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Rev Esp Quimioter 2020; 33(6): 444-447

Description of Influenza B in seasonal epidemic in Cantabria during the beginning of the pandemia due to SARS-CoV-2

DANIEL PABLO-MARCOS, ANA RODRÍGUEZ-FERNÁNDEZ, MÓNICA GOZALO, JESÚS AGÜERO, FRANCISCO ARNAIZ DE LAS REVILLAS, JORGE CALVO

Published: 22 September 2020

http://www.doi.org/10.37201/req/077.2020

Introduction. Co-circulation of the two Influenza B lineages hinders forecast of strain to include in trivalent vaccine. Autonomous Communities such as Cantabria continue without supplying tetravalent vaccine. The aim of this study was to analyse epidemiological characteristics of influenza type B in Cantabria (2019-2020 season) as well as to establish the predominant lineage and its relation to the recommended vaccine.
Methods. Retrospective study whereby flu diagnosis and lineage analysis were determined by RT-PCR.
Results. All samples belonged to the Victoria lineage. Most prevalent viral co-infection was due to SARS-CoV-2. The population affected by influenza B was mainly paediatric and non-vaccinated patients more frequently required hospital admittance.
Conclusions. Influenza type B has a higher incidence in the paediatric population and type A affects more the adult population. Only 28.8% of patients with Influenza B that presented with some underlying condition or risk factor were vaccinated. This shows the need to increase coverage with tetravalent vaccines in order to reduce the burden of disease associated with the Influenza B virus.

Rev Esp Quimioter 2020; 33(6): 444-447 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(6): 422-429

Analysis of the demand for detection of SARSCoV-2 in a health area of Spain

JESÚS GARCÍA-CRUCES, RAÚL LÓPEZ IZQUIERDO, MARTA DOMÍNGUEZ-GIL, LUIS LÓPEZ-URRUTIA, MÓNICA DE FRUTOS, BELÉN LORENZO, BEGOÑA NOGUEIRA, ANTONIO PUERTA, MARTA FERNÁNDEZ-ESGUEVA, IRENE MERINO, MARÍA CARMEN RAMOS-SANCHEZ, JOSÉ MARÍA EIROS

Published: 16 September 2020

http://www.doi.org/10.37201/req/089.2020

Introduction. Since the discovery of the SARS-CoV-2 virus, the polymerase chain reaction technique (RT-PCR) has become the fundamental method for diagnosing the disease in its acute phase. The objective is to describe the demand-based series of RT-PCR determinations received at a Microbiology Service at a third-level reference hospital for a health area for three months spanning from the onset of the epidemic by SARS-CoV-2.
Methods. A retrospective analysis of the total of the RT-PCR requested in the Microbiology Service analyzed from 02/25/2020 to 05/26/2020 (90 days) has been carried out. They have been grouped by epidemiological weeks and by the petitioner service. A descriptive analysis was carried out by age, gender and number of requests for each patient. In the tests carried out, a confidence level of 95% (p <0.05) was considered significant.
Results. A total of 27,106 requests was received corresponding to 22,037 patients. Median age 53.7 (RIC 40.9-71.7) years, women: 61.3%. Proportion of patients with any positive RT-PCR: 14%. Of the total requests for RT-PCR, positive 3,710. Week 13 had the highest diagnosis performance (39.0%). The primary care has been the service thar has made the most requests (15,953). Patients with 3 or more RT-PCR: 565, of them, 19 patients had a positive result after previously having a negative one.
Conclusions. Requests have been increasing depending on the evolution of the epidemic. The RT-PCR has a high diagnostic performance in the phases of highest contagiousness and / or transmissibility of the virus.

Rev Esp Quimioter 2020; 33(6): 422-429 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(6): 392-398

Immunity against SARS-CoV-2: walking to the vaccination

CARMEN RODRÍGUEZ HERNÁNDEZ, JUAN CARLOS SANZ MORENO

Published: 11 September 2020

http://www.doi.org/10.37201/req/086.2020

The coronavirus are a wide group of viruses among that the SARS-CoV-2 is included (family Coronaviridae, subfamily Coronavirinae, genus Betacoronavirus and subgenus Sarbecovirus). Its main structural proteins are the membrane (M), the envelope (E), the nucleocapsid (N) and spike (S). The immune response to SARS-CoV-2 involves the cellular and the humoral sides, with neutralizing antibodies fundamentally directed against the S antigen. Although the seroprevalence data are frequently assumed as protection markers, no necessarily they are. In Spain, it is estimated that, to assure the herd immunity, at least four-fifths of the population should be immunoprotected. Due the high fatality rate of COVID-19, the acquisition of the protection only by the natural infection it not assumable and other measures as the mass immunization are required. Currently, there are several vaccine prototypes (including life virus, viral vectors, peptides and proteins and nucleic acid) in different phase of clinical evaluation. Foreseeably, some of these news vaccines would be soon commercially available. In this text, aspects related to these issues are reviewed.

