First Findings and Molecular Data of Phlebotomus mascittii (Diptera: Psychodidae) in the Cantabrian Cornice (Northern Spain).

Phlebotomus (Transphlebotomus) mascittii Grassi, 1908 (Diptera: Psychodidae) has been found in several European countries. In Spain, sporadic records were reported in the early '80s in Catalonia (Northeast Spain), and it was never detected again. Recent entomological surveys carried out between 2004 and 2020 revealed the presence of several specimens of P. mascittii in Spain. The species identification was confirmed by both morphological and molecular analyses. The analyzed specimens belonged to the haplotype (COI_2) defined by one polymorphic site compared to other European specimens. Phlebotomus mascittii was found in low population densities in rural areas associated with livestock farms and in an urban cemetery during the summer season. This study provides the first records of this species in various localities along the Cantabrian cornice (Northern Spain) and represents its westernmost observation in the Palearctic region. The implications of the finding of this uncommon species are discussed at different levels, with emphasis on its suspected role in the transmission of leishmaniosis.

Culicoides biting midges and mosquito fauna at three dog and cat shelters in rural and periurban areas in Northern Spain.

The diversity and abundance of Culicoides (Diptera: Ceratopogonidae) and mosquitoes (Diptera: Culicidae) were studied in three animal protection centres (APCs) in Northern Spain between 1 July and 31 October 2018. Four miniature suction CDC light traps (two UV and two standard incandescent bulb traps, both types baited and non-baited with CO2 ) were placed in each APC to compare their efficiency in the collection of these Diptera groups. A total of 1176 biting midges (14 species), 224 mosquitoes (8 species) and 1 black fly were collected and identified by both morphological and molecular approaches. The Culicoides obsoletus complex (C. obsoletus/C. scoticus) accounted for 58.2% of the total collection within the Ceratopogonidae family, whereas Culex pipiens/Cx. torrentium comprised 76.8% of the Culicidae. The input of CO2 in light traps proved largely ineffective in improving the collections of both Diptera groups. UV-light traps were 7.8 and 2.2 times more effective than incandescent light traps in trapping Culicoides and mosquitoes, respectively. Seasonal dynamics differed between both Diptera taxa but captures of both taxa were significantly larger at the beginning of the summer. The epidemiological relevance of the most prevalent species is also discussed.

Environmental sampling coupled with real-time PCR and genotyping to investigate the source of a Q fever outbreak in a work setting.

A Q fever outbreak was declared in February 2016 in a company that manufactures hoists and chains and therefore with no apparent occupational-associated risk. Coxiella burnetii infection was diagnosed by serology in eight of the 29 workers of the company; seven of them had fever or flu-like signs and five had pneumonia, one requiring hospitalisation. A further case of C. burnetii pneumonia was diagnosed in a local resident. Real-time PCR (RTi-PCR) showed a widespread distribution of C. burnetii DNA in dust samples collected from the plant facilities, thus confirming the exposure of workers to the infection inside the factory. Epidemiological investigations identified a goat flock with high C. burnetii seroprevalence and active shedding which was owned and managed by one of the workers of the company as possible source of infection. Genotyping by multispacer sequence typing (MST) and a 10-loci single-nucleotide polymorphism (SNP) discrimination using RTi-PCR identified the same genotype (MST18 and SNP type 8, respectively) in the farm and the factory. These results confirmed the link between the goat farm and the outbreak and allowed the identification of the source of infection. The circumstances and possible vehicles for the bacteria entering the factory are discussed.

Francisella species in ticks and animals, Iberian Peninsula.

