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Vaccination in adults with HIV in Spain: Where are we? 西班牙成人艾滋病毒感染者的疫苗接种:我们在哪里?
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-01 DOI: 10.1016/j.eimc.2024.06.001
Esteban Martinez
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引用次数: 0
Sobre las limitaciones del diagnóstico de meningitis tuberculosa 结核性脑膜炎诊断的局限性
IF 2.6 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-01 DOI: 10.1016/j.eimc.2024.03.009
Javier Velasco Montes , Silvia González Díez , Elena Rivas Cilleros
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引用次数: 0
Pediatric mucormycosis associated with COVID-19: A systematic review of clinical cases 与COVID-19相关的小儿粘孢子菌病:临床病例的系统回顾
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.11.002
Laura Batista Amaral , Fabianne Carlesse , Luana Rossato

The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation, diagnostic certainty, and outcome of this infection in children. PubMed, MEDLINE, Scopus, Embase, Web of Science, LitCovid, and back-references of the identified manuscripts were systematically searched from December 2019 to March 2023. We have identified 14 cases of pediatric mucormycosis in patients with COVID-19. The median age of patients was 10.7 years. Among these cases, 10 were associated with active COVID-19. In 7 cases, the patients had pre-existing diabetes mellitus and concomitant diabetic ketoacidosis. Corticosteroids were administered to treat COVID-19 in 7 of the patients. The most common clinical presentation of the disease was rhino-orbital cerebral mucormycosis. Seven patients died (50%). Given the high mortality rate, clinicians should maintain a high level of clinical suspicion of mucormycosis in pediatric patients with COVID-19.

在 COVID-19 感染者中发现了粘孢子菌病。然而,有关儿童感染这种疾病的流行病学因素、表现形式、诊断确定性和结果的信息非常有限。从2019年12月到2023年3月,我们系统地检索了PubMed、MEDLINE、Scopus、Embase、Web of Science、LitCovid以及已确定手稿的参考文献。我们在COVID-19患者中发现了14例小儿粘液瘤病。患者的中位年龄为 10.7 岁。在这些病例中,10 例与活跃的 COVID-19 相关。其中7例患者在患病前患有糖尿病,并同时出现糖尿病酮症酸中毒。其中 7 例患者使用皮质类固醇治疗 COVID-19。最常见的临床表现是鼻眶脑粘液瘤病。七名患者死亡(50%)。鉴于该病的高死亡率,临床医生应高度怀疑COVID-19儿童患者患有粘孢子菌病。
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引用次数: 0
Evaluación de FebriDx® para el manejo de niños con infección respiratoria aguda febril 对FebriDx®治疗发热性急性呼吸道感染患儿的评估
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.01.009
Paula de la Matta Farrando , Maria Teresa Suay Torres , Anna Sabater Sabaté , Victoria Trenchs Sainz de la Maza , Carles Luaces Cubells , Susanna Hernández Bou

Introduction

Acute respiratory infections (ARI) are a common cause of inappropriate antibiotic prescription (ATB) in pediatrics. FebriDx® is a rapid diagnostic test that differentiates between viral and bacterial infections. The objective is to analyse the impact of FebriDx® on ATB prescription when managing febrile ARI.

Methods

Prospective study carried out in patients aged 1-< 18 years with febrile ARI in the emergency department. FebriDx® was performed and the impact on management was evaluated at follow-up.

Results

A total of 216 patients were included. Clinical assessment and FebriDx® result coincided in 174 (80.5%) cases. A modification of the initial therapeutic plan was made in 22 (52.4%) of the 42 discordant ones (10.2% of the overall patients). In pneumonia the impact was 34.5%; in all cases it involved not prescribing ATB.

Conclusion

FebriDx® could be a useful tool in the management of pediatric patients with febrile ARI to optimize ATB prescription.

