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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.
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COVID-19 , SARS-CoV-2 , España/epidemiología , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Humanos , SARS-CoV-2/genética , Genoma Viral , Filogenia , PandemiasRESUMEN
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.
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Introducción: La implementación del diagnóstico en un solo paso (DUSP) de la infección activa por virus de la hepatitis C (VHC) conjuntamente con la incorporación de alertas informativas ha demostrado que reduce de forma significativa, respecto al diagnóstico tradicional, la cifra de pacientes que no eran remitidos para valoración terapéutica. Métodos: A partir de la implementación en 2018 del DUSP en los servicios de microbiología de los hospitales del Servicio Gallego de Salud (SERGAS), se identifican y caracterizan de manera retrospectiva los nuevos diagnósticos de infección activa por VHC. Resultados: En 2018 se identificaron mediante DUSP un total de 258 pacientes con infección activa por VHC desconocida (70,2% hombres, mediana de edad de 52 años) procedentes de consultas de unidades de atención primaria y especializada en un 54,8% y 39,8%, respectivamente, así como de otras localizaciones en un 5,4%. De los 258 pacientes, el 81,0% fueron derivados para valoración terapéutica, con una mediana de 54 días desde su diagnóstico. En el 58,3% de los casos se determinó el DUSP mediante carga viral, el genotipo predominante fue el 1a (30,7%), un 52,1% fue tratado y se observó una respuesta viral sostenida en el 93,7% de estos. Conclusión: La implementación en toda Galicia del DUSP de la hepatitis C conjuntamente con alertas informativas ha permitido obtener, en conjunto, tasas de derivación para tratamiento similares a las obtenidas en otros estudios. Sin embargo, existe una amplia variabilidad entre los distintos centros, que exigen la incorporación de mejoras, como la formación o la utilización de medidas de rescate para su optimización.(AU)
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.(AU)
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Humanos , Hepatitis C/diagnóstico , Hepatitis C/tratamiento farmacológico , Terapéutica , Diagnóstico , Carga Viral , Estudios Retrospectivos , España , Microbiología , Enfermedades TransmisiblesRESUMEN
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Humanos , Masculino , Persona de Mediana Edad , Moniliformis/aislamiento & purificación , Streptobacillus , Técnicas In Vitro/métodos , Resistencia a las Penicilinas , Antibacterianos/administración & dosificación , Reacción en Cadena de la Polimerasa/métodos , Artrocentesis/métodos , Neutrófilos , Ceftriaxona/administración & dosificación , Amicacina/administración & dosificaciónRESUMEN
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Humanos , Femenino , Anciano de 80 o más Años , Staphylococcus epidermidis , Staphylococcus epidermidis/aislamiento & purificación , Resistencia a Medicamentos , Linezolid/uso terapéutico , Prótesis Articulares/tendencias , Prótesis Articulares , Biopelículas , Infecciones Relacionadas con Prótesis/complicaciones , Infecciones Relacionadas con Prótesis/tratamiento farmacológicoRESUMEN
INTRODUCCIÓN: Descripción clínica y epidemiológica de un brote en una unidad de cuidados intensivos (UCI) causado por Enterobacter cloacae complex multirresistente productor de una beta-lactamasa de espectro extendido (BLEE) tipo CTX-M-9. MÉTODOS: Se realizó un estudio retrospectivo de las características clínicas y epidemiológicas del brote causado por E. cloacae complex. La identificación y estudio de sensibilidad de las cepas fueron realizados mediante el sistema semiautomático BD Phoenix™, y la caracterización de la BLEE, por PCR y secuenciación. La tipificación molecular se realizó mediante electroforesis en gel de campo pulsado (PFGE). RESULTADOS: Durante febrero de 2014, 6 pacientes (50% mujeres; media de edad: 61,5 años; rango de edad: 44-76 años) ingresados en la UCI del Complejo Hospitalario de Pontevedra (CHOP) presentaron aislamientos de E. cloacae complex resistente a cefalosporinas de amplio espectro. Tres pacientes desarrollaron infección; uno presentó bacteriemia primaria y shock séptico, y 2 neumonía asociada a ventilación mecánica. En los 3 casos restantes los aislamientos de E. cloacae complex se consideraron colonización. El análisis fenotípico y genotípico reveló que todos los aislados presentaban el mismo perfil por PFGE y que portaban la misma BLEE del tipo CTX-M-9. El brote se controló mediante la mejora de las medidas universales y el aislamiento de contacto de los pacientes infectados y/o colonizados. CONCLUSIÓN: Se describe desde un punto de vista clínico y epidemiológico un brote de E. cloacae complex portador de CTX-M-9 en una UCI
