Pub Date : 2024-07-31DOI: 10.1016/j.eimce.2024.07.003
Sergio Ferra Murcia, Ana Belén Lozano Serrano, Marta Segura Díaz, Antonio Ramón Collado Romacho
{"title":"Oral intolerance: new scenario for parenteral antiretroviral therapy.","authors":"Sergio Ferra Murcia, Ana Belén Lozano Serrano, Marta Segura Díaz, Antonio Ramón Collado Romacho","doi":"10.1016/j.eimce.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.07.003","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876875","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 : 2024-06-19DOI: 10.1016/j.eimce.2024.06.002
María Del Mar Rodero Roldán, Valentín Yuste Benavente, Rosa María Martínez Álvarez, Ana Isabel López Calleja, Juan Manuel García Lechuz
Introduction: The management of infections in war wounds is a problem aggravated by the presence of multiresistant bacteria and requires a combined approach with surgery. Literature has identified the risks and patterns of antibiotic resistance in previous armed conflicts, but the Russian-Ukrainian conflict has required the study of specific bacterial resistance patterns.
Methods: We included war-injured patients from the Russian-Ukrainian conflict transferred for treatment to the General Defense Hospital of Zaragoza from May 2022 to October 2023. Epidemiological data, factors related to the injury, presence of infection and microbiological results were collected; These data were subsequently analyzed statistically.
Results: Fifty-three patients were included in the study, with a mean age of 35.6 years; 83% were injured by an explosive mechanism and all received antibiotic therapy prior to transfer. Seventeen patients had skin, soft tissue or joint infection. Correlation was demonstrated with the presence of bone lesion (p 0.03), skin coverage defect (p 0.000) and presence of foreign bodies (p 0.006). Nine patients had monomicrobial cultures, and the most frequently isolated microorganisms were Gram negative bacilli (GNB) and Staphylococcus aureus. Virtually all GNB presented some resistance mechanism.
Conclusion: Our work shows the correlation of war wound infection with the presence of foreign bodies and affected tissues. Likewise, the presence of polymicrobial wounds is emphasized, with a predominance of GNB and multidrug-resistant S. aureus.
{"title":"Characterization of wound infections among patients injured during the Ruso-Ukrainian war in a Role 4 hospital.","authors":"María Del Mar Rodero Roldán, Valentín Yuste Benavente, Rosa María Martínez Álvarez, Ana Isabel López Calleja, Juan Manuel García Lechuz","doi":"10.1016/j.eimce.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>The management of infections in war wounds is a problem aggravated by the presence of multiresistant bacteria and requires a combined approach with surgery. Literature has identified the risks and patterns of antibiotic resistance in previous armed conflicts, but the Russian-Ukrainian conflict has required the study of specific bacterial resistance patterns.</p><p><strong>Methods: </strong>We included war-injured patients from the Russian-Ukrainian conflict transferred for treatment to the General Defense Hospital of Zaragoza from May 2022 to October 2023. Epidemiological data, factors related to the injury, presence of infection and microbiological results were collected; These data were subsequently analyzed statistically.</p><p><strong>Results: </strong>Fifty-three patients were included in the study, with a mean age of 35.6 years; 83% were injured by an explosive mechanism and all received antibiotic therapy prior to transfer. Seventeen patients had skin, soft tissue or joint infection. Correlation was demonstrated with the presence of bone lesion (p 0.03), skin coverage defect (p 0.000) and presence of foreign bodies (p 0.006). Nine patients had monomicrobial cultures, and the most frequently isolated microorganisms were Gram negative bacilli (GNB) and Staphylococcus aureus. Virtually all GNB presented some resistance mechanism.</p><p><strong>Conclusion: </strong>Our work shows the correlation of war wound infection with the presence of foreign bodies and affected tissues. Likewise, the presence of polymicrobial wounds is emphasized, with a predominance of GNB and multidrug-resistant S. aureus.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433529","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}
Introduction: 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":"https://doi.org/10.1016/j.eimce.2024.04.007","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","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}
Pub Date : 2024-06-19DOI: 10.1016/j.eimce.2024.04.010
Carles Rubio Maturana, Marta Guerrero, Maria Casas Claramunt, Susana Nuria Ayala-Cortés, Victoria López, Patricia Martínez-Vallejo, Begoña Treviño, Elena Sulleiro, Juliana Esperalba, Ariadna Rando, Diana Pou, Maria Luisa Aznar, Pau Bosch-Nicolau, Fernando Salvador, Inés Oliveira-Souto, Israel Molina, Núria Serre-Delcor
Introduction: Almost 281 million people were living in a foreign country in 2022, and more than 100 million were displaced because of war conflicts and human right violations. Vaccination coverage of infectious diseases in migrants from some disadvantaged settings could be lower than reception countries populations, consequently seroprevalence studies and better access to vaccination could contribute to reducing these differences.
