[Social and economic impact of chicken pox vaccine at 15 months of age. Castile and Leon, Spain, 2004]. / Impacto social y económico de la vacunación frente a la varicela a los 15 meses de edad en Castilla y León en 2004.

BACKGROUND: Chicken pox is a mainly childhood contagious disease caused by the Varicella Zoster Virus which gives rise to major healthcare and social costs. In 2005, Castile and Leon added chicken pox vaccine injections to its childhood vaccination schedule for eleven year-olds subject to coming down with this disease. This strategy does not modify the major mobility generated thereby at younger ages. This study is aimed at evaluating the profitability of systematic vaccination for chicken pox in infants 15 months of age in Castile and Leon. METHODS: An economic cost-benefit evaluation has been set out by jeans of a decision-making tree. A fictitious cohort of 100,000 children in Castile and Leon having reached 15 months of age in 2004 is studied, to whom the chicken pox vaccine would be administered in conjunction with the mumps, measles, rubella vaccines. This study is approached from the social standpoint. The time horizon selected was that of up until the study cohort was to reach 15 years of age, applying a 3% discount rate. A sensitivity analysis was made for evaluating the uncertainty of some variables... RESULTS: The cost-benefit ratio of adding this vaccine to the childhood vaccination schedule amounts to 1.23. CONCLUSIONS: From the social standpoint, administering chicken pox vaccine in conjunction with the mumps, measles, rubella vaccines show itself to be profitable. The profitability is modified both if a second dose of vaccine is added as well as if only the direct healthcare costs are analyzed.

Impacto social y económico de la vacunación frente a la varicela a los 15 meses de edad en Castilla y León en 2004 / Social and economic impact of chickem pox vaccine at 15 months of age. Castile and Leon, Spain, 2004

Fundamento: La varicela es una enfermedad infecciosa fundamentalmente infantil producida por el virus Herpes Varicela Zoster que produce importantes costes sanitarios y sociales. En 2005 Castilla y León introdujo en su calendario de vacunación infantil la vacuna de la varicela a los niños de once años susceptibles de padecerla. Dicha estrategia no modifica la importante morbilidad que genera en edades inferiores. El objetivo de este trabajo es valorar la rentabilidad de la vacunación sistemática frente a la varicela a los niños de 15 meses de edad en Castilla y León. Métodos: Se ha planteado una evaluación económica de coste-beneficio a través de un árbol de decisión. Se estudia una cohorte ficticia de 100.000 niños castellano-leoneses que en el año 2004 cumplieran 15 meses, a los que se les administraría junto a la vacuna triple vírica la de la varicela. El estudio se plantea desde la perspectiva social. El horizonte temporal elegido ha sido hasta que la cohorte de estudio cumpliera 15 años, aplicando una tasa de descuento del 3%. Para valorar la incertidumbre de algunas variables se ha desarrollado un análisis de sensibilidad. Resultados: El coste-beneficio de la introducción de la vacuna en el calendario de vacunación infantil se cifra en 1,23. Conclusiones: Desde la perspectiva social la estrategia de vacunación frente a la varicela, junto a la triple vírica se muestra rentable. La rentabilidad se ve modificada tanto si se introduce una segunda dosis de vacuna como si se analizan sólo los costes directos sanitarios (AU)

Background: Chicken pox is a mainly childhood contagious disease caused by the Varicella Zoster Virus which gives rise to major healthcare and social costs. In 2005, Castile and Leon added chicken pox vaccine injections to its childhood vaccination schedule for eleven year-olds subject to coming down with this disease. This strategy does not modify the major mobility generated thereby at younger ages. This study is aimed at evaluating the profitability of systematic vaccination for chicken pox in infants 15 months of age in Castile and Leon. Methods: An economic cost-benefit evaluation has been set out by jeans of a decision-making tree. A fictitious cohort of 100,000 children in Castile and Leon having reached 15 months of age in 2004 is studied, to whom the chicken pox vaccine would be administered in conjunction with the mumps, measles, rubella vaccines. This study is approached from the social standpoint. The time horizon selected was that of up until the study cohort was to reach 15 years of age, applying a 3% discount rate. A sensitivity analysis was made for evaluating the uncertainty of some variables... Results: The cost-benefit ratio of adding this vaccine to the childhood vaccination schedule amounts to 1.23. Conclusions: From the social standpoint, administering chicken pox vaccine in conjunction with the mumps, measles, rubella vaccines show itself to be profitable. The profitability is modified both if a second dose of vaccine is added as well as if only the direct healthcare costs are analyzed (AU)

[Epidemiological study of Staphylococcus aureus nasal carriage in senior centers]. / Estudio epidemiológico de portadores nasales de Staphylococcus aureus en centros de mayores.

