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Among 3967 Staphylococcus aureus recovered from a Gran Canaria hospital (2003-2010), 28 strains were Panton-Valentine leukocidin-positive community-associated methicillin-resistant Staphylococcus aureus and were included in this study. Most isolates (89.3%) caused skin and skin-structure infections. Isolates belonging to clonal complex (CC)8 (ST8 and ST931; USA300) prevailed (82.1%). Among these, 5 (21.7%) were resistant to at least 3 antimicrobial classes., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: The introduction of pneumococcal conjugate vaccine (PCV-7) has modified the epidemiology of invasive pneumococcal disease (IPD). Our aim was to investigate the epidemiological features of IPD before and after implementing the use of PCV-7., Methods: All invasive Streptococcus pneumoniae strains isolated in our hospital from 2000 to 2006 were included. Serotypes were identified and antibiograms were performed in all cases. Data obtained before (2000-2001) and after (2004-2006) authorization of PCV-7 use in Spain were compared., Results: There were 241 cases of IPD. None of the patients with IPD aged 2 years or younger had received PCV-7. PCV-7 coverage in children aged 5 or younger was about 48%. There was a non-significant increase in the incidence of IPD in children (from 53.8 to 57.8 cases/100 000 population), with no change in adults. When IPD incidence was adjusted by the number of blood samples collected, there was a non-significant decrease in both children and adults. Since PCV-7 came on the market, there has been a decrease in vaccine serotypes and an increase in non-vaccine serotypes. The emergent serotypes since that time include 3, 6A, 15, and 19A. Penicillin resistance decreased significantly (p<0.001) from the pre-vaccine period (87.3%) to 2003 (13.8%), and later rose from 2003 through 2006 (41.7%). Erythromycin resistance showed no changes during the study., Conclusions: The incidence of IPD in children aged 2 years and younger in Gran Canaria has not decreased despite the introduction of PCV-7. However, there has been a reduction in the number of cases related to vaccine serotypes and a significant decrease in penicillin resistance. In contrast, non-vaccine serotype IPD cases have increased. Universal vaccination and the use of new polyvalent vaccines may enhance these effects.

Objective: To assess the performance of a polymerase chain reaction (PCR) method in cerebrospinal fluid (CSF) for the diagnosis of nervous system infections caused by herpesvirus, and to estimate the incidence of encephalitis due to herpes simplex virus type 1 in the adult population of the island of Gran Canaria., Methods: We studied 330 CSF specimens from 312 patients (281 HIV-negative and 31 HIV-positive) remitted to investigate clinically suspected encephalitis or meningitis, or to study neuropathy or demyelinating disease. A multiplex PCR technique was used to detect herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV), Epstein-Barr virus and human herpesvirus type 6. The patients' clinical records were reviewed to establish the definite diagnosis., Results: Nine samples from eight patients (2.6%) showed positive results (9.7% of patients with pathological CSF and none with normal CSF). The eight patients had clinical and analytic findings of herpesvirus nervous system infection: HSV-1 DNA in four patients with encephalitis, HSV-2 DNA in one patient with meningitis, VZV DNA in two patients with meningitis and CMV DNA in one HIV-positive patient with encephalitis. Herpesvirus was the cause of 50% of encephalitis cases and 10% of meningitis cases. The incidence of HSV-1 encephalitis was five cases per million inhabitants per year., Conclusions: Diagnosis of herpesvirus nervous system infections by PCR in CSF is not appropriate when CSF parameters are normal. We found a higher incidence of herpesvirus encephalitis than has been reported in other studies.

Background: In recent years several population based studies using restriction fragment length polymorphism (RFLP) analysis have shown a higher rate of recent transmission of tuberculosis than previously thought. This study was undertaken to determine the transmission patterns of tuberculosis and the potential causes of recent transmission on the island of Gran Canaria (Spain)., Methods: The strains of all patients diagnosed with tuberculosis confirmed by culture between 1 January 1993 and 31 December 1996 were typed by RFLP using the insertion sequence IS6110. A cluster was defined as two or more isolates with an identical RFLP pattern. Epidemiological linkage through contact tracing was investigated., Results: Of the total of 719 patients, 153 (21.3%) were excluded because there was inadequate bacterial DNA for genotyping (n=129) or the isolates of Mycobacterium tuberculosis had less than five copies of IS6110 (n=24). The isolates from 409 patients (72.3%) were grouped into 78 different clusters with an estimated 58.5% of the cases being due to recent transmission. Young age was the only significant predictor of clustering. Only in 147 (35.9%) of the 409 patients belonging to a cluster could an epidemiological link be found. 111 patients (19.6%) were identified as having had previous contact with a tuberculosis patient and 81 of them (72.9%) belonged to a cluster. The three largest clusters included 75, 49 and 20 patients, respectively., Conclusion: Recent transmission is frequent among patients with tuberculosis on Gran Canaria and could be associated with certain aspects of control measures. Some of the clusters described in the study could be due to the prevalence of particular strains of M tuberculosis on the island.

