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Rev Esp Quimioter 2024; December 20

Maintained susceptibility to fosfomycin in extra-hospitalary urinary isolates of Escherichia coli. Strong association of fosfomycin resistance with age and ESBL production

ELENA HIDALGO, ANA GONZÁLEZ-TORRALBA, JIMENA RAMÓN, JUAN-IGNACIO ALÓS

Published: 20 December 2024

http://www.doi.org/10.37201/req/016.2024

Introduction. Escherichia coli is isolated in most of uncomplicated community-acquired urinary tract infections (UTI) and fosfomycin is one of the treatments of choice. We analyzed the evolution of fosfomycin resistance in extrahospitalary E. coli urinary isolates and whether age and extended spectrum beta-lactamase (ESBL) production were associated to antibiotic resistance.
Methods. A retrospective descriptive study was conducted from January 2017 to December 2022 including E. coli isolates from extrahospitalary urine samples.
Results. The susceptibility to fosfomycin remained above 95% during the study period. ESBL production and age above 80 years were significantly associated with increased fosfomycin resistance. We also analyzed the consumption of fosfomycin and it remained stable, although it was higher in the population >65 years.
Conclusions. Greater resistance is observed in ESBL-producing strains and in patients over 65 years of age. A stable consumption of fosfomycin is associated with low resistance percentages maintained over the time.

Rev Esp Quimioter 2024; December 20 [Full-text PDF]


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Rev Esp Quimioter 2024; December 4

Absceso esplénico por Coprobacillus catenaformis. A propósito de un caso

FÁTIMA VIOQUE, DANIEL TENA

Published: 4 December 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/084.2024

Rev Esp Quimioter 2024; November 25 [Texto completo PDF]


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Rev Esp Quimioter 2024; November 26

Evaluation of the management of Clostridioides difficile infection as a risk factor for recurrence. A retrospective observational study

JOSÉ Mª BARBERO ALLENDE, IVÁN UREÑA, LETICIA CAÑIVANO, SARA GARCÍA, CRISTINA PAZ, ÁLVARO OLMO-RUILOBA, KOLDO JAUREGI, SANDRA CORONADO, LUCAS LÓPEZ REQUEJO, LAURA PORCEL, VERÓNICA PEREA, MARÍA IRIGOYEN, JULIANA CANO, AUREA GARCÍA, ELENA LEÓN, NEREA FERNÁNDEZ-DOMINGO, PALOMA LANCHARES, BRYAN LINO, MARTA ORTOLÁ, ANA LIZASOAIN, VIRGINIA SÁNCHEZ, CORAL ARÉVALO-CAÑAS, JUAN ARÉVALO-SERRANO

Published: 26 November 2024

http://www.doi.org/10.37201/req/086.2024

Introduction. One of the main problems with Clostridioides difficile infection (CDI) is its tendency to recur. The objective of the study is to analyze which factors in the clinical management of CDI favor recurrence.
Material and methods. This is a retrospective study conducted at the Hospital Universitario Príncipe de Asturias on cases of CDI between January 2021 and June 2023. Demographic variables, comorbidities, risk factors for recurrence, and treatments used for CDI were recorded. Non-optimal clinical management was defined as: not discontinuing treatment with proton pump inhibitors (PPIs) if the patient was on them, not discontinuing concomitant antibiotic treatments if the patient was on these, the use of metronidazole monotherapy in any case, or the use of standard-dose vancomycin if there were risk factors for recurrence.
Results. A total of 327 cases were found in 256 patients. 69 patients died within 8 weeks after the episode (26.9%). Among the remaining 258 episodes, there were 68 recurrences (26.3%). Of these 68 recurrences, 63 cases received nonoptimal treatment (93.2%), compared to 112/190 (58.9%) among those who did not recur. In the multivariate analysis adjusted for confounding factors, patients who received optimal treatment had an 89% lower risk of recurrence compared to those who did not receive it (OR 0.1; p < 0.001).
Conclusions. Reducing the use of PPIs and antibiotics and prioritizing more effective treatments against CDI could improve the recurrence rates of this infection.

Rev Esp Quimioter 2024; November 26 [Texto completo PDF]


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Rev Esp Quimioter 2024; November 25

Prevalence of anal infection by human papillomavirus in men who have sex with men and its associated clinical and epidemiological factors

MARÍA JOSÉ MUNOZ-DAVILA, CARMEN CANDEL-PEREZ, EVA GARCÍA VILLALBA, MARÍA ANGELES MUÑOZ PÉREZ

Published: 25 November 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/085.2024

Rev Esp Quimioter 2024; November 25 [Full-text PDF]


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Rev Esp Quimioter 2024; November 25

¿Una simple celulitis tras podar el jardín?: A propósito de un caso

ANDER URIBARRI, MARTA LORENTE-ESCUDERO, CRISTINA VÁZQUEZ, LUCÍA LOZANO-VICARIO

Published: 25 November 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/081.2024

Rev Esp Quimioter 2024; November 25 [Texto completo PDF]


