Kodamaea ohmeri: A rare yeast causing invasive infections in immunocompromised patients.

INTRODUCTION: Kodamaea ohmeri is a rare, recognized pathogen that has previously been isolated from environmental sources. The patients commonly affected by this yeast include immunocompromised as well as immunocompetent patients having several associated risk factors. METHODOLOGY: We report three cases in which K. ohmeri was isolated from blood using Bact T/ALERT. Identification was carried out by MALDI-TOF MS (Vitek-MS, BioMérieux, Marcy-l'Etoile, France) in addition to color characteristics on chromogenic media. The patients had diminished immune response on account of a multitude of comorbidities. RESULTS: K. ohmeri can be misidentified as Candida tropicalis, Candida albicans, or Candida hemolounii by conventional methods; correct and timely identification can be achieved by MALDI-TOF MS. Antifungal susceptibility breakpoints for K. ohmeri are currently not defined. An Echinocandin was added to the treatment regimen of all three of the cases. CONCLUSIONS: Identification of K. ohmeri using conventional methods is difficult and unusual yeasts should be carefully observed, especially upon prolonged incubation.

Undervalued tuna meat (Thunus obesus and Katsuwonus pelamis lineaus) to develop sausages / Carne infravalorada de atún (Thunnus obesus y Katsuwonus pelamis linnaeus) para desarrollar salchichas

Background: The tuna industry is one of the most essential sectors in global food production. Nevertheless, commercial meat known as "tuna loin" holds the utmost significance in producing and marketing its various products. Regrettably, fractions like tail and head meat have been overlooked and wasted due to their comparatively lower commercial value. Despite possessing notable technological value, this meat is typically reutilized into animal feed through flour production, missing the chance to create alternative high-value food products. Objective: This study aimed to develop and evaluate the sausages produced with the underutilized cuts of tuna (tail and head meat). Methods: The tuna utilized were Big-eye (Thunus obesus) and Skip-jack (Katsuwonus pelamis lineaus). Three (3) different types of sausages were formulated using 100% of Big-eye (BE), 100% of Skip-jack (SJ) tuna meat, and 100% of beef/pork meat (Control). The sausage pH changes during storage at 4 ± 1oC were analyzed and compared with the control. Proximal, microbiological, and sensory characteristics were evaluated. Results: The pH of sausages showed that the values tended to decrease in control, while this value increased in two types of tuna. The formulated tuna sausages yielded 72% moisture, 18% protein, 4.1% lipid, 0.4% ash, 0.4 % fiber, and 4.5% carbohydrates. Sensory attributes showed excellent acceptance regarding color, smell, flavor, and texture. Overall acceptability was qualified as "liked," and the acceptability index ranged from 76% to 86%. During the refrigeration storage, the microbiological analyses indicated that the total coliform count was < 3 CFU/g. Escherichia coli, Staphylococcus aureus, and mesophilic aerobic bacteria in tuna sausage showed absence during 24 days of storage. Conclusion: Using tuna tail and head meat enabled the development of gel-type emulsified products (sausages) that exhibited good nutritional, sensory, and microbiological quality

Antecedentes: La industria atunera se erige como uno de los sectores más importantes en la producción mundial de alimentos. Sin embargo, entre sus diversos productos, la carne comercial conocida como "lomo de atún" ostenta la mayor importancia tanto en su producción como en su comercialización. Lamentablemente, fracciones de carne provenientes de la cola y la cabeza se han desperdiciado debido a su reducido valor comercial. A pesar de poseer un notable valor tecnológico, esta carne normalmente es utilizada en la alimentación animal mediante la producción de harina, perdiendo la oportunidad de desarrollar productos alimenticios alternativos con alto valor nutricional. Objetivo: Este estudio tuvo como objetivo desarrollar y evaluar salchichas producidas con carne subutilizada de atún (carne de cola y cabeza). Métodos: Las especies de atún utilizadas fueron Big-eye (Thunus obesus) and Skip-jack (Katsuwonus pelamis lineaus). Se formularon tres (3) tipos diferentes de salchichas usando 100 % de carne de atún Big-eye (BE), 100 % de Skip-jack (SJ) y 100 % de carne de res/cerdo (Control). Se analizaron los cambios de pH en las salchichas durante el almacenamiento a 4 ± 1 oC y se compararon con el Control. También se evaluaron la composición proximal, calidad microbiológica y atributos sensoriales. Resultados: El pH mostró que los valores tendieron a disminuir en relación a la muestra Control, mientras que este valor aumentó en los dos tipos de salchicha con carne de atún. Las salchichas con carne de atún mostraron un 72 % de humedad, 18 % de proteína, 4,1 % de lípidos, 0,4 % de ceniza, 0,4 % de fibra, 4,5 % de carbohidratos. Los atributos sensoriales mostraron buena aceptabilidad de los parámetros de color, olor, sabor y textura. La aceptabilidad general se calificó como "me gusta" y el índice de aceptabilidad osciló entre el 76 % y el 86 %. Durante el periodo de almacenamiento en refrigeración, los análisis microbiológicos indicaron que el recuento de coliformes totales fue < 3 UFC/g. No se evidenció la presencia de Escherichia coli, Staphylococcus aureus y bacterias aerobias mesófilas durante 24 días de almacenamiento. Conclusión: El aprovechamiento de la carne de la cola y cabeza del atún permitió desarrollar productos emulsionados tipo gel (embutidos) que exhibieron buena calidad nutricional, sensorial y microbiológica.

