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2.
Anaerobe ; 51: 54-60, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29655966

RESUMO

OBJECTIVE: Describe secular trends in the epidemiology and outcome of Clostridium difficile infection (CDI) at a tertiary hospital. METHODS: All consecutive primary CDI episodes in adults (January 2006-December 2015) were included. CDI was diagnosed on the presence of diarrhoea and a positive stool test for C. difficile toxin A and/or B. To define trends, a time-series analysis was performed using yearly data on demographics, clinical characteristics, management, antimicrobial treatment, and outcome of CDI. Patients were followed-up for three months after the diagnosis. RESULTS: There were 724 CDI episodes. Over the period from 2006 to 2015, the incidence rose from 0.18 episodes/1000 admissions to 0.26 episodes (relative rate [RR] 1.43; 95%CI, 1.02-2.00; P = 0.035). Median Charlson comorbidity index increased from 2 (IQR 1-3) to 4 (IQR 2-4) (RR 1.65; 95%CI, 1.12-2.41; P = 0.005). Overall, 80.4% of patients received proton pump inhibitors (PPIs) prior to CDI, and the percentage of PPI discontinuations rose from 2.3% to 20.4% (RR 8.80; 95%CI 1.20-64.36; P = 0.006). Management of non-Clostridium antibiotics also changed: antibiotic withdrawals or switches increased from 4.2% to 29.2% (RR 7.00; 95%CI 1.68-29.15, P = 0.001). Regarding CDI treatment, the percentage of patients treated with metronidazole decreased (88.9% vs 52.6%) (RR 0.59 (0.48-0.73), P < 0.001), whereas the percentage receiving vancomycin increased (1.9% vs 32.6%) (RR 17.62 (2.47-125.49), P < 0.001). The percentages of cures, deaths, and first recurrences did not significantly change over the 10-year period. CONCLUSIONS: Changes in CDI management were associated with a stable prognosis (percentage of cures and first recurrences), even though affected patients had a greater number of comorbidities over time.


Assuntos
Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Técnicas Bacteriológicas , Infecções por Clostridium/tratamento farmacológico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha/epidemiologia , Centros de Atenção Terciária , Resultado do Tratamento , Adulto Jovem
3.
Emerg Infect Dis ; 23(9): 1531-1534, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28820131

RESUMO

In April 2016, an outbreak of gastrointestinal illness (4,136 cases) occurred in Catalonia, Spain. We detected high levels of norovirus genotypes I and II in office water coolers associated with the outbreak. Infectious viral titer estimates were 33-49 genome copies/L for genotype I and 327-660 genome copies/L for genotype II.


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Água Potável/virologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Microbiologia da Água , Infecções por Caliciviridae/virologia , Gastroenterite/virologia , Genótipo , Humanos , Norovirus/classificação , Norovirus/genética , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Espanha/epidemiologia
4.
Antimicrob Agents Chemother ; 59(6): 3406-12, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25824224

RESUMO

The aim of this study was to determine the impact of carbapenemase-producing Enterobacteriaceae (CPE) in Spain in 2013 by describing the prevalence, dissemination, and geographic distribution of CPE clones, and their population structure and antibiotic susceptibility. From February 2013 to May 2013, 83 hospitals (about 40,000 hospital beds) prospectively collected nonduplicate Enterobacteriaceae using the screening cutoff recommended by EUCAST. Carbapenemase characterization was performed by phenotypic methods and confirmed by PCR and sequencing. Multilocus sequencing types (MLST) were determined for Klebsiella pneumoniae and Escherichia coli. A total of 702 Enterobacteriaceae isolates met the inclusion criteria; 379 (54%) were CPE. OXA-48 (71.5%) and VIM-1 (25.3%) were the most frequent carbapenemases, and K. pneumoniae (74.4%), Enterobacter cloacae (10.3%), and E. coli (8.4%) were the species most affected. Susceptibility to colistin, amikacin, and meropenem was 95.5%, 81.3%, and 74.7%, respectively. The most prevalent sequence types (STs) were ST11 and ST405 for K. pneumoniae and ST131 for E. coli. Forty-five (54.1%) of the hospitals had at least one CPE case. For K. pneumoniae, ST11/OXA-48, ST15/OXA-48, ST405/OXA-48, and ST11/VIM-1 were detected in two or more Spanish provinces. ST11 isolates carried four carbapenemases (VIM-1, OXA-48, KPC-2, and OXA-245), but ST405 isolates carried OXA-48 only. A wide interregional spread of CPE in Spain was observed, mainly due to a few successful clones of OXA-48-producing K. pneumoniae (e.g., ST11 and ST405). The dissemination of OXA-48-producing E. coli is a new finding of public health concern. According to the susceptibilities determined in vitro, most of the CPE (94.5%) had three or more options for antibiotic treatment.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/metabolismo , Colistina/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/enzimologia , Tienamicinas/farmacologia , beta-Lactamases/metabolismo , Idoso , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Meropeném , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Estudos Prospectivos , Espanha
5.
BMC Public Health ; 15: 999, 2015 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-26424707

