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Resumen Introduccion El sarampion es una infeccion casi erradicada que en los ultimos anos esta reemergiendo en Espana y en Europa. El objetivo del estudio fue describir las caracteristicas microbiologicas y clinico-epidemiologicas de un brote de sarampion ocurrido en la provincia de Guadalajara de junio a agosto de 2012. Metodos Estudio descriptivo y retrospectivo. Se analizaron 117 muestras (suero, orina y exudado faringeo) de 52 casos sospechosos de sarampion. Resultados Se confirmaron 50 casos de sarampion, 41 por laboratorio y 9 por vinculo epidemiologico, agrupados en 4 brotes comunitarios. No se observaron casos importados. La IgM y la PCR fueron positivas en 25 pacientes, solo PCR en 11 y solo IgM en 5. El genotipo fue D4 en 13/14 cepas y genotipo A en un caso posvacunal. Los grupos de edades mas afectados fueron adultos entre 20 y 34 anos (38%) y menores de 15 meses (26%). El 88% de pacientes no estaban vacunados (43% etnia gitana, 27% menores de 15 meses, 11% razones ideologicas), y el 6% habia recibido una dosis. La clinica fue exantema y fiebre (100%), tos (82%) y conjuntivitis (50%). El 32% requirio hospitalizacion y el 28% presento complicaciones. Conclusion Es de especial importancia intensificar la vigilancia epidemiologica en infecciones en fase de eliminacion. El aumento de la incidencia de sarampion estuvo asociado a bolsas de no vacunados que representan un desafio para la salud publica, que debera elaborar estrategias para conseguir una elevada cobertura vacunal y alcanzar la erradicacion del sarampion.

Measles is a viral infection that was almost eradicated, but it is re-emerging in Spain and Europe in recent years. The aim of this study was to describe the microbiological, clinical and epidemiological characteristics of a measles outbreak that occurred in Guadalajara (Spain) from June to August 2012.A descriptive and retrospective study was conducted. A total of 117 samples (including serum, urine and pharyngeal swabs) from 52 patients were analyzed for measles.Measles was diagnosed in 50 patients, 41 of them by microbiological diagnosis, and 9 by epidemiological link. The patients were grouped in four community outbreaks. No imported cases were observed. Positive IgM and positive CRP were detected in 25 patients, positive CRP only in 11 and positive IgM only in 5. The genotype D4 was identified in 13 patients and the genotype A in a post-vaccine case. The age groups most affected were adults between 20-34 years of age (38%) and younger than 15 months (26%). The large majority (86%) of patients were unvaccinated (44% Roma population, 27% younger than 15 months, 11% ideological reasons), 6% had one vaccine dose. The signs/symptoms were: rash and fever, 100%, cough, 82%, and conjunctivitis 50%. Almost one-third (32%) of patients were hospitalized, and 28% had complications.It is very important to intensify the epidemiological surveillance of infections in the elimination phase. The increased incidence of measles was associated to unvaccinated pockets, presenting a challenge for Public Health Centers. These agencies should prepare strategies to obtain a higher vaccine coverage for the eradication of measles.

L'auteur a souhaité limiter l'accès de ce document aux membres de l'Université de Lorraine.; Due to the increase use of carbapenems, resistant bacteria are emerging. In Cuba, carbapenem resistance genes have started to emerge in healthcare facilities, in particular the blaKPC, blaNDM and blaOXA – 23 genes. These genes have been regularly reported in animals worldwide. Thus, we were interested in detecting these genes coding for carbapenemases in swine samples from Cuba. In order to achieve the objective, we implemented a detection method based on PCR, which identified a positive sample as the gene blaOXA – 23. Therefore, the resistance to carbapenems in Cuban animals does not seem to be widespread for the moment. However, monitoring of these carbapenem resistance genes is recommended for future studies.; En raison d’une utilisation accrue des carbapénèmes, les bactéries résistantes émergent. À Cuba, les gènes de résistance aux carbapénèmes ont commencé à émerger dans les milieux hospitaliers, en particulier les gènes blaKPC, blaNDM, et blaOXA – 23. Ces gènes ont également été signalés autour du monde chez les animaux. Nous nous sommes ainsi intéressés à détecter ces gènes codant pour les carbapénémases dans des échantillons de porcs provenant de Cuba. Afin d’atteindre l’objectif de l’étude, nous avons mis en oeuvre une méthode de détection basée sur la PCR, qui a identifié un échantillon positif pour le gène blaOXA – 23. Donc, la résistance aux carbapénèmes chez les animaux cubains ne semble pas être très répandue à l’heure actuelle. Cependant, la surveillance de ces gènes est recommandée pour les futures études.