TB is one of the most deathly infections worldwide, affecting disproportionally people living with HIV (PLHIV). Furthermore, HIV co-infection is related to worse outcomes for TB patients, including lower treatment success.
Methods
Using surveillance records of all TB cases notified in Barcelona city from 2001 to 2021, we analyzed TB treatment success according to HIV status. Additionally, we explored potential social and health related and factors associated to unsuccessful treatment in PLHIV, using multiple regression analyses.
Results
Out of the 8406 new TB cases diagnosed during the study period, 9% were co-infected with HIV. According to our regression models, PLHIV were more frequently men, users of injected drugs (aOR = 45.81; 95% CI (33.10–64.26)), had previously been treated for TB (aOR = 1.77; 95% CI (1.30–2.40)) and had a lower rate of contact tracing (aOR = 0.51; 95% CI (0.40–0.64)). Among PLHIV, unsuccessful treatment was related to the use of injected drugs and homelessness, but it was lower for those who had undergone contact tracing.
Conclusion
PLHIV have higher odds of unsuccessful TB treatment, especially those who are homeless and use injected drugs. Contact tracing improved treatment success, calling for further efforts and resources to correctly follow-up on these patients, with the goal of increasing treatment success.
{"title":"Unsuccessful tuberculosis-treatment in HIV-positive patients and associated factors","authors":"Guillermo Bosch , Joan-Pau Millet , Àngels Orcau , Isabel Moreira , Carles Pericas , Lluïsa Forns , Isabel Marcos , Raquel Prieto , Anna Hernandez , Lídia Arranz , Cristina Rius","doi":"10.1016/j.eimce.2025.06.013","DOIUrl":"10.1016/j.eimce.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>TB is one of the most deathly infections worldwide, affecting disproportionally people living with HIV (PLHIV). Furthermore, HIV co-infection is related to worse outcomes for TB patients, including lower treatment success.</div></div><div><h3>Methods</h3><div>Using surveillance records of all TB cases notified in Barcelona city from 2001 to 2021, we analyzed TB treatment success according to HIV status. Additionally, we explored potential social and health related and factors associated to unsuccessful treatment in PLHIV, using multiple regression analyses.</div></div><div><h3>Results</h3><div>Out of the 8406 new TB cases diagnosed during the study period, 9% were co-infected with HIV. According to our regression models, PLHIV were more frequently men, users of injected drugs (aOR<!--> <!-->=<!--> <!-->45.81; 95% CI (33.10–64.26)), had previously been treated for TB (aOR<!--> <!-->=<!--> <!-->1.77; 95% CI (1.30–2.40)) and had a lower rate of contact tracing (aOR<!--> <!-->=<!--> <!-->0.51; 95% CI (0.40–0.64)). Among PLHIV, unsuccessful treatment was related to the use of injected drugs and homelessness, but it was lower for those who had undergone contact tracing.</div></div><div><h3>Conclusion</h3><div>PLHIV have higher odds of unsuccessful TB treatment, especially those who are homeless and use injected drugs. Contact tracing improved treatment success, calling for further efforts and resources to correctly follow-up on these patients, with the goal of increasing treatment success.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 666-673"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645988","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}
{"title":"Transforming long-term care for people with HIV: Movimiento AHORA","authors":"Maria Velasco , Matilde Sanchez-Conde , Julián Olalla , Eugenia Negredo","doi":"10.1016/j.eimce.2025.04.006","DOIUrl":"10.1016/j.eimce.2025.04.006","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 632-635"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646004","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}
Nocardia species are opportunistic pathogens with intrinsic antimicrobial resistance and regional variability in susceptibility patterns. Argentina lacks standardized surveillance data, complicating empirical therapy. This study aimed to characterize Nocardia species distribution and antimicrobial resistance profiles nationwide.
Methods
We analyzed 62 clinical Nocardia isolates from 41 laboratories across eight Argentine provinces (2020–2022). Species identification utilized MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed via broth microdilution for 11 antibiotics according to CLSI guidelines, with additional E-test comparisons.
Results
Respiratory specimens predominated (67.7%), followed by central nervous system (14.5%), skin/soft tissue (8.1%), and bloodstream (6.5%) infections. Primary species identified were N. cyriacigeorgica (30.6%), N. abscessus complex (22.6%), and N. farcinica complex (17.7%). Highest susceptibility rates occurred with linezolid (100%) and trimethoprim–sulfamethoxazole (97.6%). Significant resistance was observed for clarithromycin (81.0%), ciprofloxacin (76.2%), and moxifloxacin (57.1%). N. farcinica dominated CNS infections (55.6%), while N. brasiliensis complex prevailed in skin/soft tissue cases (80%). Methodological discrepancies between testing methods showed 33.3% major errors for ceftriaxone (E-test vs. microdilution).
