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Zamorano M, Redondo Marcos I, González-López JJ. Bilateral macular edema in sistemic sclerosis. Arch Soc Esp Oftalmol (Engl Ed) 2024:S2173-5794(24)00060-4. [PMID: 38593979 DOI: 10.1016/j.oftale.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/20/2024] [Indexed: 04/11/2024]
Abstract
Systemic sclerosis is a chronic, autoimmune, multisystem disease characterized by vascular dysfunction, chronic inflammation and widespread fibrosis. Although vascular involvement commonly manifests in the skin, it can also affect other organs, including the eyes. The characteristic vascular alteration is an obliterative fibroproliferative vasculopathy leading to hypoxia and tissue ischemia. We present a case of bilateral macular edema in a patient diagnosed with systemic sclerosis, as a consequence of retinal and choroidal vascular changes.
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Affiliation(s)
- M Zamorano
- Departamento de Oftalmología, Hospital Universitario de Guadalajara, Guadalajara, Spain.
| | - I Redondo Marcos
- Departamento de Oftalmología, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J J González-López
- Departamento de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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2
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Salmerón P, Moreno-Mingorance A, Trejo J, Amado R, Viñado B, Cornejo-Sanchez T, Alberny M, Barbera MJ, Arando M, Pumarola T, Hoyos-Mallecot Y, Serra-Pladevall J, González-López JJ. Emergence and dissemination of three mild outbreaks of Neisseria gonorrhoeae with high-level resistance to azithromycin in Barcelona, 2016-18. J Antimicrob Chemother 2021; 76:930-935. [PMID: 33367806 DOI: 10.1093/jac/dkaa536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/02/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Neisseria gonorrhoeae (NG) isolates with high-level azithromycin resistance (HL-AziR) have emerged worldwide in recent decades, threatening the sustainability of current dual-antimicrobial therapy. OBJECTIVES This study aimed to characterize the first 16 NG isolates with HL-AziR in Barcelona between 2016 and 2018. METHODS WGS was used to identify the mechanisms of antimicrobial resistance, to establish the MLST ST, NG multiantigen sequence typing (NG-MAST) ST and NG sequence typing for antimicrobial resistance (NG-STAR) ST and to identify the clonal relatedness of the isolates with other closely related NG previously described in other countries based on a whole-genome SNP analysis approach. The sociodemographic characteristics of the patients included in the study were collected by comprehensive review of their medical records. RESULTS Twelve out of 16 HL-AziR isolates belonged to the MLST ST7823/NG-MAST ST5309 genotype and 4 to MLST ST9363/NG-MAST ST3935. All presented the A2059G mutation in all four alleles of the 23S rRNA gene. MLST ST7823/NG-MAST ST5309 isolates were only identified in men who have sex with women and MLST ST9363/NG-MAST ST3935 were found in MSM. Phylogenomic analysis revealed the presence of three transmission clusters of three different NG strains independently associated with sexual behaviour. CONCLUSIONS Our findings support the first appearance of three mild outbreaks of NG with HL-AziR in Spain. These results highlight the continuous capacity of NG to develop antimicrobial resistance and spread among sexual networks. The enhanced resolution of WGS provides valuable information for outbreak investigation, complementing the implementation of public health measures focused on the prevention and dissemination of MDR NG.
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Affiliation(s)
- P Salmerón
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain
| | - A Moreno-Mingorance
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - J Trejo
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - R Amado
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - B Viñado
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain
| | - T Cornejo-Sanchez
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - M Alberny
- Institut Català de Salut (ICS), Barcelona, Spain
| | - M J Barbera
- Drassanes-Vall d'Hebron Sexually Transmitted Infections Unit, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - M Arando
- Drassanes-Vall d'Hebron Sexually Transmitted Infections Unit, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - T Pumarola
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Y Hoyos-Mallecot
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - J Serra-Pladevall
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - J J González-López
- Department of Microbiology, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
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Gómez-Mariscal M, González-López JJ, Alonso-Formento N, Martínez-San Millán JS, Peña-Jaimes L, Albandea-Jiménez AR. Endogenous endophthalmitis associated with lens dislocation and vitreous gas bubble in a diabetic patient. J Fr Ophtalmol 2021; 44:e335-e337. [PMID: 33608172 DOI: 10.1016/j.jfo.2020.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/27/2020] [Indexed: 11/27/2022]
Affiliation(s)
- M Gómez-Mariscal
- Department of Ophthalmology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain.
