Javier Velasco Montes , María Victoria Pardo Gutiérrez , Carlos Hernando Martín , Silvia González Díez
{"title":"Which corticosteroid should be used in severe pneumonia?","authors":"Javier Velasco Montes , María Victoria Pardo Gutiérrez , Carlos Hernando Martín , Silvia González Díez","doi":"10.1016/j.eimce.2024.11.001","DOIUrl":"10.1016/j.eimce.2024.11.001","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 2","pages":"Page 121"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076708","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}
Daniela de la Rosa-Zamboni, Mónica Villa-Guillén, Anaíd Bustos-Hamdan, María Isabel Rosas-Mateos, Marisol Medina-Pelcastre, Margarita Torres-García, María Isabel Franco-Hernández, María del Carmen Castellanos-Cruz, Israel Parra-Ortega, Edmedt Fest-Parra, María Citlalli Casillas-Casillas, Ana Carmen Guerrero-Díaz
{"title":"Effect of UV-C disinfection and copper plating on healthcare-associated infections in a NICU with high ESBL infections","authors":"Daniela de la Rosa-Zamboni, Mónica Villa-Guillén, Anaíd Bustos-Hamdan, María Isabel Rosas-Mateos, Marisol Medina-Pelcastre, Margarita Torres-García, María Isabel Franco-Hernández, María del Carmen Castellanos-Cruz, Israel Parra-Ortega, Edmedt Fest-Parra, María Citlalli Casillas-Casillas, Ana Carmen Guerrero-Díaz","doi":"10.1016/j.eimce.2024.02.014","DOIUrl":"10.1016/j.eimce.2024.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthcare-associated infections (HCAIs) in neonates are frequent and highly lethal, in particular those caused by extended spectrum beta-lactamase (ESBL) producing bacteria. We evaluated the beneficial effects of ultraviolet C (UV-C) disinfection and copper adhesive plating on HCAIs in the Neonatal Intensive Care Unit (NICU) of a third level paediatric hospital in Mexico City, both in combination of hand-hygiene (HH) and prevention bundles.</div></div><div><h3>Methods</h3><div>All NICU patients were included. There were 4 periods (P): P1: HH monitoring and prevention bundles; P2: P1<!--> <!-->+<!--> <!-->UV-C disinfection; P3: P2<!--> <!-->+<!--> <!-->Copper adhesive plating on frequent-contact surfaces and P4: Monitoring of P3 actions.</div></div><div><h3>Results</h3><div>552 neonates were monitored during 15,467 patient days (PD). HCAI rates decreased from 11.03/1000 PD in P1 to 5.35/1000 PD in P4 (<em>p</em> <!-->=<!--> <!-->0.006). HCAIs with bacterial isolates dropped from 5.39/1000 PD in PI to 1.79/1000 PD in P4 (<em>p</em> <!-->=<!--> <!-->0.011). UV-C and copper were associated with significant HCAI prevention (RR 0.49, CI<sub>95%</sub> 0.30–0.81, <em>p</em> <!-->=<!--> <!-->0.005) and with lesser HCAIs with bacterial isolates (RR 0.33, CI<sub>95%</sub> 0.14–0.77, <em>p</em> <!-->=<!--> <!-->0.011).</div></div><div><h3>Conclusions</h3><div>Copper adhesive plating combined with UV-C disinfection were associated with a drop in HCAI rates and with the elimination of ESBL-caused HCAIs. Hence, we propose that these strategies be considered in MDRO proliferation preventions.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 2","pages":"Pages 64-70"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867811","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}
Miguel Suárez-Robles , Clara Crespillo Andújar , Sandra Chamorro-Tojeiro , Begoña Monge-Maillo , Francesca Norman , Ignacio Peña , Martina Corral , Cristina Arcas , Santiago Moreno , Jose A. Pérez-Molina
{"title":"Real-life application of a stratification model for HIV care","authors":"Miguel Suárez-Robles , Clara Crespillo Andújar , Sandra Chamorro-Tojeiro , Begoña Monge-Maillo , Francesca Norman , Ignacio Peña , Martina Corral , Cristina Arcas , Santiago Moreno , Jose A. Pérez-Molina","doi":"10.1016/j.eimce.2024.05.008","DOIUrl":"10.1016/j.eimce.2024.05.008","url":null,"abstract":"<div><h3>Introduction</h3><div>HIV infection<span> has become a chronic disease with a good long-term prognosis, necessitating a change in the care model. For this study, we applied a proposal for an Optimal Care Model (OCM) for people with HIV (PHIV), which includes tools for assessing patient complexity and their classification into profiles to optimize care provision.</span></div></div><div><h3>Methods</h3><div>Observational, cross-sectional, and retrospective study. Adult PHIV treated at the Tropical Medicine consultations at Ramón y Cajal Hospital from January 1 to June 30, 2023, were included. The complexity calculation and the stratification into profiles for each patient were done according to the OCM.</div></div><div><h3>Results</h3><div>Ninety-four participants were included, 76.6% cisgender men, with a median age of 41 years (range 23−76). Latin America and Africa were the main regions of origin (72.4%). 98% had an undetectable HIV viral load. The degree of complexity was 78.7% low, 11.7% medium, 1% high, and 8.5% extreme. The predominant profile was blue (64.9%), followed by lilac (11.7%), purple (6.3%), and green (4.3%). 7.4% were unclassifiable, of whom 57.2% had high/extreme complexity. Among the unclassifiable, mental health problems were the most common.</div></div><div><h3>Conclusions</h3><div>The OCM tools for People Living with HIV (PLWH) allow for the classification and stratification of most patients in a consultation with a non-standard population. Patients who did not fit into the pre-established profiles presented high complexity. Creating a profile focused on mental health or mixed profiles could facilitate the classification of more patients.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 2","pages":"Pages 80-85"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066253","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}