The presence of Francisella species in 2134 ticks, 93 lagomorphs and 280 small mammals from the Iberian Peninsula was studied. Overall, 19 ticks and 6 lagomorphs were positive for Francisella tularensis subsp. holarctica, suggesting, as described for other regions, that lagomorphs may have an important role in the maintenance of F. tularensis in nature. Of the 6 positive lagomorphs, 4 were identified as the European rabbit, Oryctogalus cuniculus. Additionally, 353 ticks and 3 small mammals were PCR positive for Francisella-like endosymbionts (FLEs) and one small mammal was also positive for Francisella hispaniensis-like DNA sequences. Among FLE positive specimens, a variety of sequence types were detected: ticks were associated with 5 lpnA sequence types, with only one type identified per tick, in contrast to 2 lpnA sequence types detected in a single wood mouse (Apodemus sylvaticus). To our knowledge, this is the first report of FLEs in free-living small mammals as well as the first detection of F. hispaniensis-like sequences in a natural setting.

Anaplasmataceae in wild ungulates and carnivores in northern Spain.

Wild vertebrates are essential hosts for tick-borne diseases but data on the prevalence and diversity of Anaplasma spp. in wildlife are scarce. In this study, we used real-time PCR to investigate the distribution of Anaplasma species in spleen samples collected from 625 wild animals (137 cervids, 227 wild boar, and 261 carnivores) in two regions in northern Spain. A first generic real-time PCR assay was used to screen for the presence of Anaplasma spp. followed by a second species-specific multiplex real-time PCR or partial sequencing of the 16S rRNA gene for species identification. Anaplasma phagocytophilum was highly prevalent in cervids (64.2%), but it was absent from wild boar and carnivores. Interestingly, Anaplasma marginale and Anaplasma ovis were not detected in cervids, but Anaplasma centrale was identified in 1 roe deer and 1 red deer, A. bovis in 4 roe deer, and a novel Ehrlichia sp. in one badger. These findings were highly associated with the tick burden identified in the different hosts. Thus, Ixodes ricinus, the recognized vector of A. phagocytophilum in Europe, was the main tick species parasitizing cervids (93.5%, 1674/1791), whereas Dermacentor reticulatus was the most abundant in wild boar (76.1%, 35/46) and Ixodes hexagonus in carnivores (58.4%, 265/454). More investigations are needed to assess the impact of the different Anaplasma species in wildlife and the risk of transmission to domestic animals.

Bartonella chomelii is the most frequent species infecting cattle grazing in communal mountain pastures in Spain.

The presence of Bartonella spp. was investigated in domestic ungulates grazing in communal pastures from a mountain area in northern Spain, where 18.3% (17/93) of cattle were found to be positive by PCR combined with a reverse line blot (PCR/RLB), whereas sheep (n = 133) or horses (n = 91) were found not to be infected by this pathogen. Bartonella infection was significantly associated with age, since older animals showed a higher prevalence than heifers and calves. In contrast to other studies, B. chomelii was the most frequent species found in cattle (14/17), while B. bovis was detected in only three animals. Moreover, 18 B. chomelii isolates and one B. bovis isolate were obtained from nine animals. Afterwards, B. chomelii isolates were characterized by a multilocus sequence typing (MLST) method which was adapted in this study. This method presented a high discrimination power, identifying nine different sequence types (STs). This characterization also showed the presence of different STs simultaneously in the same host and that STs had switched over time in one of the animals. In addition, B. chomelii STs seem to group phylogenetically in two different lineages. The only B. bovis isolate was characterized with a previously described MLST method. This isolate corresponded to a new ST which is located in lineage I, where the B. bovis strains infecting Bos taurus subsp. taurus are grouped. Further studies on the dynamics of Bartonella infection in cattle and the potential ectoparasites involved in the transmission of this microorganism should be performed, improving knowledge about the interaction of Bartonella spp. and domestic ungulates.

Changes in the dynamics of Coxiella burnetii infection in dairy cattle: an approach to match field data with the epidemiological cycle of C. burnetii in endemic herds.