RESUMO

BACKGROUND: To determine the direct and indirect costs of outbreaks of acute viral gastroenteritis (AVG) due to norovirus in closed institutions (hospitals, social health centers or nursing homes) and the community in Catalonia in 2010-11. METHODS: Information on outbreaks were gathered from the reports made by epidemiological surveillance units. Direct costs (medical visits, hospital stays, drug treatment, sample processing, transport, diagnostic tests, monitoring and control of the outbreaks investigated) and indirect costs (lost productivity due to work absenteeism, caregivers time and working hours lost due to medical visits) were calculated. RESULTS: Twenty-seven outbreaks affecting 816 people in closed institutions and 74 outbreaks affecting 1,940 people in the community were detected. The direct and indirect costs of outbreaks were € 131,997.36 (€ 4,888.79 per outbreak) in closed institutions and € 260,557.16 (€ 3,521.04 per outbreak) in community outbreaks. The cost per case was € 161.76 in outbreaks in closed institutions and € 134.31 in community outbreaks. The main costs were surveillance unit monitoring (€ 116,652.93), laboratory diagnoses (€ 119,950.95), transport of samples (€ 69,970.90), medical visits (€ 25,250.50) and hospitalization (€ 13,400.00). CONCLUSIONS: The cost of outbreaks of acute viral gastroenteritis due to norovirus obtained in this study was influenced by the number of people affected and the severity of the outbreak, which determined hospitalizations and work absenteeism. Urgent reporting of outbreaks would allow the implementation of control measures that could reduce the numbers affected and the duration of the illness and thus the costs derived from them.


Assuntos
Infecções por Caliciviridae/economia , Custos e Análise de Custo , Surtos de Doenças/economia , Gastroenterite/economia , Instalações de Saúde , Norovirus , Características de Residência , Doença Aguda , Adulto , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/virologia , Criança , Centros Comunitários de Saúde , Feminino , Gastroenterite/epidemiologia , Gastroenterite/virologia , Custos de Cuidados de Saúde , Hospitais , Humanos , Masculino , Casas de Saúde , Espanha/epidemiologia
6.
Enferm Infecc Microbiol Clin ; 33(8): 536-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25600024

RESUMO

INTRODUCTION: In neonatal units, Salmonella infections have been attributed to food-borne sources and person to person transmission. METHODS: The outbreak described is the first reported by Salmonella enterica serotype Newport in a neonatal facility in Spain. RESULTS: The index case was an 8-day premature newborn that developed clinical sepsis with positive blood cultures. The outbreak source was the mother of the index case. CONCLUSIONS: It is essential to improve infection control measures taking into account the parents, as they can be an important source of infection.


