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Rev Esp Quimioter 2020; 33(1):44-48

Micafungin as antifungal prophylaxis in non-transplanted haemotological patients  

TERESA VILLAESCUSA, LOURDES VÁZQUEZ, JUAN MIGUEL BERGUA, JULIO GARCÍA, ANTONIO ROMERO, M. TERESA OLAVE, DANIEL GARCÍA BELMONTE, M. PAZ QUEIPO DE LLANO, GRUPO DE INFECCIONES EN PACIENTES HEMATOLÓGICOS. SOCIEDAD ANDALUZA DE HEMATOLOGÍA Y HEMOTERAPIA.

http://www.doi.org/10.37201/req/067.2019

Introduction. Fungal infections are a major cause of morbidity and mortality in the haematological patients. These infections are mainly due to Candida spp. and Aspergillus spp. Mortality by these infections is high, but rates have descended in the latest series due to better antifungal agents. Echinocandins are, in vitro, very active against Candida and Aspergillus spp. The objective of the study is to analyse the efficacy and safety of micafungin in the antifungal prophylaxis of haematological patients on chemotherapy.
 Material and methods. A multicentre, observational retrospective study was performed in 7 Haematology Departments in Spain. Patients admitted to these departments with chemotherapy or immunosuppressive treatment, and who had received antifungal prophylaxis with micafungin between 1 January 2009 and 31 December 2014 were included.
Results. There were 5 cases of probable or proven fungal infection (4.8%) according to the 2008 EORTC criteria: 2 proven, 3 probable. The types of fungal infection were 3 aspergillosis and 2 candidiasis. There were no drop-outs from the prophylaxis with micafungin due to toxicity. .
Conclusion. Micafungin is an antifungal agent which, used in prophylaxis, has demonstrated good efficacy and an excellent toxicity profile, making it an apparently interesting option in patients requiring antifungal prophylaxis during their hospitalisation episode.

Rev Esp Quimioter 2020; 33(1):44-48 [Full-text PDF]

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Rev Esp Quimioter 2019; 32(6):571-576

Evaluación de la actividad investigadora en Microbiología: el papel de la Revista Española de Quimioterapia  

(Evaluation of research activity in Microbiology: the role of the Spanish Journal of Chemotherapy)

DAVID CARABANTES ALARCÓN, LUIS ALOU CERVERA

CARTA AL DIRECTOR

Rev Esp Quimioter 2019; 32(6):571-576 [Texto completo PDF]

Palabras clave: Sexenio de investigación, Journal Impact Factor, Journal Citation Reports, Impacto Normalizado, Highly Cited Researchers

Keywords: Six Year Research Period, Journal Impact Factor, Journal Citation Reports, Normalized Impact, Highly Cited Researchers

 


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Rev Esp Quimioter 2019; 32(6): 497-515

Three keys to the appropriate choice of oral antibiotic treatment in the respiratory tract infections  

ROSARIO MENÉNDEZ, RAFAEL CANTÓN, ANDREA GARCÍA-CABALLERO, JOSÉ BARBERÁN

Exacerbation of chronic obstructive pulmonary disease and community-acquired pneumonia are the most frequent infections of the lower respiratory tract in daily clinical practice. Antibiotic selection is a crucial component in its treatment and, in most cases, it is performed empirically. Scientific societies make therapeutic recommendations based on scientific evidence and / or expert recommendations that are of great help to clinicians. Beta-lactams, fluoroquinolones and macrolides are the most commonly used drugs for oral administration. From a practical point of view, there are three keys to the appropriate choice of oral antibiotic treatment, which are the effectiveness, safety and the ecological impact on the patient’s microbiota, including the development of resistance, which will be assessed in depth in this review.

