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1. Exploring the genetic background of the botulism neurotoxin BoNT/B2 in Spain

Author

Sylvia Valdezate, Gema Carrasco, María J. Medina, Noelia Garrido, Silvia del Pino, Monica Valiente, María P. Pallarés, and Pilar Villalon

Subjects
Clostridium botulinum, botulism, food-borne, infant, neurotoxin, BoNT, Microbiology, QR1-502
Abstract

ABSTRACT To determine whether the neurotoxin BoNT/B2 causing botulism in Spain is clonal, the genetic diversity and phylogenetic relationships of Clostridium botulinum from food-borne episodes and infant cases of the condition were explored. The botulinum toxin gene (bont) subtype, the variable region of the flagellin gene (flaVR), and a seven-gene multi-locus sequence type were examined by sequencing 37 BoNT-positive cultures obtained over the period 2010 to 2022. Out of 37 botulism events, 16 food-borne episodes and 16 infant cases were associated with bont/b2. Eight bont/b2 alleles were detected [nucleotide distance range 0.0259–0.415%, Hunter and Gaston discrimination index (HGDI) 0.71]. The most common bont/b2 allele corresponded to that of strain Prevot 25 NCASE and its single and double locus variations (87.5%). Four known flaVR types were identified (HGDI 0.79), along with one previously unknown (flaVR-15). Sixteen sequence types (STs) (HGDI 0.89) were recorded including seven new STs (ST164–ST170; 10 new alleles) and five new STs (ST171–ST175; with new allele combinations) were also noted. Correlations among some STs and flaVR types were seen. Overall, the present results show that the combined analysis of bont/b2-flaVR-ST at the nucleotide level could be used to track botulism events in Spain. The neurotoxin BoNT/B2 has largely been responsible for human botulism in Spain. The polymorphism analysis of bont/b2, flaVR typing, and sequence type determinations, revealed a wide variety of clones to be responsible for human botulism, ruling out a common source of acquisition. IMPORTANCE Botulism, a potentially fatal disease, is classically characterized by a symmetrical descending flaccid paralysis, which if left untreated can lead to respiratory failure and death. Botulinum neurotoxin (BoNT), produced by certain species of Clostridium, is the most potent biological toxin known, and the direct cause of botulism. This study characterizes the acquisition in Spain of two forms of botulism, i.e., food-borne and infant botulism, which are largely caused by the main neurotoxin BoNT/B2. Polymorphism analysis of the bont/b2 gene, typing of the flagellin variable region sequence (flaVR), and multilocus sequence typing, were used to explore the genetic background of Clostridium botulinum group I. To our knowledge, this is the first phylogenetic and typing study of botulism undertaken in Spain.

Published
2023
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2. Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study

Author

Ana Moyá-Amengual, Antonio Ruiz-García, Vicente Pallarés-Carratalá, Adalberto Serrano-Cumplido, Miguel Ángel Prieto-Díaz, Antonio Segura-Fragoso, Sergio Cinza-Sanjurjo, the researchers of the IBERICAN study, Alfonso Barquilla García, Ángel Díaz Rodríguez, Carlos Escobar Cervantes, Francisco Javier Alonso Moreno, Jesús Vergara Martín, Juan José Badimón, José Polo García, Luis Rodríguez Padial, Miguel Ángel Prieto, Rafael Vidal Pérez, Sergio Cinza Sanjurjo, Sònia Miravet Jiménez, Sonsoles Velilla Zancada, José Ramón Banegas, Vicente Martín Sánchez, Vicente Pallares Carratalá, Antonio Segura Fragoso y Rafael Manuel Micó Pérez, Antonio López Téllez, Jesús Vergara Martin, María De Los Ángeles Ortega Osuna, Cristóbal Prieto Cid, Mª José Hidalgo Fajardo, José Lorente Serna, Ángel Domínguez Requena, Ricardo Alberola Cañizares, Manuel Ruiz Peña, Filomena Herrero Collado, Marcela Montes Vázquez, Rafael Ángel Carrascal Garrido, María Reyes Herrera Lozano, Beatriz Ortiz Oliva, Francisco José Anguita, Carmen Pérez Ibáñez, Carlos Alberto Cabrera Rodríguez, María José Cruz Rodríguez, Sandra Bonilla Ruiz, Rocio Reina González, Salome Abad Sánchez, Inmaculada Santana Martínez, Rafael Sánchez Jordán, Juan Mª Ramos Navas-Parejo, José Manuel Ramírez Torres, José María Beltrán Poveda, María Adoración De Cruz Benayas, Carmen Fernández Gil, Jon Iñaki Esturo Alcaine, Antonio Mora Quintero, Fernando Leiva Cepas, José Luis Carrasco Martín, Emilio García Criado, Mercedes Vázquez Blanco, Isabel Mora Ortiz, Leovigildo Ginel Mendoza, Juan Carlos Aguirre Rodríguez, Esperanza María Romero Rodríguez, José Acevedo Vázquez, Juan Gabriel García Ballesteros, María De La Paz Fernández Lara, Patricia Agüera Moreno, Eduardo Paños Maturana, Juan Manuel Ignacio Expósito, Noelia Carrillo Peñas, Carmen María Abad Faya, Ana Marina Almagro Duque, Rubén Torrescusa Camisón, Paloma Menéndez Polo, Marina Peña García, Cristina López Fernández, Ascensión Estepa Torres, Miguel Gutiérrez Jansen, Esperanza Loizaga González, Lisardo García Matarín, Enrique José Gamero De Luna, Javier Benítez Rivero, María José Gómez González, Carmen Gómez Montes, Juan Carlos Rodríguez Rodríguez, Juana María González Barranco, Josefa Ramírez Vizcaíno, María Ángeles Miranda Sánchez, Eva Trillo Calvo, Concepción Bayod Calvo, Susana Larripa De La Natividad, German Grasa Lambea, Emilio Jiménez Marín, Ana Cristina Navarro Gonzalvo, Antonio Pablo Martínez Barseló, Irene Peña León, Ángel González Pérez, Liliana Mahulea, María José Pérez Martínez, Ana Piera Carbonell, Margarita Alonso Fernández, María Montserrat Rueda Cuadrado, Rodrigo Abad Rodríguez, José Miguel Álvarez Cabo, Rubén Sánchez Rodríguez, Eva María Cano Cabo, Anny Romero Secin, Miguel Ángel Prieto Díaz, Juan Jesús García Fernández, Saúl Suárez García, Fernando García Romanos, Antonia Moreno González, María Lara Amengual Sastre, Susana Martínez Palli, José Alfonso Ramón Bauza, Jose Ortiz Bolinches, Carmen Fernández Fernández, María Isabel Orlandis Vázquez, Ana Sanchís Mezquita, Fernando Unceta Aramburu, Juan Fernando Peiró Morant, Ana Moyá Amengual, Matéu Seguí-Díaz, José Félix Zuazagoitia Nubla, Ana Echevarría Ituiño, Gregorio Mediavilla Tris, María Carmen Noriega Bosch, Esther González, María Luisa Ruiz Macho, Ruth Sendino Del Olmo, Asunción Olagorta De Prado, Ana López De Viñaspre Muguerza, Jesús Iturralde Iriso, Mª Rosario Virtus Iñurrieta, Lucas Ulloa Bahamonde, Isidro Godoy García, Fernando Rubio Sevillano, María Isabel González González, Marta Pérez Souto, Raquel De León Contreras, Sara Isabel Almeida González, Irene Almería Diez, Virginia Maria Mirabal Sánchez, Francisco José Escobar Lavado, Yoel Anta Pérez, Nayra Sánchez Hernández, Juan Luis Alonso Jerez, Ricardo Koch, Nayra Ramírez Mendoza, Héctor Suárez Hernández, Francisco Jesús Morales Escobar, E Lidia Gutiérrez Fernández, Fernando Andrés Mantecón, Ana Belén García Garrido, Asunción Vélez Escalante, Luisa Alonso Rentería, Jesús Sainz Jiménez, Guillermo Pombo Alles, Esperanza Rueda Alonso, Juan Antonio Divisón Garrote, Pedro Martínez Sotodosos, Juan Antonio Vivancos Fuster, María García Palencia, José Ambrosio Torres Moraleda, Sara González Ballesteros, Ana Carmen Gil Adrados, Antonio González Cabrera, Miguel Ángel Babiano Fernández, Guillermo Rico García, Juan José Criado-Álvarez, Pilar Torres Moreno, Francisco Javier Arribas Aguirregaviria, Alicia Sahuquillo Martínez, Lourdes Maria Santos Bejar, Miguel Laborda Peralta, Raúl Piedra Castro, Carlos Santos Altozano, Lucia González-Tarrio Polo, Pedro Valiente Maresca, Reinilda Mota Santana, Noemi Elizabeth Terrero Ledesma, Noelia Garrido Espada, Gabriela Delia Rosa Zambrana Calvi, Cristina de Castro Mesa, Blanca Cordero García, Pilar Sorrius Sitges, Ana María de Santiago Nocito, César Lozano Suárez, Juan Lorenzo Gutiérrez Montero, Juan Ignacio López Gil, María Dolores Fernández Ortega, Miren Elizari Roncal, María Ascensión López Serrano, Nuria Esther Adrián De La Fuente, Belén Angulo Fdez. De Larrea, Naiara Cubelos Fernández, Guiomar Luz Ferreiro Gómez, Diana Gómez Rodríguez, Sonia María Andrés Tuñón, María Ajenjo González, Serafín De Abajo Olea, Juan José León Regueras, César Manuel Gallego Nieto, Delio Vázquez Mallada, Maria De La O Gutiérrez García, Pablo Baz Rodríguez, José Ignacio Ferradal García, Blanca Delia De Román Martínez, Ana Arconada Pérez, Omar Mahmoud Atoui, Álvaro Morán Bayón, María Teresa Armenteros Del Olmo, Francisco Javier García-Norro Herreros, Enrique Méndez Rodríguez, Diana María Narganes Pineda, Verónica Ortiz Ainaga, Milagros Sonlei Sánchez Guevara, Laura Villota Ferreiro, M Teresa Grande Grande, Francisco Vicente Martínez Gracia, Jesús Palomo del Arco, María Dolores Moriano García, Beatriz Jiménez Muñoz, Gemma Rovira Marcelino, Diana Elizabeth Fernández Valverde, Roser Rodó Bernadó, Maria Teresa Ortiz Lupiañez, Najlaa Najih, José María Diéguez Parra, Mª Rosa Benedicto Acebo, Mari Luz Bravo Vicien, Alberto Ramón León Estella, Juan Antonio Muñoz Gómez, Alicia Mostazo Muntané, Isabel Ortega Abarca, Anna Gasol Fargas, Brenda Elizabeth Riesgo Escudero, Susana Elizabeth Riesgo, Edgar Zaballos Castellvi, Celia Cols Sagarra, Marta Herranz Fernández, Josep Alins Presas, Idaira Damas Pérez, Rosa M Alcolea Garcia, Ines Monte Collado, Roberto Genique Martínez, María José Guasch Villanueva, Teresa Rama Martínez, Lucio Pinto Pena, Josefa María Panisello Royo, Inés Gil Gil, Carlos Gómez Ruiz, Rita Sahun Font, Anna Fuentes Lloveras, Alberto Calderón Montero, María Del Mar Zamora Gómez, Elena Alarcón Cebrián, Mª José Piñero Acin, Celia Pecharroman Sacristán, M Soledad Mayayo Vicente, Mª Paz Pérez Unanua, Nuria Marañón Henrich, Saray Gómez Monreal, Sonia Redondo De Pedro, Blanca Sanz Pozo, Irene Moreno Martínez, Beatriz Lopez Uriarte, Carmelina Sanz Velasco, Amaya Gárriz Aguirre, Montserrat Rivera Teijido, German Reviriego Jaén, Jose Ignacio Aza Pascual-Salcedo, Josefa Vázquez Gallego, Julia Caballer Rodilla, Aida Herrera, Ezequiel Arranz Martínez, Ana María Gómez Calvo, Paula Morán Oliva, Mª Milagros González Béjar, Julio Antonio Heras Hitos, Olga García Vallejo, Manuel De Jesús Frías Vargas, María Jesús Castillejo Boguerin, Aurora García Lerín, Miguel Ángel María Tablado, Elena Concepción García García, Leticia De Miguel Acero, Carmen Zárate Oñate, Aránzazu Barranco Apoita, María Ester Montes Belloso, Ana María Huertas Velasco, Rafael Sáez Jiménez, Julia Natividad García Pascual, María Clemencia Zuluaga Zuluaga, Mª Cruz Díez Pérez, Antonio Ruiz García, Cristina Murillo Jelsbak, Virginia Lasso Oria, Amelia González Gamarra, Elena Rodilla Rodilla, Alberto Galgo Nafría, María Mestre de Juan, Mª Carmen García Albiñana, Mª del Pilar Moreno Cano, Paula Hernanz López, Paloma Casado Pérez, Jacinto Espinosa García, José Ignacio Prieto Romo, Leandro Fernández Fernández, Javier Sierratapia, Nieves Moreno Regidor, Francisco Javier Zaballos Sánchez, Ana Moreno Moreno, Francisco Carramiñana Barrera, Juan Jose Torres Vázquez, María José Gamero Samino, Miguel Ángel De Santiago Rodríguez, Pablo Rafael Gómez Martínez, Antonio Carlos Elías Becerra, Javier Soto Olivera, Víctor Cambero, Julián Domínguez Ávila, Andrés Simón Fuentes, Jorge Manuel De Nicolás Jiménez, Dimas Igual Fraile, Guadalupe Nieto Barco, Ignacio Araujo Ramos, Mª Luz Serrano Berrocal, Francisco Buitrago Ramírez, Minerva Gallego Marcos, Félix Suarez González, Victoriano Chavero Carrasco, Francisco Guerra Peguero, Francisco Javier Sánchez Vega, Manuel Tejero Mas, Alba Palmerín Donoso, Miguel Turégano Yedro, María Beatriz Esteban Rojas, Fátima Cabezudo Moreno, Nawson Elver Quevedo Saldaña, María Del Mar García Fenés, Timotea Garrote Florencio, José María Fernández Toro, Vicente Caballero Pajares, María José Gómez Barquero, Alejandra Rey Rañal, Elena García Del Río, Enrique Nieto Pol, Julio Álvarez Fernández, Pilar Alonso Álvarez, Mª Luisa Jorge Gómez, Antonio Calvo Guerrero, Isabel Celemín Colomina, Lucia Barreiro Casal, Juana Fernández Moreno, Mª Angelines Carballal Martínez, Nabor Díaz Rodríguez, Carlos Moral Paredes, Dolores Recarey García, Francisco Javier Iglesias Mato, Antonio Fouz Ulloa, Amparo Fidalgo González, Noelia Dios Parada, Patricia Conde Sabarís, Ana Isabel Rodríguez Pérez, Ana Inés García Palacio, Víctor Julio Quesada Varela, Lidia Romero Iglesias, Ángel Lado Llerena, Carmen Lires Rodríguez, María Luisa Carretero Díaz, José Carreira Arias, José Luís Vázquez Camino, María Del Carmen Torreiro Penas, Sandra Yáñez Freire, Daniel Rey Aldana, Carlos Piñeiro Díaz, Portal González Lorenzo, José Rodríguez Campos, Rubén Blanco Rodríguez, Manuel Portela Romero, Lucía Vilela de Castro, Sonsoles María Velilla Zancada, Rafael Crespo Sabarís, Oscar Fernando Isaula Jiménez, Jesús Manuel González Puga, Jorge Antonio Benaín Ávila, Óscar Del Toro González, Vicente Llorca Bueno, Ana María Ballesteros Pérez, Domingo J Rubira López, Mª Dolores Esteve Franco, Elena Sánchez Pablo, María Teresa Palacios López, Juan Castillo Meroño, José María Lobo Martínez, Isabel María Peral Martínez, J Eduardo Carrasco Carrasco, Armando Santo González, Juan Gomáriz García, Beatriz Ríos Morata, Laura Sánchez Iñigo, Inés Sanz Pérez, Vicente Pascual Fuster, Mª Dolores Aicart Bort, Natividad Vázquez Gómez, Carlos Lluna Gasco, Teresa Amorós Barber, Pedro Antonio Medina Cano, Miguel Monteagudo Moncho, María Jesús Larré Muñoz, Raquel Navarro Hernández, Francisco José Martínez Egea, Antonio Tramontano, Marta Ferrer Royo, Belén Persiva Saura, Juan A Contreras Torres, José Mª Tirado Moliner, Alejandro Salanova Penalba, Ariadna Cucó Alberola, Fernando María Navarro I Ros, Enrique Beltrán Llicer, Ana Seoane Novás, Inmaculada Martín Valls, Gracia Verdú Mahiques, Enrique Peña Forcada, Nieves Aguilar Gómez, Francisco Javier Sanz García, María Dolores Paradís Bueso, María Eugenia Alegre Romero, Antonio Francés Camus, María Amparo Antón Peinado, Rosa Latorre Santos, Mª Asunción Palomar Marín, María Carmen Botella García, Eva Sánchez Fresquet, Pedro Sala Paños, Tomás Sánchez Ruiz, Rosa Ana Valero Valero, María Seoane Vicente, Magdalena Martin Llinares, Antonio Masiá Alegre, José Luis Llisterri Caro, Irene Lluch Verdu, Vicente Pallarés Carratalá, Francisco Valls Roca, Rafael Manuel Micó Pérez, Carmen Barceló Dupuy, Elena Benages Vicente, María José Gimeno Tortajada, Mercedes Calleja del Ser, Martín Menéndez Rodríguez, and Rosalía Victoria Carbonell Castelló

