Cytomegalovirus seropositivity correlates with both human ß-defensin 1 and IFN-γ downregulation in women with obesity.

Human ß-defensin 1 (hBD-1) is a constitutively expressed antimicrobial peptide with antiviral properties. CMV seropositivity has been associated with obesity. It is unknown if hBD-1 levels of are altered in women with obesity and/or CMV seropositivity. In a pilot project of 31 adult women with CMV seropositivity, we calculated the correlation among hBD-1 serum levels (ELISA) and IgG anti-CMV-Index with anthropometric measurements, lipid profiles and glucose levels. hBD-1 showed negative correlation with triglycerides (TG) (r = -0.617; p = 0.033,) and hip circumference (r = -0.596; p = 0.041,). IgG anti-CMV index was negatively correlated with hBD-1 levels and positively correlated with TG (r = 0.702; p = 0.011,) and HC (r = 0.583; p = 0.047,) in women with obesity. As expected, hBD-1 levels correlates with IFN-γ (an antimicrobial peptide elicitor) in the three analyzed groups.These results shows that CMV seropositivity correlates with both IFN-γ levels and hBD-1 levels which in contrast with non-CMV seropositivity scenario, is commonly found an IFN-γ upregulation in individuals with obesity. Further research is encouraged to test if CMV is causing the observed downregulation of the antiviral immune responses of both hBD-1 and IFN-γ as well as their involved mechanisms.

Establishment of the upstream processing for renewable production of hydrogen using vermicomposting-tea and molasses as substrate.

This study aimed to establish the optimal operational conditions for hydrogen production using vermicomposting-tea and sugarcane molasses as substrate. The experiments were carried out by triplicate in 110 ml serological bottles, a Box-Behnken design of experiments was performed in anaerobic dark conditions. The maximal hydrogen production (HP), hydrogen production rate (HPR), and hydrogen yield (HY) attained were 1021.0 mlL-1, 5.32 mlL-1h-1, and 60.3 mlLH2-1/gTCC, respectively. The statistical model showed that the optimal operational conditions for pH, molasses concentration, and temperature were 6.5; 30 % (v/v) and 25 °C. The bioreactor run showed 17.202 L of hydrogen, 0.58 Lh-1, and 77.2 mlH2gTCC-1 For HP, HPR, and HY. Chemometric analysis for the volatile fatty acids obtained at the fermentation showed that only two principal components are required to explain 90 % of the variance. The representative pathways for hydrogen production were acetic and butyric acids. This study established the operational conditions for the upstream processing amenable to pilot and industrial-scale operations. Our results add value to molasses within the circular economy for hydrogen production using a novel consortium from vermicompost.

Inverse behavior of IL-23R and IL-17RA in chronic and aggressive periodontitis.

PURPOSE: Periodontitis is associated with a dysbiosis of periodontopathic bacteria, which stimulate the interleukin (IL)-23/IL-17 axis that plays an essential role in the immunopathogenesis of this disease, leading to alveolar bone destruction through receptor activator of nuclear factor κB ligand (RANKL). IL-23 receptor mRNA (IL-23R) has been identified in periodontitis, and IL-17 receptor A mRNA (IL-17RA) and its protein have not yet been evaluated in patients with periodontitis. In this study was measure IL-23R and IL-17RA in gingival tissue (GT) from patients with generalized chronic periodontitis (GCP) and generalized aggressive periodontitis (GAP) and to explore correlations with clinical parameters. METHODS: We included 16 healthy subjects (HS), 18 patients with GCP, and 14 with GAP. GT samples were collected during periodontal surgery. Both IL-23R and IL-17RA were detected by enzyme-linked immunosorbent assay. RESULTS: The results were analyzed with Mann-Whitney U test and Spearman' rank correlation coefficients using SPSS version 25.0. We found lower IL-23R levels in patients with GCP and GAP than in HS. Contrarily, we observed higher IL-17RA levels in GCP and GAP patients than in HS. Moreover, we found negative correlations between IL-23R in GT and probing depth and clinical attachment loss (CAL). Likewise, a positive correlation of IL-17RA in GT with CAL was found. CONCLUSIONS: The results of these findings suggest that the reverse behavior between IL-23R and IL-17RA in periodontitis patients may also be involved with the activation of RANKL, which promotes alveolar bone loss.

