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Resumen Objetivo Describir un acuerdo entre expertos basado en la evidencia y la experiencia sobre los aspectos mas relevantes del paciente exacerbador con EPOC. Metodos Se siguio la metodologia Delphi. Tras revisar la evidencia por un comite cientifico y 60 expertos, se elaboro un cuestionario con 3 apartados: diagnostico del paciente exacerbador; tratamiento, y proceso asistencial. La encuesta fue respondida online en 2 rondas por 60 neumologos. El grado de acuerdo siguio la escala Likert de 1 (total desacuerdo) a 9 (total acuerdo), definiendose acuerdo y desacuerdo como una puntuacion de 7-9 o 1-3, respectivamente, otorgada por mas de dos tercios de los participantes. Resultados Se incluyeron un total de 48 aseveraciones, una anadida en la segunda ronda. Hubo consenso en 37 (78,7%) tras la primera ronda (acuerdo), y en 43 (89,5%) tras la segunda (42 acuerdo y 1 desacuerdo). Las afirmaciones con mayor proporcion de expertos en el rango de acuerdo se refirieron a que, en el paciente exacerbador, la infeccion bronquial cronica favorece el deterioro de la funcion pulmonar (93,1%), a que no se deben retirar los broncodilatadores de larga duracion (93,1%), a la conveniencia de personalizar el tratamiento si se dan nuevas exacerbaciones pese a un tratamiento broncodilatador optimo (96,6%), o al cuidado y manejo de este paciente, que debe ser coordinado entre atencion primaria y neumologia (93,1%) y controlado en programas integrados especificos multicomponente (94,8%). Conclusiones La informacion proporcionada por este consenso puede facilitar el diagnostico y tratamiento del paciente exacerbador con EPOC en nuestro ambito.

[EN] The application of low ozone dosage to minimize the problems caused by filamentous foaming was evaluated in two bioreactors of an urban wastewater treatment plant. Filamentous and nitrifying bacteria, as well as protist and metazoa, were monitored throughout a one-year period by FISH and conventional microscopy to examine the effects of ozone application on these specific groups of microorganisms. Multivariate data analysis was used to determine if the ozone dosage was a key factor determining the low carbon and nitrogen removal efficiencies observed throughout the study period, as well as to evaluate its impact on the biological communities monitored. The results of this study suggested that ozonation did not significantly affect the COD removal efficiency, although it had a moderate effect on ammonia removal efficiency. Filamentous bacteria were the community most influenced by ozone (24.9% of the variance explained by ozone loading rate), whilst protist and metazoa were less affected (11.9% of the variance explained). Conversely, ozone loading rate was not a factor in determining the nitrifying bacterial community abundance and composition, although this environmental variable was correlated with ammonia removal efficiency. The results of this study suggest that different filamentous morphotypes were selectively affected by ozone. (C) 2019 Elsevier Ltd. All rights reserved., This work was supported by grant from the Entitat de Sanejament d Aigües (EPSAR). P. Barbarroja acknowledges support from MINECO grant PTA2014-09555-I.

Free-living amoebae (FLA) are ubiquitous microorganisms commonly found in water. They can act as Trojan Horses for some amoebaresistant bacteria (ARB). Helicobacter pylori is a pathogenic bacteria, suggested to be transmitted through water, which could belong to the ARB group. In this work, a co-culture assay of H. pylori and Acanthamoeba castellanii, one of the most common FLA, was carried out to identify the presence and survival of viable and potentially infective forms of the bacteria internalized by the amoeba. Molecular techniques including FISH, DVC-FISH, qPCR and PMA-qPCR were used to detect the presence of internalized and viable H. pylori. After 24 h in coculture and disinfection treatment to kill extra-amoebic bacteria, viable H. pylori cells were observed inside A. castellanii. When PMAqPCR was applied to the co-culture samples, only DNA from internalized H. pylori cells was detected, whereas qPCR amplified total DNA from the sample. By the combined DVC-FISH method, the viability of H. pylori cells in A. castellanii was observed. Both specific techniques provided evidence, for the first time, that the pathogen is able to survive chlorination treatment in occurrence with A. castellanii and could be very useful methods for performing further studies in environmental samples., The work has also been partially funded by AGL2014-53875-R grant (Ministerio de Economia y Competitividad, Spain) and the "Recovery and joint resources from I+D+i of VLC/CAMPUS program" - MECD (International Excellence Campus Program)