| | - J J González-López
- Department of Ophthalmology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain; School of Medicine and Health Science, University of Alcalá, Madrid, Spain
| | - N Alonso-Formento
- Department of Ophthalmology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain
| | - J S Martínez-San Millán
- Department of Radiology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain
| | - L Peña-Jaimes
- Department of Pathology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain
| | - A R Albandea-Jiménez
- Department of Ophthalmology, Ramón y Cajal University Hospital, IRYCIS, Carretera Colmenar Viejo, km 9.100, 28034 Madrid, Spain
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de-Arriba-Palomero P, de-Arriba-Palomero F, González-López JJ. What is a Roth's spot hiding? Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:e91. [PMID: 32847709 DOI: 10.1016/j.oftal.2020.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
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Belushkin A, Yesilkoy F, González-López JJ, Ruiz-Rodríguez JC, Ferrer R, Fàbrega A, Altug H. Rapid and Digital Detection of Inflammatory Biomarkers Enabled by a Novel Portable Nanoplasmonic Imager. Small 2020; 16:e1906108. [PMID: 31830370 DOI: 10.1002/smll.201906108] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Indexed: 05/18/2023]
Abstract
New point-of-care diagnostic devices are urgently needed for rapid and accurate diagnosis, particularly in the management of life-threatening infections and sepsis, where immediate treatment is key. Sepsis is a critical condition caused by systemic response to infection, with chances of survival drastically decreasing every hour. A novel portable biosensor based on nanoparticle-enhanced digital plasmonic imaging is reported for rapid and sensitive detection of two sepsis-related inflammatory biomarkers, procalcitonin (PCT) and C-reactive protein (CRP) directly from blood serum. The device achieves outstanding limit of detection of 21.3 pg mL-1 for PCT and 36 pg mL-1 for CRP, and dynamic range of at least three orders of magnitude. The portable device is deployed at Vall d'Hebron University Hospital in Spain and tested with a wide range of patient samples with sepsis, noninfectious systemic inflammatory response syndrome (SIRS), and healthy subjects. The results are validated against ultimate clinical diagnosis and currently used immunoassays, and show that the device provides accurate and robust performance equivalent to gold-standard laboratory tests. Importantly, the plasmonic imager can enable identification of PCT levels typical of sepsis and SIRS patients in less than 15 min. The compact and low-cost device is a promising solution for assisting rapid and accurate on-site sepsis diagnosis.
