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

英文中文

Patient with septic picture, urothelial carcinoma and lung lesions 有脓毒症、尿路上皮癌及肺部病变的病人。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.09.006

Mónica Pilar Ariza Samper , Sara Sanz Sanz , Desiré Gil Pérez , Jesús Viñuelas Bayón

引用次数: 0

Progression towards microelimination of hepatitis B virus infection among people living with HIV in Spain 西班牙艾滋病毒感染者在微消除乙型肝炎病毒感染方面的进展。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.02.016

Marta Santos , Jesica Martín Carmona , Anais Corma-Gómez , Margarita Pérez-García , Carmen Martín-Sierra , Pilar Rincón-Mayo , Juan Antonio Pineda , Luis Miguel Real , Juan Macías

Introduction

The WHO proposed to achieve hepatitis B virus (HBV) elimination by 2030, but this goal is very difficult to attain. People living with HIV (PLWH) may represent a subset where microelimination can be reached sooner. This study aimed to assess the incidence of HBV infections and changes in the prevalence of active HBV infection among PLWH in Spain.

Methods

A prospective cohort study, including all PLWH attending a university hospital in Southern Spain from January 2011 to December 2022, was conducted. Serum HBV markers (HBsAg, anti-HBs, anti-HBc) were tested at baseline and at least yearly afterwards. Incident cases were identified by anti-HBc seroconversion.

Results

Nine hundred and eighty PLWH were included. At the beginning of the study, 26 (2.7% [95% CI: 1.7–3.8%]) tested positive for HBsAg, 428 (43.7% [95% CI: 42.8–49.4%]) for anti-HBc and 386 (39.4% [95% CI: 39.8–46.3%]) for anti-HBs. After a median (Q1–Q3) follow-up of 115 (35–143) months, two new infections were documented, yielding an incidence rate of 2.24 (95% CI: 0.27–8.1)/100,000 person-years. The prevalence of active HBV infection declined from 3.4% [95% CI: 2.0–5.0%] in 2011 to 2% [95% CI: 1.0–3.0%] in 2022 (p for linear trend = 0.027). At the end of the study, 167 (24%) PLWH still were susceptible to HBV.

Conclusions

The incidence of HBV infection among PLWH in Spain is close to the WHO target. The prevalence of active HBV infection has decreased substantially during the last 12 years. These data suggest that micro-elimination of HBV/HIV infection is on the track in Spain.

世界卫生组织提出到2030年实现消除乙型肝炎病毒（HBV）的目标，但这一目标很难实现。艾滋病毒感染者（PLWH）可能是可以更快实现微消除的一个子集。本研究旨在评估西班牙PLWH中HBV感染的发生率和活动性HBV感染流行率的变化。方法：对2011年1月至2022年12月在西班牙南部一所大学医院就诊的所有PLWH患者进行前瞻性队列研究。血清HBV标志物（HBsAg, anti-HBs, anti-HBc）在基线和之后至少每年检测一次。通过抗- hbc血清转换来确定事件病例。结果：共纳入PLWH 980例。在研究开始时，26例（2.7% [95% CI: 1.7-3.8%]）检测HBsAg阳性，428例（43.7% [95% CI: 42.8-49.4%]）检测抗hbc阳性，386例（39.4% [95% CI: 39.8-46.3%]）检测抗hbs阳性。在中位（Q1-Q3）随访115（35-143）个月后，记录了2例新感染，发病率为2.24 (95% CI: 0.27-8.1)/100,000人年。活动性HBV感染的患病率从2011年的3.4% [95% CI: 2.0-5.0%]下降到2022年的2% [95% CI: 1.0-3.0%]（线性趋势p =0.027）。在研究结束时，167名（24%）PLWH仍对HBV易感。结论：西班牙PLWH人群HBV感染发生率接近WHO目标。在过去12年中，活动性乙型肝炎病毒感染的流行率大幅下降。这些数据表明，西班牙正在逐步消除HBV/HIV感染。