Subjects
hypertension, pulse pressure, cardiovascular risk factors, subclinical target organ damage, hypertensive cardiovascular disease, cardiovascular disease, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

IntroductionElevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD.ObjectiveTo evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).Materials and methodsObservational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.ResultsThe mean of PP was 52.35 mmHg, and was significantly higher (p

Published
2023
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3. Focusing on Gordonia Infections: Distribution, Antimicrobial Susceptibilities and Phylogeny

Author

Silvia Pino-Rosa, María J. Medina-Pascual, Gema Carrasco, Noelia Garrido, Pilar Villalón, Mónica Valiente, and Sylvia Valdezate

Subjects
Gordonia spp. Gordonia sputi, Gordonia bronchialis, Gordonia terrae, Gordonia otitidis, secA1, resistance, Therapeutics. Pharmacology, RM1-950
Abstract

The immunosuppression conditions and the presence of medical devices in patients favor the Gordonia infections. However, the features of this aerobic actinomycete have been little explored. Strains (n = 164) were characterized with 16S rDNA and secA1 genes to define their phylogenetic relationships, and subjected to broth microdilution to profile the antimicrobial susceptibilities of Gordonia species that caused infections in Spain during the 2005–2021 period. Four out of the eleven identified species were responsible for 86.0% of the infections: Gordonia sputi (53.0%), Gordonia bronchialis (18.3%), Gordonia terrae (8.5%) and Gordonia otitidis (6.1%). Respiratory tract infections (61.6%) and bacteremia (21.9%) were the most common infections. The secA1 gene resolved the inconclusive identification, and two major clonal lineages were observed for G. sputi and G. bronchialis. Species showed a wide antimicrobial susceptibility profile. Cefoxitin resistance varies depending on the species, reaching 94.2% for G. sputi and 36.0% for G. terrae. What is noteworthy is the minocycline resistance in G. sputi (11.5%), the clarithromycin resistance in G. bronchialis secA1 lineage II (30.0%) and the amoxicillin–clavulanate and cefepime resistance in G. terrae (21.4% and 42.8%, respectively). G. sputi and G. bronchialis stand out as the prevalent species causing infections in Spain. Resistance against cefoxitin and other antimicrobials should be considered.

Published
2023
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4. Differences in Trends in Admissions and Outcomes among Patients from a Secondary Hospital in Madrid during the COVID-19 Pandemic: A Hospital-Based Epidemiological Analysis (2020–2022)

Author

Rafael Garcia-Carretero, Oscar Vazquez-Gomez, María Ordoñez-Garcia, Noelia Garrido-Peño, Ruth Gil-Prieto, and Angel Gil-de-Miguel

Subjects
COVID-19, health care, SARS-CoV-2, time series visualization, Microbiology, QR1-502
Abstract

Spain had some of Europe’s highest incidence and mortality rates for coronavirus disease 2019 (COVID-19). This study highlights the impact of the COVID-19 pandemic on daily health care in terms of incidence, critical patients, and mortality. We describe the characteristics and clinical outcomes of patients, comparing variables over the different waves. We performed a descriptive, retrospective study using the historical records of patients hospitalized with COVID-19. We describe demographic characteristics, admissions, and occupancy. Time series allowed us to visualize and analyze trends and patterns, and identify several waves during the 27-month period. A total of 3315 patients had been hospitalized with confirmed COVID-19. One-third of these patients were hospitalized during the first weeks of the pandemic. We observed that 4.6% of all hospitalizations had been admitted to the intensive care unit, and we identified a mortality rate of 9.4% among hospitalized patients. Arithmetic- and semi-logarithmic-scale charts showed how admissions and deaths rose sharply during the first weeks, increasing by 10 every few days. We described a single hospital’s response and experiences during the pandemic. This research highlights certain demographic profiles in a population and emphasizes the importance of identifying waves when performing research on COVID-19. Our results can extend the analysis of the impact of COVID-19 and can be applied in other contexts, and can be considered when further analyzing the clinical, epidemiological, or demographic characteristics of populations with COVID-19. Our findings suggest that the pandemic should be analyzed not as a whole but rather in different waves.

Published
2023
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5. National Surveillance of Tetracycline, Erythromycin, and Clindamycin Resistance in Invasive Streptococcus pyogenes: A Retrospective Study of the Situation in Spain, 2007–2020

Author

Pilar Villalón, Marta Bárcena, María José Medina-Pascual, Noelia Garrido, Silvia Pino-Rosa, Gema Carrasco, and Sylvia Valdezate

Subjects
Streptococcus pyogenes, genotype, phenotype, antimicrobial resistance, tetracycline, erythromycin, Therapeutics. Pharmacology, RM1-950
Abstract

Background: This work reports on antimicrobial resistance data for invasive Streptococcus pyogenes in Spain, collected by the ‘Surveillance Program for Invasive Group A Streptococcus’, in 2007–2020. Methods: emm typing was determined by sequencing. Susceptibility to penicillin, tetracycline, erythromycin, and clindamycin was determined via the E-test. tetM, tetO, msrD, mefA, ermB, ermTR, and ermT were sought by PCR. Macrolide-resistant phenotypes (M, cMLSB, and iMLSB) were detected using the erythromycin–clindamycin double-disk test. Resistant clones were identified via their emm type, multilocus sequence type (ST), resistance genotype, and macrolide resistance phenotype. Results: Penicillin susceptibility was universal. Tetracycline resistance was recorded for 237/1983 isolates (12.0%) (152 carried only tetM, 48 carried only tetO, and 33 carried both). Erythromycin resistance was detected in 172/1983 isolates (8.7%); ermB was present in 83, mefA in 58, msrD in 51, ermTR in 46, and ermT in 36. Clindamycin resistance (methylase-mediated) was present in 78/1983 isolates (3.9%). Eight main resistant clones were identified: two that were tetracycline-resistant only (emm22/ST46/tetM and emm77/ST63/tetO), three that were erythromycin-resistant only (emm4/ST39/mefA-msrD/M, emm12/ST36/mefA-msrD/M, and emm28/ST52/ermB/cMLSB), and three that were tetracycline–erythromycin co-resistant (emm11/ST403/tetM-ermB/cMLSB, emm77/ST63/tetO-ermTR/iMLSB, and emm77/ST63/tetM-tetO-ermTR/iMLSB). Conclusions: Tetracycline, erythromycin, and clindamycin resistance rates declined between 2007 and 2020. Temporal variations in the proportion of resistant clones determined the change in resistance rates.