Assuntos
Portador Sadio/microbiologia , Infecção Hospitalar/transmissão , Doenças do Prematuro/microbiologia , Mães , Infecções por Salmonella/transmissão , Salmonella enterica/isolamento & purificação , Adulto , Doença de Crohn/microbiologia , Infecção Hospitalar/microbiologia , Surtos de Doenças , Feminino , Higiene das Mãos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Leite Humano/microbiologia , Berçários Hospitalares , Recursos Humanos de Enfermagem Hospitalar , Quartos de Pacientes , Infecções por Salmonella/microbiologia , Sepse/etiologia
7.
Antimicrob Agents Chemother ; 58(7): 3874-81, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24777096

RESUMO

In a previous prospective multicenter study in Spain, we found that OXA-1 and inhibitor-resistant TEM (IRT) ß-lactamases constitute the most common plasmid-borne mechanisms of genuine amoxicillin-clavulanate (AMC) resistance in Escherichia coli. In the present study, we investigated the population structure and virulence traits of clinical AMC-resistant E. coli strains expressing OXA-1 or IRT and compared these traits to those in a control group of clinical AMC-susceptible E. coli isolates. All OXA-1-producing (n = 67) and IRT-producing (n = 45) isolates were matched by geographical and temporal origin to the AMC-susceptible control set (n = 56). We performed multilocus sequence typing and phylogenetic group characterization for each isolate and then studied the isolates for the presence of 49 virulence factors (VFs) by PCR and sequencing. The most prevalent clone detected was distinct for each group: group C isolates of sequence type (ST) 88 (C/ST88) were the most common in OXA-1 producers, B2/ST131 isolates were the most common in IRT producers, and B2/ST73 isolates were the most common in AMC-susceptible isolates. The median numbers of isolates per ST were 3.72 in OXA-1 producers, 2.04 in IRT producers, and 1.69 in AMC-susceptible isolates; the proportions of STs represented by one unique isolate in each group were 19.4%, 31.1%, and 48.2%, respectively. The sum of all VFs detected, calculated as a virulence score, was significantly higher in AMC-susceptible isolates than OXA-1 and IRT producers (means, 12.5 versus 8.3 and 8.2, respectively). Our findings suggest that IRT- and OXA-1-producing E. coli isolates resistant to AMC have a different and less diverse population structure than AMC-susceptible clinical E. coli isolates. The AMC-susceptible population also contains more VFs than AMC-resistant isolates.


Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Escherichia coli/patogenicidade , Inibidores de beta-Lactamases/farmacologia , beta-Lactamases/biossíntese , beta-Lactamases/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Humanos , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Filogenia , Virulência/efeitos dos fármacos , Virulência/genética , Fatores de Virulência/genética , beta-Lactamases/genética
8.
J Clin Microbiol ; 51(5): 1465-73, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23447638

RESUMO

Prospective hospital-based surveillance for Clostridium difficile-associated disease (CDAD) was conducted in Barcelona (Spain) to describe the epidemiology of this condition and investigate the risk factors for an unfavorable outcome. All patients diagnosed with CDAD during 2009 were included. Using logistic regression modeling, we analyzed the potential risk factors associated with recurrent and complicated CDAD, defined as a need for colectomy or death within 30 days. There were 365 episodes of CDAD, yielding an incidence of 22.5 cases/10(5) person-years, 1.22 cases/10(3) hospital discharges, and 1.93 cases/10(4) patient-days. The main PCR ribotypes identified were 241 (26%), 126 (18%), 078 (7%), and 020 (5%). PCR ribotype 027 was not detected. Among the 348 cases analyzed, 232 (67%) patients were cured, 63 (18%) had a recurrence of CDAD, and 53 (15%) developed complicated CDAD. Predictors of complicated CDAD were continued use of antibiotics following CDAD diagnosis (odds ratio [OR], 2.009; 95% confidence interval [CI], 1.012 to 3.988; P = 0.046), Charlson comorbidity index score (OR, 1.265; 95% CI, 1.105 to 1.449; P = 0.001), and age (OR, 1.028; 95% CI, 1.005 to 1.053; P = 0.019). A leukocyte count of >15 × 10(3) cells/ml (OR, 2.277; 95% CI, 1.189 to 4.362; P = 0.013), continuation of proton pump inhibitor (PPI) use after CDAD diagnosis (OR, 2.168; 95% CI, 1.081 to 4.347; P = 0.029), and age (OR, 1.021; 95% CI, 1.001 to 1.041; P = 0.036) were independently associated with higher odds of recurrence. The incidence of CDAD in Barcelona during 2009 was on the lower end of the previously described range for all of Europe. Our analysis suggests that the continuation of non-C. difficile antibiotics and use of PPIs in patients diagnosed with CDAD are associated with unfavorable clinical outcomes.