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引用次数: 0

More on endocarditis risk scores in gram positive bacteremias: Caveats to their implantation in clinical practice 更多关于革兰氏阳性菌血症的心内膜炎风险评分：临床实践中植入的注意事项

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.05.010

Itziar Diego-Yagüe , Antonio Ramos-Martinez , Jorge Calderón-Parra

引用次数: 0

Listeria monocytogenes prosthetic joint infection: Two clinical cases and a review of the literature 单核细胞增生李斯特菌假体关节感染：2例临床病例及文献复习。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.06.007

Begoña Fachal Bugarín, Lucía Ramos Merino, Joaquín Manuel Serrano Arreba, Alicia Alonso Álvarez, Ramón María Fernández Varela, Berta Pernas Souto, Laura Gutiérrez Fernández, María Dolores Sousa Regueiro, Enrique Míguez Rey, Efrén Sánchez Vidal

Introduction

Most infections caused by Listeria monocytogenes occur in individuals with predisposing conditions, such as advanced age or the use of immunosuppressive therapies, and primarily manifest as bacteremia or meningoencephalitis. Osteoarticular infections are uncommon and typically affect joint prostheses, with late-onset infections following surgery. Treatment in these cases should include antibiotic therapy along with a surgical strategy, which generally involves the removal of the affected prosthesis.

Methods

Two cases of prosthetic joint infection caused by L. monocytogenes are presented, along with a narrative review of the English and Spanish literature via PubMed up to December 2024.

Results

To the best of our knowledge, 52 cases of prosthetic joint infection caused by L. monocytogenes have been reported since 2000. All patients had predisposing conditions, with advanced age being the most common (mean age of 71 years). Most cases were late infections following surgery. Combined treatment (antibiotic therapy and surgery) was used in two-thirds of cases. The prognosis was favorable in almost all instances.

Discussion

It is important to consider L. monocytogenes in the etiological diagnosis of prosthetic joint infections, especially in elderly or immunocompromised patients. While the most used antibiotics have been ampicillin and cotrimoxazole, oxazolidinones could serve as an oral alternative for the treatment of these infections.

简介：大多数由单核细胞增生李斯特菌引起的感染发生在有易感条件的个体中，如高龄或使用免疫抑制疗法，主要表现为菌血症或脑膜脑炎。骨关节感染不常见，通常影响关节假体，手术后迟发性感染。这些病例的治疗应包括抗生素治疗和手术治疗，通常包括切除受影响的假体。方法：报告两例假体关节感染由单核增生L.菌引起的病例，并通过PubMed对截至2024年12月的英文和西班牙文文献进行叙述性回顾。结果：自2000年以来，据我们所知，共报告52例假体关节感染。所有患者都有易感条件，以高龄最常见（平均年龄71岁）。大多数病例为手术后晚期感染。三分之二的病例采用联合治疗（抗生素治疗和手术）。几乎所有病例的预后都是良好的。讨论：在假体关节感染的病原学诊断中，特别是在老年人或免疫功能低下的患者中，考虑单核细胞增生乳杆菌是很重要的。虽然最常用的抗生素是氨苄西林和复方新诺明，但恶唑烷酮可以作为治疗这些感染的口服替代药物。

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引用次数: 0

Anelloviruses as a marker of immunosuppression and inflammation in different clinical settings 在不同的临床环境中，作为免疫抑制和炎症标志物的肛肠病毒

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.09.016

Fabrizio Maggi , Daniele Focosi

引用次数: 0

Rifapentine-based treatment of tuberculosis infection in Spanish adolescents 以利福喷丁为基础的西班牙青少年结核病感染治疗

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.09.004

Antoni Noguera-Julian , Cristina Latre , Montserrat Ruiz , Carmen Garcia-Rebollo , Milena Peraita , Clàudia Fortuny

Introduction

Tuberculosis infection (TBI) in adolescents carries a high risk of progression to tuberculosis disease, yet treatment adherence remains a challenge.

