23 results on '"Navarro, Ferran"'
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2. Crisis económica y patología infecciosa. Informe SESPAS 2014
- Author
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Llácer, Alicia, Fernández-Cuenca, Rafael, and Martínez-Navarro, Ferrán
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- 2014
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3. Utilización de diferentes técnicas de biología molecular integradas en un algoritmo de identificación de micobacterias no tuberculosas
- Author
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Esparcia, Óscar, Español, Montserrat, Garrigó, Montserrat, Moreno, Carmen, Montemayor, Michel, Navarro, Ferran, and Coll, Pere
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- 2012
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4. Detección fenotípica de mecanismos de resistencia en microorganismos gramnegativos
- Author
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Navarro, Ferran, Calvo, Jorge, Cantón, Rafael, Fernández-Cuenca, Felipe, and Mirelis, Beatriz
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- 2011
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5. Infecciones producidas por Clostridium difficile
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Rodríguez-Pardo, Dolors, Mirelis, Beatriz, and Navarro, Ferran
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- 2013
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6. Lectura interpretada del antibiograma de enterobacterias
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Navarro, Ferran, Miró, Elisenda, and Mirelis, Beatriz
- Published
- 2010
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7. Réplica a «Infecciones producidas por Clostridium difficile. Observaciones»
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Rodríguez-Pardo, Dolors, Mirelis, Beatriz, and Navarro, Ferran
- Published
- 2013
- Full Text
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8. Fe de errores de «Caracterización y epidemiología molecular de betalactamasas de espectro extendido en Escherichia coli y Klebsiella pneumoniae en once hospitales españoles (2004)»
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Diestra, Karol, Coque, Teresa M., Miró, Elisenda, Oteo, Jesús, Juan Nicolau, Carlos, Campos, José, Moyá, Bartolomé, Curiao, Tânia, Pérez-Vázquez, María, Cantón, Rafael, Oliver, Antonio, and Navarro, Ferran
- Published
- 2010
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9. Considerations to the comments on the recommendations of the Spanish Antibiogram Committee (COESANT) for the preparation of Cumulative Antibiotic Sensitivity Reports.
- Author
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Navarro F, Oliver A, and Larrosa MN
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- 2024
- Full Text
- View/download PDF
10. Recommendations of the Spanish Antibiogram Committee (COESANT) for in vitro susceptibility testing of antimicrobial agents by disk diffusion.
- Author
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Rivera A, Viñado B, Benito N, Docobo-Pérez F, Fernández-Cuenca F, Fernández-Domínguez J, Guinea J, López-Navas A, Moreno MÁ, Larrosa MN, Oliver A, and Navarro F
- Subjects
- Microbial Sensitivity Tests, Spain, Anti-Infective Agents
- Abstract
Disk diffusion is a well standardized method that provides reliable categorical results to guide antimicrobial therapy in numerous types of infections. Based on the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST), which are widely implemented in Spain, the Spanish Antibiogram Committee (COESANT) has drawn up recommendations for antimicrobial selection by the disk diffusion technique, including selective reporting and its use for the detection of resistance mechanisms. Factors affecting disk diffusion results, along with advantages and shortcomings of the method, are also discussed., (Copyright © 2022 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
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11. Spanish Antibiogram Committee (COESANT) recommendations for cumulative antibiogram reports.
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Larrosa MN, Canut-Blasco A, Benito N, Cantón R, Cercenado E, Docobo-Pérez F, Fernández-Cuenca F, Fernández-Domínguez J, Guinea J, López-Navas A, Moreno MÁ, Morosini MI, Navarro F, Martínez-Martínez L, and Oliver A
- Abstract
The Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) presents in this document a series of recommendations intending to unify how cumulative antibiogram reports must be made in Clinical Microbiology Spanish laboratories. This article is based on the information included in the Clinical Microbiology Procedure No. 51, «Preparation of cumulative reports on antimicrobial susceptibility» of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), published in 2014. The recommendations also include the modifications in the definition of clinical interpretive categories recently published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2019. Its final objective is to establish a homogeneous way of preparing these summaries to compare results from different centers or aggregate the information from these in order to carry out an adequate local or even national surveillance regarding the evolution of antimicrobial susceptibility., (Copyright © 2022 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
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12. Recommendations of the Spanish Antibiogram Committee (COESANT) for selecting antimicrobial agents and concentrations for in vitro susceptibility studies using automated systems.
