Disminución de la tuberculosis osteoarticular en España entre 1997 y 2018 / Decrease in osteoarticular tuberculosis in Spain between 1997 and 2018

Antecedentes y objetivo: La tuberculosis osteoarticular representa el 2-5% de las presentaciones de la tuberculosis. El objetivo fue calcular la incidencia y describir las características epidemiológicas de los pacientes con tuberculosis osteoarticular que recibieron atención hospitalaria en España entre 1997-2018. Método: Se realizó un estudio retrospectivo de los pacientes atendidos con tuberculosis osteoarticular en los hospitales españoles entre los años 1997 y 2018, a través del Conjunto Mínimo Básico de Datos al alta hospitalaria, usando los códigos del CIE-9-MC y CIE-10. Resultados principales: Se detectaron 5710 pacientes con tuberculosis osteoarticular durante los 22 años. La incidencia anual media del periodo se situó en 6 casos por millón de habitantes (IC95% 5,58-6,30). Existió una diferencia significativa entre la incidencia media anual por millón de habitantes del primer periodo (1997-2007) de 6,95 y la del segundo (2008-2018) de 5,35 (p<0,001). Conclusión: La incidencia de la tuberculosis osteoarticular en España es baja, se ha reducido a lo largo de 22 años y predomina en hombres.(AU)

Background and objective: Osteoarticular tuberculosis represents 2-5% of the manifestations of tuberculosis. The objective was to calculate the incidence and describe the epidemiological characteristics of patients with osteoarticular tuberculosis who received hospital care in Spain between 1997-2018. Methods: A retrospective study was conducted of patients treated with osteoarticular tuberculosis in Spanish hospitals between 1997 and 2018, using the data from the Minimum Basic Data Set at hospital discharge, using the ICD-9-CM and ICD-10 codes. Results: 5710 patients with osteoarticular tuberculosis were detected over the 22 years in Spain. The mean annual incidence for the period was 6 cases per million inhabitants (95% CI 5.58-6.30). There was a significant difference between the mean annual incidence per million inhabitants of the first period (1997-2007) of 6.95 and that of the second (2008-2018) of 5.35 (p <.001). Conclusions: The incidence of osteoarticular tuberculosis in Spain is low, has reduced over 22 years and predominates in men.(AU)

Incidencia y distribución geográfica de pacientes hospitalizados con fascioliasis en España / Incidence and geographical distribution of patients hospitalised with fascioliasis in Spain

INTRODUCCIÓN: La epidemiología de la fascioliasis humana está relacionada con las características geográficas y ambientales del área donde se produce la transmisión. Existen lagunas en el conocimiento actual de la distribución de la fascioliasis en España. El objetivo del estudio fue conocer la incidencia y distribución geográfica de pacientes con fascioliasis que requirieron hospitalización en España. MÉTODO: Se realizó un estudio observacional de población hospitalizada con diagnóstico de fascioliasis, según el conjunto mínimo de datos al alta hospitalaria (CMBD), entre 1997 y 2014 (166 pacientes), de la mayoría de los hospitales del Sistema Nacional de Salud de España. RESULTADOS: La incidencia de ingresos con fascioliasis fue de 2,1 (IC99%, 2,03-2,13) casos/10.000.000 habitantes y año. La incidencia anual se redujo durante los 18 años del estudio. El riesgo relativo de los hombres fue de 1,136 (IC99%, 0,299-0,993) respecto a las mujeres. Se observó una agregación geográfica focal de casos en determinadas áreas, especialmente del norte y centro de España. Las mayores incidencias se encontraron en las provincias de Segovia y Lugo. El fallecimiento intrahospitalario se produjo en 3 pacientes. CONCLUSIÓN: La incidencia de hospitalizaciones con fascioliasis en España es baja, se ha reducido y ha predominado en las provincias de Segovia y Lugo

