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Rev Esp Quimioter 2022; September 23

Impact of the use of antibiotics on the clinical response to immune checkpoint inhibitors in patients with non-small cell lung cancer

CRISTINA MARTINEZ-MUGICA BARBOSA, ANA CRISTINA CERCÓS LLETÍ, RUBÉN PAMPÍN SÁNCHEZ, CRISTINA DURÁN ROMÁN, PALOMA TERROBA ALONSO, BEATRIZ FERNÁNDEZ GONZÁLEZ

Published: 23 September 2022

http://www.doi.org/10.37201/req/040.2022

Objectives. Recent research suggests that the use of antibiotics could reduce the efficacy of checkpoint inhibitors, in addition to other well-known factors. It could be due to gut microbiota modification, which impact over the immune system response. However, the information available so far is contradictory. The objective of this research was to clarify whether antibiotic use influences efficacy of checkpoint inhibitors treatments in non-small cell lung cancer patients in clinical practice.
Methods. Therefore, a retrospective observational study was designed. Use of antibiotics among patients treated with atezolizumab, pembrolizumab or nivolumab was assessed within 2 months of checkpoint inhibitors treatments initiation.
Results. A total of 140 patients were included, mostly men, with good performance status (ECOG 0-1), all of them previously treated with chemotherapy. An antibiotic prescription was identified in 31% of these patients, mainly fluoroquinolones or beta-lactams. The most frequent indication was respiratory infection. Both progression-free survival and overall survival were lower for patients treated with anti-infective drugs, although this difference was not statistically significant.
Conclusion. More studies are needed to draw conclusions about the impact of antibiotics on the efficacy of immunotherapy.

Rev Esp Quimioter 2022; September  23 [Full-text PDF]


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Rev Esp Quimioter 2022; September 22

Limitations of the Xpert-MTB/RIF® assay in the initial diagnosis of tuberculosis in the context of a rural hospital in Ethiopia

BELÉN COMECHE, MARIO PÉREZ-BUTRAGUEÑO, JUAN CUADROS, GEBRE TIZIANO, MIGUEL GÓRGOLAS, JOSÉ-MANUEL RAMOS-RINCÓN

Published: 22 September 2022

http://www.doi.org/10.37201/req/052.2022

Introduction. To evaluate the implementation of Xpert-MTB/RIF®, as an early diagnosis technique, in a rural area of Ethiopia.
Material and methods. Data were retrospectively collected from those patients over 13 years of age who were requested to take the Xpert MTB/RIF® test in a rural hospital located 45 km from the reference laboratory, during the first 3 years of its implementation (2015, April -2018, April).
Results. A total of 306 patients older than 13 years were evaluated, in 85 (27.8%) there was an error in the processing of the test and the result was not obtained. Of the 221 samples with results, the median time between obtaining the sample and receiving the result was 21 days and 42 of them were positive (19%, 95% CI: 14.2-24.9%). The sample with the highest diagnostic yield was adenopathy (88.8%; [8/9]; p<0.001).
Conclusions. There are more bacteriological diagnoses with Xpert-MTB/RIF®, but with a delay in obtaining the result and its main objective, which is early diagnosis, is not achieved.

Rev Esp Quimioter 2022; September  22 [Texto completo PDF]


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Rev Esp Quimioter 2022; September 15

Impacto de la COVID-19 en el diagnóstico tardío de VIH: a propósito de un caso

ALEJANDRA ROMANO CARDOZO, LUIS SAINZ COMAS, MONTSERRAT SERES ROIG, AITOR ALQUÉZAR-ARBÉ

Published: 15 September 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/143.2021

Rev Esp Quimioter 2022; September 15  [Texto completo PDF]


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Rev Esp Quimioter 2022; July 28

Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper

DAVID ALONSO-MENCHÉN, PATRICIA MUÑOZ, CARLOS SÁNCHEZ-CARRILLO, LEIRE PÉREZ-LATORRE, EMILIO BOUZA

Published: 28 July 2022

http://www.doi.org/10.37201/req/066.2022

Bacteremia is an important cause of morbidity and mortality worldwide and, despite the diagnostic and therapeutic advances of the last decades, the evidence supporting many diagnostic aspects of bacteremia is scarce. Information on the epidemiological evolution of this entity is limited and many methodological aspects of blood culture collection and analysis are under discussion. Furthermore, the recommendations of the main scientific societies on many of these aspects are variable and, in many cases, have not been updated recently.
In this scenario, we have arranged a series of questions on different aspects of bacteremia and reviewed the literature trying to find proper answers for them. We offer our opinion on the topics where the evidence was weak.
The topics covered include epidemiological aspects of bacteremia, indications for blood culture extraction, methods for obtaining and incubating samples, or ways of transmitting results from the microbiology laboratory.
We do not intend to summarize the current clinical practice guidelines, nor will we deal with the therapeutic management of this entity. The aim of this paper is to review the current perspective on the diagnosis of bacteremia with a critical approach, to point out the gaps in the literature, to offer the opinion of a team dedicated to infectious diseases and clinical microbiology, and to identify some areas of knowledge on which future studies should focus.

Rev Esp Quimioter 2022; July  28 [Full-text PDF]


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Rev Esp Quimioter 2022; July 22

Impact of Staphylococcus aureus bacteremia in COVID-19 patients

MARIA ESPINOSA PEREZ, ROSA GARCÍA FENOLL, SARAY MORMENEO BAYO, ROSA MARÍA MARTÍNEZ ÁLVAREZ, VIOLETA FRUTOS MILLÁN, MARÍA CRUZ VILLUENDAS USÓN, MARÍA PILAR PALACIÁN RUIZ, JOSÉ MIGUEL ARBONÉS MAINAR, MARÍA CARMEN MARTÍNEZ JIMÉNEZ, CARLOS RAMOS PAESA

Published: 22 July 2022

http://www.doi.org/10.37201/req/022.2022

Introduction. The disease caused by SARS-CoV-2 (COVID-19) has been a challenge for healthcare professionals since its appearance. Staphylococcus aureus has been described as one of the main pathogens causing bacterial infections in viral pandemics. However, co- infection with S. aureus causing bacteremia in patients with COVID-19 has yet to be well studied.
Methods. We performed a e study of S. aureus bacteremia (SAB) at Hospital Miguel Servet (Zaragoza) from March 2020 to February 2021. The clinical characteristics, mortality and risk factors of adults hospitalized patients with BSA associated COVID-19 compared to patients without COVID-19.
Results. A total of 95 patients with SAB were identified. 27.3% were positive for SARS-CoV-2. SAB represented 9.9% of bacteremia, being the second agent in frequency after E. coli. Nosocomial bacteremia was more frequent in the group of COVID-19 patients. The most frequent source of BSA in these patients was the respiratory source (26.9% vs 0%; P<0.001) followed by the skin (15.5% vs 15.9%; P=1). The development of sepsis was more frequent in COVID-19 patients (61,5% vs 7,8%; P=0,336) and among them, who received dexamethasone at doses > 6 mg/day (62.5% vs. 37.5%, P<0.05).
Conclusions. Our data suggest that BSA has a negative impact on the evolution of patients with COVID-19. However, further and preferably prospective studies are required to obtain solid data on the impact of BSA on coronavirus patients.

Rev Esp Quimioter 2022; July  22 [Texto completo PDF]


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Rev Esp Quimioter 2022; July 21

A systematic literature review and expert consensus on risk factors associated to infection progression in adult patients with respiratory tract or rectal colonisation by carbapenem-resistant Gram-negative bacteria

RICARD FERRER, ALEX SORIANO, RAFAEL CANTÓN, JOSÉ LUIS DEL POZO, CAROLINA GARCÍA-VIDAL, JOSÉ GARNACHO-MONTERO, NIEVES LARROSA, PEDRO RASCADO, MIGUEL SALAVERT, VICENTE PINTADO, ARIADNA GIRÓ-PERAFITA, XAVIER BADIA

