Unlocking Potential: Low Bovine Serum Albumin Enhances the Chondrogenicity of Human Adipose-Derived Stromal Cells in Pellet Cultures.

Bovine serum albumin (BSA) plays a crucial role in cell culture media, influencing cellular processes such as proliferation and differentiation. Although it is commonly included in chondrogenic differentiation media, its specific function remains unclear. This study explores the effect of different BSA concentrations on the chondrogenic differentiation of human adipose-derived stromal/stem cells (hASCs). hASC pellets from six donors were cultured under chondrogenic conditions with three BSA concentrations. Surprisingly, a lower BSA concentration led to enhanced chondrogenesis. The degree of this effect was donor-dependent, classifying them into two groups: (1) high responders, forming at least 35% larger, differentiated pellets with low BSA in comparison to high BSA; (2) low responders, which benefitted only slightly from low BSA doses with a decrease in pellet size and marginal differentiation, indicative of low intrinsic differentiation potential. In all cases, increased chondrogenesis was accompanied by hypertrophy under low BSA concentrations. To the best of our knowledge, this is the first study showing improved chondrogenicity and the tendency for hypertrophy with low BSA concentration compared to standard levels. Once the tendency for hypertrophy is understood, the determination of BSA concentration might be used to tune hASC chondrogenic or osteogenic differentiation.

Estudio de sensibilidad de Escherichia coli productores de infecciones del tracto urinario comunitarias en Galicia. Período: 2016-2017 / Antimicrobial susceptibility of Escherichia coli producers of community urinary tract infections in Galicia (Spain). Period: 2016-2017

OBJETIVO: Escherichia coli (E. coli) es el responsable de la mayoría de las infecciones del tracto urinario comunitarias. El objetivo del estudio es conocer el espectro de sensibilidad de E. coli en infecciones del tracto urinario para recomendar el tratamiento antibiótico empírico adecuado. DISEÑO: Estudio transversal, multicéntrico, retrospectivo. EMPLAZAMIENTO: Ocho hospitales públicos gallegos, prácticamente toda la población de Galicia (España). PARTICIPANTES: Cuarenta y tres mil ciento treinta y siete pacientes ambulatorios con infección del tracto urinario por E. coli aislados en orina en 2016/2017. MEDICIONES PRINCIPALES: Variables analizadas: demográficas, concentración mínima inhibitoria e interpretación de la sensibilidad según criterios de CLSI y mecanismos de resistencia. Los antibióticos estudiados fueron: ampicilina, amoxicilina-ácido clavulánico, ciprofloxacino, cefotaxima, cefepime, gentamicina, nitrofurantoína, fosfomicina, cotrimoxazol, imipenem y ertapenem. La identificación y sensibilidad se hicieron principalmente por sistemas automatizados. RESULTADOS: Los porcentajes de no sensibilidad de los aislamientos de E. coli fueron: ampicilina 49,2%, amoxicilina-ácido clavulánico 17,8%, cefotaxima 6,7%, cefepime 5,7%, ertapenem 0,04%, imipenem 0,05%, gentamicina 9,1%, ciprofloxacino 26,2%, fosfomicina 3,3%, nitrofurantoína 2,4% y cotrimoxazol 23,9%. Las no sensibilidades fueron superiores en hombres y a medida que aumenta la edad. El 6% fueron productores de betalactamasas de espectro extendido. CONCLUSIONES: El tratamiento empírico en Galicia para cistitis no complicadas producidas por E. coli en mujeres continúa siendo nitrofurantoína y fosfomicina. En hombres menores de 15 años se indica fosfomicina y en hombres mayores de 15 años el tratamiento en nuestro medio debe incluir la realización de cultivo y administrar una cefalosporina de 3.a generación oral empíricamente. No se recomienda cotrimoxazol ni ciprofloxacino como tratamiento empírico por sus altos porcentajes de resistencia

