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Inflammation in HIV: A persistent challenge 艾滋病毒的炎症:持续的挑战
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.09.007
Julia Barrado , Vicente Estrada
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引用次数: 0
Respuesta a «Caracterización de las infecciones de herida entre pacientes procedentes de la guerra ruso-ucraniana en un hospital Role 4» 对 "Role 4 医院俄乌战争患者伤口感染的特点 "的答复
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.06.014
María del Mar Rodero Roldán , Valentín Yuste Benavente , Ana Isabel López Calleja , Juan Manuel García-Lechuz
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引用次数: 0
Recurrent invasive pneumococcal disease (RIPD) in an immunocompromised patient 一名免疫力低下患者的复发性侵袭性肺炎球菌疾病(RIPD)
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.06.004
Ivonne Andrea Torres Jiménez , Sara de Miguel García , Julio Sempere García , Juan Carlos Sanz Moreno
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引用次数: 0
Meningitis tuberculosa por Mycobacterium africanum en España, a propósito de un caso 西班牙非洲分枝杆菌引起的结核性脑膜炎:病例报告
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.06.007
Nuria Torrellas Bertran , Gemma Garcia Continente , Oscar Villarreal
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引用次数: 0
Utilidad predictiva de mortalidad de las escalas qSOFA, NEWS y GYM en el paciente anciano con infección en urgencias: estudio EDEN-5 qSOFA、NEWS 和 GYM 量表对急诊科感染老年患者死亡率的预测作用:EDEN-5 研究。
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2023.07.004

Objective

To analyze the prognostic accuracy of the scores NEWS, qSOFA, GYM used in hospital emergency department (ED) in the assessment of elderly patients who consult for an infectious disease.

Methods

Data from the EDEN (Emergency Department and Elderly Needs) cohort were used. This retrospective cohort included all patients aged ≥ 65 years seen in 52 Spanish EDs during two weeks (from 1/4/2019 to 7/4/2019 and 30/3/2020 to 5/4/2020) with an infectious disease diagnosis in the emergency department. Demographic variables, comorbidities, Charlson and Barthel index and needed scores parameters were recorded. The predictive capacity for 30-day mortality of each scale was estimated by calculating the area under the receiver operating characteristic (ROC) curve, and sensitivity and specificity were calculated for different cut-off points. The primary outcome variable was 30-day mortality.

Results

Six thousand fifty-four patients were analyzed. Median age was 80 years (IQR 73-87) and 45.3% women. Nine hundred and ninety-three (16.4%) patients died. NEWS score had better AUC than qSOFA (0.765; 95% CI: 0.725-0.806, vs. 0.700; 95% CI: 0.653-0.746; P < .001) and GYM (0.716; 95% CI: 0.675-0.758; P = .024), and there was no difference between qSOFA and GYM (P = .345). The highest sensitivity scores for 30-day mortality were GYM ≥ 1 point (85.4%) while the qSOFA score ≥ 2 points showed high specificity. In the case of the NEWS scale, the cut-off point ≥ 4 showed high sensitivity, while the cut-off point NEWS ≥ 8 showed high specificity.

Conclusion

NEWS score showed the highest predictive capacity for 30-day mortality. GYM score ≥ 1 showed a great sensitivity, while qSOFA ≥ 2 scores provide the highest specificity but lower sensitivity.
目的 分析医院急诊科(ED)在评估因感染性疾病就诊的老年患者时使用的NEWS、qSOFA和GYM评分的预后准确性。方法 使用EDEN(急诊科和老年人需求)队列的数据。该回顾性队列包括两周内(2019 年 1 月 4 日至 2019 年 4 月 7 日和 2020 年 3 月 30 日至 2020 年 4 月 5 日)在西班牙 52 家急诊室就诊的所有年龄≥ 65 岁、在急诊室诊断为传染病的患者。记录了人口统计学变量、合并症、查尔森和巴特尔指数以及所需评分参数。通过计算接收者操作特征曲线(ROC)下的面积来估计每种量表对 30 天死亡率的预测能力,并计算不同截断点的敏感性和特异性。主要结果变量为 30 天死亡率。中位年龄为 80 岁(IQR 73-87),女性占 45.3%。有 993 名患者(16.4%)死亡。NEWS 评分的 AUC 优于 qSOFA(0.765;95% CI:0.725-0.806,vs. 0.700;95% CI:0.653-0.746;P <;.001)和 GYM(0.716;95% CI:0.675-0.758;P = .024),而 qSOFA 和 GYM 之间没有差异(P = .345)。对 30 天死亡率敏感度最高的是 GYM ≥ 1 分(85.4%),而 qSOFA ≥ 2 分则显示出较高的特异性。NEWS评分对30天死亡率的预测能力最高。GYM 评分≥ 1 显示出很高的灵敏度,而 qSOFA 评分≥ 2 显示出最高的特异性,但灵敏度较低。
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引用次数: 0
Knowledge, attitudes and practices in HIV-related chronic inflammation and cardiovascular risk in Spain 西班牙对艾滋病毒相关慢性炎症和心血管风险的认识、态度和做法
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2023.07.005

