Typing and antimicrobial susceptibility of 134 Neisseria gonorrhoeae strains from Southern Spain / Tipado y sensibilidad a antimicrobianos de 134 cepas de Neisseria gonorrhoeae en el sur de España

Introduction: Last guidelines have recommended the introduction of dual antimicrobial therapy in order to avoid treatment failure. In the present report, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was performed. Material and methods: Gonococcal isolates were tested for susceptibility according to the recommendations of both CLSI and EUCAST. A total of 134 isolates were typed by the NG-MAST technique. Results: Seventy-two different N. gonorrhoeae types were found, and the most frequent types obtained were ST 1407, ST 14958, ST 7192, ST 13251 and ST 5405. If CLSI/EUCAST criteria were applied, a ST 9807 type was found nonsusceptible to ceftriaxone and cefixime (MIC 0.5 mg/L), and a ST 12800 type was found nonsusceptible only to cefixime (MIC 0.25 mg/L). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25 mg/L) and three isolates were resistant to ceftriaxone (MIC 0.19, 0.16 and 0.25 mg/L, respectively). The majority of strains were resistant to ciprofloxacin (68.6%), and all N. gonorrhoeae strains were susceptible to spectinomycin; 9.7% of isolates were resistant to azithromycin. Conclusions: Molecular typing may be a useful tool to predict antimicrobial resistance. High rates of resistance to penicillin, tetracycline and ciprofloxacin were found in this area. It is highly recommended to carry out antimicrobial susceptibility in all gonorrhoea cases and to identify treatment failures to verify emerging resistance

Introducción: Las últimas guías recomiendan la introducción de tratamiento antimicrobiano doble para evitar fallos de tratamiento. En esta publicación, se evaluó la sensibilidad a algunos antibióticos, y se realizó el tipado de las cepas de Neisseria gonorrhoeae. Material y métodos: La determinación de sensibilidad fue realizada según las recomendaciones tanto del CLSI como del (EUCAST). Un total de 134 cepas fueron tipadas mediante la técnica de NG-MAST. Resultados: Se encontraron 72 tipos diferentes de N. gonorrhoeae, siendo los más frecuentes el ST 1407, 14958, 7192, 13251 y 5405. Aplicando los criterios del CLSI/EUCAST, un tipo ST 9807 fue no sensible a ceftriaxona y cefixima (CMI 0,5 mg/L), y un tipo ST 12800 fue no sensible solo a cefixima (CMI 0,25 mg/L). Al aplicar solamente los puntos de corte de EUCAST, tres cepas fueron también resistentes a cefixima (CMI 0,25 mg/L) y tres lo fueron también a ceftriaxona (CMI 0,19, 0,16 y 0,25 mg/L, respectivamente). La mayoría de cepas fueron resistentes a ciprofloxacino (68,6%), y todas las cepas de N. gonorrhoeae fueron sensibles a espectinomicina; el 9,7% de aislamientos fueron resistentes a azitromicina. Conclusiones: El tipado molecular puede ser una herramienta útil para predecir resistencia a antimicrobianos. En esta área se encontraron altas tasas de resistencia a penicilina, tetraciclina y ciprofloxacino. Se recomienda encarecidamente realizar estudio de sensibilidad a antibióticos en todos los casos de gonorrea e identificar fallos de tratamiento para verificar la aparición de resistencias

Strategies for the successful implementation of viral laboratory automation.

It has been estimated that more than 70% of all medical activity is directly related to information providing analytical data. Substantial technological advances have taken place recently, which have allowed a previously unimagined number of analytical samples to be processed while offering high quality results. Concurrently, yet more new diagnostic determinations have been introduced - all of which has led to a significant increase in the prescription of analytical parameters. This increased workload has placed great pressure on the laboratory with respect to health costs. The present manager of the Clinical Laboratory (CL) has had to examine cost control as well as rationing - meaning that the CL's focus has not been strictly metrological, as if it were purely a system producing results, but instead has had to concentrate on its efficiency and efficacy. By applying re-engineering criteria, an emphasis has had to be placed on improved organisation and operating practice within the CL, focussing on the current criteria of the Integrated Management Areas where the technical and human resources are brought together. This re-engineering has been based on the concepts of consolidating and integrating the analytical platforms, while differentiating the production areas (CORE Laboratory) from the information areas. With these present concepts in mind, automation and virological treatment, along with serology in general, follow the same criteria as the rest of the operating methodology in the Clinical Laboratory.

Anemia ferropénica y síndrome constitucional / Ferropenic anemia and constitutional syndrome

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