Evaluation of infection prevention and control programmes according to the European Centre for Disease Prevention and Control and the World Health Organization in Spain 2012-2022: indicators of core component 1.

BACKGROUND: Key and core components of effective infection prevention and control programmes (IPCPs) issued by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have been described. WHO core component 1 relates to the structure, organization and management of IPCPs. AIM: The objective of this study was to assess the status and the time trends of some indicators of core component 1 of IPCPs in acute hospitals in Spain throughout the period 2012-2022. METHODS: Hospital-level data from the Spanish point prevalence survey for years 2012-2022 were analysed. Core component 1 indicators were calculated and tested for association to healthcare-associated infections (HAIs). In addition, trends were also examined. RESULTS: Overall, 67.0% and 57.2% of Spanish hospitals reported having an annual infection prevention and control (IPC) plan and an annual IPC report that was approved by the hospital managing director, respectively. The global median number of full-time equivalent (FTE) IPC nurses per 250 beds for the period was 0.87 and the global median number of FTE IPC doctors was 0.70. The rates of blood cultures and stool tests for Clostridioides difficile were 39.9 and 6.1 per 1000 patient-days, respectively. No significant correlation was found between core component 1 indicators and HAI prevalence. CONCLUSION: Spain is currently at a basic level on the structure, organization and management of IPCPs. Profound differences were found between hospitals depending on size and type.

Trends of antimicrobial use through selected antimicrobial indicators in Spanish hospitals, 2012 to 2021.

BACKGROUND: Surveillance of antimicrobial consumption is an important component of control strategies to tackle antimicrobial resistance. AIM: To evaluate the consumption of antimicrobials using six indicators proposed by the European Center for Disease Prevention and Control. METHODS: Point prevalence survey data on antimicrobial use in Spanish hospitals throughout the period 2012-2021 were analysed. A descriptive analysis of each indicator by year was performed globally and by hospital size. A logistic regression model was used to identify significant time trends. FINDINGS: In all, 515,414 patients and 318,125 antimicrobials were included. The prevalence of antimicrobial use remained stable throughout the study period (45.7%; 95% confidence interval (CI): 45.6-45.8). Percentages of antimicrobials for systemic use and those administered parenterally showed a small and significant increasing trend (odds ratio (OR): 1.02; 95% CI: 1.01-1.02; and OR: 1.03; 95% CI: 1.02-1.03, respectively). Small improvements were found in the percentages of antimicrobials prescribed for medical prophylaxis and with the reason for use documented in patients' medical records (-0.6% and 4.2%, respectively). The percentage of surgical prophylaxis prescribed for more than 24 h shows a significant improvement, decreasing from 49.9% (95% CI: 48.6-51.3) in 2012 to 37.1% (95% CI: 35.7-38.5) in 2021. CONCLUSION: During the last decade, Spanish hospitals have had a stable but high prevalence of antimicrobial use. Little to no improvement has been made in most of the indicators analysed, except for a reduction in the prescription of surgical prophylaxis for more than 24 h.

HLA-G expression in Merkel cell carcinoma and the correlation with Merkel cell polyomavirus infection.

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine cutaneous carcinoma with a high mortality rate. The MCC etiology is not fully understood. Merkel cell-associated polyomavirus (MCPyV) was found in MCC patients, indicating a risk factor for the tumor. Caucasian, elderly, and immunocompromised individuals are more likely to develop this tumor. HLA-G consists of a non-classical class I (Ib) HLA molecule with an immunoregulatory function and was associated with tumor escape in different types of tumors, nonetheless, never been studied in MCC. The purpose of this study was to evaluate the HLA-G expression and also to detect the MCPyV in MCC patients and correlate it with the clinical course of the disease. Forty-five MCC patients were included in a retrospective study. Formalin-fixed paraffin-embedded cutaneous skin biopsies were used by immunohistochemistry and RT-PCR to verify the HLA-G expression and MCPyV infection. HLA-G expression was found in 7 (15.6%), while the presence of MCPyV was detected in 28 (62.2%) of the studied patients. No significant association was found between HLA-G expression and MCPyV infection (p = 0.250). The presence of MCPyV was associated with areas of low sunlight exposure (p = 0.042) and the HLA-G expression with progression to death (p = 0.038). HLA-G expression was detected in MCC patients, as well as the MCPyV presence was confirmed. These markers could represent factors with a possible impact on patient survival; however, further studies with a greater number of patients are needed, to better elucidate the possible role in disease progression.

