Pub Date : 2024-12-19DOI: 10.1016/j.eimce.2024.08.003
Rita González-Resina, Laura Eva Franco-Fobe, Concepción López-Gómez, Isabel Izquierdo-García
{"title":"Probable breakthrough fungal infection in immunocompromised patient with isolation of an infrequent species.","authors":"Rita González-Resina, Laura Eva Franco-Fobe, Concepción López-Gómez, Isabel Izquierdo-García","doi":"10.1016/j.eimce.2024.08.003","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.08.003","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873592","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 : 2024-12-18DOI: 10.1016/j.eimce.2024.12.004
Carmen Palacios Clar, Diego García Martínez de Artola, Julia Alcoba Flórez
{"title":"New ST6423 sequence type of hypervirulent Klebsiella pneumoniae carrying carbapenemase OXA-48-like causing bacteraemia in an immunocompromised patient.","authors":"Carmen Palacios Clar, Diego García Martínez de Artola, Julia Alcoba Flórez","doi":"10.1016/j.eimce.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.12.004","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866743","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.07.005
Laura Pastor Gómez , Ana Isabel Aller García , Inmaculada López-Hernández , Lorena López-Cerero
{"title":"First characterization of a Klebsiella pneumoniae clinical isolate producing VEB-1 and OXA-436 in Spain","authors":"Laura Pastor Gómez , Ana Isabel Aller García , Inmaculada López-Hernández , Lorena López-Cerero","doi":"10.1016/j.eimce.2024.07.005","DOIUrl":"10.1016/j.eimce.2024.07.005","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 602-604"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759802","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.03.004
Oskar Ayerdi , Eva Orviz , Adrián Valls Carbó , Nuria Fernández Piñeiro , Mar Vera García , Teresa Puerta López , Juan Ballesteros Martín , Carmen Rodríguez Martín , Begoña Baza Caraciolo , Clara Lejarraga Cañas , Jorge-Alfredo Pérez-García , Dulce Carrió , Mónica García Lotero , María Ferreras Forcada , Montserrat González Polo , Montserrat Raposo Utrilla , Alberto Delgado-Iribarren , Jorge Del Romero-Guerrero , Vicente Estrada Pérez
Introduction
There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up.
Methodology
A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (CI) and incidence rate (IR).
Results
The overall CI by quarterly screening was 8.3 (95% CI: 7.6–9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was Neisseria gonorrhoeae, with a IR of 0.76 (95% CI: 0.68–0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5–0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73–0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32–0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25–0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24–0.42).
Conclusions
The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.
{"title":"Incidence of sexually transmitted infections and screening models among pre-exposure prophylaxis users","authors":"Oskar Ayerdi , Eva Orviz , Adrián Valls Carbó , Nuria Fernández Piñeiro , Mar Vera García , Teresa Puerta López , Juan Ballesteros Martín , Carmen Rodríguez Martín , Begoña Baza Caraciolo , Clara Lejarraga Cañas , Jorge-Alfredo Pérez-García , Dulce Carrió , Mónica García Lotero , María Ferreras Forcada , Montserrat González Polo , Montserrat Raposo Utrilla , Alberto Delgado-Iribarren , Jorge Del Romero-Guerrero , Vicente Estrada Pérez","doi":"10.1016/j.eimce.2024.03.004","DOIUrl":"10.1016/j.eimce.2024.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up.</div></div><div><h3>Methodology</h3><div>A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (<span>C</span>I) and incidence rate (IR).</div></div><div><h3>Results</h3><div>The overall CI by quarterly screening was 8.3 (95% CI: 7.6–9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was <em>Neisseria gonorrhoeae</em>, with a IR of 0.76 (95% CI: 0.68–0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5–0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73–0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32–0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25–0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24–0.42).</div></div><div><h3>Conclusions</h3><div>The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 570-576"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.eimce.2024.05.015
Javier De La Torre Lima, Nicolas Jiménez García
{"title":"COVID-19 and disruptions in HIV care: Assessment and future directions","authors":"Javier De La Torre Lima, Nicolas Jiménez García","doi":"10.1016/j.eimce.2024.05.015","DOIUrl":"10.1016/j.eimce.2024.05.015","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 543-545"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759805","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.01.007
Félix Gutiérrez , Sergio Padilla , Javier García-Abellán , Ana Gutiérrez-Ortiz de la Tabla , Christian Ledesma , Mar Masiá
Objective
To assess the degree of implementation of cancer screening recommendations in people living with HIV (PLHIV) in Spain.
