[Evaluation of a rapid detection method for broad-spectrum beta-lactamases using a chromogenic cephalosporin].
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Bacteria↗
Biomedical subjects
J C Rodríguez
Publications and source records attributed to J C Rodríguez.
Cytosolic levels of TFF1/pS2 in breast cancer: Their relationship with clinical-pathological parameters and their prognostic significance.
BACKGROUND: The Trefoil Factor 1 (TFF1/pS2), a peptide consisting of 60 amino acids, is the most abundant estrogen-induced messenger RNA present in MCF-7 breast cancer cells. The objective of this work was to evaluate the cytosolic TFF1 content in breast carcinomas, its possible relationship with different clinical-pathological parameters, and its potential prognostic significance and predictive value. METHODS: Cytosolic TFF1 levels were examined by immunoradiometric assay in 1031 patients with invasive breast cancer. The median follow-up period was of 50 months. RESULTS: There was a wide variability of cytosolic TFF1 levels in tumors (0.9-743.2 ng/mg protein). Statistical analysis showed that TFF1 levels were significantly higher in premenopausal patients (p = 0.001), as well as in tumors showing any of the following characteristics: good differentiation (p = 0.0001), ER and PgR positivity (p = 0.0001 and p = 0.001, respectively), diploidy (p = 0.045) and a high S-phase fraction (p = 0.001). In addition, the presence of high intratumoral TFF1 levels (cut-off: 2 ng/mg protein) was independently associated with a shorter overall survival in the group of patients as a whole (p = 0.001) as well as in the subgroup with node-negative breast cancer (p = 0.0004). Likewise, high intratumoral TFF1 levels were associated with a more prolonged overall survival in patients who received adjuvant tamoxifen (p = 0.004). CONCLUSIONS: In breast cancer patients, intratumoral TFF1 levels are associated with a better clinical outcome, especially in those with node-negative tumors. In addition, TFF1 levels have a low but significant predictive value in regards to response to adjuvant therapy with tamoxifen.
Adult↗
Mutant prevention concentration of isoniazid, rifampicin and rifabutin against Mycobacterium tuberculosis.
BACKGROUND: Mutant prevention concentration (MPC) is a new parameter that may be of aid in determining the risk of resistant mutants being selected. METHODS: The MPCs of 224 Mycobacterium tuberculosis clinical isolates were estimated by plating more than 10(10) cells on drug-containing agar and determining the concentration that allowed no colony growth. Antibiotics used were isoniazid, rifampicin and rifabutin. RESULTS: The MPC90 of clinical isolates in our setting is 2.4, 2.2 and 0.4 mg/l for isoniazid, rifampicin and rifabutin, respectively. CONCLUSIONS: Isoniazid and rifampicin are two drugs that present a low risk of selection of resistant mutants when used in monotherapy. However, determination of the MPC of each strain can provide data to minimize this risk and thus enable treatment to be optimized.
Antitubercular Agents↗
Usefulness of various antibiotics against Mycobacterium avium-intracellulare, measured by their mutant prevention concentration.
This study looked the selection of resistant mutants in Mycobacterium avium-intracellulare during antibiotic treatment. The mutant prevention concentration (MPC) of 20 Mycobacterium avium and 12 Mycobacterium intracellulare isolates was determined. Fifty percent of Mycobacterium avium strains had MPC (MPC50) values lower than 16, 64, 40, 55 and 60 mg/L for rifabutin, rifampicin, ciprofloxacin, levofloxacin and moxifloxacin, respectively. In the case of Mycobacterium intracellulare, 50% had MPC (MPC50) values below 60, 30, 35, 16, 2.5 and 14 mg/L for linezolid, rifabutin, levofloxacin, gatifloxacin, moxifloxacin and clarithromycin, respectively. The high capacity for selecting resistant mutants of all the antibiotics studied emphasises the need to restore the immune system if necessary and to administer combined treatments in order to cure patients.
Acetamides↗
Community-acquired pneumonia of mixed etiology: prevalence, clinical characteristics, and outcome.
