Enfermedades infecciosas y microbiologia clinica最新文献

英文中文

Mycolicibacterium iranicum en un paciente con bronquiectasias: importancia clínica y dificultades diagnósticas 支气管扩张患者中的伊朗分枝杆菌：临床意义和诊断困难

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.014

Diego González Polo, David Vázquez Gómez, Nieves Gutiérrez Zufiaurre

引用次数: 0

Impacto de la implementación de MALDI-TOF y programas PROA en la optimización de la antibioterapia en bacteriemias por Staphylococcus aureus 实施MALDI-TOF和PROA项目对金黄色葡萄球菌细菌抗生素治疗优化的影响

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.005

Sara Vela-Bernal , Carlos Bea-Serrano , Ana Isabel de Gracia-Leon , Andreu Belmonte-Domingo , Carolina Pinto-Pla , Ana Ferrer-Ribera , Andrea de Castro-Oliver , Ignacio Torres , Javier Colomina , María Rosa Oltra-Sempere

Introduction

Rapid pathogen identification is key in the management of bloodstream infections. Antimicrobial stewardship programs (ASPs) have been shown to reduce resistance, adverse effects, and healthcare costs. MALDI-TOF MS enables fast and accurate microbial identification. This study evaluates the impact of its implementation on antibiotic therapy adequacy and mortality in Staphylococcus aureus bacteremia.

Methods

A quasi-experimental pre-post study was conducted at a university hospital, covering two periods: June 2015/April 2017 (pre) and June 2021/April 2023 (post). The impact of MALDI-TOF on antibiotic adequacy and mortality was analyzed.

Results

A total of 176 episodes were included (85 pre, 91 post). No significant epidemiological differences were observed between groups, although higher rates of sepsis and septic shock were noted in the post phase. MALDI-TOF was associated with improved antibiotic adjustment (3.51 vs. 1.75 days; P<.001). A non-significant trend toward lower early mortality was observed in the post-intervention group (P=.06). Mortality was associated with higher comorbidity (Charlson index), sepsis/septic shock, and MRSA bacteremia.

Conclusion

The implementation of MALDI-TOF, in conjunction with a multidisciplinary ASP, enhances early adjustment of empirical antibiotic therapy and may be associated with reduced early mortality in Staphylococcus aureus bacteremia. Incorporating rapid diagnostics, especially for MRSA detection, is a key strategy to improve clinical outcomes.

快速病原体鉴定是管理血液感染的关键。抗菌药物管理计划（asp）已被证明可以减少耐药性、不良反应和医疗保健费用。MALDI-TOF质谱能够快速准确地进行微生物鉴定。本研究评估其实施对金黄色葡萄球菌菌血症的抗生素治疗充分性和死亡率的影响。方法2015年6月/ 2017年4月（前期）和2021年6月/ 2023年4月（后期）在某大学附属医院进行准实验性的前后研究。分析MALDI-TOF对抗生素充分性和死亡率的影响。结果共收录176期，其中术前85期，术后91期。各组之间没有明显的流行病学差异，尽管在后期发现较高的败血症和感染性休克发生率。MALDI-TOF与改善抗生素调整相关（3.51天vs. 1.75天；P< 0.001）。干预后组早期死亡率降低的趋势不显著（P=.06）。死亡率与较高的合并症（Charlson指数）、败血症/感染性休克和MRSA菌血症相关。结论MALDI-TOF的实施，结合多学科ASP，加强了经验性抗生素治疗的早期调整，并可能与降低金黄色葡萄球菌菌血症的早期死亡率有关。结合快速诊断，特别是MRSA检测，是改善临床结果的关键策略。

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引用次数: 0

Manejo de esofagitis por citomegalovirus refractaria en un paciente con linfoma e inmunosupresión severa: foscarnet versus maribavir 在严重免疫抑制的淋巴瘤患者中，难以控制的巨细胞病毒引起的食管炎：foscarnet vs . maribavir

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.019

María Ángeles Asencio Egea , José María López-Pintor Huertas , Martín Cabero Becerra , Javier Sánchez López