Methods: A descriptive retrospective cross-sectional study was conducted including migrants, living ≤5 years in the reception country and ≥16 years old, who requested a medical exam between January 1st, 2020 and January 31st, 2021. Seroprevalence assessment was performed, and vaccination was offered to those individuals without immunity to hepatitis B, hepatitis A, varicella, measles, mumps, and rubella.
Results: A total of 315 migrants were attended during the study period. Immunity protection at arrival was 252/296 (85.1%) for measles, 274/295 (92.9%) for rubella, 257/296 (86.8%) for mumps, 264/295 (89.5%) for varicella, 267/313 (85.3%) for hepatitis A, and 104/300 (34.6%) for hepatitis B. The final immunity protection after full vaccination schedules was 278/296 (93.9%) for measles, 287/295 (97.3%) for rubella, 274/296 (92.6%) for mumps, 276/295 (93.6%) for varicella, 280/313 (89.5%) for hepatitis A, and 139/300 (46.3%) for hepatitis B.
Conclusions: The vaccination intervention has increased immunity rates for the studied diseases in the attended migrants in our center, however, such interventions should be maintained to reach local population immunization levels. Moreover, the collaboration between shelter and reference specialized health centers is fundamental to implement such vaccination programs.
{"title":"Seroprevalence status of vaccine-preventable diseases in migrants living in shelter centers in Barcelona, Spain.","authors":"Carles Rubio Maturana, Marta Guerrero, Maria Casas Claramunt, Susana Nuria Ayala-Cortés, Victoria López, Patricia Martínez-Vallejo, Begoña Treviño, Elena Sulleiro, Juliana Esperalba, Ariadna Rando, Diana Pou, Maria Luisa Aznar, Pau Bosch-Nicolau, Fernando Salvador, Inés Oliveira-Souto, Israel Molina, Núria Serre-Delcor","doi":"10.1016/j.eimce.2024.04.010","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.04.010","url":null,"abstract":"<p><strong>Introduction: </strong>Almost 281 million people were living in a foreign country in 2022, and more than 100 million were displaced because of war conflicts and human right violations. Vaccination coverage of infectious diseases in migrants from some disadvantaged settings could be lower than reception countries populations, consequently seroprevalence studies and better access to vaccination could contribute to reducing these differences.</p><p><strong>Methods: </strong>A descriptive retrospective cross-sectional study was conducted including migrants, living ≤5 years in the reception country and ≥16 years old, who requested a medical exam between January 1st, 2020 and January 31st, 2021. Seroprevalence assessment was performed, and vaccination was offered to those individuals without immunity to hepatitis B, hepatitis A, varicella, measles, mumps, and rubella.</p><p><strong>Results: </strong>A total of 315 migrants were attended during the study period. Immunity protection at arrival was 252/296 (85.1%) for measles, 274/295 (92.9%) for rubella, 257/296 (86.8%) for mumps, 264/295 (89.5%) for varicella, 267/313 (85.3%) for hepatitis A, and 104/300 (34.6%) for hepatitis B. The final immunity protection after full vaccination schedules was 278/296 (93.9%) for measles, 287/295 (97.3%) for rubella, 274/296 (92.6%) for mumps, 276/295 (93.6%) for varicella, 280/313 (89.5%) for hepatitis A, and 139/300 (46.3%) for hepatitis B.</p><p><strong>Conclusions: </strong>The vaccination intervention has increased immunity rates for the studied diseases in the attended migrants in our center, however, such interventions should be maintained to reach local population immunization levels. Moreover, the collaboration between shelter and reference specialized health centers is fundamental to implement such vaccination programs.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433560","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 : 2024-06-19DOI: 10.1016/j.eimce.2024.04.012
Eduardo Aparicio-Minguijón, Jorge Boán, Antonio Terrón, Carlos Heredia, Cristina Puente, Asunción Pérez-Jacoiste Asín, M Ángeles Orellana, Laura Domínguez, José Manuel Caro, M Jesús López-Gude, Eva María Aguilar-Blanco, Andrea Eixerés-Esteve, Francisco López-Medrano
Objectives: This study aimed to evaluate the effectiveness of dalbavancin as sequential therapy in patients with infective endocarditis (IE) due to gram positive bacteria (GPB) in a real-life heterogenous cohort with comorbid patients.