Assuntos
Clostridioides difficile/classificação , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Proteínas de Bactérias , Toxinas Bacterianas , Clostridioides difficile/isolamento & purificação , Colectomia , Infecção Hospitalar/epidemiologia , Diarreia/epidemiologia , Farmacorresistência Bacteriana Múltipla , Enterotoxinas , Fezes/microbiologia , Feminino , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Prospectivos , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Espanha/epidemiologia , Resultado do Tratamento
9.
J Clin Microbiol ; 51(7): 2414-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23637303

RESUMO

Two hundred twelve patients with colonization/infection due to amoxicillin-clavulanate (AMC)-resistant Escherichia coli were studied. OXA-1- and inhibitor-resistant TEM (IRT)-producing strains were associated with urinary tract infections, while OXA-1 producers and chromosomal AmpC hyperproducers were associated with bacteremic infections. AMC resistance in E. coli is a complex phenomenon with heterogeneous clinical implications.


Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/farmacologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/patologia , Escherichia coli/efeitos dos fármacos , Resistência beta-Lactâmica , Adolescente , Adulto , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Bacteriemia/patologia , Criança , Estudos Transversais , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/patologia , Adulto Jovem
10.
Sci Rep ; 13(1): 1659, 2023 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-36717621

RESUMO

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide, with genotypes GII.2 and GII.4 being the most prevalent. The aim of this study was to compare the characteristics of GII.2 and GII.4 norovirus outbreaks reported in Catalonia in closed or semi-closed institutions in 2017 and 2018. The epidemiological and clinical characteristics of GII.2 and GII.4 outbreaks were compared using the chi-square test or Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. Odds ratios and their 95% confidence intervals were estimated. 61 outbreaks were reported: GII.4 was the causative agent in 12 outbreaks (30%) and GII.2 in 9 outbreaks (22.5%). GII.2 outbreaks were detected more frequently in schools or summer camps (66.7%) and GII.4 outbreaks in nursing homes (91.7%) (p = 0.01). Ninety-three people were affected in GII.2 outbreaks and 94 in GII.4 outbreaks. The median age was 15 years (range: 1-95 years) in GII.2 outbreaks and 86 years (range: 0-100 years) in GII.4 outbreaks (p < 0.001). Nausea, abdominal pain, and headache were observed more frequently in persons affected by GII.2 outbreaks (p < 0.05). Symptomatic cases presented a higher viral load suggestive of greater transmission capacity, although asymptomatic patients presented relevant loads indicative of transmission capacity.


Assuntos
Infecções por Caliciviridae , Gastroenterite , Norovirus , Humanos , Adolescente , Norovirus/genética , Genótipo , Gastroenterite/epidemiologia , Epidemiologia Molecular , Surtos de Doenças , Infecções por Caliciviridae/epidemiologia , Filogenia
11.
Antimicrob Agents Chemother ; 56(7): 3576-81, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22491692

