Search

CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain., This research was supported by grants from the Instituto de Salud Carlos III (numbers PI18CIII/00030 and PI21CIII/00039). It was also supported by Plan Nacional de I + D + i 2013–2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía y Competitividad, Spanish Network for Research in Infectious Diseases (grants RD16CIII/0004/0002, RD16/0016/0001, RD16/0016/0003, RD16/0016/0004, RD16/0016/0006, RD16/0016/0007, RD16/0016/0008, RD16/0016/0010, and RD16/0016/0011). Cofinanced by the European Development Regional Fund “A way to achieve Europe,” Operative Program Intelligent Growth 2014–2020. CIBER – Consorcio Centro de Investigación Biomédica en Red (CB21/13/00095, CB21/13/00012, CB21/13/00049, CB21/13/00054, CB21/13/00055, CB21/13/00068, CB21/13/00081, CB21/13/00084, and CB21/13/00099) (CIBERINFEC) and Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU also supported this work.

Background: Colorectal cancer has high incidence and associated mortality worldwide. Screening programs are recommended for men and women over 50. Intermediate screens such as fecal immunochemical testing (FIT) select patients for colonoscopy with suboptimal sensitivity. Additional biomarkers could improve the current scenario. Methods: We included 2,893 individuals with a positive FIT test. They were classified as cases when a high-risk lesion for colorectal cancer was detected after colonoscopy, whereas the control group comprised individuals with low-risk or no lesions. 65 colorectal cancer risk genetic variants were genotyped. Polygenic risk score (PRS) and additive models for risk prediction incorporating sex, age, FIT value, and PRS were generated. Results: Risk score was higher in cases compared with controls [per allele OR = 1.04; 95% confidence interval (CI), 1.02–1.06; P < 0.0001]. A 2-fold increase in colorectal cancer risk was observed for subjects in the highest decile of risk alleles (≥65), compared with those in the first decile (≤54; OR = 2.22; 95% CI, 1.59–3.12; P < 0.0001). The model combining sex, age, FIT value, and PRS reached the highest accuracy for identifying patients with a high-risk lesion [cross-validated area under the ROC curve (AUROC): 0.64; 95% CI, 0.62–0.66]. Conclusions: This is the first investigation analyzing PRS in a two-step colorectal cancer screening program. PRS could improve current colorectal cancer screening, most likely for higher at-risk subgroups. However, its capacity is limited to predict colorectal cancer risk status and should be complemented by additional biomarkers. Impact: PRS has capacity for risk stratification of colorectal cancer suggesting its potential for optimizing screening strategies alongside with other biomarkers.

Background Population-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. Aim We describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain. Methods This population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES. Results Of 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)). Conclusions COVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.

