Feliu Bella

Prospective epidemiological study of invasiveHaemophilus influenzae disease in adults

The incidence and characteristics of invasiveHaemophilus influenzae disease were studied in 43 adult patients admitted to the acute care hospitals in El Vallés County (Barcelona, Spain) between January 1987 and June 1992. The annual incidence ofHaemophilus influenzae disease was 1.2 per 100,000 inhabitants. Pneumonia occurred in 24 patients, meningitis in five, intraabdominal infections in three, obstetric infections in two, epiglottitis in two and cellulitis in one. In six patients the source of infection was unknown. Ten (23 %) of the infections were hospital acquired. Underlying conditions were diagnosed in 30 (70 %) patients. NontypeableHaemophilus influenzae strains predominated in all adult age groups. Sixty-one percent of type b and 34 % of nontypeable strains were ampicillin resistant (p=0.08). Multiple antibiotic resistance was also high among type b (53 %) and nontypeable (18 %) strains. The mortality rate was significantly higher in patients with pneumonia, bactaeremia from an unidentified focus or shock at presentation.

Neisseria meningitidis with reduced sensitivity to penicillin: observations in 10 children.

10/84 strains (11.9%) of Neisseria meningitidis isolated from blood and/or cerebrospinal fluid in children 1986-1987 had reduced sensitivity to benzylpenicillin (MICs 0.1-0.4 mg/l). Group C meningococci predominated among these strains. The clinical course was satisfactory in all cases regardless of the antibiotic treatment used, although the time to abatement of fever was prolonged compared to that of children infected with susceptible strains.

Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) in acute care hospitals. Results of the VINCat Program (2008-2010)

Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of healthcare-related infection. Surveillance and prevention of MRSA is a priority in infection control programs. The aim of this study was to describe rates and trends of MRSA colonization or infection in 40 hospitals participating in the VINCat Program from 2008 to 2010. The study included all patients treated in acute care areas of participating hospitals. Hospitals were stratified into 3 groups based on size. The following annual indicators were reported: Methicillin-resistance rate, incidence density of new cases of MRSA and incidence density of MRSA bacteremia. Between 2008 and 2010, the yearly mean rate of resistance to methicillin remained stable for the study period (24%-25%), while the mean incidence of new cases of MRSA decreased from 0.65 to 0.54 cases per 1000 patient-days (p=NS) and the mean incidence of MRSA bacteremia decreased from 0.06 to 0.05 cases per 1,000 patient-days (p=NS). The implementation of a MRSA surveillance system in hospitals that participated in the VINCat Program provides information on the situation of each institution and facilitated interhospital comparisons in order to establish appropriate preventive measures.

Clinical presentation of acute Q fever in Spain: seasonal and geographical differences

OBJECTIVES The aims of this study were to improve our understanding of the clinical forms of presentation of acute Q fever in Spain and to determine any possible relationships with geographical and seasonal factors. METHODS This was a retrospective study of 183 cases of acute Q fever from three Spanish regions, Catalonia, Canary Islands, and La Rioja. RESULTS The main clinical form of presentation was hepatitis (49.2%), followed by isolate febrile syndrome (31.7%) and pneumonia (19.1%). The proportion of cases presenting as pneumonia was significantly higher in La Rioja (40.7%) than in Catalonia (18.3%) or the Canary Islands (12.9%) (p=0.001). In Catalonia and the Canary Islands, most cases (52.1% and 57.6%, respectively) were diagnosed between March and June, whereas in La Rioja, most cases (51.8%) occurred between November and February. Overall, the proportion of cases presenting as pneumonia was significantly higher in the period from November to February (32.6%) than in the periods March-June (16.0%) and July-October (13.0%) (p=0.01). CONCLUSIONS Our results suggest the existence of seasonal differences in the presentation of acute Q fever in Spain, with a higher proportion of pneumonic forms in the colder months. Furthermore, we confirmed the existence of geographical differences, with a higher proportion of pneumonic forms in the region of La Rioja, in the north of the country.

Prospective Cohort Study of Single-Day Doxycycline Therapy for Mediterranean Spotted Fever

Original Article 1 Length of the paper: 2032 words 2 Length of the abstract: 250 words 3 4 5 Title: Single-day doxycycline therapy for Mediterranean spotted fever: a prospective 6 cohort study 7 Running title: One-day doxycycline therapy for Mediterranean spotted fever 8 9 Authors: Elena Espejo, Marta Andrés, Maria-Consol Garcia, Anna Fajardo, Josefa 10 Pérez, Feliu Bella. 11 1 Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa (Consorci 12 Sanitari de Terrassa), Ctra. Torrebonica s/n, 08227 Terrassa, Spain. 13 2 Internal Medicine Service, Hospital de Terrassa (Consorci Sanitari de Terrassa), Ctra. 14 Torrebonica s/n, 08227 Terrassa, Spain. 15 3 Microbiology Laboratory, Catlab, Vial Sant Jordi s/n, Pol. Ind. Can Mitjans, 08232 16 Viladecavalls, Spain. 17 18 19 20 Corresponding author: 21 Elena Espejo 22 Infectious Diseases Unit. Hospital de Terrassa (Consorci Sanitari de Terrassa). 23 Ctra. Torrebonica s/n. 08227 Terrassa, Spain 24 e-mail: 12088eea@comb.cat 25 Telephone: 34-937839488 26 Fax: 34-937003614 27 28 AAC Accepted Manuscript Posted Online 27 August 2018 Antimicrob. Agents Chemother. doi:10.1128/AAC.00978-18 Copyright