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

{"title":"Factors associated with high-flow therapy failure in COVID-19-related acute hypoxemic respiratory failure: A prospective single-centre cohort study.","authors":"Toni Marín, Marina Galdeano, Roxana Chirinos, Agnés Hernández, Esther Roca, Adriana Martín, Andrea Garcia, Leire Mendiluce, Carmen Fernández, Cristian Tebé, Ignasi Garcia-Olivé, Roger Paredes, Antoni Rosell, Irene Aldás","doi":"10.1016/j.eimce.2026.503293","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503293","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal selection of non-invasive respiratory support for patients with COVID-19-related acute hypoxemic respiratory failure remains uncertain. High-flow therapy (HFT) is frequently used as initial support, but early identification of patients at risk of escalation is clinically relevant. We evaluated clinical and laboratory variables associated with escalation from HFT to non-invasive positive-pressure ventilation (NPPV).</p><p><strong>Methods: </strong>We conducted a prospective single-centre cohort study including 139 consecutive patients initiated on HFT in a respiratory intermediate care unit. The primary outcome was HFT failure, defined as escalation from HFT to NPPV. Time to HFT failure was analysed from HFT initiation using cause-specific Cox regression; successful HFT withdrawal without escalation was treated as censoring. A parsimonious adjusted model included age, time from symptom onset to HFT initiation, baseline PaO₂/FiO₂ ratio, and lactate dehydrogenase (LDH). Logistic regression and a supplementary bicarbonate model were used as sensitivity analyses.</p><p><strong>Results: </strong>Seventy-two of 139 patients (51.8%) required escalation to NPPV. Seventeen escalations were recorded on day 0 and 44 of 72 failures (61.1%) occurred by day 1. In the adjusted Cox model, higher LDH levels were associated with an increased hazard of escalation (adjusted hazard ratio [aHR] per 100U/L, 1.33; 95% confidence interval [CI], 1.06-1.66; p=0.014), whereas higher baseline PaO₂/FiO₂ ratios were associated with a lower hazard (aHR per 25mmHg, 0.78; 95% CI, 0.67-0.90; p=0.001). A longer interval from symptom onset to HFT initiation was also associated with a lower hazard of escalation (aHR per day, 0.93; 95% CI, 0.86-0.99; p=0.033). In a supplementary sensitivity model, higher arterial bicarbonate levels were associated with a lower hazard of escalation (aHR per 3mmol/L, 0.81; 95% CI, 0.66-0.99; p=0.039).</p><p><strong>Conclusion: </strong>In this prospective single-centre cohort, LDH and baseline PaO₂/FiO₂ were associated with escalation from HFT to NPPV after adjustment. Arterial bicarbonate showed a supportive exploratory signal in sensitivity analysis. These findings require external validation before incorporation into treatment-selection algorithms.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503293"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208235","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":"Multiple intramuscular collections as a presentation of metastatic MSSA infection.","authors":"Raquel Diogo, Diogo Mendes Pedro, Tiago Marques","doi":"10.1016/j.eimce.2026.503297","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503297","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503297"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208208","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":"Disseminated histoplasmosis with gastrointestinal involvement in a patient with HIV: Case report and systematic review of the literature.","authors":"Estefania Cristancho, Santiago Pino, Angel León, Carlos Zapata","doi":"10.1016/j.eimce.2026.503111","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503111","url":null,"abstract":"<p><p>Disseminated histoplasmosis is a life-threatening opportunistic infection in patients with advanced HIV. We report the case of a 43-year-old man with untreated HIV who presented with disseminated histoplasmosis and gastrointestinal involvement, including recurrent intestinal obstruction. Follow-up revealed colonic auto-amputation, a previously unreported complication. A systematic review of the literature was conducted following PRISMA guidelines. Most reported cases occurred in Southeast Asia and Latin America. Colonic and duodenal involvement were the most frequent gastrointestinal manifestations. CD4 counts below 200cells/mm³ were consistently associated with worse outcomes. This case highlights an exceptional complication of intestinal histoplasmosis and underscores the need for early recognition and treatment in immunocompromised patients.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503111"},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208202","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":"Diagnostic performance of sexually transmitted infection screening in men with sterile leukocyturia detected by flow cytometry.","authors":"Itziar Angulo López, Leonora Hernández Ragpa, María Jesús Barberá Gracia, Mikel Urrutikoetxea Gutiérrez, Guillermo Quindós Andrés, José Luis Díaz de Tuesta Del Arco","doi":"10.1016/j.eimce.2026.503298","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503298","url":null,"abstract":"<p><strong>Introduction: </strong>Sexually transmitted infections (STIs) have increased in recent years, especially amongst young men. However, genitourinary symptoms continue to be initially managed as a urinary tract infection. The aim of this study was to evaluate the diagnostic yield of STI screening in urine samples submitted for culture from men with sterile leukocyturia and to assess the discriminative ability of leukocyturia for detecting STIs.