[Demographic and clinical features of diagnosed individuals of enterobiasis in the southern Gran Canaria: sampling assessment]. / Características clínico-demográficas de la población del Sur de Gran Canaria con diagnóstico de enterobiasis: valoración de la toma de muestras.

OBJECTIVE: Enterobius vermicularis, also known as pinworn, is the responsible agent for Human Enterobiasis. It is one of the most prevalent, but underrated, parasitic disease in children population. Diagnosis involves demonstration of either eggs or adult worms by Graham test. The aim of this study is to describe the clinical, demographic and microbiological features of patients with suspected diagnosis of Enterobiasis in southern Gran Canaria. METHODS: Descriptive and prospective study of perianal samples evaluated by Graham test in the Microbiology Department of `Insular de Gran Canaria´ University Hospital between November 2014 and November 2015. Descriptive analysis to evaluate the correlation between clinical and demographic variables and the results of Graham test microbiological observation. RESULTS: 1,128 samples were analyzed. E. vermicularis was found in 11.4% of the samples. Among the positives samples, 88.4% belonged to children under 14 years, and 53.5% were male. Abdominal pain (18.6%), anal itching (11.6%), eosinophilia (8.5%) and intestinal parasitosis suspicion (7.8%) were the reasons of parasitological investigation request in positive samples. Nevertheless, a high proportion of the requests was not founded in a suspicious diagnosis or was unrelated to Enterobiasis. CONCLUSIONS: Enterobiasis is a common disease in primary health care and is of great importance in Gran Canaria. Quality in sample collection as well as diagnosis suspicious information are necessary for a good microbiological analysis.

Effect of date palm coproducts and annatto extract on lipid oxidation and microbial quality in a pork liver pâté.

Dates are an interesting source of bioactive compounds, and coproducts from the date industry are of potential use in the manufacturing of meat products. In the present research, spreadable pork liver pâtés were made using fresh date coproducts (2.5% and 7.5%) as a potential functional ingredient and an ethanolic annatto extract (128 mg/kg) as colorant. The effect of these 2 ingredients on the lipid oxidation and microbial quality of the pâtés was assessed during 21 d of storage. The pâtés containing 7.5% date paste were seen to have the highest content of phenolic compounds during storage. The combination of 2.5% date paste and annatto protected pâtés against lipid oxidation throughout the 21 d of storage, thiobarbituric acid-reactive substances values being 0.47 mg MDA/kg at the end of this period, while other combinations increased oxidation compared to the control pâté. The control and those made with 2.5% date paste alone showed the highest counts of mesophilic aerobic bacteria, while the addition of annatto and/or 7.5% date paste reduced this count. The results suggest that a combination of both ingredients is necessary to reduce oxidation and microbial growth, but whereas the concentration of 2.5% is more appropriate to reduce oxidation, the combination with 7.5% date paste reduces the microbial counts. Both ingredients could have an opportunity of valorization in the meat industry for improving the quality.

Factors impacting on length of stay and mortality of community-acquired pneumonia.

A 1-year retrospective multicentre study was performed to identify factors influencing hospital length of stay (LOS) and mortality of patients (n = 3233) admitted to hospital because of community-acquired pneumonia (CAP). Pneumonia severity index (PSI) high-risk classes (IV and V), positive blood culture, admission to an intensive care unit (ICU), multi-lobar involvement and alcohol consumption were associated independently with prolonged LOS. Tobacco smoking was associated with a reduced LOS. The LOS varied markedly among centres. Only PSI high-risk class, admission to ICU and multi-lobar involvement were associated with early, late and global mortality. Positive blood cultures, antimicrobial therapy according to treatment guidelines and the establishment of an aetiological diagnosis were linked to reduced late and global mortality. These data suggest that early mortality associated with CAP is highly dependent on the clinical status of the patient at presentation. Conversely, late mortality seems to be associated more closely with clinical management factors; hence, an aetiological diagnosis and compliance with appropriate therapeutic guidelines have a significant influence on outcome.

[Intestinal parasitosis in the asymptomatic Subsaharian immigrant population. Gran Canaria 2000]. / Parasitosis intestinales en población inmigrante subsahariana asintomática. Gran Canaria 2000.