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Affiliation(s)
- Alexander Belushkin
- Institute of BioEngineering, École Polytechnique Fédérale de Lausanne, CH-1015, Lausanne, Switzerland
| | - Filiz Yesilkoy
- Institute of BioEngineering, École Polytechnique Fédérale de Lausanne, CH-1015, Lausanne, Switzerland
| | - Juan Jose González-López
- Department of Clinical Microbiology, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Juan Carlos Ruiz-Rodríguez
- Intensive Care Department, Vall d'Hebron University Hospital, Shock, Organ Dysfunction and Resuscitation Research Group, Vall d'Hebron Institut de Recerca, 08035, Barcelona, Spain
| | - Ricard Ferrer
- Intensive Care Department, Vall d'Hebron University Hospital, Shock, Organ Dysfunction and Resuscitation Research Group, Vall d'Hebron Institut de Recerca, 08035, Barcelona, Spain
| | - Anna Fàbrega
- Department of Clinical Microbiology, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain
| | - Hatice Altug
- Institute of BioEngineering, École Polytechnique Fédérale de Lausanne, CH-1015, Lausanne, Switzerland
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Gómez-Mariscal M, De Arriba F, Revenga M, González-López JJ. Do Season and Environment Have a Role in the Incidence of Anterior Uveitis Attacks? Ocul Immunol Inflamm 2019; 28:786-790. [PMID: 31418617 DOI: 10.1080/09273948.2019.1636092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate the seasonal influence on the incidence of uveitis attacks. METHODS An ecological study was designed including 731 uveitis attacks in 594 patients diagnosed at the eye emergency of a hospital in Madrid between 2014 and 2017. The incidence of uveitis attacks, B27+, and presumed herpetic attacks were calculated, and their correlations with seasonal and environmental variables in the same timeframe were analyzed. The analyzed variables were precipitation, barometric pressure, temperature, humidity, wind speed, global solar radiation, ultraviolet radiation, air pollution components (particulate matter and polluting gases), and the incidence of influenza. RESULTS The incidence of attacks was significantly higher in the winter than in the autumn (p = .025). It showed a significant correlation to the number of rainy days per month (r = 0.612;p = .04), and the average wind speed (r = 0.469;p = .02) after Bonferroni correction. CONCLUSION Uveitis episodes happened more frequently under rainy and windy conditions. Most factors were not significantly correlated to attacks.
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Affiliation(s)
- M Gómez-Mariscal
- Ramón y Cajal University Hospital, Universidad de Alcalá , Madrid, Spain
| | - F De Arriba
- Ramón y Cajal University Hospital, Universidad de Alcalá , Madrid, Spain
| | - M Revenga
- Ramón y Cajal University Hospital, Universidad de Alcalá , Madrid, Spain
| | - J J González-López
- Ramón y Cajal University Hospital, Universidad de Alcalá , Madrid, Spain
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7
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González-López JJ, Fuente García C, Muñoz-Negrete FJ, Rebolleda G. Author's reply. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:e47. [PMID: 29548556 DOI: 10.1016/j.oftal.2018.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Affiliation(s)
- J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España.
| | - C Fuente García
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
| | - G Rebolleda
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
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8
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Fuente García C, González-López JJ, Muñoz-Negrete FJ, Rebolleda G. The diagnostic usefulness of the negative electroretinogram. ACTA ACUST UNITED AC 2017; 93:126-135. [PMID: 29198644 DOI: 10.1016/j.oftal.2017.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/18/2022]
Abstract
The definition of the negative response of the full field electroretinogram is the presence of a b-wave with less amplitude than the a-wave (b/a ratio<1) in the combined response of cones and rods. The presence of this pattern reflects an alteration in the bipolar cells, the Müller cells, or in the transmission of the stimulus from the photoreceptors to the bipolar cells, with preserved photoreceptor function. This finding can be seen bilaterally and symmetrically in different hereditary conditions, such as congenital stationary night blindness, juvenile X-linked retinoschisis, and Duchenne and Becker muscular dystrophies. On the other hand, it can also be found unilaterally (or asymmetrically) in acquired pathologies, such as some types of immuno-mediated retinitis (Birdshot retinochoroiditis), autoimmune retinopathies, cancer/melanoma associated retinopathy, or retinal toxicity. The objective of this review is to summarise the characteristics of the pathologies in which this finding can be observed, in order to highlight its usefulness in the differential diagnosis of retinal conditions.
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Affiliation(s)
- C Fuente García
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España
| | - J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España.
