Dispersal history of SARS-CoV-2 in Galicia, Spain.

The dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission are influenced by a variety of factors, including social restrictions and the emergence of distinct variants. In this study, we delve into the origins and dissemination of the Alpha, Delta, and Omicron-BA.1 variants of concern in Galicia, northwest Spain. For this, we leveraged genomic data collected by the EPICOVIGAL Consortium and from the GISAID database, along with mobility information from other Spanish regions and foreign countries. Our analysis indicates that initial introductions during the Alpha phase were predominantly from other Spanish regions and France. However, as the pandemic progressed, introductions from Portugal and the United States became increasingly significant. The number of detected introductions varied from 96 and 101 for Alpha and Delta to 39 for Omicron-BA.1. Most of these introductions left a low number of descendants (<10), suggesting a limited impact on the evolution of the pandemic in Galicia. Notably, Galicia's major coastal cities emerged as critical hubs for viral transmission, highlighting their role in sustaining and spreading the virus. This research emphasizes the critical role of regional connectivity in the spread of SARS-CoV-2 and offers essential insights for enhancing public health strategies and surveillance measures.

Dispersal history of SARS-CoV-2 in Galicia, Spain.

The dynamics of SARS-CoV-2 transmission are influenced by a variety of factors, including social restrictions and the emergence of distinct variants. In this study, we delve into the origins and dissemination of the Alpha, Delta, and Omicron variants of concern in Galicia, northwest Spain. For this, we leveraged genomic data collected by the EPICOVIGAL Consortium and from the GISAID database, along with mobility information from other Spanish regions and foreign countries. Our analysis indicates that initial introductions during the Alpha phase were predominantly from other Spanish regions and France. However, as the pandemic progressed, introductions from Portugal and the USA became increasingly significant. Notably, Galicia's major coastal cities emerged as critical hubs for viral transmission, highlighting their role in sustaining and spreading the virus. This research emphasizes the critical role of regional connectivity in the spread of SARS-CoV-2 and offers essential insights for enhancing public health strategies and surveillance measures.

Chorioamnionitis secondary to Ureaplasma parvum infection: a case report.

Objectives: Ureaplasma species are the most frequently isolated microorganisms in cases of spontaneous preterm labor, premature rupture of the membranes, or chorioamnionitis. Case presentation: A woman at 28+6 weeks of gestation with no apparent history of interest presented at the hospital with contractions. Upon suspicion of chorioamnionitis, the patient was admitted for a low segment transverse cesarean section, which was completed without any complications. The patient was discharged at 7 days. The newborn remained stable and showed no clinical signs of infection. However, on suspicion of chorioamnionitis, empirical treatment with intravenous ampicillin (2 g every 6 h) and gentamicin (5 mg/kg once daily) was initiated. Samples of pharyngeal/tonsillar, ear, and anal/rectal exudates were collected. At 24 h, all samples were positive for Ureaplasma parvum. Empirical treatment was suspended, and treatment with intravenous azithromycin was initiated (12 mg once daily). Endocervical and placental exudates were also positive for U. parvum. Fifty-two days after birth, the newborn was discharged. Conclusions: The relationship between Ureaplasma spp. colonization and perinatal disease seem to be clear. However, the high frequency of vaginal Ureaplasma spp. colonization and high rates of term labor among pregnant women with this colonization make further studies necessary.

Microscopía vs. biología molecular en el diagnóstico de infecciones protozoarias intestinales, ¿es el momento del cambio? / Microscopy vs. molecular biology in the diagnosis of intestinal protozoal infections, is it time for a change?

