J. A. Garcia Rodriguez

In vitro susceptibility of community-acquired urinary tract pathogens to commonly used antimicrobial agents in Spain: a comparative multicenter study (2002-2004).

Abstract The susceptibility patterns of 2724 uropathogens isolated in 9 Spanish regions during 2002, and 3013 obtained in 2004 were determined. The antibiotics tested were fosfomycin trometamol, amoxicillin, co-amoxiclav, cefixime, cefuroxime-axetil pipemidic acid, ciprofloxacin, trimethoprim plus sulphamethoxazole and nitrofurantoin. Escherichia coli was the main pathogen in both studies (73% vs. 68.3%) followed by Proteus mirabilis (7.2% vs. 6.4%) and Klebsiella pneumoniae (5.4% vs. 5.2%). Enterococcus spp. (4.7% vs. 6.8%)Streptococcus agalactiae (1.7% vs.3.1%) and Staphylococcus saprophyticus (0.7% vs. 1.3%) were the most frequent Gram-positive pathogens. 31.3% of E. coli in 2002 and 32% in 2004 were susceptible to all antibiotics tested. Around 40% of E. coli were resistant to a single agent. 21.6-24.1% were resistant to two antibiotics. 35.4% of first period isolates, and 37.6% of second period ones were resistant to two or more classes of antibiotics. Fosfomycin (2.1- 2.8%) and nitrofurantoin (3.5-5.7%) had the lowest resistance rates for E. coli. Amoxicillin (58.2-58.7%), co-trimoxazole (30.8-33.8%) and ciprofloxacin (22.6-22.7%) showed the highest resistance rates, and their suitability as empiric treatments for UTI should probably be re-evaluated.

In vitro activity of newer antibiotics against Corynebacterium jeikeium, Corynebacterium amycolatum and Corynebacterium urealyticum

Abstract The in vitro activity of ciprofloxacin, erythromycin, telithromycin, teicoplanin, linezolid and quinupristin–dalfopristin was tested against human derived pathogenic corynebacteria. The MICs of these antibiotics were measured using the agar dilution method against 31 strains of Corynebacterium jeikeium , 58 Corynebacterium amycolatum (including 33 multidrug-resistant strains) and 64 Corynebacterium urealyticum clinical strains. A high resistance rate to ciprofloxacin and erythromycin was found in the three species. Telithromycin was much more active than erythromycin (MIC 90 of erythromycin ≥128 mg/l for all three species; MIC 90 of telithromycin: 4 mg/l for C. jeikeium , 64 mg/l for C. amycolatum and 1 mg/l for C. urealyticum ). There were no teicoplanin-resistant (MIC 90 1, 0.5 and 1 mg/l, respectively) or linezolid-resistant strains (MIC 90 1, 0.2 and 0.5 mg/l, respectively). Quinupristin–dalfopristin was active against most strains with an activity similar to linezolid, but three C. jeikeium and one C. amycolatum showed MICs ≥4 mg/l. Telithromycin showed much better activity against corynebacteria than older macrolides. Synercid and linezolid were active against most isolates tested, including multidrug resistant strains.

Fascioliasis in Spain: A review of the literature and personal observations

The fascioliasis induced by Fasciola hepatica is a syndrome which has still not been fully clarified in this country, though the different peninsular regions are suitable for completion of the life cycle of the worm; infested animals may found throughout these regions and in almost all of them human fascioliasis has been diagnosed, with the greatest incidence in the Basque Country, Navarra and La-Rioja. This greater appearance is probably related to the dietary habits in those areas, since the consumption of water cress is undoubtedly the principal source of contamination and is entirely responsible for the rest of the epidemiology of the diseases in humans. In the cases studied, the clinical symptoms did not differ from those habitually found in this syndrome. Serological methods have resolved the diagnosis in the acute phase of the disease and furthermore are of great use for monitoring post-treatment evolution. The cases studied by this Department were diagnosed with immunodiffusion, haemagglutination and immunoelectrophoresis techniques and the evolution of the patients was also followed by immunodiffusion and haemagglutination.

Comparison of GenoType® MTBC with RFLP-PCR and multiplex PCR to identify Mycobacterium tuberculosis complex species

The aims of the work presented here were to evaluate a commercial system based on DNA hybridization technology on nitrocellulose strips (GenoType® MTBC; Hain Diagnostika, Nehren, Germany) for identifying Mycobacterium tuberculosis complex isolates to the species level and to compare the results with those obtained using the RFLP-PCR and multiplex PCR molecular techniques, biochemical tests and susceptibility testing. The commercial system correctly identified 102 of 103 (99.03%) strains studied, indicating it is capable of discriminating among the tuberculosis complex species.

Comparison of a biphasic system and a non-radiometric system for blood culture.

The performance of a biphasic system for blood culture and a non-radiometric system using infrared spectroscopy was compared using 2,000 blood samples. The biphasic system detected bacteria or fungi in 237 blood cultures in 114 patients, while the non-radiometric system detected these microorganisms in only 186 blood cultures in 91 patients (p≤0.05). The speed with which the bacteria were detected and the rate of contamination were similar in the two systems. The capacity to detect different genera and species was similar except in the case ofBrucella spp., which the biphasic system detected in 28 blood cultures but the non-radiometric system in only 12 (p≤0.05).