Resumen En los ultimos anos existe un creciente interes por las acciones extraoseas de la vitamina D. En este articulo revisamos la fisiologia de la vitamina D, los aspectos fisiopatologicos asociados a su deficit y la evidencia existente sobre su papel etiopatogenico en enfermedades respiratorias. Teniendo en cuenta las acciones pleiotropicas de la vitamina D, existe plausibilidad biologica sobre un potencial papel patogenico del deficit de esta vitamina en el desarrollo de diversas enfermedades respiratorias. Sin embargo, los numerosos estudios epidemiologicos que han encontrado asociacion entre niveles bajos de vitamina D y mayor riesgo de desarrollar diversas enfermedades respiratorias o de conllevar un peor pronostico no permiten demostrar causalidad. Los analisis post hoc de algunos ensayos clinicos, especialmente en enfermedad pulmonar obstructiva cronica (EPOC) y asma, parecen demostrar que ciertos subtipos de pacientes podrian beneficiarse de la correccion del deficit de vitamina D. En este sentido, resultara interesante averiguar si las variantes geneticas implicadas en el metabolismo de la vitamina D pueden explicar las diferencias interindividuales encontradas en cuanto al efecto del deficit de vitamina D y la respuesta a su correccion. En ultimo termino, solo los ensayos clinicos adecuadamente disenados permitiran determinar si los suplementos de 25-OH D pueden tener un efecto preventivo o mejorar la evolucion de las distintas enfermedades respiratorias en las que se ha descrito asociacion epidemiologica entre su pronostico y el deficit de esta vitamina.

a b s t r a c t Objectives: To analyze the clinical utility and economic impact of conventional transbronchial needle aspiration (TBNA) in patients with diagnosis of bronchogenic carcinoma (BC) and mediastinal lymphadenopathies in thoracic computed tomography (CT). To assess the predictive factors of valid aspirations. Patients and methods: Retrospective observational study between 2006 and 2011 of all TBNA performed in patients with final diagnosis of BC and accessible hilar or mediastinal lymphadenopathies on thoracic CT. Results: We performed TBNA on 267 lymphadenopathies of 192 patients. In 34.9% of patients, two or more lymph nodes were biopsied. Valid aspirations were obtained in 153 patients (79.7%) that were diagnostic in 124 (64.6%). Multivariate analysis showed that factors associated with valid or diagnostic results are the diameter of the lymph node and the number of lymph nodes explored. TBNA was the only endoscopic technique that provided the diagnosis of BC in 54 patients (28.1%). Staging mediastinoscopy was avoided in 67.6% of patients. The prevalence of mediastinal lymph node involvement was 74.4%, sensitivity of TBNA was 86.2% and negative predictive value was 63.6%. Including mediastinoscopy and other avoided diagnostic techniques, TBNA saved 451.57 D per patient.

The objective of this study is to analyze the clinical characteristics of two COPD patient populations: one diagnosed using the lower limit of normal (LLN) and another diagnosed by the GOLD criteria. We also compared the population excluded by the LLN criterion with a non-COPD control population. The COPD patients determined with the LLN criterion presented significantly lower levels of FEV1/FVC at 0.55 (0.8) vs 0.66 (0.2), P = .000; FEV1 44.9% (14) vs 53.8% (13), P = .000, and FVC 64.7% (17) vs 70.4%, P=.04. The two COPD groups presented more frequent ER visits in the last year (57% and 52% of the patients, respectively, compared with 11.9% of the control group), without any statistically significant differences between the two. This same pattern was observed in the number of ER visits in the last year: 1.98 (1.6), 1.84 (1.5), and 1.18 (0.7), respectively. When we analyzed the prevalence of the comorbidities that are most frequently associated COPD, there was a clear increase in the percentage of patients who presented associated disorders compared with the control group. Nevertheless, these differences were not very relevant between the two COPD groups. The differences also were not relevant between both COPD groups in the pharmacological prescription profile. In conclusion, the use of the LLN as a criterion for establishing the diagnosis of COPD, compared with the GOLD criteria, excludes a population with important clinical manifestations and with a high consumption of health-care resources. Before its implementation, the relevance of applying this criterion in clinical practice should be analyzed.

