Prevalence of methicillin-resistant Staphylococcus aureus colonization in HIV-infected patients in Barcelona, Spain: a cross-sectional study.

BACKGROUND: Colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has been found to be markedly more common in HIV-infected individuals in the USA. Studies evaluating the prevalence MRSA colonization in HIV-infected populations in Europe are scarce. The aim of this study was to investigate the prevalence of MRSA colonization in a cohort of HIV-infected patients in Barcelona, Spain. METHODS: Nasal and pharyngeal S. aureus carriage was assessed in a random sample of 190 patients from an outpatient HIV clinic. Nasal and pharyngeal swab specimens were obtained for staphylococcal culture from 190 and 110 patients respectively. All MRSA isolates were screened for Panton-Valentine leukocidin (PVL) genes by PCR. Molecular characterization of MRSA isolates was performed by multilocus sequence typing. Data related to HIV infection, healthcare exposure, and previously described risk factors for MRSA were collected from medical records and a questionnaire administered to each patient. RESULTS: The patients' characteristics were as follows: male, 83 %; median (IQR) age, 45 (39-49) years; intravenous drug users, 39 %; men who have sex with men, 32 %; heterosexual, 26 %; CD4 count, 528/µL (IQR 351-740); on antiretroviral therapy, 96 %; and undetectable plasma viral load, 80 %. Sixty-five patients (34 %) were colonized by S. aureus. MRSA colonization was found in 1 % and 2 % of nasal and pharyngeal samples respectively. No PVL positive MRSA strains were detected and all the MRSA isolates belonged to typical hospital-acquired clones. CONCLUSIONS: Our data suggest that CA-MRSA colonization is not currently a problem in HIV-infected individuals in our area.

Ira, fibromialgia y ansiedad: aproximación terapéutica desde un CSM / Anger, fibromyalgia and anxiety: therapeutic approach from a mental health centre

Mostramos un programa de tratamiento grupal de la fibromialgia realizado en un centro de salud mental (AU)

We show a group treatment program of fibromyalgia done in a mental health facility (AU)

Immigration status and HIV-risk related behaviors among female sex workers in South America.

This study compares immigrant (i.e., foreigner) with non-immigrant (i.e., local/native) HIV-related risk behaviors among female sex workers (FSW) in South America. A total of 1,845 FSW were enrolled in Argentina, Bolivia, Ecuador, and Uruguay. According to their nationality, 10.1% of participants were immigrant FSW. Immigrant FSW were more likely to be younger in Argentina; to work in a disco/bar in Bolivia; to be single and use illegal drugs in Ecuador; and to work in a brothel, consume alcohol, and have sex with foreign clients in Uruguay. HIV-related sexual and drug use behaviors were more common among immigrant FSW in Bolivia, Ecuador, and Uruguay. Country-specific HIV/STI prevention and control programs should be developed for immigrant FSW populations in South America.

Procedimiento de cuidados en cirugía craneal sin rasurado en el Hospitla Universitaio de Bellvitge / Procedure of taken care of in shaved surgery craneal withour in HUB

El procedimiento de higiene pre y post quirúrgica del paciente de neurocirugía en el Hospital Universitario de Bellvitge, iniciado en el año 1995, garantiza la correcta preparación de la zona quirúrgica. La frecuencia y realización del lavado terapéutico reduce el riesgo de infección de la herida y mantiene la integridad del cuero cabelludo. Minimiza la angustia prequirúrgica del paciente y mejora la adaptación a los cambios corporales por cirugía(AU)

The procedure of hygiene pre and post surgical of the patient of neurosurgery in the University Hospital of Bellvitge, initiated in 1995, guarantees the correct preparation of the surgical zone, the frequency and accomplishment of the therapeutic washing reduces the risk of infection of the wound and maintains the integrity of the hairy leather. It diminishes the presurgical anguish of the patient and improves the adaptation to the corporal changes by surgery(AU)

[Procedure of taken care of in shaved surgery craneal without in hub]. / Procedimiento de cuidados en cirugía craneal sin rasurado en el Hospital Universitario de Bellvitge.

The procedure of hygiene pre and post surgical of the patient of neurosurgery in the University Hospital of Bellvitge, initiated in 1995, guarantees the correct preparation of the surgical zone, the frequency and accomplishment of the therapeutic washing reduces the risk of infection of the wound and maintains the integrity of the hairy leather. It diminishes the presurgical anguish of the patient and improves the adaptation to the corporal changes by surgery.

[Detection of HIV infection in pregnant women by rapid testing: a successful strategy to reduce its vertical transmission]. / Detección de infección por VIH a través de test rápido en mujeres embarazadas: una estrategia exitosa para disminuir su transmisión vertical.