Published
2023
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6. Dynamics of a Sporadic Nosocomial Acinetobacter calcoaceticus – Acinetobacter baumannii Complex Population

Author

Pilar Villalón, Montserrat Ortega, Juan A. Sáez-Nieto, Gema Carrasco, María J. Medina-Pascual, Noelia Garrido, and Sylvia Valdezate

Subjects
Acinetobacter calcoaceticus-baumannii complex, sporadic strains, epidemic strains, species identification, clonal distribution, antimicrobial susceptibility, Microbiology, QR1-502
Abstract

Our objective was to improve current knowledge of sporadic (Spo) nosocomial Acinetobactercalcoaceticus-Acinetobacter baumannii (Acb) complex populations, and thus better understand the epidemiology of Spo and endemoepidemic (EE) strains. Between 1999 and 2010, 133 isolates of Spo Acb complex were obtained from a single hospital. Species were identified by gyrB-PCR, and via gyrB- and rpoB-sequencing. Clonal analysis was undertaken using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. Susceptibility to antimicrobial agents was determined by microdilution and E-tests. Carbapenemase genes were detected by PCR. One hundred and one PFGE types were detected. A. baumannii was the most common (67/101 PFGE types), followed by Acinetobacter pittii (22/101), Acinetobacter lactucae (6/101), and Acinetobacter calcoaceticus (2/101). gyrB, rpoB1, and rpoB2 sequencing returned 49, 13, and 16 novel sequences, respectively. Sixty-three sequence types (STs) (38 new STs and 66 new alleles) were detected; the most common were ST2 (29/133 isolates) and ST132 (14/133). Twenty-six OXA-51 allelic variants were detected, nine of which were novel. The PFGE types were generally susceptible (88/101) to all the tested antimicrobials; 3/101 were carbapenem-resistant due to the presence of the genetic structure ISAba2-blaOXA-58-like-ISAba3, and 2/101 were multidrug-resistant. It can be concluded that the examined Spo Acb complex population was mainly composed of A. baumannii. Many different clones were detected (with ST2 clearly dominant), all largely susceptible to antimicrobials; multidrug resistance was rare. In contrast, a previously examined EE Acb population was composed of just four expanding, multidrug-resistant A. baumannii clones -ST2, ST3, ST15, and ST80-.

Published
2019
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7. Molecular Characterization and Antimicrobial Susceptibilities of Nocardia Species Isolated from the Soil; A Comparison with Species Isolated from Humans

Author

Gema Carrasco, Sara Monzón, María San Segundo, Enrique García, Noelia Garrido, María J. Medina-Pascual, Pilar Villalón, Ana Ramírez, Pilar Jiménez, Isabel Cuesta, and Sylvia Valdezate

Subjects
Nocardia spp., Nocardia cyriacigeorgica, soil, nocardiosis, gyrB, MLSA, Biology (General), QH301-705.5
Abstract

Nocardia species, one of the most predominant Actinobacteria of the soil microbiota, cause infection in humans following traumatic inoculation or inhalation. The identification, typing, phylogenetic relationship and antimicrobial susceptibilities of 38 soil Nocardia strains from Lara State, Venezuela, were studied by 16S rRNA and gyrB (subunit B of topoisomerase II) genes, multilocus sequence analysis (MLSA), whole-genome sequencing (WGS), and microdilution. The results were compared with those for human strains. Just seven Nocardia species with one or two strains each, except for Nocardia cyriacigeorgica with 29, were identified. MLSA confirmed the species assignments made by 16S rRNA and gyrB analyses (89.5% and 71.0% respectively), and grouped each soil strain with its corresponding reference and clinical strains, except for 19 N. cyriacigeorgica strains found at five locations which grouped into a soil-only cluster. The soil strains of N. cyriacigeorgica showed fewer gyrB haplotypes than the examined human strains (13 vs. 17) but did show a larger number of gyrB SNPs (212 vs. 77). Their susceptibilities to antimicrobials were similar except for beta-lactams, fluoroquinolones, minocycline, and clarithromycin, with the soil strains more susceptible to the first three (p ≤ 0.05). WGS was performed on four strains belonging to the soil-only cluster and on two outside it, and the results compared with public N. cyriacigeorgica genomes. The average nucleotide/amino acid identity, in silico genome-to-genome hybridization similarity, and the difference in the genomic GC content, suggest that some strains of the soil-only cluster may belong to a novel subspecies or even a new species (proposed name Nocardia venezuelensis).

Published
2020
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8. Prevalencia de la enfermedad renal crónica y factores asociados en la población asistida en atención primaria de España: resultados del estudio IBERICAN

