Preservation of Neisseria gonorrhoeae: should swabs be refrigerated or not?: Neisseria gonorrhoeae preservation.

Although molecular diagnosis has replaced culture as the reference technique in gonococcal infection, conventional culture is still performed. The aim was to compare the survival of Neisseria gonorrhoeae (NG) in transport swabs at room temperature (RT) and at 4°C. Fifty-four NG isolates were tested. A 1.5×108CFUmL-1 suspension was prepared for each strain, in which two swabs (Amies liquid medium with flocked swabs) were absorbed; one was preserved at RT and the other at 4°C. At 24 and 48h, 150µL of Amies medium were plated in Thayer Martin agar. The recovery percentage was significantly higher for the swabs kept at 4°C than for those kept at RT, both at 24h (94.4% vs. 16.7%), and at 48h (37% vs. 0%). This study clearly demonstrates the higher survival of NG when transport swabs are kept refrigerated. Modifying the guidelines could greatly improve the efficiency of microbiological diagnosis of the gonococcal infection.

[Bacterial vaginosis]. / Vaginosis bacteriana.

Bacterial vaginosis (BV) is the main cause of vaginal dysbacteriosis in the women during the reproductive age. It is an entity in which many studies have focused for years and which is still open for discussion topics. This is due to the diversity of microorganisms that cause it and therefore, its difficult treatment. Bacterial vaginosis is probably the result of vaginal colonization by complex bacterial communities, many of them non-cultivable and with interdependent metabolism where anaerobic populations most likely play an important role in its pathogenesis. The main symptoms are an increase of vaginal discharge and the unpleasant smell of it. It can lead to serious consequences for women, such as an increased risk of contracting sexually transmitted infections including human immunodeficiency virus and upper genital tract and pregnancy complications. Gram stain is the gold standard for microbiological diagnosis of BV, but can also be diagnosed using the Amsel clinical criteria. It should not be considered a sexually transmitted disease but it is highly related to sex. Recurrence is the main problem of medical treatment. Apart from BV, there are other dysbacteriosis less characterized like aerobic vaginitis of which further studies are coming slowly but are achieving more attention and consensus among specialists.

Vaginosis bacteriana / Bacterial vaginosis

La vaginosis bacteriana (VB) es la principal causa de disbacteriosis vaginal de la mujer en edad reproductiva. Es una entidad en la que se centran numerosos estudios desde hace años y sobre la que sigue habiendo temas abiertos de debate. Esto se debe a la diversidad de microorganismos causantes y, por tanto, a su difícil tratamiento. La VB es el resultado de la colonización vaginal por comunidades bacterianas complejas, muchas de ellas no cultivables y con metabolismos interdependientes, donde las poblaciones anaerobias tienen muy probablemente un papel importante en su patogenia. Los principales síntomas son el aumento de la secreción vaginal y su desagradable olor. Puede comportar graves consecuencias para la mujer, como un mayor riesgo de contraer infecciones de transmisión sexual (ITS) incluyendo el virus de la inmunodeficiencia humana, así como complicaciones del tracto genital superior y durante el embarazo. La tinción de Gram es el método de referencia para el diagnóstico microbiológico de la VB, aunque también se puede diagnosticar aplicando los criterios clínicos de Amsel. No se debe considerar una ITS, sino una patología altamente relacionada con el sexo. La recidiva es el principal problema médico de su tratamiento. Además de la VB, existen otras disbacteriosis menos caracterizadas como la vaginitis aeróbica, de las que poco a poco van saliendo más estudios y sobre las que se va logrando una mayor atención y consenso entre especialistas

Bacterial vaginosis (BV) is the main cause of vaginal dysbacteriosis in the women during the reproductive age. It is an entity in which many studies have focused for years and which is still open for discussion topics. This is due to the diversity of microorganisms that cause it and therefore, its difficult treatment. Bacterial vaginosis is probably the result of vaginal colonization by complex bacterial communities, many of them non-cultivable and with interdependent metabolism where anaerobic populations most likely play an important role in its pathogenesis. The main symptoms are an increase of vaginal discharge and the unpleasant smell of it. It can lead to serious consequences for women, such as an increased risk of contracting sexually transmitted infections including human immunodeficiency virus and upper genital tract and pregnancy complications. Gram stain is the gold standard for microbiological diagnosis of BV, but can also be diagnosed using the Amsel clinical criteria. It should not be considered a sexually transmitted disease but it is highly related to sex. Recurrence is the main problem of medical treatment. Apart from BV, there are other dysbacteriosis less characterized like aerobic vaginitis of which further studies are coming slowly but are achieving more attention and consensus among specialists

