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Development of humanization indicators for the care of patients with severe bacterial infections: Design and validation. 重症细菌感染患者护理人性化指标的制定:设计与验证。
Pub Date : 2026-01-02 DOI: 10.1016/j.eimce.2025.503036
Julio Zarco Rodríguez, Jaime Lora-Tamayo Morillo-Velarde, Laura Morata Ruiz, Irantzu Rosselló Taberna, Xavier Oleart Martínez

Introduction: The care of patients with severe bacterial infections presents clinical, organizational, and human challenges. This study proposes a system to objectively assess the quality of humanized care in this context.

Methods: Using a multidisciplinary approach, unmet needs were identified and five strategic lines, twenty subdimensions, and a set of evaluation indicators were defined. The proposal was validated through a pilot in two hospitals.

Results: The indicators were designed to be applicable in different hospital settings to assess aspects such as treatment, care coordination, and communication. The pilot confirmed the feasibility of implementation and their usefulness for improvement planning.

Conclusions: The proposed indicator system is a useful tool to support progress toward more humanized and objectively measurable care for patients with severe bacterial infections.

对严重细菌感染患者的护理提出了临床、组织和人类的挑战。本研究提出了一个系统来客观地评估在这种情况下的人性化护理的质量。方法:采用多学科方法,确定未满足的需求,定义5条战略线、20个子维度和一套评价指标。该建议在两家医院进行了试点,得到了证实。结果:设计的指标适用于不同的医院环境,以评估治疗、护理协调和沟通等方面。试验证实了实施的可行性及其对改进计划的有用性。结论:所提出的指标体系是一种有用的工具,可以支持对严重细菌感染患者进行更人性化和客观可衡量的护理。
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引用次数: 0
Epidemiology, diagnosis and treatment of Mayaro and Oropouche virus infections: implication for clinical practice and public health. 马亚罗病毒和欧罗波切病毒感染的流行病学、诊断和治疗:对临床实践和公共卫生的影响。
Pub Date : 2026-01-02 DOI: 10.1016/j.eimce.2025.503055
Jaime R Torres, Wilmer Villamil Gómez, Octavio Arce García, Francisco Javier Membrillo de Novales

Mayaro virus (MAYV) and Oropouche virus (OROV) cause emerging infections in Latin America. They represent an increasing public health threat in this and other regions due to their geographic spread, rising case numbers, and the identification of complications and fatal cases. This review, developed by specialists from Latin America and Spain, addresses the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of both infections, aiming to provide valuable information for the diagnosis and management of these diseases based on updated scientific evidence. The diagnostic challenges are emphasized, particularly the clinical overlap with other arboviral infections, the lack of commercial diagnostic tools, and the urgent need for active epidemiological surveillance. The risk of undetected outbreaks is highlighted, along with the importance of including these viruses in clinical algorithms-especially in residents or travellers to endemic areas and, specifically for OROV, in pregnant women with suspected arboviral infection.

马亚罗病毒(MAYV)和Oropouche病毒(OROV)在拉丁美洲引起新发感染。由于其地理分布、病例数量不断增加以及并发症和致命病例的发现,它们在该区域和其他区域构成了日益严重的公共卫生威胁。本综述由拉丁美洲和西班牙的专家撰写,涉及两种感染的流行病学、病理生理学、临床表现、诊断和治疗,旨在根据最新的科学证据为这两种疾病的诊断和管理提供有价值的信息。强调了诊断方面的挑战,特别是与其他虫媒病毒感染的临床重叠,缺乏商业诊断工具,以及迫切需要积极开展流行病学监测。强调了未被发现的暴发风险,以及将这些病毒纳入临床算法的重要性,特别是在流行地区的居民或旅行者中,特别是对于OROV,怀疑有虫媒病毒感染的孕妇。
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引用次数: 0
A rare case of purulent pericarditis secondary to Streptococcus constellatus due to contiguity of a liver lesion under study. 一个罕见的继发于星形链球菌的化脓性心包炎病例。
Pub Date : 2026-01-02 DOI: 10.1016/j.eimce.2025.503040
Jordi Martinez-Matencio, Inmaculada Palacios-Garcia, Eduardo Cantón-Puig, José Garnacho-Montero
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引用次数: 0
Identification of lineages and sublineages of the Mycobacterium tuberculosis complex using advanced molecular strategies and WGS in Seville, Spain (2015–2022) 利用先进的分子策略和WGS在西班牙塞维利亚鉴定结核分枝杆菌复体的谱系和亚谱系(2015-2022)。
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503038
María Aznar , Mariana G. López , María José Torres , Eduardo Briones , Juan Francisco Medina , Verónica González-Galán