Author

García, Alfonso Barquilla, Rodríguez, Ángel Díaz, Cervantes, Carlos Escobar, Moreno, Francisco Javier Alonso, Roca, Gustavo Cristóbal Rodríguez, Martín, Jesús Vergara, Caro, José Luis Llisterri, Badimón, Juan José, García, José Polo, Padial, Luis Rodríguez, Prieto, Miguel Ángel, Pérez, Rafael Vidal, Sanjurjo, Sergio Cinza, Jiménez, Sonia Miravet, Zancada, Sonsoles Velilla, Téllez, Antonio López, de Los Ángeles Ortega Osuna, Maria, Cid, Cristóbal Prieto, Fajardo, María José Hidalgo, Serna, José Lorente, Requena, Ángel Domínguez, Cañizares, Ricardo Alberola, Peña, Manuel Ruiz, Collado, Filomena Herrero, Vázquez, Marcela Montes, Garrido, Rafael Ángel Carrascal, Lozano, María Reyes Herrera, Oliva, Beatriz Ortiz, Anguita, Francisco José, Ibáñez, Carmen Pérez, Rodríguez, Carlos Alberto Cabrera, Rodríguez, María José Cruz, Ruiz, Sandra Bonilla, González, Rocío Reina, Sánchez, Salomé Abad, Martínez, Inmaculada Santana, Jordán, Rafael Sánchez, Navas-Parejo, Juan María Ramos, Torres, José Manuel Ramírez, Poveda, José María Beltrán, Benayas, María Adoración de Cruz, Gil, Carmen Fernandez, Alcaine, Jon Iñaki Esturo, Quintero, Antonio Mora, Cepas, Fernando Leiva, Martín, José Luis Carrasco, Criado, Emilio García, Blanco, Mercedes Vázquez, Ortiz, Isabel Mora, Mendoza, Leovigildo Ginel, Rodríguez, Juan Carlos Aguirre, Rodríguez, Esperanza María Romero, Vázquez, José Acevedo, Ballesteros, Juan Gabriel García, Lara, María de La Paz Fernández, Moreno, Patricia Agüera, Maturana, Eduardo Paños, Expósito, Juan Manuel Ignacio, Peñas, Noelia Carrillo, Faya, Carmen María Abad, Duque, Ana Marina Almagro, Camisón, Rubén Torrescusa, Polo, Paloma Menéndez, García, Marina Peña, Fernández, Cristina López, Torres, Ascensión Estepa, Jansen, Miguel Gutiérrez, González, Esperanza Loizaga, Matarin, Lisardo García, Luna, Enrique José Gamero de, Rivero, Javier Benítez, Gómez González, María José, Montes, Carmen Gómez, Calvo, Eva Trillo, Calvo, Concepción Bayod, Natividad, Susana Larripa de La, Lambea, Germán Grasa, Marín, Emilio Jiménez, Gonzalvo, Ana Cristina Navarro, Martínez Barseló, Antonio Pablo, León, Irene Peña, Fernández, E. Lidia Gutiérrez, Mantecón, Fernando Andrés, Garrido, Ana Belén García, Escalante, Asunción Velez, Rentería, Luisa Alonso, Jiménez, Jesús Sainz, Alles, Guillermo Pombo, Garrote, Juan Antonio Divison, Sotodosos, Pedro Martínez, Fuster, Juan Antonio Vivancos, Palencia, María García, Moraleda, José Ambrosio Torres, Ballesteros, Sara González, Adrados, Ana Carmen Gil, Cabrera, Antonio González, Fernández, Miguel Ángel Babiano, García, Guillermo Rico, Criado-Álvarez, Juan José, Moreno, Pilar Torres, Aguirregaviria, Francisco Javier Arribas, Martínez, Alicia Sahuquillo, Béjar, Lourdes María Santos, Peralta, Miguel Laborda, Castro, Raúl Piedra, Altozano, Carlos Santos, Polo, Lucía González-Tarrio, Maresca, Pedro Valiente, Santana, Reinilda Mota, Ledesma, Noemi Elizabeth Terrero, Espada, Noelia Garrido, Calvi, Gabriela Delia Rosa Zambrana, Montero, Juan Lorenzo Gutiérrez, Gil, Juan Ignacio López, Ortega, María Dolores Fernández, Roncal, Miren Elizari, Serrano, María Ascensión López, Fuente, Nuria Esther Adrián de La, Larrea, Belén Angulo Fdez. de, Fernández, Naiara Cubelos, Gómez, Guiomar Luz Ferreiro, Rodríguez, Diana Gómez, Tuñón, Sonia María Andrés, González, María Ajenjo, Olea, Serafín de Abajo, Regueras, Juan José León, Nieto, César Manuel Gallego, Mallada, Delio Vázquez, García, Maria de La O Gutiérrez, Rodríguez, Pablo Baz, García, José Ignacio Ferradal, Martínez, Blanca Delia de Román, Pérez, Ana Arconada, Atoui, Omar Mahmoud, Bayón, Álvaro Morán, Olmo, María Teresa Armenteros del, Herreros, Fco. Javier García-Norro, Rodríguez, Enrique Méndez, Pineda, Diana María Narganes, Ainaga, Verónica Ortiz, Guevara, Milagros Sonlei Sánchez, Ferreiro, Laura Villota, Grande, M. Teresa Grande, Gracía, Francisco Vicente Martínez, García, María Dolores Moriano, Muñoz, Beatriz Jiménez, Marcelino, Gemma Rovira, Valverde, Diana Elizabeth Fernández, Bernadó, Roser Rodó, Lupiáñez, María Teresa Ortiz, Najih, Najlaa, Parra, José María Diéguez, Acebo, María Rosa Benedicto, Vicien, Mari Luz Bravo, Estella, Alberto Ramón León, Gómez, Juan Antonio Muñoz, Muntané, Alicia Mostazo, Abarca, Isabel Ortega, Fargas, Anna Gasol, Escudero, Brenda Elizabeth Riesgo, Riesgo, Susana Elizabeth, Castellvi, Edgar Zaballos, Sagarra, Celia Cols, Fernández, Marta Herranz, Presas, Josep Alins, Pérez, Idaira Damas, García, Rosa M. Alcolea, Collado, Inés Monte, Martínez, Roberto Genique, Villanueva, María José Guasch, Martínez, Teresa Rama, Pena, Lucio Pinto, Royo, Josefa María Panisello, Gil, Inés Gil, Montero, Alberto Calderón, Gómez, María del Mar Zamora, Cebrián, Elena Alarcón, Acin, María José Piñero, Sacristán, Celia Pecharromán, Vicente, M. Soledad Mayayo, Unanua, María Paz Pérez, Henrich, Nuria Marañón, Monreal, Saray Gómez, Pedro, Sonia Redondo de, Pozo, Blanca Sanz, Martínez, Irene Moreno, Uriarte, Beatriz López, Velasco, Carmelina Sanz, Aguirre, Amaya Gárriz, Teijido, Montserrat Rivera, Jaén, Germán Reviriego, Pascual-Salcedo, José Ignacio Aza, Gallego, Josefa Vázquez, Rodilla, Julia Caballer, Herrera, Aida, Martínez, Ezequiel Arranz, Calvo, Ana María Gómez, Oliva, Paula Morán, Béjar, María Milagros González, Hitos, Julio Antonio Heras, Vallejo, Olga García, Vargas, Manuel de Jesús Frías, Boguerin, María Jesús Castillejo, Lerin, Aurora García, Tablado, Miguel Ángel María, García, Elena Concepción García, Acero, Leticia de Miguel, Oñate, Carmen Zárate, Apoita, Aránzazu Barranco, Belloso, María Ester Montes, Velasco, Ana María Huertas, Jiménez, Rafael Sáez, Pascual, Julia Natividad García, Zuluaga, María Clemencia Zuluaga, Perez, María Cruz Díez, García, Antonio Ruiz, Jelsbak, Cristina Murillo, Oria, Virginia Lasso, Gamarra, Amelia González, Fuster, Vicente Pascual, Bort, María Dolores Aicart, Gómez, Natividad Vázquez, Gasco, Carlos Lluna, Barber, Teresa Amoros, Cano, Pedro Antonio Medina, Moncho, Miguel Monteagudo, Muñoz, María Jesús Larré, Hernández, Raquel Navarro, Egea, Francisco José Martínez, Tramontano, Antonio, Royo, Marta Ferrer, Saura, Belén Persiva, Torres, Juan A. Contreras, Moliner, José María Tirado, Penalba, Alejandro Salanova, Alberola, Ariadna Cucó, Ros, Fernando María Navarro I., Llicer, Enrique Beltrán, Novás, Ana Seoane, Valls, Inmaculada Martín, Mahiques, Gracia Verdú, Forcada, Enrique Peña, Gómez, Nieves Aguilar, García, Francisco Javier Sanz, Bueso, M. Dolores Paradís, Romero, María Eugenia Alegre, Camus, Antonio Francés, Peinado, María Amparo Antón, Santos, Rosa Latorre, Marín, María Asunción Palomar, García, María Carmen Botella, Fresquet, Eva Sánchez, Paños, Pedro Sala, Ruiz, Tomás Sánchez, Valero, Rosa Ana Valero, Vicente, María Seoane, Llinares, Magdalena Martín, Alegre, Antonio Masiá, Verdú, Irene Lluch, Carratala, Vicente Pallares, Roca, Francisco Valls, Pérez, Rafael Manuel Micó, García, Jacinto Espinosa, Romo, José Ignacio Prieto, Fernández, Leandro Fernández, Sierratapia, Javier, Regidor, Nieves Moreno, Sánchez, Francisco Javier Zaballos, Moreno, Ana Moreno, Barrera, Francisco Carramiñana, Vázquez, Juan José Torres, Samino, María José Gamero, Rodríguez, Miguel Ángel de Santiago, Martínez, Pablo Rafael Gómez, Becerra, Antonio Carlos Elías, Olivera, Javier Soto, Cambero, Víctor, Ávila, Julián Domínguez, Fuentes, Andrés Simón, Jiménez, Jorge Manuel de Nicolás, Fraile, Dimas Igual, Barco, Guadalupe Nieto, Ramos, Ignacio Araujo, Berrocal, María Luz Serrano, Ramírez, Francisco Buitrago, Marcos, Minerva Gallego, González, Félix Suárez, Carrasco, Victoriano Chavero, Peguero, Francisco Guerra, Vega, Francisco Javier Sánchez, Mas, Manuel Tejero, Donoso, Alba Palmerín, Yedro, Miguel Turégano, Rojas, María Beatriz Esteban, Moreno, Fátima Cabezudo, Saldaña, Nawson Elver Quevedo, Fenés, María del Mar García, Florencio, Timotea Garrote, Toro, José María Fernández, Rañal, Alejandra Rey, Río, Elena García del, Pol, Enrique Nieto, Fernández, Julio Álvarez, Álvarez, Pilar Alonso, Gómez, María Luisa Jorge, Guerrero, Antonio Calvo, Colomina, Isabel Celemín, Casal, Lucía Barreiro, Moreno, Juana Fernández, Martínez, María Angelines Carballal, Rodríguez, Nabor Díaz, Paredes, Carlos Moral, García, Dolores Recarey, Mato, Fco. Javier Iglesias, Ulloa, Antonio Fouz, González, Amparo Fidalgo, Parada, Noelia Dios, Sabarís, Patricia Conde, Pérez, Ana Isabel Rodríguez, Palacio, Ana Inés García, Varela, Víctor Julio Quesada, Iglesias, Lidia Romero, Llerena, Ángel Lado, Rodríguez, Carmen Lires, Diaz, María Luisa Carretero, Arias, José Carreira, Camino, Jose Luis Vázquez, Penas, María del Carmen Torreiro, Freire, Sandra Yáñez, Aldana, Daniel Rey, Díaz, Carlos Piñeiro, Romanos, Fernando García, González, Antonia Moreno, Sastre, María Lara Amengual, Palli, Susana Martínez, Bauza, José Alfonso Ramón, Bolinches, José Ortiz, Fernández, Carmen Fernández, Vázquez, María Isabel Orlandis, Mezquita, Ana Sanchís, Aramburu, Fernando Unceta, Morant, Juan Fernando Peiró, Amengual, Ana Moyá, García, Isidro Godoy, Sevillano, Fernando Rubio, González, María Isabel González, Souto, Marta Pérez, Contreras, Raquel de León, González, Sara Isabel Almeida, Diez, Irene Almería, Sánchez, Virginia María Mirabal, Lavado, Francisco José Escobar, Pérez, Yoel Anta, Hernández, Nayra Sánchez, Jerez, Juan Luis Alonso, Koch, Ricardo, Mendoza, Nayra Ramírez, Hernández, Héctor Suárez, Escobar, Francisco Jesús Morales, Zancada, Sonsoles María Velilla, Sabarís, Rafael Crespo, Jiménez, Óscar Fernando Isaula, Puga, Jesús Manuel González, Ávila, Jorge Antonio Benaín, González, Óscar del Toro, Íñigo, Laura Sánchez, Pérez, Inés Sanz, Nubla, José Félix Zuazagoitia, Ituiño, Ana Echebarría, Tris, Gregorio Mediavilla, Bosch, María Carmen Noriega, González, Esther, Macho, María Luisa Ruiz, Olmo, Ruth Sendino del, Prado, Asunción Olagorta de, Muguerza, Ana López de Viñaspre, Iriso, Jesús Iturralde, Martínez, María José Pérez, Carbonell, Ana Piera, Fernández, Margarita Alonso, Cuadrado, María Montserrat Rueda, Rodríguez, Rodrigo Abad, Cabo, José Miguel Álvarez, Rodríguez, Rubén Sánchez, Cabo, Eva María Cano, Secin, Anny Romero, Díaz, Miguel Ángel Prieto, Fernández, Juan Jesús García, Bueno, Vicente Llorca, Pérez, Ana María Ballesteros, López, Domingo J. Rubira, Franco, María Dolores Esteve, Pablo, Elena Sánchez, López, María Teresa Palacios, Meroño, Juan Castillo, Martínez, José María Lobo, Martínez, Isabel María Peral, Carrasco, J. Eduardo Carrasco, González, Armando Santo, Llisterri, José Luis, Micó-Pérez, Rafael Manuel, Velilla-Zancada, Sonsoles, Rodríguez-Roca, Gustavo Cristóbal, Prieto-Díaz, Miguel Ángel, Martín-Sánchez, Vicente, Barquilla, Alfonso, Polo-García, José, Segura-Fragoso, Antonio, and Cinza-Sanjurjo, Sergio

Published
2021
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9. Simplification and Multidimensional Adaptation of the Stratification Tool for Pharmaceutical Care in People Living With HIV

Author

Ramón Morillo-Verdugo, Tamara Aguilar Pérez, Mercedes Gimeno-Gracia, Carmen Rodríguez-González, María de las Aguas Robustillo-Cortes, Aitziber Illaro Uranga, Alicia Lázaro López, Angels Andreu Crespo, Aránzazu Linares Alarcón, Beatriz Proy Vega, Belén López García, Carlos Seguí Solanes, Carolina Aguilar Guisado, Elena Cárdaba García, Emilio Molina Cuadrado, Emilio Monte Boquet, Encarna Abad Lecha, Esther Vicente Escrig, Gabriel Mercadal Orfila, Herminia Navarro Aznárez, Inmaculada Nacle López, Irene Cañamares Orbis, Jara Gallardo Anciano, Javier Casas Arrate, Javier Sánchez-Rubio Ferrández, Joaquín Ignacio Serrano López, José Alberto Peña Pedrosa, Jose Sebastián Roldan González, Luis Carlos Fernández Lisón, Luis Margusino Framinan, Luis Ortega Valín, Maite Martin, Manuel Vélez, María Ángeles Andreu Crespo, Maria Carmen Rosado Maria, María García Coronel, Maria Jose Huertas Fernández, Mercedes Manzano García, Noelia Garrido Peña, Oihana Mora Atorrasagasti, Patricia Sanmartin Fenollera, Pilar Díaz Ruíz, Ramón San Miguel Elcano, Raquel Fresquet Molina, Vera Áreas del Águila, Dr Elena Rebollo-Gómez, and Dr Vanessa Marfil

Subjects
Consensus, Delphi Technique, Pharmaceutical Services, Humans, HIV, Pharmacology (medical), HIV Infections, Pharmacists
Abstract

Background People living with human immunodeficiency virus (HIV) require specific pharmaceutical care (PC). Although the 2017 Capacity-Motivation-Opportunity (CMO) PC model allows a multidisciplinary approach that focuses on patient needs, it is too complex and presents room for improvement. Objective The aim of this study is to simplify and adapt the previous 2017 PC tool through a multidimensional approach to improve HIV patient care, to prove the validity of the model in real-life patients. Methods The new PC tool was generated by keeping some of the variables of the 2017 document and conducting a literature search. Content validity was determined by a 2-round Delphi methodology with an expert panel of 42 pharmacists. Consensus for the first and second rounds was defined as ≥70% agreement. The tool generated was validated in 407 real-life patients. Results Thirty-seven experts completed the first round of the Delphi survey and 36 the second. No consensus was reached for 3 variables, any of the frequency options and 4 interventions, while the experts agreed not to include 1 intervention in round 1. Consensus to include them was found for all but 1 variable and 1 intervention in round 2. The final tool obtained to select and stratify HIV-positive patients was composed of 9 dimensions divided into 17 variables. The new tool was validated with real-life patients and 3 priority levels were defined. Conclusions and relevance We created a new pyramid of score thresholds to classify patients into priority levels. The new tool simplifies the 2017 model and improves its utility to help HIV-positive patients, owing to its multidimensional approach.

