Search

El desarrollo de la Inteligencia Artificial afecta a las formas de concebir la seguridad nacional e internacional de nuestro tiempo. Nuevas herramientas de control y defensa, pero también desafíos que surgen en un espacio virtual difícilmente controlable por los Estados y las organizaciones internacionales. En este paradigma surge el metaverso como espacio virtual anárquico, donde se desarrollan actividades recreativas, originales formas de consumo y de marketing, pero también acciones violentas y de desestabilización nunca vistas anteriormente. Estos hechos han derivado en un aumento de la participación de actores no estatales en parcelas tradicionalmente competencia de los Estados. También ha aumentado la actividad de organizaciones del crimen organizado y de grupos terroristas. Por otro lado, que los Estados usen estas tecnologías implica riesgos en materia de derechos humanos y libertades civiles. Existe una necesidad imperiosa de establecer marcos de gobernanza internacional que ayuden a prevenir conflictos y promover el uso responsable de estas tecnologías, Artificial Intelligence affects the way we understand national and international security. New tools for control and defense, but also new challenges that appear within a virtual world that is difficult for States and International Organizations to control. In this new paradigm, the Metaverse appears as a virtual and anarchic space, where recreational activities, new ways of consuming and trading, and violent and destabilizing actions never seen in the past take place. As a result, the involvement of non-state actors, in areas traditionally under the authority of states, has increased, and terrorist and illicit activities in cyberspace have grown. Moreover, if states use this technology, it poses some risk to human rights and freedom. We must create an international governance framework to prevent conflict and promote responsible use of Artificial Intelligence and the metaverse., Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

[Objective] Human monkeypox (mpox) is usually self-limited infection; however, rising data show a worse outcome in patients with impaired immune status, particularly those co-infected with HIV [Mitjà O, Alemany A, Marks M, Lezama Mora JI, Rodríguez-Aldama JC, Torres Silva MS et al. Mpox in people with advanced HIV infection: A global case series. Lancet. 2023; 401:939–49. DOI:https://doi.org/10.1016/S0140-6736(23)00273-8] [Govind A, Lazarte SM, Kitchell E, Chow JY, Estelle CD, Fixsen E et al. Severe mpox infections in people with uncontrolled human immunodeficiency virus (HIV). Clin Infect Dis. 2023; 76:1843–6. DOI:https://doi.org/10.1093/cid/ciad052]., [Methods] We report the clinical, pathological, and molecular study of a patient with mpox infection and a late HIV diagnosis, with fatal outcome., [Results] Necropsy revealed visceral spread of mpox. Mpox virus was sequenced twice during the admission, uncovering an emerging mutation near a genomic region where mutations associated with tecovirimat resistance have been documented., [Discussion] Monkeypox can manifest as an opportunistic infection in individuals with advanced HIV-associated immunosuppression.

We aimed to define a novel indicator for monitoring antimicrobial use specifically in the Emergency Department Observation Unit (EDOU) and to assess the long-term impact of an institutional education-based antimicrobial stewardship program (ASP) on the antimicrobial prescribing pattern and clinical outcomes in this setting. A quasi-experimental interrupted time-series study was performed from 2011 to 2022. An educational ASP was implemented at the EDOU in 2015. To estimate changes in antimicrobial use, we designed an indicator adjusted for patients at risk of antimicrobial prescribing: defined daily doses (DDDs) per 100 patients transferred from the Emergency Department to the Observation Unit (TOs) per quarter. The number of bloodstream infections (BSIs) and the crude all-cause 14-day mortality were assessed as clinical outcomes. Antimicrobial use showed a sustained reduction with a trend change of −1.17 DDD per 100 TO and a relative effect of −45.6% (CI95% −64.5 to −26.7), particularly relevant for meropenem and piperacillin-tazobactam, with relative effects of −80.4% (−115.0 to −45.7) and −67.9% (−93.9 to −41.9), respectively. The incidence density of all BSIs increased significantly during the ASP period, with a relative effect of 123.2% (41.3 to 284.7). The mortality rate remained low and stable throughout the study period, with an absolute effect of −0.7% (−16.0 to 14.7). The regular monitoring of antimicrobial use in the EDOU by using this new quantitative indicator was useful to demonstrate that an institutional education-based ASP successfully achieved a long-term reduction in overall antimicrobial use, with a low and steady BSI mortality rate.

