Fungal Keratitis Due to Beauveria bassiana in a Contact Lenses Wearer and Review of Published Reports.

Fungal keratitis is a severe ocular infection that primarily affects subjects engaged in outdoor activities. Risk factors include allergic conjunctivitis, previous eye surgery, previous treatment with wide-spectrum antimicrobial agents and corticosteroids and using contact lenses. Corneal infection is usually secondary to trauma involving organic material, which is often the only predisposing factor. Early diagnosis based on clinical examination and microbiological investigation (microscopy, cultures and molecular techniques) is crucial to selecting the appropriate antifungal therapy and prevent progression. We report the case of a patient with keratitis due to Beauveria bassiana, an opportunistic and entomopathogenic filamentous fungus that is used as a biological insecticide and which is a rare cause of corneal infection. We review previous cases reports of B. bassiana keratitis published and its main features to compare with our case, a female occasional agriculture worker who had not suffered any trauma involving organic material. The patient received topical and oral antifungal therapy and debridement surgery, with a satisfactory outcome.

Development of a web application for recording bacterial etiologic agents and their antimicrobial susceptibility to improve the treatment of urinary tract infections and monitor resistance to antibiotics / Desarrollo de una aplicación web para el registro de agentes etiológicos bacterianos y su sensibilidad a los antibióticos para mejorar el tratamiento de infecciones del tracto urinario y monitorización de las resistencias

Introduction. We describe the development of a web platform that provides an updated record of the etiology and antimicrobial susceptibility of the different microorganisms responsible for urinary tract infections. Material and Methods. The MicrobDinamyc system (Francisco Soria Melguizo, SA, Madrid, Spain) is employed for the management of information derived from the urine culture results. The web application database automatically gathers the results of urine cultures conducted in the laboratory. Results. The user can consult the distribution of bacterial etiologies and antimicrobial susceptibilities in the different clinical settings during a specific time window. Conclusions. Using susceptibility data obtained in previous studies and stored on the web platform, it is possible to deduce the clinical activity of a given antibiotic in a specific setting (AU)

Introducción. Describimos el desarrollo de una plataforma web que proporciona un registro actualizado de la etiología y sensibilidad a los antibióticos de los diferentes microorganismos responsables de infecciones del tracto urinario. Material y métodos. El sistema de MicrobDinamyc (Francisco Soria Melguizo, S.A., Madrid, España) se emplea para la gestión de la información derivada de los resultados del cultivo de orina. La base de datos de la aplicación web automáticamente recoge los resultados de los urocultivos realizados en el laboratorio. Resultados. El usuario puede consultar la distribución de etiologías bacterianas y sensibilidad a los antibióticos en los diferentes escenarios clínicos durante un período de tiempo específico. Conclusiones. Usando datos de susceptibilidad obtenidos en estudios previos y almacenados en la plataforma web, es posible deducir la actividad clínica de un determinado antibiótico en una configuración específica (AU)

Development of a web application for recording bacterial etiologic agents and their antimicrobial susceptibility to improve the treatment of urinary tract infections and monitor resistance to antibiotics.

OBJECTIVE: We describe the development of a web platform that provides an updated record of the etiology and antimicrobial susceptibility of the different microorganisms responsible for urinary tract infections. METHODS: The MicrobDinamyc system (Francisco Soria Melguizo, SA, Madrid, Spain) is employed for the management of information derived from the urine culture results. The web application database automatically gathers the results of urine cultures conducted in the laboratory. RESULTS: Results. The user can consult the distribution of bacterial etiologies and antimicrobial susceptibilities in the different clinical settings during a specific time window. CONCLUSIONS: Using susceptibility data obtained in previous studies and stored on the web platform, it is possible to deduce the clinical activity of a given antibiotic in a specific setting.

Diagnóstico de paludismo en un hospital regional con asistencia a inmigrantes y viajeros / Diagnosis of malaria in a regional hospital with assistance to immigrants and travelers

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Serotipos y patrones de resistencia antibiótica en aislados betahemolíticos deStreptococcus agalactiae de madres colonizadas y recién nacidos con enfermedad invasiva / Serotypes and antibiotic resistance patterns in beta-hemolytic Streptococcus agalactiae isolates in colonized mothers and newborns with invasive disease

