[Changes in the antimicrobial susceptibility of Escherichia coli isolates from community diagnosed urinary tract infections during the period 2003-2007. Multicentre study in Castilla la Mancha (Spain)]. / Evolución del patrón de sensibilidad de Escherichia coli en infecciones del tracto urinario diagnosticadas en la comunidad durante el periodo 2003-2007. Estudio multicéntrico en Castilla la Mancha.

OBJECTIVE: To know the evolution of susceptibility patterns of Escherichia coli in patients with community diagnosed urinary tract infections (UTIs) during last years in Castilla la Mancha (Spain). METHODS: Descriptive and retrospective study performed between january 2003 and december 2007. We studied data about frequency and susceptibility of 33.651 E. coli isolates from urine cultures that were remited from primary care centres depending of 6 hospitals in Castilla la Mancha (Spain). RESULTS: Susceptibility rates of E. coli for most antibiotics decreased significantly during the 5-year period, especially for amoxicillin-clavulanic acid, cefuroxime and quinolones. Average rates of susceptibility for amoxicillin-clavulanic acid, ciprofloxacin, cefuroxime, fosfomycin and nitrofurantoin were: 86.7, 75.4, 87.3, 97.6 and 96.2%, respectively. We observed a significantly increase of E. coli isolates producing extended-spectrum betalactamases ESBLs), from 1.9% in 2003 to 4,9% in 2007 (χ² TL = 143.6, p<0.001). CONCLUSIONS: We observed a significantly reduction of E. coli susceptibility for most antibiotics and an increase of E. coli isolates producing ESBLs. Fosfomycin and nitrofurantoin are the best choices for empiric treatment. Prospective studies should be performed in the future to confirm the results of our study.

Evolución del patrón de sensibilidad de Escherichia coli en infecciones del tracto urinario diagnosticadas en la comunidad durante el periodo 2003-2007. Estudio multicéntrico en Castilla la Mancha / Changes in the antimicrobial susceptibility of Escherichia coli isolates from communitydiagnosed urinary tract infections during the period 2003-2007. Multicentre study in Castilla la Mancha (Spain)

Objetivo: Conocer la evolución del patrón de sensibilidadantimicrobiana de Escherichia coli en infecciones del tractourinario (ITUs) diagnosticadas en la comunidad durante los últimosaños en Castilla la Mancha.Métodos: Estudio descriptivo de carácter retrospectivo queabarcó desde enero de 2003 hasta diciembre de 2007. Se analizarondatos de sensibilidad de 33.651 aislados de E. coli procedentesde urocultivos remitidos desde los Centros de Atención Primariadependientes de 6 hospitales de Castilla la Mancha.Resultados: Se obtuvo una tendencia lineal significativaen la disminución de la sensibilidad de E. coli para la mayorparte de antibióticos, siendo más acusado para amoxicilinaácidoclavulánico, cefuroxima y quinolonas. Los porcentajesmedios de sensibilidad a amoxicilina-ácido clavulánico, ciprofloxacino,cefuroxima, fosfomicina y nitrofurantoína fueron:86,7, 75,4, 87,3, 97,6 y 96,2%, respectivamente. Se observó unincremento significativo de la frecuencia de cepas de E. coliportadoras de betalactamasas de espectro extendido (BLEEs),oscilando desde el 1,9% en el año 2003 hasta el 4,9% en el año2007 (χ2 TL = 143,6, p<0,001).Conclusiones: En Castilla la Mancha se está produciendoun descenso significativo de la sensibilidad de E. coli a la mayorparte de antibióticos y un incremento progresivo de las cepasportadoras de BLEEs. Fosfomicina y nitrofurantoína constituyenlas mejores opciones terapéuticas para el tratamientoempírico. Sería necesario llevar a cabo futuros trabajos de carácterprospectivo con el fin de confirmar los resultados obtenidosen el presente estudio(AU)

Objective: To know the evolution of susceptibilitypatterns of Escherichia coli in patients with communitydiagnosedurinary tract infections (UTIs) during last yearsin Castilla la Mancha (Spain).Methods: Descriptive and retrospective study performedbetween january 2003 and december 2007. We studieddata about frequency and susceptibility of 33.651E. coli isolates from urine cultures that were remitedfrom primary care centres depending of 6 hospitals inCastilla la Mancha (Spain).Results: Susceptibility rates of E. coli for most antibioticsdecreased significantly during the 5-year period,especially for amoxicillin-clavulanic acid, cefuroximeand quinolones. Average rates of susceptibility for amoxicillin-clavulanic acid, ciprofloxacin, cefuroxime, fosfomycinand nitrofurantoin were: 86,7, 75,4, 87,3, 97,6and 96,2%, respectively. We observed a significantly increaseof E. coli isolates producing extended-spectrumbetalactamases (ESBLs), from 1,9% in 2003 to 4,9% in2007 (χ2 TL = 143,6, p<0,001).Conclusions: We observed a significantly reductionof E. coli susceptibility for most antibiotics and an increaseof E. coli isolates producing ESBLs. Fosfomycinand nitrofurantoin are the best choices for empiric treatment.Prospective studies should be performed in the futureto confirm the results of our study(AU)

[Acute Q Fever: 35 cases in Castilla-La Mancha]. / Fiebre Q aguda: 35 casos en Castilla-La Mancha.

We report 35 sporadic cases of acute Q fever diagnosed in the area of Castilla-La Mancha (Spain). Diagnosis was based on a fourfold or greater rise in specific antibody titer. The mean age of the patients was 33 years and the male/female ratio was 2.5. Seventeen patients had hepatitis, 9 had pneumonia, 8 had isolated fever and 1 had myocarditis. An underlying disease was more frequent among patients with pneumonia.

Fiebre Q y miocarditis / Q fever and myocarditis

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