The lungs of cystic fibrosis (CF) patients are chronically infected for years by one or a few lineages of Pseudomonas aeruginosa. These bacterial populations adapt to the highly compartmentalized and anatomically deteriorating lung environment of CF patients, as well as to the challenges of the immune defenses and antibiotic therapy. These selective conditions are precisely those that recent theoretical studies predict for the evolution of mechanisms that augment the rate of variation. Determination of spontaneous mutation rates in 128 P. aeruginosa isolates from 30 CF patients revealed that 36% of the patients were colonized by a hypermutable (mutator) strain that persisted for years in most patients. Mutator strains were not found in 75 non-CF patients acutely infected with P. aeruginosa. This investigation also reveals a link between high mutation rates in vivo and the evolution of antibiotic resistance.

Summary Thrombocytopenia has been identified as a common complication of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection in the general population. In an attempt to determine the impact of coronavirus disease 2019 (COVID‐19) in patients with immune thrombocytopenia (ITP), a retrospective single‐centre study was performed. Thrombocytosis was observed in patients with chronic ITP after SARS‐CoV‐2 infection, frequently needing treatment adjustment or even discontinuation of therapy. Relapses and newly diagnosed cases showed a fast response after initial treatment compared to ITP. Reduced immune activity due to lymphopenia during COVID‐19 could explain this paradoxical effect, although further studies are needed.

Summary The COVID‐19 pandemic has dramatically challenged care for cancer patients, especially those with active treatment who represent a vulnerable population for SARS‐CoV‐2 infection. Aggressive lymphoid neoplasms, such as diffuse large B cell lymphoma and high‐grade B cell lymphoma, need to be treated without delay in order to get the best disease outcome. Because of that, our clinical practice was changed to minimise the risk of SARS‐CoV‐2 infection while continuing haematological treatment. In this report, we analyse the management of front‐line therapy in 18 patients during the COVID‐19 outbreak, as well as the results of the implemented measures in their outcome.

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We report the evolution of the antimicrobial resistance of non-typhi Salmonella (1992-1994) in a Spanish hospital in relation with a case of infection due to a fluoroquinolone-resistant strain of Salmonella ser. Typhimurium. None of the isolates were resistant to ciprofloxacin. The resistance to ampicillin has increased from 20.6% (1992) to 29.5% (1994) whereas no significative differences in chloramphenicol and cotrimoxazole susceptibility were noted.

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