[Evolution of the serotypes causing invasive pneumococcal disease along 2008-2022 in a Level 2 Public Hospital of the Madrid Region, in relation to their inclusion in different conjugate vaccines]. / Evolución de los serotipos causantes de enfermedad neumocócica invasiva aislados durante 2008-2022 en un Hospital Público Madrileño de nivel dos, en relación con su inclusión en diferentes vacunas conjugadas.

OBJECTIVE: The use of conjugate vaccines against Streptococcus pneumoniae originates changes in the invasive pneumococcal disease (IPD). The aim of this study was to in vestigate the evolution of S. pneumoniae serotypes isolated in the Hospital Universitario de Getafe between 2008 and 2022. METHODS: 313 of S. pneumoniae strains were studied. Serotyping was carried out by latex agglutination (Pneumotest-latex) and the Quellung reaction. In addition, the minimal inhibitory concentration (MIC) was determined against penicillin, erythromycin and levofloxacin by the concentration gradient method (E-test) according the EUCAST breakpoints. RESULTS: The most frequent serotypes throughout the study period were 8, 3, 19A, 1, 11A and 22F corresponding to 46.6% of the isolates. Along 2008-2012 the serotypes 3, 1, 19A, 7F, 6C and 11A represented altogether 53.6% of the isolates. Between 2013 and 2017 the serotypes 3, 8, 12F, 19A, 22F and 19F grouped 51% of the isolates. During 2018-2022 the serotypes 8, 3, 11A, 15A, 4 and 6C included the 55.5% of the cases. In total 5 strains (1.6%) were penicillin resistant, 64 (20.4%) erythromycin resistant and 11 (3.5%) levofloxacin resistant. The MIC50 and MIC90 levels maintained stables along the time. CONCLUSIONS: The conjugate vaccines use with different serotype coverage conditioned a decrease of the vaccine-included and an increase of non-covered. Despite these changes, the global antimicrobial susceptibility patterns to erythromycin and levofloxacin maintained relatively stables. The resistance a penicillin was low, not finding this type of resistant strains in the last study period.

Development of an adjustable Kirkpatrick-Baez microscope for laser driven x-ray sources.

A prototype of a highly adjustable Kirkpatrick-Baez (KB) microscope has been designed, built, and tested in a number of laser driven x-ray experiments using the high power (200 TW) VEGA-2 laser system of the Spanish Centre for Pulsed Lasers (CLPU). The presented KB version consists of two, perpendicularly mounted, 500 µm thick silicon wafers, coated with a layer of platinum, a few tens of nanometers thick. Unlike the usual millimeter thick glass substrate, this design allows for a larger bending flexibility and large adjustment range. According to simulations, this KB microscope offers broadband multikiloelectron volt reflection spectra (1 eV-20 keV), allowing more spectral tunability than conventional Bragg crystals. In addition to be vacuum compatible, this prototype is characterized by a relatively small size (21 cm × 31 cm × 27 cm) and permits remote control and modification both of the radii of curvature (down to 10 m) and of the grazing incidence angle (up to 60 mrad). A few examples of focusing performance tests and experimental results are discussed.

Concurrent interspecies and clonal dissemination of OXA-48 carbapenemase.

Several isolates of four different carbapenemase-producing Enterobacteriaceae species were recovered from a patient hospitalized for 4 months in a teaching hospital in Madrid. These species comprised seven Klebsiella pneumoniae belonging to ST15, four Escherichia coli belonging to ST2531, two Serratia marcescens and one Citrobacter freundii. This patient was the index case of a small outbreak of four patients infected and/or colonized by carbapenemase-producing K. pneumoniae. Molecular results identified the bla(OXA-48) gene in all Enterobacteriaceae isolates from the index case and in all isolates from the other three patients, suggesting intra- and interpatient dissemination. Our results highlight the great ability of OXA-48 carbapenemase to spread among different enterobacterial species by both clonal and nonclonal dissemination.

Extended-spectrum beta-lactamases in urinary tract infections caused by Enterobacteria: understanding and guidelines for action.