Resumen El objetivo de este estudio es analizar las caracteristicas clinicas de 2 poblaciones de pacientes con EPOC, una diagnosticada utilizando el limite inferior de la normalidad (LIN) y otra por criterio GOLD, y comparar la poblacion excluida por el criterio LIN con una poblacion control sin EPOC. Los pacientes con EPOC por criterio LIN presentaban valores significativamente mas bajos de FEV1/FVC 0,55 (0,8) vs 0,66 (0,2), p = 0,000; de FEV1 44,9% (14) vs 53,8% (13), p = 0,000, y de FVC 64,7% (17) vs 70,4% p 0,04. Los 2 grupos de EPOC presentaron una mayor frecuentacion en urgencias en el ultimo ano (57 y 52% de los pacientes, respectivamente, frente al 11,9% del grupo control), sin que hubiera diferencias estadisticamente significativas entre ambos. Este mismo patron se observo en el numero de visitas a urgencias en el ultimo ano: 1,98 (1,6), 1,84 (1,5) y 1,18 (0,7), respectivamente. Cuando se analizo la prevalencia de las comorbilidades que mas frecuentemente se asocian a EPOC se detecto, frente al grupo control, un claro incremento en el porcentaje de pacientes que presentaban trastornos asociados; sin embargo, estas diferencias fueron poco relevantes entre los dos grupos de EPOC. Las diferencias tampoco fueron relevantes entre ambos grupos de EPOC en el perfil de prescripcion farmacologica. Como conclusion, el uso del LIN como criterio para establecer el diagnostico de EPOC, frente al criterio GOLD, excluye una poblacion con importantes manifestaciones clinicas y con un elevado consumo de recursos sanitarios. Antes de su implementacion debe analizarse la relevancia de aplicar este criterio en la practica clinica.

Resumen A pesar de que las recomendaciones de las principales guias clinicas han restringido las indicaciones de los corticoides inhalados en la enfermedad pulmonar obstructiva cronica (EPOC), actualmente mas del 80% de los pacientes estan recibiendo este tratamiento en Espana, en su mayoria con dosis elevadas. Una revision detallada de la literatura no justifica el uso de estas dosis elevadas, posicionamiento que esta de acuerdo con las recomendaciones de la FDA. Una revaloracion de su seguridad, la consistencia de los datos de eficacia, que muestran resultados similares con dosis moderadas, y una mejor seleccion de los pacientes exige un replanteamiento del uso de este tratamiento en el paciente con EPOC.

Vibrio vulnificus is an opportunistic human pathogen that may cause gastroenteritis, severe necrotizing soft-tissue infections and primary septicaemia, with a high lethality rate. Illness is associated to ingestion of seafood or to the exposure of contaminated water. The aim of this work was to determine the occurrence of V. vulnificus in water and seafood samples from a coastal area near the Mediterranean (Valencia, Spain). A TaqMan probe-based real-time PCR assay was optimised and applied to 22 sea water, 42 raw sewage and 40 seafood samples. Results were compared with those obtained for culture isolation. The detection level of the PCR assay was 10 CFU g⁻¹ in inoculated samples. Seven seawater, four shellfish and six wastewater samples were positive by real time PCR. V. vulnificus was isolated from two oyster, three sea water and two wastewater samples. All the strains were obtained after 20 h enrichment, except for wastewater strains, which were isolated directly from the sample. To our knowledge, this is the first report on the isolation of V. vulnificus from sewage in Spain. Our results about the presence of V. vulnificus in food and environmental samples are strong enough to consider that the organism may represent a human health hazard in our geographical area.

