Papers by Natalia Montiel
Journal of viral hepatitis, 2017
We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-20... more We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid-Community, Valencian-Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV-coinfection, and treatment details were recorded. We recruited 48595 chronically infected HCV patients; median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was: 66.9% GT1 (24.9% subtype1a and 37.9% subtype1b), 2.8% GT2, 17.3% GT3, 11.4% GT4, and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were...
Revista Espanola De Quimioterapia Publicacion Oficial De La Sociedad Espanola De Quimioterapia, Jun 1, 2011
The inappropriate use of antimicrobial agents may contribute to the development of bacterial resi... more The inappropriate use of antimicrobial agents may contribute to the development of bacterial resistance to the principal antimicrobial drugs. There is no provision in the immediate future of marketing of new broad-spectrum antibiotics, especially with activity against Enterobacteriaceae, so programs should be implemented to optimize antimicrobial therapy. We describe the results of a year of a counselling program in antibiotic treatment in a secondary Andalusian hospital. We describe 276 interventions of a multidisciplinary non-compulsory counselling program of antimicrobial management on the Costa del Sol Hospital in Marbella. We evaluated the adequacy of empirical treatment, possibility of antibiotic de-escalation, duration and dose used. We analyzed the evolution of the sensitivity profile of the main microorganisms as well as a cost-effective analysis. 90% of the recommendations were accepted. The main actions were assessment of empirical therapy and deescalation in relation with the result of cultures. The main drugs tested were imipenem, meropenem, cefepime, and linezolid. The sensitivity profile of imipenem and meropenem improved slightly over previous years. It was found a considerable savings in annual drug spending. The non-compulsory counselling programs are useful tools for optimization of antimicrobial therapy, can prevent an increase of antimicrobial resistance and reduce the cost of antibiotic treatment.
Descripción: Berlin, Germany Springer Verlag, 2003. Softcover. Estado de conservación: Gut. Zusta... more Descripción: Berlin, Germany Springer Verlag, 2003. Softcover. Estado de conservación: Gut. Zustand: Gut, Mängelexemplar, Approx. 140 p. 50 illus. About this book Preface Introduction Heino von Prondzynski, Member of the Executive Committee of F. Hoffmann-La Roche AG and Head of the Diagnostics Division Winner of the 2002 IFCC- Roche Diagnostics Award "Apoptosis In Sepsis And Multiple Organ Dysfunction Snydrome" S. Zeerleder, B. Zwart, W. A. Wuillemin, L. A. Aarden, A. B. J. Groeneveld, C. Caliez, A. E. M. van Nieuwenhuijze; G. J. van Mierlo, A. J. M. Eerenberg, B. Lämmle, and C. E Hack Inflammation ? Infection ? Sepsis Finalists "Plasma Procalcitonin And C- Reactive Protein In Acute Septic Shock: Clinical And Biological Correlates" R. Claeys, S. Vinken, H. Spapen, K. ver Elst, L. Huyghens, F. K. Gorus National Winners "4G/5G Promoter Polymorphism In The Plasminogen Activator Inhibitor-1 Gene In Children With Systemic Meningococcaemia" G. Geishofer, W. ...
Medicina
Resumen El primer caso autóctono de leishmaniasis visceral (LV) en la Argentina se notificó en el... more Resumen El primer caso autóctono de leishmaniasis visceral (LV) en la Argentina se notificó en el año 2006 en posadas, Misiones, y en el verano 2008-2009 se comprobó la dispersión del vector de lV, Lutzomyia longipalpis y casos de lV canina en la provincia de Corrientes. para conocer la distribución del riesgo, entre febrero y marzo del 2010 se realizó la búsqueda sistemática del vector de lV en 18 localidades de las provincias de Entre ríos, Corrientes y en la ciudad de puerto Iguazú, Misiones, totalizando 313 trampas/noche. Se comprobó la presencia de Lu. longipalpis, por primera vez, en las localidades de Chajarí (Entre Ríos), Alvear, La Cruz, Curuzú Cuatiá y Bella Vista (Corrientes), y en Puerto Iguazú (Misiones). En Santo Tomé y Monte Caseros (Corrientes) se volvió a registrar la presencia del vector, y se obtuvieron las trampas con más ejemplares, 830 y 126 Lu. longipalpis trampa/sitio/noche respectivamente. Los resultados muestran que el vector de la LV urbana, continúa dispersándose en el territorio argentino. Simultáneamente, la propagación del parásito, y los consecuentes casos de LV humana se asocian al aumento de reservorios, perros infectados con o sin clínica, debidos al tránsito humano.