SeqCOVID-Spain consortium: Álvaro Chiner-Oms, Irving Cancino-Muñoz, Mariana G. López, Manuela Torres-Puente, Inmaculada Gómez-Navarro, Santiago Jiménez-Serrano, Jordi Pérez-Tur, Darío García de Viedma, Laura Pérez-Lago, Marta Herranz, Jon Sicilia, Pilar Catalán-Alonso, Julia Suárez González, Patricia Muñoz, Mireia Coscolla, Paula Ruiz-Rodríguez, Fernando González-Candelas, Iñaki Comas, Lidia Ruiz-Roldán, María Alma Bracho, Neris García-González, Llúcia Martínez Priego, Inmaculada Galán-Vendrell, Paula Ruiz-Hueso, Griselda De Marco, María Loreto Ferrús-Abad, Sandra Carbó-Ramírez, Giuseppe D’Auria, Galo Adrian Goig, Juan Alberola, Jose Miguel Nogueira, Juan José Camarena, David Navarro, Eliseo Albert, Ignacio Torres, Maitane Aranzamendi Zaldumbide, Óscar Martínez Expósito, Nerea Antona Urieta, María de Toro, María Pilar Bea-Escudero, Jose Antonio Boga, Cristian Castelló-Abietar, Susana Rojo-Alba, Marta Elena Álvarez-Argüelles, Santiago Melón, Elisa Martró, Antoni E. Bordoy, Anna Not, Adrián Antuori, Anabel Fernández-Navarro, Andrés Canut-Blasco, Silvia Hernáez Crespo, Maria Luz Cordón Rodríguez, Maria Concepción Lecaroz Agara, Carmen Gómez-González, Amaia Aguirre-Quiñonero, José Israel López-Mirones, Marina Fernández-Torres, Maria Rosario Almela-Ferrer, Ana Carvajal, Juan Miguel Fregeneda-Grandes, Héctor Argüello, Gustavo Cilla Eguiluz, Milagrosa Montes Ros, Luis Piñeiro Vázquez, Ane Sorarrain, José María Marimón, José J. Costa-Alcalde, Rocío Trastoy, Gema Barbeito Castiñeiras, Amparo Coira, María Luisa Pérez del Molino, Antonio Aguilera, Begoña Palop-Borrás, Inmaculada de Toro Peinado, Maria Concepción Mediavilla Gradolph, Mercedes Pérez-Ruiz, Mirian Fernández-Alonso, Jose Luis del Pozo, Oscar González-Recio, Mónica Gutiérrez-Rivas, Jovita Fernández-Pinero, Miguel Ángel Jiménez Clavero, Begoña Fuster Escrivá, Concepción Gimeno Cardona, María Dolores Ocete Mochón, Rafael Medina-Gonzalez, José Antonio Lepe, Verónica González Galán, Ángel Rodríguez-Villodres, Nieves Gonzalo Jiménez, Jordi Reina, Carla López-Causapé, Maria Dolores Gómez-Ruiz, Eva M. Gonzalez-Barbera, José Luis López-Hontangas, Vicente Martín, Antonio J. Molina, Tania Fernandez-Villa, Ana Milagro Beamonte, Nieves Felisa Martínez-Cameo, Yolanda Gracia-Grataloup, Rosario Moreno-Muñoz, Maria Dolores Tirado Balaguer, José María Navarro-Marí, Irene Pedrosa-Corral, Sara Sanbonmatsu-Gámez, Antonio Oliver, Mónica Parra Grande, Bárbara Gómez Alonso, Francisco José Arjona Zaragozí, Maria Carmen Pérez González, Francisco Javier Chamizo López, Ana Bordes-Benítez, Núria Rabella, Ferran Navarro, Elisenda Miró, Antonio Rezusta, Alexander Tristancho, Encarnación Simarro Córdoba, Julia Lozano-Serra, Lorena Robles Fonseca, Álex Soriano, Francisco Javier Roig Sena, Hermelinda Vanaclocha Luna, Isabel Sanmartín, Daniel García-Souto, Ana Pequeño-Valtierra, Jose M. C. Tubio, Javier Temes, Jorge Rodríguez-Castro, Martín Santamarina García, Manuel Rodríguez-Iglesias, Fátima Galán-Sanchez, Salud Rodríguez-Pallares, José Manuel Azcona-Gutiérrez, Miriam Blasco-Alberdi, Alfredo Mayor, Alberto L. García-Basteiro, Gemma Moncunill, Carlota Dobaño, Pau Cisteró, Oriol Mitjà, Camila González-Beiras, Martí Vall-Mayans, Marc Corbacho-Monné, Andrea Alemany, Cristina Muñoz-Cuevas, Guadalupe Rodríguez-Rodríguez, Rafael Benito, Sonia Algarate, Jessica Bueno, Andrea Vergara-Gómez, Miguel J. Martínez, Jordi Vila, Elisa Rubio, Aida Peiró-Mestres, Jessica Navero-Castillejos, David Posada, Diana Valverde, Nuria Estévez, Iria Fernández-Silva, Loretta de Chiara, Pilar Gallego-García, Nair Varela, Ulises Gómez-Pinedo, Mónica Gozalo-Margüello, Maria Eliecer Cano García, José Manuel Méndez-Legaza, Jesus Rodríguez-Lozano, María Siller, Daniel Pablo-Marcos, Maria Montserrat Ruiz-García, Antonio Galiana, Judith Sánchez-Almendro, Maria Isabel Gascón Ros, Cristina Juana Torregrosa-Hetland, Eva María Pastor Boix, Paloma Cascales Ramos, Pedro Luis Garcinuño Enríquez, Salvador Raga Borja, Julia González Cantó, Olalla Martínez Macias, Adolfo de Salazar, Laura Viñuela González, Natalia Chueca, Federico García, Cristina Gómez-Camarasa, Amparo Farga Martí, Rocío Falcón, Victoria Domínguez-Márquez, Anna M. Planas, Israel Fernández-Cádenas, Maria Ángeles Marcos, Carmen Ezpeleta, Ana Navascués, Ana Miqueleiz Zapatero, Manuel Segovia, Antonio Moreno-Docón, Esther Viedma, Raúl Recio Martínez, Irene Muñoz-Gallego, Sara Gonzalez-Bodi, Maria Dolores Folgueira, Jesús Mingorance, Elias Dahdouh, Fernando Lázaro-Perona, María Rodríguez-Tejedor, María Pilar Romero-Gómez, Julio García-Rodríguez, Juan Carlos Galán, Mario Rodríguez-Dominguez, Laura Martínez-García, Melanie Abreu Di Berardino, Manuel Ponce-Alonso, Jose Maria González-Alba, Ivan Sanz-Muñoz, Diana Pérez San José, Maria Gil Fortuño, Juan B. Bellido-Blasco, Alberto Yagüe Muñoz, Noelia Hernández Pérez, Helena Buj Jordá, Óscar Pérez Olaso, Alejandro González Praetorius, Nora Mariela Martínez Ramírez, Aida Ramírez Marinero, Eduardo Padilla León, Alba Vilas Basil, Mireia Canal Aranda, Albert Bernet Sánchez, Alba Bellés Bellés, Eric López González, Iván Prats Sánchez, Mercè García-González, Miguel José Martínez-Lirola, Manuel Ángel Rodríguez Maresca, Maria Teresa Cabezas Fernández, María Eugenia Carrillo Gil, Maria Paz Ventero Martín, Carmen Molina Pardines, Nieves Orta Mira, María Navarro Cots, Inmaculada Vidal Catalá, Isabel García Nava, Soledad Illescas Fernández-Bermejo, José Martínez-Alarcón, Marta Torres-Narbona, Cristina Colmenarejo, Lidia García-Agudo, Jorge A. Pérez García, Martín Yago López, María Ángeles Goberna Bravo, Victoria Simón García, Gonzalo Llop Furquet, Agustín Iranzo Tatay, Sandra Moreno-Marro, Noelia Lozano Rodríguez, Amparo Broseta Tamarit, Juan José Badiola Díez, Amparo Martínez-Ramírez, Ana Dopazo, Sergio Callejas, Alberto Benguría, Begoña Aguado, Antonio Alcamí, Marta Bermejo Bermejo, Ricardo Ramos-Ruíz, Víctor Manuel Fernández Soria, Fernando Simón Soria & Mercedes Roig Cardells, The coronavirus disease 2019 (COVID-19) pandemic has affected the world radically since 2020. Spain was one of the European countries with the highest incidence during the first wave. As a part of a consortium to monitor and study the evolution of the epidemic, we sequenced 2,170 samples, diagnosed mostly before lockdown measures. Here, we identified at least 500 introductions from multiple international sources and documented the early rise of two dominant Spanish epidemic clades (SECs), probably amplified by superspreading events. Both SECs were related closely to the initial Asian variants of SARS-CoV-2 and spread widely across Spain. We inferred a substantial reduction in the effective reproductive number of both SECs due to public-health interventions (Re, This work was mainly funded by the Instituto de Salud Carlos III project COV20/00140, with additional funding by Spanish National Research Council project CSIC-COV19-021, Ministerio de Ciencia project PID2019-104477RB-100, ERC StG 638553 and ERC CoG 101001038 to I.C., and BFU2017-89594R to F.G.C. M.C. is supported by Ramón y Cajal program from Ministerio de Ciencia and grants RTI2018-094399-A-I00 and Generalitat Valenciana (Regional Government) project SEJI/2019/011. We gratefully acknowledge Hospital Universitari Vall d’Hebron, Instituto de Salud Carlos III, IrsiCaixa AIDS Research Lab and all the international researchers and institutions that submitted sequenced SARS-CoV-2 genomes to the GISAID’s EpiCov Database (Supplementary Table 1), as an important part of our analyses has been made possible by the sharing of their work. We also thank Unidad de Bioinformática y Estadística, Centro de Investigación Príncipe Felipe, for allowing us to use the Computer Cluster to perform some of the bioinformatic analysis.

Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.), the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229&ndash, 0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8&ndash, 1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.

Campylobacter jejuni is the causal agent of the food-borne infection with the highest incidence in Europe. Both poultry and wild birds are a major reservoir. To gain insight into the population structure, virulence potential, and antimicrobial resistance (AMR), a collection of 150 isolates from three different ecological niches (broilers, wild birds, and human patients) was studied. Despite the high genetic diversity found, the population structure defined two distinct clusters, one formed mostly by broiler and human isolates and another one by most wild bird isolates. The ST-21 complex exhibits highest prevalence (in humans and broilers), followed by ST-1275 complex (only in wild birds). The ST-48, -45, and -354 complexes were found in all three niches, but represent only 22 out of 150 studied strains. A higher occurrence of AMR and multidrug resistance was detected among broiler and human isolates. Moreover, significant differences were found in the distribution of certain putative virulence genes. Remarkably, many wild bird strains were negative for either cdtA, cdtB, or cdtC from the canonical strain 81-176, whereas all broiler and human strains were positive. These data suggest that the different variants of the cdt genes might be relevant for the efficient colonization of certain hosts by C. jejuni. Our study contributes to the understanding of the role of the diverse Campylobacter reservoirs in the transmission of campylobacteriosis to humans info:eu-repo/semantics/publishedVersion

