Etiological spectrum and diagnostic challenges of short-duration fever in West Bengal (India). A cross-sectional tertiary care study.

INTRODUCTION: The scarcity of epidemiological data on acute febrile illnesses from South Asia impairs evidence-based clinical decision-making. Our study aimed to explore the etiological spectrum of short-duration fever in patients admitted to a tertiary care hospital in West Bengal, India. METHODS: We conducted a cross-sectional study from May 2021 to April 2022 involving 150 adult patients presenting with a fever lasting less than two weeks at Burdwan Medical College and Hospital (West Bengal, India). We performed comprehensive clinical assessments, including microbiological, serological, and other specific investigations, to identify the causes of the fever. RESULTS: The demographic profile predominantly included individuals aged 21-40 years, with a male-to-female ratio of 1.9:1; 60.7% of participants were from rural areas. The primary etiological agents identified were scrub typhus (25.3%), dengue (15.3%), and enteric fever (13.3%). Notably, 80% of patients presented with non-localizing symptoms, while 14.7% had respiratory symptoms. Blood cultures pinpointed Salmonella typhi and Staphylococcus aureus in a minority of cases (3.3%); malaria, primarily Plasmodium vivax, was diagnosed in 12% of the cases. CONCLUSION: Our findings highlight the complexity of diagnosing short-duration fevers, dominated by a wide range of etiological agents, with a notable prevalence of scrub typhus. These results underscore the urgent need for enhanced diagnostic facilities, including the availability of scrub typhus testing at primary healthcare centers. We recommend empirical doxycycline therapy for suspected cases and emphasize the need for further research to develop management guidelines for acute febrile illnesses. This study also highlights the importance of raising both community and clinician awareness to prevent irrational antibiotic use.

Seroprevalence status of vaccine-preventable diseases in migrants living in shelter centers in Barcelona, Spain.

INTRODUCTION: Almost 281 million people were living in a foreign country in 2022, and more than 100 million were displaced because of war conflicts and human right violations. Vaccination coverage of infectious diseases in migrants from some disadvantaged settings could be lower than reception countries populations, consequently seroprevalence studies and better access to vaccination could contribute to reducing these differences. METHODS: A descriptive retrospective cross-sectional study was conducted including migrants, living ≤5 years in the reception country and ≥16 years old, who requested a medical exam between January 1st, 2020 and January 31st, 2021. Seroprevalence assessment was performed, and vaccination was offered to those individuals without immunity to hepatitis B, hepatitis A, varicella, measles, mumps, and rubella. RESULTS: A total of 315 migrants were attended during the study period. Immunity protection at arrival was 252/296 (85.1%) for measles, 274/295 (92.9%) for rubella, 257/296 (86.8%) for mumps, 264/295 (89.5%) for varicella, 267/313 (85.3%) for hepatitis A, and 104/300 (34.6%) for hepatitis B. The final immunity protection after full vaccination schedules was 278/296 (93.9%) for measles, 287/295 (97.3%) for rubella, 274/296 (92.6%) for mumps, 276/295 (93.6%) for varicella, 280/313 (89.5%) for hepatitis A, and 139/300 (46.3%) for hepatitis B. CONCLUSIONS: The vaccination intervention has increased immunity rates for the studied diseases in the attended migrants in our center, however, such interventions should be maintained to reach local population immunization levels. Moreover, the collaboration between shelter and reference specialized health centers is fundamental to implement such vaccination programs.

Diagnóstico por amplificación isotérmica de ácidos nucleicos. Oportunidad para la farmacia comunitaria / Diagnosis by isothermal amplification of nucleic acids. Opportunity for community pharmacy

Esta revisión se centra en describir nuevos sistemas de diagnóstico molecular de tipo POC disponibles en el mercado que pueden implementarse fácilmente en farmacias comunitarias y tienen el potencial de ampliar la cartera de servicios farmacéuticos y hacer una contribución significativa a la mejora de la salud pública.El conocimiento de nuevas técnicas de diagnóstico molecular distintas de la PCR es relativamente desconocido. Sin embargo, las opciones disponibles son diversas y han alcanzado suficiente madurez tecnológica para su uso a gran escala. La pandemia de SARS-CoV-2 ha sacado al mercado pruebas de diagnóstico que, en algunos casos, se han utilizado exclusivamente en investigación durante décadas.La tecnología isotérmica de amplificación de ácidos nucleicos sigue evolucionando y es probable que en los próximos años seamos testigos de un aumento exponencial de su uso, así como del desarrollo de nuevas mejoras que simplifiquen y reduzcan aún más el coste de cada ensayo.Igualmente, no podemos obviar el hecho de que durante la pandemia de COVID-19, el público se ha habituado a autodiagnosticarse a través de canales de distribución masiva como las farmacias comunitarias, lo que puede abrir el sector a otras enfermedades —como las de transmisión sexual o salud animal—, el control de alimentos, la contaminación del agua y del aire (hongos) o la presencia de alérgenos.El conocimiento de estas nuevas tecnologías es esencial estrategia de vigilancia tecnológica e inteligencia competitiva del sector farmacéutico.(AU)

Evaluación de la eficacia de la N-acetilcisteína y la bromhexina en comparación con la atención estándar en la prevención de la hospitalización de pacientes ambulatorios con COVID-19: un ensayo clínico aleatorizado doble ciego / Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial

Introducción y objetivo Desde su aparición en diciembre de 2019, la enfermedad por coronavirus causada por el síndrome respiratorio agudo severo coronavirus2 se ha convertido en una emergencia mundial, propagándose rápidamente por todo el mundo. En respuesta a la derivación temprana de estos pacientes a centros de salud ambulatorios, decidimos buscar tratamientos más eficaces en las primeras etapas de su derivación. Este estudio tiene como objetivo prevenir tanto la progresión como el deterioro de las condiciones físicas de los pacientes con COVID-19, reducir la tasa de derivaciones y mitigar los riesgos de hospitalización y de muerte. Material y métodos Realizado en el Centro Terapéutico Dibaj, ciudad de Hamadan, Irán, un ensayo controlado aleatorizado doble ciego abarcó 225 pacientes con COVID-19 de abril a septiembre de 2022. Se obtuvo la aprobación ética de la Universidad de Ciencias Médicas de Hamadan (Aprobación n.° IR.UMSHA .REC.1400.957), con el protocolo registrado en el Registro Iraní de Ensayos Clínicos (Registro n.° IRCT20220302054167N1). Los pacientes cumplieron con el diagnóstico de COVID-19 a través de la presentación de síntomas y la confirmación por PCR, excluyendo aquellos con antecedentes de vacunas y afectación de órganos. Los pacientes con una saturación de oxígeno superior al 92% se asignaron a tres grupos: el grupoA recibió N-acetilcisteína, el grupoB recibió bromhexina y el grupoC recibió atención estándar. Los seguimientos de los niveles de oxígeno, los síntomas y las necesidades de hospitalización se realizaron los días7 y 14, con pacientes hospitalizados monitorizados durante un mes después de la hospitalización. Resultados El estudio encontró que tanto la N-acetilcisteína como la bromhexina pueden reducir efectivamente las tasas de hospitalización y la mortalidad y acortar la duración de la hospitalización... (AU)