Published
2022

11. Simplification and Multidimensional Adaptation of the Stratification Tool for Pharmaceutical Care in People Living With HIV

Author

Morillo-Verdugo, Ramón, primary, Aguilar Pérez, Tamara, additional, Gimeno-Gracia, Mercedes, additional, Rodríguez-González, Carmen, additional, Robustillo-Cortes, María de las Aguas, additional, Uranga, Aitziber Illaro, additional, López, Alicia Lázaro, additional, Crespo, Angels Andreu, additional, Alarcón, Aránzazu Linares, additional, Vega, Beatriz Proy, additional, García, Belén López, additional, Solanes, Carlos Seguí, additional, Guisado, Carolina Aguilar, additional, García, Elena Cárdaba, additional, Cuadrado, Emilio Molina, additional, Boquet, Emilio Monte, additional, Lecha, Encarna Abad, additional, Escrig, Esther Vicente, additional, Orfila, Gabriel Mercadal, additional, Aznárez, Herminia Navarro, additional, López, Inmaculada Nacle, additional, Orbis, Irene Cañamares, additional, Anciano, Jara Gallardo, additional, Arrate, Javier Casas, additional, Ferrández, Javier Sánchez-Rubio, additional, López, Joaquín Ignacio Serrano, additional, Pedrosa, José Alberto Peña, additional, González, Jose Sebastián Roldan, additional, Lisón, Luis Carlos Fernández, additional, Framinan, Luis Margusino, additional, Valín, Luis Ortega, additional, Martin, Maite, additional, Vélez, Manuel, additional, Crespo, María Ángeles Andreu, additional, Maria, Maria Carmen Rosado, additional, Coronel, María García, additional, Fernández, Maria Jose Huertas, additional, García, Mercedes Manzano, additional, Peña, Noelia Garrido, additional, Atorrasagasti, Oihana Mora, additional, Fenollera, Patricia Sanmartin, additional, Ruíz, Pilar Díaz, additional, Elcano, Ramón San Miguel, additional, Molina, Raquel Fresquet, additional, del Águila, Vera Áreas, additional, Rebollo-Gómez, Dr Elena, additional, and Marfil, Dr Vanessa, additional

Published
2022
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12. Invasive Streptococcus pyogenes disease in Spain: a microbiological and epidemiological study covering the period 2007-2019

Author

Virginia Rubio-López, Noelia Garrido, María J. Medina-Pascual, Juan Antonio Sáez-Nieto, Sylvia Valdezate, Pilar Villalón, Gema Carrasco, and Silvia Pino-Rosa

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, Adolescent, Tetracycline, Streptococcus pyogenes, 030106 microbiology, Erythromycin, Exotoxins, Microbial Sensitivity Tests, Penicillins, medicine.disease_cause, Microbiology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Antibiotic resistance, Bacterial Proteins, Streptococcal Infections, medicine, Humans, 030212 general & internal medicine, Child, Aged, Aged, 80 and over, Streptococcus, business.industry, Clindamycin, Infant, Membrane Proteins, General Medicine, Middle Aged, medicine.disease, Anti-Bacterial Agents, Infectious Diseases, Spain, Cellulitis, Child, Preschool, Scarlet fever, Female, business, Carrier Proteins, medicine.drug
Abstract

The aim of this study is to present the first nationwide microbiological and epidemiological study of invasive group A Streptococcus (iGAS) disease in Spain. One thousand eight hundred ninety-three iGAS isolates were analyzed over 2007-2019. emm typing was performed by sequencing the gene's variable 5' end, exotoxin genes were identified by PCR, and antimicrobial susceptibility explored via the E test and disk diffusion. Five hundred twenty-three isolates were associated with sepsis, 292 with cellulitis, 232 with scarlet fever, 153 with pneumonia, 141 with streptococcal toxic shock syndrome, and 94 with necrotizing fasciitis. The most prevalent emm types were emm1 (449/1893 isolates), emm89 (210/1893), emm3 (208/1893), emm4 (150/1893), emm12 (112/1893) emm6 (107/1893), emm87 (89/1893), emm28 (88/1893), emm75 (78/1893), emm77 (78/1893), emm11 (58/1893), and emm22 (35/1893). emm1, emm3, emm4, and emm6 were the predominant types affecting children (mostly respiratory infections), while emm11, emm77, and emm89 prevailed in the elderly (mostly skin infections). Each emm type was associated with one or more exotoxin gene (spe, sme, and ssa) profiles. speA was detected in 660 isolates, speB in 1829, speC in 1014, speF in 1826, speG in 1651, speJ in 716, speH in 331, smeZ in 720, and ssa in 512. Isolates with speA were associated with the most severe infections. Penicillin susceptibility was universal. Two hundred twenty-four isolates were resistant to tetracycline, 169 to erythromycin, and 81 to clindamycin. Tetracycline, erythromycin, and clindamycin resistance rates declined over the study period. The above information could serve as the basis for continued surveillance efforts designed to control disease cause by this bacterium.

Published
2021

13. Molecular Characterization and Antimicrobial Susceptibilities of Nocardia Species Isolated from the Soil; A Comparison with Species Isolated from Humans

Author

María Jesús San Segundo, Isabel Cuesta, Sylvia Valdezate, Pilar Jiménez, Ana Ramírez, Noelia Garrido, Sara Monzón, María J. Medina-Pascual, Pilar Villalón, Gema Carrasco, Enrique García, Instituto de Salud Carlos III, and Instituto de Salud Carlos III - ISCIII

Subjects
Microbiology (medical), MLSA, Potential new species/subspecies N. venezuelensis, Sequence analysis, gyrB, Subspecies, Antimicrobial resistance, Microbiology, Actinobacteria, Nocardia cyriacigeorgica, soil, 03 medical and health sciences, Nocardiosis, Soil, Virology, medicine, Typing, lcsh:QH301-705.5, 030304 developmental biology, Nocardia spp, nocardiosis, 0303 health sciences, biology, 030306 microbiology, Nocardia, 16S ribosomal RNA, biology.organism_classification, medicine.disease, lcsh:Biology (General), GC-content, WGS
Abstract

Nocardia species, one of the most predominant Actinobacteria of the soil microbiota, cause infection in humans following traumatic inoculation or inhalation. The identification, typing, phylogenetic relationship and antimicrobial susceptibilities of 38 soil Nocardia strains from Lara State, Venezuela, were studied by 16S rRNA and gyrB (subunit B of topoisomerase II) genes, multilocus sequence analysis (MLSA), whole-genome sequencing (WGS), and microdilution. The results were compared with those for human strains. Just seven Nocardia species with one or two strains each, except for Nocardia cyriacigeorgica with 29, were identified. MLSA confirmed the species assignments made by 16S rRNA and gyrB analyses (89.5% and 71.0% respectively), and grouped each soil strain with its corresponding reference and clinical strains, except for 19 N. cyriacigeorgica strains found at five locations which grouped into a soil-only cluster. The soil strains of N. cyriacigeorgica showed fewer gyrB haplotypes than the examined human strains (13 vs. 17) but did show a larger number of gyrB SNPs (212 vs. 77). Their susceptibilities to antimicrobials were similar except for beta-lactams, fluoroquinolones, minocycline, and clarithromycin, with the soil strains more susceptible to the first three (p ≤ 0.05). WGS was performed on four strains belonging to the soil-only cluster and on two outside it, and the results compared with public N. cyriacigeorgica genomes. The average nucleotide/amino acid identity, in silico genome-to-genome hybridization similarity, and the difference in the genomic GC content, suggest that some strains of the soil-only cluster may belong to a novel subspecies or even a new species (proposed name Nocardia venezuelensis). This work was funded by a grant to N.G. from the Instituto de Salud Carlos III (MPY 1278/15). A part of this manuscript forms the M.S project undertaken at the Faculty of Science, Universidad Autónoma de Madrid (Spain). Sí

Published
2020

14. Prevalencia de la enfermedad renal crónica y factores asociados en la población asistida en atención primaria de España: resultados del estudio IBERICAN

