Pub Date : 2026-03-09DOI: 10.1016/j.eimce.2026.503100
Virginia Vilar-García, M Carmen Domínguez-Jiménez, Álvaro Pascual
Introduction: Toxigenic Clostridioides difficile (CDI) is a leading cause of nosocomial infection. To optimize the diagnosis of this infection, several algorithms have been proposed: in the two-step algorithm, the first step involves the detection of glutamate dehydrogenase (GDH), while in the three-step/multistep algorithm, GDH and toxins are detected simultaneously.
Methods: Between January 2023 and April 2025, immunochromatography (ICT) was used to detect GDH and toxins A/B in stool samples from patients with suspected CDI, with PCR used as a confirmatory test. The number of CDI cases that would be reported according to each algorithm was compared.
Results: The application of the three-step/multistep algorithm generated 135 additional positive cases compared to the two-step algorithm, representing a 36.9% increase.
Conclusion: The diagnostic algorithm for CDI needs to be reviewed when using ICT as the initial test to avoid potential overdiagnosis.
{"title":"Consequences of applying two-step or three-step/multistep algorithm in the diagnosis of Clostridioides difficile infection.","authors":"Virginia Vilar-García, M Carmen Domínguez-Jiménez, Álvaro Pascual","doi":"10.1016/j.eimce.2026.503100","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503100","url":null,"abstract":"<p><strong>Introduction: </strong>Toxigenic Clostridioides difficile (CDI) is a leading cause of nosocomial infection. To optimize the diagnosis of this infection, several algorithms have been proposed: in the two-step algorithm, the first step involves the detection of glutamate dehydrogenase (GDH), while in the three-step/multistep algorithm, GDH and toxins are detected simultaneously.</p><p><strong>Methods: </strong>Between January 2023 and April 2025, immunochromatography (ICT) was used to detect GDH and toxins A/B in stool samples from patients with suspected CDI, with PCR used as a confirmatory test. The number of CDI cases that would be reported according to each algorithm was compared.</p><p><strong>Results: </strong>The application of the three-step/multistep algorithm generated 135 additional positive cases compared to the two-step algorithm, representing a 36.9% increase.</p><p><strong>Conclusion: </strong>The diagnostic algorithm for CDI needs to be reviewed when using ICT as the initial test to avoid potential overdiagnosis.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503100"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-02DOI: 10.1016/j.eimce.2026.503075
Ana María Gómez Ortiz, Laura Carrasco Hernández, Carmen Calero Acuña, Marta Ferrer Galván, Juan Francisco Medina Gallardo, José Antonio Lepe Jiménez, Rafael Luque Márquez, Esther Quintana Gallego, Verónica González Galán
Objective: To analyse the characteristics of nontuberculous mycobacteria(NTM) cases with ATS-IDSA criteria from respiratory samples in the healthcare area of Virgen del Rocío University Hospital (VRUH).
Methods: A prospective descriptive analysis was conducted including a total of 77 patients from the HUVR healthcare area who met ATS/IDSA criteria and had respiratory isolates of NTM between January 2020 and November 2023.
Results: NTM were isolated in a total of 367 patients, of whom 77 (20.98%) met the IDSA/ATS criteria. The most useful diagnostic respiratory sample was sputum (84.3%). The most frequently isolated species was Mycobacterium intracellulare (n = 26 [33.76%]), followed by Mycobacterium avium (n = 17 [22.07%]). In this series, 21 patients had COPD (27.27%).
Conclusions: In our setting, the most common species is M. intracellulare. The typical patient profile is a woman with non-cystic fibrosis bronchiectasis. However, we have detected 21 cases of COPD with NTM, which makes it necessary to continue studying this group in the future.
