Artritis séptica por Sneathia sanguinegens en un varón. Primer caso descrito en la literatura científica / Septic Arthritis due to Sneathia Sanguinegens in a Male. First Case Described in the Scientific Literature

Varón de 88 años que ingresa por artritis séptica de hombro por un bacilo Gram negativo. Se identifica el microorganismo mediante secuenciación del gen 16 S ADNr como Sneathia sanguinegens. Se trata del primer caso descrito en la literatura en un varón, ya que hasta el momento solo se habían descrito infecciones en mujeres en edad fértil.(AU)

An 88-year-old male admitted with septic shoulder arthritis due to a gram-negative bacillus. The microorganism is identified by sequencing the 16 S rDNA gene as Sneathia sanguinegens. This is the first case described in the literature in a male, since so far only infections in women of childbearing age have been described.(AU)

Septic Arthritis due to Sneathia Sanguinegens in a Male. First Case Described in the Scientific Literature. / Artritis séptica por Sneathia sanguinegens en un varón. Primer caso descrito en la literatura científica.

An 88-year-old male admitted with septic shoulder arthritis due to a gram-negative bacillus. The microorganism is identified by sequencing the 16 S rDNA gene as Sneathia sanguinegens. This is the first case described in the literature in a male, since so far only infections in women of childbearing age have been described.

Epidemiología descriptiva de infección por Yersinia enterocolitica en un área de alta incidencia durante 8 años, 2006-2013. Proyecto EDICS / Descriptive epidemiology of Yersinia enterocolitica infection in a high-incidence area over an 8-year period, 2006-2013. EDICS Project

Epidemiología descriptiva de la infección por Yersinia enterocolitica en un área de Castellón (España) entre 2006 y 2013 a partir de las cepas de Yersinia enterocolitica aisladas en el área y confirmadas por el laboratorio de referencia nacional. Total 144 casos. La incidencia estimada fue de 9,7 casos 105 persona-año. El grupo de edad más afectado fue el de 0-4 años (tasa 110,3 por 105 persona-año), con una máximo en lactantes de 6 a 11 meses de edad (190,4 por 105 persona-año). La duración media de la enfermedad fue de 15,5 días. El 7% de los pacientes fueron hospitalizados. Solo se detectaron 2 brotes, de carácter familiar relacionados con el consumo de carne de cerdo. La evolución temporal refleja mayor incidencia en invierno (enero). El factor de exposición más frecuente entre los casos fue el consumo de longaniza seca de cerdo (el 50% de los casos entrevistados). Las 58 cepas tipadas fueron todas del biotipo 4, serotipo O:3, excepto una O:9. Se distinguieron 21 pulsotipos agrupados en 8 clusters con similitud del 97%. A lo largo de algunos años se observó una sustitución de unos pulsotipos por otros.La yersiniosis tiene una incidencia alta en nuestra área, con una estacionalidad clara de predominio invernal. Afecta sobre todo a niños muy pequeños. Las cepas son del mismo serotipo, pero la variedad de pulsotipos cambió a lo largo del tiempo. Como factor de exposición para ulteriores estudios analíticos se propone el consumo de algunos productos del cerdo, sin descartar otros factores

Descriptive epidemiology of Yersinia enterocolitica infection in an area of Castellón (Spain) between 2006 and 2013 from Yersinia enterocolitica strains isolated in the area and confirmed by the Spanish national reference laboratory. There were a total of 144 cases. The estimated incidence was 9.7 cases per 105 person-year. The age group most affected was 0-4 years (rate 110.3 per 105 p-y), with a maximum in infants aged 6 to 11 months of age (190.4 per 105 p-y). The average duration of the disease was 15.5 days. 7% of the patients were hospitalised. Only 2 outbreaks of a family nature related to the consumption of pork were detected. The temporal evolution reflects higher incidence during the winter season (January). The most common exposure factor among the cases was the consumption of dried pork sausage (50% of the cases interviewed). The 58 typed strains were all of the biotype 4, serotype O:3, except one O:9. We distinguished 21 pulsotypes grouped in 8 clusters with a similarity of 97%. Over a number of years, a substitution of some pulsotypes for others was observed. Yersiniosis has a high incidence in our area, with a clear seasonality of winter predominance. It affects very young children, in particular. The strains are of the same serotype, but the variety of pulsotypes changed over time. As an exposure factor for further analytical studies, the consumption of some pork products is proposed, without ruling out other factors

Descriptive epidemiology of Yersinia enterocolitica infection in a high-incidence area over an 8-year period, 2006-2013. EDICS project. / Epidemiología descriptiva de infección por Yersinia enterocolitica en un área de alta incidencia durante 8 años, 2006-2013. Proyecto EDICS.

