Adverse drug reactions in paediatric surgery: prospective study on frequency and risk related factors.

BACKGROUND: Paediatric patients are especially prone to experiencing adverse drug reactions (ADRs), and the surgical environment gathers many conditions for such reactions to occur. Additionally, little information exists in the literature on ADRs in the paediatric surgical population. We aimed to quantify the ADR frequency in this population, and to investigate the characteristics and risk factors associated with ADR development. METHODS: A prospective observational study was conducted in a cohort of 311 paediatric patients, aged 1-16 years, admitted for surgery at a tertiary referral hospital in Spain (2019-2021). Incidence rates were used to assess ADR frequency. Odds ratios (ORs) were calculated to evaluate the influence of potential risk factors on ADR development. RESULTS: Distinct ADRs (103) were detected in 80 patients (25.7%). The most frequent being hypotension (N = 32; 35%), nausea (N = 16; 15.5%), and emergence delirium (N = 16; 15.5%). Most ADRs occurred because of drug-drug interactions. The combination of sevoflurane and fentanyl was responsible for most of these events (N = 32; 31.1%). The variable most robustly associated to ADR development, was the number of off-label drugs prescribed per patient (OR = 2.99; 95% CI 1.73 to 5.16), followed by the number of drugs prescribed per patient (OR = 1.26, 95% CI 1.13 to 1.41), and older age (OR = 1.26, 95% CI 1.07 to 1.49). The severity of ADRs was assessed according to the criteria of Venulet and the Spanish Pharmacovigilance System. According to both methods, only four ADRs (3.9%) were considered serious. CONCLUSIONS: ADRs have a high incidence rate in the paediatric surgical population. The off-label use of drugs is a key risk factor for ADRs development.

In vitro assessment of the antimicrobial susceptibility of caprine isolates of Mycoplasma mycoides subsp. capri.

The minimum inhibitory concentration (MIC) and minimum mycoplasmacidal concentration (MMC) of 17 antimicrobials against 41 Spanish caprine isolates of Mycoplasma mycoides subsp. capri (Mmc) obtained from different specimens (milk, external auricular canal and semen) were determined using a liquid microdilution method. For half of the isolates, the MIC was also estimated for seven of the antimicrobials using an epsilometric test (ET), in order to compare both methods and assess the validity of ET. Mutations in genes gyrA, gyrB, parC and parE conferring fluoroquinolone resistance, which have been recently described in Mmc, were investigated using PCR. The anatomical origin of the isolate had no effect on its antimicrobial susceptibility. Moxifloxacin and doxycycline had the lowest MIC values. The rest of the fluoroquinolones studied (except norfloxacin), together with tylosin and clindamycin, also had low MIC values, although the MMC obtained for clindamycin was higher than for the other antimicrobials. For all the aminoglycosides, spiramycin and erythromycin, a notable level of resistance was observed. The ET was in close agreement with broth microdilution at low MICs, but not at intermediate or high MICs. The analysis of the genomic sequences revealed the presence of an amino acid substitution in codon 83 of the gene gyrA, which has not been described previously in Mmc.

Epidemiological role of birds in the transmission and maintenance of zoonoses. / Papel epidemiológico de las aves en la transmisión y mantenimiento de zoonosis.

The risk of zoonoses spreading from birds to humans is lower, quantitatively speaking, than the risk of transmission between other host groups, because the two taxonomic groups share fewer pathogens. Nevertheless, birds have a number of epidemiological characteristics that make them extremely important hosts in the transmission and maintenance of zoonoses, including their susceptibility to pathogens that are extremely hazardous to humans (such as highly pathogenic avian influenza virus, West Nile virus and Chlamydia psittaci) and their ability to travel long distances, especially in the case of migratory birds. The fact that the human diet includes poultry products (meat, eggs and their by-products) also means that most human cases of foodborne zoonoses are infections of avian origin. Lastly, close contact between humans and pet birds or urban birds leads to interactions of public health concern. This article sets out to describe the main factors that determine the role of birds in the epidemiology of zoonotic infections.