RESUMO

We conducted a prospective multicenter study in Spain to characterize the mechanisms of resistance to amoxicillin-clavulanate (AMC) in Escherichia coli. Up to 44 AMC-resistant E. coli isolates (MIC ≥ 32/16 µg/ml) were collected at each of the seven participant hospitals. Resistance mechanisms were characterized by PCR and sequencing. Molecular epidemiology was studied by pulsed-field gel electrophoresis (PFGE) and by multilocus sequence typing. Overall AMC resistance was 9.3%. The resistance mechanisms detected in the 257 AMC-resistant isolates were OXA-1 production (26.1%), hyperproduction of penicillinase (22.6%), production of plasmidic AmpC (19.5%), hyperproduction of chromosomic AmpC (18.3%), and production of inhibitor-resistant TEM (IRT) (17.5%). The IRTs identified were TEM-40 (33.3%), TEM-30 (28.9%), TEM-33 (11.1%), TEM-32 (4.4%), TEM-34 (4.4%), TEM-35 (2.2%), TEM-54 (2.2%), TEM-76 (2.2%), TEM-79 (2.2%), and the new TEM-185 (8.8%). By PFGE, a high degree of genetic diversity was observed although two well-defined clusters were detected in the OXA-1-producing isolates: the C1 cluster consisting of 19 phylogroup A/sequence type 88 [ST88] isolates and the C2 cluster consisting of 19 phylogroup B2/ST131 isolates (16 of them producing CTX-M-15). Each of the clusters was detected in six different hospitals. In total, 21.8% of the isolates were serotype O25b/phylogroup B2 (O25b/B2). AMC resistance in E. coli is widespread in Spain at the hospital and community levels. A high prevalence of OXA-1 was found. Although resistant isolates were genetically diverse, clonality was linked to OXA-1-producing isolates of the STs 88 and 131. Dissemination of IRTs was frequent, and the epidemic O25b/B2/ST131 clone carried many different mechanisms of AMC resistance.


Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/patogenicidade , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Farmacorresistência Bacteriana/genética , Escherichia coli/classificação , Escherichia coli/genética , Epidemiologia Molecular , Estudos Prospectivos , Espanha/epidemiologia
12.
Enferm Infecc Microbiol Clin ; 30(5): 243-5, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22425422

RESUMO

INTRODUCTION: Campylobacter outbreaks are less common and described than sporadic Campylobacteriosis. METHODS: We describe the epidemiological investigation including stool examination and bacteriological typing of a Campylobacter outbreak affecting 75 primary school children. RESULTS: The highest risk ratio was associated with the food served 4 days before the peak of cases, namely roast chicken and Russian salad. DISCUSSION: Poor food preparation practices and deficient kitchen facilities appear to be key issues for cross-contamination of Campylobacter from raw chicken to cooked food.


Assuntos
Infecções por Campylobacter/epidemiologia , Surtos de Doenças , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Retrospectivos , Instituições Acadêmicas , Espanha/epidemiologia
13.
Microbiol Spectr ; 10(3): e0011922, 2022 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-35543555

RESUMO

We studied outbreaks of acute gastroenteritis due to norovirus in schools and summer camps during 2017-2019 in Catalonia (Spain). The overall attack rate was 21.27% in schools and 33.42% in summer camps (RR 0.64 [95% CI 0.58-0.70]) and 52.63% of outbreaks occurred in cold months and 47.37% in warm months. The mean delay in reporting was 5.61 days (SD 5.58 days) and the mean duration was 6.11 days (SD 6.08 days), with a Pearson correlation coefficient of 0.84 (P < 0.001) between these variables. In outbreaks with person-to-person transmission, the aOR was higher the longer the delay in reporting: 3.07 (95% CI 1.21-7.81) when the delay was 5-8 days and 3.81 when it was >9 days (95% CI 1.42-10.23). The cold months posed a higher risk than the warm months. In common source outbreaks the risk was higher in children in secondary-higher education and in summer camps. IMPORTANCE Norovirus is the main cause of viral acute gastroenteritis outbreaks worldwide. The low infectious dose and the lack of long-term immunity in infected persons means that norovirus often causes outbreaks in institutions and closed and semiclosed centers. Norovirus gastroenteritis are usually mild, with no complications, but occasionally can result in hospital admission. Understanding the risk factors involved in a norovirus outbreak can reduce the spread, severity, and duration of the outbreak and, when a vaccine becomes available, this understanding would help us identify the population groups need to get vaccinated. Here, we show the outbreaks due to norovirus in schools and summer camps, the correlation between the delay in reporting and duration of outbreaks and the relationship of the attack rate and the size of the groups.


