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

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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 : 2026-02-01 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
Bictegravir/emtricitabine/tenofovir alafenamide: A review of the real-world experience in Spain within the last five years Bictegravir/emtricitabine/替诺福韦alafenamide:回顾过去五年来西班牙的实际经验
Pub Date : 2026-02-01 DOI: 10.1016/j.eimce.2026.503056
Concha Amador , Juan Ambrosioni , Luz Martín-Carbonero , Carmen Hidalgo-Tenorio , Juan Tiraboschi , Santiago Moreno
Integrase strand inhibitor (INSTI)-based antiretroviral regimens are the preferred choices for treating people with human immunodeficiency virus (PWH). The once-daily single-tablet combination of INSTI bictegravir, co-formulated with emtricitabine and tenofovir alafenamide (BIC/FTC/TAF), has shown effectiveness and good tolerability in randomized clinical trials, both in treatment-naïve (TN) and virologically suppressed patients switched to this regimen. Real-world evidence represents clinical practice and may fill data gaps left by pivotal studies. Based on literature search for real-world studies in Spain within five years, and using clinical trial data as a contextual framework, this narrative review synthesizes observational experience with BIC/FTC/TAF, focusing on the interplay between comorbidities, advanced age, and treatment outcomes from underrepresented subgroups in clinical trials. This fixed-dose combination proved effective and well-tolerated for TN and treatment-experienced PWH, with low virological failure even in difficult-to-treat patients. Low rates of treatment discontinuations due to adverse events or drug-drug interactions aligned with clinical trial findings.
基于整合酶链抑制剂(INSTI)的抗逆转录病毒治疗方案是治疗人类免疫缺陷病毒(PWH)患者的首选方案。每日一次的INSTI bictegravir单片剂联合恩曲他滨和替诺福韦alafenamide (BIC/FTC/TAF)在随机临床试验中显示出有效性和良好的耐受性,无论是treatment-naïve (TN)还是改用该方案的病毒学抑制患者。真实世界的证据代表临床实践,可能填补关键研究留下的数据空白。基于对五年内西班牙真实世界研究的文献检索,并以临床试验数据为背景框架,本叙述性综述综合了BIC/FTC/TAF的观察经验,重点关注临床试验中代表性不足亚组的合并症、高龄和治疗结果之间的相互作用。这种固定剂量组合被证明对TN和治疗经验丰富的PWH有效且耐受性良好,即使在难以治疗的患者中也具有低病毒学失败。由于不良事件或药物-药物相互作用导致的低停药率与临床试验结果一致。
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引用次数: 0
Validation of FEN-COVID phenotypes in hospitalised COVID-19 patients across the first four waves of the pandemic 在大流行的前四波中,住院的COVID-19患者的FEN-COVID表型验证
Pub Date : 2026-02-01 DOI: 10.1016/j.eimce.2026.503059
Maria Giulia Caponcello , María Del Rocío Fernández-Ojeda , Natalia Maldonado , Manuel Diéguez-Serrano , Ana Laura Blanco-Taboada , Paula Olivares Navarro , Adriana Rivera-Sequeiros , Rafael Perera , Jose A. Delgado-Torralbo , Luisa González-Iglesias , Miguel A. Rico-Corral , María Dolores Del Toro , Jesús Rodríguez-Baño , Zaira R. Palacios-Baena , Belén Gutiérrez-Gutiérrez

Introduction

The FEN-COVID study identified 3 clinical phenotypes (PhA, PhB and PhC) in hospital-admitted patients with COVID-19, which were associated with mortality. The aim of this study is to validate the assignment to phenotypes and their association with mortality in two hospitals in Spain across the first 4 waves of the pandemic, including the impact of corticosteroids and anticoagulant drugs.

Methods

A prospective cohort study of patients admitted for COVID-19 in the first 4 waves in two hospitals was performed. Phenotypes were assigned using the FEN-COVID calculator. The primary outcome was 30-day all-cause mortality. Kaplan–Meier (KM) curves were compared using the log-rank test. Multivariate analysis was performed using Cox regression analysis to assess the association of phenotypes with mortality.

Results

1839 patients were included. Of these, 257 patients were identified as PhA, 1451 as PhB and 130 as PhC; their 30-day mortality was 1.9%, 15.4% and 45.4%, respectively. In multivariate analysis and controlling for wave effect, belonging to phenotype B and phenotype C was associated with progressive increased hazards of death. In addition, appropriate treatment with corticosteroids was significantly associated with lower mortality in PhB, while low-molecular weight heparin use was significantly associated with lower mortality in PhB and PhC.