INTRODUCCIÓN: Las actuales medidas de prevención frente a la enfermedad neonatal causada por Streptococcus agalactiae, estreptococo del grupoB (EGB), son la realización de un cribado prenatal y la administración de profilaxis antibiótica intraparto con antimicrobianos adecuados. Una alternativa a esta estrategia sería la administración de una vacuna polisacarídica, por lo que es necesario conocer la distribución de serotipos capsulares de las cepas circulantes. MÉTODOS: Se estudiaron 188 cepas procedentes de gestantes del área sanitaria norte de Granada portadoras vaginorrectales de EGB y 24 de recién nacidos con enfermedad neonatal enviadas al laboratorio desde distintos hospitales andaluces. Se realizó antibiograma frente a penicilina, eritromicina y clindamicina siguiendo las normas del Clinical and Laboratory Standards Institute (CLSI), y se determinó su serotipo capsular mediante 2 métodos: aglutinación con partículas de látex y métodos moleculares. RESULTADOS: De las 188 cepas de S.agalactiae pertenecientes a mujeres embarazadas, se obtuvo una concordancia en los resultados del 80,8% entre ambas técnicas. Se detectó resistencia a eritromicina y clindamicina en el 16,5 y el 10,1% de cepas, respectivamente. En las cepas neonatales, en el 95,8% de los aislados los resultados obtenidos por ambas técnicas fueron coincidentes. Las tasas de resistencia frente a eritromicina y clindamicina fueron del 8,3 y del 4,1%, respectivamente. En ambos grupos de aislados el serotipo más frecuente fue el III y el más relacionado con resistencia frente a antimicrobianos, el V. CONCLUSIÓN: Se deberían realizar más estudios epidemiológicos que permitan continuar con una vigilancia de los serotipos causantes de enfermedad invasiva así como sus patrones de sensibilidad antibiótica utilizando métodos sensibles y específicos

INTRODUCTION: Current preventive measures against neonatal disease caused by Streptococcus agalactiae (GBS) are prenatal screening and intrapartum antibiotic prophylaxis with appropriate antimicrobials. An alternative to this strategy would be the administration of a polysaccharide vaccine as the distribution of capsular serotypes of circulating strains needs to be known. METHODS: A study was made of 188 strains from pregnant women carrying GBS and 24 newborns with neonatal disease. Susceptibility testing was performed with penicillin, erythromycin and clindamycin following CLSI standards, and capsular serotype was determined by two methods: latex agglutination and PCR. RESULTS: Of the 188 strains of S.agalactiae from the pregnant women, there was 80.8% agreement in the results between the two techniques. Resistant to erythromycin and clindamycin was found in 16.5% and 10.1%, respectively. For neonatal strains, 95.8% of the results obtained by the two techniques were identical. The rates of resistance to erythromycin and clindamycin were 8.3% and 4.1%, respectively. In both groups, most frequently isolated serotype was III, and the most related to antimicrobial resistance serotype was V. CONCLUSIÓN: Epidemiological studies are necessary to continue surveillance of serotypes causing invasive disease and its antibiotic sensitivity patterns using sensitive and specific methods

[Serotypes and antibiotic resistance patterns in beta-hemolytic Streptococcus agalactiae isolates in colonized mothers and newborns with invasive disease]. / Serotipos y patrones de resistencia antibiótica en aislados betahemolíticos de Streptococcus agalactiae de madres colonizadas y recién nacidos con enfermedad invasiva.

INTRODUCTION: Current preventive measures against neonatal disease caused by Streptococcus agalactiae (GBS) are prenatal screening and intrapartum antibiotic prophylaxis with appropriate antimicrobials. An alternative to this strategy would be the administration of a polysaccharide vaccine as the distribution of capsular serotypes of circulating strains needs to be known. METHODS: A study was made of 188 strains from pregnant women carrying GBS and 24 newborns with neonatal disease. Susceptibility testing was performed with penicillin, erythromycin and clindamycin following CLSI standards, and capsular serotype was determined by two methods: latex agglutination and PCR. RESULTS: Of the 188 strains of S.agalactiae from the pregnant women, there was 80.8% agreement in the results between the two techniques. Resistant to erythromycin and clindamycin was found in 16.5% and 10.1%, respectively. For neonatal strains, 95.8% of the results obtained by the two techniques were identical. The rates of resistance to erythromycin and clindamycin were 8.3% and 4.1%, respectively. In both groups, most frequently isolated serotype was iii, and the most related to antimicrobial resistance serotype was v. CONCLUSION: Epidemiological studies are necessary to continue surveillance of serotypes causing invasive disease and its antibiotic sensitivity patterns using sensitive and specific methods.

