COVID -19: On the threshold of the fifth year. The situation in Spain

FERNANDO RODRÍGUEZ-ARTALEJO, JULIÁN RUIZ-GALIANA, RAFAEL CANTÓN, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, DARÍO GARCÍA DE VIEDMA, EMILIO BOUZA

Published: 27 November 2023

http://www.doi.org/10.37201/req/123.2023

Despite having emerged from pandemic status, the incidence of COVID-19 episodes has recently increased in Spain, including pediatric cases and admissions to Intensive Care Units. Several recombinant variants are circulating among us, particularly XBB arising from two Omicron BA.2 sublineages with mutations in the genes encoding the spicule proteins that could increase binding to the ACE2 receptor and be more prone to immune escape. Faced with these, 3 pharmaceutical companies have developed vaccines adapted to the XBB.1.5 sublineage that are already available for administration in our setting with risks that should not be different from those of previous mRNA vaccines and with clearly favorable benefit/risk ratios. They should be applied to patients with potential for poor COVID-19 evolution and to collectives that have a particular relationship of proximity with them. Their application should be understood not only from a perspective of individual convenience but also from that of collective responsibility. The most convenient seems to be a simultaneous immunization of COVID-19 and influenza in our environment. In the therapeutic aspect, there is little to expect right now from antisera, but the already known antiviral drugs are still available and indicated, although their efficacy will have to be reevaluated due to their impact on populations that are mostly immunized and with a better prognosis than in the past. In our opinion, it is necessary to continue to make a reasonable and timely use of masks and other non-pharmacological means of protection.

Rev Esp Quimioter 2023; November 27 [Full-text PDF]

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What are the most relevant publications in Clinical Microbiology in the last two years?

EMILIA CERCENADO

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.15.2023

ABSTRACT
This minireview describes some of the articles published in the last two years related to innovative technologies including CRISPR-Cas, surface-enhanced Raman spectroscopy, microfluidics, flow cytometry, Fourier transform infrared spectroscopy, and artificial intelligence and their application to microbiological diagnosis, molecular typing and antimicrobial susceptibility testing. In addition, some articles related to resistance to new antimicrobials (ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, and cefiderocol) are also described.

Rev Esp Quimioter 2023; 36(Suppl.1):64-67 [Full-text PDF]

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Present and future of resistance in Pseudomonas aeruginosa: implications for treatment

MANUEL PINA-SÁNCHEZ, MARTA RUA, JOSÉ LUIS DEL POZO

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.13.2023

ABSTRACT
Pseudomonas aeruginosa is a pathogen that has a high propensity to develop antibiotic resistance, and the emergence of multidrug-resistant strains is a major concern for global health. The mortality rate associated with infections caused by this microorganism is significant, especially those caused by multidrug-resistant strains. The antibiotics used to treat these infections include quinolones, aminoglycosides, colistin, and β-lactams. However, novel combinations of β-lactams-β-lactamase inhibitors and cefiderocol offer advantages over other members of their family due to their better activity against certain resistance mechanisms.
Selecting the appropriate empiric antibiotic treatment requires consideration of the patient’s clinical entity, comorbidities, and risk factors for multidrug-resistant pathogen infections, and local epidemiological data. Optimizing antibiotic pharmacokinetics, controlling the source of infection, and appropriate collection of samples are crucial for successful treatment.
In the future, the development of alternative treatments and strategies, such as antimicrobial peptides, new antibiotics, phage therapy, vaccines, and colonization control, holds great promise for the management of P. aeruginosa infections.

Rev Esp Quimioter 2023; 36(Suppl.1):54-58 [Full-text PDF]

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Treatment guidelines for multidrug-resistant Gram-negative microorganisms

RAFAEL CANTÓN, PATRICIA RUIZ-GARBAJOSA

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.11.2023

ABSTRACT
In recent years, new antimicrobials have been introduced in therapeutics, including new beta-lactam-beta-lactamase inhibitor combinations and cefiderocol in response to therapeutic needs in the face of increasing resistance. There are also different treatment guidelines for infections caused by these microorganisms that have been approved by different professional societies, including those of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Infectious Disease Society of America (IDSA) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). All of them are based on scientific evidence, but with differences in the weight of expert opinion in their recommendations. Both ESCMID and IDSA include recommendations for the treatment of extended-spectrum beta-lactamase-producing microorganisms. The IDSA is the only one including AmpC producers, all address the treatment of infections caused by carbapenem-resistant Enterobacterales and Acinetobacter baumannii and multidrug-resistant or difficult-to-treat Pseudomonas aeruginosa, and the IDSA and SEIMC include recommendations on the treatment of Stenotrophomonas maltophilia. Future guidelines should integrate new antimicrobials and new innovative management options not covered by current guidelines.

Rev Esp Quimioter 2023; 36(Suppl.1):46-51 [Full-text PDF]

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Group A Streptococcus invasive infection in children: Epidemiologic changes and implications

JOSÉ TOMÁS RAMOS AMADOR, ARANTXA BERZOSA SÁNCHEZ, MARTA ILLÁN RAMOS

Published: 24 November 2023

http://www.doi.org/10.37201/req/s01.09.2023

ABSTRACT
Group A Streptococcus (GAS) can cause a broad array of clinical manifestations and complications. Recently, in post COVID-19 postpandemic months, there has been an increased incidence and severity of invasive infections in the pediatric age group in Spain and other European countries with high morbidity, affecting mostly to young children, associated with seasonal peaks in incidence of viral respiratory pathogens. The increased in incidence and severity has not been associated with predominant GAS strains, but rather to the lack of immunity to both GAS and common viral respiratory infections due to isolation measures to prevent COVID-19. Due to the nonspecific initial clinical manifestations a high index of suspicion is necessary in order to initiate a prompt medical and surgical treatment when necessary to improve the outcome. Prevention strategies are needed as well as continuous microbiological surveillance of iGAS strains.

Rev Esp Quimioter 2023; 36(Suppl.1):33-36 [Full-text PDF]