This study aimed to evaluate changes in the epidemiological status of Coxiella burnetii in dairy cattle herds to better understand the epidemiology of the infection and to predict its evolution. Bulk-tank milk (BTM) and serum samples were collected from 94 dairy cattle herds and analyzed by ELISA (BTM and sera) and PCR (BTM) in study 1 (S1). Two years later (study 2; S2), the same farms were visited with a similar sampling approach. To estimate seroconversion during this period, blood samples were collected from the maximum possible number of animals surveyed in S1. Environmental samples were collected in S2 to identify active shedding. Farms were allocated into 3 different categories in each study according to PCR and ELISA results: category A, with BTM ELISA and PCR positive herds and at least 1 seropositive animal; category B, with BTM ELISA or PCR positive herds or individual sera positive; and category C, with all negative results among herds. Changes in herd category between S1 and S2 were grouped in 9 classes. Two statistical models, one to search for drives of within-herd changes in C. burnetii infection status and another to look for variables modulating individual changes in C. burnetii antibody level, were built. Several herds in category A in S1 remained in that category 2 yr later, indicating that C. burnetii can remain within a herd for a long time. Most of the herds with seroconversion and detection of the bacterium in the environment belonged to category A, suggesting active and recent infections. Changes in the epidemiological status of herds were driven by local densities of domestic ruminants, showing the implication of neighbor reservoirs; whereas individual changes in antibody levels were modulated by variation in the epidemiological status of herds. Observed changes in epidemiological status allowed depiction of the hypothesized life cycle of C. burnetii within dairy cattle herds, which should be tested by future long-term series studies on C. burnetii infection to help fitting control measures (e.g., vaccination) to within-herd C. burnetii status.

Evaluation of Coxiella burnetii status in dairy cattle herds with bulk-tank milk positive by ELISA and PCR.

Bulk-tank milk (BTM) samples are frequently used to evaluate the health status of dairy livestock. A large-scale investigation carried out in BTM samples from dairy cattle herds from a Q fever-endemic region in Northern Spain revealed a high degree of exposure to Coxiella burnetii. This study was aimed at assessing the value of BTM samples analysis as an indicator of the C. burnetii status in dairy cattle herds. Three herds with BTM samples positive for C. burnetii by ELISA and PCR were selected, and blood, faeces and individual milk and BTM samples were analysed by serology and PCR. In spite of the high antibodies titres found in BTM samples, only one of the three farms presented an active infection by C. burnetii, as revealed by the presence of bacterial DNA in vaginal mucus and in environmental samples collected in the calving area, a seroprevalence around 40% in heifers and the seroconversion rate observed in cows. Results obtained indicated that the analysis of BTM samples is a good epidemiological tool at the population level that can be used to discriminate between seropositive and seronegative herds, but at the herd level, additional tests are necessary to evaluate whether Q fever is a potential problem in the farm. When Q fever is suspected in a cattle herd, sera from a small group of 1- to 3-year-old animals need to be analysed to investigate recent contact with C. burnetii.

Monitoring piroplasms infection in three cattle farms in Minorca (Balearic Islands, Spain) with previous history of clinical piroplamosis.

Bovine piroplasmosis are tick-borne protozoan diseases caused by parasites of the genera Theileria and Babesia. Three Friesian cattle farms (F1-F3) with previous history of clinical piroplamosis were selected in Minorca (Balearic Islands, Spain). Blood samples were collected from 8 to 11 animals every two months throughout a year and, a newly developed multiplex DNA bead-based suspension array based on the Luminex(®) xMAP technology was used to monitor for the presence of piroplasms. The assay incorporated probes for Babesia divergens, Babesia bovis, Babesia bigemina, Babesia major, Babesia occultans, Theileria annulata and Theileria buffeli, and a Catch-all Theileria and Babesia (TB) control probe. An internal amplification control that was detected with a Luminex probe was also included to monitor for inhibition. Infection was detected in 87.5% of the samples, 38.7% as single infections and 48.8% as mixed infections. T. annulata was widespread in Farm F1, with all animals positive over the whole study; albeit less frequently, T. annulata was also detected in Farms F2 and F3. T. buffeli was the overall most prevalent piroplasm, with a wide distribution in Farms F2 and F3 but only occasionally detected in F1. B. bigemina was the most frequent Babesia species, but was absent from Farm F1. B. bovis, previously reported in Minorca, was only sporadically detected in F2 and F3. A further 3 Babesia species not previously found in Minorca were also identified: B. major present in the 3 farms; B. divergens detected once in 2 animals in F2; and B. occultans found in 4 animals in F2 and in 1 Hyalomma marginatum female tick collected from a positive animal. Sequencing confirmed the identity of B. occultans thus extending the distribution of this species to Mediterranean Europe. This study confirmed the endemic situation for piroplasm infection in the region and detected the presence of a large number of chronic asymptomatic carriers. More importantly, 3 Babesia species not previously detected in the region were detected for the first time.