Evolution of the resistance to antibiotics of bacteria involved in urinary tract infections: a 7-year surveillance study.

BACKGROUND: We conducted a retrospective analysis on the identification and antibiogram of all bacteria isolated from urine samples with microbiological confirmation of urinary tract infection (UTI) in a Spanish reference hospital over a 7-year period. METHODS: A retrospective analysis was performed of the identification and antibiogram data. RESULTS: A total of 31,758 uropathogens were isolated. Escherichia coli accounted for the majority (55.2%) of these, followed by Enterococcus faecalis (18.0%) and Klebsiella spp (10.3%). The highest E coli susceptibility rates were to imipenem (93.0%-99.8%), amikacin (97.3%-99.5%), nitrofurantoin (96.7%-98.9%), and fosfomycin (95.3%-100%), and the lowest were to cefuroxime (67.8%-86.4%), ciprofloxacin (61.2%-69.8%), and co-trimoxazole (55.0%-65.5%). We highlight the overall high activity of imipenem, piperacillin-tazobactam, nitrofurantoin, and fosfomycin on isolates versus the low activity of fluoroquinolones, co-trimoxazole, or cephalosporins. The activity of amoxicillin-clavulanic acid and fosfomycin decreased significantly over the 7-year study period. CONCLUSIONS: Imipenem and piperacillin-tazobactam appear to be good options for the empiric treatment of UTI acquired in hospital or requiring hospitalization, whereas nitrofurantoin and fosfomycin can be first-choice antibiotics for the treatment of uncomplicated community-acquired cystitis. However, surveillance studies are required to detect resistance to these antibiotics, given that an increase in uropathogen resistance rates may contraindicate its future use in empiric UTI therapy.

Disseminated infection due to Saksenaea vasiformis secondary to cutaneous mucormycosis.

Mucormycosis is an uncommon opportunistic fungal infection caused by Zygomycetes. It usually affects immunocompromised, diabetic and trauma patients with infected wounds. We report a case of disseminated infection secondary to facial cutaneous mucormycosis caused by Saksenaea vasiformis in a diabetic patient who had a farming accident causing him severe head injury. The patient was treated with a combination of surgical debridement and antifungal therapy with liposomal amphotericin B, but he had a slow and fatal outcome. In cases of tissue necrosis following trauma involving wound contact with soil (i.e., potential fungal contamination), testing for the presence of Zygomycetes fungi such as S. vasiformis in both immunocompetent and immunocompromised patients is crucial. The reason is that this infection usually has a rapid progression and may be fatal if appropriate treatment is not administered.

Identificación bacteriana directamente del hemocultivo mediante una técnica rápida de espectrometría de masas Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight / Bacterial identification from blood cultures by a rapid Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight mass spectrometry technique

Introducción La espectrometría de masas Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight (MALDI-TOF) es una técnica rápida y fiable de identificación bacteriana. Métodos Se evalúa un método para identificación directa del hemocultivo fácil, rápido de realizar y de bajo coste. Resultados El porcentaje de identificaciones con (..) (AU)

Introduction Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight (MALDI-TOF) Mass Spectrometry is rapid and accurate for the bacterial identification. Methods We have evaluated a less laborious and less time consuming method for microorganism identification directly from positive blood cultures. Results When we considered the scores (..) (AU)

[Bacterial identification from blood cultures by a rapid Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight mass spectrometry technique]. / Identificación bacteriana directamente del hemocultivo mediante una técnica rápida de espectrometría de masas Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight.

INTRODUCTION: Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight (MALDI-TOF) Mass Spectrometry is rapid and accurate for the bacterial identification. METHODS: We have evaluated a less laborious and less time consuming method for microorganism identification directly from positive blood cultures. RESULTS: When we considered the scores ≥1.7 and ≥1.4 for acceptable identification of species and genus, the percentage of identification was 77.5% and 93.9%, respectively. CONCLUSIONS: This method is reliable, rapid and cost-effective for implementation in routine use in clinical microbiology laboratories.

Implementation and monitoring of a quality management system based on the standard UNE-EN-ISO 15189 in a urine culture unit.

OBJECTIVES: To evaluate the implementation of a quality management system based on ISO-15189 in a urine culture unit. DESIGN AND METHODS: The effectiveness of improvement actions was measured by quality indicators. RESULTS: The errors in the pre-analytical phase and the rate of contaminated urine decreased significantly. The traceability, response time and external quality control were fulfilled. CONCLUSIONS: The implementation of ISO-15189 was effective in improving the management of a urine culture unit.