- Author
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Cantón R, Oliver A, Alós JI, de Benito N, Bou G, Campos J, Calvo J, Canut A, Castillo J, Cercenado E, Domínguez MÁ, Fernández-Cuenca F, Guinea J, Larrosa N, Liñares J, López-Cerero L, López-Navas A, Marco F, Mirelis B, Moreno-Romo MÁ, Morosini MI, Navarro F, Oteo J, Pascual Á, Pérez-Trallero E, Pérez-Vázquez M, Soriano A, Torres C, Vila J, and Martínez-Martínez L
- Subjects
- Automation, Laboratory, Spain, Anti-Infective Agents pharmacology, Microbial Sensitivity Tests standards
- Abstract
Automated antimicrobial susceptibility testing devices are widely implemented in clinical microbiology laboratories in Spain, mainly using EUCAST (European Committee on Antimicrobial Susceptibility Testing) breakpoints. In 2007, a group of experts published recommendations for including antimicrobial agents and selecting concentrations in these systems. Under the patronage of the Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) and the Study Group on Mechanisms of Action and Resistance to Antimicrobial Agents (GEMARA) from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and aligned with the Spanish National Plan against Antimicrobial Resistance (PRAN), a group of experts have updated this document. The main modifications from the previous version comprise the inclusion of new antimicrobial agents, adaptation of the ranges of concentrations to cover the EUCAST breakpoints and epidemiological cut-off values (ECOFFs), and the inference of new resistance mechanisms. This proposal should be considered by different manufacturers and users when designing new panels or cards. In addition, recommendations for selective reporting are also included. With this approach, the implementation of EUCAST breakpoints will be easier, increasing the quality of antimicrobial susceptibility testing data and their microbiological interpretation. It will also benefit epidemiological surveillance studies as well as the clinical use of antimicrobials aligned with antimicrobial stewardship programs., (Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)
- Published
- 2020
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13. Molecular characterization of OXA-48 carbapenemase-producing Klebsiella pneumoniae strains after a carbapenem resistance increase in Catalonia.
- Author
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Argente M, Miró E, Martí C, Vilamala A, Alonso-Tarrés C, Ballester F, Calderón A, Gallés C, Gasós A, Mirelis B, Morta M, Olsina M, Sauca G, Sierra M, Rivera A, and Navarro F
- Subjects
- Community-Acquired Infections epidemiology, Community-Acquired Infections microbiology, Conjugation, Genetic, Cross Infection epidemiology, Cross Infection microbiology, DNA Transposable Elements genetics, Humans, Klebsiella Infections epidemiology, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae enzymology, Klebsiella pneumoniae isolation & purification, Microbial Sensitivity Tests, Molecular Epidemiology, Prospective Studies, R Factors genetics, Spain epidemiology, beta-Lactamases analysis, Drug Resistance, Multiple, Bacterial genetics, Klebsiella Infections microbiology, Klebsiella pneumoniae genetics, beta-Lactam Resistance genetics, beta-Lactamases genetics
- Abstract
Introduction: To characterize OXA-48 carbapenemase-producing Klebsiella pneumoniae strains isolated after an increase in carbapenem resistance in Catalonia., Methodology: K. pneumoniae identification, antimicrobial susceptibility studies, the Modified Hodge Test method, amplification of antimicrobial resistance genes (against β-lactamases, quinolones and aminoglycosides), molecular typing (by PFGE and MLST), conjugation assays, plasmid characterization (PBRT-PCR and Southern blot), a description of mobile genetic elements and statistical analysis were done., Results: OXA-48 was the only carbapenemase detected, with a prevalence of 1.9%. The bla
OXA-48 gene was located in an IncL conjugative plasmid of 62kb and integrated into the transposons Tn1999.2 (91.7%) or Tn1999.1. Five PFGE profiles (A to E) were found, which exactly matched the MLST: ST101, ST17, ST1233, ST14 and ST405, respectively. ST1233 is described here for the first time. K. pneumoniae OXA-48-producing strains were also CTX-M-15 carriers, some producing OXA-1 and TEM-1 penicillinases. The acquired qnrB66 and qnrB1 and aac(3')-IIa, aac(6')-Ib genes were also identified., Conclusion: The K. pneumoniae ST405 clone has played an important role in the growing prevalence of OXA-48 in Catalonia. All clones described preserved the blaOXA-48 genetic environment and mobile genetic elements (Tn1999). Notably, the three strains with minor sequence types in this study are not multiresistant strains. These strains are expanding in elderly patients (average age of 76 years) with serious underlying diseases, mainly women (61.2%)., (Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)- Published
- 2019
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14. Prevalence of quinolone resistance mechanisms in Enterobacteriaceae producing acquired AmpC β-lactamases and/or carbapenemases in Spain.
