Update in Infectious Diseases 2019.

The IX Course of Antimicrobials and Infectious Diseases update included a review of the main issues in clinical microbiology, epidemiology and clinical aspects for a current approach of infectious pathology. The present introduction summarizes about the most important meetings related to infectious diseases during 2018 (ECCMID, IAS, ASM and ID Week). In addition, the course provides a practical information to focus on nosocomial infection models, with immunosuppressed patients or complex multidrug-resistant pathogens.

Postmortem microbiology sampling following death in hospital: an ESGFOR task force consensus statement.

Postmortem microbiology (PMM) is a valuable tool in the identification of the cause of death and of factors contributory to death where death has been caused by infection. The value of PMM is dependent on careful autopsy planning, appropriate sampling, minimisation of postmortem bacterial translocation and avoidance of sample contamination. Interpretation of PMM results requires careful consideration in light of the clinical history, macroscopic findings and the histological appearances of the tissues.

Update in Infectious Diseases 2018.

VIII Updating Course of Antimicrobials and Infectious Diseases has reviewed useful microbiological, epidemiological and clinical aspects for a current approach of infectious pathology. Present manuscript summarizes a chronicle about the main infection related meetings during 2017 (ECCMID, IAS, ASM and ID Week). In addition, the course proposed a practical approach for understanding different type of pathogens and our selected topics this year were the epidemiology of bacterial nosocomial infection, a practical approach to Clostridium difficile infection patients, a two year selection of the top ten papers about fungal infection and an update in fungal biofilms.

abscess of the cerebellum in an immunocompetent patient: A case report and review of the literature.

Nocardial brain abscesses are uncommon and rarely occur in patients without predisposing factors. They may be mistaken for gliomas or necrotic metastases, and surgical intervention may be required to make the diagnosis. We report the first case of cerebellar abscess in a patient without immunosuppression.

How should we approach Aspergillus in lung secretions of patients with COPD?

Aspergillus spp. is frequently isolated in respiratory samples from patients with severe COPD; however, the clinical significance of this mold is unclear and its presence may indicate temporary passage, benign chronic carriage, or onset of invasive disease. The definitive diagnosis of pulmonary aspergillosis in COPD patients is often difficult owing to the lack of specific clinical and radiological signs.

Clinical outbreak of linezolid-resistant Staphylococcus aureus in an intensive care unit.

Context: Linezolid resistance is extremely uncommon in Staphylococcus aureus.

Objective: To report an outbreak with linezolid and methicillin-resistant S. aureus (LRSA) in an intensive care department and the effective control measures taken.

Resistance to linezolid is mediated by the cfr gene in the first report of an outbreak of linezolid-resistant Staphylococcus aureus.

Background: From April through June 2008, we identified 12 patients in the intensive care unit and 3 patients on other wards infected with methicillin-resistant Staphylococcus aureus that was also resistant to linezolid. We investigated the mechanism of resistance--point mutations in domain V of 23S ribosomal RNA (rRNA) or presence of the cfr gene--involved in the outbreak.

Methods: Strains for the study were obtained in the intensive care unit and other wards.

[Pilot Drug Utilization Study of systemic antifungal agents in the Hospital Clínico San Carlos. Proposal of a study method].

Introduction: The study aims to define a method for the evaluation of the usage of systemic antifungal agents, and test it, in order to be able to develop larger studies.

Method: Drug Use Study, pilot, observational, prescription- indication. We proposed a definition of antifungal type of treatment using as host factors the EORTC (European Organization for Research and Treatment of Cancer) criteria, the patient's clinical data as well as any evidence of fungal infection.

Utility of real-time PCR for the detection of Paracoccidioides brasiliensis DNA in the diagnosis of imported paracoccidioidomycosis.

An increase in immigration from endemic regions has resulted in a number of cases of paracoccidioidomycosis (PCM) being imported into Spain. A molecular diagnostic technique based on real-time PCR was developed for the detection of Paracoccidioides brasiliensis DNA in both culture and patients' clinical samples. A Molecular Beacon probe was used, labelled with FAM and directed at the ITS1 region of ribosomic DNA.

[Five cases of zygomycosis.].

Combined histological and mycological study of tissue specimens established a proven diagnosis of cutaneous zygomycosis in four patients. All patients had been treated with wide spectrum antibiotics and one patient (liver transplantation) was in addition also treated with cyclosporine. All had acidosis and cutaneous breaks and four had also been treated with systemic corticosteroids.

[Scedosporium apiospermum external otitis.].

We report a case of Scedosporium apiospermum external otitis. The patient was topically treated with miconazole cream and achieved a clinical and mycological cure. The etiology, diagnosis and treatment of external fungal otitis are discussed.

[Candidemia and cutaneous lesions in two patients without intravenous drug addiction.].

We report here two cases of disseminated candidosis with typical folliculitis, cutaneous nodules and chorioretinitis in two patients with severe underlying conditions. Histological and microbiological studies showed Candida albicans in blood and cutaneous lesions. The outcome was favourable with azole systemic treatment.

[Bipolaris australiensis in a Spanish patient with allergic chronic sinusitis].

Allergic fungal sinusitis is a disease that results from hypersensitivity reaction of the host against fungi colonizing the paranasal sinuses. A 36 years old Spanish man with no history of travel abroad had a history of asthma, nasal polyps, allergic rhinitis and a chronic sinusitis with nasal congestion and headaches. Computed tomography showed pansinusitis and opacification of the paranasal sinuses.

[Invasive maxilar sinusitis by Rhizopus oryzae].

We herein present a diabetic with non Hodgkin lymphoma patient that had been treated with steroids and developed fungal invasive sinusitis. The patient had intensive facial pain that did not respond to antibiotics and on clinical inspection had a necrotic lesion on right nasal area. A smear and biopsy tissue showed broad non septate hyphae and on cultures Rhizopus oryzae was isolated.

[Need for systematic HIV serological study during pregnancy].

Background: To evaluate human immunodeficiency virus (HIV) screening usefulness in pregnancy and to know the prevalence of this infection in an urban area of Spain.

Patients And Method: Routine prenatal screening for antibodies to HIV was offered to pregnant women from Fuenlabrada-Leganés Health Care Area (Madrid) from 1992 to 1995. Unlinked anonymous screening of HIV was done with the sera from women refusing the assay or if it had not been offered.

[Factors of pathogenicity, biotype, serotype and antimicrobial sensitivity of 150 clinical isolates of Yersinia enterocolitica (1992-1994)].

Background: Yersinia enterocolitica is an important pathogen in temperate climates. The heterogeneity of the microorganisms covered by this denomination has a made grouping and identification schemes necessary.

Methods: A series of 150 different, consecutive isolates from patients with diarrheic syndrome living in an urban area with a population of approximately 500,000 inhabitants, were studied in order to evaluate their biochemical, antigenic and sensitivity characteristics.