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
| | - G Rebolleda
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
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González-López JJ, Hernández-Martínez P, Muñoz-Negrete FJ. Medical errors and patient safety in Ophthalmology. Arch Soc Esp Oftalmol 2017; 92:299-301. [PMID: 28318834 DOI: 10.1016/j.oftal.2017.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 01/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España.
| | - P Hernández-Martínez
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, España; Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá de Henares, Madrid, España
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González-López G, Ceballos-Rodríguez RM, González-López JJ, Feito Rodríguez M, Herranz-Pinto P. Efficacy and safety of wet wrap therapy for patients with atopic dermatitis: a systematic review and meta-analysis. Br J Dermatol 2017; 177:688-695. [PMID: 27861727 DOI: 10.1111/bjd.15165] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2016] [Indexed: 11/30/2022]
Abstract
Wet wrap therapy (WWT) consists of topical steroids administered under a layer of wet cotton bandages or garments. Several trials with WWT have reported promising results in atopic dermatitis (AD). However, no systematic review and meta-analysis on its efficacy and safety has been published. Our objective was to conduct a systematic review of the literature on WWT in AD to assess its efficacy and safety. We included randomized controlled trials among patients of all ages with a diagnosis of AD based on predefined criteria or made by a dermatologist. Electronic searches were performed from 1970 to 30 March 2016 in the Cochrane Central Register of Controlled Trials, MEDLINE, Embase and the World Health Organization International Clinical Trials Registry. Selection of studies and data extraction were performed independently by two researchers, and discrepancies were resolved by consensus. Six trials comparing WWT with topical steroids in children or adults with AD were included. Sample sizes ranged from 19 to 51 patients. Results on clinical severity and quality of life were reported incompletely and proved heterogeneous across studies. A nonsignificant tendency to increased risk of mild skin infections was observed in those treated with WWT (pooled relative risk 6·35, 95% confidence interval 0·83-48·55). The overall grade of quality of evidence for the efficacy and safety outcomes was low. In conclusion, the evidence that WWT is more effective than conventional treatment with topical steroids in AD is of low quality. Further clinical trials should establish the efficacy of WWT in AD.
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Affiliation(s)
- G González-López
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | | | - J J González-López
- Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Feito Rodríguez
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - P Herranz-Pinto
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
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González-López JJ, Ciancas E, Revenga M. Recommendations for the management of Birdshot retinochoroiditis. Arch Soc Esp Oftalmol 2017; 92:195-197. [PMID: 27206618 DOI: 10.1016/j.oftal.2016.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 06/05/2023]
Affiliation(s)
- J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España.
| | - E Ciancas
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - M Revenga
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
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Porrúa L, Oblanca N, González-López JJ. Spontaneous closure of a blue laser induced full thickness macular hole. ACTA ACUST UNITED AC 2016; 92:29-32. [PMID: 27769554 DOI: 10.1016/j.oftal.2016.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/28/2016] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
Abstract
CASE REPORT A 14 year-old boy attended our clinic complaining of a scotoma after an accidental exposure to a 10W, 450nm laser beam from a blue-light handheld laser device. Optical coherence tomography confirmed a full thickness macular hole. As visual acuity (VA) remained 20/20 Snellen, observation was decided. Spontaneous closure was confirmed after one month. DISCUSSION Reckless use of high-power handheld laser devices may induce severe retinal lesions, including full thickness macular holes. Observation is a sensible treatment option in this type of macular hole, especially when VA is preserved. The pathophysiology of these cases differs from senile full thickness macular holes.
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Affiliation(s)
- L Porrúa
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - N Oblanca
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España.
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González-López JJ, McGowan G, Chapman E, Yorston D. Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases. Eye (Lond) 2016; 30:929-35. [PMID: 27055681 DOI: 10.1038/eye.2016.65] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 02/11/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo assess the efficacy of small-gauge vitrectomy with subretinal recombinant tissue plasminogen activator (rtPA) and ranibizumab for submacular haemorrhages secondary to neovascular age-related macular degeneration (nAMD), and to identify the factors associated with visual outcome.MethodsA retrospective case series was performed, including all patients who had small-gauge vitrectomy with subretinal rtPA and ranibizumab for submacular haemorrhages secondary to nAMD. All patients received three consecutive monthly injections of ranibizumab after the surgery, and were reviewed monthly and treated on a pro re nata regime.ResultsA total of 45 eyes of 45 patients were included in the study. Mean age was 77.07±9.67 years, and 32 of 45 patients (71.1%) were women. Surgery was performed on average 6.98±5.70 days after the onset of symptoms, and patients were observed for a follow-up period of 12.9±10.8 months. On average, visual acuity improved -0.59±0.61 LogMAR between presentation and last follow-up. Visual acuity improved in 33 patients (73.3%), remained unchanged in 10 patients (22.2%), and worsened in 2 patients (4.4%). Multiple linear regression showed that patients with smaller haemorrhages (P=0.012) and prompt surgery (P=0.008) had better final visual acuities. A haemorrhage area of ≤30 mm(2) had 91.3% sensitivity and 73.3% specificity for predicting a final visual acuity ≥6/60.ConclusionSmall-gauge vitrectomy with subretinal rtPA and ranibizumab is effective for improving visual acuity in patients with submacular haemorrhages secondary to nAMD. Small haemorrhage area and prompt surgery are associated with better final visual acuity.