Background

People with HIV (PWH) in suppressive antiretroviral treatment suffer from chronic inflammation-related comorbidities, mainly cardiovascular diseases. However, given the lack of specific evidence about inflammation in PWH, clinical guidelines do not provide recommendations for the management of this issue. To date, physician awareness of inflammation in PWH remains unclear. We analyzed the knowledge, attitudes, and practices (KAP) related to inflammation, particularly in the clinical management of PWH, of infectious disease specialists (IDS)/internists compared to other specialists treating inflammation directly (rheumatologists) or its cardiovascular consequences (cardiologists).

Methods

A committee of IDS/internists treating PWH, cardiologists, and rheumatologists designed the KAP questionnaire. The survey was completed by 405 participants (135 physicians per specialty) stratified by Spanish geography, hospital size, and number of PWH under care (IDS/internists only).

Results

IDS/internists treating PWH scored higher than cardiologists and rheumatologists on knowledge of inflammation (5.5 ± 1.4 out of 8 points vs. 5.2 ± 1.3 and 4.6 ± 1.4 points, respectively; p < 0.05). Nevertheless, rheumatologists showed the most proactive attitude toward inflammation (i.e., biomarkers monitoring, anti-inflammatory drug prescription and cardiologist referral), followed by cardiologists and IDS/internists (13 ± 3 of a total of 16 points vs. 11 ± 3 and 10 ± 3.3 points, respectively; p < 0.05), irrespective of hospital size and years of experience. Most IDS/internists (59%) include inflammation in their therapeutic recommendations. However, in IDS/internists treating PWH, we observed a negative correlation between years of experience and concern about the clinical consequences of inflammation.