Conclusions

Our results confirmed that the clinical phenotypes identified in the FEN-COVID study were predictive of mortality across all waves studied. Furthermore, we confirmed the importance of identifying the phenotype to which a patient belongs on admission when considering appropriate treatment with corticosteroids and/or anticoagulants.
FEN-COVID研究在入院的COVID-19患者中发现了3种与死亡率相关的临床表型(PhA、PhB和PhC)。本研究的目的是验证西班牙两家医院在大流行前4波中的表型分配及其与死亡率的关系,包括皮质类固醇和抗凝药物的影响。方法对两家医院前4波新冠肺炎住院患者进行前瞻性队列研究。使用FEN-COVID计算器分配表型。主要终点为30天全因死亡率。Kaplan-Meier (KM)曲线比较采用log-rank检验。采用Cox回归分析进行多变量分析,以评估表型与死亡率的关系。结果纳入1839例患者。其中PhA 257例,PhB 1451例,PhC 130例;30天死亡率分别为1.9%、15.4%和45.4%。在多变量分析和波浪效应控制中,属于表型B和表型C与死亡风险的进行性增加相关。此外,适当的皮质类固醇治疗与PhB的较低死亡率显著相关,而低分子量肝素的使用与PhB和PhC的较低死亡率显著相关。结论我们的研究结果证实,在FEN-COVID研究中确定的临床表型可预测所有研究波的死亡率。此外,我们证实了在考虑使用皮质类固醇和/或抗凝剂进行适当治疗时,在入院时确定患者所属表型的重要性。
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引用次数: 0
Dengue serotypes and their severity correlation: A hospital-based observational study 登革热血清型及其严重程度相关性:一项基于医院的观察性研究
Pub Date : 2026-02-01 DOI: 10.1016/j.eimce.2026.503074
Anju Dinkar , Jitendra Singh

Introduction

Dengue virus (DENV) infection can present a range of clinical manifestations, from mild fever to severe complications. Emerging data suggest that specific viral serotypes may influence disease severity. This study aimed to evaluate the circulating DENV serotypes and their correlation with clinical outcomes in hospitalized patients.

Methods

A retrospective, cross-sectional study was conducted at a tertiary care center in northern India from August 2022 to January 2023. Laboratory-confirmed dengue cases (N = 356) were included, and serotyping was performed via nested reverse transcription-polymerase chain reaction (nested RT-PCR). Demographic, clinical, and biochemical data were analyzed. Statistical comparisons and relative risk analyses were performed to identify associations between serotypes and disease severity, including mortality predictors.

Results

Out of the 111 dengue cases, 7 had mixed serotypes. Among the remaining 104 patients, DENV-2 was the predominant serotype (71.2%), followed by DENV-3 (26.9%), DENV-1 (1.9%), and mixed serotypes (6.3%) infections. Overall, 71.2% of patients presented with warning signs, and 28.8% progressed to severe dengue. The highest severe dengue cases were observed in DENV-2 (33.8%) and in mixed DENV-2 & 3 infections (100%). DENV-2 was significantly associated with severe manifestations such as plasma leakage (RR = 24.73, p < 0.001), hemorrhagic rash, and elevated transaminases. Mortality (21.6%) occurred exclusively in DENV-2 and mixed DENV-2 and 3 infections. Predictors of mortality included thrombocytopenia, leucopenia, elevated SGPT/SGOT, and hypoalbuminemia.

Conclusion

DENV-2 is the principal serotype associated with severe dengue and adverse outcomes in this region. Early identification of serotype and key laboratory parameters can improve risk stratification and clinical management, with implications for surveillance and public health response.
登革热病毒(DENV)感染可呈现一系列临床表现,从轻度发热到严重并发症。新出现的数据表明,特定的病毒血清型可能影响疾病的严重程度。本研究旨在评估住院患者流行DENV血清型及其与临床结局的相关性。方法回顾性横断面研究于2022年8月至2023年1月在印度北部的一家三级保健中心进行。纳入实验室确诊登革热病例(N = 356),通过巢式逆转录聚合酶链反应(巢式RT-PCR)进行血清分型。分析人口学、临床和生化数据。进行了统计比较和相对风险分析,以确定血清型与疾病严重程度之间的关联,包括死亡率预测因子。结果111例登革热病例中,混合血清型7例。其余104例患者中,以DENV-2型为主(71.2%),其次是DENV-3型(26.9%)、DENV-1型(1.9%)和混合血清型(6.3%)感染。总体而言,71.2%的患者出现警告信号,28.8%的患者进展为严重登革热。重症登革热病例最高的是DENV-2感染(33.8%)和DENV-2和denv - 3混合感染(100%)。DENV-2与血浆漏出(RR = 24.73, p < 0.001)、出疹和转氨酶升高等严重症状显著相关。死亡率(21.6%)仅发生在DENV-2和DENV-2和3混合感染中。死亡率的预测因素包括血小板减少、白细胞减少、SGPT/SGOT升高和低白蛋白血症。结论denv -2是该地区与严重登革热和不良结局相关的主要血清型。早期识别血清型和关键实验室参数可改善风险分层和临床管理,从而对监测和公共卫生应对产生影响。
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引用次数: 0
Two vaccine-associated measles cases: Transmission or coincidental cases? 两例疫苗相关麻疹病例:传播病例还是偶发病例?
Pub Date : 2026-02-01 DOI: 10.1016/j.eimce.2026.503071
Ana Hernandez-Aceituno , Diana Sanabria Curbelo , Isabel Falcón García , Álvaro Torres Lana , Roque Abián Montesdeoca Melián , Eneko Larumbe-Zabala