急性呼吸道感染(ARI)是儿科不当使用抗生素(ATB)的常见原因。FebriDx® 是一种能区分病毒和细菌感染的快速诊断测试。目的是分析它对发热性急性呼吸道感染患儿管理的影响。前瞻性研究针对急诊科 1-<18 岁发热 ARF 患者。进行了FebriDx®检查,并评估了其对ATB处方管理的影响。共纳入 216 名患者。174例(80.5%)患者的医疗指导与FebriDx®结果相符。在 42 例不一致的病例中,有 22 例(52.4%)(占患者总数的 10.2%)修改了最初的治疗方案。对肺炎的影响为 34.5%;在所有病例中,均涉及不开具 ATB。FebriDx®是治疗发热性ARF儿科患者的有效工具,可优化ATB处方。
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引用次数: 0
Pitfalls in the interpretation of results returned by multiplex real-time PCR panels in the diagnosis of non-gonococcal male urethritis: The case of Ureaplasma urealyticum 在诊断非淋菌性男性尿道炎时解读多重实时 PCR 检测板结果的误区:尿解支原体病例
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.02.004
María Jesús Castaño , María Jesús Alcaraz , Eliseo Albert , David Navarro
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引用次数: 0
Brotes por Klebsiella oxytoca en unidades de cuidados intensivos neonatales: análisis de un brote en un hospital de tercer nivel y revisión sistemática 新生儿重症监护室爆发的氧合克雷伯氏菌:一家三级医院爆发疫情的分析和系统综述
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.04.004
María Liébana-Rodríguez , Esther Recacha-Villamor , Carmen Díaz-Molina , Patricia Pérez-Palacios , Lina Martín-Hita , Francisca Enríquez-Maroto , José Gutiérrez-Fernández

Objectives

Klebsiella oxytoca can cause nosocomial infections, affecting vulnerable newborns. There are few studies describing nosocomial outbreaks in the neonatal intensive care units (NICU). In this study, a systematic review of the literature was carried out to know the main characteristics of these outbreaks and the evolution of one is described.

Methods

We conducted a systematic review in the Medline database up to July 2022, and present a descriptive study of an outbreak with 21 episodes in the NICU of a tertiary hospital, between September 2021 and January 2022.

Results

Nine articles met the inclusion criteria. The duration of outbreaks was found to be variable, of which 4 (44.4%) lasted for a year or more. Colonization (69%) was more frequent than infections (31%) and the mortality rate was 22.4%. In studies describing sources, the most frequent was the environmental origin (57.1%). In our outbreak there were 15 colonizations and 6 infections. The infections were mild conjunctivitis without sequelae. Molecular typing analysis made it possible to detect 4 different clusters.

Conclusions

There is an important variability in the evolution and results of the published outbreaks, highlighting a greater number of colonized, use of pulsed-field gel electrophoresis (PFGE) techniques for molecular typing and implementation of control measures. Finally, we describe an outbreak in which 21 neonates were affected with mild infections, resolved without sequelae and whose control measures were effective.

目的 克雷伯菌可引起院内感染,影响脆弱的新生儿。有关新生儿重症监护室(NICU)内爆发的院内感染的研究很少。我们在 Medline 数据库中对截至 2022 年 7 月的文献进行了系统回顾,并对 2021 年 9 月至 2022 年 1 月期间一家三甲医院新生儿重症监护室内爆发的 21 次疫情进行了描述性研究。疫情持续时间长短不一,其中 4 篇(44.4%)持续一年或更长时间。定植(69%)比感染(31%)更常见,死亡率为 22.4%。在描述病源的研究中,最常见的病源是环境因素(57.1%)。在我们的疫情中,有 15 例定植和 6 例感染。感染为轻度结膜炎,无后遗症。结论在已发表的疫情演变和结果方面存在很大的差异,突出表现在定植人数较多、使用脉冲场凝胶电泳(PFGE)技术进行分子分型和实施控制措施等方面。最后,我们介绍了一次疫情爆发,其中 21 名新生儿受到轻微感染,但没有留下后遗症,控制措施也很有效。
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引用次数: 0
Una causa inesperada de miopericarditis en un paciente inmunodeprimido 免疫力低下患者心肌炎的意外病因
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.01.010
Elisa González de Herrero , Victoriano Moreno , María Luisa Martín-Pena , Enrique Ruiz de Gopegui
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引用次数: 0
Una interesante pareja de baile en un inmigrante subsahariano 撒哈拉以南移民的有趣舞伴
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.11.004
Mar Redero Cascón , Inmaculada Izquierdo , Juan Luis Muñoz Bellido , Moncef Belhassen-Garcia
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引用次数: 0
Correlates of one-year mortality among patients living with HIV according to the stratification level of the pharmaceutical care model 根据药物护理模式的分层水平,HIV感染者一年死亡率的相关因素。
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.04.002
Enrique Contreras-Macías , María de las Aguas Robustillo-Cortés , Ramón Morillo-Verdugo