IL-23/IL-17 axis and soluble receptors isoforms sIL-23R and sIL-17RA in patients with rheumatoid arthritis-presenting periodontitis.

BACKGROUND: Rheumatoid arthritis (RA) and periodontitis (P) are chronic inflammatory diseases characterized by joint and radiographic bone loss, respectively. IL-23 and IL-17 have an essential role in the immunopathogenesis of RA, and P. IL-23 stimulates Th17 cells through which produces IL-17, IL-21, and RANKL. IL-17 stimulates fibroblasts to produce RANKL, which initiates bone loss in the joints in RA and the periodontal tissue in periodontitis. The aim of this study was to determine the expression pattern of IL-23/IL-17 axis and soluble receptors isoforms sIL-23R and sIL-17RA of patients with RA presenting P (RAP). MATERIAL AND METHODS: Healthy subjects (HS) (n = 42), patients with P (n = 40), RA (n = 20), and patients with RAP (n = 40) were included. Plasma samples were obtained to evaluate the IL-23, IL-17A, sIL-23R, and sIL-17RA by ELISA technique. A nonparametric Mann-Whitney U test was used to compare the differences between groups. A Chi-square was used to compare gender, grade and stage of periodontitis, and DAS28-ESR between the groups. Spearman's rank correlation coefficient was used to study the association between the molecules and clinical parameters. RESULTS: IL-23 levels were increased in the RAP group, and lower sIL-23R levels were found in the RAP groups. However, IL-17A was lower in the P and RAP group but not in RA patients. RAP group showed a decrease IL-17A levels in advanced stages of the periodontal disease. CONCLUSION: These results suggest that IL-23 and IL-17A tend to downregulate their expression patterns when patients present both rheumatoid arthritis and periodontitis.

Immunomodulatory Effect of Lactobacillus casei in a Murine Model of Colon Carcinogenesis.

We previously reported beneficial effects of the probiotic strain Lactobacillus casei 393 in hindering colon carcinogenesis in a 1,2-dimethylhydrazine (DMH)-induced BALB/c mouse model of colon cancer. In the present study, we investigated the effect of preventive administration of L. casei 393 on the levels of selected pro- and anti-inflammatory circulating cytokines, as well as subpopulations of splenic T cells. The resulting experimental data on IFNγ, TNFα, IL-10, and colon histological features demonstrated that administration of L. casei 2 weeks before DMH treatment impaired the pro-inflammatory effect of DMH, while maintaining the levels of the three cytokines as well as colon histology; it also modulated splenic CD4+, CD8+, and NK T cell subpopulations. The preventive administration of L. casei to DMH-treated mice increased IL-17A synthesis and Treg percentages, further indicating a tumor-protecting role. Together, the results suggest that the colon-cancer-protective properties of L. casei 393 involve the dampening of inflammation through cytokine homeostasis and the maintenance of a healthy T cell subpopulation dynamic. For these reasons, probiotics such as L. casei may contribute to the health of the host as they promote optimal control of the immune response. Further, they may be used as prophylactic agents in combination with standard therapies against colon cancer.

Adaptive Memory of Human NK-like CD8+ T-Cells to Aging, and Viral and Tumor Antigens.