OBJECTIVE: Escherichia coli (E. coli) is responsible for the majority of community urinary tract infections. The objective of the study is to know the sensitivity spectrum of E. coli in urinary tract infections to be able to recommend the appropriate empirical antibiotic treatment. DESIGN: Cross-sectional, multicentric, retrospective study. LOCATION: Galician 8 public hospitals, practically the entire population of Galicia (Spain). PARTICIPANTS: 43,137 outpatients with urinary tract infection due to E. coli isolated in urine in 2016/2017. MAIN MEASUREMENTS: Analyzed variables: demographic, minimum inhibitory concentration and interpretation of sensitivity according to CLSI criteria and resistance mechanisms. The antibiotics studied were: ampicillin, amoxicillin-clavulanic acid, ciprofloxacin, cefotaxime, cefepime, gentamicin, nitrofurantoin, fosfomycin, cotrimoxazole, imipenem and ertapenem. The identification and sensitivity were made mainly by automated methods. RESULTS: The percentages of non-sensitivity of E. coli isolates were: ampicillin 49.2%, amoxicillin-clavulanic acid 17.8%, cefotaxime 6.7%, cefepime 5.7%, ertapenem 0.04%, imipenem 0.05%, gentamicin 9,1%, ciprofloxacin 26.2%, fosfomycin 3.3%, nitrofurantoin 2.4% and cotrimoxazole 23.9%. The non-sensitivities were higher in men and as age increases. Six percent of E. coli were producers of extended-spectrum beta-lactamases. CONCLUSIONS: The empirical treatment in Galicia for uncomplicated cystitis produced by E. coli in women continues to be nitrofurantoin and fosfomycin. In men under 15 years of age, fosfomycin is indicated and in men older than 15 years, treatment in our environment should include culture and administer a 3rd generation oral cephalosporin empirically. Cotrimoxazole and ciprofloxacin are not recommended as empirical treatment because of their high resistance rates

[Antimicrobial susceptibility of Escherichia coli producers of community urinary tract infections in Galicia (Spain). Period: 2016-2017]. / Estudio de sensibilidad de Escherichia coli productores de infecciones del tracto urinario comunitarias en Galicia. Período: 2016-2017.

OBJECTIVE: Escherichia coli (E. coli) is responsible for the majority of community urinary tract infections. The objective of the study is to know the sensitivity spectrum of E. coli in urinary tract infections to be able to recommend the appropriate empirical antibiotic treatment. DESIGN: Cross-sectional, multicentric, retrospective study. LOCATION: Galician 8 public hospitals, practically the entire population of Galicia (Spain). PARTICIPANTS: 43,137 outpatients with urinary tract infection due to E. coli isolated in urine in 2016/2017. MAIN MEASUREMENTS: Analyzed variables: demographic, minimum inhibitory concentration and interpretation of sensitivity according to CLSI criteria and resistance mechanisms. The antibiotics studied were: ampicillin, amoxicillin-clavulanic acid, ciprofloxacin, cefotaxime, cefepime, gentamicin, nitrofurantoin, fosfomycin, cotrimoxazole, imipenem and ertapenem. The identification and sensitivity were made mainly by automated methods. RESULTS: The percentages of non-sensitivity of E. coli isolates were: ampicillin 49.2%, amoxicillin-clavulanic acid 17.8%, cefotaxime 6.7%, cefepime 5.7%, ertapenem 0.04%, imipenem 0.05%, gentamicin 9,1%, ciprofloxacin 26.2%, fosfomycin 3.3%, nitrofurantoin 2.4% and cotrimoxazole 23.9%. The non-sensitivities were higher in men and as age increases. Six percent of E. coli were producers of extended-spectrum beta-lactamases. CONCLUSIONS: The empirical treatment in Galicia for uncomplicated cystitis produced by E. coli in women continues to be nitrofurantoin and fosfomycin. In men under 15 years of age, fosfomycin is indicated and in men older than 15 years, treatment in our environment should include culture and administer a 3rd generation oral cephalosporin empirically. Cotrimoxazole and ciprofloxacin are not recommended as empirical treatment because of their high resistance rates.

Design and fabrication of biocompatible wrinkled hydrogel films with selective antibiofouling properties.