Methods

Case series description.

Results

We describe a real-world experience of implementing a 12-dose weekly regimen of isoniazid (INH) and rifapentine (RPT) under video-observed therapy (VOT) in four adolescent diagnosed with TBI in a contact tracing study. This approach was chosen due to logistical and adherence concerns that made daily regimens and directly observed therapy (DOT) unfeasible. RPT was requested as a foreign medication and approved within three weeks. All patients completed treatment with 100% adherence and good tolerance.

Conclusions

Our experience supports the feasibility, tolerability, and high adherence of VOT-based weekly INH-RPT regimens in adolescents, despite regulatory barriers limiting RPT access in Europe. Broader availability of RPT and innovative adherence strategies like VOT are urgently needed to optimize TB preventive treatment in this age group.

青少年结核病感染（TBI）具有发展为结核病的高风险，但治疗依从性仍然是一个挑战。方法案例系列描述。结果：我们描述了在一项接触者追踪研究中，对四名被诊断为TBI的青少年实施每周12剂异烟肼（INH）和利福喷丁（RPT）视频观察治疗（VOT）的现实经验。选择这种方法是由于后勤和依从性问题，使得日常方案和直接观察治疗（DOT）不可行。RPT作为外来药申请，并在三周内获得批准。所有患者均以100%的依从性和良好的耐受性完成了治疗。尽管欧洲的监管障碍限制了RPT的使用，但我们的经验支持基于vot的每周INH-RPT方案在青少年中的可行性、耐受性和高依从性。迫切需要更广泛地提供RPT和创新的依从性策略，如VOT，以优化该年龄组的结核病预防治疗。

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引用次数: 0

Executive summary of the consensus document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC: GEPI, GeSIDA, GESITRA-IC, GEIRAS) on screening for imported infectious diseases in immunocompromised patients 西班牙传染病和临床微生物学会（SEIMC: GEPI、GeSIDA、GESITRA-IC、GEIRAS）关于在免疫功能低下患者中筛查输入性传染病的共识文件执行摘要

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.07.005

María Velasco , María-Delmans Flores-Chávez , Jara Llenas-García , Magdalena García Rodríguez , Elisa García Vázquez , Francisco López-Medrano , Oscar Len , Juliana Esperalba Esquerra , Ángela Martínez Pérez , Marta Díaz-Menéndez , Zaira Moure García , Ana Pérez Ayala , Azucena Rodríguez Guardado , Adaia Albasanz Puig , Marina Alguacil , Míriam J. Álvarez-Martínez , Marta Arsuaga Vicente , Moncef Belhassen Garcia , María José Buitrago , Eva Calabuig , Elena Sulleiro Igual

The increase in global mobility has led to a higher prevalence of imported diseases in immunocompromised patients, often asymptomatic but with the potential for reactivation or severe progression. This executive summary presents the key recommendations of the consensus document developed by the Imported Pathology Study Group (GEPI-SEIMC) in collaboration with GeSIDA, GESITRA and GEIRAS (SEIMC), targeting healthcare professionals who manage immunocompromised individuals. Based on a structured narrative review, the document proposes systematic screening strategies to detect imported infections during their asymptomatic phase, clearly distinguishing them from the clinical approach in symptomatic patients. Major infections of concern are summarized. Specific guidance is provided for people living with HIV, donors and transplant recipients, oncohematologic patients, and those receiving immunosuppressive therapy. Differences in reactivation risk, preferred diagnostic methods, and therapeutic decisions in cases of latent infection are highlighted. The document underscores the need to incorporate screening into pre-treatment and pre-transplant assessments, promoting standardized protocols.