Conclusion

Our findings show that, compared to other specialists, infectious disease specialists/internists have high knowledge about inflammation in HIV infection, but, in the absence of scientific evidence to base their decisions on inflammatory markers, the therapeutic implications are scarce. The results support the need for more evidence on the monitoring and treatment of inflammation in PWH.
背景正在接受抑制性抗逆转录病毒治疗的艾滋病病毒感染者(PWH)患有与炎症相关的慢性并发症,主要是心血管疾病。然而,由于缺乏有关 PWH 炎症的具体证据,临床指南并未就这一问题的管理提出建议。迄今为止,医生对 PWH 炎症的认识仍不明确。我们分析了传染病专科医生(IDS)/实习医生与其他直接治疗炎症(风湿病医生)或其心血管后果(心脏病医生)的专科医生相比,对炎症的相关知识、态度和实践(KAP),尤其是在 PWH 的临床管理中。405名参与者(每个专业135名医生)完成了调查,调查按西班牙地理位置、医院规模和接受治疗的PWH人数进行了分层(仅限于IDS/实习医生)。结果 治疗PWH的IDS/实习医生在炎症知识方面的得分高于心脏病学家和风湿病学家(满分8分,分别为5.5 ± 1.4分 vs. 5.2 ± 1.3分和4.6 ± 1.4分;p <0.05)。尽管如此,风湿免疫科医生对炎症表现出最积极的态度(即生物标记物监测、抗炎药物处方和心脏科医生转诊),其次是心脏科医生和内科医生(16 分中的 13 ± 3 分 vs. 11 ± 3 分和 10 ± 3.3 分;p <0.05),与医院规模和工作年限无关。大多数 IDS/实习医生(59%)将炎症纳入其治疗建议中。结论我们的研究结果表明,与其他专科医生相比,传染病专科医生/实习医生对艾滋病感染中的炎症具有较高的认识,但由于缺乏科学证据来依据炎症标志物做出决定,因此治疗意义不大。研究结果表明,需要更多的证据来监测和治疗艾滋病感染者的炎症。
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引用次数: 0
Clinical and microbiological characteristics of Eggerthella lenta causing bacteremia 引起菌血症的 Eggerthella lenta 的临床和微生物学特征
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.05.003
Domingo Fernández Vecilla , Mikel Joseba Urrutikoetxea Gutiérrez , Mary Paz Roche Matheus , Felicitas Elena Calvo Muro , José Luis Díaz de Tuesta del Arco
Eggerthella lenta is an obligate anaerobic, Gram-positive bacilli, belonging to the human microbiota of gastrointestinal and female reproductive tracts, oral cavity and prostate gland. In this article, we aim to describe clinical and microbiological characteristics of seven E. lenta strains causing bacteremia. We conducted a descriptive retrospective study including all E. lenta strains causing bacteremia, from February 2019 to August 2023 at the Basurto University Hospital. Seven patients were included in the study with a mean age of 72.7 years. Six patients presented risk factors associated with bacterial infections. All patients were admitted to the hospital because of suspicious of bloodstream infection associated with abdominal symptoms for intravenous antibiotic treatment. Four E. lenta isolates were resistant to penicillin, while all isolates presented high MICs to piperacillin/tazobactam and low MICs to amoxicillin/clavulanic acid. All patients recovered without no complications.
连塔卵球菌(Eggerthella lenta)是一种厌氧革兰阳性杆菌,属于人类胃肠道、女性生殖道、口腔和前列腺微生物群。本文旨在描述引起菌血症的 7 株伦他大肠杆菌的临床和微生物学特征。我们开展了一项描述性回顾研究,其中包括 2019 年 2 月至 2023 年 8 月期间在巴苏托大学医院引起菌血症的所有连塔菌菌株。研究共纳入七名患者,平均年龄为 72.7 岁。六名患者存在与细菌感染相关的风险因素。所有患者均因怀疑血流感染并伴有腹部症状而入院接受静脉抗生素治疗。4 例伦他大肠杆菌分离株对青霉素耐药,所有分离株对哌拉西林/他唑巴坦的 MIC 值较高,对阿莫西林/克拉维酸的 MIC 值较低。所有患者均已康复,未出现并发症。
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引用次数: 0
The current status of arboviruses with major epidemiological significance in Europe 欧洲具有重大流行病学意义的虫媒病毒现状
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.09.002
Fernando de la Calle-Prieto , Marta Arsuaga , Graciela Rodríguez-Sevilla , Nancy Sandoval Paiz , Marta Díaz-Menéndez
Currently, an increasing impact of some arboviruses has been observed in Europe, mainly Dengue (DENV), Chikungunya (CHIKV), Zika (ZIKV), West Nile (WNV), and Crimean-Congo hemorrhagic fever (CCHFV) analyzed through a One Health perspective that considers their expansion across the continent. Arboviruses are primarily transmitted by vectors such as mosquitoes and ticks, with human activities and climate change playing crucial roles in their spread. The review highlights the ecological and epidemiological aspects of arboviruses, emphasizing the roles of diverse hosts and reservoirs, including humans, animals, and vectors, in their life cycles. The influence of climate change on the ecology of the vector, which potentially favors the arbovirus transmission, is also reviewed. Focusing on diagnosis, prevention and in the absence of specific treatments, the importance of understanding vector–host interactions and environmental impacts to develop effective control and prevention strategies is emphasized. Ongoing research on vaccines and therapies is crucial to mitigate the public health impact of these diseases.
目前,一些虫媒病毒在欧洲的影响越来越大,主要是登革热(DENV)、基孔肯雅热(CHIKV)、寨卡热(ZIKV)、西尼罗河病毒(WNV)和克里米亚-刚果出血热(CCHFV),分析时采用了 "一体健康 "视角,考虑了这些病毒在欧洲大陆的扩展情况。虫媒病毒主要通过蚊子和蜱虫等载体传播,人类活动和气候变化对其传播起着至关重要的作用。综述突出了虫媒病毒的生态学和流行病学方面,强调了人类、动物和病媒等不同宿主和储库在虫媒病毒生命周期中的作用。气候变化对病媒生态的影响可能有利于虫媒病毒的传播,本文也对此进行了综述。文章以诊断和预防为重点,在缺乏特定治疗方法的情况下,强调了了解病媒与宿主之间的相互作用和环境影响对于制定有效的控制和预防策略的重要性。正在进行的疫苗和疗法研究对于减轻这些疾病对公共卫生的影响至关重要。
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引用次数: 0
Caracterización de las infecciones de herida entre pacientes procedentes de la guerra ruso-ucraniana en un hospital Role 4 一家医院的俄乌战争伤员伤口感染特征 Role 4
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.06.013
Rafael García-Cañas , Francisco Javier Areta-Jiménez
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引用次数: 0
¿Fascitis necrosante por una picadura de araña? 被蜘蛛咬伤引发坏死性筋膜炎?
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-11-01 DOI: 10.1016/j.eimc.2024.01.006
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引用次数: 0
期刊
Enfermedades infecciosas y microbiologia clinica
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