Estimation of Coxiella burnetii prevalence in dairy cattle in intensive systems by serological and molecular analyses of bulk-tank milk samples.

A large-scale investigation on Coxiella burnetii was carried out in dairy cattle herds from a Q fever-endemic region to evaluate the degree of exposure to C. burnetii and to estimate prevalences. This study included all of the dairy cattle herds from the province of Bizkaia, Northern Spain (n=178). Herds were visited between September 2009 and February 2010, and 100mL of bulk-tank milk (BTM) per farm was collected to be analyzed by ELISA and PCR. Blood samples were also taken from about 15 animals randomly selected from each herd. One hundred nineteen of the 178 studied herds (66.9±6.9%) were positive for the presence of anti-C. burnetii antibodies in BTM. Serum samples from 1,306 cows, 654 heifers, and 502 calves were analyzed by ELISA, and cows showed a statistically significantly higher seroprevalence (12.3±1.8%) than heifers (1.1±0.8%) and calves (0.0±0.0%). Eighty-nine herds (50.0±7.3%) had at least 1 seropositive animal, but within-herd prevalences higher than 20% were only observed in 24 herds (13.5±5.0%). A significant correlation was observed between BTM ELISA sample-to-positive control ratios and within-herd seroprevalence, being higher when considering only cows (R(2)=0.21). Animals from herds with negative BTM by ELISA showed a mean seroprevalence of 2.5%, whereas animals from herds with positive BTM samples had a statistically significantly higher seroprevalence (8.9%, F=19.7, degrees of freedom=1). The proportion of herds C. burnetii positive by BTM PCR was 51.7±7.3% (92/178). The widespread distribution of C. burnetii in cattle advocates for the implementation of Q fever control strategies.

Differences in questing tick species distribution between Atlantic and continental climate regions in Spain.

Climate and vegetation in Spain vary from north to south, affecting tick distribution and consequently the presence of tick-borne diseases. The aim of this study was to investigate throughout a 2-yr study the distribution of the different exophilic questing tick species present in 18 areas: eight located in central and 10 in northern Spain. The same methodology was used in both areas, sampling vegetation on a monthly basis by blanket dragging for 20- to 30-min intervals. A total of 12 species belonging to the genera Ixodes, Haemaphysalis, Rhipicephalus, Dermacentor, and Hyalomma was identified. Differences in species distribution and prevalence were dramatically different. The most frequent and abundant species in northern Spain were Ixodes ricinus (67% of adult ticks) and Haemaphysalis punctata (8%), whereas Hyalomma lusitanicum (86%) and Dermacentor marginatus (12%) were the most abundant in central Spain. There were important differences in the monthly seasonal patterns for the different tick species. These results highlight important differences in tick distribution in neighboring areas and underline the need for ongoing surveillance programs to monitor tick population dynamics and the prevalence of tick-borne pathogens.

Measuring antibody levels in bulk-tank milk as an epidemiological tool to search for the status of Coxiella burnetii in dairy sheep.

Pooling samples may provide a valuable alternative to individual testing for pathogen surveillance purposes. We studied the reliability of measuring the level of antibodies against Coxiella burnetii in bulk-tank milk (BTM) to estimate the seroprevalence of C. burnetii in dairy sheep in 34 flocks. We then estimated the seroprevalence of C. burnetii in 154 dairy sheep flocks according to the level of antibodies in BTM. We tested for the accuracy of our estimation at the population level by comparing predicted mean C. burnetii flock seroprevalence with that obtained in another survey performed on the same population. Our findings showed that testing BTM by ELISA is a cost-effective and relatively good index of the seroprevalence of C. burnetii in dairy sheep and may be a useful tool for epidemiological surveillance at the population level.

