Enterococcus isolated from poultry intestine for potential probiotic use.

Background and Aim: To develop species-specific probiotics for poultry, it is ideal to obtain these probiotic microorganisms directly from the intestinal tract of broiler and egg-laying chicks in production environments to ensure adaptation to actual conditions. This study aimed to isolate lactic acid bacteria (LAB) from the intestinal tract of broiler and egg-laying chicks to determine their probiotic potential. Materials and Methods: Twenty-five Ross-308 broilers and 25 Isa Brown egg-laying chicks were raised until days 42 and 120, respectively; they were housed in an individual poultry building. Lactic acid bacteria were isolated and identified from the small intestine mucus of broiler and layer chicks and then evaluated based on resistance to acidic pH levels, bile salt concentration, and antagonistic activity against wild strains of Escherichia coli and Salmonella spp. selected strains with probiotic potential were identified by polymerase chain reaction and confirmed by rDNA sequencing. Results: One hundred and fifty Gram-positive isolates were obtained; 28% (42) were catalase and oxidase negative and biochemical identification was made by crystal system: 76.2% (32) Enterococcus spp., 16.6% (7) Lactococcus spp., and 7.2% (3) Streptococcus spp.; and evaluated for hemolysin production; tolerance to low pH and bile salts, and antagonistic potential were carried out. Molecular characterization yielded 56% (24) Enterococcus faecium, and 44% (18) Enterococcus faecalis. About 81% (34) of strains were without vancomycin resistance genes criterion. Conclusion: This study isolated and characterized 36 strains of LAB with probiotic qualities, from the intestines of broiler and egg-laying chicks, selecting E. faecium, Enterococcus avium, and Enterococcus casseliflavus, Lactococcus garviae as promising strains for further in vitro and in vivo research.

Nodal and systemic recurrence following observation of a positive sentinel lymph node in melanoma.

BACKGROUND: Two RCTs found no survival benefit for completion lymphadenectomy after positive sentinel lymph node biopsy compared with observation with ultrasound in patients with melanoma. Recurrence patterns and regional control are not well described for patients undergoing observation alone. METHODS: All patients with a positive sentinel node biopsy who did not have immediate completion lymphadenectomy were identified from a single-institution database (1995-2018). First recurrences were classified as node only, local and in-transit (LCIT) only, LCIT and nodal, or systemic. Regional control and factors associated with recurrence survival were analysed. RESULTS: Median follow-up was 33 months. Of 370 patients, 158 (42·7 per cent) had a recurrence. The sites of first recurrence were node only (13·2 per cent), LCIT only (11·9 per cent), LCIT and nodal (3·5 per cent), and systemic (13·8 per cent). The 3-year postrecurrence melanoma-specific survival rate was 73 (95 per cent c.i. 54 to 86) per cent for patients with node-only first recurrence, and 51 (31 to 68) per cent for those with initial systemic recurrence. In multivariable analysis, ulceration in the primary lesion (hazard ratio (HR) 2·53, 95 per cent c.i. 1·27 to 5·04), disease-free interval 12 months or less (HR 2·38, 1·28 to 4·35), and systemic (HR 2·57, 1·16 to 5·65) or LCIT and nodal (HR 2·94, 1·11 to 7·79) first recurrence were associated significantly with decreased postrecurrence survival. Maintenance of regional control required therapeutic lymphadenectomy in 13·0 per cent of patients during follow-up. CONCLUSION: Observation after a positive sentinel lymph node biopsy is associated with good regional control, permits assessment of the time to and pattern of recurrence, and spares lymphadenectomy-related morbidity in patients with melanoma.