Introducción: El examen microscópico de las parasitosis intestinales, a partir de las heces concentradas del paciente, presenta una menor sensibilidad si se compara con las técnicas de diagnóstico molecular. Por ello, el objetivo del presente estudio ha sido comparar ambas técnicas, así como evaluar si existe correlación entre el examen microscópico y los ciclos umbrales (Ct) obtenidos para Blastocystis hominis. Material y métodos: Estudio retrospectivo de las muestras recibidas en el laboratorio de Microbiología durante septiembre de 2021. Se realizó la prueba de concentración MiniParasep SF® para la visualización microscópica y posteriormente se realizó la PCR con el panel Seegene AllplexTM Parasite Assay. Resultados: Un 27% (n=74) de las muestras fueron positivas por diagnóstico molecular, con un total de 87 parásitosdetectados. El 53% (n=39) fueron mujeres con una edad media de 47 ± 24 años. En el 76% (n=56) de los casos el servicio de procedencia fue Atención Primaria. El parásito hallado con más frecuencia fue B. hominis, 85% (n=64), seguido de Dientamoeba fragilis 20% (n=15) y Giardia lamblia 11% (n=8). En 13 casos se detectaron co-infección por dos parásitos (en 6 casos B. hominis + D. fragilis, y en 7 casos B. hominis + G. lamblia). En el diagnóstico microscópico se obtuvo un 9,5% (n=26) de positividad. El parásito hallado con más frecuencia fue B. hominis,84% (n=23), seguido de G. lamblia se visualizó en tres casos por microscopía. D. fragilis no se visualizó en ningún caso. En una muestra se observó coinfección de B. hominis + G. lamblia. Conclusiones: Las técnicas para el diagnóstico molecular de las parasitosis intestinales son rápidas, fiables y más sensibles que las técnicas microscópicas, mejorando el diagnóstico microbiológico y la calidad asistencial. (AU)

Introduction: Microscopic examination of the intestinal parasites, from the patient’s concentrated feces, has a lower sensitivity when compared to molecular diagnostic techniques. Therefore, the objective of this study has been to compare both techniques, as well as to evaluate whether there is a correlation between the microscopic examination and the threshold cycles (Ct) obtained for Blastocystis hominis. Material and methods: Retrospective study of the samples received in the Microbiology laboratory during September 2021. The MiniParasep SF® concentration test was performed for microscopic visualization and then PCR was performed with the Seegene AllplexTM Parasite Assay panel. Results: A 27% (n=74) of the samples were positive by molecular diagnosis, with a total of 87 parasites detected. 53% (n=39) were women with a mean age of 47 ± 24 years. In 76% (n=56) of the cases the service of origin was Primary Care. The most frequently found parasite was B. hominis, 85% (n=64), followed by Dientamoeba fragilis 20% (n=15) and Giardia lamblia 11% (n=8). Co-infection by two parasites was detected in 13 cases (B. hominis + D. fragilis in 6 cases, and B. hominis + G. lamblia in 7 cases). In the microscopic diagnosis, 9.5% (n=26) positivity was obtained. The most frequently found parasite was B. hominis, 84% (n=23), followed by G. lamblia, which was seen in three cases by microscopy. D. fragilis was not seen in any case. Coinfection of B. hominis + G. lamblia was observed in one sample. Conclusions: Techniques for molecular diagnosis of intestinal parasites are fast, reliable and more sensitive than microscopic techniques, improving microbiological diagnosis and quality of care. (AU)

[Description of the first case of SARS-CoV-2 reinfection in Galicia (Spain).] / Descripción del primer caso de reinfección por SARS-CoV-2 en Galicia (España).

Since the first reinfection by SARS-CoV-2 was known in August 2020, several cases have been described around the world. We present the first reinfection of an immunocompetent patient confirmed in Galicia (Spain). The clinical-epidemiological information was obtained through an interview with the patient. The microbiological diagnosis was made by PCR of the nasopharyngeal exudate samples, and a serological study was carried out. In addition, a summary of the characteristics of all reinfections identified between 04-01-2021 and 03-10-2021 is presented.

Desde que en Agosto de 2020 se conociese la primera reinfección por SARS-CoV-2, se han descrito varios casos en todo el Mundo. Presentamos el primer caso confirmado en Galicia (España) de reinfección, en una paciente inmunocompetente. La información clínico-epidemiológica se obtuvo mediante entrevista con la paciente. El diagnóstico microbiológico se realizó mediante PCR de las muestras de exudado nasofaríngeo y se realizó estudio serológico. Además, se presenta un resumen de las características de todas las reinfecciones identificadas entre el 04-01-2021 y el 03-10-2021.

The benefits and safety of oral sequential antibiotic therapy in non-complicated and complicated Staphylococcus aureus bacteremia.

