Enfermedades infecciosas y microbiologia clinica (English ed.)最新文献

Introduction: Crimean-Congo haemorrhagic fever (CCHF) is an emerging tick-borne viral disease. It has been described in Spain in both ticks and humans. Until July 2024 most cases have been described in the central-western part of the Iberian Peninsula. This study aims to assess the seroprevalence of antibodies against CCHF virus (CCHFV) in humans in the area that has reported the highest number of cases in Spain.

Methods: The study was conducted to estimate the seroprevalence of antibodies against CCHFV antibodies among patients referred to a hospital located in the central-western area of Spain, an endemic area for CCHFV of Spain. Patients were recruited from April 1, 2023, to June 30, 2023. A commercial ELISA was used to detect serum antibodies against the CCHFV.

Results: We screened 658 samples from 370 (56.2%) men, with a mean (±SD) age of 58.6 years (±14.3). Of these, 4 were IgG positive, representing an IgG seropositivity of 0.6% (95% CI, 0.01-1.19). None of these four patients recalled having a clinical picture that strongly suggested CCHF. Over the study period, in the population analysed in an area with circulation of CCHFV the seroprevalence of antibodies was 0.6%.

Conclusion: Our results suggest active circulation of the virus in humans in western Spain. Although the risk of developing CCHF is currently considered low, physicians should be alert to the imminent possibility of developing new cases of CCHF.

Introduction: The introduction of pneumococcal conjugate vaccine (PCV) into childhood vaccination programmes has reduced the prevalence of vaccine serotypes (VTs) that cause invasive pneumococcal disease (IPD) in children. In the elderly population, an impact has also been seen through indirect protection (herd effect). The aim of this study was to estimate the changes in serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae isolates recovered from adult IPD and to evaluate the indirect effect of immunization with PCV10 based on laboratory records by analyzing the period from 2005 to 2019 for six years before and eight years after the universal PCV10 administration to Colombian children.

Methods: A total of 2204 S. pneumoniae isolates from adults (≥50 years) with IPD were analyzed. The analysis examined the percentage changes in proportions (prevalence) and percentage variations in population rates (annual reported rates - ARR) of VTs between the pre-PCV10 (2005-2009) and post-PCV10 (2015-2019) periods.

Results: The findings were (1) evidence of a significant percentage decrease of pneumococcal VT10 causing IPD in adults (50% pre-PCV10 and 16% post-PCV10); (2) significant increase of serotype 19A (from 1.6% to 14.8%) and less important increase of serotype 3 (from 10.5% to 14.5%) and non-vaccine serotypes (NVT) (from 21.4% to 38.4%) non-significant; and (3) meningitis and non-meningitis multidrug resistant isolates associated with serotype 19A. An improvement in the surveillance system is associated with the immunization of children, as noted by the increased ARRs across the analysis period.

Conclusions: Our results show the indirect impact of PCV10 vaccination in children on the VT10 distribution and antimicrobial resistance of S. pneumoniae causing IPD in Colombian adults over 50 when comparing the pre-PCV10 (2005-2009) and post-PCV10 (2015-2019) periods.

Introduction: The extent to which commercially available nucleic acid extraction platforms impact the magnitude of Cytomegalovirus (CMV) DNA loads measured in plasma specimens by 1st WHO standard-normalized real-time PCR assays is uncertain.

Methods: This retrospective study compares the performance of Abbott m2000sp, Qiagen QIAsymphony SP, and KingFisher Flex platforms using plasma samples from allogeneic hematopoietic stem cell transplant recipients and plasma spiked with the CMV AD169 strain. The Abbott RealTime CMV PCR assay was used for CMV DNA quantitation.

Results: Maximum differences in CMV DNA loads quantified in plasma from 11 allo-HSCT and spiked plasma over a wide range of viral DNA concentrations (2.0-4.0 log₁₀ IU/ml) were ≤0.5 log₁₀ IU/ml.

Conclusions: The CMV DNA extraction efficiency of the platforms evaluated varies. The impact of these variations on CMV DNA loads quantified in plasma may not be clinically relevant.

