[Evolution of the serotypes causing invasive pneumococcal disease along 2008-2022 in a Level 2 Public Hospital of the Madrid Region, in relation to their inclusion in different conjugate vaccines]. / Evolución de los serotipos causantes de enfermedad neumocócica invasiva aislados durante 2008-2022 en un Hospital Público Madrileño de nivel dos, en relación con su inclusión en diferentes vacunas conjugadas.

OBJECTIVE: The use of conjugate vaccines against Streptococcus pneumoniae originates changes in the invasive pneumococcal disease (IPD). The aim of this study was to in vestigate the evolution of S. pneumoniae serotypes isolated in the Hospital Universitario de Getafe between 2008 and 2022. METHODS: 313 of S. pneumoniae strains were studied. Serotyping was carried out by latex agglutination (Pneumotest-latex) and the Quellung reaction. In addition, the minimal inhibitory concentration (MIC) was determined against penicillin, erythromycin and levofloxacin by the concentration gradient method (E-test) according the EUCAST breakpoints. RESULTS: The most frequent serotypes throughout the study period were 8, 3, 19A, 1, 11A and 22F corresponding to 46.6% of the isolates. Along 2008-2012 the serotypes 3, 1, 19A, 7F, 6C and 11A represented altogether 53.6% of the isolates. Between 2013 and 2017 the serotypes 3, 8, 12F, 19A, 22F and 19F grouped 51% of the isolates. During 2018-2022 the serotypes 8, 3, 11A, 15A, 4 and 6C included the 55.5% of the cases. In total 5 strains (1.6%) were penicillin resistant, 64 (20.4%) erythromycin resistant and 11 (3.5%) levofloxacin resistant. The MIC50 and MIC90 levels maintained stables along the time. CONCLUSIONS: The conjugate vaccines use with different serotype coverage conditioned a decrease of the vaccine-included and an increase of non-covered. Despite these changes, the global antimicrobial susceptibility patterns to erythromycin and levofloxacin maintained relatively stables. The resistance a penicillin was low, not finding this type of resistant strains in the last study period.

[SARS-CoV-2 variants, a still unfinished story]. / Variantes de SARS-CoV-2, una historia todavía inacabada.

Mutations in the SARS-CoV-2 genome can affect the gene encoding the Spike (S) antigen, which interacts with the host cell specific receptor, selecting mutant variants with changes in their infective capacity, pathogenic potential and resistance to neutralizing antibodies. The nomenclature to design the variants uses a colloquial form referred to the country or place of detection, a code from the "Pangolin" database and one from the "Nextstrain" page. New variants that have spread include the British B.1.1.7 (20I/501Y.V1), the South African B.1.351 (20H/501.V2), the Brazilian P.1 (20J/501Y.V3), the Californians B.1.427 B.1.429 (20C/S:452R) and the most recent, the Indian B.1.617 (VUI-21APR-01).The gold standard for the identification of the variants is whole genome sequencing. However, real-time PCR techniques have already been developed for the detection of specific mutations that can facilitate their presumptive identification.The impact of these variants on global vaccination programs has raised concern. It is generally thought that, since the response evoked by the vaccine against the S antigen is directed at the entire protein and the mutations only affect specific regions, the escape effect of the vaccine antibodies will be limited. Among the future strategies proposed for immuno-protection, the increase in the number of doses, the alternation of vaccines and the development of specific vaccines against different variants has been suggested.

Development of an active risk-based surveillance strategy for avian influenza in Cuba.

The authors designed a risk-based approach to the selection of poultry flocks to be sampled in order to further improve the sensitivity of avian influenza (AI) active surveillance programme in Cuba. The study focused on the western region of Cuba, which harbours nearly 70% of national poultry holdings and comprise several wetlands where migratory waterfowl settle (migratory waterfowl settlements - MWS). The model took into account the potential risk of commercial poultry farms in western Cuba contracting from migratory waterfowl of the orders Anseriformes and Charadriiformes through dispersion for pasturing of migratory birds around the MWS. We computed spatial risk index by geographical analysis with Python scripts in ESRI(®) ArcGIS 10 on data projected in the reference system NAD 1927-UTM17. Farms located closer to MWS had the highest values for the risk indicator pj and in total 31 farms were chosen for targeted surveillance during the risk period. The authors proposed to start active surveillance in the study area 3 weeks after the onset of Anseriformes migration, with additional sampling repeated twice in the same selected poultry farms at 15 days interval (Comin et al., 2012; EFSA, 2008) to cover the whole migration season. In this way, the antibody detectability would be favoured in case of either a posterior AI introduction or enhancement of a previous seroprevalence under the sensitivity level. The model identified the areas with higher risk for AIV introduction from MW, aiming at selecting poultry premises for the application of risk-based surveillance. Given the infrequency of HPAI introduction into domestic poultry populations and the relative paucity of occurrences of LPAI epidemics, the evaluation of the effectiveness of this approach would require its application for several migration seasons to allow the collection of sufficient reliable data.