Introduction and aim Since its emergence in December 2019, the coronavirus disease caused by the severe acute respiratory syndrome coronavirus2 has become a global emergency, spreading rapidly worldwide. In response to the early referral of these patients to outpatient health centers, we decided to seek more effective treatments in the early stages of their referral. This study aims to prevent both the progression and deterioration of the physical conditions of COVID-19 patients, reduce the rate of referrals, and mitigate the risks of hospitalization and death. Material and methods Conducted at Dibaj Therapeutic Center, Hamadan City, Iran, a double-blind randomized controlled trial encompassed 225 COVID-19 patients from April to September 2022. Ethical approval was obtained from Hamadan University of Medical Sciences (Approval No.: IR.UMSHA.REC.1400.957), with the protocol registered in the Iranian Registry of Clinical Trials (Registration No.: IRCT20220302054167N1). In this study, we included patients who tested positive for COVID-19 PCR and were symptomatic, excluding those who were pregnant or had received a COVID-19 vaccine. Patients with oxygen saturation above 92% were allocated to three groups: GroupA received N-acetylcysteine, GroupB received Bromhexine, and GroupC received standard care. Follow-ups on oxygen levels, symptoms, and hospitalization needs were conducted on days 7 and 14, with hospitalized patients monitored for one month post-hospitalization. Results The study found that both N-acetylcysteine and Bromhexine can effectively reduce hospitalization rates and mortality and shorten the duration of hospitalization. The third visit of patients who received N-acetylcysteine showed an increase of 1.33% in oxygen saturation compared to their first visit, and in patients who received Bromhexine, this increase was 1.19%. The mortality rate was 9.33% in the control group and zero in both groups of patients who received medication... (AU)

Evaluación de la eficacia de la N-acetilcisteína y la bromhexina en comparación con la atención estándar en la prevención de la hospitalización de pacientes ambulatorios con COVID-19: un ensayo clínico aleatorizado doble ciego / Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial

Introducción y objetivo Desde su aparición en diciembre de 2019, la enfermedad por coronavirus causada por el síndrome respiratorio agudo severo coronavirus2 se ha convertido en una emergencia mundial, propagándose rápidamente por todo el mundo. En respuesta a la derivación temprana de estos pacientes a centros de salud ambulatorios, decidimos buscar tratamientos más eficaces en las primeras etapas de su derivación. Este estudio tiene como objetivo prevenir tanto la progresión como el deterioro de las condiciones físicas de los pacientes con COVID-19, reducir la tasa de derivaciones y mitigar los riesgos de hospitalización y de muerte. Material y métodos Realizado en el Centro Terapéutico Dibaj, ciudad de Hamadan, Irán, un ensayo controlado aleatorizado doble ciego abarcó 225 pacientes con COVID-19 de abril a septiembre de 2022. Se obtuvo la aprobación ética de la Universidad de Ciencias Médicas de Hamadan (Aprobación n.° IR.UMSHA .REC.1400.957), con el protocolo registrado en el Registro Iraní de Ensayos Clínicos (Registro n.° IRCT20220302054167N1). Los pacientes cumplieron con el diagnóstico de COVID-19 a través de la presentación de síntomas y la confirmación por PCR, excluyendo aquellos con antecedentes de vacunas y afectación de órganos. Los pacientes con una saturación de oxígeno superior al 92% se asignaron a tres grupos: el grupoA recibió N-acetilcisteína, el grupoB recibió bromhexina y el grupoC recibió atención estándar. Los seguimientos de los niveles de oxígeno, los síntomas y las necesidades de hospitalización se realizaron los días7 y 14, con pacientes hospitalizados monitorizados durante un mes después de la hospitalización. Resultados El estudio encontró que tanto la N-acetilcisteína como la bromhexina pueden reducir efectivamente las tasas de hospitalización y la mortalidad y acortar la duración de la hospitalización... (AU)

Introduction and aim Since its emergence in December 2019, the coronavirus disease caused by the severe acute respiratory syndrome coronavirus2 has become a global emergency, spreading rapidly worldwide. In response to the early referral of these patients to outpatient health centers, we decided to seek more effective treatments in the early stages of their referral. This study aims to prevent both the progression and deterioration of the physical conditions of COVID-19 patients, reduce the rate of referrals, and mitigate the risks of hospitalization and death. Material and methods Conducted at Dibaj Therapeutic Center, Hamadan City, Iran, a double-blind randomized controlled trial encompassed 225 COVID-19 patients from April to September 2022. Ethical approval was obtained from Hamadan University of Medical Sciences (Approval No.: IR.UMSHA.REC.1400.957), with the protocol registered in the Iranian Registry of Clinical Trials (Registration No.: IRCT20220302054167N1). In this study, we included patients who tested positive for COVID-19 PCR and were symptomatic, excluding those who were pregnant or had received a COVID-19 vaccine. Patients with oxygen saturation above 92% were allocated to three groups: GroupA received N-acetylcysteine, GroupB received Bromhexine, and GroupC received standard care. Follow-ups on oxygen levels, symptoms, and hospitalization needs were conducted on days 7 and 14, with hospitalized patients monitored for one month post-hospitalization. Results The study found that both N-acetylcysteine and Bromhexine can effectively reduce hospitalization rates and mortality and shorten the duration of hospitalization. The third visit of patients who received N-acetylcysteine showed an increase of 1.33% in oxygen saturation compared to their first visit, and in patients who received Bromhexine, this increase was 1.19%. The mortality rate was 9.33% in the control group and zero in both groups of patients who received medication... (AU)

Análisis bibliométrico de la producción científica española en Enfermedades Infecciosas y en Microbiología (2014-2021) / Bibliometric analysis of the Spanish scientific production in Infectious Diseases and Microbiology (2014-2021)

Introducción: El profundo impacto que ha tenido la pandemia de COVID-19 junto a otros factores como la globalización o el cambio climático, ha enfatizado la relevancia creciente que tienen las Enfermedades Infecciosas y la Microbiología. Métodos: Se ha analizado la producción científica española en ambas categorías de la Web of Science a lo largo del periodo 2014-2021. Resultados: Se han identificado 8.037 documentos en Enfermedades Infecciosas y 12.008 documentos en Microbiología (6° país más productivo a nivel mundial en ambos casos, con tasas de crecimiento de 41% y 46,2%, respectivamente). Ambas áreas presentan una elevada colaboración internacional (45-48% de los documentos) y entre 45-66% de los documentos han sido publicados en revistas de excelencia (primer cuartil) según los ránquines del Journal Citation Reports. Conclusiones: España se sitúa en una destacada posición a nivel mundial en ambas áreas, con una gran producción científica en revistas de elevada visibilidad e impacto.(AU)

