The fate of SARS-COV-2 in WWTPS points out the sludge line as a suitable spot for detection of COVID-19.

SARS-CoV-2 genetic material is detectable in the faeces of a considerable part of COVID-19 cases and hence, in municipal wastewater. This fact was confirmed early during the spread of the COVID-19 pandemic and prompted several studies that proposed monitoring its incidence by wastewater. This paper studies the fate of SARS-CoV-2 genetic material in wastewater treatment plants using RT-qPCR with a two-fold goal: i) to check its presence in the water effluent and in the produced sludge and ii) based on the understanding of the virus particles fate, to identify the most suitable spots for detecting the incidence of COVID-19 and monitor its evolution. On the grounds of the affinity of enveloped virus towards biosolids, we hypothesized that the sludge line acts as a concentrator of SARS-CoV-2 genetic material. Sampling several spots in primary, secondary and sludge treatment at the Ourense (Spain) WWTP in 5 different days showed that, in effect, most of SARS-CoV-2 particles cannot be detected in the water effluent as they are retained by the sludge line. We identified the sludge thickener as a suitable spot for detecting SARS-CoV-2 particles thanks to its higher solids concentration (more virus particles) and longer residence time (less sensitive to dilution caused by precipitation). These findings could be useful to develop a suitable strategy for early warning of COVID-19 incidence based on WWTP monitoring.

The benefits and safety of oral sequential antibiotic therapy in non-complicated and complicated Staphylococcus aureus bacteremia.

BACKGROUND: Treatment optimization for serious infections, such as Staphylococcus aureus bacteremia (SAB), is a challenge for antimicrobial stewardship teams. Currently, SAB guidelines recommend a completely intravenous therapy (CIT). OBJECTIVES: The objective of the study was to analyze the usefulness and safety of oral sequential therapy (OST) in SAB. PATIENTS AND METHODS: We conducted a retrospective, observational study in a tertiary teaching hospital in Spain. The inclusion criteria were complicated and non-complicated monomicrobial SAB and an adequate duration of therapy, with patients classified into OST or CIT. The primary endpoint was the 90-day recurrence of S. aureus infection. We also analyzed the mortality, the length of the hospital stay, and the duration of the intravenous antibiotic administration. RESULTS: Of a total of 201 patients with SAB, 125 (62%) underwent OST. The most commonly administered oral antibiotic was trimethoprim-sulfamethoxazole (66% of patients). Of those administered OST, 43% had complicated bacteremia (most with an osteoarticular source of infection), and 6% had an intravascular device. The 90-day recurrence rate was 4%, with no differences between the two groups. The duration of the therapy (22 [16-28] vs. 13 days [8-17] for CIT and OST, respectively; p < 0.001) and the hospital stay (36 [27-71] vs. 18 days [13-29] for CIT and OST, respectively; p < 0.001) were shorter for OST. MRSA was related with mortality (OR 4.4, 95% CI [1.67-11.37]; p = 0.003). CONCLUSIONS: OST for properly selected patients with SAB could be a safe therapeutic option and can reduce their use of CIT and their hospital stay.

Diarrea aguda en paciente con artritis reumatoide / Acute diarrhea in a patient with rheumatoid arthritis

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Neurobrucellosis mimicking cerebral tumor: case report and literature review.

We are reporting a case of neurobrucellosis that was clinically and radiologically indistinguishable from a cerebral tumor. The histological diagnosis was granulomatous encephalitis. The diagnosis was established by enzyme-linked immunosorbent assay (ELISA), detecting high levels of Ig G and Ig M Brucella antibodies in the serum and the cerebrospinal fluid. We suggest that patients with granulomatous encephalitis, without a clear etiological agent, should be studied for Brucella.