Background: Extended-spectrum ␤-lactamase (ESBL)producing Escherichia coli is an increasingly important group of community pathogens worldwide. These organisms are frequently resistant to many of the antimicrobial agents usually recommended for the treatment of infections caused by E coli, such as penicillins, cephalosporins, fluoroquinolones, and trimethoprim-sulfamethoxazole. Data concerning risk factors, clinical features, and therapeutic options for such infections are scarce. Methods: A case-control study was performed to investigate the risk factors for all types of community-acquired infections caused by ESBL-producing E coli in 11 Spanish hospitals from February 2002 to May 2003. Controls were randomly chosen from among outpatients with a clinical sample not yielding ESBL-producing E coli. The clinical features of these infections were investigated in the case patients. The efficacy of fosfomycin tromethamine and amoxicillin-clavulanate potassium was observationally studied in patients with cystitis. Results: A total of 122 cases were included. Risk factors selected by multivariate analysis included the fol-Author Affiliations are listed at the end of this article.

Background: The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. Methods: Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged !18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. Results: A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). Conclusions: The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.

The aim of this article is to describe epidemiological and clinical data of patients with tuberculous lymphadenitis (TL) and evaluate the yield of the diagnostic techniques employed.Retrospective observational study was performed at the Vall d’Hebron University Hospital, Barcelona, Spain. All adult patients with confirmed TL (microbiologically) or probable TL (suspected by clinical presentation, cyto/histopathological features, and clinical improvement after specific treatment) diagnosed from January 2001 to December 2013 were included.One hundred twenty-two patients were included: 78 (63.9%) patients with confirmed diagnosis and 44 (36.1%) patients with probable TL. Seventy (57.4%) patients were nonnative residents. From 83 fine-needle aspiration (FNA) specimens, 54.8% (40/73) showed granulomatous inflammation, 62.5% (40/64) had positive mycobacterial culture, and 73.3% (11/15) tested positive with Xpert MTB/RIF (Cepheid, Sunnyvale, CA). From 62 biopsy samples, 96.8% (60/62) showed granulomatous inflammation, 64.6% (31/48) had positive mycobacterial culture, and 46.1% (6/13) tested positive with Xpert MTB/RIF.TL has increasingly been diagnosed in our setting, mostly because of cases diagnosed in nonnative residents. FNA is an easy and safe technique for the diagnosis of suspected TL, and the yield regarding mycobacterial culture seems to be similar to the obtained with biopsy. The Xpert MTB/RIF test from FNA specimens may increase the accuracy of the TL diagnosis and provides quicker results.