Introduction: The profound impact of the COVID-19 pandemic, together with other factors such as globalisation and climate change, has emphasised the growing relevance of Infectious Diseases and Microbiology. Methods: The Spanish scientific production in both categories of the Web of Science databases over the period 2014-2021 has been analysed. Results: 8037 documents have been identified in Infectious Diseases and 12008 documents in Microbiology (6th most productive country worldwide in both cases, with growth rates of 41% and 46.2%, respectively). Both areas present a high degree of international collaboration (45-48% of the documents) and between 45-66% of the documents have been published in journals of excellence (first quartile) according to the rankings of the Journal Citation Reports. Conclusions: Spain is in a prominent position worldwide in both areas, with an outstanding scientific production in journals of high visibility and impact.(AU)

Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial.

INTRODUCTION AND AIM: Since its emergence in December 2019, the coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 has become a global emergency, spreading rapidly worldwide. In response to the early referral of these patients to outpatient health centers, we decided to seek more effective treatments in the early stages of their referral. This study aims to prevent both the progression and deterioration of the physical conditions of COVID-19 patients, reduce the rate of referrals, and mitigate the risks of hospitalization and death. MATERIAL AND METHODS: Conducted at Dibaj Therapeutic Center, Hamadan City, Iran, a double-blind randomized controlled trial encompassed 225 COVID-19 patients from April to September 2022. Ethical approval was obtained from Hamadan University of Medical Sciences (Approval No.: IR.UMSHA.REC.1400.957), with the protocol registered in the Iranian Registry of Clinical Trials (Registration No. : IRCT20220302054167N1). In this study, we included patients who tested positive for COVID-19- PCR and were symptomatic, excluding those who were pregnant or had received a COVID-19 vaccine. Patients with oxygen saturation above 92% were allocated to three groups: Group A received N-acetylcysteine, Group B received Bromhexine, and Group C received standard care. Follow-ups on oxygen levels, symptoms, and hospitalization needs were conducted on days 7 and 14, with hospitalized patients monitored for one month post-hospitalization. RESULTS: The study found that both N-acetylcysteine and Bromhexine can effectively reduce hospitalization rates and mortality and shorten the duration of hospitalization. The third visit of patients who received N-acetylcysteine showed an increase of 1.33% in oxygen saturation compared to their first visit, and in patients who received Bromhexine, this increase was 1.19%. The mortality rate was 9.33% in the control group and zero in both groups of patients who received medication. CONCLUSION: In conclusion, the results of this study indicate that NAC and bromhexine may be effective in the treatment of patients with positive COVID-19, with a lower hospitalization rate, shorter hospitalization, faster recovery time, and reduced mortality compared to the control group.

Bibliometric analysis of the Spanish scientific production in Infectious Diseases and Microbiology (2014-2021).

INTRODUCTION: The profound impact of the Covid-19 pandemic, together with other factors such as globalisation and climate change, has emphasised the growing relevance of Infectious Diseases and Microbiology. METHODS: The Spanish scientific production in both categories of the Web of Science databases over the period 2014-2021 has been analysed. RESULTS: 8037 documents have been identified in Infectious Diseases and 12008 documents in Microbiology (6th most productive country worldwide in both cases, with growth rates of 41% and 46.2%, respectively). Both areas present a high degree of international collaboration (45-48% of the documents) and between 45-66% of the documents have been published in journals of excellence (first quartile) according to the rankings of the Journal Citation Reports. CONCLUSIONS: Spain is in a prominent position worldwide in both areas, with an outstanding scientific production in journals of high visibility and impact.

Caracterización clínica-epidemiológica de COVID-19

Las epidemias y las pandemias son eventos de ocurrencia natural. La aparición de una nueva enfermedad infecciosa supone siempre una situación compleja, sobre todo si lo hace como una epidemia de extensión o gravedad significativa, con el objetivo de describir las características clínico-epidemiológicas en pacientes confirmados con COVID-19. Se realizó un estudio descriptivo y retrospectivo sobre las características clínico-epidemiológicas de los 161 pacientes diagnosticados con esta enfermedad, en el municipio Yara, de la provincia Granma durante el período comprendido de junio de 2020-2021. Se estudiaron las variables: edad, sexo, lugar de infección, presencia o no de síntomas y signos, antecedentes patológicos personales, área de salud y consejo popular. El 60,8% de los afectados fueron del sexo femenino con 98 pacientes y el grupo de 30-44 años de edad quedó representado por 50 pacientes (31.0%); en 150 casos, la transmisión fue mayormente autóctona (93,1%) y asintomática en 86 casos para el 53,4%. De los pacientes sintomáticos fueron las manifestaciones respiratorias, los principales síntomas con 70 casos para el 93,3%, 63 pacientes tenían antecedentes personales de hipertensión arterial (39,1%). El área de salud que más casos notificó fue "Luis Enrique de la Paz" con 106 pacientes para el 65,8% y Yara el consejo popular más afectado con 72 casos (44,7%), la mayoría de los pacientes fueron del sexo femenino, predominó la transmisión autóctona y la presentación asintomática. La epidemia en el municipio Yara se comportó similar al resto del país.

Epidemics and pandemics are naturally occurring events. The emergence of a new infectious disease is always a complex situation, especially when it occurs as an epidemic of significant spread or severity. The aim of this study was to describe the clinical-epidemiologic characteristics of patients confirmed with COVID-19. A descriptive and retrospective study was carried out on the clinical-epidemiological characteristics of 161 patients diagnosed with this disease, in the municipality of Yara, province of Granma. The following variables were studied: age, sex, site of infection, presence or not of symptoms and signs, personal pathological antecedents, health area and locality. Out of the total, 98 patients were female (60.8%), and the age group 30-44 years was represented by 50 patients (31.0%). Transmission was generally autochthonous in 150 cases (93.1%), and asymptomatic in 86 cases (53.4%). Among the symptomatic patients, respiratory manifestations were the main symptom in 70 cases (93.3%). Also, 63 patients had a personal medical history of hypertension (39.1%). Luis Enrique de la Paz was the health area that reported the most cases with 106 patients (65.8%), and Yara was the most affected locality with 72 cases (44.7%). The majority of patients were female; and autochthonous transmission and asymptomatic presentation predominated. The epidemic in Yara municipality behaved alike in the whole country.