Introduction

Measles, a highly contagious airborne disease, has seen a resurgence in Spain despite the successful implementation of vaccination programs. This study examines two cases of vaccine-associated measles in children attending the same nursery school, both of whom received the measles–mumps–rubella vaccine.

Methods

Retrospective descriptive study of two children with vaccine-associated measles in May 2025 on the island of Gran Canaria (Spain).

Results

The first case involved a 12-month-old girl who developed symptoms six days post-vaccination, while the second case, a 13-month-old boy, exhibited symptoms eight days after receiving the vaccine. Both cases were confirmed as genotype A, indicating the vaccine strain. The investigation included extensive contact tracing, identifying 107 close contacts, with vaccinations administered to susceptible individuals. Laboratory tests confirmed measles through polymerase chain reaction (PCR) analysis. The findings highlight the rarity of clinically significant vaccine-associated disease and the absence of evidence for human-to-human transmission of the vaccine strain.

Conclusion

This study underscores the importance of genotyping in distinguishing between vaccine-associated rash illness and wild-type measles, as well as the need for continued vigilance in monitoring vaccine efficacy and outbreak responses. Ultimately, while the possibility of transmission cannot be entirely dismissed, the evidence suggests that these cases are more likely coincidental rather than a result of transmission.
麻疹是一种高度传染性的空气传播疾病,尽管成功实施了疫苗接种计划,但在西班牙仍出现了死灰复燃。本研究调查了在同一所幼儿园就读的儿童中发生的两例与疫苗有关的麻疹病例,他们都接种了麻疹-腮腺炎-风疹疫苗。方法回顾性描述性研究2025年5月西班牙大加那利岛(Gran Canaria) 2例疫苗相关麻疹患儿。结果第一例病例涉及一名12个月大的女孩,她在接种疫苗6天后出现症状,而第二例病例是一名13个月大的男孩,在接种疫苗8天后出现症状。这两例均被确认为基因型A,表明疫苗株。调查包括广泛追踪接触者,确定了107名密切接触者,并对易感个体进行了疫苗接种。实验室检测通过聚合酶链反应(PCR)分析证实麻疹。这些发现强调了临床显著的疫苗相关疾病的罕见性,以及缺乏该疫苗毒株在人与人之间传播的证据。结论本研究强调了基因分型在区分疫苗相关性皮疹疾病和野生型麻疹方面的重要性,以及在监测疫苗疗效和疫情应对方面继续保持警惕的必要性。最终,虽然不能完全排除传播的可能性,但证据表明,这些病例更有可能是巧合,而不是传播的结果。
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引用次数: 0
An unexpected opportunistic infection in a patient with diffuse large B-cell lymphoma 弥漫性大b细胞淋巴瘤患者的意外机会性感染
Pub Date : 2026-02-01 DOI: 10.1016/j.eimce.2026.503061
Claudia Beatriz Pérez González , Isabel Fradejas Villajos , Lucía Villalón Blanco , Leonor Moreno Núñez
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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
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
{"title":"An exceptional cause of infective endocarditis: Lactobacillus paracasei","authors":"Antonio Moreno-Flores ,&nbsp;Elena García-Campos Losada ,&nbsp;Francisco José Vasallo-Vidal ,&nbsp;María Teresa Pérez-Rodríguez","doi":"10.1016/j.eimce.2025.503031","DOIUrl":"10.1016/j.eimce.2025.503031","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503031"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957889","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}
引用次数: 0
期刊
Enfermedades infecciosas y microbiologia clinica (English ed.)
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