Introduction

Tuberculosis (TB) in the Virgen del Rocío university hospital health area, included in the Seville Health District, Spain, exceeds the rate of 17 cases/100,000 inhabitants. Within the Mycobacterium tuberculosis complex (MTBC), M. tuberculosis sensu stricto comprises seven phylogenetic lineages (L1–L4 and L7–L9). The objective of this work is to know the circulating lineages in the area.

Methods

Molecular typing and sequencing were performed to identify circulating lineages from 2015 to 2022.

Results

From 2015 to 2019, the following were identified: L4 (95.95%, n = 355), L2 (1.62%, n = 6), and L6 (1.08%, n = 4). From 2020 to 2022: L4 94.62% (n = 123); L1 1.5% (n = 2); L3 1.5% (n = 2) and L2 0.76% (n = 1).

Conclusions

The emergence of different lineages in our area and their recognition are key to contributing to disease control. These findings demonstrate the need to continue surveillance and apply sequencing to understand and control the dynamics of TB transmission.
简介:在西班牙塞维利亚卫生区所属的Rocío大学医院卫生区,结核病发病率超过每10万居民17例。在结核分枝杆菌复合体(MTBC)中,严格意义结核分枝杆菌包括7个系统发育谱系(L1-L4和L7-L9)。这项工作的目的是了解该地区的流通血统。方法:采用分子分型和测序方法鉴定2015 - 2022年的循环谱系。结果:2015 - 2019年共鉴定出L4 (95.95%, n = 355)、L2 (1.62%, n = 6)、L6 (1.08%, n = 4)。2020 - 2022年:L4 94.62% (n = 123);L1 1.5% (n = 2);L3 1.5% (n = 2), L2 0.76% (n = 1)。结论:本地区不同谱系的出现和识别是疾病控制的关键。这些发现表明,需要继续进行监测并应用测序来了解和控制结核传播的动态。
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引用次数: 0
Increasing clinical and public health role of Mycobacterium tuberculosis genomics 结核分枝杆菌基因组学在临床和公共卫生中的作用日益增强
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503044
Iñaki Comas
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引用次数: 0
An exceptional cause of infective endocarditis: Lactobacillus paracasei 感染性心内膜炎的一个特殊原因:副干酪乳杆菌
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503031
Antonio Moreno-Flores , Elena García-Campos Losada , Francisco José Vasallo-Vidal , María Teresa Pérez-Rodríguez
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引用次数: 0
Implementing CLIA for QuantiFERON®-CMV testing: Optimizing cellular immune response against cytomegalovirus 实施CLIA QuantiFERON®-巨细胞病毒检测:优化细胞免疫应答巨细胞病毒
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503050
Juliana Esperalba , Maria Arnedo-Muñoz , Ariadna Rando-Segura , Ibai Los-Arcos , Eva Revilla-López , Aroa Gomez-Brey , Patricia Nadal-Barón , Ester Marquez-Algaba , Víctor Monforte , Alberto Sandiumenge , Nieves Larrosa , Tomàs Pumarola , Oscar Len , Andrés Antón

Introduction

Cytomegalovirus (CMV) remains a significant infectious complication in solid organ transplant recipients. Assessing cellular immunity through interferon-gamma (IFN-γ) release assays, such as QuantiFERON®-CMV (QTF-CMV), is useful for guiding prophylactic and therapeutic decisions. Although ELISA is the validated method for QTF-CMV, chemiluminescence immunoassay (CLIA) may offer technical advantages. This study aimed to evaluate the performance of the CLIA-based LIAISON® QuantiFERON®-TB Gold Plus assay in quantifying IFN-γ in QTF-CMV testing, compared to the ELISA-based QuantiFERON®-CMV assay.