Le risque que les oiseaux transmettent des zoonoses à l'homme est moins élevé, au plan quantitatif, qu'entre hôtes d'autres catégories, car le nombre d'agents pathogènes affectant à la fois ces deux groupes taxonomiques est moindre. Cependant, certaines particularités épidémiologiques des oiseaux leur font jouer un rôle d'hôtes importants dans la persistance et la transmission de zoonoses : d'une part, leur sensibilité à des agents pathogènes dangereux pour l'homme (par exemple, le virus de l'influenza aviaire hautement pathogène, le virus de West Nile, Chlamydia psittaci) et, d'autre part, leur capacité à se déplacer sur de longues distances, notamment dans le cas des oiseaux migrateurs. En outre, les produits avicoles faisant partie des denrées alimentaires consommées par l'homme (viande de volaille, oeufs et produits dérivés), la majorité des cas de zoonoses d'origine alimentaire diagnostiqués chez l'homme sont d'origine aviaire. Enfin, les contacts étroits entre les humains et leurs oiseaux de compagnie ou avec des oiseaux des villes entraînent des interactions qui sont à prendre en compte en santé publique. Les auteurs décrivent les principales caractéristiques épidémiologiques des oiseaux jugées déterminantes par rapport aux infections zoonotiques.

El riesgo de transmisión de zoonosis de aves a humanos es menor, cuantitativamente hablando, que el que tiene lugar entre otros grupos de hospedadores, debido a que estos dos grupos taxonómicos comparten un menor número de agentes patógenos. No obstante, algunas particularidades epidemiológicas de las aves las convierten en hospedadores de gran importancia en el mantenimiento y la transmisión de zoonosis, como su capacidad de contraer infecciones por agentes patógenos peligrosos para los humanos (como el virus de la influenza aviar altamente patógena, el virus del Nilo Occidental o Chlamydia psittaci, entre otros) así como su gran capacidad de desplazamiento, especialmente en el caso de las aves migratorias. Además, el hecho de que la alimentación humana incluya productos avícolas (carne y huevos y productos derivados) hace que la mayoría de casos de zoonosis de origen alimentario diagnosticados en humanos sean infecciones de origen aviar. Por último, el estrecho contacto entre humanos y mascotas aviares o aves urbanas conlleva interacciones de interés para la salud pública. Este trabajo pretende describir los principales determinantes epidemiológicos de las aves en relación con las infecciones zoonósicas.

Sensitivity of two methods to detect Mycoplasma agalactiae in goat milk.

BACKGROUND: Laboratory diagnostic techniques able to detect Mycoplasma agalactiae are essential in contagious agalactia in dairy goats. This study was designed: 1) to determine the detection limits of PCR and culture in goat milk samples, 2) to examine the effects of experimental conditions including the DNA extraction method, PCR technique and storage conditions (fresh versus frozen stored milk samples) on these methods and 3), to establish agreement between PCR and culture techniques using milk samples from goats with mastitis in commercial dairy herds. The study was conducted both on artificially inoculated and field samples. RESULTS: Our findings indicate that culture is able to detect M. agalactiae in goat milk at lower concentrations than PCR. Qualitative detection of M.agalactiae by culture and PCR was not affected by sample freezing, though the DNA extraction method used significantly affected the results of the different PCR protocols. When clinical samples were used, both techniques showed good agreement. CONCLUSIONS: The results from this study indicate that both culture and PCR are able to detect M. agalactiae in clinical goat mastitis samples. However, in bulk tank milk samples with presumably lower M. agalactiae concentrations, culture is recommended within the first 24 h of sample collection due to its lower limit of detection. To improve the diagnostic sensitivity of PCR in milk samples, there is a need to increase the efficiency of extracting DNA from milk samples using protocols including a previous step of enzymatic digestion.

Implicaciones sanitarias del manejo del calostro en el ganado caprino / Sanitary involvements of management of colostrum in caprine herds

El calostro supone la primera fuente de inmunidad para los rumiantes y por tanto determina su resistencia a enfermedades durante las primeras horas de vida. No obstante, la ingesta de calostro puede suponer en sí misma una vía de transmisión de diversas enfermedades, como la paratuberculosis, la artritis-encefalitis caprina o la agalaxia contagiosa. Este riesgo puede evitarse siguiendo un régimen de lactancia artificial con unas adecuadas pautas de manejo del calostro. Entre dichas pautas, el tratamiento del calostro supone un punto crítico. En este sentido, se han empleado los tratamientos térmicos para higienizar el calostro, observándose resultados diversos en la viabilidad de distintos microorganismos. Al mismo tiempo, se debe considerar el efecto negativo del calor sobre la composición nutricional del calostro, principalmente la pérdida de inmunoglobulinas. Como alternativa a los tratamientos térmicos, a nivel experimental, se han empleado métodos como la adición de dodecil sulfato de sodio, capaz de inactivar el virus del síndrome de inmunodeficiencia humana en leche, y otros procesos como la liofilización o el uso de altas presiones. Previamente a la aplicación práctica de las diferentes opciones de tratamiento del calostro se deberá considerar su viabilidad económica y su factibilidad en la explotación (AU)

