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

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Knowledge, attitudes and practices in HIV-related chronic inflammation and cardiovascular risk in Spain 西班牙与艾滋病毒相关的慢性炎症和心血管风险方面的知识、态度和做法。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2023.07.009

Background

People with HIV (PWH) in suppressive antiretroviral treatment suffer from chronic inflammation-related comorbidities, mainly cardiovascular diseases. However, given the lack of specific evidence about inflammation in PWH, clinical guidelines do not provide recommendations for the management of this issue. To date, physician awareness of inflammation in PWH remains unclear. We analyzed the knowledge, attitudes, and practices (KAP) related to inflammation, particularly in the clinical management of PWH, of infectious disease specialists (IDS)/internists compared to other specialists treating inflammation directly (rheumatologists) or its cardiovascular consequences (cardiologists).

Methods

A committee of IDS/internists treating PWH, cardiologists, and rheumatologists designed the KAP questionnaire. The survey was completed by 405 participants (135 physicians per specialty) stratified by Spanish geography, hospital size, and number of PWH under care (IDS/internists only).

Results

IDS/internists treating PWH scored higher than cardiologists and rheumatologists on knowledge of inflammation (5.5 ± 1.4 out of 8 points vs. 5.2 ± 1.3 and 4.6 ± 1.4 points, respectively; p < 0.05). Nevertheless, rheumatologists showed the most proactive attitude toward inflammation (i.e., biomarkers monitoring, anti-inflammatory drug prescription and cardiologist referral), followed by cardiologists and IDS/internists (13 ± 3 of a total of 16 points vs. 11 ± 3 and 10 ± 3.3 points, respectively; p < 0.05), irrespective of hospital size and years of experience. Most IDS/internists (59%) include inflammation in their therapeutic recommendations. However, in IDS/internists treating PWH, we observed a negative correlation between years of experience and concern about the clinical consequences of inflammation.

Conclusion

Our findings show that, compared to other specialists, infectious disease specialists/internists have high knowledge about inflammation in HIV infection, but, in the absence of scientific evidence to base their decisions on inflammatory markers, the therapeutic implications are scarce. The results support the need for more evidence on the monitoring and treatment of inflammation in PWH.
背景:接受抑制性抗逆转录病毒治疗的HIV感染者患有慢性炎症相关的合并症,主要是心血管疾病。然而,鉴于缺乏关于PWH炎症的具体证据,临床指南没有为该问题的管理提供建议。到目前为止,医生对PWH炎症的认识尚不清楚。我们分析了传染病专家(IDS)/内科医生与其他直接治疗炎症或其心血管后果的专家(心脏病专家)相比,与炎症相关的知识、态度和实践(KAP),特别是在PWH的临床管理中,风湿病学家设计了KAP问卷。该调查由405名参与者(每个专业135名医生)完成,结果:治疗PWH的IDS/内科医生在炎症知识方面得分高于心脏病学家和风湿病学家结论:与其他专家相比,传染病专家/内科医生对HIV感染的炎症有很高的了解,但由于缺乏基于炎症标志物的科学证据,其治疗意义很少需要更多关于PWH炎症监测和治疗的证据。
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引用次数: 0
Clinical and microbiological characteristics of Eggerthella lenta causing bacteremia 引起菌血症的 Eggerthella lenta 的临床和微生物学特征
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.05.014
Domingo Fernández Vecilla , Mikel Joseba Urrutikoetxea Gutiérrez , Mary Paz Roche Matheus , Felicitas Elena Calvo Muro , José Luis Díaz de Tuesta del Arco
Eggerthella lenta is an obligate anaerobic, Gram-positive bacilli, belonging to the human microbiota of gastrointestinal and female reproductive tracts, oral cavity and prostate gland. In this article, we aim to describe clinical and microbiological characteristics of seven E. lenta strains causing bacteremia. We conducted a descriptive retrospective study including all E. lenta strains causing bacteremia, from February 2019 to August 2023 at the Basurto University Hospital. Seven patients were included in the study with a mean age of 72.7 years. Six patients presented risk factors associated with bacterial infections. All patients were admitted to the hospital because of suspicious of bloodstream infection associated with abdominal symptoms for intravenous antibiotic treatment. Four E. lenta isolates were resistant to penicillin, while all isolates presented high MICs to piperacillin/tazobactam and low MICs to amoxicillin/clavulanic acid. All patients recovered without no complications.
连塔卵球菌(Eggerthella lenta)是一种厌氧革兰阳性杆菌,属于人类胃肠道、女性生殖道、口腔和前列腺微生物群。本文旨在描述引起菌血症的 7 株伦他大肠杆菌的临床和微生物学特征。我们开展了一项描述性回顾研究,其中包括 2019 年 2 月至 2023 年 8 月期间在巴苏托大学医院引起菌血症的所有连塔菌菌株。研究共纳入七名患者,平均年龄为 72.7 岁。六名患者存在与细菌感染相关的风险因素。所有患者均因怀疑血流感染并伴有腹部症状而入院接受静脉抗生素治疗。4 例伦他大肠杆菌分离株对青霉素耐药,所有分离株对哌拉西林/他唑巴坦的 MIC 值较高,对阿莫西林/克拉维酸的 MIC 值较低。所有患者均已康复,未出现并发症。
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引用次数: 0
Results of the REIV-TOXO national survey on prenatal screening for toxoplasmosis in Spain 西班牙全国弓形虫产前筛查 REIV-TOXO 调查的结果。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.01.005

