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Rev Esp Quimioter 2022;35(Suppl.3):97-101

Treatment of Clostridioides difficile infection: from guidelines to clinical practice

ESPERANZA MERINO, MIGUEL SALAVERT

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.21.2022

The Clostridioides difficile Infection (CDI) treatment guidelines were published in 2021; however, the incorporation of these recommendations into clinical practice was rather irregular and inconsistent. The differences in the implementation of these new guidelines were due, in part, to the variety in the different professionals who provided patient care, as well as to the issues involved in either their accessibility or availability or both. The main requirements for implementation include appropriate reflection on patient stratification, drug positioning, accessibility to drugs, as well as the organization of structured clinical pathways that can facilitate the functionality and evaluation of the management of CDI.

Rev Esp Quimioter 2022; 35(Suppl.3):97-101 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):94-96

Latent tuberculosis infection: approach and therapeutic schemes

JESÚS FORTÚN, ENRIQUE NAVAS

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.20.2022

Tuberculosis continues to be a major public health problem. A priority objective is the implementation of early diagnosis, contact investigation and latent tuberculosis infection (LTBI) testing. World Health Organization (WHO) concludes that there is no gold standard for the diagnosis of LTBI; both the tuberculin test and IGRA (interferon gamma release assays) indirectly identify tuberculosis infection; both tests are considered acceptable but imperfect. WHO recommends that regimens that include rifamycins are equally effective but less toxic and more adherent than long regimens with isoniazid.

Rev Esp Quimioter 2022; 35(Suppl.3):94-96 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):89-93

Models for bacteraemia risk prediction. Clinical implications

CARLOTA CLEMENTE-CALLEJO, AGUSTÍN JULIÁN-JIMÉNEZ, FRANCISCO JAVIER CANDEL GONZÁLEZ, JUAN GONZÁLEZ DEL CASTILLO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.19.2022

Bacteraemia has important consequences for the patient, as it is associated with worse clinical outcomes. On the other hand, unnecessarily obtaining samples for blood cultures increases costs and the workload in the microbiology laboratory. Its diagnosis implies a time delay, but decisions about start antibiotic treatment, discharge, or admits the patient must be taken during the first attention and, therefore, before known the blood cultures results. This manuscript reviews the different strategies based on clinical scores and biomarkers that are useful for predicting bacteraemia and improving initial decision-making.

Rev Esp Quimioter 2022; 35(Suppl.3):89-93 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):84-88

New definitions of susceptibility categories EUCAST 2019: clinic application

SANDRA G. NABAL DÍAZ, OLGA ALGARA ROBLES, JUAN M. GARCÍA-LECHUZ MOYA

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.18.2022

In January 2019, the European Committee for the Study of Antimicrobial Susceptibility (EUCAST) introduced some changes in the definitions of clinical categories for antibiotic susceptibility. The objective of these changes was to improve the credibility of category “I”, optimizing and lengthening the survival and use of available antibiotics in the face of increasing antimicrobial resistance. This article aims to describe and explain these changes in the EUCAST criteria as well as make a short review about the factors on which the antibiotic susceptibility criteria depend.

Rev Esp Quimioter 2022; 35(Suppl.3):84-88 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):80-83

Rapid techniques for therapeutic optimization. Diagnostic stewardship

EMILIA CERCENADO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.17.2022

Rapid microbiologic methods provide clinicians with information regarding the causative organisms of infections and their resistance to antimicrobials to optimize patient outcomes and antimicrobial use. Diagnostic stewardship requires that appropriate tests are requested and information is translated into appropriate management. The implementation of rapid techniques also provides collaborative opportunities between antimicrobial stewardship and diagnostic stewardship programs contributing to limiting the spread of antimicrobial resistance, and decreasing mortality, hospital length of stay, and healthcare costs

Rev Esp Quimioter 2022; 35(Suppl.3):80-83 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):74-79

Current management of CMV infection in cancer patients (solid tumors). Epidemiology and therapeutic strategies

VÍCTOR GARCÍA-BUSTOS, MIGUEL SALAVERT, ROSA BLANES, DAFNE CABAÑERO, MARINO BLANES

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.16.2022

Little evidence is available regarding the incidence of CMV disease in patients with solid cancers. Latest data show that approximately 50 % of these patients with CMV PCR positivity developed clinically relevant CMV-viremia, and would require specific therapy. In the clinical arena, CMV reactivation is an important differential diagnosis in the infectological work up of these patients, but guidelines of management on this subject are not yet available. CMV reactivation should be considered during differential diagnosis for patients with a severe decline in lymphocyte counts when receiving chemoradiotherapy or immunochemotherapy with lymphocyte-depleting or blocking agents. Monitoring of CMV reactivation followed by the implementation of preemptive strategies or the establishment of early antiviral treatment improves the prognosis and reduces the morbidity and mortality of these patients.

