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Rev Esp Quimioter 2021;34(6):599-609

Community-acquired pneumonia: selection of empirical treatment and sequential therapy. SARS-CoV-2 implications

JUAN GONZÁLEZ DEL CASTILLO, AGUSTÍN JULIÁN JIMÉNEZ, FRANCISCO JAVIER CANDEL

Published: 29 October 2021

http://www.doi.org/10.37201/req/144.2021

Pneumonia is a major cause of global mortality in developed countries. The adequacy of the antibiotic treatment is essential for the good evolution of the patients. When selecting the antimicrobial, the severity of the patient, the characteristics of the antibiotics, and the profile of the patient to be treated should be considered. Recommendations for the selection of antibiotic treatment may differ between the patient who requires admission and the one who can be treated as outpatient. Beta-lactams, fluoroquinolones, and macrolides are the most widely used antimicrobials in this last circumstance. However, not all are the same in terms of efficacy, safety and ecological impact. This review delves into the aforementioned aspects to improve decision-making and offers concrete recommendations for the selection of antibiotic treatment. Likewise, it includes recommendations for performing sequential therapy. Finally, a brief review is made about the impact of SARS-CoV-2 infection on this pathology.

Rev Esp Quimioter 2021;34(6):599-609 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):687-688

Piomiositis glútea con absceso del obturador interno en contexto de infección aguda por Bartonella henselae 

MARÍA ISABEL SÁNCHEZ-CÓDEZ, ESTRELLA PEROMINGO-MATUTE

Published: 28 October 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/097.2021

Rev Esp Quimioter 2021;34(6):687-688 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(5):511-524

Recommendations for antibiotic selection for severe nosocomial infections

JOSEP MENSA, JOSÉ BARBERÁN RICARD FERRER, MARCIO BORGES, PEDRO RASCADO, EMILIO MASEDA, ANTONIO OLIVER, FRANCESC MARCO, RAMÓN ADALIA, GERARDO AGUILAR, ÁNGEL ESTELLA, RAFAEL LEÓN LÓPEZ, MANUEL SANTIAGO ROBLES MARCOS, FRANCISCO JAVIER GONZÁLEZ DE MOLINA, RICARDO SERRANO GARCÍA, MIGUEL SALAVERT, JAVIER FERNÁNDEZ GÓMEZ, YULIYA POLIAKOVA, JUAN PASQUAU, JOSÉ RAMÓN AZANZA, GERMÁN BOU ARÉVALO, PEDRO LLINARES MONDÉJAR, PABLO CARDINAL-FERNÁNDEZ, ALEX SORIANO

Published: 25 October 2021

http://www.doi.org/10.37201/req/126.2021

Severe infection and its evolution to sepsis are becoming more prevalent every day and are among the leading causes of critical illness and mortality. Proper management is crucial to improve prognosis. This document addresses three essential points that have a significant impact on this objective: a) early recognition of patients with sepsis criteria, b) identification of those patients who suffer from an infection and have a high risk of progressing to sepsis, and c) adequate selection and optimization of the initial antimicrobial treatment.

Rev Esp Quimioter 2021;34(5):511-524 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):7-15

Actions and attitudes on the immunized patients against SARS-CoV-2

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

Published: 21 October 2021

http://www.doi.org/10.37201/req/131.2021

The access to COVID vaccines by millions of human beings and their high level of protection against the disease, both in its mild and severe forms, together with a plausible decrease in the transmission of the infection from vaccinated patients, has prompted a series of questions from the members of the College of Physicians of Madrid (ICOMEM) and the society. The ICOMEM Scientific Committee on this subject has tried to answer these questions after discussion and consensus among its members. The main answers can be summarized as follows:
The occurrence of new SARS-CoV-2 infections in both vaccinated and previously infected patients is very low, in the observation time we already have. When breakthrough infections do occur, they are usually asymptomatic or mild and, purportedly, should have a lower capacity for transmission to other persons.
Vaccinated subjects who have contact with a SARS-CoV-2 infected patient can avoid quarantine as long as they are asymptomatic, although this decision depends on variables such as age, occupation, circulating variants, degree of contact and time since vaccination. In countries with a high proportion of the population vaccinated, it is already suggested that fully vaccinated persons could avoid the use of masks and social distancing in most circumstances.
Systematic use of diagnostic tests to assess the immune response or the degree of protection against reinfection after natural infection or vaccination is discouraged, since their practical consequences are not known at this time. The existing information precludes any precision regarding a possible need for future revaccination.
This Committee considers that when mass vaccination of health care workers and the general population is achieved, SARS-CoV-2 screening tests could be avoided at least in outpatient care and in the case of exploratory procedures that do not require hospitalization.