Molecular investigation of the occurrence of Coxiella burnetii in wildlife and ticks in an endemic area.

At present few studies have been carried out on the distribution and incidence of Coxiella burnetii infection in wildlife. Therefore, the aim of this study was to investigate the distribution of C. burnetii in the main wild species in the Basque Country (Northern Spain), such as carnivores, cervids, wild boar, lagomorphs and several species of birds. Tissues from a total of 601 animals and 340 adult ticks collected from them were analyzed by PCR. DNA of C. burnetii was detected in 5.1% of roe deer (Capreolus capreolus), 4.3% of wild boar (Sus scrofa), 9.1% of European hare (Lepus europaeus), and among wild birds, in 11% of vultures (Gyps fulvus) and 14% of black kites (Milvus migrans). These results showed that C. burnetii circulates in wildlife in Spain participating in the cycle of Q fever in nature. All of the adult ticks analyzed were negative for C. burnetii, suggesting that ticks do not play an important role in the transmission of C. burnetii in this area.

Coxiella burnetii shedding and environmental contamination at lambing in two highly naturally-infected dairy sheep flocks after vaccination.

Abortion due to Coxiella burnetii was confirmed in the 2007/08 season in two naturally-infected dairy sheep flocks. Proportion of C. burnetii shedders and bacterial loads in vaginal mucus were high among aborted or lambed ewes, as was within-flock seroprevalence. Before the next reproductive season (2008/09) 75% of ewes and 50% of replacement lambs were vaccinated (Coxevac, CEVA Santé Animale) keeping the remaining as untreated controls. Compared with the previous year results when abortion outbreak started, a great reduction in the percentage of abortions, in the number of shedders and in the bacterial burden excreted by the ewes was found in both flocks. However, seroconversion in non-vaccinated yearlings from both flocks and the presence of C. burnetii DNA in bioaerosols taken at sheep premises at lambing indicated that infection was still active. No differences were observed between vaccinated and control groups in terms of proportion of C. burnetii shedders. These results suggest that optimal results of vaccination in heavily infected flocks may not be obtained in a short-term period.

Variability of Bartonella genotypes among small mammals in Spain.

In order to study which Bartonella genotypes are circulating among small mammals in Spain, we analyzed the spleens of 395 animals from three different areas-247 animals from the Basque Country (northern Spain), 121 animals from Catalonia (northeastern Spain), and 27 animals from Madrid (central Spain)-by a triplex PCR combined with a reverse line blot previously described by our group. The prevalence of Bartonella was 26.8% (106/395), and in 4.8% (19/395) of the animals more than one Bartonella genotype was detected. The study of gltA and the intergenic transcribed spacer in the positive samples demonstrated a large diversity, allowing the assignation of them into 22 genotypes. The most prevalent genotypes were 2 and 3, which are closely related to Bartonella taylorii. In addition, nine genotypes were associated with specific mammal species. Genotypes close to the zoonotic Bartonella grahamii, Bartonella elizabethae, and Bartonella rochalimae were also detected. Ten genotypes showed a percentage of similarity with known Bartonella species lower than 96%, suggesting the presence of potential new species. Further studies of the impact of these pathogens on human health and especially in cases of febrile illness in Spain are strongly recommended. Furthermore, our method has been updated with 21 new probes in a final panel of 36, which represents a robust molecular tool for clinical and environmental Bartonella studies.

Border disease virus seroprevalence correlates to antibodies in bulk-tank milk and reproductive performance of dairy sheep flocks.

