SummarySince the latest taxonomical changes in the genus Scedosporium by Gilgado et al. in 2010, no species-specific studies on epidemiology and antifungal susceptibility patterns (AFSP) have so far been published. This study aimed to provide qualitative epidemiological data of Scedosporium spp. isolated from cystic fibrosis (CF) patients and immunocompromised patients from Northern Spain. Isolates were identified by using amplified fragment length polymorphism (AFLP), and species-specific AFSP were generated for all currently available antifungal compounds. AFLP was a useful tool for identification to species-level and for the discrimination of inter-and intra-patient isolates. Scedosporium prolificans represents the most prevalent species in the respiratory tract of CF patients and immunocompromised patients in Northern-Spain, followed by Pseudallescheria boydii, P. apiosperma, and P. ellipsoidea. CF patients were exclusively colonised with either P. boydii or S. prolificans. Patients were colonised over years exclusively with isolates affiliated to one species, but some patients were colonised with multiple strains with different AFSP. The sum of those co-colonising strains in one patient, may appear in vitro and in vivo as a multi-resistant S. prolificans isolate, as strains are morphologically identical and might therefore be regarded as only one strain. A majority of Scedosporium strains (with exception of S. prolificans) were found susceptible for voriconazole and micafungin.
Introduction Evidence implicates vitamin D deficiency in poorer outcomes and increased susceptibility to hospital-acquired infections (HAIs). This study examined the association between serum vitamin D levels and HAIs in a population of hepatobiliary surgery patients. Methods Participants in this prospective analytical observational study were patients who underwent hepatobiliary surgery in a tertiary hospital in Aragon, Spain, between February 2018 and March 2019. Vitamin D concentrations were measured at admission and all nosocomial infections during hospitalization and after discharge were recorded. Results The mean 25-hydroxyvitamin D concentration of the study population (n = 301) was 38.56 nmol/L, which corresponds to vitamin D deficiency. Higher vitamin D concentrations were associated with a decreased likelihood of developing a HAI in general (p = 0.014), and in particularly surgical site infection (p = 0.026). The risk of HAI decreased by 34% with each 26.2-nmol/L increase in serum vitamin D levels. Conclusions Vitamin D levels may constitute a modifiable risk factor for postoperative nosocomial infections in hepatobiliary surgery patients.
Presentación de casos clínicos RESUMENKingella kingae es un microorganismo que coloniza el tracto respiratorio superior. A pesar de su baja patogenicidad en esta localización, los procesos patológicos respiratorios previos pueden favorecer su diseminación sistémica y producir infecciones osteoarticulares, principalmente en menores de cinco años. En pacientes pediátricos, se considera un patógeno emergente en la infección osteoarticular. Presentamos el caso de una niña de dos años de edad con cuadro clínico de dolor de caderas, limitación de la abducción y extensión, y fiebre. La radiografía y la ecografía eran compatibles con sinovitis transitoria y la gammagrafía con patología osteoarticular inflamatoria de la cadera derecha. Se realizó punción articular y los parámetros bioquímicos arrojaron resultados alterados. Se procesó microbiológicamente y se aisló K. kingae sensible a antibióticos betalactámicos, azitromicina y trimetoprima-sulfametoxazol. Los hemocultivos fueron negativos. Se trató empíricamente con cloxacilina y cefotaxima IV y se continuó oralmente con amoxicilina-clavulánico, con mejoría osteoarticular. Palabras clave: Kingella kingae, artritis, infancia. SUMMARYKingella kingae is a bacterium that colonizes the upper respiratory tract. Despite its low pathogenicity in this location, previous respiratory pathological processes may favor its systemic spread causing bone and joint infections, mainly in children under five years. It can be considered an emerging pathogen in osteoarticular infection in pediatric patients. We report the case of a two-year-old girl with hips pain and limitation of both abduction and extension, and fever. Radiography and ultrasonography were compatible with transitory synovitis; showed scintigraphy inflammatory pathology of the right hip. Articular puncture was performed. The material showed altered biochemical parameters. Microbiological culture yielded isolation of a strain of K. kingae susceptible to beta-lactam antibiotics, azithromycin and trimethoprim-sulfamethoxazole. Blood cultures were negative. The patient was treated empirically with cloxacillin and cefotaxime iv. and continued with amoxicillinclavulanate orally with osteoarticular improvement. INTRODUCCIÓNLa artritis séptica de la cadera infantil es un proceso poco frecuente, caracterizado por la invasión del espacio articular por diversos microorganismos. Su relevancia radica en la asociación de un manejo difícil, desde el punto de vista mé-dico-quirúrgico, con numerosas complicaciones. Por esta razón se plantean importantes retos diagnósticos que deben ser abordados de forma multidisciplinar. La tinción de Gram y el cultivo son los métodos convencionales más frecuentemente empleados para detectar el agente etiológico de una forma rápida y precisa, de modo de abordar un correcto tratamiento en forma precoz.Kingella kingae pertenece a la familia Neisseriaceae. Coloniza el tracto respiratorio superior a nivel amigdalino, condición que favorece su transmisión persona-persona, especialmente entre niños de corta ed...
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