Rev Esp Quimioter 2020; 33(6): 392-398 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(6): 410-414

Repetition of microbiological tests in suspect of SARS-CoV-2 infection: utility of a score based on clinical probability

JAVIER PARDO LLEDIAS, LAURA AYARZA, PABLO GONZÁLEZ-GARCÍA, ZAIDA SALMÓN GONZÁLEZ, JORGE CALVO MONTES, MÓNICA GOZALO MARGUELLO, JOSÉ LUIS HERNÁNDEZ HERNÁNDEZ, JOSÉ MANUEL OLMOS MARTÍNEZ

Published: 11 September 2020

http://www.doi.org/10.37201/req/080.2020

Background. The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities.
Methods. Retrospective observational study of the first patients admitted to a two COVID Internal Medicine wards at the University Hospital Marqués de Valdecilla, Santander, from March to April 2020. RT-PCR targering E, N, RdRP and ORFab1 genes and antibody tests detecting IgG.
Results. A total of 145 hospitalized patients with suspected SARS-Cov2 infection were admitted and in 98 (67.5%) diagnosis was confirmed. The independent predictive variables for SARS-CoV-2 infection were: epidemiological contact, clinical presentation as pneumonia, absence of pneumonia in the last year, onset of symptoms > 7 days, two or more of the following symptoms -dyspnea, cough or fever- and serum lactate dehydrogenase levels >350 U/L (p<0.05). A score based on these variables yielded an AUC-ROC of 0.89 (CI95%, 0.831-0.946; p<0.001). The accuracy of the first nasopharyngeal swabs was 54.9%. Repeating nasopharyngeal swabs two or three times allows to detect an additional 16% of positive cases. The overall accuracy of successive RT-PCR tests in patients with low pre-test probability was <5%.
Conclusions. We have defined a pre-test probability score based on epidemiological and clinical data with a high accuracy for diagnosis of SARS-CoV-2. Repeating nasopharyngeal swabs avoids sampling errors, but only in medium of high probability pre-test clinical scenarios.

Rev Esp Quimioter 2020; 33(6): 410-414 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(6): 459-461

Importancia de los resultados de los hemocultivos: especial atención para los solicitados desde los Servicios de Urgencias   

(Importance of blood cultures results: and special attention for applicants from the Emergency Departament)

RAFAEL RUBIO DÍAZ, ISABEL NIETO ROJAS, AGUSTÍN JULIÁN-JIMÉNEZ

Published: 10 September 2020

http://www.doi.org/10.37201/req/075.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2020; 33(6): 459-461 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(5): 327-349

The situation of infection in the elderly in Spain: a multidisciplinary opinion document

EMILIO BOUZA, FRANCISCO JOSÉ BRENES, JAVIER DÍEZ DOMINGO, JOSÉ MARÍA EIROS BOUZA, JOSÉ GONZÁLEZ, DIEGO GRACIA, RICARDO JUÁREZ GONZÁLEZ, PATRICIA MUÑOZ, ROBERTO PETIDIER TORREGROSSA, JOSÉ MANUEL RIBERA CASADO, PRIMITIVO RAMOS CORDERO, EDUARDO RODRÍGUEZ ROVIRA, MARÍA EVA SÁEZ TORRALBA, JOSÉ ANTONIO SERRA REXACH, JAVIER TOVAR GARCÍA, CARLOS VERDEJO BRAVO, ESTEBAN PALOMO

Published: 8 September 2020

http://www.doi.org/10.37201/req/057.2020

Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed.

Rev Esp Quimioter 2020; 33(5): 327-349 [Full-text PDF]


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Rev Esp Quimioter 2020; 33(6): 399-409

Evaluation of training on the programs to optimize antimicrobial use in medical residents of the province of Las Palmas

ALEJANDRO DE ARRIBA-FERNÁNDEZ, MANUEL JESÚS MOLINA-CABRILLANA, ANA HERNÁNDEZ-ACEITUNO, FERNANDO JOSÉ GARCÍA-LÓPEZ

Published: 12 August 2020

http://www.doi.org/10.37201/req/066.2020

Background. Antibiotic resistance is a threat to global public health. This situation makes essential to establish programs to optimize antimicrobial use (PROA). Training needs are identified in the PROA of resident physicians and the results of the analysis of the associations between study variables and training in the rational and prudent use of antibiotics are presented in this analysis.
Methods. Cross-sectional and analytical study through a self-administered questionnaire to a group of 506 medical residents of the province of Las Palmas. The association between resident’s characteristics and PROA training was calculated through logistic regression.
Results. The associations between response variance and speciality were observed in most of the core component analysis (opportunity p=0.003, training p=0.007, motivation p=0.055 and hand hygiene p=0.044), followed by variance according to sex (capacity p=0.028, theoretical knowledge p=0.013, hand hygiene p=0.002). Very few differences were associated with age (capacity p=0,051 and hand hygiene p=0,054) or the year of expertise (hand hygiene p=0,032).
Conclusions. The main training needs of resident physicians include one health, motivation, training, hand hygiene and information. The type of speciality followed by sex are the most important determinants on antibiotic use and resistance for resident physicians.