La infección neonatal tardía por Streptococcus agalactiae en el área de Barcelona (1996-2010) / Streptococcus agalactiae late-onset neonatal infections in Barcelona (1996-2010)

OBJETIVO: Analizar las características de la sepsis neonatal tardía (SNT) por estreptococo del grupo B (EGB) y la evolución de su incidencia en 8 hospitales del área de Barcelona a lo largo de los 15 años de consolidación de las medidas de prevención de la infección neonatal precoz. MÉTODOS: Revisión retrospectiva de los pacientes diagnosticados de SNT por EGB desde 1996 a 2010. RESULTADOS: Se diagnosticaron 143 pacientes, de los que 51 habían nacido en otros centros. La incidencia global fue del 0,4 2‰ de recién nacidos vivos (RNV), oscilando entre el 0,14‰ en 2000 y el 0,80‰ en 2009. Se observó una tendencia al incremento del riesgo discreta pero sostenida a lo largo de los años, del 6,9% en las SNT totales, aunque sin la suficiente significación estadística. El 63,6% de los pacientes presentaron sepsis/bacteriemia, el 32,8% meningitis y el 3,5% artritis/osteomielitis. De los casos en los que se pudo obtener información sobre los antecedentes obstétricos, el 53% de las madres presentaron cultivo positivo a EGB al final del embarazo, el 53,8% recibieron profilaxis antibiótica intraparto y el 41,2% presentaron algún factor de riesgo, principalmente parto prematuro en el 35,9% de los casos. La mortalidad fue del 2,8%, y los serotipos mayoritarios, el III y el Ia. CONCLUSIONES: La incidencia de SNT por EGB no ha disminuido a pesar de las medidas de prevención de la SNP, y la posibilidad de su aparición debe ser tenida en cuenta

OBJECTIVE: To study the characteristics and evolution of group B Streptococcus (GBS) late-onset diseases, over a period of 15 years in 8 hospitals the Barcelona area and analyze the possible impact of prophylactic measures for the prevention of early-onset neonatal infections. METHODS: Retrospective review of all patients diagnosed with late-onset neonatal disease due to GBS from 1996 to 2010. RESULTS: A total of 143 patients were diagnosed. Of these, 51 were born in others hospitals. The overalll incidence was 0.42 per 1000 live births, varying between 0.14‰ in the year 2000 and 0.80‰ in 2009. A slight but sustained tendency of increased risk was observed over the years, 6.9% in the overall disease (with no statistical significance). Sepsis/bacteremia was detected in 63.6% of the newborns, meningitis in 32.8%, and arthritis/osteomyelitis in 3.5%. In cases with known obstetrics dates, 53% of mothers had been colonized by GBS during pregnancy, 53.8% received intrapartum antibiotic prophylaxis, and 41.2% had some obstetric risk factors, particularly premature birth in 35.9%. There was a 2.8% mortality rate in the neonates, and predominant serotypes were III and Ia. CONCLUSIONS: The incidence of GBS late-onset disease has not decreased despite the control practices of early-onset disease, and possibility of this appearing must be taken into account

[Streptococcus agalactiae late-onset neonatal infections in Barcelona (1996-2010)]. / La infección neonatal tardía por Streptococcus agalactiae en el área de Barcelona (1996-2010).

OBJETIVE: To study the characteristics and evolution of group B Streptococcus (GBS) late-onset diseases, over a period of 15years in 8hospitals the Barcelona area and analyze the possible impact of prophylactic measures for the prevention of early-onset neonatal infections. METHODS: Retrospective review of all patients diagnosed with late-onset neonatal disease due to GBS from 1996 to 2010. RESULTS: A total of 143 patients were diagnosed. Of these, 51 were born in others hospitals. The overalll incidence was 0.42 per 1000 live births, varying between 0.14‰ in the year 2000 and 0.80‰ in 2009. A slight but sustained tendency of increased risk was observed over the years, 6.9% in the overall disease (with no statistical significance). Sepsis/bacteremia was detected in 63.6% of the newborns, meningitis in 32.8%, and arthritis/osteomyelitis in 3.5%. In cases with known obstetrics dates, 53% of mothers had been colonized by GBS during pregnancy, 53.8% received intrapartum antibiotic prophylaxis, and 41.2% had some obstetric risk factors, particularly premature birth in 35.9%. There was a 2.8% mortality rate in the neonates, and predominant serotypes were III and Ia. CONCLUSIONS: The incidence of GBS late-onset disease has not decreased despite the control practices of early-onset disease, and possibility of this appearing must be taken into account.