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Affiliation(s)
- J J González-López
- Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - G McGowan
- Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - E Chapman
- Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - D Yorston
- Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK
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14
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de Dompablo E, Díez-Álvarez L, Ruiz-Casas D, Sánchez-Gutiérrez V, Ciancas E, González-López JJ. [Recurrent neurosensory macular detachment in carotid-cavernous fistula]. ACTA ACUST UNITED AC 2014; 90:331-4. [PMID: 25443195 DOI: 10.1016/j.oftal.2014.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 02/08/2014] [Accepted: 03/18/2014] [Indexed: 11/26/2022]
Abstract
CASE REPORT A 46 year-old man was seen in the emergency department complaining of vision loss and exophthalmos in his right eye. He also complained of headache, diplopia of 4 months onset, and neurosensory detachment that resolved spontaneously the month before. The study revealed tortuous conjunctival and episcleral vessels and neurosensory macular detachment in his right eye. A carotid-cavernous fistula was confirmed by computed tomography angiography. The fistula closed spontaneously during the hospitalization. One month later, the neurosensory detachment disappeared again. DISCUSSION Carotid-cavernous fistula should be included in the differential diagnosis of neurosensory macular detachments. These neurosensory detachments can resolve spontaneously 11 the fistula is closed.
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Affiliation(s)
- E de Dompablo
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España.
| | - L Díez-Álvarez
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - D Ruiz-Casas
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - V Sánchez-Gutiérrez
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - E Ciancas
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - J J González-López
- Departamento de Retina Médica, Moorfields Eye Hospital NHS Foundation Trust, Londres, Reino Unido
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15
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González-Martín-Moro J, González-López JJ, Gómez-Sanz F, Zarallo-Gallardo J, Cobo-Soriano R. [Posterior capsule opacification, capsular bag distension syndrome, and anterior capsular phimosis: A retrospective cohort study]. ACTA ACUST UNITED AC 2014; 90:69-75. [PMID: 25443463 DOI: 10.1016/j.oftal.2014.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 01/26/2014] [Accepted: 09/04/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the incidence and the risk factors involved in the development of the three main postoperative capsular complications: posterior capsule opacification (PCO), capsular bag distension syndrome (CBDS), and anterior capsular phimosis syndrome (ACP). SUBJECTS, MATERIAL AND METHODS A retrospective cohort study was conducted on 801 patients submitted to cataract surgery in the ophthalmology unit of Hospital del Henares (Madrid) from March 2, 2009 to February 28, 2010. Computerized clinical charts were reviewed during July 2012. PCO was studied using the Kaplan-Meier method (log rank test). RESULTS A total of 167 patients developed PCO. No association could be demonstrated between PCO and age, sex, diabetes mellitus, phaco technique, IOL model, tamsulosin intake, glaucoma, and age-related macular degeneration. Three patients developed CBDS, all of them have received and Akreos Adapt AO(®) (Bausch & Lomb). Two of them were young men who had received surgery for posterior subcapsular cataracts. Three patients developed ACP, 2 of whom had received a MicroSlim(®) IOL (PhysIOL). CONCLUSIONS No association was found between PCO and any of the studied variables. Male gender, young age, subcapsular cataract and large non-angulated lens such as Akreos Adapt AO(®) could be associated with CBDS. ACP could be more frequent when microincision IOLs (like MicroSlim(®)) are implanted.