La Asamblea General de las Naciones Unidas (AGNU) ha aprobado los Objetivos de Desarrollo Sostenible (ODS) y una nueva Agenda de desarrollo −también llamada Agenda 2030−. Los ODS pretenden ser metas ambiciosas que incidan en las causas de la pobreza a nivel mundial y que, al mismo tiempo, se dirijan a construir sociedades más igualitarias y productivas en un plazo de quince años. Por otro lado, las negociaciones entre los Estados Unidos (EEUU) y la Unión Europea (UE) para el acuerdo de Asociación Transatlántica para el Comercio y la Inversión (TTIP) pretenden crear la mayor relación económica y comercial a nivel mundial. El objetivo de este artículo es el de analizar en qué medida la posible firma del TTIP contribuirá a conseguir satisfactoriamente los ODS y si se está teniendo en cuenta la nueva agenda de desarrollo en las negociaciones de este importante tratado entre los EEUU y la UE., Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

El movimiento talibán1 recuperó el poder el 15 de agosto de 2021 y lo ha conseguido a través de una violenta insurgencia. En la actualidad, los talibanes practican una estrategias de contraterrorismo para frenar la violencia indiscriminada utilizada por el Estado Islámico (isis-k). Y, al mismo tiempo, han de hacer frente a la oposición del Frente Nacional de Resistencia, herederos de la Alianza del Norte, que utiliza tácticas diferentes a las terroristas. La paradoja afgana es que los talibanes, acostumbrados al uso de los medios terroristas para conseguir sus fines, han de poner en práctica políticas contraterroristas para frenar el impulso de sus enemigos. El objetivo de este trabajo es analizar cómo el movimiento talibán está organizando su lucha contra la oposición con el fin de identificar puntos comunes y novedosos entre su etapa insurgente y su posición de gobierno., Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

Los talibán justifican su política contra las mujeres en la tradición afgana, en una costumbre construida para ejercer una dominación absoluta de los hombres sobre las mujeres. Sin embargo, esta dinámica no es más que una consecuencia del delirio de los fundamentalistas que desean apartar a la mujer de cualquier espacio público y relegarlas al ámbito familiar y a la sumisión ejercida por los hombres. Estas acciones están encontrando la reacción de los movimientos sociales en defensa de los derechos de las mujeres en Afganistán, ubicados principalmente en las grandes ciudades del país, pero no tienen el apoyo suficiente para defender su causa, que no es otra que la de conseguir los mismos derechos y libertades que los hombres. Ante este escenario, las mujeres afganas se encuentran en una situación de absoluta vulnerabilidad y son víctimas, ante los ojos de la comunidad internacional, de una violación sistemática de sus derechos humanos., Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

Afghanistan has been in conflict for many reasons since 1978. Opium production is one of these reasons. Afghanistan has been the world's leading illicit opium producer since 1992. Opium is a focal point of instability to security and development in Afghanistan. The United States has been practicing an unsuccessful eradication policy since 2001. After more than fifteen years, Afghanistan needs a different strategy in this area. One of the alternatives would be implementing a policy of legalization to promote a legal opium poppy cultivation market. However, there are some obstacles —political and legal— to implement this policy. The restrictive international legal framework and the weakness of the Afghan´s State prevent the implementation these policies. We would like to argue the utility level that a policy of legalization of opium poppy cultivation could have over security and human development improvement in Afghanistan., Afganistán es un conflicto de larga duración debido a varios factores. En el amplio abanico de causas, el cultivo y producción de adormidera es uno de los elementos de desestabilización que incide directamente en la situación actual de seguridad y desarrollo del país. Desde 1992, Afganistán ha sido el principal productor ilegal de opio a nivel mundial. Desde la intervención de los Estados Unidos, se ha practicado una política de erradicación de estos cultivos que no ha obtenido los resultados esperados. Después de más de quince años ejecutando este tipo de políticas se requiere un cambio de estrategia. Una de las alternativas pasa por establecer un modelo basado en la legalización del cultivo y la producción de adormidera. Sin embargo, varios son los obstáculos —políticos y jurídicos— que dificultan llevar a cabo este tipo de políticas. El restrictivo marco jurídico internacional y la debilidad del Estado afgano condicionan la puesta en práctica de políticas de esta dimensión. Con este artículo pretendemos ofrecer algunas claves para analizar el grado de eficacia de una política alternativa en torno al cultivo y producción de adormidera con el fin de mejorar la seguridad y el desarrollo humano en Afganistán., Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