Identification of microorganisms in wet coffee fermentation Coffea arabica Var Catimor and Castillo in Jardín, Antioquia-Colombia, using culture-dependent methods / Identificación de microorganismos en fermentación húmeda de café Coffea arabica Var Catimor y Castillo en Jardín, Antioquia-Colombia, usando métodos cultivo-dependientes

Background: Mild Colombian coffees are recognized worldwide for their high-quality coffee cup. However, there have been some failures in post-harvest practices, such as coffee grain fermentation. These failures could occasionally lead to defects and inconsistencies in quality products and economic losses for coffee farmers. In Colombia, one of the fermentation methods most used by coffee growers is wet fermentation, conducted by submerging the de-pulped coffee beans for enough time in water tanks to remove the mucilage. Objectives: We evaluated the effect of the water (g)/de-pulped coffee (g) ratio (I: 0/25, II: 10/25, III: 20/25) and final fermentation time (24, 48, and 72 hours) on the total number of microbial groups. We also identified microorganisms of interest as starter cultures. Methods: We used a completely randomized experimental design with two factors; the effect of the water (g)/de-pulped coffee (g) ratio (I: 0/25, II: 10/25, III: 20/25) and final fermentation time (24, 48, and 72 hours), for 9 treatments with two replicates. During the coffee fermentation (1,950 g), the pH and °Brix were monitored. Total counts of different microbial groups (mesophiles, coliforms, lactic-acid bacteria, acetic-acid bacteria, and yeasts) were performed. Various isolates of microorganisms of interest as starter cultures (lactic-acid bacteria and yeasts) were identified using molecular sequencing techniques. Results: 21 lactic-acid bacteria (LAB) isolates and 22 yeasts were obtained from the different mini-batch fermentation systems. The most abundant lactic-acid bacteria species found were Lactiplantibacillus plantarum (46%) and Levilactobacillus brevis (31%). Pichia kluivery (39%) and Torulaspora delbrueckii (22%) were the most abundant yeast species. Conclusion The studied factors did not have effect over the microorganism's development. The identified bacterial and yeasts species have potential as starter cultures for better-quality coffees and in fermentation-related applications.

