LAURA RITA IOTTI, MÓNICA DE FRUTOS, IRENE BERMÚDEZ-CASTELLANOS, VERÓNICA RODRÍGUEZ LÓPEZ, JOSÉ M. EIROS
Published: 21 November 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/089.2024
Rev Esp Quimioter 2024; November 21 [Texto completo PDF]
DIEGO CECCHINI, MARTÍN BRIZUELA, MARÍA SOLEDAD SELEME, MARÍA VERÓNICA MINGRONE, GASTÓN COPERTARI, BRENDA BACELAR, ROMINA MAUAS, EDGARDO BOTTARO, ISABEL CASSETTI
Published: 20 November 2024
http://www.doi.org/10.37201/req/080.2024
Introduction. Real-world data on bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) fixed-dose combination from resource-constrained settings like Latin America are limited.
Material and methods. We conducted an observational retrospective cohort study of treatment-naive (TN, n=315) and treatment-experienced (TE, n= 2356) people living with HIV prescribed BIC/FTC/TAF in Argentina from 10/2019 to 12/2021, with 24 and 48-week follow-up data analyzed for virological suppression, persistence, safety, and metabolic parameters. Patient-reported outcomes were assessed via across-sectional online survey.
Results. Baseline characteristics: median age 45 years, 72.2% male, 99.6% Hispanic/Latino ethnicity. Treatment per sistence at 48 weeks was 99.3% (TN) and 99.5% (TE). Virological suppression rates (<200/<50 copies/mL) at 24 weeks were 97.4/88% (TN) and 99/97% (TE). At 48 weeks were 100/92% (TN) and 99/97% (TE). In the TE group, triglycerides decreased with no other lipid changes. In TN, mild total/LDL/HDL cholesterol increases occurred. eGFR mildly decreased in both groups. The online survey (n=536) showed 91.5% reported no medication concerns. Median quality of life scores were 90 (TN) and 88 (TE). Most reported no self-care, activity, mobility, pain/discomfort, or anxiety/depression issues.
Conclusions. BIC/FTC/TAF demonstrated high persistence, safety, virological efficacy, and favorable metabolic profile over 48 weeks. The cross-sectional survey indicated high treatment satisfaction and good quality of life in this cohort from Argentina.
Rev Esp Quimioter 2024; November 20 [Full-text PDF]
PAOLA MAFFEZZOLI, MARTHA KESTLER, ALMUDENA BURILLO, SILVIA CORCIONE, FRANCESCO GIUSEPPE DE ROSA, PATRICIA MUÑOZ, EMILIO BOUZA
Published: 19 November 2024
http://www.doi.org/10.37201/req/094.2024
Time to positivity (TTP) refers to the duration required for a microbiological culture test to indicate a positive result, marking the onset of detectable bacterial or fungal growth in the sample. Numerous variables, including patient characteristics, infection source, former antimicrobial therapy, blood sample volume, and sample transportation time can influence the value of TTP. Several studies have been conducted on bloodstream infections, whereas studies on the clinical significance of yeast TTP are quite limited in the literature. Furthermore, many studies are retrospective and have a small sample size. In this opinion paper, we have formulated some questions and attempted to provide answers based on the available literature and our perspective. The objective of this opinion paper is to summarise current knowledge based on the literature, aiming to offer a critical perspective, particularly on aspects with weaker evidence, which could guide future studies in this area. We believe that TTP of blood cultures appears to exhibit considerable potential and may prove to be a valuable tool in clinical practice for estimating patient mortality risk and guiding antimicrobial therapy choices. Topics discussed include the diagnostic and prognostic role of TTP in Gram-positive and Gram-negative bacteremias and in candidemias, and the significance of differential time to positivity (DTTP). In summary, our opinion is that, based on the available literature, it is not possible to determine whether TTP provides prognostic information, particularly concerning candidemia. Therefore, clinical decisions cannot be systematically based on this parameter.
Rev Esp Quimioter 2024; November 19 [Full-text PDF]
CARMEN PIÑA DELGADO, MARGARITA BOLAÑOS RIVERO, MARÍA NIEVES CARMONA TELLO, CATALINA JESÚS RAMÍREZ ESTUPIÑÁN, PILAR MICHELE HERNÁNDEZ CABRERA, ISABEL DE MIGUEL MARTÍNEZ
Published: 18 November 2024
http://www.doi.org/10.37201/req/063.2024
Introduction. Anaerobic bacteremia represents 0.5-12% of all bacteremias and its mortality is high, ranging from 25-44%. The aim was to know our data to compare them with existing data and demonstrate the importance of actively searching for these microorganisms in blood culture samples.
Material and methods. A retrospective descriptive study in which the medical records of patients with significant episodes of anaerobic bacteremia were reviewed over a period of 8 years (2014-2022).