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Rev Esp Quimioter 2024; November 21

Visión microbiológica de la cavidad anoftálmica

LAURA RITA IOTTI, MÓNICA DE FRUTOS, IRENE BERMÚDEZ-CASTELLANOS, VERÓNICA RODRÍGUEZ LÓPEZ, JOSÉ M. EIROS

Published: 21 November 2024

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/089.2024

Rev Esp Quimioter 2024; November 21 [Texto completo PDF]


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Rev Esp Quimioter 2024; November 20

Effectiveness, safety, and patient-reported outcomes of treatment with bictegravir/emtricitabine/tenofovir alafenamide fixed dose combination in people living with HIV in Argentina: the BICTARG cohort

DIEGO CECCHINI, MARTÍN BRIZUELA, MARÍA SOLEDAD SELEME, MARÍA VERÓNICA MINGRONE, GASTÓN COPERTARI, BRENDA BACELAR, ROMINA MAUAS, EDGARDO BOTTARO, ISABEL CASSETTI

Published: 20 November 2024

http://www.doi.org/10.37201/req/080.2024

Introduction. Real-world data on bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) fixed-dose combination from resource-constrained settings like Latin America are limited.
Material and methods. We conducted an observational retrospective cohort study of treatment-naive (TN, n=315) and treatment-experienced (TE, n= 2356) people living with HIV prescribed BIC/FTC/TAF in Argentina from 10/2019 to 12/2021, with 24 and 48-week follow-up data analyzed for virological suppression, persistence, safety, and metabolic parameters. Patient-reported outcomes were assessed via across-sectional online survey.
Results. Baseline characteristics: median age 45 years, 72.2% male, 99.6% Hispanic/Latino ethnicity. Treatment per sistence at 48 weeks was 99.3% (TN) and 99.5% (TE). Virological suppression rates (<200/<50 copies/mL) at 24 weeks were 97.4/88% (TN) and 99/97% (TE). At 48 weeks were 100/92% (TN) and 99/97% (TE). In the TE group, triglycerides decreased with no other lipid changes. In TN, mild total/LDL/HDL cholesterol increases occurred. eGFR mildly decreased in both groups. The online survey (n=536) showed 91.5% reported no medication concerns. Median quality of life scores were 90 (TN) and 88 (TE). Most reported no self-care, activity, mobility, pain/discomfort, or anxiety/depression issues.
Conclusions. BIC/FTC/TAF demonstrated high persistence, safety, virological efficacy, and favorable metabolic profile over 48 weeks. The cross-sectional survey indicated high treatment satisfaction and good quality of life in this cohort from Argentina.

Rev Esp Quimioter 2024; November 20 [Full-text PDF]


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Rev Esp Quimioter 2024; November 19

Diagnostic and prognostic value of time to positivity in blood cultures. An opinion paper

PAOLA MAFFEZZOLI, MARTHA KESTLER, ALMUDENA BURILLO, SILVIA CORCIONE, FRANCESCO GIUSEPPE DE ROSA, PATRICIA MUÑOZ, EMILIO BOUZA

Published: 19 November 2024

http://www.doi.org/10.37201/req/094.2024

Time to positivity (TTP) refers to the duration required for a microbiological culture test to indicate a positive result, marking the onset of detectable bacterial or fungal growth in the sample. Numerous variables, including patient characteristics, infection source, former antimicrobial therapy, blood sample volume, and sample transportation time can influence the value of TTP. Several studies have been conducted on bloodstream infections, whereas studies on the clinical significance of yeast TTP are quite limited in the literature. Furthermore, many studies are retrospective and have a small sample size. In this opinion paper, we have formulated some questions and attempted to provide answers based on the available literature and our perspective. The objective of this opinion paper is to summarise current knowledge based on the literature, aiming to offer a critical perspective, particularly on aspects with weaker evidence, which could guide future studies in this area. We believe that TTP of blood cultures appears to exhibit considerable potential and may prove to be a valuable tool in clinical practice for estimating patient mortality risk and guiding antimicrobial therapy choices. Topics discussed include the diagnostic and prognostic role of TTP in Gram-positive and Gram-negative bacteremias and in candidemias, and the significance of differential time to positivity (DTTP). In summary, our opinion is that, based on the available literature, it is not possible to determine whether TTP provides prognostic information, particularly concerning candidemia. Therefore, clinical decisions cannot be systematically based on this parameter.