Antecedentes: Los cafés suaves lavados colombianos son reconocidos a nivel mundial por su buena puntuación sensorial; sin embargo, se han detectado fallas en las prácticas de postcosecha, como lo es la fermentación de los granos de café. Dichas fallas pueden causar defectos y carecer de consistencia en la calidad del producto, ocasionando pérdidas económicas para los caficultores. En Colombia, uno de los métodos más usados por los caficultores es la fermentación húmeda, la cual consiste en sumergir los granos de café despulpado en tanques con agua por un período de tiempo que permita la remoción del mucílago. Objetivos: La presente investigación evaluó la incidencia que tienen la proporción agua/granos despulpados de café (I: 0/25, II: 10/25, III: 20/25) y el tiempo final de fermentación (24, 48 y 72 horas) en el recuento final de grupos microbianos. Por otra parte, se identificaron taxonómicamente microorganismos de interés para su uso como cultivos iniciadores. Métodos: Mini-lotes consistieron en café despulpado (1950 g) puesto en recipientes de plástico abiertos y sumergidos en agua. Se aplicó un diseño experimental completamente aleatorizado de dos factores (proporción agua/ granos de café despulpado y tiempo) a tres niveles, para un total de nueve tratamientos con dos replicas. Durante las fermentaciones de café (1,950 g), el pH y los grados ºBrix, fueron monitoreados. Se realizaron los recuentos totales de los diferentes grupos microbianos: mesófilos, coliformes, bacterias ácido-lácticas, bacterias ácido-acéticas y levaduras. Se identificaron molecularmente diferentes aislados con potencial para ser usados como cultivos iniciadores (bacterias ácido-lácticas y levaduras). Resultados: Los resultados obtenidos mostraron que no hubo diferencia estádisticamente significativa entre los tratamientos aplicados y el recuento final de microorganismos. Un total de 21 aislados de bacterias ácido-lácticas (BAL) y 22 levaduras lograron obtenerse a partir de los diferentes sistemas de fermentación en mini-lote. Las especies de bacterias ácido-lácticas con mayor porcentaje acorde a su identificación taxonómica, corresponden a Lactiplantibacillus plantarum (46%), Levilactobacillus brevis (31%). Las especies de levaduras con mayor porcentaje acorde a su identificación taxonómica corresponden a Pichia kluivery (39%) y Torulaspora delbrueckii (22%). Conclusión Los factores estudiados no afectaron el crecimiento de ninguno de los grupos microbianos presentes en la fermentacion del café. Las especies de microorganismos identificados tienen potencial para se usados como cultivos starter o en aplicaciones dentro de las ciencias de fermentación.

The clinical value of mNGS of bronchoalveolar lavage fluid versus traditional microbiological tests for pathogen identification and prognosis of severe pneumonia (NT-BALF):study protocol for a prospective multi-center randomized clinical trial.

BACKGROUND: Early, rapid, and accurate pathogen diagnosis can help clinicians select targeted treatment options, thus improving prognosis and reducing mortality rates of severe pneumonia. Metagenomic next-generation sequencing (mNGS) has a higher sensitivity and broader pathogen spectrum than traditional microbiological tests. However, the effects of mNGS-based antimicrobial treatment procedures on clinical outcomes and cost-effectiveness in patients with severe pneumonia have not been evaluated. METHODS: This is a regional, multi-center, open, prospective, randomized controlled trial to evaluate that whether the combination of mNGS and traditional testing methods could decrease 28-day call-cause mortality with moderate cost-effectiveness. A total of 192 patients with severe pneumonia will be recruited from four large tertiary hospitals in China. Bronchoalveolar lavage fluid will be obtained in all patients and randomly assigned to the study group (mNGS combined with traditional microbiological tests) or the control group (traditional microbiological tests only) in a 1:1 ratio. Individualized antimicrobial treatment and strategy will be selected according to the analysis results. The primary outcome is 28-day all-cause mortality. The secondary outcomes are ICU and hospital length of stay (LOS), ventilator-free days and ICU-free days, consistency between mNGS and traditional microbiological tests, detective rate of mNGS and traditional microbiological tests, turn-out time, time from group allocation to start of treatment, duration of vasopressor support, types and duration of anti-infective regimens, source of drug-resistant bacteria or fungi, and ICU cost. DISCUSSION: The clinical benefits of mNGS are potentially significant, but its limitations should also be considered. TRIAL REGISTRATION: ChineseClinicalTrialRegistry.org, ChiCTR2300076853. Registered on 22 October 2023.

Microorganism-mediated biodegradation for effective management and/or removal of micro-plastics from the environment: a comprehensive review.

