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Introduction and Objective: Sexually transmitted infections of the rectum and anus (STI-RA) mainly affect men who have sex with men (MSM). The incidence of STI-RA among them has increased in recent years., Material and Methods: Retrospective study in patients with diagnoses of STI-RA in an STI unit during the years 2014 and 2015. Epidemiological, clinical and microbiological data were collected., Results: We included 95 patients, all of whom were MSM; 88.42% were HIV+; 67.17% did not use a condom during their most recent sexual intercourse; 17.91% had had sex with sex workers and 72.22% had used drugs during sexual intercourse during the previous year. A percentage of 32.92 reported symptoms that had lasted longer than 30 days. Lymphogranuloma venereum (LGV) was diagnosed in 54.73% of the patients. All patients who presented with proctitis and perianal ulcers were diagnosed with LGV infection. All those who presented perianal ulcers without proctitis were diagnosed with syphilis., Conclusions: All the patients affected by STI-RA were MSM, most of them HIV+, had engaged in high-risk sexual behaviour and had suffered prolonged symptomatology. Clinical and microbiological characteristics of STI-AR could help adjust the empiric therapy., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)

Background: There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae., Methods: A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples., Results: An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors., Conclusion: There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection., (Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Objetive: To study the characteristics and evolution of group B Streptococcus (GBS) late-onset diseases, over a period of 15years in 8hospitals the Barcelona area and analyze the possible impact of prophylactic measures for the prevention of early-onset neonatal infections., Methods: Retrospective review of all patients diagnosed with late-onset neonatal disease due to GBS from 1996 to 2010., Results: A total of 143 patients were diagnosed. Of these, 51 were born in others hospitals. The overalll incidence was 0.42 per 1000 live births, varying between 0.14‰ in the year 2000 and 0.80‰ in 2009. A slight but sustained tendency of increased risk was observed over the years, 6.9% in the overall disease (with no statistical significance). Sepsis/bacteremia was detected in 63.6% of the newborns, meningitis in 32.8%, and arthritis/osteomyelitis in 3.5%. In cases with known obstetrics dates, 53% of mothers had been colonized by GBS during pregnancy, 53.8% received intrapartum antibiotic prophylaxis, and 41.2% had some obstetric risk factors, particularly premature birth in 35.9%. There was a 2.8% mortality rate in the neonates, and predominant serotypes were III and Ia., Conclusions: The incidence of GBS late-onset disease has not decreased despite the control practices of early-onset disease, and possibility of this appearing must be taken into account., (Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Background and Objective: The aim of this study was to know: 1) the prevalence of antibodies against toxoplasma in pregnant women, 2) the incidence of primary infection during pregnancy and 3) the prevalence of congenital toxoplasmosis., Subjects and Method: Seroprevalence was prospectively analyzed in 16,362 pregnant women visited in 8 hospitals and 2 day care centers in Barcelona during 1999. Each participant laboratory included their own assays to detect toxoplasma-specific immunoglobulins IgM, IgA, IgG and IgG avidity antibodies. In case of positive specific IgM, a second serum sample was requested, which was processed in parallel with the first one. Three infection stages were defined: acute, possible and past (latent). Congenital infection was determined prenatally by polymerase chain reaction (PCR) in amniotic fluid or postnatally by serology in the newborn., Results: Seroprevalence was 28.6%. The incidence of primary infection during pregnancy was 1.02/1,000 susceptible pregnant women. Nine women out of 12 with an acute toxoplasma infection became seroconverted during their pregnancies and five of them had infants with congenital toxoplasmosis (vertical transmission: 41.6%). All four children born alive had no symptoms during their follow-up., Conclusions: In this study, the prevalence of toxoplasmosis was low. Acute toxoplasmosis was detected mainly by seroconversion during pregnancy. The frequency of maternal-fetal transmission was near half of cases.