全球流动性的增加导致免疫功能低下患者中输入性疾病的流行率更高，这些患者通常无症状，但有可能重新激活或严重进展。本执行摘要介绍了由进口病理学研究组（GEPI-SEIMC）与GeSIDA、GESITRA和GEIRAS （SEIMC）合作制定的共识文件的关键建议，目标是管理免疫功能低下个体的医疗保健专业人员。基于结构化的叙述性综述，该文件提出了在无症状阶段发现输入性感染的系统筛查策略，明确区分其与有症状患者的临床方法。总结了值得关注的主要感染。为艾滋病毒感染者、供体和移植受者、血液肿瘤患者和接受免疫抑制治疗的患者提供了具体指导。不同的再激活风险，首选的诊断方法，并在潜伏性感染的情况下治疗决定强调。该文件强调需要将筛查纳入治疗前和移植前评估，促进标准化方案。

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引用次数: 0

External validation of the HANDOC score in a Spanish cohort—Analysis of blood culture scoring and time to positivity 西班牙队列中HANDOC评分的外部验证——血培养评分和阳性时间分析。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2024.12.015

Pedro Manuel García-Ceberino , Francisco Anguita-Santos , Jara Llenas-García , Miguel Ángel Montero-Alonso , Natalia Chueca-Porcuna , Emilio Borrajo , Adolfo de Salazar , Ana María Hernández-Campillo , Emilio Guirao-Arrabal , Andrés Ruiz-Sancho

Introduction

Bacteremia caused by gram-positive cocci (GPC) remains challenging, particularly in assessing the risk of infective endocarditis (IE). Various scoring systems have been developed to guide the use of echocardiography. The HANDOC score was specifically designed for non-β-hemolytic streptococci (NBHS). This study aimed to validate the HANDOC score in a cohort across diverse geographic settings.

Methods

A retrospective study enrolled patients with NBHS bacteremia from 2017 to 2021 at two Spanish hospitals. Cases of IE were defined according to European Society of Cardiology 2015 modified Duke criteria. Patient characteristics were extracted from medical records for the analysis of HANDOC score validation in our cohort.

Results

Among 280 patients diagnosed with NBHS bacteremia, 31 met the modified Duke criteria for infective endocarditis (11.1%). Using a cutoff of ≥3, the HANDOC score demonstrated a sensitivity of 95%, specificity of 74% and a negative predictive value of 98%. The same metrics were analyzed with an adapted score based on positive blood culture vials, yielding similar results. Time to positivity (TTP) was analyzed with different cutoffs or by each NBHS group showing no statistically significant difference.

Conclusions

The HANDOC score is a valuable tool for decision-making in NBHS bacteriemia in a Spanish cohort. Scoring by vials may be employed for blood culture item in different clinical settings. Time-to-positivity did not show a significant difference that would justify its potential inclusion in the score.

由革兰氏阳性球菌（GPC）引起的菌血症仍然具有挑战性，特别是在评估感染性心内膜炎（IE）的风险方面。各种评分系统已经开发出来，以指导超声心动图的使用。HANDOC评分是专门为非β溶血性链球菌（NBHS）设计的。本研究旨在在不同地理环境的队列中验证HANDOC评分。方法：一项回顾性研究纳入了2017年至2021年西班牙两家医院的NBHS菌血症患者。IE病例根据欧洲心脏病学会2015年修订的杜克标准进行定义。从医疗记录中提取患者特征，对我们的队列进行HANDOC评分验证分析。结果：280例诊断为NBHS菌血症的患者中，31例（11.1%）符合感染性心内膜炎修改后的Duke标准。采用≥3的截止值，HANDOC评分的敏感性为95%，特异性为74%，阴性预测值为98%。采用基于阳性血培养瓶的适应性评分分析相同的指标，得出类似的结果。采用不同的截止点或各NBHS组对阳性时间（TTP）进行分析，差异无统计学意义。结论：HANDOC评分是西班牙队列中NBHS菌血症决策的有价值的工具。在不同的临床环境中，血液培养项目可采用小瓶计分法。达到积极状态的时间并没有显示出显著的差异，这可以证明将其纳入得分的可能性。