{"title":"Clinical and epidemiological characteristics of nontuberculous mycobacteria pulmonary infections in the healthcare area of Virgen del Rocío University Hospital in Seville (2020-2023).","authors":"Ana María Gómez Ortiz, Laura Carrasco Hernández, Carmen Calero Acuña, Marta Ferrer Galván, Juan Francisco Medina Gallardo, José Antonio Lepe Jiménez, Rafael Luque Márquez, Esther Quintana Gallego, Verónica González Galán","doi":"10.1016/j.eimce.2026.503075","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503075","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the characteristics of nontuberculous mycobacteria(NTM) cases with ATS-IDSA criteria from respiratory samples in the healthcare area of Virgen del Rocío University Hospital (VRUH).</p><p><strong>Methods: </strong>A prospective descriptive analysis was conducted including a total of 77 patients from the HUVR healthcare area who met ATS/IDSA criteria and had respiratory isolates of NTM between January 2020 and November 2023.</p><p><strong>Results: </strong>NTM were isolated in a total of 367 patients, of whom 77 (20.98%) met the IDSA/ATS criteria. The most useful diagnostic respiratory sample was sputum (84.3%). The most frequently isolated species was Mycobacterium intracellulare (n = 26 [33.76%]), followed by Mycobacterium avium (n = 17 [22.07%]). In this series, 21 patients had COPD (27.27%).</p><p><strong>Conclusions: </strong>In our setting, the most common species is M. intracellulare. The typical patient profile is a woman with non-cystic fibrosis bronchiectasis. However, we have detected 21 cases of COPD with NTM, which makes it necessary to continue studying this group in the future.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503075"},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-20DOI: 10.1016/j.eimce.2026.503068
Albert Bernet Sánchez , Alba Bellés Bellés , Eric López González , Iván Prats Sanchez , Saray Mormeneo Bayo , María Riesgo Magaña , Mercè García González
Introduction
SARS-CoV-2 caused a pandemic with more than 778 million cases and 7 million deaths. The high diagnostic demand forced laboratories to incorporate new techniques, such as transcription-mediated amplification (TMA). This study compares TMA with RT-PCR in routine clinical samples and evaluates the relationship between relative light units (RLU) and RT-PCR results to define possible cut-off ranges.
Methods
A prospective study was carried out over 1 year in the microbiology laboratory of Arnau de Vilanova University Hospital in Lleida. All samples for SARS-CoV-2 were processed using TMA (Aptima Hologic), and a portion was analyzed in parallel with RT-PCR (LightMix®, GeneXpert®, or Cobas®). Concordance between techniques, sensitivity, and specificity were calculated. RT-PCR was considered the reference technique.
Results
A total of 15,156 samples were analyzed with both techniques. Concordance was substantial (κ = 0.692), with a sensitivity of 97.89% and a specificity of 64.74%. Of the results, 11.28% corresponded to false positives and 8.44% to false negatives for TMA. RLU values between 350 and 559, considered negative by the TMA system, were positive by RT-PCR in 20.56%. In intermediate RLU values (560–899), the probability of having a negative RT-PCR was around 50%, dropping to 3.78% for values between 1000 and 1099.
Conclusions
These results support the use of TMA as a screening method, provided the positivity threshold is lowered to 350 RLU and positive cases are confirmed by RT-PCR.
{"title":"Comparison between RT-PCR and TMA for SARS-CoV-2 detection and proposal of a diagnostic algorithm based on cut-off values","authors":"Albert Bernet Sánchez , Alba Bellés Bellés , Eric López González , Iván Prats Sanchez , Saray Mormeneo Bayo , María Riesgo Magaña , Mercè García González","doi":"10.1016/j.eimce.2026.503068","DOIUrl":"10.1016/j.eimce.2026.503068","url":null,"abstract":"<div><h3>Introduction</h3><div>SARS-CoV-2 caused a pandemic with more than 778 million cases and 7 million deaths. The high diagnostic demand forced laboratories to incorporate new techniques, such as transcription-mediated amplification (TMA). This study compares TMA with RT-PCR in routine clinical samples and evaluates the relationship between relative light units (RLU) and RT-PCR results to define possible cut-off ranges.</div></div><div><h3>Methods</h3><div>A prospective study was carried out over 1 year in the microbiology laboratory of Arnau de Vilanova University Hospital in Lleida. All samples for SARS-CoV-2 were processed using TMA (Aptima Hologic), and a portion was analyzed in parallel with RT-PCR (LightMix®, GeneXpert®, or Cobas®). Concordance between techniques, sensitivity, and specificity were calculated. RT-PCR was considered the reference technique.</div></div><div><h3>Results</h3><div>A total of 15,156 samples were analyzed with both techniques. Concordance was substantial (κ = 0.692), with a sensitivity of 97.89% and a specificity of 64.74%. Of the results, 11.28% corresponded to false positives and 8.44% to false negatives for TMA. RLU values between 350 and 559, considered negative by the TMA system, were positive by RT-PCR in 20.56%. In intermediate RLU values (560–899), the probability of having a negative RT-PCR was around 50%, dropping to 3.78% for values between 1000 and 1099.</div></div><div><h3>Conclusions</h3><div>These results support the use of TMA as a screening method, provided the positivity threshold is lowered to 350 RLU and positive cases are confirmed by RT-PCR.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503068"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-07DOI: 10.1016/j.eimce.2026.503101
María Lezaun Andreu , Belén María Lambán Per , Paula Martín Soler , Andrea Carilla San Román , Amparo Boquera Albert , Juan Manuel García-Lechuz Moya
Introduction
Corynebacterium kroppenstedtii is a gram-positive, non-spore-forming, non-motile, lipophilic bacillus that belongs to the normal human skin flora. Granulomatous mastitis is a benign inflammatory breast condition with a complex diagnosis and treatment. Numerous studies have linked C. kroppenstedtii to granulomatous mastitis.