- Author
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Machuca J, Agüero J, Miró E, Conejo MDC, Oteo J, Bou G, González-López JJ, Oliver A, Navarro F, Pascual Á, and Martínez-Martínez L
- Subjects
- Bacterial Proteins genetics, Enterobacteriaceae enzymology, Enterobacteriaceae genetics, Enterobacteriaceae isolation & purification, Enterobacteriaceae Infections epidemiology, Genes, Bacterial, Humans, Nalidixic Acid pharmacology, R Factors genetics, Spain epidemiology, beta-Lactam Resistance genetics, beta-Lactamases genetics, Bacterial Proteins metabolism, Drug Resistance, Multiple, Bacterial genetics, Enterobacteriaceae drug effects, Enterobacteriaceae Infections microbiology, Fluoroquinolones pharmacology, beta-Lactamases metabolism
- Abstract
Background: Quinolone resistance in Enterobacteriaceae species has increased over the past few years, and is significantly associated to beta-lactam resistance. The aim of this study was to evaluate the prevalence of chromosomal- and plasmid-mediated quinolone resistance in acquired AmpC β-lactamase and/or carbapenemase-producing Enterobacteriaceae isolates., Methods: The presence of chromosomal- and plasmid-mediated quinolone resistance mechanisms [mutations in the quinolone resistance determining region (QRDR) of gyrA and parC and qnr, aac(6')-Ib-cr and qepA genes] was evaluated in 289 isolates of acquired AmpC β-lactamase- and/or carbapenemase-producing Enterobacteriaceae collected between February and July 2009 in 35 Spanish hospitals., Results: Plasmid mediated quinolone resistance (PMQR) genes were detected in 92 isolates (31.8%), qnr genes were detected in 83 isolates (28.7%), and the aac(6')-Ib-cr gene was detected in 20 isolates (7%). qnrB4 gene was the most prevalent qnr gene detected (20%), associated, in most cases, with DHA-1. Only 14.6% of isolates showed no mutations in gyrA or parC with a ciprofloxacin MIC of 0.5mg/L or higher, whereas PMQR genes were detected in 90% of such isolates., Conclusion: qnrB4 gene was the most prevalent PMQR gene detected, and was significantly associated with acquired AmpC β-lactamase DHA-1. PMQR determinants in association with other chromosomal-mediated quinolone resistance mechanisms, different to mutations in gyrA and parC (increased energy-dependent efflux, altered lipopolysaccharide or porin loss), could lead to ciprofloxacin MIC values that exceed breakpoints established by the main international committees to define clinical antimicrobial susceptibility breakpoints., (Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)
- Published
- 2017
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15. Speeding up antimicrobial susceptibility testing.
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Navarro F and Coll P
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- Humans, Anti-Bacterial Agents pharmacology, Microbial Sensitivity Tests methods
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- 2016
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16. [Importance of quality control for the detection of β-lactam antibiotic resistance in Enterobacteriaceae].
- Author
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Rivera A, Larrosa N, Mirelis B, and Navarro F
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- Humans, Microbial Sensitivity Tests standards, Enterobacteriaceae drug effects, Quality Control, beta-Lactam Resistance
- Abstract
β-lactam antimicrobial agents are frequently used to treat infections caused by Enterobacteriaceae. The main mechanism of resistance to these antibiotics is the production of certain enzymes, collectively named β-lactamases. Due to their substrate profile and their epidemiological implications, the most clinically important β-lactamases are extended-spectrum β-lactamases, class C β-lactamases and carbapenemases. Phenotypic detection of these enzymes may be complicated and is based on the use of specific inhibitors of each β-lactamase and on the loss of activity on some β-lactam indicators. Various international committees postulate that it is no longer necessary to interpret the susceptibility results or determine the mechanism of resistance. Several critics disagree, however, and consider that susceptibility results should be interpreted until more data are available on the clinical efficacy of treatment with β-lactams. Given these methodological difficulties and constant changes in the interpretation criteria, we consider that training and external quality controls are essential to keep updated in this field. For learning purposes, these external quality controls should always be accompanied by a review of the results and methodology used, and the analysis of errors. In this paper we review and contextualize all the aspects related to the detection and interpretation of these β-lactamases., (Copyright © 2014 Elsevier España, S.L. All rights reserved.)