Human natural killer (NK)-like CD8+ T-cells are singular T-cells that express both T and NK cell markers such as CD56; their frequencies depend on their differentiation and activation during their lifetime. There is evidence of the presence of these innate CD8+ T-cells in the human umbilical cord, highlighting the necessity of investigating whether the NK-like CD8+ T-cells arise in the early stages of life (gestation). Based on the presence of cell surface markers, these cells have also been referred to as CD8+KIR+ T-cells, innate CD8+ T-cells, CD8+CD28-KIR+ T-cells or NKT-like CD8+CD56+ cells. However, the functional and co-signaling significance of these NK cell receptors on NK-like CD8+ T-cells is less clear. Also, the diverse array of costimulatory and co-inhibitory receptors are spatially and temporally regulated and may have distinct overlapping functions on NK-like CD8+ T-cell priming, activation, differentiation, and memory responses associated with different cell phenotypes. Currently, there is no consensus regarding the functional properties and phenotypic characterization of human NK-like CD8+ T-cells. Environmental factors, such as aging, autoimmunity, inflammation, viral antigen re-exposure, or the presence of persistent tumor antigens have been shown to allow differentiation ("adaptation") of the NK-like CD8+ T-cells; the elucidation of this differentiation process and a greater understanding of the characteristics of these cells could be important for their eventual in potential therapeutic applications aimed at improving protective immunity. This review will attempt to elucidate an understanding of the characteristics of these cells with the goal toward their eventual use in potential therapeutic applications aimed at improving protective immunity.

Indicadores de estrés oxidativo en suero y comportamiento alimentario en adultos de una zona rural de Jalisco, México / Levels of oxidative striess in serum and dietary behavior in adults in a ruralarea of Jalisco, Mexico

Introducción: El comportamiento alimentario establece la relación del ser humano con la alimentación, comprende hábitos alimentarios que podrían intervenir en el desarrollo del estrés oxidativo. Objetivos: Evaluar la relación de indicadores de estrés oxidativo (lipoperóxidos) y capacidad antioxidante (ácido ascórbico, catalasa, superóxido dismutasa) con el comportamiento alimentario en adultos que residen en Teocuitatlán de Corona, Jalisco, México. Método: Estudio observacional, descriptivo, transversal, comparativo de 44 adultos de 43 a 88 años de edad. Se aplicó un instrumento de comportamiento alimentario. Los resultados del cuestionario se relacionaron con los indicadores de estrés oxidativo. Se utilizó estadística descriptiva, distribución de frecuencias y análisis de co-varianza con ajuste de variables, se consideró una significancia de p <0.05. Resultados: Los valores de lipoperóxidos en suero se relacionaron a las siguientes conductas: considerar el contenido nutrimental como factor más importante al elegir el alimento (p=0.042), desagrado por lácteos (p=0.027), ingesta de dulces entre las comidas (p=0.001), inclusión habitual de verduras y ensaladas en la comida principal (p=0.018). No se encontró relación significativa de los valores de cantidad total de ácido ascórbico, colesterol en lipoproteínas de baja densidad y actividades enzimáticas de catalasa y superóxido dismutasa con las conductas alimentarios analizados. Discusión: Los hábitos y conductas de alimentación analizados pueden intervenir en el desarrollo del estrés oxidativo y presentar un efecto protector o perjudicial hacia las complicaciones de enfermedades crónicas no trasmisibles y el envejecimiento de esta población. Se sugiere profundizar en aspectos sociodemográficos y socioculturales de la región, además de integrar un análisis de consumo de alimentos y de marcadores metabólicos relacionados con la alimentación (AU)

Introduction: The feeding behavior establishes a relation of humans with food, includes food habits that could be involved with oxidative stress. Objective: To evaluate the relation of indicators of oxidative stress (lipid peroxides) and antioxidant (ascorbic acid, catalase, superoxide dismutase) with feeding behavior in adults of Teocuhitatlan Corona, Jalisco, Mexico. Method: Study observational, descriptive, cross-sectional of 44 adults with 43 to 88 years, was used a instrument of feeding behavior. The questionnaire were related to indicators of oxidative stress. Were used descriptive statistics, frequency distribution and analysis of covariance with adjustment variables, was considered significant p <0.05. Results: The values of serum lipid peroxides were related to behaviors: consider the nutritional content as most important when choosing food (p = 0.042), dislike milk (p = 0.027), intake of sweets between meals (p = 0.001), habitual inclusion of vegetables and salads in main meal (p = 0.018). We do not found association in to values of ascorbic acid, cholesterol in low density lipoproteins and enzymatic activities of catalase and superoxide dismutase with food behaviors. Discussion: The feeding behaviors analyzed in this study may be involved with development of oxidative stress and could be have protective or harmful effect in development to complications of chronic non-communicable diseases and aging in this population. This suggests to analyze demographic and socio-cultural aspects of region and besides analyzing the consumption and metabolic markers related to food (AU)

CD28-, CD45RA(null/dim) and natural killer-like CD8+ T cells are increased in peripheral blood of women with low-grade cervical lesions.

