Positive-pressure needleless connectors did not increase rates of catheter hub colonization respecting the use of neutral-pressure needleless connectors in a prospective randomized trial.

Introduction: The aim of this study was to compare the colonization rates of central venous catheter (CVC) and arterial catheter (ArtC) hubs fitted with two types of needleless connectors (NCs).

Methods: We designed a prospective randomized study to compare rates of catheter hub colonization of CVC and ArtC hubs fitted with two types of needleless connectors: neutral-pressure NCs (NP-NCs) and positive-pressure NCs (PP-NCs) in critically ill patients. All NCs were replaced every 7 days of use.

Molecular characterization of OXA-48 carbapenemase-producing Klebsiella pneumoniae strains after a carbapenem resistance increase in Catalonia.

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.

Serotypes and Clonal Diversity of Streptococcus pneumoniae Causing Invasive Disease in the Era of PCV13 in Catalonia, Spain.

The aim of this study was to study the serotypes and clonal diversity of pneumococci causing invasive pneumococcal disease in Catalonia, Spain, in the era of 13-valent pneumococcal conjugate vaccine (PCV13). In our region, this vaccine is only available in the private market and it is estimated a PCV13 vaccine coverage around 55% in children. A total of 1551 pneumococcal invasive isolates received between 2010 and 2013 in the Molecular Microbiology Department at Hospital Sant Joan de Déu, Barcelona, were included.

Mortality among methicillin-resistant Staphylococcus aureus carriers in long-term care facilities.

Introduction: Little is known about the natural course of patients with chronic stable illnesses colonized with methicillin-resistant Staphylococcus aureus (MRSA). The aim is to determine the impact of MRSA colonization in mortality among long-term health care facility (LTHCF) residents.

Method: A multicenter, prospective, observational study was designed.

Prevalence and risk factors for meticillin-resistant Staphylococcus aureus in an acute care hospital and long-term care facilities located in the same geographic area.

Unlabelled: To determine the prevalence and risk factors (RF) for methicillin-resistant Staphylococcus aureus (MRSA) during stay in 1 acute care hospital (ACH) and 4 long-term care facilities (LTCF). After obtaining the informed consent, nasal and skin ulcer swabs were taken and a survey was conducted to determine RF for MRSA. Six hundred and ninety nine patients were included, 413 LTCF and 286 ACH patients and MRSA prevalence were 22.

High prevalence of genetically-determined mannose binding lectin deficiency in young children with invasive pneumococcal disease.

Susceptibility to invasive pneumococcal disease (IPD) correlates with age, younger children being the group with the highest burden of disease. The relevance of the innate immune response and particularly the role of mannose-binding lectin (MBL) in combating IPD is not well known. This is a 2-year prospective study (February 2011 to March 2013) including patients with IPD who attended two hospitals from Catalonia, Spain.

Microbiological study of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) and the usefulness of analytical and clinical parameters in its identification (VIRAE study).

Purpose: Respiratory infection is the most common cause for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). The aim of this work was to study the etiology of the respiratory infection in order to assess the usefulness of the clinical and analytical parameters used for COPD identification.

Patients And Methods: We included 132 patients over a period of 2 years.

[Peripheral venous catheter-related bacteremia in a general hospital].

Introduction: Catheter sepsis is a constant and serious problem in our hospitals for the cost it generates, both in terms of morbidity and economics. It's becoming more frequent also in peripherally inserted catheters. Our study aims to know the importance and characteristics of peripheral venous catheter bacteremia in a general hospital.

Serotypes and clones causing invasive pneumococcal disease before the use of new conjugate vaccines in Catalonia, Spain.

Objectives: The objective of this study was to learn the serotype distribution and clonal composition of pneumococci causing invasive pneumococcal disease (IPD) in children and adults in Spain before the introduction of new 10-valent (PCV10) and 13-valent (PCV13) conjugate vaccines.

Methods: This is a 1-year prospective study including all patients with culture-proved IPD admitted to 30 medical centers in Catalonia, Spain, during the year 2009.

Results: A total of 614 episodes of IPD occurred in 612 patients.

Safety of positive-pressure valve connectors in arterial catheters inserted into critically ill patients.

Needleless valve connectors were introduced to avoid needlestick injuries in healthcare workers but some concerns exist about their microbiological safety. A randomised controlled trial was performed to assess hub colonisation affecting positive-pressure valve connectors (PPVCs) compared to conventional caps used for radial arterial catheters inserted into critically ill patients. Patients were randomly assigned either to the PPVC (Smartsite Plus positive bolus valve) or to the conventional cap group.

Efficacy of three different valve systems of needle-free closed connectors in avoiding access of microorganisms to endovascular catheters after incorrect handling.

Objective: Disinfectable needle-free closed connectors were designed to avoid needle-stick injuries and to be easily disinfected before handling. Workloads or lack of knowledge, however, could impede the correct handling of these devices, allowing endoluminal catheter colonization. The aim of our study was to assess the barrier effect of different disinfectable needle-free closed connectors during correct and incorrect handling using an experimental model.

[Imported malaria: clinical and epidemiological review of an emerging disease].

Objective: To describe the epidemiology, clinical and laboratory features and outcome of children younger than 15 years with malaria in our hospital.