- Published
- 2014
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17. [Interpretive reading of enterobacteria antibiograms].
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Navarro F, Miró E, and Mirelis B
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- Enterobacteriaceae genetics, Fluoroquinolones pharmacology, Phenotype, beta-Lactams pharmacology, Enterobacteriaceae drug effects, Microbial Sensitivity Tests
- Abstract
The resistance pattern observed in the antibiogram of an isolate should be the sum of its natural resistance pattern, characteristic of the species, plus the acquired resistances. In Enterobacteriaceae, the production of inactivating enzymes is the main mechanism of resistance to beta-lactams and aminoglycosides. Each one of these enzymes recognizes one or more specific beta-lactams or aminoglycosides as substrate. This substrate specificity implies a specific resistance pattern from which we can deduce the enzymes present in the isolate. However, enzymatic-mediated resistance is not the only mechanism implicated and resistance is frequently multifactorial. Resistance to quinolones is mainly due to precise, sequential chromosomal mutations that can be selected by fluoroquinolone treatments. Recently, certain plasmid-mediated genes which code enzymes that modify quinolones or that are target protectors have been implicated in the low level resistance to quinolones., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)
- Published
- 2010
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18. [Characterization and molecular epidemiology of ESBL in Escherichia coli and Klebsiella pneumoniae in 11 Spanish hospitals (2004)].
- Author
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Diestra K, Coque TM, Miró E, Oteo J, Nicolau CJ, Campos J, Moyá B, Curiao T, Pérez-Vázquez M, Cantón R, Oliver A, and Navarro F
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Community-Acquired Infections enzymology, Community-Acquired Infections epidemiology, Community-Acquired Infections microbiology, Cross Infection microbiology, Cross Infection transmission, Escherichia coli genetics, Escherichia coli isolation & purification, Escherichia coli Infections enzymology, Escherichia coli Infections microbiology, Escherichia coli Infections transmission, Female, Hospital Departments statistics & numerical data, Humans, Infant, Infant, Newborn, Klebsiella Infections enzymology, Klebsiella Infections microbiology, Klebsiella Infections transmission, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Male, Middle Aged, Phylogeny, Prevalence, Spain epidemiology, Substrate Specificity, beta-Lactamases classification, Cross Infection epidemiology, Escherichia coli enzymology, Escherichia coli Infections epidemiology, Klebsiella Infections epidemiology, Klebsiella pneumoniae enzymology, beta-Lactam Resistance genetics, beta-Lactamases genetics
- Abstract
Introduction: The epidemiological distribution of extended-spectrum beta-lactamase (ESBL) types in Escherichia coli and Klebsiella pneumoniae was evaluated in various hospitals in Spain and compared with previous studies., Methods: A total of 11 Spanish hospitals participated in this study. Each center collected the first 15 isolates of E. coli and the first 5 of K. pneumoniae suspected of being ESBL-producers and isolated during the first quarter of 2004. Clonal study was done by PFGE after total DNA digestion with XbaI and by ERIC-PCR (Enterobacterial Repetitive Intergenic Consensus Sequences-Polymerase Chain Reaction), typing. ESBL-producers were characterized by isoelectric focusing (IEF), PCR and sequencing., Results: A total of 124 strains were collected. PFGE restriction patterns showed considerable diversity among E. coli strains; 4 clusters of 2 strains each were detected. ESBL characterization of 92 E. coli strains showed a predominance of CTX-M-14 (45.7%), CTX-M-9 (20.6%) and SHV-12 (21.7%). Clonal diversity among the 32 K. pneumoniae strains was less pronounced than in E. coli; 3 clusters included 53.1% of strains. The ESBL detected in these strains included a CTX-M type in 20 cases (62.5%) (CTX-M-1, CTX-M-9, CTX-M-14 and CTX-M-15); a SHV type in 11 (34.4%) (SHV-12 and SHV-5) and TEM-4 (3.1%) in 1 case., Conclusion: The E. coli and K. pneumoniae strains analyzed in this period displayed a greater diversity of ESBL than has been observed in previous epidemiological studies. Analysis of clonal relationships revealed a greater diversity in E. coli than in K. pneumoniae.
- Published
- 2008
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19. [Recommendations for selecting antimicrobial agents for in vitro susceptibility studies using automatic and semiautomatic systems].