Rev Esp Quimioter 2019; 32(6): 497-515 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(1):18-23

Development of animal experimental model for bacterial peritonitis

OMAR MONTENEGRO, SOLEDAD ILLESCAS, JOSÉ CARLOS GONZÁLEZ, DAVID PADILLA, PEDRO VILLAREJO, VICTOR BALADRÓN, ROCIO GALÁN, NATALIA BEJARANO, LUCIA MEDINA-PRADO, NATALIA VILLASECA, JOSÉ MANUEL PÉREZ-ORTIZ, JOSÉ RAMÓN MUÑOZ-RODRÍGUEZ, JUAN LUIS SANTIAGO, FRANCISCO JAVIER REDONDO

http://www.doi.org/10.37201/req/064.2019

Objective. The aim of the study was to develop a model of abdominal sepsis in the experimental animal.
Material and methods. Sprague-Dawley male rats of 5 weeks (N=39) were used. Initially, a pilot study (N = 9) was performed and distributed in 3 groups with 1cc inoculum of Escherichia coli ATCC 25922 intraperitoneally at concentrations of 10E8, 10E9 and 10E10 CFU. Subsequently, concentrations of 10E10 CFU are used in two groups of 3 rats with dilutions of 10 cc and 15 cc of distilled water respectively. Finally, a randomized trial of 24 rats was started in three treatment groups after intraperitoneal infection: Group I with physiological serum (N = 6), Group II with ceftriaxone (N = 9), Group III with ceftriaxone plus allicin (N = 9). Microbiological samples of blood and peritoneal fluid were made, as well as histopathological study of intraperitoneal organs (liver, diaphragm and peritoneum).
Results. Death of 100% of the rats infected with 10E10 E. coli UFC concentration with the dilution of 15 ml of distilled water and without antibiotic was oberved. The blood culture and peritoneal fluid culture was positive for the same strain in all of them. The formation of abscesses on the liver surface and polymorphonuclear infiltration in tissues were observed.
Conclusion. The lethal dose of E. coli is 10E10 CFU diluted in 15 cc distilled water by intraperitoneal injection

Rev Esp Quimioter 2020; 33(1):18-23 [Texto completo PDF]

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Rev Esp Quimioter 2020; 33(1):24-31

Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

GINA OSORIO, LETICIA FRESCO, ESTER MONCLÚS, MÍRIAM CARBÓ, MAR ORTEGA

http://www.doi.org/10.37201/req/066.2019

Objective. The aim of the study was to analyze the adequacy of the special category antibiotics prescriptions in the Emergency Department (ED) of a third level urban Hospital.
Material and methods. A random sample of 100 different patients who were started with a special category antibiotic along 2018 in the ED was selected. The research team reviewed the medical history of the emergency and admission episode. The independent factors associated with the degree of adequacy of the treatment were determined by logistic regression.
Results. A total of 97 prescriptions were analyzed of which 66 (68%) met the criteria of adequate prescription, 23 (24%) adequate prescription, but with equally recommended alternatives and 8 (8%) were inappropriate prescriptions. The degree of adequacy was 70% if the infection was related to healthcare and 75% if the patient had risk factors for mul-tiresistant (MR) microorganisms’ infection. The percentage of adequacy was higher in the cases in which the focus of the infection (72%) and the severity of the episode (73%) were specified. The independent variables that were associated with an adequate prescription were: the presence of risk factors for MR microorganisms’ infection (OR: 2.35 95% CI: 1.65 – 3.17 p: 0.01), if the focus of the infection (OR: 3.79 95% CI: 1.72 – 4.22 p: 0.02) and the severity of the episode (OR: 3.09 95% CI: 1.12 – 3.09 p: 0.03) were specified.
Conclusions. The prescription of special category antibiotics in ED is appropriate if the clinical guidelines are followed and if the setting of infection acquisition, the risk factors of MR microorganisms, the focus and the severity of infection are taken into account in clinical picture.

Rev Esp Quimioter 2020; 33(1):24-31 [Texto completo PDF]

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Rev Esp Quimioter 2020; 33(1):32-43

Predictive factors of bacteraemia in the patients seen in emergency departments due to infections