引用次数: 0

Enfermedad diseminada grave en paciente gestante 孕妇的严重弥漫性疾病

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.05.009

Álvaro Liesa-Tordera , María Cano Navarro , Elisa Ibáñez-Martínez , Rafael Garcés-González

引用次数: 0

Estudio del microbioma intestinal humano mediante metagenómica: avances recientes y desafíos para su implementación clínica 使用宏基因组学研究人类肠道微生物组：临床实施的最新进展和挑战

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.017

Cristina Jiménez-Arroyo , Natalia Molinero , Rosa del Campo , Susana Delgado , M. Victoria Moreno-Arribas

Metagenomics has decisively advanced the study of the gut microbiome, enabling a better understanding of its importance for human health. Metataxonomics, based on the sequencing of the 16S rRNA gene, provides taxonomic profiles of prokaryotes, while shotgun metagenomics allows a comprehensive characterization of all DNA present in a sample. With adequate sequencing depth, the latter increases taxonomic resolution to the strain level and provides detailed information on the functional potential of the microbiota. However, the lack of standardization in sample collection and processing, sequencing technologies, and data management limits the comparability of results and their implementation in clinical laboratories. This review offers a practical and updated framework on metagenomic methodologies, data analysis, and the application of artificial intelligence tools, highlighting advances and best practices to facilitate the integration of functional microbiome analysis into clinical practice and to overcome current challenges.

宏基因组学决定性地推进了肠道微生物组的研究，使人们能够更好地了解其对人类健康的重要性。元基因组学基于16S rRNA基因的测序，提供了原核生物的分类概况，而散弹枪元基因组学允许对样本中存在的所有DNA进行全面表征。有了足够的测序深度，后者将分类学分辨率提高到菌株水平，并提供有关微生物群功能潜力的详细信息。然而，在样本采集和处理、测序技术和数据管理方面缺乏标准化，限制了结果的可比性及其在临床实验室中的实施。这篇综述为宏基因组学方法、数据分析和人工智能工具的应用提供了一个实用的和最新的框架，强调了将功能微生物组分析整合到临床实践中并克服当前挑战的进展和最佳实践。

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引用次数: 0

Seroprevalence and incidence of Toxoplasma gondii infection in pregnant women in the health care area of Santiago de Compostela (NW Spain): 2015–2022 圣地亚哥德孔波斯特拉（西班牙西北部）卫生保健区孕妇弓形虫感染血清阳性率和发病率：2015-2022

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.013

Noelia Parajó Pazos , Alberto Molares-Vila , Maria Jesús Purriños Hermida , Maria Mercedes Treviño Castellano

Background

Toxoplasmosis is an infection caused by Toxoplasma gondii, a globally distributed parasite. In pregnant women, primary infection can lead to congenital toxoplasmosis, resulting in severe birth defects or serious sequelae later in life. The main objective of the present study was to provide epidemiological data on T. gondii infection in pregnant women in our health care area.

Method

We collected the results of T. gondii serology in pregnant women in the health area of our hospital between 2015 and 2022. Both prevalence and incidence were studied. Differences in prevalence and incidence were analysed based on the womeńs age and their area of residence (differentiating between urban and rural areas). The evolution of incidence and prevalence over the years was also examined.

Results

A total of 20,117 pregnant women were included in the study. The prevalence found was 26.98% (5427/20,117), and the incidence was 0.19% (26/13,443). The incidence decreased significantly during the study period, by 34.6% per year, and the prevalence also showed a significant annual decrease of 5.25% since 2018 using Joinpoint regression model. The seroprevalence was significantly higher in women from rural areas and in women above or equal to the median age. Additionally, a subgroup of 379 women from Central and South America was studied, revealing a prevalence of 32.7% (124/379).

Conclusion

Incidence and prevalence of T. gondii have declined significantly in recent years. To guide the implementation of effective gestational screening, it is essential to have up-to-date prevalence and incidence data for different geographical areas of Spain. This will help determine not only the necessity of screening but also the most suitable methods for its implementation.