BACKGROUND: In response to antigen naive CD8+, T cells differentiate into effector cells, which express Natural killer (NK) receptors, lose CD28 expression, and die by apoptosis. However, in smaller quantities, the cells are retained for subsequent exposure to the same antigen. Knowledge is limited regarding whether the percentages of CD28-, Effector memory (EMRA(null/dim)), and the CD16+/CD56 + CD8+ T cells of women with low-grade cervical lesions are altered at a systemic level. METHODS: We enrolled in this study women controls and women with Human papilloma virus infection (HPV-I) without associated cellular neoplastic changes and with Cervical Intraepithelial Neoplastic-I (CIN-I). Flow cytometry (FC) was performed for measurement of CD28-, memory subset, and NK-like CD8 + T cells, and IL-17, IFN-gamma, Tumor necrosis factor (TNF)-alpha, Interleukin (IL)-10, IL-6, IL-4, and IL-2. Finally, we genotyped the HPV. RESULTS: The CIN-I group increased the CD8 + CD28- and CD16+/56+ T cell percentage compared with that of HPV-I and controls (p <0.01), and CD8 + CCR7-CD45RA(null/dim) (EMRA(null/dim)) T cells were also increased in the CIN-I group compared with the controls (p <0.01). These two study groups were HPV- genotyped; 49% were HPV18+, and we did not observe differences in cytokine levels among all groups. CONCLUSIONS: Increased levels of CD28-, EMRA(null/dim), and CD16+/CD56 + CD8+ T cells of peripheral blood in women with CIN-I may be associated with persistent HPV infection and could exert an influence on progression to cervical cancer.

Implantación de un sistema de vigilancia de infección de la herida quirúrgica al alta en herniorrafia y mastectomía / Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures

INTRODUCCIÓN: La vigilancia tradicional de la infección de localización quirúrgica (ILQ) que se realiza durante el ingreso hospitalario puede infraestimar su incidencia, al ser cada vez más corta la estancia hospitalaria. El objetivo de este trabajo es conocer las tasas reales de ILQ prolongando la vigilancia después del alta. MÉTODOS: Se incluyó a todos los pacientes sometidos a los procedimientos de herniorrafia y mastectomía en el Hospital Universitario Ramón y Cajal entre el 1 de enero y el 31 de diciembre de 2011. Los datos de ILQ se recogieron prospectivamente según el sistema de vigilancia de infección nosocomial de Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC). La vigilancia postalta (VPA) se realizó mediante encuesta telefónica. RESULTADOS: Se incluyeron 409pacientes en el estudio: 299herniorrafias y 110mastectomías. En herniorrafia la tasa de infección antes del alta era del 6,02%, incrementándose tras VPA al 7,69%. En mastectomía la tasa de infección antes del alta era del 1,8%, incrementándose tras VPA al 3,6%. Del total de infecciones se detectaron tras VPA el 50% en mastectomía y el 21,7% en herniorrafia. CONCLUSIONES: La VPA incrementó la incidencia de ILQ en los procedimientos estudiados; La VPA es útil para analizar la tendencia real de ILQ y evaluar posibles acciones de mejora. Es necesario estandarizar los protocolos de VPA

INTRODUCTION: Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. METHODS: All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. RESULTS: A total of 409 patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). CONCLUSIONS: Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised

Surgical wound infection rates in Spain: data summary, January 1997 through June 2012.