SADAF ZAFAR IQBAL-MIRZA, RAQUEL ESTÉVEZ-GONZÁLEZ, VICENTE SERRANO-ROMERO DE ÁVILA, ELENA DE RAFAEL GONZÁLEZ, EVA HEREDERO-GÁLVEZ, AGUSTÍN JULIÁN-JIMÉNEZ

http://www.doi.org/10.37201/req/075.2019

Objectives. The aim of the study was to analyze predictive factors of bacteraemia in patients seen in the emergency department (ED) for an episode of infectious disease.
Patients and methods. Observational, retrospective and descriptive analytical study of all blood cultures extracted in an ED in adult patients (≥ 18 years) seen in ED due to infec-tious disease from 1-1-2019 to 1-7-2019. The follow-up was carried out during 30 days. Thirty-eight variables for predicting bacteraemia were assessed. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Univariate and multivariate logistic regression analysis was performed.
Results. A total of 1,425 blood cultures were finally enrolled in the study. Of those were considered true bacteremia 179 (12.6 %) and as negative blood cultures 1,246 (87.4 %). Amongst negatives, 1,130 (79.3%) without growth and 116 (8.1%) as contaminants blood cultures. Five variables were significantly associated with true bacteraemia: serum procalcitonin (PCT) ≥ 0.51 ng/ml [odds ratio (OR): 4.52; 95% confidence interval (CI): 4.20-4.84, P <.001], temperature > 38.3°C [OR:1.60; 95% CI:1.29-1.90, P <.001], systolic blood pressure (SBP) < 100 mmHg [OR:3.68; 95% CI:2.78-4.58, P <.001], septic shock [OR:2.96; 95% CI:1.78-4.13, P <.001] and malignancy [OR:1.73; 95% CI:1.27-2.20, P <.001].
Conclusions. Several factors evaluated in an initial assessment in the ED, including serum PCT, temperature, hypotension (with/without septic shock) and being malignancy, were found to predict true bacteraemia.

Rev Esp Quimioter 2020; 33(1):32-43 [Texto completo PDF]

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Rev Esp Quimioter 2020; 33(1):1-10

Biomarkers of fungal infection: Expert opinion on the current situation 

EMILIO BOUZA, BENITO ALMIRANTE, JULIO GARCÍA RODRÍGUEZ, JOSÉ GARNACHO-MONTERO, MIGUEL SALAVERT, PATRICIA MUÑOZ, MAURIZIO SANGUINETTI

http://www.doi.org/10.37201/req/2260.2019

The introduction of non-culture-based diagnostic techniques is revolutionizing the world of microbiological diagnosis and infection assessment. Fungi are no exception, and the introduction of biomarkers has opened up enormous expectations for better management of these entities. Biomarkers are diverse, their targets are also diverse and their evaluation has been done preferably in an individualized use and with deficient designs. Less is known about the value of the combined use of biomarkers and the impact of the negativity of two or more biomarkers on antifungal treatment decisions has been poorly studied. Given the paucity of prospective, randomized and definitive studies, we have convened experts from different fields, with an interest in invasive fungal infections, to an-swer some questions about the current relevant use of fungal biomarkers. This document summarizes the answers of these experts to the different questions.

Rev Esp Quimioter 2020; 33(1):1-10 [Full-text PDF]

 

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Rev Esp Quimioter 2019; 32(6): 485-496

HTLV-1 infection: An emerging risk. Pathogenesis, epidemiology, diagnosis and associated diseases 

EMILIANA EUSEBIO-PONCE, EDUARDO ANGUITA, ROBERT PAULINO-RAMIREZ, FRANCISCO JAVIER CANDEL

The Human T-Lymphotropic Virus type 1 (HTLV-1) affects up to 10 million people worldwide. It is directly associated to one of the most aggressive T cell malignancies: Adult T Cell Leukemia-Lymphoma (ATLL) and a progressive neurological disorder, Tropical Spastic Paraparesis/ HTLV-1 Associated Myelopathy (TSP/HAM). Also, infected patients tend to have more severe forms of infectious diseases such as Strongyloidiasis and Tuberculosis. HTLV spreads through parenteral, sexual, and vertical (mother-to-child) routes. Effective viral transmission is produced mainly by cell to cell mechanism, unlike other retroviruses such as HIV, which usually spread infecting cells in a cell-free form. HTLV also has a peculiar distribution, with clusters of high endemicity in nearby areas of very low prevalence or absence of the virus. This could be explained by factors including a possible founder effect, the predominance of mother to child transmission and the cell-to-cell trans-mission mechanisms. More data on viral epidemiology are needed in order to develop strategies in endemic areas aimed at reducing viral dissemination. In this review, we critically analyze HTLV-1 pathogenesis, epidemiology, diagnosis, associated diseases, preventive strategies, and treatments, with emphasis to the emerging risk for Europe and particularly Spain, focusing on prevention methods to avoid viral transmission and associated diseases.