Descriptive epidemiology of Yersinia enterocolitica infection in an area of Castellón (Spain) between 2006 and 2013 from Yersinia enterocolitica strains isolated in the area and confirmed by the Spanish national reference laboratory. There were a total of 144 cases. The estimated incidence was 9.7 cases per 105 person-year. The age group most affected was 0-4 years (rate 110.3 per 105 p-y), with a maximum in infants aged 6 to 11 months of age (190.4 per 105 p-y). The average duration of the disease was 15.5 days. 7% of the patients were hospitalised. Only 2 outbreaks of a family nature related to the consumption of pork were detected. The temporal evolution reflects higher incidence during the winter season (January). The most common exposure factor among the cases was the consumption of dried pork sausage (50% of the cases interviewed). The 58 typed strains were all of the biotype 4, serotype O:3, except one O:9. We distinguished 21 pulsotypes grouped in 8 clusters with a similarity of 97%. Over a number of years, a substitution of some pulsotypes for others was observed. Yersiniosis has a high incidence in our area, with a clear seasonality of winter predominance. It affects very young children, in particular. The strains are of the same serotype, but the variety of pulsotypes changed over time. As an exposure factor for further analytical studies, the consumption of some pork products is proposed, without ruling out other factors.

Comparison of sporadic cases of Salmonella Typhimurium with other Salmonella serotypes in Castellon (Spain): case-case study / Comparación de casos esporádicos de Salmonella typhimurium con otros serotipos de Salmonella en Castellón (España): un estudio caso-caso

INTRODUCTION: Salmonella infections (SI) are common in Spain. The aim of this study was to appraise risk factors and the clinical characteristics of sporadic Salmonella Typhimurium infections compared with other sporadic salmonella serotype infections (OSI). METHODS: From September 2014 to August 2015, a case-case study was carried out by the Epidemiology Division of the Public Health Centre of Castellon. Case 1 consisted of patients with sporadic S. Typhimurium infections, while case 2 comprised OSI patients, assessed according to the stool cultures analyzed by the Microbiology Laboratories of Hospital General de Castellon and Hospital de La Plana in Vila-real. Patients from detected outbreaks were not included. The salmonella serotype was identified by the National Centre of Microbiology (Madrid). RESULTS: The total number of SI patients reported was 327, 242 of whom were studied (74.0%). 148 patients had sporadic S. Typhimurium infection and 64 had OSI, with median ages of 4 and 8.5 years, respectively. Sporadic S. Typhimurium infection patients presented more blood in feces and diarrhea episodes. Consumption of pork meat (OR = 2.22; 95% CI 1.12-4.43), cold pork meats (OR = 2.49; 95% CI 1.32-4.68) and playing in the dirt (OR=3.02; 95% CI 1.55-5.88), were associated with sporadic S. Typhimurium infection. In the 0-4 year-old group, the associated factors were consumption of cold pork meats, omelets and female gender. In the 5-year-old and over group, only playing in soil was associated with sporadic S. Typhimurium infection. CONCLUSIONS: The consumption of pork and omelets, as well as playing in the dirt, were the main factors associated with infection. Children were most affected by sporadic S. Typhimurium infection

INTRODUCCIÓN: Las infecciones por Salmonella son frecuentes en España. El objetivo de este estudio fue estimar factores de riesgo y características de las infecciones esporádicas por Salmonella typhimurium (IET), comparadas con infecciones esporádicas por otros serotipos de Salmonella. MÉTODOS: Desde septiembre de 2014 a agosto de 2015 se efectuó un estudio caso-caso por la Sección de Epidemiología del Centro de Salud Pública de Castellón. El caso 1 fueron los pacientes con IET y el caso 2 aquellos con infecciones esporádicas por otros serotipos de Samonella, según los coprocultivos realizados por los laboratorios de Microbiología de los hospitales General de Castellón y La Plana de Vila-real, sin incluir los pacientes de brotes detectados. El serotipo de Salmonella fue identificado en el Centro Nacional de Microbiología (Madrid). RESULTADOS: Se notificaron 327 pacientes con infección por Salmonella, de los que 242 fueron estudiados (74,0%). Ciento cuarenta y ocho pacientes tenían IET y 64, infecciones esporádicas por otros serotipos de Salmonella, con una mediana de edad de 4 y 8,5 años, respectivamente. Los pacientes IET presentaron más episodios diarreicos y sangre en las heces. El consumo de carne de cerdo (OR 2,22; IC 95% 1,12-4,43), fiambres de cerdo (OR 2,49; IC 95% 1,32-4,68) y jugar en la tierra (OR 3,02; IC 95% 1,55-5,88) fueron asociados con IET. En el grupo de 0-4 años, los factores asociados fueron consumo de fiambres de cerdo, tortillas y ser mujer. En el grupo de 5 y más años, solo jugar en la tierra fue asociado con IET. CONCLUSIONES: El consumo de productos porcinos y tortillas, así como jugar en la tierra fueron los factores asociados, y los niños, los más afectados

Comparison of sporadic cases of Salmonella Typhimurium with other Salmonella serotypes in Castellon (Spain): case-case study.