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Affiliation(s)
| | | | - F Gómez-Sanz
- Servicio de Oftalmología, Hospital Universitario del Henares, Madrid, España
| | - J Zarallo-Gallardo
- Servicio de Oftalmología, Hospital Universitario del Henares, Madrid, España
| | - R Cobo-Soriano
- Servicio de Oftalmología, Hospital Universitario del Henares, Madrid, España
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16
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González-López JJ, Morcillo-Laiz R, Muñoz-Negrete FJ. Adenoviral keratoconjunctivitis: an update. ACTA ACUST UNITED AC 2012; 88:108-15. [PMID: 23473088 DOI: 10.1016/j.oftal.2012.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 06/25/2012] [Accepted: 07/06/2012] [Indexed: 12/01/2022]
Abstract
The objective of this review is to describe the clinical and epidemiological characteristics of adenoviral conjunctivitis, as well as to present a practical update on its diagnosis, treatment and prophylaxis. There are two well-defined adenoviral keratoconjunctivitis clinical syndromes: epidemic keratoconjunctivitis and pharyngoconjunctival fever, which are caused by different adenovirus serotypes. The exact incidence of adenoviral conjunctivitis is unknown. However, cases are more frequent during warmer months. Contagion is possible through direct contact or fomites and the virus is extremely resistant to different physical and chemical agents. The symptomatology of conjunctival infection is similar to any other conjunctivitis, with a higher incidence of pseudomembranes. In the cornea, adenoviral infection may lead to keratitis nummularis. Diagnosis is mainly clinical, but its etiology can be confirmed using cell cultures, polymerase chain reaction or immunochromatography. Multiple treatments have been tried for this disease, but none of them seem to be completely effective. Prevention is the most reliable way to control this contagious infection.
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Affiliation(s)
- J J González-López
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain.
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17
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Miró E, Agüero J, Larrosa MN, Fernández A, Conejo MC, Bou G, González-López JJ, Lara N, Martínez-Martínez L, Oliver A, Aracil B, Oteo J, Pascual A, Rodríguez-Baño J, Zamorano L, Navarro F. Prevalence and molecular epidemiology of acquired AmpC β-lactamases and carbapenemases in Enterobacteriaceae isolates from 35 hospitals in Spain. Eur J Clin Microbiol Infect Dis 2012; 32:253-9. [PMID: 22956023 DOI: 10.1007/s10096-012-1737-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 08/20/2012] [Indexed: 01/19/2023]
Abstract
The purpose of this investigation was to determine the prevalence of plasmid-mediated AmpC (pAmpC) and carbapenemases in Enterobacteriaceae collected from 35 hospitals in Spain and to establish their epidemiological relationships. We conducted a prospective multi-centre study on pAmpC- or carbapenemase-producing Enterobacteriaceae isolates from clinical samples collected from February to July 2009. The strains suspected to carry pAmpC were resistant or showed intermediate susceptibility to co-amoxiclav and second- or third-generation cephalosporins. Strains suspected to carry a carbapenemase were selected because they showed a minimum inhibitory concentration (MIC) to imipenem >1 mg/L. Polymerase chain reaction (PCR) and a sequencing strategy were used to characterise the enzymes. The clonal relationships between isolates was analysed by pulsed field gel electrophoresis (PFGE). Among 100,132 Enterobacteriaceae isolates collected, 1,654 were compatible with the production of pAmpC or carbapenemases. We found a prevalence of 0.64 % of pAmpC (n = 635) and 0.04 % of carbapenemases (n = 43). The most prevalent pAmpC enzymes were CMY-type (78.3 %), DHA-type (19.5 %), ACC-type (1.6 %) and FOX-type (0.6 %). The CMY-type was the most frequent in Escherichia coli and Proteus mirabilis species, whereas the DHA-type was mainly found in Klebsiella spp. The enzymes involved in carbapenem resistance were VIM-1, IMP-22 and the new IMP-28. Nine new bla genes were described: bla (CMY-54), bla (CMY-55), bla (CMY-56), bla (CMY-57), bla (CMY-96), bla (DHA-6), bla (DHA-7), bla (FOX-8) and bla (IMP-28). The prevalence of pAmpC or carbapenemases found is not negligible. The CMY-types were the predominant pAmpC, whereas the VIM or IMP enzymes were the predominant carbapenemases. Furthermore, we observed a great genetic diversity among pAmpC-producing strains and a close clonal relationship between carbapenemase-producing strains.