Conclusion
This first Argentine nationwide surveillance study confirms trimethoprim–sulfamethoxazole and linezolid as reliable empiric therapy options while highlighting concerning resistance to fluoroquinolones and macrolides. The observed methodological discordance emphasizes the critical need for standardized antimicrobial susceptibility testing protocols for Nocardia species.
{"title":"Antimicrobial resistance patterns of Nocardia species in clinical isolates from Argentina (2020–2022)","authors":"Mónica Prieto, María Florencia Rocca, Rita Armitano, Ariel Gianecini, Lucía Cipolla","doi":"10.1016/j.eimce.2025.07.003","DOIUrl":"10.1016/j.eimce.2025.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Nocardia</em> species are opportunistic pathogens with intrinsic antimicrobial resistance and regional variability in susceptibility patterns. Argentina lacks standardized surveillance data, complicating empirical therapy. This study aimed to characterize <em>Nocardia</em> species distribution and antimicrobial resistance profiles nationwide.</div></div><div><h3>Methods</h3><div>We analyzed 62 clinical <em>Nocardia</em> isolates from 41 laboratories across eight Argentine provinces (2020–2022). Species identification utilized MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed via broth microdilution for 11 antibiotics according to CLSI guidelines, with additional E-test comparisons.</div></div><div><h3>Results</h3><div>Respiratory specimens predominated (67.7%), followed by central nervous system (14.5%), skin/soft tissue (8.1%), and bloodstream (6.5%) infections. Primary species identified were <em>N. cyriacigeorgica</em> (30.6%), <em>N. abscessus</em> complex (22.6%), and <em>N. farcinica</em> complex (17.7%). Highest susceptibility rates occurred with linezolid (100%) and trimethoprim–sulfamethoxazole (97.6%). Significant resistance was observed for clarithromycin (81.0%), ciprofloxacin (76.2%), and moxifloxacin (57.1%). <em>N. farcinica</em> dominated CNS infections (55.6%), while <em>N. brasiliensis</em> complex prevailed in skin/soft tissue cases (80%). Methodological discrepancies between testing methods showed 33.3% major errors for ceftriaxone (E-test vs. microdilution).</div></div><div><h3>Conclusion</h3><div>This first Argentine nationwide surveillance study confirms trimethoprim–sulfamethoxazole and linezolid as reliable empiric therapy options while highlighting concerning resistance to fluoroquinolones and macrolides. The observed methodological discordance emphasizes the critical need for standardized antimicrobial susceptibility testing protocols for <em>Nocardia</em> species.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 659-665"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645987","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 : 2025-12-01DOI: 10.1016/j.eimce.2025.07.006
Min Guo , Chaoyang Chen , Wenling Wang , Cairong Zhang , Jie Ma , Maidinamu Sadike , Mayinuer Niyazi , Xiaoli Feng , Kaichun Zhu
Objective
To investigate the changes in vaginal microbiota under different HPV infection statuses and explore the correlation between vaginal microbiota alterations and HPV infection.
Methods
151 cervical samples from gynecological outpatients were grouped into HPV-negative (HN, N = 51), transient infection (HTI, N = 42), and persistent infection (HPI, N = 58). Vaginal secretions were collected to assess microecology (pH, vaginal cleanliness, hydrogen peroxide, leukocyte esterase) via genital secretion analyzer. 16S ribosomal RNA (rRNA) sequencing analyzed vaginal microbiota characteristics, community state types (CST), richness, diversity, and biomarkers.
Results
16S rRNA sequencing identified 5 CST II, 52 CST III, and 94 mixed CST IV samples, showing diverse microbiota. Compared with HN, HTI and HPI had lower vaginal cleanliness, higher sialidase activity, elevated pH, and fewer Lactobacilli (P < 0.05). Lactobacillus iners dominated all groups, while Sneathia amnii was significantly higher in HPI (P < 0.05). HPV infection increased vaginal microbiota richness (HPI > HTI/HN, P < 0.05), with distinct group compositions (P < 0.05). Linear Discriminant Analysis Effect Size identified Lactobacillus gasseri, Atopobium vaginae, and Lactobacillus jensenii as biomarkers.