Effect of Different Wheat-Based Diets and Corn Meal Addition on Development Parameters of Ephestia kuehniella (Zeller, 1879) (Lepidoptera: Pyralidae).

The expansion of Integrated Pest Management (IPM), including biological control, has had several positive consequences for the agricultural environment and participants in the production chain. To enable successful operation and applications of biological control, production of insects used for rearing natural enemies (parasitoids and predators) must be optimized to reduce time and costs and improve production both qualitatively and quantitatively. The present study evaluated the effect of wheat varieties, the main component of artificial diets for Ephestia kuehniella, on the reproductive performance and biological parameters of this flour moth, which is used for mass production of Trichogramma spp. (Hymenoptera: Trichogrammatidae) and other parasitoids and predators. Four varieties of wheat were compared: BRS 327, BRS Marcante, BRS Parrudo, and KBR, with and without the addition of corn E. kuehniella reared on 97% BRS 327 wheat flour + 3% nutritional yeast had the best biological parameters and substitution of corn for about half of the wheat increased the number of eggs per female.

HLA-G expression in Merkel cell carcinoma and the correlation with Merkel cell polyomavirus infection

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine cutaneous carcinoma with a high mortality rate. The MCC etiology is not fully understood. Merkel cell-associated polyomavirus (MCPyV) was found in MCC patients, indicating a risk factor for the tumor. Caucasian, elderly, and immunocompromised individuals are more likely to develop this tumor. HLA-G consists of a non-classical class I (Ib) HLA molecule with an immunoregulatory function and was associated with tumor escape in different types of tumors, nonetheless, never been studied in MCC. The purpose of this study was to evaluate the HLA-G expression and also to detect the MCPyV in MCC patients and correlate it with the clinical course of the disease. Forty-five MCC patients were included in a retrospective study. Formalin-fixed paraffin-embedded cutaneous skin biopsies were used by immunohistochemistry and RT-PCR to verify the HLA-G expression and MCPyV infection. HLA-G expression was found in 7 (15.6%), while the presence of MCPyV was detected in 28 (62.2%) of the studied patients. No significant association was found between HLA-G expression and MCPyV infection (p = 0.250). The presence of MCPyV was associated with areas of low sunlight exposure (p = 0.042) and the HLA-G expression with progression to death (p = 0.038). HLA-G expression was detected in MCC patients, as well as the MCPyV presence was confirmed. These markers could represent factors with a possible impact on patient survival; however, further studies with a greater number of patients are needed, to better elucidate the possible role in disease progression.

[Prevalence of chronic diseases and risk factors among the Spanish prison population]. / Prevalencia de patologías crónicas y factores de riesgo en población penitenciaria española.

BACKGROUND: chronic diseases are responsible for 60% of deaths and 75% of spending on public health. There are few works on the prevalence of this type of pathology in prison. OBJECTIVE: Describe the prevalence of chronic major diseases in the population and the major risk factors observed. METHODS: Multicenter transversal descriptive study. The sample size was 1,170 people, who were selected through sampling stratified with simple allocation by strata among 9 prisons in the country. There were interviews and physical examinations between May and June 2013. Variables were collected: socio-demographic, diagnostic, anthropometric, clinical-analytical and risk factors. A descriptive and subsequent comparative analysis was carried out using non-parametric tests for quantitative variables using the Mann-Whitney test and a Ji-square test for categorical variables. Subsequently, binary logistic regression models to evaluate the influence of factors of risk in major pathologies. The manuscript was approved by the Ethics Committee for clinical research of the University General Hospital of Castellon. RESULTS: 1 of every 2 inmates has some type of chronic disease out of the 1,077 participated (92.1). Median age of 37.4 years IQR (30.0 to 44.8). 95 males, 40.6 foreigners. Prevalence: dyslipidemias (34.8); arterial hypertension (17.8); Diabetes (5.3); asthma (4.6); COPD (2.2); ischaemic heart disease (1.8) and (1.5) cardio-circulatory pathologies. Main risk factors: smoking, obesity, abdominal fat distribution, consumption of cocaine and age. CONCLUSIONS: It would be interesting to establish early diagnosis, encourage giving up smoking, and physical activity and dietary advice to combat the major modifiable risk factors.

[Job satisfaction of nursing staff in Spanish prisons]. / Satisfacción laboral de la enfermería en las prisiones españolas.