INTRODUCTION: Clinical and epidemiological description of an outbreak in an intensive care unit (ICU) caused by a strain of multidrug-resistant Enterobacter cloacae complex carrying a CTX-M-9-type extended-spectrum beta-lactamase (ESBL). METHODS: A retrospective study of the clinical and epidemiological features of the outbreak caused by E. cloacaecomplex was performed. Identifying and studying the sensitivity of the strains were performed using the semi-automated system BD Phoenix™, and the characterisation of ESBL using PCR and sequencing. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). RESULTS: During February 2014, 6 patients (50% women; mean age: 61.5 years; age range: 44-76 years) admitted to the ICU of the Hospital of Pontevedra (CHOP) presented resistant E. cloacae complex isolates to extended-spectrum cephalosporins. Three patients developed infection; one had primary bacteraemia and septic shock, and 2 with ventilator-associated pneumonia. In the remaining three cases E. cloacae complex isolates were considered as colonisation. Phenotypic and genotypic analysis revealed that all isolates had the same PFGE profile and carried the same CTX-M-9 ESBL. The outbreak was controlled by improving universal precautions and contact isolation of patients infected and/or colonized. CONCLUSION: The clinical and epidemiological features of an outbreak in an ICU caused by E. cloacae complex carrying CTX-M-9 are described
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Humanos , Enterobacter cloacae/patogenicidad , Infecciones por Enterobacteriaceae/epidemiología , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Resistencia a Múltiples Medicamentos/inmunología , beta-Lactamas/inmunologíaRESUMEN
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Femenino , Humanos , Masculino , Listeriosis/epidemiología , Monitoreo Epidemiológico/normas , Monitoreo Epidemiológico/tendencias , Monitoreo Epidemiológico , Microbiota , Seguridad de Productos para el Consumidor/normas , Abastecimiento de Alimentos/normas , Monitoreo Epidemiológico/organización & administración , Sepsis/complicaciones , Sepsis/diagnóstico , Meningitis/complicaciones , Encefalitis/complicaciones , Estudios Retrospectivos , 50328RESUMEN
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Humanos , Femenino , Adulto , Absceso/microbiología , Infecciones Urinarias/microbiología , Uretra/microbiología , Gardnerella vaginalis/aislamiento & purificación , Farmacorresistencia Microbiana , Pruebas de Sensibilidad MicrobianaAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/tratamiento farmacológico , Shigella dysenteriae , Shigella dysenteriae/aislamiento & purificación , Cefuroxima/uso terapéutico , Cistitis/complicaciones , Cistitis/tratamiento farmacológico , Shigella flexneri , Shigella flexneri/aislamiento & purificación , 51426 , Enfermedades Gastrointestinales/complicaciones , Enfermedades Gastrointestinales/tratamiento farmacológicoRESUMEN
The mechanisms of antimicrobial resistance were characterized in 90 Salmonella enterica isolates either resistant or with intermediate resistance to amoxicillin/clavulanate (AMC(R/I)) or resistant to third-generation cephalosporins (C3G(R)). These isolates were recovered in three Spanish hospitals during 2007-2009. The C3G(R) phenotype was expressed by three isolates that carried the following extended-spectrum β-lactamase genes: phage-associated bla(CTX M-10) in S. Virchow, bla(CTX-M-14a) surrounded by ISEcp1 and IS903 in S. Enteritidis, and bla(CTX-M-15) linked to ISEcp1 and orf477 in S. Gnesta (first description in this serotype). The AMC(R/I) phenotype was found in 87 isolates (79 S. Typhimurim, 7 S. Enteritidis, and one S. Thompson). The bla(PSE-1) gene, followed by bla(OXA-1) was mostly found among S. Typhimurim, and the bla(TEM-1) gene among S. Enteritidis. Three different gene combinations [bla(PSE-1) +floR+aadA2+sul+tet(G); bla(OXA-1) +catA+aadA1/strA-strB+sul+tet(B) and bla(TEM-1) + cmlA1+aadA/strA-strB+sul+tet(A)/tet(B) genes] were associated with the ampicillin-chloramphenicol-streptomycin-sulfonamides-tetracycline phenotype in 68 AMC(R/I) S. enterica isolates. Class 1 integrons were observed in 79% of the isolates and in most of them (45 isolates) two integrons including the aadA2 and bla(PSE-1) gene cassettes, respectively, were detected. The bla(OXA-1) +aadA1 arrangement was detected in 23 isolates, and the aac(6)-Ib-cr+bla(OXA-1) +catB3+arr3 in another one. Non-classic class 1 integrons were found in three isolates: dfrA12+orfF+aadA2+cmlA1+aadA1 (1 isolate), dfrA12+orfF+aadA2+ cmlA1+aadA1+qacH+IS440+sul3 (1 isolate) and dfrA12+orfF+aadA2+cmlA1+aadA1+qacH+IS440+ sul3+orf1+mef(B)Δ-IS26 (1 isolate). Taken together, these results underline the need for clinical concern regarding β-lactam resistance in Salmonella and thus for continuous monitoring (AU)
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Humanos , Integrones/genética , Infección Hospitalaria/tratamiento farmacológico , Ácido Clavulánico/administración & dosificación , Cefalosporinas/administración & dosificación , Salmonella enterica/genética , Resistencia betalactámica/genética , Infecciones por Salmonella/tratamiento farmacológico , España , Combinación Amoxicilina-Clavulanato de Potasio , Penicilinasa/genética , Antibacterianos , Electroforesis en Gel de Campo PulsadoRESUMEN
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