Conclusion
This study found significant differences in microbial community characteristics under different HPV infection statuses. The identification of biomarkers in vaginal microbiota under different infection statuses could provide new targets for clinical screening and prevention of cervical cancer.
目的观察不同HPV感染状态下阴道菌群的变化，探讨阴道菌群变化与HPV感染的相关性。方法将151例妇科门诊患者宫颈标本分为hpv阴性（HN, N = 51）、短暂性感染（HTI, N = 42）和持续性感染（HPI, N = 58）。收集阴道分泌物，通过阴道分泌物分析仪评估微生态（pH、阴道清洁度、过氧化氢、白细胞酯酶）。16S核糖体RNA （rRNA）测序分析阴道微生物群特征、群落状态类型（CST）、丰富度、多样性和生物标志物。结果16s rRNA测序鉴定出5份CST II、52份CST III和94份混合CST IV样品，显示出不同的微生物群。与HN相比，HTI和HPI阴道清洁度较低，唾液酸酶活性较高，pH升高，乳酸菌较少（P < 0.05）。各组均以嗜乳杆菌为主，羊水Sneathia HPI显著高于对照组（P < 0.05）。HPV感染增加了阴道菌群丰富度（HPI > HTI/HN, P < 0.05），但组间组成差异显著（P < 0.05）。线性判别分析效应大小鉴定出气体乳杆菌、阴道托泊菌和延seni乳杆菌作为生物标志物。结论不同HPV感染状态下微生物群落特征存在显著差异。不同感染状态下阴道菌群生物标志物的鉴定可为宫颈癌的临床筛查和预防提供新的靶点。
{"title":"Research on the relationship between HPV infection and alterations in vaginal microbial ecology","authors":"Min Guo , Chaoyang Chen , Wenling Wang , Cairong Zhang , Jie Ma , Maidinamu Sadike , Mayinuer Niyazi , Xiaoli Feng , Kaichun Zhu","doi":"10.1016/j.eimce.2025.07.006","DOIUrl":"10.1016/j.eimce.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the changes in vaginal microbiota under different HPV infection statuses and explore the correlation between vaginal microbiota alterations and HPV infection.</div></div><div><h3>Methods</h3><div>151 cervical samples from gynecological outpatients were grouped into HPV-negative (HN, <em>N</em> <!-->=<!--> <!-->51), transient infection (HTI, <em>N</em> <!-->=<!--> <!-->42), and persistent infection (HPI, <em>N</em> <!-->=<!--> <!-->58). Vaginal secretions were collected to assess microecology (pH, vaginal cleanliness, hydrogen peroxide, leukocyte esterase) via genital secretion analyzer. 16S ribosomal RNA (rRNA) sequencing analyzed vaginal microbiota characteristics, community state types (CST), richness, diversity, and biomarkers.</div></div><div><h3>Results</h3><div>16S rRNA sequencing identified 5 CST II, 52 CST III, and 94 mixed CST IV samples, showing diverse microbiota. Compared with HN, HTI and HPI had lower vaginal cleanliness, higher sialidase activity, elevated pH, and fewer <em>Lactobacilli</em> (<em>P</em> <!--><<!--> <!-->0.05). <em>Lactobacillus iners</em> dominated all groups, while <em>Sneathia amnii</em> was significantly higher in HPI (<em>P</em> <!--><<!--> <!-->0.05). HPV infection increased vaginal microbiota richness (HPI<!--> <!-->><!--> <!-->HTI/HN, <em>P</em> <!--><<!--> <!-->0.05), with distinct group compositions (<em>P</em> <!--><<!--> <!-->0.05). Linear Discriminant Analysis Effect Size identified <em>Lactobacillus gasseri</em>, <em>Atopobium vaginae</em>, and <em>Lactobacillus jensenii</em> as biomarkers.</div></div><div><h3>Conclusion</h3><div>This study found significant differences in microbial community characteristics under different HPV infection statuses. The identification of biomarkers in vaginal microbiota under different infection statuses could provide new targets for clinical screening and prevention of cervical cancer.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 688-697"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645991","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 : 2025-12-01DOI: 10.1016/j.eimce.2025.08.001
Francisco Carmona-Torre, Maialen Ibarguren Pinilla, Miguel Ángel Goenaga
{"title":"Acute Q fever in Spain: Aligning diagnosis and one health surveillance","authors":"Francisco Carmona-Torre, Maialen Ibarguren Pinilla, Miguel Ángel Goenaga","doi":"10.1016/j.eimce.2025.08.001","DOIUrl":"10.1016/j.eimce.2025.08.001","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 629-631"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645955","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 : 2025-12-01DOI: 10.1016/j.eimce.2025.09.012
Iker Alonso-González , Maider Zuriarrain-Alonso , Koldo López-Guridi , Paula Lara-Esbrí , Rita Sainz de Rozas , Itxasne Lekue , José Luis Barrios-Andrés
Introduction
With the aim of reducing the number of Post-Treatment Control Urine Cultures (UC) from Health Centers in our healthcare area, we conducted an Antimicrobial Stewardship Program (ASP) intervention throughout 2022. To do this, we set out to introduce effective methods to quantify, analyze, and subsequently try to reduce the number of inappropiate UC.