BACKGROUND: There are no available studies assessing job satisfaction amongst nursing staff in Spanish prisons. The aim of this study is to establish overall levels of job satisfaction and determine each of the components. METHOD: Cross-sectional and multi-centre descriptive study conducted in Spanish prisons. A Font Roja satisfaction questionnaire adapted by J. Arranz for the study was used to measure degrees of job satisfaction using a Likert's scale. A parametric test was used and a regression model was constructed for predictive ends. RESULTS: 376 nurses answered the questionnaire (Participation Rate 62.7%; Response Rate 76.7%) 67 centres took part (91.8%). The average satisfaction mark was 2.84 (CL 95%: 2.81-2.87). The lowest ranked components were job variety 1.66 (CL 95%: 1.58-1.74), job-related stress 2.15 (CL 95%: 2.08-2.23) and control over job 2.77 (CL 95%: 2.73-2.82). The highest ranked aspect was job satisfaction, averaging 3.52 (CL 95%: 3.44-3.58). CONCLUSIONS: The average satisfaction mark for prison nursing staff was low when compared to other groups of health care professionals, which implies the need for corrective measures.

Cholinesterases activities and lipid peroxidation levels in muscle from shelf and slope dwelling fish from the NW Mediterranean: its potential use in pollution monitoring.

We selected muscle tissue from nine commercial fish species, seven teleosts and two elasmobranchs, frequently caught in the NW Mediterranean trawling grounds in two different habitats (the continental shelf at 53 m and the slope at 660 m) for cholinesterases (ChEs) characterisation and activities determination, as well as the measure of lipid peroxidation (LP) levels. Acethyl- (AChE), butyryl- (BChE) and propionyl- (PrChE) cholinesterase were chosen as exposure markers of neurotoxic chemicals/molecules and LP as an effect marker of oxidative damage. The use of diagnose inhibitors: eserine sulphate, iso-OMPA and BW284c51 confirmed the measurement of true ChEs as well as the presence of pseudocholinesterases. The present study has evidenced the existence of interspecies differences, especially between teleosts and elasmobranchs but not in relation to depth. Moreover, the good correlation observed between all ChEs in most of the studied fish, supports the use of AChE as neurotoxic marker in field pollution monitoring. The non-metric multidimensional scaling analysis identified the commercial species hake Merluccius merluccius, among teleosts, and the shark, Galeus melastomus, as more adequate sentinel species in commercial fishing grounds. AChE activity showed a relationship with the fish trophic level, while all ChEs revealed a relationship with the feeding habits (benthic, suprabenthic, pelagic) and the stomach fullness. BChE activity and LP levels were the only markers to show a relationship with their swimming capacity.

Esterase activities and lipid peroxidation levels in offshore commercial species of the NW Mediterranean Sea.

There is a lack of information on monitoring neurotoxicity in offshore commercial species. To help fill this gap, we sampled hake (Merluccius merluccius) and Norway lobster (Nephrops norvegicus) in fishing grounds off the coast of l'Ametlla de Mar (NW Mediterranean) in June 2005 at a depth of 100 m and 400 m. Additionally, at 400 m depth, two other fish species, Micromesistius poutassou and Phycis blennoides were included. Neurotoxicity markers such as Colinesterases (ChEs), namely acethyl- (AChE), butyryl- (BChE), propionyl- (PrChE) and carboxilesterase (CbE) were measured in muscle. Lipid peroxidation (LP), a marker of oxidative damage, was also included. The results are discussed in relation to the animal's sex, size and fishing depth. A comparison of esterases and LP levels between muscle and liver of hake and between muscle and hepatopancreas of Norway Lobster was made. AChE was dominant in muscle and CbE in hepatopancreas. No differences between fish species were seen for AChE. However, N. norvegicus, presented lower levels of ChEs and LP. A size-dependence in ChEs was seen for M. merluccius, with larger animals showing significantly lower activities (p<0.05). Sex-dependence was seen in N. norvegicus for most esterases, except AChE, with males displaying higher activities (p<0.05). A sampling-depth effect was also seen in the crustacea, with animals from 100 m generally presenting lower esterase activities and higher LP levels.

Copepods and larvae of nematodes parasitizing (correction of parasiting) the white mullet Mugil curema (Valenciennes, 1836): indicators of anthropogenic impacts in tropical coastal lagoons?

