Luis Otero

Actualización en infecciones de transmisión sexual: epidemiología, diagnóstico y tratamiento

immune-response modifier in the treatment of genital warts, and that are questions in the goal of this review. Viral hepatitis and HIV were no reviewed by space reasons.

Trends in the prevalence of pathogens causing urethritis in Asturias, Spain, 1989-2000.

Background There are few studies of recent trends in the etiology and epidemiologic characteristics of specific microorganisms causing urethritis in men. Goal The objective of the current study was to show the clinical experience in our country and to evaluate the trends in the prevalence of the pathogens in male urethritis, as well as the epidemiologic patterns in a series of 2101 patients. Study Design This was a descriptive study of the etiological agents causing urethritis in our sexually transmitted disease clinics in a period of 12 years (1989–2000), with a comparison of two periods of time. Results There were 97 cases of gonococcal urethritis (4.6%), 2004 of nongonococcal urethritis (95.4%), and 82 of mixed urethritis (3.9%). An association was found between gonococcal urethritis and heterosexual men; between chlamydial urethritis and homosexual/bisexual men;Ureaplasma urealyticum urethritis and heterosexual men and patients younger than 30 years of age; and between trichomonal urethritis and patients more than 30 years of age and the presence of HIV antibodies. Conclusion During the period of research there was a significant decrease in cases of Neisseria gonorrhoeae and Chlamydia trachomatis urethritis and an increase in those of U urealyticum urethritis. In conclusion, this report describes changes in the etiology and epidemiologic patterns of urethritis in our country in recent years.

Fatal Pulmonary Nocardia farcinica Infection

ABSTRACT Nocardia farcinica infections are rare and potentially life threatening. Identification is based on growth at 45°C, opacification of Middlebrook 7H10 agar, and resistance to antibiotics. We describe a case of fatal pulmonary N. farcinica infection in a patient with pneumoconiosis that was diagnosed by culture of sputum onto selective media.

Diagnóstico microbiológico de las infecciones de transmisión sexual (2007)

Las infecciones de transmision sexual (ITS) constituyen un importante problema de salud publica a nivel mundial. El diagnostico microbiologico precoz mediante tecnicas sensibles y especificas es crucial para una reduccion exitosa de la transmision y de las secuelas de las ITS. La presente revision realiza una descripcion de los metodos actuales empleados en el diagnostico. Neisseria gonorrhoeae y Chlamydia trachomatis son los patogenos mas frecuentes en la uretritis y la cervicitis. El cultivo sigue siendo la tecnica de referencia para el diagnostico de la gonococia; en el caso de C. trachomatis, las tecnicas de amplificacion de acidos nucleicos se consideran el nuevo patron de referencia, aunque el cultivo sigue siendo la tecnica mas especifica. Las ulceras genitales debidas a Treponema pallidum, Haemophilus ducreyi o virus del herpes simple tienen una pequena correlacion clinicobacteriologica y, por tanto, es esencial llevar a cabo estudios microbiologicos para establecer el diagnostico. Las lesiones presentes en el periodo primario o secundario de la sifilis se pueden diagnosticar por microscopia de campo oscuro; el diagnostico serologico en el resto de periodos implica la realizacion de pruebas no treponemicas junto con pruebas treponemicas confirmatorias. Para el virus del herpes simple, el cultivo celular se considera el metodo de referencia; los metodos moleculares tambien tienen una sensibilidad y especificidad cercanas al 100%. Actualmente, el diagnostico microbiologico de H. ducreyi y del linfogranuloma venereo se basa en el empleo de tecnicas moleculares sobre muestras obtenidas de la ulceracion o adenopatia. El diagnostico de las verrugas genitales en el paciente inmunocompetente en la mayoria de los casos es solo clinico al ser las lesiones suficientemente caracteristicas. Respecto a las infecciones por Trichomonas vaginalis, el cultivo se considera el metodo de referencia.

