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Tudo G.,University of Barcelona | Rey E.,University of Barcelona | Borrell S.,University of Barcelona | Alcaide F.,Hospital Universitari Of Bellvitge Idibell | And 9 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2010

Objectives: To determine the proportion and type of mutations in Mycobacterium tuberculosis isolates resistant to streptomycin, and their relationship with the level of resistance and with the epidemiological molecular pattern of the isolates. Methods: Sixty-nine streptomycin-resistant isolates from a M. tuberculosis strain collection (1995-2005) from Barcelona were studied. The MIC of streptomycin for each isolate was determined using the proportions method with Middlebrook 7H11 medium. The entire rpsL gene and two specific fragments of the rrs gene (the 530 loop and the 912 region) were sequenced. IS6110-restriction fragment length polymorphism and spoligotyping were performed in each isolate. Results: Twenty-six (26/69, 37.7%) streptomycin-resistant isolates presented a mutation in either the rpsL gene and/or the rrs530 loop, with no mutation in the rrs912 region. Seventeen (24.6%) isolates showed rpsL mutations (codons 43 and 88) associated with high MIC levels. Nine (13.0%) isolates had alterations in the rrs gene (A513T, A513C and C516T). Nineteen isolates (19/64, 29.7%) were classified into seven clusters (containing 2-5 isolates per cluster). Nineteen different spoligotype patterns were found. All the LAM3 spoligotype isolates (10/67, 14.9%) were associated with a C491T change in the rrs gene, being also observed in all LAM3 streptomycin-susceptible isolates. Conclusions: Mutations in the rpsL and rrs genes were detected in 37.7% of streptomycin-resistant M. tuberculosis isolates. High-level resistance was associated with mutations in the rpsL gene, whereas wild-type isolates showed low MIC levels. The presence of the C491T substitution in the rrs gene in streptomycin-susceptible and -resistant isolates demonstrates that this change is an epidemiological marker associated with LAM3 sublineage. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Source


Vas J.,Institute Salud Carlos III | Ramos-Monserrat M.,Servei dEpidemiologia | Rivas-Ruiz F.,Institute Salud Carlos III
Revista Internacional de Acupuntura | Year: 2014

Objective To compare the effectiveness of additional moxibustion at point BL 67 with moxibustion at a non-specific acupuncture point and with usual care alone to correct non-vertex presentation. Methods This was a multicentre randomised controlled trial in which 406 low-risk pregnant women with a fetus in ultrasound breech presentation, with a gestational age of 33-35 weeks, were assigned to: a) true moxibustión at point BL 67 plus usual care; b) moxibustion at SP 1, a non-specific acupuncture point (sham moxibustion) plus usual care; or c) usual care alone. The primary outcome was cephalic presentation at birth. Women were recruited at health centres in primary healthcare. Results In the true moxibustion group, 58.1% of the full-term presentations were cephalic compared with 43.4% in the sham moxibustion group (relative risk [RR]: 1.34; 95% confidence interval [95%CI], 1.05-1.70) and 44.8% of those in the usual care group (RR: 1.29; 95%CI, 1.02-1.64). The reduction in RR of the primary outcome in women allocated to the true moxibustion group compared with the usual care group was 29.7% (95%CI, 3.1-55.2) and the number needed to treat was 8 (95%CI, 4-72). There were no severe adverse effects during the treatment. Conclusions Moxibustion at acupuncture point BL 67 is effective and safe to correct non-vertex presentation when used between 33 and 35 weeks of gestation. We believe that moxibustion represents a treatment option that should be considered to achieve version of the non-vertex fetus. © 2014 Elsevier Espana, S.L. All rights reserved. Source


Hurtado I.,CIBER ISCIII | Garcia de Olalla P.,Servei dEpidemiologia | Albiach D.,Colectivo Lambda de Valencia | Martin M.,Unitat dEpidemiologia i Estadistica | And 2 more authors.
Gaceta Sanitaria | Year: 2010

An intervention in venues for interaction used by men who have sex with men in Valencia (Spain) was performed to prevent human immunodeficiency virus (HIV) infection or avoid delay in diagnosis and to facilitate contact with the health circuit. Information was provided on prevention and a rapid test for HIV and syphilis was performed. We contacted 500 men and the intervention was performed in 171; 37% of the subjects in saunas and one in four of those in prostitution apartments had never been tested. The prevalence of HIV was 1.6% (n=2) in the saunas, and 11% (n=5) in the apartments (n=5). For syphilis, these percentages were 5% and 2.3% respectively. The intervention revealed the existence of highly exposed population groups with low compliance and facilitated access to the health system in these groups. © 2008 SESPAS. Source


Jacques Avino C.,Servei dEpidemiologia | Jacques Avino C.,CIBER ISCIII | Garcia de Olalla P.,Servei dEpidemiologia | Garcia de Olalla P.,CIBER ISCIII | And 4 more authors.
Gaceta Sanitaria | Year: 2015

Objective: To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men. Methods: We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis. Results: Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues. Conclusions: The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective. © 2014 SESPAS. Source


Roy K.M.,Health Protection Scotland | Galmes-Truyols A.,Servei dEpidemiologia | Gimenez-Duran J.,Servei dEpidemiologia | Anderson E.,Greater Glasgow and Clyde NHS Board | And 8 more authors.
Journal of Hospital Infection | Year: 2012

Background: Hepatitis C virus infection (HCV) is not infrequent among haemodialysis patients. Most published reports suggest that patient-to-patient spread, either directly or indirectly, is the most common mode of transmission in renal units. Aim: To investigate the source of an outbreak, and the route of transmission, of acute HCV infection in two Scottish patients occurring within eight weeks of receiving haemodialysis in the same unit while on holiday in Majorca. Methods: This was an international epidemiological and molecular investigation of HCV infection among a cohort of haemodialysis patients from nine countries. Findings: No further HCV-positive infections were observed among residents and holidaymakers receiving haemodialysis at the unit in Majorca. Molecular investigations confirmed that a Spanish healthcare worker (HCW) was the source of infection for the two Scottish patients. The investigators were unable to determine the route of transmission. Conclusions: This outbreak is the first reported case of HCW-to-patient transmission of HCV in a renal unit, and the third reported case of transmission involving a HCW who had not performed invasive procedures. The issue of whether renal units are an exceptional case with regards to the risk of transmission associated with non-invasive procedures should be considered, in conjunction with the need to improve surveillance of blood-borne virus transmissions in renal units in the UK and abroad. © 2012 The Healthcare Infection Society. Source

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