Bacteriophages, viruses that infect bacteria, have re-emerged as powerful regulators of bacterial populations in natural ecosystems. Phages invade the human body, just as they do other natural environments, to such an extent that they are the most numerous group in the human virome. This was only revealed in recent metagenomic studies, despite the fact that the presence of phages in the human body was reported decades ago. The influence of the presence of phages in humans has yet to be evaluated; but as in marine environments, a clear role in the regulation of bacterial populations could be envisaged, that might have an impact on human health. Moreover, phages are excellent vehicles of genetic transfer, and they contribute to the evolution of bacterial cells in the human body by spreading and acquiring DNA horizontally. The abundance of phages in the human body does not pass unnoticed and the immune system reacts to them, although it is not clear to what extent. Finally, the presence of phages in human samples, which most of the time is not considered, can influence and bias microbiological and molecular results; and, in view of the evidences, some studies suggest that more attention needs to be paid to their interference.

We studied in parallel the population structure of 90 carbapenemase-producing and 88 carbapenemase-susceptible Klebsiella pneumoniae isolates collected in 20 Spanish hospitals, in the context of the EuSCAPE project. Fourteen and 50 multilocus sequence types (MLSTs) were detected among the carbapenemase-producing and carbapenem-susceptible isolates, respectively. ST11 and ST15 clones were more frequent in the carbapenemase-producing group than in the carbapenemase-susceptible group (P < 0.0001). Among the members of the carbapenem-suceptible group, the cefotaxime-resistant population showed population parameters that differed between the populations of the wild-type strains and the carbapenemase producers. This study was part of the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) project coordinated by the University Medical Center Groningen and funded by ECDC through a specific framework contract (ECDC/2012/055) following an open call for tender (OJ/25/04/2012-PROC/2012/036). This work was also supported by a grant from the Instituto de Salud Carlos III (grant number MPY 1135/16) and by the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund “A way to achieve Europe” ERDF, and the Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015). Sí

The ability of the new VITEK 2Neisseria-Haemophilus card (bioMerieux) for the identification ofNeisseria, Haemophilus and other fastidious Gram-negative organisms was compared with 16S rRNA gene sequencing and others reference methods, in a clinical microbiology laboratory. The VITEK 2 NH card correctly identified 100 isolates (95%) of 105 isolates. Four isolates were misidentified (1Campylobacter coli, 1Campylobacter jejuni, 1Neisseria meningitidis and 1Haemophilus influenzae) and oneC. coli was unidentified. With its extended database and results available within 6 hours, this card could be considered a useful tool for routine use in clinical microbiology laboratory.

The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is a matter of particular concern worldwide and primarily in Europe, one of first continents where the emergence of acquired MBLs has been reported and possibly the geographical area where the increasing diversity of these enzymes and the number of bacterial species affected are most impressive. This spread has not been paralleled by accuracy/standardisation of detection methods, completeness of epidemiological knowledge or a clear understanding of what MBL production entails in terms of clinical impact, hospital infection control and antimicrobial chemotherapy. A number of European experts in the field met to review the current knowledge on this phenomenon, to point out open issues and to reinforce and relate to one another the existing activities set forth by research institutes, scientific societies and European Union-driven networks. (c) 2006 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

BACKGROUND: In January 2000 the Public Health Service of Area 2, in the Region of Madrid, began to publish a weekly sheet on epidemiological and public health information (HISP) addressed to health professionals working in the Area. The aim of the present study was to estimate to how extend the "HISP" was known among health professionals of Area 2, and also to estimate the suitability and usefulness of its contents, during 2000. METHODS: A postal survey was carried out among a random sample of professionals working in Area 2. A descriptive analysis of main variables was done, variables associated to the knowledge of the "HISP" were investigated. Epi Info 2000 program was used for the analysis. RESULTS: The response rate was 79.7%. The best evaluated content was that related to epidemic outbreaks. An association between knowing the "HISP" and knowing the regional epidemiological bulletin (Boletin Epidemiológico de la Comunidad de Madrid) was found (OR = 9.3, IC 95% = 2.9-29.5), and also an association between knowing the "HISP" and being a physician (OR = 4.3, IC: 1.5-12.6, p = 0.005). CONCLUSIONS: The "HISP" has a good acceptance among health professionals of Area 2. They were more interested in contents related to stressful situations. It is necessary to improve the diffusion of information on public health among nursing professionals. Fundamento: En enero del año 2000 el Servicio de Salud Pública del Área Sanitaria 2 de la Comunidad de Madrid, inició la edición semanal de una Hoja de Información en Salud Pública (HISP) dirigida a los profesionales de la salud del Área. El presente trabajo tiene como objetivo estimar el conocimiento, aceptabilidad, utilidad y difusión de la HISP durante el año 2000. Métodos: Se realizó una encuesta por correo a una muestra de profesionales sanitarios del Área 2. Tras un análisis descriptivo se investigó, mediante análisis multivariante, qué factores explicaban que un profesional del Área conociera la HISP. Se utilizó el programa Epi Info 2000. Resultados: La tasa de respuesta fue del 79,7%. El apartado mejor valorado fue el de alertas en salud pública. Se encontró una asociación entre conocer la HISP y conocer el Boletín Epidemiológico de la Comunidad de Madrid (OR=9,3, IC 95%=2,9-29,5), y entre ser médico y recibir información de salud pública (OR=4,3, IC:1,5-12,6, p=0,005). Conclusiones: La HISP ha tenido buena aceptación entre los profesionales sanitarios del Área 2 que valoran más los contenidos relacionados con situaciones estresantes. Es necesario mejorar la difusión de la información de salud pública entre los profesionales de enfermería.

