Síndrome de Lady Windermere en Castilla y León / Lady Windermere syndrome in Castile and León

INTRODUCCIÓN: El síndrome de Lady Windermere (SLW) es una patología pulmonar causada por Mycobacterium avium complex (MAC). El objetivo es conocer su frecuencia y sus características en el área norte de la comunidad de Castilla y León. MÉTODOS: Estudio retrospectivo de pacientes con aislamientos de MAC en muestras respiratorias de cinco hospitales públicos de la comunidad a lo largo de seis años, siguiendo criterios de la ATS/IDSA. Las cepas de MAC se identificaron por sondas de hibridación inversa Genotype Mycobacterium o PCR-RFLP del gen hsp65. RESULTADOS: De 183 casos de MAC identificados, únicamente 5 (2,7%) mujeres de 68,8 ± 10,7 años cumplían criterios de SLW. En tres casos se aisló MAC conjunta e intermitentemente con otros patógenos. Solo un paciente se trató siguiendo criterios de la ATS/IDSA. DISCUSIÓN: El SLW permanece infraestimado, y al ser los afectados muy demandantes de recursos sanitarios durante largos periodos, es necesario un mayor conocimiento microbiológico y terapéutico

INTRODUCTION: Lady Windermere syndrome (LWS) is a pulmonary disease caused by Mycobacterium avium complex (MAC). The objective of this study is to ascertain its frequency and characteristics in the northern area of the autonomous community of Castile and León. METHODS: A retrospective study of patients with MAC isolates in respiratory samples from five public hospitals in the autonomous community over a six-year period, following the ATS/IDSA criteria. The MAC strains were identified by GenoType Mycobacterium reverse hybridisation probes or PCR-RFLP analysis of the hsp65 gene. RESULTS: Of 183 cases of MAC identified, only five women (2.7 %) aged 68.8± 10.7 years met LWS criteria. In three cases, MAC was isolated jointly and intermittently with other pathogens. Only one patient was treated according to ATS/IDSA criteria. DISCUSSION: LWS remains underestimated, with affected patients representing a significant burden on healthcare resources over long periods of time. As a result, greater microbiological and therapeutic knowledge of the syndrome is needed

Contribución de la microbiología al diagnóstico de la tuberculosis en Castilla y León: conclusiones del estudio GRUMICALE 2013 / Contribution of microbiology in the diagnosis of tuberculosis in Castile and León (Spain): Findings of the GRUMICALE 2013 study

Introducción y objetivos: Estudio retrospectivo que recoge datos microbiológicos de tuberculosis (TB) en Castilla y León durante el año 2013 para conocer los datos microbiológicos de incidencia y distribución de TB, resistencias a los fármacos antituberculosos y compararlos con los datos epidemiológicos ofrecidos por los servicios de vigilancia epidemiológica (SIVE). Material y métodos: Microbiólogos de los 14 hospitales de la red sanitaria pública de Castilla y León (GRUMICALE) han recogido datos epidemiológicos, microbiológicos y de funcionamiento de los laboratorios de microbiología de la comunidad durante el año 2013. Se consideró un solo aislamiento de Mycobacterium tuberculosis complex (MTC) por paciente. Resultados: Se obtuvieron 270 aislamientos de MTC (tasa de incidencia de 11,63 casos/100.000 hab./año). Según datos epidemiológicos, se recogieron un total de 288 casos de TB (11,43 casos/100.000 hab./año), 243 confirmados, 29 sospechosos y 16 probables. Predomina la localización pulmonar, seguida de lejos por la pleural y por el resto. Se procesaron un total de 27.620 muestras para micobacterias. En un 3,46% de los medios de cultivos líquidos se obtuvo crecimiento de micobacterias, y en un 50,37% la tinción directa (baciloscopia) fue positiva. Dieciséis aislamientos de Mycobacterium tuberculosis (MT) presentaron resistencia a algún fármaco antituberculoso, predominando la resistencia a isoniazida (5,92%). La provincia con mayor incidencia y número de aislamientos fue León (24,23 casos/100.000 hab./año), siendo la máxima en el área sanitaria de El Bierzo (30,46 casos/100.000 hab./año). Conclusiones: Una adecuada recogida de la información microbiológica es fundamental para el conocimiento de la epidemiologia de la TB en nuestra comunidad (AU)

