Enfermedades infecciosas y microbiologia clinica最新文献

{"title":"Clinical characteristics and outcomes of Rickettsia japonica infection: A retrospective case series of five patients","authors":"Miaoni Kong,&nbsp;Wen Zhou","doi":"10.1016/j.eimc.2025.503047","DOIUrl":"10.1016/j.eimc.2025.503047","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the clinical manifestations of <em>Rickettsia japonica</em> (<em>R. japonica</em>) infection and to generate evidence facilitating early diagnosis and targeted treatment.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the clinical data of five patients with <em>R. japonica</em> infection who were treated in the Emergency Department, Xiling Campus, Yichang Central People's Hospital, between January 2023 and December 2024.</div></div><div><h3>Results</h3><div>All patients were residents of Yichang City, Hubei Province, aged 58–70 years, and 80% (4/5) were farmers. The onset of illness occurred exclusively between May and September, and all patients reported a definite history of outdoor exposure. The predominant clinical manifestations were fever, rash, and eschar. Laboratory findings revealed thrombocytopenia, elevated aspartate aminotransferase (AST) and creatine kinase (CK), as well as increased inflammatory markers including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). <em>R. japonica</em> nucleic acid was detected in all patients by metagenomic next-generation sequencing (mNGS) of blood samples. Three patients initially received empirical doxycycline therapy, which was subsequently adjusted to a standard regimen after diagnostic confirmation. Defervescence occurred at a median of two days (range, 1–7 days), followed by gradual resolution of rash and alleviation of systemic symptoms. All patients achieved complete clinical recovery and were discharged without complications.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of heightened clinical awareness of <em>R. japonica</em> infection, emphasizing the integration of epidemiological context with hallmark clinical features – particularly fever, rash, and eschar – during peak transmission seasons in endemic areas. Early recognition allows the timely initiation of doxycycline therapy, which is essential for achieving favorable outcomes. Moreover, metagenomic next-generation sequencing (mNGS) provides the definitive identification of pathogens and guides targeted antimicrobial therapy.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503047"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the BD Phoenix CPO detect assay for the detection and classification of OXA-48 producing-Escherichia coli that do not co-produce ESBL/pAmpC","authors":"Fátima Galán-Sánchez ,&nbsp;Inés Portillo-Calderón ,&nbsp;Manuel Rodriguez-Iglesias ,&nbsp;Álvaro Pascual ,&nbsp;Lorena López-Cerero","doi":"10.1016/j.eimc.2025.503035","DOIUrl":"10.1016/j.eimc.2025.503035","url":null,"abstract":"<div><h3>Introduction</h3><div>The BD Phoenix™ Emerge panel incorporates the CPO detect test (CPO-T), which enables both detection and classification of carbapenemases. Integrating reliable carbapenemase detection – particularly group D enzymes – into routine antimicrobial susceptibility testing (AST), along with rapid susceptibility results, supports early optimization of antimicrobial therapy and implementation of infection control measures. These actions are essential for improving clinical outcomes and limiting the spread of resistance. This study evaluated the performance of CPO-T in detecting carbapenemase activity in a well-characterized collection of <em>Escherichia coli</em> isolates producing only OXA-48, without co-production of ESBL or p<em>AmpC</em> (OXA48-NoE-NoA-<em>E. coli</em>). Additionally, we assessed the BD Phoenix™ system ability to provide rapid antimicrobial susceptibility results.</div></div><div><h3>Methods</h3><div>Fifty-one OXA48-NoE-NoA-<em>E. coli</em> isolates were included. Ten carbapenem-resistant, non-carbapenemase-producing isolates served as negative controls (NC). All isolates underwent whole-genome sequencing using Illumina technology, and carbapenem MICs were determined by reference broth microdilution.</div></div><div><h3>Results</h3><div>CPO-T detected carbapenemase activity in 100% of the OXA48-NoE-NoA-<em>E. coli</em> isolates, with 82.4% correctly assigned to Ambler class D. Three NC isolates were misclassified as carbapenemase producers. The BD Phoenix™ system provided definitive susceptibility results in under 8<!--> <!-->h for 64.6% of the antibiotics tested.</div></div><div><h3>Conclusions</h3><div>CPO-T is a reliable tool for detecting OXA48-NoE-NoA-<em>E. coli</em>, even in phenotypically complex cases. To ensure rapid and accurate classification, a confirmatory test – such as immunochromatography – should be performed. The BD Phoenix™ system also enables timely AST, supporting early and informed therapeutic decisions.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503035"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the epidemiology and management of nontuberculous mycobacteria pulmonary disease in La Rioja-Spain (2006–2019)","authors":"Javier Ugedo ,&nbsp;Carla Andrea Alonso ,&nbsp;Nisa Boukichou-Abdelkader ,&nbsp;Marta Lamata ,&nbsp;Carlos Ruiz-Martínez ,&nbsp;José-Ramón Blanco","doi":"10.1016/j.eimc.2025.503029","DOIUrl":"10.1016/j.eimc.2025.503029","url":null,"abstract":"<div><h3>Introduction</h3><div>Understanding the local epidemiology of nontuberculous mycobacteria (NTM) and assessing clinical practices related to NTM pulmonary disease (NTM-PD) are crucial for optimizing patient management. To this end, we analysed these aspects in the Spanish region of La Rioja.