[Distribution of patterns of sensitivity and associated phenotypes of resistance in nosocomial and community acquired Escherichia coli during 2005]. / Distribución de los patrones de sensibilidad de Escherichia coli intrahospitalario y extrahospitalario y los fenotipos de resistencia asociados durante el año 2005.

INTRODUCTION: The increase of resistances to Escherichia coli over recent years has made it necessary to know the patterns of sensitivity in a certain area in order to be able to orient adequate empirical treatment with this knowledge. METHOD: Prospective longitudinal study using E. coli isolations obtained during year 2005 in the University Hospital Virgen de la Victoria was performed. Sensitivity identification and study were made according to standardized laboratory protocols. RESULTS: A total of 2,612 strains of E. coli were isolated from 2,098 patients with an average age of 52 years who had urinary infection as the most frequent sign. E. coli sensitivity was: ampicillin (AMP) (35.4%), ciprofloxacin (QUIN) (67.3 %), trimethoprim-sulfametoxazole (SXT) (63.4 %), phosphomycin (97.2 %) and amoxicillin-clavulanic acid (89%). The percentage of E. coli extended-spectrum beta-lactamase (ESBL) producers was 8.2%. In general, nosocomial isolations were more resistant, this difference being significant for third generation cephalosporins, gentamicin and piperacillin/tazobactam (p < 0.005). Resistance in men was greater than in women and also in adults compared to children, with significant differences to ciprofloxacin and gentamicin (p < 0.005). A total of 27.5% of the strains were multiresistant, the most frequent phenotype being the one to AMP/SXT (11.9%), followed by AMP/QUIN/SXT (10.9%). CONCLUSIONS: Resistances to E. coli are very elevated in out setting, above all, in quinolones, that even appear in children, so that up to half of the multiresistant phenotypes present resistance to this family. Furthermore, during the last year, an increase in the isolations of E. coli ESBL producers has been observed.

Mesoporous silica based MCM-41 as solid-phase extraction sorbent combined with micro-liquid chromatography-quadrupole-mass spectrometry for the analysis of pharmaceuticals in waters.

This paper reports the first application of the silica based mesoporous material MCM-41 as a sorbent in solid phase extraction, to pre-concentrate pharmaceuticals of very different polarity (atenolol, nadolol, pindolol, timolol, bisoprolol, metoprolol, betaxolol, ketoprofen, naproxen, ibuprofen, diclofenac, tolfenamic acid, flufenamic acid and meclofenamic acid) in surface waters. The analytes were extracted from 100mL water samples at pH 2.0 (containing 10(-3) mol/L of sodium chloride) by passing the solution through a cartridge filled with 100 mg of MCM-41. Following elution, the pharmaceuticals were determined by micro-liquid chromatography and triple quadrupole-mass spectrometry. Two selected reaction monitoring transitions were monitored per compound, the most intense one being used for quantification and the second one for confirmation. Matrix effect was found in real waters for most analytes and was overcome using the standard addition method, which compared favorably with the matrix matched calibration method. The detection limits in solvent (acetonitrile:water 10:90, v/v) ranged from 0.01 to 1.48 µg/L and in real water extracts from 0.10 to 3.85 µg/L (0.001-0.0385 µg/L in the water samples). The quantitation limits in solvent were in the range 0.02-4.93 µg/L, whereas in real water extracts were between 0.45 and 10.00 µg/L (0.0045 and 0.1000 µg/L in the water samples). When ultrapure water samples were spiked at two concentration levels of each pharmaceutical (0.1 and 0.2 µg/L) and quantified using solvent based calibration graphs, recoveries were near 100%. However, recoveries for most pharmaceuticals were comparable or better than de described above, when river water samples (spiked at the same concentration levels) were quantified by the standard addition method and slightly worse using the matrix matched calibration method. Five real samples (two rivers, one dam and two fountain water samples) were analyzed by the developed method, atenolol, timolol, betaxolol, nadolol and diclofenac being found in some of them, at levels higher than their quantitation limits.

Adsorption of chloridazon from aqueous solution on heat and acid treated sepiolites.

