New definitions of susceptibility categories EUCAST 2019: clinic application.

In January 2019, the European Committee for the Study of Antimicrobial Susceptibility (EUCAST) introduced some changes in the definitions of clinical categories for antibiotic susceptibility. The objective of these changes was to improve the credibility of category "I", optimizing and lengthening the survival and use of available antibiotics in the face of increasing antimicrobial resistance. This article aims to describe and explain these changes in the EUCAST criteria as well as make a short review about the factors on which the antibiotic susceptibility criteria depend.

What happened to infectious diseases and anti-infective therapy in 2020 beyond COVID-19?

The year 2020 was the year of infectious diseases with the arrival of SARS-CoV-2, which represented a profound change in the world we knew. However, we present a brief description of some of the top infectious diseases articles from 2020 not related with SARS-CoV-2. We reviewed a selection of the most important and relevant achievements in diagnosis and therapy related to bacteremia, nosocomial pneumonia, skin and soft tissue infections, infections by Clostridioides difficile, mycobacterial infections and invasive fungal infections. This year entailed a significant step forward in the indisputable value of the health care stewardship programs.

A review of difficult-to-treat post-traumatic osteomyelitis: Role of Clostridium celerecrescens. / Osteomielitis postraumática difícil de tratar: papel del Clostridium celerecrescens.

PURPOSE: We reviewed the clinical features of post-traumatic infections produced by Clostridium celerecrescens reported in the literature. C. celerecrescens is an emerging pathogen involved in traumatic wound infection that progresses to deep infection and osteomyelitis. METHODS: We found only 4 cases reported in the literature with enough data to be analysed and we added our own case and experience with this type of infection. The identification was performed by matrix-assisted desorption ionization-time of flight mass spectrometry (MALDI TOF) or API gallery, and 16S rRNA gene sequencing were performed to confirm identification in all cases. RESULTS: Identification of the bacteria is discrepant according to the method used due to the genetic and phenotypic similarities of other species of the genus. Identification through MALDI-TOF and API gallery is not suitable for determining the specie, confirmation by 16S rRNA sequencing being necessary. Treatment of the infection included complex antibiotic combinations and surgical treatment together with skin and soft tissue dressings due to the persistence of the pathogen over time. CONCLUSION: This report supports the pathogenic role of C. celerecrescens in post-traumatic infections and the need to improve the management of these difficult-to-treat infections.

Antimicrobial activity of ceftolozane-tazobactam against multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa clinical isolates from a Spanish hospital.

OBJECTIVE: Our objective was to evaluate the in vitro activity of ceftolozane-tazobactam against multidrug resistant (MDR) and extensively drug-resistant (XDR) non metallo-ß-lactamase producing Pseudomonas aeruginosa clinical isolates at Hospital Universitario Miguel Servet (Zaragoza, Spain) from February 2016 to October 2017. METHODS: We evaluated the in vitro activity of ceftolozane-tazobactam and other antipseudomonal antibiotics against 12 MDR and 117 XDR non metallo-ß-lactamase producing P. aeruginosa isolates. Ceftolozane-tazobactam minimal inhibitory concentrations (MICs) were determined by MIC gradient diffusion test strip. RESULTS: Among the 129 MDR/XDR isolates included, 119 (92.2%) were susceptible to ceftolozane-tazobactam, and ten (7.8%) were resistant. MIC50 was 2 mg/L, and MIC90 4 mg/L. Ceftolozane-tazobactam was the second most active antibiotic after colistin, overtaking amikacin. CONCLUSIONS: Ceftolozane-tazobactam is a valuable treatment option for MDR and XDR P. aeruginosa infections in our setting.

Commitment to quality of the Spanish scientific societies. / Compromiso por la calidad de las sociedades científicas en España.

This article summarises the objectives, methodology and initial conclusions of the project "Commitment to Quality of the Spanish Scientific Societies", coordinated by the Ministry of Health, Social Services and Equality, the Spanish Society of Internal Medicine and the Aragon Institute of Health Sciences, in which 48 scientific societies participate. This project's objectives are to decrease the use of unnecessary medical interventions, which are those that have shown no efficacy, have little or questionable effectiveness or are not cost-effective; decrease variability in clinical practice; promote the commitment among physicians and patients to properly use healthcare resources; and to promote clinical safety. The document includes 135 final recommendations for what not to do, prepared by 30 Spanish scientific societies.

Lesiones orales en la lepra lepromatosa. Presentación de un caso y revisión de la literatura / Oral lesions in lepromatous leprosy. Presentation of a case and literature review

La lepra es una enfermedad infecciosa crónica, exclusivamente humana, causada por Mycobacterium leprae. En España, a pesar de seguir siendo considerada por la OMS como país endémico en el último año sólo sé han presentado once nuevos casos. Esta enfermedad presenta un gran polimorfismo clínico, lo que hace en ocasiones muy difícil su diagnóstico. La afectación oral se presenta en un tercio de los casos y se asocia. a estadios avanzados de la enfermedad. Realizamos una revisión de la enfermedad, con sus formas clínicas, manifestaciones orales y tratamiento, y presentamos un caso de lepra lepromatosa de larga evolución, en el cual las lesiones orales fueron la clave para el diagnóstico de la enfermedad (AU)