Objective: To analyze the prevalence of infection, the frequency of HCV genotypes and the epidemiology characteristics among the patients in hemodialysis treatment in one 25 years old hospital hemodialysis center and one 15 years old secondary unit by a transversal cross-section study in 1998., Patients and Methods: 171 hemodialyzed-patients were studied. Patients sera were analyzed by the presence of HCV antibodies anti-VHC by a enzymoimmunoassay (Abbott Cientifica) and the presence of antibodies was confirmed by a line immunoassay (Inno-LIA HCV AbIII) and by the presence of VHC-RNA by reverse transcriptase PCR (Cobas Amplicor HCV). Genotypes were determinate by reverse hybridization (Inno-LIA HCV III)., Results: Fifty (29.2%) of the patients were HCV antibody positive. Forty-five (26.3%) were HCV-RNA positive, all of them with antibodies positive. The distribution of genotypes was: 1b, 34 (75.5%); 4f, 4 (8.9%); 1a, 3 (6.7%); 1, 3 (6.7%) and 1 case could not be typed (2.2%). In 14 patients (28.0%), seroconversions were documented Twenty-one patients (42.0%) were diagnosed when the routine tests were available and 15 patients (30.0%) were diagnosed pre-dialysis. The multivariate analysis showed that the risk of HCV infection was greater for patients who had been more 8 years on dialysis (OR: 6.22; 95% CI: 1.24-31.07)., Conclusions: Data presented indicate that the prevalence of HCV infections in our hemodialysis units and the number of seroconversions were high and the HCV subtype 1b was more frequent; because of this, the screening by both serological and molecular methods is necessary, at least twice a year, to identify all the infected patients. Besides, we think that is necessary to increase the control of the completion of the Universal Precautions.

Background: It is necessary to have an easy and quickly test to distinguish "false positive" rubella IgM results and residual antibodies from the antibodies produced in the primary infection, in pregnant women. The avidity of IgG antibodies test seems to differentiate between primary rubella infection and past infections, reinfections or postvaccination, showing its utility in the diagnosis of primary infection in other infectious diseases., Method: For 30 months, 178 sera from 157 patients with clinical and/or epidemiological rubella suspicion or with a positive rubella IgM result as result of an accidental serological finding, were remitted to our laboratory for a serological follow up. We distinguished 3 patient groups: outbreak group, 112; pregnant women, 36, and newborn 11. Rubella IgM antibodies by indirect EIA previous the rheumatoid factor absorption; IgG antibodies of low avidity by indirect EIA previous treatment of serum with 6 M urea, were detected in the sera. It considered a positive result, a rubella avidity index (AI) < 50%., Results: In the epidemic outbreak group, 90.2% of the patients were not vaccinated. 80% of cases occurred in young men between 14 an 20 years old. From 109 patients (97.3%) with rubella IgG antibodies, 92 (84.4%) showed AI-IgG lower than 50%. In this group, the mean rate of AI-IgG rubella was 29.0%. In the pregnant women group, except for two of them, rubella IgM antibodies were an accidental finding in a serological pregnancy screening. Thirty patients (83.8%) showed AI-IgG rubella > 50%. The two pregnant women who had evidence of clinical and epidemiological rubella showed AI-IgG rubella of 37.4% and 20.9%. Another four pregnant women showed AI-IgG rubella close to cut-off (44.7-49.0%). The mean AI-IgG rubella in this group was 71.8%. The mean AI-IgG Rubella between the epidemic outbreak group and the pregnant women group, 29.0 and 71.8% respectively, was statistical significance (p < 0.001)., Conclusions: The avidity IgG test is simple and quickly, and it allow to exclude most of positive results because of residual IgM antibodies and false reactive.

Background: Schistosomiasis in Spain is always an imported disease mainly presented in travellers from endemic areas with a history of having bathed in fresh water and in immigrants from these areas. A group of travellers presenting infection by schistosomes following an 8-day journey to Burkina Faso., Patients and Methods: The travellers, residents of Gran Canaria (Spain), who had bathed in fresh water were studied by schistosomiasis serology and parasitologic examination in stools and urine., Results: A total of 29 travellers were studied, 20 (69%) of whom were considered to be infected, on presenting positive serology and/or coproparasitologic examination. Fourteen of the infected patients presented clinical symptomatology compatible with the Katayama syndrome, while 6 were asymptomatic. The mean time to appearance of the symptoms was 27 days and these were most frequently fever, headache, neck pain, diarrhea and arthromyalgia together with eosinophilia achieving a mean value of 3,513 eosinophils/microliter. All the infected travellers presented positive serology and in 5 eggs of a Schistosoma mansoni were observed in stools. All the infected patients were treated with praziquantel., Conclusions: Limited exposure by bathing in fresh water in this group of travellers led to a high rate of infection. The diagnosis of schistosomiasis should be considered in any traveller from an endemic area with a history of having bathed in fresh water. In the case of an outbreak, investigation of all the travellers who had bathed is recommendable given that the infection may be asymptomatic.

Background and Methods: Human infections caused by Listeria monocytogenes often present as sporadic cases without any epidemiological relationship among them; however they also appear as outbreaks that are usually detected by an increase in the number of cases diagnosed by hospitals of the geographic area. Between December 1991 and May 1993, twenty four cases of listeriosis were detected in three hospitals of Las Palmas de Gran Canaria; and they were classified as an outbreak. Our report describes its clinical, epidemiological and microbiological aspects., Results and Conclusions: Twenty four cases of listeriosis were diagnosed, 12 occurred in pregnant women or neonates (5 and 7 respectively) and 12 in non pregnant adults. All adult infections were community-acquired. The incidence rate was, for the epidemic area, 76.3 cases per million population during the period considered (18 months). Among non pregnant adults, 9/12 patients had some underlying disease and 9/12 presented CNS affection (meningitis and/or cerebritis). In the group of pregnant women, 4 cases occurred in the second trimester and fetal loss was caused; one case was detected in the third trimester and four weeks later the patient delivered an unaffected infant. All cases of neonatal listeriosis presented as early-onset sepsis. Of the 24 strains of L. monocytogenes, 21 were serotype 4, two were serotype 1 and one was not typeable. Strains from 12 patients were available for epidemiological analysis, seven of which corresponded to the same pattern and there were three more different patterns.