Dispersal history of SARS-CoV-2 in Galicia, Spain.

The dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission are influenced by a variety of factors, including social restrictions and the emergence of distinct variants. In this study, we delve into the origins and dissemination of the Alpha, Delta, and Omicron-BA.1 variants of concern in Galicia, northwest Spain. For this, we leveraged genomic data collected by the EPICOVIGAL Consortium and from the GISAID database, along with mobility information from other Spanish regions and foreign countries. Our analysis indicates that initial introductions during the Alpha phase were predominantly from other Spanish regions and France. However, as the pandemic progressed, introductions from Portugal and the United States became increasingly significant. The number of detected introductions varied from 96 and 101 for Alpha and Delta to 39 for Omicron-BA.1. Most of these introductions left a low number of descendants (<10), suggesting a limited impact on the evolution of the pandemic in Galicia. Notably, Galicia's major coastal cities emerged as critical hubs for viral transmission, highlighting their role in sustaining and spreading the virus. This research emphasizes the critical role of regional connectivity in the spread of SARS-CoV-2 and offers essential insights for enhancing public health strategies and surveillance measures.

Dispersal history of SARS-CoV-2 in Galicia, Spain.

The dynamics of SARS-CoV-2 transmission are influenced by a variety of factors, including social restrictions and the emergence of distinct variants. In this study, we delve into the origins and dissemination of the Alpha, Delta, and Omicron variants of concern in Galicia, northwest Spain. For this, we leveraged genomic data collected by the EPICOVIGAL Consortium and from the GISAID database, along with mobility information from other Spanish regions and foreign countries. Our analysis indicates that initial introductions during the Alpha phase were predominantly from other Spanish regions and France. However, as the pandemic progressed, introductions from Portugal and the USA became increasingly significant. Notably, Galicia's major coastal cities emerged as critical hubs for viral transmission, highlighting their role in sustaining and spreading the virus. This research emphasizes the critical role of regional connectivity in the spread of SARS-CoV-2 and offers essential insights for enhancing public health strategies and surveillance measures.

Generalized implementation of reflex testing of hepatitis C in Galicia: Results for reflection.

INTRODUCTION: The implementation of reflex testing of active hepatitis C virus (HCV) infection, together with the incorporation of informative alerts in the reports, has shown that it significantly reduces the number of patients who were not referred for therapeutic evaluation. METHODS: Since the implementation in 2018 of the DUSP in the Microbiology Services of the Galician Health Service hospitals (SERGAS), new diagnoses of active HCV infection have been retrospectively identified and characterized. RESULTS: In 2018, a total of 258 patients with unknown active HCV infection (70,2% men, middle age 52 years) were identified through by reflex testing from consultations of primary and specialized care units in 54.8% and 39.8% respectively, as well as from other locations by 5.4%. Of the 258 patients, 81.0% were referred for therapeutic evaluation, with a median of 54 days from their diagnosis. In 58.3% of the cases the reflex testing was determined by viral load, the predominant genotype was 1a (30,7%) and 52,1% were treated, observing sustained viral response (SVR) in 93.7 % of these. CONCLUSION: The generalized implementation of the HCV reflex testing together with informative alerts in Galicia has allowed us to obtain referral rates for treatment similar to those obtained in other studies. However, there is a wide variability between the different centers that require the incorporation of improvements, such as training or the use of rescue measures for optimization.

Generalized implementation of reflex testing of hepatitis C in Galicia: Results for reflection. / Implementación generalizada del diagnóstico en un solo paso (DUSP) de la hepatitis C en Galicia: resultados para la reflexión.

INTRODUCTION: The implementation of reflex testing of active hepatitis C virus (HCV) infection, together with the incorporation of informative alerts in the reports, has shown that it significantly reduces the number of patients who were not referred for therapeutic evaluation. METHODS: Since the implementation in 2018 of the DUSP in the microbiology services of the Galician Health Service hospitals (SERGAS), new diagnoses of active HCV infection have been retrospectively identified and characterized. RESULTS: In 2018, a total of 258 patients with unknown active HCV infection (70,2% men, middle age 52 years) were identified through by reflex testing from consultations of primary and specialized care units in 54.8% and 39.8% respectively, as well as from other locations by 5.4%. Of the 258 patients, 81.0% were referred for therapeutic evaluation, with a median of 54 days from their diagnosis. In 58.3% of the cases the reflex testing was determined by viral load, the predominant genotype was 1a (30,7%) and 52,1% were treated, observing sustained viral response in 93.7% of these. CONCLUSION: The generalized implementation of the HCV reflex testing together with informative alerts in Galicia has allowed us to obtain referral rates for treatment similar to those obtained in other studies. However, there is a wide variability between the different centers that require the incorporation of improvements, such as training or the use of rescue measures for optimization.