This study evaluates the safety of early oral ambulatory treatment of adult patients diagnosed with bacteremia after their discharge from the emergency department. A cohort of 206 febrile ambulatory patients was assessed. Bacteremic low-risk patients were recommended an oral treatment and were compared with matched febrile non-bacteremic outpatients. Rates of 14-day mortality and unplanned re-consultations were similar and below 5% in both cohorts, highlighting the safety of oral therapy of low-risk bacteremia, even from its onset.

Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, TRUE, pub

Depto. de Relaciones Internacionales e Historia Global, Fac. de Ciencias Políticas y Sociología, FALSE, pub

In 2019, the biggest listeriosis outbreak by Listeria monocytogenes (Lm) in the South of Spain was reported, resulting in the death of three patients from 207 confirmed cases. One strain, belonging to clonal complex 388 (Lm CC388), has been isolated. We aimed to determine the Lm CC388 virulence in comparison with other highly virulent clones such as Lm CC1 and Lm CC4, in vitro and in vivo. Four L. monocytogenes strains (Lm CC388, Lm CC1, Lm CC4 and ATCC 19115) were used. Attachment to human lung epithelial cells (A549 cells) by these strains was characterized by adherence and invasion assays. Their cytotoxicities to A549 cells were evaluated by determining the cells viability. Their hemolysis activity was determined also. A murine intravenous infection model using these was performed to determine the concentration of bacteria in tissues and blood. Lm CC388 interaction with A549 cells is non-significantly higher than that of ATCC 19115 and Lm CC1, and lower than that of Lm CC4. Lm CC388 cytotoxicity is higher than that of ATCC 19115 and Lm CC1, and lower than that of Lm CC4. Moreover, Lm CC388 hemolysis activity is lower than that of the Lm CC4 strain, and higher than that of Lm CC1. Finally, in the murine intravenous infection model by Lm CC388, higher bacterial loads in tissues and at similar levels of Lm CC4 were observed. Although a lower rate of mortality of patients during the listeriosis outbreak in Spain in 2019 has been reported, the Lm CC388 strain has shown a greater or similar pathogenicity level in vitro and in an animal model, like Lm CC1 and Lm CC4.

Objectives: The BIChromET selective medium for detecting piperacillin-tazobactam (TZP) and cefepime (FEP) resistant Pseudomonas aeruginosa was developed. Methods: The performance of this medium was first evaluated using a collection of 100 P. aeruginosa clinical strains (70 TZP-susceptible, 30 TZP-resistant, 58 FEP-susceptible, and 42 FEP-resistant). Then, we performed clinical validation by testing 173 respiratory clinical samples. Results: The BIChromET medium showed excellent sensitivity (TZP (avg. 96.7%); FEP (avg. 92.7%)) and specificity (TZP (avg. 98.9%); FEP (avg. 98%)) in distinguishing the detection limit ranging from 104 to 108 CFU/mL. Then, testing the bronchoalveolar lavage (BAL) and tracheobronchial aspirate (TBA) clinical specimens (N = 173) revealed the excellent performance of the medium with P. aeruginosa, showing 100% and 92.6% of categorical agreements with the results obtained via the broth microdilution methods (BMD) for TZP and FEP, respectively. Conclusion: This medium allows for easy and accurate detection of TZP/FEP-resistant isolates regardless of their resistance mechanisms.

La invasión de Ucrania tiene un impacto desigual en el Norte de África y Oriente Medio (MENA). Lógicamente, el escenario donde se desarrollan las operaciones militares está sufriendo directamente las consecuencias de una agresión ilegal, al margen por completo del Derecho internacional público, que en ningún caso autoriza una agresión de estas características. El resto del continente europeo también se ve afectado por las consecuencias de la agresión rusa observando con inquietud los efectos políticos, económicos y humanitarios de una guerra que se desarrolla al otro lado de su frontera. Otros Estados del mundo observan desde la lejanía y con la decisión de condenar la agresión o posicionarse en una neutralidad ambigua. Los menos —Siria, Bielorrusia, Malí, Eritrea, Nicaragua y Corea del Norte— apoyan la agresión de Rusia.