Pollution of water by sewage and run-off from farms produces a serious public health problem in many countries. Viruses, along with bacteria and protozoa in the intestine or in urine are shed and transported through the sewer system. Even in highly industrialized countries, pathogens, including viruses, are prevalent throughout the environment. Molecular methods are used to monitor viral, bacterial, and protozoan pathogens, and to track pathogen- and source-specific markers in the environment. Molecular techniques, specifically polymerase chain reaction-based methods, provide sensitive, rapid, and quantitative analytical tools with which to study such pathogens, including new or emerging strains. These techniques are used to evaluate the microbiological quality of food and water, and to assess the efficiency of virus removal in drinking and wastewater treatment plants. The range of methods available for the application of molecular techniques has increased, and the costs involved have fallen. These developments have allowed the potential standardization and automation of certain techniques. In some cases they facilitate the identification, genotyping, enumeration, viability assessment, and source-tracking of human and animal contamination. Additionally, recent improvements in detection technologies have allowed the simultaneous detection of multiple targets in a single assay. However, the molecular techniques available today and those under development require further refinement in order to be standardized and applicable to a diversity of matrices. Water disinfection treatments may have an effect on the viability of pathogens and the numbers obtained by molecular techniques may overestimate the quantification of infectious microorganisms. The pros and cons of molecular techniques for the detection and quantification of pathogens in water are discussed.

Antecedentes Existe poca informacion sobre el manejo clinico de pacientes ingresados en hospitales publicos espanoles con un diagnostico de exacerbacion de enfermedad pulmonar obstructiva cronica. AUDIPOC es una auditoria clinica sobre el manejo de exacerbacion de EPOC en Espana. Objetivos Validar la adecuacion y validez de los instrumentos de medicion de las variables propuestas en AUDIPOC Espana (estudio preliminar) y verificar su viabilidad en un medio complejo con hospitales de tamano, recursos y organizacion diferentes (estudio piloto). Material y metodos El estudio preliminar se realizo en 4 hospitales y 213 casos. El estudio piloto en 30 hospitales de 6 comunidades autonomas y 1.203 casos. Resultados Los resultados de ambos estudios contribuyeron a mejorar el diseno y los metodos y organizacion del estudio AUDIPOC, incluyendo un mejor entrenamiento de los responsables hospitalarios, una nueva clasificacion de hospitales, la incorporacion de nuevas variables y la creacion de una oficina de coordinacion y gestion del proyecto. Conclusiones El estudio AUDIPOC es viable y preve reclutar 10.000 pacientes en 142 hospitales de todas las Comunidades Autonomas.

Patients with chronic obstructive pulmonary disease (COPD) and associated bronchitis are at higher risk of exacerbations, which are a major cause of morbidity and impaired quality of life. Moreover, exacerbations are associated with more rapid disease progression and higher mortality. The typical symptoms of chronic bronchitis (chronic cough and sputum production) are correlated with inflammatory markers in COPD. Roflumilast is an anti-inflammator y drug belonging to the novel therapeutic class of phosphodiesterase-4 inhibitors and is the first drug to be developed for the treatment of a specific COPD phenotype (COPD associated with chronic bronchitis). The results of clinical trials indicate that, in patients with COPD associated with chronic bronchitis and a history of exacerbations, roflumilast improves pulmonary function and reduces the symptoms and frequency of exacerbations requiring medical intervention. This effect is maintained when regular treatment with a long-acting bronchodilator or an inhaled corticosteroid is added.

In the last decade, various studies have suggested that chronic obstructive pulmonary disease (COPD) could favor the development of ischemic heart disease. Several observational and case-control studies have confirmed that patients with COPD have a higher risk of cardiovascular disorders. However, this increased risk could be largely explained by a greater prevalence of classical risk factors. Currently, there are no data to indicate a causal relation between COPD and cardiovascular disease and the concept of systemic inflammation as a common pathogenic mechanism has not been demonstrated. Equally, there is insufficient evidence to conclude that some drugs, such as statins or inhaled corticoids, could decrease cardiovascular risk in patients with COPD by reducing systemic inflammation. Currently, these drugs should only be recommended if patients show specific indications for their use.