The observation of an increasing number of methicillin-resistant Staphylococcus aureus (MRSA) isolates in some population groups prompted us to study the risk factors and the epidemiological profile of S. aureus nasal carriage in healthy adults 65 years of age and older residing in the province of Segovia. Attention was particularly focused on the possibility that some of the infections were community-acquired. We conducted a prospective and observational study of people who usually visited senior citizen centers in the province of Segovia (Carbonero, Cuéllar, Cantalejo) and its capital. The analysis period took place between January and May 2003. Infections were classified as community-acquired, hospital-acquired or health-care associated. Isolates of methicillin-resistant (MRSA) and methicillin-susceptible S. aureus (MSSA) were studied by pulsed-field gel electrophoresis (PFGE). There were 34 (19.5%) The prevalence of nasal carriage of S. aureus was 19.5% and that for MRSA was 1.1%. Female sex was significantly associated with the carriage state. All S. aureus isolates were mupirocin-susceptible. 100% susceptibility and specificity was obtained through latex agglutination testing. The molecular study showed that the transmission for MRSA was monoclonal and that for MSSA was more policlonal. The results presented here form the basis for similar studies in other Spanish senior citizen centers and provide evidence that MRSA strains are beginning to circulate and are becoming significantly established within the community, thus highlighting the need for implementing control strategies to prevent dissemination.

Estudio epidemiológico de portadores nasales de Staphylococcus aureus en centros de mayores / Epidemiological study of Staphylococcus aureus nasal carriage in senior people centers

El aparente incremento en el número de aislamientos de Staphylococcus aureus resistentes a la meticilina (SARM) de origen comunitario en algunos grupos de población nos llevó a estudiar los factores de riesgo y el perfil epidemiológico de los portadores nasales de S. aureus de edad ≥ 65 años, sanos y autónomos, de la comunidad de Segovia. Se estudió con especial atención su posible origen comunitario. Se realizó un estudio prospectivo y observacional con personas que acudían habitualmente a los Centros de Mayores pertenecientes a Segovia capital y provincia (Carbonero, Cuéllar, Cantalejo). El periodo de estudio fue de enero a mayo de 2003. Se distinguió entre adquisición intrahospitalaria y extrahospitalaria (adquirida en la comunidad). Los aislamientos tanto de SARM como de SAMS (S. aureus sensible a la meticilina) se estudiaron mediante electroforesis en campo pulsante (ECP). La prevalencia de portadores nasales de S. aureus fue del 19,5% y de SARM del 1,1%. El sexo femenino se asoció de manera significativa con el estado de portador. El 100% de los aislamientos de S. aureus fueron sensibles a la mupirocina. Se obtuvo un 100% de sensibilidad y especificidad con la prueba de aglutinación en látex sobre soporte. El estudio molecular de las cepas de SARM mostró que la transmisión fue monoclonal; sin embargo, en el caso de los SAMS la transmisión resultó ser más policlonal. Nuestros resultados sientan las bases para emprender estudios similares en otros Centros de Mayores españoles, y proporcionan pruebas acerca de la posibilidad de que empiecen a circular cepas de SARM y se establezcan de forma importante en la comunidad, señalando así la necesidad de establecer estrategias de control para prevenir tal diseminación

The observation of an increasing number of methicillin-resistant Staphylococcus aureus (MRSA) isolates in some population groups prompted us to study the risk factors and the epidemiological profile of S. aureus nasal carriage in healthy adults 65 years of age and older residing in the province of Segovia. Attention was particularly focused on the possibility that some of the infections were community-acquired. We conducted a prospective and observational study of people who usually visited senior citizen centers in the province of Segovia (Carbonero, Cuéllar, Cantalejo) and its capital. The analysis period took place between January and May 2003. Infections were classified as community-acquired, hospital-acquired or health-care associated. Isolates of methicillin-resistant (MRSA) and methicillin-susceptible S. aureus (MSSA) were studied by pulsed-field gel electrophoresis (PFGE). There were 34 (19.5%) The prevalence of nasal carriage of S. aureus was 19.5% and that for MRSA was 1.1%. Female sex was significantly associated with the carriage state. All S. aureus isolates were mupirocin-susceptible. 100% susceptibility and specificity was obtained through latex agglutination testing. The molecular study showed that the transmission for MRSA was monoclonal and that for MSSA was more policlonal. The results presented here form the basis for similar studies in other Spanish senior citizen centers and provide evidence that MRSA strains are beginning to circulate and are becoming significantly established within the community, thus highlighting the need for implementing control strategies to prevent dissemination

[Analysis of antibiotic consumption in the pediatric population of Castile and León (Spain) from 2001 to 2005]. / Análisis del consumo de antibióticos en la población pediátrica de Castilla y León durante el período 2001 a 2005.