BACKGROUND: The Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC) program was established in Spain in 1997. METHODS: INCLIMECC is a prospective system of health care-associated infection (HAI) surveillance that collects incidence data in surgical and intensive care unit patients. The protocol is based on the National Healthcare Safety Network (NHSN) surveillance system, formerly known as the National Nosocomial Infection Surveillance (NNIS) system, and uses standard infection definitions from the US Centers for Disease Control and Prevention. Each hospital takes part voluntarily and selects the units and surgical procedures to be surveyed. RESULTS: This report is a summary of the data collected between January 1997 and June 2012. A total of 370,015 patients were included, and the overall incidence of surgical wound infection (SWI) was 4.51%. SWI rates are provided by NHSN operating procedure category and NNIS risk index category. More than 27% of the patients received inadequate antibiotic prophylaxis, the main reason being unsuitable duration (57.05% of cases). CONCLUSIONS: Today, the INCLIMECC network includes 64 Spanish hospitals. We believe that an HAI surveillance system with trained personnel external to the surveyed unit is a key component not only in infection control and prevention, but also in a quality improvement system.

[Levels of oxidative stress in serum and dietary behavior in adults in a rural area of Jalisco, Mexico]. / Indicadores de estrés oxidativo en suero y comportamiento alimentario en adultos de una zona rural de Jalisco, México.

INTRODUCTION: The feeding behavior establishes a relation of humans with food, includes food habits that could be involved with oxidative stress. OBJECTIVE: To evaluate the relation of indicators of oxidative stress (lipid peroxides) and antioxidant (ascorbic acid, catalase, superoxide dismutase) with feeding behavior in adults of Teocuhitatlan Corona, Jalisco, Mexico. METHOD: Study observational, descriptive, cross-sectional of 44 adults with 43 to 88 years, was used a instrument of feeding behavior. The questionnaire were related to indicators of oxidative stress. Were used descriptive statistics, frequency distribution and analysis of covariance with adjustment variables, was considered significant p <0.05. RESULTS: The values of serum lipid peroxides were related to behaviors: consider the nutritional content as most important when choosing food (p = 0.042), dislike milk (p = 0.027), intake of sweets between meals (p = 0.001), habitual inclusion of vegetables and salads in main meal (p = 0.018). We do not found association in to values of ascorbic acid, cholesterol in low density lipoproteins and enzymatic activities of catalase and superoxide dismutase with food behaviors. DISCUSSION: The feeding behaviors analyzed in this study may be involved with development of oxidative stress and could be have protective or harmful effect in development to complications of chronic non-communicable diseases and aging in this population. This suggests to analyze demographic and socio-cultural aspects of region and besides analyzing the consumption and metabolic markers related to food.

Introducción: El comportamiento alimentario establece la relación del ser humano con la alimentación, comprende hábitos alimentarios que podrían intervenir en el desarrollo del estrés oxidativo. Objetivos: Evaluar la relación de indicadores de estrés oxidativo (lipoperóxidos) y capacidad antioxidante (ácido ascórbico, catalasa, superóxido dismutasa) con el comportamiento alimentario en adultos que residen en Teocuitatlán de Corona, Jalisco, México. Método: Estudio observacional, descriptivo, transversal, comparativo de 44 adultos de 43 a 88 años de edad. Se aplicó un instrumento de comportamiento alimentario. Los resultados del cuestionario se relacionaron con los indicadores de estrés oxidativo. Se utilizó estadística descriptiva, distribución de frecuencias y análisis de co-varianza con ajuste de variables, se consideró una significancia de p.

[Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures]. / Implantación de un sistema de vigilancia de infección de la herida quirúrgica al alta en herniorrafia y mastectomía.

INTRODUCTION: Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. METHODS: All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. RESULTS: A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). CONCLUSIONS: Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised.