CONTEXT: Beta-lactamases are bacterial enzymes that protect microorganisms from the lethal effects of ß-lactam antibiotics. The production of beta-lactamases is the most important mechanism of resistance to these antibiotics, especially in Gram-negative bacteria. OBJECTIVE: Review the magnitude of the problem of extended-spectrum beta-lactamases (ESBL) in the urological setting and present the fundamental action guidelines on the issue, the main risk factors and the prevention strategies. ACQUISITION OF EVIDENCE: A structured search strategy for patient, problem, intervention, comparison and result was conducted in the PubMed-Medline database to identify the most relevant studies related to the management of patients with urinary tract infection by ESBL-producing microorganisms. We also present a caseload analysis of our center on this issue. SUMMARY OF THE EVIDENCE: ESBL are found in Enterobacteria, mainly Klebsiella sp. and Escherichia coli and are characterized by their hydrolytic ability compared with beta-lactam antibiotics, which entails resistance to penicillin, cephalosporin and aztreonam. They are also associated with resistance to other antibiotics. There is a high risk of infection and colonization by ESBL producers in patients with prolonged hospital stays or who required invasive devices. The prior use of antibiotics and stays in residential care are also risk factors. Prevention programs should focus on preventing nosocomial infection. It is essential that a restrictive policy on the use of antibiotics be implemented. The therapy of choice for severe infections is focused on carbapenems, although their indiscriminate use should be avoided. In uncomplicated lower urinary tract infections, fosfomycin and nitrofurantoin are the best treatment alternatives. CONCLUSION: ESBL-producing strains constitute a true global health problem. Prevention strategies should focus on nosocomial infection. We should not forget, however, that the appearance of these pathogens in community-acquired infections is increasingly frequent. Therapeutic decisions should be based on an understanding of the local distribution of microorganisms and their resistance patterns.

Efecto del grabado de la dentina radicular con ácido dietilenoaminotetra acético (EDTA) en la resistencia de unión de cementos autoadhesivos y autograbantes / Effect of engraving dietilenoaminotetra acetic acid (EDTA) root dentin in the resistance of cemented joints stickers and etching

Fue evaluado el efecto del grabado de la dentina radicular con EDTA en la resistencia de unión (RU) inmediata (IM) y después de termociclaje (TM) de un cemento autoadhesivo (AA) y uno auto grabador (AG) para la cementación de postes de fibra de vidrio. Fueron utilizadas 40 raíces de premolares humanos divididas en 4 grupos según tipo de cementación (n=10) G1 RelyX U100 (UC) según indicaciones del fabricante(IF); G2 grabado con EDTA 24% por 60 s antes de la aplicación del UC ; G3 Para Post Para Core Automix (PC) (IF)G4 - grabado con EDTA 24% por 60 s antes de la aplicación del (PC).Las raíces fueron cortadas en discos de 1 mm (dos discos por tercio radicular), la mitad de los discos fueron sometidos a ensayo expulsión IM (0,5mm/min) y la otra mitad después de TM (5º C e 55º C).los datos fueron analizados en test de ANOVA y Tukey (?=0,05).dando como resultado que el grabado con EDTA altero negativamente los valores de RU solo del tercio cervical en los dos cementos. Cuando fue comparado TM con IM con o sin aplicación de EDTA no se encontraron diferencias estadísticas significativas. Para todos los grupos testados.El cemento PC obtuvo mayores valores de RU (19,59 MPa) comparado con el UC (15,80 MPa).concluyéndose que el tratamiento con EDTA afecto la RU solo para el tercio cervical tanto en IM como TM en los dos cementos. El TM con o sin EDTA no afecto los valores de RU cuando comparado con IM

The effect of post-space treatment whit EDTA on the bond strength (BS) of fiber posts in different root regions was evaluated using two different type of resin cements Rely X U100 (UC) and Para Post Para Core automix (PC) . Fourty extracted premolars root canals were assigned to four groups of 10 roots each. G1 RelyX U100 (UC) according to manufacturer's instructions (MI), G2 etching whit EDTA 24% for 60 s before application of UC; G3 Para Post Para Core Automix (PC) MI; G4 Etching whit EDTA 24% for 60s before application off PC. After cementation the roots were sectioned in 6 slices 1mm each (two slides for root region) and randomly divided into two subgroups, depending on testing time immediate (IM) vs. after termocicling(TM) ), for expulsion test. Statistical analysis was performed with ANOVA and Tukey test (?=.05) No differences in BS was found among the groups whit and whit out EDTA 24 %. Etching whit EDTA adversely alter the BS values of the cervical third in the two cements. When TM was compared with IM with or without application of EDTA there was no statistically significant difference. For all groups tested, PC show higher values of BS (19.59 MPa) was compared with UC (15.80 MPa). Concluded that treatment with EDTA affected the BS only on the cervical third in both IM and TM in the two cements. The TM with or without EDTA did not affect the values of BS when compared with IM

The chemoreceptor genes of the waterflea Daphnia pulex: many Grs but no Ors.