Epidemias e pandemias são eventos naturais. O surgimento de uma nova doença infecciosa é sempre uma situação complexa, especialmente se for uma epidemia de extensão ou gravidade significativa, com o objetivo de descrever as características clínico-epidemiológicas em pacientes confirmados com COVID-19. Foi realizado um estudo descritivo e retrospectivo sobre as características clínico-epidemiológicas dos 161 pacientes diagnosticados com essa doença, no município de Yara, província de Granma, no período de junho de 2020 a 2021, as variáveis foram estudadas: idade, sexo, local de infecção, presença ou não de sintomas e sinais, história patológica pessoal, área de saúde e conselho popular. O 60,8% dos acometidos eram do sexo feminino com 98 pacientes e a faixa etária de 30 a 44 anos foi representada por 50 pacientes (31,0%); Em 150 casos, a transmissão foi predominantemente autóctone (93,1%) e assintomática em 86 casos para 53,4%, entre os sintomáticos foram manifestações respiratórias, sendo os principais sintomas 70 casos para 93,3%, 63 pacientes tinham história pessoal de hipertensão arterial (39,1%). A área de saúde que mais registrou casos foi "Luis Enrique de la Paz" com 106 pacientes para 65,8% e Yara o município popular mais afetado com 72 casos (44,7%), a maioria dos pacientes era do sexo feminino, de transmissão autóctone e apresentação assintomática. A epidemia no município de Yara se comportou de forma semelhante ao resto do país.

Infecções urinárias e processo do cuidado: perfil etiológico e de sensibilidade no setor de clínica médica de um hospital público da Paraíba / Urinary infections and care process: etiological profile and sensitivity in the medical clinic sector of a public hospital in Paraiba / Infecciones urinarias y proceso asistencial: perfil etiológico y de sensibilidad en el sector clínico de un hospital público de Paraíba

Introdução: Há alguns fatores preditores para ocorrência de Infecção de Trato Urinário (ITU) no processo do cuidado na Clínica Médica (CM) de um Hospital Universitário (HU) como idade e tempo de internamento sendo o controle um desafio para a saúde pública. Objetivo: Descrever os principais agentes microbiológicos de ITU hospitalar na CM nos anos de 2015-16 e avaliar a suscetibilidade aos antimicrobianos. Metodologia: Trata-se de um estudo descritivo seccional e de busca na base de dados da CCIH do HU. Resultados: Em 2015 obteve se uma prevalência de 6,5% de ITU hospitalar, o agente biológico mais comum foi Klebsiella pneumoniae. Já em 2016, a prevalência foi de 5,3%; os agentes microbiológicos foram Candida spp. e Escherichia coli. Conclusão: A ITU hospitalar demonstra ser uma condição ainda bastante prevalente no HU, tendo como principal agente em 2015 a Klebsiella pneumoniae e em 2016 a Escherichia coli, ambos com uma maior susceptibilidade aos carbapenêmicos.

Introduction: There are some predictive factors for the occurrence of Urinary Tract Infection (UTI) in the care process at the Medical Clinic (CM) of a University Hospital (HU) such as age and length of stay, being control a challenge for public health. Objective: To describe the main microbiological agents of hospital UTI in CM in the years 2015-16 and to assess susceptibility to antimicrobials. Methodology: It is a descriptive and sectional study with research through the database of hospital infection control committee (HICC). Results: In 2015, there was a 6.5% prevalence of hospital UTI, the most common biological agent was Klebsiella pneumoniae. In 2016, the prevalence was 5.3%; the microbiological agents were Candida spp. and Escherichia coli. Conclusion: Hospital UTI proves to be still a very prevalent condition in HU, having Klebsiella pneumoniae as its main agent in 2015 and Escherichia coli in 2016, both with greater susceptibility to carbapenems.

Introducción: Existen algunos factores predictores de aparición de Infección del Tracto Urinario (ITU) en el proceso asistencial en la Clínica Médica (CM) de un Hospital Universitario (HU), como la edad y el tiempo de estancia, y su control es un reto para la salud pública. Objetivo: Describir los principales agentes microbiológicos de ITU de adquisición hospitalaria en la CM en 2015-16 y evaluar la susceptibilidad antimicrobiana. Metodología: Se trata de un estudio descriptivo, transversal, basado en una búsqueda en la base de datos CCIH del HU. Resultados: En 2015, la prevalencia de ITU adquirida en el hospital fue del 6,5%, y el agente biológico más frecuente fue Klebsiella pneumoniae. En 2016, la prevalencia fue del 5,3%; los agentes microbiológicos fueron Candida spp. y Escherichia coli. Conclusión: La ITU hospitalaria sigue siendo una patología muy prevalente en la UH, siendo Klebsiella pneumoniae el principal agente en 2015 y Escherichia coli en 2016, ambos con mayor susceptibilidad a carbapenems.

Prevalencia de enfermedades infecciosas y parasitarias en el servicio de pacientes con necesidades especiales de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia / Prevalence of infectious and parasitic diseases in the service of patients with special needs of the Faculty of Stomatology of the Universidad Peruana Cayetano Heredia / Prevalência de doenças infecciosas e parasitárias no serviço de pacientes com necessidades especiais da Faculdade de Estomatologia da Universidad Peruana Cayetano Heredia

RESUMEN Objetivo: Determinar la prevalencia de diagnósticos médicos de las enfermedades infecciosas y/o parasitarias de pacientes que acudieron al servicio de Estomatología en Pacientes Especiales (EPE) de la Universidad Peruana Cayetano Heredia. Material y métodos: La población (n = 38) estuvo conformada por el número de diagnósticos médicos de pacientes con enfermedades infecciosas y/o parasitarias que acudieron al servicio de EPE durante los años 2015 y 2016. La información se trasladó a una base de datos en el programa Excel 2017, para posteriormente ser procesada y analizada de acuerdo con lo requerido por el programa Stata 12. Resultados: De un total de 1718 diagnósticos médicos, las enfermedades infecciosas y/o parasitarias tuvieron una prevalencia de 2,21 % (n = 38). Dentro de este grupo de enfermedades, el virus de inmunodeficiencia humana (VIH) fue el más prevalente con 63,2 % (n = 24), siendo el sexo masculino el más prevalente con 79 % (n = 19); y dentro del grupo etario de 21 a 40 años de edad, el segundo diagnóstico específico más prevalente fue la hepatitis A con un 15,8 % (n = 6), en donde el sexo femenino fue el más prevalente con 83 % (n = 5). Conclusiones: El diagnóstico específico, dentro del grupo de las enfermedades infecciosas y/o parasitarias, con mayor prevalencia fue el VIH con un 63,2 % (n = 24).

