Vigilancia epidemiológica de Shigelosis en España, 2016-2021

[ES] Se analizaron los casos y brotes de shigelosis notificados entre los años 2016 y 2021 a la Red Nacional de Vigilancia Epidemiológica (RENAVE), que recoge, entre otra, información relativa a edad y sexo de los casos, posibles mecanismos de transmisión y características microbiológicas de los aislados, aunque no incluye información sobre resistencias antibióticas. Durante el periodo de estudio, se notificaron 1.985 casos y 18 brotes de shigelosis. La incidencia acumulada aumentó en el periodo 2016-2019 (con un máximo de 1,2 casos por 100.000 habitantes en el año 2019), disminuyendo posteriormente durante los años 2020 y 2021, con 0,3 casos por 100.000 habitantes en ambos años. No obstante, en el año 2021, a pesar de que sólo algunas Comunidades Autónomas notificaron casos a la RENAVE, el número de casos fue ligeramente superior al año previo. La enfermedad fue más frecuente en hombres que en mujeres, fundamentalmente en individuos entre 15 y 49 años, siendo estos grupos de edad los que presentaron mayor razón hombre/mujer. La especie de Shigella más aislada durante el periodo de estudio fue S. sonnei, seguida de S. flexneri, aunque no se disponía de información en aproximadamente la mitad de los casos. Únicamente en 9 casos constaba como mecanismo de transmisión las relaciones sexuales, aunque la información sobre el posible mecanismo de transmisión no se recogió en más del 90% de los casos. Es necesario reforzar la notificación de la enfermedad en España, especialmente la información relativa a la transmisión, a la caracterización microbiológica y a las resistencias a los antimicrobianos. [EN] Cases and outbreaks of shigelosis reported from 2016 to 2021 to the National Epidemiological Surveillance Network (RENAVE in Spanish) were analysed, including information about age and sex of cases, possible routes of transmission and microbiological characteristics of isolates, although information about antimicrobial resistance was not reported. During the study period, 1,985 cases and 18 outbreaks of shigelosis were reported. The cumulative incidence raised during 2016-2019 period (with a maximum of 1.2 cases per 100.000 inhabitants in 2019), declining in 2020 and 2021, with 0.3 cases per 100.000 inhabitants both years. Nevertheless, during 2021, although only some Autonomous Regions reported cases to RENAVE, the number of cases was slightly higher than the previous year, due to some regions reporting similar or higher figures than in the pre-pandemic period. The disease was more frequent in men than in women, mainly in individuals from 15 to 49 years old, being these age groups those that presented the highest maleto-female ratio. S. sonnei was the most frequent species of Shigella isolated, followed by S. flexneri, although the information was not available in approximately half of the cases. Sexual transmission was mentioned only in a small percentage of cases, but information about exposure/transmission was not available for more than 90% cases. It is necessary to strengthen the epidemiological surveillance of this disease in Spain, regarding the transmission, microbiological characterization and antimicrobial resistance.N

An imported case of vaccine-derived poliovirus type 2, Spain in the context of the ongoing polio Public Health Emergency of International Concern, September 2021

The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.S

Epidemiologic Features and Control Measures during Monkeypox Outbreak, Spain, June 2022

During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.S

COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied

Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit

Multidrug-resistant Gram-negative bacteria (MDR-GNB) are microorganisms that have acquired resistance to extended-spectrum antibacterials and constitute an emerging threat to public health. Although carriers are an important source of transmission in healthcare settings, data about risk factors for MDR-GNB carriage are limited. Therefore, we aimed to identify risk factors for MDR-GNB carriage upon intensive care unit (ICU) admission and to optimise screening strategies. We conducted a case–control study. Admissions of adult patients to the ICU of a 1000-bed hospital during a year were included. We collected sociodemographic, clinical and microbiological data and performed a multivariate logistic regression model. A total of 1342 patients resulted in 1476 episodes of ICU admission, 91 (6.2%) of whom harboured MDR-GNB (38.5% women; median age 63.9 years). The most frequently isolated pathogens were Escherichia coli (57%) and Klebsiella pneumoniae (16%). The most frequent resistance mechanism was production of extended-spectrum beta lactamases. MDR-GNB carriage was associated to liver cirrhosis (OR 6.54, 95% CI 2.17–19.17), previous MDR-GNB carriage (OR 5.34, 1.55–16.60), digestive surgery (OR 2.83, 1.29–5.89) and length of hospital stay (OR 1.01 per day, 1.00–1.03). Several risk factors for MDR-GNB carriage upon admission to a high-risk setting were identified; the main comorbidity was liver cirrhosis

Mpox (formerly monkeypox) in women: epidemiological features and clinical characteristics of mpox cases in Spain, April to November 2022

Over 79,000 confirmed cases of mpox were notified worldwide between May and November 2022, most of them in men who have sex with men. Cases in women, for whom mpox might pose different risks, are rare, and Spain has reported more than one third of those in Europe. Using surveillance data, our study found similar time trends, but differences in delay of diagnosis, sexual transmission and signs and symptoms between men and women.S