The adsorption of chloridazon on heat treated sepiolite samples at 110 degrees C (S-110), 200 degrees C (S-200), 400 degrees C (S-400), 600 degrees C (S-600) and acid treated samples with H2SO4 solutions of two different concentrations (0.25 and 1.0M) (S-0.25 and S-1.0, respectively) from pure water at 25 degrees C has been studied by using batch experiments. In addition, column experiments were carried out with the natural (S-110) and 600 degrees C (S-600) heat treated samples, using a 10.30 mg l-1 aqueous solution of chloridazon. The adsorption experimental data points have been fitted to the Freundlich equation in order to calculate the adsorption capacities (Kf) of the samples; Kf values range from 2.89 mg kg-1 for the S-1.0 sample up to 164 mg kg-1 for the S-600 sample; so, the heat treatment given to the sepiolite greatly increases its adsorption capacity for the herbicide chloridazon whereas the acid treatment produces a clear decrease in the amount of chloridazon adsorbed. The removal efficiency (R) has also been calculated; R values ranging from 5.08% for S-1.0 up to 60.9% for S-600. The batch experiments showed that the strongest heat treatment is more effective than the natural and acid treated sepiolite in relation to adsorption of chloridazon. The column experiments also showed that 600 degrees C heat treated sepiolite might be reasonably used in removing chloridazon from water. Thus, as this type of clay is relatively plentiful, these activated samples might be reasonably used in order to remove chloridazon from water.

Effects of ionic strength and temperature on adsorption of atrazine by a heat treated kerolite.

The adsorption of 6-chloro-N2-ethyl-N4-isopropyl-1,3,5-triazine-2,4-diamine (atrazine) on a heat treated kerolite sample at 600 degrees C (K-600) from pure water solution at 10 degrees C, 25 degrees C and 40 degrees C has been studied. The influence of the presence of 0.1 M KCl in the medium was also investigated for a better understanding of variables affecting the adsorption of this herbicide. The experimental adsorption data points were fitted to the Langmuir equation in order to calculate the adsorption capacities (Xm) of the samples; Xm values range from 2.3x10(3) mg kg-1 (pure water solution at 40 degrees C) up to 15.2x10(3) mg kg-1 (0.1 M KCl solution at 10 degrees C). The adsorption data were also fitted to the Freundlich equation in order to clarify the influence of the presence of 0.1 M KCl on atrazine adsorption. The parameter K10 obtained from this equation (adsorption capacity at an equilibrium solution concentration of atrazine equal to 10 mg l-1) shows clearly that the presence of 0.1 M KCl in the medium tends to increase the adsorption of atrazine in the range of temperature studied. The adsorption experiment also showed that the lower temperature, the more effective the adsorption of atrazine from both, pure water and 0.1 M KCl solutions. The values of the removal efficiency (R) obtained ranged from 39% at 40 degrees C (pure water solution) up to 93% at 10 degrees C (0.1 M KCl solution).

Effects of dissolved organic carbon on sorption of 3,4-dichloroaniline and 4-bromoaniline in a calcareous soil.

To evaluate the effects of dissolved organic carbon on sorption of 3,4-dichloroaniline (3,4-DCA) and 4-bromoaniline (4-BA) on soils, batch sorption experiments were carried out. The soil used was a typical calcareous soil from south-eastern Spain. Two different types of dissolved organic carbon were used, that is, dissolved organic carbon extracts from a commercial peat (DOC-PE) and high-purity tannic acid (DOC-TA). The experiments were carried out in a 0.01 M CaCl2 aqueous medium at 25 degrees C. The results obtained from the sorption experiments show that the presence of both DOC-PE and DOC-TA, over a concentration range of 15-100 mg l-1, produced in all cases, an increase in the amount of 3,4-DCA and 4-BA adsorbed on the soil studied.

Sorption and leaching of atrazine and MCPA in natural and peat-amended calcareous soils from Spain.