Introduction and objectives: A retrospective study was conducted by collecting microbiological tuberculosis (TB) data in Castile and León during the year 2013 in order to determine the incidence and distribution of TB, and resistance to the tuberculostatic drug, and compare them with the epidemiological data provided by the Department of Epidemiological Surveillance (SIVE). Material and methods: Microbiologists of the 14 hospitals of the Castile and León public health network (GRUMICALE) collected epidemiological, microbiological, and management data from the Microbiology laboratories in the community during the year 2013. A single isolate of Mycobacterium tuberculosis complex (MTC) per patient was considered. Results: The study included a total of 270 MTC isolates (an incidence rate of 11.63 cases/100,000 inhab./year). A total of 288 cases of TB (11.43 cases/100,000 inhab. year) were recovered using epidemiological data, which included 243 confirmed, 29 suspected, and 16 as probable cases. Pulmonary TB was predominant, followed a long way off by the pleural TB and the remaining locations. A total of 27,620 samples were processed for mycobacterial detection. Mycobacterial growth was observed in 3.46% of automated fluid cultures, and 50.37% were positive by direct staining of the smear. Resistance to one tuberculostatic drug, mostly to isoniazid, was observed in 16 (5.92%) isolates of Mycobacterium tuberculosis (MT). The province with greater incidence and number of isolates was León (24.23 cases/100,000 inhab./year), with the highest being observed in El Bierzo health area (30.46 cases/100,000 inhab./year). Conclusions: An adequate collection of microbiological information is essential to determine the epidemiology of TB in our region (AU)

Lady Windermere syndrome in Castile and León. / Síndrome de Lady Windermere en Castilla y León.

INTRODUCTION: Lady Windermere syndrome (LWS) is a pulmonary disease caused by Mycobacterium avium complex (MAC). The objective of this study is to ascertain its frequency and characteristics in the northern area of the autonomous community of Castile and León. METHODS: A retrospective study of patients with MAC isolates in respiratory samples from five public hospitals in the autonomous community over a six-year period, following the ATS/IDSA criteria. The MAC strains were identified by GenoType Mycobacterium reverse hybridisation probes or PCR-RFLP analysis of the hsp65 gene. RESULTS: Of 183 cases of MAC identified, only five women (2.7%) aged 68.8±10.7years met LWS criteria. In three cases, MAC was isolated jointly and intermittently with other pathogens. Only one patient was treated according to ATS/IDSA criteria. DISCUSSION: LWS remains underestimated, with affected patients representing a significant burden on healthcare resources over long periods of time. As a result, greater microbiological and therapeutic knowledge of the syndrome is needed.

Contribution of microbiology in the diagnosis of tuberculosis in Castile and León (Spain): Findings of the GRUMICALE 2013 study. / Contribución de la microbiología al diagnóstico de la tuberculosis en Castilla y León: conclusiones del estudio GRUMICALE 2013.

INTRODUCTION AND OBJECTIVES: A retrospective study was conducted by collecting microbiological tuberculosis (TB) data in Castile and León during the year 2013 in order to determine the incidence and distribution of TB, and resistance to the tuberculostatic drug, and compare them with the epidemiological data provided by the Department of Epidemiological Surveillance (SIVE). MATERIAL AND METHODS: Microbiologists of the 14 hospitals of the Castile and León public health network (GRUMICALE) collected epidemiological, microbiological, and management data from the Microbiology laboratories in the community during the year 2013. A single isolate of Mycobacterium tuberculosis complex (MTC) per patient was considered. RESULTS: The study included a total of 270 MTC isolates (an incidence rate of 11.63 cases/100,000 inhab./year). A total of 288 cases of TB (11.43 cases/100,000 inhab. year) were recovered using epidemiological data, which included 243 confirmed, 29 suspected, and 16 as probable cases. Pulmonary TB was predominant, followed a long way off by the pleural TB and the remaining locations. A total of 27,620 samples were processed for mycobacterial detection. Mycobacterial growth was observed in 3.46% of automated fluid cultures, and 50.37% were positive by direct staining of the smear. Resistance to one tuberculostatic drug, mostly to isoniazid, was observed in 16 (5.92%) isolates of Mycobacterium tuberculosis (MT). The province with greater incidence and number of isolates was León (24.23 cases/100,000 inhab./year), with the highest being observed in El Bierzo health area (30.46 cases/100,000 inhab./year). CONCLUSIONS: An adequate collection of microbiological information is essential to determine the epidemiology of TB in our region.

Tuberculosis miliar con afectación pulmonar, meníngea y ósea / Miliary tuberculosis with pulmonary, meningeal and bone involvement

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