Methods
We conducted a prospective and non-restrictive quasi-experimental intervention study with historical and parallel control group to evaluate the impact of the intervention. The UC evaluation was performed by analyzing all the medical records of repeated UC in a period of less than 31 days. UC were classified as: appropriate, inappropriate and doubtful. The study was conducted in 3 phases: phase 1) measurement of the baseline situation; phase 2) intervention in intervention group: simple educational presentations and implementation of a non-restrictive computerized rule, and phase 3) analysis of results in both groups and periods.
Results
Looking at the %AUC, we observed that in the control group there was hardly any variation while in the intervention group (IG) these increased by 152.4 (p < 0.001). In addition, in the IG there was a decrease in total UCs of 55.4% (n = 418), representing an estimated savings of €7524. The acceptance of the CR in the IG was 9.6%.
Conclusions
This ASP intervention is useful in decreasing the number of IUCs, especially the educational presentations. Achieving this can reduce direct and indirect patient harm and healthcare overload, in addition to improving the management of healthcare resources.
{"title":"Impact of an ASP intervention on the request for post-treatment control urine cultures in primary care","authors":"Iker Alonso-González , Maider Zuriarrain-Alonso , Koldo López-Guridi , Paula Lara-Esbrí , Rita Sainz de Rozas , Itxasne Lekue , José Luis Barrios-Andrés","doi":"10.1016/j.eimce.2025.09.012","DOIUrl":"10.1016/j.eimce.2025.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>With the aim of reducing the number of Post-Treatment Control Urine Cultures (UC) from Health Centers in our healthcare area, we conducted an Antimicrobial Stewardship Program (ASP) intervention throughout 2022. To do this, we set out to introduce effective methods to quantify, analyze, and subsequently try to reduce the number of inappropiate UC.</div></div><div><h3>Methods</h3><div>We conducted a prospective and non-restrictive quasi-experimental intervention study with historical and parallel control group to evaluate the impact of the intervention. The UC evaluation was performed by analyzing all the medical records of repeated UC in a period of less than 31 days. UC were classified as: appropriate, inappropriate and doubtful. The study was conducted in 3 phases: phase 1) measurement of the baseline situation; phase 2) intervention in intervention group: simple educational presentations and implementation of a non-restrictive computerized rule, and phase 3) analysis of results in both groups and periods.</div></div><div><h3>Results</h3><div>Looking at the %AUC, we observed that in the control group there was hardly any variation while in the intervention group (IG) these increased by 152.4 (p < 0.001). In addition, in the IG there was a decrease in total UCs of 55.4% (n = 418), representing an estimated savings of €7524. The acceptance of the CR in the IG was 9.6%.</div></div><div><h3>Conclusions</h3><div>This ASP intervention is useful in decreasing the number of IUCs, especially the educational presentations. Achieving this can reduce direct and indirect patient harm and healthcare overload, in addition to improving the management of healthcare resources.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 652-658"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234495","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 : 2025-12-01DOI: 10.1016/j.eimce.2025.06.017
Sara Vela-Bernal , Carlos Bea-Serrano , Ana Isabel de Gracia-Leon , Andreu Belmonte-Domingo , Carolina Pinto-Pla , Ana Ferrer-Ribera , Andrea de Castro-Oliver , Ignacio Torres , Javier Colomina , María Rosa Oltra-Sempere
Introduction
Rapid pathogen identification is key in the management of bloodstream infections. Antimicrobial stewardship programs (ASPs) have been shown to reduce resistance, adverse effects, and healthcare costs. MALDI-TOF MS enables fast and accurate microbial identification. This study evaluates the impact of its implementation on antibiotic therapy adequacy and mortality in Staphylococcus aureus bacteremia.