Methods
We conducted a clinical review on three patients with granulomatous mastitis caused by C. kroppenstedtii, identified by MALDI-TOF MS. We tested antibiotic susceptibility combining both disk diffusion and gradient diffusion assays, following EUCAST and CLSI guidelines.
Results
In all three cases, C. kroppenstedtii was isolated in pure culture. Antibiotic susceptibility results were similar for most antibiotics, with variable susceptibility to clindamycin and tetracycline.
Conclusions
These three cases support the role of C. kroppenstedtii in the etiopathogenesis of granulomatous mastitis highlighting the importance of evaluating is isolation in patients with this disease.
{"title":"Corynebacterium kroppenstedtii and granulomatous mastitis: The importance of recognizing when normal flora matters","authors":"María Lezaun Andreu , Belén María Lambán Per , Paula Martín Soler , Andrea Carilla San Román , Amparo Boquera Albert , Juan Manuel García-Lechuz Moya","doi":"10.1016/j.eimce.2026.503101","DOIUrl":"10.1016/j.eimce.2026.503101","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Corynebacterium kroppenstedtii</em> is a gram-positive, non-spore-forming, non-motile, lipophilic bacillus that belongs to the normal human skin flora. Granulomatous mastitis is a benign inflammatory breast condition with a complex diagnosis and treatment. Numerous studies have linked <em>C. kroppenstedtii</em> to granulomatous mastitis.</div></div><div><h3>Methods</h3><div>We conducted a clinical review on three patients with granulomatous mastitis caused by <em>C. kroppenstedtii</em>, identified by MALDI-TOF MS. We tested antibiotic susceptibility combining both disk diffusion and gradient diffusion assays, following EUCAST and CLSI guidelines.</div></div><div><h3>Results</h3><div>In all three cases, <em>C. kroppenstedtii</em> was isolated in pure culture. Antibiotic susceptibility results were similar for most antibiotics, with variable susceptibility to clindamycin and tetracycline.</div></div><div><h3>Conclusions</h3><div>These three cases support the role of <em>C. kroppenstedtii</em> in the etiopathogenesis of granulomatous mastitis highlighting the importance of evaluating is isolation in patients with this disease.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503101"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neisseria gonorrhoeae is a well-known cause of conjunctivitis but an exceptionally rare cause of preseptal or orbital cellulitis. While sexual contact is the main mode of transmission, non-sexual routes have been documented, posing a diagnostic challenge. This article reports a case of N. gonorrhoeae orbital cellulitis with an associated abscess in an adolescent female who denied sexual activity and reviews the existing literature on this unusual presentation.
Methods
We present the case of a 16-year-old female who was admitted for evaluation of unilateral vision loss and proptosis. Additionally, a literature search of multiple core databases was performed for publications between 1975 and 2025 to identify all documented cases of gonococcal preseptal and orbital cellulitis.
Results
A 16-year-old patient was diagnosed with orbital cellulitis and a pre-septal abscess. Gram stain of the purulent eye discharge revealed Gram-negative diplococci, and cultures subsequently confirmed N. gonorrhoeae isolation. The patient responded favorably to treatment with ceftriaxone and doxycycline. Literature review was able to identify only seven documented cases of N. gonorrhoeae-associated orbital cellulitis and nine cases of preseptal cellulitis reported over the last 50 years, highlighting the importance of this clinical entity.
Conclusions
This case expands the known clinical spectrum of atypical gonococcal infections. N. gonorrhoeae should be considered in the differential diagnosis of orbital cellulitis in adolescent patients, even when a history of sexual activity is denied. This report underscores the importance of considering alternative transmission routes and utilizing appropriate microbiological diagnostics to ensure timely and effective treatment.
