BCGitis con afectación de aneurisma aortoilíaco: aportación de dos casos y revisión de la literatura / BCGitis with aortoiliac aneurysm involvement: Report of two cases and review of the literature

La BCGitis es una complicación infrecuente del tratamiento intravesical con Bacillus Calmette-Guérin para el cáncer superficial de vejiga de alto grado y el carcinoma in situ. Puede causar afectación vascular. Presentamos 2 casos y una revisión de la literatura de series de casos publicadas en los 10 años previos a la finalización de este trabajo en abril de 2022, que describiesen un caso de aneurisma micótico aortoilíaco tras recibir este tratamiento. De los 51 casos incluidos (49 revisados y 2 originales), el 100% eran hombres, 82% tenían más de 65 años. La mediana del período de latencia fue de 15 meses (RIQ 18). La localización más frecuente fue la aorta abdominal, documentándose rotura en el 45,1%. El síntoma más frecuente fue dolor abdominal o lumbar (61%), seguido de síndrome general (49%). Asoció absceso retroperitoneal un 39,2%. La mortalidad atribuible fue de 13,6%. La BCGitis debería incluirse como diagnóstico diferencial de pacientes que hayan recibido terapia con BCG y presenten afectación vascular, incluso años tras el tratamiento.(AU)

BCGitis is a rare complication after intravesical administration of Bacillus Calmette-Guérin for high-grade superficial bladder cancer and carcinoma in situ. May cause vascular involvement. We present two cases and a review of the literature of the case reports published on the 10 years prior to April of 2022, when this project was finished, which described a case of aortoiliac mycotic aneurysm after receiving this treatment. Of the 51 cases included (49 revised and 2 original), 100% were men, 82% were older than 65 years. The median latency period was 15 months (IQR 18). The most frequent location was the abdominal aorta, rupture occurred in 45.1% of patients. The most frequent symptom was abdominal or lumbar pain (61%), followed by general syndrome (49%). In 39.2% cases, it was associated with retroperitoneal abscesses. Attributable mortality was 13.6%. BCGitis should be included in the differential diagnosis in patients who have received BCG therapy and present vascular involvement, even years after being treated.(AU)

Retrospective study of home antibiotic infusion therapy in elastomeric infusion pumps. / Estudio retrospectivo de la terapia de infusión de antibióticos domiciliaria en bombas de infusión elastoméricas.

OBJECTIVES: To describe the experience of home antibiotic infusion therapy using elastomeric infusion pumps, administered to patients admitted to the Home Hospitalization Unit of a tertiary hospital for three years and to analyse clinical evolution and mortality. METHOD: Retrospective observational study. The medical history of the patients included in the study was reviewed. Information was obtained on personal history, antimicrobial therapy received and clinical evolution. Statistical analysis was performed using SPSS® 19 software. RESULTS: Eighty-one patients were included, 61.7% men, with a mean age of 73.5 ± 17.5 years. The most frequent comorbidities were diabetes mellitus (30.9%) and chronic kidney disease (28.4%). Patients received a mean of 11.9 ± 8.5 days of antibiotic treatment in an elastomeric infusion pump. The main focus of infection was respiratory (27.2%), followed by bacteremia (16%) and skin and soft tissue infections (12.3%). Of the infections, 65.4% were monomicrobial, with Pseudomonas aeruginosa being the main microorganism involved (39.6%). The most commonly used antimicrobial was piperacillin/tazobactam (33.3%). The clinical course was good in 85.2% of the patients, but the mortality rate in the 30 days following the end of treatment was 24.7%. In the univariate analysis, a history of neoplasia in the last 5 years (p = 0.01) and having received fewer days of antibiotic therapy prior to the start of outpatient antimicrobial therapy in infusion pump (p = 0.04) were associated with worse clinical outcome. Age over 80 years was associated with better outcome (p = 0.03). The diagnosis of heart failure was associated with higher mortality (p = 0.026) and patients from surgical services, with lower mortality (p = 0.047). In the multivariate analysis, the presence of neoplasia was associated with unfavorable evolution (p = 0.012) and heart failure with higher mortality (p = 0.027). CONCLUSIONS: Outpatient antimicrobial therapy in elastomeric infusion pumps is an alternative in patients requiring prolonged intravenous treatment, and age is not a conditioning factor for inclusion in these programs. However, the presence of certain comorbidities can negatively affect the clinical course and mortality of patients.