BACKGROUND: Treatment optimization for serious infections, such as Staphylococcus aureus bacteremia (SAB), is a challenge for antimicrobial stewardship teams. Currently, SAB guidelines recommend a completely intravenous therapy (CIT). OBJECTIVES: The objective of the study was to analyze the usefulness and safety of oral sequential therapy (OST) in SAB. PATIENTS AND METHODS: We conducted a retrospective, observational study in a tertiary teaching hospital in Spain. The inclusion criteria were complicated and non-complicated monomicrobial SAB and an adequate duration of therapy, with patients classified into OST or CIT. The primary endpoint was the 90-day recurrence of S. aureus infection. We also analyzed the mortality, the length of the hospital stay, and the duration of the intravenous antibiotic administration. RESULTS: Of a total of 201 patients with SAB, 125 (62%) underwent OST. The most commonly administered oral antibiotic was trimethoprim-sulfamethoxazole (66% of patients). Of those administered OST, 43% had complicated bacteremia (most with an osteoarticular source of infection), and 6% had an intravascular device. The 90-day recurrence rate was 4%, with no differences between the two groups. The duration of the therapy (22 [16-28] vs. 13 days [8-17] for CIT and OST, respectively; p < 0.001) and the hospital stay (36 [27-71] vs. 18 days [13-29] for CIT and OST, respectively; p < 0.001) were shorter for OST. MRSA was related with mortality (OR 4.4, 95% CI [1.67-11.37]; p = 0.003). CONCLUSIONS: OST for properly selected patients with SAB could be a safe therapeutic option and can reduce their use of CIT and their hospital stay.

Queratitis por Albifimbria verrucaria: a propósito de un caso / Albifimbria verrucaria keratitis: a case report

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Methicillin-resistant Staphylococcus aureus in swine housed indoors in Galicia, Spain / Staphylococcus aureus resistente a la meticilina en cerdos estabulados en Galicia, España

INTRODUCTION: Livestock are known reservoirs of methicillin-resistant Staphylococcus aureus (MRSA) and this constitutes an important public health issue. The prevalence of nasal MRSA carriers in swine housed indoors in Galicia, Spain, was studied. METHODS: 197 samples from swine aged three, eight, 12, 16 and 24 weeks, and from adult pigs, were obtained from four farms. The cleaning procedures implemented to clean the barns and antimicrobial consumption were analyzed. Antimicrobial susceptibility and antimicrobial resistance genes were studied. PFGE, spa typing and MLST were used to classify the isolates. SCCmec, agr and pvl were analyzed. RESULTS: MRSA prevalence was 12.7%. Swine younger than 16 weeks had a higher colonization rate; 22.9% vs 3.5% (OR, 8.16; 95% CI, 2.47-29.79; p < 0.01). The only farm found to be MRSA-free used disinfectants as part of its cleaning procedure. All MRSA were tetracycline-resistant (identifying the tetK and tetM genes), 80% were resistant to erythromycin and clindamycin and 16% were only clindamycin-resistant. The ermC and vgaA genes were identified in these two phenotypes. A single genotype (PFGE type A) and ST398 - spa t011 (84%) and t1451 (16%) were identified. SCCmec type V and agrI were identified in all isolates, and all were pvl-negative. CONCLUSION: A correlation between swine age and MRSA colonization was observed. Appropriate cleaning procedures could have an impact on MRSA colonization in farming. Resistance to antibiotics used in human health was identified. Clinicians should be aware if their patients have come into contact with farm animals

INTRODUCCIÓN: Los animales de granja son reservorios de Staphylococcus aureus resistente a la meticilina (SARM), y constituyen un problema de salud pública. Se estudia la prevalencia de portadores nasales de SARM en cerdos estabulados en Galicia, España. MÉTODOS: En 4 explotaciones se obtuvieron 197 muestras de cerdos con edades en semanas de 3, 8, 12, 16, 24 y adultos. Se analizaron los métodos empleados para limpiar los establos y el consumo de antimicrobianos. Se estudió la resistencia a antimicrobianos, y los genes involucrados en esta. Los aislamientos fueron clasificados mediante PFGE, spa y MLST. Se analizaron SCCmec, agr y pvl. RESULTADOS: La prevalencia de SARM fue del 12,7%. Los cerdos de <16 semanas presentaron las frecuencias de colonización más elevadas 22,9 vs. 3,5% (OR: 8,16; IC 95%: 2,47-29,79; p < 0,01). En la única explotación libre de SARM se empleaban desinfectantes en la limpieza. Todos los SARM fueron resistentes a tetraciclina identificándose los genes tetK y tetM, el 80% fueron resistentes a eritromicina y clindamicina, y el 16% fueron únicamente resistentes a clindamicina. Se identificaron los genes ermC y vgaA en estos 2 fenotipos. Se identificó un único genotipo (PFGE-A) y ST398, siendo spa t011 (84%) y t1451 (16%). En todos los aislamientos se identificó SCCmec V y agrI, siendo estos pvl negativos. CONCLUSIONES: Se observó la asociación entre edad y colonización SARM. La limpieza adecuada podría modificar la colonización por SARM. Se detectaron resistencias a antibióticos empleados en humanos. Los médicos deberían conocer si los pacientes tienen contacto con animales de granja