Micro- plastics (MPs) pose significant global threats, requiring an environment-friendly mode of decomposition. Microbial-mediated biodegradation and biodeterioration of micro-plastics (MPs) have been widely known for their cost-effectiveness, and environment-friendly techniques for removing MPs. MPs resistance to various biocidal microbes has also been reported by various studies. The biocidal resistance degree of biodegradability and/or microbiological susceptibility of MPs can be determined by defacement, structural deformation, erosion, degree of plasticizer degradation, metabolization, and/or solubilization of MPs. The degradation of microplastics involves microbial organisms like bacteria, mold, yeast, algae, and associated enzymes. Analytical and microbiological techniques monitor microplastic biodegradation, but no microbial organism can eliminate microplastics. MPs can pose environmental risks to aquatic and human life. Micro-plastic biodegradation involves fragmentation, assimilation, and mineralization, influenced by abiotic and biotic factors. Environmental factors and pre-treatment agents can naturally degrade large polymers or induce bio-fragmentation, which may impact their efficiency. A clear understanding of MPs pollution and the microbial degradation process is crucial for mitigating its effects. The study aimed to identify deteriogenic microorganism species that contribute to the biodegradation of micro-plastics (MPs). This knowledge is crucial for designing novel biodeterioration and biodegradation formulations, both lab-scale and industrial, that exhibit MPs-cidal actions, potentially predicting MPs-free aquatic and atmospheric environments. The study emphasizes the urgent need for global cooperation, research advancements, and public involvement to reduce micro-plastic contamination through policy proposals and improved waste management practices.

Comparison of MBT biotargets with MBT steel targets for matrix-assisted laser desorption/ionization time of flight mass spectrometry identifications of microorganisms in a clinical microbiology laboratory.

MALDI-TOF MS identifications of microorganisms in a clinical laboratory were investigated, comparing steel targets with MBT Biotargets. By using MBT Biotargets, the score values of yeast identifications increased, whereas the score values of Gram-negative bacteria decreased. Switching to MBT Biotargets did not negatively impact overall frequencies of high confidence identifications.

Mortality and sequelae of tuberculous meningitis in a high-resource setting: A cohort study, 1990–2017 / Mortalidad y secuelas de la meningitis tuberculosa en Barcelona (España): Estudio de cohortes, 1990-2017

Introduction: Tuberculous meningitis (TBM), the most serious form of tuberculosis, results in high mortality and long-term disability in low-resource countries. We investigated temporal trends in mortality and sequelae in a high-resource low-incidence country. Methods: We performed a retrospective cohort study of all adult patients with TBM at two third-level teaching hospitals in Barcelona (Spain), between January 1990 and December 2017, assessing temporal trends in mortality and sequelae after 12 months over four consecutive 7-year time windows. Rates observed across the four periods were adjusted for covariates. Results: Of the 135 cases included, all but one started tuberculosis (TB) treatment and 120 (89.6%) received rifampicin, isoniazid, and pyrazinamide, with or without ethambutol. The probability of being alive at month 12 was 81.8%, with no differences among the four periods: in comparison with the 1990–1996 period, the adjusted hazard ratios and 95% confidence intervals (CI) were 2.55 (0.71–9.25), 0.70 (0.13–3.85), and 1.29 (0.28–5.91) for the 1997–2003, 2004–2010, and 2011–2017 periods respectively. Sequelae were present in 28.3% at month 12, with no differences across the four periods in the adjusted analysis: in comparison with the 1990–1996 period, the odds ratios and 95% CIs were 0.80 (0.09–7.22); 1.94 (0.21–17.96), and 2.42 (0.25–23.07) for the 1997–2003, 2004–2010, and 2011–2017 periods respectively. Conclusion: This study shows that TBM still causes high mortality and disability even in a high-resource low-incidence TB setting and without improvement over time.(AU)

Introducción: La meningitis tuberculosa (TBM), la forma más grave de tuberculosis, provoca una alta mortalidad y discapacidad a largo plazo en países con bajos recursos. Nuestro objetivo es investigar la tendencia temporal de la mortalidad y las secuelas en un país con recursos elevados y baja incidencia. Métodos: Hemos realizado un estudio de cohortes retrospectivo de los pacientes adultos con TBM en dos hospitales universitarios de tercer nivel en Barcelona (España), entre 1990 y 2017, evaluando las tendencias temporales de mortalidad y secuelas a los 12 meses, comparando cuatro periodos consecutivos de siete años. Las tasas observadas en los cuatro periodos se han ajustado por covariables. Resultados: De los 135 casos incluidos, todos menos uno inició tratamiento antituberculoso y 120 (89,6%) recibieron rifampicina, isoniazida y pirazinamida, con o sin etambutol. La probabilidad de estar vivo a los 12 meses fue de 81,8%, sin diferencias entre los cuatro periodos: en comparación con el periodo 1990-1996, los coeficientes de riesgo ajustados y los intervalos de confianza (IC) del 95% fueron 2,55 (0,71-9,25), 0,70 (0,13-3,85) y 1,29 (0,28-5,91) para los periodos 1997-2003, 2004-2010 y 2011-2017, respectivamente. Las secuelas estaban presentes en 28,3% en el mes 12, sin diferencias entre los cuatro periodos en el análisis ajustado: en comparación con el periodo 1990-1996, los coeficientes de probabilidad y los IC 95% fueron 0,80 (0,09-7,22); 1,94 (0,21-17,96) y 2,42 (0,25-23,07) para los periodos 1997-2003, 2004-2010 y 2011-2017, respectivamente. Conclusión: Este estudio muestra que la TBM todavía causa una alta mortalidad y discapacidad sin mejoría con el tiempo, incluso en un entorno con baja incidencia de tuberculosis y con elevados recursos.(AU)