INTRODUCTION: Salmonella infections (SI) are common in Spain. The aim of this study was to appraise risk factors and the clinical characteristics of sporadic Salmonella Typhimurium infections compared with other sporadic salmonella serotype infections (OSI). METHODS: From September 2014 to August 2015, a case-case study was carried out by the Epidemiology Division of the Public Health Centre of Castellon. Case 1 consisted of patients with sporadic S. Typhimurium infections, while case 2 comprised OSI patients, assessed according to the stool cultures analyzed by the Microbiology Laboratories of Hospital General de Castellon and Hospital de La Plana in Vila-real. Patients from detected outbreaks were not included. The salmonella serotype was identified by the National Centre of Microbiology (Madrid). RESULTS: The total number of SI patients reported was 327, 242 of whom were studied (74.0%). 148 patients had sporadic S. Typhimurium infection and 64 had OSI, with median ages of 4 and 8.5 years, respectively. Sporadic S. Typhimurium infection patients presented more blood in feces and diarrhea episodes. Consumption of pork meat (OR=2.22; 95% CI 1.12-4.43), cold pork meats (OR=2.49; 95% CI 1.32-4.68) and playing in the dirt (OR=3.02; 95% CI 1.55-5.88), were associated with sporadic S. Typhimurium infection. In the 0-4 year-old group, the associated factors were consumption of cold pork meats, omelets and female gender. In the 5-year-old and over group, only playing in soil was associated with sporadic S. Typhimurium infection. CONCLUSIONS: The consumption of pork and omelets, as well as playing in the dirt, were the main factors associated with infection. Children were most affected by sporadic S. Typhimurium infection.

An outbreak of monophasic and biphasic SalmonellaTyphimurium, and Salmonella Derby associated with the consumption of dried pork sausage in Castellon (Spain) / Un brote de Salmonella Typhimurium monofásica y bifásica y Salmonella Derby asociado al consumo de longaniza seca de cerdo en Castellón (España)

An outbreak of S.Typhimurium occurred in several towns and cities in the province of Castellon (Spain) between 23 February and 27 May 2011. On April 5, the microbiology laboratory of a hospital in Castellon alerted the health authorities to the increase in S.Typhimurium isolated in fecal culture of children with gastroenteritis. The serotype and phage-type of 83 positive cases of S.Typhimurium isolated in these period included 49 monophasic/biphasic S.Typhimurium phage type 138, phage type 193, S.Derby, and 34 other S.Typhimurium phage-types. The median of age of patients was 4 years with a range of 0.6-80 years, and the 18% of patients were hospitalised. Two incident matched case-control studies were carried out; the first with S.Typhimurium phage type 138, 193, and S.Derby cases and the second with the other cases. The two studies found that the consumption of brand X dried pork sausage, purchased in a supermarket chain A, was associated with the disease (matched Odds Ratio [mOR]=13.74 95% Confidence Interval [CI] 4.84-39.06 and mOR=8.20 95% CI 2.32-28.89), respectively). S.Typhimurium phage type 193 and S.Derby were isolated in the food taken from the household of two patients and from the supermarket chain's A central warehouse. The pulsed-field gel electrophoresis study confirmed the similarity of the strains from the patients and the food. On May 25 2011, a national food alert led to the withdrawal of the food from the chain A and the outbreak ended

Entre el 23 de febrero y el 27 de mayo del 2011, un brote de Salmonella Typhimurium ocurrió en varios pueblos y ciudades en la provincia de Castellón (España). El día 5 de abril del 2011 el laboratorio de Microbiología de un hospital de Castellón alertó a las autoridades sanitarias del incremento de aislamientos de S.Typhimurium en coprocultivos de niños con gastroenteritis. El serotipo y fagotipo de 83 casos positivos a S.Typhimurium aislados en este periodo incluyó 49 casos con monofásica/bifásica S.Typhimurium fagotipo 138, fagotipo 193, y Salmonella Derby y otros 34 casos con distintos S.Typhimurium fagotipos. La mediana de los pacientes era de 4 años, con un rango de 0,6 a 80años. Dos incidentes casos-control apareados fueron llevados a cabo, el primero con los casos S.Typhimurium fagotipos 138,193 y S.Derby, y el segundo con los demás casos. Los 2 estudios encontraron que el consumo de la marca X de longaniza seca de cerdo comprada en una cadena de supermercados A estaba asociado con la enfermedad (odds ratio apareada [ORa]=13,74; intervalo de confianza [IC] del 95%: 4,84-39,06, y ORa=8,20; IC95%: 2,32-28,89, respectivamente). S.Typhimurium fagotipo 193 y S.Derby fueron aislados en dicho alimento recogido en la casa de 2 pacientes y en el almacén central de la cadena A de supermercados. La electroforesis en gel de campo pulsado confirmó la similitud de las cepas de los pacientes y del alimento. El día de 25 de mayo de 2011 una alerta alimentaria nacional obligó a la retirada del alimento de la cadena A y el brote terminó

