Monitoring System of the Mar Menor Coastal Lagoon (Spain) and Its Watershed Basin Using the Integration of Massive Heterogeneous Data.

The tool created aims at the environmental monitoring of the Mar Menor coastal lagoon (Spain) and the monitoring of the land use of its watershed. It integrates heterogeneous data sources ranging from ecological data obtained from a multiparametric oceanographic sonde to agro-meteorological data from IMIDA's network of stations or hydrological data from the SAIH network as multispectral satellite images from Sentinel and Landsat space missions. The system is based on free and open source software and has been designed to guarantee maximum levels of flexibility and scalability and minimum coupling so that the incorporation of new components does not affect the existing ones. The platform is designed to handle a data volume of more than 12 million records, experiencing exponential growth in the last six months. The tool allows the transformation of a large volume of data into information, offering them through microservices with optimal response times. As practical applications, the platform created allows us to know the ecological state of the Mar Menor with a very high level of detail, both at biophysical and nutrient levels, being able to detect periods of oxygen deficit and delimit the affected area. In addition, it facilitates the detailed monitoring of the cultivated areas of the watershed, detecting the agricultural use and crop cycles at the plot level. It also makes it possible to calculate the amount of water precipitated on the watershed and to monitor the runoff produced and the amount of water entering the Mar Menor in extreme events. The information is offered in different ways depending on the user profile, offering a very high level of detail for research or data analysis profiles, concrete and direct information to support decision-making for users with managerial profiles and validated and concise information for citizens. It is an integrated and distributed system that will provide data and services for the Mar Menor Observatory.

Neumonía por Chryseobacterium indologenes asociada a ventilación mecánica / Ventilator-associated pneumonia by Chryseobacterium indologenes

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[Empirical antimicrobial therapy in ICU admitted patients. Influence of microbiological confirmation on the length of treatment]. / Influencia de la confirmación microbiológica en la duración y adaptación del tratamiento antimicrobiano empírico de los pacientes ingresados en UCI.

Introduction. Most patients admitted to the Intensive Care Units (ICU) receive antimicrobial treatment. A proper therapeutic strategy may be useful in decreasing inappropriate empirical antibiotic treatments. When the infection is not microbiologically confirmed, the antimicrobial streamlining may be difficult. Nevertheless, there is scant information about the influence of the microbiological confirmation of the infections on empirical antimicrobial treatment duration. Method. Post-hoc analysis of prospective data (ENVIN-UCI register) and observational study of patients admitted (> 24 hours) in a medico-surgical ICU, through the three-months annual surveillance interval for a period of ten years, receiving antimicrobial treatment for treating an infection. Demographic, infection and microbiological data were collected as well as empirical antimicrobial treatment and causes of adaptation. The main goal was to establish the influence of microbiological confirmation on empirical antimicrobial treatment duration. Results. During the study period 1,526 patients were included, 1,260 infections were diagnosed and an empirical antibiotic treatment was started in 1,754 cases. Infections were microbiologically confirmed in 1,073 (62.2%) of the empirical antibiotic treatment. In 593 (55.3%) cases, the antimicrobial treatment was considered appropriate. The main cause of treatment adaptation in the microbiologically confirmed infections was streamlining (39%). The microbiological confirmation of the infection was not associated with significantly shorter empirical antibiotic treatments (6.6 ± 5.2 VS. 6.8 ± 4.5 days). Conclusion. The microbiological confirmation of infections in patients admitted to UCI was associated with a higher reduction of antimicrobial spectrum, although had no effect on the length of empirical antimicrobial therapy.

Influencia de la confirmación microbiológica en la duración y adaptación del tratamiento antimicrobiano empírico de los pacientes ingresados en UCI / Empirical antimicrobial therapy in ICU admitted patients. Influence of microbiological confirmation on the length of treatment

Introducción. Un elevado porcentaje de pacientes que ingresan en las Unidades de Cuidados intensivos (UCI) reciben tratamiento antimicrobiano. Inicialmente, éste ha de ser empírico, en espera de la confirmación microbiológica. Sin embargo, la adaptación y la duración del tratamiento empírico inicial son dificultosas en los casos en los que no se existe confirmación microbiológica de la infección. Además, existe escasa información sobre la influencia de la confirmación microbiológica en la duración y adaptación del tratamiento empírico. Método. Estudio post-hoc de datos prospectivos (registro ENVIN-UCI), observacional de pacientes ingresados (> 24 horas), en una UCI médico-quirúrgica durante los cortes de 3 meses anuales de 2001 a 2011, y que recibieron tratamiento antimicrobiano para el tratamiento de una infección. Se recogieron datos demográficos, de las infecciones, de la microbiología, del tratamiento antimicrobiano empírico y de las causas de adaptación del mismo, con el objetivo de determinar la influencia de la información microbiológica en la duración y adaptación del tratamiento empírico inicial. Resultados. Durante el periodo de estudio se incluyeron 1.516 pacientes y 1.260 infecciones que condicionaron 1.754 indicaciones de tratamiento empírico. En 1.073 (62,2%) de las indicaciones realizadas como tratamiento empírico se obtuvo confirmación microbiológica de la infección. En 593 (55,3%) casos los antibióticos prescritos se consideraron adecuados. La principal causa de adaptación del tratamiento en las infecciones con confirmación microbiológica fue la reducción de espectro (39%). La confirmación microbiológica no se asoció a diferencias significativas en la duración del tratamiento antimicrobiano en su indicación empírica (6,6 ± 5,2 vs. 6,8 ± 4,5 días). Conclusión. La confirmación microbiológica de las infecciones en pacientes ingresados en UCI permitió la reducción del espectro aunque no modificó de forma significativa la duración del tratamiento antimicrobiano en las indicaciones realizadas como tratamiento empírico (AU)

Introduction. Most patients admitted to the Intensive Care Units (ICU) receive antimicrobial treatment. A proper therapeutic strategy may be useful in decreasing inappropriate empirical antibiotic treatments. When the infection is not microbiologically confirmed, the antimicrobial streamlining may be difficult. Nevertheless, there is scant information about the influence of the microbiological confirmation of the infections on empirical antimicrobial treatment duration. Method. Post-hoc analysis of prospective data (ENVIN-UCI register) and observational study of patients admitted (> 24 hours) in a medico-surgical ICU, through the three-months annual surveillance interval for a period of ten years, receiving antimicrobial treatment for treating an infection. Demographic, infection and microbiological data were collected as well as empirical antimicrobial treatment and causes of adaptation. The main goal was to establish the influence of microbiological confirmation on empirical antimicrobial treatment duration. Results. During the study period 1,526 patients were included, 1,260 infections were diagnosed and an empirical antibiotic treatment was started in 1,754 cases. Infections were microbiologically confirmed in 1,073 (62.2%) of the empirical antibiotic treatment. In 593 (55.3%) cases, the antimicrobial treatment was considered appropriate. The main cause of treatment adaptation in the microbiologically confirmed infections was streamlining (39%). The microbiological confirmation of the infection was not associated with significantly shorter empirical antibiotic treatments (6.6 ± 5.2 VS. 6.8 ± 4.5 days). Conclusion. The microbiological confirmation of infections in patients admitted to UCI was associated with a higher reduction of antimicrobial spectrum, although had no effect on the length of empirical antimicrobial therapy (AU)