Rev Esp Quimioter 2022; 35(1):7-15 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):1-6

Persistence and viability of SARS-CoV-2 in primary infection and reinfections

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

Published: 18 October 2021

http://www.doi.org/10.37201/req/129.2021

Since the beginning of the SARS-CoV-2 epidemic, virus isolation in the infected patient was only possible for a short period of time and it was striking that this occurred constantly and did not provide guidance on the clinical course. This fact led to confusion about the efficacy of some of the drugs initially used, which seemed to have a high efficiency in viral clearance and proved ineffective in modifying the course of the disease. The immune response also did not prove to be definitive in terms of evolution, although most of the patients with very mild disease had a weak or no antibody response, and the opposite was true for the most severe patients.
With whatever the antibody response, few cases have been re-infected after a first infection and generally, those that have, have not reproduced a spectrum of disease similar to the first infection. Among those re-infected, a large number have been asymptomatic or with very few symptoms, others have had a moderate picture and very few have had a poor evolution.
Despite this dynamic of rapid viral clearance, laboratory tests were still able to generate positive results in the recovery of genomic sequences and this occurred in patients who were already symptom-free, in others who were still ill and in those who were very seriously ill. There was also no good correlate.
For this reason and with the perspective of this year and the half of pandemic, we compiled what the literature leaves us in these aspects and anticipating that, as always in biology, there are cases that jump the limits of the general behavior of the dynamics of infection in general.

Rev Esp Quimioter 2022; 35(1):1-6 [Full-text PDF]


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Rev Esp Quimioter 2021;34(6):679-681

Grangrena de Fournier secundaria a un absceso inguinoperineal por Acidaminococcus intestini y Streptococcus gallolyticus spp. pasteurianusa

ISMAIL ZAKARIYA-YOUSEF BREVAL, NOELIA TRUJILLO DÍAZ, PABLO DE LA HERRANZ GUERRERO

Published: 14 October 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/070.2021

Rev Esp Quimioter 2021;34(6):679-681 [Texto completo PDF]


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Rev Esp Quimioter 2021;34(6):668-671

In vitro activity of imipenem/relebactam against Gram-negative clinical isolates in two Spanish tertiary hospitals

MARINA PEÑUELAS, CRISTINA GARCÍA-SALGUERO, MELANIA IÑIGO, JOSE MANUEL VIÑUELA-PRIETO, FRANCISCO JAVIER CANDEL, JOSÉ LUIS DEL POZO, ESTHER CULEBRAS

Published: 13 October 2021

http://www.doi.org/10.37201/req/102.2021

Objetive. The aim of this study was to analyze the activity of the imipenem-relebactam combination (IMI/REL) against a collection of multidrug-resist Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates.
Material and methods. The study was conducted in two tertiary hospitals in Spain and included 192 clinical isolates of these 3 genera (139 resistant and 53 susceptible to IMI). The MICs for IMI with and without REL (at a fixed concentration of 4 mg/L) were determined by a standard broth microdilution method according to international recommendations.
Results. All IMI-susceptible E. coli strains were also susceptible to IMI/REL. Enterobacterales resistant to IMI due to the production of carbapenemases, the MIC50 and MIC90 decreased from 64/256 with IMI to 8/64 mg/L with IMI/REL. This high activity was principally detected among isolates with KPC enzymes. Enterobacterales with class B carbapenemases, P. aeruginosa carrying VIM carbapenemase and A. baumannii strains showed no changes on IMI MIC50 or MIC90 after adding REL. Among P. aeruginosa strains without carbapenemase the MIC for IMI/REL was reduced between 1 to 5 dilutions.
Conclusions. IMI/REL showed high activity against the strains that carry Klebsiella pneumoniae carbapenemase (KPC) and against carbapenem-resistant P. aeruginosa unrelated to the VIM enzyme, mainly AmpC beta lactamase associated with impermeability. Against strains carrying oxacillinase 48 (OXA-48) associated with extended-spectrum beta-lactamase (ESBL), IMI/REL presented activity only slightly better than IMI and had no beneficial effect superior to IMI against A. baumannii.