Colostrum represents the first source of immunity for the ruminants, and thus determines its resistance to disease during the first hours of life. However, colostrum intake could be itself the way of transmition of several diseases, as paratuberculosis, caprine arthritis-encephalytis, or micoplasmosis like contagious agalactia. This risk could be avoided by means of an artificial rearing program which should include correct management practices for colostrum. Between them, the treatment of colostrum represents a critical point. In this sense, thermic treatments have been used to higienitize colostrum, showing different results about microorganism viability. Nevertheless, it should be considered the negative effect of these treatments over nutritional components of colostrum, particularly the loss of immunoglobulines. As an alternative to thermic treatments, there have been experimentally assayed other methods as the addition of sodium dodecyl sulphate, which inactivates AIDS virus in breast milk, and others as liophilization or high pression methods. In this works, apart from the effect of the treatment should be also taken into account its economical viability and on-farm feasibility (AU)

Particularidades etiológicas y epimediológicas de la agalaxia contagiosa ovina: similitudes y diferencias con el caprino / Etiological and epidemiological particularities of ovine contagious agalactia: similarities and differences with goats

Este trabajo describe las diferencias existentes en la presentación de la agalaxia contagiosa, síndrome infectocontagioso causado por varias especies del genero Mycoplasma spp., en el ganado ovino y caprino. Las particularidades etiológicas y epidemiológicas de la infección crónica en la cabra, y la ausencia de datos similares en el ovino, evidencian la necesidad de realizar nuevos trabajos que determinen si las diferencias observadas en referencia a la presencia de portadores auriculares en los rebaños o la participación de los sementales en la difusión de la enfermedad son fruto de la escasez de trabajos científicos o por el contrario, establecen verdaderas diferencias sobre las que desarrollar estrategias dirigidas de control en función de la especie de rumiante afectada (AU)

Contagious agalactia (CA) is an infectious syndrome caused by several species of Mycoplasma spp. which affects small ruminants. The aim of this review is to describe the main differences noted between the disease in sheep and goats, especially with regard to its etiologic and epidemiological peculiarities. Thus, the presence of asymptomatic auricular carriers of CA-causing mycoplasmas and the stud’s role in the transmission of the disease are well known in goats, but scarcely evaluated in sheep. Further studies are needed to determine if these differences are real or if they are due to the shortage of scientific work in this matter (AU)

Short communication: In vitro antimicrobial susceptibility of Mycoplasma agalactiae strains isolated from dairy goats.

This study examined the susceptibility to several antimicrobials of 28 isolates of Mycoplasma agalactiae obtained from goats in a region (southeastern Spain) where contagious agalactia is endemic. For each isolate, the minimum inhibitory concentration (MIC) against 12 antimicrobials of the quinolone, macrolide, aminoglycoside, and tetracycline families was determined. The antimicrobials with the lowest MIC were enrofloxacin, ciprofloxacin, tylosin, and doxycycline, all with MIC90 (concentration at which growth of 90% of the isolates is inhibited) <1 µg/mL. Norfloxacin (a quinolone) showed a wide MIC range (0.1-12.8 µg/mL), suggesting a resistance mechanism toward this antimicrobial that was not elicited by enrofloxacin or ciprofloxacin (the other quinolones tested). Erythromycin showed the highest MIC90 such that its use against Mycoplasma agalactiae is not recommended. Finally, Mycoplasma agalactiae isolates obtained from goat herds with clinical symptoms of contagious agalactia featured higher MIC90 and MIC50 (concentration at which growth of 50% of the isolates is inhibited) values for many of the antimicrobials compared with isolates from asymptomatic animals. The relationship between the extensive use of antimicrobials in herds with clinical contagious agalactia and variations in MIC requires further study.

