Enfermedades infecciosas y microbiologia clinica最新文献

英文中文

Investigating outbreaks in neonatal intensive care units: A crucial battle in the cradle of care 调查新生儿重症监护室的疫情爆发：护理摇篮中的一场关键战役

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.03.004

Esther Calbo , Laura Gisbert , Maria López-Sánchez

引用次数: 0

Análisis transversal de una cohorte de personas de más de 65 años que viven con VIH 对 65 岁以上艾滋病毒感染者队列的横断面分析

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.01.008

Iván Fernández-Castro, Clara Casar-Cocheteux, Hadrian Pernas-Pardavila, Elena Losada-Arias, Antonio Antela

Introduction

This study aims to describe and analyze the characteristics of aged people who are living with HIV (APHIV) and evaluate their association on the comorbidities they currently have.

Methods

Cross-sectional analysis of APHIV under active follow-up at the Infectious Diseases Unit of the University Clinical Hospital of Santiago de Compostela. Demographic and clinical data were analyzed, along with their association with the development of comorbidities in this population. A correlation and multiple linear regression analysis were performed for this purpose.

Results

Eighty-five APHIV, 65 males and 20 females, with an average age of 69 years (IQR: 8) and a duration of living with HIV of 17 years (SD: 7), were studied. 41% of them had their initial diagnosis with AIDS. The most common comorbidities are hypertension and dyslipidemia in 55% and 52%, respectively. 40% of APHIV take at least 5 medications. 35% have received more than 5 lines of antiretroviral treatment. At the time of analysis, all APHIV have an undetectable viral load. No significant association was observed between the number of comorbidities and various characteristics of APHIV; however, a weak correlation was noted among age, the cumulative number of antiretroviral treatments received throughout their lives, and the number of comorbidities.

Conclusions

This analysis highlights the substantial burden of comorbidities and polypharmacy experienced by APHIV. Further studies are needed to better understand the characteristics and variables influencing their development.

本研究旨在描述和分析 65 岁以上艾滋病病毒感染者（PLWHIV）的特征，并评估这些特征与他们当前合并症的关系。对圣地亚哥-德孔波斯特拉大学医院传染病科积极跟踪的艾滋病毒感染者进行横断面分析。分析了人口统计学和临床数据，以及这些数据与该人群中出现的合并症之间的关系，并进行了相关性和多元线性回归分析。85 名艾滋病毒感染者中，65 名男性，20 名女性，平均年龄为 69 岁（RIC：8），感染艾滋病毒的时间为 17 年（SD：7）。41%的患者最初患有艾滋病。最常见的并发症是高血压和血脂异常，分别占 55% 和 52%。40% 的 PLWHIV 至少服用 5 种药物。35%的 PLWHIV 接受过 5 种以上的抗逆转录病毒治疗。在进行分析时，所有 PLHIV 的病毒载量均检测不到。合并症的数量与 PLHIV 的不同特征之间没有关联；但年龄、一生中接受抗逆转录病毒治疗的次数和接受抗逆转录病毒治疗的次数之间存在微弱的相关性。这项分析凸显了 PLHIV 中合并症和多重药物治疗带来的沉重负担。需要进一步开展研究，以更好地确定影响其发展的特征和变量。

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引用次数: 0

Brote nosocomial causado por Serratia marcescens en una unidad de cuidados intensivos neonatal de un hospital regional. Análisis y propuestas de mejora 一家地区医院的新生儿重症监护室爆发了由肉豆蔻沙雷氏菌引起的医院内感染。分析和改进建议

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.04.001

María Liébana-Rodríguez , Inés Portillo-Calderón , María Amelia Fernández-Sierra , Mercedes Delgado-Valverde , Lina Martín-Hita , José Gutiérrez-Fernández

Objectives

Serratia marcescens may cause nosocomial outbreaks in neonatal intensive care units. We describe an outbreak of Serratia marcescens in a neonatal intensive care unit and propose additional prevention and control recommendations.

Methods

Between March 2019 and January 2020, samples were taken from patients in the neonatal intensive care unit (rectal, pharyngeal, axillary and other locations) and from 15 taps and their sinks. Control measures were implemented including thorough cleaning of incubators, health education to staff and neonates’ relatives, and use of single-dose containers. PFGE was performed in 19 isolates from patients and in 5 environmental samples.

