Bacteremia caused by Paracoccus yeei in patient with compensated cirrhosis of the liver / Bacteremia por Paracoccus yeei en un paciente con cirrosis hepática compensada

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[Erythrovirus B19 infections. Six years of follow-up in adults and children]. / Infecciones por Erythrovirus B19. Seis años de seguimiento en población adulta y pediátrica.

INTRODUCTION: The aetiological agent of erythema infectiosum is Erythrovirus B19 (also known as parvovirus B19), frequently found in children and adolescents, but also associated with arthropathy, aplastic crisis, and abortion in adults. MATERIAL AND METHODS: A retrospective study of Erythrovirus B19 cases in the years 2010-2015. RESULTS: Of the 56 cases of Erythrovirus B19 diagnosed, 34 were adults (32 women and 2 men) and 22 younger than 18 years (12 girls and 10 boys). Six cases were in pregnant women. Infections mainly occurred between spring and summer. In childhood, fever (64%), rash (50%), and anaemia (55%) were the most frequent symptoms. However, arthralgia (59%) was the most frequent symptom in adults, and less frequent were anaemia (41%), fever (32%), and rash (29%). CONCLUSIONS: The characteristic clinical presentation in childhood was rash and fever, whereas in adults it was arthralgia. Anaemia is also frequent, but only severe in previous haematological disease. It should be pointed out that Erythrovirus B19 infection during pregnancy could severely affect the foetus.

Infecciones por Erythrovirus B19. Seis años de seguimiento en población adulta y pediátrica / Erythrovirus B19 infections. Six years of follow-up in adults and children

Introducción: El Erythrovirus B19 (anteriormente denominado parvovirus B19) es el agente etiológico del eritema infeccioso que afecta mayoritariamente durante la infancia y la adolescencia, pero también está relacionado con artropatías, crisis aplásicas y abortos en adultos. El propósito de esta revisión es estudiar las características de las infecciones causadas por Erythrovirus B19 diagnosticadas en nuestro hospital en los últimos 6 años y las diferencias entre la población adulta y la pediátrica. Material y métodos: Estudio retrospectivo de los casos diagnosticados de Erythrovirus B19 mediante serología, entre enero de 2010 y diciembre de 2015. Resultados: Fueron diagnosticados 56 casos, 34 adultos (32 mujeres y 2 varones) y 22 menores de 18 años (12 niñas y 10 niños). El 75% de los casos se dieron entre primavera y verano. Seis fueron en gestantes y en 2 hubo complicaciones graves que conllevaron la muerte fetal. En la población pediátrica los síntomas más frecuentes fueron fiebre (64%), exantema (50%) y anemia (55%). En adultos las artralgias (59%) y menos frecuentemente la anemia (41%), la fiebre (32%) y el exantema (29%). Conclusiones: En pediatría la clínica más frecuente es el exantema y la fiebre, y en adultos las artralgias. También es frecuente la anemia, los casos más graves en presencia de enfermedad hematológica previa. Hay que destacar la grave afectación que pueden sufrir los fetos en las gestantes

Introduction: The aetiological agent of erythema infectiosum is Erythrovirus B19 (also known as parvovirus B19), frequently found in children and adolescents, but also associated with arthropathy, aplastic crisis, and abortion in adults. Material and methods: A retrospective study of Erythrovirus B19 cases in the years 2010-2015. Results: Of the 56 cases of Erythrovirus B19 diagnosed, 34 were adults (32 women and 2 men) and 22 younger than 18 years (12 girls and 10 boys). Six cases were in pregnant women. Infections mainly occurred between spring and summer. In childhood, fever (64%), rash (50%), and anaemia (55%) were the most frequent symptoms. However, arthralgia (59%) was the most frequent symptom in adults, and less frequent were anaemia (41%), fever (32%), and rash (29%). Conclusions: The characteristic clinical presentation in childhood was rash and fever, whereas in adults it was arthralgia. Anaemia is also frequent, but only severe in previous haematological disease. It should be pointed out that Erythrovirus B19 infection during pregnancy could severely affect the foetus

Multiplex PCR reveals that viruses are more frequent than bacteria in children with cystic fibrosis.