Evaluación de la viabilidad y motilidad espermática en dosis seminales caprinas para el desarrollo de un modelo de contaminación experimental con Mycoplasmaspp / Goat model for experimental mycoplasma contamination of semen: preliminary results

En los últimos años se ha detectado en diversos centros de inseminación artificial la presencia de machos caprinos en los que se han aislado Mycoplasma agalactiae y Mycoplasma mycoides subsp. capri en muestras de semen, sin que presenten ningún síntoma clínico asociado. La capacidad de las bacterias del género Mycoplasma spp. para producir efectos perjudiciales en la calidad espermática es un hecho constatado en diversas especies animales, incluido el hombre. Además, el riesgo de una posible transmisión venérea y afectación de la calidad espermática podría comprometer los programas de mejora genética caprinos fundamentados en la inseminación artificial. El objetivo del presente trabajo es desarrollar un modelo experimental para el estudio del efecto de la contaminación seminal con Mycoplasma spp. en ganado caprino. Para ello, evaluamos la viabilidad y motilidad espermática de dosis seminales, tras dos horas de incubación a 37 ºC en muestras previamente transportadas bajo dos condiciones de temperatura (4-5 °C y 15-16 ºC). Posteriormente se estudió el efecto de la adición del medio PPLO, en el que se preparan los inóculos de Mycoplasma spp., sobre la calidad espermática. El transporte de dosis seminales a 4 ºC ofrece mejores resultados de motilidad total en semen incubado a 37 ºC durante 120 minutos. El medio PPLO no ejerció efecto significativo sobre los porcentajes de espermatozoides vivos o mótiles totales a lo largo de 150 minutos de incubación. Con dicho medio, se pueden obtener valores de viabilidad y motilidad (total y progresiva) espermática superiores al 50% después de 150 y 60 minutos de incubación, respectivamente. En conjunto, este modelo permitiría el desarrollo de contaminaciones experimentales de dosis seminales caprinas con Mycoplasma spp. con el fin de evaluar su efecto sobre la viabilidad y motilidad espermática (AU)

The presence of Mycoplasma agalactiae and Mycoplasma mycoides subsp. capri in semen samples taken from asymptomatic bucks placed in artificial insemination centres has been confirmed in the last years. The ability of Mycoplasma spp. to cause adverse effects on sperm quality has been also demonstrated in several animal species including humans. In this sense, the risk of venereal transmission and the effects of mycoplasmas on sperm quality could affect goat breed improvement programs based on artificial insemination. The present study was conducted to develop an experimental model useful to study the effect of Mycoplasma spp. in goat semen. We evaluated the viability and motility of seminal doses maintained during two hours at 37 ºC in semen samples previously kept under two temperature conditions (4-5 °C or 15-16 ºC). The effect of PPLO medium in sperm motility, in which Mycoplasma spp. inocula are prepared, was also studied. Motility results registered in semen samples incubated at 37 ºC during 120 minutes are better in seminal doses kept at 4-5 ºC. PPLO medium had no significant effect on live or motile spermatozoa percentages registered after 150 minutes. Sperm viability and motility values (total and progressive) higher than 50% during the 150 and 60 minutes of incubation respectively were obtained using this medium. Overall, the present model is useful to conduct experimental contamination of goat semen doses with Mycoplasma spp. in order to evaluate its effect on spermatic viability and motility (AU)

Controlling contagious agalactia in artificial insemination centers for goats and detection of Mycoplasma mycoides subspecies capri in semen.

Many goat artificial insemination (AI) centers in Spain have adopted new measures to control contagious agalactia (CA). To avoid the introduction of male goats carrying mycoplasma organisms subclinically in their external ear canal (auricular carriers) in these centers, two ear swabs and a blood sample are obtained from all candidate animals for polymerase chain reaction (PCR), culture (swabs) and serologic tests to detect the presence of mycoplasmas. In addition, the semen produced at these centers is routinely cultured and PCR tested also to detect the presence of mycoplasmas. One y after the introduction of this program, we tested 48 ear swabs and 24 blood samples from 24 candidates for admission to these AI Centers. Three of these ear swab samples (3/48, 6.25%) scored positive for the presence of mycoplasmas; Mycoplasma agalactiae (Ma) was detected in two samples and Mycoplasma mycoides subsp. capri (Mmc) in one. All animals were serologically negative for Ma. Also, out of 173 semen samples obtained from 137 admitted animals (2 and 3 samples were obtained in 16 and 10 bucks, respectively), one (1/173, 0.56%) was positive for Mmc. Our findings suggest that ear swab and semen samples are useful tools to control CA at AI Centers. The introduction of this program has also resulted in the first detection of Mmc in semen from a naturally infected goat, confirming the ability of this mycoplasma to colonize the reproductive tract of male goats. These results highlight the need to improve control measures in semen producing centers to minimize the risk of CA transmission.