{"title":"Gonococcal orbital cellulitis in an adolescent: A diagnostic challenge in determining the transmission pathway","authors":"Samantha Pérez-Cavazos , Adrián Camacho-Ortiz , Eduardo Pérez-Alba , Samanta Denis Ibarra-Treviño","doi":"10.1016/j.eimce.2026.503106","DOIUrl":"10.1016/j.eimce.2026.503106","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Neisseria gonorrhoeae</em> is a well-known cause of conjunctivitis but an exceptionally rare cause of preseptal or orbital cellulitis. While sexual contact is the main mode of transmission, non-sexual routes have been documented, posing a diagnostic challenge. This article reports a case of <em>N. gonorrhoeae</em> orbital cellulitis with an associated abscess in an adolescent female who denied sexual activity and reviews the existing literature on this unusual presentation.</div></div><div><h3>Methods</h3><div>We present the case of a 16-year-old female who was admitted for evaluation of unilateral vision loss and proptosis. Additionally, a literature search of multiple core databases was performed for publications between 1975 and 2025 to identify all documented cases of gonococcal preseptal and orbital cellulitis.</div></div><div><h3>Results</h3><div>A 16-year-old patient was diagnosed with orbital cellulitis and a pre-septal abscess. Gram stain of the purulent eye discharge revealed Gram-negative diplococci, and cultures subsequently confirmed <em>N. gonorrhoeae</em> isolation. The patient responded favorably to treatment with ceftriaxone and doxycycline. Literature review was able to identify only seven documented cases of <em>N. gonorrhoeae</em>-associated orbital cellulitis and nine cases of preseptal cellulitis reported over the last 50 years, highlighting the importance of this clinical entity.</div></div><div><h3>Conclusions</h3><div>This case expands the known clinical spectrum of atypical gonococcal infections. <em>N. gonorrhoeae</em> should be considered in the differential diagnosis of orbital cellulitis in adolescent patients, even when a history of sexual activity is denied. This report underscores the importance of considering alternative transmission routes and utilizing appropriate microbiological diagnostics to ensure timely and effective treatment.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503106"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-20DOI: 10.1016/j.eimce.2026.503115
Víctor García Bustos , Miguel Salavert Lletí
{"title":"No calm after the storm: Infections following storm disasters and flash floods","authors":"Víctor García Bustos , Miguel Salavert Lletí","doi":"10.1016/j.eimce.2026.503115","DOIUrl":"10.1016/j.eimce.2026.503115","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503115"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-07DOI: 10.1016/j.eimce.2026.503135
Julia Barrado Cuchillo , Adrián Valls Carbó , María José Núñez Orantos , Noemí Cabello Clotet , Juncal Pérez-Somarriba Moreno , Ana Muñoz Gómez , Carolina Olmos Mata , Virginia Víctor Palomares , Vicente Estrada Pérez
Introduction
Thanks to improvements in antiretroviral therapy (ART), HIV infection has become a chronic disease in developed countries. The stratification of the complexity of chronic patients is a procedure used in other diseases that allows for identifying the risk level of patients and organizing care based on their characteristics.
The objective of this study is to analyze the complexity of a large cohort of people living with HIV (PLWH) on ART and in regular follow-up consultations.
Methods
Descriptive study of complexity according to the GeSIDA stratification scale (GSS), which includes social aspects, risk behaviors, comorbidities, psychological and cognitive status, and viral control in a cohort of PLWH on ART. Patients were classified as extreme, high, medium, or low complexity based on their GSS score.
Results
A total of 1127 patients were included, 83.7% male, with a mean age of 48 years (SD: 13.10). 65.3% had low complexity, 18.5% medium, 8.3% high, and 7.9% extreme complexity. The most determining factors for higher complexity on the GSS were lower social support, drug use and risky sexual behaviors. Female sex, lower educational level, history of AIDS, a lower CD4 count and a lower CD4/CD8 ratio were associated with higher complexity.
Conclusions
The GSS identifies most PLWH on ART as low complexity. There are clinical factors associated with greater complexity, suggesting that there are subgroups of PLWH who should receive differentiated clinical care to prevent complications and improve their quality of life.
