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Objective: Streptococcus pneumoniae is a very rare cause of skin and soft tissue infections (SSTI). The aim of this study was to determine the clinical and microbiological characteristics of these infections., Methods: The medical records of patients with SSTIs due to S. pneumoniae diagnosed at the University Hospital of Guadalajara between January 2012 and December 2020 were retrospectively reviewed. Microbiological identification was performed using conventional procedures. Antimicrobial sensitivity was performed using the MicroScan WalkAway-96 plus automatic system and E-test strips following the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST)., Results: Fifteen cases of SSTIs were diagnosed. 73,3% of the cases presented underlying diseases, neoplasias being the most frequent. 60% of the cases presented predisposing factors, immunosuppression being the most common. The clinical presentations were: abscesses in different locations, ulcers, surgical wounds, lactational mastitis and necrotizing fasciitis. Polymicrobial infections were detected in 73.3% and the etiology was nosocomial in 6.6%. The clinical course was favorable in 90.9% of the cases. The antibiotics with the highest percentages of sensitivity against S. pneumoniae were cefotaxime, levofloxacin, vancomycin, linezolid and rifampicin., Conclusions: S. pneumoniae should be kept in mind as a possible causative agent of SSTIs, especially in patients with neoplasias and immunosuppression. Its involvement in infections such as lactational mastitis and necrotizing fasciitis should be highlighted. The clinical evolution is favorable in most patients, but it is important to pay special attention to cases of necrotizing fasciitis due to the severity of these infections., (©The Author 2021. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Objective: To know the evolution of susceptibility patterns of Escherichia coli in patients with community diagnosed urinary tract infections (UTIs) during last years in Castilla la Mancha (Spain)., Methods: Descriptive and retrospective study performed between january 2003 and december 2007. We studied data about frequency and susceptibility of 33.651 E. coli isolates from urine cultures that were remited from primary care centres depending of 6 hospitals in Castilla la Mancha (Spain)., Results: Susceptibility rates of E. coli for most antibiotics decreased significantly during the 5-year period, especially for amoxicillin-clavulanic acid, cefuroxime and quinolones. Average rates of susceptibility for amoxicillin-clavulanic acid, ciprofloxacin, cefuroxime, fosfomycin and nitrofurantoin were: 86.7, 75.4, 87.3, 97.6 and 96.2%, respectively. We observed a significantly increase of E. coli isolates producing extended-spectrum betalactamases ESBLs), from 1.9% in 2003 to 4,9% in 2007 (χ² TL = 143.6, p<0.001)., Conclusions: We observed a significantly reduction of E. coli susceptibility for most antibiotics and an increase of E. coli isolates producing ESBLs. Fosfomycin and nitrofurantoin are the best choices for empiric treatment. Prospective studies should be performed in the future to confirm the results of our study.

Introduction: Aeromonas spp. typically cause gastroenteritis, but can occasionally produce extraintestinal infections. The aim of this study was to determine the clinical and microbiological characteristics of extraintestinal infections caused by Aeromonas spp. in our area., Patients and Methods: The clinical histories of patients with extraintestinal infections by Aeromonas spp. diagnosed in Hospital Universitario de Guadalajara (Guadalajara, Spain) from January 1990 to December 2005 were reviewed. Identification and susceptibility testing of the strains were performed by the MicroScan WalkAway-40 automated method (DadeBerhing)., Results: Thirty-eight cases of extraintestinal infections were diagnosed: 18 abdominal infections, 11 skin and soft tissue infections, 3 urinary tract infections, and 3 episodes of bacteremia with no primary focus. The species most frequently found was A. hydrophila (16 cases). Infection occurred most often in patients with underlying diseases (76.3%), including malignancy (34.2%) and diabetes mellitus (21%). Polymicrobial infections were detected in 50% and the etiology was nosocomial in 21%. The mortality rate was 16.2%. Gentamicin, amikacin, cefotaxime and ciprofloxacin had the highest activity against the Aeromonas species isolated., Conclusions: Aeromonas spp. as the causative infectious agent should be kept in mind in patients with infections of the biliary system, surgical wounds in the abdomen and posttraumatic cellulitis. Extraintestinal infection is usually polymicrobial, appears most commonly in patients with underlying diseases, and generally has a good prognosis. The most active antibiotics in vitro were gentamicin, amikacin, cefotaxime and ciprofloxacin.

Myonecrosis due to Aeromonas spp is exceptional. We report the case of a diabetic patient with liver cirrhosis who developed a rapidly progressive myonecrosis by Aeromonas veronii biotype sobria. The portal of entry was an injury after falling down in an irrigation canal. The outcome was not favourable and surgical amputation of left leg was performed in spite of antibiotic treatment with cefotaxime and tobramicin. Aeromonas spp can be very aggressive and this microorganism should be considered in the differential diagnosis of skin and soft tissue infections with myonecrosis, specially after posttraumatic wound infections with a history of freshwater exposure.

Introduction: The objectives of the study were to investigate the usefulness of high-risk human papillomavirus (HR-HPV) detection in women with abnormal pap-smears as an adjunct to screening by cervical cytology, and to determine the viral load distribution according to the histological grade of the lesions., Methods: A total of 75 women were referred for cytological study of atypical cells of unknown origin (ASCUS), low-grade squamous intraepithelial lesions (LG-SIL) or high-grade squamous intraepithelial lesions (HG-SIL). All patients underwent colposcopy, histological study and HR-HPV detection using the Hybrid Capture II test., Results: In the pap-smear studies, HR-HPV was detected in 31.2% of women with ASCUS and 65.7% with LG-SIL. Histological examination showed HR-HPV in 46.4% of women without lesions, 69.5% of those with LG-SIL and 75% with HG-SIL. Negative predictive values for HG-SIL in women with cytological diagnoses of ASCUS and LG-SIL were 81.8% and 92.3%, respectively. Percentages of infection with high viral load significantly increased in accordance with the histological grade., Conclusions: The Hybrid Capture II test can be useful for the management of women with cytological evidence of ASCUS because of the low prevalence of HR-HPV infection and the high negative predictive value for HG-SIL. The usefulness in women with a cytological diagnosis of LG-SIL is limited due to the high prevalence of HR-HPV infection. High viral load can be a risk factor for the development of premalignant cervical lesions.

Background: The aim of this study was to know the frequency and the clinical characteristics of urinary infection by non typhi Salmonella in our area in Spain., Patients and Methods: The clinical histories of patients with urinary infection by non typhi Salmonella diagnosed in the Hospital General del Guadalajara from January 1990 to July 1999 were reviewed., Results: During the period studied nine patients with urinary infection by non typhi Salmonella were diagnosed, representing 0.056% of the urinary infection diagnosed in our hospital over the same period. All the patients presented underlying disease and five were undergoing immunosuppressor treatment. Four patients presented urological disease. The most frequent serogroup was Salmonella enteritidis (7 cases). All the episodes were symptomatic. The same microorganism was isolated in stools in four patients. The evolution was favorable in five of the nine cases. Recurrence was observed in two patients and secondary bacteremia in one. Six patients required antibiotic treatment over two or more weeks. The mean length of treatment was of 2.5 weeks., Conclusions: Urinary infection by non typhi Salmonella is predominantly observed in patients undergoing immunosuppression or with urological disease. Prolonged antibiotic treatment is recommended due to its bad evolution.

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.

In this paper we discuss the published relevant mycology dermatological reports which appeared in 1997 and 1998. The aims of this review is to give an actual view on antifungal therapy with a critical discussion on the efficacy of antifungals.