Servicio de Microbiologia


Servicio de Microbiologia

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Gonzalez-Martin J.,University of Barcelona | Garcia-Garcia J.M.,Hospital San Agustin | Anibarro L.,Complexo Hospitalario Of Pontevedra | Vidal R.,Hospital Vall dHebron | And 4 more authors.
Archivos de Bronconeumologia | Year: 2010

Pulmonary TB should be suspected in patients with respiratory symptoms longer than 2-3 weeks. Immunosuppression may modify clinical and radiological presentation. Chest X-ray shows very suggestive, albeit sometimes atypical, signs of TB. Complex radiological tests (CT scan, MR) are more useful in extrapulmonary TB.At least 3 serial representative samples of the clinical location are used for diagnosis whenever possible. Bacilloscopy and liquid medium cultures are indicated in all cases. Genetic amplification techniques are coadjuvant in moderate or high TB suspicion.Administration of isoniazid, rifampicin, ethambutol and pyrazinamide (HREZ) for 2 months and HR for 4 additional months is recommended in new cases of TB, except in cases of meningitis in which treatment should continue for up to 12 months and up to 9 months in spinal TB with neurological involvement, and in silicosis. Appropriate adjustments with antiretroviral treatment should be made in HIV patients. Combined therapy is recommended to avoid development of resistance. An antibiogram to first line drugs should be performed in all the initial isolations of new patients. Treatment control is one of the most important activities in TB management.The Tuberculin Skin Test (TST) is positive in TB infection when ≥5. mm, and Interferon-Gamma Release Assays (IGRA) are recommended in combination with TT. The standard treatment schedule for infection is 6 months with isoniazid. In pulmonary TB, respiratory isolation is applied for 3 weeks or until 3 negative bacilloscopy samples are obtained. © 2010 SEPAR.

PubMed | Autonomous University of Madrid, Servicio de Microbiologia and CIBER ISCIII
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2015

The aim of this study was to describe the evolution and epidemiologic characteristics of shigellosis patients over a 25 year period in a large city.Shigellosis is a notifiable disease in Spain since 1988. Cases are analyzed in Barcelona residents included in the registry between 1988-2012. A descriptive analysis by sex, age, mode of transmission and Shigella species is presented. Trend analysis and time series were performed.Of the 559 cases analyzed, 60.15% were males. A sustained increase was observed in the trend since 2008 in males (p<0,05), especially at the expense of males who had no history of food poisoning or travel to endemic areas. The increasing tendency was greater in males from 21 to 60 years, both for S. flexneri (since 2009), and for S. sonnei (since 2004). In 2012 it was noted that in the men with S. flexneri, the 63% were men who have sex with men.An increased trend was detected in men who had no history of food poisoning or travel to endemic areas. This increase points to a change in the pattern of shigellosis, becoming predominantly male and its main mechanism probably by sexual transmission.

PubMed | Servicio de Microbiologia, University of Salamanca, Institute Investigacion Biomedica Of Salamanca Ibsal Csic and inMediata
Type: | Journal: New microbes and new infections | Year: 2016

Small colony variants (SCV) are slow-growing subpopulations of bacteria usually associated with auxotrophism, causing persistent or recurrent infections. Enterococcus faecalis SCV have been seldom described, and only one case of Enterococcus faecium SCV has been reported, associated with sepsis in a leukaemia patient. Here we report the first case described of bacteraemia and endocarditis by SCV E.faecium in an immunocompetent patient.