INTRODUCTION: The epidemiology of human fascioliasis is related to the geographical and environmental characteristics of the area where transmission occurs. There are gaps in the current knowledge of the distribution of fascioliasis in Spain. The objective of the study was to determine the incidence and geographic distribution of patients with fascioliasis who required hospitalisation in Spain. METHOD: An observational study of the hospitalised population (166 patients) with a diagnosis of fascioliasis, according to the minimum basic data set (MBDS) for hospital discharge, between 1997 and 2014 was carried out. Most of the hospitals were Spanish National Health System hospitals. RESULTS: The incidence of hospitalised patients with fascioliasis was 2.1 (99% CI, 2.03-2.13) cases/10,000,000 inhabitants per year. The annual incidence was reduced during the 18 years of the study. The relative risk of men was 1.136 (99% CI, 0.299-0.993) with respect to women. A focal geographic aggregation of cases was observed in areas especially in northern and central Spain. The greatest incidents were found in the provinces of Segovia and Lugo. Intrahospital death occurred in 3 patients. CONCLUSION: The incidence of hospitalisations with fascioliasis in Spain is low, has been reduced and has predominated in the provinces of Segovia and Lugo

Incidence and geographical distribution of patients hospitalised with fascioliasis in Spain. / Incidencia y distribución geográfica de pacientes hospitalizados con fascioliasis en España.

INTRODUCTION: The epidemiology of human fascioliasis is related to the geographical and environmental characteristics of the area where transmission occurs. There are gaps in the current knowledge of the distribution of fascioliasis in Spain. The objective of the study was to determine the incidence and geographic distribution of patients with fascioliasis who required hospitalisation in Spain. METHOD: An observational study of the hospitalised population (166 patients) with a diagnosis of fascioliasis, according to the minimum basic data set (MBDS) for hospital discharge, between 1997 and 2014 was carried out. Most of the hospitals were Spanish National Health System hospitals. RESULTS: The incidence of hospitalised patients with fascioliasis was 2.1 (99% CI, 2.03-2.13) cases/10,000,000 inhabitants per year. The annual incidence was reduced during the 18 years of the study. The relative risk of men was 1.136 (99% CI, 0.299-0.993) with respect to women. A focal geographic aggregation of cases was observed in areas especially in northern and central Spain. The greatest incidents were found in the provinces of Segovia and Lugo. Intrahospital death occurred in 3 patients. CONCLUSION: The incidence of hospitalisations with fascioliasis in Spain is low, has been reduced and has predominated in the provinces of Segovia and Lugo.

Incidencia y mortalidad de la osteomielitis en España según el conjunto mínimo básico de datos / Incidence and mortality of osteomielitis in Spain according to the basic minimum data set

Fundamento y objetivos: Conocer la incidencia y mortalidad de pacientes hospitalizados por osteomielitis en España. Material y método: Se realizó un estudio observacional de población ingresada con diagnóstico principal de osteomielitis en hospitales españoles según el conjunto mínimo de datos al alta hospitalaria, entre 1997-2014 (29.290 casos). Resultados: La incidencia de ingresos por osteomielitis fue de 3,85 (IC 99%: 3,79-3,91) casos/100.000 habitantes y año. El riesgo relativo de los hombres fue de 2,02. La mortalidad intrahospitalaria fue del 1,72% (IC 99%: 1,4 -1,93). La mortalidad de la osteomielitis asociada a septicemia alcanzó el 27,12% (IC 99%: 20,5-35), la de la infección por Staphylococcus aureus resistente a meticilina (MRSA) el 5,5% (IC 99%: 2,18-13,2) y la de mayores de 64 años el 4,65% (IC 99%: 3,89-5,0). En el análisis multivariante la mortalidad se asoció de forma independiente a los diagnósticos de septicemia, osteomielitis aguda, ingresos urgentes, infección por MRSA, mayores de 64 años, comorbilidad y mujeres (p<0,001). Conclusiones: La incidencia de hospitalizaciones por osteomielitis en España es sustancial. La sepsis, la edad superior a los 64 años e infección por MRSA son factores importantes de riesgo de muerte

Background and objectives: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. Material and method: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. Results: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. Conclusions: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death

Incidence and mortality of osteomielitis in Spain according to the basic minimum data set. / Incidencia y mortalidad de la osteomielitis en España según el conjunto mínimo básico de datos.