Published: 21 July 2022

http://www.doi.org/10.37201/req/062.2022

Objective. Risk factors (RFs) associated with infection progression in patients already colonised by carbapenem-resistant Gram-negative bacteria (CRGNB) have been addressed in few and disperse works. The aim of this study is to identify the relevant RFs associated to infection progression in patients with respiratory tract or rectal colonisation.
Material and methods. A systematic literature review was developed to identify RFs associated with infection
progression in patients with CRGNB respiratory tract or rectal colonisation. Identified RFs were then evaluated and discussed by the expert panel to identify those that are relevant according to the evidence and expert’s experience.
Results. A total of 8 articles were included for the CRGNB respiratory tract colonisation and 21 for CRGNB rectal colonisation, identifying 19 RFs associated with pneumonia development and 44 RFs associated with infection progression, respectively. After discussion, the experts agreed on 13 RFs to be associated with pneumonia development after respiratory tract CRGNB colonisation and 33 RFs to be associated with infection progression after rectal CRGNB colonisation. Respiratory tract and rectal colonisation, previous stay in the ICU and longer stay in the ICU were classified as relevant RF independently of the pathogen and site of colonisation. Previous exposure to antibiotic therapy or previous carbapenem use were also common relevant RF for patients with CRGNB respiratory tract and rectal colonisation.
Conclusion. The results of this study may contribute to the early identification of CRGNB colonized patients at higher risk of infection development, favouring time-to-effective therapy and improving health outcomes.

Rev Esp Quimioter 2022; July  21 [Full-text PDF] [Supplementary material PDF]


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Rev Esp Quimioter 2022; July 20

Osteomielitis polimicrobiana en extremidad de la mano tras mordedura de gato

PABLO CAMACHO ZAMORA, MERCEDES ROMÁN CABELLO, PATRICIA ÁLVAREZ GARCÍA, ESTHER VÁZQUEZ CANAL

Published: 20 July 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/009.2022

Rev Esp Quimioter 2022; July 20  [Texto completo PDF]


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Rev Esp Quimioter 2022; July 19

Congenital tuberculosis in a premature newborn

LAURA SOLAZ ESCRIG, MANUEL BELDA ÁLVAREZ, RAQUEL SORIA MARTIN, AARON ROMUALDO PUPLÀ BARTOLL, MA DOLORES TIRADO BALAGUER

Published: 19 July 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/018.2022

Rev Esp Quimioter 2022; July 19  [Full-text PDF]


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Rev Esp Quimioter 2022; July 18

Osteomielitis del cuboides por Mycobacterium smegmatis  

ANA RUIZ-CASTILLO, ALBERTO TENORIO-ABREU, ALICIA HIDALGO-JIMÉNEZ, JOSÉ MARÍA SAAVEDRA-MARTÍN

Published: 18 July 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/049.2022

Rev Esp Quimioter 2022; July 18  [Texto completo PDF]


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Rev Esp Quimioter 2022; July 18

Congenital cytomegalovirus infection, is more prevalent in our country in newborns exposed to HIV?

JORGE BUSTAMANTE-AMADOR, ISABEL MELLADO-SOLA, MARÍA PILAR ROMERO-GÓMEZ, MARTA CABRERA-LAFUENTE, MARÍA DE LA CALLE-FERNÁNDEZ-MIRANDA, TALÍA SAINZ-COSTA, MARÍA JOSÉ MELLADO-PEÑA, LUIS ESCOSA-GARCÍA, EN REPRESENTACIÓN DEL GRUPO DE TRABAJO SOBRE INFECCIÓN PERINATAL-NEONATOLOGÍA-GINECOLOGÍA (GINPER)

Published: 18 July 2022

http://www.doi.org/10.37201/req/037.2022

Objectives. Congenital cytomegalovirus infection (cCMV) has been considered more prevalent among HIV-exposed children during pregnancy. Spanish national guidelines recommend the cCMV screening in these newborns. Nowadays, pregnant women have a better control of HIV infection compared to previous decades. We aim to analyze the prevalence and associated risk factors to cCMV in these children.
Patients and methods. A retrospective cross-sectorial study was performed. All newborns exposed to HIV were assisted in a third-level hospital (2014-2020). Epidemiological and clinical data of the mother and newborn were recorded. Shell vial urine culture and/or CRP were performed along the two first weeks of life for the neonatal screening of cCMV.
Results. Overall 69 newborns were enrolled. A high proportion (82.4%) of the mothers had been diagnosed with HIV before getting pregnant. All women received ART during the pregnancy. Median T-CD4 lymphocytes before delivery was 641/mm3 (IQR: 480-865) and the viral load was undetectable in 83.6%. Serological test for CMV along the first trimester of pregnancy was performed in 73.5% (positive IgG in 96%). There were no congenital cases of HIV neither cCMV (CI 95%:0-5.3%).
Conclusions. The cCMV prevalence in newborns exposed to HIV was 0%, lower than reported before, probably related to a better and earlier ART during pregnancy, leading to a better immunological status.

Rev Esp Quimioter 2022; July  18 [Texto completo PDF]