Methods
A self-administered questionnaire was designed on the strategies used for early detection of the main types of cancer in PLHIV. The survey was distributed electronically to HIV physicians participating in the Spanish CoRIS cohort.
Results
106 questionnaires were received from 12 different Spanish Autonomous Communities, with an overall response rate among those who accessed the questionnaire of 60.2%. The majority responded that they followed the CPGs recommendations for the early detection of liver (94.3%), cervical (93.2%) and breast (85.8%) cancers. In colorectal and anal cancer, the proportion was 68.9% and 63.2%, and in prostate and lung cancer of 46.2% and 19.8%, respectively. In hospitals with a greater number of beds, a tendency to perform more cancer screening and greater participation of the Infectious Diseases/HIV Services in the screening programmes was observed. Significant differences were observed in the frequency of colorectal and anal cancer screening among the different Autonomous Communities. The most frequent reasons for not performing screening were the scarcity of material and/or human resources and not being aware of what is recommended in the CPGs.
Conclusions
There are barriers and opportunities to expand cancer screening programmes in PLHIV, especially in colorectal, anal and lung cancers. It is necessary to allocate resources for the early detection of cancer in PLHIV, but also to disseminate CPGs screening recommendations among medical specialists.
{"title":"Cancer screening in people with HIV: Implementation in clinical practice and barriers perceived by medical specialists in Spain","authors":"Félix Gutiérrez , Sergio Padilla , Javier García-Abellán , Ana Gutiérrez-Ortiz de la Tabla , Christian Ledesma , Mar Masiá","doi":"10.1016/j.eimce.2024.01.007","DOIUrl":"10.1016/j.eimce.2024.01.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the degree of implementation of cancer screening recommendations in people living with HIV (PLHIV) in Spain.</div></div><div><h3>Methods</h3><div>A self-administered questionnaire was designed on the strategies used for early detection of the main types of cancer in PLHIV. The survey was distributed electronically to HIV physicians participating in the Spanish CoRIS cohort.</div></div><div><h3>Results</h3><div>106 questionnaires were received from 12 different Spanish Autonomous Communities, with an overall response rate among those who accessed the questionnaire of 60.2%. The majority responded that they followed the CPGs recommendations for the early detection of liver (94.3%), cervical (93.2%) and breast (85.8%) cancers. In colorectal and anal cancer, the proportion was 68.9% and 63.2%, and in prostate and lung cancer of 46.2% and 19.8%, respectively. In hospitals with a greater number of beds, a tendency to perform more cancer screening and greater participation of the Infectious Diseases/HIV Services in the screening programmes was observed. Significant differences were observed in the frequency of colorectal and anal cancer screening among the different Autonomous Communities. The most frequent reasons for not performing screening were the scarcity of material and/or human resources and not being aware of what is recommended in the CPGs.</div></div><div><h3>Conclusions</h3><div>There are barriers and opportunities to expand cancer screening programmes in PLHIV, especially in colorectal, anal and lung cancers. It is necessary to allocate resources for the early detection of cancer in PLHIV, but also to disseminate CPGs screening recommendations among medical specialists.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 563-569"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543751","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}
This study aimed to present real-life data on the use, efficacy, and safety of administering antibiotic therapy through portable elastomeric pumps (pEP) in the outpatient setting.
Methods
This retrospective observational cohort study was conducted from January 2020 to May 2023 in a large academic hospital in Rome, Italy. All patients receiving antibiotic therapy via pEP were included up to a follow-up period of 90 days after the end of antibiotic therapy.
The primary outcome was the treatment response. Secondary endpoints were adverse events attributable to the drug administered, the vascular catheter, or the infection itself.
Results
Of the 490 patients referred to our outpatient parenteral antibiotic therapy (OPAT) unit, 94 (19.2%) received antibiotic therapy via pEP and were included in the final analysis. The most frequently treated infections were those involving bone and prosthetics, including spondylodiscitis (n = 27; 28.8%). Most infections were due to Pseudomonas aeruginosa (n = 55; 48.3%). Cefepime (n = 32; 34.0%), piperacillin/tazobactam (n = 29; 30.9%), ceftolozane/tazobactam (n = 7; 7.5%), and oxacillin (n = 7; 7.5%) were the most frequently administered antibiotics. The infection cure rate reached 88.3% (n = 83). 12 patients (12.8%) reported adverse events, of which half (6.4%) were drug-related and half (6.4%) were line-related.