Cambios en las características epidemiológicas y en el pronóstico de la hepatitis crónica B en personas que viven con VIH / Epidemiological characteristic and prognosis changes in chronic hepatitis B in people living with HIV

Introducción: La vacunación, los avances en el tratamiento frente al virus de la hepatitis B (VHB) y los cambios epidemiológicos producidos en España en las últimas décadas han podido modificar las características y el pronóstico de la hepatitis crónica B (HCB) en personas que viven con VIH (PVIH). Métodos: Estudio observacional retrospectivo donde se incluyeron PVIH-HCB en seguimiento en una unidad de referencia madrileña hasta el año 2019. Se comparó la incidencia y las características epidemiológicas y clínicas según el momento del diagnóstico (antes del año 2000 y posteriormente en periodos de cinco años). Además, se realizó un estudio longitudinal retrospectivo evaluando la tasa de mortalidad, descompensación hepática y factores asociados. Resultados: De 5.452 PVIH, 160 presentaban HCB en el momento basal (prevalencia 2,92%, IC 95%: 2,5-3,4), 85,6% hombres, edad mediana al diagnóstico 32,1 (27-37,2) años. La incidencia (2,4/100 pacientes-año) no varió en los diferentes periodos. Los pacientes diagnosticados antes del 2000 (n = 87) comparados con los diagnosticados entre 2015-2019 (n = 11) con mayor frecuencia eran nativos españoles (90,8 vs. 18,2%), habían consumido drogas intravenosas (55,2 vs. 0), tenían antecedentes de hepatitis C (40 vs. 9,1%) y delta (30,4 vs. 0) y mayor afectación hepática (24,1% cirróticos vs. 0). Tras un seguimiento de 20,4 años, 23 pacientes murieron (7,1/1.000 pacientes-año) y 19 presentaron descompensación hepática (4,9/1.000 pacientes-año), todos diagnosticados antes del año 2010. La mortalidad se asoció con mayor fibrosis hepática basal estimada por Fibroscan® (HR 1,06; IC 95%: 1,03-1,09). Conclusión: Las PVIH-HCB con diagnóstico previo al año 2000 son más frecuentemente de nacionalidad española, infectadas por vía parenteral y con mayor prevalencia de otras coinfecciones. Los pacientes diagnosticados antes del 2010 tienen peor pronóstico condicionado por presentar mayor grado de fibrosis hepática.(AU)

Introduction: Due to hepatitis B virus (HBV) treatment and vaccination during the last decades in Spain, epidemiological and prognosis of chronic hepatitis B (CHB) may have changed. Methods: Retrospective review of CHB–HIV coinfected patients in a single reference center in Madrid until year 2019. We compared incidence, epidemiological and clinical characteristics according diagnosis period (before 2000, 2000–2004, 2005–2009, 2010–2014, 2015–2019). A retrospective longitudinal study was done to assess mortality, related risk factors and hepatic decompensation. Results: Out of 5452 PLHIV, 160 had CHB (prevalence 2.92%; 95% CI: 2.5–3.4), 85.6% were men, median age 32.1 (27–37.2). Incidence rate did not change over the years (2.4/100 patients-year). PLHIV with CHB diagnosed before year 2000 (n = 87) compared with those diagnosed between 2015 and 2019 (n = 11) were more often native-Spanish (90.8% vs. 18.2%), had infected using intravenous drugs (55.2% vs. 0), were coinfected with hepatitis C (40% vs. 9.1%) or hepatitis delta virus (30.4% vs. 0) and had more severe liver disease (cirrhosis 24.1% vs. 0). After a median follow-up of 20.4 years, 23 patients died (7.1/1000 patients-year) and 19 had liver decompensation (4.9/1000 patients-year). All deaths and liver decompensation occurred in patients diagnosed before year 2010. Mortality was associated with higher liver fibrosis in Fibroscan® (HR 1.06, 95% CI: 1.03–1.09). Conclusion: The epidemiology of CHB in PLHIV in our cohort is changing with less native Spanish, more sexually transmitted cases and less coinfection with other hepatotropic virus. Patients diagnosed before 2010 have worst prognosis related to higher grades of liver fibrosis.(AU)