The sorption and leaching of atrazine and MCPA (0.02 M CaCl(2) aqueous solution at 25 degrees C) by a calcareous soil from Southeastern Spain, after organic carbon (OC) amendment with a commercial peat (from 0.18% to 4.61% OC), were studied in batch and soil column experiments. Adsorption capacity (K(f)) values, obtained by fitting the experimental data to the Freundlich equation, ranged from 0.24 mg kg(-)(1) for MCPA sorption on the original soil to 5.47 mg kg(-)(1) for atrazine sorption on the peat-amended soil containing 4.61% OC. The breakthrough curves obtained from the step-function soil column experiments indicated that the amount of herbicide adsorbed ranged from 17.5 mg kg(-)(1) for MCPA in the original soil to 331 mg kg(-)(1) for atrazine in the peat-amended soil containing 1.67% OC. The results obtained from the pulse experiments indicate that the mobility of MCPA is much greater than that corresponding to atrazine.

Papillary carcinoma of the thyroid with mucoepidermoid differentiation.

A case of papillary carcinoma of the thyroid with mucoepidermoid differentiation is reported. There have been different hypotheses of the histogenesis of this tumor, one of which attributes the origin of the tumor to the ultimobranchial body, mainly because of the presence of neuroendocrine markers. In our case, no neuroendocrine immunohistochemical markers were demonstrated, but a progressive transition between follicular cells and mucinous cells with gradual loss of thyroglobulin immunoreactivity and acquisition of polyclonal carcinoembryonic antigen reactivity was noted. Therefore, we propose that mucoepidermoid carcinoma may be a simple metaplastic transformation of a papillary carcinoma, because the thyroid glandular epithelium, which is of endodermal origin, is capable of differentiating easily into squamous, mucus-secreting, or even polypeptide-secreting epithelium.

Adsorption of atrazine from aqueous solution on heat treated kerolites.

The adsorption of 6-chloro-N(2)-ethyl-N(4)-isopropyl-1,3,5-triazine-2,4-diamine (atrazine) on heat treated kerolite samples at 110 degrees C (K-110), 200 degrees C (K-200), 400 degrees C (K-400) and 600 degrees C (K-600) from aqueous solution at 25 degrees C has been studied. The evolution of surface properties of kerolite samples such as specific surface area and porosity after heat treatment was analysed. The clays were characterised by using usual techniques: FTIR spectroscopy, XRD diffraction, TG and DTG analysis, surface analysis and Hg porosimetry. The adsorption experimental data points have been fitted to the Freundlich equation in order to calculate the adsorption capacities (K(f)) of the samples; K(f) values range from 468 mgkg(-1) for the K-110 sample up to 2291 mgkg(-1) for the K-600 sample. The values obtained for the removal efficiency (R), (percentage of pesticide removed), ranged from 48% for K-110 up to 78% for K-600. The adsorption experiments showed that the stronger heat treatment, the most effective adsorption of atrazine, so, as this type of clay is relatively plentiful, these activated samples might be used in order to remove this pesticide from water.

Effects of dissolved organic carbon on sorption and mobility of imidacloprid in soil.

To evaluate the effects of dissolved organic carbon on sorption and mobility of the insecticide imidacloprid [1-(6-chloro-3-pyridinyl) methyl-N-nitro-2-imidazolidinimine] in soils, adsorption and column experiments were performed by using a typical calcareous soil from southeastern Spain and two different types of dissolved organic carbon, that is, dissolved organic carbon extracts from a commercial peat (DOC-PE) and high-purity tannic acid (DOC-TA). The experiments were carried out from a 0.01 M CaCl2 aqueous medium at 25 degrees C. The results obtained from the sorption experiments show that the presence of both DOC-PE and DOC-TA, over a concentration range of 15 to 100 mg L(-1), produces in all cases a decreasing amount of imidacloprid adsorbed in the soil studied. From the column experiments the retardation coefficients (RC) were calculated for imidacloprid by using either 0.01 M CaCl2 aqueous solution (RC = 2.10), 0.01 M CaCl2 DOC-PE solution (RC = 1.65), or 0.01 M CaCl2 DOC-TA solution (RC = 1.87). The results indicate that mobility of imidacloprid is increased 21.4 and 11.0% in the presence of DOC-PE and DOC-TA solutions, respectively. Dissolved organic carbon reduces imidacloprid sorption by competing with the pesticide molecules for sorption sites on the soil surface, allowing enhanced leaching of imidacloprid and potentially increasing ground water contamination.

The potential removal of imidacloprid from water by heat-treated kerolites.

