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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2020;154:279-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Cost-effectiveness of the withdrawal of treatment with inhaled colistin in patients with adult bronchiectasis not due to cystic fibrosis colonized by Pseudomonas aeruginosa" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "279" "paginaFinal" => "280" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Coste-efectividad de la suspensión del tratamiento con colistina inhalada en los pacientes con bronquiectasias del adulto no debidas a fibrosis quística colonizadas por Pseudomonas aeruginosa" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rubén Lera Álvarez, Eva Martínez Moragón, María Morales Suárez Varela" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Rubén" "apellidos" => "Lera Álvarez" ] 1 => array:2 [ "nombre" => "Eva" "apellidos" => "Martínez Moragón" ] 2 => array:2 [ "nombre" => "María Morales" "apellidos" => "Suárez Varela" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318307255" "doi" => "10.1016/j.medcli.2018.11.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318307255?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620300656?idApp=UINPBA00004N" "url" => "/23870206/0000015400000007/v1_202004071208/S2387020620300656/v1_202004071208/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Detection of Salmonella enterica in stool of immunosuppressed patients using two point of care techniques" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "280" "paginaFinal" => "281" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana De Malet, Israel Nieto" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Ana" "apellidos" => "De Malet" "email" => array:1 [ 0 => "dmaletpf@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Israel" "apellidos" => "Nieto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio Microbiología, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio Inmunología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Detección en heces de Salmonella enterica en pacientes inmunodeprimidos usando dos técnicas “point of care”" ] ] "textoCompleto" => "Salmonella enterica is a species of the genus Salmonella belonging to the enterobacteriaceae family. S. enterica is divided into six subspecies: enterica (I), salamae (II), arizonae (IIIa), diarizonae (IIIb), houtenae (IV) and indica (VI).<a class="elsevierStyleCrossRef" href="#bib0030">1</a>Considering clinical aspects, S. enterica is classified into (a) typhoid serotypes (S. enterica serotypes typhi and paratyphi) that cause typhoid fever and (b) Salmonella not typhoid serotype (the rest).<a class="elsevierStyleCrossRef" href="#bib0030">1</a>Typhoid fever is a potentially fatal invasive gastroenteritis. There are about 20 million cases per year with around 200,000 deaths worldwide, being humans the only carrier. For its part, non-typhoid salmonellas are zoonoses of global distribution.<a class="elsevierStyleCrossRef" href="#bib0035">2</a>The culture and subsequent biochemical characterization or identification by mass spectrometry are the techniques of choice for the diagnosis of enteropathogen bacterias,<a class="elsevierStyleCrossRef" href="#bib0040">3</a> although both of them are long processes that takes between 24 and 72h.The use of rapid and simple tests for the diagnosis of Salmonellosis in risk population could facilitate clinical decision making. Currently there are available several tests based on immunochromatography that could be used as a “point of care” technique. We evaluated the suitability of two rapid diagnostic methods for Salmonella sp. in 184 stool cultures collected from May 2014 to April 2015 of patients with some type of immunosuppression (oncological process, transplanted patients, HIV, diabetics, renal failure or previous viral infections) and gastrointestinal symptomatology, of both community and nosocomial origin.The stools were distributed into 4 aliquots. One was used for spreading, another for PCR testing and another 2 for the immunochromatographic tests Salmonella Letitest (Leti®) and Salmonella test (Francisco Soria Melguizo).Spreading was carried out on SS agar (bioMérieux), MacConkey (bioMérieux) with incubation at 37°C–24h, and selenite broth from which a subculture was done after 12h with incubation at 37°C in Brillant Green (bioMérieux). For the identification of enteropathogens, VITEK® 2 system (bioMérieux) was used.For the detection by PCR, 100μL of selenite broth was used. This was diluted in 5mL of new selenite broth and incubated 37°C–4h. Subsequently, it was centrifuged at 3000×g, suspending the pellet in physiological saline solution; after a new centrifugation at 3000×g the pellet was finally suspended in 200μL of distilled water.<a class="elsevierStyleCrossRef" href="#bib0045">4</a> The extraction of DNA was carried out with QIAmp DNA stool minikit (Qiagen, Valencia). The primers and cycling reaction used were described by Kwang et al.<a class="elsevierStyleCrossRef" href="#bib0050">5</a>The results are specified in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Statistical analysis (IBM SPSS Version 20.0) was made in reference to the presence of bacterial DNA.