Introduction Evidence implicates vitamin D deficiency in poorer outcomes and increased susceptibility to hospital-acquired infections (HAIs). This study examined the association between serum vitamin D levels and HAIs in a population of hepatobiliary surgery patients. Methods Participants in this prospective analytical observational study were patients who underwent hepatobiliary surgery in a tertiary hospital in Aragon, Spain, between February 2018 and March 2019. Vitamin D concentrations were measured at admission and all nosocomial infections during hospitalization and after discharge were recorded. Results The mean 25-hydroxyvitamin D concentration of the study population (n = 301) was 38.56 nmol/L, which corresponds to vitamin D deficiency. Higher vitamin D concentrations were associated with a decreased likelihood of developing a HAI in general (p = 0.014), and in particularly surgical site infection (p = 0.026). The risk of HAI decreased by 34% with each 26.2-nmol/L increase in serum vitamin D levels. Conclusions Vitamin D levels may constitute a modifiable risk factor for postoperative nosocomial infections in hepatobiliary surgery patients.

There are three types of influenza viruses: A, B, C. These viruses evolves constantly due to two main characteristics: the first one is the lack of the correction ability of the viral polymerase which causes the accumulation of single nucleotide mutations in the viral genes introduced by an error-prone viral RNA polymerase, (antigenic shift). The second one is the nature of their genome, formed by eight segments, which allows the interchange of genes between two different viral strains (antigenic drift). This viral plasticity, has allowed to the influenza A viruses to infect new host species and to cause infections with a pandemic characteristics. The Spanish influenza surveillance system, SVGE (its Spanish acronym), arises as a response to the possibility of facing a pandemic situation, especially after the transmission of avian influenza viruses to humans. This surveillance system is formed by sixteen physician and paediatrics network, nineteen epidemiological services coordinated by the National Epidemiological Centre (CNE) and eighteen laboratories , the Spanish Laboratories of Influenza network (ReLEG), coordinated by the National Centre of Microbiology. The aim of this article is to show the action of the ReLEG, in the pandemic caused by the influenza virus A(H1N1) during the season 2009-2010. The main objective of this network is the surveillance of the circulating viruses by means of their detection and their subsequent antigenic and genetic characterization, including the detection of resistance mutations against the main drugs, such as Oseltamivir.

c i r e s p . 2 0 2 0 ; x x ( x x ) : x x x -x x x informació n del artículo Historia del artículo: Recibido el 31 de octubre de 2019 Aceptado el 9 de marzo de 2020 On-line el xxx Palabras clave: Cirugía hepatobiliopancreá tica Infecció n nosocomial Infecció n del sitio quirú rgico Vitamina D r e s u m e nIntroduccio´n: La relació n entre las infecciones nosocomiales en pacientes quirú rgicos y la vitamina D ha sido estudiada por algunos autores. Sin embargo, hasta la fecha no existe ningú n estudio realizado sobre pacientes de cirugía hepatobiliar. El objetivo de nuestro trabajo es estudiar la infecció n del sitio quirú rgico (ISQ) en la unidad de cirugía hepatobiliar, y valorar su relació n con la concentració n sé rica de vitamina D.Me´todos: Se llevó a cabo un estudio analítico observacional de pacientes sucesivos intervenidos en la unidad de cirugía hepatobiliar de nuestro centro durante un añ o. Se incluyeron las intervenciones relativas a enfermedad biliar, pancreá tica y hepá tica. Se determinaron los niveles de vitamina D al ingreso, así como las ISQ de tipo superficial, profunda y ó rganocavitaria diagnosticadas durante el estudio. El seguimiento del paciente se realizó durante al menos un mes tras la cirugía, dependiendo de la enfermedad. La estadística se realizó mediante el programa estadístico R v.3.1.3.Resultados: La muestra quedó constituida por 321 pacientes, de los cuales el 25,8% presentó ISQ a expensas fundamentalmente de las infecciones ó rgano-cavitarias que presentaron una incidencia del 24,3%. Concentraciones sé ricas superiores a 33,5 nmol/l demostraron reducir en un 50% el riesgo de ISQ.Conclusiones: Las concentraciones elevadas de vitamina D en sangre demostraron ser un factor protector frente a las ISQ (OR: 0,99). Nuestros resultados sugieren una relació n directa entre la concentració n sé rica de vitamina D y la ISQ, justificando la realizació n de nuevos estudios prospectivos.

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