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Aims: To determine the Staphylococcus aureus carriage rate in wild mammals in Aragon, northern Spain, to analyse their antimicrobial resistance phenotype/genotype and to characterize the recovered isolates. Methods and Results: Nasal and rectal swabs of 103 mammals were collected in Aragón during the period 2012–2015. Antimicrobial susceptibility, the presence of antimicrobial resistance genes and virulence factors were investigated. Molecular characterization was carried out by spa, MLST, agr and SCCmec. Staphylococcus aureus were recovered from 23 animals (22%). Four of the 23 S. aureus were methicillin‐resistant S. aureus (MRSA). Three MRSA were mecC‐positive and were isolated from European rabbits and were typed as t843 (ascribed to CC130). The remaining MRSA was a mecA‐carrying isolate from European hedgehog, typed as ST1‐t386‐SCCmecIVa‐agrIII and it harboured the blaZ, erm(C), ant(6)‐Ia and aph(3´)‐IIIa resistance genes. A high diversity of spa‐types was detected among the 19 methicillin‐susceptible S. aureus isolates, which showed high susceptibility to the antimicrobials tested. The tst gene and different combinations of staphylococcal enterotoxins were found. Conclusions: Staphylococcus aureus were detected in nasal and rectal samples of wild mammals. Wild rabbits could be a reservoir of mecC‐MRSA. Significance and Impact of the Study: This work provides information on the presence and characteristics of S. aureus from mammals in a defined geographic region in Spain. [ABSTRACT FROM AUTHOR]

Objectives: Prediction of patients with poor outcome is necessary in order to plan the proper management of Clostridium difficile infection (CDI); however, clinical criteria are insufficient. In a previous study, we observed that high toxigenic C. difficile cfu stool counts at diagnosis were associated with a poor outcome. Our objective was to investigate the role of the PCR toxin B amplification cycle threshold (Ct) in the prediction of CDI poor outcome and to derive and validate a high-risk prediction rule using this marker.Methods: We prospectively included patients with CDI (derivation cohort, January 2013 to June 2014; and validation cohort, December 2014 to May 2015), who were followed for at least 2 months after their last episode/recurrence. All samples were tested with Xpert™ C. difficile.Results: For the derivation cohort (n = 129) toxin B Ct was independently associated with poor outcome (P < 0.001). The receiver operating characteristic (ROC) curve yielded an AUC of 0.816. Using a cut-off of <23.5 cycles for high risk of poor outcome, the diagnostic accuracy was 81.4%, the sensitivity was 46.5% (95% CI 32.5-61.1) and the specificity was 98.8% (95% CI 93.7-99.8). For the validation cohort (n = 170), the diagnostic accuracy was 81.8%, the sensitivity was 88.4% (95% CI 75.5-94.9) and the specificity was 79.5% (95% CI 71.7-85.6). The ROC curve yielded an AUC of 0.857.Conclusions: Low toxin B Ct values from samples collected at the initial moment of diagnosis appears to be a strong marker for poor outcome. This available test may identify, at an early stage, patients who are at higher risk of a poor outcome CDI. [ABSTRACT FROM AUTHOR]

Interest has been increasing to enhance the contents of healthy polyunsaturated fatty acid (PUFA) in milk. However, trans fatty acids and conjugated linoleic acid (CLA) can be altered after thermal processing and high pressures disrupt the milk fat globule membrane, exposing the lipid core and helping its oxidation. The objective of the present research was to study whether processing can alter the fatty acid composition of milk and if these changes are affected by PUFA concentration as previous studies suggest. Two cow milk batches (500 L each), one naturally enriched in PUFA, were processed to obtain pasteurized; high temperature, short time; UHT; high pressure; and microwave pasteurized samples. The detailed fatty acid composition was analyzed with special attention to trans fatty acids and CLA isomers. Results showed that after high temperature, short time processing, total CLA content increased in both milk batches, whereas sterilization resulted in a sigmatropic rearrangement of C18:2 cis-9,trans-11 to C18:2 trans-9,trans-11. The extent of these effects was greater in milks naturally enriched in PUFA. [ABSTRACT FROM AUTHOR]