ABSTRACT Objective: To determine the prevalence of medical diagnoses of infectious and/or parasitic diseases in patients who attended the Special Patients Stomatology Service (EPE) of the Cayetano Heredia Peruvian University. Material and methods: The population (n = 38) comprised the number of medical diagnoses of patients with infectious and/or parasitic diseases who attended the EPE service during 2015 and 2016. The information was transferred to a database in the Excel 2017 program to be processed and analyzed as required by the Stata 12 program. Results: Of 1718 medical diagnoses, infectious and/or parasitic diseases had a prevalence of 2.21% (n = 38). Within this group of diseases, human immunodeficiency virus (HIV) was the most prevalent, with 63.2 % (n = 24), with the male sex being the most prevalent with 79 % (n = 19). Within the age group of 21 to 40 years of age, the second most prevalent specific diagnosis was hepatitis A with 15.8 % (n = 6), whereas the female sex was the most prevalent with 83 % (n = 5). Conclusions: The specific diagnosis within the group of infectious and/or parasitic diseases with the highest prevalence was HIV, with 63.2% (n = 24).

RESUMO Objetivo: Determinar a prevalência de diagnósticos médicos de doenças infecciosas e/ou parasitárias em pacientes que frequentaram o Serviço de Estomatologia para Pacientes Especiais (EPE) da Universidad Peruana Cayetano Heredia. Material e métodos: A população (n = 38) consistiu no número de diagnósticos médicos de pacientes com doenças infecciosas e/ou parasitárias que frequentaram o serviço EPE durante 2015 e 2016. A informação foi transferida para uma base de dados em Excel 2017, para posteriormente ser processada e analisada conforme requerido pelo programa Stata 12. Resultados: De um total de 1718 diagnósticos médicos, as doenças infeciosas e/ou parasitárias tiveram uma prevalência de 2,21 % (n = 38). Dentro deste grupo de doenças, o vírus da imunodeficiência humana (VIH) foi o mais prevalente com 63,2 % (n = 24), sendo o sexo masculino o mais prevalente com 79 % (n = 19); e dentro do grupo etário dos 21-40 anos, o segundo diagnóstico específico mais prevalente foi a hepatite A com 15,8 % (n = 6), sendo o sexo feminino o mais prevalente com 83 % (n = 5). Conclusões: O diagnóstico específico mais prevalente no grupo das doenças infecciosas e/ou parasitárias foi o VIH com 63,2 % (n = 24).

Estudio transversal sobre la percepción de los factores favorecedores de la actividad investigadora en enfermedades infecciosas / Cross-sectional study on the perception of factors favoring research activity in infectious diseases

Introducción: La implicación de los médicos asistenciales en tareas de investigación clínica presenta grandes diferencias entre las diversas instituciones. Material y método: Estudio transversal basado en una encuesta enviada a los miembros del Grupo de Trabajo de Enfermedades Infecciosas (GTei) de la Sociedad Española de Medicina Interna (SEMI) durante el mes de mayo de 2022. Resultados: De 1.789 miembros del GTei, 169 miembros (9,45%) cumplimentaron la encuesta. La percepción de la conveniencia de participación de cada facultativo en una o varias líneas de investigación fue de 8 puntos (P25:7; P75: 9 puntos). La percepción sobre el estímulo para investigar del sistema sanitario o de la dirección del hospital fue de 2 puntos (1-4), respectivamente. El apoyo a la investigación fue valorado con de 5 (2-7) y 6 (3-7) puntos en relación con el jefe de servicio y los compañeros del departamento, respectivamente. Otros factores evaluados fueron la falta de tiempo por no poder reducir la actividad asistencial (9; 7-10 puntos), la priorización de las actividades de ocio durante el tiempo libre disponible (7; 5-8 puntos), la organización de la carga asistencial (6; 3-9 puntos), las dificultades en la coordinación con otros servicios clínicos o centrales (6; 5-7 puntos y 6; 5-8 puntos, respectivamente). Conclusiones: La investigación clínica es muy bien valorada por los internistas dedicados a la patología infecciosa. Las principales necesidades percibidas son un mayor apoyo institucional y de la dirección del hospital, una mejor organización del departamento, la coordinación interdepartamental y disponer de más tiempo para esta actividad.(AU)

Background: The involvement of attending physicians in clinical research activities differs greatly among institutions. Method: Cross-sectional study based on a survey submitted to the members of the Working Group on Infectious Diseases (GTei) of the Spanish Society of Internal Medicine (SEMI) during the month of May 2022. Results: Out of 1,789 members of the GTei, 169 members (9.45%) completed the survey. The perception of the convenience of participation of each physician in one or more lines of research was 8 points (P25:7; P75: 9 points). The perception of encouragement to do research by the health system or hospital management was 2points (1-4), respectively. Support for research was rated at 5 (2-7) and 6 (3-7) points inrelation to the head of service and colleagues in the department, respectively. Other factors evaluated were the lack of time due to not being able to reduce the care activity (9; 7-10 points), prioritization of leisure activities during available free time (7; 5-8 points), organization of the care load (6; 3-9 points), difficulties in coordinating with other clinical or central services (6; 5-7 points and 6; 5-8 points, respectively). Conclusions: Clinical research is highly valued by internists dedicated to infectious diseases. The main perceived needs are greater institutional and hospital managementsupport, better organization of the department, interdepartmental coordination and more time for this activity. (AU)

Infección por SARS-CoV-2 en pacientes con o en riesgo de infecciones venéreas: estudio de su incidencia y factores asociados en un centro monográfico de infecciones de transmisión sexual / SARS-CoV-2 infection in patients with or at risk for venereal infections: Incidence and associated factors in a sexual health clinic

Antecedentes y objetivo El SARS-CoV-2 se transmite con más facilidad por cercanía física, inherente a las relaciones sexuales, lo que ha hecho plantearse que pueda haber una mayor incidencia de COVID-19 en personas con infecciones venéreas o de transmisión sexual (ITS) o en riesgo de adquirirlas. Por este motivo, buscamos estimar la seroprevalencia de anticuerpos frente a SARS-CoV-2 en personas que acuden a una consulta monográfica de ITS, comparar dicha seroprevalencia con la estimada en nuestra región y estudiar los factores asociados. Material y método Estudio observacional transversal que incluye a pacientes mayores de 18 años aún no vacunados atendidos en una consulta monográfica municipal de ITS para estudio o cribado, incluidos de forma consecutiva de marzo a abril de 2021. Se realizó test serológico rápido para SARS-CoV-2 y se recogieron variables demográficas, sociales y sexuales, diagnósticos de ITS y antecedentes de síntomas compatibles con infección por SARS-CoV-2. Resultados Se incluyó a 512 pacientes, el 37% mujeres. Tuvieron alguna prueba positiva a SARS-CoV-2 124 pacientes (24,2%). Se relacionaron con un resultado positivo: el uso de mascarillas tipo FFP2 (OR 0,50) y el número de parejas sexuales superior a la mediana (OR 1,80). El uso de mascarillas FFP2 no se distribuyó de manera aleatoria en la muestra. Conclusiones La población sexualmente activa ha tenido pruebas positivas a SARS-CoV-2 con más frecuencia que la población general. La principal vía de contagio en este grupo parece ser la vía respiratoria, por lo que la transmisión sexual es probablemente limitada y está relacionada con la proximidad que implican las relaciones sexuales (AU)