In this article, we explored the selective antibiofouling capacity acquired by functional wrinkled hydrogel films via a fine tuning of their chemical structure through the gradual insertion of hydrophobic radical groups in their network. The hydrogel consists of three main components: hydroxyethyl methacrylate (HEMA, amphiphilic monomer), trifluoroethyl methacrylate (TFMA, hydrophobic monomer), and poly(ethylene glycol) diacrylate (PEGDA, hydrophilic crosslinking agent). Interestingly, the manipulation of the chemical composition affects both, surface morphology and physicochemical characteristics of the patterns, inducing transitions between different surface microstructures, i.e. from wrinkles to creases, to folds, and to crumples. Contact angle measurements show that the insertion of TFMA produces a slight decrease in surface wettability, remaining however highly hydrophilic. By using confocal Raman spectroscopy, important information about wrinkle formation mechanism could be obtained. The procedure presented in this article involves two consecutive thermal and photopolymerization steps, generating a "pseudo" two-layer system, which contracts at different extents when is exposed to external stimuli, leading to the formation of wrinkled surfaces. Finally, bacterial and cellular adhesion/proliferation studies were carried out, evidencing that the amount of TFMA included clearly reduce the bacterial adhesion while mammalian cells are able to still proliferate.

Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years' experience, Spain, 1998 to 2015.

Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000-0.78/100,000). Two periods (P) are described: P1 (1998-2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007-2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain-Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.

Facile one-pot exfoliation and integration of 2D layered materials by dispersion in a photocurable polymer precursor.

Efficient exfoliation of graphene and related materials (GRM) and fast and inexpensive integration/assembly are crucial to fulfil their full potential. A high degree of exfoliation in organic media can be achieved with high boiling point liquids that usually leave residues after drying, which is a handicap for many applications. Here, the effective exfoliation and dispersion of GRM in a vinyl monomer, which is subsequently converted to a functional polymer by photopolymerization, is reported. Nanocomposite membranes and three-dimensional objects are produced by the photo-curing process and stereolithography 3D printing, respectively.

Vigilancia de la sensibilidad a antimicrobianos de Escherichia coli productor de infecciones del tracto urinario comunitarias en Galicia / Surveillance of antimicrobial susceptibility of Escherichia coli producing urinary tract infections in Galicia (Spain)

Introducción. Escherichia coli es el microorganismo responsable de la mayoría de las infecciones del tracto urinario (ITU) comunitarias. Nuestro propósito fue conocer la sensibilidad de E. coli asociado a ITU en Galicia y considerar los antibióticos más apropiados para su tratamiento empírico. Métodos. Estudio retrospectivo durante el período 2011-2012 de los aislamientos de E. coli en muestras de orina procedentes de prácticamente toda la población gallega. Se recogieron variables demográficas, concentración mínima inhibitoria y categoría de interpretación para: amoxicilina/clavulánico, cefotaxima, gentamicina, amikacina, ciprofloxacino, cotrimoxazol, fosfomicina y nitrofurantoína. La identificación y estudios de sensibilidad se realizaron principalmente mediante sistemas automatizados. La interpretación de los resultados se realizó de acuerdo con los criterios de CLSI. Resultados: En el período estudiado se aislaron 55.046 E. coli en ITU. Los porcentajes de resistencia fueron: cotrimoxazol 30%; ciprofloxacino 33%; amoxicilina/clavulánico 23% y del 10% para cefalosporinas de 3ª generación. Fosfomicina y nitrofurantoína son los que mantienen mayor actividad, con más de un 96% de sensibilidad en nuestro estudio. La tendencia lineal de las resistencias en relación a la edad fue estadísticamente significativa (p<0,0001) y también lo fue en relación al sexo masculino (p<0,00001) para todos los antibióticos. Conclusiones. En Galicia los antibióticos más activos frente a E. coli asociado a ITU son fosfomicina y nitrofurantoína por lo que deberían ser considerados como tratamiento empírico de elección de la ITU comunitaria no complicada por E. coli (AU)

Introduction. Escherichia coli is the microorganism responsible for most of the community-acquired urinary tract infections (UTI). Our purpose was to determine the susceptibility of E. coli associated with UTI in Galicia and consider the most appropriate antibiotics for empirical treatment. Methods. Retrospective study during the period 2011-2012 of the isolation of E. coli in urine samples from almost all the Galician population. Demographic variables, minimum inhibitory concentration, and reading data were collected: amoxicillin-clavulanate, cefotaxime, gentamicin, amikacin, ciprofloxacin, cotrimoxazole, nitrofurantoin and fosfomycin. The identification and susceptibility studies were mainly conducted by automated systems. The interpretation of the results was performed according to CLSI criteria. Results. During the study period 55,046 E. coli were isolated in UTI. The percentages of resistance were: cotrimoxazole, 30%; ciprofloxacin, 33%; amoxicillin-clavulanate, 23% and 10% for 3rd generation cephalosporins. Fosfomycin and nitrofurantoin showed the highest activity with more than 96% of susceptibility in our study. The linear trend of resistance regarding age was statistically significant (p <0.0001) as it was regarding males (p <0.00001) for all antibiotics. Conclusions. In Galicia, the most active antibiotics against E. coli associated with UTI are fosfomycin and nitrofurantoin so they should be considered as empirical treatment of choice by the community-acquired UTI not complicated by E. coli (AU)