Methods: A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate.
Results: The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2-85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4-9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was Staphylococcus aureus (26.3%) followed by Enterococcus faecalis (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20-34) and 14 days (IQR 14-28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with Enterococcus faecalis IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%).
Conclusion: This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.
{"title":"Dalbavancin as sequential therapy in infective endocarditis: Real-life experience in elder and comorbid patients.","authors":"Eduardo Aparicio-Minguijón, Jorge Boán, Antonio Terrón, Carlos Heredia, Cristina Puente, Asunción Pérez-Jacoiste Asín, M Ángeles Orellana, Laura Domínguez, José Manuel Caro, M Jesús López-Gude, Eva María Aguilar-Blanco, Andrea Eixerés-Esteve, Francisco López-Medrano","doi":"10.1016/j.eimce.2024.04.012","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.04.012","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the effectiveness of dalbavancin as sequential therapy in patients with infective endocarditis (IE) due to gram positive bacteria (GPB) in a real-life heterogenous cohort with comorbid patients.</p><p><strong>Methods: </strong>A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate.</p><p><strong>Results: </strong>The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2-85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4-9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was Staphylococcus aureus (26.3%) followed by Enterococcus faecalis (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20-34) and 14 days (IQR 14-28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with Enterococcus faecalis IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%).</p><p><strong>Conclusion: </strong>This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433530","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 : 2024-06-18DOI: 10.1016/j.eimce.2024.06.001
Nuria Fernández Piñeiro, Oskar Ayerdi Aguirrebengoa, Eva Orviz García, Cristina González Pérez, Mar Vera García, Teresa Puerta López, Carmen Rodríguez Martín, Clara Lejarraga Cañas, Jorge Perez García, Begoña Baza Caraciolo, Monserrat González Polo, Florentina Alcudia Pérez, Marta Ruiz Fernández, Natividad Jerez Zamora, Diego Morales Irala, Beatriz López Centeno, Daniele Alioto, José Manuel Martínez Sesmero, Vicente Estrada Pérez, María Teresa Benítez Gimenez, Jorge Del Romero Guerrero
Introduction: Pre-exposure prophylaxis (PrEP) against the human immunodeficiency virus (HIV) is an effective and safe preventive measure. However, it has not reached all target users who could benefit from it. The study aimed to understand the sociodemographic, clinical and behavioral baseline characteristics of PrEP users. As a secondary objective, the use of concomitant medication and drug consumption were described.
Methodology: Observational, retrospective and descriptive study of the sociodemographic, clinical and behavioral characteristics of the users who were included in the PrEP program of the Community of Madrid during the first two years of experience.
Results: Two thousand two hundred fifty-six PrEP users were included, 99.0% men, with a mean age of 36.9 years (SD 8.68). 33.1% presented a sexually transmitted infection (STI) on the first visit, highlighting chlamydiasis and rectal gonococci. 70.4% reported using drugs associated with sex, and 42.4% participated in chemsex sessions in the last 3 months. A high percentage of users with concomitant medication was observed (37.6%), highlighting drugs related to mental health and alopecia.
Conclusions: A multidisciplinary approach is required to cover all the needs of PrEP users, including mental health evaluation measures and addiction treatment with the clinical approach.