Material And Methods: A retrospective case review of all children admitted to our hospital with malaria between 1997 and 2005 was performed. The following epidemiological data were analyzed: age, sex, nationality of the child and of the family, country and date of trip, chemoprophylaxis used, clinical features, laboratory parameters (hemogram and biochemistry), type of plasmodium and degree of parasitization, treatment, associated diseases, length of hospital stay, and outcome.

Differences in the etiology of community-acquired pneumonia according to site of care: a population-based study.

Background: A few population-based studies assessing the etiology of community-acquired pneumonia in both hospitalized and ambulatory patients, with special emphasis on the etiologic role of viral infections, have been reported. The purpose of this study was to assess microbiological differences according to initial site of care in patients with community-acquired pneumonia.

Methods: We studied 496 patients > 14 years of age collected from the study samples of three population-based studies carried out in the same geographical area ("Maresme" region in the Mediterranean coast in Barcelona, Spain) with the same methodology over an 8-year period (1987-1995).

Sporadic and epidemic community legionellosis: two faces of the same illness.

The present study compares the risk factors, presentation and outcome of community-acquired Legionella pneumophila pneumonia in 138 sporadic-case patients (1994-2004) and 113 outbreak-case patients (2002) treated in two hospitals in Catalonia (Spain) since urinary antigen assays were adopted. Univariate and multivariate analysis were performed to compare epidemiological and clinical features, blood chemistry values, radiological findings and outcome of sporadic and epidemic legionnaires' disease. Univariate analysis showed that male sex, chronic lung disease, HIV infection and immunosuppressive therapy prevailed in sporadic cases.

A community outbreak of Legionnaires' disease: evidence of a cooling tower as the source.

A community outbreak of Legionella pneumonia in the district of Cerdanyola, Mataró (Catalonia, Spain) was investigated in an epidemiological, environmental and molecular study. Each patient was interviewed to ascertain personal risk-factors and the clinical and epidemiological data. Isolates of Legionella from patients and water samples were subtyped by pulsed-field gel electrophoresis.

Isolation of an amikacin-resistant Escherichia coli strain after tobramycin treatment of previous recurrent episodes of respiratory tract infections caused by Pseudomonas aeruginosa.

Amikacin-resistant Escherichia coli strains are isolated rarely from clinical samples. In the present study, investigation of an amikacin-resistant clinical isolate of E. coli demonstrated the presence of two class 1 integrons carrying the aacA4 gene plus the aacA7 gene, and the dfrA17 gene plus the aadA5 gene, respectively.

Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia.

Study Objective: To assess the usefulness of serum C-reactive protein (CRP) in the diagnosis and treatment approach of patients with community-acquired pneumonia (CAP).

Design: Population-based case-control study.

Setting: A mixed residential-industrial urban area of 74,368 adult inhabitants in the Maresme region (Barcelona, Spain).

Resistance to the migration of microorganisms of a needle-free disinfectable connector.

The aim of this study was to assess the efficacy of a disinfectable needle-free connector in reducing the pass of micro-organisms to the lumen of the catheter. A prospective, controlled, experimental trial was performed in which a laboratory model simulated the insertion of a peripheral venous catheter. Catheters inserted in sterile conditions in a hemoculture bottle were closed with the disinfectable needle-free connector (study group) or with a cap (control group).

Molecular characterization of ciprofloxacin resistance of gonococcal strains in Spain.

Background: Over the past several years, the emergence of gonococcal isolates with intermediate or full resistance to fluoroquinolones has become a significant concern in several countries, including Spain.

Goal: The goal was to determine the occurrence of ciprofloxacin resistance among Neisseria gonorrhoeae strains in Spain during 2000 to 2001 and determine the frequency and patterns of mutations at gyrA, gyrB, and parC genes in these isolates.

Study Design: Eleven ciprofloxacin-resistant strains (with MICs ranging from 1 to 64 micrograms/mL) and two intermediate isolates (with MICs of 0.

[Imported hookworm infection in African immigrants in Spain: study of 285 patients].

Background And Objective: Hookworm infection is a worldwide intestinal parasitic disease affecting more than one billion people. It represents an important public health problem in rural areas of developing countries. In our environment, it is generally considered an imported disease due to the immigration process.

[Imported diseases in African immigrants in Spain: study of 1,321 patients].

Background: Immigrants can carry diseases characteristic from their countries of origin. These are known as imported diseases (ID) and can be classified into tropical diseases (TD) or cosmopolitan diseases (CD). The aim of this study was to analyse the ID in African immigrants and evaluate their repercussion in the Spanish Public Health.

Comparative, clinico-epidemiologic study of Schistosoma mansoni infections in travellers and immigrants in Spain.

The study presented here aimed to contrast the marked clinical differences in the presentation of Schistosoma mansoni-induced infection between immigrants and travellers entering Spain from endemic regions, and to elucidate the therapeutic implications of these infections. A total of 200 African immigrants and 80 travellers with schistosomiasis were included in the study. Among the immigrants, 25 patients were diagnosed with Schistosoma mansoni infection; 15 presented with nonspecific symptoms, and 10 were asymptomatic.

Epidemiology of community-acquired pneumonia in adults: a population-based study.

In this prospective study, the authors assessed the incidence, aetiology, and outcome of patients with community-acquired pneumonia in the general population. From December 1993 to November 1995, a study was performed in a mixed residential-industrial urban population of the "Maresme" region in Barcelona, Spain. All subjects > or =14 yrs of age (annual average population size 74,368 inhabitants) with clinically suspected community-acquired pneumonia were registered.