Neisseria gonorrhoeae: resistencias antimicrobianas y estudio de la dinámica poblacional. Situación en 2011 en Barcelona / Neisseria gonorrhoeae: Antimicrobial resistance and study of population dynamics. Situation in Barcelona in 2011

INTRODUCCIÓN: Las altas tasas de resistencia de Neisseria gonorrhoeae (NG) a ciertos antibióticos, junto con la aparición de cepas con sensibilidad disminuida y resistencia a las cefalosporinas, hacen de la infección gonocócica un problema de salud pública. Los objetivos del estudio fueron: realizar el seguimiento de la sensibilidad antimicrobiana de NG obtenidas entre enero y agosto de 2011, y estudiar su dinámica poblacional. MÉTODOS: Se estudió la sensibilidad mediante el método disco-difusión y E-test. El genotipado se realizó mediante el NG-MAST. RESULTADOS: De un total de 100 cepas, el 59% presentaron sensibilidad intermedia a penicilina y el 9% resistencia. Según EUCAST, se detectaron 3 gonococos con sensibilidad disminuida a ceftriaxona, 10 a cefixima y uno con resistencia de alto nivel a ambos (CMI 1,5 μg/ml). La CMI50 y la CMI90 a cefixima fue de 0,016 y de 0,125 μg/ml, mientras que a ceftriaxona fue < 0,016 y 0,064 μg/ml. El 99% presentó resistencia a doxiciclina, el 53% a ciprofloxacino, el 3% a azitromicina y el 1% a espectinomicina. El ST más prevalente fue el ST1407, mayoritariamente asociado a resistencia o sensibilidad disminuida a cefalosporinas o macrólidos. CONCLUSIÓN: NG ha desarrollado tasas importantes de resistencia a distintos antibióticos. Se ha detectado una cepa con resistencia de alto nivel a las cefalosporinas de tercera generación y varias con sensibilidad disminuida, además de observarse un aumento de la CMI50 y de la CMI90 a estos antibióticos. La estructura poblacional de NG permanece estable y común al resto de Europa, aunque se han identificado 2 nuevos secuencio tipos (ST7226 y ST7227) con potencial para seleccionarse y adquirir altos niveles de resistencia a cefalosporinas

BACKGROUND: Due to the high rates of antimicrobial resistance to certain antibiotics, together with the emergence of Neisseria gonorrhoeae (NG) with reduced susceptibility and resistance to third-generation cephalosporins, gonococcal infection is becoming a public health problem. The objectives of the study were: To keep track of the antimicrobial susceptibility of NG strains obtained from January to August 2011. To study the population dynamics. METHODS: The antimicrobial susceptibility was studied by disk-diffusion and E-test. The genotyping was performed by NG-MAST method. RESULTS: Of a total of 100strains studied, 59% showed intermediate sensitivity to penicillin and 9% were resistant. According to EUCAST, we detected 3gonococci with reduced susceptibility to ceftriaxone, 10 to cefixime and one with high-level resistance to both antibiotics (MIC 1.5 μg/ml). MIC50 and MIC90 to cefixime were 0.016 and 0.125 μg/ml, respectively, whereas to ceftriaxone they were < 0.016 and 0.064 μg/ml, respectively. Almost all (99%) of the strains were resistant to doxycycline, 53% to ciprofloxacin, 3% to azithromycin, and 1% to spectinomycin. The most prevalent ST was ST1407, predominantly associated to resistance or reduced sensitivity to cephalosporins or macrolides. CONCLUSIONS: NG has developed significant rates of resistance to various antibiotics. One strain has been detected with high level resistance to third generation cephalosporins, and several strains with reduced susceptibility. An increase in MIC50 and MIC90 to these antibiotics has also been observed. NG population structure remains stable and common to the rest of Europe, although two new ST (ST7226 and ST7227) have been identified that could be selected and acquire high levels of resistance to cephalosporins

[Neisseria gonorrhoeae: antimicrobial resistance and study of population dynamics. Situation in Barcelona in 2011]. / Neisseria gonorrhoeae: resistencias antimicrobianas y estudio de la dinámica poblacional. Situación en 2011 en Barcelona.