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Affiliation(s)
- E Miró
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Sant Quintí 89, 08041 Barcelona, Spain
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18
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Fernández Guerrero ML, Torres R, Mancebo B, González-López JJ, Górgolas M, Jusdado JJ, Roblas RF. Antimicrobial treatment of invasive non-perinatal human listeriosis and the impact of the underlying disease on prognosis. Clin Microbiol Infect 2011; 18:690-5. [PMID: 21851486 DOI: 10.1111/j.1469-0691.2011.03616.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Listeriosis is a resurgent foodborne disease in European countries. Benefits of combined β-lactam-aminoglycoside treatment remain controversial and the impact of the underlying disease on prognosis has not been fully assessed. We conducted a retrospective review of cases of sporadic listeriosis in adults from 1995 to 2008 at two university-affiliated hospitals serving a population of 600,000 people in Madrid, Spain. The primary end-point was the associated in-hospital mortality. Sixty-four patients were studied. Estimated incidence of listeriosis was 0.76/100.000 persons/year. Seventy-four per cent had chronic underlying diseases; cirrhosis of the liver and haematological and solid neoplasias were the most common comorbidities. Primary bacteraemia (58%) and meningitis (42%) were the most frequent manifestations. Focal infections were seen in ten cases. In-hospital mortality was 31%. Patients treated with ampicillin or with an ampicillin-gentamicin combination did not differ in age, severity of underlying disease or type of presentation. Differences in mortality were not seen between patients treated with monotherapy and those given combined treatment (28% vs 35%; p 0.634). Ten patients were treated with trimethoprim-sulfamethozaxole alone and only one died. All patients without comorbidities survived infection but mortality of patients with cirrhosis of the liver was 21% and that of patients with haematological or solid neoplasias was 66%. Only haematological neoplasia (OR 6.67; 95% CI 1.71-26.04; p 0.006) was significantly associated with an increased risk of mortality (R(2) (Cox-Snell) = 0.262). Mortality of listeriosis mainly depended on the severity of the underlying disease. Combined ampicillin-gentamicin therapy did not improved survival. Trimethoprim-sulfamethozaxole may be an effective alternative therapy for listerial infections.
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Affiliation(s)
- M L Fernández Guerrero
- Division of Infectious Diseases, Department of Medicine, Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz and Service of Internal Medicine, Hospital Severo Ochoa, Madrid, Spain.
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19
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Blanch AR, Hispano C, Bultó P, Ballesté E, González-López JJ, Vilanova X. Comparison of Vibrio spp. populations found in seawater, in exhibition aquaria, in fish intestine and in fish feed. J Appl Microbiol 2008; 106:57-65. [PMID: 19040706 DOI: 10.1111/j.1365-2672.2008.03974.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Vibrio populations in the seawater supply and the water of seven exhibition aquaria that simulate various Mediterranean and tropical ecosystems were compared. The similarity of Vibrio populations in the intestine of various fish species, feed and water was examined. Resistance to the antibiotics used in fish health management was analysed for the dominant Vibrio isolates. METHODS AND RESULTS Samples were collected for 1 year from seven exhibition tanks reproducing different ecosystems. The diversity and population similarity among vibrios were determined using a miniaturized biochemical phenotyping method. Similar Vibrio populations were found in the water supply and in the water of the Mediterranean ecosystems. However, different Vibrio populations were found in the water of tanks with tropical ecosystems. Vibrio populations in the water seemed to have a greater effect on the composition of intestinal Vibrio populations than those in feed. No resistance to antibiotics was observed, indicating their appropriate use for health management. CONCLUSIONS Water characteristics have a greater impact on the composition of Vibrio populations in aquaria and fish intestinal microbiota than bacteria in feed. SIGNIFICANCE AND IMPACT OF THE STUDY The microbiological monitoring water could provide valuable information for managing the health of exhibition aquaria.