Impact on tuberculosis diagnostic during COVID-19 pandemic in a tertiary care hospital / Impacto de la pandemia COVID-19 en el diagnóstico de tuberculosis en un hospital de tercer nivel

Introduction: The aim of this study is to review how did the first three COVID-19 waves affected the diagnostic of tuberculosis and to describe the extra-pulmonary Mycobacterium tuberculosis complex (TB) diagnosis. Materials and methods: A retrospective observational study was done during the first three waves of pandemic to ascertain the impact on TB samples and to recover the extra-pulmonary TB cases we included the first two years of COVID-19. All relevant data was recovered from hospital and Clinical Microbiology records. Results: Prepandemic period showed an average of 44 samples per week for TB study; during the first three waves this number dropped to 23.1 per week. A reduction of 67.7% of pulmonary TB diagnosis was observed and an increase of 33.3% diagnosis of extra-pulmonary TB was noted when comparing pre-pandemic and pandemic period. Discussion: The number of declared cases and samples for TB diagnosis dropped during the first three COVID-19 waves due to the overstretched Public Health System which could lead to a delay in diagnosis, treatment and to the spread of TB disease in the general population. Surveillance programs should be reinforced to avoid this.(AU)

Introducción: El objetivo de este estudio fue revisar cómo afectaron las primeras tres olas de la pandemia COVID-19 al diagnóstico de tuberculosis y describir el diagnóstico de las infecciones extrapulmonares causadas por Mycobacterium tuberculosis complex (TB). Materiales y métodos: Se realizó un estudio observacional y retrospectivo durante el periodo que incluye las tres primeras olas de la pandemia para valorar el impacto en las muestras de TB y para valorar el diagnóstico de las TB extrapulmonares se amplió el periodo de estudio para incluir los 2 primeros años de la COVID-19. Todos los datos relevantes se extrajeron de la base de datos del hospital y del Servicio de Microbiología y Parasitología Clínica. Resultados: En el periodo prepandémico se recibían una media de 44 muestras por semana para el estudio de TB; durante las tres primeras olas ese número cayó a 23,1 por semana. Se observó una reducción del 67,7% en el diagnóstico de la TB pulmonar y un aumento del 33,3% en el diagnóstico de la TB extrapulmonar cuando se comparó con los datos prepandemia. Discusión: El número de casos declarados y el número de muestras para el diagnóstico de TB cayó durante las tres primeras olas del COVID-19 debido a la saturación del Sistema Nacional de Salud, lo que podría llevar a un retraso en el diagnóstico, tratamiento y a un aumento de la transmisión en la población general. Los sistemas de vigilancia deberían reforzarse para evitar esto.(AU)

Efectividad de la vacuna antigripal para prevenir casos graves de gripe. Temporada 2022/2023 / Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023

Introducción: La gripe supone una importante carga en términos de morbimortalidad, siendo la vacunación una de las medidas más efectivas para su prevención. Por lo que el objetivo de este estudio es conocer la efectividad de la vacuna antigripal para prevenir casos de gripe grave en los pacientes ingresados en un hospital de tercer nivel durante la temporada 2022/23. Metodología: Estudio de casos y controles. Se incluyeron todos los pacientes hospitalizados con resultado positivo en una RT-PCR de gripe. Se consideró caso a aquellos que cumplieron criterio de caso grave (neumonía, sepsis, fallo multiorgánico, ingreso en la UCI o exitus). Quienes no los cumplían se consideraron controles. Se calculó la efectividad vacunal (EV) para prevenir los casos graves y su intervalo de confianza al 95%. Resultados: Un total de 403 pacientes ingresaron con gripe confirmada. Noventa y ocho (24,3%) de ellos desarrollaron gripe grave. Del total, el 50,6% fueron varones y el 47,1% fueron mayores de 65 años. La EV ajustada por tipo de gripe, edad y ciertas comorbilidades fue del 40,6% (−21,9-71,1). En un análisis segmentado, la vacuna de la gripe resultó efectiva para la prevención de los casos graves en todas las categorías. Resultó especialmente relevante en el grupo de 65 años o más (EVa=60,9%; −2,0-85,0) y en los pacientes con gripe A (EVa=56,7%; 1,5-80,9). Conclusiones: La vacunación antigripal redujo notablemente la aparición de casos graves de gripe en los pacientes hospitalizados, por tanto, sigue siendo la principal estrategia para reducir la morbimortalidad y los costes asociados.(AU)