Streptococcus bovis infection of the central nervous system in adults: Report of 4 cases and literature review / Infección del sistema nervioso central por Streptococcus bovis en adultos: reporte de 4 casos y revisión de la literatura

Objectives: To describe the clinical features, history and association with intestinal disease in central nervous system (CNS) S. bovis infections. Methods: Four cases of S. bovis CNS infections from our institution are presented. Additionally a systematic literature review of articles published between 1975 and 2021 in PubMed/MEDLINE was conducted. Results: 52 studies with 65 cases were found; five were excluded because of incomplete data. In total 64 cases were analyzed including our four cases: 55 with meningitis and 9 with intracranial focal infections. Both infections were frequently associated with underlying conditions (70.3%) such as immunosuppression (32.8%) or cancer (10.9%). In 23 cases a biotype was identified, with biotype II being the most frequent (69.6%) and S. pasteurianus the most common within this subgroup. Intestinal diseases were found in 60.9% of cases, most commonly neoplasms (41.0%) and Strongyloides infestation (30.8%). Overall mortality was 17.1%, with a higher rate in focal infection (44.4% vs 12.7%; p=0.001). Conclusions: CNS infections due to S. bovis are infrequent and the most common clinical form is meningitis. Compared with focal infections, meningitis had a more acute course, was less associated with endocarditis and had a lower mortality. Immunosuppression and intestinal disease were frequent in both infections.(AU)

Introducción: Streptococcus bovis, una causa bien conocida de endocarditis asociada a cáncer colorrectal, es también una causa poco frecuente de infecciones del sistema nervioso central (SNC), incluyendo meningitis, abscesos cerebrales o empiema subdural. El objetivo de este estudio es describir las características clínicas, los antecedentes médicos y la asociación con la enfermedad intestinal en las infecciones por S. bovis en el SNC. Métodos: Describimos 4 infecciones por S. bovis en el SNC en nuestra Unidad y, a continuación, presentamos una revisión bibliográfica de los artículos publicados entre 1975-2021 en PubMed/MEDLINE. Resultados: Se encontraron 52 estudios con 65 casos; 5 se excluyeron por datos incompletos. En total se analizaron 64 casos incluyendo nuestros 4: 55 con meningitis y 9 con infecciones focales intracraneales. Ambas infecciones se asociaron con frecuencia a condiciones subyacentes (70,3%) como la inmunosupresión (32,8%) o el cáncer (10,9%). En 23 casos se identificó un biotipo, siendo el más frecuente el biotipo ii (69,6%), y dentro de ellos, S. pasteurianus. En el 60,9% de los casos se detectaron enfermedades intestinales, siendo las más frecuentes las neoplasias (41,0%) y la infestación por Strongyloides (30,8%). La mortalidad global fue del 17,1%, con una tasa mayor en la infección focal (44,4 frente a 12,7%; p=0,001). Conclusiones: Las infecciones del SNC debidas a S. bovis son poco frecuentes y la forma clínica más común es la meningitis. En comparación con las infecciones focales, la meningitis tiene un curso más agudo, está menos asociada a la endocarditis y tiene una menor mortalidad. La inmunosupresión y la enfermedad intestinal fueron frecuentes en ambas infecciones.(AU)

Streptococcus bovis infection of the central nervous system in adults: Report of 4 cases and literature review.

OBJECTIVES: To describe the clinical features, history and association with intestinal disease in central nervous system (CNS) S. bovis infections. METHODS: Four cases of S. bovis CNS infections from our institution are presented. Additionally a systematic literature review of articles published between 1975 and 2021 in PubMed/MEDLINE was conducted. RESULTS: 52 studies with 65 cases were found; five were excluded because of incomplete data. In total 64 cases were analyzed including our four cases: 55 with meningitis and 9 with intracranial focal infections. Both infections were frequently associated with underlying conditions (70.3%) such as immunosuppression (32.8%) or cancer (10.9%). In 23 cases a biotype was identified, with biotype II being the most frequent (69.6%) and S. pasteurianus the most common within this subgroup. Intestinal diseases were found in 60.9% of cases, most commonly neoplasms (41.0%) and Strongyloides infestation (30.8%). Overall mortality was 17.1%, with a higher rate in focal infection (44.4% vs 12.7%; p=0.001). CONCLUSIONS: CNS infections due to S. bovis are infrequent and the most common clinical form is meningitis. Compared with focal infections, meningitis had a more acute course, was less associated with endocarditis and had a lower mortality. Immunosuppression and intestinal disease were frequent in both infections.

