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Mycoplasma pneumoniae is a bacterium that lacks a cell wall. It produces infections all It produces infections world-wide, in epidemic outbreaks every 4-7 years, or endemically. Its clinical manifestations occur mostly in the respiratory tract and it is a common cause of atypical pneumonia. The treatment is with macrolides, tetracyclines or fluoroquinolones. Since 2000, an increase in resistance to macrolides has been detected worldwide, being more frequent in Asia. In Europe the frequency of resistance ranges between 1% and 25%, depending on the country. Molecular techniques and serology techniques provides very high sensitivity in diagnostic confirmation, being very useful for detecting and controlling M. pneumoniae outbreaks. The detection of resistance to macrolides requires a sequencing technique.

To describe the characteristics of patients diagnosed with Mycoplasma pneumoniae infection.A retrospective study of clinical and epidemiological characteristics of acute infections by M. pneumoniae confirmed by PCR was carried out in the Navarra Health Service (Spain) in 2014-2018.M. pneumoniae infection was confirmed in 9.5% of analyzed patients. Among 123 confirmed cases, 65% were 5-14 years old, 21.1%lt;5 years old, and 13.8% were ≥14 years old. Pneumonia was radiologically confirmed in 83.7% of cases, and 22.0% presented extra-respiratory manifestations. A total of 44.7% of cases required hospitalization. Bilateral pneumonia, asthmatic crisis and extra-respiratory manifestations were associated to higher risk of hospitalization (81.3, 72.2 and 66.7%, respectively). Microbiological targeted treatment was monotherapy with macrolides in 60.2% of cases and combined with other antibiotics in 13.0%.M. pneumoniae was the cause of acute respiratory infection affecting mainly to children younger than 14 years old and frequently required hospitalization.

Summary Background Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. Methods 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). Findings Seroprevalence was 5·0% (95% CI 4·7–5·4) by the point-of-care test and 4·6% (4·3–5·0) by immunoassay, with a specificity–sensitivity range of 3·7% (3·3–4·0; both tests positive) to 6·2% (5·8–6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (10%) and lower in coastal areas (

Resumen El medio ambiente hospitalario raramente esta implicado en la transmision de infecciones salvo en pacientes inmunodeprimidos. Algunos autores no recomiendan los cultivos ambientales porque son caros y laboriosos y no deben utilizarse como sustitutos de controles de calidad y practicas adecuadas en los procesos de desinfeccion y mantenimiento de instalaciones. No se recomiendan cultivos de vigilancia sistematicos salvo en situaciones en que las muestras tengan importancia epidemiologica y los resultados puedan aplicarse para adoptar medidas de control de infeccion. La incidencia de infecciones nosocomiales puede minimizarse mediante un adecuado mantenimiento de dispositivos como la desinfeccion de endoscopios, la calidad del agua de dialisis o los sistemas de ventilacion de quirofanos y unidades de aislamiento protector. En este articulo se revisan las indicaciones y los procedimientos de los cultivos de vigilancia para prevenir infecciones en unidades de inmunodeprimidos y quirofanos, dialisis y unidades de desinfeccion de endoscopios y brotes de infeccion nosocomial.

The environmental microbiological control is necessary to prevent infections associated with certain procedures that are performed at the hospital. In this review the procedures for control of water and dialysis fluids, and air in operating rooms and immunocompromised units are addressed. The dialysis quality management guidelines define the highest levels of chemical, microbiological and endotoxin in purified water and dialysis fluids based on the recommendations of scientific societies. The microbiological control of water and dialysis fluids should include detection of microorganisms and endotoxin levels. Regarding the microbiological air sampling of operating rooms and immunocompromised units the types of clean rooms in which is recommended to perform microbiological air monitoring; the sample collection methods; culture media; incubation conditions; the most common microorganisms, and permissible levels depending on the type of surgery are described.

Introduccion La bacteriemia por Enterococcus haadquirido un papel relevante en los ultimos anos, principalmente debido al aumento del numero de casos intrahospitalarios. Metodos Estudio retrospectivo de historias clinicas de los pacientes diagnosticados de bacteriemia por enterococo e ingresados en el hospital durante un periodo de 12 anos (enero 1994-abril 2006), analizando sus caracteristicas epidemiologicas, clinicas y microbiologicas, asi como la evolucion y los factores pronosticos de la enfermedad. Resultados Se registraron 182 episodios de bacteriemia, el 68% de los cuales fueron de origen nosocomial, lo que represento el 5% de las bacteriemias intrahospitalarias durante ese periodo. Las localizaciones mas frecuentes de la infeccion fueron la urinaria (29%), la cardiovascular (25%), la intraabdominal (21%) y la bacteriemia primaria (12%). El 85% de los pacientes presentaron comorbilidad asociada, especialmente enfermedades neoplasicas (33%). El Enterococcus faecalis fue el responsable del 70% de los casos; E. faecium , del 22%, y otras especies de enterococo, del 8%. El 20% de las bacteriemias eran polimicrobianas. Se encontraron un 23% de cepas con resistencia a antibioticos: 14% a ampicilina, 8% a gentamicina, 3% a ampicilina y gentamicina y 0,5% a vancomicina. La mortalidad global de la serie fue del 31%. La presencia de comorbilidad y la bacteriemia polimicrobiana fueron factores de mal pronostico. Conclusion En nuestro hospital, el enterococo constituye el quinto patogeno mas frecuente de bacteriemia intrahospitalaria, y destaca la elevada incidencia de E. faecium , resistente a ampicilina en mas de la mitad de los casos.

The inanimate hospital environment is rarely implicated in infection transmission, except among vulnerable patients. Some authors argue against the use of environmental surveillance cultures because the tests can be expensive and time consuming, and because they should not be used instead of quality control and good practices in disinfection and maintenance procedures. Routine environmental sampling is not usually advised, except in situations where sampling is directed by epidemiologic principles, and results can be applied to adopt infection control measures. The incidence of health-care associated infections can be minimised by appropriate maintenance of medical equipment such as endoscope cleaning and disinfection, adherence to water-quality standards for haemodialysis, and to ventilation standards for specialised care environments such as isolation units, or operating rooms. This paper reviews the current knowledge on surveillance cultures in these settings in order to prevent iatrogenic infections in operating and isolation rooms, haemodialysis and endoscope reprocessing units, and cultures related to nosocomial infection outbreaks.

Enterococcal bloodstream infections have acquired considerable importance in recent years, mainly because of the increasing number of cases that occur during hospital admission.Retrospective study of the clinical records of patients diagnosed with enterococcal bacteremia and hospitalized over a 12-year period (January 1994-April 2006), analyzing epidemiological, clinical and microbiological characteristics, outcome and prognostic factors.A total of 182 episodes of bacteremia were recorded; 68% of them were nosocomial infections, accounting for 5% of the in-hospital bacteremia episodes in this period. The most frequent sources of infection were urinary tract (29%), cardiovascular (25%), intra-abdominal (21%) and primary bacteremia (12%). Associated comorbid conditions were present in 85% of patients, mainly neoplasms (33%). Enterococcus faecalis was responsible for 70% of cases, E. faecium 22%, and other species of enterococci 8%. Twenty percent were polymicrobial bacteremia. Antibiotic resistance was documented in 23% of the strains: 14% ampicillin, 8% gentamicin, 3% ampicillin and gentamicin, and 0.5% vancomycin. Overall mortality was 31%. Polymicrobial bacteremia and comorbidity were associated with a poor prognosis.In our hospital, Enterococcus is the fifth most frequent cause of nosocomial bacteremia. E. faecium is characterized by a high incidence (more than 50% of cases) of ampicillin resistance.