Signo de Hutchinson como predictor de afectación ocular en herpes zoster oftálmico / Hutchinson's sign as a predictor of ocular impairment in herpes zoster ophthalmicus

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Ictère néonatal. Etude des facteurs associés au Centre Hospitalier Départemental de l'Ouéme-Plateau (CHD-OP)

Introduction : l'ictère néonatal est très fréquent dans le monde et est dominé par les ictères à bilirubine libre. Son évolution est le plus souvent favorable mais il peut être grave et engendrer des complications comme une encéphalopathie hyperbilirubinique, une anémie, voire le décès en absence ou en cas de retard à la prise en charge. L'objectif de ce travail était d'étudier les facteurs associés à l'ictère néonatal dans l'unité de néonatologie du CHUD-OP.Méthodes : il s'agissait d'une étude transversale descriptive et analytique qui avait été conduite du 01 juillet 2015 au 30 juin 2016 et avait porté sur tous les nouveau-nés ayant présenté un ictère et admis dans l'unité de néonatologie du service de pédiatrie du CHUD-OP. La saisie et l'analyse des données avaient été faites à l'aide de Epi info 2000 version 3.5.3 et Microsoft Excel 2016. Le test de Pearson avait été utilisé pour les proportions et le test de Student pour la comparaison des moyennes. La différence était statistiquement significative lorsque p est inférieur à 0,05. Résultats : la fréquence hospitalière de l'ictère néonatal était de 11,0% (170, N=1542). Les principales causes retrouvées étaient : l'infection néonatale bactérienne (29,4% ; n=50), l'incompatibilité fœto-maternelle dans les systèmes ABO et rhésus (15,9% ; n=27). La majorité de ces nouveau-nés était guérie et 22,4% (n=38) avaient présenté : une anémie sévère 21,6% (n=25), une encéphalopathie hyperbilirubinémique 18,2% (n=31) et 26 étaient décédés (15,3%). Les nouveau-nés accouchés en dehors de l'hôpital, la prématurité et l'incompatibilité fœto-maternelle dans les systèmes ABO et rhésus étaient des facteurs associés aux complications de l'ictère néonatal. Conclusion : l'organisation de la référence et l'amélioration de la qualité des soins au couple mère-enfant permettra la réduction des facteurs associées à l'évolution défavorable de l'ictère

Dosis altas de corticoides sistémicos en pacientes ingresados por exacerbación de enfermedad pulmonar obstructiva crónica. Un estudio de cohortes / High doses of systemic corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. A cohort study

Objetivos. Evaluar el efecto de las dosis altas de corticoides en pacientes ingresados por exacerbación de una enfermedad pulmonar obstructiva crónica (EPOC). Pacientes y métodos. Estudio de cohortes prospectivo de enfermos hospitalizados con EPOC entre enero y marzo de 2015, agrupados en función de la dosis de glucocorticoides recibida (punto de corte: 40mg de prednisona/día). Se compararon los resultados de estancia hospitalaria, y de reingreso y mortalidad a los 3 meses del alta. Resultados. Se analizaron 87 pacientes. La mediana de la dosis diaria recibida fue de 60mg de prednisona/día (rango intercuartílico: 46,67-82,33mg/día); la vía de administración fue endovenosa en el 96,6% de los casos. Se estableció un riesgo relativo (RR) de estancia superior a 8 días de 1,095 [intervalo de confianza (IC) 95%: 0,597-2,007; p=0,765] cuando se usaban dosis de esteroides superiores a 40mg/día. Además, en estos pacientes la hazard ratio (HR) para el reingreso durante los 3 meses siguientes al alta fue de 0,903 [IC 95%: 0,392-2,082; p=0,811] y la mortalidad de 1,832 (IC 95%: 0,229-16,645; p=0,568]. Ni el RR ni las HR observadas variaron de forma estadísticamente significativa tras el ajuste por factores de confusión. Conclusiones. Una dosis superior a 40mg diarios de prednisona en pacientes ingresados por exacerbación de EPOC no se asocia a una menor estancia hospitalaria ni a una disminución del reingreso y de la mortalidad a los 3 meses (AU)

Objectives. To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). Patients and methods. A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. Results. We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. Conclusions. A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months (AU)

High doses of systemic corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. A cohort study. / Dosis altas de corticoides sistémicos en pacientes ingresados por exacerbación de enfermedad pulmonar obstructiva crónica. Un estudio de cohortes.