Author

Llisterri, José Luis, primary, Micó-Pérez, Rafael Manuel, additional, Velilla-Zancada, Sonsoles, additional, Rodríguez-Roca, Gustavo Cristóbal, additional, Prieto-Díaz, Miguel Ángel, additional, Martín-Sánchez, Vicente, additional, Barquilla, Alfonso, additional, Polo-García, José, additional, Segura-Fragoso, Antonio, additional, Cinza-Sanjurjo, Sergio, additional, García, Alfonso Barquilla, additional, Rodríguez, Ángel Díaz, additional, Cervantes, Carlos Escobar, additional, Moreno, Francisco Javier Alonso, additional, Roca, Gustavo Cristóbal Rodríguez, additional, Martín, Jesús Vergara, additional, Caro, José Luis Llisterri, additional, Badimón, Juan José, additional, García, José Polo, additional, Padial, Luis Rodríguez, additional, Prieto, Miguel Ángel, additional, Pérez, Rafael Vidal, additional, Sanjurjo, Sergio Cinza, additional, Jiménez, Sonia Miravet, additional, Zancada, Sonsoles Velilla, additional, Téllez, Antonio López, additional, de Los Ángeles Ortega Osuna, Maria, additional, Cid, Cristóbal Prieto, additional, Fajardo, María José Hidalgo, additional, Serna, José Lorente, additional, Requena, Ángel Domínguez, additional, Cañizares, Ricardo Alberola, additional, Peña, Manuel Ruiz, additional, Collado, Filomena Herrero, additional, Vázquez, Marcela Montes, additional, Garrido, Rafael Ángel Carrascal, additional, Lozano, María Reyes Herrera, additional, Oliva, Beatriz Ortiz, additional, Anguita, Francisco José, additional, Ibáñez, Carmen Pérez, additional, Rodríguez, Carlos Alberto Cabrera, additional, Rodríguez, María José Cruz, additional, Ruiz, Sandra Bonilla, additional, González, Rocío Reina, additional, Sánchez, Salomé Abad, additional, Martínez, Inmaculada Santana, additional, Jordán, Rafael Sánchez, additional, Navas-Parejo, Juan María Ramos, additional, Torres, José Manuel Ramírez, additional, Poveda, José María Beltrán, additional, Benayas, María Adoración de Cruz, additional, Gil, Carmen Fernandez, additional, Alcaine, Jon Iñaki Esturo, additional, Quintero, Antonio Mora, additional, Cepas, Fernando Leiva, additional, Martín, José Luis Carrasco, additional, Criado, Emilio García, additional, Blanco, Mercedes Vázquez, additional, Ortiz, Isabel Mora, additional, Mendoza, Leovigildo Ginel, additional, Rodríguez, Juan Carlos Aguirre, additional, Rodríguez, Esperanza María Romero, additional, Vázquez, José Acevedo, additional, Ballesteros, Juan Gabriel García, additional, Lara, María de La Paz Fernández, additional, Moreno, Patricia Agüera, additional, Maturana, Eduardo Paños, additional, Expósito, Juan Manuel Ignacio, additional, Peñas, Noelia Carrillo, additional, Faya, Carmen María Abad, additional, Duque, Ana Marina Almagro, additional, Camisón, Rubén Torrescusa, additional, Polo, Paloma Menéndez, additional, García, Marina Peña, additional, Fernández, Cristina López, additional, Torres, Ascensión Estepa, additional, Jansen, Miguel Gutiérrez, additional, González, Esperanza Loizaga, additional, Matarin, Lisardo García, additional, Luna, Enrique José Gamero de, additional, Rivero, Javier Benítez, additional, Gómez González, María José, additional, Montes, Carmen Gómez, additional, Calvo, Eva Trillo, additional, Calvo, Concepción Bayod, additional, Natividad, Susana Larripa de La, additional, Lambea, Germán Grasa, additional, Marín, Emilio Jiménez, additional, Gonzalvo, Ana Cristina Navarro, additional, Martínez Barseló, Antonio Pablo, additional, León, Irene Peña, additional, Fernández, E. Lidia Gutiérrez, additional, Mantecón, Fernando Andrés, additional, Garrido, Ana Belén García, additional, Escalante, Asunción Velez, additional, Rentería, Luisa Alonso, additional, Jiménez, Jesús Sainz, additional, Alles, Guillermo Pombo, additional, Garrote, Juan Antonio Divison, additional, Sotodosos, Pedro Martínez, additional, Fuster, Juan Antonio Vivancos, additional, Palencia, María García, additional, Moraleda, José Ambrosio Torres, additional, Ballesteros, Sara González, additional, Adrados, Ana Carmen Gil, additional, Cabrera, Antonio González, additional, Fernández, Miguel Ángel Babiano, additional, García, Guillermo Rico, additional, Criado-Álvarez, Juan José, additional, Moreno, Pilar Torres, additional, Aguirregaviria, Francisco Javier Arribas, additional, Martínez, Alicia Sahuquillo, additional, Béjar, Lourdes María Santos, additional, Peralta, Miguel Laborda, additional, Castro, Raúl Piedra, additional, Altozano, Carlos Santos, additional, Polo, Lucía González-Tarrio, additional, Maresca, Pedro Valiente, additional, Santana, Reinilda Mota, additional, Ledesma, Noemi Elizabeth Terrero, additional, Espada, Noelia Garrido, additional, Calvi, Gabriela Delia Rosa Zambrana, additional, Montero, Juan Lorenzo Gutiérrez, additional, Gil, Juan Ignacio López, additional, Ortega, María Dolores Fernández, additional, Roncal, Miren Elizari, additional, Serrano, María Ascensión López, additional, Fuente, Nuria Esther Adrián de La, additional, Larrea, Belén Angulo Fdez. de, additional, Fernández, Naiara Cubelos, additional, Gómez, Guiomar Luz Ferreiro, additional, Rodríguez, Diana Gómez, additional, Tuñón, Sonia María Andrés, additional, González, María Ajenjo, additional, Olea, Serafín de Abajo, additional, Regueras, Juan José León, additional, Nieto, César Manuel Gallego, additional, Mallada, Delio Vázquez, additional, García, Maria de La O Gutiérrez, additional, Rodríguez, Pablo Baz, additional, García, José Ignacio Ferradal, additional, Martínez, Blanca Delia de Román, additional, Pérez, Ana Arconada, additional, Atoui, Omar Mahmoud, additional, Bayón, Álvaro Morán, additional, Olmo, María Teresa Armenteros del, additional, Herreros, Fco. Javier García-Norro, additional, Rodríguez, Enrique Méndez, additional, Pineda, Diana María Narganes, additional, Ainaga, Verónica Ortiz, additional, Guevara, Milagros Sonlei Sánchez, additional, Ferreiro, Laura Villota, additional, Grande, M. Teresa Grande, additional, Gracía, Francisco Vicente Martínez, additional, García, María Dolores Moriano, additional, Muñoz, Beatriz Jiménez, additional, Marcelino, Gemma Rovira, additional, Valverde, Diana Elizabeth Fernández, additional, Bernadó, Roser Rodó, additional, Lupiáñez, María Teresa Ortiz, additional, Najih, Najlaa, additional, Parra, José María Diéguez, additional, Acebo, María Rosa Benedicto, additional, Vicien, Mari Luz Bravo, additional, Estella, Alberto Ramón León, additional, Gómez, Juan Antonio Muñoz, additional, Muntané, Alicia Mostazo, additional, Abarca, Isabel Ortega, additional, Fargas, Anna Gasol, additional, Escudero, Brenda Elizabeth Riesgo, additional, Riesgo, Susana Elizabeth, additional, Castellvi, Edgar Zaballos, additional, Sagarra, Celia Cols, additional, Fernández, Marta Herranz, additional, Presas, Josep Alins, additional, Pérez, Idaira Damas, additional, García, Rosa M. Alcolea, additional, Collado, Inés Monte, additional, Martínez, Roberto Genique, additional, Villanueva, María José Guasch, additional, Martínez, Teresa Rama, additional, Pena, Lucio Pinto, additional, Royo, Josefa María Panisello, additional, Gil, Inés Gil, additional, Montero, Alberto Calderón, additional, Gómez, María del Mar Zamora, additional, Cebrián, Elena Alarcón, additional, Acin, María José Piñero, additional, Sacristán, Celia Pecharromán, additional, Vicente, M. Soledad Mayayo, additional, Unanua, María Paz Pérez, additional, Henrich, Nuria Marañón, additional, Monreal, Saray Gómez, additional, Pedro, Sonia Redondo de, additional, Pozo, Blanca Sanz, additional, Martínez, Irene Moreno, additional, Uriarte, Beatriz López, additional, Velasco, Carmelina Sanz, additional, Aguirre, Amaya Gárriz, additional, Teijido, Montserrat Rivera, additional, Jaén, Germán Reviriego, additional, Pascual-Salcedo, José Ignacio Aza, additional, Gallego, Josefa Vázquez, additional, Rodilla, Julia Caballer, additional, Herrera, Aida, additional, Martínez, Ezequiel Arranz, additional, Calvo, Ana María Gómez, additional, Oliva, Paula Morán, additional, Béjar, María Milagros González, additional, Hitos, Julio Antonio Heras, additional, Vallejo, Olga García, additional, Vargas, Manuel de Jesús Frías, additional, Boguerin, María Jesús Castillejo, additional, Lerin, Aurora García, additional, Tablado, Miguel Ángel María, additional, García, Elena Concepción García, additional, Acero, Leticia de Miguel, additional, Oñate, Carmen Zárate, additional, Apoita, Aránzazu Barranco, additional, Belloso, María Ester Montes, additional, Velasco, Ana María Huertas, additional, Jiménez, Rafael Sáez, additional, Pascual, Julia Natividad García, additional, Zuluaga, María Clemencia Zuluaga, additional, Perez, María Cruz Díez, additional, García, Antonio Ruiz, additional, Jelsbak, Cristina Murillo, additional, Oria, Virginia Lasso, additional, Gamarra, Amelia González, additional, Fuster, Vicente Pascual, additional, Bort, María Dolores Aicart, additional, Gómez, Natividad Vázquez, additional, Gasco, Carlos Lluna, additional, Barber, Teresa Amoros, additional, Cano, Pedro Antonio Medina, additional, Moncho, Miguel Monteagudo, additional, Muñoz, María Jesús Larré, additional, Hernández, Raquel Navarro, additional, Egea, Francisco José Martínez, additional, Tramontano, Antonio, additional, Royo, Marta Ferrer, additional, Saura, Belén Persiva, additional, Torres, Juan A. Contreras, additional, Moliner, José María Tirado, additional, Penalba, Alejandro Salanova, additional, Alberola, Ariadna Cucó, additional, Ros, Fernando María Navarro I., additional, Llicer, Enrique Beltrán, additional, Novás, Ana Seoane, additional, Valls, Inmaculada Martín, additional, Mahiques, Gracia Verdú, additional, Forcada, Enrique Peña, additional, Gómez, Nieves Aguilar, additional, García, Francisco Javier Sanz, additional, Bueso, M. Dolores Paradís, additional, Romero, María Eugenia Alegre, additional, Camus, Antonio Francés, additional, Peinado, María Amparo Antón, additional, Santos, Rosa Latorre, additional, Marín, María Asunción Palomar, additional, García, María Carmen Botella, additional, Fresquet, Eva Sánchez, additional, Paños, Pedro Sala, additional, Ruiz, Tomás Sánchez, additional, Valero, Rosa Ana Valero, additional, Vicente, María Seoane, additional, Llinares, Magdalena Martín, additional, Alegre, Antonio Masiá, additional, Verdú, Irene Lluch, additional, Carratala, Vicente Pallares, additional, Roca, Francisco Valls, additional, Pérez, Rafael Manuel Micó, additional, García, Jacinto Espinosa, additional, Romo, José Ignacio Prieto, additional, Fernández, Leandro Fernández, additional, Sierratapia, Javier, additional, Regidor, Nieves Moreno, additional, Sánchez, Francisco Javier Zaballos, additional, Moreno, Ana Moreno, additional, Barrera, Francisco Carramiñana, additional, Vázquez, Juan José Torres, additional, Samino, María José Gamero, additional, Rodríguez, Miguel Ángel de Santiago, additional, Martínez, Pablo Rafael Gómez, additional, Becerra, Antonio Carlos Elías, additional, Olivera, Javier Soto, additional, Cambero, Víctor, additional, Ávila, Julián Domínguez, additional, Fuentes, Andrés Simón, additional, Jiménez, Jorge Manuel de Nicolás, additional, Fraile, Dimas Igual, additional, Barco, Guadalupe Nieto, additional, Ramos, Ignacio Araujo, additional, Berrocal, María Luz Serrano, additional, Ramírez, Francisco Buitrago, additional, Marcos, Minerva Gallego, additional, González, Félix Suárez, additional, Carrasco, Victoriano Chavero, additional, Peguero, Francisco Guerra, additional, Vega, Francisco Javier Sánchez, additional, Mas, Manuel Tejero, additional, Donoso, Alba Palmerín, additional, Yedro, Miguel Turégano, additional, Rojas, María Beatriz Esteban, additional, Moreno, Fátima Cabezudo, additional, Saldaña, Nawson Elver Quevedo, additional, Fenés, María del Mar García, additional, Florencio, Timotea Garrote, additional, Toro, José María Fernández, additional, Rañal, Alejandra Rey, additional, Río, Elena García del, additional, Pol, Enrique Nieto, additional, Fernández, Julio Álvarez, additional, Álvarez, Pilar Alonso, additional, Gómez, María Luisa Jorge, additional, Guerrero, Antonio Calvo, additional, Colomina, Isabel Celemín, additional, Casal, Lucía Barreiro, additional, Moreno, Juana Fernández, additional, Martínez, María Angelines Carballal, additional, Rodríguez, Nabor Díaz, additional, Paredes, Carlos Moral, additional, García, Dolores Recarey, additional, Mato, Fco. Javier Iglesias, additional, Ulloa, Antonio Fouz, additional, González, Amparo Fidalgo, additional, Parada, Noelia Dios, additional, Sabarís, Patricia Conde, additional, Pérez, Ana Isabel Rodríguez, additional, Palacio, Ana Inés García, additional, Varela, Víctor Julio Quesada, additional, Iglesias, Lidia Romero, additional, Llerena, Ángel Lado, additional, Rodríguez, Carmen Lires, additional, Diaz, María Luisa Carretero, additional, Arias, José Carreira, additional, Camino, Jose Luis Vázquez, additional, Penas, María del Carmen Torreiro, additional, Freire, Sandra Yáñez, additional, Aldana, Daniel Rey, additional, Díaz, Carlos Piñeiro, additional, Romanos, Fernando García, additional, González, Antonia Moreno, additional, Sastre, María Lara Amengual, additional, Palli, Susana Martínez, additional, Bauza, José Alfonso Ramón, additional, Bolinches, José Ortiz, additional, Fernández, Carmen Fernández, additional, Vázquez, María Isabel Orlandis, additional, Mezquita, Ana Sanchís, additional, Aramburu, Fernando Unceta, additional, Morant, Juan Fernando Peiró, additional, Amengual, Ana Moyá, additional, García, Isidro Godoy, additional, Sevillano, Fernando Rubio, additional, González, María Isabel González, additional, Souto, Marta Pérez, additional, Contreras, Raquel de León, additional, González, Sara Isabel Almeida, additional, Diez, Irene Almería, additional, Sánchez, Virginia María Mirabal, additional, Lavado, Francisco José Escobar, additional, Pérez, Yoel Anta, additional, Hernández, Nayra Sánchez, additional, Jerez, Juan Luis Alonso, additional, Koch, Ricardo, additional, Mendoza, Nayra Ramírez, additional, Hernández, Héctor Suárez, additional, Escobar, Francisco Jesús Morales, additional, Zancada, Sonsoles María Velilla, additional, Sabarís, Rafael Crespo, additional, Jiménez, Óscar Fernando Isaula, additional, Puga, Jesús Manuel González, additional, Ávila, Jorge Antonio Benaín, additional, González, Óscar del Toro, additional, Íñigo, Laura Sánchez, additional, Pérez, Inés Sanz, additional, Nubla, José Félix Zuazagoitia, additional, Ituiño, Ana Echebarría, additional, Tris, Gregorio Mediavilla, additional, Bosch, María Carmen Noriega, additional, González, Esther, additional, Macho, María Luisa Ruiz, additional, Olmo, Ruth Sendino del, additional, Prado, Asunción Olagorta de, additional, Muguerza, Ana López de Viñaspre, additional, Iriso, Jesús Iturralde, additional, Martínez, María José Pérez, additional, Carbonell, Ana Piera, additional, Fernández, Margarita Alonso, additional, Cuadrado, María Montserrat Rueda, additional, Rodríguez, Rodrigo Abad, additional, Cabo, José Miguel Álvarez, additional, Rodríguez, Rubén Sánchez, additional, Cabo, Eva María Cano, additional, Secin, Anny Romero, additional, Díaz, Miguel Ángel Prieto, additional, Fernández, Juan Jesús García, additional, Bueno, Vicente Llorca, additional, Pérez, Ana María Ballesteros, additional, López, Domingo J. Rubira, additional, Franco, María Dolores Esteve, additional, Pablo, Elena Sánchez, additional, López, María Teresa Palacios, additional, Meroño, Juan Castillo, additional, Martínez, José María Lobo, additional, Martínez, Isabel María Peral, additional, Carrasco, J. Eduardo Carrasco, additional, and González, Armando Santo, additional

Published
2021
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15. First Insight into the Genome Sequences of Two Linezolid-Resistant

Author

Sylvia, Valdezate, Sara, Monzón, Noelia, Garrido, Angel, Zaballos, María J, Medina-Pascual, José M, Azcona-Gutiérrez, Begoña, Vilar, and Isabel, Cuesta

Subjects
bacteria, Prokaryotes, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses
Abstract

The draft genome sequences of two Nocardia farcinica strains isolated from two patients with cystic fibrosis (CF), resistant to trimethoprim/sulfamethoxazole and linezolid, are reported here. The estimated genome sizes were 5.8 Mb with a 70.63% G+C content. Transposases from Tn916 were detected, but not 23S rRNA mutation (G2576T) related to linezolid resistance.