Objectives

The patient living with HIV (PLWH) profile has changed and with it, the importance of patient-oriented pharmaceutical care (PC) has been highlighted, for which the stratification tool of the Capacity-Motivation-Opportunity (CMO) PC model helps us which adapts to the needs of each patient. To assess the true relevance, our main objective is to evaluate the differences of one-year mortality among PLWH stratified according to this model.

Methods

A single-center observational analytical survival research study including adult PLWH on antiretroviral therapy (ART) from January-2021 to January-2022 treated at hospital pharmacy outpatient service according to CMO pharmaceutical care model.

Results

A total of 428 patients were included, a median age of 51 years (interquartile range 42–57 year). Overall, the number of patients stratified according to the CMO PC model was 86.2% at level 3, 9.8% at level 2, and 4.0% at level 1. Cox proportional hazard model that included the stratification level was associated with a higher mortality, whose level 1 patients had a 99.7% higher mortality (Hazard ratio = 0.0003; 95%CI: 0.001–0.027).

Conclusions

To sum up, mortality of-one year differs when comparing the PC strata of level 1 and non-level 1, although being similar in age and other clinical conditions. This result suggests that the multidimensional stratification tool, included in the CMO PC model, could be used to modulate the patients intensity follow-up and design interventions more tailored to their needs.

目的艾滋病病毒感染者(PLWH)的情况发生了变化,以患者为导向的药物治疗(PC)的重要性也随之凸显,能力-动机-机会(CMO)PC 模型的分层工具可以帮助我们适应每位患者的需求。为了评估其真正的相关性,我们的主要目标是评估根据该模型进行分层的 PLWH 一年死亡率的差异。结果 共纳入 428 名患者,中位年龄为 51 岁(四分位距为 42-57 岁)。总体而言,根据 CMO PC 模型进行分层的患者中,86.2% 的患者处于 3 级,9.8% 的患者处于 2 级,4.0% 的患者处于 1 级。结论综上所述,尽管年龄和其他临床条件相似,但将 PC 分层 1 级和非 PC 分层 1 级的患者进行比较,其一年的死亡率是不同的。这一结果表明,CMO PC 模型中包含的多维分层工具可用于调整患者的随访强度,并设计出更符合患者需求的干预措施。
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引用次数: 0
Relevancia clínica de la codetección viral en lactantes con bronquiolitis por virus respiratorio sincitial 呼吸道合胞病毒支气管炎婴儿合并病毒检测的临床意义
IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.04.009
Albert Bernet Sánchez , Alba Bellés Bellés , Mercè García González , Laura Minguell Domingo , Eduard Solé Mir

Introduction

Respiratory syncytial virus (RSV) is the main cause of severe bronchiolitis, especially in infants. The aim of this study is to assess whether codetection of RSV and other respiratory viruses could affect the severity of this infection comparing with unique RSV detection.