</p><p><strong>Methods: </strong>A prospective study (June 2019-May 2024) was conducted using midstream urine samples from men aged 15-59 years with leukocyturia ≥20 leukocytes/μL detected by flow cytometry (UF-1000i and UF-5000i, Sysmex®) and negative urine culture. STI detection was performed using multiplex PCR (Allplex™ STI Essential Assay, Seegene). Demographic variables and leukocyturia were analyzed.</p><p><strong>Results: </strong>A total of 495 samples were included, with STIs diagnosed in 201 (40.6%). Chlamydia trachomatis was the most frequently detected pathogen (59.7%). Diagnostic yield was similar in Primary Care and the Emergency Department (41.6% vs 37.6%). Patients with STIs were younger (29 vs. 35 years; p< 0.001) and more frequently of foreign origin (51.6% vs. 35.3%; p< 0.001). Leukocyturia was higher in STI-positive than STI-negative samples [median (IQR): 358 (110-959) vs. 85 (35-315) WBC/μL; p < 0.001], mainly due to Neisseria gonorrhoeae [median (IQR): 1264 (690-3526) WBC/μL].</p><p><strong>Conclusions: </strong>Opportunistic STI screening in men with sterile leukocyturia showed a high diagnostic yield and supports the systematic inclusion of molecular STI testing in this population. However, the discriminative ability of leukocyturia was limited.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503298"},"PeriodicalIF":0.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169005","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":"Infection of an implantable automatic defibrillator due to Pasteurella multocida.","authors":"Maite Arancegui, Inés Martínez Rienda, Josune Goikoetxea, Gorane Euba","doi":"10.1016/j.eimce.2026.503294","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503294","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503294"},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129309","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":"Eumycetoma at an unusual site.","authors":"Cristina Miranda Valverde, Isabel Pérez Hernández, Lourdes Balderas Fernández, Enrique Herrera Acosta","doi":"10.1016/j.eimce.2026.503292","DOIUrl":"https://doi.org/10.1016/j.eimce.2026.503292","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503292"},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129324","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":"Pharmacokinetic and pharmacodynamic concepts in antibiotic therapy for clinicians","authors":"Alejandro Díez-Vidal","doi":"10.1016/j.eimce.2026.503223","DOIUrl":"10.1016/j.eimce.2026.503223","url":null,"abstract":"<div><div>Antibiotic efficacy depends on attaining adequate drug exposure at the site of infection while minimizing toxicity and resistance selection. This clinician-oriented review integrates pharmacokinetic determinants of exposure with pharmacodynamic drivers of bacterial killing. Emphasis is placed on the relevance of unbound concentrations, tissue distribution, and the limitations of MIC-based targets when interpreted without appropriate biological and microbiological context. Determinants of antibiotic performance are examined from an integrated perspective, considering drug-related properties, microorganism characteristics, host factors, and features intrinsic to the infectious process. Practical implications for regimen design are addressed, including loading doses, dose intensity, and infusion strategies aimed at optimizing exposure profiles. Mechanisms connecting suboptimal exposure with resistance amplification are discussed, with particular attention to selective pressure and the mutant selection window. Therapeutic drug monitoring and model-informed dose adjustment are presented as complementary tools to support more precise and rational antibiotic dosing.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 8","pages":"Article 503223"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096823","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":"Reactive arthritis due to Clostridioides difficile: A new case, literature review and role of toxin B","authors":"Carla Iglesias Iglesias,&nbsp;Beatriz Suárez Rodríguez,&nbsp;Tatiana Añón Blanco","doi":"10.1016/j.eimce.2026.503225","DOIUrl":"10.1016/j.eimce.2026.503225","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 8","pages":"Article 503225"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586125","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":"Septic olecranon bursitis caused by Wickerhamiella pararugosa","authors":"Santiago Martínez-García,&nbsp;Daniel Navarro de la Cruz,&nbsp;Lucía Martínez-Lamas,&nbsp;Irene Álvarez Losada","doi":"10.1016/j.eimce.2026.503232","DOIUrl":"10.1016/j.eimce.2026.503232","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 8","pages":"Article 503232"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763044","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":"Chlamydia trachomatis screening in young women: From local evidence to public health action","authors":"Santiago Fernandez-Castelao,&nbsp;Mar Vera García","doi":"10.1016/j.eimce.2026.503228","DOIUrl":"10.1016/j.eimce.2026.503228","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 8","pages":"Article 503228"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766476","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}