BACKGROUND: Due to the high rates of antimicrobial resistance to certain antibiotics, together with the emergence of Neisseria gonorrhoeae (NG) with reduced susceptibility and resistance to third-generation cephalosporins, gonococcal infection is becoming a public health problem. The objectives of the study were: To keep track of the antimicrobial susceptibility of NG strains obtained from January to August 2011. To study the population dynamics. METHODS: The antimicrobial susceptibility was studied by disk-diffusion and E-test. The genotyping was performed by NG-MAST method. RESULTS: Of a total of 100strains studied, 59% showed intermediate sensitivity to penicillin and 9% were resistant. According to EUCAST, we detected 3gonococci with reduced susceptibility to ceftriaxone, 10 to cefixime and one with high-level resistance to both antibiotics (MIC 1.5µg/ml). MIC50 and MIC90 to cefixime were 0.016 and 0.125µg/ml, respectively, whereas to ceftriaxone they were <0.016 and 0.064µg/ml, respectively. Almost all (99%) of the strains were resistant to doxycycline, 53% to ciprofloxacin, 3% to azithromycin, and 1% to spectinomycin. The most prevalent ST was ST1407, predominantly associated to resistance or reduced sensitivity to cephalosporins or macrolides. CONCLUSIONS: NG has developed significant rates of resistance to various antibiotics. One strain has been detected with high level resistance to third generation cephalosporins, and several strains with reduced susceptibility. An increase in MIC50 and MIC90 to these antibiotics has also been observed. NG population structure remains stable and common to the rest of Europe, although two new ST (ST7226 and ST7227) have been identified that could be selected and acquire high levels of resistance to cephalosporins.

Prevención de la infección perinatal por estreptococo del grupo B. Recomendaciones españolas. Actualización 2012. Documento de consenso SEIMC/SEGO/SEN/SEQ/SEMFYC / Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document

La infección por Streptococcus agalactiae, estreptococo grupo B (EGB), continúa siendo la causa más frecuente de sepsis neonatal de etiología bacteriana. En 2003, las Sociedades Españolas de Ginecología y Obstetricia, Neonatología, Enfermedades Infecciosas y Microbiología Clínica, Quimioterapia y Medicina Familiar y Comunitaria publicaron recomendaciones actualizadas para la prevención de la infección neonatal precoz por EGB. En ellas se recomendaba la identificación de gestantes portadoras de EGB mediante cultivo de muestra de exudado vaginorrectal realizado en las 35-37 semanas de gestación y la administración de profilaxis antibiótica intraparto (PAI) a todas las gestantes colonizadas. En estas nuevas recomendaciones se actualizan los métodos microbiológicos para realizar la identificación de portadoras de EGB y la técnica de sensibilidad a antibióticos; se revisan los antibióticos de primera línea que pueden usarse para PAI (penicilina, ampicilina, cefazolina) y sus alternativas (clindamicina y vancomicina); se clarifica el significado de la presencia de EGB en orina, incluyendo criterios para el diagnóstico de infección urinaria y bacteriuria asintomática por EGB en la embarazada; se define el uso de PAI en la amenaza de parto prematuro y rotura prematura de membranas, y se revisa el manejo del recién nacido en relación con el estado de portadora de EGB de la madre. Estas recomendaciones solo son válidas para la prevención de la infección neonatal precoz por EGB, y no son efectivas frente a la infección neonatal tardía. Tras la aplicación generalizada de la PAI, la incidencia de la sepsis neonatal precoz por EGB ha disminuido (..) (AU)

Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including (..) (AU)

[Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document]. / Prevención de la infección perinatal por estreptococo del grupo B. Recomendaciones españolas. Actualización 2012. Documento de consenso SEIMC/SEGO/SEN/SEQ/SEMFYC.

Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.

[Prevention of perinatal group B Streptococcal disease. Updated Spanish recommendations 2012]. / Prevención de la infección perinatal por estreptococo del grupo B. Recomendaciones españolas revisadas 2012.