Methicillin-resistant Staphylococcus aureus in swine housed indoors in Galicia, Spain.

INTRODUCTION: Livestock are known reservoirs of methicillin-resistant Staphylococcus aureus (MRSA) and this constitutes an important public health issue. The prevalence of nasal MRSA carriers in swine housed indoors in Galicia, Spain, was studied. METHODS: 197 samples from swine aged three, eight, 12, 16 and 24 weeks, and from adult pigs, were obtained from four farms. The cleaning procedures implemented to clean the barns and antimicrobial consumption were analyzed. Antimicrobial susceptibility and antimicrobial resistance genes were studied. PFGE, spa typing and MLST were used to classify the isolates. SCCmec, agr and pvl were analyzed. RESULTS: MRSA prevalence was 12.7%. Swine younger than 16 weeks had a higher colonization rate; 22.9% vs 3.5% (OR, 8.16; 95% CI, 2.47-29.79; p<0.01). The only farm found to be MRSA-free used disinfectants as part of its cleaning procedure. All MRSA were tetracycline-resistant (identifying the tetK and tetM genes), 80% were resistant to erythromycin and clindamycin and 16% were only clindamycin-resistant. The ermC and vgaA genes were identified in these two phenotypes. A single genotype (PFGE type A) and ST398 - spa t011 (84%) and t1451 (16%) were identified. SCCmec type V and agrI were identified in all isolates, and all were pvl-negative. CONCLUSION: A correlation between swine age and MRSA colonization was observed. Appropriate cleaning procedures could have an impact on MRSA colonization in farming. Resistance to antibiotics used in human health was identified. Clinicians should be aware if their patients have come into contact with farm animals.

Phenotypic and genetic characteristics of fluoroquinolone- and methicillin-resistant Staphylococcus aureus / Características fenotípicas y genéticas de Staphylococcus aureus resistente a meticilina y a fluoroquinolonas

INTRODUCTION: Fluoroquinolon:e resistance in methicillin-resistant Staphylococcus aureus (MRSA) has ncreased in recent years. The objective of this study was to characterise two MRSA populations, one susceptible to fluoroquinolones and other resistant identifying the clonal types and the differential characteristics of both MRSA populations. METHODS: Molecular typing using PFGE, MLST, spa and SSCmec was performed on 192 MRSA strains isolated from 2009 to 2011, 49 only oxacillin-resistant (OX-R) and 143 oxacillin and levofloxacin-resistant (OX-R-LEV-R). Mutations that conferred resistance to fluoroquinolones, hypermutable phenotypes and the presence of eight microbial surface components recognising adhesive matrix molecules (MSCRAMMs) were also studied. RESULTS: A statistically significant increase in the OX-R-LEV-R phenotype was observed (p < 0.05). The most common clone of the OX-R isolates was sequence type (ST) 8 (32.6%), followed by ST72 (26.5%) and ST5 (26.5%). In the OX-R-LEV-R phenotype, the ST5 clone was the most common (65.7%), followed by ST72 (15.4%), and ST125 (12.6%). All isolates except the ST398 clone carried the SCCmecIVc. Clones ST5, ST72, ST125, and ST30 had hypermutable phenotypes. The ST72 clone and the ST30 clone in the OX-R phenotype harboured the highest number of MSCRAMMs. CONCLUSION: ST5 and ST72 clones were the most frequent clones identified in OX-R-LEV-R phenotype. Both clones showed a hypermutable phenotype that favours their selection as the fluoroquinolone resistant clones. The genetic relationships identified indicate that OX-R-LEV-R clones have evolved from OX-R MRSA clones