En la actualidad asistimos al debilitamiento del orden internacional nacido tras la Segunda Guerra Mundial y levantado sobre los pilares del liberalismo económico y democrático representativo. Es evidente que el sistema multilateral actual, por diversas razones que expondremos más adelante, ha perdido vigor, pero cometeríamos un grave error de cálculo si pensamos que esta situación es consecuencia de hechos aislados que se producen en el escenario mundial, como las repetidas agresiones de Rusia a Ucrania en 2014 y 2022, la pandemia de la Covid-19 o el resurgir de las políticas proteccionistas, por poner algunos ejemplos.

Objectives To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort. Methods Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S. Aureus bloodstream infection cases observed between January 2013 and April 2015. Multivariable analysis was performed to evaluate the impact of adherence to QCIs on 90-day mortality. Results A total of 1784 cases were included. Overall, 90-day mortality was 29.9% and mean follow-up period was 118 days. Adherence was 67% (n = 1180/1762) for follow-up blood cultures, 31% (n = 416/1342) for early focus control, 77.6% (n = 546/704) for performance of echocardiography, 75.5% (n = 1348/1784) for adequacy of targeted antimicrobial therapy, 88.6% (n = 851/960) for adequacy of treatment duration in non-complicated bloodstream infections and 61.2% (n = 366/598) in complicated bloodstream infections. Full bundle adherence was 18.4% (n = 328/1784). After controlling for immortal time bias and potential confounders, focus control (adjusted hazard ratio = 0.76; 95% CI, 0.59–0.99; p 0.038) and adequate targeted antimicrobial therapy (adjusted hazard ratio = 0.75; 95% CI, 0.61–0.91; p 0.004) were associated with low 90-day mortality. Discussion Adherence to QCIs in S. Aureus bloodstream infection did not reach expected rates. Apart from the benefits of application as a bundle, focus control and adequate targeted therapy were independently associated with low mortality.

Background We aim to compare the effect of short versus long treatment duration in Gram-negative bacteremia on all-cause mortality in pre-specified sub-groups. Methods Individual participant data meta-analysis of randomized controlled trials (RCTs) comparing short (≤7) versus longer (>7 days) antibiotic treatment for Gram-negative bacteremia. Participants were adults (≥18 years), with Gram-negative bacteremia during hospital stay. We searched PubMed, Cochrane Central Register of Controlled Trials, and Web of Science to identify trials conducted up to May 2022. Primary outcome was 90-day all-cause mortality. Secondary outcomes were 30-day mortality, relapse of bacteremia, length of hospital stay, readmission, local or distant infection complications, adverse events, and resistance emergence. Outcomes were assessed in pre-specified subgroups: women vs men; non-urinary vs urinary source; presence vs absence of hypotension on initial presentation; immunocompromised patients versus non-immunocompromised patients, and age (above/below 65). Fixed-effect meta-analysis model was used to estimate pooled odds ratio (OR) and 95% confidence interval (CI). All three trials had low risk of bias for allocation generation and concealment. Findings Three RCTs (1186 patients) were included; 1121 with enterobacterales bacteremia. No significant difference in mortality was demonstrated between 7- and 14-days treatment (90-day mortality: OR 1.08, 95% CI 0.73–1.58; 30-day mortality: 1.08, 0.62–1.91). Relapse (1.00, 0.50–1.97); length of hospital stay (P = 0.78); readmission (0.96, 0.80–1.22); and infection complications (local: 1.62 0.76–3.47; distant: 2.00, 0.18–22.08), were without significant difference, and so were adverse events or resistance emergence. No significant difference in clinical outcomes between 7 and 14 days of antibiotics was demonstrated in the subgroups of gender, age, hemodynamic status, immune status, and source of infection. Interpretation For patients hemodynamica