Rev Esp Quimioter 2019; 32(6): 485-496 [Full-text PDF]


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Rev Esp Quimioter 2019; 32(6):525-531

Seroprevalence of measles, mumps, rubella, and varicella zoster virus antibodies among healthcare students: analysis of vaccine efficacy and cost-effectiveness 

İLKER ÖDEMIŞ, ŞÜKRAN KÖSE, İLKAY AKBULUT, HAZAL ALBAYRAK

Introduction. The aims of this study are to determine the seroprevalence for measles, mumps, rubella, and varicella zoster virus (VZV) in a cohort of nursing students, to evaluate vaccination response rates of nonimmune students, and to calculate the cost of vaccinating students based on seroprevalence screening.
Material and methods. A cross-sectional study was conducted August 2015–November 2016 among 326 healthy nursing students aged 14.1–18.1 years. Serum IgG antibodies were measured by ELISA. Results were analyzed by the Chi-square test; a p-value of < 0.05 was considered statistically significant.
Results. The number of seropositive participants (%) was 308 (94.5%) for rubella, 295 (90.5%) for VZV, 244 (74.9%) for measles, and 219 (67.2%) for mumps. A significant correlation was found between measles IgG and age. A relationship was also observed between VZV IgG and kindergarten attendance. Response rates to measles, rubella, VZV, and mumps vaccination were 96%, 92.3%, 87.5%, 78.8%, respectively. The total cost of vaccination after IgG screening was less than vaccination without screening.
Conclusions. In this study, participants’ immunity to measles and VZV was low. Prevaccination serological screening was cost-effectiveness method for preventing measles, mumps, rubella, and varicella infections. We believe that administering booster measles, mumps, and rubella (MMR) vaccine doses or developing a special MMR vaccination strategy for at-risk groups may prevent MMR outbreaks.

Rev Esp Quimioter 2019; 32(6):525-531 [Full-text PDF]



 

 

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Rev Esp Quimioter 2019; 32(6): 516-524

HPV genotype distribution among women with normal and abnormal cervical cytology in Turkey 

TUBA MUDERRIS, ILHAN AFSAR, ASKIN YILDIZ, CEREN AKPINAR VARER

Objectives. The aim of this study was to determine the human papillomavirus (HPV) genotype distribution and to investigate the relationship between HPV genotypes and cervical cytology in women with HPV infection.
Material and methods. In this study, 493 women who were admitted to the obstetrics clinic between 2007 and 2015 years and had HPV positivity were examined retrospectively.
Results. The median age of women included in the study was 37.3 ±10.6. The positivity of single and multiple HPV genotypes was 64.1% and 35.9%, respectively. HPV16 was the most common genotype in women with normal and abnormal cytology. The incidence of atypical squamous cells of undetermined significance (chi-square:8.32 p=0.04) and high-grade squamous intraepithelial lesion (chi-square:13.75 p<0.001) with HPV16 was significantly higher than in other HPV genotypes. In additional, abnormal cytology results in the group 1 (includ-ed HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) and group 4 (included HPV40, 42, 54, 55, 61, 62, 81, 83, 84) were significantly higher than other groups (chi-square:23.15 p<0.001).
Conclusions. Group 1 genotype ratios were found to be quite high among women with abnormal cytology and women with normal cytology. For this reason, close follow-up is very important in addition to cytological findings along with genotyping, especially from an early age. We were found that multiple HPV infection was not related to the grades of cytological abnormalities. Although abnormal cytology results in group 4 were significantly higher than the other groups, it was not possible to comment on the relationship between these genotypes and cervical cancer since more than one HPV genotype was found in most of these women.

Rev Esp Quimioter 2019; 32(6): 516-524 [Full-text PDF]


 

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