Results

From the first case in March 2019 to the detection of the outbreak, a month elapsed. Finally, 20 patients were infected and 5 colonized. Eighty percent of infected neonates had conjunctivitis, 25% bacteremia, 15% pneumonia, 5% wound infection, and 5% urinary tract infection. Six neonates had 2 foci of infection. Among the 19 isolates studied, 18 presented the same pulsotype and only one of the isolates from the sinkhole showed a clonal relationship with those of the outbreak. Initial measures established were ineffective to control the outbreak and were implemented with exhaustive cleaning, use of individual eye drops, environmental sampling and changing sinks.

Conclusion

This outbreak presented a high number of neonates affected due to its late detection and torpid evolution. The microorganisms isolated from the neonates were related to an environmental isolate. Additional prevention and control measures are proposed, including routine weekly microbiological sampling.

目的沙雷氏菌可能会导致新生儿重症监护病房的院内暴发。方法在 2019 年 3 月至 2020 年 1 月期间，从新生儿重症监护病房的患者（直肠、咽部、腋窝和其他部位）和 15 个水龙头及其水槽中采集样本。采取的控制措施包括彻底清洁培养箱、对员工和新生儿亲属进行健康教育以及使用单剂量容器。对来自患者的 19 份分离物和 5 份环境样本进行了 PFGE 检测。最终，20 名患者受到感染，5 名患者被定植。80%受感染的新生儿患有结膜炎，25%患有菌血症，15%患有肺炎，5%患有伤口感染，5%患有尿路感染。6 名新生儿有 2 个感染病灶。在研究的 19 个分离株中，有 18 个呈现相同的脉冲型，只有一个来自天坑的分离株与疫情中的分离株有克隆关系。最初制定的措施未能有效控制疫情，后来采取了彻底清洁、使用个别眼药水、环境采样和更换水槽等措施。从新生儿体内分离出的微生物与环境分离物有关。建议采取额外的预防和控制措施，包括每周例行微生物采样。

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引用次数: 0

A case of unresolved skin lesion in a cobbler 一个鞋匠身上未治愈的皮损病例

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2023.12.002

Ali Mert , Abdurrahman Kaya , Sibel Yildiz Kaya

引用次数: 0

Celulitis craneo-facial con pericondritis y otitis externa profesional, a propósito de un caso 颅面蜂窝织炎伴软骨周炎和职业性外耳道炎，病例报告

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-06-01 DOI: 10.1016/j.eimc.2024.02.008

Eloy Sempere Moreno, Santos Ibáñez Barceló, Marta Montero Alonso

引用次数: 0

Espiroquetosis intestinal humana como entidad asociada a infecciones de transmisión sexual 作为性传播感染相关实体的人类肠道螺旋体病

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-05-01 DOI: 10.1016/j.eimc.2023.03.001

Alejandro De Gea-Grela , Alfredo Maldonado-Barrueco , Clara Cabañuz , Mariana Díaz-Almiron , Alicia Rico , Guillermo Ruíz-Carrascoso , Maria Elena Palacios , Eduardo Martín-Arranz , Raquel Escudero-Nieto , José I Bernardino

Introduction

Human intestinal spirochetosis (HIE) is a poorly studied clinical entity with variable clinical manifestations. However, in recent years it has gained special relevance because an increasing number of cases have been described in people living with HIV (PWH) and in patients with a history of sexually transmitted infections (STI) or immunosuppression.

Methods

retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014-2021.

Results

36 cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs 28%; p < 0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%).

Conclusión

HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.

导言人类肠道螺旋体病（HIE）是一种临床研究较少的疾病，临床表现多变。方法回顾性研究一家三级医院（马德里帕斯大学医院）在2014-2021年间发现的所有HIE病例，结果发现36例HIE病例。大多数病例为男性（94%），中位年龄为 45 岁。10名患者（占29.4%）为PWH，20名患者（占56%）为男男性行为者。虽然临床表现各不相同，但最常见的是慢性腹泻（47%），多达 25% 的受试者患有临床直肠炎。39%的患者在过去两年中被诊断出患有性传播疾病，与未感染艾滋病毒的患者相比，PWH 患者的这一特征更为常见（90% vs 28%；p <0.01）。与HIE诊断相关的性传播感染中最常见的是梅毒（31%）。