Rapid determination of susceptibility to piperacillin-tazobactam (TZP) is very important since the development of antibiotic resistance and inadequate treatment could increase the risk of clinical failure in infected patients, especially if such resistance is unknown to the clinician. Therefore, based on color change from orange to yellow of phenol red due to glucose metabolism (bacterial growth) in the presence of an adequate concentration of TZP (10 mg/L piperacillin and 5 mg/L tazobactam), the RapidTZP test has been developed to detect TZP resistance in Escherichia coli and Klebsiella pneumoniae isolates in a maximum of 3 h. A total of 140 isolates, 43 of E. coli and 97 of K. pneumoniae, were used to evaluate the performance of the test, 60 being resistant to TZP. The sensitivity and specificity of the test were 98.24% and 100%, respectively. Additionally, the RapidTZP test was validated by a pellet obtained directly from blood culture bottles. A total of 37 positive blood cultures for E. coli and 43 for K. pneumoniae were used for validation, 8 of them resistant to TZP. The sensitivity and specificity shown in the evaluation were 100% for both parameters. This new test is easy, fast, and accurate, providing results in 3 h.

Objectives To evaluate the clinical and epidemiological impact of a new molecular surveillance strategy based on qPCR to control an outbreak by Serratia marcescens in a Neonatal Intensive Care Unit (NICU). Methods We design a specific qPCR for the detection of S. marcescens in rectal swabs of patients admitted to a NICU. We divided the surveillance study into two periods: (a) the pre-PCR, from the outbreak declaration to the qPCR introduction, and (b) the PCR period, from the introduction of the qPCR until the outbreak was solved. In all cases, S. marcescens isolates were recovered and their clonal relationship was analysed by PFGE. Control measures were implemented during the outbreak. Finally, the number of bloodstream infections (BSI) was investigated in order to evaluate the clinical impact of this molecular strategy. Results Nineteen patients colonized/infected by S. marcescens were detected in the pre-PCR period (October 2020–April 2021). On the contrary, after the PCR implementation, 16 new patients were detected. The PFGE revealed 24 different pulsotypes belonging to 7 different clonal groups, that were not overlapping at the same time. Regarding the clinical impact, 18 months after the qPCR implementation, no more outbreaks by S. marcescens have been declared in the NICU of our hospital, and only 1 episode of BSI has occurred, compared with 11 BSI episodes declared previously to the outbreak control. Conclusions The implementation of this qPCR strategy has proved to be a useful tool to control the nosocomial spread of S. marcescens in the NICU.

[Background] Antimicrobial stewardship programs (ASPs) are recommended in nursing homes (NHs), although data are limited. We aimed to determine the clinical and ecological impact of an ASP for NHs., [Methods] We performed a cluster, randomized, controlled trial and a before–after study with interrupted time-series analyses in 14 NHs for 30 consecutive months from July 2018 to December 2020 in Andalusia, Spain. Seven facilities implemented an ASP with a bundle of 5 educational measures (general ASP) and 7 added 1-to-1 educational interviews (experimental ASP). The primary outcome was the overall use of antimicrobials, calculated monthly as defined daily doses (DDD) per 1000 resident days (DRD)., [Results] The total mean antimicrobial consumption decreased by 31.2% (−16.72 DRD; P = .045) with respect to the preintervention period; the overall use of quinolones and amoxicillin–clavulanic acid dropped by 52.2% (P = .001) and 42.5% (P = .006), respectively; and the overall prevalence of multidrug-resistant organisms (MDROs) decreased from 24.7% to 17.4% (P = .012). During the intervention period, 12.5 educational interviews per doctor were performed in the experimental ASP group; no differences were found in the total mean antimicrobial use between groups (−14.62 DRD; P = .25). Two unexpected coronavirus disease 2019 waves affected the centers increasing the overall mean use of antimicrobials by 40% (51.56 DRD; P < .0001)., [Conclusions] This study suggests that an ASP for NHs appears to be associated with a decrease in total consumption of antimicrobials and prevalence of MDROs. This trial did not find benefits associated with educational interviews, probably due to the coronavirus disease 2019 pandemic., [Clinical Trials Registration] NCT03543605.