UNLABELLED: A high percentage of Uruguayan pregnant women are not under medical control. As a consequence, vertically transmission of HIV infection reaches to 50%. The aim of this study was to know the prevalence of HIV infection in pregnant women who did not know their serological status and to decrease mother-to-child transmission. PATIENTS AND METHODS: from January 2002 to January 2004 the HIV rapid test was performed to every pregnant woman that assisted to a public Uruguayan hospital unaware of her condition. The proper prophylactic decisions were adopted according to gestational age. The newborn infants were classified according to CDC criteria. HIV infection prevalence in pregnant women and in their newborn infants was calculated. RESULTS: there were 34,338 obstetric consultations and 4,599 rapid tests were performed. Fifty-nine turned out positive in 58 women, 8 of them knew their serological status previously. The HIV infection prevalence was 1.1% (IC95% 0.8-1.4). Five cases were discharged: 1 false positive and 3 miscarriages and 1 abortion. Ten women dropped out in the follow up. Twelve women received TARV during pregnancy for over a week. Thirty-nine infants could be controlled: 33 seroreverted, 4 were exposed and 2 became infected. Mother-to-child transmission was 5.1%. If all patients who dropped out the follow up were infected, the transmission rate should be of 20.4%; therefore the infection would have been prevented in 16 children. As many women and children were lost, other complementary actions as counseling and social worker interview should be adopted in order to improve the yield of rapid test screening strategy.

Prevalences, genotypes, and risk factors for HIV transmission in South America.

HIV cross-sectional studies were conducted among high-risk populations in 9 countries of South America. Enzyme-linked immunosorbent assay screening and Western blot confirmatory testing were performed, and env heteroduplex mobility assay genotyping and DNA sequencing were performed on a subset of HIV-positive subjects. HIV prevalences were highest among men who have sex with men (MSM; 2.0%-27.8%) and were found to be associated with multiple partners, noninjection drug use (non-IDU), and sexually transmitted infections (STIs). By comparison, much lower prevalences were noted among female commercial sex workers (FCSWs; 0%-6.3%) and were associated mainly with a prior IDU and STI history. Env subtype B predominated among MSM throughout the region (more than 90% of strains), whereas env subtype F predominated among FCSWs in Argentina and male commercial sex workers in Uruguay (more than 50% of strains). A renewed effort in controlling STIs, especially among MSM groups, could significantly lessen the impact of the HIV epidemic in South America.

Seroincidence and phylogeny of human immunodeficiency virus infections in a cohort of commercial sex workers in Montevideo, Uruguay.

A cohort study involving 60 human immunodeficiency virus (HIV)-negative male transvestite commercial sex workers (CSWs) was conducted in Montevideo, Uruguay in 1999-2001. Serum samples were tested for HIV by an enzyme-linked immunosorbent assay screening with immunoblot confirmation. Six participants seroconverted for an incidence-density rate of 6.03 (95% confidence interval = 2.21-13.12) per 100 person-years. Inconsistent condom use during client sex (adjusted hazard ratio [AHR] = 6.7), during oral sex (AHR = 5.6), and at the last sexual encounter (AHR = 7.8), and use of marihuana (AHR = 5.4) were marginally associated with HIV seroconversion. Five samples were genotyped in the protease and reverse transcriptase regions; three were subtypes B and two were BF recombinants. Full genome analysis of four samples confirmed all three subtype B samples and one of the two BF recombinants. Male transvestite CSWs sustained a high rate of HIV infection. Larger prospective studies are required to better define subtypes and associated sexual and drug-related risk factors.

Sexual transmission of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus type 1 infections among male transvestite comercial sex workers in Montevideo, Uruguay.

Prostitution may constitute a risk behavior for infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). We conducted a seroepidemiologic study among 200 male transvestite commercial sex workers (CSWs) in Montevideo, Uruguay in 1999. Evidence of exposure to HBV, HCV, and HIV was found in 101 (50.5%), 13 (6.5%), and 43 (21.5%) individuals, respectively. Positivity for HIV was correlated with both HBV (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.01-4.67) and HCV (OR = 3.47, 95% CI = 0.90-12.79) infection. Predictors of infection were older age (> or = 26 years; P < 0.01) for all 3 viruses and time in CSW (> or = 5 years; P < 0.05) for HBV and HIV. Prior history of use of drugs (OR = 3.54, 95% CI = 1.09-11.52) and sexual contact with foreigners (OR = 9.2, 95% CI = 1.16-73.12) were found to be associated only with HCV infection. Sexual transmission of these viruses constitutes a significant problem among male transvestite CSWs.