The adsorption of imidacloprid [1-(6-chloro-3-pyridinylmethyl)-N-nitroimidazolidin-2-ylideneamine] on heat-treated kerolite samples at 110 degrees C (K-110), 200 degrees C (K-200), 400 degrees C (K-400) and 600 degrees C (K-600) from pure water solution at 25 degrees C has been studied. The evolution of the surface properties of the kerolite samples, such as specific surface area and porosity, after heat treatment were analysed. The clays were characterised by using FTIR spectroscopy, X-ray diffraction, thermogravimetric and differential thermogravimetric analysis, surface analysis and Hg porosimetry. The experimental adsorption data points were fitted to the Freundlich equation in order to calculate the adsorption capacities (Kf) of the samples; Kf values ranged from 242 mg kg(-1) for the K-110 sample to 1005 mg kg(-1) for the K-600 sample. The values obtained for the removal efficiency (R) ranged from 62.8% for K-110 to 87.2% for K-600. The adsorption experiments showed that the stronger the heat treatment, the more effective was the adsorption of imidacloprid from pure water. This work shows the potential use of heat-activated kerolite for the removal of imidacloprid from environmental waters and drinking water resources.

[Microbiological, clinical and epidemiological aspects of Streptococcus pneumoniae isolates recovered over two years]. / Aspectos microbiológicos y clinicoepidemiológicos de los aislados de Streptococcus pneumoniae durante dos años.

INTRODUCTION: Streptococcus pneumoniae is the most frequent cause of non-hospital acquired pneumonia and meningitis in adults, and bacterial otitis media in children. Moreover, it causes a third of all acute sinusitis cases. Penicillin has been the treatment of choice for almost 50 years. Gradually, penicillin-resistant pneumococci have appeared throughout the world. Our aim was to investigate the epidemiology, pattern of resistance and serotypes of Streptococcus pneumoniae infection in our area. METHODS: Over a period of two years (May 1997-May 1999), Streptococcus pneumoniae strains were isolated in the Clinical Microbiology Unit of the University Hospital Virgen de la Victoria in Málaga, Spain. This is a 750-bed hospital covering a population of 407,480 inhabitants, and admitting 21,500 hospitalized patients per year. Streptococcus was identified by standard procedures: serotyping was done with the Quellung test and antibiotic susceptibility study by the disk diffusion method and E-test. RESULTS: Streptococcus pneumoniae infection was diagnosed in 170 patients during the years studied. The microorganism was isolated from samples of sputum (82), blood (43), aspirated bronchial fluid, cerebrospinal fluid (6), and exudates (7). Non-hospital origin was identified in 88% of cases. The mean hospital stay was 12 days and mortality was 12.4%. Some 45.9% of the isolated strains were resistant to penicillin and 20% to cefotaxime. We found 31 different serotypes, with 77% of the isolated strains belonging to 12 serotypes. Serotypes 19, 3 and 6B were the most frequent in non-hospital infection, whereas 9V and 23F were related with nosocomial infection. Penicillin-resistant strains of Streptococcus pneumoniae belonged to 19 different serotypes; 6B, 9V, 14, 19 and 23F were the most important. CONCLUSIONS: As was expected, Streptococcus pneumoniae infections of mainly non-hospital origin in our area were characterized by elevated mortality and high-level resistance to penicillin. Immunosuppression was a predisposing factor.

[Primary pyomyositis in mild climates. Presentation of 2 new cases]. / Piomiositis primaria en climas templados. Aportación de dos nuevos casos.

Pyomyositis is an acute bacterial infection which affects striated muscles. It is a relatively rare process in mild climates. Staphylococcus aureus is responsible for 90-95% of cases. Klebsiella pneumoniae pyomyositis is extremely rare with only one other case reported in a mild climate. Two new cases of pyomyositis are described one caused by K. pneumoniae, increasing thus the etiology spectrum in our country, and the other caused by S. aureus ending in fatality, with two focus of pyomyositis (one of which was chronic) and multisystemic secondary affectation. We highlight the appearance of this process in our environment and the necessity to keep it in mind when making a differential diagnosis in order to recognize it and treat it as soon as possible since its prognosis depends on the moment the diagnosis is made.