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Biomedical subjects

E Perez-Trallero

Publications and source records attributed to E Perez-Trallero.

At least 19 recordsLinked to original sources

Gipuzkoa, Basque Country, Spain (1984-2004): a hyperendemic area of Q fever.

Overall 1,261 cases of Q fever were diagnosed between 1984 and 2004 in Gipuzkoa (Basque Country, Spain). Most (75.5%) of the cases ocurred in subjects 15-45 years of age. A total of 79.5% of the cases (n = 1003) ocurred between January and June. The annual incidence for acute Q fever in Gipuzkoa was 7.7, 15.8, 9.6, and 5.7 for the periods 1984-1989, 1990-1994, 1995-1999, and 2000-2004, respectively. In 94% of the cases IgM titer was >/=1/256. The most frequent clinical manifestation was pneumonia (79%). Only two cases of chronic Q fever were detected during the 21 years studied.

Adolescent↗

Dissemination of emm28 erythromycin-, clindamycin- and bacitracin-resistant Streptococcus pyogenes in Spain.

Reported here is an unusual cluster of non-invasive infections caused by an emm28 Streptococcus pyogenes strain resistant to bacitracin, erythromycin and clindamycin detected in Santander, Spain. Since one of the characteristics of group A streptococci is their almost uniform susceptibility to bacitracin, this finding was unusual, and a search for bacitracin-resistant Streptococcus pyogenes strains was conducted in two other distant cities of Spain (Madrid and San Sebastián) where their presence was confirmed. These strains were frequently associated with erythromycin- and clindamycin-resistance, and most of them belonged to a unique emm28 T28, ST52 clone.

Bacitracin↗

Hospitalization for respiratory syncytial virus in the paediatric population in Spain.

The aim of this population-based retrospective study was to determine the incidence of hospitalization for community-acquired, laboratory-confirmed respiratory syncytial virus (RSV) infection in an unselected paediatric population from southern Europe. The study was performed in an area with 15,700 children aged less than 5 years attended by a single hospital. The presence of RSV in nasopharyngeal aspirates from children with acute respiratory infection treated in the hospital was investigated in four seasons (July 1996-June 2000). A total of 390 episodes of hospitalization for RSV infection were detected and 83.3% of the children were aged less than 1 year old. The annual hospitalization rate was 37/1000 for infants aged less than 6 months and 25/1000 for those aged less than 1 year. During the study period, 2.5% of the infants younger than 1 year and approximately 5% of those younger than 3 months were hospitalized for RSV infection. The mean length of hospital stay was 5.9 days. Seven per cent of the patients required admission to the intensive care unit and more than half of these children were aged less than 1 month. In Spain, community-acquired RSV infection is a highly frequent cause of hospitalization in young children, especially in those aged less than 1 year. Prevention of RSV infection, through the development of vaccines and/or other strategies, should be a public health priority.

Child, Preschool↗

CMY-2-producing Salmonella enterica, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis and Escherichia coli strains isolated in Spain (October 1999-December 2000).

CMY-2 plasmid-mediated AmpC beta-lactamase (CMY-2) was detected in 21 isolates from two hospitals located in different geographical regions of Spain between October 1999 and December 2000. The isolates comprised two Salmonella enterica serovars (Mikawasima and Montevideo), 16 Escherichia coli, one Klebsiella pneumoniae, one Klebsiella oxytoca and one Proteus mirabilis. In addition to the expected resistance to beta-lactams, including extended-spectrum cephalosporins and cefoxitin, all isolates showed a broad spectrum of associated resistance. All were resistant to sulfamethoxazole, chloramphenicol, tetracycline and streptomycin, and all but two were also resistant to gentamicin. Five isolates were studied in detail and all transferred CMY-2 and other resistance determinants by conjugation. Genomic DNA restriction pattern analysis of the E. coli isolates excluded the dissemination of a single clone. To the best of our knowledge this is the first time that CMY-2 has been detected in P. mirabilis, K. oxytoca and S. enterica serovars Mikawasima and Montevideo. It is also the first time that CMY-2 has been described in Spain.

Anti-Bacterial Agents↗

Emergence of Streptococcus pyogenes strains resistant to erythromycin in Gipuzkoa, Spain.