Introduction

Currently, the status of serological screening for toxoplasmosis in pregnant women in Spain is unknown, and there is no official recommendation. The objective of this study is to show the current practice of gestational screening for toxoplasmosis in hospitals belonging to the Spanish Network for Research on Congenital Toxoplasmosis (REIV-TOXO).

Methods

An electronic survey was sent between April 2021 and September 2021 to investigators from 118 hospitals of REIV-TOXO, representing all Spanish regions. Nine items related to gestational screening for toxoplasmosis were collected. This information was compared with cases of congenital toxoplasmosis (CT) identified in REIV-TOXO to determine if these were diagnosed in the presence of gestational screening.

Results

During the study period, serological screening was performed in 53.3% (63/118) hospitals, with variations between regions and even among hospitals within the same region. Testing performed in each trimester was the most common practice (57.7%), followed by a single determination (24.4%). 89.4% of CT cases between January 2015 and September 2021 were diagnosed due to gestational screening.

Conclusion

The decision to perform gestational screening for toxoplasmosis in Spain is highly heterogeneous, with significant local and regional differences. Despite this, screening still allows the diagnosis of most CT cases. It is urgent to have current epidemiological data to inform decision-making in public health.
简介:目前,西班牙孕妇弓形虫血清学筛查的情况尚不清楚,也没有官方建议。本研究旨在介绍西班牙先天性弓形虫病研究网络(REIV-TOXO)下属医院目前开展妊娠期弓形虫病筛查的情况:方法:在 2021 年 4 月至 2021 年 9 月期间,向 REIV-TOXO 的 118 家医院(代表西班牙所有地区)的调查人员发送了一份电子调查问卷。调查收集了与妊娠弓形虫筛查相关的九个项目。这些信息与REIV-TOXO发现的先天性弓形虫病(CT)病例进行了比较,以确定这些病例是否在妊娠筛查中得到诊断:在研究期间,53.3%(63/118)的医院进行了血清学筛查,不同地区之间存在差异,甚至同一地区的不同医院之间也存在差异。在每个孕期进行检测是最常见的做法(57.7%),其次是一次性检测(24.4%)。2015年1月至2021年9月期间,89.4%的CT病例是通过妊娠筛查确诊的:在西班牙,妊娠期弓形虫筛查的决策差异很大,地方和区域差异显著。尽管如此,筛查仍能诊断出大多数 CT 病例。当务之急是掌握最新的流行病学数据,为公共卫生决策提供依据。
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引用次数: 0
Tuberculous meningitis due to Mycobacterium africanum in Spain, a case report 西班牙非洲分枝杆菌结核性脑膜炎病例报告。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.09.002
Nuria Torrellas Bertran , Gemma Garcia Continente , Oscar Villarreal
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引用次数: 0
Prevalence and clinical-epidemiological characteristics of chronic hepatitis due to hepatitis delta virus on Gran Canaria Island 大加那利岛由三角肝炎病毒引起的慢性肝炎的发病率和临床流行病学特征。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.09.006
Goretti Redondo Betancor , Melisa Hernández Febles , Raquel Zaragozá González , Rafael Granados Monzón , Ildefonso Quiñones Morales , Adolfo de Salazar , Federico García García , María José Pena López