{"title":"Analysis of the clinical complexity of people living with HIV based on the GeSIDA stratification system","authors":"Julia Barrado Cuchillo , Adrián Valls Carbó , María José Núñez Orantos , Noemí Cabello Clotet , Juncal Pérez-Somarriba Moreno , Ana Muñoz Gómez , Carolina Olmos Mata , Virginia Víctor Palomares , Vicente Estrada Pérez","doi":"10.1016/j.eimce.2026.503135","DOIUrl":"10.1016/j.eimce.2026.503135","url":null,"abstract":"<div><h3>Introduction</h3><div>Thanks to improvements in antiretroviral therapy (ART), HIV infection has become a chronic disease in developed countries. The stratification of the complexity of chronic patients is a procedure used in other diseases that allows for identifying the risk level of patients and organizing care based on their characteristics.</div><div>The objective of this study is to analyze the complexity of a large cohort of people living with HIV (PLWH) on ART and in regular follow-up consultations.</div></div><div><h3>Methods</h3><div>Descriptive study of complexity according to the GeSIDA stratification scale (GSS), which includes social aspects, risk behaviors, comorbidities, psychological and cognitive status, and viral control in a cohort of PLWH on ART. Patients were classified as extreme, high, medium, or low complexity based on their GSS score.</div></div><div><h3>Results</h3><div>A total of 1127 patients were included, 83.7% male, with a mean age of 48 years (SD: 13.10). 65.3% had low complexity, 18.5% medium, 8.3% high, and 7.9% extreme complexity. The most determining factors for higher complexity on the GSS were lower social support, drug use and risky sexual behaviors. Female sex, lower educational level, history of AIDS, a lower CD4 count and a lower CD4/CD8 ratio were associated with higher complexity.</div></div><div><h3>Conclusions</h3><div>The GSS identifies most PLWH on ART as low complexity. There are clinical factors associated with greater complexity, suggesting that there are subgroups of PLWH who should receive differentiated clinical care to prevent complications and improve their quality of life.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503135"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-20DOI: 10.1016/j.eimce.2026.503077
Iciar Echavarren Churruca , Gabriela Milagros Acuña Vila , Carmen Gómez Traseira , Begoña de Miguel Lavisier , Miguel Ángel Molina Gutiérrez
Introduction
Reactions to β-lactam antibiotics account for up to 80% of pediatric consultations for suspected drug allergy. This study aimed to describe the characteristics of children evaluated in the emergency department for suspected allergy to amoxicillin or amoxicillin–clavulanate.
Materials and methods
We conducted a descriptive, retrospective study in a tertiary hospital (January 2019–May 2024), including patients ≤16 years with a diagnosis of suspected allergy to these antibiotics.
Results
Eighty-two cases were analysed; 93.9% presented with cutaneous lesions and none showed hemodynamic instability. Two patients received intramuscular epinephrine for immediate reactions consistent with mild anaphylaxis. Antibiotic treatment was discontinued in 95.1% of cases, and 54.7% of the substitutions were considered inappropriate. A total of 69.5% were referred to Allergy, and only seven patients (12.3%) were confirmed to have true amoxicillin allergy.
Conclusions
Suspected amoxicillin allergy in pediatric emergency care generally has a favourable prognosis. The low diagnostic confirmation rate and frequent inappropriate antibiotic changes highlight the need to improve adherence to clinical guidelines.
{"title":"Suspected allergy to amoxicillin in pediatric emergency departments: low diagnostic confirmation and high rate of inappropriate antibiotic changes","authors":"Iciar Echavarren Churruca , Gabriela Milagros Acuña Vila , Carmen Gómez Traseira , Begoña de Miguel Lavisier , Miguel Ángel Molina Gutiérrez","doi":"10.1016/j.eimce.2026.503077","DOIUrl":"10.1016/j.eimce.2026.503077","url":null,"abstract":"<div><h3>Introduction</h3><div>Reactions to β-lactam antibiotics account for up to 80% of pediatric consultations for suspected drug allergy. This study aimed to describe the characteristics of children evaluated in the emergency department for suspected allergy to amoxicillin or amoxicillin–clavulanate.</div></div><div><h3>Materials and methods</h3><div>We conducted a descriptive, retrospective study in a tertiary hospital (January 2019–May 2024), including patients ≤16 years with a diagnosis of suspected allergy to these antibiotics.</div></div><div><h3>Results</h3><div>Eighty-two cases were analysed; 93.9% presented with cutaneous lesions and none showed hemodynamic instability. Two patients received intramuscular epinephrine for immediate reactions consistent with mild anaphylaxis. Antibiotic treatment was discontinued in 95.1% of cases, and 54.7% of the substitutions were considered inappropriate. A total of 69.5% were referred to Allergy, and only seven patients (12.3%) were confirmed to have true amoxicillin allergy.</div></div><div><h3>Conclusions</h3><div>Suspected amoxicillin allergy in pediatric emergency care generally has a favourable prognosis. The low diagnostic confirmation rate and frequent inappropriate antibiotic changes highlight the need to improve adherence to clinical guidelines.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 3","pages":"Article 503077"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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