An outbreak of monophasic and biphasic Salmonella Typhimurium, and Salmonella Derby associated with the consumption of dried pork sausage in Castellon (Spain).

An outbreak of S.Typhimurium occurred in several towns and cities in the province of Castellon (Spain) between 23 February and 27 May 2011. On April 5, the microbiology laboratory of a hospital in Castellon alerted the health authorities to the increase in S.Typhimurium isolated in fecal culture of children with gastroenteritis. The serotype and phage-type of 83 positive cases of S.Typhimurium isolated in these period included 49 monophasic/biphasic S.Typhimurium phage type 138, phage type 193, S.Derby, and 34 other S.Typhimurium phage-types. The median of age of patients was 4 years with a range of 0.6-80 years, and the 18% of patients were hospitalised. Two incident matched case-control studies were carried out; the first with S.Typhimurium phage type 138, 193, and S.Derby cases and the second with the other cases. The two studies found that the consumption of brand X dried pork sausage, purchased in a supermarket chain A, was associated with the disease (matched Odds Ratio [mOR]=13.74 95% Confidence Interval [CI] 4.84-39.06 and mOR=8.20 95% CI 2.32-28.89), respectively). S.Typhimurium phage type 193 and S.Derby were isolated in the food taken from the household of two patients and from the supermarket chain's A central warehouse. The pulsed-field gel electrophoresis study confirmed the similarity of the strains from the patients and the food. On May 25 2011, a national food alert led to the withdrawal of the food from the chain A and the outbreak ended.

Brotes de gastroenteritis aguda vírica en residencias de ancianos. Sistema de detección por umbral de prevalencia (SIDUP) / Outbreaks of acute viral gastroenteritis in geriatric homes. Threshold detection system for prevalence (SiDUP)

Se describen las intervenciones llevadas a cabo en una unidadde epidemiología local, durante varios años, relacionadascon la epidemiología de la gastroenteritis por norovirus enresidencias de ancianos de Castellón. Desde varios brotesacaecidos en un mismo geriátrico, hasta el estudio de los casosesporádicos que determinan la situación endémica en variasresidencias. Este trabajo se centra en el análisis de esa situaciónendémica de síntomas digestivos en periodos de silencioepidémico y la propuesta de un método sencillo para detectarel inicio de brotes de GEA de transmisión progresiva (persona-persona) que hemos denominado Sistema de Detección porUmbral de Prevalencia (SiDUP). Se discute el espectro epidemiológicode la gastroenteritis por norovirus en estas institucionespara personas mayores(AU)

We describe the interventions carried out in a local epidemiologyunit related to the epidemiology of gastroenteritis dueto norovirus in geriatric homes in Castellón (Spain) duringseveral years. These range from various outbreaks in the samegeriatric home to the study of sporadic cases which determinethe endemic situation. This study focuses on the analysis ofthis endemic situation of digestive symptoms in silent epidemicperiods and proposes a simple method to detect the initiationof GEA of progressive transmission (person-person)which we call System of Detection by Prevalence Threshold(SiDUP). The epidemiological spectrum of gastroenteritis dueto norovirus in geriatric homes is discussed(AU)

[Outbreaks of acute viral gastroenteritis in geriatric homes: threshold detection system for prevalence (SiDUP)]. / Brotes de gastroenteritis aguda vírica en residencias de ancianos: Sistema de detección por umbral de prevalencia (SiDUP).

We describe the interventions carried out in a local epidemiology unit related to the epidemiology of gastroenteritis due to norovirus in geriatric homes in Castellón (Spain) during several years. These range from various outbreaks in the same geriatric home to the study of sporadic cases which determine the endemic situation. This study focuses on the analysis of this endemic situation of digestive symptoms in silent epidemic periods and proposes a simple method to detect the initiation of GEA of progressive transmission (person-person) which we call System of Detection by Prevalence Threshold (SiDUP). The epidemiological spectrum of gastroenteritis due to norovirus in geriatric homes is discussed.