Revista española de quimioterapia : publicación oficial de la Sociedad Española de Quimioterapia, 2011
The inappropriate use of antimicrobial agents may contribute to the development of bacterial resi... more The inappropriate use of antimicrobial agents may contribute to the development of bacterial resistance to the principal antimicrobial drugs. There is no provision in the immediate future of marketing of new broad-spectrum antibiotics, especially with activity against Enterobacteriaceae, so programs should be implemented to optimize antimicrobial therapy. We describe the results of a year of a counselling program in antibiotic treatment in a secondary Andalusian hospital. We describe 276 interventions of a multidisciplinary non-compulsory counselling program of antimicrobial management on the Costa del Sol Hospital in Marbella. We evaluated the adequacy of empirical treatment, possibility of antibiotic de-escalation, duration and dose used. We analyzed the evolution of the sensitivity profile of the main microorganisms as well as a cost-effective analysis. 90% of the recommendations were accepted. The main actions were assessment of empirical therapy and deescalation in relation wit...
Acta otorrinolaringológica española, 2006
To obtain the main responsible organisms, its sensitivity and resistances to antibiotics in tonsi... more To obtain the main responsible organisms, its sensitivity and resistances to antibiotics in tonsillitis. We have studied the post-surgical tonsils, carrying out a microbiologic study, its culture and sensitivity. The most frequent isolated organisms were Staphylococcus aureus (29.3%), followed by Streptococcus pyogenes (23.4%), and Haemophilus influenzae (12.1%). The highest resistances were for the S. aureus (penicillin 91%, erythromycin 18% and 5% to the rest of the beta-lactams), followed by H. influenzae (50% clarithromycin, 30% amoxyciIlin and 2% cephalosporins) and S. pyogenes (28% erytromycin, 10% clindamycin and 3% penicillin). We noticed the minimal resistance found to cephalosporins, and for this reason they appear to be the safest option, except in children under five years old, in which amoxicillin is still the first line treatment, because the causative agent is S. pyogenes, sensitive to that antibiotic.
Anales de medicina interna (Madrid, Spain : 1984), 2005
... Unidad de Medicina Interna. 1 Unidad de Microbiología. ... 3. Swing S, Ruiz M, Torres A, Marc... more ... Unidad de Medicina Interna. 1 Unidad de Microbiología. ... 3. Swing S, Ruiz M, Torres A, Marco F, Martínez JA, Sánchez M, et al. ... 4. Sanz Herrero F, Juan Samper G, Ramón Capilla M, Navarro Ibáñez R, Lloret Pérez T. Neumonía neumocócica en pacientes hospitalizados. ...
Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva, 1997
We report a case of severe acute diarrhoea produced by Aeromonas sobria, a specimen with controve... more We report a case of severe acute diarrhoea produced by Aeromonas sobria, a specimen with controversial human pathogenicity. A 26-year-old man with Crohn's disease previously colectomized was admitted with a cholera-like clinical presentation and renal failure. Aeromonas sp. can be isolated in both children and adults and in healthy people, A. hydrophila being most often detected. Severe infections due to other Aeromonas sp., usually A. sobria and A. caviae, have been rarely described. Most patients have underlying illnesses such as chronic liver disease or neoplasms. In our patient colectomy played a key role.