- Author
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Cantón R, Alós JI, Baquero F, Calvo J, Campos J, Castillo J, Cercenado E, Domínguez MA, Liñares J, López-Cerezo L, Marco F, Mirelis B, Morosini MI, Navarro F, Oliver A, Pérez-Trallero E, Torres C, and Martínez-Martínez L
- Subjects
- Guidelines as Topic, Sensitivity and Specificity, Anti-Infective Agents pharmacology, Microbial Sensitivity Tests standards
- Abstract
The number of clinical microbiology laboratories that have incorporated automatic susceptibility testing devices has increased in recent years. The majority of these systems determine MIC values using microdilution panels or specific cards, with grouping into clinical categories (susceptible, intermediate or resistant) and incorporate expert systems to infer resistance mechanisms. This document presents the recommendations of a group of experts designated by Grupo de Estudio de los Mecanismos de Acción y Resistencia a los Antimicrobianos (GEMARA, Study group on mechanisms of action and resistance to antimicrobial agents) and Mesa Española de Normalización de la Sensibilidad y Resistencia a los Antimicrobianos (MENSURA, Spanish Group for Normalizing Antimicrobial Susceptibility and Antimicrobial Resistance), with the aim of including antimicrobial agents and selecting concentrations for the susceptibility testing panels of automatic systems. The following have been defined: various antimicrobial categories (A: must be included in the study panel; B: inclusion is recommended; and C: inclusion is secondary, but may facilitate interpretative reading of the antibiogram) and groups (0: not used in therapeutics but may facilitate the detection of resistance mechanisms; 1: must be studied and always reported; 2: must be studied and selectively reported; 3: must be studied and reported at a second level; and 4: should be studied in urinary tract pathogens isolated in urine and other specimens). Recommended antimicrobial concentrations are adapted from the breakpoints established by EUCAST, CLSI and MENSURA. This approach will lead to more accurate susceptibility testing results with better detection of resistance mechanisms, and allowing to reach the clinical goal of the antibiogram.
- Published
- 2007
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20. [Relevance of synergism and antagonism phenomena detected among antimicrobial agents with automated systems for antibiogram reading].
- Author
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Navarro F and Mirelis B
- Subjects
- Automation, Bacteria enzymology, Bacteria genetics, Bacterial Proteins analysis, Carbapenems pharmacology, DNA, Bacterial genetics, Drug Antagonism, Drug Resistance, Multiple, Bacterial genetics, Drug Synergism, False Negative Reactions, False Positive Reactions, Phenotype, beta-Lactam Resistance genetics, beta-Lactamases analysis, Anti-Bacterial Agents pharmacology, Bacteria drug effects, Drug Interactions, Drug Resistance genetics, Microbial Sensitivity Tests methods
- Published
- 2007
- Full Text
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21. A simple phenotypic method for differentiation between acquired and chromosomal AmpC beta-lactamases in Escherichia coli.
- Author
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Mirelis B, Rivera A, Miró E, Mesa RJ, Navarro F, and Coll P
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- Aztreonam pharmacology, Bacterial Proteins antagonists & inhibitors, Cefotaxime pharmacology, Cefoxitin pharmacology, Ceftazidime pharmacology, Escherichia coli drug effects, Escherichia coli genetics, Escherichia coli isolation & purification, Escherichia coli Infections microbiology, Escherichia coli Proteins antagonists & inhibitors, Escherichia coli Proteins genetics, Klebsiella Infections microbiology, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Mass Screening, Microbial Sensitivity Tests, Phenotype, Prospective Studies, Proteus Infections microbiology, Proteus mirabilis drug effects, Proteus mirabilis genetics, Proteus mirabilis isolation & purification, beta-Lactamase Inhibitors, Bacterial Proteins genetics, Chromosomes, Bacterial genetics, Cloxacillin pharmacology, Drug Resistance, Multiple, Bacterial genetics, Escherichia coli enzymology, Klebsiella pneumoniae enzymology, Proteus mirabilis enzymology, R Factors genetics, beta-Lactam Resistance genetics, beta-Lactamases genetics
- Abstract
Background: Screening methods for the detection of plasmid-mediated AmpC beta-lactamases are technically demanding. The purpose of this study was to assess screening methods for the detection of these enzymes in clinical isolates of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis., Methods: Isolates were selected according to a resistance phenotype consistent with production of an AmpC-type beta-lactamase. Detection of acquired ampC genes was done with a multiplex ampC-PCR and sequencing. The phenotypic detection methods evaluated included visual examination of antibiogram plates to identify the presence of scattered colonies located near the edge of the inhibition halo of cefoxitin, cefotaxime, ceftazidime and aztreonam, and a double-disc synergy test using cloxacillin (500 mg) to inhibit AmpC enzymes., Results: Seventy-seven isolates were selected from among 6,209 isolates recovered. Acquired ampC genes (blaCMY-2, blaDHA-1, blaCMY-4 and blaACC-1) were found in 19 (24.7%) of these isolates, including 14 E. coli, two K. pneumoniae and three P. mirabilis isolates. The differential trait for the presence of colonies in the inhibition halo was 100% sensitive and specific. Similar results were obtained for the cloxacillin test, except for the E. coli isolates in which specificity was 10.3%., Conclusion: The phenotypic trait described here can be considered useful for suspecting the presence of these enzymes. The cloxacillin test was only useful in isolates lacking a natural AmpC beta-lactamase.
