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Rev Esp Quimioter 2023; 36(1):65-81

Antimicrobial resistance in Gram-negative bacilli in Spain: an experts’ view

PILAR RETAMAR-GENTIL, RAFAEL CANTÓN, VICENTE ABRIL LÓPEZ DE MEDRANO, JOSÉ BARBERÁN, ANDRÉS CANUT BLASCO, CARLOS DUEÑAS GUTIÉRREZ, CAROLINA GARCÍA-VIDAL, NIEVES LARROSA ESCARTÍN, JAIME LORA-TAMAYO, FRANCISCO JAVIER MARTÍNEZ MARCOS, CARLOS MARTÍN RUÍZ, JUAN PASQUAU LIAÑO, PEDRO RASCADO, ÓSCAR SANZ PELÁEZ, GENOVEVA YAGÜE GIRAO, JUAN P. HORCAJADA

Published: 13 December 2022

http://www.doi.org/10.37201/req/119.2022

Background. Antibiotic resistance in Gram-negative bacilli poses a serious problem for public health. In hospitals, in addition to high mortality rates, the emergence and spread of resistance to practically all antibiotics restricts therapeutic options against serious and frequent infections.
Objectives. The aim of this work is to present the views of a group of experts on the following aspects regarding resistance to antimicrobial agents in Gram-negative bacilli: 1) the current epidemiology in Spain, 2) how it is related to local clinical practice and 3) new therapies in this area, based on currently available evidence.
Methodology. After reviewing the most noteworthy evidence, the most relevant data on these three aspects were presented at a national meeting to 99 experts in infectious diseases, clinical microbiology, internal medicine, intensive care medicine, anaesthesiology and hospital pharmacy.
Results and conclusions. Subsequent local debates among these experts led to conclusions in this matter, including the opinion that the approval of new antibiotics makes it necessary to train the specialists involved in order to optimise how they use them and improve health outcomes; microbiology laboratories in hospitals must be available throughout a continuous timetable; all antibiotics must be available when needed and it is necessary to learn to use them correctly; and the Antimicrobial Stewardship Programs (ASP) play a key role in quickly allocating the new antibiotics within the guidelines and ensure appropriate use of them.

Rev Esp Quimioter 2023; 36(1):65-81 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(2):114-124

Insights for COVID-19 in 2023

FRANCISCO JAVIER MARTÍN-SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, 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, EMILIO BOUZA

Published: 13 December 2022

http://www.doi.org/10.37201/req/122.2022

Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources.

Rev Esp Quimioter 2023; 36(2):114-124 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):30-44

A systematic review on extensively drug-resistant tuberculosis from 2009 to 2020: special emphases on treatment outcomes

SHRUTI SUBHASH SHIROMWAR, AMER HAYAT KHAN, VIJAY CHIDRAWAR

Published: 9 December 2022

http://www.doi.org/10.37201/req/029.2022

Objectives. Extensively drug-resistant tuberculosis (XDR-TB) has raised a great threat to human health globally, especially in developing countries. The objective of the present study is to collate and contrast the proportions of treatment outcome in the previously published XDR-TB articles.
Material and methods. By considering inclusion criteria and search engines, a total of 22 articles were enrolled.
Results. Our findings revealed that the overall favorable treatment outcome was 24.04%. From the cohort of enrolled studies 19.76% (397) and 43.35% (871) patients were cured and died respectively. In 90.9% of enrolled articles, the investigators performed drug-susceptibility testing at the baseline. The overall treatment outcome was improved by the use of new drugs (linezolid, bedaquiline, ciprofloxacin, clofazimine) in the treatment regimen of XDR-TB showing linezolid and bedaquiline better results i.e. 59.44 and 78.88%, respectively. Moreover, use of antiretroviral treatment in XDR-TB patients with HIV infection have not shown any significant difference in the treatment outcome.
Conclusions. XDR-TB treatment success can be achieved by implying standardized definitions, upgraded diagnostic procedures, and novel drugs.

Rev Esp Quimioter 2023; 36(1):30-44 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):97-100

Mejora en la rentabilidad e indicaciones de la extracción de hemocultivos en los servicios de urgencias: otro paso adelante

ISABEL NIETO ROJAS, WILLIAN ESNAIDER LÓPEZ FORERO

Published: 9 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/075.2022

Rev Esp Quimioter 2023; 36(1):97-100  [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(1):101-102

The role of hospital emergency departments in identifying patients with unknown HIV infection: an opportunity for diagnosis

ANA GARCÍA-MARTÍNEZ, MIRIAM CARBÓ

Published: 5 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/079.2022

Rev Esp Quimioter 2023; 36(1):101-102  [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):110-113

Streptococcus cristatus, an infrequent cause of bacteremia and infective endocarditis. Case report and literature review

DOMINGO FERNÁNDEZ VECILLA, MIKEL JOSEBA URRUTIKOETXEA GUTIÉRREZ, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 2 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/090.2022

Rev Esp Quimioter 2023; 36(1):110-113  [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1): 107-109

Is Propionimicrobium lymphophilum a new urinary tract infection cause?