Rev Esp Quimioter 2024; November 19 [Full-text PDF]


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Rev Esp Quimioter 2024; November 18

Bacteremia due to strict anaerobes

CARMEN PIÑA DELGADO, MARGARITA BOLAÑOS RIVERO, MARÍA NIEVES CARMONA TELLO, CATALINA JESÚS RAMÍREZ ESTUPIÑÁN, PILAR MICHELE HERNÁNDEZ CABRERA, ISABEL DE MIGUEL MARTÍNEZ

Published: 18 November 2024

http://www.doi.org/10.37201/req/063.2024

Introduction. Anaerobic bacteremia represents 0.5-12% of all bacteremias and its mortality is high, ranging from 25-44%. The aim was to know our data to compare them with existing data and demonstrate the importance of actively searching for these microorganisms in blood culture samples.
Material and methods. A retrospective descriptive study in which the medical records of patients with significant episodes of anaerobic bacteremia were reviewed over a period of 8 years (2014-2022).
Results. A total of 59,898 blood cultures were processed, of which 10,451 were positive (17%). An anaerobic microorganism was identified in 209 patients. Anaerobic bacteremia accounted for 2.11% of the total number of positive blood cultures. The mean age was 63.55 years (17-96), 66% of whom were men. The origin was community in 63.64%, of nosocomial origin in 15.31% and associated with health care in 17.70%. The focus of infection was the abdominal (39.23%), followed by the respiratory (13.88%) and skin and soft tissues (13.39%). The most frequent comorbidities were: arterial hypertension (49.76%), dyslipidemia (29.67%), neoplasia (26.32%) and diabetes (26.32%). The main species isolated were the group Bacteroides spp. (44.50%) (n=93) highlighting Bacteroides group fragilis (n=65), followed by Clostridium spp. (20%) (n=42) highlighting Clostridium perfringens (n=30). The clinical evolution was good in 67.46%. The mean length of stay was 27.8 days and was associated with 20% mortality.
Conclusions. Bacteremias due to anaerobes represented 2.11% of the total number of true bacteremias, so we consider the active search for these microorganisms to be appropriate.

Rev Esp Quimioter 2024; November 18 [Texto completo PDF]


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Rev Esp Quimioter 2024; November 14

Epidemiological and clinical management aspects related to urinary tract infections diagnosed in the emergency department in elderly patients in Spain: Results of the EDEN-36 study

OCTAVIO JOSÉ SALMERÓN BÉLIZ, ELIA PÉREZ-FERNÁNDEZ, ÒSCAR MIRÓ, SIRA AGUILÓ, GUILLERMO BURILLO-PUTZE, AITOR ALQUÉZAR-ARBÉ, CESÁREO FERNÁNDEZ-ALONSO, JAVIER JACOB, FRANCISCO JAVIER MONTERO PÉREZ, ALEJANDRO MELCON VILLALIBRE, SANDRA CUERPO CARDEÑOSA, LETICIA SERRANO LÁZARO, MARÍA CABALLERO MARTÍNEZ, ESTHER MUÑOZ SOLER, INMACULADA BAJO FERNÁNDEZ, ANA ISABEL CASTUERA GIL, ROCÍO HERNANDO GONZÁLEZ, ALBERT CARBÓ-JORDÁ, IRENE CABRERA RODRIGO, BELÉN GROS BAÑERES, CARLOS ROMERO CARRETE, RAFAELA RÍOS GALLARDO, ALEJANDRO CORTÉS SOLER, EMMA GONZÁLEZ NESPEREIRA, ÁNGEL GARCÍA GARCÍA, JOSÉ RAMÓN OLIVA RAMOS, LUCIA HINOJOSA DIAZ, JUAN GONZÁLEZ DEL CASTILLO, EN NOMBRE DE LOS INVESTIGADORES DE LA RED SPANISH INVESTIGATORS IN EMERGENCY SITUATIONS TEAM (SIESTA)

Published: 14 November 2024

http://www.doi.org/10.37201/req/066.2024

Objective. To estimate the incidence of urinary tract infections (UTI) in elderly patients in Spanish emergency departments (ED), the need for hospitalization, diagnostic confirmation in hospitalized patients, adverse events and the predictive capacity of several biomarkers.
Methods. In this a posteriori substudy of a generic study of reasons for ED visits in elderly patients, we included patients aged ≥65 years seen in 52 Spanish EDs for 1 week, selecting those diagnosed with UTI. As adverse events, in-hospital and 30-day mortality and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Relative risks (RR) were calculated. The predictive capacity of 10 variables and 6 biomarkers was investigated.
Results. A total of 25,375 patients were included, 1058 with UTI (annual incidence: 24.7 per 1000 inhabitants aged ≥65 years and year, 95%CI: 24.5-24.9). A total of 36.5% were hospitalized, and in 80% the diagnosis of UTI was confirmed at discharge. Overall 30-day mortality was 5.4% and in-hospital mortality was 3.4%. Functional dependence was associated with both events (RR:2.91;1.18-7.17 and RR:12.61;1.47-108.11, respectively), as was having a CRP greater than 100 mg/L (RR:2.24;1.17-4.30 and RR:3.21;1.37-7.51, respectively). The combined post-high event occurred in 10.6%, and was associated with functional dependence (RR:2.05;1.04-4.06). CRP and hemoglobin had significant value in predicting 30-day post-discharge mortality or hospitalization.
Conclusions. UTI is a frequent diagnosis in elderly patients consulting in the ED. Functional dependence is the best factor associated with adverse events. The biomarkers analyzed do not have a good predictive capacity.

Rev Esp Quimioter 2024; November 14 [Texto completo PDF]


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