BCGitis with aortoiliac aneurysm involvement: Report of two cases and review of the literature.

BCGitis is a rare complication after intravesical administration of Bacillus Calmette-Guérin for high-grade superficial bladder cancer and carcinoma in situ. May cause vascular involvement. We present 2 cases and a review of the literature of the case reports pubished on the 10 years prior to April of 2022, when this proyect was finished, which described a case of aortoiliac mycotic aneurysm after receiving this treatment. Of the 51 cases included (49 revised and 2 original), 100% were men, 82% were older than 65 years. The median latency period was 15 months (IQR 18). The most frequent location was the abdominal aorta, rupture occurred in 45,1% of patients. The most frequent symptom was abdominal or lumbar pain (61%), followed by general syndrome (49%). In 39,2% cases, it was associated with retroperitoneal abscesess. Attributable mortality was 13,6%. BCGitis should be included in the differential diagnosis in patients who have received BCG therapy and present vascular involvement, even years after being treated.

Demographic transition and hospital admissions in Spanish centenarians, 2004-2020: Geographical variations and sex-related differences.

BACKGROUND: This study aims to describe the distribution and temporal trends of the centenarian population and their hospital admissions in Spain over the past two decades, focusing on regional and sex-based differences. METHODS: A retrospective study was conducted using data from the Spanish National Health System's Hospital Discharge Records-Minimum Basic Data Set. The analysis included all hospitalized patients ≥100 years between January 2004 and December 2020. The crude annual centenarian population and admission rates were calculated. Joinpoint regression analysis and cross-correlation analysis were used to identify trends and associations. RESULTS: From 2004 to 2020, the centenarian population in Spain increased by 89.0 %, with a larger increase observed in women (86.6 %) than men (32.9 %). Significant geographic variability was found, with rates from 1.1 to 5.2 × 10,000 inhabitants per year across different regions. Joinpoint analysis identified three trends: a decline from 2004 to 2008, an increase from 2008 to 2015, and a slower increase from 2015 to 2020. Hospital admissions of centenarians increased by 121.5 %, with a larger increase in women than men (212.1% vs 90.7 %); women represented 75.4 % of admissions. The proportion of centenarian admissions to total hospitalizations showed an upward trend until 2015 and then stabilized; it also varied among regions. CONCLUSION: There was a significant increase in the centenarian population and hospital admissions of centenarians in Spain. There are regional disparities in their distribution, with women representing a larger proportion of centenarians and hospital admissions. Understanding these trends and differences is crucial for implementing interventions that ensure adequate healthcare for centenarians.

Assessment of Post-COVID Symptoms Using the C19-YRS Tool in a Cohort of Patients from the First Pandemic Wave in Northwestern Spain.

Introduction: The emergence or persistence of symptoms after acute SARS-CoV-2 infection has made it necessary to develop tools to detect them and assess their impact on patients' quality of life. One of these tools is the COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) scale. We present the results of this tool in a cohort of first pandemic wave patients. Methods: A cross-sectional study of patients with confirmed SARS-CoV-2 infection from March to May 2020 in Lugo (northwestern Spain). C19-YRS was administered via phone 10 months after the acute infection to both former inpatients and outpatients. Electronic medical records were reviewed and relevant data from the acute episode were collected. The main outcome was the presence of impairment in different areas measured by the C19-YRS scale. Results: The answer rate was 63.2%. The mean age was 54 ± 16 years, 38.4% were male and 190 (42.9%) had some comorbidity. Eighty-seven patients (19.6%) required hospitalization and 10 (2.3%) required intensive care unit admission. Ten (3.5%) patients lost their job due to the pandemic. Two hundred seventy-six patients (62.3%) related any symptoms; fatigue (37.2%) and exertional dyspnea (33.4%) were the most common with significant worsening in both cases compared with the situation before the infection. Subgroup analysis showed that more symptom domains were impaired in women than men. Older patients, those with comorbidity and those who needed hospital admission, demanded more health resources after the acute infection. Discussion: C19-YRS is useful for the detection and quantification of symptoms after COVID-19 and provides relevant social, health, and occupational information.