[Surveillance of antimicrobial susceptibility of Escherichia coli producing urinary tract infections in Galicia (Spain)]. / Vigilancia de la sensibilidad a antimicrobianos de Escherichia coli productor de infecciones del tracto urinario comunitarias en Galicia.

OBJECTIVE: Escherichia coli is the microorganism responsible for most of the community-acquired urinary tract infections (UTI). Our purpose was to determine the susceptibility of E. coli associated with UTI in Galicia and consider the most appropriate antibiotics for empirical treatment. METHODS: Retrospective study during the period 2011- 2012 of the isolation of E. coli in urine samples from almost all the Galician population. Demographic variables, minimum inhibitory concentration, and reading data were collected: amoxicillin-clavulanate, cefotaxime, gentamicin, amikacin, ciprofloxacin, cotrimoxazole, nitrofurantoin and fosfomycin. The identification and susceptibility studies were mainly conducted by automated systems. The interpretation of the results was performed according to CLSI criteria. RESULTS: During the study period 55,046 E. coli were isolated in UTI. The percentages of resistance were: cotrimoxazole, 30%; ciprofloxacin, 33%; amoxicillin-clavulanate, 23% and 10% for 3rd generation cephalosporins. Fosfomycin and nitrofurantoin showed the highest activity with more than 96% of susceptibility in our study. The linear trend of resistance regarding age was statistically significant (p <0.0001) as it was regarding males (p <0.00001) for all antibiotics. CONCLUSIONS: In Galicia, the most active antibiotics against E. coli associated with UTI are fosfomycin and nitrofurantoin so they should be considered as empirical treatment of choice by the community-acquired UTI not complicated by E. coli.

[Surveillance of resistance of Staphylococcus aureus to antibiotics in Galicia: 2007-2012]. / Vigilancia de la resistencia a los antibióticos en Staphylococcus aureus en Galicia: 2007-2012.

INTRODUCTION: Since 2007 the Galician Surveillance Program on Antimicrobial Resistance has been collected data of Staphylococcus aureus susceptibility patterns. The data from 2007 to 2012 have been analyzed and are reported. METHODS: A total of 4,577 different isolates of S. aureus from cerebrospinal fluid and blood cultures were included. The Institutions involved provided the information about the susceptibility patterns, the assay methods used and the interpretative guidelines followed, and demographic data of patients. RESULTS: The rate of methicillin-resistance S. aureus (MRSA) was 22% in 2007-2010 and 26% in 2011-2012, although in some areas the percentage reached 57% (2007- 2010) or 66% (2011-2012). The higher rates of resistance were found in patients older than 75 years. Gentamycin resistance was less than 9% and for quinolones were about 25%. A strong association between methicillin and quinolone-resistance were observed (91%). The resistance against linezolid and glycopeptides were exceptional. CONCLUSIONS: The percentage of MRSA has evolved slightly along the period of this study reaching no significant differences between Galicia and the global data in Spain in 2012. Nevertheless, there are significant differences among the geographic areas studied. Most MRSA isolates were recovered from hospitalized patients, but an increase in the number of MRSA among outpatients was observed, while old patients from nursing homes are included in the outpatient group, so the MRSA rate in this group could be overestimated.

