ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Hand Dermatoses/etiology , Hand Dermatoses/diagnosis , Onychomycosis/etiology , ProtothecaSubject(s)
Hand Dermatoses/etiology , Prototheca , Humans , Male , Middle Aged , Onychomycosis/etiologyABSTRACT
BACKGROUND: Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with substantial morbidity. Our objective was to identify surgical predictors of SSI in patients undergoing colorectal surgery using a retrospective case-control design. MATERIAL AND METHODS: Randomly selected patients from all those undergoing colorectal surgery (2007-2013). Cases were patients who developed SSI within 30 days. Controls were patients who did not develop SSI within 30 days. Patients undergoing multiple procedures during a single surgical intervention were excluded. SSI was diagnosed according to Centers for Disease Control and Prevention definitions. The main outcome measures were SSI, surgical variables, and cumulative survival (Kaplan-Meier method). Variables considered predictors were compared using log-rank test. RESULTS: Of 911 patients undergoing colorectal surgery, 221 developed SSI (24.3%; 95% confidence interval, 24.0-24.6). On univariate analysis, significant risk factors for SSI were: female sex (P = .02), >72 hours preoperative stay (P = .04), open surgery (P = .08), incision class: contaminated and dirty (P = .001), and emergency procedures (P = .006). On multivariate analysis, significant independent predictors of SSI and survival were dirty surgery (hazard ratio [HR], 2.12; P = .015), contaminated surgery (HR, 1.74; P = .009), female sex (HR, 1.58; P = .003), open surgery, (HR, 1.51; P = .015) and >72 hours preoperative stay (HR, 1.48; P = .024). CONCLUSIONS: Dirty or contaminated surgery, female sex, open surgery, and >72 hours preoperative stay were significant predictors of SSI.
Subject(s)
Colorectal Surgery/adverse effects , Decision Support Techniques , Surgical Wound Infection/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Risk Factors , Young AdultABSTRACT
Clonal distribution of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals may differ according to the geographic location and time period. Knowledge of MRSA clonal epidemiology in hospital settings involves much more than the study of healthcare-associated MRSA (HA-MRSA) clones. In recent years, investigators have documented the introduction of both community-associated MRSA (CA-MRSA) and livestock-associated MRSA (LA-MRSA) clones, the emergence of clones carrying Staphylococcal cassette chromosome mec (SCCmec) XI, and the genetic diversity among sporadic MRSA isolates. The allocation of certain antibiotypes to dominant MRSA clones in an institution allows their use as phenotypic markers for a preliminary search for new clones, early detection of clonal shift, and as a guide for better empirical therapy, infection control, and treatment within a particular institution. For these reasons, we identified 938 strains detected in a System of Universal Active Surveillance of MRSA in clinical samples during the period 2009-2010, obtaining the clonal distribution of MRSA at the Hospital Universitario de Canarias (Tenerife, Spain) and the relationship between antimicrobial susceptibility and three major clones present. The antibiotypes that best defined the ST5-MRSA-IV (Pediatric) clone showed resistance to tobramycin and susceptibility to clindamycin, erythromycin, gentamicin, rifampin, trimethoprim-sulfamethoxazole, vancomycin, quinupristin/dalfopristin, and linezolid, whereas the ST22-MRSA-IV clone (EMRSA-15) showed susceptibility to these antibiotics, and finally, the ST36-MRSA-II clone (EMRSA-16) was resistant to clindamycin, erythromycin, and tobramycin and susceptible to the remaining antimicrobials. Similar observations would allow the early detection of changes in clonal epidemiology by analysis of antimicrobial susceptibility of the isolates within a single institution.