OBJECTIVES: To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. RESULTS: We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. CONCLUSIONS: A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months.

Real-time parameter estimation of Zika outbreaks using model averaging.

Early prediction of the final size of any epidemic and in particular for Zika disease outbreaks can be useful for health authorities in order to plan the response to the outbreak. The Richards model is often been used to estimate epidemiological parameters for arboviral diseases based on the reported cumulative cases in single- and multi-wave outbreaks. However, other non-linear models can also fit the data as well. Typically, one follows the so called post selection estimation procedure, i.e., selects the best fitting model out of the set of candidate models and ignores the model uncertainty in both estimation and inference since these procedures are based on a single model. In this paper we focus on the estimation of the final size and the turning point of the epidemic and conduct a real-time prediction for the final size of the outbreak using several non-linear models in which these parameters are estimated via model averaging. The proposed method is applied to Zika outbreak data in four cities from Colombia, during the outbreak ocurred in 2015-2016.

Effect of Moxidectin Treatment at Peripartum on Gastrointestinal Parasite Infections in Ewes Raised under Tropical Andes High Altitude Conditions.

This study tested the impact of moxidectin at peripartum on nematode fecal egg count (FEC) and clinical parameters on ewes in the high altitude tropical Andes of Colombia. FEC and clinical evaluations were performed on 9 occasions in 43 naturally infected ewes before and during gestation and after lambing. Moxidectin (Mox, 200 µg kg(-1)) was applied at late pregnancy (T 1, n = 15) or 48 hours after parturition (T 2, n = 14). 14 untreated ewes served as controls (C). Suckling lambs (n = 58) remained untreated and underwent four clinical and parasitological evaluations until 8 weeks after birth. Mox efficacy equaled 99.3% (T 1) and 96.9% (T 2). Highest mean FEC value reflecting periparturient nematode egg rise (PPER) was recorded in C ewes at 4-6 weeks after lambing. Significant FEC reductions were found in T 1 (94.8%) and T 2 (96.7%) ewes (p < 0.05). All lambs showed a significant and ewes-group independent increase in FEC before weaning (p < 0.05). Clinical parameters (anemia and diarrhea) showed time- and treatment-related differences (p < 0.05). Monitoring of FEC and clinical parameters linked to gastrointestinal parasite infections allowed demonstrating that postpartum or preweaning are two critical periods to nematode infection for sheep raised under tropical Andes high altitude conditions. Use of Mox as anthelmintic treatment prevented PPER.

Situational analysis of orphans and vulnerable children in urban and rural communities of Plateau State.

BACKGROUND: Orphans and Vulnerable Children (OVC) are children affected by HIV and AIDS by virtue of, among others, living in a household where one or more people are ill, dying or deceased, or which fosters orphans, and children whose care givers are too ill or old to continue to care for them. They often have more health needs than their peers. This study was carried out to obtain baseline information on the needs of OVC in North-Central Nigeria as a basis for provision of relief services. METHODS: A house to house cross-sectional survey of OVC recruited via a multistage sampling technique was carried out in four LGAs of Plateau State, Nigeria. The Child Status Index (CSI) tool was used to obtain information from the respondents and/or their caregivers. Vulnerability of the children was assessed using a Vulnerability Index (VI) scoring which ranged from 1-21, with 1-9 being vulnerable, 10-14 more vulnerable, and 15-21 being most vulnerable. RESULTS: A total of 825 OVC ages ranging from 0-17 years and mean age of 9.8 ± 4.5 years were studied. 432 were males (52.4%) and 393 females (47.6%). 64.8% lived in households headed by women out of which 77.6% were widows. Six hundred and one (72.8%) household heads were farmers. Paternal orphans made up 59.8% of the respondents and 12.1% had lost both parents. Prevalence of abuse/exploitation was 17.7% and 66.7% experienced household food insecurity. Four hundred and seventy-eight (57.9%) OVC lived in households with no source of income. One hundred and fifty-one (18.3%) children (54.9% boys and 45.1% girls) had never been to school. 55.0% had minimal health problems. Majority of them (60.3%) lived in dilapidated shelter and 3.3% were living on the street. CONCLUSION: This survey revealed the various needs of OVC. Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as education, shelter and clothing, but also on long-term developmental needs that reduce children's vulnerability such as life skills, child protection, vocational training, food security and household economic strengthening.

