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

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Analysis of the serological diagnosis of syphilis: A proposal for improvement

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-02-01 DOI: 10.1016/j.eimce.2024.09.011

Javier Gutiérrez Ballesteros , Sonsoles Garcinuño Pérez , Marta Domínguez-Gil González , Silvia Rojo Rello

引用次数: 0

Hypervirulent Klebsiella pneumoniae: Epidemiology outside Asian countries, antibiotic resistance association, methods of detection and clinical management

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-02-01 DOI: 10.1016/j.eimce.2024.12.008

Silvia García-Cobos , Jesús Oteo-Iglesias , María Pérez-Vázquez

Two main Klebsiella pneumoniae pathotypes are of public health concern, classical K. pneumoniae (cKP), with high antibiotic resistance acquisition capacity, and hypervirulent K. pneumoniae (hvKP). The emergence of hypervirulent and antibiotic-resistant K. pneumoniae, especially carbapenem resistance, is worrisome and require effective methods for detection and treatment. Different evolutionary paths contribute to the emergence of hypervirulence and antibiotic resistance, commonly via the acquisition of resistance plasmids by hvKP (CR-hvKP) or the acquisition of virulence plasmids by CRKp (hv-CRKp). ST11-KL64 together with bla_KPC-2, is the most extended hv-CRKP lineage acquiring virulence plasmids with associated biomarkers, rmpA, rmpa2, iroBCDEN, iucABCDiutA, and peg344. In addition to ST11, other hv-CRKP clones have been reported in Europe such as ST101, ST147 and ST512, highlighting the association of ST147 with OXA-48 and NDM carbapenemases. Although still very rare in Spain, hvKP cases are increasing in recent years, mainly due to ST23-K1, ST380-K2 and ST86-K2. Management of hvKP infections requires active antibiotic therapy based primarily on antibiotic susceptibility patters and site of infection.

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引用次数: 0

Probable breakthrough fungal infection in immunocompromised patient with isolation of an infrequent species 在免疫功能低下患者中分离出罕见菌种的可能突破真菌感染。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.08.003

Rita González-Resina , Laura Eva Franco-Fobe , Concepción López-Gómez , Isabel Izquierdo-García

引用次数: 0

New COVID-19 vaccination recommendations in Spain: Optimizing for next seasons 西班牙新的COVID-19疫苗接种建议：为下一季进行优化

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.08.006

Pilar Arrazola , María Fernández Prada , Ángel Gil , José Gómez Rial , Cristina Hernán , Rosario Menéndez , Antoni Trilla , Raúl Ortiz de Lejarazu

Despite high initial vaccination rates, Spain's current COVID-19 vaccination coverage in recommended groups does not meet WHO targets. For the upcoming season, challenges include revising vaccination age, updating risk groups, and unifying criteria with flu vaccine co-administration. European Commission's advance purchase agreements limit access to certain vaccines, and the need for vaccines effective against current variants adds administrative complexities. Spain's COVID-19 vaccination recommendations should adapt to these specific circumstances. Using vaccines effective against predominant variants with appropriate response duration is crucial to protect at-risk populations. Enhancing training and health education campaigns for health professionals and the general public, alongside utilizing tools to simplify vaccination recommendations, can promote higher vaccination rates in Spain. Addressing these challenges is essential to ensure adequate protection and improve vaccination coverage, ultimately achieving better public health outcomes in the face of evolving COVID-19 threats.

尽管初始疫苗接种率很高，但西班牙目前在推荐人群中的COVID-19疫苗接种覆盖率未达到世卫组织的目标。对于即将到来的季节，挑战包括修改疫苗接种年龄，更新风险群体，以及统一流感疫苗联合接种标准。欧洲委员会的预先购买协议限制了获得某些疫苗的机会，对有效预防当前变种的疫苗的需求增加了管理的复杂性。西班牙的COVID-19疫苗接种建议应适应这些具体情况。使用对主要变异体有效且反应持续时间适当的疫苗对于保护高危人群至关重要。加强对卫生专业人员和公众的培训和卫生教育运动，同时利用工具简化疫苗接种建议，可促进西班牙的疫苗接种率提高。应对这些挑战对于确保充分保护和提高疫苗接种覆盖率至关重要，面对不断变化的COVID-19威胁，最终实现更好的公共卫生成果。

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引用次数: 0

Infant with thick nails 婴儿指甲过厚。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.07.002

Karol Nicole Sabas Ortega, Lydia Corbalán Escortell, Mariano Ara Martín, Javier Sánchez Bernal

引用次数: 0

More threats: The increase in tick-borne diseases and their spectrum 更多威胁：蜱传疾病及其范围的增加。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.10.005

José A. Oteo, Ana M. Palomar

引用次数: 0

A man with recurrent axillary abscess 一名腋窝脓肿反复发作的男子。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.03.006

Gamze Durmaz , Esin Beycan , Abdurrahman Kaya , Ali Mert

引用次数: 0

Are corticosteroids safe in adolescent and adult patients with infectious mononucleosis? A retrospective cohort study 皮质类固醇对青少年和成年传染性单核细胞增多症患者安全吗？一项回顾性队列研究。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2023.10.005

Emilio-Manuel Páez-Guillán, Joaquín Campos-Franco, Rosario Alende, Arturo González-Quintela

Background and aim

The use of systemic corticosteroids during Epstein-Barr virus (EBV)-induced infectious mononucleosis is a controversial but widespread practice. We aimed to investigate the frequency of complications in adolescents and adults with infectious mononucleosis in relation to the use of corticosteroids.