Neisseria gonorrhoeae resistente a quinolonas: un nuevo problema de salud pública en España

aSeccion de Microbiologia. Hospital de Cabuenes. Gijon. bServicio de Microbiologia. Hospital San Agustin. Aviles. cLaboratorio de Referencia de Neisserias. Centro Nacional de Microbiologia. Instituto de Salud Carlos III. Majadahonda. Madrid.dServicio de Microbiologia. Hospital Monte Naranco. Oviedo. eDepartamento de Biologia Funcional. Area de Microbiologia. Facultad de Medicina. Universidad de Oviedo. Espana.

Phthirus pubis in a sexually transmitted diseases unit: A study of 14 years

Background There have been few epidemiologic studies of pubic lice in recent times, and the exact incidence is unknown. Goal The goal was to determine the trends of pubic lice infestation in a risk group of males and female prostitutes in an STD unit in Spain. Study Design This was a prospective 14-year study, from 1988 to 2001, of all patients attending the STD unit in Gijón (Asturias, Spain), investigating crab lice and other STDs. Results One hundred ninety-seven patients (2.2%) had pubic lice, with a male/female proportion of 1.8/1. The yearly infestation rate ranged from 1.3% to 4.6%. The mean age was 30.3 years, and 18.8% of patients were older than 35 years. There were more cases involving men who had sex with men (MSM) (P < 0.001) than those involving heterosexual men. Reinfestation occurred in 7.6% of patients, more often in males (P < 0.05) and mainly in MSM (P < 0.01). Conclusion Infestation rates were stable during the period of study, with more older patients involved than reported previously, and infestation frequently was associated with STDs. MSM were infested and reinfested more often than heterosexual men, and in general reinfestations occurred more frequently in males than in females.

Molluscum contagiosum: A 20-Year Study in a Sexually Transmitted Infections Unit

A prospective 20-year (1988-2007) study in an STI unit in Spain investigating trends in Molluscum contagiosum infection included 12,424 patients. We found 339 Molluscum contagiosum infections (2.7% incidence) with a yearly distribution ranging from 0% to 6.8%. There was a three-fold increase from an incidence of 1.3% in the first decade (1988-1997) to 4.0% in the second (1998-2007) (P < 0.001).

Bordetella bronchiseptica Pleural Infection in a Patient with AIDS

Bordetella bronchiseptica is an important veterinary pathogen but a rare cause of opportunistic respiratory tract infection in humans. We describe a case of pleural effusion caused by B. bronchiseptica in a patient with AIDS who was coinfected with Mycobacterium tuberculosis. To the best of our knowledge this is the first case in the medical literature in which the microorganism has been isolated from pleural fluid.

First isolate of a Neisseria gonorrhoeae strain associated with an ofloxacin treatment failure in Spain: case report.

FLUOROQUINOLONE REGIMENS, recommended for the treatment of uncomplicated gonorrhea, 1 have been used widely for this purpose. The recent emergence of clinical isolates resistant to fluoroquinolones has become a major problem for the treatment of gonococcal infections in several countries. 2 Genetic characterization of a treatment failure in Spain resulting from a high-level fluoroquinoloneresistant strain of Neisseria gonorrhoeae is reported.

Campylobacter fetus subspecies fetus bacteremia associated with chorioamnionitis and intact fetal membranes.

Campylobacter fetus subspecies fetus was isolated from the blood of a patient with chorioamnionitis and intact fetal membranes. The mother improved after appropriate antibiotic treatment, but the infant died of neonatal infection a few minutes after delivery. This is a very unusual etiology of intra-amniotic infection.Campylobacter fetus subspecies fetus was isolated from the blood of a patient with chorioamnionitis and intact fetal membranes. The mother improved after appropriate antibiotic treatment, but the infant died of neonatal infection a few minutes after delivery. This is a very unusual etiology of intra-amniotic infection.