In-hospital incidence of and risk factors for influenza-associated respiratory failure.

BACKGROUND: Respiratory failure (RF) is the most important complication of influenza virus infection. Its definition and incidence are heterogeneous in the literature. METHODS: This systematic review and meta-analysis aim to determine the incidence of and risk factors for RF in patients hospitalized with influenza. Electronic databases were searched for articles on RF in patients hospitalized for influenza infection up to December 2021 regardless of their geographical location. Observational and experimental studies were considered for inclusion, excluding case series. The Newcastle-Ottawa and Johanna Briggs scales were used for quality assessment. A random-effects meta-analysis was performed, followed by subgroup analyses according to, among others, presence/absence of pneumonia, RF definition, serotype and time period. PRISMA guidelines were followed for this review. RESULTS: Thirty-six studies were finally included in the meta-analysis. Overall, RF incidence was 24% (range 5%-85%, 95% confidence interval [95CI] 19%-31%). Significantly higher incidences of RF were found in patients with pneumonia (42%, 95CI 28%-57%, p = .006), when RF was defined as hypoxemia (58%, 95CI 31%-81%, p < .001), and during the 2009 pandemic (25%, 95CI 16%-36%) and postpandemic period (23%, 95CI 15%-34%, p = .01). No differences were found between human influenza serotypes. Assessment of risk factors associated with the development of RF was not possible due to their inconsistent and heterogeneous reporting. CONCLUSION: Respiratory failure is frequent in hospitalized influenza patients, especially in patients with pneumonia and since the 2009 pandemic, although its definition and reporting widely vary in the literature. This complicates its characterization and comparison between cohorts and with other respiratory viruses.

Health Perception among Female COVID-19 Patients. Comment on Fernández-de-las-Peñas et al. Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study. J. Clin. Med. 2022, 11, 413.

We read with interest the original paper by Fernández-de-las-Peñas et al. [...].

Espondilodiscitis por Streptococcus suis: 2 nuevos casos y revisión bibliográfica / Streptococcus suis spondylodiscitis: 2 new cases and a literature review

IntroducciónLa infección por Streptococcus suis (S. suis) es una zoonosis poco descrita en nuestro país, que se relaciona con la exposición al ganado porcino o su carne. La forma de presentación más frecuente es la meningitis, mientras que la afectación de la columna vertebral es rara.MétodosPresentamos 2 casos de infección por S. suis y realizamos una revisión sistemática de los trabajos publicados sobre espondilodiscitis por S. suis entre enero de 1994 y mayo de 2020 con el objetivo de definir las características clínicas, sus factores predisponentes y su evolución.ResultadosSe describen 17 casos, el 76,5% varones con una edad media de 57,6 años, generalmente sin enfermedad de base asociada. El enolismo fue un factor presente en casi el 17,6% de los pacientes. Un 70,6% presentaron exposición a ganado porcino o su carne y un 20% heridas en manos. La duración media de los síntomas fue de 10,2 días y el segmento más afectado fue el lumbar. Un 70,6% cursó con meningitis. Todos se trataron con betalactámicos con una duración media de 53,2 días. Hubo una recidiva y ninguno falleció.ConclusiónExisten pocos casos de espondilodiscitis por S. suis en la literatura. Cuando ocurre, se asocia a otro tipo de infección en la mayoría de los casos. Presentan buena respuesta al tratamiento médico y buen pronóstico.