Background and objective SARS-CoV-2 is more easily spread by close contact, which is inherent to sexual intercourse. People with, or at risk for, sexually transmitted infections (STIs) may therefore have higher rates of COVID-19. The aim of this study was to estimate SARS-CoV-2 antibody seroprevalence in people seen at a dedicated STI clinic, compare our findings to the estimated seroprevalence in the local general population, and study factors associated with SARS-CoV-2 infection in this setting. Material and methods Cross-sectional observational study including consecutive patients older than 18 years of age who had not yet been vaccinated against COVID-19 and who underwent examination or screening at a dedicated municipal STI clinic in March and April 2021. We ordered rapid SARS-CoV-2 serology and collected information on demographic, social, and sexual variables, STI diagnoses, and history of symptoms compatible with SARS-CoV-2 infection. Results We studied 512 patients (37% women). Fourteen (24.2%) had a positive SARS-CoV-2 test. Variables associated with positivity were use of FFP2 masks (odds ratio 0.50) and a higher-than-average number of sexual partners (odds ratio 1.80). Use of FFP2 masks was not randomly distributed in this sample. Conclusions Sexually active members of the population in this study had a higher incidence of SARS-CoV-2 infection than the general population. The main route of infection in this group appears to be respiratory, linked to close contact during sexual encounters; sexual transmission of the virus is probably limited (AU)

[Translated article] SARS-CoV-2 Infection in Patients With or at Risk for Venereal Infections: Incidence and Associated Factors in a Sexual Health Clinic / Infección por SARS-CoV-2 en pacientes con o en riesgo de infecciones venéreas: estudio de su incidencia y factores asociados en un centro monográfico de infecciones de transmisión sexual

Background and objective SARS-CoV-2 is more easily spread by close contact, which is inherent to sexual intercourse. People with, or at risk for, sexually transmitted infections (STIs) may therefore have higher rates of COVID-19. The aim of this study was to estimate SARS-CoV-2 antibody seroprevalence in people seen at a dedicated STI clinic, compare our findings to the estimated seroprevalence in the local general population, and study factors associated with SARS-CoV-2 infection in this setting. Material and methods Cross-sectional observational study including consecutive patients older than 18 years of age who had not yet been vaccinated against COVID-19 and who underwent examination or screening at a dedicated municipal STI clinic in March and April 2021. We ordered rapid SARS-CoV-2 serology and collected information on demographic, social, and sexual variables, STI diagnoses, and history of symptoms compatible with SARS-CoV-2 infection. Results We studied 512 patients (37% women). Fourteen (24.2%) had a positive SARS-CoV-2 test. Variables associated with positivity were use of FFP2 masks (odds ratio 0.50) and a higher-than-average number of sexual partners (odds ratio 1.80). Use of FFP2 masks was not randomly distributed in this sample. Conclusions Sexually active members of the population in this study had a higher incidence of SARS-CoV-2 infection than the general population. The main route of infection in this group appears to be respiratory, linked to close contact during sexual encounters; sexual transmission of the virus is probably limited (AU)

Antecedentes y objetivo El SARS-CoV-2 se transmite con más facilidad por cercanía física, inherente a las relaciones sexuales, lo que ha hecho plantearse que pueda haber una mayor incidencia de COVID-19 en personas con infecciones venéreas o de transmisión sexual (ITS) o en riesgo de adquirirlas. Por este motivo, buscamos estimar la seroprevalencia de anticuerpos frente a SARS-CoV-2 en personas que acuden a una consulta monográfica de ITS, comparar dicha seroprevalencia con la estimada en nuestra región y estudiar los factores asociados. Material y método Estudio observacional transversal que incluye a pacientes mayores de 18 años aún no vacunados atendidos en una consulta monográfica municipal de ITS para estudio o cribado, incluidos de forma consecutiva de marzo a abril de 2021. Se realizó test serológico rápido para SARS-CoV-2 y se recogieron variables demográficas, sociales y sexuales, diagnósticos de ITS y antecedentes de síntomas compatibles con infección por SARS-CoV-2. Resultados Se incluyó a 512 pacientes, el 37% mujeres. Tuvieron alguna prueba positiva a SARS-CoV-2 124 pacientes (24,2%). Se relacionaron con un resultado positivo: el uso de mascarillas tipo FFP2 (OR 0,50) y el número de parejas sexuales superior a la mediana (OR 1,80). El uso de mascarillas FFP2 no se distribuyó de manera aleatoria en la muestra. Conclusiones La población sexualmente activa ha tenido pruebas positivas a SARS-CoV-2 con más frecuencia que la población general. La principal vía de contagio en este grupo parece ser la vía respiratoria, por lo que la transmisión sexual es probablemente limitada y está relacionada con la proximidad que implican las relaciones sexuales (AU)

Inteligencia artificial en enfermedades infecciosas / Artificial intelligence in infectious diseases

Estamos asistiendo a una verdadera revolución tecnológi-ca en el campo de la salud. Los procesos basados en la aplicación de la inteligencia artificial (IA) y el aprendizaje automático (AA) están llegando progresivamente a todas las áreas disciplinares, y su aplicación en el campo de las enfermedades infecciosas es ya vertiginoso, acelerado por la pandemia de COVID-19.Hoy disponemos de herramientas que no solamente pue-den asistir o llevar adelante el proceso de toma de deci-siones basadas en guías o algoritmos, sino que también pueden modificar su desempeño a partir de los procesos previamente realizados. Desde la optimización en la identificación de microorganis-mos resistentes, la selección de candidatos a participar en ensayos clínicos, la búsqueda de nuevos agentes terapéu-ticos antimicrobianos, el desarrollo de nuevas vacunas, la predicción de futuras epidemias y pandemias, y el segui-miento clínico de pacientes con enfermedades infecciosas hasta la asignación de recursos en el curso de manejo de un brote son actividades que hoy ya pueden valerse de la inteligencia artificial para obtener un mejor resultado. El desarrollo de la IA tiene un potencial de aplicación expo-nencial y sin dudas será uno de los determinantes principa-les que moldearán la actividad médica del futuro cercano.Sin embargo, la maduración de esta tecnología, necesaria para su inserción definitiva en las actividades cotidianas del cuidado de la salud, requiere la definición de paráme-tros de referencia, sistemas de validación y lineamientos regulatorios que todavía no existen o son aún solo inci-pientes

