MARTA GARCIA-MONTERO, CARLOS ORTIZ-BAUTISTA, MARICELA VALERIO, MARÍA OLMEDO, PATRICIA MUÑOZ, EDUARDO ZATARAIN NICOLÁS, CLARA FERNANDEZ-CORDON, FRANCISCO FERNÁNDEZ-AVILÉS
Published: 12 July 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/033.2022
Rev Esp Quimioter 2022; 35(4):415-417 [Full-text PDF]
ADELA FERNÁNDEZ-GALILEA, ÁNGEL ESTELLA, JOSÉ LUIS GARCÍA-GARMENDIA, ANA LOZA, INMACULADA PALACIOS-GARCÍA, RAFAEL SIERRA-CAMERINO, GEMMA SELLER, MARINA RODRÍGUEZ-DELGADO, ISABEL RODRIGUEZ-HIGUERAS, JOSÉ GARNACHO-MONTERO
Published: 7 July 2022
http://www.doi.org/10.37201/req/030.2022
Objectives. Mortality of patients requiring Intensive Care Unit (ICU) admission for an invasive group A streptococcal (GAS) infection continues being high. In critically ill patients with bacteremic GAS infection we aimed at determining risk factors for mortality.
Patients and methods. Retrospective multicentre study carried out in nine ICU in Southern Spain. All adult patients admitted to the participant ICUs from January 2014 to June 2019 with one positive blood culture for S. pyogenes were included in this study. Patient characteristics, infection-related variables, therapeutic interventions, failure of organs, and outcomes were registered. Risk factors independently associated with ICU and in-hospital mortalities were determined by multivariate regression analyses.
Results. Fifty-seven patients were included: median age was 63 (45-73) years, median SOFA score at admission was 11 (7-13). The most frequent source was skin and soft tissue infection (n=32) followed by unknown origin of bacteremia (n=12). In the multivariate analysis, age (OR 1.079; 95% CI 1.016-1.145), SOFA score (OR 2.129; 95% CI 1.339-3.383) were the risk factors for ICU mortality and the use of clindamycin was identified as a protective factor (OR 0.049; 95% CI 0.003-0.737). Age and SOFA were the independent factors associated with hospital mortality however the use of clindamycin showed
a strong trend but without reaching statistical significance (OR 0.085; 95% CI 0.007-1.095).
Conclusion. In this cohort of critically ill patients the use of intravenous immunoglobulin was not identified as a protective factor for ICU or hospital mortality treatment with clindamycin significantly reduced mortality after controlling for confounders.
Rev Esp Quimioter 2022; 35(5):475-481 [Full-text PDF]
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, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, PATRICIA MUÑOZ, MARICELA VALERIO, PILAR CATALÁN, ALMUDENA BURILLO, ALEJANDRO COBO, ANTONIO ALCAMÍ, EMILIO BOUZA
Published: 6 July 2022
http://www.doi.org/10.37201/req/059.2022
Infection caused by Monkeypox Virus (MPVX) has small rodents as its natural reservoir and both monkeys and humans are occasional hosts. The causative agent is an Orthopoxvirus (MPVX) that was isolated in monkeys in 1958 and proved capable of passing to humans in 1970. It remained contained in Africa, causing isolated episodes of infection, until 2003 when an outbreak occurred in the United States following importation of animals from that continent. Since then, anecdotal cases have continued to be reported outside Africa, usually very clearly linked to travelers to those countries, but in May 2022, a broad outbreak of this disease has begun, now affecting several continents, with the emergence of human cases of MPVX (H-MPVX) infection mainly among Men that have Sex with Men (MSM). The disease has an incubation time ranging from 5 to 15 days and is characterized by the presence of pustules, fever, malaise and headache. The presence of significant regional lymphadenopathy is a differential feature with episodes of classical smallpox. Proctitis and pharyngitis, with minimal skin lesions, may be another form of presentation. Diagnosis can be confirmed by PCR testing of lesions or by demonstration of MPVX in other body fluids or tissues, although in the appropriate epidemiologic setting the clinical picture is highly suggestive of the disease. Effective drug treatment has been developed as part of programs to protect against potential bioterrorist agents and smallpox vaccinees are known to have high protection against monkeypox. New vaccines are available, but neither the drugs nor the vaccines are yet freely available on the market. The prognosis of the disease appears, at least in adults in developed countries, to be good, with very low mortality figures and much less aggressive behavior than that described in classical smallpox. Isolation measures, essential for the control of the outbreak, have been published by the health authorities.