Results. A total of 59,898 blood cultures were processed, of which 10,451 were positive (17%). An anaerobic microorganism was identified in 209 patients. Anaerobic bacteremia accounted for 2.11% of the total number of positive blood cultures. The mean age was 63.55 years (17-96), 66% of whom were men. The origin was community in 63.64%, of nosocomial origin in 15.31% and associated with health care in 17.70%. The focus of infection was the abdominal (39.23%), followed by the respiratory (13.88%) and skin and soft tissues (13.39%). The most frequent comorbidities were: arterial hypertension (49.76%), dyslipidemia (29.67%), neoplasia (26.32%) and diabetes (26.32%). The main species isolated were the group Bacteroides spp. (44.50%) (n=93) highlighting Bacteroides group fragilis (n=65), followed by Clostridium spp. (20%) (n=42) highlighting Clostridium perfringens (n=30). The clinical evolution was good in 67.46%. The mean length of stay was 27.8 days and was associated with 20% mortality.
Conclusions. Bacteremias due to anaerobes represented 2.11% of the total number of true bacteremias, so we consider the active search for these microorganisms to be appropriate.
Rev Esp Quimioter 2024; November 18 [Texto completo PDF]
OCTAVIO JOSÉ SALMERÓN BÉLIZ, ELIA PÉREZ-FERNÁNDEZ, ÒSCAR MIRÓ, SIRA AGUILÓ, GUILLERMO BURILLO-PUTZE, AITOR ALQUÉZAR-ARBÉ, CESÁREO FERNÁNDEZ-ALONSO, JAVIER JACOB, FRANCISCO JAVIER MONTERO PÉREZ, ALEJANDRO MELCON VILLALIBRE, SANDRA CUERPO CARDEÑOSA, LETICIA SERRANO LÁZARO, MARÍA CABALLERO MARTÍNEZ, ESTHER MUÑOZ SOLER, INMACULADA BAJO FERNÁNDEZ, ANA ISABEL CASTUERA GIL, ROCÍO HERNANDO GONZÁLEZ, ALBERT CARBÓ-JORDÁ, IRENE CABRERA RODRIGO, BELÉN GROS BAÑERES, CARLOS ROMERO CARRETE, RAFAELA RÍOS GALLARDO, ALEJANDRO CORTÉS SOLER, EMMA GONZÁLEZ NESPEREIRA, ÁNGEL GARCÍA GARCÍA, JOSÉ RAMÓN OLIVA RAMOS, LUCIA HINOJOSA DIAZ, JUAN GONZÁLEZ DEL CASTILLO, EN NOMBRE DE LOS INVESTIGADORES DE LA RED SPANISH INVESTIGATORS IN EMERGENCY SITUATIONS TEAM (SIESTA)
Published: 14 November 2024
http://www.doi.org/10.37201/req/066.2024
Objective. To estimate the incidence of urinary tract infections (UTI) in elderly patients in Spanish emergency departments (ED), the need for hospitalization, diagnostic confirmation in hospitalized patients, adverse events and the predictive capacity of several biomarkers.
Methods. In this a posteriori substudy of a generic study of reasons for ED visits in elderly patients, we included patients aged ≥65 years seen in 52 Spanish EDs for 1 week, selecting those diagnosed with UTI. As adverse events, in-hospital and 30-day mortality and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Relative risks (RR) were calculated. The predictive capacity of 10 variables and 6 biomarkers was investigated.
Results. A total of 25,375 patients were included, 1058 with UTI (annual incidence: 24.7 per 1000 inhabitants aged ≥65 years and year, 95%CI: 24.5-24.9). A total of 36.5% were hospitalized, and in 80% the diagnosis of UTI was confirmed at discharge. Overall 30-day mortality was 5.4% and in-hospital mortality was 3.4%. Functional dependence was associated with both events (RR:2.91;1.18-7.17 and RR:12.61;1.47-108.11, respectively), as was having a CRP greater than 100 mg/L (RR:2.24;1.17-4.30 and RR:3.21;1.37-7.51, respectively). The combined post-high event occurred in 10.6%, and was associated with functional dependence (RR:2.05;1.04-4.06). CRP and hemoglobin had significant value in predicting 30-day post-discharge mortality or hospitalization.
Conclusions. UTI is a frequent diagnosis in elderly patients consulting in the ED. Functional dependence is the best factor associated with adverse events. The biomarkers analyzed do not have a good predictive capacity.