Methods

A prospective study from 2016 to 2019 including children under 2 years who were admitted in the Emergency Service of the Hospital Universitari Arnau de Vilanova de Lleida (Spain) was performed. Nasopharyngeal samples from all patients were sent to the laboratory for RSV real-time PCR detection (GeneXpert®). A multiplex PCR that detects other respiratory viruses was done in all RSV-positive samples. Patients’ medical records were checked to collect clinical data (hospital length of stay, BROSJOD score, ICU admission, need for ventilatory support or transfer to a reference hospital). Patients were divided in 2 groups: infants with unique RSV detection and infants with viral codetection. Bivariant analyses were performed to analyze the data obtained.

Results

During the period of study 437 RSV bronchiolitis were diagnosed. In 199 of them (177/437; 45.5%) another respiratory virus was detected concomitantly. Bivariant analyses do not show statistically significant differences between both groups.

Conclusions

Viral codetection in infants with RSV bronchiolitis is frequent. However, it does not seems to affect the severity of this infection.

导言呼吸道合胞病毒(RSV)是导致严重支气管炎的主要原因,尤其是在婴儿中。本研究的目的是评估与单独检测 RSV 相比,RSV 和其他呼吸道病毒的编码检测是否会影响这种感染的严重程度。方法从 2016 年到 2019 年进行了一项前瞻性研究,研究对象包括在西班牙阿瑙-德-比拉诺瓦-德-莱里达大学医院急诊科住院的 2 岁以下儿童。所有患者的鼻咽部样本都被送往实验室进行 RSV 实时 PCR 检测(GeneXpert®)。在所有 RSV 阳性样本中还进行了检测其他呼吸道病毒的多重 PCR 检测。检查患者病历以收集临床数据(住院时间、BROSJOD 评分、入住重症监护室、呼吸机支持需求或转入参考医院)。患者分为两组:检测到唯一的 RSV 的婴儿和检测到病毒编码的婴儿。研究期间共诊断出 437 例 RSV 支气管炎。其中 199 例(177/437;45.5%)同时检测到另一种呼吸道病毒。双变量分析未显示两组之间存在显著的统计学差异。然而,这似乎并不影响感染的严重程度。
{"title":"Relevancia clínica de la codetección viral en lactantes con bronquiolitis por virus respiratorio sincitial","authors":"Albert Bernet Sánchez ,&nbsp;Alba Bellés Bellés ,&nbsp;Mercè García González ,&nbsp;Laura Minguell Domingo ,&nbsp;Eduard Solé Mir","doi":"10.1016/j.eimc.2023.04.009","DOIUrl":"10.1016/j.eimc.2023.04.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Respiratory syncytial virus (RSV) is the main cause of severe bronchiolitis, especially in infants. The aim of this study is to assess whether codetection of RSV and other respiratory viruses could affect the severity of this infection comparing with unique RSV detection.</p></div><div><h3>Methods</h3><p>A prospective study from 2016 to 2019 including children under 2 years who were admitted in the Emergency Service of the Hospital Universitari Arnau de Vilanova de Lleida (Spain) was performed. Nasopharyngeal samples from all patients were sent to the laboratory for RSV real-time PCR detection (GeneXpert®). A multiplex PCR that detects other respiratory viruses was done in all RSV-positive samples. Patients’ medical records were checked to collect clinical data (hospital length of stay, BROSJOD score, ICU admission, need for ventilatory support or transfer to a reference hospital). Patients were divided in 2 groups: infants with unique RSV detection and infants with viral codetection. Bivariant analyses were performed to analyze the data obtained.</p></div><div><h3>Results</h3><p>During the period of study 437 RSV bronchiolitis were diagnosed. In 199 of them (177/437; 45.5%) another respiratory virus was detected concomitantly. Bivariant analyses do not show statistically significant differences between both groups.</p></div><div><h3>Conclusions</h3><p>Viral codetection in infants with RSV bronchiolitis is frequent. However, it does not seems to affect the severity of this infection.</p></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"42 6","pages":"Pages 308-312"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121298669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Enfermedades infecciosas y microbiologia clinica
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