There is a great need to establish effective tools to control border disease virus (BDV) in European dairy sheep flocks. Hence, our main aim was to investigate the accuracy of analyzing anti-BDV antibodies in bulk-tank milk (BTM) in detecting the real BDV seroprevalence in dairy sheep flocks. Furthermore, the relevance of BDV to reproductive performance of dairy sheep flocks prompted us to search for the association between BDV seroprevalence and reproductive parameters. For these purposes, 34 flocks were selected based on different percentages of antibody inhibition (AIP) values in BTM as estimated by ELISA. Serum samples from 10 replacement lambs older than 6 mo, 10 ewes 1 to 2 yr old, and 10 ewes > 2 yr old were collected and analyzed for the presence of anti-BDV antibodies by ELISA. A negative relationship between BDV AIP in BTM and within-flock seroprevalence was observed. Flocks with a high AIP (> 80%) had an average of 2.5% seropositive animals; flocks with a moderate AIP (46-79%) had 11.4% seropositive animals; and finally, flocks with an AIP < or = 45% showed a high flock seroprevalence (57.2%). Ten out of 34 flocks showed a high BDV seroprevalence in lambs, suggesting the presence of persistently infected animals in the flock. The observed AIP values in BTM from these likely BDV-infected flocks were indicative of a high seroprevalence. The analysis of reproductive-parameters data collected from these flocks showed no differences in fertility or prolificacy in relation to BDV circulation rates. Nonetheless, lamb mortality was significantly greater in flocks with low-moderate seroprevalence (10-30%), probably as a result of a first-time contact with BDV of previously naïve ewes. These findings suggest that testing of BTM samples may be useful in inferring the BDV seroprevalence in a flock.

Short communication: investigation of Coxiella burnetii occurrence in dairy sheep flocks by bulk-tank milk analysis and antibody level determination.

To estimate the prevalence of Coxiella burnetii in the dairy sheep population from the Basque Country (northern Spain), a study was carried out combining molecular and serological techniques. First, bulk-tank milk samples from 154 flocks belonging to the Latxa Breed Farmers Association were analyzed by PCR, with 22% of flocks testing positive for C. burnetii. Then, a selection of 34 flocks (7 PCR positive and 17 negative) was investigated for the presence of serum antibodies by ELISA test on 1,011 ewes (approximately 30 ewes per flock). A total of 8.9% of the animals were seropositive, 67.6% of the flocks had at least one seropositive animal, but only in 14.7% of them was seroprevalence greater than 25%. Older ewes showed a significantly greater prevalence (17.5%) compared with yearlings (7.5%) or replacement lambs (1.5%). A marginally significant association was found between seroprevalence and PCR detection of C. burnetii in bulk-tank milk. The widespread distribution of C. burnetii in the region advocates for the implementation of Q fever control strategies and highlights the potential risk of sheep as a reservoir and infection source for other domestic and wildlife species and the human population.

Clinical and laboratorial findings in pregnant ewes and their progeny infected with Border disease virus (BDV-4 genotype).

To evaluate the pathogenicity of local isolates of ovine pestiviruses (BDV-4 genotype), 13 virus- and antibody-negative, artificially inseminated pregnant ewes were challenged on days 108 (5 ewes), 76 (5 ewes) and 55 of pregnancy (3 ewes) with 2 ml of ovine pestivirus containing 10(6) TCID(50). Viraemia was detected by RT-PCR from 2 to 15 days pi in most ewes. No abortion due to the infection was observed but the number of stillbirths was high (32%), and bodyweight at lambing was significantly reduced compared to the experimental flock of origin used as control. Clinical symptoms in live lambs consisted on tremors, gait anomalies and inability to stand unaided. Skeletal abnormalities (brachygnathia, prognathia, arthrogryposis) were present in 44% of the lambs. Only 20% of the lambs were clinically normal. RT-PCR was a very sensitive technique compared to antigen ELISA in detecting viral presence in experimentally infected ewes and their progeny.

Distribution and molecular detection of Theileria and Babesia in questing ticks from northern Spain.