Rev Esp Quimioter 2020; 33(6): 399-409 [Texto completo PDF] [Material suplementario]


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Rev Esp Quimioter 2020; 33(5): 385-386

Emerging infectious diseases: Streptococcus suis meningitis   

(Enfermedades infecciosas emergentes: Meningitis por Streptococcus suis)

JORGE JOVER-GARCÍA, CELIA LÓPEZ-MILLÁN, JESÚS J. GIL-TOMÁS

Published: 7 August 2020

http://www.doi.org/10.37201/req/055.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2020; 33(5): 385-386 [Full-text PDF]


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Rev Esp Quimioter 2020; 33(5): 350-357

Development of a predictive model for hospital mortality and re-admission in a cohort of infected patients that require hospitalization

JULIO VILLANUEVA, LARA MONTES-ANDUJAR, ORVILLE V BAEZ-PRAVIA, ERIC JORGE GARCÍA-LAMBERECHTS, JUAN GONZÁLEZ DEL CASTILLO, ANDRÉS RUIZ, CARMEN ZURDO, JOSÉ BARBERÁN, JUSTO MENÉNDEZ, PABLO CARDINAL-FERNÁNDEZ

Published: 5 August 2020

http://www.doi.org/10.37201/req/063.2020

Introduction. The aims of the study were: to develop a predictive model for hospital mortality and another for hospital re-admission, to identify the impact of antibiotic delay in the mortality rate and, to report the rate of inappropriate antibiotic therapy.
Material and methods. A cohort and retrospective study was conducted at the HM Sanchinarro University Hospital during the period September 1st, 2012 to March 31th, 2013. The inclusion criteria were: age> 18 years, hospital admission from the ED with a diagnosis of bacterial infection. The exclusion criteria were: suspected viral infection, negative bacteriological cultures, life expectancy less than 6 months, lack of clinical information, assistance exclusively by the trauma emergency department. Two logistic models were made (hospital mortality and hospital re-admission).
Results. A total of 517 patients were included. The final mortality model (30 deaths) include the following variables: respiratory rate (OR 1.12; IC95% 1.02; 1.22), oxygen saturation (OR 0.92; IC95% 0.87; 0.98), creatinine (OR 2.33; IC95% 1.62; 3.36), COPD (OR 3.02; IC95% 1.06; 8.21), cancer (OR 3.34; IC95% 1.07; 9.98) and chemotherapy in the last 3 months (OR 4.83; IC95% 1.54; 16.41). The final model for hospital re-admission (28 re-admissions) include the following variables: hepatopathy (OR 5.51; IC95% 1.57; 16.88), GPT (OR 1.005; IC95% 1.003; 1.008), history of stroke (OR 5.06; IC95% 1.04; 18.80) and arterial hypertension (OR 3.15; IC95% 1.38; 7.56). The antibiotic therapy delays not influenced the mortality or re-admission rate. In 24.3% the causative microorganism was identified and antibiotic treatment was inappropriate 19.6%.
Conclusion. Hospital mortality rate was 5.8% and readmission rate was 5.7%. Variables associated with mortality differ from those associated with re-admission. The delay in the antibiotic initiation was not associated with a deleterious effect. Antibiotic therapy was inadequate in almost 20% of patients.

Rev Esp Quimioter 2020; 33(5): 350-357 [Texto completo PDF]


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Rev Esp Quimioter 2020; 33(5): 379-382

Is stratification of antibiotic susceptibility of urinary pathogens useful in the Emergency Department?

YOLANDA HERNÁNDEZ-HERMIDA, NEREA LÓPEZ-MUÑOZ, JUAN-IGNACIO ALÓS

Published: 3 August 2020

http://www.doi.org/10.37201/req/068.2020

Objective. The aim of the study wat to analyze the antibiotic susceptibility of the pathogens causing urinary tract infection (UTI) and to stratify the results in function of patient´s clinical and demographic dates.
Material and methods. The susceptibility of the pathogens isolated in the urine of 144 patients with UTI randomly chosen was analyzed. The results were stratified in function of sex, age, type of UTI, previous UTI and previous antibiotic treatment.
Results. The susceptibility of the all isolates and of the Escherichia coli isolates was analyzed. There were significant differences between groups in function of sex (fluoroquinolones), age (cefuroxime, ertapenem and gentamicin), type of UTI (cefuroxime, cefotaxime, ertapenem and fluoroquinolones), previous UTI and previous antibiotic treatment (cefotaxime, fluoroquinolones and fosfomycin).
Conclusions. The use of clinical and demographic data according to population and local resistance epidemiology of the pathogen causing UTI may help to select an adequate empirical treatment for UTI.

Rev Esp Quimioter 2020; 33(5): 379-382 [Texto completo PDF]


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