Rev Esp Quimioter 2022; 35(Suppl.3):74-79 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):67-73

Diagnostic and therapeutic approach to pulmonary infiltrates in cancer patients receiving immune checkpoint inhibitors

MARIO FERNÁNDEZ-RUIZ

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.15.2022

The advent of immune checkpoint inhibitors (ICIs) targeting cytotoxic T lymphocyte antigen 4 (CTLA-4) and the programmed cell death (PD-1)/PD-1 ligand 1 (PD-L1) axis has transformed the treatment paradigm for multiple cancer types. ICIs are able to restore T-cell-mediated antitumor responses and do not entail an increased risk of infection per se. However, immunotherapy is associated to a unique form of toxicity due to the off-target effects on healthy tissues of the excessively enhanced immune response in form of immune-related adverse events (irAEs). Although ICI-induced pneumonitis ranks the fifth of all irAEs in terms of frequency of occurrence, it is associated with a relevant attributable mortality. This review summarizes the incidence, risk factors, clinical and radiological presentation, and therapeutic approach of ICI-induced pneumonitis. Particular focus is on the differential diagnosis of new or worsening pulmonary infiltrates in cancer patients receiving ICI therapy. Finally, the impact on the risk of opportunistic infection of ICIs and immunosuppressive therapy used to treat associated irAEs is reviewed. The diagnosis and management of suspected ICI-induced pneumonitis remains clinically challenging.

Rev Esp Quimioter 2022; 35(Suppl.3):67-73 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):63-66

Norovirus infection as a model of chronic or recurrent infection in common variable immunodeficiency

PEDRO MORAL MORAL, DAFNE CABAÑERO-NAVALON, VICTOR GARCIA-BUSTOS, MARÍA NÚÑEZ BELTRÁN, MIGUEL SALAVERT LLETÍ

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.14.2022

Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency (PID) in general population. PID are genetic diseases that share a dysfunction in the immune system entailing a greater risk of both chronic and recurrent infections. These patients can also develop chronic gastrointestinal infections caused by norovirus with persistent viral dissemination, which can be detected months after primoinfection. Additionally, a proportion of CVID patients show a typical severe enteropathy presenting with recurrent diarrhoea, intestinal malabsorption, inflammatory lesions, and villous atrophy. Some studies have related this enteropathy with chronic intestinal infection caused by norovirus.

Rev Esp Quimioter 2022; 35(Suppl.3):63-66 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):54-62

COVID-19 in donation and transplant

FRANCISCO JAVIER CANDEL, CÁNDIDO PARDO REY, JUAN IGNACIO TORRES-GONZÁLEZ, PAULA FERNÁNDEZ-VEGA, MARCOS FRAGIEL, DAVID OTEO, ENRIQUE DEL TORO, MÓNICA VEGA-BAYOL, CRISTINA OUTON, MARTA ENCABO, AGUSTÍN GARCÍA-MARUGÁN, SARA RESINO, DOLORES PARRA, MAYRA MATESANZ, FRANCISCO J. DEL RIO GALLEGOS

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.13.2022

SARS-CoV-2 infection has had a major impact on donation and transplantation. Since the cessation of activity two
years ago, the international medical community has rapidly generated evidence capable of sustaining and increasing this neccesary activity. This paper analyses the epidemiology and burden of COVID-19 in donation and transplantation, the pathogenesis of the infection and its relationship with graft-mediated transmission, the impact of vaccination on donation and transplantation, the evolution of donation in Spain throughout the pandemic, some lessons learned in SARS-CoV-2 infected donor recipients with positive PCR and the applicability of the main therapeutic tools recently approved for treatment among transplant recipients.

Rev Esp Quimioter 2022; 35(Suppl.3):54-62 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):51-53

New treatments for multidrug-resistant non-fermenting Gram-negative bacilli Infections

MARIANA CHUMBITA, PATRICIA MONZO-GALLO, CARLOS LOPERA-MÁRMOL, TOMMASO FRANCESCO AIELLO, PEDRO PUERTA-ALCALDE, CAROLINA GARCIA-VIDAL

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.12.2022

Ceftolozane/tazobactam, ceftazidime/avibactam and cefiderocol belong to a novel generation of antibiotics that correspond with the β-lactam family. It is necessary to having new options in treating infections caused by Gram-negative, non-fermenting multidrug-resistant bacilli due to the significant increase in multidrug resistance in the last decades. Knowing the main characteristics of each drug is key for correct use.

Rev Esp Quimioter 2022; 35(Suppl.3):51-53 [Full-text PDF]


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