Objective: To compare the efficacy of three culture media to detect vaginal and rectal colonization by group B streptococci (GBS) in pregnant women., Methods: We processed 1334 samples from 861 pregnant women: in 388 patients only vaginal swab was cultured (Group A) and in 473 vaginal and rectal swabs were cultured (Group B). Samples were inoculated on blood agar with colistin-nalidixic acid (BA-CNA), on plates with Granada medium, and on Todd-Hewitt broth (THB) with amikacin followed by subculture in BA-CNA., Results: GBS was isolated in 181 samples (13.6%): 114 vaginal swabs (13.2%) and 67 rectal swabs (14.2%). Among the positive samples, GBS was isolated on BA-CNA in 60.5% of vaginal swabs and in 59.7% of rectal swabs, on Granada medium in 80.7% of vaginal swabs and in 91% of rectal swabs, and on THB in 97.4% of vaginal swabs and in 97% of rectal swabs.We detected 130 GBS carriers, 54 (13.9%) in Group A and 76 (16.1%) in Group B. The percent of carriers detected in groups A and B, respectively, was 59.3% and 75% with BA-CNA, 77.8% and 93.4% with Granada medium, and 96.3% and 97.4% with THB., Conclusions: THB was the most reliable medium for the detection of GBS. Use of Granada medium allows fast detection of about 87% of carriers. The combination of THB and an initial plate of Granada medium or BA-CNA allows detection of more than 99% of GBS carriers.

Two cases are reported of cat scratch disease which we consider worth describing both because of their familial presentation (the involved patients were brothers) and the serologic follow-up performed after diagnosis, which showed significant increases in IgG antibody titers to Bartonella henselae in both patients, one on day 35 and the other on day 45 after diagnosis. Cat scratch disease is a rarely diagnosed condition in our environment and it is easily misdiagnosed with other regional lymphadenitis; hence, a serologic test revealing a seroconversion or a significant increase in serologic titers will be very useful, as well as the epidemiologic antecedent of cat exposure.

Objectives: The objectives of this study were to determine the characteristics of early onset neonatal sepsis (EONS) due to group B streptococci (GBS) in our population and to evaluate the efficacy of a prevention program in our hospital during a 4 year period., Material and Methods: We revised all cases of EONS due to GBS between 1985 and 1994 and studied pregnant women colonized by GBS and their infants between 1991 and 1994., Results: In ten years, we diagnosed 45 cases of EONS due to GBS, 30 born in our hospital and 15 born in other hospitals. Sixty-two percent of the patients presented some risk factor (gestation < 37 weeks, rupture of membranes > 18 hours or intrapartum fever > or = 37.8 degrees C. Between 1991 and 1994, 93% of pregnant women colonized by GBS received antibiotic prophylaxis, 14.7% of these women had some risk factor for infection. Two infants from mothers colonized had EONS due to GBS. One mother did not receive antibiotic prophylaxis and the other presented intrapartum fever. In another 5 cases observed during this period, the vaginal culture of the mother was negative for GBS. The incidence of EONS due to GBS during these 4 years was 0.82 cases per 1,000 live births., Conclusion: We consider it necessary to use antibiotic prophylaxis in all pregnant carriers of GBS, as well as the administration of antibiotics to pregnant women with a rupture of membranes < 34 weeks of gestation and the practice of an intrapartum culture for the detection of GBS in pregnant women without previous cultures and premature rupture of the membranes.

Three cases of serious infections due to Candida parapsilosis in infants are reported. Two patients are children exposed to abdominal surgery, parenteral nutrition and antibiotic treatment, who developed catheter-associated sepsis with successful response to change of catheter and intravenous amphotericin B, despite one of the patients showed a relapse some weeks after. Third patient, a hydrocephalic child with external ventricular shunt, developed cerebrospinal fluid infection without response to antifungal treatment and died. Sepsis and meningitis due to Candida parapsilosis can be observed in infants with some risk factors, as use of intravascular or intraventricular catheters. Change of the catheter and treatment with amphotericin B are indicated in these infections.