弓形虫病是一种由弓形虫引起的感染，弓形虫是一种全球分布的寄生虫。在孕妇中，原发性感染可导致先天性弓形虫病，导致严重的出生缺陷或生命后期的严重后遗症。本研究的主要目的是提供本地区孕妇弓形虫感染的流行病学资料。方法收集2015 - 2022年我院卫生区孕妇弓形虫血清学检测结果。研究了患病率和发病率。根据womeńs年龄及其居住地区（区分城市和农村地区）分析患病率和发病率的差异。还审查了多年来发病率和流行率的演变。结果共有20117名孕妇被纳入研究。检出率为26.98%(5427/ 20117)，发病率为0.19%（26/ 13443）。在研究期间，发病率显著下降，每年下降34.6%，自2018年以来，患病率也出现了5.25%的显著下降。农村地区妇女和年龄中位数以上或等于中位数的妇女的血清患病率明显较高。此外，对来自中南美洲的379名妇女进行了亚组研究，发现患病率为32.7%（124/379）。结论弓形虫的发病率和流行率近年来呈明显下降趋势。为了指导有效妊娠筛查的实施，掌握西班牙不同地理区域的最新患病率和发病率数据至关重要。这不仅有助于确定筛查的必要性，而且有助于确定实施筛查的最合适方法。

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引用次数: 0

Transforming long-term care for people with HIV: Movimiento AHORA 改变艾滋病毒感染者的长期护理：AHORA运动

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.04.008

Maria Velasco , Matilde Sanchez-Conde , Julián Olalla , Eugenia Negredo

引用次数: 0

Bacteriemia relacionada con catéter por Brevibacterium casei en un paciente hematológico 血液学患者中干酪短杆菌导管相关细菌性血症

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.07.007

Cristian Mateo León, Noelia Hernando Parreño, Diego García Martínez de Artola

引用次数: 0

Impacto de una intervención PROA en la solicitud de urocultivos de control postratamiento en atención primaria PROA干预对初级保健中治疗后控制尿路培养需求的影响

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.06.018

Iker Alonso-González , Maider Zuriarrain-Alonso , Koldo López-Guridi , Paula Lara-Esbrí , Rita Sainz de Rozas , Itxasne Lekue , José Luis Barrios-Andrés

Introduction

With the aim of reducing the number of post-treatment control urine cultures (UC) from health centers in our healthcare area, we conducted an ASP intervention throughout 2022. To do this, we set out to introduce effective methods to quantify, analyze, and subsequently try to reduce the number of inappropiate UC.

Methods

We conducted a prospective and non-restrictive quasi-experimental intervention study with historical and parallel control group to evaluate the impact of the intervention. The UC evaluation was performed by analyzing all the medical records of repeated UC in a period of less than 31 days. UC were classified as: appropriate, inappropriate and doubtful. The study was conducted in 3 phases: phase 1) measurement of the baseline situation; phase 2) intervention in intervention group: simple educational presentations and implementation of a non-restrictive computerized rule, and phase 3) analysis of results in both groups and periods.

Results

Looking at the percentage of appropriate UC, we observed that in the control group there was hardly any variation while in the intervention group these increased by 152.4 (p < 0.001). In addition, in the intervention group there was a decrease in total UCs of 55.4% (n = 418), representing an estimated savings of €7524. The acceptance of the computerized rule in the intervention group was 9.6%.

Conclusions

This ASP intervention is useful in decreasing the number of IUCs, especially the educational presentations. Achieving this can reduce direct and indirect patient harm and healthcare overload, in addition to improving the management of healthcare resources.

前言：为了减少我们医疗保健地区卫生中心治疗后对照尿培养（UC）的数量，我们在2022年进行了ASP干预。为了做到这一点，我们开始引入有效的方法来量化、分析，并随后尝试减少不适当的UC的数量。方法采用前瞻性、非限制性准实验干预研究，采用历史对照组和平行对照组，评价干预效果。通过分析所有在31天以内重复UC的医疗记录进行UC评估。UC分为：适当、不适当和可疑。研究分三个阶段进行：第一阶段测量基线情况；第二阶段对干预组进行干预：简单的教育演示和非限制性计算机规则的实施，第三阶段对两组和两期的结果进行分析。结果观察适当UC的百分比，我们观察到在对照组中几乎没有任何变化，而在干预组中这些变化增加了152.4 （p < 0.001）。此外，在干预组中，总UCs减少了55.4% (n = 418)，估计节省了7524欧元。干预组对计算机化规则的接受度为9.6%。结论ASP干预可有效减少IUCs的数量，尤其是教育报告的数量。实现这一目标除了可以改善医疗资源管理外，还可以减少对患者的直接和间接伤害以及医疗保健超载。

