Antibody response in patients admitted to the hospital with suspected SARS-CoV-2 infection: results from a multicenter study across Spain.

AIM: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. METHODS: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. RESULTS: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. CONCLUSION: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19.

[First case report of catheter-related fungemia by Candida nivariensis in the Iberian Peninsula]. / Primer caso de fungemia asociada a catéter por Candida nivariensis en la Península Ibérica.

BACKGROUND: In recent years the incidence of candidemia caused by non-albicans Candida species has been increasing. Two cryptic species have been described within the Candida glabrata complex, Candida nivariensis and Candida bracarensis, which may be troublesome in laboratory identification and have lower susceptibility to fluconazole. AIMS: To describe the first isolation of C. nivariensis in the Iberian Peninsula from a patient suffering from a catheter-related fungemia. CASE REPORT: An 81-year-old man was hospitalized for surgical treatment of an intestinal fistula that was associated to a severe malnutrition. Cultures of the patient's central venous catheter tip and blood yielded white colonies in BD CHROMagar Candida(®) medium, which could not be identified by conventional microbiological methods. Although intravenous fluconazole was administered, blood cultures continued being positive 5 days later. The MIC values of the isolate were as follows: 1 µg/ml for amphotericin B, 0.015 µg/ml for anidulafungin, 0.125 µg/ml for caspofungin, 0.015 µg/ml for micafungin, 4 µg/ml for fluconazole, 0.25 µg/ml for itraconazole, 0.25 µg/ml for posaconazole, and 0.03 µg/ml for voriconazole. Antifungal treatment was changed to intravenous caspofungin for 2 weeks. The intestinal fistula was surgically treated. There was no evidence of relapse during the following month, and the patient was discharged. The isolate was identified as C. nivariensis based on DNA sequencing of the ITS regions of rRNA. CONCLUSIONS: C. nivariensis should be regarded as an emerging pathogen which requires molecular methods for a definitive identification. Our patient was successfully treated with caspofungin.

Primer caso de fungemia asociada a catéter por Candida nivariensis en la Península Ibérica / First case report of catheter-related fungemia by Candida nivariensis in the Iberian Peninsula

Antecedentes. En los últimos años estamos asistiendo a un aumento en la incidencia de la candidemia causada por especies de Candida no Candida albicans. Dentro del complejo Candida glabrata se han descrito 2 especies crípticas, Candida nivariensis y Candida bracarensis, que pueden presentar problemas en la identificación de los aislamientos en el laboratorio y una mayor resistencia a fluconazol. Objetivos. Se describe el primer aislamiento en la Península Ibérica de C. nivariensis en un paciente con fungemia asociada a catéter. Caso clínico. Varón de 81 años que ingresó en nuestro hospital con una fístula intestinal y en estado de malnutrición. En los hemocultivos y en la punta del catéter venoso central se aisló una levadura que crecía formando colonias blancas en medio BD CHROMagar Candida® y que no pudo ser identificada por la metodología convencional. A pesar del tratamiento intravenoso con fluconazol, los hemocultivos persistían positivos después de 5 días de tratamiento. Las CMI obtenidas fueron: 1μg/ml para anfotericina B, 0,015μg/ml para anidulafungina, 0,125μg/ml para caspofungina, 0,015μg/ml para micafungina, 4μg/ml para fluconazol, 0,25μg/ml para itraconazol, 0,25μg/ml para posaconazol, y 0,03μg/ml para voriconazol. Se sustituyó el fluconazol por caspofungina, que se mantuvo durante 2 semanas. El paciente fue intervenido y dado de alta tras un postoperatorio sin complicaciones. Finalmente, el aislamiento fue identificado como C. nivariensis mediante secuenciación de las regiones ITS del rARN. Conclusiones. C. nivariensis es una levadura emergente cuya identificación debe basarse en pruebas de biología molecular. En el caso clínico que presentamos el tratamiento con caspofungina fue eficaz(AU)

Background. In recent years the incidence of candidemia caused by non-albicans Candida species has been increasing. Two cryptic species have been described within the Candida glabrata complex, Candida nivariensis and Candida bracarensis, which may be troublesome in laboratory identification and have lower susceptibility to fluconazole. Aims. To describe the first isolation of C. nivariensis in the Iberian Peninsula from a patient suffering from a catheter-related fungemia. Case report. An 81-year-old man was hospitalized for surgical treatment of an intestinal fistula that was associated to a severe malnutrition. Cultures of the patient's central venous catheter tip and blood yielded white colonies in BD CHROMagar Candida® medium, which could not be identified by conventional microbiological methods. Although intravenous fluconazole was administered, blood cultures continued being positive 5 days later. The MIC values of the isolate were as follows: 1μg/ml for amphotericin B, 0.015μg/ml for anidulafungin, 0.125μg/ml for caspofungin, 0.015μg/ml for micafungin, 4μg/ml for fluconazole, 0.25μg/ml for itraconazole, 0.25μg/ml for posaconazole, and 0.03μg/ml for voriconazole. Antifungal treatment was changed to intravenous caspofungin for 2 weeks. The intestinal fistula was surgically treated. There was no evidence of relapse during the following month, and the patient was discharged. The isolate was identified as C. nivariensis based on DNA sequencing of the ITS regions of rRNA. Conclusions. C. nivariensis should be regarded as an emerging pathogen which requires molecular methods for a definitive identification. Our patient was successfully treated with caspofungin(AU)