DOMINGO FERNÁNDEZ VECILLA, ITZIAR ANGULO LÓPEZ, MARÍA LUISA GURRUCHAGA YANES, MARÍA CARMEN NIETO TOBOSO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 2 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/086.2022

Rev Esp Quimioter 2023; 36(1): 107-109  [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):103-106

Could Mycoplasma genitalium be involved in chronic granulomatous orchiepididymits? Case report and literature review

DOMINGO FERNÁNDEZ VECILLA, JULIA ARAGÓN DÍEZ, MARÍA CARMEN NIETO TOBOSO, JAUME ROSSELLÓ SORIA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 2 December 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/082.2022

Rev Esp Quimioter 2023; 36(1):103-106 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):88-91

Microscopy vs. molecular biology in the diagnosis of intestinal protozoal infections, is it time for a change?

LAURA SANTE FERNÁNDEZ, PATRICIA CAPÓN GONZÁLEZ, ANTONIO MORENO FLORES, PATRICIA COIRA MARÍN, PILAR ALONSO GARCÍA

Published: 1 December 2022

http://www.doi.org/10.37201/req/088.2022

Introduction. Microscopic examination of the intestinal parasites, from the patient’s concentrated feces, has a lower sensitivity when compared to molecular diagnostic techniques. Therefore, the objective of this study has been to compare both techniques, as well as to evaluate whether there is a correlation between the microscopic examination and the threshold cycles (Ct) obtained for Blastocystis hominis.
Material and methods. Retrospective study of the samples received in the Microbiology laboratory during September 2021. The MiniParasep SF® concentration test was performed for microscopic visualization and then PCR was performed with the Seegene AllplexTM Parasite Assay panel.
Results. A 27% (n=74) of the samples were positive by molecular diagnosis, with a total of 87 parasites detected. 53% (n=39) were women with a mean age of 47 ± 24 years. In 76% (n=56) of the cases the service of origin was Primary Care. The most frequently found parasite was B. hominis, 85% (n=64), followed by Dientamoeba fragilis 20% (n=15) and Giardia lamblia 11% (n=8). Co-infection by two parasites was detected in 13 cases (B. hominis + D. fragilis in 6 cases, and B. hominis + G. lamblia in 7 cases). In the microscopic diagnosis, 9.5% (n=26) positivity was obtained. The most frequently found parasite was B. hominis, 84% (n=23), followed by G. lamblia, which was seen in three cases by microscopy. D. fragilis was not seen in any case. Coinfection of B. hominis + G. lamblia was observed in one sample.
Conclusions. Techniques for molecular diagnosis of intestinal parasites are fast, reliable and more sensitive than microscopic techniques, improving microbiological diagnosis and quality of care.

Rev Esp Quimioter 2023; 36(1):88-91 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(2):187-193

Vitamin C and thiamine for the treatment of refractory septic shock in surgical critically ill patients: a retrospective before-and-after study

ALEJANDRO SUÁREZ-DE-LA-RICA, BRYANT CROES, LAURA CIUDAD, IRENE VALLEJO, JAIME MÚJICA, MARIANA DÍAZ-ALMIRÓN, EMILIO MASEDA

Published: 28 November 2022

http://www.doi.org/10.37201/req/107.2022

Introduction. This study aimed to evaluate whether early vitamin C and thiamine administration was associated with a lower 28-day and in-hospital mortality in surgical critically ill patients with refractory septic shock.
Patients and methods. We performed a retrospective before-and-after study on patients with refractory septic shock. According to local protocol, hydrocortisone is initiated in case of refractory septic shock. In January 2017, the protocol was changed and vitamin C and thiamine were included. Patients who were admitted in 2015-2016 and 2017-2018 were included in the control and treatment groups, respectively. The primary end point was 28-day and in-hospital mortality. Secondary end points were ICU mortality, ICU and hospital length of stay, duration of vasopressors and mechanical ventilation, use of renal replacement therapy (RRT), and the modification in serum procalcitonin and SOFA score during the first 72 h.
Results. A total of 120 patients were included (58 in the treatment group and 62 in the control group). Log-rank test in Kaplan-Meier curves showed lower 28-day and in-hospital mortality over time in the treatment group (p=0.021 and p=0.035, respectively) but it not reached statistical significance in ICU mortality over time (p=0.100). The need of RRT was less frequent in treatment group (17.2% vs. 37.1%, p=0.024). There were no differences in other secondary outcomes.
Conclusions. Intravenous vitamin C and thiamine administration in surgical patients with refractory septic shock may be associated with a lower 28-day and in-hospital mortality. Further prospective studies are needed in refractory septic shock.

Rev Esp Quimioter 2023; 36(2):187-193 [Full-text PDF]


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