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study was conducted using data of all patients with NTM isolated from respiratory specimens in La Rioja between 2006 and 2019. Demographic, microbiological, clinical, radiological, therapeutic, and outcome data were collected.</div></div><div><h3>Results</h3><div>A total of 305 patients were identified, 61 of whom met criteria for NTM-PD. The mean incidence rate of NTM isolations was 6.85 per 100,000 person-year and that of PD-NTM was 1.37. The annual incidence of PD-NTM remained stable during most of the period studied. Municipalities in the west of La Rioja had higher rates of isolation and PD-NTM than those in the east. <em>Mycobacterium avium</em> complex and <em>Mycobacterium xenopi</em> were the most frequently caused PD-NTM. Notably, 32.8% of patients with PD-NTM did not receive the antibiotic treatment recommended by guidelines.</div></div><div><h3>Conclusions</h3><div>NTM isolation and PD-NTM rates and the most frequently isolated species are in line with results from other regions of Spain and Europe, however, marked differences are appreciated between the different municipalities of La Rioja. The annual rate of EP-NTM did not show the upward trend described in other studies. The degree of adherence to the guidelines could be improved.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503029"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exceptional cause of infective endocarditis: Lactobacillus paracasei","authors":"Antonio Moreno-Flores ,&nbsp;Elena García-Campos Losada ,&nbsp;Francisco José Vasallo-Vidal ,&nbsp;María Teresa Pérez-Rodríguez","doi":"10.1016/j.eimc.2025.503031","DOIUrl":"10.1016/j.eimc.2025.503031","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503031"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enfermedad neumocócica invasiva antes, durante y después de la pandemia de SARS-CoV-2","authors":"Irati Arregui García ,&nbsp;Iñaki Beguiristain ,&nbsp;Miguel Fernández-Huerta ,&nbsp;Jesús Castilla ,&nbsp;María Eugenia Portillo Bordonabe","doi":"10.1016/j.eimc.2025.503033","DOIUrl":"10.1016/j.eimc.2025.503033","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to analyse the changes in the incidence of invasive pneumococcal disease (IPD) before, during, and after the SARS-CoV-2 pandemic.</div></div><div><h3>Methods</h3><div>Cases of IPD detected through active epidemiological surveillance in Navarre, Spain, from 2018 to 2024 were analysed. Incidence rates were compared across three periods: pre-pandemic (2018-2019), pandemic (2020-2022), and post-pandemic (2023-2024) overall and by age groups and serotypes</div></div><div><h3>Results</h3><div>From 2018 to 2024, a total of 437 IPD cases were diagnosed in Navarre. The incidence of IPD decreased from 11.6 to 5.6 cases per 100,000 persons during the pandemic period and return to 13.0 cases per 100,000 persons in the post-pandemic period. The incidence decreased across all age groups in both, serotypes included and not included in the 13-valent pneumococcal conjugate vaccine (PCV13). Serotype 3 was the most frequent in the three periods, representing 20.3% of all cases. In the post-pandemic period, 35.2% of cases were due to serotypes included in the PCV-13, 45.7% in the PCV-15 and 64.2% in the PCV-20.</div></div><div><h3>Conclusions</h3><div>During the SARS-CoV-2 pandemic, the incidence of IPD decreased across all age groups for both, PCV13-included and not included serotypes. In the post-pandemic period, incidence returned to pre-pandemic levels. Whole-genome sequencing techniques helped to serotyping of <em>S. pneumoniae,</em> and thus, complemented epidemiological surveillance.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503033"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outbreak of human external ophthalmomyiasis due to Oestrus ovis in northwestern Spain: Diagnosis, management, and case series","authors":"Elia de Esteban Maciñeira ,&nbsp;Raquel Carracedo ,&nbsp;Laura Formoso ,&nbsp;Sara Pereira ,&nbsp;José Llovo-Taboada ,&nbsp;Manuel F. Bande","doi":"10.1016/j.eimc.2025.503042","DOIUrl":"10.1016/j.eimc.2025.503042","url":null,"abstract":"<div><h3>Introduction</h3><div>To present a case series of external ophthalmomyiasis caused by <em>Oestrus ovis</em> (L. 1758) (Diptera, Oestridae) larvae over an eight-week period in Santiago de Compostela (NW Spain), highlighting its entomology facts, epidemiological factors, clinical management, and possible complications.</div></div><div><h3>Methods</h3><div>Five cases were detected at the Ophthalmology Emergency Department of the Hospital Clínico Universitario de Santiago de Compostela. All patients presented with foreign body sensation, tearing, and ocular redness. Larvae were mechanically removed and identified as <em>O. ovis</em> in the L1 larval stage.</div></div><div><h3>Results</h3><div>Early treatment with larval extraction, antiseptics, and anti-inflammatory agents led to complete resolution without complications. Cases were associated with rural exposure during late summer and early autumn under warm and humid climatic conditions.