Community-acquired pneumonia (CAP) of mixed etiology has increasingly been appreciated in the literature, but its clinical significance remains unknown. The aim of this analysis was to describe the prevalence, clinical characteristics, and outcome of CAP of mixed etiology. Data were obtained from a 2-year prospective study of consecutive patients with CAP in whom an extensive microbiological workup was performed. Predefined strict criteria were used to establish the etiology. A total of 493 patients were included. A single pathogen was detected in 222 (45%) cases and two or more pathogens in 28 (5.7%) cases. Mixed infections were seen across all age groups and in patients treated both in hospital and as outpatients. The most frequent combinations of pathogens were those of a bacterium plus an "atypical" organism (28.6%) and of two bacterial organisms (28.6%). Compared with patients with monomicrobial pneumonia, patients with mixed pneumonia were more likely to have underlying conditions (64% vs. 45%, p=0.04) and dementia (25% vs. 10%, p=0.02). The incidence of a defined series of complications was higher in patients with mixed pneumonia (39.3% vs. 18.6%; OR=2.84; p=0.02). Community-acquired pneumonia of mixed etiology is uncommon. Patients with mixed pneumonia are more likely to have underlying medical conditions, and they may have a more severe course of disease.
Adolescent↗
Influence of various criteria for elimination of duplicates when calculating the prevalence and antibiotic susceptibility of microorganisms associated with urinary infections.
The effect of applying various criteria for elimination of repeated isolates in the same patient on the prevalence and antibiotic susceptibility of microorganisms frequently associated with urinary infections were analyzed. When time criteria were applied, there was a decrease in the number of isolates of 13.4-27.5%, whereas when variations in antibiotic susceptibility were considered, between 4.3 and 20.3% of the isolates were eliminated. The absolute number of isolates varied considerably depending on which of these two criteria were used, but neither criterion was seen to modify significantly the antibiotic susceptibility of these microorganisms and this confirms the recommendations of the NCCLS for this group of pathogens.
Anti-Bacterial Agents↗
[Molecular epidemiology of tuberculosis: main findings and their application in Spain].
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Humans↗
Epidemiology of community-acquired pneumonia in adult patients at the dawn of the 21st century: a prospective study on the Mediterranean coast of Spain.
This study presents data from a prospective study of adult patients with community-acquired pneumonia (CAP). Of 493 patients included in the study, 223 (45.2%) were aged > or = 65 years, and 265 (53.7%) had one or more underlying diseases, mostly chronic obstructive pulmonary disease, diabetes mellitus or dementia. In total, 281 microorganisms were identified in 250 (50.7%) patients, with two or more pathogens detected in 28 (5.7%) cases. Microbial diagnosis varied according to age, severity, co-morbidity and site-of-care, but there was much overlap among groups. Streptococcus pneumoniae was the single most prevalent organism in outpatients, patients admitted to hospital, and patients who died, either as a single pathogen or combined with another organism. Infections caused by 'atypical' pathogens were seen across all groups, including the elderly and patients with co-morbidities. Mortality varied according to the pneumonia severity index (PSI) of the pneumonia patient outcomes research team. Shock (OR 34.48), an age of > 65 years (OR 25) and altered mental status (OR 9.92) were factors associated independently with 30-day mortality. Key findings from this study were the advanced age of the population with CAP, and the high prevalence of dementia as an underlying disease. The study also revealed that microbiological diagnosis of CAP remains problematic. Although certain epidemiological features may help to predict the microbial aetiology, the overlap among groups reduces the usefulness of this information in guiding therapeutic decisions. Greater effort should be made to improve identification methods for microbial pathogens causing CAP.
Adolescent↗
Bollgard cotton and resistance of tobacco budworm (Lepidoptera: Noctuidae) to conventional insecticides in southern Tamaulipas, Mexico.
Insecticide susceptibility in tobacco budworm, Heliothis virescens (F.) (Lepidoptera: Noctuidae), was determined for 8 yr (1991-2001) with larvae sampled from cotton in southern Tamaulipas, Mexico. Before 1996, when Bollgard cotton expressing the Cry1A(c) delta-endotoxin was introduced into the region, two important patterns were documented. The first was economically significant increases in resistance to certain insecticide groups. The second was occurrence of virtually complete control failures in the field during 1994 and 1995. The largest resistance changes were recorded for the type II pyrethroids cypermethrin and deltamethrin. These products are the most widely used products in the region. Resistance ratios for these products increased up to > 100-fold from 1991 to 1995. After 1996, the resistance levels declined. These findings did not occur with other products of scant use (e.g., permethrin, profenofos, and endosulfan) or low tobacco budworm efficacy coupled to a high use pattern (e.g., methyl parathion). This clear trend toward reversal of resistance to type II pyrethroids can be understood, in part, with respect to two factors: 1) the high adoption rate of transgenic cotton in the region, from 31.2% in the beginning (1996) to approximately 90% in 1998; this has considerably curbed the use of synthetic insecticides, with the attending loss of selection pressure on this pest; and 2) the potential immigration to the region of susceptible tobacco budworms from cultivated and wild suitable hosts as well as from transgenic cotton might have influenced the pest population as a whole. The influence of transgenic cotton on southern Tamaulipas can be more clearly seen by the drastic reduction of insecticide use to control this important pest. Now tobacco budworms in this region are susceptible to type II pyrethroids. Two effective and fundamentally different pest management tools are now available to cotton growers in southern Tamaulipas: transgenic cotton, coupled with careful use of pyrethroids, offers the possibility of sustainable and profitable cotton production.