The aim of this study was to determine the evolution of resistance to macrolides and other antibiotics in strains of Streptococcus pyogenes isolated in the province of Gipuzkoa, Spain. During the period 1984-1996, all 2561 strains of Streptococcus pyogenes studied showed full susceptibility to penicillin. Until 1990, only 1.2% of Streptococcus pyogenes isolates were resistant to erythromycin. Since then, resistance to erythromycin increased every year until 1995, when 34.8% (87/250) of Streptococcus pyogenes strains were found to be resistant. In 1996 the rate of resistance to erythromycin was 17.8% (75/422). During the study period, 96.1% (246/256) of the Streptococcus pyogenes isolates resistant to erythromycin were susceptible to clindamycin. Of the remaining erythromycin-resistant Streptococcus pyogenes strains, resistance to clindamycin was constitutive in seven strains and inducible in three. When investigated by the polymerase chain reaction (PCR), all Streptococcus pyogenes strains resistant to erythromycin and susceptible to clindamycin showed the 1.4 kb fragment of the mefA gene, recently described as the novel macrolide-efflux-resistance determinant. The most frequent T-agglutination patterns among Streptococcus pyogenes resistant to erythromycin were T4 and T8,25. The emergence and rapid spread of erythromycin-resistant Streptococcus pyogenes in Gipuzkoa and its relationship to the presence of the mefA gene are described.

Agglutination↗

Erythromycin resistance of Streptococcus pyogenes in Madrid.

BACKGROUND: Erythromycin is considered to be an adequate alternative to penicillin for patients who are allergic to penicillin. Erythromycin-resistant Streptococcus pyogenes strains have been reported in some parts of the world. METHOD: The in vitro activity of erythromycin and other antimicrobial agents was determined in a total of 1310 clinical Streptococcus pyogenes isolates collected in the city of Madrid from January, 1993, through December, 1996. RESULTS: All strains showed susceptibility to penicillin, rifampin, vancomycin and chloramphenicol. Tetracycline resistance was 8.5%. In 36 of the strains (2.7%) MIC was 4 microg/ml for ofloxacin. Clindamycin resistance was observed in only 18 strains (1.4%); this resistance was constitutive in 15 and inducible in 3 strains. Resistance to erythromycin was observed in 14.3% of the strains, showing an increase during the study period (2.0% in 1993 vs. 22.4% in 1996; chi square for linear trend 68.8, P < 0,0001); >90% of them showed the novel resistance phenotype described by Seppälä et al. and 32 of 32 of these strains showed by PCR the 1.4-kb fragment of the mefA gene recently described as the novel macrolide efflux resistance determinant. The erythromycin-resistant strains were isolated more often in pediatric patients (144 of 872) than in adults (44 of 438) (chi square 9.9, P = 0.0016). CONCLUSION: The study emphasizes the need to screen for resistance to macrolides in S. pyogenes and indicates that resistance to erythromycin in S. pyogenes has increased significantly in Madrid.

Adolescent↗

Genotyping of hepatitis C virus isolates from Basque Country, Spain.

The genotype of HCV was determined in 161 chronic HCV-infected patients. The patients were classified into three groups on the basis of the origin of the HCV infection: 50 patients had a history of intravenous drug use (IVDU) but no HIV infection; 41 patients had received blood transfusions, and 70 patients had no known exposure. The distribution of HCV genotypes was associated with the origin of infection and age of patients: genotype 1b was predominant among patients who had received blood transfusions and those without evidence of parenteral exposure (84.6% and 67.7%, respectively), whereas genotype 3a was present in 65.3% of IVDUs. Patients with genotype 1b were older than those with genotypes 1a or 3a: 50.3 +/- 12 vs. 34.1 +/- 9.9 and 31 +/- 5.4 years, respectively. These findings suggest that the pattern of HCV genotypes in our region is changing and that genotype 1b may be substituted by 3a as the dominant genotype in the future.

Adult↗

Non-endoscopic method to obtain Helicobacter pylori for culture.

A sampling method to collect samples for Helicobacter pylori culture that is easier than endoscopy would be useful. We used a capsule attached to a highly absorbent nylon string, which is swallowed to obtain gastric secretions. Antral biopsy and string specimens, sequentially obtained from 36 adults with clinically suspected ulcer or gastric disease were cultured. 9 (25%) patients were negative in both tests; 18 (50%) were positive by both methods; 6 (17%) were biopsy positive and string-test negative; and 3 (8%) were biopsy negative and string-test positive. The new test is useful, simple, and causes little discomfort.