INTRODUCCIÓN: La resistencia a fluoroquinolonas en Staphylococcus aureus resistente a meticilina (SARM) se ha incrementado en los últimos años. El objetivo de este estudio consistió en caracterizar 2 poblaciones de SARM, una sensible a fluoroquinolonas y otra resistente identificando los tipos clonales y las características diferenciales entre los mismos. MÉTODOS: En un total de 192 SARM aislados entre los años 2009-2011, 49 solo oxacilina resistentes (OX-R) y 143 oxacilina y levofloxacino resistentes (OX-R-LEV-R), se realizó el tipado molecular mediante PFGE, MLST, spa y SSCmec. Además se estudiaron las mutaciones que confieren resistencia a las fluoroquinolonas, los fenotipos hipermutadores y la presencia de 8 componentes de la superficie microbiana que reconocen adhesinas de la matriz extracelular. RESULTADOS: En el periodo de estudio se detectó un incremento estadísticamente significativo del fenotipo OX-R-LEV-R (p < 0,05). Entre los OX-R el clon ST8 (32,6%) fue el más frecuente seguido de los clones ST72 (26,5%) y ST5 (26,5%). Entre los aislados del fenotipo OX-R-LEV-R, el clon ST5 fue el más frecuente (65,7%), seguido de los clones ST72 (15,4%) y ST125 (12,6%). Todos los aislamientos, excepto el clon ST398, portaban el SCCmec-IVc. Los clones ST5, ST30, ST72 y ST125 presentaron un fenotipo hipermutador. Los clones ST72 y ST30 OX-R son los que poseen una mayor dotación de componentes de la superficie microbiana que reconocen adhesinas de la matriz extracelular. CONCLUSIÓN: Los clones ST5 y ST72 fueron los más frecuentes en el fenotipo OX-R-LEV-R. Ambos clones poseían un fenotipo hipermutador. La estrecha relación genética entre los clones OX-R y OX-R-LEV-R pertenecientes al mismo ST sugiere que estos últimos han evolucionado a partir de una población OX-R preexistente

Phenotypic and genetic characteristics of fluoroquinolone- and methicillin-resistant Staphylococcus aureus.

INTRODUCTION: Fluoroquinolone resistance in methicillin-resistant Staphylococcus aureus (MRSA) has increased in recent years. The objective of this study was to characterise two MRSA populations, one susceptible to fluoroquinolones and other resistant identifying the clonal types and the differential characteristics of both MRSA populations. METHODS: Molecular typing using PFGE, MLST, spa and SSCmec was performed on 192 MRSA strains isolated from 2009 to 2011, 49 only oxacillin-resistant (OX-R) and 143 oxacillin and levofloxacin-resistant (OX-R-LEV-R). Mutations that conferred resistance to fluoroquinolones, hypermutable phenotypes and the presence of eight microbial surface components recognising adhesive matrix molecules (MSCRAMMs) were also studied. RESULTS: A statistically significant increase in the OX-R-LEV-R phenotype was observed (p<0.05). The most common clone of the OX-R isolates was sequence type (ST) 8 (32.6%), followed by ST72 (26.5%) and ST5 (26.5%). In the OX-R-LEV-R phenotype, the ST5 clone was the most common (65.7%), followed by ST72 (15.4%), and ST125 (12.6%). All isolates except the ST398 clone carried the SCCmecIVc. Clones ST5, ST72, ST125, and ST30 had hypermutable phenotypes. The ST72 clone and the ST30 clone in the OX-R phenotype harboured the highest number of MSCRAMMs. CONCLUSION: ST5 and ST72 clones were the most frequent clones identified in OX-R-LEV-R phenotype. Both clones showed a hypermutable phenotype that favours their selection as the fluoroquinolone resistant clones. The genetic relationships identified indicate that OX-R-LEV-R clones have evolved from OX-R MRSA clones.

Celulitis por mordedura de gato: Bergeyella zoohelcum / Cat bite-induced cellulitis: Bergeyella zoohelcum

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