Results of a multi-faceted educational intervention to prevent peripheral venous catheter-associated bloodstream infections.

Peripheral venous catheter-associated bloodstream infections (PVC-BSIs) lead to prolonged hospitalization, morbidity and increased costs. The impact of infection-prevention measures on the rate of PVC-BSIs in a university hospital in Spain was assessed. An active surveillance programme was initiated in 2015, which revealed a high PVC-BSI incidence ratio (0.48/1000 patient-days). A bundle aimed at nurses, medical staff and patients was implemented, and a Catheter Infection Team (CIT) was set up. The intervention achieved a decrease in PVC-BSI rate: 0.34 in 2016, 0.29 in 2017, and 0.17 in 2018. The decline was greatest for Gram-negative PVC-BSIs (67.6% in 2015, 35.3% in 2018).

Consenso multidisciplinar sobre prevención y tratamiento de la tuberculosis en pacientes candidatos a tratamiento biológico. Adaptación al paciente dermatológico / Prevention and treatment of tuberculosis infection in candidates for biologic therapy: A multidisciplinary consensus statement adapted to the dermatology patient

El riesgo de infección por Mycobacterium tuberculosis se halla aumentado en los pacientes con enfermedades inflamatorias crónicas y en tratamiento inmunosupresor, en particular con terapia antifactor de necrosis tumoral α. La detección de la infección tuberculosa latente y el tratamiento preventivo dirigido a reducir el riesgo de progresión a tuberculosis activa es obligatoria en este grupo de pacientes. Este documento de consenso multidisciplinar actualiza la opinión de expertos y establece recomendaciones para el diagnóstico y tratamiento de la infección tuberculosa latente en estos pacientes, según los conocimientos actuales en terapias biológicas

Patients with chronic inflammatory diseases being treated with immunosuppressive drugs, and with tumor necrosis factor inhibitors in particular, have an increased risk of infection by Mycobacterium tuberculosis. Screening for latent tuberculosis infection and preventive therapy to reduce the risk of progression to active tuberculosis are mandatory in this group of patients. This updated multidisciplinary consensus document presents the latest expert opinions on the treatment and prevention of tuberculosis in candidates for biologic therapy and establishes recommendations based on current knowledge relating to the use of biologic agents

Prevention and treatment of tuberculosis infection in candidates for biologic therapy: A multidisciplinary consensus statement adapted to the dermatology patient. / Consenso multidisciplinar sobre prevención y tratamiento de la tuberculosis en pacientes candidatos a tratamiento biológico. Adaptación al paciente dermatológico.

Patients with chronic inflammatory diseases being treated with immunosuppressive drugs, and with tumor necrosis factor inhibitors in particular, have an increased risk of infection by Mycobacterium tuberculosis. Screening for latent tuberculosis infection and preventive therapy to reduce the risk of progression to active tuberculosis are mandatory in this group of patients. This updated multidisciplinary consensus document presents the latest expert opinions on the treatment and prevention of tuberculosis in candidates for biologic therapy and establishes recommendations based on current knowledge relating to the use of biologic agents.

Mannose-binding lectin exon 1 and promoter polymorphisms in tuberculosis disease in a Mediterranean area.

Mannose-binding lectin (MBL) is a serum protein that activates the complement and mediates phagocytosis. MBL levels and MBL2 genotype may impact upon host susceptibility to tuberculosis (TB) disease but evidence to date has been conflicting. MBL2 exon 1 and promoter genotyping and serum MBL concentrations were determined in 79 patients with active tuberculosis (58 pulmonary TB and 21 extrapulmonary or miliary TB) and 120 household healthy contacts (HHC) from a Mediterranean area (Majorca Island, Spain). Significantly higher serum MBL levels were found in patients with active tuberculosis than in HHC [median MBL concentrations 3430 ng mL(-1) (10-28 415) and 2600 ng mL(-1) (5-20 000) respectively, P = 0.002]. These higher MBL levels were mainly related to the most prevalent YA/YA wild-type diplotype. There was a strong correlation between MBL2 exon 1 and promoter genotype and MBL levels. The diplotype LYQA/HYPA was present in 12 out of 57 of the pulmonary TB cases but in none of the extrapulmonary TB patients. Diplotype LXPA/HYPA, producer of high levels of MBL, was significantly more frequent in HHC than in patients (16.8% vs. 6.4%, P = 0.031) suggesting a protective role against the development of TB disease that has not been previously found.