Methods

We reviewed the clinical records of 396 patients admitted to the hospital with infectious mononucleosis (52.0% male; median age, 19 years; range, 15–87 years), with a focus on both short-term (infectious and non-infectious) and long-term (hematological malignancies) complications in relation to corticosteroid use.

Results

A total of 155 (38.6%) patients received corticosteroids at some point during infectious mononucleosis. Corticosteroid use was significantly (P ≤ 0.002) associated with sore throat, lymphadenopathy, leukocytosis, and with antibiotics use (mainly indicated after suspicion of tonsillar bacterial superinfection). Overall, 139/155 (89.7%) patients who were treated with corticosteroids also received antibiotics either before or during hospitalization, compared with 168/241 (69.7%) patients who did not. The frequency of short-term severe complications, either infectious (peritonsillar–parapharyngeal abscess or bacteremia) or non-infectious (splenic rupture, severe thrombocytopenia, myopericarditis, or lymphocytic meningitis) were similar in patients receiving and not receiving corticosteroids. After a median of 15 years of follow-up, only one Hodgkin's lymphoma was diagnosed, in a patient who was not treated with corticosteroids during infectious mononucleosis.

Conclusions

The use of systemic corticosteroids during EBV-induced infectious mononucleosis is generally safe, at least with concomitant antibiotic therapy. However, this should not encourage the use of corticosteroids in this context, given that their efficacy has yet to be demonstrated.

背景和目的：在爱泼斯坦-巴氏病毒（EBV）诱发的传染性单核细胞增多症期间使用全身性皮质类固醇是一种有争议但却很普遍的做法。我们旨在调查青少年和成人传染性单核细胞增多症患者并发症的发生率与使用皮质类固醇激素的关系：我们查阅了 396 名入院的传染性单核细胞增多症患者（52.0% 为男性；中位年龄为 19 岁；年龄范围为 15-87 岁）的临床病历，重点关注与使用皮质类固醇激素相关的短期（感染性和非感染性）和长期（血液恶性肿瘤）并发症：共有155名（38.6%）患者在感染性单核细胞增多症期间的某个阶段使用过皮质类固醇。皮质类固醇的使用与咽喉痛、淋巴结病、白细胞增多以及抗生素的使用（主要是在怀疑扁桃体细菌超级感染后）有显著相关性（P≤0.002）。总体而言，139/155（89.7%）名接受皮质类固醇治疗的患者在住院前或住院期间也接受了抗生素治疗，而 168/241（69.7%）名未接受抗生素治疗的患者接受了皮质类固醇治疗。接受和未接受皮质类固醇治疗的患者发生短期严重并发症的频率相似，无论是感染性并发症（腹腔-咽旁脓肿或菌血症）还是非感染性并发症（脾破裂、严重血小板减少、心肌炎或淋巴细胞性脑膜炎）。经过中位 15 年的随访，只有一名在感染性单核细胞增多症期间未接受皮质类固醇治疗的患者确诊为霍奇金淋巴瘤：结论：在 EB 病毒引起的传染性单核细胞增多症期间使用全身性皮质类固醇激素一般是安全的，至少在同时使用抗生素治疗的情况下是如此。然而，鉴于皮质类固醇的疗效尚未得到证实，因此不应鼓励在这种情况下使用皮质类固醇。

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引用次数: 0

Systemic bartonellosis with hepatosplenic granulomas 伴有肝脾肉芽肿的全身性巴顿氏菌病。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.09.005

Sara Rodríguez-Vega , Julio Noval Menéndez , Elena Criado Hevia , Diana Galiana Martín

引用次数: 0

Screening for Crimean-Congo Haemorrhagic Fever Virus antibodies in humans living in an endemic area of Spain 对居住在西班牙某流行地区的人进行克里米亚-刚果出血热病毒抗体筛查。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-01-01 DOI: 10.1016/j.eimce.2024.09.009

Helena Miriam Lorenzo Juanes , Montserrat Alonso-Sardón , Belen Vicente , Beatriz Rodríguez Alonso , Amparo López-Bernus , Josue Pendones Ulerio , Rufino Alamo Sanz , Antonio Muro , Juan Luis Muñoz Bellido , Moncef Belhassen-García

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.

克里米亚-刚果出血热（CCHF）是一种新出现的蜱传病毒性疾病。在西班牙，蜱虫和人类都发现了这种疾病。直到2024年7月，大多数病例都发生在伊比利亚半岛的中西部地区。本研究旨在评估西班牙报告病例数最多的地区人类抗CCHF病毒（CCHFV）抗体的血清流行率。方法：对西班牙中部-西部地区CCHFV流行区某医院转诊患者血清CCHFV抗体阳性率进行研究。患者于2023年4月1日至2023年6月30日招募。采用商用ELISA检测CCHFV血清抗体。结果：我们从370例（56.2%）男性中筛选了658例样本，平均（±SD）年龄为58.6岁（±14.3）。其中4例IgG阳性，IgG血清阳性为0.6% （95% CI, 0.01-1.19）。这4例患者均没有强烈提示CCHF的临床表现。在研究期间，在CCHFV流行地区分析的人群中，抗体的血清阳性率为0.6%。结论：我们的研究结果提示西班牙西部存在病毒在人体内的活跃传播。虽然目前认为发生CCHF的风险较低，但医生应警惕即将发生新病例的可能性。

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