Tendencia de la prevalencia de bacilos gramnegativos productores de betalactamasas de espectro extendido en un hospital universitario de Madrid / Trends in the prevalence of extended-spectrum beta-lactamase-producing gram-negative bacilli in a teaching hospital in Madrid, Spain

Fundamento y objetivo: La prevalencia de infección/colonización por bacilos gramnegativos productores de betalactamasas de espectro extendido (BGN-BLEE) ha aumentado en los últimos años. El objetivo de este estudio es estimar la prevalencia de infección/colonización de estos microorganismos por cada 100 ingresos hospitalarios y analizar su tendencia a lo largo del período 2007-2010. Pacientes y métodos: Estudio observacional prospectivo de todos los pacientes con infección y/o colonización por BGN-BLEE ingresados entre enero de 2007 y diciembre de 2010 en el Hospital Universitario Ramón y Cajal. Para el cálculo de la prevalencia de infección/colonización por BGN-BLEE se siguieron las recomendaciones de la guía de indicadores de microorganismos multirresistentes de The Society for Healthcare Epidemiology of America y el Healthcare Infection Control Practices Advisory Committe. El análisis de la tendencia se realizó mediante regresión de Poisson, con el programa Joinpoint Regression 3.4.3 del U.S. National Institutes of Health. Resultados: A lo largo del período de estudio se observó una tendencia ascendente de la prevalencia para el conjunto de BGN-BLEE. El análisis de la tendencia con regresión de Poisson identificó un punto de inflexión significativo en el mes de agosto de 2009 (p = 0,014) (AU)

Background and objective: The prevalence of extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli has increased in recent years. The aim of this study is to estimate the prevalence of infection/colonization due to theses microorganisms per 100 admissions and its trend during the period 2007-2010. Patients and methods: Prospective observational study of all patients admitted from January 2007 to December 2010 infected or colonized with ESBL-producing gram-negative bacilli at Hospital Universitario Ramón y Cajal. The prevalence of infection/colonization of ESBL-producing gram-negative rods was calculated according to the recommendations for metrics for multidrug-resistant organisms in healthcare settings of The Society for Healthcare Epidemiology of America and the Healthcare Infection Control Practices Advisory Committee. To analyse trends, Poisson regression was used (Joinpoint Regression Program Version 3.4.3, U.S. National Institutes of Health). Results: Through the study period there was an upward trend of prevalence of all the ESBL-producing gram-negative bacilli. The Poisson trend analysis indentified a significant inflection point in August 2009 (p = 0.014). Conclusion: The inflection point in the prevalence of the ESBL-producing gram-negative bacilli trend can be explained by a slowdown in the prevalence of some microorganisms such as ESBL-producing Klebsiella pneumonia (AU)

[Trends in the prevalence of extended-spectrum beta-lactamase-producing gram-negative bacilli in a teaching hospital in Madrid, Spain]. / Tendencia de la prevalencia de bacilos gramnegativos productores de betalactamasas de espectro extendido en un hospital universitario de Madrid.

BACKGROUND AND OBJECTIVE: The pprevalence of extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli has increased in recent years. The aim of this study is to estimate the prevalence of infection/colonization due to theses microorganisms per 100 admissions and its trend during the period 2007-2010. PATIENTS AND METHODS: Prospective observational study of all patients admitted from January 2007 to December 2010 infected or colonized with ESBL-producing gram-negative bacilli at Hospital Universitario Ramón y Cajal. The prevalence of infection/colonization of ESBL-producing gram-negative rods was calculated according to the recommendations for metrics for multidrug-resistant organisms in healthcare settings of The Society for Healthcare Epidemiology of America and the Healthcare Infection Control Practices Advisory Committee. To analyse trends, Poisson regression was used (Joinpoint Regression Program Version 3.4.3, U.S. National Institutes of Health). RESULTS: Through the study period there was an upward trend of prevalence of all the ESBL-producing gram-negative bacilli. The Poisson trend analysis indentified a significant inflection point in August 2009 (p=0.014). CONCLUSION: The inflection point in the prevalence of the ESBL-producing gram-negative bacilli trend can be explained by a slowdown in the prevalence of some microorganisms such as ESBL-producing Klebsiella pneumoniae.