Assuntos
Infecções por Caliciviridae , Infecções por Enterovirus , Gastroenterite , Norovirus , Infecções por Caliciviridae/epidemiologia , Criança , Surtos de Doenças , Infecções por Enterovirus/epidemiologia , Gastroenterite/epidemiologia , Humanos , Instituições Acadêmicas , Espanha/epidemiologia
14.
Viruses ; 14(3)2022 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-35336893

RESUMO

Molecular characterization of human norovirus (HuNoV) genotypes enhances the understanding of viral features and illustrates distinctive evolutionary patterns. The aim of our study was to describe the prevalence of the genetic diversity and the epidemiology of the genotypes involved in HuNoV outbreaks in Catalonia (Spain) between 2017 and 2019. A total of 100 HuNoV outbreaks were notified with the predominance of GII (70%), followed by GI (27%) and mixed GI/GII (3%). Seasonality was observed for GII outbreaks only. The most prevalent genotypes identified were GII.4[P31] Sydney 2012, GII.4[P16] Sydney 2012 and GII.2[P16]. As compared to person-to-person (P/P) transmitted outbreaks, foodborne outbreaks showed significantly higher attack rates and lower duration. The average attack rate was higher in youth hostel/campgrounds compared to nursing homes. Only genotypes GI.4[P4], GII.2[P16], GII.4[P16], GII.4[P31] and GII.17[P17] were consistently detected every year, and only abundance of GII.2[P16] showed a negative trend over time. GII.4 Sydney 2012 outbreaks were significantly associated to nursing homes, while GII.2[P16] and GI.3[P3] were most frequently identified in youth hostel/campgrounds. The average attack rate was significantly higher when comparing GII.2[P16] vs. GI.4[P4], GII.2[P16] vs. GII.4[P31] Sydney 2012, and GII.6[P7] vs. GII.4[P31] Sydney 2012. No correlations were found between genotype and outbreak duration or age of affected individuals.


Assuntos
Infecções por Caliciviridae , Gastroenterite , Norovirus , Adolescente , Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Genótipo , Humanos , Norovirus/genética , Filogenia , Espanha/epidemiologia
15.
BMC Infect Dis ; 10: 269, 2010 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-20843351

RESUMO

BACKGROUND: In July 2005 an outbreak of acute gastroenteritis occurred on a residential summer camp in the province of Barcelona (northeast of Spain). Forty-four people were affected among residents and employees. All of them had in common a meal at lunch time on 13 July (paella, round of beef and fruit). The aim of this study was to investigate a foodborne norovirus outbreak that occurred in the residential summer camp and in which the implication of a food handler was demonstrated by laboratory tests. METHODS: A retrospective cohort study was designed. Personal or telephone interview was carried out to collect demographic, clinical and microbiological data of the exposed people, as well as food consumption in the suspected lunch. Food handlers of the mentioned summer camp were interviewed.Ten stool samples were requested from symptomatic exposed residents and the three food handlers that prepared the suspected food. Stools were tested for bacteries and noroviruses. Norovirus was detected using RT-PCR and sequence analysis.Attack rate, relative risks (RR) and its 95% confidence intervals (CI) were calculated to assess the association between food consumption and disease. RESULTS: The global attack rate of the outbreak was 55%. The main symptoms were abdominal pain (90%), nausea (85%), vomiting (70%) and diarrhoea (42.5%). The disease remitted in 24-48 hours. Norovirus was detected in seven faecal samples, one of them was from an asymptomatic food handler who had not eaten the suspected food (round of beef), but cooked and served the lunch. Analysis of the two suspected foods isolated no pathogenic bacteria and detected no viruses. Molecular analysis showed that the viral strain was the same in ill patients and in the asymptomatic food handler (genotype GII.2 Melksham-like). CONCLUSIONS: In outbreaks of foodborne disease, the search for viruses in affected patients and all food handlers, even in those that are asymptomatic, is essential. Health education of food handlers with respect to hand washing should be promoted.