BACKGROUND AND OBJECTIVES: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. MATERIAL AND METHOD: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. RESULTS: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. CONCLUSIONS: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death.

Una causa inusual de dolor lumbar en paciente con sepsis / An unusual cause of low back pain in a patient with sepsis

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Incidencia de la babesiosis humana en España basada en los diagnósticos al alta hospitalaria / Incidence of human babesiosis in Spain obtained from the diagnoses at hospital discharge

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Otitis externa maligna en España / Malignant external otitis in Spain

Introducción. La otitis externa maligna, una infección necrosante, se extiende desde el epitelio escamoso del conducto auditivo externo hasta tejidos adyacentes. Se estimó la incidencia y otros datos epidemiológicos de esta enfermedad en España con la serie más amplia de casos descrita. Métodos. Se realizó un estudio retrospectivo de la población ingresada en los hospitales españoles con los datos del conjunto mínimo básico de datos (CMBD) durante el periodo 2008-2013. Se consideró «caso» a los pacientes cuyo diagnóstico (principal o secundario) al alta hospitalaria se hubiera codificado, de acuerdo al CIE 9-MC, como 380.14 (otitis externa maligna). Se calculó la tasa de incidencia por sexo, por grupos etarios, además de la estacionalidad y la mortalidad. Resultados. Se diagnosticaron 355 pacientes (302 como diagnóstico principal y 53 como secundario). La tasa de incidencia global por 1.000.000 de habitantes y año en España fue de 1,30 (IC 95%: 1,17 a 1,44), aunque varió de unas zonas geográficas a otras. La mediana de edad de los casos con diagnostico principal de OEM fue de 74 años (rango: 10 a 95 años). La mayor incidencia se situó por encima de los 84 años (19,3 casos por 106 de habitantes y año). La incidencia fue mayor en hombres y el riesgo relativo hombre-mujer de 2,4. El 74,6% de los pacientes fue diagnosticado de diabetes. El diagnóstico predominó en el último cuatrimestre del año. La tasa de mortalidad bruta intrahospitalaria fue del 3,7%. Conclusiones. La otitis externa maligna, con una incidencia y mortalidad baja, afecta principalmente a varones diabéticos de mayor edad (AU)

Introduction. Malignant external otitis is a necrotizing infection, which extends from the squamous epithelium of the ear canal to the adjacent tissue. The objective of the study was to investigate its incidence and other epidemiological data in Spain, reporting the largest case series to date. Methods. A descriptive, retrospective study of the Spanish population was carried out using the minimum basic data set (MBDS) based on data of patients admitted to hospitals in the 2008-2013 period. Patients whose diagnosis (principal or secondary) at discharge was encoded as 380.14 (malignant external otitis), according to ICD-9-CM, were included as cases. The Spanish incidence rate was calculated for all its communities and provinces, as well as by season and mortality. Results. A total of 355 patients (302 as principal diagnosis and 53 as secondary) were diagnosed. The incidence rate was 1.30 (95% CI, 1.17 to 1.44) per 106 inhabitants and year, although there were variations among geographical areas. The median age of cases with main diagnosis was 74 years (range 10-95 years). The predominant age group was in patients over 84 years old (19.3 cases per 106 inhabitants and year). The incidence was higher in men and the male-female relative risk was 2.4. Diabetes was present in 74.6% of patients. The diagnosis was predominant in the last quarter of the year. The gross in-hospital mortality rate was 3.7%. Conclusions. Malignant external otitis is seen mostly among male elderly and diabetic patients. The incidence and mortality rate are low in Spain (AU)

Malignant external otitis in Spain. / Otitis externa maligna en España.