Although chronic obstructive pulmonary disease (COPD) is characterized by poorly reversible, chronic airfl ow obstruction, from the clinical point of view we must continue to make progress in the diagnosis and management of these patients so that spirometry is not the only technique used. Understanding that COPD is a heterogeneous process and that patient complexity usually increases due to the presence of comorbidities will allow more individualized strategies to be designed, which may improve control of the process. The TORCH and UPLIFT trials have shown that current treatment can improve important aspects of the disease, including mortality. However, the fi nalizing of these two large trials has generated a current of opinion favoring a more individually-tailored approach that should include all the factors -both pulmonary and extrapulmonary- that can modify the patient's form of presentation. Although we are witnessing a change in the therapeutic approach to COPD, future treatment will probably be based on studies performed in specifi c patient subgroups and on clarifying the interrelation between COPD and other diseases that are common in these patients. Greater knowledge of the pathogenesis of the disease may improve pharmacological treatment but drugs that, by themselves, alter the short- and long- term course of COPD are not on the horizon. However, a more patient-focussed approach may be the main tool available to physicians to increase quality of life -and possibly survival- in these patients.

Objetivo La enfermedad cardiovascular es una causa de muerte frecuente en los pacientes con enfermedad pulmonar obstructiva cronica (EPOC). No esta claro si el exceso de comorbilidad cardiovascular se relaciona con un incremento de factores de riesgo clasicos o si, por el contrario, la EPOC puede considerarse un factor de riesgo independiente. El objetivo de este estudio ha sido analizar la prevalencia de factores de riesgo y comorbilidad cardiovascular en una poblacion atendida en la comunidad por presentar EPOC. Pacientes y metodos Se ha realizado un estudio multicentrico, concurrente y transversal, en el que se incluyo a 572 pacientes con diagnostico confirmado de EPOC. Se recogieron datos de factores de riesgo y comorbilidad cardiovascular extraidos de la historia clinica del centro. Resultados El valor medio ± desviacion estandar del volumen espiratorio forzado en el primer segundo era del 53,7 ± 16,85% y la relacion volumen espiratorio forzado en el primer segundo/capacidad vital forzada del 57,9 ± 10,9%. La prevalencia de hipertension arterial era del 53%, la de obesidad del 27%, la de dislipemia del 26% y la de diabetes del 23%. La prevalencia de factores de riesgo no se relaciono con la gravedad de la enfermedad, pero si habia una tendencia de asociacion con la edad. La prevalencia de cardiopatia isquemica fue del 16,4%, la de enfermedad cerebrovascular del 7% y la de enfermedad vascular periferica del 17%. La prevalencia de comorbilidad vascular no se relaciono con la gravedad de la enfermedad, pero si con la edad y los factores de riesgo clasicos. Conclusiones Los pacientes con EPOC muestran una elevada prevalencia de factores de riesgo cardiovascular. La prevalencia de enfermedad cardiovascular y cerebrovascular excede la comunicada en poblacion general. No se ha observado relacion entre la gravedad de la obstruccion al flujo aereo y la presencia de comorbilidad cardiovascular.

A new Aeromonas bioassay is described to assess the potential harmful effects of the glyphosate-based herbicide, Roundup, in the Albufera lake, a protected area near Valencia. Viability markers as membrane integrity, culturability and beta-galactosidase production of Aeromonas caviae were studied to determine the influence of the herbicide in the bacterial cells. Data from the multifactor analysis of variance test showed no significant differences (P>0.05) between A. caviae counts of viability markers at the studied concentrations (0, 50 and 100 mg l-1 of glyphosate). The effects of Roundup on microbial biota present in the lake were assessed by measuring the number of indigenous mesophilic Aeromonas in presence of different amounts of the herbicide at 0, 50 and 100 mg l-1 of glyphosate. In samples containing 50 and 100 mg l-1 of glyphosate a significant (P