This study explored the feasibility of a bundle of indicators aimed at assessing the quality of antimicrobial use in intensive care units (ICUs) through an observational prospective study spanning 12 quarters (January 2019-December 2021) in a 1290-bed teaching hospital in Spain. Members of the antimicrobial stewardship programme team selected the indicators to analyse the quality of antimicrobial use based on consumption data from a list proposed in a previous study. Antimicrobial use in the ICU was measured as defined daily dose (DDD) per 100 occupied bed-days. Trends and points of change were analysed with segmented regression. The intravenous macrolides/intravenous respiratory fluoroquinolones ratio in the ICU increased progressively, although not significantly, by 11.14% per quarter, likely related to prioritization of the use of macrolides in serious community-acquired pneumonia and the coronavirus disease 2019 pandemic. A remarkable upward trend of 2.5% per quarter was detected in the anti-methicillin-susceptible Staphylococcus aureus/anti-methicillin-resistant S. aureus agents ratio in the ICU, which could be explained by the low prevalence of methicillin-resistant S. aureus at the study centre. Patterns of amoxicillin-clavulanic acid/piperacillin-tazobactam ratio and diversification of anti-pseudomonal beta-lactams showed an increment in use over the study. The use of these novel indicators provides additional information for the current analysis of DDD. Implementation is feasible, and led to the detection of patterns that agree with local guidelines and cumulative antibiogram reports, and foster targeted improvement actions within antimicrobial stewardship programmes.

West Nile virus (WNV) is a neurotropic flavivirus transmitted by the bites of infected mosquitoes. Severe forms of West Nile disease (WND) can curse with meningitis, encephalitis or acute flaccid paralysis. A better understanding of the physiopathology associated with disease progression is mandatory to find biomarkers and effective therapies. In this scenario, blood derivatives (plasma and serum) constitute the more commonly used biofluids due to its ease of collection and high value for diagnostic purposes. Therefore, the potential impact of this virus in the circulating lipidome was addressed combining the analysis of samples from experimentally infected mice and naturally WND patients. Our results unveil dynamic alterations in the lipidome that define specific metabolic fingerprints of different infection stages. Concomitant with neuroinvasion in mice, the lipid landscape was dominated by a metabolic reprograming that resulted in significant elevations of circulating sphingolipids (ceramides, dihydroceramides, and dihydrosphingomyelins), phosphatidylethanolamines and triacylglycerols. Remarkably, patients suffering from WND also displayed an elevation of ceramides, dihydroceramides, lactosylceramides, and monoacylglycerols in their sera. The dysregulation of sphingolipid metabolism by WNV may provide new therapeutic opportunities and supports the potential of certain lipids as novel peripheral biomarkers of WND progression.

In 2019, the biggest listeriosis outbreak by Listeria monocytogenes (Lm) in the South of Spain was reported, resulting in the death of three patients from 207 confirmed cases. One strain, belonging to clonal complex 388 (Lm CC388), has been isolated. We aimed to determine the Lm CC388 virulence in comparison with other highly virulent clones such as Lm CC1 and Lm CC4, in vitro and in vivo. Four L. monocytogenes strains (Lm CC388, Lm CC1, Lm CC4 and ATCC 19115) were used. Attachment to human lung epithelial cells (A549 cells) by these strains was characterized by adherence and invasion assays. Their cytotoxicities to A549 cells were evaluated by determining the cells viability. Their hemolysis activity was determined also. A murine intravenous infection model using these was performed to determine the concentration of bacteria in tissues and blood. Lm CC388 interaction with A549 cells is non-significantly higher than that of ATCC 19115 and Lm CC1, and lower than that of Lm CC4. Lm CC388 cytotoxicity is higher than that of ATCC 19115 and Lm CC1, and lower than that of Lm CC4. Moreover, Lm CC388 hemolysis activity is lower than that of the Lm CC4 strain, and higher than that of Lm CC1. Finally, in the murine intravenous infection model by Lm CC388, higher bacterial loads in tissues and at similar levels of Lm CC4 were observed. Although a lower rate of mortality of patients during the listeriosis outbreak in Spain in 2019 has been reported, the Lm CC388 strain has shown a greater or similar pathogenicity level in vitro and in an animal model, like Lm CC1 and Lm CC4.