INTRODUCTION: Malignant external otitis is a necrotizing infection, which extends from the squamous epithelium of the ear canal to the adjacent tissue. The objective of the study was to investigate its incidence and other epidemiological data in Spain, reporting the largest case series to date. METHODS: A descriptive, retrospective study of the Spanish population was carried out using the minimum basic data set (MBDS) based on data of patients admitted to hospitals in the 2008-2013 period. Patients whose diagnosis (principal or secondary) at discharge was encoded as 380.14 (malignant external otitis), according to ICD-9-CM, were included as cases. The Spanish incidence rate was calculated for all its communities and provinces, as well as by season and mortality. RESULTS: A total of 355 patients (302 as principal diagnosis and 53 as secondary) were diagnosed. The incidence rate was 1.30 (95% CI, 1.17 to 1.44) per 106 inhabitants and year, although there were variations among geographical areas. The median age of cases with main diagnosis was 74 years (range 10-95 years). The predominant age group was in patients over 84 years old (19.3 cases per 106 inhabitants and year). The incidence was higher in men and the male-female relative risk was 2.4. Diabetes was present in 74.6% of patients. The diagnosis was predominant in the last quarter of the year. The gross in-hospital mortality rate was 3.7%. CONCLUSIONS: Malignant external otitis is seen mostly among male elderly and diabetic patients. The incidence and mortality rate are low in Spain.

Incidencia de la enfermedad de Lyme en España / Incidence of Lyme disease in Spain

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[Mediterranean Spotted Fever: epidemiological Assessment in Spain during the Period 2009-2012]. / Fiebre botonosa mediterránea: epidemiología en España durante el periodo 2009-2012.

BACKGROUND: The Mediterranean Spotted Fever (MSF) is a zoonosis, produced by Rickettsia conorii whose vector is Rhipicephallus sanguineus. The aim of this study was to describe the epidemiology in Spain and its Autonomous Communities (AA.CC) and the average cost during the period 2009-2012. METHODS: We conducted a retrospective observational study of patients, between 2009-2012, whose diagnostic at hospital discharge was encoded, according to the International Classification of Diseases 9th revision Clinical Modification (ICD-9CM) as 82.1 (MSF). The information was collected through the minimum basic data set. Incidence rates of the disease were calculated in Spain and its Autonomous Communities. The fStats software was used for comparison of rates based on age, sex, annual, seasonal and AA.CC's distribution. The average cost (in euros) was calculated according to the state standard. RESULTS: The incidence rate was 0,36 cases per 100,000 inhabitants and year during 2009-2012, with 667 admissions. The highest incidence was obtained in Ceuta and La Rioja with an incidence of 1,9 and 1,87 cases per 100,000 inhabitants per year. No cases were detected in Cantabria nor Canarias. The relative risk male female was 2:1 (p value<0,05). The predominant age group was over 55 years (327 cases). The months with the most cases were from June to September (466 cases), producing a peak in the number of cases in August (137 cases). The mortality rate was 0,3%. The average cost was 4.647,205 €. CONCLUSION: The incidence of MSF was low, with a heterogeneous geographical distribution and with higher frequency during the month of August. Patients of all ages were detected, predominantly for males over 55 years old. The hospital mortality rate was small.

[Incidence of Bartonella Henselae Infection during the period 2009-2012 in the Valencian Community, Spain]. / Incidencia de la infección por Bartonella henselae en la Comunidad Valenciana durante el período 2009-2012.