CONTEXT: A prospective study has been conducted in order to known the prevalence and the type of intestinal parasitoses in a cohort of healthy Subsaharian immigrants that reached Gran Canaria along the year 2000. METHODS: 348 fecal samples of 121 immigrants have been studied. In each patient a minimum of two samples and a maximum of three samples was studied. Each sample was evaluated through two techniques: visualization of a direct preparation dyed with Lugol and through the technique of concentration of Kato. RESULTS: 23.1% of the patients presented pathogenic parasites in feces, being observed 2 parasites in 5 of the patients (17.8%). The geohelminths (Ancylostoma duodenale/Necator americanus, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercolaris) were the parasites more frequently found (87.9%). Specifically, the parasitosis found in the greatest number of participants was hookworm disease (44.8%). In this study the effectiveness of the evaluation of three feces samples is demonstrated in order to increase the percentage of diagnosed intestinal parasitoses. The visualization of a direct preparation dyed with Lugol permitted the diagnosis of 63.6% of the parasitoses, while the technique of Kato detected 56.6% of the helminth infections. CONCLUSIONS: The prevalence of geohelminths in the asymptomatic Subsaharian immigrant population is elevated. The complementary use of the microscopic study of a direct preparation dyed with Lugol and the technique of Kato increase the diagnostic performance.

Seroprevalence of infection by Coxiella burnetii in Canary Islands (Spain).

THE AIMS OF OUR STUDY WERE: (i) to know the seroprevalence of Coxiella burnetii infection in the Canary Islands, (ii) to evaluate its epidemiologic features and (iii) to compare the rates of seroprevalence using two different cut-offs (1:20 and 1:80) for the diagnosis of past infection. METHODS: We analysed a representative sample of the canarian population. 662 sera were tested. For the detection of IgG and IgM antibodies against C. burnetii phase II antigens an immuofluorescence assay was used. The serologic screening for IgG detection begun with a 1:20 dilution. A titer of IgG > or = 1:80 along with a negative IgM were used as criteria for previous infection. RESULTS: At an IgG antibody titer against C. burnetii of 1:80 as diagnostic for past infection, the observed global seroprevalence was 21.5%. If the cut-off used was 1:20, the observed prevalence increased up to 35.8% (p = 0.001). Significantly different seroprevalence rates were obtained at these different cut-offs when results were analysed for groups of age and socioeconomic status, but not for either the island of origin or for farmers. CONCLUSION: Our results strongly suggest that Coxiella burnetii infection is endemic in all the Canary Islands. Although it is more frequent in males above 30 years old, it do affect people of all ages, and thus it should be borne in mind in the face of any acute febrile syndrome.

Activities of six different quinolones against clinical respiratory isolates of Streptococcus pneumoniae with reduced susceptibility to ciprofloxacin in Spain.

Six quinolones were tested on 817 consecutive pneumococcal isolates for which ciprofloxacin MICs were high (> or =2 microg/ml); the isolates had been collected during two recent Spanish surveillance studies. For strains for which the ciprofloxacin MIC was >or =4 microg/ml, the MICs at which 90% of the isolates tested against gemifloxacin, moxifloxacin, gatifloxacin, sparfloxacin, levofloxacin, and ofloxacin were inhibited were 0.25, 1, 1, 1, 4 and 16 microg/ml, respectively, and the corresponding prevalences of resistance were 0, 1, 4.5, 9.5, 8.4 and 23%. The proportion of isolates for which the ciprofloxacin MIC is high has increased over time.

Isolated renoureteric aspergilloma due to Aspergillus flavus: case report and review of the literature.

In this paper we describe a case in which acute renal colic was associated with elimination of multiple hyphal masses of Aspergillus flavus. Also, we reviewed the literature on similar cases and we found a similar pattern characterized by a marked male predominance, association with at least one underlying medical condition that predisposes to fungal infection, the presence of local symptoms resembling acute ureteral colic, and the absence of systemic manifestations. Moreover, our data suggest that Aspergillus balls must be suspected when a diabetic and intravenous drug user presents with acute renal colic and that non-obstructive renal aspergillosis may be initially treated with itraconazole.

