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Background High-speed global travel, increased trade, world population growth, migration, urbanization and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012–2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns. Methods In this retrospective study (January 2012 to December 2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalized weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes. Results We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3 weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis, whereas a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses. Conclusions Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasizing how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effectiveness of ceftaroline vs. vancomycin or daptomycin in the treatment of methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSIs)., Methods: This multicentre retrospective study conducted in 15 Spanish hospitals, included data from the first MRSA-BSIs of adult patients between January-2019 and December-2022. The ceftaroline group included patients who received ceftaroline for ≥72h within the first week of BSI onset; the standard of care (SOC) group included patients who received vancomycin or daptomycin ≥72h after BSI onset. Primary outcome was 30-day all-cause mortality; secondary outcomes included 90-day mortality and incidence of adverse events (AEs). Propensity-score (PS) matching and Cox proportional-hazards analyses were performed., Results: A total of 429 MRSA-BSIs were included: 133 in the ceftaroline group and 296 in the SOC group. More patients in the ceftaroline group had a SOFA score>2 (51.1% vs. 36.5%; p<0.01), complicated-BSI (66.2% vs. 42.2%; p<0.01), infective endocarditis (18.8% vs. 6.4%; p<0.01) and prescribed in combination treatment (65.4% vs. 11.5%; p<0.01), with no statistically significant differences in 30-day mortality: 23.3% ceftaroline (95%CI 16.1%-30.5%) vs. 16.2% SOC (95%CI 12.0%-20.4%), p=0.08. There were no statistically significant differences in 90-day mortality (33.1% ceftaroline vs. 26.7% SOC; p=0.17). After PS matching, 105 patients treated with ceftaroline were matched with 105 controls: the 30-day mortality rates were 21.9% and 16.2% (p=0.38). Cox-regression analysis of the entire cohort (n=429) revealed that age (HR 1.05, 95%CI 1.03-1.07) and SOFA score>2 (HR 2.34, 95%CI 1.50-3.65) were associated with 90-day mortality risk, although ceftaroline treatment did not demonstrate a significant effect (HR 1.00, 95%CI 0.97-1.02). Incidence of AEs was 12.0% in ceftaroline vs. 4.4% in SOC group (p<0.01). Most AEs occurred when ceftaroline was used in combination vs. monotherapy (17.2% vs. 2.2%; p=0.01)., Conclusions: Ceftaroline was an effective treatment for MRSA-BSIs but was commonly prescribed in combination showing a higher incidence of AEs., Competing Interests: Transparency declarations S.V. has received financial support from Pfizer(TM) for speaking engagements and attendance at conferences. L.B.P. has financial support for attending meetings from Menarini(TM) and Pfizer(TM). L.B. has received payment for consulting fees from Angelini(TM), Jannsen(TM) and Shionogi(TM) and for lecture fees and advisory boards from Jannsen(TM), ViiV(TM) and GILEAD(TM). All the rest authors reported no conflict of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)