Journal of the European Academy of Dermatology and VenereologyVolume 36, Issue 9 p. e689-e691 Letter to the Editor Active tuberculosis in a cohort of patients with psoriasis on biologic therapy: learnings from real-life medical practice E. Lopez-Trujillo, E. Lopez-Trujillo orcid.org/0000-0003-3784-7670 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorD. Pesqué, D. Pesqué orcid.org/0000-0002-5821-9780 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorF. Sanchez, F. Sanchez Department of Infectious Diseases, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorM. Dominguez, M. Dominguez Department of Pneumology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorF. Gallardo, F. Gallardo orcid.org/0000-0002-8996-3828 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorR.M. Pujol, R.M. Pujol orcid.org/0000-0002-5622-6055 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorM. Ferran, Corresponding Author M. Ferran mferran@psmar.cat orcid.org/0000-0003-1198-0641 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainCorrespondence: M. Ferran. E-mail: mferran@psmar.catSearch for more papers by this author E. Lopez-Trujillo, E. Lopez-Trujillo orcid.org/0000-0003-3784-7670 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorD. Pesqué, D. Pesqué orcid.org/0000-0002-5821-9780 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorF. Sanchez, F. Sanchez Department of Infectious Diseases, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorM. Dominguez, M. Dominguez Department of Pneumology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorF. Gallardo, F. Gallardo orcid.org/0000-0002-8996-3828 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorR.M. Pujol, R.M. Pujol orcid.org/0000-0002-5622-6055 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainSearch for more papers by this authorM. Ferran, Corresponding Author M. Ferran mferran@psmar.cat orcid.org/0000-0003-1198-0641 Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, SpainCorrespondence: M. Ferran. E-mail: mferran@psmar.catSearch for more papers by this author First published: 10 April 2022 https://doi.org/10.1111/jdv.18131Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume36, Issue9September 2022Pages e689-e691 RelatedInformation

Objective: To analyze the clinical and economic impact of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli requiring hospitalization.Methods: Matched cohort study including adults with UTI caused by ESBL-producing E. coli admitted to a tertiary care hospital in Barcelona, Spain, between August 2010 and July 2013. Demographic, clinical and economic data were analyzed.Results: One hundred and twenty episodes of UTI were studied: 60 due to ESBL-producing E. coli and 60 due to non-ESBL-producing E. coli. Bivariate analysis showed that prior antimicrobial treatment (p = 0.007) and ESBL production (p < 0.001) were related to clinical failure during the first 7 days. Multivariate analysis selected ESBL as the sole risk factor for clinical failure (p = 0.002). Regarding the economic impact of infections caused by ESBL-producing E. coli, an ESBL-producing infection cost more than a non-ESBL-producing E. coli infection (mean (sic)4980 vs. (sic)2612). Looking at hospital expenses separately, the total pharmacy costs and antibiotic costs of ESBL infections were considerably higher than for non-ESBL infections (p < 0.001), as was the need for outpatient parenteral antibiotic therapy (OPAT) and its related costs. Multivariate analysis performed for the higher costs of UTI episodes found statistically significant differences for males (p = 0.004), chronic renal failure (p = 0.025), ESBL production (p = 0.008) and OPAT (p = 0.009).Conclusion: UTIs caused by EBSL-producing E. coli requiring hospital admission are associated with worse clinical and economic outcomes. (C) 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

OBJECTIVES To determine predictive factors for changes in standard anti-tuberculosis chemotherapy at the time of diagnosis. METHODS A prospective study was performed among tuberculosis (TB) patients treated at specialised centres during 2008-2009. Treatment outcome was monitored per standard guidelines. Treatment was considered successful if the patient was cured or completed treatment. Factors associated with treatment modification were analysed at the bivariate and multivariate levels using logistic regression. RESULTS A total of 427 patients were included in the study. The initial standard treatment regimen was retained for 249 patients (58.3%), extended to 9 months for 36 (8.4%) and changed for 142 (33.3%). Factors associated with a change of regimen at the multivariate level were female sex, age ≥ 50 years, human immunodeficiency virus infection, comorbidities, alcoholism, hospitalisation and culture-positive sputum. Drug resistance and toxicity were analysed independently. Treatment outcome was successful in 97.2% of cases without a regimen change and in 87.3% of those with a changed regimen (P < 0.001). CONCLUSION Factors associated with changes in the initial anti-tuberculosis regimen should be considered for rigorous follow-up. Results obtained through individualised treatment provided by specialists were good despite the complexity of the cases treated.

During a 2-year period (2003-2004), tuberculosis (TB) transmission in Barcelona and the factors related to transmission among the Spanish- and foreign-born populations were studied by molecular epidemiology. Data were obtained from TB cases and Conventional Contact Tracing registries and genotyping was performed using restriction fragment length polymorphism (RFLP)-IS6110 and MIRU12 as a secondary typing method. Of the 892 TB cases reported, 583 (65.3%) corresponded to Spanish-born and 309 (34.6%) to foreign-born. Six hundred and eighty-seven cases (77%) were confirmed by culture. RFLP typing of 463/687 (67.4%) isolates was performed, revealing 280 (60.5%) unique and 183 (39.5%) shared patterns, which were grouped into 65 clusters. Spanish-born individuals were significantly more clustered than foreign-born individuals (44.6% vs. 28.8%; p 0.016). Clustering in foreign-born individuals was associated with HIV (p 0.051, odds ratio = 3.1, 95% confidence interval 1-10.9) and alcohol abuse (p 0.022), whereas, in the Spanish-born individuals, clustering was associated with age in the range 21-50 years, (p 0.024). Of the total clusters, 36/65 (55.3%) included only Spanish-born patients, whereas 22/65 (33.8%) included individuals from both populations. In mixed clusters, the index case was Spanish-born in 53% and foreign-born in 47%. Among the foreign-born, 2.8% were ill on arrival, 30% developed TB within the first year and 50.3% developed TB within the first 2 years; 58.3% were from South America. In conclusion, half of the foreign-born TB patients developed the disease during the first 2 years after arrival, which, in most cases, was the result of endogenous reactivation. Recent TB transmission among Spanish-born and foreign-born populations, as well as bidirectional transmission between communities, contributed significantly to the burden of TB in Barcelona, suggesting the need to improve Public Health interventions in both populations.

BACKGROUND:The aim of this study was to describe the characteristics of imported tuberculosis (TB) in Barcelona during 1999 and 2000.MATERIAL AND METHOD:Epidemiological surveillance questionnaire.RESULTS:During 1999 and 2000, a 7.9% decrease in TB cases was observed among the native population in Barcelona, whereas cases among immigrants grew up to 47.2%. In 2000, 449 TB cases were detected among the native population (incidence, 29.5/100,000) and 121 among immigrants (incidence, 555.9/100,000). Three outbreaks were identified, involving one Indian community (11 cases), two Dominican families (4 cases) and one city school (2 cases) whose index case was a cooperant. Isolated strains of Mycobacterium tuberculosis at the first, second and third outbreak were multisensitive, multidrug-resistant and isoniazid-resistant, respectively.CONCLUSIONS:The emergence of imported TB cases in Barcelona over 1999 and 2000 suggests that current preventive guidelines must be reviewed.