IntroductionStreptococcus suis (S. suis) infection is poorly described zoonosis in our country, which is related with exposure to pigs or their meat. The most common clinical presentation is meningitis, while spinés involvement is rare.MethodsWe report 2 cases of S. suis infection and perform a systematic review of the articles published on S. suis spondylodiscitis between January 1994 and May 2020 with the aim of defining the clinical characteristics, predisposing factors and evolution.Results17 cases are described, 76.5% males with a mean age of 57.6 years, generally without associated underlying disease. Enolism was a factor present in 17.6%. 70.6% had exposure to pigs or their meat and 20% hand injuries. The mean duration of symptoms was 10.2 days and the most affected segment was the lumbar level. 70.6% had meningitis. All were treated with beta-lactams with an average duration of 53.2 days. There was a recurrence and none died.ConclusionThere are few cases of S. suis spondylodiscitis in the literature. When occurs, it is associated with another type of infection in most cases. They present a good response to medical treatment and a good prognosis.

Streptococcus suis spondylodiscitis: 2 new cases and a literature review.

INTRODUCTION: Streptococcus suis (S. suis) infection is poorly described zoonosis in our country, which is related with exposure to pigs or their meat. The most common clinical presentation is meningitis, while spine's involvement is rare. METHODS: We report 2 cases of S. suis infection and perform a systematic review of the articles published on S. suis spondylodiscitis between January 1994 and May 2020 with the aim of defining the clinical characteristics, predisposing factors and evolution. RESULTS: 17 cases are described, 76.5% males with a mean age of 57.6 years, generally without associated underlying disease. Enolism was a factor present in 17.6%. 70.6% had exposure to pigs or their meat and 20% hand injuries. The mean duration of symptoms was 10.2 days and the most affected segment was the lumbar level. 70.6% had meningitis. All were treated with beta-lactams with an average duration of 53.2 days. There was a recurrence and none died. CONCLUSION: There are few cases of S. suis spondylodiscitis in the literature. When occurs, it is associated with another type of infection in most cases. They present a good response to medical treatment and a good prognosis.

Evaluación a los dos meses del alta hospitalaria tras la primera ola de COVID-19: presencia de síntomas persistentes / Assessment of hospitalized covid-19 patients two month after discharge: characterization of persistent symptoms

Introduction: a series of symptoms have been reported after COVID-19, which have been encompassed in the so-named “postCOVID syndrome”. PostCOVID syndrome is a heterogeneous disorder with an uncertain pathophysiology. The aim of this study is to describe the characteristics and frequence of symptoms after COVID-19 discharge and to analyze the possible implicated factors. Methods: this is an observational propective study with COVID-19 patients hospitalized from March to April 2020. Patients were assessed in an outpatient clinic two months after discharge, and serological, radiological and laboratory workup was conducted. Previous medical history, length of stay (LOS) and intensive care unit (ICU) admission were recorded. Persistent symptons (PS) were defined as those appearing after the acute infection and present at follow-up. Results: 74 patients were included. Mean age was 66±13 years, and 54.4% patients were men. Six (8.1%) patients needed ICU admission, and median LOS was 8 (6-12) days. Forty (54.8%) patients presented PS, the most frequent being fatigue and dyspnea (20.3% each). 77% patients presented laboratory abnormalities but just in 11 cases (15.1%) were they severe. Ten (13.5%) had radiological abnormalities. 71 (95.9%) had positive IgG serology. There were no differences between patients with and without PS regarding previous medical history or acute infection course. PS patients had a higher heart rate 83 (75-93) vs 76 65-85) bpm; p=0.038) at assessment. Conclusion: symptoms and laboratory abnormalities are frequent two months after COVID-19, although usually mild. No predictors... (AU)