Emergence of clonal groups O1:HNM-D-ST59, O15:H1-D-ST393, O20:H34/HNM-D-ST354, O25b:H4-B2-ST131 and ONT:H21,42-B1-ST101 among CTX-M-14-producing Escherichia coli clinical isolates in Galicia, northwest Spain.

CTX-M enzymes, mainly CTX-M-14 and CTX-M-15, have emerged as the most prevalent extended-spectrum ß-lactamase (ESBL) type produced by Escherichia coli in Spain, with successful dissemination of clonal group O25b:H4-B2-ST131 producing CTX-M-15 within the hospital and community settings. However, until now CTX-M-14-producing E. coli in Spain had been shown to belong to a wide variety of serotypes with no predominance of a certain clonal group. In the present study, 654 E. coli strains positive for ESBL production obtained between 2005 and 2008 from inpatients and outpatients of four hospitals in Galicia, northwest Spain, were analysed. The strains were characterised with regard to ESBL enzymes, serotype, virulence genes, phylogenetic group, multilocus sequence type, and pulsed-field gel electrophoresis of XbaI-digested DNA. As a result, the emergence of certain clonal groups of extraintestinal pathogenic E. coli producing CTX-M-14 has been detected in this geographic area, including O1:HNM-D-ST59, O15:H1-D-ST393/ST1394, O20:H34/HNM-D-ST354, O25b:H4-B2-ST131 and ONT:H21,42-B1-ST101. These five clonal groups showed a high virulence potential as they harboured more than eight virulence factors, which could explain their successful dissemination.

[Prevalence of hepatitis C virus genotypes in the area of El Ferrol (La Coruña, Spain)]. / Prevalencia de genotipos del virus de la hepatitis C en el área de El Ferrol (La Coruña).

BACKGROUND: To determine the prevalence of hepatitis C virus (HCV) genotypes in the area of El Ferrol, as well as their distribution according to risk factors. METHODS: A total of 479 patients with hepatitis C were studied, including 254 with no known risk factors, 161 intravenous drug abusers (IVDA) and 64 with a history of blood transfusions. The presence of HCV RNA was studied by RT-PCR, and a reverse hybridization method (INNO-LiPA) was used for genotyping. RESULTS: Genotype distribution was as follows: 1b, 269 (56.2%); 1a, 79 (16.5%); 3a, 59 (12.3%); 4c/4d, 35 (7.3%); 1, 19 (4.0%); 2a/2c, 3 (0.6%); 4, 3 (0.6%); 2b, 2 (0.4%). In 10 patients (2.1%) genotype could not be determined. In patients with no known risk factor, the predominant genotype was 1b, detected in 191 of the 254 patients in this group (75.2%). Distribution of genotypes was more varied in the IVDA group, with the most frequent being 1a in 49 (30.4%) and 3a in 43 (26.7%). In the 64 patients who had received transfusions, 1b was predominant, detected in 54 of 64 patients (84.4%). CONCLUSIONS: The predominant HCV genotype in our area is 1b. Differences in genotype distribution were observed in the population groups studied, according to their underlying risk factors.

Prevalencia de genotipos del virus de la hepatitis C en el área de El Ferrol (La Coruña) / Prevalence of hepatitis C virus genotypes in the area of El Ferrol (La Coruña, Spain)

FUNDAMENTOS. Conocer la prevalencia de los distintos genotipos del virus de la hepatitis C (VHC) en el área de El Ferrol (La Coruña), así como su distribución según los factores de riesgo. MÉTODOS. Se estudiaron 479 pacientes con hepatitis C: 254 sin antecedentes de riesgo conocidos, 161 con antecedentes de adicción a drogas por vía parenteral (ADVP) y 64 con historia de transfusiones. La presencia de ARN del VHC se estudió mediante reacción en cadena de la polimerasa-transcripción inversa (RT-PCR) y para la genotipificación se utilizó una prueba de hibridación reversa (INNO-LiPA). RESULTADOS. La distribución de genotipos fue 1b, 269 (56,2 por ciento); 1a, 79 (16,5 por ciento); 3a, 59 (12,3 por ciento); 4c/4d, 35 (7,3 por ciento); 1, 19 (4,0 por ciento); 2a/2c, 3 (0,6 por ciento); 4, 3 (0,6 por ciento); 2b, 2 (0,4 por ciento). En 10 pacientes (2,1 por ciento) no se pudo determinar el genotipo. En los pacientes sin factores de riesgo conocidos el genotipo predominante fue el 1b, 191 de los 254 estudiados (75,2 por ciento). En el grupo de pacientes con ADVP la distribución de genotipos fue más variada, siendo los más prevalentes el 1a en 49 (30,4 por ciento) y el 3a en 43 (26,7 por ciento). En los 64 pacientes con historia de transfusiones predominó el 1b, 54 de 64 (84,4 por ciento). CONCLUSIONES. El genotipo VHC predominante en nuestra área fue el 1b. Se observaron diferencias en la distribución de genotipos en los diferentes grupos de población según sus antecedentes de riesgo (AU)