Adult↗

Anti-tetanus toxin titers in sera of the women who gave births in 1985 and 1989 in Gipuzkoa (Basque Country, Spain).

14.9% (208/1400) of the women who gave births in 1985 and 1989 in Gipuzkoa (Basque Country, Spain), was considered to have 'protective' levels (> or = 0.01 IU/ml) of tetanus antitoxin as measured by the passive haemagglutination test. Prevalence of protective antibodies was correlated to the years when women were born: 54.7% (64/117) of those born after 1965 were considered to have 'protective' levels (> or = 0.01 IU/ml) of tetanus antitoxin in contrast to those born before 1956 [only 6.2% (21/338)]. This is considered to be due to the infant immunization campaign introduced in 1965 in the Basque Country. Thus, we conclude that the tetanus immunization campaigns in the Basque Country adult population is urgent.

Adolescent↗

Prevalence of hepatitis A antibody among disadvantaged gypsy children in northern Spain.

The prevalence of antibody to hepatitis A virus (HAV) in a group of socially and economically disadvantaged Spanish gypsy children was compared to that of a group of non-gypsy middle-class children. The study included 438 children, 73 gypsies (38 girls and 35 boys, mean age 8.5 years, age range 2-16 years) and 365 non-gypsy controls, randomly selected by age. The presence of anti-HAV was investigated using ELISA. Among the gypsy children, 82% had antibodies to HAV compared with 9.3% of the children in the control group. The unfavourable living conditions of the gypsy population (e.g. homes with poor sanitary conditions, overcrowding) may explain the high prevalence of HAV infection. These findings underline the need for specific action which targets disadvantaged populations.

Adolescent↗

Coxiella burnetii infection in subjects with HIV infection and HIV infection in patients with Q fever.

The objective of the study was to determine whether HIV infection favors the acquisition of Coxiella burnetii infection or increases the frequency of symptomatic Coxiella infections. A total of 754 subjects were tested for Coxiella antibodies: 596 intravenous drug users (IVDUs) (306 HIV-infected IVDUs matched by aged and sex with 291 non-HIV-infected IVDUs), and 157 healthy puerperal women matched to the IVDU women. A total of 520 patients with Q fever were tested for HIV antibodies. The seroprevalence of Coxiella antibodies was similar in the 2 groups of IVDUs (19.3% of HIV + IVDUs vs 22.9% of HIV - IVDUs). Likewise, there was no difference in the prevalence of Coxiella antibodies in the groups of IVDU women and healthy women. Of the 520 subjects with acute Q fever, diagnosed between 1987 and 1992, only 4 (0.77%) had HIV infection. The proportions of HIV-infected subjects in the population of patients, with Q fever, of 20-39 years of age (the age of maximum incidence of both HIV and Coxiella infection in our region), coincided with the estimated proportions of HIV subjects in the respective general populations of the province. In conclusion, infection by Coxiella burnetii was not more frequent among HIV-infected subjects. It is not likely that Coxiella infection produces symptomatic infections more often in HIV-infected subjects.

Adolescent↗

Falling incidence and prevalence of hepatitis A in northern Spain.

The prevalence of hepatitis A virus antibodies was studied using a commercial ELISA method. 2,214 subjects were included, 1,211 in 1992 and 1,003 during 1986-87. In 1992 the seroprevalence rates among subjects 1-9, 10-19, 20-29 and 30-39 years old were 2.4%, 21%, 57.6% and 87.5% respectively, as compared with 7.7%, 37.9%, 80.6% and 98.1% respectively, in a similar group of subjects studied 5 years earlier (p < or = 0.001). The reported number viral hepatitis cases declined from 35.0 per 100,000 people in 1984 to 8.9 per 100,000 in 1992. Concurrently, the age when contracting the disease rose. The mean age for patients acquiring hepatitis A was 15.5 in 1986-88 and 20.1 in 1991-92. The decline in incidence and prevalence of HAV infection indicates a progressive and continuous decrease in HAV circulation in this geographical area.

Adolescent↗