Objective

The objective of this study was to know the prevalence and clinical-epidemiological characteristics of patients with chronic infection due to hepatitis D virus (HDV).

Patients and methods

A retrospective descriptive study was carried out on patients with HDV infection under follow-up in a hospital in 2023. All patients carrying HBsAg were tested for antibodies against HDV. HDV RNA detection was performed in all antibody-positive samples. The medical records were reviewed.

Results

Of the 340 patients carrying HBsAg, 24 (7.1%) had anti-HDV antibodies, and 6 (25%) had detectable HDV RNA (chronic infection). The prevalence of chronic hepatitis in HBsAg carriers was 1.8%. All patients had a genotype 1 infection. Half of the patients were of African origin and 29.2% were Spanish. Of the 6 patients with chronic infection, 5 (83.3%) had cirrhosis and 2 (33.3%) had hepatocellular carcinoma. Half of the patients had some exacerbation of the disease during follow-up. Of the 18 patients without viremia, 2 (11.1%) presented cirrhosis (one recently diagnosed). The mean follow-up time of patients without viremia was 13.5 years.

Conclusions

The prevalence of chronic HDV hepatitis in our area is low and in all cases it presents as an advanced disease, with exacerbations during follow-up. Patients without viremia have probably resolved the infection, as viremia was not detected in any moment.
研究目的本研究旨在了解丁型肝炎病毒(HDV)慢性感染患者的患病率和临床流行病学特征:本研究对 2023 年在一家医院接受随访的 HDV 感染患者进行了回顾性描述性研究。对所有携带 HBsAg 的患者进行了 HDV 抗体检测。对所有抗体阳性样本进行 HDV RNA 检测。对病历进行了审查:结果:在 340 名携带 HBsAg 的患者中,24 人(7.1%)有抗 HDV 抗体,6 人(25%)检测到 HDV RNA(慢性感染)。HBsAg 携带者中慢性肝炎的发病率为 1.8%。所有患者均为基因型 1 感染。半数患者为非洲裔,29.2%为西班牙裔。在 6 名慢性感染患者中,5 人(83.3%)患有肝硬化,2 人(33.3%)患有肝细胞癌。半数患者在随访期间病情有所加重。在 18 名无病毒感染的患者中,有 2 人(11.1%)患有肝硬化(其中一人最近确诊)。无病毒血症患者的平均随访时间为13.5年:结论:本地区慢性 HDV 肝炎的发病率较低,所有病例均为晚期,随访期间病情加重。没有病毒血症的患者很可能已经摆脱了感染,因为在任何时候都没有检测到病毒血症。
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引用次数: 0
Characterization of wound infections among patients injured during the Ruso-Ukrainian war in a Role 4 hospital Role 4 医院中俄乌战争期间受伤病人伤口感染的特点。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.09.003
Rafael García-Cañas , Francisco Javier Areta-Jiménez
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引用次数: 0
Predictive usefulness of qSOFA, NEWS and GYM scores in the elderly patient: EDEN-5 study qSOFA、NEWS 和 GYM 评分对老年患者的预测作用:EDEN-5 研究。
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.01.002

Objective

To analyze the prognostic accuracy of the scores NEWS, qSOFA, GYM used in hospital emergency department (ED) in the assessment of elderly patients who consult for an infectious disease.