Animals↗
Expression and prognostic value of EGFR in invasive breast cancer.
Epidermal growth factor receptor (EGFR) is a membrane receptor expressed in a variety of solid human cancers and directly related with poor prognosis. The objective of this work was to evaluate the EGFR content in breast carcinomas, its possible relationship with different clinical-pathological parameters, and its potential prognostic significance and predictive value. EGFR levels were examined by radioligand binding assays in 846 patients with invasive breast cancer. The median follow-up period was 50 months. There was a wide variability of EGFR levels among the studied tumors (0.01-403 fmol/mg protein). Statistical analysis showed that EGFR levels were significantly higher in younger patients (p=0.0001). EGFR were also notably higher in ER-negative or PgR-negative tumors than in ER-positive (p=0.0001) or PgR-positive tumors (p=0.001). In addition, the presence of high intratumoral EGFR levels (cut-off: 6 fmol/mg protein) was associated with both shorter relapse-free survival (p=0.04) and overall survival (p=0.01) in the group of patients as a whole, as well as with overall survival in the subgroup of patients without any type of systemic adjuvant treatment (p=0.02). However, EGFR levels did not achieve significance as independent prognostic factor in the multivariate analysis. There is a wide variability of intratumoral EGFR levels in breast carcinomas, and these protein levels correlated positively with a poor prognosis in the t univariate analysis. However, further studies are necessary in order to assess the possible clinical value of EGFR in combination with other essential components of the EGFR family network.
Adult↗
Action of fluoroquinolones and Linezolid on logarithmic- and stationary-phase culture of Mycobacterium tuberculosis.
BACKGROUND: The new challenges involved in the chemotherapy of tuberculosis make it necessary to find novel drugs, especially ones that are useful in the latent phase of the disease. METHODS: We evaluated the activity of linezolid and fluoroquinolones against logarithmic- and stationary-phase Mycobacterium tuberculosis. RESULTS: We observed that linezolid exhibits antibacterial action, although slowly, in both situations. Quinolones with an 8-methoxy group exhibit greater activity than levofloxacin in logarithmic growth phases, whereas levofloxacin exhibits greater activity in stationary-phase growth. CONCLUSION: The study of the activity of drugs against the M. tuberculosis microorganism in the latent phase is one of the most important tools available in the fight against the tuberculosis epidemic, and both linezolid and the new fluoroquinolones appear to be promising drugs.
Acetamides↗
Mutant prevention concentration: comparison of fluoroquinolones and linezolid with Mycobacterium tuberculosis.
OBJECTIVES: The mutant prevention concentration (MPC) has recently been defined to characterize the capacity for severely restricting the selection of resistant mutants during antibiotic treatment. We determined this parameter for ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin and linezolid in Mycobacterium tuberculosis clinical isolates in our setting. METHODS: We determined the antibiotic concentration that prevents the selection of resistant mutants following inoculation with a high mycobacteria inoculum on Middlebrook 7H11 plates with serial dilutions of the antibiotics in 224 M. tuberculosis isolates. RESULTS: Fifty percent of the strains exhibited values of MPC (MPC(50)) lower than 0.8, 0.6, 0.4, 0.4 and 0.6 mg/L for ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin and linezolid, respectively. If 90% of the strains are considered (MPC(90)), the values are seen to rise to 2, 1.8, 1, 1.2 and 1.2 mg/L, respectively. CONCLUSIONS: When we compare this parameter with the drug levels in serum and tissue, it can be seen that ciprofloxacin is the least useful of the fluoroquinolones studied, whereas moxifloxacin appears to be the most active. Linezolid exhibits excellent activity against this microorganism (MPC(90) 1.2 mg/L and AUC 140.3 mg.h/L) and this makes us consider that its usefulness in the treatment of this pathology should be thoroughly evaluated.
Acetamides↗
[Therapeutic guide to primary care based on the evidence, 2nd edition: an honest and practical work].
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Evidence-Based Medicine↗
[Clinical significance of tumor content of epidermal growth factor receptor in breast cancer].