Gastroenterología y Hepatología, 2005
28(8):445-6
Medicina, 2011
The first case of visceral leishmaniasis (VL) in Argentina was reported in 2006 in Posadas, Misio... more The first case of visceral leishmaniasis (VL) in Argentina was reported in 2006 in Posadas, Misiones. During the summer 2008-2009 Lutzomyia longipalpis, the VL vector, and canine VL cases were already spread along the province of Corrientes. In order to know the distribution of VL risk, systematic captures of the vector were performed between February and March 2010, in 18 areas of the provinces of Entre Ríos and Corrientes, and the city of Puerto Iguazú, Misiones, with a total of 313 traps/night. We confirmed the presence of Lu. longipalpis, for the first time in Chajarí (Entre Ríos), Alvear, La Cruz, Curuzú Cuatiá and Bella Vista (Corrientes), and Puerto Iguazú (Misiones). In Santo Tome and Monte Caseros (Corrientes), where the vector had been previously reported, traps with more samples were obtained with 830 and 126 Lu. Longipalpis trap/site/night respectively. These results show that the vector of urban VL continues spreading in the Argentine territory. Simultaneously, the spre...
Journal of Hepatology, 1991
Revista española de salud pública
The proportion of asymptomatic individuals infected by influenza AH1N1v varies depending on the s... more The proportion of asymptomatic individuals infected by influenza AH1N1v varies depending on the studies. Health personnel were exposed to the AH1N1v virus due to their professional activity, thus an high seroprevalence to the virus could be expected in the absence of symptomatology. The objective of this study was to determine the prevalence of asymptomatic individuals serologically positive for influenza AH1N1v virus.
Enfermedades Infecciosas y Microbiología Clínica, 2012
Our aim was to study the proportion of healthcare workers with a positive serology for Influenza ... more Our aim was to study the proportion of healthcare workers with a positive serology for Influenza A(H1N1)2009 without having flu, in a Spanish hospital at the beginning of the pandemic. A survey study carried out during August 2009 (before the peak of the pandemic in Spain) in the Hospital Costa del Sol, a second level hospital with almost 300 beds in the South of Spain. The participants were workers in the following hospital units: Emergencies, Medical Area (Internal Medicine, Chest Diseases), Surgical Area (General Surgery and Anaesthesia) of any professional category. A study was made of the proportion of healthcare workers in our hospital with positive serology for the new influenza A (H1N1)2009 virus, as determined by the haemagglutination inhibition technique (≥1/40). The subjects completed a health status questionnaire, and provided a blood sample for serology testing. A total of 239 workers participated, of whom 25.1% had positive serology. The hospital area in which most individuals had positive serology was the Emergency Department (36.6%), while the professional category in which most individuals with a positive serology worked was that of the orderlies (41.7%). Around 25% of healthcare workers in our hospital had positive serology before the peak of the pandemic, none of them had received vaccine for Influenza A (H1N1) 2009 or had been diagnosed of influenza previously.
Emerging Infectious Diseases, 2011
... Julián Olalla, Miguel Marcos, Fernando Fernández, Jaouad Oulkadi, Natalia Montiel, Alfonso de... more ... Julián Olalla, Miguel Marcos, Fernando Fernández, Jaouad Oulkadi, Natalia Montiel, Alfonso del Arco, Víctor Fuentes, Javier de la Torre, José Luis Prada, and Javier García-Alegría Author affiliation: Hospital Costa del Sol, Marbella, Spain Vol. 17, No. 6 June 2011. Figure. ...
Diagnostic Microbiology and Infectious Disease, 2010
We evaluated the ability of a novel DNA strip assay (Speed-oligo® Mycobacteria) to differentiate ... more We evaluated the ability of a novel DNA strip assay (Speed-oligo® Mycobacteria) to differentiate mycobacterial species. It is based on polymerase chain reaction targeting 16S rRNA and 16S-23S rRNA regions and double-reverse hybridization on a dipstick using probes bound to colloidal gold and to the membrane. We blindly tested its capacity to identify 182 acid-fast bacilli grown on fresh liquid (BacT/ Alert, MGIT) and solid (Lowenstein-Jensen) cultures (from Spanish mycobacteriology laboratories), previously identified by means of Genotype ® Mycob.CM/AS or Gen-Probe ® AccuprobeMTC, and 11 collection strains of mycobacteria-related organisms. Discrepancies were resolved by 16S rRNA sequencing. Results were interpreted by identification of 7 specific bands for the following: Mycobacterium sp., M. fortuitum, Mycobacterium avium-intracellulare complex, Mycobacterium tuberculosis complex, Mycobacterium kansasii, M. gordonae, and M. abscessus-chelonae complex. No cross-reactivity was observed with any mycobacteria-related organism. Concordant results were obtained for 177/182 bacilli (97.2%). There was only 1 major discrepancy, misidentification of Mycobacterium marinum as M. kansasii, verified by sequencing.