Effects of crossbreeding on endocrine patterns determined in pregnant beef/dairy cows naturally infected with Neospora caninum.

Neospora caninum is an intracellular coccidian parasite causing abortion worldwide in dairy cattle. Studies have shown that N caninum infection modifies endocrine patterns and that beef cows or cows with a crossbreed pregnancy, especially for a greater maternal-paternal genetic distance, show a reduced risk of abortion when naturally infected compared with pure-breed Holstein Friesian (HF) pregnancies. This study examined the effects of crossbreeding on plasma progesterone (P4), pregnancy-associated glycoprotein (PAG)-1 and -2, and prolactin patterns produced during gestation in N caninum-infected beef/dairy cows. We analyzed 74 pregnancies in nonaborting cows carrying a single fetus established in 26 lactating HF cows bred with Holstein bulls (H-H), 13 HF cows bred with Limousin bulls (H-L), 12 HF cows used as recipients of transferred in vivo-produced frozen-thawed Rubia Gallega (beef breed; RG) embryos (H-RG-ET), and 23 RG suckling cows bred with RG bulls (RG-RG). Of the cows, 29 (39%) were seropositive for N caninum. Blood samples for hormone and placental protein determinations were collected on Days 30, 60, 90, 120, 150, and 180 of gestation. Procedures of repeated measures analysis of variance throughout gestation revealed higher PAG-1 levels in the H-L and H-RG-ET groups compared with H-H and RG-RG. Higher prolactin levels were detected in RG-RG than in the remaining groups. N caninum seropositivity and fetal genotype had a significant effect on PAG-2 concentrations, such that highest levels of PAG-2 occurred in RG-RG seropositive cows and lowest in H-H seropositive cows, whereas Neospora-seropositive cows showed lower P4 concentrations than their seronegative partners. In conclusion, chronic N caninum infection modifies endocrine patterns of PAG-2 and P4 during pregnancy, whereas PAG-1 and prolactin concentrations are affected by breed and fetal genotype, irrespective of Neospora infection status.

Factors affecting the utilization of long lasting insecticide treated bed nets among people living with HIV/AIDS in Bassa Local Government area of Plateau State, Nigeria.

OBJECTIVE: Malaria and HIV account for over four million deaths per year thereby contributing significantly to the current global health burden. Insecticide Treated Nets (ITNs) represent a practical and effective means to prevent malaria in Africa. This study was conducted to determine the factors affecting the utilization of Long Lasting Insecticide Treated bed Nets (LLITNs) among People Living with HIV/AIDS (PLHIV). METHODS: An interventional study with a before and after design conducted among PLHIV to determine the factors affecting the utilization of LLITNs. EPI info statistical software version 3.5.4 was used for data analysis. Confidence interval for this study was set at 95% with a corresponding P ⩽ 0.05 considered statistically significant. RESULTS: This study reported a mean 33.86 + 11.50 years with statistically significant improvement in the consistency of LLITNs use after the intervention. Furthermore, the likelihood of use of LLITNs was 9 times more among respondents with tertiary education when compared to other levels of education (Odd's ratio = 9.3712; 95% CI = 2.5261 - 34.7652; P = 0.0008). CONCLUSION: This study has demonstrated positive influence of provision of free LLITNs supported with health education on the consistent utilization of LLITNs as well as certain factors that can influence LLITNs use.