Vigilancia de la resistencia a los antibióticos en Staphylococcus aureus en Galicia: 2007-2012 / Surveillance of resistance of Staphylococcus aureus to antibiotics in Galicia: 2007-2012

Introducción. Desde 2007 el Programa Gallego de Vigilancia de Resistencias Antimicrobianas recogió datos de los patrones de sensibilidad de Staphylococcus aureus. Se analizaron e informaron los datos entre 2007 y 2012. Métodos. Se incluyeron 4.577 aislamientos de S. aureus procedentes de líquido cefalorraquídeo o de sangre. Los distintos centros enviaron información sobre los patrones de sensibilidad, los métodos de ensayo, los criterios de interpretación seguidos y datos demográficos de los pacientes. Resultados. El porcentaje de aislamientos S. aureus resistentes a meticillina (SARM) fue del 22% (2007-2010) y del 26% (2011-2012), aunque en determinada área el porcentaje alcanzó el 57% (2007-2010) o 66% (2011-2012). Las tasas más altas de resistencias se encontraron en los mayores de 75 años. La resistencia a gentamicina fue menor del 9% y la de quinolonas sobre el 25%. Existe fuerte asociación entre resistencias a meticilina y quinolonas (91%). La resistencia frente a linezolid y glicopéptidos fue excepcional. Conclusiones. El porcentaje de SARM a lo largo del periodo de estudio ha presentado ciertas fluctuaciones alcanzándose en 2012 una situación similar en Galicia a la del conjunto de España. No obstante, hay importantes diferencias entre las áreas geográficas estudiadas. La mayoría de los SARM fueron aislados en pacientes hospitalizados, pero se observó un incremento entre ambulatorios. Dado que los pacientes mayores institucionalizados fueron incluidos en el grupo de los ambulatorios es posible que las tasas de SARM en este grupo hayan sido sobreestimadas (AU)

Introduction. Since 2007 the Galician Surveillance Program on Antimicrobial Resistance has been collected data of Staphylococcus aureus susceptibility patterns. The data from 2007 to 2012 have been analyzed and are reported. Methods. A total of 4,577 different isolates of S. aureus from cerebrospinal fluid and blood cultures were included. The Institutions involved provided the information about the susceptibility patterns, the assay methods used and the interpretative guidelines followed, and demographic data of patients. Results. The rate of methicillin-resistance S. aureus (MRSA) was 22% in 2007-2010 and 26% in 2011-2012, although in some areas the percentage reached 57% (2007-2010) or 66% (2011-2012). The higher rates of resistance were found in patients older than 75 years. Gentamycin resistance was less than 9% and for quinolones were about 25%. A strong association between methicillin and quinolone-resistance were observed (91%). The resistance against linezolid and glycopeptides were exceptional. Conclusions. The percentage of MRSA has evolved slightly along the period of this study reaching no significant differences between Galicia and the global data in Spain in 2012. Nevertheless, there are significant differences among the geographic areas studied. Most MRSA isolates were recovered from hospitalized patients, but an increase in the number of MRSA among outpatients was observed, while old patients from nursing homes are included in the outpatient group, so the MRSA rate in this group could be overestimated (AU)

Microbiology of bacteria causing recurrent acute otitis media (AOM) and AOM treatment failure in young children in Spain: shifting pathogens in the post-pneumococcal conjugate vaccination era.

OBJECTIVE: To prospectively identify the bacterial aetiology and antimicrobial susceptibility of problematic (recurrent and treatment failure) acute otitis media in Spanish children several years after the introduction of 7-valent pneumococcal conjugate vaccine. METHODS: Tympanocentesis or careful sampling of spontaneous otorrhoea was performed on children aged 3 to <36 months with recurrent acute otitis media, acute otitis media treatment failure or unresolved acute otitis media. RESULTS: 105 acute otitis media episodes (77 sampled by tympanocentesis, 28 otorrhoea samples) were evaluated: 46 recurrent, 35 treatment failures, 24 unresolved acute otitis media. 74 episodes (70.4%) had at least one bacterium identified on culture: Streptococcus pneumoniae was identified in 21 episodes, Haemophilus influenzae (all non-typeable) in 44, Streptococcus pyogenes in 2, Moraxella catarrhalis in 2. No statistically significant difference in bacterial aetiology by episode type was detected. Non-typeable H. influenzae was the most commonly isolated pathogen in all acute otitis media types and in all age sub-groups. Forty percent of S. pneumoniae isolates were multi-drug resistant. Pneumococcal serotype 19A was the most frequently identified serotype (7/21 episodes). Multi-drug resistance was found in 56% of 19A isolates. Of non-typeable H. influenzae isolates, 15% were ampicillin resistant and 13% were amoxicillin/clavulanate resistant. S. pneumoniae and non-typeable H. influenzae DNA were each detected in 57% of samples culture negative for these pathogens, including 12 co-infections. CONCLUSION: Combining culture and polymerase chain reaction results, H. influenzae and S. pneumoniae may be implicated in 70% and 43% of clinically problematic bacterial acute otitis media episodes, respectively. The impact of new vaccines to prevent both S. pneumoniae and non-typeable H. influenzae acute otitis media may be substantial in this population and is worth investigating.