[Design and implementation of a national serum bank for the surveillance of exotic animal diseases in the Republic of Cuba]. / Diseño e instauración de un banco nacional de sueros para la vigilancia de enfermedades exóticas de los animales en la República de Cuba.

A serum bank for the surveillance of exotic diseases was designed in accordance with the provisions of the Information and Epizootiological Surveillance System in the Republic of Cuba. Sera were collected from imported animals, from sentinel animals used for monitoring target areas at biological risk and from animals located in high animal-density areas. Methodologies were developed for the selection and characterisation of target areas at biological risk and sentinel animal points, the collection and storage of serum samples and the management of the national animal serum bank. After developing the methodologies, the serum bank was established throughout Cuba. The national animal serum bank operates using a quality management system based on the recommendations of the World Organisation for Animal Health and the International Organization for Standardization.

Tiamulin-nitrovin interaction in pigs: a case report and experimental reproduction.

Tiamulin is a diterpenic veterinary drug widely used in swine for the control of infectious diseases, including swine dysentery and enzootic pneumonia. Tiamulin is well tolerated and only a few drug interactions have been reported with some ionophore antibiotics. A case of tiamulin adverse drug interaction with nitrovin, a nitrofuranic growth promoter, in fattening pigs from a commercial farm is described. To confirm the diagnosis, experimental reproduction was conducted using 20 healthy female pigs. The animals were randomly divided into 4 groups: 1 of them receiving feed medicated with 100 mg tiamulin hydrogen fumarate/kg, another received 20 mg nitrovin/kg to establish the harmlessness of the drugs alone. The other 2 groups received feeds containing both drugs at the previous concentrations, one of which came from the farm. In the last 2 groups clinical signs appeared 72-96 h after initially feeding pigs the tiamulin hydrogen fumarate + nitrovin-containing feed. The animals had uneasiness, anxiety, skin erythema, and rash on snout, vulva and abdomen, and increased body temperatures. No mortality occurred, and there were no characteristic findings during pathological examination. The signs disappeared after 96 h of consuming the medicated feed, leaving a slight skin thickening of the affected regions. All signs disappeared spontaneously 4-5 d after ceasing medication.

[Giant intraventricular arachnoid cyst: report of 2 cases]. / Quiste aracnoideo intraventricular gigante: a propóposito de dos casos.

INTRODUCTION: It is very unusual to find cysts situated intraventricularly. Only 24 cases have been described to date in the literature. CLINICAL CASES: In this paper we present two new cases considering that because of their exceptional size they deserve to be called 'giant'. The two patients had been diagnosed as having epilepsy during childhood or youth. No neuroradiological studies had ever been done. The cause of hospital admission in the first case was headache and vomiting and in the second case a convulsive crisis. We did cerebral CT scans in both cases and a MR control scan in the second case. This formed the basis for our diagnosis. Unlike previous cases they were not operated on. Their clinical course may be considered satisfactory to date, since there have been no further convulsive crisis nor other neurological alterations. We have therefore been conservative with regard to the indication for surgery in these patients. CONCLUSIONS: Review of the literature does not completely clarify the origin of these lesions but we are inclined to believe that there is an intimate relationship between the formation of an intraventricular arachnoid cyst and the choroid plexus. Many new cases will have to be diagnosed before we can fully understand the true physiopathology of these cysts.

Radicular compression by gas in a spinal extra dural cyst. Report on two cases.

The authors describe two cases of secondary sciatica due to radicular compression by a gas containing cyst in the extra dural space. The diagnosis was realized with CT-Scan and magnetic resonance imaging. In both cases removal of the cyst provided relief. The pathogenesis of the presence of epidural gas is discussed and the literature reviewed.