Methods

A retrospective study was conducted on 169 stored plasma samples from 85 lung transplant recipients. IFN-γ was quantified using both ELISA (Qiagen®) and CLIA (DiaSorin®). Specific (CMV-NIL) and nonspecific (MIT-NIL) responses were compared using Pearson and Lin's concordance correlation coefficients, Bland–Altman analysis, and ROC curves. Diagnostic agreement was assessed using the Kappa index, sensitivity, specificity, and agreement rates.

Results

CLIA yielded significantly higher IFN-γ values than ELISA for CMV-NIL (+0.41 IU/mL) and MIT-NIL (+0.33 IU/mL). Strong correlation and concordance were observed (r and ρc >0.93). Diagnostic agreement reached 95.86% (Kappa = 0.913), with fewer indeterminate results in CLIA (3.55% vs 4.73%). The optimal CLIA cut-off was 0.2754 IU/mL, achieving 100% sensitivity and specificity compared to ELISA.

Conclusions

CLIA shows excellent agreement with ELISA in QTF-CMV testing and is a reliable and automatable alternative. Its implementation may improve laboratory workflows. Adjusting the cut-off is recommended for optimal diagnostic accuracy.
巨细胞病毒(CMV)仍然是实体器官移植受者中一种重要的感染性并发症。通过干扰素γ (IFN-γ)释放试验评估细胞免疫,如QuantiFERON®-CMV (QTF-CMV),有助于指导预防和治疗决策。虽然ELISA是QTF-CMV的有效方法,但化学发光免疫分析法(CLIA)可能具有技术优势。本研究旨在评估基于clia的LIAISON®QuantiFERON®-TB Gold Plus法在QTF-CMV检测中定量IFN-γ的性能,并与基于elisa的QuantiFERON®-CMV法进行比较。方法对85例肺移植受者的169份血浆样本进行回顾性分析。采用ELISA (Qiagen®)和CLIA (DiaSorin®)对IFN-γ进行定量。特异性(CMV-NIL)和非特异性(MIT-NIL)反应采用Pearson和Lin’s一致性相关系数、Bland-Altman分析和ROC曲线进行比较。使用Kappa指数、敏感性、特异性和符合率评估诊断一致性。结果sclia检测CMV-NIL (+0.41 IU/mL)和MIT-NIL (+0.33 IU/mL)的IFN-γ值显著高于ELISA。相关性和一致性较强(r和ρc >;0.93)。诊断一致性达到95.86% (Kappa = 0.913), CLIA的不确定结果较少(3.55% vs 4.73%)。CLIA最佳临界值为0.2754 IU/mL,与ELISA相比,灵敏度和特异性均达到100%。结论sclia与ELISA在QTF-CMV检测中具有良好的一致性,是一种可靠、可自动化的替代方法。它的实施可以改善实验室的工作流程。建议调整截止值以获得最佳诊断准确性。
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引用次数: 0
Invasive pneumococcal disease before, during and after the SARS-CoV-2 pandemic 在SARS-CoV-2大流行之前、期间和之后的侵袭性肺炎球菌疾病。
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503033
Irati Arregui García , Iñaki Beguiristain , Miguel Fernández-Huerta , Jesús Castilla , María Eugenia Portillo Bordonabe

Background

The aim of this study was to analyse the changes in the incidence of invasive pneumococcal disease (IPD) before, during, and after the SARS-CoV-2 pandemic.

Methods

Cases of IPD detected through active epidemiological surveillance in Navarre, Spain, from 2018 to 2024 were analysed. Incidence rates were compared across three periods: pre-pandemic (2018–2019), pandemic (2020–2022), and post-pandemic (2023–2024) overall and by age groups and serotypes

Results

From 2018 to 2024, a total of 437 IPD cases were diagnosed in Navarre. The incidence of IPD decreased from 11.6 to 5.6 cases per 100,000 persons during the pandemic period and return to 13.0 cases per 100,000 persons in the post-pandemic period. The incidence decreased across all age groups in both, serotypes included and not included in the 13-valent pneumococcal conjugate vaccine (PCV13). Serotype 3 was the most frequent in the three periods, representing 20.3% of all cases. In the post-pandemic period, 35.2% of cases were due to serotypes included in the PCV-13, 45.7% in the PCV-15 and 64.2% in the PCV-20.