It has been a significant reduction in neonatal group B streptococcus (GBS) infection in Spain following the widespread application of intrapartum antibiotic prophylaxis. In 2010, new recommendations have been published by the CDC and this fact, together with the new knowledge and experience available, has driven to the participating scientific societies publishing these new recommendations. In these recommendations is advised to study all pregnant women at 35-37 gestation weeks` to determine if they are colonized by GBS and to administer intrapartum antibiotic prophylaxis (IAP) to all colonized mothers. Microbiological methods to identify pregnant GBS carriers are updated and intrapartrum antibiotic prophylaxis in preterm labour and premature rupture of membranes and the management of the newborn in relation to GBS carrier status of the mother are also revised.

Prevención de la infección perinatal por estreptococo del grupo B. Recomendaciones españolas revisadas 2012 / Prevention of perinatal group B Streptococcal disease. Updated Spanish recommendations 2012

Como consecuencia aplicación de la profilaxis antibiótica intraparto ha ocurrido una importante reducción de la infección neonatal por estreptococo grupo B en nuestro país. En 2010 se han publicado nuevas recomendaciones por los CDC y este hecho, junto con los nuevos conocimientos disponibles, ha llevado a las sociedades participantes a publicar estas nuevas recomendaciones. En ellas se mantiene el criterio de administrar profilaxis intraparto a todas las embarazadas colonizadas por EGB, se actualizan las técnicas de diagnostico de portadoras y se clarifica la actuación frente al parto prematuro y a los recién nacidos a riesgo de infectarse(AU)

It has been a significant reduction in neonatal group B streptococcus (GBS) infection in Spain following the widespread application of intrapartum antibiotic prophylaxis. In 2010, new recommendations have been published by the CDC and this fact, together with the new knowledge and experience available, has driven to the participating scientific societies publishing these new recommendations. In these recommendations is advised to study all pregnant women at 35-37 gestation weeks` to determine if they are colonized by GBS and to administer intrapartum antibiotic prophylaxis (IAP) to all colonized mothers. Microbiological methods to identify pregnant GBS carriers are updated and intrapartrum antibiotic prophylaxis in preterm labour and premature rupture of membranes and the management of the newborn in relation to GBS carrier status of the mother are also revised(AU)

Etiología y niveles de resistencia de los uropatógenos más frecuentes en infecciones urinarias de la comunidad / Etiology of community-acquired urinary infections and antimicrobial resistance of the more usual pathogen

Estudio de la etiología de las infecciones urinarias de vías bajas de adquisición comunitaria y de la resistencia de los uropatógenos más frecuentes a los antimicrobianos de primera línea. Entre febrero y junio de 2006, en 15 laboratorios españoles se obtuvieron 3 109 uropatógenos. Escherichia coli fue el más frecuente (70.8%), seguido de Klebsiella spp. (6.8%), Proteus spp. (6.6%) y Enterococcus spp. (5.5%). La resistencia de E.coli fue del 1.7% para fosfomicina, 3.8% para nitrofurantoína, 6.9% para cefixima, 8.1% ante amoxicilina-clavulánico, 8.9% con cefuroxima, y 23.9% para ciprofloxacina. Produjeron betalactamasas de espectro extendido (BLEE) el 5.2% de E. coli, 3.3% de E.cloacae, 2.4% de Klebsiella spp., 2.2% de P. aeruginosa y 1% de Proteus mirabilis. Las resistencias de E. coli a ciprofloxacina fueron inferiores en menores de 40 años (6.7% frente al 33.9% en > 60, p < 0.001), y en algunas áreas geográficas (12.5% frente a 37.3%). El 79.1% de E. coli BLEE se aislaron en mayores de 60 años frente al 7% en < 40, y presentaban variaciones geográficas importantes (18.4% frente a 0.8%). El 68.6% de E. coli BLEE fue resistente a cotrimoxazol y 72.2% aciprofloxacina, frente al 10.6% a nitrofurantoína y 1.9%a fosfomicina. Las tasas de resistencia y de resistencias cruzadas halladas en este estudio representan un grave problema que obliga a revaluar el tratamiento empírico de las infecciones urinarias de las vías bajas.