{"title":"Pre-exposure prophylaxis program in the Community of Madrid: Two years of experience.","authors":"Nuria Fernández Piñeiro, Oskar Ayerdi Aguirrebengoa, Eva Orviz García, Cristina González Pérez, Mar Vera García, Teresa Puerta López, Carmen Rodríguez Martín, Clara Lejarraga Cañas, Jorge Perez García, Begoña Baza Caraciolo, Monserrat González Polo, Florentina Alcudia Pérez, Marta Ruiz Fernández, Natividad Jerez Zamora, Diego Morales Irala, Beatriz López Centeno, Daniele Alioto, José Manuel Martínez Sesmero, Vicente Estrada Pérez, María Teresa Benítez Gimenez, Jorge Del Romero Guerrero","doi":"10.1016/j.eimce.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.06.001","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-exposure prophylaxis (PrEP) against the human immunodeficiency virus (HIV) is an effective and safe preventive measure. However, it has not reached all target users who could benefit from it. The study aimed to understand the sociodemographic, clinical and behavioral baseline characteristics of PrEP users. As a secondary objective, the use of concomitant medication and drug consumption were described.</p><p><strong>Methodology: </strong>Observational, retrospective and descriptive study of the sociodemographic, clinical and behavioral characteristics of the users who were included in the PrEP program of the Community of Madrid during the first two years of experience.</p><p><strong>Results: </strong>Two thousand two hundred fifty-six PrEP users were included, 99.0% men, with a mean age of 36.9 years (SD 8.68). 33.1% presented a sexually transmitted infection (STI) on the first visit, highlighting chlamydiasis and rectal gonococci. 70.4% reported using drugs associated with sex, and 42.4% participated in chemsex sessions in the last 3 months. A high percentage of users with concomitant medication was observed (37.6%), highlighting drugs related to mental health and alopecia.</p><p><strong>Conclusions: </strong>A multidisciplinary approach is required to cover all the needs of PrEP users, including mental health evaluation measures and addiction treatment with the clinical approach.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428480","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 : 2024-06-01DOI: 10.1016/j.eimce.2023.07.001
Albert Bernet Sánchez , Alba Bellés Bellés , Mercè García González , Laura Minguell Domingo , Eduard Solé Mir
Introduction
Respiratory syncytial virus (RSV) is the main cause of severe bronchiolitis, especially in infants. The aim of this study is to assess whether codetection of RSV and other respiratory viruses could affect the severity of this infection comparing with unique RSV detection.
Methods
A prospective study from 2016 to 2019 including children under 2 years who were admitted in the Emergency Service of the Hospital Universitari Arnau de Vilanova de Lleida (Spain) was performed. Nasopharyngeal samples from all patients were sent to the laboratory for RSV real-time PCR detection (GeneXpert®). A multiplex PCR that detects other respiratory viruses was done in all RSV-positive samples. Patients’medical records were checked to collect clinical data (hospital length of stay, BROSJOD score, ICU admission, need for ventilatory support or transfer to a reference hospital). Patients were divided in two groups: infants with unique RSV detection and infants with viral codetection. Bivariant analyses were performed to analyze the data obtained.
Results
During the period of study 437 RSV bronchiolitis were diagnosed. In 199 of them (177/437; 45,5%) another respiratory virus was detected concomitantly. Bivariant analyses do not show statistically significant differences between both groups.
Conclusions
Viral codetection in infants with RSV bronchiolitis is frequent. However, it does not seems to affect the severity of this infection.
{"title":"Clinical relevance of viral codetection in infants with respiratory syncytial virus bronchiolitis","authors":"Albert Bernet Sánchez , Alba Bellés Bellés , Mercè García González , Laura Minguell Domingo , Eduard Solé Mir","doi":"10.1016/j.eimce.2023.07.001","DOIUrl":"10.1016/j.eimce.2023.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Respiratory syncytial virus<span> (RSV) is the main cause of severe bronchiolitis<span>, especially in infants. The aim of this study is to assess whether codetection of RSV and other respiratory viruses could affect the severity of this infection comparing with unique RSV detection.</span></span></p></div><div><h3>Methods</h3><p>A prospective study from 2016 to 2019 including children under 2 years who were admitted in the Emergency Service of the Hospital Universitari Arnau de Vilanova de Lleida (Spain) was performed. Nasopharyngeal samples from all patients were sent to the laboratory for RSV real-time PCR detection (GeneXpert®). A multiplex PCR that detects other respiratory viruses was done in all RSV-positive samples. Patients’medical records were checked to collect clinical data (hospital length of stay, BROSJOD score, ICU admission, need for ventilatory support or transfer to a reference hospital). Patients were divided in two groups: infants with unique RSV detection and infants with viral codetection. Bivariant analyses were performed to analyze the data obtained.</p></div><div><h3>Results</h3><p>During the period of study 437 RSV bronchiolitis were diagnosed. In 199 of them (177/437; 45,5%) another respiratory virus was detected concomitantly. Bivariant analyses do not show statistically significant differences between both groups.</p></div><div><h3>Conclusions</h3><p>Viral codetection in infants with RSV bronchiolitis is frequent. However, it does not seems to affect the severity of this infection.</p></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195333","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 : 2024-06-01DOI: 10.1016/j.eimce.2023.04.020
Enrique Contreras-Macías , María de las Aguas Robustillo-Cortés , Ramón Morillo-Verdugo
Objectives
The patient living with HIV (PLWH) profile has changed and with it, the importance of patient-oriented pharmaceutical care (PC) has been highlighted, for which the stratification tool of the Capacity-Motivation-Opportunity (CMO) PC model helps us which adapts to the needs of each patient. To assess the true relevance, our main objective is to evaluate the differences of one-year mortality among PLWH stratified according to this model.