Rev Esp Quimioter 2021;34(6):668-671 [Full-text PDF]

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Rev Esp Quimioter 2021;34(6):660-663

Retrospective diagnosis of lymphatic tuberculosis in frozen samples using two genetic amplification methods, Xpert® MTB/RIF ULTRA and Abbott RealTime MTB Assay

MARIANA FERNANDEZ-PITTOL, YULIYA ZBOROMYRSKA, ANGELY ROMÁN, GRISELDA TUDÓ VILANOVA, MIGUEL ÁNGEL BENÍTEZ, JULIÁN GONZALEZ-MARTIN

Published: 13 October 2021

http://www.doi.org/10.37201/req/074.2021

Objectives. The main objective of the present study is to assess the sensitivity and specificity of a retrospective diagnostic of lymphatic tuberculosis (LTB), testing frozen samples using gene amplification PCR methods. The secondary objective
was to compare the results of two different commercial tuberculosis gene amplification methods for this purpose.
Material and methods. We retrospectively studied 38 frozen samples, previously processed for mycobacterial culture between January 2014 and August 2019. The results of the previous cultures were: 21 samples positive for Mycobacterium tuberculosis complex (MTB) (5 being smear positive), 7 samples culture positive for Mycobacterium avium-intracellulare complex and 10 samples which were mycobacterial culture negative and discarded for LTB diagnosis, used as controls. The samples were processed using two gene amplification methods: Xpert® MTB/RIF Ultra (Cepheid) and Abbott RealTime MTB Assay (Abbott).
Results. Compared to initial culture results the sensitivity and specificity of Xpert® MTB/RIF Ultra were 57.1% and 100% and 52.3 % and 92.5%, respectively for the Abbott RealTime MTB assay. The differences were not statiscally significant. In addition, there were no differences according to the period of freezing.
Conclusions. Gene amplification of frozen samples confirmed the diagnosis of lymphatic TB in almost 60% of cases, allowing retrospective diagnosis in initially non suspected cases. Both gene amplification techniques tested were equally useful.

Rev Esp Quimioter 2021;34(6):660-663[Full-text PDF]

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Rev Esp Quimioter 2021;34(6):664-667

Increased severity in SARS-CoV-2 infection of minorities in Spain

ADRIÁN VALLS CARBÓ, JUAN GONZÁLEZ DEL CASTILLO, OSCAR MIRÓ, PEDRO LOPEZ-AYALA, SONIA JIMENEZ, JAVIER JACOB, CARLOS BIBIANO, F. JAVIER MARTÍN-SÁNCHEZ

Published: 8 October 2021

http://www.doi.org/10.37201/req/099.2021

Introduction. With the global spread of COVID-19, studies in the US and UK have shown that certain communities have been strongly impacted by COVID-19 in terms of incidence and mortality. The objective of the study was to determine social determinants of health among COVID-19 patients hospitalized in the two major cities of Spain.
Material and methods. A multicenter retrospective case series study was performed collecting administrative databases of all COVID-19 patients ≥18 years belonging to two centers in Madrid and two in Barcelona (Spain) collecting data from 1st March to 15th April 2020. Variables obtained age, gender, birthplace and residence ZIP code. From ZIP code we obtained per capita income of the area. Predictors of the outcomes were explored through generalized linear mixed-effects models, using center as random effect.
Results. There were 5,235 patients included in the analysis. After multivariable analysis adjusted by age, sex, per capita income, population density, hospital experience, center and hospital saturation, patients born in Latin American countries were found to have an increase in ICU admission rates (OR 1.56 [1.13-2.15], p<0.01) but no differences were found in the same model regarding mortality (OR 1.35 [0.95-1.92], p=0.09).
Conclusions. COVID-19 severity varies widely, not only depending on biological but also socio-economic factors. With the emerging evidence that this subset of population is at higher risk of poorer outcomes, targeted public health strategies and studies are needed.

Rev Esp Quimioter 2021;34(6):664-667[Full-text PDF]


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Rev Esp Quimioter 2021;34(6):682-683

Primer caso de reinfección confirmada por SARS-CoV-2 en el área sur de Gran Canaria

MARÍA AROCA-FERRI, TOMÁS TOSCO-NÚÑEZ, ARACELI HERNÁNDEZ-BETANCOR, ISABEL DE-MIGUEL-MARTÍNEZ

Published: 7 October 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/093.2021

Rev Esp Quimioter 2021;34(6):682-683 [Texto completo PDF]


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