BACKGROUND: Bartonella henselae is the causative agent of the disease caused by cat scratches and it has a worldwide distribution. The objective of the study was to investigate its incidence in the Valencian Community during the period 2009-2012. METHODS: A study of the chosen microbiological tests for B. henselae during four years was carried out. Pacients with serology (IgM and IgG), culture, or PCR positive were considered case studies. Data from the Red de Vigilancia Microbiológica Valenciana (RedMIVA) depending on the "General Direction of Public Health" (Dirección General de Salud Pública) was used as the source of information. RESULTS: During the studied period, 14 cases were detected. The incidence rates were: 0,07 per 10(5) inhabitants and year of the Valencian Community, 0,10 per 10(5) inhabitants/year in the province of Alicante, with marked differences in relation to Valencia of 0,06 per 105 inhabitants/year and Castellon (with no cases). The temporal distribution of the cases were: 4 in 2009, 4 in 2010, 3 in 2011, and 3 in 2012. 64% of the cases were women and 36% men. The median age was 21 years (range 1-65 years). Predominant age groups arose between 1-10 years (42%) and 31-40 years (28%). CONCLUSIONS: The incidence of B. henselae in the Valencian Community is low. The data obtained suggest that its distribution varies depending on the geographical area in the Community. There is a predominance of young people.

Fiebre botonosa mediterránea: epidemiología en España durante el periodo 2009-2012 / Mediterranean Spotted Fever: Epidemiological Assessment in Spain during the Period 2009-2012

Fundamento: La Fiebre Botonosa Mediterránea (FBM) es una zoonosis producida por Rickettsia conorii cuyo vector es Rhipicephallus sanguineus. El objetivo de este trabajo fue describir la epidemiología y el coste medio de la fiebre botonosa en España y sus comunidades autónomas durante el período 2009-2012). Métodos: Se realizó un estudio observacional del período 2009-2012 utilizando como fuente de información el Conjunto Mínimo de Datos (CMBD), identificando las altas hospitalaria cuyo diagnóstico, de acuerdo a la Clasificación Internacional de Enfermedades 9ª revisión Modificación Clínica (CIE-9MC) fue 82.1 (fiebre botonosa mediterránea). Se calcularon las tasas de incidencia de dicha enfermedad en España y cada una de las comunidades autónomas. El coste medio (en euros) se calculó de acuerdo a la norma estatal para grupos diagnósticos relacionados. Se utilizó el software fStats para la comparación de tasas según la edad, sexo, distribución anual, estacional y por CCAA. Resultados: Durante el período de estudio se identificaron 667 ingresos con diagnóstico al alta de fiebre botonosa mediterránea, siendo la tasa de incidencia fue de 0,36 casos por 100.000 habitantes. La mayor incidencia se dio en Ceuta y La Rioja con una incidencia de 1,9 y 1,87 casos por 100.000 habitantes y año. No se detectaron casos en Cantabria ni en Canarias. El riesgo relativo hombre/mujer fue 2:1 (valor de p<0,05). El grupo etario predominante fue el de los mayores de 55 años (327 casos). Los meses con más casos fueron de junio-septiembre (466 casos), produciéndose un pico de casos en agosto (137 casos). La tasa de mortalidad fue 0,3%. El coste medio fue de 4.647,205€. Conclusión: La incidencia de la fiebre botonosa mediterránea durante el período estudiado fue menor que en períodos anteriores, con una distribución por comunidades autónomas heterogénea y con mayor frecuencia durante el mes de agosto. Se detectaron pacientes de todas las edades, predominando los varones mayores de 55 años. La tasa de mortalidad intrahospitalaria fue pequeña (AU)