BACKGROUND: Chemoreception is vitally important for all animals, yet little is known about the genetics of chemoreception in aquatic organisms. The keystone species Daphnia pulex, a well known crustacean, is the first aquatic invertebrate to have its genome sequenced. This has allowed us the initial investigation of chemoreceptor genes in an aquatic invertebrate, and to begin the study of chemoreceptor evolution across the arthropod phylum. RESULTS: We describe 58 Grs (gustatory receptors), belonging to the insect chemoreceptor superfamily, which were identified bioinformatically in the draft genome of the crustacean waterflea Daphnia pulex. No genes encoding proteins similar to the insect odorant receptors (Ors) were identified. These 58 Grs form 3 distinctive subfamilies of 37, 12, and 5 genes, as well as a highly divergent singleton (Gr58). In addition, Grs55-57 share distinctive amino acid motifs and cluster with the sugar receptors of insects, and may illuminate the origin of this distinctive subfamily. ESTs, tiling array, and PCR amplification results support 34 predicted gene models, and preliminary expression data comparing the sexes indicates potential female-biased expression for some genes. CONCLUSION: This repertoire of 58 chemoreceptors presumably mediates the many chemoperception abilities of waterfleas. While it is always possible that the entire Or gene lineage was lost at some point in the history of Daphnia pulex, we think it more likely that the insect Or lineage is indeed a relatively recently expanded gene lineage concomitant with the evolution of terrestriality in the insects or their hexapod ancestors.

Fungi sensing environmental stress.

Cells need to adapt to the external environment in order to survive. Signal transduction pathways are crucial mechanisms that allow cells to sense and respond to extracellular stimuli. Among the signal transduction pathways, we point out the cascades mediated by mitogen-activated protein kinases (MAPKs). The MAPKs are conserved from yeast to human and play relevant roles in the physiology of the cell. In pathogenic fungi these MAPK pathways control virulence factors. This review describes the MAPK cascades described in Candida albicans, the most frequently isolated fungus, from fungal systemic infections among individuals in developed countries.

Real-time assessment of fluid flow generated by appendage movements of Daphnia using standing square-wave chronamperometry.

Standing square-wave chronoamperometry (SSWCA) was applied to the analysis of the microfluid flow generated by the movement of the appendages of the Crustacea Daphnia. This novel approach provided for the first time real-time assessment and analysis of the breathing rate/fluid flow of individual organisms. An electrochemical tracer was delivered into the fluid inflow of the organism and a carbon fiber microelectrode placed in the fluid outflow's path. The variation of the net concentration/flux of the electroactive tracer, dopamine, at the electrode surface was measured with SSWCA. The observed chronoamperometric peaks (with fine structure) of the outflow are seen as a direct representation of appendage movement and, too, the workings and responses of the organism to its environment, e.g., external stimuli such as food or chemicals. It was concluded that SSWCA follows primarily the variation of the convective component of the Nernst-Plank equation for flux and, to lesser extent, diffusion and migration. In this work, SSWCA can clearly be used to monitor changes in the Daphnia-generated fluid outflow on a different time scale than was previously possible. This new application of SSWCA is faster and likely more accurate than using high-speed video.

The Cek1 and Hog1 mitogen-activated protein kinases play complementary roles in cell wall biogenesis and chlamydospore formation in the fungal pathogen Candida albicans.

The Hog1 mitogen-activated protein (MAP) kinase mediates an adaptive response to both osmotic and oxidative stress in the fungal pathogen Candida albicans. This protein also participates in two distinct morphogenetic processes, namely the yeast-to-hypha transition (as a repressor) and chlamydospore formation (as an inducer). We show here that repression of filamentous growth occurs both under serum limitation and under other partially inducing conditions, such as low temperature, low pH, or nitrogen starvation. To understand the relationship of the HOG pathway to other MAP kinase cascades that also play a role in morphological transitions, we have constructed and characterized a set of double mutants in which we deleted both the HOG1 gene and other signaling elements (the CST20, CLA4, and HST7 kinases, the CPH1 and EFG1 transcription factors, and the CPP1 protein phosphatase). We also show that Hog1 prevents the yeast-to-hypha switch independent of all the elements analyzed and that the inability of the hog1 mutants to form chlamydospores is suppressed when additional elements of the CEK1 pathway (CST20 or HST7) are altered. Finally, we report that Hog1 represses the activation of the Cek1 MAP kinase under basal conditions and that Cek1 activation correlates with resistance to certain cell wall inhibitors (such as Congo red), demonstrating a role for this pathway in cell wall biogenesis.