Carlos Cruz Vázquez

Antibiotic resistance and population structure of cystic fibrosis Pseudomonas aeruginosa isolates from a Spanish multi-centre study

The first Spanish multi-centre study on the microbiology of cystic fibrosis (CF) was conducted from 2013 to 2014. The study involved 24 CF units from 17 hospitals, and recruited 341 patients. The aim of this study was to characterise Pseudomonas aeruginosa isolates, 79 of which were recovered from 75 (22%) patients. The study determined the population structure, antibiotic susceptibility profile and genetic background of the strains. Fifty-five percent of the isolates were multi-drug-resistant, and 16% were extensively-drug-resistant. Defective mutS and mutL genes were observed in mutator isolates (15.2%). Considerable genetic diversity was observed by pulsed-field gel electrophoresis (70 patterns) and multi-locus sequence typing (72 sequence types). International epidemic clones were not detected. Fifty-one new and 14 previously described array tube (AT) genotypes were detected by AT technology. This study found a genetically unrelated and highly diverse CF P. aeruginosa population in Spain, not represented by the epidemic clones widely distributed across Europe, with multiple combinations of virulence factors and high antimicrobial resistance rates (except for colistin).

Bronchopulmonary infection–colonization patterns in Spanish cystic fibrosis patients: Results from a national multicenter study

BACKGROUND Clinical and demographical knowledge on Spanish cystic fibrosis (CF) patients is incomplete as no national registry exists. CF-microbiology has not been studied at national level. The results of the first Spanish multicenter study on CF microbiology are presented. METHODS 24 CF-Units for adult (n=12) and pediatric (n=12) patients from 17 hospitals provided sputa and clinical data from 15 consecutive patients. Cultures and susceptibility testing were performed. Colonization impact on pulmonary function was assessed. RESULTS 341 patients [mean (SD) age 21 (11) years, 180≥18years, mean (SD) FEV1=68 (25)%] were included. Pseudomonas aeruginosa was reported as chronic, intermittent or absent in 46%, 22% and 32% of patients, respectively. The annual prevalence was 62%. Positive P. aeruginosa and methicillin-resistant Staphylococcus aureus cultures were significantly associated with lower FEV1 (p<0.001 and p=0.003, respectively). CONCLUSIONS The representative subset of the Spanish CF-population which has been clinically, demographically and microbiologically characterized will serve as a reference for future CF studies in Spain.

PREVALENCE OF Rhipicephalus sanguineus INFESTATION IN DOGS IN CUERNAVACA, MORELOS, MEXICO

El presente estudio se realizo en el area urbana de la Cd. de Cuernavaca, Morelos, Mexico. Durante un periodo de 3 anos (1992-1995), una muestra de 1742 perros de dos clinicas veterinarias, fueron examinados para detectar la presencia de garrapatas Rhipicephalus sanguineus en cualquier estado parasito, estas fueron colectadas e identificadas. Las tasas de prevalencia fueron calculadas por mes y ano y se distribuyeron por edad y sexo. La prueba de Chi cuadrada (p < 0.05) se utilizo para comparar las proporciones de perros positivos y negativos a la infestacion. En el periodo, la prevalencia a la infestacion fue del 20%, no existiendo diferencias entre anos (P 0.05); se colectaron especimenes durante todo el periodo de estudio. Las condiciones climaticas del area y la presencia continua del huesped favorecio el ciclo de vida del parasito, calculando 2.5 generaciones por ano. No existieron diferencias (p 0.05) entre edad y sexo o ano. En este estudio, los factores que probablemente mas influenciaron la prevalencia fueron los habitos de vida domestica y el medio ambiente en que viven los perros

Frecuencia de casos e identificación molecular de Cryptosporidium spp. en corderos lactantes mantenidos en pastoreo en el estado de Veracruz, México

The objective was to determine the frequency of Cryptosporidium spp., and to identify the species or genotype of the oocysts found, in suckling lambs kept grazing in the Huasteca Alta region, State of Veracruz, Mexico. Fecal samples were collected from 210 lambs Pelibuey, Black Belly, and Katahdin, 7 to 21 d old from 21 sheep farms. Samples were stained with Kinyoun, nested PCR was used to amplify the 18S rRNA gene region of the parasite (830 bp), and positive samples were sequenced. The frequency of animals positive to Cryptosporidium spp by microscopy was 19.5 % (41/210), with a 10 to 50 % range among herds; with molecular techniques, the frequency of positive lambs was 26.8 % (11/41) with a 14 to 50 % range; all other samples were negative to both tests. All 11 samples sequenced showed 100 % homology with the 18S rRNA region of C. parvum . Results confirm the relevance of C. parvum as a major etiology of cryptosporidiosis in lactating lambs and show its broad distribution in this region of Mexico. This identification highlights that sheep can be considered as a significant potential source of human cryptosporidiosis, since it is considered a zoonotic disease, mainly for the people handling the flocks.

Cerebral oxymetry monitoring after carotid endarterectomy or stenting: A-105

A-105 Cerebral oxymetry monitoring after carotid endarterectomy or stenting M.I. Rochera1, C. Vazquez1, M. de Miguel1, A. Gonzalez1, M. Roca1, B. Alvarez2, M. de Nadal1 1Department of Anesthesiology, Vall d Hebron Universitary Hospital; 2Department of Angiology and Vascular Surgery, Vall d Hebron Universitary Hospital, Barcelona, Spain Background and Goal of Study: Hyperperfusion syndrome (HP) is a rare but potentially grave complication after carotid endarterectomy (CEA) or stenting (CS) (1). Intraoperative regional cerebral oxygen saturation (rSO2) monitoring can identify patients at risk for HP after CEA (2). The goal of this study was to determine whether intra or postoperative changes in rSO2 could help to identify patients at risk for HP after CEA or CS. Methods: 42 patients scheduled for elective severe carotid stenosis repair were studied; 24 underwent CEA and 18 CS. Bilateral rSO2, mean arterial blood pressure (MAP) and periferal oxygen saturation (SpO2) were continuously monitored intraoperatively, at arrival to postanesthesia care unit (PACU) and 12 hours postoperatively. All patients underwent strict control of postoperative blood pressure. Changes in rSO2 ( rSO2) were calculated between T1 (basal awake), T2 (after declamping), T3 (PACU arrival), 1, 6 and 12 hours postoperatively (T4 T6) and PACU discharge (T7). Changes in MAP and SpO2 were also recorded, as well as the postoperative incidence of cephalea, seizures or neurological events. Repeated measures ANOVA with post-hoc test and Pearson’s correlation coefficient were used for statistical analysis. Results: One patient had to be excluded because of intraoperative angina. From the remaining 41 patients (30 M, 11 W, mean age 73 10 years, 55–92), 11 (27%) had contralateral severe ICA stenosis. None of the patients had adverse neurological outcome. No significant changes in rSO2 were observed; however, patients with severe contralateral stenosis showed significant changes in rSO2 between T2–T3, T2–T4 and T2-T5. A positive correlation betweeen rSO2 and MAP for ipsilateral ICA (r2 0.244, p 0.001) was found. Conclusions: This study did not show significant changes in rSO2 immediately after repairing the carotid circulation or in the immediate postoperative period relative to preoperative values. Nevertheless none of the patients had symptoms of HP to be identified by cerebral oxymetry. References: 1 van Mook, Rennenberg RJ, Schuring GW. Lancet Neurol. 2005; 4:877–88. 2 Ogasawara K et al. Neurosurgery. 2003; 53:309–315.