Resistencia a antibióticos en aislamientos clínicos del género Enterococcus / Resistance to antibiotics in clinical isolates of the genus Enterococcus

El propósito de este trabajo es conocer la prevalencia de resistencias en 114 cepas de enterococos aisladas de muestras clínicas. Las identificaciones se realizaron mediante paneles PASCO y pruebas bioquímicas según el esquema de Facklam, siendo el 92,1 por ciento E. faecalis, el 7 por ciento E. faecium y el 0,9 por ciento E. avium. La sensibilidad antibiótica se determinó por el Sistema PASCO; además, las CMI de vancomicina, teicoplanina, gentamicina y estreptomicina se determinaron por el método de dilución en agar. Todos los aislamientos eran sensibles a la vancomicina y la teicoplanina. Detectamos resistencia a la penicilina en el 6 por ciento de los aislamientos, a la ampicilina en el 4,4 por ciento, a la tetraciclina en el 41,2 por ciento, a la rifampicina en el 12,3 por ciento, al cloranfenicol en el 23,7 por ciento, a la eritromicina en el 66,7 por ciento, al ciprofloxacino en el 53,5 por ciento, de alto grado a la gentamicina en el 43,9 por ciento y de alto grado a la estreptomicina en el 57 por ciento. E. faecalis se asoció con resistencia de alto grado a la gentamicina y E. faecium con resistencia a la ampicilina y la penicilina. Los aislamientos de E. faecium de nuestra colección son más resistentes que los de E. faecalis frente a quinolonas, rifampicina, eritromicina, penicilina y ampicilina, y muestran una sensibilidad similar a la tetraciclina y el cloranfenicol. Sin embargo, los aislamientos de E. faecalis presentan más resistencia de alto grado a los aminoglucósidos, sobre todo a la gentamicina (AU)

La Microbiología en el nuevo plan de enfermería de la Universidad de Las Palmas de Gran Canaria: una experiencia positiva / Microbiology in the new curriculum of nursing study of the Universidad de Las Palmas de Gran Canaria: a good experience

El objetivo de este trabajo es comunicar nuestra experiencia en la asignatura de "Microbiología y Parasitología" con el cambio de plan de estudios de la diplomatura de enfermería en la Universidad de Las Palmas de Gran Canaria (ULPGC). Se ha realizado una comparación de medias de las calificaciones de la convocatoria ordinaria de los dos últimos cursos del antiguo plan y los dos primeros cursos del nuevo plan. Los resultados revelaron una diferencia de medias con una p igual o inferior a 0,001. Trasladar los conocimientos de Microbiología y Parasitología a segundo curso de la titulación de Diplomado en Enfermería ha supuesto una mejora de las calificaciones y una mejor aceptación de la asignatura por parte de los alumnos (AU)

In vitro selected fluoroquinolone-resistant mutants of Citrobacter freundii: analysis of the quinolone resistance acquisition.

Ten quinolone-resistant mutants of Citrobacter freundii, which were selected in vitro with fluoroquinolones from two clinical isolates, were studied. The parent isolates were susceptible to quinolones in spite of showing a single substitution in the GyrB (His-417 --> Leu). No change was observed in the outer membrane proteins or in the lipopolysaccharide in any of the ten mutants studied with respect to their parent isolates. The development of quinolone resistance in selected mutants was associated with the appearance of a substitution in the GyrA (Thr-83 --> Ile) in nine of the ten mutants plus enhanced active efflux in all of them.

Decreased permeability and enhanced proton-dependent active efflux in the development of resistance to quinolones in Morganella morganii.

Five quinolone-resistant strains were developed from a clinical Morganella morganii isolate (M1 strain) which was susceptible to nalidixic acid and fluoroquinolones. All five in vitro selected mutants showed diminished norfloxacin accumulation and two of them also decreased the expression of the AgO in the outer membrane lipopolysaccharide with respect to their parent strain and to the M. morganii NCTC-235 type strain. Likewise, the M1 strain did not express a 37-38 kDa protein and accumulated less norfloxacin than the M. morganii NCTC-235 strain. The decreased norfloxacin uptake in the five mutants compared with the M. morganii NCTC-235 strain was due to an enhanced proton-dependent active efflux plus a pre-existent decreased expression of a 37-38 kDa protein in the parent strain.

Resolution of high-molecular-weight components in lipopolysaccharides of Escherichia coli, Morganella morganii, Citrobacter freundii and Citrobacter diversus strains with sodium dodecyl sulfate polyacrylamide gels.