Methods
A single-center observational analytical survival research study including adult PLWH on antiretroviral therapy (ART) from January-2021 to January-2022 treated at hospital pharmacy outpatient service according to CMO pharmaceutical care model.
Results
A total of 428 patients were included, a median age of 51 years (interquartile range 42–57 year). Overall, the number of patients stratified according to the CMO PC model was 86.2% at level 3, 9.8% at level 2, and 4.0% at level 1. Cox proportional hazard model that included the stratification level was associated with a higher mortality, whose level 1 patients had a 99.7% higher mortality (Hazard ratio = 0.0003; 95%CI: 0.001–0.027).
Conclusions
To sum up, mortality of-one year differs when comparing the PC strata of level 1 and non-level 1, although being similar in age and other clinical conditions. This result suggests that the multidimensional stratification tool, included in the CMO PC model, could be used to modulate the patients intensity follow-up and design interventions more tailored to their needs.
目的艾滋病病毒感染者(PLWH)的情况发生了变化,以患者为导向的药物治疗(PC)的重要性也随之凸显,能力-动机-机会(CMO)PC 模型的分层工具可以帮助我们适应每位患者的需求。为了评估其真正的相关性,我们的主要目标是评估根据该模型进行分层的 PLWH 一年死亡率的差异。结果 共纳入 428 名患者,中位年龄为 51 岁(四分位距为 42-57 岁)。总体而言,根据 CMO PC 模型进行分层的患者中,86.2% 的患者处于 3 级,9.8% 的患者处于 2 级,4.0% 的患者处于 1 级。结论综上所述,尽管年龄和其他临床条件相似,但将 PC 分层 1 级和非 PC 分层 1 级的患者进行比较,其一年的死亡率是不同的。这一结果表明,CMO PC 模型中包含的多维分层工具可用于调整患者的随访强度,并设计出更符合患者需求的干预措施。
{"title":"Correlates of one-year mortality among patients living with HIV according to the stratification level of the pharmaceutical care model","authors":"Enrique Contreras-Macías , María de las Aguas Robustillo-Cortés , Ramón Morillo-Verdugo","doi":"10.1016/j.eimce.2023.04.020","DOIUrl":"10.1016/j.eimce.2023.04.020","url":null,"abstract":"<div><h3>Objectives</h3><p>The patient living with HIV (PLWH) profile has changed and with it, the importance of patient-oriented pharmaceutical care (PC) has been highlighted, for which the stratification tool of the Capacity-Motivation-Opportunity (CMO) PC model helps us which adapts to the needs of each patient. To assess the true relevance, our main objective is to evaluate the differences of one-year mortality among PLWH stratified according to this model.</p></div><div><h3>Methods</h3><p>A single-center observational analytical survival research study including adult PLWH on antiretroviral therapy<span> (ART) from January-2021 to January-2022 treated at hospital pharmacy outpatient service according to CMO pharmaceutical care model.</span></p></div><div><h3>Results</h3><p><span>A total of 428 patients were included, a median age of 51 years (interquartile range 42–57 year). Overall, the number of patients stratified according to the CMO PC model was 86.2% at level 3, 9.8% at level 2, and 4.0% at level 1. Cox proportional hazard model that included the stratification level was associated with a higher mortality, whose level 1 patients had a 99.7% higher mortality (Hazard ratio</span> <!-->=<!--> <!-->0.0003; 95%CI: 0.001–0.027).</p></div><div><h3>Conclusions</h3><p>To sum up, mortality of-one year differs when comparing the PC strata of level 1 and non-level 1, although being similar in age and other clinical conditions. This result suggests that the multidimensional stratification tool, included in the CMO PC model, could be used to modulate the patients intensity follow-up and design interventions more tailored to their needs.</p></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099567","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 : 2024-06-01DOI: 10.1016/j.eimce.2024.04.004
Eloy Sempere Moreno, Santos Ibáñez Barceló, Marta Montero Alonso
{"title":"Laboral cranio-facial cellulitis with perichondritis and external otitis, a case report","authors":"Eloy Sempere Moreno, Santos Ibáñez Barceló, Marta Montero Alonso","doi":"10.1016/j.eimce.2024.04.004","DOIUrl":"10.1016/j.eimce.2024.04.004","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868305","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}