Methods

Data from the EDEN (Emergency Department and Elderly Need) cohort were used. This retrospective cohort included all patients aged ≥65 years seen in 52 Spanish EDs during two weeks (from 1-4-2019 to 7-4-2019 and 30/3/2020 to 5/4/2020) with an infectious disease diagnosis in the emergency department. Demographic variables, demographic variables, comorbidities, Charlson and Barthel index and needed scores parameters were recorded. The predictive capacity for 30-day mortality of each scale was estimated by calculating the area under the receiver operating characteristic (ROC) curve, and sensitivity and specificity were calculated for different cut-off points. The primary outcome variable was 30-day mortality.

Results

6054 patients were analyzed. Median age was 80 years (IQR 73–87) and 45.3% women. 993 (16,4%) patients died. NEWS score had better AUC than qSOFA (0.765, 95CI: 0.725–0.806, versus 0.700, 95%CI: 0.653–0.746; P < .001) and GYM (0.716, 95%CI: 0.675–0.758; P = .024), and there was no difference between qSOFA and GYM (P = .345). The highest sensitivity scores for 30-day mortality were GYM ≥ 1 point (85.4%) while the qSOFA score ≥2 points showed high specificity. In the case of the NEWS scale, the cut-off point ≥4 showed high sensitivity, while the cut-off point NEWS ≥ 8 showed high specificity.

Conclusion

NEWS score showed the highest predictive capacity for 30-day mortality. GYM score ≥1 showed a great sensitivity, while qSOFA ≥2 scores provide the highest specificity but lower sensitivity.
目的分析医院急诊科(ED)在评估因感染性疾病就诊的老年患者时使用的NEWS、qSOFA和GYM评分的预后准确性:方法:使用来自 EDEN(急诊科和老年人需求)队列的数据。该回顾性队列包括两周内(2019 年 4 月 1 日至 2019 年 4 月 7 日和 2020 年 3 月 30 日至 2020 年 4 月 5 日)在西班牙 52 家急诊室就诊的所有年龄≥65 岁的传染病患者。记录了人口统计学变量、人口统计学变量、合并症、查尔森和巴特尔指数以及所需评分参数。通过计算接收者操作特征曲线(ROC)下的面积来估计每种量表对 30 天死亡率的预测能力,并计算不同截断点的敏感性和特异性。主要结果变量为 30 天死亡率:分析了 6054 名患者。中位年龄为 80 岁(IQR 73-87),女性占 45.3%。993名(16.4%)患者死亡。NEWS 评分的 AUC 值优于 qSOFA(0.765,95CI:0.725-0.806;0.700,95CI:0.653-0.746;P 结论:NEWS评分对30天死亡率的预测能力最高。GYM 评分≥1 显示出很高的灵敏度,而 qSOFA 评分≥2 显示出最高的特异性,但灵敏度较低。
{"title":"Predictive usefulness of qSOFA, NEWS and GYM scores in the elderly patient: EDEN-5 study","authors":"","doi":"10.1016/j.eimce.2024.01.002","DOIUrl":"10.1016/j.eimce.2024.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the prognostic accuracy of the scores NEWS, qSOFA<span>, GYM used in hospital emergency department (ED) in the assessment of elderly patients who consult for an infectious disease.</span></div></div><div><h3>Methods</h3><div>Data from the EDEN (Emergency Department and Elderly Need) cohort were used. This retrospective cohort included all patients aged ≥65 years seen in 52 Spanish EDs during two weeks (from 1-4-2019 to 7-4-2019 and 30/3/2020 to 5/4/2020) with an infectious disease diagnosis<span> in the emergency department. Demographic variables, demographic variables, comorbidities, Charlson and Barthel index and needed scores parameters were recorded. The predictive capacity for 30-day mortality of each scale was estimated by calculating the area under the receiver operating characteristic (ROC) curve, and sensitivity and specificity were calculated for different cut-off points. The primary outcome variable was 30-day mortality.</span></div></div><div><h3>Results</h3><div><span><span>6054 patients were analyzed. Median age was 80 years (IQR 73–87) and 45.3% women. 993 (16,4%) patients died. NEWS score had better AUC than </span>qSOFA (0.765, 95CI: 0.725–0.806, versus 0.700, 95%CI: 0.653–0.746; </span><em>P</em> &lt; .001) and GYM (0.716, 95%CI: 0.675–0.758; <em>P</em> = .024), and there was no difference between qSOFA and GYM (<em>P</em><span> = .345). The highest sensitivity scores for 30-day mortality were GYM ≥ 1 point (85.4%) while the qSOFA score ≥2 points showed high specificity. In the case of the NEWS scale, the cut-off point ≥4 showed high sensitivity, while the cut-off point NEWS ≥ 8 showed high specificity.</span></div></div><div><h3>Conclusion</h3><div>NEWS score showed the highest predictive capacity for 30-day mortality. GYM score ≥1 showed a great sensitivity, while qSOFA ≥2 scores provide the highest specificity but lower sensitivity.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 9","pages":"Pages 468-477"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652318","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
Measles confirmed case in vaccinated patient: Role of the specific IgG avidity testing 接种过疫苗的麻疹确诊病例:特异性 IgG 反应试验的作用
Pub Date : 2024-11-01 DOI: 10.1016/j.eimce.2024.05.013
Marta Pérez-Abeledo , Fernando Martín , Susana Jiménez , Juan Carlos Sanz
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引用次数: 0
Unexpected cause of heart failure in male with prosthetic mitral and aortic valves. 患有人工二尖瓣和主动脉瓣的男性心力衰竭的意外原因。
Pub Date : 2024-10-22 DOI: 10.1016/j.eimce.2024.10.001
Yolanda García Collado, Lourdes Balderas Fernández, Laura Mora Navas, María Victoria García López
{"title":"Unexpected cause of heart failure in male with prosthetic mitral and aortic valves.","authors":"Yolanda García Collado, Lourdes Balderas Fernández, Laura Mora Navas, María Victoria García López","doi":"10.1016/j.eimce.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.eimce.2024.10.001","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514089","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
Comparative analysis of acute respiratory infections of viral etiology in children under 6 months with and without nirsevimab in the Balearic Islands (2022-2023 and 2023-2024). 巴利阿里群岛(2022-2023 年和 2023-2024 年)6 个月以下儿童病毒性急性呼吸道感染的比较分析。
Pub Date : 2024-10-22 DOI: 10.1016/j.eimce.2024.10.002
Jordi Reina, Ane Iturbe, Julia Viana-Ramírez, Guida Sbert, Jaume Carrasco, Joaquín Dueñas