Conclusions

During the SARS-CoV-2 pandemic, the incidence of IPD decreased across all age groups for both, PCV13-included and not included serotypes. In the post-pandemic period, incidence returned to pre-pandemic levels. Whole-genome sequencing techniques helped to serotyping of S. pneumoniae, and thus, complemented epidemiological surveillance.
背景:本研究的目的是分析在SARS-CoV-2大流行之前、期间和之后侵袭性肺炎球菌病(IPD)发病率的变化。方法:对2018 - 2024年西班牙纳瓦拉地区通过主动流行病学监测发现的IPD病例进行分析。研究人员比较了三个时期的发病率:大流行前(2018-2019)、大流行前(2020-2022)和大流行后(2023-2024),并按年龄组和血清型进行了比较。结果:2018年至2024年,纳瓦拉共诊断出437例IPD病例。在大流行期间,IPD的发病率从每10万人11.6例下降到5.6例,在大流行后时期又回到每10万人13.0例。在13价肺炎球菌结合疫苗(PCV13)接种和未接种的两种血清型中,所有年龄组的发病率均有所下降。血清3型在这三个时期最为常见,占所有病例的20.3%。在大流行后时期,35.2%的病例是由于PCV-13、PCV-15和PCV-20中包含的血清型,分别为45.7%和64.2%。结论:在SARS-CoV-2大流行期间,包括pcv13和未包括pcv13的血清型在内的所有年龄组IPD发病率均有所下降。在大流行后时期,发病率恢复到大流行前的水平。全基因组测序技术有助于肺炎链球菌的血清分型,从而补充了流行病学监测。
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引用次数: 0
Dengue warning signs persisting post-48 h demand monitoring to avert severe complications 登革热警告信号在48小时后持续存在,需要监测以避免严重并发症
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503049
Verónica Andrade-Amaráz, José Pedro Elizalde-Díaz

Introduction

Dengue virus infection remains a major public health challenge in tropical regions, with heterogeneous progression to severe disease.

Methods

We conducted a prospective longitudinal study of 362 laboratory-confirmed dengue patients, stratified by sex and the presence of warning signs. Serial hematological, hepatic and renal markers were collected over 96 h (at 24 h, 48 h, 72 h, and 96 h after symptom onset) to analyze their dynamic evolution.

Results

Patients with warning signs persisting beyond 48 h exhibited progressive hematological and hepatic deterioration, unlike those without warning signs. This was characterized by progressively declining platelet and neutrophil counts, elevated hematocrit, and rising AST/ALT levels. These worsening trends were more pronounced in women, who also showed a higher prevalence of warning signs (32% vs 25% in men).

Conclusion

The persistence of warning signs beyond 48 h represents a clinically relevant threshold for hematological and hepatic deterioration, supporting the need for protocolized monitoring – including serial platelet counts, hematocrit, and liver enzymes – during this critical window to enable early intervention in high-risk patients.
在热带地区,登革热病毒感染仍然是一项重大的公共卫生挑战,发展为严重疾病的过程不尽相同。方法对362例实验室确诊的登革热患者进行了前瞻性纵向研究,按性别和有无警告信号进行分层。在症状出现后24小时、48小时、72小时和96小时收集血液学、肝脏和肾脏的一系列标志物,分析其动态演变。结果有警告信号持续48 h以上的患者与无警告信号的患者不同,其血液学和肝脏功能均出现进行性恶化。其特征是血小板和中性粒细胞计数逐渐下降,红细胞压积升高,AST/ALT水平升高。这些恶化趋势在女性中更为明显,女性也显示出更高的警告信号(32%对25%)。结论警告信号持续超过48小时代表了血液学和肝脏恶化的临床相关阈值,支持在这一关键窗口期进行协议化监测的必要性,包括系列血小板计数、红细胞压积和肝酶,以便对高危患者进行早期干预。
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引用次数: 0
Reply to “Factors associated with glucocorticoid dosing in treating patients with noncritical COVID-19 pneumonia: Insights from an artificial intelligence-based CT imaging analysis” 回复“糖皮质激素治疗非危重性COVID-19肺炎的相关因素:基于人工智能的CT成像分析”
Pub Date : 2026-01-01 DOI: 10.1016/j.eimce.2025.503046
José Miguel Gómez Verdú , Sergio Alemán Belando
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引用次数: 0
期刊
Enfermedades infecciosas y microbiologia clinica (English ed.)
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