Clinica Chimica Acta, 2001
. Traditionally, point-of-care testing POCT has been used throughout the healthcare system withou... more . Traditionally, point-of-care testing POCT has been used throughout the healthcare system without the involvement of the central laboratory. After an exhaustive study of the situation of these laboratories in the Costa del Sol Healthcare Area, we designed a quality control program for the POCT. This program targeted the tests done at the points of care throughout Ž . the hospital and the Primary Healthcare Area PHA , using the Joint Commission on Accreditation of Healthcare Ž . Organisations JCAHO standards for waived testing. We developed two programs: hospital-based tests and ambulatory POCT for outpatients in PHA. The hospital-based POCT apparatus was used for gases, glucose, qualitative urinalysis, Helicobacter pylori detection in gastrointestinal biopsies and coagulation tests. Ambulatory POCT was used to detect glucose, qualitative urinalysis and pregnancy tests. The personnel responsible are nursing staff with no continuing training program. There was no explicit quality control program and most of the results were used as screening except for glucose in the neonatal department. Criteria for selection of kits and devices were basically based on ergonomic and economic evaluation. Therefore, we performed an evaluation of precision and accuracy of two glucose meter devices. We implemented Ž . the internal and external quality programs IQC and EQC for glucose testing. We elaborated a guide of standard proceedings for quantitative and qualitative POCT and created an annual course for nursing staff. The annual evaluation of the indicators showed 96% for degree of compliance with IQC; 54% of nursing staff participated in the training program; 98% of the glucometers were operating; and 88% agreement between central laboratory and POCT. As there is no previous experience in our healthcare system, this represents a promising new area of working with nurses, who show great interest in participating in these new programs. q
ASAIO Journal, 1994
This study was performed in patients with hepatitis C virus (HCV) who were treated with hemodialy... more This study was performed in patients with hepatitis C virus (HCV) who were treated with hemodialysis to determine the relationships among alanine amino-transferase (ALT) levels, immunoglobulin (Ig) G anti-HCV, IgM anti-HCV core, and HCV RNA. Of 107 patients on hemodialysis, 27 had positive IgG anti-HCV. Eight of the patients who had HCV were evaluated every 8 months during a period of 2 years, using the following selection criteria: positive IgG against c-22, c33-c, 5-1-1, and c100-3 viral peptides; absence of infection by hepatitis A virus, hepatitis B virus, cytomegalo-virus, Epstein-Barr virus, herpes simplex virus, and human immunodeficiency virus, as well as absence of hepatotoxic drugs or cholelithiasis. We considered elevated ALT values as those more than 150% of the upper limit of normal. Three of the patients had persistent elevation of ALT levels, two had alternating elevation of ALT levels, and three had normal ALT levels in all blood samples. Of the 24 blood samples, 11 had elevation of ALT (45.8%) levels that showed positive IgM anti-HCV, but only 7 of these 11 had positive HCV RNA (63.6%). None of the 13 blood samples without elevation of ALT had positive IgM anti-HCV, but 5 had positive HCV RNA (38.5%). We found an excellent correlation between IgM anti-HCV and ALT levels (r = 0.81). There was no statistically significant difference between the mean ALT values on the 12 blood samples that had positive HCV RNA and the mean ALT values of the negative HCV RNA samples (53.5 +/- 28.0 IU/l vs. 37.4 +/- 17.5 IU/l, respectively). IgM anti-HCV is related to the elevation of ALT levels and can be used as a serologic marker to indicate the presence of active HCV induced liver damage. Serum ALT levels do not correlate with the detection of viral genome in sera. IgG anti-HCV is not necessarily associated with HCV RNA or IgM anti-HCV. The absence of IgM and HCV RNA in patients with IgG anti-HCV and normal ALT levels does not necessarily suggest the absence of active HCV infection.
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Papers by Natalia Montiel