Enfermedad por Listeria monocytogenes / Listeria monocytogenes disease

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Tuberculosis cutánea en una zona de Mallorca (2003-2011) / Cutaneous tuberculosis in an area of Mallorca (2003-2011)

Antecedentes y objetivo. La tuberculosis constituye un importante problema sanitario, también en nuestro medio. Este estudio sepropone describir las características clínicas y epidemiológicas de la tuberculosis cutánea en nuestro medio. Pacientes y métodos. Estudio retrospectivo de los casos de tuberculosis cutánea diagnosticados de enero de 2003 a julio de 2011 en un hospital de Mallorca. Se registraron las formas clínicas, la metodología diagnóstica empleada, el tratamiento utilizado y la evolución clínica. Resultados. Se diagnosticaron 28 casos de tuberculosis con afectación cutánea (5,9% del total de tuberculosis), tuberculosis verdadera en 15 casos (14 escrofulodermas, un empiema necessitatis) y tubercúlides en el resto (8 casos de eritema indurado de Bazin y 5 de eritema nodoso). El foco de origen de los escrofulodermas fue ganglionar (10), óseo (4) y pleural (1); 13/28 pacientes eran originarios de otros continentes. La mayoría de los pacientes fueron tratados con 3-4 fármacos tuberculostáticos, evolucionando favorablemente. Conclusión. La tuberculosis cutánea no es infrecuente en nuestro medio. En las tuberculosis cutáneas verdaderas el cultivo es el método diagnóstico más rentable, mientras que en las tubercúlides generalmente la histología es la que proporciona el diagnóstico(AU)

Background and objective. Tuberculosis is an important health care problem, even in our setting. The objective of this study is to describe clinic and epidemiological features of cutaneous tuberculosis in our area. Patients and methods. A retrospective study was performed of all patients diagnosed of cutaneous tuberculosis in a hospital in Mallorca (Spain) from January 2003 to July 2011. The clinical forms, diagnostic methods used, treatment used and clinical course were recorded. Results. Twenty-eight cases of cutaneous tuberculosis were diagnosed (5.9% of the tuberculosis cases diagnosed in this period), 15 with classic cutaneous tuberculosis (14 scrofuloderma, 1 empyema necessitatis) and 13 patients with tuberculids (8 erythema induratum of Bazin disease and 5 erythema nodosum). Scrofulodermas came from lymph nodes in 10 of the patients, infected bone in 4 and pleural in one case; 13/28 patients came from other continents. Most of the patients were treatment with 3-4 tuberculostatic drugs, with favorable course. Conclusions. Cutaneous tuberculosis is not uncommon in our setting. In classic cutaneous tuberculosis culture is the gold standard diagnostic method while tuberculids are most commonly diagnosed by histology(AU)

[Cutaneous tuberculosis in an area of Mallorca (2003-2011)]. / Tuberculosis cutánea en una zona de Mallorca (2003-2011).

BACKGROUND AND OBJECTIVE: Tuberculosis is an important health care problem, even in our setting. The objective of this study is to describe clinic and epidemiological features of cutaneous tuberculosis in our area. PATIENTS AND METHODS: A retrospective study was performed of all patients diagnosed of cutaneous tuberculosis in a hospital in Mallorca (Spain) from January 2003 to July 2011. The clinical forms, diagnostic methods used, treatment used and clinical course were recorded. RESULTS: Twenty-eight cases of cutaneous tuberculosis were diagnosed (5.9% of the tuberculosis cases diagnosed in this period), 15 with classic cutaneous tuberculosis (14 scrofuloderma, 1 empyema necessitatis) and 13 patients with tuberculids (8 erythema induratum of Bazin disease and 5 erythema nodosum). Scrofulodermas came from lymph nodes in 10 of the patients, infected bone in 4 and pleural in one case; 13/28 patients came from other continents. Most of the patients were treatment with 3-4 tuberculostatic drugs, with favorable course. CONCLUSIONS: Cutaneous tuberculosis is not uncommon in our setting. In classic cutaneous tuberculosis culture is the gold standard diagnostic method while tuberculids are most commonly diagnosed by histology.

Neumonía por Rhodococcus equi en un paciente con infección por el VIH. A propósito de un caso / Rhodococcus equi neumonia in a HIV infected patient: a case report

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[Peptostreptococcus endocarditis: presentation of two cases and literature review]. / Endocarditis por Peptostreptococcus: presentación de dos casos y revisión de la literatura.

We describe two new cases of Peptostreptococcus endocarditis, one case of Peptostreptococcus micros prosthetic valve endocarditis and the other of Peptostreptococcus assaccharolyticus tricuspid native valve endocarditis in an intravenous drug user (IDU) patient and review nine cases previously reported.

Neumonía por Rhodoccocus equi en paciente con infección por el VIH. A propósito de un caso / Rhodococcus equi pulmonary infection in an HIV-infected patient and radiological worsening following treatment. Case report

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Endocarditis por Peptostreptococcus: presentación de dos casos y revisión de la literatura / Peptostreptococcus endocarditis: presentation of two cases and literature review

Describimos dos nuevos casos de endocarditis por Peptostreptococcus, uno de ellos sobre válvula protésica y causado por P. micros, y otro caso de endocarditis tricuspídea por P. assacharolyticus en un paciente ADVP. Revisamos los 9 casos previamente publicados en la literatura de endocarditis causada por anaerobios del género Peptostreptococcus

We describe two new cases of Peptostreptococcus endocarditis, one case of Peptostreptococcus micros prosthetic valve endocarditis and the other of Peptostreptococcus assaccharolyticus tricuspid native valve endocarditis in an intravenous drug user (IDU) patient and review nine cases previously reported

Pseudotumor inflamatorio: presentación de 12 casos

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