Cubero N.,Autonomous University of Madrid | Cubero N.,Hospital Universitario Of Bellvitge | Esteban J.,Servicio de Microbiologia | Palenque E.,Complutense University of Madrid | And 2 more authors.
Clinical Microbiology and Infection | Year: 2013

Mycobacterium tuberculosis is assumed to remain in a quiescent state during latent infection, being unable to grow in culture. The aim of this study was to evaluate the detection of viable but non-cultivable bacilli with metabolic activity in human clinical samples using a procedure that is independent of the immunological status of the patient. The study was performed on 66 human clinical samples, from patients subjected to routine diagnosis to rule out a mycobacterial infection. Specimens from pulmonary and extra-pulmonary origins were verified to contain human DNA before testing for M. tuberculosis DNA, rRNA and transient RNA by real-time quantitative PCR. Clinical records of 55 patients were also reviewed. We were able to detect viable but non-cultivable bacilli with a metabolic activity in both pulmonary and extra-pulmonary samples. Mycobacterium tuberculosis RNA was detected in the majority of culture-positive samples whereas it was detected in one-third of culture-negative samples, 20% of them showed metabolic activity. Amplifications of the ftsZ gene and particularly of the main promoter of the ribosomal operon rrnA, namely PCL1, seem to be good targets to detect active bacilli putatively involved in latent infection. Moreover, this last target would provide information on the basal metabolic activity of the bacilli detected. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

Ledesma J.,Institute Salud Carlos III | Pozo F.,Institute Salud Carlos III | Ruiz M.P.,Hospital Virgen Of Las Nieves | Navarro J.M.,Hospital Virgen Of Las Nieves | And 10 more authors.
Journal of Clinical Virology | Year: 2011

Background: A change of aspartic acid (D) to glycine (G) at position 222 in the haemagglutinin (HA) protein of pandemic influenza A (H1N1) 2009 viruses was described in Norway on November 2009 with considerable frequency in fatal and severe cases. This change was detected in other countries and was related only with severe disease. Other substitutions to glutamic acid (E) or asparagine (N) at position 222 were detected among pandemic viruses but it is unclear what implications might have in terms of severity. Objectives: To analyse the appearance of amino acid substitutions at position 222 in the HA protein of circulating viruses in Spain and to determine their relationships with the disease symptoms observed. Study design: Pandemic influenza A (H1N1) 2009 viruses detected in respiratory samples of 273 severe and 533 non-severe cases from different Spanish regions were selected for sequencing of a partial segment of HA1 subunit and studied to monitor substitutions at position 222. Results: D222G substitution was only detected in viruses from 14 severe cases (5.12%). D222E was found in viruses from 47 severe (17.21%) and from 52 non-severe cases (9.75%). D222N occurred in viruses from 3 additional severe cases (0.37%). Conclusion: Appearance of D222G and D222E substitution in HA of pandemic influenza A (H1N1) viruses circulating in Spain might be related with severe respiratory disease. © 2011 Elsevier B.V.

PubMed | Servicio de Enfermedades Infecciosas, Servicio de Medicina Preventiva, Servicio de Microbiologia, Servicio de Epidemiologia and Servicio de Nefrologia
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2015

In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepcin (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures.A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates.The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone).The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person.

Daskalaki M.,Servicio de Microbiologia | Rojo P.,Hospital Universitario 12 Of Octubre | Marin-Ferrer M.,Hospital Universitario 12 Of Octubre | Barrios M.,Hospital Universitario 12 Of Octubre | And 2 more authors.
Clinical Microbiology and Infection | Year: 2010

Fifty-three children who attended the emergency department with community-associated (CA) Staphylococcus aureus skin and soft tissue infections (SSTIs) were enrolled in the study. Seven cases of infection (13.2%) were due to methicillin-resistant S. aureus (MRSA). Twelve of 46 available isolates (26.1%) were Panton-Valentine leukocidin (PVL)-positive. PVL-positive S. aureus SSTIs were more frequently associated with abscesses and cellulitis (75% vs. 38%, p 0.028), and more commonly required incision and drainage (75% vs. 21%, p 0.001). Most PVL-positive CA-MRSA isolates belonged to a single multilocus sequence type (ST8). In contrast, PVL-positive methicillin-susceptible S. aureus isolates belonged to four different sequence types (ST8, ST30, ST80, ST120). © 2009 The Authors. Journal Compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

Molina-Cabrillana J.,Complejo Hospitalario Universitario Insular Materno Infantil | Del Rosario-Quintana C.,Servicio de Microbiologia | Tosco-Nunez T.,Servicio de Microbiologia | Dorta-Hung E.,Complejo Hospitalario Universitario Insular Materno Infantil | And 2 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2013