Rev Esp Quimioter 2024; November 14 [Texto completo PDF]
ALFREDO MALDONADO-BARRUECO, CLAUDIA SANZ-GONZÁLEZ, ANA AVELLÓN, DOLORES MONTERO-VEGA, CRISTINA VIDALES-MÍGUEZ, LAURA CARISIMO-BENAVENTE, IKER FALCES-ROMERO
Published: 13 November 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/059.2024
Rev Esp Quimioter 2024; November 13 [Full-text PDF]
IGNACIO PÉREZ-CATALÁN, CELIA ROIG-MARTÍ, BÁRBARA GOMILA-SARD, TERESA CEBOLLA-BELTRÁN, PILAR ORTÍ-JUAN, SERGIO FABRA-JUANA, RICARDO-ALFREDO CÓRDOBA-ROJAS, JORGE USÓ-BLASCO, MARIA-DOLORES BELLÉS-MEDALL
Published: 12 November 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/079.2024
Rev Esp Quimioter 2024; November 12 [Full-text PDF]
TOMMASO FRANCESCO AIELLO, CHRISTIAN TEIJON-LUMBRERAS, ANTONIO GALLARDO-PIZARRO, PATRICIA MONZÓ-GALLO, ANA MARTINEZ-URREA, GUILLERMO CUERVO, ANA DEL RIO, MARTA HERNÁNDEZ-MENESES, LAURA MORATA, JOSEP MENSA, ALEX SORIANO, CAROLINA GARCIA-VIDAL
Published: 29 October 2024
http://www.doi.org/10.37201/req/088.2024
Clinical Decision Support Systems (CDSS) are computer-based tools that leverage the analysis of large volumes of health data to assist healthcare professionals in making clinical decisions, whether preventive, diagnostic, or therapeutic. This review examines the impact of CDSS on clinical practice, highlighting both their potential benefits and their limitations and challenges. We detail the experience of clinical medical professionals in the development of a virtual control center for COVID-19 patients (C3 COVID-19) in Spain during the SARS-CoV-2 pandemic. This tool enabled real-time monitoring of clinical data for hospitalized COVID-19 patients, optimizing personalized and informed medical decision-making. CDSS can offer significant advantages, such as improving the quality of inpatient care, promoting evidence-based clinical and therapeutic decision-making, facilitating treatment personalization, and enhancing healthcare system efficiency and productivity. However, the implementation of CDSS presents challenges, including the need for physicians to become familiar with the systems and software, and the necessity for ongoing updates and technical support of the systems.
Rev Esp Quimioter 2024; October 29 [Full-text PDF]
JAVIER CABAÑAS MORAFRAILE, ELENA DE RAFAEL GONZÁLEZ, LAURA SERRANO MARTÍN, RAFAEL RUBIO DÍAZ, MARÍA TORRES FERNÁNDEZ, EVA HEREDERO GÁLVEZ, WILLIAM ESNEIDER LÓPEZ FORERO, LAURA MORELL JURADO, RAÚL CANABAL BERLANGA, M. FRANCISCA CALAFELL MAS, ELIA CHAVES PRIETO, M. REMEDIOS ASENSIO NIETO, ÁLVARO THOMAS-BALAGUER CORDERO, MARÍA CARMEN LORENZO LOZANO, AGUSTÍN JULIÁN-JIMÉNEZ, EN NOMBRE DEL GRUPO URGEN-LABQMIC DEL CHUT (IDISCAM)
Published: 16 October 2024
http://www.doi.org/10.37201/req/078.2024
Objectives. To analyze the diagnostic accuracy of the new MeMed® test to predict bacterial infection in adult patients seen in emergency departments (ED) with clinical suspicion of infection, as well as to compare its performance with other commonly used biomarkers (protein C reactive-PCR-, procalcitonin -PCT-).
Methods. A prospective, observational and analytical study was carried out on adult patients who were treated in an ED with the clinical diagnosis of an infectious process. Follow-up was carried out for 30 days. The diagnosis of bacterial infection (BI) was considered as the dependent variable. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (COR) and the values of sensitivity (Se), specificity (Es), positive predictive value (PPV) and negative predictive value (NPV) of the PCR, PCT, leukocyte count and the LIAISON® MeMed® test.
Results. The study included 258 patients, 54 (15.6%) of whom died within 30 days of visiting the ED. The mean age was 68.28 (SD 19.53) years, 57.4% (148) were men. At 30 days, the group with the IB diagnosis had 137 patients, the viral infection group 68 cases and 17 in the indeterminate group. The AUC-COR achieved by MeMed® in the group that analyzes all patients was 0.920 (95% CI: 0.877-0.962) and the PCT was 0.811 (95% CI: 0.754-0.867). With a cut-off point (PC) > 65 points of the MeMed® test, achieves a Se: 79.2% and Es: 91.2% and with PC > 90 points a Se: 57% and Es: 95.9%. Applying the Youden index, the PC > 50 points achieves Se:84.1% and Es:88.2%.
Conclusions. In adult patients treated with clinical suspicion of infection in the ED, the LIAISON MeMed® test has a great ability to diagnose its bacterial origin and achieves better performance than PCT, PCR and leukocyte count.
Rev Esp Quimioter 2024; 37(6): 486-497 [Texto completo PDF]
LAURA EVA FRANCO-FOBE, MARÍA LUISA MONFORTE, MARÍA VICTORIA FUENTELSAZ DEL BARRIO, ROCÍO CEBOLLADA, CONCEPCIÓN LÓPEZ-GÓMEZ, CARMEN ASPIROZ
Published: 15 October 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/007.2024
Rev Esp Quimioter 2024; 37(6): 509-511 [Texto completo PDF]
