ABSTRACT
A novel class C ß-lactamase (FOX-8) was isolated from a clinical strain of Escherichia coli. The FOX-8 enzyme possessed a unique substitution (Phe313Leu) compared to FOX-3. Isogenic E. coli strains carrying FOX-8 showed an 8-fold reduction in resistance to ceftazidime relative to FOX-3. In a kinetic analysis, FOX-8 displayed a 33-fold reduction in kcat/Km for ceftazidime compared to FOX-3. In the FOX family of ß-lactamases, the Phe313 residue located in the R2 loop affects ceftazidime hydrolysis and alters the phenotype of E. coli strains carrying this variant.
Subject(s)
Bacterial Proteins/metabolism , Ceftazidime/metabolism , Escherichia coli/enzymology , beta-Lactamases/metabolism , Bacterial Proteins/genetics , Escherichia coli/genetics , Escherichia coli/metabolism , Hydrolysis , Mutation , beta-Lactamases/geneticsABSTRACT
INTRODUCTION: Remdesivir seems to reduce the risk of hospitalization and improve clinical outcome in hospitalized patients with COVID-19. OBJECTIVES: To compare the clinical outcome of COVID-19 hospitalized patients treated with remdesivir plus dexamethasone versus dexamethasone alone, according to their vaccination status. MATERIAL AND METHODS: A retrospective observational study was carried out in 165 patients hospitalized for COVID-19 from October 2021 to January 2022. Multivariate logistic regression, Kaplan-Meier and the log-rank tests were used to evaluate the event (need for ventilation or death). RESULTS: Patients treated with remdesivir plus dexamethasone (n=87) compared with dexamethasone alone (n=78) showed similar age (60±16, 47-70 vs. 62±37, 51-74 years) and number of comorbidities: 1 (0-2) versus 1.5 (1-3). Among 73 fully vaccinated patients, 42 (47.1%) were in remdesivir plus dexamethasone and 31 (41%) in dexamethasone alone. Patients treated with remdesivir plus dexamethasone needed intensive care less frequently (17.2% vs. 31%; p=0.002), high-flow oxygen (25.3% vs. 50.0%; p=0.002) and non-invasive mechanical ventilation (16.1% vs. 47.4%; p<0.001). Furthermore, they had less complications during hospitalization (31.0% vs. 52.6%; p=0.008), need of antibiotics (32.2% vs. 59%; p=0.001) and radiologic worsening (21.8% vs. 44.9%; p=0.005). Treatment with remdesivir plus dexamethasone (aHR, 0.26; 95% CI: 0.14-0.48; p<0.001) and vaccination (aHR 0.39; 95% CI: 0.21-0.74) were independent factors associated with lower progression to mechanical ventilation or death. CONCLUSIONS: Remdesivir in combination with dexamethasone and vaccination independently and synergistically protects hospitalized COVID-19 patients requiring oxygen therapy from progression to severe disease or dead.
Subject(s)
COVID-19 , Humans , COVID-19 Drug Treatment , Oxygen , Vaccination , Dexamethasone/therapeutic use , Antiviral Agents/therapeutic use , Adenosine Monophosphate/therapeutic useABSTRACT
We monitored compliance with hand hygiene (HH) by direct observation in 3 hospitals in Cantabria, Spain before and after implementation of an HH informational campaign, separately analyzing the effect of a training program. We report that training plus an informational campaign doubled the probability of HH, whereas the informational campaign without training decreased adherence, acting as a deleterious factor in HH adherence.
Subject(s)
Attitude of Health Personnel , Education/methods , Guideline Adherence/statistics & numerical data , Hand Disinfection/methods , Health Knowledge, Attitudes, Practice , Cross Infection/prevention & control , Hospitals , Humans , Infection Control/methods , SpainSubject(s)
Abscess/diagnosis , Cervical Vertebrae , Lumbar Vertebrae , Tuberculosis, Spinal/diagnosis , Abscess/microbiology , Adult , Drug Resistance, Multiple, Bacterial , Humans , Male , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Spinal/complications , Tuberculosis, Spinal/microbiologyABSTRACT
No disponible
Subject(s)
Hand Disinfection/methods , Local Health Strategies , Professional-Patient Relations , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Tuberculosis, Spinal/drug therapy , Tuberculosis, Multidrug-Resistant/drug therapy , Amikacin/therapeutic use , Mycobacterium tuberculosis/isolation & purification , Ethambutol/therapeutic use , Cycloserine/therapeutic use , Epidural Abscess/drug therapyABSTRACT
No disponible
No disponible