Preparación prequirúrgica, profilaxis antibiótica y vigilancia de infección de herida quirúrgica en cirugía de mama / Preoperative preparation, antibiotic prophylaxis and surgical wound infection in breast surgery

Introducción El impacto de la infección de herida quirúrgica (IHQ) en salud pública justifica su vigilancia y prevención. Nuestros objetivos fueron estimar la incidencia de IHQ en cirugía de mama y evaluar sus protocolos de profilaxis antibiótica y preparación prequirúrgica. Métodos Estudio de cohortes prospectivo multicéntrico de incidencia de IHQ. Se evaluó la incidencia de IHQ, se estratificó por índice de riesgo NNIS y se calculó la razón estandarizada de incidencia (REI). La REI se comparó con las tasas nacionales y americanas. Se evaluó el cumplimiento y adhesión del protocolo de profilaxis antibiótica y de preparación prequirúrgica y su influencia en la IHQ con el riesgo relativo. Resultados Se estudiaron 592 intervenciones de mama procedentes de 10 hospitales de la Comunidad de Madrid. La incidencia de IHQ acumulada fue de 3,89% (IC 95%: 2,3-5,5). La REI fue de 1,82 sobre la tasa nacional y de 2,16 sobre la americana. Se administraron el 97,81% de las profilaxis antibióticas indicadas con una adhesión global al protocolo del 75%. La preparación prequirúrgica fue correcta en el 53,8%. No se encontró asociación de la infección con la adhesión a la profilaxis antibiótica ni con el cumplimiento de la preparación prequirúgica (p>0,05). Conclusión Nuestra incidencia ha sido algo superior a la de los programas nacionales de vigilancia. Hay que mejorar la adhesión de la profilaxis antibiótica y el registro de los datos de preparación prequirúrgica (AU)

Introduction: The impact of surgical wound infection on public health justifies its surveillance and prevention. Our objectives were to estimate the incidence of surgical wound infection in breast procedures and assess its protocol of antibiotic prophylaxis and preoperative preparation. Methods: Observational multicentre prospective cohort study of incidence of surgical wound infection. Incidence was evaluated, stratified by National Nosocomial Infection Surveillance (NNIS) risk index and we calculated the standardized incidence ratio (SIR). The SIR was compared with Spanish rates andU.S. rates. The compliance and performance of the antibiotic prophylaxis and preoperative preparation protocol were assessed and their influence in the incidence of infection with the relative risk. Results: Ten hospitals from the Comunidad de Madrid were included, providing 592 procedures. The cumulative incidence of surgical wound infection was 3.89% (95% CI: 2.3-5.5). The SIR was 1.82 on the Spanish rate and 2.16 on the American. Antibiotic prophylaxis was applied in 97.81% of cases, when indicated. The overall performance of antibiotic prophylaxis was 75%, and 53% for preoperative preparation. No association was found between infection and performance of prophylaxis or preoperative preparation (P > .05). Conclusion: Our incidence is with in those seen in the literature although it is some what higher than the national surveillance programs. The performance of prophylaxis antibiotic must be improved, as well as the recording of preoperative preparation data (AU)

[Preoperative preparation, antibiotic prophylaxis and surgical wound infection in breast surgery]. / Preparación prequirúrgica, profilaxis antibiótica y vigilancia de infección de herida quirúrgica en cirugía de mama.

INTRODUCTION: The impact of surgical wound infection on public health justifies its surveillance and prevention. Our objectives were to estimate the incidence of surgical wound infection in breast procedures and assess its protocol of antibiotic prophylaxis and preoperative preparation. METHODS: Observational multicentre prospective cohort study of incidence of surgical wound infection. Incidence was evaluated, stratified by National Nosocomial Infection Surveillance (NNIS) risk index and we calculated the standardized incidence ratio (SIR). The SIR was compared with Spanish rates and U.S. rates. The compliance and performance of the antibiotic prophylaxis and preoperative preparation protocol were assessed and their influence in the incidence of infection with the relative risk. RESULTS: Ten hospitals from the Comunidad de Madrid were included, providing 592 procedures. The cumulative incidence of surgical wound infection was 3.89% (95% CI: 2.3-5.5). The SIR was 1.82 on the Spanish rate and 2.16 on the American. Antibiotic prophylaxis was applied in 97.81% of cases, when indicated. The overall performance of antibiotic prophylaxis was 75%, and 53% for preoperative preparation. No association was found between infection and performance of prophylaxis or preoperative preparation (P>.05). CONCLUSION: Our incidence is within those seen in the literature although it is somewhat higher than the national surveillance programs. The performance of prophylaxis antibiotic must be improved, as well as the recording of preoperative preparation data.