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adolescente , Adulto , Infecções por Caliciviridae/virologia , Criança , Estudos de Coortes , Fezes/virologia , Feminino , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/virologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , RNA Viral/genética , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , Espanha/epidemiologia , Adulto Jovem
16.
Enferm Infecc Microbiol Clin ; 28(10): 713-5, 2010 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-21035233

RESUMO

INTRODUCTION: The aim of this study was to describe the investigation of a case of meningitis in a neonatal intensive care unit in order to identify the source of infection and the associated risk factors. MATERIAL AND METHODS: An analysis was carried out on the possible risk factors associated with the infection. E. sakazakii was detected in the batch of the powdered infant formula used during the feeding of the neonate and the initial level of contamination of the microorganism was estimated. The strains of E. sakazakii previously isolated in blood and faeces of the infected neonate and those isolated in infant formula were characterised by biotype, pulsotype and antimicrobial susceptibility. RESULTS: E. sakazakii was detected in one opened and two unopened cases of a single batch of powdered infant formula. The E. sakazakii strains isolated in the samples of the product and those isolated in the infected neonate showed the same biochemical, antibiotic susceptibility and PFGE pattern. CONCLUSIONS: The case of meningitis in the neonatal intensive care unit occurred as a result of the use of a powered infant formula contaminated with E. sakazakii at manufacturing level, and an inadequate preparation and storing of the reconstituted product were identified as risk factors.


Assuntos
Cronobacter sakazakii/isolamento & purificação , Infecções por Enterobacteriaceae/transmissão , Contaminação de Alimentos , Microbiologia de Alimentos , Fórmulas Infantis , Doenças do Prematuro/etiologia , Meningites Bacterianas/etiologia , Infecções Oportunistas/transmissão , Bacteriemia/etiologia , Bacteriemia/microbiologia , Técnicas de Tipagem Bacteriana , Dano Encefálico Crônico/etiologia , Cronobacter sakazakii/classificação , Cronobacter sakazakii/efeitos dos fármacos , Resistência Microbiana a Medicamentos , Infecções por Enterobacteriaceae/sangue , Infecções por Enterobacteriaceae/microbiologia , Fezes/microbiologia , Conservação de Alimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/microbiologia , Unidades de Terapia Intensiva Neonatal , Meningites Bacterianas/sangue , Meningites Bacterianas/microbiologia , Infecções Oportunistas/sangue , Infecções Oportunistas/microbiologia , Pós , Refrigeração , Fatores de Risco
17.
Enferm Infecc Microbiol Clin ; 28(10): 675-9, 2010 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-20678828

RESUMO

INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections were first reported in the 1990s. Young, healthy individuals are frequently affected. The incidence of CA-MRSA in Spain is increasing. METHODS: All children seen between August 2006 and January 2009 with CA-MRSA infections were included. The S. aureus isolates were studied by conventional techniques, their antibiotic susceptibility by agar disk diffusion, the presence of mecA gene was detected by multiplex polymerase chain reaction (PCR) and the gene encoding the Panton-Valentine leukocidin (PVL) by conventional PCR. CA-MRSA colonization was studied both in patients and their family members. RESULTS: CA-MRSA was isolated in 15 samples from 12 patients, aged between 6 days and 14 years. Half of them were not native. Eight patients required hospital admission. The most common clinical presentation was skin and soft tissue infection (92%). Secondary CA-MRSA bacteraemia was present in two patients. All strains were PVL producers and two were resistant to macrolides associated to methicillin resistance and one of them was also resistant to lincosamides. An intra-familial transmission was identified. The clinical outcome was favourable in all patients. CONCLUSION: CA-MRSA infections are emerging in Spain. Empirical treatment of skin and soft tissue infections should not be changed, since their incidence is still low. The drainage of CA-MRSA suppurative infections plays an important role in their treatment. Clindamycin or trimethoprim-sulfamethoxazole should be used for mild or moderate skin and soft tissue infections. Controlling the spread of these strains presents a challenge in the community today.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Abscesso/epidemiologia , Abscesso/microbiologia , Adolescente , Proteínas de Bactérias/genética , Toxinas Bacterianas/análise , Portador Sadio , Criança , Pré-Escolar , Doenças Transmissíveis Emergentes/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Resistência Microbiana a Medicamentos , Emigrantes e Imigrantes , Exotoxinas/análise , Saúde da Família , Hospitalização , Humanos , Lactente , Recém-Nascido , Leucocidinas/análise , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Proteínas de Ligação às Penicilinas , Infecções dos Tecidos Moles/epidemiologia , Infecções dos Tecidos Moles/microbiologia , Espanha/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecções Cutâneas Estafilocócicas/epidemiologia , Infecções Cutâneas Estafilocócicas/microbiologia
18.
Viruses ; 12(12)2020 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-33322135