Published
2017

16. Identification, Typing, and Phylogenetic Relationships of the Main Clinical Nocardia Species in Spain According to Their gyrB and rpoB Genes

Author

Sylvia Valdezate, Juan Antonio Sáez-Nieto, María J. Medina-Pascual, Noelia Garrido, Pilar Villalón, and Gema Carrasco

Subjects
DNA, Bacterial, Microbiology (medical), Epidemiology, Sequence analysis, Molecular Sequence Data, Nocardia Infections, Biology, DNA, Ribosomal, Nocardia, RNA, Ribosomal, 16S, Prevalence, Cluster Analysis, Humans, Typing, Phylogeny, Genetics, Molecular Epidemiology, Molecular epidemiology, Phylogenetic tree, Genetic Variation, DNA-Directed RNA Polymerases, Sequence Analysis, DNA, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, rpoB, Housekeeping gene, DNA Gyrase, Spain, bacteria
Abstract

This study compares the identification, typing, and phylogenetic relationships of the most prevalent clinical Nocardia species in Spain, as determined via sequence analysis of their housekeeping genes gyrB and rpoB , with the results returned by the gold standard 16S rRNA method. gyrB and rpoB analyses identified Nocardia abscessus , N. cyriacigeorgica , N. farcinica , and the N. nova complex, species that together account for more than half of the human nocardiosis cases recorded in Spain. The individual discriminatory power of gyrB and rpoB with respect to intraspecies typing, calculated using the Hunter-Gaston discriminatory index (HGDI), was generally high (HGDI, 0.85 to 1), except for rpoB with respect to N. farcinica (HGDI, 0.71). Phylogenetically, different degrees of intra- and interspecies microheterogeneity were observed for gyrB and rpoB in a group of 119 clinical strains. A single 16S haplotype was obtained for each species, except for the N. nova complex (8 types), while gyrB and rpoB were more polymorphic: N. abscessus had 14 and 18 haplotypes, N. cyriacigeorgica had 17 and 12, N. farcinica had 11 and 5, and the N. nova complex had 26 and 29 haplotypes, respectively. A diversity gradient was therefore seen, with N. farcinica at the bottom followed by N. abscessus and N. cyriacigeorgica in the middle and N. nova complex at the top. The complexity of the N. nova complex is highlighted by its six variations in the GyrB 126 AAAPEH motif. gyrB sequencing (with or without rpoB sequencing) offers a simple means for identifying the most prevalent Nocardia species in Spanish medical laboratories and for determining the intraspecific diversity among their strains.

Published
2013
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17. First Insight into the Genome Sequences of Two Linezolid-Resistant Nocardia farcinica Strains Isolated from Patients with Cystic Fibrosis

Author

María J. Medina-Pascual, Ángel Zaballos, Noelia Garrido, José Manuel Azcona-Gutiérrez, Begoña Vilar, Sylvia Valdezate, Sara Monzón, Isabel Cuesta, and Instituto de Salud Carlos III

Subjects
0301 basic medicine, Mutation, biology, Sulfamethoxazole, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, medicine.disease, medicine.disease_cause, bacterial infections and mycoses, Cystic fibrosis, Genome, Trimethoprim, Microbiology, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, chemistry, 23S ribosomal RNA, Linezolid, Genetics, medicine, bacteria, Molecular Biology, Nocardia farcinica, medicine.drug
Abstract

The draft genome sequences of two Nocardia farcinica strains isolated from two patients with cystic fibrosis (CF), resistant to trimethoprim/sulfamethoxazole and linezolid, are reported here. The estimated genome sizes were 5.8 Mb with a 70.63% G+C content. Transposases from Tn916 were detected, but not 23S rRNA mutation (G2576T) related to linezolid resistance. We are grateful to G. Carrasco, P. Jimenez, and J. A. Saéz-Nieto for their help in different stages of genome sequencing, and Adrian Burton for editing and language assistance (Physical Evidence Scientific Translations; http://www.physicalevidence.es). This work was funded by project MPY1278/15 of the Instituto de Salud Carlos III. Sí

Published
2017

18. Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain

Author

Pilar Villalón, Gema Carrasco, Juan Antonio Sáez-Nieto, María J. Medina-Pascual, Noelia Garrido, Sylvia Valdezate, and Ana Navarro

Subjects
0301 basic medicine, Microbiology (medical), 030106 microbiology, Nocardia Infections, Microbial Sensitivity Tests, Nocardia, Microbiology, 03 medical and health sciences, 0302 clinical medicine, RNA, Ribosomal, 16S, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Prevalence, Humans, Pharmacology (medical), 030212 general & internal medicine, Amikacin, Etest, Nocardia farcinica, Pharmacology, Antiinfective agent, Nocardia brasiliensis, biology, Nocardiosis, Linezolid, bacterial infections and mycoses, biology.organism_classification, medicine.disease, Trimethoprim, Anti-Bacterial Agents, Imipenem, Infectious Diseases, Spain, bacteria, medicine.drug
Abstract

Objectives The aims of this study were to explore the clinical distribution, by species, of the genus Nocardia and to assess the antimicrobial susceptibilities of the 10 most prevalent species identified in Spain. Methods Over a 10 year period (2005-14), 1119 Nocardia strains were molecularly identified and subjected to the Etest. The distribution and resistance trends over the sub-periods 2005-09 and 2010-14 were also examined. Results Of the strains examined, 82.9% belonged to the following species: Nocardia cyriacigeorgica (25.3%), Nocardia nova (15.0%), Nocardia abscessus (12.7%), Nocardia farcinica (11.4%), Nocardia carnea (4.3%), Nocardia brasiliensis (3.5%), Nocardia otitidiscaviarum (3.1%), Nocardia flavorosea (2.6%), Nocardia rhamnosiphila (2.6%) and Nocardia transvalensis (2.4%). Their prevalence values were similar during 2005-09 and 2010-14, except for those of N. abscessus , N. farcinica and N. transvalensis , which fell significantly in the second sub-period ( P ≤ 0.05). The major location of isolation was the respiratory tract (∼86%). Half (13/27) of all strains from the CNS were N. farcinica . Significant differences in MIC results were recorded for some species between the two sub-periods. According to the CLSI's breakpoints, low resistance rates (≤15%) were recorded for seven species with respect to cefotaxime, imipenem and tobramycin; five species showed similar rates with respect to trimethoprim/sulfamethoxazole. Linezolid and amikacin were the most frequently active agents. Conclusion The accurate identification of the infecting species and the determination of its susceptibility to antimicrobial agents, given the large number of strains with atypical patterns, are crucial if patients with nocardiosis are to be successfully treated.

Published
2016

19. Shortcomings of the Commercial MALDI-TOF MS Database and Use of MLSA as an Arbiter in the Identification of Nocardia Species

Author

Rafael Cantón, Gema Carrasco, Sylvia Valdezate, Noelia Garrido, Juan de Dios Caballero, Juan Antonio Sáez-Nieto, and Instituto de Salud Carlos III

Subjects
0301 basic medicine, Microbiology (medical), MLSA, 030106 microbiology, lcsh:QR1-502, Nocardia species, computer.software_genre, Microbiology, lcsh:Microbiology, 03 medical and health sciences, MALDI-TOF MS, 16S rRNA identification, Nocardia farcinica, Original Research, High prevalence, Database, biology, prevalence in Spain, Nocardia, biology.organism_classification, 16S ribosomal RNA, Housekeeping gene, Matrix-assisted laser desorption/ionization, Identification (biology), Nocardia spp, computer
Abstract

Nocardia species are difficult to identify, a consequence of the ever increasing number of species known and their homogeneous genetic characteristics. 16S rRNA analysis has been the gold standard for identifying these organisms, but proteomic techniques such as matrix-assisted laser desorption ionization-time of flight (MALDI-TOF MS) and housekeeping gene analysis, have also been explored. One hundred high (n = 25), intermediate (n = 20), and low (n = 55) prevalence (for Spain) Nocardia strains belonging to 30 species were identified via 16S rRNA and MALDI-TOF MS analysis. The manufacturer-provided database MALDI Biotyper library v4.0 (5.627 entries, Bruker Daltonik) was employed. In the high prevalence group (Nocardia farcinica, N. abscessus, N. cyriacigeorgica and N. nova), the 16S rRNA and MALDI-TOF MS methods provided the same identification for 76% of the strains examined. For the intermediate prevalence group (N. brasiliensis, N. carnea, N. otitidiscaviarum and N. transvalensis complex), this figure fell to 45%. In the low-prevalence group (22 species), these two methods were concordant only in six strains at the species level. Tetra-gene multi-locus sequencing analysis (MLSA) involving the concatemer gyrB-16S rRNA-hsp65-secA1 was used to arbitrate between discrepant identifications (n = 67). Overall, the MLSA confirmed the results provided at species level by 16S rRNA analysis in 34.3% of discrepancies, and those provided by MALDI-TOF MS in 13.4%. MALDI-TOF MS could be a strong candidate for the identification of Nocardia species, but only if its reference spectrum database improves, especially with respect to unusual, recently described species and species included in the described Nocardia complexes. This work was funded by a grant to NG from the Instituto de Salud Carlos III (MPY 1278/15). Sí

Published
2016

20. Resistance gene pool to co-trimoxazole in non-susceptible Nocardia strains

Author

María J. Medina-Pascual, Juan Antonio Sáez-Nieto, Sylvia Valdezate, Noelia Garrido, Pilar Villalón, and Gema Carrasco

Subjects
Microbiology (medical), Antimicrobial resistant determinants, lcsh:QR1-502, antimicrobial resistant determinants, Microbiology, lcsh:Microbiology, Integrons, environmental bacteria, medicine, Pathogen, co-trimoxazole, Original Research, biology, Sulfamethoxazole, Antimicrobial resistance determinants, Nocardia, biology.organism_classification, Trimethoprim, Nocardia species, Resistome, Co-trimoxazole, Trimethoprim Resistance, integrons, Gene pool, Co-trimoxazol resistance, Bacteria, medicine.drug
Abstract