Introducción: se han notificado tras el alta por COVID-19 una serie de síntomas englobados dentro del llamado “síndrome post-COVID”, un cuadro heterogéneo cuya fisiopatología es incierta. Nuestro objetivo es describir las características y frecuencia de síntomas tras el alta y analizar los posibles factores relacionados. Métodos: estudio observacional prospectivo con pacientes ingresados por COVID-19 durante marzo-abril de 2020. Se evaluó en consulta a los dos meses tras el alta con valoración clínica, analítica, serología y radiografía de tórax. Se recogieron los antecedentes, la estancia hospitalaria y la necesidad de UCI. Se definieron síntomas persistentes (SP) como síntomas que aparecieron desde la infección aguda y que se mantenían al seguimiento. Resultados: se revisaron 74 pacientes. La edad media fue 66±13 años, siendo un 51,4% hombres. Seis (8,1%) ingresaron en UCI, y la mediana de estancia fue 8 (6-12) días. Cuarenta (54,8%) presentaron SP, siendo los más frecuentes astenia y disnea (20,3% ambos). Un 77% tenía alteraciones analíticas pero solo en 11 (15,1%) fueron relevantes. Diez (13,5%) presentaban alteraciones radiológicas y 71 (95,9%) tenían IgG positiva. No hubo diferencias entre los pacientes con y sin SP en sus antecedentes o evolución hospitalaria. Los pacientes con SP estaban más taquicárdicos [83 (75-93) lpm vs 76 (65-85) lpm; p=0,038], no existiendo diferencias significativas en el resto de variables... (AU)

COVID-19 pneumonia in Galicia (Spain): Impact of prognostic factors and therapies on mortality and need for mechanical ventilation.

INTRODUCTION: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia. METHODS: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable. RESULTS: A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01-1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39-3.63)] and [OR = 3.04 (95% CI: 1.88-4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06-1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91-0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12-0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45-2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15-5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02-1.11)]. CONCLUSION: These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.

Streptococcus suis spondylodiscitis: 2 new cases and a literature review. / Espondilodiscitis por Streptococcus suis: 2 nuevos casos y revisión bibliográfica.

INTRODUCTION: Streptococcus suis (S. suis) infection is poorly described zoonosis in our country, which is related with exposure to pigs or their meat. The most common clinical presentation is meningitis, while spinés involvement is rare. METHODS: We report 2 cases of S. suis infection and perform a systematic review of the articles published on S. suis spondylodiscitis between January 1994 and May 2020 with the aim of defining the clinical characteristics, predisposing factors and evolution. RESULTS: 17 cases are described, 76.5% males with a mean age of 57.6 years, generally without associated underlying disease. Enolism was a factor present in 17.6%. 70.6% had exposure to pigs or their meat and 20% hand injuries. The mean duration of symptoms was 10.2 days and the most affected segment was the lumbar level. 70.6% had meningitis. All were treated with beta-lactams with an average duration of 53.2 days. There was a recurrence and none died. CONCLUSION: There are few cases of S. suis spondylodiscitis in the literature. When occurs, it is associated with another type of infection in most cases. They present a good response to medical treatment and a good prognosis.

Usefulness of a Telemedicine Tool TELEA in the Management of the COVID-19 Pandemic.

Background: The usefulness of telemedicine in the management of the coronavirus disease 2019 (COVID-19) pandemic has not been evaluated. Methods: We conducted a descriptive study of the process of recruitment and follow-up of patients using a telemedicine tool (TELEA) in the management of patients at risk, in a rural environment with a dispersed population in Lugo in north western Spain. Results: A large number of patients diagnosed with COVID-19 infection (N = 545) were evaluated. Of this group, 275 had comorbidities and were enrolled in the program, with a mean age of 57.6 ± 16.3 years, 43.1% male. The risk factors were hypertension (38%), diabetes (16%), asthma (9.5%), heart disease (8.8%), and immunosuppression (5.1%). Patients were followed through the platform with daily control of symptoms and vital signs. Only 8% were admitted to the hospital, 5.1% on a scheduled basis and 2.9% through the emergency room. Conclusion: The telemedicine tool TELEA is useful for the management of high-risk patients with COVID-19.

Neumonía comunitaria por Legionella pneumophila: estudio de 136 casos / Community acquired pneumonia by Legionella pneumophila: Study of 136 cases