OBJECTIVES: To analyze trends in antibiotic use among the pediatric population of Castile and León from 2001 to 2005. MATERIAL AND METHODS: The antibiotics prescribed to the pediatric population in primary care were processed using the CONCYLIA database. The technical unit of measurement was the defined daily dose (DDD) and the comparative indicator used was the DDD per 1000 inhabitants/day (DID). RESULTS: Overall consumption was high (21.21 DID). Throughout the 5 years of the study we observed substantial variations, especially in 2005, the year in which consumption was highest (25.05 DID). The therapeutic subgroups most frequently prescribed were wide-spectrum penicillins (8.08 DID) and penicillins associated with beta-lactamase inhibitors (7.29 DID), followed by cephalosporins (2.81 DHD) and macrolides (2.52 DHD). The percentage of wide-spectrum penicillin prescription was higher than that of penicillins associated with beta-lactamase inhibitors between 2001 and 2002. These percentages were similar in 2003, and the percentage of wide-spectrum penicillin prescription was lower than that of penicillins associated with beta-lactamase inhibitors in the last 2 years of the study. CONCLUSIONS: Marked differences in consumption were observed over the study period. Changes in patterns of use were found, with an increase in the use of penicillins associated with beta-lactamase inhibitors in the last 2 years of the study.

Actualización en Medicina de Familia. Sistemas de Información Microbiológica: utilidad en la vigilancia de las enfermedades infecciosas / Up-Date in Family Medicine. The usefulness of Microbiological Information Systems in the surveillance of infectious diseases

Las enfermedades infecciosas engloban las ocasionadas por bacterias, virus, hongos y parásitos, al tiempo que presentan un ámbito absolutamente transversal en el que interesan a gran parte de las especialidades médicas y quirúrgicas. En nuestro país la realidad que configuran los diferentes sistemas de salud a nivel público se apoya en la actividad de los laboratorios de Microbiología, si bien se desdibujan en ocasiones algunas herramientas de utilidad en la vigilancia de las mismas. Parece necesario alinear a los médicos de Atención Primaria para que actúen como agentes en la cultura del conocimiento, al tiempo que se deben establecer mecanismos prácticos para integrarlos en sistemas de decisión y control en este ámbito de la patología

Infectious diseases can be caused by bacteria, viruses, fungi, or parasites. Infectious diseases cut across all different fields of medicine and are thus of interest to the vast majority of medical and surgical specialties. In Spain, the different public health systems receive support from Microbiology laboratories; however, occasionally, some useful tools for the surveillance of infectious diseases are not clearly employed. It seems necessary to train primary care physicians to act as agents of the culture of knowledge and to establish practical mechanisms to integrate them into decision-making circuits in this area

Gastroenteritis por rotavirus: análisis de la carga de enfermedad / Rotavirus gastroenteritis: analysis of disease burden

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Etiología viral de las gastroenteritis pediátricas. Análisis de una serie temporal de 20 años / Viral etiology of pediatric gastroenteritis. A 20-year time-series analysis

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Calidad del aire en ambientes hospitalarios. Nuevas tecnologías / Air quality in hospital environments. New technologies

En la actualidad existe interés en identificar y predecir los distintos contaminantes en el aire interior para reducir su influencia en la salud de sus ocupantes. Las características de los hospitales crean un ambiente en el que muchos gérmenes encuentran un medio adecuado para desarrollarse. Los sistemas de filtración que logran la eliminación de microorganismos se presentan como alternativa a los distintos instrumentos de descontaminación aérea. Así, el objetivo de este trabajo es valorar la efectividad de descontaminación bacteriana y fúngica del sistema de filtración Electromedia en una sala hospitalaria. Es un estudio de epidemiología ambiental cuasiexperimental antes-después. En los resultados se señala que entre los dos períodos de estudio, con y sin sistema de filtración, se han observado diferencias estadísticamente significativas del crecimiento de bacterias (diferencia de 1597,46 m3) y de hongos (6,21/m3). El modelo de regresión lineal multivariante ajustado por humedad relativa y número de personas en la sala muestra una reducción significativa del crecimiento de microorganismos. Se concluye objetivando que el sistema de filtración Electromedia reduce de forma significativa el crecimiento tanto de las bacterias como de los hongos, y se presenta como método efectivo para el control de las cargas microbianas de ambientes interiores hospitalarios

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