La cartografía de enfermedades infecciosas en periodos sucesivos plantea la necesidad de su extensión al caso dinámico.En este trabajo proponemos la concatenación temporal de modelos autoregresivos espaciales para abordar el análisis de mortalidad por meningitis en España en el peíódo 1950-1990 con datos agregados a nivel provincial.Para la estimación y selección del modelo usamos técnicas basadas en la función de verosimilitud The authors want to thank the referees for comments and suggestions.This work has been partially supported by the Dirección General de Investigación Científica y Técnica(DGICYT)and Generalitat Valenciana (projects PB96-0776 and GV99-621-01).

El progrés científic segueix sovint uns camins que no estan exempts de risc i veiem com moltes novetats tecnològiques, inicialment acollides amb entusiasme, es converteixen en armes de dos talls, representant alhora un benefici i un risc: aquest és el cas de l'energia nuclear.

Curs 2014-2015, Cancer research is continuously shedding light into these worldwide leading diseases. It is mandatory to have higher knowledge in cancer biology to consequently find out new candidate biomarkers and therapeutics. Among all of them, Colorectal cancer is the most commonly seen of human malignant cancers and has the third highest mortality rate[1]. Since the release of the first human genome sequence in 2004, new techniques have revolutionised the study of genetics and its possible applications. A broad type of studies has been carried out; being Single Nucleotide Polymorphisms and Copy Number Variants the most intensively studied analysis. However, other kinds of mutations involving larger parts of the genome, the so-called structural variants, have been substantially less analyzed due to technical limitations. High-throughput sequencing methods seem to have lowered these restrictions. In this study, gene fusions have been searched in whole exome sequencing samples taking 42 paired normal and cancer tissues. Beginning with short-read files obtained with the mentioned method, they have been aligned against a reference genome to later be analyzed with Breakdancer, a structural variant calling algorithm. After some filtering criteria performed in order to remove a high proportion of false positives, a highly probable list of 22 balanced structural variants (translocations and/or inversions) has been manually studied to get a final result of 20 chromosomal rearrangements, 8 of which are considered gene fusions. In addition, it has been found that one recurrent translocation seen in recent studies is indeed a false positive. Further studies taking into account these results may contribute to the findings of new biomarkers for certain subtypes of colorectal cancer., Director/a: Victor Moreno, co-director: Mireia Olivella

Actualmente, la sociedad vive una constante evolución donde el diseño de un mismo producto se va reinventando con tal de ofrecer un mejor servicio a sus clientes y un proceso de fabricación cada vez más óptimo. De esta manera, el objeto del presente proyecto es analizar la posibilidad de llevar a cabo un rediseño de la boca de aspiración instalada en las paredes de las piscinas perteneciente a la empresa METALAST SAU, del grupo Fluidra, empleando la metodología del análisis de valor. A este elemento se le denomina skimmer, y tiene como función principal aspirar la lámina de agua para su filtración y tratamiento. Se analizaran todos los campos que intervienen en su proceso de diseño y fabricación con tal de presentar una nueva propuesta que optimice la relación función/coste. Utilizando la técnica de análisis de valor se va a rediseñar este elemento de manera que manteniendo sus funcionalidades se van a reducir sus costes de manufactura, ensamblaje y mantenimiento.