A multi-center study assessing the etiology of community acquiredlower urinary tract infections and the antimicrobial resistance patterns of the more commonuro-phatogens was undertaken. Between February and June 2006, 3 109 isolates were collected and analyzedin 15 clinical microbiology laboratories. Escherichia coliwas the most frequent isolate (70.8%), followed by theKlebsiella spp. (6.8%) Proteus spp. (6.6%), and by Enterococcus spp. (5.5%). E. coli resistance rate tofosfomycin was 1.7%, to nitrofurantoin, 3.8%, tocefexime 6.9%, to amoxicilin-clavulanic 8.1%, tocefuroxime 8.9%, and to ciprofloxacin 23.9%. It is alsoremarkable that the 5.2% of E. coli, 3.3% E. cloacae,2.4% Klebsiella spp., 2.2% P. aeruginosa and 1% Proteusmirabilis produced extended-spectrum beta-lactamases(ESBL). E. coli resistance rate to ciprofloxacin was lowerin people younger than 40 years (6.7% vs. 33.9% in >60, p < 0.001), and in some geographic regions (12.5%vs. 37.3%). E. coli producing ESBL were recovered inpeople older than 60 years (79.1% vs. 7% in youngerthan 40), and presented important geographic variations(18.4% vs. 0.8%). E. coli producing ESBL were 68.6%resistant to cotrimoxazol, 72.2% to ciprofloxacin vs.10.6% to nitrofurantoin and 1.9% to fosfomycin. Theincreasing rates of resistance and cross-resistancedescribed in this study points out a real problem thatstrengthens the need of new evaluations of the empiric treatment of lower urinary tract infections.

Prevención de la infección perinatal por estreptococo del grupo B. Recomendaciones españolas revisadas / Prevention of perinatal group B streptococcal disease. Spanish revised guidelines

No disponible

[Prevalence of Chlamydia trachomatis infection, as evaluated by molecular biology methods]. / Prevalencia de infección por Chlamydia trachomatis determinada mediante métodos de biología molecular.

BACKGROUND: To determine the prevalence of Chlamydia trachomatis infection in our area by molecular methods. METHODS: We describe the combined results of three studies carried out in the city of Barcelona including a total of 408 women considered to be at high risk for acquiring a sexually transmitted disease (STD). The first study was performed in 94 women attended at a public STD clinic located downtown, the second in 112 women attended at the Hospital Clinic and the third in 202 women attended at Hospital Vall d'Hebron (both third-level hospitals). In the first and third study endocervical exudate was tested with a PCR technique, and in the second study LCR was performed in 20-ml urine samples. RESULTS: Chlamydia trachomatis was detected in 1 woman in the first study, in no women in the second and in 3 women in the third. The prevalence of Chlamydia trachomatis infection detected in the three studies using molecular biology techniques was 1.06%, 0% and 1.48% respectively, giving an overall prevalence of 0.98%. CONCLUSION: The prevalence of Chlamydia trachomatis infection in our geographic area is surprisingly low.

Prevalencia de infección por Chlamydia trachomatis determinada mediante métodos de biología molecular / Prevalence of Chlamydia trachomatis infection, as evaluated by molecular biology methods

FUNDAMENTO. Determinar la prevalencia de la infección por Chlamydia trachomatis por métodos moleculares. MÉTODOS. Se describen conjuntamente los resultados de 3 trabajos realizados en la ciudad de Barcelona y en los que se estudiaron 408 mujeres consideradas como de alto riesgo para la adquisición de una enfermedad de transmisión sexual (ETS). El primer estudio incluyó a 94 mujeres atendidas en un centro público de ETS, el segundo a 112 mujeres atendidas en el Hospital Clínico y el tercero a 202 mujeres atendidas en el Hospital Vall d'Hebron de Barcelona. En el primer y tercer estudio se practicó toma endocervical y se realizó una técnica de reacción en cadena de la polimerasa (PCR). En el segundo se realizó reacción en cadena de la ligasa (LCR) a partir del primer chorro de orina. RESULTADOS. Chlamydia trachomatis se detectó en una sola paciente en el primer estudio, en ninguna en el segundo y en 3 pacientes en el tercero. Es decir que utilizando técnicas de biología molecular las prevalencias de infección por Chlamydia trachomatis fueron del 1,06, 0 y 1,48 por ciento, respectivamente, siendo la prevalencia total del 0,98 por ciento. CONCLUSIONES. La prevalencia de la infección por Chlamydia trachomatis en nuestra área geográfica es sorprendentemente baja (AU)