Although milk polar lipids such as phospholipids and sphingolipids located in the milk fat globule membrane constitute 0.1 to 1% of the total milk fat, those lipid fractions are gaining increasing interest because of their potential beneficial effects on human health and technological properties. In this context, the accurate quantification of the milk polar lipids is crucial for comparison of different milk species, products, or dairy treatments. Although the official International Organization for Standardization-International Dairy Federation method for milk lipid extraction gives satisfactory results for neutral lipids, it has important disadvantages in terms of polar lipid losses. Other methods using mixtures of solvents such as chloroform:methanol are highly efficient for extracting polar lipids but are also associated with low sample throughput, long time, and large solvent consumption. As an alternative, we have optimized the milk fat extraction yield by using a pressurized liquid extraction (PLE) method at different temperatures and times in comparison with those traditional lipid extraction procedures using 2:1 chloroform:methanol as a mixture of solvents. Comparison of classical extraction methods with the developed PLE procedure were carried out using raw whole milk from different species (cows, ewes, and goats) and considering fat yield, fatty acid methyl ester composition, triacylglyceride species, cholesterol content, and lipid class compositions, with special attention to polar lipids such as phospholipids and sphingolipids. The developed PLE procedure was validated for milk fat extraction and the results show that this method performs a complete or close to complete extraction of all lipid classes and in less time than the official and Folch methods. In conclusion, the PLE method optimized in this study could be an alternative to carry out milk fat extraction as a routine method. [ABSTRACT FROM AUTHOR]

Conjugated linoleic acid (CLA) exerts a strong positive influence on human health but intake of these fatty acids is typically too low, and increased consumption of CLA is recommended. A good way to raise the CLA content in the diet without a radical change in eating habits seems to be the enrichment of commonly consumed food products with CLA supplements. This study analyzed the total fatty acid content and the CLA isomer composition of 6 commercially available CLA-fortified dairy products during processing and 10 wk of refrigerated storage. Research was carried out by combining gas chromatography and silver-ion HPLC. The tested samples were a CLA oil supplement, and several skim milk dairy products fortified with the supplement (milk, milk powder, fermented milk, yogurt, fresh cheese, and milk-juice blend). The CLA oil supplement was added such that the consumer received 2.4 g/d of CLA by consuming 2 servings. The predominant isomers present, C18:2 cis-9, trans-11 CLA and C18:2 cis-10, trans-12 CLA, were in at a similar ratio, which ranged from 0.97 to 1.05. These major isomers were not significantly affected by processing but a decrease in total CLA in fresh cheese samples was detected after 10 wk of refrigerated storage. Refrigerated storage and thermal treatment resulted in significant decreases or disappearance of some of the minor CLA isomers and a significant increase of trans, trans isomers from both cis, trans, trans, cis, and cis, cis isomers especially in CLA-fortified milk powder but also in fermented milk, yogurt, and milk-juice blend. [ABSTRACT FROM AUTHOR]

Highlights the Fourth International Meeting on Bone Diagenesis which took place in Teruel, Spain in May 2000. Organizers of the meeting; Panel members.

Classification of patients according to their risk of poor outcomes in Clostridioides difficile infection (CDI) would enable implementation of costly new treatment options in a subset of patients at higher risk of poor outcome. In a previous study, we found that low toxin B amplification cycle thresholds (C t) were independently associated with poor outcome CDI. Our objective was to perform a multicentre external validation of a PCR-toxin B C t as a marker of poor outcome CDI. We carried out a multicentre study (14 hospitals) in which the characteristics and outcome of patients with CDI were evaluated. A subanalysis of the results of the amplification curve of real-time PCR gene toxin B (XpertTM C. difficile) was performed. A total of 223 patients were included. The median age was 73.0 years, 50.2% were female, and the median Charlson index was 3.0. The comparison of poor outcome and non–poor outcome CDI episodes revealed, respectively, the following results: median age (years), 77.0 vs 72.0 (p = 0.009); patients from nursing homes, 24.4% vs 10.8% (p = 0.039); median leukocytes (cells/μl), 10,740.0 vs 8795.0 (p = 0.026); and median PCR-toxin B C t , 23.3 vs 25.4 (p = 0.004). Multivariate analysis showed that a PCR-toxin B C t cut-off <23.5 was significantly and independently associated with poor outcome CDI (p = 0.002; OR, 3.371; 95%CI, 1.565–7.264). This variable correctly classified 68.5% of patients. The use of this microbiological marker could facilitate early selection of patients who are at higher risk of poor outcome and are more likely to benefit from newer and more costly therapeutic options. • Patients with poor outcome CDI presented lower PCR toxin B amplification C t • When cut-off (<23.5C t) was applied we found independent association with poor outcome • We successfully stratified nearly 70% of patients with poor outcome CDI [ABSTRACT FROM AUTHOR]

We evaluated the in vitro activities of ofloxacin, levofloxacin, grepafloxacin, trovafloxacin and ciprofloxacin against Clostridium difficile. The MIC(90) was 128 mg/L for ofloxacin and levofloxacin, 64 mg/L for ciprofloxacin, 16 mg/L for grepafloxacin and 8 mg/L for trovafloxacin. Thirty per cent of isolates were resistant to trovafloxacin, and rates of resistance to ofloxacin, levofloxacin, grepafloxacin and ciprofloxacin were considerably higher. None of the antimicrobials studied would be a reliable therapeutic option against C. difficile. Whether some of the new fluoroquinolones can induce C. difficile-associated diarrhoea remains to be answered. [ABSTRACT FROM AUTHOR]

We compared the performance of the new chromogenic medium ChromID C. difficile with that of CLO agar. ChromID C. difficile agar is a sensitive medium that can accelerate the presumptive identification of C. difficile , however ribotype 023 might go undetected when using this chromogenic medium. [ABSTRACT FROM AUTHOR]

A correction to the article "In vitro activity of surotomycin against contemporary clinical isolates of toxigenic Clostridium difficile strains obtained in Spain," by E. Reigada and colleagues published in a 2015 issue of the journal is presented.