</div></div><div><h3>Conclusion</h3><div>External ophthalmomyiasis is an uncommon parasitic zoonosis caused by dipteran larvae, with <em>O. ovis</em> being the most common agent. Accurate diagnosis and early treatment prevent complications. This series highlights the importance of considering climatic and rural exposure factors in endemic areas and suggests the potential impact of climate change on the disease's distribution.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503042"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing clinical and public health role of Mycobacterium tuberculosis genomics","authors":"Iñaki Comas","doi":"10.1016/j.eimc.2025.503044","DOIUrl":"10.1016/j.eimc.2025.503044","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503044"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue warning signs persisting post-48 h demand monitoring to avert severe complications","authors":"Verónica Andrade-Amaráz,&nbsp;José Pedro Elizalde-Díaz","doi":"10.1016/j.eimc.2025.503049","DOIUrl":"10.1016/j.eimc.2025.503049","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue virus infection remains a major public health challenge in tropical regions, with heterogeneous progression to severe disease.</div></div><div><h3>Methods</h3><div>We conducted a prospective longitudinal study of 362 laboratory-confirmed dengue patients, stratified by sex and the presence of warning signs. Serial hematological, hepatic and renal markers were collected over 96<!--> <!-->h (at 24<!--> <!-->h, 48<!--> <!-->h, 72<!--> <!-->h, and 96<!--> <!-->h after symptom onset) to analyze their dynamic evolution.</div></div><div><h3>Results</h3><div>Patients with warning signs persisting beyond 48<!--> <!-->h exhibited progressive hematological and hepatic deterioration, unlike those without warning signs. This was characterized by progressively declining platelet and neutrophil counts, elevated hematocrit, and rising AST/ALT levels. These worsening trends were more pronounced in women, who also showed a higher prevalence of warning signs (32% vs 25% in men).</div></div><div><h3>Conclusion</h3><div>The persistence of warning signs beyond 48<!--> <!-->h represents a clinically relevant threshold for hematological and hepatic deterioration, supporting the need for protocolized monitoring – including serial platelet counts, hematocrit, and liver enzymes – during this critical window to enable early intervention in high-risk patients.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503049"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adecuación del tratamiento de la malaria de acuerdo con los criterios de gravedad definidos por la Organización Mundial de la Salud en un país no endémico","authors":"María Asunción Pérez-Jacoiste Asín ,&nbsp;Andrea Navarro Flores ,&nbsp;Anatolio Alonso Crespo ,&nbsp;Ana Pérez-Ayala ,&nbsp;Irene Losada Galván ,&nbsp;Begoña de Dios ,&nbsp;Pilar Hernández-Jiménez ,&nbsp;Manuel Gil-Mosquera ,&nbsp;Francisco Jiménez-Morillas ,&nbsp;Carlos Lumbreras ,&nbsp;Manuel Lizasoain ,&nbsp;Juan María Herrero-Martínez","doi":"10.1016/j.eimc.2025.503051","DOIUrl":"10.1016/j.eimc.2025.503051","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of cases of malaria is increasing in Spain due to tourism and migration. Unfamiliarity with this disease may lead doctors to misrecognize its severity and over-/under-treat it. We aimed to analyse the adequacy of treatment according to malaria severity.</div></div><div><h3>Methods</h3><div>Single-centre retrospective study at “Hospital 12 de Octubre” (Madrid). We identified all patients over 16-years-old with symptomatic malaria from January 2015 to December 2023. The severity of malaria was defined according to WHO criteria. Parenteral artesunate was the treatment of choice for severe malaria. Oral artemisinin combination or atovaquone/proguanil were used for non-severe malaria.</div></div><div><h3>Results</h3><div>We identified 64 patients (median age 39,5 years (IQR 32,25-47), 75% <em>Visiting Friends and Relatives</em>. Malaria was severe in 15 patients (23.4%). Antimalarial treatment was adequate to severity in 46 patients (71.8%). Three cases classified as severe malaria received oral treatment while 15 cases apparently non-severe received parenteral artesunate. Those who received oral treatment for severe malaria had been misclassified (mild epistaxis, chronic renal insufficiency, and 3.5% parasitaemia in an immigrant). Among those treated parenterally for non-severe malaria, four had oral intolerance and in the remaining eleven, there was an overuse of artesunate. The main reason for artesunate overuse was the presence of thrombocytopenia (median platelet-count: 33,000/mm3, IQR: 28,000-51,000/mm3).</div></div><div><h3>Conclusions</h3><div>Antimalarial treatments were mostly adequate, especially in severe cases. The most common reason for artesunate overuse was the presence of thrombocytopenia, which is not included in the WHO criteria for severe malaria.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503051"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Factors associated with glucocorticoid dosing in treating patients with noncritical COVID-19 pneumonia: Insights from an artificial intelligence-based CT imaging analysis”","authors":"José Miguel Gómez Verdú ,&nbsp;Sergio Alemán Belando","doi":"10.1016/j.eimc.2025.503046","DOIUrl":"10.1016/j.eimc.2025.503046","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 1","pages":"Article 503046"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}