Targeted Diagnosis and Advances in the Clinical Application of Infectious Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 1655

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Biomedical and Diagnostic Sciences, School of Medicine, University of Salamanca, 37007 Salamanca, Spain
Interests: epidemiology; statistics; biostatistics; public health
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Special Issue Information

Dear Colleagues,

Clinical and healthcare safety is an essential dimension of current healthcare quality. Among the most important and transcendent threats are healthcare-associated infections. These develop mainly during the hospitalisation of patients, which increases hospital stays and costs. It is estimated that globally, 1,270,000 deaths are attributable to multi-resistant pathogens such as E Coli, Staphylococcus aureus, Klebsiela pneumoniae, Streptococcus pneunomonie, Acinetobacter baumannii and carbapenem-resistant Pseudomonas aureoginosa, which are responsible for 70% of antimicrobial resistance in terms of premature morbidity and mortality in healthcare settings. Their surveillance, prevention and control are carried out by the Preventive Medicine and Public Health Services in coordination with the Microbiology and Internal Medicine/Infectious Diseases Services.

On the other hand, there are emerging infections that currently pose a threat to the public health of countries, such as viruses transmitted by Aedes mosquitoes, viruses transmitted by arthropods such as the Nile, Ebola and Marburg viruses, respiratory coronaviruses and avian influenza viruses A/H5N1 and A/H7N9.

Prof. Dr. José Antonio Mirón-Canelo
Guest Editor

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Keywords

  • care-associated infections
  • emerging infections
  • prevention and control measures and guidelines
  • prevention and control training

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Published Papers (2 papers)

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Research

16 pages, 971 KiB  
Article
Ventriculoperitoneal Shunt Infections: Causative Pathogens and Associated Outcomes from Multiple Hospitals in Saudi Arabia
by Mohammed Alqasmi, Yousif A. Kariri, Rawaf Alenazy, Mohammed Thabet, Ghaith Fallata and Nasser Alqurainy
J. Clin. Med. 2025, 14(6), 2006; https://doi.org/10.3390/jcm14062006 - 16 Mar 2025
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Abstract
Background: Ventriculoperitoneal shunting (VPS) is the primary treatment for hydrocephalus, significantly improving patients’ outcomes. However, it is marred by high failure rates due to infections, which account for a third of these malfunctions and escalate morbidity, mortality, and healthcare costs. Method: This study [...] Read more.
Background: Ventriculoperitoneal shunting (VPS) is the primary treatment for hydrocephalus, significantly improving patients’ outcomes. However, it is marred by high failure rates due to infections, which account for a third of these malfunctions and escalate morbidity, mortality, and healthcare costs. Method: This study focused on evaluating VPS infection rates, pathogens, their resistance patterns, and the impact on clinical outcomes using retrospective data from multiple hospitals in Saudi Arabia. It included data from hydrocephalus patients who underwent VPS and only considered positive cultures that were confirmed from CSF or shunt tip samples. Results: This study excluded patients with prior infections before VPS placement or those treated with alternatives to VPS. Out of 317 patients who met the inclusion criteria, the analysis revealed that 23 patients (7.26%) suffered from VPS infections, mostly within the first two weeks post-surgery (58.06% of cases), with a significant discrepancy in infection rates between hospitals. Infections predominantly involved Gram-positive bacteria (58.08%), especially coagulase-negative staphylococci and Staphylococcus aureus (25.81% and 12.90%, respectively). There was also a substantial presence of Gram-negative bacteria and fungi, accounting for 35.46% and 6.46%, respectively. Despite general antibiotic susceptibility, resistance was significant in certain cases, including multidrug-resistant isolates like Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter ursingii. Importantly, patients with VPS infections had a tenfold increase in the length of hospital stay (70.84 days, SD ± 139.5) compared to non-infected patients (7.69 days, SD ± 20.72), indicating high morbidity and associated treatment costs. Conclusions: Our results emphasize the importance of better VPS infection control and standardized hospital protocols to decrease the incidence of VPS-related infections, both in Saudi Arabia and globally. Full article
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15 pages, 552 KiB  
Article
Factors Associated with Complicated Parapneumonic Pleural Effusion/Empyema in Patients with Community-Acquired Pneumonia: The EMPIR Study
by Rosa María Bravo Jover, Vicente F. Gil-Guillen, Carlos Pérez Barba, Jose Antonio Quesada, María García López, Isabel García Soriano and María de los Reyes Pascual Pérez
J. Clin. Med. 2025, 14(5), 1739; https://doi.org/10.3390/jcm14051739 - 5 Mar 2025
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Abstract
Objectives: To identify factors associated with complicated parapneumonic pleural effusion/empyema (CPPE/empyema) in inpatients with community-acquired pneumonia (CAP) and to build a mathematical model for CPPE/empyema. Methods: This is an observational case–control study nested within a retrospective cohort, based on clinical practice, and [...] Read more.
Objectives: To identify factors associated with complicated parapneumonic pleural effusion/empyema (CPPE/empyema) in inpatients with community-acquired pneumonia (CAP) and to build a mathematical model for CPPE/empyema. Methods: This is an observational case–control study nested within a retrospective cohort, based on clinical practice, and including adults hospitalized with CAP from 2009 to 2019. Cases and controls were defined according to diagnosis of CPPE/empyema during admission. For each case, two controls were randomly selected and matched for the period of admission to avoid seasonality bias. Explanatory variables included demographic, analytical, clinical, and radiological data; treatment with corticosteroids on admission; prognostic and CAP severity scales; comorbidity; and the interval between symptoms onset and admission. Results: Of 4372 pneumonias reviewed, 2015 were excluded due to pleural effusion, blunting of the costophrenic angle without thoracentesis, or heart failure. Of the remaining 2357 patients, 106 developed CPPE/empyema (cases), and 212 were selected as controls. Factors associated with CPPE/empyema were pleuritic pain (odds ratio [OR] 7.42, 95% confidence interval [CI] 3.83–14.38), multilobar radiological involvement (OR 4.48, 95% CI 2.26–8.88), and leukocytosis (OR 4.12, 95% CI 1.94–8.76). Corticosteroids showed a protective effect (OR 0.24, 95% CI 0.09–0.61). Age (OR 0.99, 95% CI 0.97–1.02; p = 0.56) and sex (OR 1.91, 95% CI 0.94–3.88; p = 0.074) were adjustment variables. The area under the receiver operating characteristic curve was 0.847 (95% CI 0.772–0.921). Conclusions: Pleuritic pain, multilobar radiological involvement, and leukocytosis are associated with CPPE/empyema in inpatients with CAP. Treatment with corticosteroids upon admission seems to be a protective factor. The discriminative capacity of the resulting multivariable model presents moderate/high accuracy. Full article
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