OBJECTIF: Le Paludisme et le VIH Compte Pour plus de 4 millions de décèsv parano ainsi contribuant ainsi de manièresignificative à l' insectiade de la charge mondiale de santé actuelle imprégnées (MSA) représentent un moyen pratique et éfficace pour prévenir le paludisme en Afrique. Cette étude a été menée afin de déterminer les facteurs qui influent sur l'utilisation à long terme des Moustiquaires imprégnéesd'insecticide (LLTNS) chez les personnes vivantes avec le VIH le SIDA. MÉTHODE: Une étude interventionnelle avec un avant ou après la conception menée auprès la conception menée auprès dc PVVIH afin, de déterminer les facteurs qui influent sur l'utilisation de LTMII EPI info version du logiciel statistique 3.5.4 a été employé pour analyser des données; confidence de l'intervalle pour cette étude a été fixée à 5% avec un correspondant P ⩽ 0.05 considère comme statistiquement significatif. RÉSULTAT: Cette étude a signalé une moyenne de 33.86 + 11.50 ans avec l'amélioration statistiquement significative dans la cohérence de LTMII employé aprèsl'intervention. En outre, la vraisemblance de l'utilisation des TMII était 9 fois plus chez les répondants ayant l'éducation supérieure par rapport aux autres niveaux de l'éducation(le ratio = 9.3712, 95% Cl = 2.5261 ­ 34.7652; P = 0.0008). CONCLUSION: Cette étude avail démontré les influences positives de la provision de LTMI libres, soutenu à l'éducation sanitaire sur l'utilisation cohérente des (LTMII) ainsi que certains facteurs qui peuvent influencer l'utilisation de LTMII.

El residente como docente: percepción de estudiantes de medicina de una universidad española / The resident as teacher: medical students’ perception in a Spanish university

Fundamento y objetivos. El médico residente desempeña una labor importante, aunque escasamente evaluada, en la enseñanza del estudiante de medicina. El objetivo de este estudio fue conocer la opinión de los estudiantes sobre la actividad docente del residente. Material y método. Encuesta autocumplimentada por estudiantes de medicina de la Universidad de Alcalá (España) durante el último año de su formación universitaria. Se evaluó la opinión de los estudiantes en relación con las habilidades docentes y asistenciales de los residentes y de los facultativos especialistas según una escala de Likert de 5 puntos. Resultados. Se obtuvieron 104 encuestas. Un 69,9% de los alumnos percibían al residente como fuente de más de la mitad de lo aprendido durante sus prácticas. Los estudiantes piensan que la labor docente del residente no está suficientemente reconocida (94,2%), creen necesaria la adquisición de habilidades docentes durante la residencia (82,7%) y se muestran favorables a tutorizar a alumnos de cursos anteriores (88,5%). Además, puntúan mejor al residente en habilidades relacionales en comparación con los facultativos especialistas. Conclusiones. Existe una percepción positiva del residente como docente entre los estudiantes de medicina, lo que sugiere la necesidad de mejorar las habilidades docentes del residente (AU)

Background and objectives. Residents play an important but scanty assessed role in medical students teaching. The aim of this study was to assess the perception of medical students about residents’ teaching activity. Material and methods. Autofilled survey provided to medical students of the University of Alcalá (Spain) in the final year in their school of medicine. Student opinion about care and teaching abilities of residents and physicians was evaluated using a 5-point Likert scale. Results. 104 surveys were collected. A 69,9% of students consider that as much as 50% of their knowledge came from rounds with residents. Students believe that resident teaching lacks enough academical acknowledgment (94.2%); they estimate necessary to acquire teaching skills during residency (82,7%), and they would like to provide tutoring other medical students (88,5%). Students rated residents better than physicians on relational and motivational abilities. Conclusions. There is a positive view about resident as a teacher among medical students, which suggests the need to improve the resident's teaching skills (AU)

Prediction of pregnancy viability in bovine in vitro-produced embryos and recipient plasma with Fourier transform infrared spectroscopy.