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Reports on the registration of "Juchi F2000" wheat cultivar in the U.S. Description of the cultivar; Grain yield and performance; Growth habit.

Introducción. La satisfacción de usuarios a los sistemas de salud es una prioridad en el ámbito de la salud pública, elevar la calidad de atención con eficiencia y calidez es un reto en las Unidades de Cuidado Intensivo Neonatal. Estos indicadores de calidad no se conocen con exactitud en la región centro-occidente de México y en nuestra terapia UCINEX. Objetivo: determinar el índice de satisfacción de los usuarios externos en la UCINEX. Material y métodos. Mediante el método de encuesta directa y entrevista se practicó por el departamento de trabajo social de nuestra terapia un estudio descriptivo y prospectivo, longitudinal a la totalidad de familiares directos de neonatos ingresados a la UCINEX, del período de agosto a octubre de 2004. Las variables a determinar fueron: con relación a la atención, trato, respeto, información del diagnóstico, consentimiento validado de información, confidencialidad, atención médica, de enfermería, de intendencia y otros. El procesamiento de datos fue en hoja electrónica con el programa epi info 6 y se utilizó únicamente estadísticas descriptivas. Resultados. Se encontró el índice de satisfacción al egreso del bebé en 58 (96%) altamente satisfactorio; en lo que respecta a los siguientes rubros confidencialidad, trato digno y respetuoso, información, validada, confidencialidad 59 (98%) reportaron altos indicadores de calidad. En la evaluación general, de 60 familiares de pacientes ingresados en la UCINEX, 100% respondieron haber recibido un servicio de alta calidad. Conclusiones. Los resultados del presente estudio revelan que el índice de satisfacción del usuario en la UCINEX HCG FA, presentó calificaciones máximas en las evaluaciones; debido a que estos usuarios pertenecen al grupo de extrema pobreza es muy probable que exista un sesgo en la apreciación de estos indicadores, y pueden ser susceptibles de mejorar de acuerdo a la cruzada nacional de la calidad de atención médica. Las acciones que proponemos son elevar el nivel educacional en el personal que trabaja. [ABSTRACT FROM AUTHOR]

Introducción. El parto fortuito se define como aquel que sucede de manera casual, o imprevista y que acontece fuera de las condiciones óptimas para el binomio madre e hijo, por lo que consideramos conveniente el estudio de estos neonatos y determinar su comportamiento clínico y sociodemográfico en la región centro occidente de México. Material y métodos. Se ingresaron como sujetos de estudio a todos los recién nacidos de manera fortuita que fueron remitidos a la unidad del 1 de enero de 1995 al 31 de diciembre de 2003. Resultados. Se evaluaron 4 750 expedientes de pacientes internados, de los cuales 570 (12%) fueron neonatos nacidos por parto fortuito, siendo la tercera causa de ingreso; de éstos, 308 (54%) fueron del sexo femenino, y 262 (46%) del masculino; 387 (68%) fueron hijos de madres multíparas; el promedio de estancia hospitalaria fue de 3.1 días; los diagnósticos de egreso fueron: recién nacido sano 450 (79%), sepsis neonatal 23 (4%), ictericia 57 (10%), neumonía 17 (3%), alteraciones metabólicas 17 (3%), otros 14 (2%); 359 (63%) procedían de la zona metropolitana, 211 (31%) del interior del estado, y 34 (6%) de otros estados; el lugar del nacimiento fue en alguna parte de casa en 114 (20%), baño 51 (9%), taza del baño 29 (5%), en el automóvil 125 (22%), vía pública 56 (10%), al ingresar al hospital 103 (18%), en ambulancia 40 (7%), sitios no especificados 51 (9%). Conclusiones. El parto fortuito es un evento obstétrico fisiológico que manifiesta la naturaleza misma del nacimiento sin la intervención del personal especialmente entrenado y capacitado para mejorar la calidad de atención en los neonatos. En nuestro estudio observamos que 78% de los niños que nacen de manera fortuita no presentan complicación alguna, evidenciándonos la normalidad de este proceso fisiológico. [ABSTRACT FROM AUTHOR]