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引用次数: 0

Clinical case report: Complicated puerperal mastitis 临床报告：合并产褥期乳腺炎。

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.04.001

Maialen Larrea Ayo, Begoña Vilar Achabal, Elena Urra Zalbidegoitia, Mikel Gallego Rodrigo

引用次数: 0

Bacterial load comparison of enteroaggregative Escherichia coli (EAEC) by real-time PCR (qPCR) between children with diarrhea and asymptomatic infection 实时荧光定量PCR （qPCR）检测腹泻患儿与无症状感染患儿肠聚集性大肠杆菌（EAEC）菌量比较

Enfermedades infecciosas y microbiologia clinica (English ed.)

Pub Date : 2025-11-01 DOI: 10.1016/j.eimce.2025.05.003

David Durand , Joaquim Ruíz , Theresa J. Ochoa

Introduction

Enteroaggregative Escherichia coli (EAEC) is a pathotype of diarrheagenic E. coli (DEC) that causes acute and persistent diarrhoea in children, HIV-infected patients and travelers. However, EAEC can also be isolated in people without diarrhoea. The aim of this study was to evaluated if the EAEC bacterial load in stool samples is associated with diarrhoea in comparison with asymptomatic infection.

Methods

We selected 165 stool samples (children with diarrhoea: 80 and asymptomatic children: 85) that previously were identified as EAEC by Real-Time PCR for diagnostic of DEC from E. coli isolated from stool cultures. We extracted DNA from fecal samples using the cetyltrimethylammonium bromide (CTAB) method and standardised a qPCR to evaluate the bacterial load using EAEC strain 042.

Results

The detection limit of the qPCR was 10 copies ofaggR gene (5 bacterias)/mg stool and the reaction efficiency was ≥ 93%. We found a higher bacterial load in patients with diarrhoea [2781, 95% CI (688−6875) bacteria/mg feces] than in asymptomatic children [138, 95% CI (75−306) bacteria/mg feces], including samples with single pathogen infection and co-infections. Among diarrheal samples, the bacterial load was higher in boys than girls and in children older than 18 months than younger.

Conclusions

EAEC load in stool samples are higher in children with diarrhoea than in asymptomatic infection. This qPCR could be useful for studying the role of colonisation in children living in endemic areas where the isolation of this pathogen is similar in both groups.

肠聚集性大肠杆菌（EAEC）是致泻性大肠杆菌（DEC）的一种致病型，可在儿童、艾滋病毒感染者和旅行者中引起急性和持续性腹泻。然而，EAEC也可以在没有腹泻的人群中分离出来。本研究的目的是评估与无症状感染相比，粪便样本中的EAEC细菌负荷是否与腹泻有关。方法：我们选择165份粪便样本（腹泻患儿80份，无症状儿童85份），这些粪便样本之前通过Real-Time PCR鉴定为EAEC，用于从粪便培养物中分离的大肠杆菌中诊断DEC。我们使用十六烷基三甲基溴化铵（CTAB）法从粪便样本中提取DNA，并使用EAEC菌株042标准化qPCR来评估细菌负荷。结果：qPCR检测限为10个aggr基因拷贝（5个细菌）/mg粪便，反应效率≥93%。我们发现腹泻患者的细菌负荷[2781,95% CI（688-6875）细菌/mg粪便]高于无症状儿童[138,95% CI（75-306）细菌/mg粪便]，包括单一病原体感染和合并感染的样本。在腹泻样本中，男孩的细菌载量高于女孩，18个月以上的儿童的细菌载量高于18个月以下的儿童。结论：腹泻患儿粪便样本中的EAEC载量高于无症状感染患儿。该qPCR可用于研究定植在流行地区儿童中的作用，这些地区的儿童在两组中分离出的病原体相似。

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