[Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area]. / Características sociodemográficas y factores de riesgo asociados a las bacteriurias significativas en un área de salud del sudeste español.

OBJECTIVE: To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients. METHODS: Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set. RESULTS: A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19. CONCLUSIONS: The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas.

Adaptation of antibiotic treatment to clinical practice guidelines in patients aged ⩾65 years hospitalised due to community-acquired pneumonia.

Early, conforming antibiotic treatment in elderly patients hospitalised for community-acquired pneumonia (CAP) is a key factor in the prognosis and mortality. The objective was to examine whether empirical antibiotic treatment was conforming according to the Spanish Society of Pulmonology and Thoracic Surgery guidelines in these patients. Multicentre study in patients aged ⩾65 years hospitalised due to CAP in the 2013-14 and 2014-15 influenza seasons. We collected socio-demographic information, comorbidities, influenza/pneumococcal vaccination history and antibiotics administered using a questionnaire and medical records. Bivariate analyses and multilevel logistic regression were made. In total, 1857 hospitalised patients were included, 82 of whom required intensive care unit (ICU) admission. Treatment was conforming in 51.4% (95% confidence interval (CI) 49.1-53.8%) of patients without ICU admission and was associated with absence of renal failure without haemodialysis (odds ratio (OR) 1.49, 95% CI 1.15-1.95) and no cognitive dysfunction (OR 1.71, 95% CI 1.25-2.35), when the effect of the autonomous community was controlled for. In patients with ICU admission, treatment was conforming in 45.1% (95% CI 34.1-56.1%) of patients and was associated with the hospital visits in the last year (<3 vs. ⩾3, OR 2.70, 95% CI 1.03-7.12) and there was some evidence that this was associated with season. Although the reference guidelines are national, wide variability between autonomous communities was found. In patients hospitalised due to CAP, health services should guarantee the administration of antibiotics in a consensual manner that is conforming according to clinical practice guidelines.

[Demands and expectations of parents who refuse vaccinations and perspective of health professional on the refusal to vaccinate]. / Demandas y expectativas de padres y madres que rechazan la vacunación y perspectiva de los profesionales sanitarios sobre la negativa a vacunar.

OBJECTIVES: To examine the opinions, beliefs and attitudes about vaccination, of parents who decide not to vaccinate their children. To determine the opinions and attitudes of the health professionals on the behaviour towards childhood vaccination. METHOD: Qualitative research based on semi-structured interviews and focal groups in Granada, Spain, including parents who chose to not vaccinate their children, and healthcare professionals who can provide a technical point of view. An analysis was made of the semantic content, and answers were categorized in thematic units. RESULTS: The parents argued on the benefit of suffering vaccine-preventable diseases in a natural way, without non-natural, aggressive or toxic products. Vaccination was considered unnecessary, if given adequate hygienic-sanitary conditions, effectiveness unproven and more dangerous than the diseases they prevent, especially the polyvalent vaccines. They believed that vaccination programs are moved by biased studies and interests other than prevention. Health care professionals believe that they had fears without scientific basis, which requires improving information systems. CONCLUSIONS: Non-vaccinators are unaware of the benefit/risk ratio between the vaccination and the individual risk for preventable diseases, and ask for informed consent. Health care professionals believe that non-vaccinators' arguments are not correctly contrasted and expose the existence of failures in actual vaccination coverage and information registration systems. It was suggested to centralize registers and compare them in schools, working with local leaders and reporting regularly on the status of vaccine-preventable diseases.

[Opinion of healthcare professionals on patient safety in a primary level hospital]. / Opinión de los profesionales sanitarios sobre seguridad del paciente en un hospital de primer nivel.

OBJECTIVE: To identify the patient safety (PS) culture perceived by health professionals of the Hospital Universitario Virgen de las Nieves (HUVN) in Granada. METHODOLOGY: A descriptive cross-sectional study of professionals working in HUVN using the Spanish version of the questionnaire Hospital Survey On Patient Safety Culture (AHRQ), in July-August 2008. The sample size was estimated as 476 surveys (included 60% losses). RESULTS: The response rate was 62.8% (299 questionnaires). In the previous 12 months, 90.2% of professionals had not notified any adverse event (AE). The average perception of PS was 6.57 ± 1.82 (scale 0-10). Teamwork in the unit for PS was the best rated dimension (66.9%). There was a positive correlation (c. Pearson) between the perception of PS and the years that professionals had worked in specialisation (0.21), hospital (0.197) and unit (0.138), respectively (all, p < 0.05). According to category, the physicians have reported an AE with a likelihood 32.26 times greater than the assistants and technicians (p < 0.05). The PS perception dimension was viewed favourably by 34.1%. The management support (3.7%) and staffing (9%) were the main areas for improvement. CONCLUSIONS: The perception of PS at HUVN is good, even if the communication of errors is poor. The main area for improvement is a non-punitive communication of errors. It is advisable to promote a campaign to raise public awareness of the problem, to perform training programs for professionals and to implement systems for recording adverse events.

Desinfección de superficies en el hospital / Disinfection of surface in the Hospital

Este artículo, revis el uso de desinfectantes para la desinfcción de suelos y otras superficies de amterial no crítico en el hospital. Basados en la bilbografia, hemos evaluado la necesidad de la desinfección de las superficies ambientales hospitalaias. De acuerdo con los conocimientos científicos actuaes y teniendo en cuenta la compleja naturaleza de los factores de riesgo de la infección nosocomial, los smilares porcntajes de nfección cuando se realiza limpieza o desinfección del suelo y la peligrosidad de los desnfectantes para el personal sanitario, concluimos que la desinfeccin es razonable para desinfectar el suelo y conveniente para otras superficies ambientaes (mesitas de noche, cuñas, aparatos de tensión…) (AU)

Review of the use of disifectants on the floor and other surfaces of non-critical material in the hospital (AU)

[Infection by the human immunodeficiency virus among the Spanish population (I). Qualitative meta-analysis]. / Infección por el virus de la inmunodeficiencia humana en la población española (I). Metaanálisis cualitativo.

A meta-analysis of the original papers on human immunodeficiency virus (HIV) published in Spain was performed to better know the characteristics of HIV infection in Spain. Between 1985 and 1989, 67 investigations fulfilled the inclusion criteria. They were evaluated by means of a quantified questionnaire. The mean quality of the investigations was 44.65 +/- 1.5%. A bias in the selection was highly probable in 80% of the studies, whereas a bias in information and in confusion was less frequent (35.8% and 77.6%, respectively). The investigations of more quality were those carried out recently at the University in collaboration with other Institutions and with participation of sanitary personnel published in microbiologic journals.

[Infection by the human immunodeficiency virus in the Spanish population (II). A meta-analysis of the time and geographic trends]. / Infección por el virus de la inmunodeficiencia humana en la población española (II). Metaanálisis de las tendencias temporales y geográficas.

The aim of this research was to study the prevalence of infection by the human immunodeficiency virus (HIV) among the Spanish population. Due to the lack of available data we have applied meta-analysis techniques. We analyzed 67 original publications on this field appeared between 1985 and 1989. The prevalence of the illness has progressively increased among the risk groups (ADVP, homosexuals, prostitutes, heterosexual transmission) but not in hemophilic patients. The geographical distribution showed statistically significant differences being Barcelona as the province with the area of highest prevalence of the infection in ADVP and homosexuals.