Artritis séptica recidivante por Staphylococcus lugdunensis sobre prótesis de rodilla / Relapsing Staphylococcus lugdunensis septic arthritis associated with a knee prosthesis

No disponible

Meningoencefalitis causada por el VHH-6A en un adulto inmunocompetente previamente sano / Meningoencephalitis caused by HHV-6A in a previously healthy immunocompetent adult

No disponible

[Early infection in liver transplant recipients: incidence, severity, risk factors and antibiotic sensitivity of bacterial isolates]. / Infección precoz en el paciente con trasplante hepático: incidencia, gravedad, factores de riesgo y sensibilidad antibiótica de los aislados bacterianos.

OBJECTIVES: To conduct a descriptive study with an analysis of risk factors for early infection in liver transplant patients, and to determine the resistance of the bacteria involved. PATIENTS AND METHODS: The study included 149 liver transplant recipients. All cases of infection occurring 0-90 days after transplantation were considered early infection. Pre-, intra- and postoperative variables were analyzed, and isolated microorganisms were studied. Selective bowel decontamination with quinolones, and perioperative and antifungal prophylaxis were carried out in all patients. RESULTS: The incidence of infection was 73.1%: bacterial (49.7%), viral (35.5%), fungal (10.1%) and mixed (4.5%). In the first postoperative month the most frequent infections were bacterial and in the second and third months, viral (p = 0.001). Multivariate analysis of risk factors identified the following: days of parenteral nutrition, duration of surgery > 5 hours, rejection and CMV seronegative status. Among 1278 cultures, the following microorganisms were isolated: 77.9% gram-positive cocci (GP) and 19% aerobic gram-negative bacilli (GNB). Sensitivity of Staphylococcus to vancomycin was 99.6-100% and to teicoplanin 97.9-100%. VAN resistance was observed in 1.2% of E. faecalis and 4.5% of E. faecium. Among S. aureus strains, 68.7% were MRSA. The resistance rate of GNB to quinolones was 38.8%. CONCLUSIONS: Incidence of infection was higher the first 30 days after transplantation, with bacterial infection predominating. Duration of surgery > 5 hours was the most important risk factor for acquiring bacterial infection. GP were the most frequently isolated bacteria. Empirical treatment of early bacterial infection should include vancomycin or teicoplanin. Selective bowel decontamination resulted in a low incidence of GNB infections, among which there was 38.8% resistance to quinolones.

Infección precoz en el paciente con trasplante hepático: incidencia, gravedad, factores de riesgo y sensibilidad antibiótica de los aislados bacterianos / Early infection in liver transplant recipients: incidence, severity, risk factors and antibiotic sensitivity of bacterial isolate

OBJETIVOS. Estudio descriptivo y análisis de factores de riesgo de infección precoz. Estudio de resistencias de los aislados bacterianos. PACIENTES Y MÉTODOS. Se estudiaron 149 trasplantados hepáticos. Se definió infección precoz en 0-90 días postrasplante. Se analizaron variables preoperatorias, intraoperatorias y postoperatorias. Se estudiaron los microorganismos aislados. Se utilizó descontaminación intestinal selectiva (DIS) con quinolonas y profilaxis perioperatoria y antifúngica en todos los pacientes. RESULTADOS. La incidencia de infección fue del 73,1 por ciento: bacterianas (49,7 por ciento), virales (35,5 por ciento), fúngicas (10,1 por ciento) y mixtas (4,5 por ciento). Las más frecuentes en el primer mes fueron bacterianas y en el segundo y tercero, virales (p = 0,001). Factores de riesgo en el análisis multivariante: días de nutrición parenteral, cirugía más de 5 h, rechazo y estado seronegativo para citomegalovirus. En 1.278 cultivos se aislaron microorganismos: 77,9 por ciento cocos grampositivos y 19 por ciento bacilos gramnegativos aerobios. La sensibilidad a vancomicina (VAN) de Staphylococcus fue del 99,6-100 por ciento y a teicoplanina (TEI) del 97,9-100 por ciento. El 1,2 por ciento de Enterococcus faecalis y el 4,5 por ciento de Enterococcus faecium fueron resistentes a VAN. El 68,7 por ciento de los S. aureus fueron SAMR. La tasa de resistencias de bacilos gramnegativos a quinolonas fue del 38,8 por ciento. CONCLUSIONES. La mayor incidencia de infección fue observada en los primeros 30 días postrasplante, siendo la bacteriana la más frecuente. La duración de la cirugía de más de 5 h fue el factor de riesgo más importante de infección bacteriana. Los grampositivos fueron las bacterias más frecuentes. El tratamiento empírico de la infección bacteriana precoz debe incluir VAN o TEI. La DIS condicionó escasa incidencia de infecciones por bacilos gramnegativos, de los cuales el 38,8 por ciento presentaban resistencia a quinolonas (AU)