Conclusions
OPAT through portable elastomeric infusion pumps proved to be safe and effective. It also contributed to the reduction of healthcare costs, fully respecting the principles of personalized medicine. This strategy has emerged as a promising tool for antibiotic stewardship and infection control.
简介：本研究旨在介绍在门诊环境中使用便携式弹性泵（pEP）进行抗生素治疗的实际数据：本研究旨在提供有关在门诊环境中通过便携式弹性泵（pEP）进行抗生素治疗的使用、疗效和安全性的真实数据：这项回顾性观察队列研究于 2020 年 1 月至 2023 年 5 月在意大利罗马的一家大型学术医院进行。研究纳入了所有通过 pEP 接受抗生素治疗的患者，随访期为抗生素治疗结束后 90 天。主要结果是治疗反应。次要终点是因用药、血管导管或感染本身引起的不良事件：在转诊到我们门诊肠外抗生素治疗（OPAT）病房的 490 名患者中，有 94 人（19.2%）通过 pEP 接受了抗生素治疗，并纳入了最终分析。最常治疗的感染是涉及骨骼和假体的感染，包括脊柱盘炎（27 人；28.8%）。大多数感染由铜绿假单胞菌引起（样本数=55；48.3%）。头孢吡肟（32 人；34.0%）、哌拉西林/他唑巴坦（29 人；30.9%）、头孢妥赞/他唑巴坦（7 人；7.5%）和奥沙西林（7 人；7.5%）是最常用的抗生素。感染治愈率达到 88.3%（83 人）。12名患者（12.8%）报告了不良事件，其中一半（6.4%）与药物有关，一半（6.4%）与管路有关：事实证明，通过便携式弹性输液泵进行 OPAT 是安全有效的。结论：事实证明，通过便携式弹性输液泵进行 OPAT 既安全又有效，还有助于降低医疗成本，充分体现了个性化医疗的原则。这一策略已成为抗生素管理和感染控制的一种有前途的工具。
{"title":"Outpatient parenteral antibiotic therapy (OPAT) through elastomeric continuous infusion pumps in a real-life observational study: Characteristics, safety, and efficacy analysis","authors":"Gabriele Giuliano , Domenico Tarantino , Enrica Tamburrini , Mario Cesare Nurchis , Giancarlo Scoppettuolo , Francesca Raffaelli","doi":"10.1016/j.eimce.2024.04.007","DOIUrl":"10.1016/j.eimce.2024.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to present real-life data on the use, efficacy, and safety of administering antibiotic therapy through portable elastomeric pumps (pEP) in the outpatient setting.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study was conducted from January 2020 to May 2023 in a large academic hospital in Rome, Italy. All patients receiving antibiotic therapy via pEP were included up to a follow-up period of 90 days after the end of antibiotic therapy.</div><div>The primary outcome was the treatment response. Secondary endpoints were adverse events attributable to the drug administered, the vascular catheter, or the infection itself.</div></div><div><h3>Results</h3><div>Of the 490 patients referred to our outpatient parenteral antibiotic therapy (OPAT) unit, 94 (19.2%) received antibiotic therapy via pEP and were included in the final analysis. The most frequently treated infections were those involving bone and prosthetics, including spondylodiscitis (<em>n</em> <!-->=<!--> <!-->27; 28.8%). Most infections were due to <span><span>Pseudomonas aeruginosa</span></span> (<em>n</em> <!-->=<!--> <!-->55; 48.3%). Cefepime (<em>n</em> <!-->=<!--> <!-->32; 34.0%), piperacillin/tazobactam (<em>n</em> <!-->=<!--> <!-->29; 30.9%), ceftolozane/tazobactam (<em>n</em> <!-->=<!--> <!-->7; 7.5%), and oxacillin (<em>n</em> <!-->=<!--> <!-->7; 7.5%) were the most frequently administered antibiotics. The infection cure rate reached 88.3% (<em>n</em> <!-->=<!--> <!-->83). 12 patients (12.8%) reported adverse events, of which half (6.4%) were drug-related and half (6.4%) were line-related.</div></div><div><h3>Conclusions</h3><div>OPAT through portable elastomeric infusion pumps proved to be safe and effective. It also contributed to the reduction of healthcare costs, fully respecting the principles of personalized medicine. This strategy has emerged as a promising tool for antibiotic stewardship and infection control.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 581-587"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433558","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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