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Sex distribution was men (65–35%), women (119–65%). The mean age was 68 years and among the most frequent risk factors were found advanced age, ≥80 years (66–35.8%), patients with some oncological process (40–27.7%) and diabetics (31–16.8%). 27% of the patients needed hospital admission.The average time spent with the culture for the identification of Salmonella sp was 62h from the reception of the sample in laboratory, while with both immunochromatographic techniques the results were obtained in less than 1h.The two tests presented a high sensitivity (>80%) demonstrating its usefulness for the screening of gastrointestinal syndrome in immunosuppressed patients.ROC curves analysis showed that the 2 immunochromatographic techniques are good diagnostic tests of Salmonella sp. in stool (area under the curve>0.9). On the other hand, Pearson's Kappa index showed a good correlation with the data obtained by PCR.In conclusion, thin-layer immunochromatography is a quick and simple technique very valuable for the early diagnosis of Salmonella sp. in stool even for its use as a diagnosis at bedside, especially in patients with underlying or immunosuppressed pathologies in which a delayed diagnosis can lead to serious complications." "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "n: number of positives, AUC: area under curve, CI: confidence interval, K: Kappa index." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Specificity \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sensitivity \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AUC \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CI: 95% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">K \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Culture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.929 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.877–0.980 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.893 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leti test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.968 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.933–1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.952 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Test Soria Melguizo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.944 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.898–0.990 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.917 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2270877.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Positivity pattern depending on the technique used for the detection of Salmonella sp." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nomenclature and taxonomy of the genus Salmonella" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.J. Tindall" 1 => "P.A. Grimont" 2 => "G.M. Garrity" 3 => "J.P. Euzeby" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/ijs.0.63580-0" "Revista" => array:7 [ "tituloSerie" => "Int J Syst Evol Microbiol" "fecha" => "2005" "volumen" => "55" "paginaInicial" => "521" "paginaFinal" => "524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15653930" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508516002304" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Typhoid fever and paratyphoid fever: systematic review to estimate globalmorbidity and mortalityfor" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.C. Buckle" 1 => "C.L. Walker" 2 => "R.E. 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Navarro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Quimioter" "fecha" => "2014" "volumen" => "27" "paginaInicial" => "102" "paginaFinal" => "105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24940890" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of a multiplex PCR technique for detection and epidemiological typing of Salmonella in human clinical samples" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Alvarez" 1 => "M. Sota" 2 => "A.B. Vivanco" 3 => "I. Perales" 4 => "R. Cisterna" 5 => "A. 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ISSN: 2387-0206

Launched in 1943, Medicina Clínica is a fortnightly journal aimed at the promotion of clinical research and practice among internal medicine and other specialists. The key characteristics of Medicina Clínica are the scientific and methodological rigor of its manuscripts, the topicality of its contents, and, especially, its practical focus with highly useful information for clinical practice. Medicina Clínica is predominantly interested in publishing original research manuscripts, which are rigorously selected according to their quality, originality, and interest, and also in continued medical education-oriented manuscripts, which are commissioned by the journal to relevant authors (Editorials, Reviews, and Diagnosis and Treatment). These manuscripts contain updated topics with a major clinical or conceptual relevance in modern medicine. The journal adheres to the standards of academic research publications in all aspects including peer-review and ethical principles. Medicina Clínica is included in the General and Internal Medicine category of Thomson Reuters.

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0.511

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