Case-control study of Clostridioides difficile in a rural health care area.

Objective: To determine the risk and prognostic factors for Clostridioides difficile infection (CDI).

Patients And Methods: Prospective, case-control study with 61 cases and 64 controls, aged ≥2 years with diarrhoea, carried out in Castilla-La Mancha Health Care Area for 14 months. The diagnosis was made by immunochromatography technics (glutamate dehydrogenase and toxin A/B), confirming discordant cases by isothermal amplification.

Association between antibiotic pressure and the risk of colonization/infection by multidrug-resistant Acinetobacter baumannii complex: a time series analysis.

Objective: To analyze the association between antibiotic pressure and the risk of colonization/infection by Acinetobacter baumannii complex (AB), evaluating both the individual and general prescriptions of antibiotics.

Methods: This is an analytical, observational, case-control study on patients admitted to an Intensive Care Unit (ICU) during an AB outbreak (14 months). A five-year time series was constructed with the monthly incidence of cases of infection/colonization with strains of AB resistant to each antibiotic administered and with the monthly consumption of these antibiotics in the ICU.

Interhospital dissemination of KPC-3 producing-Klebsiella pneumoniae ST512. Detection by MALDI-TOF.

Introduction/objective: To describe an outbreak of KPC-3-producing Klebsiella pneumoniae (KPN) and determine the diagnostic efficacy of MALDI-TOF in its detection.

Methods: Retrospective study of the KPC-3-KPN isolated in 2 hospitals in Ciudad Real. The peak at 11,109kDa±15 was sought in the KPN spectra provided by MALDI-TOF.

[Economic evaluation of the Alfred 60/AST device implantation for bacterial growth detection with automatic sewing machine].

Objective: It is becoming increasingly necessary to automatize screening of urine samples to culture at Microbiology laboratories. Our objective was to estimate the budget threshold from which the Alfred 60/AST device would be profitable for our hospital.

Methods: Cost minimization study by decision trees, carried out in a General Hospital.

Approach of clinicians to candiduria and related outcome in the elderly.

Objective: Candiduria is increasingly frequent in hospitalized debilitated patients. We aimed to evaluate the approach of clinicians to candiduria in the oldest old, and its effect on clearance and mortality.

Material And Methods: An observational study without intervention was carried out during 2012 and 2013 in three Spanish hospitals over patients with nosocomial candiduria aged 80 and over.

[Results of the implementation of an Antimicrobial Stewardship Program in the "Gerencia de Atención Integrada" of Alcazar de San Juan (Castilla La Mancha)].

Objective: Our aim was to evaluate the efficiency of an ASP after its implementation in 2016 in a Spanish hospital quality system.

Methods: Efficiency of the ASP was measured by process and outcome indicators at the level of the patient's quality of life, antimicrobial consumption and percentage of resistance to them during the 2016-2017 period. In 2017, the failures mode and effects analysis (FMEA) methodology was applied.

[Monoclonal spread of multi-drug resistant CTX-M-15-producing Klebsiella pneumoniae. Impact of measures to control the outbreak].

Objective: To describe an outbreak of multi-drug resistant extended-spectrum β-lactamases-producing Klebsiella pneumoniae (MDR-ESBL-KPN) and the impact of measures for its control.

Methods: We reviewed the patients´ clinical records with MDR-ESBL-KPN isolation during 2013-2016 with resistance to fluoroquinolones, aminoglycosides, fosfomycin, and nitrofurantoin; susceptible to imipenem, meropenem, colistin, and tigecycline and variable to ertapenem and cotrimoxazole (Vitek-2). The genetic relationship between 35 isolates was established by PFGE and MLST.

[Clinical significance and risk factors for multidrug resistant Enterobacteriaceae colonization].

Objective: To identify the main risk factors of rectal colonization by multidrug resistant Enterobacteriaceae (MRE), and their clinical impact.

Methods: An observational, prospective cohort study was carried out, between April 2016 and June 2017, where every Monday of each week rectal samples were taken from all the patients admitted at that moment in the Intensive Care Unit. We performed a descriptive analysis of all the variables collected during the study and a multivariate logistic regression analysis to determine the independent association of carriers of MRE against non-carriers and several possible risk factors.

Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models.

Introduction: We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics.

Methods: A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012.

Nosocomial Candiduria in the Elderly: Microbiological Diagnosis.

Candiduria is associated with high morbidity, mortality, and long hospitalization, involving high costs for the healthcare system. The use of increasingly aggressive treatments has prolonged the lives of patients susceptible to candiduria, namely the immunosuppressed, the premature, and the elderly. Our objective was to evaluate the incidence of nosocomial candiduria and the implicated species in hospitalized patients aged over 80 years old from three Spanish centers during 2012 and 2013.

Cost-effectiveness study of the microbiological diagnosis of tuberculosis using geneXpert MTB/RIF.

Introduction/objective: To perform a cost-effectiveness analysis of a molecular biology technique for the diagnosis of tuberculosis compared to the classical diagnostic alternative.

Methods: A cost-effectiveness analysis was performed to evaluate the theoretical implementation of a molecular biology method including two alternative techniques for early detection of Mycobacterium tuberculosis Complex, and resistance to rifampicin (alternative1: one determination in selected patients; alternative2: two determinations in all the patients). Both alternatives were compared with the usual procedure for microbiological diagnosis of tuberculosis (staining and microbiological culture), and was accomplished on 1,972 patients in the period in 2008-2012.

[Endogenous endophthalmitis: case report and brief review of a serious ocular disease].

Introduction: Endogenous endophthalmitis (EE) is a prevalent but serious disease. Our aim was to describe cases of EE, with emphasis in the risk factors and the improvement of the prognosis.

Methods: A review of EE cases was done between 1996-2011 in a secondary care hospital in Spain.

[Economic impact of the introduction of a technique for early detection of Mycobacterium tuberculosis Complex in clinical samples in a Spanish hospital].

Background: Tuberculosis (TB) remains an important public health problem worldwide. Our objective was to estimate the economic and health care impact of the introduction of an early diagnosis tecnique of TB, the Xpert MTB/RIF® assay (Xpert).

Methods: The savings was estimated on the basis of reduction in the time of TB hospitalization at avoid the false-negative (FN) and false-positive (FP) TB cases diagnosed by auramine staining that could have been detected by Xpert between 2008-2012 in our hospital.

[Pneumonia by Corynebacterium pseudodiphteriticum: an infection to consider].

Corynebacterium pseudodiphteriticum has been considered a very infrequent respiratory pathogen. We report three cases of pneumonia due to C. pseudodiphteriticum, describing their clinical and microbiological features.