La carbapenemasa OXA-48 esta àmpliament estesa arreu del món i principalment en Enterobacteriaceae. A Catalunya, Klebsiella pneumoniae productora de la carbapenemasa OXA-48 es va detectar per primer cop al 2009, i des d’aleshores semblava observar-se un cert increment. L’observació d’aquest increment per part de diferents hospitals fou la raó per a iniciar aquest estudi multicèntric que inclou 11 hospitals comarcals i l’Hospital de la Santa Creu i Sant Pau i que té com a principal objectiu la caracterització, tant a nivell epidemiològic com molecular, de les soques de K. pneumoniae productores d’OXA-48 aïllades al llarg del 2012. En l’estudi es van incloure totes aquelles soques de K. pneumoniae que presentaven un fenotip de resistència als antibiòtics betalactàmics diferent al patró natural esperat. A les soques seleccionades se’ls hi va realitzar el test de Hodge modificat (THM) per poder evidenciar la presència de qualsevol enzim amb activitat enfront els carbapenèmics. D’un total de 3.901 soques de K. pneumoniae aïllades, 171 (4,4%) van ser positives per al THM. Per PCR es van confirmar com a portadores de l’OXA-48 85 soques (49,7%). El vuitanta nou percent de les 85 soques productores de l’OXA-48 coexpressaven la BLEA CTX-M-15, acompanyada o no d’OXA-1 i/o TEM-1. Es va estudiar la clonalitat d’aquestes 85 soques per macrorestricció genòmica (PFGE) i MultiLocus Sequencing Type (MLST). Per PFGE es varen observar cinc clones: A, B, C, D i E; que es van correlacionar perfectament amb les cinc seqüència tipus trobades: ST101, ST17, ST1233, ST14 i ST405. La ST1233 va ser descrita per primer cop en aquest estudi. El gen blaOXA-48 es trobat situat en un plasmidi conjugatiu del grup d’incompatibilitat IncL, (62 Kb aprox) i localitzat majoritàriament en Tn1999.2 (91,7%). Es va descartar que la resta de betalactamases trobades estiguessin en aquest plasmidi. De les 85 soques productores d’OXA-48, 75 (88,23%) tenien el gen qnrB. També es varen estudiar els gens implicats en la resistència enzimàtica als aminoglicòsids. De les 85 soques estudiades, 82 es mostraren resistents a algun dels aminoglicòsid estudiats, El fenotip majoritari, va ser la resistència a kanamicina, tobramicina i gentamicina (KTG) i s’explica per la presència dels gens aac(3’)-IIa (KTGN) i aac(6)-Ib (KTAN). Es van observat que soques genèticament relacionades (igual PFGE, ST i presencia dels mateixos gens de resistència) presentaven nivells de resistència diferents. Aquestes diferencies no es varen poder associar a l’activació de bombes d’expulsió AcrAB ni alteracions de les porines estudiades. Els resultats obtinguts per les tècniques clàssiques (PCR, Seqüenciació, PFGE i MLST) van ser comparats en 37 soques amb la nova tècnica de la seqüenciació massiva del genoma microbià (Whole Genome Sequencing: WGS) i el cgMLST (core genome MultiLocus Sequence Typing). Es resultats mostraren una bona correlació entre PFGE-MLST i cgMLST. A l’introduir les seqüències obtingudes pel WGS als webs PlasmidFinder i al ResFinder, vàrem poder identificar plasmidis recentment tipificats i la presència d’altres gens de resistència, com: strA/strB, oqxA/oqxB ,drfA, sul2, fosA, catB3, tet(A) i tet(D). Amb les seqüències obtingudes per WGS també es va obtenir les seqüències de les dianes d’acció de les quinolones, els QRDR. Nomes es varen detectar alteracions en les tres soques del ST101. En conclusió, l’increment de la prevalença de K. pneumoniae portadora d’OXA-48 a Catalunya es deu a la presència en tots els hospitals on s’han aïllat aquestes soques de l’expansió de les clones ST405 i ST101. No havent-hi trobat diferencies en l’entorn genètic del gen que es el mateix que s’ha anat a descrivint arreu. Per altra banda, podem afirmar que la WGS és una bona eina per a la descripció epidemiològica i molecular de brots produïts per a soques multiresistents., The OXA-48 carbapenemase is widely spread around the world and found mainly in Enterobacteriaceae. In Catalonia, OXA-48-producing Klebsiella pneumoniae was first detected in 2009, since then, a growing prevalence has been observed in different hospitals, which prompted the aim of this multicenter study, which includes 11 regional hospitals and the Hospital de Santa Creu i Sant Pau, is the characterization, both epidemiological and molecular, of OXA-48–producing K. pneumoniae strains isolated throughout 2012. The study included all K. pneumoniae strains with an unusual pattern of resistance to beta-lactam antibiotics. Selected strains underwent a modified Hodge test (MHT) to detect any enzyme activity against carbapenemics. A total of 3,901 K. pneumoniae strains, 171 MHT-positive strains (4.4%) were selected. PCR confirmed that 85 strains carried OXA-48 (49.7%). Eighty nine percent of the 85 OXA-48–producing strains coexpressed the ESBL CTX-M-15, with or without beta-lactamases OXA-1 and TEM-1. The clonality of these 85 OXA-48–producing strains was studied by macrorestriction analysis (PFGE) and multilocus sequence typing (MLST). Five clones were observed by PFGE: A, B, C, D and E. These five clones were perfectly correlated with the five sequence types found, ST101, ST17I, ST1233, ST14 and ST405. ST1233 is described for the first time in this study. The blaOXA-48 gene was found in a conjugative plasmid of incompatibility group IncL (aprox. 62 Kb) and located in Tn1999.2 (91.7%). The other beta-lactamase genes of these strains were not found in this plasmid. Of the 85 OXA-48–producing strains, 75 (88.23%) harboured the qnrB gene. Genes involved in enzyme-mediated resistance against aminoglycosides were also studied. Of the 85 OXA-48–producing strains, 82 showed resistance to some of the aminoglycosides studied. The major phenotype showed resistance to kanamycin, gentamicin and tobramycin (KTG), and it was explained by the presence of aac(3')-IIa (KTGN) and aac(6’)-Ib (KTAN) genes. We observed that genetically related strains (that is, closely related PFGE, identical ST and the presence of the same resistance genes) showed different levels of resistance. These differences couldn’t be due to alterations in the expression of the efflux pump AcrAB or in porins. Results obtained by classical techniques (PCR, sequencing, PFGE and MLST) in 37 strains selected were compared with those of the new techniques of massive sequencing of microbial genomes (Whole Genome Sequencing: WGS) and cgMLST (core genome MultiLocus Sequence Typing). A good correlation was found between PFGE-MLST and cgMLST, and four strains were identical by cgMLST but not by PFGE. After uploading the sequences obtained by WGS to the PlasmidFinder and ResFinder online search tools, we were able to identify recently classified plasmids and determine the presence of other resistance genes, such as: strA / strB, oqxA / oqxB, drfA, sul2, fosA, catB3, tet(A) and tet(D). The use of WGS allowed us to obtain sequences of the targets of the quinolones, the QRDR. Surprisingly, only alterations described as responsible for this resistance were detected in all three ST101 strains. In conclusion, the increase in the prevalence of OXA-48-carrying K. pneumoniae in Catalonia is due to the expansion of the ST405 and ST101 clones in all hospitals where strains were isolated. No differences in the genetic background of the blaOXA-48 gene were found, as reported elsewhere. Moreover, WGS was found to be a useful tool for the molecular and epidemiological analysis of outbreaks caused by multidrug-resistant strains.

