The immunosuppressive treatment that recipients receive from a solid organ transplantation hinders the defensive response to infection. Its transmission from the donor can cause dysfunction or loss of the graft and even death of the recipient if proper preventive measures are not established. This potential risk should be thoroughly evaluated to minimise the risk of infection transmission from donor to recipient, especially with organ transplantation from donors with infections, without increasing graft dysfunction and morbidity and mortality in the recipient. This document aims to review current knowledge about infection screening in potential donors and offer clinical and microbiological recommendations about the use of organs from donors with infection based on available scientific evidence.

In recent decades, Clostridium difficile infection (CDI) has become a worldwide health problem. Mexico is no exception, and therefore the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, endoscopists, internists, infectious disease specialists, and microbiologists) to carry out the \"Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection\", establishing useful recommendations (in relation to the adult population) for the medical community. Said recommendations are presented herein. Among them, it was recognized that CDI should be suspected in subjects with diarrhea that have a history of antibiotic and/or immunosuppressant use, but that it can also be a community-acquired infection. A 2-step diagnostic algorithm was proposed, in which a highly sensitive test, such as glutamate dehydrogenase (GDH), is first utilized, and if positive, confirmed by the detection of toxins through immunoassay or nucleic acid detection tests. Another recommendation was that CDI based on clinical evaluation be categorized as mild-moderate, severe, and complicated severe, given that such a classification enables better therapeutic decisions to be made. In mild-moderate CDI, oral vancomycin is the medication of choice, and metronidazole is recommended as an alternative treatment. In addition, fecal microbiota transplantation was recognized as an efficacious option in patients with recurrence or in the more severe cases of infection, and surgery should be reserved for patients with severe colitis (toxic megacolon), in whom all medical treatment has failed.

To develop expert consensus-based recommendations and proposals on how to improve the care of elderly emergency patients with suspected infection in the autonomous community of Valencia.
This project was carried out in 3 phases: 1) design of a questionnaire by means of consensus among a group of experts; 2) online survey to determine the opinions of emergency physicians in the community of Valencia; and 3) drafting of expert consensus-based recommendations and proposals arising from the results of the survey. The experts used the Delphi method to reach consensus and the survey was posted online.
After 2 rounds of voting, 21 emergency medicine experts reached consensus on 15 of the 30 survey items initially proposed: 4 items (26.6%) referred to patient classification and placement, 5 (33.3%) to diagnosis, and 6 (40.0%) to treatment. The resulting online questionnaire was returned by 142 (77.2%) of the 184 emergency physicians belonging to 21 hospital emergency departments in the community of Valencia. The experts reached a high level of consensus (mean score, > 7) on 11 (73.3%) of the 15 recommendations posed by the group\'s coordinator after the survey.
The experts were able to propose 11 consensus-based recommendations and proposals for improving the care of elderly patients with suspected infection in emergency departments in Valencia.
Desarrollar una serie de recomendaciones y propuestas de mejora basadas en un consenso clínico de expertos sobre aspectos relacionados con la atención del paciente anciano con sospecha de infección en los Servicios de Urgencias y Emergencias (SUH-E) de la Comunidad Valenciana (CV).
El estudio se divide en tres fases: 1) Diseño de un cuestionario por consenso de un grupo de expertos; 2) Realización de una encuesta electrónica para conocer la opinión de los médicos de urgencias y emergencias (MUyE) de la CV; 3) Elaboración de una serie de recomendaciones y propuestas de mejora por consenso de un grupo de expertos a partir de los resultados de dicha encuesta. El consenso se llevó a cabo mediante una metodología Delphi y la encuesta a través de una página web.
Un grupo de expertos de 21 MUyE consensuaron, tras dos rondas de votación, un cuestionario final de 15 preguntas de las 30 inicialmente planteadas [4 (26,6%) relativas a la clasificación y ubicación del paciente, 5 (33,3%) al diagnóstico, y 6 (40,0%) al tratamiento]. El cuestionario final fue sometido a una votación, mediante una encuesta electrónica, de 142 MUyE (77,2%) de los 184 posibles procedentes de 21 SUH-E de la CV. De las 15 recomendaciones planteadas por el grupo coordinador tras la encuesta, se alcanzó un alto grado de consenso (mediana con puntuación > 7) en 11 (73,3%) de ellas por parte del grupo de expertos.
Se establecieron once recomendaciones y propuestas de mejora con un alto grado de consenso para la atención del paciente anciano con sospecha de infección en los SUH-E de la CV.

The incidence of community-acquired pneumonia increases with age and is associated with an elevated morbidity and mortality due to the physiological changes associated with aging and a greater presence of chronic disease. Taking into account the importance of this disease from an epidemiological and prognostic point of view, and the enormous heterogeneity described in the clinical management of the elderly, we believe a specific consensus document regarding this patient profile is necessary. The purpose of the present work was to perform a review of the evidence related to the risk factors for the etiology, the clinical presentation, the management and the treatment of community-acquired pneumonia in elderly patients with the aim of producing a series of specific recommendations based on critical analysis of the literature. This document is the result of the collaboration of different specialists representing the Spanish Society of Emergency Medicine and Emergency Care (SEMES), the Spanish Society of Geriatrics and Gerontology (SEGG), the Spanish Society of Chemotherapy (SEQ), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Respiratory Medicine and Thoracic Surgery (SEPAR), Spanish Society of Home Hospitalization (SEHAD) and the Spanish Society of Infectious Disease and Clinical Microbiology (SEIMC).