Methods
A quasi-experimental pre-post study was conducted at a university hospital, covering two periods: June 2015/April 2017 (pre) and June 2021/April 2023 (post). The impact of MALDI-TOF on antibiotic adequacy and mortality was analyzed.
Results
A total of 176 episodes were included (85 pre, 91 post). No significant epidemiological differences were observed between groups, although higher rates of sepsis and septic shock were noted in the post phase. MALDI-TOF was associated with improved antibiotic adjustment (3.51 vs. 1.75 days; P < .001). A non-significant trend toward lower early mortality was observed in the post-intervention group (P = .06). Mortality was associated with higher comorbidity (Charlson index), sepsis/septic shock, and MRSA bacteremia.
Conclusion
The implementation of MALDI-TOF, in conjunction with a multidisciplinary ASP, enhances early adjustment of empirical antibiotic therapy and may be associated with reduced early mortality in S. aureus bacteremia. Incorporating rapid diagnostics, especially for MRSA detection, is a key strategy to improve clinical outcomes.
快速病原体鉴定是管理血液感染的关键。抗菌药物管理计划（asp）已被证明可以减少耐药性、不良反应和医疗保健费用。MALDI-TOF质谱能够快速准确地进行微生物鉴定。本研究评估其实施对金黄色葡萄球菌菌血症的抗生素治疗充分性和死亡率的影响。方法：在某大学医院进行准实验性的前后研究，研究时间为2015年6月/ 2017年4月（前后）和2021年6月/ 2023年4月（前后）。分析MALDI-TOF对抗生素充分性和死亡率的影响。结果：共纳入176例（术前85例，术后91例）。各组之间没有明显的流行病学差异，尽管在后期发现较高的败血症和感染性休克发生率。MALDI-TOF与改善抗生素调整相关（3.51 vs. 1.75天；P ）结论：MALDI-TOF的实施与多学科ASP结合，增强了经验抗生素治疗的早期调整，并可能与降低金黄色葡萄球菌菌血症的早期死亡率相关。结合快速诊断，特别是MRSA检测，是改善临床结果的关键策略。
{"title":"Impact of MALDI-TOF implementation and antimicrobial stewardship programs on the optimization of antibiotic therapy in Staphylococcus aureus bloodstream infections","authors":"Sara Vela-Bernal , Carlos Bea-Serrano , Ana Isabel de Gracia-Leon , Andreu Belmonte-Domingo , Carolina Pinto-Pla , Ana Ferrer-Ribera , Andrea de Castro-Oliver , Ignacio Torres , Javier Colomina , María Rosa Oltra-Sempere","doi":"10.1016/j.eimce.2025.06.017","DOIUrl":"10.1016/j.eimce.2025.06.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Rapid pathogen identification is key in the management of bloodstream infections. Antimicrobial stewardship programs (ASPs) have been shown to reduce resistance, adverse effects, and healthcare costs. MALDI-TOF MS enables fast and accurate microbial identification. This study evaluates the impact of its implementation on antibiotic therapy adequacy and mortality in <em>Staphylococcus aureus</em> bacteremia.</div></div><div><h3>Methods</h3><div>A quasi-experimental pre-post study was conducted at a university hospital, covering two periods: June 2015/April 2017 (pre) and June 2021/April 2023 (post). The impact of MALDI-TOF on antibiotic adequacy and mortality was analyzed.</div></div><div><h3>Results</h3><div>A total of 176 episodes were included (85 pre, 91 post). No significant epidemiological differences were observed between groups, although higher rates of sepsis and septic shock were noted in the post phase. MALDI-TOF was associated with improved antibiotic adjustment (3.51 vs. 1.75 days; <em>P</em> < .001). A non-significant trend toward lower early mortality was observed in the post-intervention group (<em>P</em> = .06). Mortality was associated with higher comorbidity (Charlson index), sepsis/septic shock, and MRSA bacteremia.</div></div><div><h3>Conclusion</h3><div>The implementation of MALDI-TOF, in conjunction with a multidisciplinary ASP, enhances early adjustment of empirical antibiotic therapy and may be associated with reduced early mortality in <em>S. aureus</em> bacteremia. Incorporating rapid diagnostics, especially for MRSA detection, is a key strategy to improve clinical outcomes.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 10","pages":"Pages 674-681"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294612","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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