-Arenas A.,Area de Epidemiologia |
Serrano-Martino C.,Hospital San Juan Of Dios Del Aljarafe |
And 2 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2014
Objective To assess the profile of patients receiving antibiotics and the appropriateness of these prescriptions for the clinical conditions. Methods Design: Cross-sectional study of prescription-indication. Setting A primary health care area in Andalusia. Subjects Patients assigned to primary care centres. Patients with antibiotic prescriptions during 2009 were selected by simple random sampling (confidence level: 95%, accuracy: 5%). Primary endpoint: appropriateness of antibiotics prescribing to recommendations included in local guidelines. Data were obtained through the billing computerised prescriptions system and medical histories. Results Twenty-five per cent of the population area received antibiotics during 2009. The 1,266 patient samples showed the following characteristics: 57.9% were women, with a mean age of 41 (± 1) years. There were 39.3% pensioners. The percentage of appropriate antibiotic prescriptions was 19.9%, with no difference due to gender. Statistically significant differences were related to age, being those over 65 years the group of patients with the highest percentage of inappropriateness. The main reasons for inappropriateness were: no recording of the infectious process (44.5%), a wrong treatment duration (15.5%), and the use of an inadequate antibiotic (11.5%). Conclusion There is a high level of inappropriateness in antibiotic prescribing in primary care. The high level of under-recording of diagnoses, mainly in elderly patients, followed by the use of wrong schedules, and the wrong type of antibiotics were the main reasons of inappropriateness. © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica.Todos los derechos reservados.