A total of 562 questing adult ixodid ticks, collected during 2003-05 in 10 recreational mountain areas in northern Spain, were analysed for piroplasm infection. Reverse line blot (RLB) analysis using a panel of probes for 23 piroplasm species identified 16 different piroplasms, with an overall prevalence of 9.3%. Most were Theileria spp.-positive (7.7%), 3.0% were positive for Babesia spp. and 1.4% of ticks harboured both genera. Ixodes ricinus (Linnaeus, 1758), the most abundant tick in the vegetation, ranked third with regard to piroplasm infection prevalence (11.4%) after Rhipicephalus bursa (Canestrini & Fanzago, 1878) (16.0%) and Haemaphysalis punctata (Canestrini & Fanzago, 1878) (13.5%). Infection was detected in 6.2% of Dermacentor reticulatus (Fabricius, 1794) and in 1.1% of Haemaphysalis inermis (Birula, 1895), but was absent from Haemaphysalis concinna (Koch, 1844). Ixodes ricinus carried more piroplasm species (13), followed by H. punctata (10), D. reticulatus (8), R. bursa (3) and H. inermis (1). Although most of the positive ticks harboured a single infection (76.9%), mixed infections with two or three different piroplasm species were also detected (23.1%). The various tick-pathogen associations found are discussed and prevalences of infection in ticks are compared with previous results on piroplasms infecting animals in the same region.

Determinación de microonganismos más frecuentes que aparecen en lesiones d epacientes que padecen pie diabético / Determination of frquent microorganisms in injuries of patients with diabetic food infections

Una de las complicaciones tardías de la Diabetes Mellitus es el pie diabético. El diagnóstico de la infección es fundamental. Conocer el comportamiento microbiológico de la enfermedad a nivel hospitalario, permite crear condiciones necesarias para el tratamiento adecuado. OBJETIVOS. Identificar los microorganismos más frecuentes y determinar la sensibilidad a los antimicrobianos. MÉTODO. Se revisaron 118 historias clínicas de pacientes ingresados con el diagnóstico de pie diabético neuro infeccioso de Enero-Diciembre 2006 en el Instituto Nacional de Angiología y Cirugía Vascular. RESULTADOS. El Staphylococcus aureus con un 35% resultó ser el microorganismo más frecuentemente encontrado, seguido de Escherichia coli 24%, Pseudomonas aeruginosa 16% y Proteus mirabilis 8%, otros cocos Gram positivos y bacilos Gram negativos aparecieron en cuantía menor en nuestro estudio. Las cefalosporinas de la 1ª y 3ª generación fueron sensibles “in vitro” entre un 60-80%, los carbepenémicos con un 100% de sensibilidad para todos los tipos de bacterias aisladas. CONCLUSIONES. Una vez establecido el diagnóstico de la infección en el paciente con pie diabético. En cada hospital debe optarse por una pauta antibiótica que tenga en consideración los distintos patrones de sensibilidad a los antimicrobianos detectados localmente (AU)

One of the delayed complications of the Mellitus Diabetes is the Diabetic Foot. The diagnosis of the infection is fundamental. To know the microbiological behavior the disease hospitable level, allows to create necessary conditions for the suitable treatment. OBJECTIVES. To identify the most frequent microorganisms and to determine sensitivity to the antimicrobial ones. METHOD. 118 clinical histories of patients entered with the standing up Diabetic diagnosis were reviewed neural infectious of January to December 2006 in the National Institute of Angiology and Vascular Surgery. RESULTS. The Staphylococcus aureus with a 35% turned out to be more the frequently found microorganism, followed of Escherichia coli 24%, aeruginosus Pseudomonas 16% and Proteus mirabilis 8%, other positive Gram coconuts and negative Gram bacilli appeared in smaller quantity in our study. The cephalosporins of 1ª and 3ª sensible generation were “in vitro” between a 60-80%, the carbapenems with a 100% of sensitivity for all the types of isolated bacteria. CONCLUSIONS. Once established the diagnosis of the infection in the patient with Diabetic Foot. In each hospital it must be decided on an antibiotic guideline that has in consideration the different locally detected patterns from sensitivity from the antimicrobial ones (AU)