We are in the midst of a true technological revolution in healthcare. Processes based upon artificial intelligence and machine learning are progressively touching all disciplinary areas, and its implementation in the field of infectious diseases is astonishing, accelerated by the COVID-19 pandemic. Today we have tools that can not only assist or carry on decision-making processes based upon guidelines or algorithms, but also modify its performance from the previously completed tasks. From optimization of the identification of resistant pathogens, selection of candidates for participating in clinical trials, the search of new antimicrobial therapeutic agents, the development of new vaccines, the prediction of future epidemics and pandemics, the clinical follow up of patients suffering infectious diseases up to the resource allocation in the management of an outbreak, are all current activities that can apply artificial intelligence in order to improve their final outcomes.This development has an exponential possibility of application, and is undoubtedly one of the main determinants that will shape medical activity in the future.Notwithstanding the maturation of this technology that is required for its definitive insertion in day-to-day healthcare activities, should be accompanied by definition of reference parameters, validation systems and regulatory guidelines that do not exist yet or are still in its initial stages

Enfermedades infecciosas no venéreas atendidas en consultas de Dermatología en España: resultados del estudio DIADERM / Nonvenereal Infections in Spanish Dermatology Clinics: Results of the DIADERM Study

Antecedentes y objetivo El peso e impacto de las enfermedades infecciosas no venéreas en Dermatología no ha sido evaluado hasta el momento en nuestro medio. El objetivo de este estudio es analizar su prevalencia global en el ámbito de la asistencia ambulatoria dermatológica. Material y métodos Estudio observacional de corte transversal de los diagnósticos realizados en consultas de Dermatología por una muestra aleatoria de dermatólogos de la Academia Española de Dermatología y Venereología (AEDV). Los datos fueron obtenidos a partir de la encuesta anónima DIADERM. Se seleccionaron los diagnósticos correspondientes a enfermedades infecciosas, codificados mediante el sistema CIE-10. Se excluyeron las infecciones de transmisión sexual y los diagnósticos restantes se clasificaron en 22 grupos diagnósticos. Resultados Se estimó que los dermatólogos españoles hacen 16.190 diagnósticos de patología infecciosa no venérea en una semana laboral (IC 95%, 9.338-23.042), lo que representaba el 9,33% del total de las consultas dermatológicas. Las verrugas víricas fuera de la región anogenital (7.475, 46,17% de las infecciones), las dermatofitosis (3.336, 20,61% de las infecciones) y «otras infecciones víricas», donde se incluía la infección por Molluscum contagiosum (1.592, 9,84%), fueron los diagnósticos más frecuentes. En la comparativa frente a la patología no infecciosa, las infecciones cutáneas fueron más frecuentes en el ámbito de las consultas privadas (p<0,0020) y en los pacientes adultos (p<0,00001). Los pacientes con infecciones cutáneas recibieron el alta con mayor frecuencia que los pacientes con otras patologías, tanto en el sistema público (p<0,0004) como en el privado (p<0,0002) (AU)

Background and objective The burden of nonvenereal infections in Spanish dermatology practice has not yet been evaluated. The aim of this study was to analyze the overall weight of these infections in outpatient dermatology caseloads.Material and methods Observational cross-sectional study of diagnoses made by a random selection of dermatologists from the Spanish Association of Dermatology and Venereology (AEDV) working in outpatient dermatology clinics. The data were obtained through the anonymous DIADERM survey. Diagnoses of infectious diseases were selected using codes from the International Classification of Diseases, Tenth Revision. After excluding sexually transmitted infections, the diagnoses were classified into 22 groups. Results Spanish dermatologists diagnosed an estimated 16190 (95% CI, 9338-23042) nonvenereal infections on average per week, a figure that accounted for 9.33% of the dermatology caseload. The most common diagnostic groups were nonanogenital viral warts (7475 diagnoses, 46.17% of nonvenereal infections), dermatophytosis (3336, 20.61%), and other viral infections (1592, 9.84%), which included Molluscum contagiosum infections. Nonvenereal infections were more common than noninfectious dermatologic conditions in private clinics (P<.0020) and adults (P<.00001). Patients with these infections were also more likely to be discharged than those with other conditions in both public (P<.0004) and private (P<.0002) practices. Conclusions Nonvenereal infections are frequent in dermatology. They are the third most common reason for outpatient visits, behind actinic keratosis and nonmelanoma skin cancer. By enhancing the participation of dermatologists in the management of skin infections and encouraging interactions with other specialists, we will be able to carve out a niche in an area we have scarcely ventured into to date (AU)

[Translated article] Nonvenereal Infections in Spanish Dermatology Clinics: Results of the DIADERM Study / Enfermedades infecciosas no venéreas atendidas en consultas de dermatología en España: resultados del estudio DIADERM

Background and objective The burden of nonvenereal infections in Spanish dermatology practice has not yet been evaluated. The aim of this study was to analyze the overall weight of these infections in outpatient dermatology caseloads.Material and methods Observational cross-sectional study of diagnoses made by a random selection of dermatologists from the Spanish Association of Dermatology and Venereology (AEDV) working in outpatient dermatology clinics. The data were obtained through the anonymous DIADERM survey. Diagnoses of infectious diseases were selected using codes from the International Classification of Diseases, Tenth Revision. After excluding sexually transmitted infections, the diagnoses were classified into 22 groups. Results Spanish dermatologists diagnosed an estimated 16190 (95% CI, 9338-23042) nonvenereal infections on average per week, a figure that accounted for 9.33% of the dermatology caseload. The most common diagnostic groups were nonanogenital viral warts (7475 diagnoses, 46.17% of nonvenereal infections), dermatophytosis (3336, 20.61%), and other viral infections (1592, 9.84%), which included Molluscum contagiosum infections. Nonvenereal infections were more common than noninfectious dermatologic conditions in private clinics (P<.0020) and adults (P<.00001). Patients with these infections were also more likely to be discharged than those with other conditions in both public (P<.0004) and private (P<.0002) practices. Conclusions Nonvenereal infections are frequent in dermatology. They are the third most common reason for outpatient visits, behind actinic keratosis and nonmelanoma skin cancer. By enhancing the participation of dermatologists in the management of skin infections and encouraging interactions with other specialists, we will be able to carve out a niche in an area we have scarcely ventured into to date (AU)