Rev Esp Quimioter 2022; 35(6):509-518 [Full-text PDF]
JUAN GONZÁLEZ DEL CASTILLO, 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, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, JAVIER GÓMEZ-PAVÓN, EMILIO BOUZA
Published: 27 June 2022
http://www.doi.org/10.37201/req/058.2022
A “Pandemic/Disaster Law” is needed to condense and organize the current dispersed and multiple legislation. The State must exercise a single power and command appropriate to each situation, with national validity. The production of plans for the use of land and real estate as potential centers for health care, shelter or refuge is recommended. There should be specific disaster plans at least for Primary Health Care, Hospitals and Socio-sanitary Centers. The guarantee of the maintenance of communication and supply routes is essential, as well as the guarantee of the autochthonous production of basic goods. The pandemic has highlighted the need to redefine the training plans for physicians who, in their different specialties, have to undertake reforms that allow a more versatile and transversal training. National research must have plans to be able to respond quickly to questions posed by the various crises, using all the nation’s resources and in particular, all the data and capabilities of the health sector. Contingency plans must consider ethical aspects, and meet the needs of patients and families with a humanized approach. In circumstances of catastrophe, conflicts increase and require a bioethical response that allows the best decisions to be made, with the utmost respect for people’s values. Rapid, efficient and truthful communication systems must be contained in a special project for this sector in critic circumstances. Finally, we believe that the creation of National Coordination Centers for major disasters and Public Health can contribute to better face the crises of the future.
Rev Esp Quimioter 2022; 35(5):444-454 [Full-text PDF]
CARMEN VELICIA PEÑAS, VÍCTOR MIGUEL DEL CAMPO PÉREZ, IRENE RIVERO CALLE, LORENZO ARMENTEROS DEL OLMO, MARÍA TERESA PÉREZ RODRÍGUEZ, JUAN JESÚS GESTAL OTERO
Published: 21 June 2022
http://www.doi.org/10.37201/req/031.2022
Seasonal flu continues to be a major public health concern, and the influenza vaccine remains the most effective preventive measure. In Spain, vaccination coverage data from previous seasons show vaccination rates well below official targets; however, these figures improved significantly after the COVID-19 pandemic. Given the importance of achieving and maintaining high vaccination rates in order to avoid the clinical and economic impact of influenza, our multidisciplinary group of experts on vaccines analyzed the impact of low vaccination rates in Spain and drafted a series of measures to boost influenza vaccination coverage, particularly among priority groups.
Rev Esp Quimioter 2022; 35(5):435-443 [Texto completo PDF]
ALBERTO TENORIO-ABREU, ANA RUIZ-CASTILLO, ANTONIO FRANCISCO GUZMÁN-GONZÁLEZ, ALEJANDRO PEÑA-MONJE, JOSÉ MARÍA SAAVEDRA-MARTÍN, FRANCISCO FRANCO-ÁLVAREZ DE LUNAO
Published: 20 June 2022
http://www.doi.org/10.37201/req/076.2020
Introduction. Since the first cases of SARS-CoV-2 appeared, there have been numerous techniques that have been developed for the diagnosis or monitoring of infection, both direct and serological techniques. Choosing a good diagnostic tool is essential for epidemiological control. The objective was to compare five commercialized RT-PCR techniques in real time, in sensitivity, specificity and agreement for the detection of SARS-CoV-2.