El siguiente trabajo presenta primeramente a los motores Stirling, realizando una breve explicación de su funcionamiento y características. Una vez conocidos, se centra en los motores Stirling con configuración Alfa. Se establece un proceso de diseño de motores Stirling tipo Alfa con el que poder hacer frente a cálculos matemáticos que ayudan a conocer las características del motor diseñado antes de su fabricación. Se realizan un estudio térmico y cinemático de forma que se conozcan las variables que afectan al funcionamiento del motor y que serán objeto de estudio a la hora del diseño. Esto sirve para así obtener relaciones entre variables térmicas y cinemáticas con las que poder establecer los cálculos que condicionarán el diseño del motor. Una vez realizado un primer cálculo, se realiza un proceso de optimización mediante el estudio de los cálculos obtenidos al modificar alguna de las variables más expuestas a ser objeto de cambio, como son la presión o el ángulo de desfase entre pistones. Lo citado anteriormente se realiza primeramente con carácter general, sin embargo se realiza posteriormente el diseño de un motor, con característica de funcionamiento especificadas por el autor, a modo de prueba. Esto se realiza con el fin de valorar los cálculos realizados y el proceso de diseño. Finalmente se realiza el diseño en soporte CAD con el que poder realizar pruebas de movimiento del motor diseñado, ver variaciones de volumen, realizar planos y demás características cinemáticas del motor objeto de diseño propuesto.

Aquest projecte estudia els problemes de qualitat que sorgeixen en una planta fabricació de pilots per automoció, concretament el problema en l’allotjament del casquet que uneix el pilot posterior amb la carrosseria de l’actual Volkswagen Polo. Per solucionar-lo, es proposa una millora funcional per canviar el sistema d’unió entre l’allotjament del casquet en el cos del pilot i el casquet. Es segueix un camí basat en la prova-error, que integra càlculs i simulacions, per arribar a una solució final.

