[Influence of immigration on XXXX transmission patterns in Castell  n, Spain (2004-2007)].

@entity1 @entity378
BACKGROUND: This study aimed to identify @entity378 transmission patterns in Castell  n in a period of major demographic changes. METHODS: A prospective study of @entity1 with positive culture in the province of Castellon over a 4-year period (2004-2007) was carried out. Cases were described by year and nationality and were compared with those reported to the Department of Public Health. We studied the population with available molecular patterns, identified through restriction fragment length polymorphism (RFLP) and analyzed the variables from @entity1 clusters, based on data collected in surveys of the Department of Health and the Laboratory Management Program. RESULTS: According to data from the Department of Public Health, the overall rate of @entity378 per 100,000 inhabitants in the province of Castell  n was 15.7 in 2004, 19.9 in 2005, 18.2 in 2006 and 17.5 in 2007. In our laboratory, strains were identified from 301 @entity1 , representing 77% (301/390) of reported cases and 94% (301/321) of reported cases with a positive culture. The percentage of @entity378 among foreigners increased with age, exceeding 50% in 2007. Molecular studies were available in 95% of @entity1 (286); 58% were Spanish and 42% were foreigners, of whom 54% were Romanians. The cluster percentage was 40%, with 30% of mixed clusters. According to conventional contact studies, 85% of @entity1 in clusters had been considered isolated cases. CONCLUSIONS: The increased rate of @entity378 in Castell  n was mainly due to the increasing number of cases among foreigners, mostly Romanians. The availability of molecular studies in all @entity1 with a positive culture allowed us to analyze how and where @entity378 is transmitted in our province. Forty percent of the @entity1 were grouped into clusters; of these, mixed clusters accounted for one third, indicating the high integration of immigrants in our area.