BACKGROUND: Cystic fibrosis is a degenerative disease characterized by progressive epithelial secretory gland dysfunction associated with repeated respiratory infections. Bacterial infections are very frequent in children with cystic fibrosis, but because rapid METHODS: for screening for the wide variety of potentially involved viruses were unavailable until recently, the frequency of viral presence is unknown. Multiplex PCR enables screening for many viruses involved in respiratory infections. OBJECTIVES: This study aimed to evaluate the frequency of viruses and bacteria in respiratory specimens from children with cystic fibrosis and to clarify the incidence and characteristics (seasonality and age of patients) of different viruses detected in children with cystic fibrosis. STUDY DESIGN: In this 2-year prospective study, we obtained paired nasopharyngeal-swab and sputum specimens from children with cystic fibrosis during clinical respiratory examinations separated by at least 14days. We analyzed viruses in nasopharyngeal-swab specimens with multiplex PCR and bacteria in sputum with standard methods. RESULTS: We analyzed 368 paired specimens from 33 children. We detected viruses in 154 (41.8%) and bacteria in 132 (35.9%). Bacteria were commoner in spring and summer; viruses were commoner in autumn and winter. In every season, Staphylococcus aureus was the commonest bacteria and rhinovirus was the commonest virus. Nearly all infections with Haemophilus influenzae occurred in autumn and winter. Viruses were more prevalent in children <5 years old, and bacteria were more prevalent in children ≥12 years old. CONCLUSIONS: Multiplex PCR screening for respiratory viruses is feasible in children with cystic fibrosis; the clinical implications of screening warrant further study.

La infección neonatal tardía por Streptococcus agalactiae en el área de Barcelona (1996-2010) / Streptococcus agalactiae late-onset neonatal infections in Barcelona (1996-2010)

OBJETIVO: Analizar las características de la sepsis neonatal tardía (SNT) por estreptococo del grupo B (EGB) y la evolución de su incidencia en 8 hospitales del área de Barcelona a lo largo de los 15 años de consolidación de las medidas de prevención de la infección neonatal precoz. MÉTODOS: Revisión retrospectiva de los pacientes diagnosticados de SNT por EGB desde 1996 a 2010. RESULTADOS: Se diagnosticaron 143 pacientes, de los que 51 habían nacido en otros centros. La incidencia global fue del 0,4 2‰ de recién nacidos vivos (RNV), oscilando entre el 0,14‰ en 2000 y el 0,80‰ en 2009. Se observó una tendencia al incremento del riesgo discreta pero sostenida a lo largo de los años, del 6,9% en las SNT totales, aunque sin la suficiente significación estadística. El 63,6% de los pacientes presentaron sepsis/bacteriemia, el 32,8% meningitis y el 3,5% artritis/osteomielitis. De los casos en los que se pudo obtener información sobre los antecedentes obstétricos, el 53% de las madres presentaron cultivo positivo a EGB al final del embarazo, el 53,8% recibieron profilaxis antibiótica intraparto y el 41,2% presentaron algún factor de riesgo, principalmente parto prematuro en el 35,9% de los casos. La mortalidad fue del 2,8%, y los serotipos mayoritarios, el III y el Ia. CONCLUSIONES: La incidencia de SNT por EGB no ha disminuido a pesar de las medidas de prevención de la SNP, y la posibilidad de su aparición debe ser tenida en cuenta