El present estudi té l’objectiu de dissenyar un seient de tren individual que compleixi els requeriments estructurals i ergonòmics de diverses normatives europees i americanes a partir de les eines CAD/CAE adequades (Catia V5 i PamCrash). Per a la consecució d’aquest objectiu, s’ha partit del model Metropolis de l’empresa especialitzada en la fabricació de seients per a vehicles industrials, Fainsa. Mitjançant l’enginyeria inversa, s’ha realitzat el disseny bàsic d’aquest seient. Paral·lelament, s’ha fet un estudi de la normativa europea i americana, a partir de les quals s’han redactat els plecs de condicions estructurals i ergonòmiques. A partir de la geometria obtinguda, s’han realitzat les simulacions dels assajos i s’han dut a terme diferents modificacions estructurals (afegint un nervi posterior i costelles internes) per tal de millorar aquests resultats i optimitzar el disseny. Les simulacions dels diferents assajos es realitzen amb Catia V5, juntament amb el software PamCrash. En funció dels resultats obtinguts en cadascun dels models, s’ha escollit la millor opció. Finalment, s’ha realitzat un estudi del impacte ambiental del disseny realitzat i una avaluació econòmica de les diferents fases del projecte. En aquest estudi, també s’inclouen annexos amb informació addicional sobre els punts tractats, com el disseny pas a pas del seient, una explicació detallada dels càlculs realitzats, catàlegs de materials, plànols, etc.

Premi al millor Projecte de Fi de Carrera presentat durant l'any 2012 en l'àmbit d'Automoció que atorga la CÀTEDRA SEAT-UPC. El present document tracta del disseny i fabricació d'una carrosseria no estructural per al monoplaça CAT03 de l'equip ETSEIB Motorsport, en el marc de la Formula Student. Es desenvolupa el disseny conceptual, d'estil, el projectat, es realitzen els càlculs necessaris per la seva validació i posteriorment es fabrica la carrosseria amb fibra de carboni i fibra de vidre. El projecte representa una formació complementària als estudis d'Enginyeria Industrial a l'Escola Tècnica Superior d'Enginyeria Industrial de Barcelona i correspon a la tercera participació de l'equip en la competició (temporada 2010). El monoplaça ha competit a Alemanya (Hockenheim), Itàlia (Varano) i Catalunya (Montmeló). Està estructurat per àrees temàtiques i l’ordre dels capítols manté una certa relació amb la seqüència cronològica de les diferents fases de disseny i fabricació. Els primers capítols presenten la carrosseria com a concepte, es planteja la normativa aplicable i les normes de competició. Es realitza un anàlisi d'usuaris, funcions i alternatives. La memòria tècnica mostra com es resolen els diferents sistemes de la carrosseria, les línies de caràcter, les superfícies d'estil, es projecta la carrosseria i es decideix la tipologia de material compost a utilitzar. Es mostra els càlculs bàsics d'aerodinàmica i càlculs d'esforç i la resolució del disseny final. Es tracta el disseny i fabricació dels motllos amb els que fabricar la carrosseria i les últimes accions per integrar-ho al monoplaça. Per últim s'explica quin hauria de ser el treball d'edicions posteriors per l'equip ETSEIB Motorsport, l'estudi econòmic i a quins pactes s'arriben amb els espònsors, l'estimació de l'impacte ambiental del projecte i la planificació temporal del departament encarregat de confeccionar la carrosseria. Award-winning

En el presente proyecto final de carrera se muestran los procedimientos que se han llevado a cabo para promover una reducción de variantes de elementos de fijación en las piezas de acabados internos de los modelos Seat. Gran parte del procedimiento se centra en un tipo de clip que suma aproximadamente el 50% del total de fijaciones que aparece en los revestimientos internos. Dada la gran importancia de este tipo de fijación en el área, su estudio se convierte en una necesidad para poder conocer de primera mano las variables del entorno que afectan a su correcto funcionamiento. Para ello, se han analizado estadísticamente los resultados experimentales que se habían llevado a cabo previamente con el objetivo de encontrar el único elemento que mejor se adaptase a un conjunto de situaciones y poder modelar su entorno a través de expresiones matemáticas. Asimismo, en este proyecto se analizan económicamente las consecuencias de promover dicha reducción de variantes, que además proporciona ventajas y facilidades a los operarios de la línea de montaje, permitiendo indirectamente una reducción en los tiempos de montaje. En líneas de reducción y simplificación, se ha optimizado el diseño de un componente utilizado frecuentemente en acabados internos para facilitar al proyectista el desarrollo de este elemento en un tiempo altamente reducido.