Introduction: Carbapenemase-producing Enterobacterales (CPE) is a global threat. We evaluate the prevalence of CPE among isolates categorized as meropenem-susceptible, but that meet the European Committee on Antimicrobial Susceptibility Testing (EUCAST) screening cut-off values for carbapenemase detection, and analyze the susceptibility of these isolates to new available drugs.

Methods: We analyzed 257 isolates from patients hospitalized in a tertiary hospital in Brazil, from July 2022 to April 2023. Only isolates that met the screening cut-off values established by EUCAST for detection of carbapenemases were analyzed (i.e. meropenem inhibition zones of 25-27mm by disk diffusion). The detection of carbapenemases was performed by immnunochromatographic testing and confirmed by high-resolution melting-PCR (HRM-qPCR).

Results: We identified 12 (4.7%) CPE including 7 KPC, 4 NDM, and 1 OXA-48-like. The isolates were susceptible to ceftazidime-avibactam (72.7%), meropenem-vaborbactam (100%), imipenem-relebactam (63.6%) and ceftolozane-tazobactam (36.4%).

Conclusion: We highlight the importance of tracking carbapenemases for epidemiological control and therapeutic guidance.

Introduction: The COVID-19 pandemic caused by the SARS-CoV-2 virus greatly affected healthcare workers and healthcare systems. It also challenged schools and universities worldwide negatively affecting in-person education. We conducted this study is to assess the evolution of SARs-CoV-2 virulence over the course of the pandemic.

Methods: A combined cohort of University students in Spain and HCWs from the two hospitals in Spain, and one healthcare system in the Greater Boston area was followed prospectively from March 8th, 2020, to January 31st, 2022 for diagnosis with COVID-19 by PCR testing and related sequelae. Follow-up time was divided into four periods according to distinct waves of infection during the pandemic. Severity of COVID-19 was measured by case-hospitalization rate. Descriptive statistics and multivariable-adjusted statistics using the Poisson mixed-effects regression model were applied. As a sensitivity analysis, information on SARS-CoV-2 RNA in wastewater and COVID-19 deaths through May 30, 2023 from the Boston area was collected.

Results: For the last two periods of the study (January 1st to December 15th, 2021 and December 16th, 2021 to January 31st, 2022) and relative to the first period (March 8th to May 31st, 2020), the incidence rate ratios (IRRs) of hospitalization were 0.08 (95% CI, 0.03-0.17) and 0.03 (95% CI, 0.01-0.15), respectively. In addition, a relative risk 0.012 CI95% (0.012-0.012) was observed when comparing COVID-19 mortality versus SARS-CoV-2 RNA copies/mL in Boston-area wastewater over the period (16th December 2021 to 30th May 2023) and relative to the first period.

Conclusions: The severity of COVID-19 and immunity of our populations evolved over time, resulting in a decrease in case severity. We found the case-hospitalization rate decreased more than 90% in our cohort despite an increase in incidence.

Background: Dermatophytosis caused by Nannizzia gypsea are considered rare. The clinical picture is indistinguishable from that produced by other dermatophytes, but, being this a geophilic fungus, it can cause more inflammatory disease.

Methods: Retrospective study. Patients with positive culture for N. gypsea observed at the Dermatological Institute of Jalisco "Dr. José Barba Rubio", from 2001 to 2023, were included. Frequency, sex, age, evolution, and clinical variant were investigated. We compared the findings between the pediatric versus adult population. Descriptive and inferential statistics were used.

Results: Over 23 years, 155 patients were diagnosed (6.7 cases per year). Female sex predominated (53.5%). The median age was 9 years (minimum 1year and maximum 85 years), the more affected age group was 1-10 years (54.2%). The median time of evolution was 30 days (minimum one day and maximum three years), and 74.8% had an evolution ≤30 days. Tinea capitis predominated in pediatric patients (41.0%, p<0.01) whereas tinea corporis predominated in adults (72.7%, p<0.01). Inflammatory tinea was more prevalent in the pediatric population (21.0% vs. 3.6%, p<0.01).

Conclusion: The ability of Nannizzia gypsea to cause inflammatory tinea was observed primarily in pediatric patients. Since there is no clinical data to suspect this fungus, it will always be necessary to carry out a mycological study to identify the species and to implement the appropriate treatment.