We analyzed embryo culture medium (CM) and recipient blood plasma using Fourier transform infrared (FTIR) metabolomics to predict pregnancy outcome. Individually cultured, in vitro-produced (IVP) blastocysts were transferred to recipients as fresh and vitrified-warmed. Spent CM and plasma samples were evaluated using FTIR. The discrimination capability of the classifiers was assessed for accuracy, sensitivity (pregnancy), specificity (nonpregnancy), and area under the receiver operator characteristic curve (AUC). Within all IVP fresh embryos (birth rate=52%), high AUC were obtained at birth, especially with expanded blastocysts (CM: 0.80±0.053; plasma: 0.89±0.034). The AUC of vitrified IVP embryos (birth rate = 31%) were 0.607±0.038 (CM, expanded blastocysts) and 0.672±0.023 (plasma, all stages). Recipient plasma generally predicted pregnancy outcome better than did embryo CM. Embryos and recipients with improved pregnancy viability were identified, which could increase the economic benefit to the breeding industry.

The resident as teacher: Medical students' perception in a Spanish university. / El residente como docente: percepción de estudiantes de medicina de una universidad española.

BACKGROUND AND OBJECTIVES: Residents play an important but scanty assessed role in medical students teaching. The aim of this study was to assess the perception of medical students about residents' teaching activity. MATERIAL AND METHODS: Autofilled survey provided to medical students of the University of Alcalá (Spain) in the final year in their school of medicine. Student opinion about care and teaching abilities of residents and physicians was evaluated using a 5-point Likert scale. RESULTS: 104 surveys were collected. A 69,9% of students consider that as much as 50% of their knowledge came from rounds with residents. Students believe that resident teaching lacks enough academical acknowledgment (94.2%); they estimate necessary to acquire teaching skills during residency (82,7%), and they would like to provide tutoring other medical students (88,5%). Students rated residents better than physicians on relational and motivational abilities. CONCLUSIONS: There is a positive view about resident as a teacher among medical students, which suggests the need to improve the resident's teaching skills.

Fluoroquinolone resistance and molecular characterization of gyrA and parC quinolone resistance-determining regions in Escherichia coli isolated from poultry.

Escherichia coli are a common inhabitant of the gastrointestinal tract of mammals and birds; nevertheless, they may be associated with a variety of severe and invasive infections. Whereas fluoroquinolones (FQ) have been banned in the United States for use in poultry production, the use of these antimicrobials in poultry husbandry is still possible in the European Union, although with some restrictions. The aim of this study was to investigate the FQ resistance of 235 E. coli isolates recovered from chickens and turkeys. Minimum inhibitory concentrations were determined by a microdilution method, whereas mutations in the quinolone resistance-determining regions of the target genes, gyrA and parC, were detected by a PCR-based method. High resistance rates (>60%) were observed for nalidixic acid, flumequine, and difloxacin, whereas resistance to ciprofloxacin, danofloxacin, enrofloxacin, marbofloxacin, and sarafloxacin was less frequently reported (<40%). Sixty-four isolates (27.2%) showed full susceptibility toward the tested FQ, but 57 isolates (24.2%) were resistant to all tested FQ. The remaining 114 E. coli isolates (48.5%) were grouped in 5 different resistance patterns. Isolates resistant only to flumequine or nalidixic acid or both possessed 1 gyrA mutation, whereas isolates with further resistance to enrofloxacin, difloxacin, danofloxacin, and sarafloxacin had in addition 1 or 2 parC substitutions. Two gyrA mutations coupled with 1 substitution in parC were detected in isolates resistant to all tested FQ. The number of mutations and their correlation with the in vitro activity of FQ reflected the currently accepted model, according to which a single gyrA substitution is associated with resistance or decreased susceptibility to older quinolones, whereas further gyrA or parC substitutions are needed for a higher level of resistance.

Enseñanza de la Patología General en España: ¿es el residente un convidado de piedra? / General Pathology training in Spain: is the resident a stone guest?

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