The relationship between parasites and environmental stress were studied in two tropical coastal lagoons of Northwest Mexico: Urias estuary (highly polluted) and Teacapan estuary (slightly polluted). Metazoan parasites were examined in 292 white mullet (Mugil curema) specimens collected bimonthly during a year from both systems. Haliotrema mugilinus, Metamicrocotyla macracantha, Ergasilus sp., Caligus sp., Holobomolochus sp., and Lernaeopodidae were found in gills, while Contracaecum sp. larvae III was found liver, hepatic portal vein and kidneys. Ecological indices were influenced by the slightly higher number of parasitic species in Urias compared to Teacapan, as well as the clear dominance of two species: Ergasilus sp. and Contracaecum sp. in both systems. In fact, Ergasilus sp. showed considerably higher abundance in Urias, possibly indicating that its success was a result of adverse conditions affecting the host, while Contracaecum sp showed higher abundances in Teacapan, suggesting that the environmental conditions occurring in Urias could have produced negative impacts on the nematode's infective potential.

Seasonal variations of selected biomarkers in sand gobies Pomatoschistus minutus from the Guadalquivir Estuary, Southwest Spain.

Sand gobies, Pomatoschistus minutus, were collected monthly from September 2002 to August 2003 at a station situated 8 km upstream from the mouth of the Guadalquivir estuary (southwest Spain). Physical parameters of the water and selected biomarkers of organic pollution were recorded in the fish to discuss its potential as a sentinel species in estuaries. The biomarkers selected were the activities of catalase (CAT), 7-ethoxyresorufin-O-deethylase (EROD), and glutathione S-transferase (GST) in the liver and acetylcholinesterase (AChE) and lipid peroxidation (LP) in the head. The results showed an increase in total protein synthesis in late spring and early summer coinciding with the reproductive period as well as the release of fresh water from a dam situated 110 km upstream. During the same period, a significant depletion of hepatic GST and head AChE but higher LP levels in this tissue suggest exposure to pesticides such as those applied to crops established along the course of the river and reaching the estuary mostly when the freshwater discharges occur. Changes in CAT and EROD activities fluctuated randomly and were not noted as seasonally dependent. Biomarker fluctuations in sand goby are discussed as normal seasonal variations, but other variables-such as potential local pollution inputs-cannot be disregarded.

Effects of methamidophos on acetylcholinesterase activity, behavior, and feeding rate of the white shrimp (Litopenaeus vannamei).

The toxicity of methamidophos on the shrimp Litopenaeus vannamei was evaluated using acetylcholinesterase (AChE) activity, behavior, and feeding rate as effect criteria. The biochemical characterization of the soluble cholunesterase (ChE) present in both muscle and eye tissues of L. vannamei was performed in a first phase of the study. In both tissues, almost full inhibition of enzyme activity by eserine sulfate was found, indicating that the measured activity is mainly from ChE and not from other esterases. The highest rate of substrate hydrolysis was found when acetylthiocholine was used as substrate. To evaluate the effects of methamidophos on L. vannamei AChE, behavior, and feeding rate, shrimps were exposed for 24h to several sublethal concentrations of methamidophos. Significant effects of the pesticide on behavior and AChE were found, with behavior being a more sensitive endpoint than AChE inhibition. Feeding rate was not a sensible endpoint under conditions tested.

Evaluation of the susceptibility of the cultured shrimp Litopenaeus vannamei to vibriosis when orally exposed to the insecticide methyl parathion.

The causes of disease in cultured shrimp are difficult to ascertain but there is evidence that disease is correlated with environmental factors. Crustaceans are particularly sensitive to insecticides due to their close phylogenetic relationship with insects. The objective of this study was to investigate whether there was an increased susceptibility of the shrimp Litopenaeus vannamei to Vibrio parahaemolyticus, when exposed to methyl parathion. The outline of the study was the following: An LC50 96 h was determined to methyl parathion orally offered to juvenile shrimp. Further experiments were carried out in order to determine a concentration that affected the shrimp (verified by measuring the acethylcholinesterase activity) while producing minimal mortalities. This sublethal concentration was used in a susceptibility experiment where methyl parathion was offered to shrimp which were later injected with V. parahaemolyticus in a dose expected to kill less than 15%. Probit analysis estimated a 96 h median lethal concentration (LC50) of 1.56 microg g(-1). Mortality and AChE activity showed a concentration-response relationship in the exposure treatments. The median inhibitory concentration (IC50) determined was 0.029 microg g(-1). These results suggested that a concentration of 0.1 microg g(-1) was appropriate for the bacteria-pesticide interaction test as it was able to elicit 11.1% mortality after 10 days of exposure, while producing an AChE inhibition of 57.12%. Cumulative mortalities were significantly increased (P<0.01) in the treatment that combined exposure to methyl parathion and V. parahaemolyticus (35.19%) in comparison with methyl parathion or V. parahaemolyticus alone (9.26% and 7.41%, respectively).