- Published
- 2006
- Full Text
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22. [Evaluation of the impact of the heat wave in the summer of 2003 on mortality].
- Author
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Martínez Navarro F, Simón-Soria F, and López-Abente G
- Subjects
- Aged, Humans, Middle Aged, Mortality trends, Rural Population, Seasons, Heat Stroke mortality, Hot Temperature adverse effects
- Abstract
The effect of the elevated temperatures experimented in Europe during the summer 2003 on mortality was observed in several countries. This study, carried out in Spain, describes the mortality between the 1st June and the 31st August and evaluates the effect of the heat wave on mortality. Observed deaths were obtained from official vital Registers of the capital city of the 50 provinces. Deaths from 107 randomly selected rural villages were also obtained from the same source. Observed deaths were compared with expected estimated applying a Poisson regression model to historical mortality series adjusting for the upwards trend and seasonality observed. Meteorological information was provided by the National Institute of Meteorology. Spain experienced three heat waves. Total excess deaths associated was 8% (43,212 observed compared with 40,046 expected). Excess deaths were only observed among 65 years old and over (15%). The increased mortality was also observed in rural villages. This phenomenon is becoming an emerging public health problem because of its increasing attributable risk because of the aging of Spanish population. Alert and response systems based on monitoring of climate related risks, emergency rooms activity and mortality and the strengthening of social and health services response capacity should be considered.
- Published
- 2004
- Full Text
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23. [Nosocomial epidemic outbreak of acute gastroenteritis by Norwalk-like virus].
- Author
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González Morán F, Moreno Civantos A, de Mateo Ontañón S, Barrasa Blanco A, Valadés Rodríguez J, Domínguez Berjón F, Herrera Guibert D, and Martínez Navarro F
- Subjects
- Acute Disease, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Male, Spain, Caliciviridae Infections epidemiology, Cross Infection epidemiology, Disease Outbreaks, Gastroenteritis epidemiology, Gastroenteritis virology, Norovirus
- Abstract
Background: From the notification of an acute gastroenteritis outbreak in a nursing home, an epidemiological study was started to determine the characteristics of the outbreak and its spreading pattern and to identify determining factors., Patients and Method: A study of historic cohorts was performed and the case was defined by the presence of diarrhea and vomiting. Spatial aggregation in double rooms was analyzed by a binomial distribution and temporal aggregation was analyzed by a relative risks model. The variables in the study allowed us to calculate the adjusted relative risk; the odds ratio was calculated in relation to the meal on day January 30., Results: We studied 95.9% residents. The total attack rate was 28.7% (31.8% employees, 30.1% permanent residents and 15.2% day residents). The attack rate in rotation health personnel was 45.2%. Spatial and temporal spread in double rooms was negative. There was a significant association with the disease in rotator employees (RR = 3.22; CI 95%, 1.30-7.99; p = 0.02). No association was found between eating and disease (OR = 1.5; CI 95%, 0.4-6.1; p = 0.46). Norwalk-like virus was isolated in four faecal samples., Conclusions: This epidemic outbreak had the characteristic of a nosocomial infection with a likely person-to-person transmission mechanism. The main factor contributing to the spread of the infection was the existence of employees in permanent contact with residents with an important physical and mental impairment, hence highly dependent on the care provided by these health workers.
- Published
- 2002
- Full Text
- View/download PDF
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