OBJECTIVE: To study the characteristics and evolution of group B Streptococcus (GBS) late-onset diseases, over a period of 15 years in 8 hospitals the Barcelona area and analyze the possible impact of prophylactic measures for the prevention of early-onset neonatal infections. METHODS: Retrospective review of all patients diagnosed with late-onset neonatal disease due to GBS from 1996 to 2010. RESULTS: A total of 143 patients were diagnosed. Of these, 51 were born in others hospitals. The overalll incidence was 0.42 per 1000 live births, varying between 0.14‰ in the year 2000 and 0.80‰ in 2009. A slight but sustained tendency of increased risk was observed over the years, 6.9% in the overall disease (with no statistical significance). Sepsis/bacteremia was detected in 63.6% of the newborns, meningitis in 32.8%, and arthritis/osteomyelitis in 3.5%. In cases with known obstetrics dates, 53% of mothers had been colonized by GBS during pregnancy, 53.8% received intrapartum antibiotic prophylaxis, and 41.2% had some obstetric risk factors, particularly premature birth in 35.9%. There was a 2.8% mortality rate in the neonates, and predominant serotypes were III and Ia. CONCLUSIONS: The incidence of GBS late-onset disease has not decreased despite the control practices of early-onset disease, and possibility of this appearing must be taken into account

[Streptococcus agalactiae late-onset neonatal infections in Barcelona (1996-2010)]. / La infección neonatal tardía por Streptococcus agalactiae en el área de Barcelona (1996-2010).

OBJETIVE: To study the characteristics and evolution of group B Streptococcus (GBS) late-onset diseases, over a period of 15years in 8hospitals the Barcelona area and analyze the possible impact of prophylactic measures for the prevention of early-onset neonatal infections. METHODS: Retrospective review of all patients diagnosed with late-onset neonatal disease due to GBS from 1996 to 2010. RESULTS: A total of 143 patients were diagnosed. Of these, 51 were born in others hospitals. The overalll incidence was 0.42 per 1000 live births, varying between 0.14‰ in the year 2000 and 0.80‰ in 2009. A slight but sustained tendency of increased risk was observed over the years, 6.9% in the overall disease (with no statistical significance). Sepsis/bacteremia was detected in 63.6% of the newborns, meningitis in 32.8%, and arthritis/osteomyelitis in 3.5%. In cases with known obstetrics dates, 53% of mothers had been colonized by GBS during pregnancy, 53.8% received intrapartum antibiotic prophylaxis, and 41.2% had some obstetric risk factors, particularly premature birth in 35.9%. There was a 2.8% mortality rate in the neonates, and predominant serotypes were III and Ia. CONCLUSIONS: The incidence of GBS late-onset disease has not decreased despite the control practices of early-onset disease, and possibility of this appearing must be taken into account.

[Toxoplasmosis and pregnancy. Multicenter study of 16,362 pregnant women in Barcelona]. / Toxoplasmosis y embarazo. Estudio multicéntrico realizado en 16.362 gestantes de Barcelona.

BACKGROUND AND OBJECTIVE: The aim of this study was to know: 1) the prevalence of antibodies against toxoplasma in pregnant women, 2) the incidence of primary infection during pregnancy and 3) the prevalence of congenital toxoplasmosis. SUBJECTS AND METHOD: Seroprevalence was prospectively analyzed in 16,362 pregnant women visited in 8 hospitals and 2 day care centers in Barcelona during 1999. Each participant laboratory included their own assays to detect toxoplasma-specific immunoglobulins IgM, IgA, IgG and IgG avidity antibodies. In case of positive specific IgM, a second serum sample was requested, which was processed in parallel with the first one. Three infection stages were defined: acute, possible and past (latent). Congenital infection was determined prenatally by polymerase chain reaction (PCR) in amniotic fluid or postnatally by serology in the newborn. RESULTS: Seroprevalence was 28.6%. The incidence of primary infection during pregnancy was 1.02/1,000 susceptible pregnant women. Nine women out of 12 with an acute toxoplasma infection became seroconverted during their pregnancies and five of them had infants with congenital toxoplasmosis (vertical transmission: 41.6%). All four children born alive had no symptoms during their follow-up. CONCLUSIONS: In this study, the prevalence of toxoplasmosis was low. Acute toxoplasmosis was detected mainly by seroconversion during pregnancy. The frequency of maternal-fetal transmission was near half of cases.