Material and methods. Five commercial RT-PCR kits for the detection of SARS-CoV-2 were compared. Eight known positive samples were taken and subjected to seven different dilutions or concentrations, and another 135 negative samples were used to determine sensitivity, specificity, and agreement values.
Results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Palex, Roche and GeneXpert techniques with respect to Seegene were identical, corresponding to 98.21%, 100%, 100% and 99.26% respectively. For Becton Dickinson the sensitivity was 89.28%, the specificity of 100%, the PPV of 100% and the NPV of 95.74%. The agreement using the Kappa index for Palex, Roche and GeneXpert was 0.9892, while the agreement for Becton Dickinson was with a Kappa index of 0.9215.
Conclusion. All commercial RT-PCR kits had high sensitivities and specificities, as well as PPV, NPV, and concordance.
Rev Esp Quimioter 2022; 35(4):401-405 [Texto completo PDF]
DAVID SÁNCHEZ-RAMOS, ESTEBAN VEGA-TORRES, CARLOS IRLES-VIDAL, JAVIER COLOMINA-RODRÍGUEZ
Published: 17 June 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/034.2022
Rev Esp Quimioter 2022; 35(4):418-420 [Full-text PDF]
PABLO VIDAL-CORTÉS, MARÍA CRUZ MARTÍN, EMILI DÍAZ, MARÍA BODÍ, JOSÉ CARLOS IGEÑO, JOSÉ GARNACHO-MONTERO
Published: 9 June 2022
http://www.doi.org/10.37201/req/025.2022
Objective. To measure the impact of the pandemic in Spanish ICUs.
Material and methods. On-line survey, conducted in April 2021, among SEMICYUC members. Participants were asked about number of patients admitted, increase in the number of beds and staff, structures created in the hospital and self-assessment of the work performed.
Results. We received 246 answers from 157 hospitals. 67.7% of the ICUs were expanded during the pandemic, overall increase in beds of 58.6%. The ICU medical staff increased by 6.1% and there has been a nursing shortage in 93.7% of units. Patients exceeded 200% the pre-pandemic ICU capacity. In 88% of the hospitals the collaboration of other specialists was necessary. The predominant collaboration model consisted of the intensive care medicine specialist being responsible for triage and coordinating patient management. Despite that 53.2% centres offered training for critical care, a deterioration in the quality of care was perceived. 84.2% hospitals drew up a Contingency Plan and in 77.8% of the hospitals a multidisciplinary committee was set up to agree on decision-making. Self-evaluation of the work performed was outstanding and 91.9% felt proud of what they had achieved, however, up to 15% considered leaving their job.
Conclusions. The Spanish ICUs assumed an unprecedented increase in the number of patients. They achieved it without hardly increasing their staff and, while intensive care medicine training was carried out for other specialists who collaborated. The degree of job satisfaction was consistent with pre-pandemic levels.
.
Rev Esp Quimioter 2022; 35(4):392-400 [Full-text PDF]
DOMINGO FERNÁNDEZ VECILLA, CRISTINA ASPICHUETA VIVANCO, FELICITAS ELENA CALVO MURO, LANDER ANTÓN MÉNDEZ, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 9 June 2022
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/024.2022
Rev Esp Quimioter 2022; 35(4):411-414 [Texto completo PDF]
Mª DEL MAR RODRÍGUEZ DEL ÁGUILA, ANTONIO SORLÓZANO-PUERTO, Mª AMELIA FERNÁNDEZ-SIERRA, JOSÉ Mª NAVARRO MARÍ, JOSÉ GUTIÉRREZ FERNÁNDEZ
Published: 6 June 2022
http://www.doi.org/10.37201/req/016.2022
Objective. To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients.
Material and methods. Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set.
Results. A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19.
Conclusion. The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas.
Rev Esp Quimioter 2022; 35(4):382-391 [Texto completo PDF]