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patientsby the hands or clothing of staff as the main mode of transmission.Methods: Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, usingepidemiological and microbiological resources.Results: From September 2010 to February 2012, sixteen patients had at least one culture positive forMRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared.By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demons-trated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA.Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situa-tion was controlled by placing the carrier in a different job, with no further cases to date (September,2012).Conclusion: This report illustrates the risk of nosocomial transmission linked to care delivered by health-care workers. © 2012 Elsevier España, S.L.

PubMed | Servicio de Microbiologia, Complejo Asistencial Universitario Of Palencia Caupa and University of Salamanca
Type: | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2016

In Spain, minors represent approximately 20% of the immigration flow. Many of these immigrants come from countries in the tropics and sub-tropics where intestinal parasitic infections caused by helminths and protozoa are one of the major causes of human disease. The main objective of the present work was to describe parasite infections in a group of immigrant children.A prospective evaluation was performed in 373 minors from Sub-Saharan Africa, North Africa, and Latin America. Details were collected from the medical records and physical examination. Urine, stool and peripheral blood samples were obtained for serological and routine laboratory tests. Direct and indirect parasitological tests were also performed.At least 1 parasitic disease was diagnosed in 176 (47.1%) immigrant children, while 77 (20.6%) minors were infected with two or more parasites. The number of parasites was highest in children from Sub-Saharan Africa compared with the rest of the areas of origin (p<.001), and in children from urban areas compared with those from rural areas (OR 1.27 [1.059-1.552], p=.011). The most frequent causes of multiple parasite infection were filariasis plus strongyloidiasis and filariasis plus schistosomiasis. Intestinal parasite infection was diagnosed in 38 cases (13.8%). Logistic regression analysis revealed that for each month of stay, the probability of a positive finding in the stool sample decreased by 0.02% [=-0.020, (p=.07)].The high infection rates of parasite diseases in immigrant children point to the need for screening protocols for certain infectious diseases in these children according to their country of origin and their length of residence in Spain.

Doi Y.,University of Pittsburgh | Paterson D. L.,University of Pittsburgh | Paterson D. L.,University of Queensland | Egea P.,Servicio de Microbiologia | And 8 more authors.
Clinical Microbiology and Infection | Year: 2010

Infections due to Escherichia coli producing extended-spectrum β-lactamase (ESBL) or CMY-type β-lactamase (CMY) are increasingly observed in non-hospitalized patients. The origin of these organisms is uncertain, but retail meat contaminated with E. coli may be a source. In the present study, clinical information and strains collected from patients infected or colonized with ESBL-producing and CMY-producing E. coli at hospitals in Pittsburgh, USA and Seville, Spain were investigated. Retail meat purchased in these cities was also studied for the presence of these organisms. Twenty-five and 79 clinical cases with ESBL-producing E. coli and 22 cases and one case with CMY-producing E. coli were identified in Pittsburgh and Seville, respectively. Among them all, community-acquired and healthcare-associated cases together constituted 60% of the cases in Pittsburgh and 73% in Seville. Community-acquired cases were more common in Seville than in Pittsburgh (49% vs. 13%; p. <0.001). ESBL-producing and CMY-producing E. coli isolates were commonly recovered from the local retail meat. In particular, 67% (8/12) of retail chickens in Seville and 85% (17/20) of those in Pittsburgh contained ESBL-producing and CMY-producing E. coli isolates, respectively. Among the ESBL-producing isolates, CTX-M and SHV were the most common ESBL types in both clinical and meat isolates. Approximately half of the ESBL-producing and CMY-producing E. coli isolates from meat belonged to phylogenetic groups associated with virulent extra-intestinal infections in humans. Community and healthcare environments are now significant reservoirs of ESBL-producing and CMY-producing E. coli. Retail meat is a potential source of these organisms. © 2009 The Authors. Journal Compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases.

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