Antonio Manuel Martín-Sánchez

Fiebre Q en Gran Canaria. Aportación de 40 nuevos casos

IntroducciOn Describir las caracteristicas clinicas y epidemiologicas de la fiebre Q en la zona sur de la isla de Gran Canaria. Metodos Se realizo un analisis retrospectivo de los casos diagnosticados de fiebre Q en el Servicio de Microbiologia del Hospital Universitario Insular de Gran Canaria entre los anos 1998 y 2000. Para la deteccion de anticuerpos frente a antigenos de fase II de Coxiella burnetii se empleo una tecnica de inmunofluorescencia indirecta. El diagnostico de fiebre Q aguda se realizo cuando se detectaron titulos de inmunoglobulina G (IgG) _ 1:320 e IgM _ 1:80 o cuando se demostro seroconversion. Resultados Durante el periodo de estudio se diagnosticaron serologicamente 59 casos de fiebre Q aguda (incidencia anual de 5 casos/100.000 habitantes). La seroprevalencia (IgG _ 1:80) encontrada en los pacientes a los que se les solicitaba serologia de fiebre Q y durante este periodo fue del 23,9%. Se dispuso de datos clinicos y epidemiologicos en 40 pacientes, siendo todos los casos esporadicos; el 57% de ellos fueron hospitalizados. La edad media fue de 40,6 _ 13,3 anos (intervalo, 20-74), mas frecuente en varones (85%) y procedentes del medio rural (67,5%). El 65% de los casos se produjeron de abril a julio. La manifestacion clinica mas frecuente fue un sindrome febril con elevacion de las enzimas hepaticas (87,5%). La forma neumonica fue rara (solo 3 casos). Conclusiones La fiebre Q se manifiesta fundamentalmente en nuestra zona como un sindrome febril agudo con afectacion hepatica subclinica. Esto, y la escasez de formas neumonicas y cronicas sugieren la implicacion de cepas de C. burnetii diferentes a las de otras zonas geograficas.

Sepsis due to Multiply ResistantCorynebacterium amycolatum

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Prevalencia y factores asociados a la colonización de microorganismos multirresistentes en centros de larga estancia de Gran Canaria

INTRODUCTION Multidrug resistant organisms (MDRO) are an important cause of nosocomial infections, with complicated clinical-therapeutic management and elevated morbidity-mortality, and an increase in healthcare costs. In long term care facilities (LTCFs) colonization/infection by MDRO among residents is increasing, and they may act as reservoirs and vehicles for the dissemination and production of outbreaks by resistant strains in acute hospitals. This study aimed at determining the prevalence of carriers of some common MDRO, and identifying factors associated with carrier state. MATERIAL AND METHODS A cross-sectional prevalence study was conducted on 235 residents in two LTCFs in the province of Las Palmas de Gran Canaria (Canary Islands, Spain) between October and November of 2012. The presence of MMR was investigated in nasal, pharyngeal and rectal swabs using selective media. Risk factors associated with carrier state were calculated using univariate and multivariate analysis. RESULTS More than one-third (36.2%) of residents were found to be carriers of ≥ 1 distinct MDROs. More than one-quarter (26.6%) were carriers of ESBL producing Enterobacteriaceae, and 10.2% were MRSA carriers. Factors found to be associated with colonization by any MDRO were: prior colonization or infection by MDRO, hospitalization in the past 3 months, recurrent infections of the urinary tract, and peripheral arterial disease. CONCLUSIONS The prevalence of MDRO in the LTCFs settings studied is greater than that found in the literature, and in particular ESBL producing Enterobacteriaceae. Due to the high prevalence of infection/colonization by MDRO, it is possible that residents of LTCFs could act as important reservoirs of MDRO, and facilitate their spread into the acute care setting.

Otitis Media due to Corynebacterium jeikeium

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