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In recent years, the application of magnetic nanoparticles as alternative catalysts to conventional Fenton processes has been investigated for the removal of emerging pollutants in wastewater. While this type of catalyst reduces the release of iron hydroxides with the treated effluent, it also presents certain disadvantages, such as slower reaction kinetics associated with the availability of iron and mass transfer limitations. To overcome these drawbacks, the functionalization of the nanocatalyst surface through the addition of coatings such as polyacrylic acid (PAA) and their immobilization on a mesoporous silica matrix (SBA15) can be factors that improve the dispersion and stability of the nanoparticles. Under these premises, the performance of the nanoparticle coating and nanoparticle-mesoporous matrix binomials in the degradation of dyes as examples of recalcitrant compounds were evaluated. Based on the outcomes of dye degradation by the different functionalized nanocatalysts and nanocomposites, the nanoparticles embedded in a mesoporous matrix were applied for the removal of estrogens (E1, E2, EE2), accomplishing high removal percentages (above 90%) after the optimization of the operational variables. With the feasibility of their recovery in mind, the nanostructured materials represented a significant advantage as their magnetic character allows their separation for reuse in different successive sequential batch cycles.
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INTRODUCTION: Healthcare-associated (HCA) infections represent a growing public health problem. The aim of this study was to compare community-onset healthcare associated (CO-HCA) bacteremic urinary tract infections (BUTI) and hospital-acquired (HA)-BUTI with special focus on multidrug resistances (MDR) and outcomes. METHODS: ITUBRAS-project is a prospective multicenter cohort study of patients with HCA-BUTI. All consecutive hospitalized adult patients with CO-HCA-BUTI or HA-BUTI episode were included in the study. Exclusion criteria were: patients < 18 years old, non-hospitalized patients, bacteremia from another source or primary bacteremia, non-healthcare-related infections and infections caused by unusual pathogens of the urinary tract. The main outcome variable was 30-day all-cause mortality with day 1 as the first day of positive blood culture. Logistic regression was used to analyze factors associated with clinical cure at hospital discharge and with receiving inappropriate initial antibiotic treatment. Cox regression was used to evaluate 30-day all-cause mortality. RESULTS: Four hundred forty-three episodes were included, 223 CO-HCA-BUTI. Patients with CO-HCA-BUTI were older (p < 0.001) and had more underlying diseases (p = 0.029) than those with HA-BUTI. The severity of the acute illness (Pitt score) was also higher in CO-HCA-BUTI (p = 0.026). Overall, a very high rate of MDR profiles (271/443, 61.2%) was observed, with no statistical differences between groups. In multivariable analysis, inadequate empirical treatment was associated with MDR profile (aOR 3.35; 95% CI 1.77-6.35), Pseudomonas aeruginosa (aOR 2.86; 95% CI 1.27-6.44) and Charlson index (aOR 1.11; 95% CI 1.01-1.23). Mortality was not associated with the site of acquisition of the infection or the presence of MDR profile. However, in the logistic regression analyses patients with CO-HCA-BUTI (aOR 0.61; 95% CI 0.40-0.93) were less likely to present clinical cure. CONCLUSION: The rate of MDR infections was worryingly high in our study. No differences in MDR rates were found between CO-HCA-BUTI and HA-BUTI, in the probability of receiving inappropriate empirical treatment or in 30-day mortality. However, CO-HCA-BUTIs were associated with worse clinical cure.