Lung cancer, a steadily growing problem, ranks as the first cause of tumor-related deaths in developed countries. The relation between lung cancer and smoking makes it a potentially avoidable disease. Found mainly in men, it has made alarming gains among women. The main prognostic factor is the possibility of receiving curative surgery; however, in real practice the diagnosis usually comes when the disease has reached an advanced stage, when only 20% can be treated surgically. Nonsurgical treatments based on chemo- and radiotherapy have not advanced appreciably in recent years, and 5-year survival is poor, estimated at only around 7% to 12% in Spain. Attempts must be made to improve preventive measures and early diagnosis in order to improve the prognosis for lung cancer patients.

El cancer de pulmon es una enfermedad en permanente crecimiento, es la primera causa de muerte de origen tumoral en los paises desarrollados. Su asociacion con el tabaco hace de ella una enfermedad potencialmente evitable, presenta un claro predominio en varones, pero con un alarmante incremento en mujeres. Su principal factor pronostico es poder recibir un tratamiento quirurgico con intentos curativos; sin embargo, la realidad nos dice que el diagnostico se suele realizar en fases avanzadas de la enfermedad, cuando solo un 20% de los casos puede ser intervenido. Con los tratamientos no quirurgicos, basados en quimioterapia y radioterapia, no se han observado significativos avances en los ultimos anos. Presenta una pobre supervivencia a los 5 anos, que en nuestro medio se encuentra en un escaso 7-12%. Deberemos intentar mejorar las medidas de prevencion y su diagnostico precoz para mejorar el pronostico final de esta enfermedad.

El cancer de pulmon es la decima causa de muerte en el mundo, pero se estima que pasara a ocupar el quinto lugar en los proximos anos. En Espana esta situacion es aun peor, con un futuro poco alentador como consecuencia del cambio en el habito tabaquico en las mujeres. Ademas de su incorporacion masiva a un habito de riesgo, las mujeres que fuman son mas susceptibles que los varones a desarrollar cancer de pulmon. Tras un diagnostico de cancer de pulmon, las mujeres tienen diferencias en el tipo histologico y, en terminos generales, viven mas que los varones. En relacion con el tratamiento, las mujeres tienen mejores supervivencias tras cirugia en tumores localizados. Tambien viven mas tras quimioterapia en tumores de celulas pequenas y en los no microciticos avanzados. Estos datos nos obligan a cambiar la creencia de que el cancer de pulmon es una enfermedad que afecta principalmente al sexo masculino y a conocer las peculiaridades que puede presentar en las mujeres.

The aim of this work was to assess the effect of chlorine water treatment on Arcobacter butzleri and to study the survival strategies of this organism in chlorinated and non-chlorinated drinking water. A. butzleri NCTC 12481 was inoculated into chlorinated and non-chlorinated water and samples were removed aseptically, immediately and periodically during the next 2 days (for chlorinated drinking water) or 35 days (for non-chlorinated drinking water). The membrane integrity (Live/Dead BacLight kit), 16S rRNA (FISH technique), DNA content (23S rRNA PCR-RFLPs) and culturability changes in A. butzleri cells were analyzed. Culturability of the cells was lost at 5 min in chlorinated drinking water. At that time the cells showed membrane damage, although fluorescent intensity of 16S rRNA hybridization was constant throughout the chlorine treatment. After 48 h the amplicon specific for the 23S rRNA gene was weakly detected. In non-chlorinated drinking water cells lost their culturability after 16 days but the other factors measured indicated that Arcobacter remained viable throughout the experiment.

[EN] We have evaluated the use of a fluorescent in situ hybridization (FISH) technique for the detection of Helicobacter pylori in water (river and wastewater) samples. The assay was compared with PCR detection and isolation of cells on selective media. 16S rRNA and UreA+B sequence data were used as oligonucleotide probe and specific primers for FISH and PCR, respectively. Using FISH technique, H. pylori was detected in two river water and one wastewater samples, while PCR yielded only one positive result. H. pylori culture was not possible from any sample. According to these results, FISH technique has the potential to be used as a quick and sensitive method for detection of H. pylori in environmental samples., We thank E. Echevarrı́a from EMARSA company, which allowed us access and sampling Pinedo wastewater treatment plant.