RESUMO

Acute infectious gastroenteritis is an important illness worldwide, especially on children, with viruses accounting for approximately 70% of the acute cases. A high number of these cases have an unknown etiological agent and the rise of next generation sequencing technologies has opened new opportunities for viral pathogen detection and discovery. Viral metagenomics in routine clinical settings has the potential to identify unexpected or novel variants of viral pathogens that cause gastroenteritis. In this study, 124 samples from acute gastroenteritis patients from 2012-2014 previously tested negative for common gastroenteritis pathogens were pooled by age and analyzed by next generation sequencing (NGS) to elucidate unidentified viral infections. The most abundant sequences detected potentially associated to acute gastroenteritis were from Astroviridae and Caliciviridae families, with the detection of norovirus GIV and sapoviruses. Lower number of contigs associated to rotaviruses were detected. As expected, other viruses that may be associated to gastroenteritis but also produce persistent infections in the gut were identified including several Picornaviridae members (EV, parechoviruses, cardioviruses) and adenoviruses. According to the sequencing data, astroviruses, sapoviruses and NoV GIV should be added to the list of viral pathogens screened in routine clinical analysis.


Assuntos
Gastroenterite/virologia , Metagenoma , Metagenômica , Viroses/virologia , Fatores Etários , Criança , Pré-Escolar , Biologia Computacional/métodos , Fezes/virologia , Feminino , Genoma Viral , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Metagenômica/métodos , Filogenia , Carga Viral
19.
Viruses ; 12(12)2020 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-33266188

RESUMO

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017-2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections.


Assuntos
Infecções por Caliciviridae/diagnóstico , Infecções por Caliciviridae/virologia , Gastroenterite/diagnóstico , Gastroenterite/virologia , Norovirus , Doença Aguda , Doenças Assintomáticas , Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Fezes/virologia , Feminino , Gastroenterite/epidemiologia , Genótipo , Humanos , Masculino , Norovirus/genética , Norovirus/isolamento & purificação , RNA Viral , Saliva/virologia , Análise de Sequência de DNA , Carga Viral , Eliminação de Partículas Virais
20.
Rev Esp Salud Publica ; 83(5): 745-50, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-20111822

RESUMO

BACKGROUND: The low infectious dose and multiple transmission routes favour the appearance of norovirus outbreaks. The objective of this study was to compare the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia. METHODS: A descriptive study of norovirus outbreaks between 15/10/2004 and 30/10/2005 was carried out. An epidemiological survey was completed for each outbreak. Norovirus in clinical samples was determined by PCR techniques. The incidence in each centre and the annual incidence of outbreaks by centre were calculated. Differences were calculated using the chi-square test and the Student's t test, taking a p value of > 0.05 as significant. RESULTS: Seventeen outbreaks (6 in hospitals and 11 in nursing homes) were detected. The global attack rate was 33.4% (652/1951) and was slightly higher in nursing homes (35.2%) than in hospitals (31.4%). A total of 94.1% (16/17) of outbreaks were caused by person-to-person transmission and only 5.9% (1/17) by foods. The mean number of days between the first and last case was 11.4 (SD = 6.9). The mean duration of symptoms was 2.39 days (SD=1.6), and was higher hospitals, 2.63 (SD=1.7), than in nursing homes, 1.97 (SD=1.7) (p < 0.0001). CONCLUSIONS: Norovirus is responsible for a large number of outbreaks due to person-to-person transmission. Control should be standardized to reduce the number and duration of outbreaks.


Assuntos
Infecções por Caliciviridae/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Gastroenterite/virologia , Hospitais , Norovirus , Casas de Saúde , Idoso , Feminino , Humanos , Incidência , Masculino , Espanha/epidemiologia
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