Background: The Mediterranean Spotted Fever (MSF) is a zoonosis, produced by Rickettsia conorii whose vector is Rhipicephallus sanguineus. The aim of this study was to describe the epidemiology in Spain and its Autonomous Communities (AA.CC) and the average cost during the period 2009-2012. Methods: We conducted a retrospective observational study of patients, between 2009-2012, whose diagnostic at hospital discharge was encoded, according to the International Classification of Diseases 9th revision Clinical Modification (ICD-9CM) as 82.1 (MSF). The information was collected through the minimum basic data set. Incidence rates of the disease were calculated in Spain and its Autonomous Communities. The fStats software was used for comparison of rates based on age, sex, annual, seasonal and AA.CC´s distribution. The average cost (in euros) was calculated according to the state standard. Results: The incidence rate was 0,36 cases per 100,000 inhabitants and year during 2009-2012, with 667 admissions. The highest incidence was obtained in Ceuta and La Rioja with an incidence of 1,9 and 1,87 cases per 100,000 inhabitants per year. No cases were detected in Cantabria nor Canarias. The relative risk male female was 2:1 (p value<0,05). The predominant age group was over 55 years (327 cases). The months with the most cases were from June to September (466 cases), producing a peak in the number of cases in August (137 cases). The mortality rate was 0,3%. The average cost was 4.647,205€. Conclusion: The incidence of MSF was low, with a heterogeneous geographical distribution and with higher frequency during the month of August. Patients of all ages were detected, predominantly for males over 55 years old. The hospital mortality rate was small (AU)

Incidencia de la infección por bartonella henselae en la comunidad valenciana durante el período 2009-2012 / Incidence of Bartonella Henselae Infection during the period 2009-2012 in the Valencian Community, Spain

Fundamentos: Bartonella henselae es el agente causal de la enfermedad por arañazo de gato y su distribución es mundial. El objetivo del trabajo fue conocer la incidencia de esta infección en la Comunidad Valenciana durante el periodo 2009-2012. Métodos: Se realizó el estudio sobre las pruebas microbiológicas solicitadas para B. henselae durante cuatro años. Se consideró 'caso' al paciente con serología (IgM e IgG), cultivo o PCR positivos. Como fuente de información se utilizaron los datos procedentes de la Red de Vigilancia Microbiológica Valenciana (RedMIVA) dependiente de la Dirección General de Salud Pública. Resultados: Durante el periodo estudiado se detectaron 14 casos. Las tasas de incidencia fueron: 0,07 por 105 habitantes y año en la Comunidad Valenciana, 0,10 por 105 habitantes/año en la provincia de Alicante, 0,06 por 105 habitantes/año en Valencia y ningún caso en la provincia de Castellón. La distribución temporal de los casos fue: 4 en 2009, 4 en 2010, 3 en 2011 y 3 en 2012. El 64% fueron mujeres y el 36% hombres. La mediana de edad fue de 21 años (rango de 1-65 años). Los grupos etarios predominantes se presentaron entre 1-10 años (42%) y 31-40 años (28%). Conclusiones: La incidencia de infección por B. henselae en la Comunidad Valencia es baja. Los datos obtenidos sugieren que varía su distribución según el área geográfica dentro de la Comunidad. Se observa un predominio de casos entre la población infantil (AU)

Background: Bartonella henselae is the causative agent of the disease caused by cat scratches and it has a worldwide distribution. The objective of the study was to investigate its incidence in the Valencian Community during the period 2009-2012. Methods: A study of the chosen microbiological tests for B. henselae during four years was carried out. Pacients with serology (IgM and IgG), culture, or PCR positive were considered case studies. Data from the Red de Vigilancia Microbiológica Valenciana (RedMIVA) depending on the 'General Direction of Public Health' (Dirección General de Salud Pública) was used as the source of information. Results: During the studied period, 14 cases were detected. The incidence rates were: 0,07 per 105 inhabitants and year of the Valencian Community, 0,10 per 105 inhabitants/year in the province of Alicante, with marked differences in relation to Valencia of 0,06 per 105 inhabitants/year and Castellon (with no cases). The temporal distribution of the cases were: 4 in 2009, 4 in 2010, 3 in 2011, and 3 in 2012. 64% of the cases were women and 36% men. The median age was 21 years (range 1-65 years). Predominant age groups arose between 1-10 years (42%) and 31-40 years (28%). Conclusions: The incidence of B. henselae in the Valencian Community is low. The data obtained suggest that its distribution varies depending on the geographical area in the Community. There is a predominance of young people (AU)