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引用次数: 0

Antimicrobial resistance patterns of Nocardia species in clinical isolates from Argentina (2020–2022) 阿根廷诺卡菌临床分离株耐药性分析（2020-2022年）

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.eimc.2025.07.003

Mónica Prieto, María Florencia Rocca, Rita Armitano, Ariel Gianecini, Lucía Cipolla

Introduction

Nocardia species are opportunistic pathogens with intrinsic antimicrobial resistance and regional variability in susceptibility patterns. Argentina lacks standardized surveillance data, complicating empirical therapy. This study aimed to characterize Nocardia species distribution and antimicrobial resistance profiles nationwide.

Methods

We analyzed 62 clinical Nocardia isolates from 41 laboratories across eight Argentine provinces (2020–2022). Species identification utilized MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed via broth microdilution for 11 antibiotics according to CLSI guidelines, with additional E-test comparisons.

Results

Respiratory specimens predominated (67.7%), followed by central nervous system (14.5%), skin/soft tissue (8.1%), and bloodstream (6.5%) infections. Primary species identified were N. cyriacigeorgica (30.6%), N. abscessus complex (22.6%), and N. farcinica complex (17.7%). Highest susceptibility rates occurred with linezolid (100%) and trimethoprim–sulfamethoxazole (97.6%). Significant resistance was observed for clarithromycin (81.0%), ciprofloxacin (76.2%), and moxifloxacin (57.1%). N. farcinica dominated CNS infections (55.6%), while N. brasiliensis complex prevailed in skin/soft tissue cases (80%). Methodological discrepancies between testing methods showed 33.3% major errors for ceftriaxone (E-test vs. microdilution).

Conclusion

This first Argentine nationwide surveillance study confirms trimethoprim–sulfamethoxazole and linezolid as reliable empiric therapy options while highlighting concerning resistance to fluoroquinolones and macrolides. The observed methodological discordance emphasizes the critical need for standardized antimicrobial susceptibility testing protocols for Nocardia species.

诺卡菌属是条件致病菌，具有固有的抗菌素耐药性和药敏模式的区域差异。阿根廷缺乏标准化的监测数据，使经验性治疗复杂化。本研究旨在了解全国诺卡菌种类分布及耐药情况。方法对阿根廷8个省41个实验室的62株诺卡菌临床分离株（2020-2022年）进行分析。物种鉴定采用MALDI-TOF质谱法。根据CLSI指南，通过肉汤微量稀释对11种抗生素进行抗生素药敏试验，并进行e试验比较。结果呼吸道感染占67.7%，其次是中枢神经系统感染（14.5%）、皮肤/软组织感染（8.1%）和血液感染（6.5%）。主要种为cyriacigorgica（30.6%）、abesssus复合体（22.6%）和farcinica复合体（17.7%）。利奈唑胺（100%）和甲氧苄啶-磺胺甲恶唑（97.6%）的敏感性最高。克拉霉素（81.0%）、环丙沙星（76.2%）和莫西沙星（57.1%）耐药显著。中枢神经系统感染以法氏奈瑟菌为主（55.6%），皮肤/软组织感染以巴西奈瑟菌复体为主（80%）。不同检测方法之间的方法学差异显示头孢曲松的主要误差为33.3% （e试验与微量稀释试验）。结论阿根廷首次全国监测研究证实甲氧苄啶-磺胺甲恶唑和利奈唑胺是可靠的经验性治疗选择，同时强调对氟喹诺酮类药物和大环内酯类药物的耐药性。观察到的方法上的不一致强调了对诺卡菌种的标准化抗菌药物敏感性测试方案的迫切需要。

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