Objetivo: La mayoría de los datos de la neumonía por Legionella en nuestro país proceden del área mediterránea, y apenas existen estudios en la zona del Noroeste. Con este trabajo se pretende conocer la situación de la infección en nuestro medio. Método: Estudio retrospectivo de todos los pacientes con antigenuria positiva para Legionella en el Hospital Universitario Lucus Augusti de Lugo desde 2001, año en que se introdujo la antigenuria como prueba diagnóstica en nuestro centro, hasta 2015. Se analizaron datos epidemiológicos, factores de riesgo, hallazgos clínicos, radiológicos, analíticos y evolutivos. Resultados: Se registraron 136 pacientes. Si comparamos los primeros 5años del estudio con los 5últimos, la incidencia aumentó de 10,9 a 64,5 casos/1.000.000, el número de peticiones de antigenuria se incrementó 3,4 veces, y con respecto a otras neumonías, Legionella pasó del 0,9 al 15% de ellas. La edad media fue de 64,1años, y el 84,6% fueron varones. El 74,3% tenían comorbilidades. Los varones fueron significativamente más jóvenes (62,7±16,6 vs 71,9±17,3) y consumían más alcohol (26,1% vs 0%) y tabaco (67,8% vs 14,3%). El 88,9% se diagnosticaron dentro de las primeras 72h y la mayoría recibió levofloxacino (95,6%). El 85% necesitaron ingreso hospitalario, el 11,7% en UCI y el 4,4% fallecieron. Conclusiones: Coincidiendo con la introducción de la antigenuria, se observa un aumento de incidencia de neumonía por Legionella en nuestra área sanitaria, con tasas en los últimos años que se sitúan entre las más altas de nuestro país. A pesar de tener pacientes con elevada edad media y un alto porcentaje de comorbilidades, la mortalidad fue reducida

Objective: Most of the data on Legionella pneumonia in our country come from the Mediterranean area, and there are few studies from the Northwest area. This study tries to assess the situation of this infection in this area. Method: Retrospective study of all patients with positive Legionella antigenuria treated at the University Hospital Lucus Augusti in Lugo (Spain) from 2001, the year in which this test was introduced in our centre, until 2015. We analysed epidemiological data, risk factors, clinical, radiological and biochemical findings, and clinical outcome. Results: The sampled included 136 patients. When comparing the first five years of the study with the last five, the incidence increased from 10.9 to 64.5 cases/1,000,000; the number of antigenuria requests increased 3.4 times, and compared to other pneumonia aetiologies Legionella increased from 0.9% to 15%. The mean age was 64.1years and 84.6% were males; 74.3% had comorbidities. Males were significantly younger (62.7±16.6 vs 71.9±17.3) and consumed more alcohol (26.1% vs 0%) and tobacco (67.8% vs 14.3%). Diagnosis was established within the first 72hours in 88.9% of cases and most received levofloxacin (95.6%). Hospitalisation was needed in 85% of cases, 11.7% in ICU and 4.4% died. Conclusions: After the introduction of antigenuria there was an increase in the incidence of Legionella pneumonia recorded in our health area. Its rate in recent years has been one of the highest in our country. Despite the fact that the patients had advanced age and comorbidities, mortality was low

Community acquired pneumonia by Legionella pneumophila: Study of 136 cases. / Neumonía comunitaria por Legionella pneumophila: estudio de 136 casos.

OBJECTIVE: Most of the data on Legionella pneumonia in our country come from the Mediterranean area, and there are few studies from the Northwest area. This study tries to assess the situation of this infection in this area. METHOD: Retrospective study of all patients with positive Legionella antigenuria treated at the University Hospital Lucus Augusti in Lugo (Spain) from 2001, the year in which this test was introduced in our centre, until 2015. We analysed epidemiological data, risk factors, clinical, radiological and biochemical findings, and clinical outcome. RESULTS: The sampled included 136 patients. When comparing the first five years of the study with the last five, the incidence increased from 10.9 to 64.5 cases/1,000,000; the number of antigenuria requests increased 3.4 times, and compared to other pneumonia aetiologies Legionella increased from 0.9% to 15%. The mean age was 64.1years and 84.6% were males; 74.3% had comorbidities. Males were significantly younger (62.7±16.6 vs 71.9±17.3) and consumed more alcohol (26.1% vs 0%) and tobacco (67.8% vs 14.3%). Diagnosis was established within the first 72hours in 88.9% of cases and most received levofloxacin (95.6%). Hospitalisation was needed in 85% of cases, 11.7% in ICU and 4.4% died. CONCLUSIONS: After the introduction of antigenuria there was an increase in the incidence of Legionella pneumonia recorded in our health area. Its rate in recent years has been one of the highest in our country. Despite the fact that the patients had advanced age and comorbidities, mortality was low.