Antecedentes y objetivo El peso e impacto de las enfermedades infecciosas no venéreas en Dermatología no ha sido evaluado hasta el momento en nuestro medio. El objetivo de este estudio es analizar su prevalencia global en el ámbito de la asistencia ambulatoria dermatológica. Material y métodos Estudio observacional de corte transversal de los diagnósticos realizados en consultas de Dermatología por una muestra aleatoria de dermatólogos de la Academia Española de Dermatología y Venereología (AEDV). Los datos fueron obtenidos a partir de la encuesta anónima DIADERM. Se seleccionaron los diagnósticos correspondientes a enfermedades infecciosas, codificados mediante el sistema CIE-10. Se excluyeron las infecciones de transmisión sexual y los diagnósticos restantes se clasificaron en 22 grupos diagnósticos. Resultados Se estimó que los dermatólogos españoles hacen 16.190 diagnósticos de patología infecciosa no venérea en una semana laboral (IC 95%, 9.338-23.042), lo que representaba el 9,33% del total de las consultas dermatológicas. Las verrugas víricas fuera de la región anogenital (7.475, 46,17% de las infecciones), las dermatofitosis (3.336, 20,61% de las infecciones) y «otras infecciones víricas», donde se incluía la infección por Molluscum contagiosum (1.592, 9,84%), fueron los diagnósticos más frecuentes. En la comparativa frente a la patología no infecciosa, las infecciones cutáneas fueron más frecuentes en el ámbito de las consultas privadas (p<0,0020) y en los pacientes adultos (p<0,00001). Los pacientes con infecciones cutáneas recibieron el alta con mayor frecuencia que los pacientes con otras patologías, tanto en el sistema público (p<0,0004) como en el privado (p<0,0002) (AU)

SARS-CoV-2 infection in patients with or at risk for venereal infections: Incidence and associated factors in a sexual health clinic. / Infección por SARS-CoV-2 en pacientes con o en riesgo de infecciones venéreas: estudio de su incidencia y factores asociados en un centro monográfico de infecciones de transmisión sexual.

BACKGROUND AND OBJECTIVE: SARS-CoV-2 is more easily spread by close contact, which is inherent to sexual intercourse. People with, or at risk for, sexually transmitted infections (STIs) may therefore have higher rates of COVID-19. The aim of this study was to estimate SARS-CoV-2 antibody seroprevalence in people seen at a dedicated STI clinic, compare our findings to the estimated seroprevalence in the local general population, and study factors associated with SARS-CoV-2 infection in this setting. MATERIAL AND METHODS: Cross-sectional observational study including consecutive patients older than 18 years of age who had not yet been vaccinated against COVID-19 and who underwent examination or screening at a dedicated municipal STI clinic in March and April 2021. We ordered rapid SARS-CoV-2 serology and collected information on demographic, social, and sexual variables, STI diagnoses, and history of symptoms compatible with SARS-CoV-2 infection. RESULTS: We studied 512 patients (37% women). Fourteen (24.2%) had a positive SARS-CoV-2 test. Variables associated with positivity were use of FFP2 masks (odds ratio 0.50) and a higher-than-average number of sexual partners (odds ratio 1.80). Use of FFP2 masks was not randomly distributed in this sample. CONCLUSIONS: Sexually active members of the population in this study had a higher incidence of SARS-CoV-2 infection than the general population. The main route of infection in this group appears to be respiratory, linked to close contact during sexual encounters; sexual transmission of the virus is probably limited.

Impacto del tratamiento antimicrobiano domiciliario endovenoso (TADE) como parte de un programa de optimización del uso de antimicrobianos (PROA) específico para pediatría / Impact of an outpatient parenteral antimicrobial treatment (OPAT) as part of a paediatric-specific PROA program

Introducción: El tratamiento antimicrobiano domiciliario endovenoso (TADE) es una alternativa a la hospitalización para pacientes pediátricos bien seleccionados. Presentamos un programa TADE basado en un modelo de autoadministración e integrado en el programa de optimización del uso de antimicrobianos (PROA) de un hospital pediátrico de tercer nivel. Material y métodos: Estudio descriptivo, retrospectivo y unicéntrico que incluye todos los pacientes menores de 20años tratados con TADE prescrito en un hospital pediátrico entre 2019 y 2020. Se analizaron los datos sobre los días de ingreso ahorrados y una estimación económica del coste oportunidad que supone el programa TADE para el hospital. Resultados: Cincuenta y siete pacientes realizaron un total de 106 episodios de tratamiento. En el 74,5% hubo una evolución clínica favorable. El principal motivo de interrupción prematura fue una mala evolución de la infección (37,1%). Se liberaron 2,62 camas diarias, suponiendo un beneficio económico de 1.069.963€. Conclusión: Un programa TADE integrado en el PROA pediátrico de nuestro hospital y basado en un modelo de autoadministración se ha mostrado un programa seguro y efectivo y aporta importantes ventajas a nivel económico.(AU)

Introduction: Outpatient parenteral antimicrobial treatment (OPAT) is an alternative to in-patient care in carefully selected patients. This study presents a self-administration OPAT program integrated within the pediatric antibiotic stewardship program (ASP) in a pediatric tertiary care center. Material and methods: Descriptive, retrospective and unicentric study. Data from all patients under 20years of age who were prescribed treatment by a pediatric unit during 2019 and 2020 were included. Data regarding number of saved beds and estimating the opportunity cost of the OPAT program for the hospital were analyzed. Results: Fifty-seven patients received 106 episodes of treatment. Favorable clinical outcome occurred in 74.5% of the episodes. The main cause of premature interruption was unfavorable clinical outcome of the infection (37.1%). A total of 2.62 beds/day were saved, resulting in an economic benefit of 1,069,963€. Conclusion: A self-administration OPAT program integrated within the pediatric ASP has proven to be safe and effective and provides economic benefits.(AU)

Nonvenereal Infections in Spanish Dermatology Clinics: Results of the DIADERM Study. / Enfermedades infecciosas no venéreas atendidas en consultas de Dermatología en España: resultados del estudio DIADERM.

BACKGROUND AND OBJECTIVE: The burden of nonvenereal infections in Spanish dermatology practice has not yet been evaluated. The aim of this study was to analyze the overall weight of these infections in outpatient dermatology caseloads. MATERIAL AND METHODS: Observational cross-sectional study of diagnoses made by a random selection of dermatologists from the Spanish Association of Dermatology and Venereology (AEDV) working in outpatient dermatology clinics. The data were obtained through the anonymous DIADERM survey. Diagnoses of infectious diseases were selected using codes from the International Classification of Diseases, Tenth Revision. After excluding sexually transmitted infections, the diagnoses were classified into 22 groups. RESULTS: Spanish dermatologists diagnosed an estimated 16190 (95% CI, 9338-23042) nonvenereal infections on average per week, a figure that accounted for 9.33% of the dermatology caseload. The most common diagnostic groups were nonanogenital viral warts (7475 diagnoses, 46.17% of nonvenereal infections), dermatophytosis (3336, 20.61%), and other viral infections (1592, 9.84%), which included Molluscum contagiosum infections. Nonvenereal infections were more common than noninfectious dermatologic conditions in private clinics (P<.0020) and adults (P<.00001). Patients with these infections were also more likely to be discharged than those with other conditions in both public (P<.0004) and private (P<.0002) practices. CONCLUSIONS: Nonvenereal infections are frequent in dermatology. They are the third most common reason for outpatient visits, behind actinic keratosis and nonmelanoma skin cancer. By enhancing the participation of dermatologists in the management of skin infections and encouraging interactions with other specialists, we will be able to carve out a niche in an area we have scarcely ventured into to date.