Introduction: Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. Methods: Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. Results: A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (−21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa=60.9%; −2.0 to 85.0) and in patients with influenza A (VEa=56.7%; 1.580.9). Conclusion: Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.(AU)

Oportunidades perdidas en la detección temprana de la infección por VIH en pacientes con infecciones de transmisión sexual: un estudio de vida real / Missed opportunities in the early detection of HIV infection in patients with sexually transmitted infections: A real-life study

Introducción: Las enfermedades de transmisión sexual, como la cervicitis, la proctitis y la uretritis, se asocian a altas tasas de infección por VIH. Ante la sospecha de estas patologías, se debería solicitar una serología del VIH. Material y métodos: Estudio retrospectivo realizado durante 2018 en el Hospital Costa del Sol (Marbella, Málaga). Se revisaron las serologías para el VIH solicitadas en pacientes a los que se les pidió una PCR para Chlamydia trachomatis y Neisseria gonorrhoeae. Resultados: Se valoraron 1.818 pacientes, en los que se realizó serología para el VIH al 44,7%, de las cuales 14 (1,7%) resultaron positivas. El 55,3% restante fueron oportunidades perdidas de diagnóstico. Conclusiones: Las infecciones por C.trachomatis y N.gonorrhoeae están asociadas a una elevada tasa de infección oculta por el VIH. El grado de sospecha de VIH en esta población sigue siendo bajo, y resulta esencial que se refuerce ante la posibilidad de infección por estas patologías.(AU)

Introduction: Sexually transmitted diseases such as cervicitis, proctitis and urethritis are associated with high rates of HIV infection. When these pathologies are suspected, HIV serology should be requested. Material and methods: A Retrospective study was performed during 2018 at the Hospital Costa del Sol (Marbella, Málaga, Spain). HIV serologies requested in patients who were asked for PCR for Chlamydia trachomatis and Neisseria gonorrhoeae were reviewed. Results: A total of 1818 patients were evaluated, in which HIV serology was performed in 44.7%, of which 14 (1.7%) were positive. The remaining 55.3% were missed diagnostic opportunities. Conclusions: C.trachomatis and N.gonorrhoeae infections are associated with a high rate of occult HIV infection. The degree of suspicion of HIV in this population remains low and it is essential that it be reinforced in the presence of the possibility of infection by these pathologies.(AU)

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)

Antimicrobial use and resistance in food animal production: food safety and associated concerns in Sub-Saharan Africa / Uso de antimicrobianos y resistencia en la producción animal para consumo humano: inocuidad de los alimentos y preocupaciones asociadas en el África subsahariana

The use of antimicrobials in food animal (FA) production is a common practice all over the world, with even greater usage and dependence in the developing world, including Sub-Saharan Africa (SSA). However, this practice which serves obvious economic benefits to producers has raised public health concerns over the last decades, thus driving the selection and dissemination of antimicrobial resistance and adversely impacting food safety and environmental health. This review presents the current and comprehensive antimicrobial usage practices in food animal production across SSA. We further highlighted the overall regional drivers as well as the public health, environmental, and economic impact of antimicrobial use in the production of food animals. Antimicrobial use is likely to increase with even exacerbated outcomes unless cost-effective, safe, and sustainable alternatives to antibiotics, especially probiotics, prebiotics, bacteriocins, antimicrobial peptides, bacteriophages, vaccines, etc. are urgently advocated for and used in food animal production in SSA. These, in addition to the implementation of strong legislation on antimicrobial use, and improved hygiene will help mitigate the public health concerns associated with antimicrobial use in food animals and improve the well-being and safety of food animals and their products.(AU)