The use of 0.5% sodium dodecyl sulfate in polyacrylamide separation gels allowed the resolution in several bands of high-molecular-mass components in smooth lipopolysaccharide of bacterial outer membrane from Escherichia coli, Morganella morganii, Citrobacter freundii and Citrobacter diversus. With or without 0.1% SDS, however, such a result was not possible.

[Keratitis caused by Acanthamoeba in patients with contact lenses]. / Queratitis producida por Acanthamoeba en pacientes portadores de lentes de contacto.

BACKGROUND: Keratitis by Acanthamoeba is a severe infectious complication which may be derived from the use and bad preservation of contact lens. This disease la increasingly more frequent and rapid diagnosis and treatment condition the posterior evolution of the disease. PATIENTS AND METHODS: The cases of 2 contact lens waters who developed keratitis by Acanthamoeba are presented. The diagnostic methods and treatment are commented upon. RESULTS: Keratitis by Acanthamoeba was diagnosed in 2 patients following analysis of corneal scrapings and of the saline solution used for lens maintenance. Trophozoites and cystes of this parasite were observed in all the samples processed. The evolution was good in the patient treated at 15 days after initiation of the symptoms. However, the evolution was very bad in the patient who delayed in initiating the amebicide treatment. Penetrating keratoplasty was performed in both patients. CONCLUSIONS: Specific treatment with derivates of propamidine implemented early may avoid severe ocular complications. As prophylaxis for contact lens users, it is recommended that the contact lens be maintained clean and correctly care for, and the use of home-made saline solutions which are easily contaminated by Acanthamoeba, should be avoided.

Mechanisms involved in the development of resistance to fluoroquinolones in Escherichia coli isolates.

Eighteen quinolone-resistant isolates of Escherichia coli were selected by exposing ten clinical isolates to increasing concentrations of norfloxacin and lomefloxacin. The mutant isolates showed a multiple-antibiotic-resistance phenotype. All of them contained single mutations in gyrA consisting of the substitution of Ser-83-->Leu (n = 14), Val (n = 1) or Ala (n = 1) and the substitution of Asp-87-->Asn (n = 2). Only one concomitant mutation in parC (Ser-80-->Arg) was detected. Four parent isolates exhibited a single mutation in gyrA which required < or = 12 mg/L of norfloxacin to be inhibited. Fluoroquinolone resistance, in the 18 quinolone-resistant mutants, was a result of mutations affecting DNA gyrase plus decreased fluoroquinolone uptake. This latter mechanism of resistance was a combined effect of an absence of OmpF and an increase in active efflux in eight isolates, or an increased active efflux alone in the remaining ten selected mutants.

[Transient blood surface antigens of hepatitis B in patients on hemodialysis]. / Antigenemia transitoria de superficie de la hepatitis B en pacientes en hemodiálisis.

BACKGROUND: The presence of surface antigen of hepatitis B (HBsAg) virus in serum from recently vaccinated adults has been scarcely investigated. In this work, after the detection by chance of seven HBsAg-positive patients on hemodialysis who reported recent hepatitis B vaccination, a prospective study was undertaken to verify the presence and duration of post-vacunal antigenemia. PATIENTS AND METHODS: Nineteen non-selected patients on hemodialysis were followed for serologic markers of hepatitis B, after receiving a dose of the recombinant vaccine (Engerix B) according to their vaccination schedule. Enzyme-immunoassay techniques were used for the study of serologic markers, and the reactivity of HBsAg was confirmed by means of a neutralization assay with specific anti-HBs antibodies. RESULTS: After the administration of one vaccine dose, 31.5% of patients were HBsAg positive at least once. Antigenemia was identified more frequently 2 to 4 days (83.3%) after immunization. In all cases antigenemia was transient and had cleared after 11 days of vaccination. The follow-up of serologic markers revealed the absence of infection with virus B. Only 16.6% of patients with transient antigenemia responded to vaccination (titer of anti-HBs > or = 10 mIU/ml), while the corresponding percentage in the group of HBsAg-negative patients was 69.2% (p < 0.05). All patients were HCV and HIV negative. CONCLUSIONS: A high frequency of post-vacunal antigenemia is reported in patients on hemodialysis, in absence of virus B infection as well as the possible relationship between the presence of transient antigenemia and the non-responder status.