Activated sludge bulking by the filamentous bacteria type 021N, was repeatedly detected in the mixed liquor of an urban wastewater treatment plant receiving paper mill effluents. The effect of chlorine-induced damage on type 021N was assessed using suitable fluorescent intracellular stains (BacLight™ viability kit, BL). This approach permitted the relatively rapid assessment of the extent and site of disinfection damage in the cells of type 021N. The method permits to see and probably even quantify the injured cells or flocs. The (BL) method was useful for assessing chlorine effect on filamentous microorganisms in mixed cultures such as activated sludge.

Twenty-three strains of Pseudomonas aeruginosa isolated from bottled and well waters were biotyped, serotyped and examined by antimicrobial susceptibility, plasmid content, analysis of chromosomal DNA Eco RI ribopatterns (ribotyping) and by a PCR-based procedure. Phenotypic methods showed poor discrimination power between strains, and plasmids were detected in 29% of isolates. Southern blot hydridisation analysis showed genetic diversity between isolates, and six different ribotypes were defined. Arbitrarily primed polymerase chain reaction (AP-PCR) analysis also differentiated between the strains with higher discriminatory power than ribotyping, since 13 different profiles were obtained. Both DNA-based methods are valuable alternatives to traditional typing systems for P. aeruginosa, and AP-PCR could be particularly useful for epidemiological studies.

A new medium, CHROMagar® E. coli (CAEC), containing a combination of X-glucuronide and methyl-glucuronide for the detection of β-glucuronidase activity of Escherichia coli has been evaluated by the membrane filtration (MF) technique n fresh water samples. The CAEC agar was compared with conventional media, mFC agar and mLSB, for the enumeration of faecal coliforms. The variance analysis showed that CAEC was as sensitive as mFC agar and mLSB. A good correlation was found between E. coli versus those from faecal coliforms in the water sampling areas tested. Of 321 presumptively positive E. coli colonies (blue) and 154 presumptively negative E. coli colonies (white), only 8 (2.5%) false positive and 19 (12.4%) false negative colonies were found. Specificity of the CEAC agar in spanish samples was temperature dependent, false negative E. coli colonies occurred less frequently at 37°C (2.3%) than at 44.5°C (18.8%). The results of this study indicate that CAEC agar is efficient for the enumeration of E. coli from a wide range of environmental freshwater samples.

Eight marine recreational water areas were sampled for Campylobacter presence during the period from January to December 1990. Thirteen per cent ( 25 192 ) of samples yielded campylobacters. Thermophilic campylobacters were isolated only from samples which contained more than 1000 faecal coliforms per 100 ml but there was no relationship between the counts of faecal indicators and presence of campylobacters. Campylobacter population exhibited seasonal fluctuations, although not all the sampling sites showed the same seasonality. The dominant Campylobacter species isolated from sampling sites analysed was C. coli .

A study was undertaken to compare two enrichment broths and to test a new plate medium, Rambach agar, for their suitability to detect Salmonella from marine recreational waters. The study shows that under conditions of low levels of fecal contamination, Salmonella spp was isolated more efficiently using NR10(10)/43 broth. While at higher levels of fecal contamination NR10/43 broth effectively limits the growth of accompanying flora. For the highest level of fecal contamination Rambach agar was less selective than Hektoen enteric agar but Rambach agar was shown to be better than Hektoen agar for the recovery of Salmonella strains from low contaminated waters. On Rambach agar the distinct color of salmonellas, seen in red, enhanced correct identification. Biochemical and serological confirmation of Salmonella isolates was performed using the API Z System and Oxoid Salmonella Rapid Latext test. The combination of enrichment broths (24 h at 42°C), isolation (24 h at 37°C) and identification systems described above (2 h or I min) allowed the detection of Salmonella from marine waters, with low or high levels of fecal contamination, in 48 h.