Introduction: Since 2023, a monoclonal antibody (nirsevimab) specifically directed against the preF form of RSV has been marketed in Spain. The impact of late immunization in the population <6 months as a cause of other respiratory infections requiring a hospital visit has been analyzed.

Material and methods: The viral etiology of acute respiratory infections (ARIs) diagnosed in the 2022-2023 and 2023-2024 seasons has been prospectively compared, and in this last season between recipients and non-recipients of nirsevimab. Global provisional coverage was 77% of the population.

Results: In the 2022-2023 season, 303 < 6 months with an ARI were detected, while in the 2023-2024 season there were 278 minors (19% less). The positivity in the first season was 79.9% compared to 70.5% in the current season. A significant difference has been observed in the detection of RSV between both groups and a decrease of 82.9% of cases in the current season. Of the 278 cases <6 months detected in the 2023-2024 season, 192 (69.1%) received immunization with nirsevimab and 86 (30.9%) did not receive it. The percentage of positivity in those immunized was 69.3%, compared to 73.3% in those not immunized. Significant differences have been observed in the detections of RSV and influenza between both groups.

Conclusions: Immunization at <6 months with nirsevimab has shown a significant reduction in RSV infections compared to the previous season. It does not seem, however, that it can reduce infections by other respiratory viruses.

简介:自 2023 年起,一种专门针对前 F 型 RSV 的单克隆抗体(nirsevimab)在西班牙上市。晚期免疫接种对人群的影响 材料与方法:对 2022-2023 年和 2023-2024 年两季确诊的急性呼吸道感染(ARI)的病毒病因进行了前瞻性比较,并在最后一季对接受和未接受 nirsevimab 的人群进行了比较。全球暂定覆盖率为 77%:结果:在2022-2023年接种季,有303人接受了免疫接种:在
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引用次数: 0
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Enfermedades infecciosas y microbiologia clinica (English ed.)
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