Subject(s)
Methicillin Resistance/genetics , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Animals , Anti-Infective Agents/therapeutic use , Cross Infection/drug therapy , Cross Infection/epidemiology , Cross Infection/microbiology , Hospitals , Humans , Livestock/microbiology , Methicillin-Resistant Staphylococcus aureus/drug effects , Microbial Sensitivity Tests/methods , Spain , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiologySubject(s)
Bordetella/isolation & purification , Diabetic Foot/microbiology , Achromobacter/isolation & purification , Aged , Anti-Bacterial Agents/therapeutic use , Bordetella/pathogenicity , Ceftazidime/therapeutic use , Coinfection/drug therapy , Corynebacterium Infections/drug therapy , Corynebacterium Infections/microbiology , Diabetic Foot/complications , Female , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Humans , Microbial Sensitivity Tests , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Vancomycin/therapeutic use , Wound Infection/microbiologySubject(s)
Humans , Female , Middle Aged , Diabetic Foot/complications , Diabetic Foot/diagnosis , Diabetic Foot/drug therapy , Bordetella Infections/complications , Bordetella Infections/drug therapy , Bordetella/isolation & purification , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Ceftazidime/therapeutic use , Vancomycin/therapeutic use , Renal Insufficiency/complications , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/drug therapy , Achromobacter denitrificans , Achromobacter denitrificans/isolation & purificationABSTRACT
Se ha realizado el estudio radiológico del agua del manantial del Balneario de Alhama de Granada. Este estudio ha consistido en la determinación cuantitativa de los radionúclidos naturales más significativos existentes en las aguas de los balnearios viejo y nuevo. La medida del contenido radiactivo de las aguas constituye un tema cuyo estudio resulta de gran interés. Las aguas con elementos radiactivos disueltos pueden producir, como consecuencia directa de su consumo, dosis de irradiación interna tanto por ingestión como por inhalación de estos elementos. Debido a esto es necesario, en algunos casos, proceder al análisis y posterior evaluación de la dosis asociada a este consumo (AU)
Subject(s)
Radioactivity , Water Physicochemical Characteristics , Thermal Water , Radioisotopes/isolation & purificationABSTRACT
Se ha realizado el estudio radiológico del agua del manantial del Balneario El Paraíso situado en Manzanera (Teruel). Este estudio ha consistido en la determinación cuantitativa de los radionúclidos naturales más significativos existentes en el agua. Las aguas con radionúclidos radiactivos disueltos pueden producir en determinadas condiciones, como consecuencia directa de su consumo, dosis de irradiación interna tanto por vía de ingestión como por inhalación. Es por tanto necesario conocer el nivel de radiactividad de las aguas para evaluar la dosis recibida, en caso necesario, y verificar si está por encima o por debajo de los límites recomendados (AU)
Subject(s)
Mineral Waters/analysis , Radioactivity , Balneology , Radioisotopes/analysis , SpainABSTRACT
Fundamento: La tularemia era una enfermedad prácticamente inexistente en España hasta finales de 1997, cuando se declaró un brote epidémico en nuestra comunidad. El objetivo de nuestro trabajo ha sido estudiar los datos existentes sobre el diagnóstico microbiológico de 55 pacientes que sufrieron tularemia. Pacientes y métodos: Se obtuvieron 32 muestras para cultivo pertenecientes a 19 pacientes y 151 sueros correspondientes a 55 pacientes. El diagnóstico serológico se realizó mediante seroaglutinación en tubo y microaglutinación. En todos los sueros se realizó una seroaglutinación de Wright (SAW) y un test de Coombs frente a Brucella y seroaglutinaciones frente a Yersinia enterocolitica O:9, Yersinia enterocolitica O:3 y Proteus OX 19. Resultados: Se aisló F. tularensis en dos muestras (6,25 por ciento) de las 32 estudiadas. Se obtuvieron títulos mayores o iguales a 1/160 en el 78,2 por ciento y en el 74,5 por ciento de los sueros iniciales por sero-aglutinación en tubo y microaglutinación, respectivamente. La correlación entre las dos pruebas fue de 0,80 (p < 0,001). Se observó fenómeno de prozona en el 59,9 por ciento de los sueros, y reactividad cruzada frente a Brucella y Proteus OX19 en el 9,3 y el 22,8 por ciento, respectivamente. No se observó reactividad cruzada con Y. enterocolitica O:3 y O:9. Conclusiones: El cultivo de F. tularensis es poco sensible. La correlación obtenida entre la seroaglutinación en tubo y microaglutinación es buena. Ambas técnicas son útiles en el diagnóstico de la tularemia, con algunas ventajas de la microaglutinación sobre la aglutinación. (AU)