[In vitro susceptibility study of herpes simplex virus to acyclovir and foscarnet. Are routine susceptibility studies necessary?]. / Estudio de sensibilidad in vitro del virus herpes simple a aciclovir y foscarnet. Son necesarios los estudios de sensibilidad de forma rutinaria?

BACKGROUND: The objective of this study was to investigate the prevalence of resistance of herpes simplex virus to acyclovir and foscarnet. PATIENTS AND METHOD: An in vitro susceptibility study of HSV strains isolated from HIV-infected and non-infected (control group) patients was conducted by means of qualitative screening. When the screening results were positive, the method for reducing cytopathic effect was utilized for calculating ID50. An ID50 < 1 microgram/ml indicated susceptibility to acyclovir, ID50 1-2 microgram/ml was intermediate susceptibility to acyclovir and a value of ID50 >/= 2 microgram/ml denoted resistance. Resistance to foscarnet was considered at ID50 >/= 100 microgram/ml. RESULTS: The study involved investigating 84 HSV strains, 49 HIV-infected patients, and 19 control patients. In the control group, no strains resistant to acyclovir were present and infection recurred in only one patient. In patients with HIV infection, one acyclovir resistant strain was detected and one moderately resistant to acyclovir, with good response to acyclovir treatment. In this group, 24.4% of patients presented recurrent infection. No resistance to foscarnet was detected. CONCLUSION: Percentage of HSV strains resistant to acyclovir is very low and resistance to foscarnet was not detected. These data suggest that routine in vitro susceptibility testing of antiviral drugs against HSV does not seem to be necessary.

Estudio de sensibilidad in vitro del virus herpes simple a aciclovir y foscarnet. ¿Son necesarios los estudios de sensibilidad de forma rutinaria? / In vitro susceptibility study of herpes simplex virus to acyclovir and foscarnet. Are routine susceptibility studies necessary?

FUNDAMENTOS. El objetivo de este estudio es conocer la prevalencia de resistencias del virus herpes simple (VHS) a aciclovir y foscarnet. PACIENTES Y MÉTODO. Se realizó un estudio de sensibilidad in vitro a VHS aislados de pacientes infectados por el virus de la inmunodeficiencia humana (VIH) y no infectados por el VIH (grupo control) mediante una prueba de cribado cualitativo. Cuando la prueba de cribado fue positiva se utilizó el método de reducción de efecto citopático para calcular la DI50. Se consideró sensibilidad al aciclovir a una DI50 < 1 g/ml; una sensibilidad intermedia al aciclovir, a una DI50 1-2 g/ml y resistente, a DI50 2 g/ml. Se consideró resistencia al foscarnet a DI50 100 g/ml. RESULTADOS. Se estudiaron 84 cepas de VHS de 49 pacientes con infección por el VIH y 19 de un grupo control. En el grupo control no existió ninguna cepa resistente al aciclovir y la infección sólo recurrió en un paciente. Los enfermos infectados por el VIH tuvieron una cepa resistente a aciclovir y una cepa moderadamente resistente a este fármaco, con una buena respuesta al tratamiento. En este grupo, el 24,4 por ciento de los pacientes tuvo recurrencia de la infección. No se detectaron resistencias al foscarnet. CONCLUSIONES. La tasa de VHS resistente al aciclovir es muy baja y no se detectó resistencia al foscarnet. La baja tasa de resistencia no justificaría la realización rutinaria de la prueba de sensibilidad in vitro de antivíricos frente al VHS (AU)