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Affiliation(s)
- A R Blanch
- Department of Microbiology, University of Barcelona, Barcelona, Catalonia, Spain.
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20
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Lavilla S, González-López JJ, Sabaté M, García-Fernández A, Larrosa MN, Bartolomé RM, Carattoli A, Prats G. Prevalence of qnr genes among extended-spectrum beta-lactamase-producing enterobacterial isolates in Barcelona, Spain. J Antimicrob Chemother 2007; 61:291-5. [PMID: 18029415 DOI: 10.1093/jac/dkm448] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To evaluate the presence of qnr genes among enterobacterial isolates carrying extended-spectrum beta-lactamases (ESBLs) in Barcelona, Spain. METHODS Screening for the qnrA, qnrB and qnrS genes was carried out by PCR amplification with specific primers in 305 non-duplicate, clinically relevant ESBL-producing enterobacterial isolates obtained from February 2003 to August 2004. ESBLs from all qnr-positive isolates were characterized by isoelectric focusing, PCR amplification and DNA sequencing. Plasmid analysis was performed by S1 digestion and hybridization with specific probes for the qnr and bla genes. Plasmids containing qnr genes were transferred by conjugation or transformation. The genetic environment of qnrA1 in selected isolates was characterized by cloning experiments. RESULTS Fifteen isolates, each from a different individual, carried qnr. Among them, 14 had qnrA1 (6 Klebsiella pneumoniae, 6 Enterobacter cloacae and 2 Escherichia coli isolates) and 1 had qnrS1 (K. pneumoniae). None of the isolates carried qnrB. Among the qnrA1-carrying isolates, 10 possessed both bla(CTX-M-9) and bla(SHV-12), 2 had both bla(CTX-M-9) and bla(SHV-92) and 2 had bla(CTX-M-9) alone. The isolate with qnrS1 possessed bla(SHV-12). The qnrA1 and ESBL genes were located together on plasmids ranging in size from 40 to 320 kb. qnrS1 and bla(SHV-12) were not located on the same plasmid. Transfer of quinolone resistance was successfully achieved from all but three isolates. The cloned region surrounding qnrA in two K. pneumoniae isolates revealed a novel genetic organization. CONCLUSIONS The prevalence of qnr among enterobacterial clinical isolates carrying ESBLs between 2003 and 2004 in Barcelona was 4.9%. qnrA1 was the most prevalent, whereas only one qnrS and no qnrB were detected.
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Affiliation(s)
- S Lavilla
- Department of Microbiology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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González-López JJ, Sabaté M, Lavilla S, Larrosa MN, Bartolomé RM, Prats G. In vivo reversion to the wild-type beta-lactam resistance phenotype mediated by a plasmid carrying ampR and qnrA1 in Enterobacter cloacae. Antimicrob Agents Chemother 2006; 50:3175-8. [PMID: 16940123 PMCID: PMC1563562 DOI: 10.1128/aac.00273-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Resistance to beta-lactams and quinolones in two isogenic Enterobacter cloacae isolates was studied. One was susceptible to cefoxitin and amoxicillin-clavulanate. The other one showed its natural beta-lactam resistance pattern. Both isolates had a nonfunctional AmpR regulator. However, within the second one, the presence of a plasmid carrying ampR and qnrA1 allowed reversion to the wild-type beta-lactam resistance phenotype and decreased susceptibility to fluoroquinolones.
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Affiliation(s)
- J J González-López
- Servicio de Microbiología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
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