OBJECTIVE: To determine the content of epidermal growth factor receptor (EGFR) using a radioligand method in breast cancer and to analyze the relationship between the EGFR levels and the characteristics of patients and tumors. Prognostic significance was also analyzed. MATERIAL AND METHODS: EGFR was measured by a single point radioligand assay in 265 invasive breast carcinomas tissues. In addition, estrogen and progesterone receptors (ER and PR) were measured by enzymatic immunoassays. We analyze the relationship of EGFR levels with the different clinico-pathologic parameters. RESULTS: EGFR levels in breast carcinomas varied widely (0.1 to 403) with a median at 4 fmol/mg prot. The significantly higher concentrations of EGFR were detected in patients under 60 years old (p = 0.042), undifferentiated tumors (p = 0.04), and carcinomas with negative ER and PR (p < 0.019 y p < 0018, respectively). In addition, there was a negative correlation between EGFR and the ER and PR levels (p < 0.05). EGFR levels did not show any relationship with the patient's prognosis. CONCLUSIONS: In addition, intratumoral levels of EGFR in breast carcinomas vary widely and the highest concentrations are associated with the most aggresive characteristics of the tumor.
Adult↗
Effect of clinical and socio-economic factors on the rate of clustering of Mycobacterium tuberculosis clinical isolates in Elche (Spain).
We studied the association that exists between the epidemiological type clustering of isolates of Mycobacterium tuberculosis and certain clinical, epidemiological and socio-economic characteristics of tuberculosis patients in the Elche health district of Spain. A total of 144 patients diagnosed between 1993 and 1999 and whose isolates had been genotyped by IS6110-RFLP in an earlier study were included. Multivariate analysis showed that the independent variables associated with clustering of strain types were: age (1-25 years, OR 2.92, 95% CI 0.83 10.3), a high percentage of infection in the first circle of contacts (OR 2.89, 95% CI 0.96-8.68), urban dwelling (OR 2.12. 95% CI 0.73-6.2), use of bronchoscopy to obtain samples (OR 16.3, 95% CI 2.3-11.5) and working contact with many people (OR 2.81, 95% CI 0.94-8.3). These data contribute to a better understanding of the epidemiology of tuberculosis and improved systems of control.
Adolescent↗
Usefulness of different techniques in the study of the epidemiology of salmonellosis.
Our objective was to evaluate the usefulness of serotyping, phagotyping, antibiotyping and RAPD (random amplified polymorphic DNA) in the study of the epidemiology of salmonellosis in Elche (Spain). We examined 1232 clinical isolates of non-typhoid Salmonella serotypes. Serotyping adequately differentiates 12.3% of the isolates and phagotyping raises this percentage to 37%. Antibiotyping is a suitable complement in certain circumstances, such as in the case of specific outbreaks. RAPD is a fast and simple technique which is within the reach of most laboratories, complementing the results obtained by antibiotyping and serotyping, in order to be able to control outbreaks of salmonellosis in everyday practice.
Agglutination Tests↗
In vitro activity of moxifloxacin, levofloxacin, gatifloxacin and linezolid against Mycobacterium tuberculosis.
The in vitro activity of moxifloxacin, gatifloxacin, levofloxacin and linezolid was evaluated against 234 strains of Mycobacterium tuberculosis isolated in the Southeast of Spain. All drugs tested showed good activity, with an MIC(90) of less than 1 mg/l, and were active against isociacide and rifampicin resistant strains. Three strains were resistant to isoniazid and to the fluoroquinolones, which suggested the existence of mechanisms of resistance not yet described. These new compounds may prove to be therapeutic alternatives for treatment of multi-resistant tuberculosis and further studies should be done to demonstrate their true usefulness.
Acetamides↗
Molecular epidemiology of tuberculosis in Elche, Spain: a 7-year study.
The epidemiology of tuberculosis in Elche (Spain) was studied by restriction fragment-length polymorphism (RFLP) typing of clinical isolates of Mycobacterium tuberculosis over a 7-year period. A total of 165 isolates was typed and the clinico-epidemiological data of the patients were studied retrospectively. An overall cluster aggregation of 52.4% was found, rising to 71.43% in HIV-positive patients. There was greater aggregation in younger patients, but no statistically significant differences when other variables were analysed. The percentage of aggregation was higher than in other studies in Spain and this may be due to the longer time period of this study. The high percentage of aggregation in young patients and in thosewho were HIV-positive suggests increased recent transmission in both groups.
Adolescent↗