The soil-borne pathogen Nocardia sp. causes severe cutaneous, pulmonary, and central nervous system infections. Against them, co-trimoxazole (SXT) constitutes the mainstay of antimicrobial therapy. However, some Nocardia strains show resistance to SXT, but the underlying genetic basis is unknown. We investigated the presence of genetic resistance determinants and class 1-3 integrons in 76 SXT-resistant Nocardia strains by PCR and sequencing. By E test, these clinical strains showed SXT minimum inhibitory concentrations of ≥32:608 mg/L (ratio of 1:19 for trimethoprim: sulfamethoxazole). They belonged to 12 species, being the main representatives Nocardia farcinica (32%), followed by N. flavorosea (6.5%), N. nova (11.8%), N. carnea (10.5%), N. transvalensis (10.5%), and Nocardia sp. (6.5%). The prevalence of resistance genes in the SXT-resistant strains was as follows: sul1 and sul2 93.4 and 78.9%, respectively, dfrA(S1) 14.7%, blaTEM-1 and blaZ 2.6 and 2.6%, respectively, VIM-2 1.3%, aph(3')-IIIa 40.8%, ermA, ermB, mefA, and msrD 2.6, 77.6, 14.4, and 5.2%, respectively, and tet(O), tet(M), and tet(L) 48.6, 25.0, and 3.9%, respectively. Detected amino acid changes in GyrA were not related to fluoroquinolone resistance, but probably linked to species polymorphism. Class 1 and 3 integrons were found in 93.42 and 56.57% strains, respectively. Class 2 integrons and sul3 genes were not detected. Other mechanisms, different than dfrA(S1), dfrD, dfrF, dfrG, and dfrK, could explain the strong trimethoprim resistance shown by the other 64 strains. For first time, resistance determinants commonly found in clinically important bacteria were detected in Nocardia sp. sul1, sul2, erm(B), and tet(O) were the most prevalent in the SXT-resistant strains. The similarity in their resistome could be due to a common genetic platform, in which these determinants are co-transferred. This study was presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy, ICAAC2014, Washington, DC, USA. We thank Adrian Burton for editing and language assistance (http://physicalevidence.es/english/welcome). We are very grateful to all persons who took part in this study, and to the sample providers. Sí

Published
2015
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21. Endemic and epidemic Acinetobacter baumannii clones: a twelve-year study in a tertiary care hospital

Author

Teresa Cabezas, Ana Vindel, María J. Medina-Pascual, Juan Antonio Sáez-Nieto, Noelia Garrido, Pilar Villalón, Sylvia Valdezate, Montserrat Ortega, [Villalón,P, Valdezate,S, Ortega,M, Garrido,N, Medina-Pascual,MJ, and Saez-Nieto,JA] Laboratorio de Taxonomía, Servicio de Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. [Cabezas,T] Laboratorio de Biotecnología Hospital de Poniente, El ejido, Almería, Spain. [Videl,A] Laboratorio de Infecciones intrahospitalarias Servicio de Bacteriología, Centro Nacional de Microbiología Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

Subjects
DNA, Bacterial, Sequence type, Microbiology (medical), Acinetobacter baumannii, sequence type, Phenomena and Processes::Genetic Phenomena::Genetic Variation::Polymorphism, Genetic::Polymorphism, Restriction Fragment Length [Medical Subject Headings], Genotype, Clone, Minisatellite Repeats, Multiple Loci VNTR Analysis, Organisms::Bacteria::Proteobacteria::Gammaproteobacteria::Moraxellaceae::Acinetobacter::Acinetobacter baumannii [Medical Subject Headings], Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Nucleic Acids::DNA::DNA, Bacterial [Medical Subject Headings], Microbiology, Tertiary Care Centers, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Sequence Analysis::Sequence Analysis, DNA::Multilocus Sequence Typing [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Moraxellaceae Infections::Acinetobacter Infections [Medical Subject Headings], Tipificación de Secuencias Multilocus, Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome Components::Tandem Repeat Sequences::Minisatellite Repeats [Medical Subject Headings], Pulsed-field gel electrophoresis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Molecular Epidemiology [Medical Subject Headings], Humans, Cross Infection, Molecular Epidemiology, Genetic diversity, biology, MLVA, ADN Bacteriano, PFGE, Tertiary care hospital, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Virology, Variable number tandem repeat, Parasitology, Multilocus sequence typing, bacteria, Phenomena and Processes::Genetic Phenomena::Genotype [Medical Subject Headings], A. baumannii, A baumannii, Genotipo, Polymorphism, Restriction Fragment Length, Acinetobacter Infections, Multilocus Sequence Typing, Research Article
Abstract

BACKGROUND: Nosocomial outbreaks of multidrug-resistant Acinetobacter baumannii are of worldwide concern. Using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and multiple locus variable number tandem repeat sequence (VNTR) analysis (MLVA), the present work examines the genetic diversity of the endemic and epidemic A. baumannii clones isolated in a single hospital over a twelve-year period. RESULTS: PFGE analysis of 405 A. baumannii-calcoaceticus complex isolates detected 15 A. baumannii endemic/epidemic PFGE types (EE1 to EE15) that grouped into five clusters: EE1-EE8, EE9, EE10, EE11 and EE12-EE15. The MLST sequence type (ST) distributions were: international clone II (ST-2) 60%, international clone III (ST-3) 26.7%, ST-15 6.7%, and ST-80 6.7%. MLVA-8Orsay returned 17 allelic profiles. The large (L) VNTR marker profiles were fully concordant with the detected STs, and concordant with 14 up to 15 PFGE types. Imipenem resistance was detected in five PFGE types; the prevalence of the bla OXA-58-like and bla OXA-40-like genes was 60% and 40% respectively. CONCLUSIONS: PFGE proved to be a vital tool for analysis of the temporal and spatial distribution of the clones. MLST and the VNTR L-markers grouped the isolates into clonal clusters. The wide diversity of MLVA small (S)-markers, however, did not permit clustering. The present results demonstrate the persistence of several endemic PFGE types in the hospital, the involvement of some of them in outbreaks, and the inter hospital transmission of extensively drug-resistant ST-15 and ST-80. Sí

Published
2015

22. gyrB Analysis as a Tool for Identifying Nocardia Species and Exploring Their Phylogeny

Author

María J. Medina-Pascual, Juan Antonio Sáez-Nieto, Sylvia Valdezate, Pilar Villalón, Gema Carrasco, and Noelia Garrido

Subjects
Microbiology (medical), DNA, Bacterial, Genetic Markers, Phylogenetic tree, Sequence analysis, Molecular Sequence Data, Nocardia, Mycobacteriology and Aerobic Actinomycetes, Sequence Analysis, DNA, Biology, biology.organism_classification, DNA gyrase, Microbiology, Molecular Typing, Genetic marker, Phylogenetics, DNA Gyrase, Humans, Identification (biology), Typing, Phylogeny
Abstract

gyrB is used to improve the identification of the Nocardia species N. brasiliensis , N. higoensis , N. ignorata , N. otitidiscaviarum , N. paucivorans , N. pneumoniae , N. puris , N. takedensis , N. veterana , and N. vinacea , but it does not improve the identification of another 12 Nocardia studied species. gyrB provides typing and phylogenetic markers for N. carnea , N. transvalensis , N. brasiliensis , and N. otitidiscaviarum .

Published
2015

24. Identification, molecular characterisation and antimicrobial susceptibility of genomovars of the Burkholderia cepacia complex in Spain

Author

Noelia Garrido, Virginia Rubio, María J. Medina-Pascual, Juan Antonio Sáez-Nieto, Sylvia Valdezate, and Pilar Villalón

Subjects
Microbiology (medical), Imipenem, Cystic Fibrosis, Genotype, Microbial Sensitivity Tests, Microbiology, Disease Outbreaks, Bacterial Proteins, RNA, Ribosomal, 16S, medicine, Pulsed-field gel electrophoresis, Environmental Microbiology, Humans, Cross Infection, Molecular Epidemiology, Molecular epidemiology, biology, Burkholderia cepacia complex, Genomovar, Genetic Variation, Burkholderia Infections, General Medicine, biology.organism_classification, Antimicrobial, Virology, Electrophoresis, Gel, Pulsed-Field, Molecular Typing, Infectious Diseases, Burkholderia, Spain, medicine.drug, Piperacillin
Abstract

Burkholderia spp. strains collected in Spain over a 13-year period from patients with cystic fibrosis (CF) (n = 148), non-CF patients (n = 103) and from environmental sources (n = 64) were characterised. One hundred and forty-one of the examined strains were involved in seven suspected nosocomial disease outbreaks. Strains were identified by their 16s rRNA and recA genes. Their genetic relatedness, the possession of cable pili and the B. cepacia epidemic strain marker (BCESM), and their susceptibility to antimicrobial agents were studied using pulsed-field gel electrophoresis (PFGE), cblA and esmR genes analysis, and by the E-test, respectively. The genomovar distribution for the 315 strains was as follows: B. stabilis 29.5 %, B. cepacia 14.9 %, B. multivorans 11.1 %, B. cenocepacia IIIA 9.5 %, B. vietnamiensis 3.8 %, B. cenocepacia IIIB 3.5 %, and B. ambifaria and B. pyrrocinia 0.3 % each. The genetic diversity of the B. cepacia complex (Bcc) was ample, with 57 different SpeI types, showing a genetic similarity of 36.4-96.6 %. No strain carried cblA, whereas 25 B. cenocepacia genotypes harboured BCESM (23 from patients with CF). Antimicrobial resistance rates to tobramycin (TOB; 86 %) and imipenem (IPM; 67 %) were high. The strains from patients with CF showed significantly greater resistance to piperacillin (PIP), levofloxacin (LVX) and co-trimoxazole (SXT) than those isolated from non-CF patients (p < 0.05). In conclusion, B. cenocepacia was the most prevalent genomovar found in patients with CF (19.1 %), whereas B. cepacia was the most common among non-CF patients (20.7 %). B. stabilis (47.6 %) was the most common environmental genomovar. Susceptibility to antimicrobial agents depended on genomovar status and strain origin.

Published
2012

25. Increase in isolation of Burkholderia contaminans from Spanish patients with cystic fibrosis

Author

María J. Medina-Pascual, Noelia Garrido, Pilar Villalón, Juan Antonio Sáez-Nieto, Gema Carrasco, and Sylvia Valdezate

Subjects
Microbiology (medical), Cystic Fibrosis, Genotype, medicine.drug_class, Burkholderia, Antibiotics, Ceftazidime, multilocus sequence typing, Microbial Sensitivity Tests, pulsed field gel electrophoresis, Biology, Burkholderia contaminans, Cystic fibrosis, Antimicrobial susceptibility, Microbiology, Drug Resistance, Bacterial, medicine, Pulsed-field gel electrophoresis, Pneumonia, Bacterial, Humans, Burkholderia contaminans, cystic fibrosis, Etest, Molecular Epidemiology, Genetic Variation, Burkholderia Infections, General Medicine, genetic diversity, medicine.disease, biology.organism_classification, Anti-Bacterial Agents, Electrophoresis, Gel, Pulsed-Field, Burkholderia cepacia complex, Infectious Diseases, Spain, Multilocus sequence typing, medicine.drug
Abstract

Species of the Burkholderia cepacia complex are associated with opportunistic infection in patients with cystic fibrosis. For years now, B. multivorans and B. cenocepacia have been the most frequently isolated species within the complex in such patients. However, between 2008 and 2012, the overall incidence of these species in Spain (17.7% and 12.5% respectively) was overtaken by that of B. contaminans (36.5%). The population structure of B. contaminans isolates from Spanish patients with cystic fibrosis was analysed using multilocus sequence typing and pulsed-field gel electrophoresis (PFGE). Three major known sequence types (ST102, ST404 and ST482) and a new one (ST771) were identified among 59 isolates. In addition, PFGE detected 17 pulsotypes. Susceptibility to antibiotics was examined using the Etest. Cotrimoxazole and ceftazidime were the most active antibiotics against B. contaminans, inhibiting growth in 88% and 86% of the isolates, respectively. In addition, this species showed less resistance to most of the antibiotics tested than did either B. multivorans or B. cenocepacia isolates recovered from similar Spanish patients.

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