Eduardo Aparicio-Minguijón , Jorge Boán , Antonio Terrón , Carlos Heredia , Cristina Puente , Asunción Pérez-Jacoiste Asín , M. Ángeles Orellana , Laura Domínguez , José Manuel Caro , M. Jesús López-Gude , Eva María Aguilar-Blanco , Andrea Eixerés-Esteve , Francisco López-Medrano
{"title":"Dalbavancin as sequential therapy in infective endocarditis: Real-life experience in elder and comorbid patients","authors":"Eduardo Aparicio-Minguijón , Jorge Boán , Antonio Terrón , Carlos Heredia , Cristina Puente , Asunción Pérez-Jacoiste Asín , M. Ángeles Orellana , Laura Domínguez , José Manuel Caro , M. Jesús López-Gude , Eva María Aguilar-Blanco , Andrea Eixerés-Esteve , Francisco López-Medrano","doi":"10.1016/j.eimce.2024.04.012","DOIUrl":"10.1016/j.eimce.2024.04.012","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of dalbavancin as sequential therapy in patients with infective endocarditis (IE) due to gram positive bacteria (GPB) in a real-life heterogenous cohort with comorbid patients.</div></div><div><h3>Methods</h3><div>A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate.</div></div><div><h3>Results</h3><div>The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2–85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4–9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was <span><span>Staphylococcus aureus</span></span> (26.3%) followed by <span><span>Enterococcus faecalis</span></span> (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20–34) and 14 days (IQR 14–28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500<!--> <!-->mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with <em>Enterococcus faecalis</em> IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%).</div></div><div><h3>Conclusion</h3><div>This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 2","pages":"Pages 86-92"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433530","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}
Silvia García-Cobos , Jesús Oteo-Iglesias , María Pérez-Vázquez
{"title":"Hypervirulent Klebsiella pneumoniae: Epidemiology outside Asian countries, antibiotic resistance association, methods of detection and clinical management","authors":"Silvia García-Cobos , Jesús Oteo-Iglesias , María Pérez-Vázquez","doi":"10.1016/j.eimce.2024.12.008","DOIUrl":"10.1016/j.eimce.2024.12.008","url":null,"abstract":"<div><div>Two main <em>Klebsiella pneumoniae</em> pathotypes are of public health concern, classical <em>K. pneumoniae</em> (cKP), with high antibiotic resistance acquisition capacity, and hypervirulent <em>K. pneumoniae</em> (hvKP). The emergence of hypervirulent and antibiotic-resistant <em>K. pneumoniae</em>, especially carbapenem resistance, is worrisome and require effective methods for detection and treatment. Different evolutionary paths contribute to the emergence of hypervirulence and antibiotic resistance, commonly via the acquisition of resistance plasmids by hvKP (CR-hvKP) or the acquisition of virulence plasmids by CRKp (hv-CRKp). ST11-KL64 together with <em>bla</em><sub>KPC-2</sub>, is the most extended hv-CRKP lineage acquiring virulence plasmids with associated biomarkers, <em>rmpA</em>, <em>rmpa2</em>, <em>iroBCDEN</em>, <em>iucABCDiutA</em>, and <em>peg344</em>. In addition to ST11, other hv-CRKP clones have been reported in Europe such as ST101, ST147 and ST512, highlighting the association of ST147 with OXA-48 and NDM carbapenemases. Although still very rare in Spain, hvKP cases are increasing in recent years, mainly due to ST23-K1, ST380-K2 and ST86-K2. Management of hvKP infections requires active antibiotic therapy based primarily on antibiotic susceptibility patters and site of infection.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 2","pages":"Pages 102-109"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143165031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rita González-Resina , Laura Eva Franco-Fobe , Concepción López-Gómez , Isabel Izquierdo-García
{"title":"Probable breakthrough fungal infection in immunocompromised patient with isolation of an infrequent species","authors":"Rita González-Resina , Laura Eva Franco-Fobe , Concepción López-Gómez , Isabel Izquierdo-García","doi":"10.1016/j.eimce.2024.08.003","DOIUrl":"10.1016/j.eimce.2024.08.003","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"43 1","pages":"Pages 53-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873592","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}