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引用次数: 0

Low rate of vaccination and risk of incident hepatitis A among HIV-infected men who have sex with men in Seville, Southern Spain 在西班牙南部塞维利亚，受艾滋病毒感染的男男性行为者的疫苗接种率低，患甲型肝炎的风险高。

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-05-01 DOI: 10.1016/j.eimc.2023.03.003

Marta Fernandez-Fuertes , Juan Macias , Anaïs Corma-Gomez , Adolfo Salazar-Gonzalez , Alejandro Gonzalez-Serna , Pilar Rincon , Maria J. Arriaza-Estevez , Ana Fuentes-Lopez , Luis M. Real , Juan A. Pineda

Background

Periodic outbreaks of hepatitis A (HAV) infection in men who have sex with men (MSM) have been reported. Low vaccination uptake in HIV-infected individuals could drive new outbreaks. We aimed at evaluating the incidence of and risk factors for HAV infection in people living with HIV (PLWH) in our area. We also assessed the rates of HAV vaccination.

Methods

This was a prospective cohort study. 915 patients were included, 272 (30%) of them were anti-HAV seronegative at baseline.

Results

Twenty-six (9.6%) susceptible individuals became infected. Incident cases peaked in 2009–2010 and 2017–2018. Incident HAV infection was independently associated with MSM [adjusted odds ratio (95% confidence ratio): 4.39 (1.35–14.27), p = 0.014]. One hundred and five (38.6%) HAV seronegative patients were vaccinated, 21 (20%) of them did not respond, and one (1%) patient lost immunity against HAV. Four (29%) non-responders to vaccination showed incident HAV 5–9 years afterwards.

Conclusions

The incidence of HAV infection in a cohort of well-controlled PLWH remains low and stable, with intermittent outbreaks involving mainly non-immunized MSM. A significant proportion of PLWH remain susceptible to HAV infection due to insufficient vaccine uptake and limited response to vaccination. Importantly, patients not responding to HAV vaccination continue at risk of infection.

背景据报道，甲型肝炎（HAV）感染在男男性行为者（MSM）中定期爆发。艾滋病毒感染者的疫苗接种率低可能会导致新的爆发。我们旨在评估本地区艾滋病病毒感染者（PLWH）中甲型肝炎病毒感染的发病率和风险因素。方法这是一项前瞻性队列研究。结果26名易感人群（9.6%）受到感染。感染病例在 2009-2010 年和 2017-2018 年达到高峰。HAV感染事件与男男性行为者独立相关[调整后的几率比（95% 置信比）：4.39 (1.35-14.27)，p = 0.014]。有 15 名（38.6%）HAV 血清阴性患者接种了疫苗，其中 21 名（20%）没有应答，1 名（1%）患者失去了对 HAV 的免疫力。4名（29%）未对疫苗接种做出反应的患者在5-9年后出现了HAV感染。由于疫苗接种率不足以及对疫苗接种的反应有限，很大一部分 PLWH 仍然容易感染 HAV。重要的是，对 HAV 疫苗接种无反应的患者仍有感染风险。

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引用次数: 0

Reactivation of cutaneous tuberculosis induced by trauma: A case report 创伤诱发的皮肤结核再活化：病例报告

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-05-01 DOI: 10.1016/j.eimc.2024.02.007

Ali Mert , Abdurrahman Kaya , Sibel Yıldız Kaya

引用次数: 0

Lesiones papulares eritematosas en un paciente procedente de Venezuela 委内瑞拉一名患者的红斑丘疹性病变

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-05-01 DOI: 10.1016/j.eimc.2023.10.012

Amparo Broseta Tamarit , Víctor Dios Guillán , Marta Jiménez Mayordomo , Victoria Domínguez-Márquez

引用次数: 0

Síndrome destructivo centrofacial: una etiología inusual 中枢性面部毁损综合征：一种不寻常的病因

IF 2.5 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica

Pub Date : 2024-05-01 DOI: 10.1016/j.eimc.2023.12.005

Camilo Ruiz Mejía, Andrés Felipe Lozano Camayo, Juan David Ruiz Restrepo, Gloria Andrea Vargas Suaza

引用次数: 0

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Enfermedades infecciosas y microbiologia clinica

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