[Glucose, body mass index and pre-neoplastic lesions in the cervix]. / Glucosa, indice de masa corporal y lesiones preneoplásicas en el cuello uterino.

BACKGROUND: The obesity and abnormal blood glucose level has been associated with cervical cancer development; however, few studies have been performed about this relation. OBJECTIVE: Evaluate the blood glucose levels and body mass index (BMI) in women with human papilloma virus infection (HPV-I) and cervical intraepithelial neoplasia (CIN-I). PATIENTS AND METHOD: Transversal study of 44 women diagnosed with HPV-I and CIN-I from September to December 2010 in Dysplasia Clinic of Regional Hospital of Guzman City, Federal entity of Jalisco, Mexico. The diagnoses were carried by biopsy of cervix, glucose test results were evaluated by spectrophotometry and determinate the BMI. RESULTS: The 18% (n=8) of women were without injury, 41% (n=18), with HPV-I and 41% (n=18) CIN-I. High blood glucose was observed in GIN-I versus without injury in the cervix (p = 0.05), the correlation was OR = 2.6 (95% CI: 1.090-6.52). The young women (19-35 years) were 17% high glucose, 28% normal glucose and 55% low glucose. In group of the medium age (35-65 years) 23% showed high glucose, 50% normal and 27% low. The BMI was not relation with diagnosis, although in the age (young versus age median p=0.001). CONCLUSION: These results support the proposal about the high levels of glucose in plasma and obesity could be risk cofactors in the development of preneoplasic lesion of cervix.

Effect of ageing on CMV-specific CD8 T cells from CMV seropositive healthy donors.

BACKGROUND: Ageing is associated with changes in the immune system with substantial alterations in T-lymphocyte subsets. Cytomegalovirus (CMV) is one of the factors that affect functionality of T cells and the differentiation and large expansions of CMV pp65-specific T cells have been associated with impaired responses to other immune challenges. Moreover, the presence of clonal expansions of CMV-specific T cells may shrink the available repertoire for other antigens and contribute to the increased incidence of infectious diseases in the elderly. In this study, we analyse the effect of ageing on the phenotype and frequency of CMV pp65-specific CD8 T cell subsets according to the expression of CCR7, CD45RA, CD27, CD28, CD244 and CD85j. RESULTS: Peripheral blood from HLA-A2 healthy young, middle-aged and elderly donors was analysed by multiparametric flow cytometry using the HLA-A*0201/CMV pp65(495-504) (NLVPMVATV) pentamer and mAbs specific for the molecules analysed. The frequency of CMV pp65-specific CD8 T cells was increased in the elderly compared with young and middle-aged donors. The proportion of naïve cells was reduced in the elderly, whereas an age-associated increase of the CCR7(null) effector-memory subset, in particular those with a CD45RA(dim) phenotype, was observed, both in the pentamer-positive and pentamer-negative CD8 T cells. The results also showed that most CMV pp65-specific CD8 T cells in elderly individuals were CD27/CD28 negative and expressed CD85j and CD244. CONCLUSION: The finding that the phenotype of CMV pp65-specific CD8 T cells in elderly individuals is similar to the predominant phenotype of CD8 T cells as a whole, suggests that CMV persistent infections contributes to the age-related changes observed in the CD8 T cell compartment, and that chronic stimulation by other persistent antigens also play a role in T cell immunosenescence. Differences in subset distribution in elderly individuals showing a decrease in naive and an increase in effector-memory CD8 T cells may be relevant in the age-associated defective immune response.